"Work-Life Balance"

[newton9686]

Due to the epidemic of people mentioning "work-life balance" as a reason for choosing to pursue this profession, I've decided I need to rant.

 

There are many reasons to choose PA, some good and some bad. However the one I am tired of hearing is "work-life balance." I get that people are concerned that medical school, residency and practice as an MD/DO will take away from their personal life. However when you tell me you are concerned about "work-life balance" I cant help but question how committed you will be as a provider. Of course you are willing to take part in the excitement, salary and accomplishment that comes with being a provider. But are you going to be committed to your patients when its inconvenient.  Are you willing to study during your down time to stay up to date. Are you willing to stay late when a patient walks in at 4:45 or are you going to tell them to go to the ER because your office closes at 5pm. Most importantly, are you going look the other way when you see multiple rib fractures in that chest x-ray you ordered on a 3 y/o with suspected pneumonia. Are you willing to question a parent about possible signs of child abuse. Because if you are not willing to confront an abusive parent and ultimately go to court for a child, please think long and hard about going to PA school.

 

I am not saying being a PA means sacrificing all your responsibilities as a mother, father, husband or wife. There are plenty of great PA moms and dads out there who are committed to their patients and their family. However, if work-life balance is one of your main determining factors for choosing this profession, please be honest and ask yourself, would you be willing to stick your nose out when you saw signs of child abuse or would you look the other way.

[rev ronin]

I think you're diluting your message when you lump people who want work-life balance in with those who would willfully ignore identified signs of child abuse.

 

To be a little less terse, there's always going to be emergencies that crater your day and ruin your schedule, dinner plans, etc.  Those should be the exception, and really anyone can handle a few of those.  When greedy administrators run providers ragged regularly and on purpose and everything is an emergency and there is no spare time for anything, that is when compassion fatigue and burnout set in, and providers are tempted to stop caring.  By fighting for a good work-life balance, providers are trying to ensure the emotional stamina and staying power needed to stay with this job.  How that looks is going to be different from person to person, but the key message is the same: work life balance prevents negligence, rather than prompts it.

[Reality Check 2]

Work/Life balance means - do you own your own practice and have to be the boss in charge of everything or are you an employee?

 

It encompasses a bad employer, a bad contract, a bad practice set up.

 

It, in my mind, and experience - has NOTHING to do with your commitment to patients or practicing medicine well.

 

I worked for a nonprofit community health clinic that treated providers - doctors and PAs - like drones in a factory. See as many patients as possible with a crap computer system and the world's worst EHR and less than adequate staff and work as many hours after hours to get charts done in said conditions. Forget lunch, forget admin time but do not dare miss a single meeting. They did not care about anything but numbers. THAT IS NOT WORK/LIFE BALANCE. That is servitude and being a really bad employer whose staff will leave in droves. FOUR PAs left in 5 months - me as one of them. The patients deserved better and the admin staff deserved to be flogged.

 

Work/Life Balance is about making sure you have enough control over your environment to provide good care in adequate time with reasonable resources.

 

You have to be choosy about jobs to find any semblance of this.

 

If a job shows turnover of a PA every 2-3 years - BAD SIGN. 

Corporate Medicine - in general, bad sign - not a good employer - you are a drone and income producer - not even a human.

 

So, please rethink your statements above - my request. 

 

If I chose to live in the Sudan and man a clinic to serve the residents - I would be on call 24/7, 365 with little in the form of resources and the need to always be there for those people.

 

I am in the US in a not rural area (anymore) and I work with partners and we have sufficient coverage to prevent more than maybe once a month staying after hours for a patient in need. I have done and will do it again. I waited on the MHP for my suicidal patient and made sure he was transported to the Psych ER. That is not a question.

 

I do not want to work 14 hours a day when I get paid for 10 and be a puppy mill provider constantly producing income visits of subpar quality for the sake of the mighty billing dollar.

