Last month was a surgery rotation. By typical standards, it was mellow. Limited call, nothing all night. You get used to it really quick.

But now it’s June and I’m back on medicine. With overnight call every other weekend, and 13 hour days, the load is heavy again. This is a much better situation than it used to be, but it’s still pretty tough to put in consecutive 80-90 hour weeks. It’s best to not really think about this part of the job, and to just do it instead. It’s so much worse to think about the job, to really ponder what you are enduring, than to just show up when you’re supposed to and go home when you can. If you don’t think about it, then you just go to your job. It’s what you do.

I realized recently that yeah, docs make a lot of money, but this salary is offset by the fact that they work lots of hours, too. Someone who works two 50k/year jobs makes just about what an average FP makes. So, to REALLY make money, docs need to figure out how to keep their salary but work less. And, in fact, this is the constant pressure in the medical field. Less work, more money. Everybody’s pushing for that. It’s effectively doubling the salary. If a doc works 80 hours/week and the salary goes from 100k/year to 150k/year, they increased their salary by 50%. But, if they increase their salary that much, but also cut their work hours by 25%, they’ve effectively raised their salary by 75%. So, if a doc tells you they don’t make much money, you can only verify that stat once you know BOTH how much they make and how long they work to make it. Same the other way – if a doctor seems to make a lot of money, you should figure out how many hours they work, before concluding that they make tons of money.

Add to this the schedule itself. People don’t realize what a luxury it is to have a set, regular schedule. A regular schedule allows planning, and planning allows lots of extra things to happen if life. Especially with a family. It’s worth money to have the ability to plan and schedule. How much would you pay to have a good family life? Many docs pretend they can do it, but they actually can’t. This is why you see them ducking conspicuously our of their kid’s plays and baseball games. You don’t see grocery store manager dads doing that.

Medicine is good money and the job market in America is one of the best in the labor force. So, there’s perks. But it isn’t the financial nirvana it seems to be. There’s lots of hidden costs, either in time, life or actual money.

I wouldn’t know for sure, but it seems to me that if you really want the best bang for the buck, the job to pursue is dentistry. Maybe investment banking. But not medicine, especially primary care.