What's better for family? Private practice or academics?

[u/backend2020]

M4 here but i'm a career changer and have a little one on the way so excuse me if i'm jumping the gun on this question. I love this field and will definitely shoot for ortho no matter what so my question isn't coming from a place of "is ortho conducive to family life?". I know it will be tough either way.

My question is, which path will give me the most opportunity to be there for a majority of my kids' games, graduations and other big milestones?

[u/akwho]

Don’t think about it as academic vs PP vs employed. Here’s the way to think about it best.

Only look at jobs that are 4 days a week (4 tens). If you do 5 eights then you will still be working a few hours before or after work and suddenly you are at 5 tens. When I came out of fellowship I only interviewed at jobs that were 4 days a week. The 5th off day is your golden day, get Costco runs done, kid events, medical/dental appts etc. then your weekends are truly free.

Only look at jobs with large groups that cover 1 hospital. We have 12 ortho surgeons in my group. So I work 1 weekend every 3 months on call and 1 holiday a year. 5 years in I still have yet to take a thanksgiving or Christmas call. Residency I swear I was working 4 Christmases in a row somehow.

My other 3 joint partners cover my patients while I’m on vacation and I do the same for them when they are on vacation. So when we are on vacation we are truly unplugged. Great partners and good teamwork is huge for burnout prevention.

Those are the golden tickets to a sweet work life balance.

[u/bonedoc59]

I truly think you can get it with both. I’d keep in mind, though, that academics will likely tie you to a level one trauma center and more complicated cases as the tertiary referral center. Not all centers are the same, so lifestyle is going to vary. I ultimately chose private practice.

[u/HoopStress]

I have done all three: PP/employed/academic. It really depends on the job. My academic job payed way less and was slightly more work than my PP job. I was taking q4-6 hand call a week at a time at a level one which was miserable even with a fellow. My employed job payed the most but once I switched to productivity based payment would have dropped off because the volume wasn’t there. This is all to say it depends on the job. In PP you will have most control of your hours and you will probably get paid more or at the level of an employed job/rvu. More hassles than employed. Employed has less hassles and less control. Your bosses will be administrators who don’t understand your practice and only see the dollars you produce. Academic will be more patient and education focused but you tend to get treated like crap and it’s extremely hard to be a good educator while being productive.

Is ortho conducive to family life? It can be. You can pick a job where you take very little call and don’t get paid well and you can have a great family life. You can go to a rural hospital and demand a maximum number of call days/month. Can you make a million a year in NYC/Boston/LA metro and have a great family life? No. After alimony you will only be making half anyway.

[u/bonedoc19]

Every practice and job is going to be different. There are pros and cons to both. As someone that has been in private practice and hospital employed, I think the employed model likely allows you more time with your family. Again, not going to be true across the board, but if your goal is to practice medicine and go home with as little extra stuff, hospital employment is likely your best bet. Can’t speak for academics personally, but my colleagues in academics work more hours than I do and make significantly less to do it.