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AT DO

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Mar 24, 2019
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Hello,

Thank you guys for this forum. I just got done reading Fast Lane. It was an enlightening book and I found myself saying "yes!" many times during it. I want to start this post by saying I am not complaining in any way about my life. I have been very fortunate and make a great salary. This life however is not what I intended it to be.

I am an emergency physician 2 years out of my training and I am thoroughly a member of the slow lane. My wife is finishing her training and we are moving home (upstate NY). We are shackled by an almost insurmountable amount of student loan debt (~$1M).

I have always been business minded and wanted to pursue a finance degree however was misled by my parents and peers that pursing a medicine degree was the better option. 11 years of training later and countless hours of work I feel completely duped.

After 12 hour shifts of constant stress in the ER working rotating days, nights, weekends and holidays I am away from my family more than I ever anticipated.

I desperately have always wanted to own my own business and the freedom that entails. These days with the pressures at work and out I find myself trying to think of new business ideas and coming up short. I know these are just excuses but sometimes it is good to rant.

I will join the fast lane somehow I just don't know how at the moment.

Again I am not complaining about the opportunities I have been given.

Thank you for listening.
 

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Kevin88660

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I have always been business minded and wanted to pursue a finance degree however was misled by my parents and peers that pursing a medicine degree was the better option.
My parents are engineers but they told me to study business releated degree for that is “where the money is”. I studied Economics and I never regret that because I do have a deep passion in social science.

The truth is getting finance degree and doing a investment banking career is the sure way to be on the slowlane to retire slowly. Not to mention the caffeinated body and sleepless nights.

Welcome.
 

MJ DeMarco

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Welcome my friend, if you thought TMF was good, check out Unscripted. I think it is far more relevant to someone with a great career like yourself. We've had a lot of doctors and dentists pass through here over the years. Unfortunately the sunk cost of medicine (and the student debt you mentioned) probably keeps them grounded to the job.

Hope to see you around and welcome!
 

Knugs

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Welcome! Surgical trainee here. Your big advantage (as you probably know) is that you can work highly flexible as a locum physician. This way, you can support yourself financially and focus your energy on your fast-lane endeavors! Looks like New York has good opportunities around. Copy pasted one for you below:

Location: NEW YORK
Westchester County
An emergency medicine physician is needed for Westchester county
  • Earn $180 an hour plus full benefits and 10% bonus
  • Work 8's, 10's or 12's
  • Must be residency trained in emergency medicine
  • Award winning hospital just minutes from NYC
 

Thomas Chauvet

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Jun 26, 2017
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Hello,

Thank you guys for this forum. I just got done reading Fast Lane. It was an enlightening book and I found myself saying "yes!" many times during it. I want to start this post by saying I am not complaining in any way about my life. I have been very fortunate and make a great salary. This life however is not what I intended it to be.

I am an emergency physician 2 years out of my training and I am thoroughly a member of the slow lane. My wife is finishing her training and we are moving home (upstate NY). We are shackled by an almost insurmountable amount of student loan debt (~$1M).

I have always been business minded and wanted to pursue a finance degree however was misled by my parents and peers that pursing a medicine degree was the better option. 11 years of training later and countless hours of work I feel completely duped.

After 12 hour shifts of constant stress in the ER working rotating days, nights, weekends and holidays I am away from my family more than I ever anticipated.

I desperately have always wanted to own my own business and the freedom that entails. These days with the pressures at work and out I find myself trying to think of new business ideas and coming up short. I know these are just excuses but sometimes it is good to rant.

I will join the fast lane somehow I just don't know how at the moment.

Again I am not complaining about the opportunities I have been given.

Thank you for listening.
Hello friend, as a surgery resident in the last year of his training (in France), I can totally feel you !

Don't worry, it will take some time but we will make it, we have been through hard things and we already proved we know how to work hard and be patient, so we have everything that's needed. We just need to find a way, and if we actively look for it, it will happen.

Welcome here !!!!
 

DustinH

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May 24, 2017
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Hello,

Thank you guys for this forum. I just got done reading Fast Lane. It was an enlightening book and I found myself saying "yes!" many times during it. I want to start this post by saying I am not complaining in any way about my life. I have been very fortunate and make a great salary. This life however is not what I intended it to be.

I am an emergency physician 2 years out of my training and I am thoroughly a member of the slow lane. My wife is finishing her training and we are moving home (upstate NY). We are shackled by an almost insurmountable amount of student loan debt (~$1M).