 

Work/Life balance is about sanity, reality, ability, boundaries, expectations and being alive to enjoy the fruits of my labor. Has NOTHING to do with my commitment to practicing medicine.

[EMEDPA]

it's not the hrs worked, it's how hard the hours work you...I'm much happier doing 180 hrs/month solo coverage than 160 dual coverage

[PAMEDIC]

Not going to lie... I love the work-life balance aspect of the job. I work 6 days on and 8 days off and make good money. Beats the hell out of every M-F 8-5 job I have ever had.

[newton9686]

Number one, I know y'all who have commented have put in your time. You guys aren't newbies coming out of PA school or not yet accepted. It's different when Tom Brady requests time off versus a rookie who hasn't done anything yet

 

My point is a career in medicine should not be about work life balance from the start. Yeah obviously we can't work our selves like dogs our entire career. But if a main reason for choosing PA versus choosing MD is time off and better hours, I feel like you are making the wrong decision.

 

But then again y'all who have commented probably have more years of healthcare experience than I have been alive so you have more than earned your right to disagree.

[Reality Check 2]

ANY career should be about work/life balance.

 

Stock broker, farmer, electrician, house painter - whatever - Anything that consumes you becomes a problem rather than a joy.

 

Work to live, no live to work.

 

A good physician or a good PA has balance.

 

I think you are missing the point altogether.

[Allegro]

^THIS. I don't want an overworked ragged professional to be responsible for my care. I want someone who has slept, who has eaten, who has the time to spend on my care as opposed to throwing me down the line to the next person with a half-assed diagnosis or none at all. I think what you are describing is dedication, not work/life balance. A work/life balance fosters dedication rather than being the antithesis of it. What you are describing is people who do not care about the job, work/life balance or not.

[pa-wannabe]

This topic really hits home for me, and has been part of a lengthy discussion I had with the PA I'm currently shadowing. She and I both agreed that there seems to be a mentality nowadays that if you aren't working 50-60 hours a week, you aren't working hard enough. This is coming from a PA I have seen first-hand take patients 15 minutes before her day was supposed to be over, because she is flexible and understanding. I whole heartedly agree with the post above, that it is how hard you work in the hours you put in, rather than the number of hours you're averaging. PART of the reason the profession is so appealing to me is the thought of living a life with meaning that is also comfortable. By comfortable, I mean having the things I need and perhaps a few things I want, not neglecting patient needs while collecting a substantial paycheck. I just hate the thought that if you are concerned about finding balance in your own life as a provider, you must not have gone into medicine for the right reasons. I hope to one day be a part-time provider to spend more time with the kids and maybe do some traveling. Neither of those things makes me selfish, but they do bring me joy. Life is about so much more than just career, and frankly, the best providers I've seen are the ones who have outside interests and activities, and often like to swap short stories during the appointment.

[newton9686]

Since everyone seems to disagree I am going to conclude that work life balance means different things to different people. But my thing still is why does this seem to be the differentiating factor for so many pre-pas choosing PA over MD/DO? Just my opinion. However, contrary to popular belief on this thread I do not believe you have to sacrifice your sanity to be an excellent provider. But who knows, maybe I am just in the minority on this one. Thanks for all the responses everyone. 

[wildberry]

As a pre-PA student about to graduate undergrad, I do hear this as a differentiating factor for choosing PA over MD/DO.  Not to come across as if I know anything about anything, but since you're asking about the pre-PA side of it, I figured I'd share my opinion.

 

From day one of my undergrad in pre-health (before even thinking of PA school) it's just been said that PAs have more time for various things than MD/DOs do.  On a comparison sheet from advisors and career centers, that's always listed on there.  At the health clinic I volunteer at, that's always a conversation.  With {some} of the PAs I've shadowed, that was a conversation.  And when I put all that together, I take away that a PA has less school, meaning they start their career earlier and have the option to work in settings that may allow them to do other things besides work all day every day.  I personally don't take it as "that sounds like an easy job I won't have to put energy into." I take that as, "I love caring for my patients & I also love to xyz, so maybe this career can allow me to integrate those things into my life a bit easier than as a MD/DO."  

