Re: Family life of an orthopod

Family life will be determined by practice selection and not necessarily subspecialty. For example, I am a sports doc/arthroscopist. I have two full clinic days a week which keep me busy starting at 8 and usually home by 5 or 5:30. I operate two days a week and usually try to get out of the hospital around 3. I also have a day off every week. In addition, I practice out of a hospital that takes very little trauma. So my call days are usually benign. An occasional trip to the ER, an occasional evening case. But I only take call about 3 or 4 days a month and one weekend every other month.

Practice selection is key. If you are looking for a good lifestyle, you need to live close to where you work (so your not stuck in your car). You need to join a group that has one clinic location or very few and also only work out of one hospital. It also helps if the hospital has a very low trauma load.

This is one example of a typical week. Probably a much better lifestyle than some of my friends. So there is light at the end of the tunnel. The question will be if you can find a nice practice opportunity in a place you want to live.

my husband is a pgy-3. i am sure that some specialties are more demanding than others, but i have a feeling that my husband will always have a demanding schedule. i think that, unfortunately or fortunately - depending on what day you ask me - he is where he is because of his dedication to ortho. and no matter what specialty we end up in, i have a feeling there will be times that our family life is going to take a hit.
that said, i do think that life after residency has to be better. it does, doesn't it?

I would like to re-emphasize what orthodoc said. It is more about your particular practice setup than your subspecialty. Many people think trauma has an inherently poor schedule/lifestyle. I know a trauma guy that is in private practice at a level one non-university hospital. He only does trauma, no scopes/joints/general. He takes 4 overnight calls a month and covers the ER M-F until 4pm. The majority of his cases are cases seen by others in the community while they are on call and refered to him the next morning. Emergent stuff is taken care of obviously (open fx, compartments, etc) but they have an agreement that he will take whatever they (about 12 other docs) want to refer to him, no questions asked. He has available OR times each day so he is not starting cases after 5pm usually. He rarely is in the hospital (when not on call) after 5 or 6. Basically the other people in the practice do not want to disrupt their clinics/elective cases during the day, so they are willing to basically do night triage and handle emergencies and dish of stuff than can wait so that their 5 ACL reconstructions are not cancelled the next day.

SO in my opinion its all about the setup you find.

Family life will be determined by practice selection and not necessarily subspecialty. For example, I am a sports doc/arthroscopist. I have two full clinic days a week which keep me busy starting at 8 and usually home by 5 or 5]

So it is possible to have a sports practice and a decent life. Is this type of lifestyle possible with a spine practice?

The lifestyle is there for any subspecialty, although traumatologists tend to have the most disruption and unusual hours. It's just the ability to find a group that allows a reasonable clinic and case load and doesn't force you to work your butt off. Part of it will be driven by you. How much money do you really want to make? What's more important, a bigger pay check at the end of the week or being home for dinner at night with the family and watching your kids' games? So some docs out there choose to work their tail off while others enjoy their lives.

How difficult is it to find practices that allow more time off? Your practice situation seems like a rarity.

I don't think my practice is a rarity. I think most students see the lifestyle of an academic orthopod which is usually busier due to being at a trauma center, having research and teaching commitments, etc....

Now having a full day off every week may be a rarity, but most of my private orthopod friends have a least a half day off a week.

That gives me hope! What type of city (small, large, north, south) do you practice in? Could you please decribe the practice you are in (number of orthopods, specialties, etc)? Thank you for all your advice so far.

I practice in Iowa City which has around 100,000 in the local county. We have ten orthopods and two PAs in our practice. Most of my partners are generalists with subspecialty interests such as spine, total joints, and sports medicine. We have two hand surgeons included as well. We also have a physiatrist joining the group soon to handle non-operative back for us. In addition, a foot/ankle specialist will be joining us in January.

We work out of a single level II hospital with 200 beds. All major trauma goes directly to the University across town which makes our call lifestyle real nice.

I have two full clinic days a week which keep me busy starting at 8 and usually home by 5 or 5]

With two clinic days, two OR days and one day off what do you do on the other two days of the week?

Well, I have my never ending "honey do" list that I have to attend to. I also do alot of boating (skiing, wakeboarding, airchairing) and fishing. As well as haul the kids around to various events. We also like to catch a lot of athletic events like home football and basketball games.

So you really have three days off per week? I was under the impression you worked six days per week.

The only weekends I work are the ones that I'm on call. One weekend every other month. Now I do occasional go in and round for a few minutes on Saturday morning if I happen to have any inpatients, but usually the weekend call doc does all of the patient rounds.

Family life will be determined by practice selection and not necessarily subspecialty. For example, I am a sports doc/arthroscopist. I have two full clinic days a week which keep me busy starting at 8 and usually home by 5 or 5]

how are you on call 3-4 times/month? i thought attendings went on call for 1 whole week at a time?

In an academic center you may see attendings taking call a week at a time b/c they have residents to do most of the work for them. In the private world, rarely are there residents to do your work. Therefore, taking call a week at a time would be a killer unless you're in a place where call is extremely quiet.

Most groups divide call by weekdays and weekends. So if you have a group of eight docs that all share call, then each doc takes one weekday every two weeks and one weekend every other month. Of course, different groups do different things so this can vary, but this is a very common way to setup the call schedule.

In our group, you can only take call on the days you are operating since our clinic is a few miles from the hospital. It would be too hard to cover the ER when you're in clinic and disrupt your clinic schedule.

Sounds to me like you need to go chat with some of your local orthopods in the community so you can see what the real world is like outside of an academic institution.

you are correct, i definitely would appreciate speaking to a community orthopod. is this a common thing for med students to do? i feel like a big part of matching is convincing programs that you love research and are committed to academics. i really appreciate your advice and experiences.

If you are interested in orthopedics, you should definitely go out and chat with the community orthopods and see what their lifestyle is like. Some medical schools have interest groups set up with contacts you can use. Just remember that only 10% of trained orthopedists go into academics.

Bump for those currently convincing spouses/SOs that they really want to do this.

also, don't forget about how much a PA can help you out. if you are out in the community, a good PA will do all of your busy work for you (H&P, notes, discharge summaries, floor callls, prescriptions) granted to have to pay their salary, but if you use them correctly in the OR and the office, they can make you money in the long run and be a huge impact on your life. they can even take call for you once you are comfortable with them and do things for you at night and let you sleep...

Thanks OrthoDoc, very informative