I have always been business minded and wanted to pursue a finance degree however was misled by my parents and peers that pursing a medicine degree was the better option. 11 years of training later and countless hours of work I feel completely duped.

After 12 hour shifts of constant stress in the ER working rotating days, nights, weekends and holidays I am away from my family more than I ever anticipated.

I desperately have always wanted to own my own business and the freedom that entails. These days with the pressures at work and out I find myself trying to think of new business ideas and coming up short. I know these are just excuses but sometimes it is good to rant.

I will join the fast lane somehow I just don't know how at the moment.

Again I am not complaining about the opportunities I have been given.

Thank you for listening.
Welcome. Stop apologizing for not wanting to follow the status quo. You're having conflicting feelings of the "sunken cost" syndrome. You think because you spent 4 years of med school, 3-4 years of residency, and half a million dollars that you "must" do ER medicine. That's the sunken cost fallacy. An unscripted life rejects these "life traps." Start right now planning your future of what you want to be doing. You don't want to reach your 42nd birthday and realize you're still in an ER. Make a 1-year, 3-year, 5-year, and long-term plan.

Now, people around you won't understand why you wouldn't want to do medicine anymore and you will have to create some analogy or explanation to help them understand (or ignore them). This process will annoying but die away quickly over time.

There's plenty of ways to transition into fastlane while still working in the medical field. Once you're looking for those opportunities you will start to figure these things out. Here in Nashville we have the largest hospital conglomerates in the country and there are a plethora of spinoff companies that serve HCA, CHS, etc. There are companies that sell SaaS products like billing, patient recording, patient communication, marketing, HR/staff consulting, ER efficiency management/consulting, device sales, merger & acquisition services, real estate search firm for new offices/hospitals, insurance contract negotiators, and on and on.

Let me get you started with some ideas:

1) figure out how to pay off that debt quickly, track it, record it, and write a book about it. Do coaching services for others in a lot of student loan debt. Or create something that teaches people to avoid student loan debt.

2) Open up urgent care clinics (multiple clinics, not just one). Growing piece of the medical industry and costs are relatively low. This is also in your realm. Don't need to pay a bunch of nurse practitioners as much as internal or family medicine docs. Once you get 2 or 3 successful ones cash flowing then you can sell the process to anyone else interested in opening clinics.

3) Figure out how to transition out of medicine and then package that process and teach it to others. Trust me, there's plenty of other docs out there who would rather be doing something else.

4) Have the wife start a blog about being a female doctor in the 21st century. How to become a doctor, how to overcome any adversities, etc.

That's all I could think of off the top of my head.
 
OP
OP
A

AT DO

New Contributor
Mar 24, 2019
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Thank you all for the replies. I do appreciate it. I already talk about different ideas to some colleagues at work at at least 3 other young ER docs have told me they would be in if I think of something. Medicine is not what it used to be.

I do love my medical scribes and wished there was a way to pay them more (they make my work life tolerable). Scribe America currently has the market share with over $245M in revenue in 2017 (the owners are fast lane material). Their next biggest competitor is around $25M. Some of my scribes have told me to start a scribe company but I am not sure where the innovation is or how to compete with the big boys.

Another idea I had was since there is so much burnout and unhappiness in medicine I have seen a lot of physician career coaches popping up. I wonder if a brokerage type concept as a website to aggregate coaches and connect them with struggling physicians would work or some other way to connect burnt out docs with some salvation.

Thank you guys for the support and @MJ DeMarco I will certainly check out the next book.

Locums is a decent option but unfortunately it keeps me away from my family as well with travel to assignments.

I have always liked the urgent care idea @DustinH but I feel the start up costs may be too high and the market is saturated with them.
 

Knugs

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I wish I had a medical scribe in ER but in Europe it probably doesn't pay having them. So does Scribe America send external Personal to support physicians? I don't really understand their service. If there is a demand, why doesn't the hospital just employ a scribe?

Quick comment to locum. Beauty about locum is that you choose your hours around your life. Since your wife is also a doctor, I can only imagine how little quality time you get to spend with each other. You can always line up your schedule to hers so you both have the weekends off/weekends on. If you have a family you can balance work/life better out. Maybe you only work 1 day a week, maybe 1 week in a month. Its nice to have that in control.

I usually locumed locally, max 1 hour away (its up to you what assignments you pick), but my Dad often locums for a weekend away and sometimes is gone for an entire week. I still cant wrap around my head how one weekend locum is equal to my monthly salary. In my experience, when you find a local employer and do a decent job, they will continue to come back to you with more assignments. Their locum needs are usually chronic. Depending what kind of network you need, you can easily build relationships with local ERs (One call/one e-mail is all it takes) and get on their list of non-agency go-to locums, which by the way are always preferred. This way, you also get rid of the uncomfortable feeling of being in an unknown new environment.