 

I plan on busting my butt to be the best PA I can be, and I also want to bust my butt to do xyz - because they will both be huge parts of my life that I'm passionate about.  This is the balance that I see between work (as a PA) and life-balance (being able to do xyz). And MD/DO has a drawback of having to go through about 12 years that are solely dedicated to just work & not much life balance - then some after the ~12 years of school/intern/residency. I hope this sheds light from a different angle 

[MyNameWasUsed]

I'll be happy if I can work 3 12 hour shifts in the ED per week and make 120k. How realistic is that? 

[EMEDPA]

I'll be happy if I can work 3 12 hour shifts in the ED per week and make 120k. How realistic is that? 

after 5 years? probably. as a new grad? unlikely.

[newton9686]

And EMed that's my problem. These young guns (and I can be classified as one) want the 100+ salary working 30 hrs a week before they are even accepted into school. Once you have done your time, yeah, but you are not worth 75 dollars an hour right out of school, so don't expect to paid as such.

[MT2PA]

And EMed that's my problem. These young guns (and I can be classified as one) want the 100+ salary working 30 hrs a week before they are even accepted into school. Once you have done your time, yeah, but you are not worth 75 dollars an hour right out of school, so don't expect to paid as such.

 

I feel like that's exaggerating a bit.  I am absolutely one of those 'work-life balance' people but for me that means a more realistic 40-50 hrs/wk instead of 80 or something insane like that.  And yes, the potential for a 6 figure salary is appealing but I'm certainly not expecting it right out of school - and I'm in a high cost of living area that can probably pull that with the right offer.

 

The example you speak of probably exists, but I don't think it's the majority of new, young applicants.

[db_pavnp]

I'll be happy if I can work 3 12 hour shifts in the ED per week and make 120k. How realistic is that? 

 

I hate to get all philosophical on you, but if you are saying you require x hours for y pay, you might kinda be unlikely to be happy with much of anything.  The recent medscape happy doctor survey had like 50% unhappy at 300k+ (super rough, "I glanced at it" ballpark estimate).  Just a head's up.

[Reality Check 2]

We all tend to live to our limits or means unless we have super discipline - a rarity at best.

 

So, if you set yourself up for "I can't work for less than this...." - then you have nowhere to go.

 

A lot of PA jobs have ceilings. I certainly get paid more than a new grad because I have done this forever and have experience.

 

You have to start somewhere and you have to have someplace to go.

 

Yes, new grads will have school debt. I do not. I have kids going to college.

 

So, WANT WHAT YOU HAVE and learn to live within means. 

 

Work hard, play hard.

 

My very old 2 cents

[EMEDPA]

RC2- agree. when I started working as a PA $24/hr for ER work was good for a new grad. now it's more like 45-55. experienced folks can make a lot more, but it takes a while to get there. lots of crap jobs and bad hours. lots of nights/weekends/holidays. sure, there are markets that pay a new grad 120k right off the bat, but in those places the cost of living is ridiculous.

[DejaBlu]

All I can say is that everyone should be careful when making assumptions.  It will come back to bite you.  I'm sure we've all learned that at some point in time.  I know I have been bitten on more than one occasion.

 

Don't generalize why people chose PA vs MD/DO.  There are several reasons to choose either path.  I'm choosing PA because I am an older student and do not want to spend 4 years in medical school plus another 3-5 in residency (depending on specialty).  I do not have that kind of time.  Nor do I want to come out with $200K-$300K in debt.  With PA school, I'll be in school for 28 months, have very little student loan debt, and hopefully have a good work-life balance working about 40-50 hours per week (give or take).  Plus, if I ever decide I want to change my area of practice (e.g., going from emergency to family practice) I will have that option.  None of these reasons means that I will be any less dedicated than a doctor. 

 

So you see, there are several reasons why people make choices.  Be very careful about making assumptions and judgments.