Perhaps you can tell by now that I'm a big supporter of locum work. Its in my mind the only transferable way for us physicians out of the slowlane into the fastlane. With the working hours that we have, I don't see how anybody can put 100% into an idea.
 
OP
OP
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AT DO

New Contributor
Mar 24, 2019
4
11
15
@Knugs so basically scribes are pre-med students who get paid garbage money but are told it will be a great clinical experience and get close contact with MDs willing to write letters of recommendation etc. Scribe America employees these people and trains them in proper billing and documentation and then contracts with the individual hospital.

Trust me I love the idea of locums. I have been doing local locums exclusively for the past 2 years and it has been great. Unfortunately moving from a big city like Chicago to a small one like Buffalo, NY there are not many opportunities for locums. I have looked but there is nothing less than a 2 hour drive from home.


I wish I had a medical scribe in ER but in Europe it probably doesn't pay having them. So does Scribe America send external Personal to support physicians? I don't really understand their service. If there is a demand, why doesn't the hospital just employ a scribe?

Quick comment to locum. Beauty about locum is that you choose your hours around your life. Since your wife is also a doctor, I can only imagine how little quality time you get to spend with each other. You can always line up your schedule to hers so you both have the weekends off/weekends on. If you have a family you can balance work/life better out. Maybe you only work 1 day a week, maybe 1 week in a month. Its nice to have that in control.

I usually locumed locally, max 1 hour away (its up to you what assignments you pick), but my Dad often locums for a weekend away and sometimes is gone for an entire week. I still cant wrap around my head how one weekend locum is equal to my monthly salary. In my experience, when you find a local employer and do a decent job, they will continue to come back to you with more assignments. Their locum needs are usually chronic. Depending what kind of network you need, you can easily build relationships with local ERs (One call/one e-mail is all it takes) and get on their list of non-agency go-to locums, which by the way are always preferred. This way, you also get rid of the uncomfortable feeling of being in an unknown new environment.

Perhaps you can tell by now that I'm a big supporter of locum work. Its in my mind the only transferable way for us physicians out of the slowlane into the fastlane. With the working hours that we have, I don't see how anybody can put 100% into an idea.
 

404profound

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Welcome, I'm also from upstate NY (Cuse).

While i cannot relate to your magnitude of debt, I can relate to pursuing higher education as a nontrivial debt amount. I went about 90K in for a masters in organizational psychology and stats. If I could do it again, I would have taught myself software development and build scalable, in-demand applications.

Well, I can do it again. And I am. Last October I knew nothing about programming. My app will be released in about two months. It IS all mindset. Your current mindset is regret / shock (which is kind of normal when reading MJ's stuff the first time). But don't be defined by the mistake. Overcome it.

- Cheers
 
OP
OP
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AT DO

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Mar 24, 2019
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Flash forward to today. Have not yet figured out my Fastlane journey but I did start and launch a podcast about team-based communication in healthcare.

Now to figure out how to monetize it...
 

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Jon L

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In your original post, you used a lot of 'I' statements. "I'm frustrated." "I feel like I've been duped." "I'm a million dollars in debt." "I, I, I." "So therefore, I want to start a business." My initial reaction to this was that that isn't a good reason to start a business. The market doesn't care about you. It cares about its own needs.

Your post about the podcast, though, was very different. You didn't say much about it, but there's some passion behind it. You obviously care about improving communication in health care. That's something the market can use a lot of.

I don't know what its like amongst doctors and other staff, but I do know that communication between doctors and patients is pretty bad, and that poor communication causes all sorts of trouble - from missed diagnoses to poor compliance with doctors' orders. I'm guessing that the communication among medical staff is also not great ... if doctors can't communicate well with patients, its doubtful that they can communicate with non doctors all that well, either. Somehow, with all that medical training, their humanity has been trained out of them.

I know someone that's a consultant in this area. She sets up training programs for mid-sized clinics that teaches clinicians how to communicate with patients across cultures. Blacks, for example, tend to understate the severity of their symptoms. Her training programs help to correct mis-diagnoses that can result from cross-cultural communication. She's just getting started as a consultant, but she has a first client that has already replaced her salary. As she progresses and systematizes what she does, I'm betting that she will dramatically increase her income.

What do you see the market needing from your perspective?
 

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