To any attending willing to take the time to comment specifically on what life is like and demystify the stereotype that ortho is a "hard lifestyle" even as an attending.
I know I'm going to be a surgeon. I know that means I'll work my butt off during residency. That I know is expected for me to be a competent surgeon when I finish. I don't think I appreciate the differences among different surgical specialties after residency. I know I'll work hard doing what I love and I'll enjoy it. However, what does working hard really mean for ortho? What makes orthopedics stereotypically a challenging lifestyle (longer hours? middle of the night calls? more emergencies? more weekends? more litigation? less desirable patients?)compared to ENT stereotypically a controllable lifestyle after residency?
Correct me if my assumptions are wrong concerning general ENT vs general ortho in a private practice type of setting:
General ENT
- patients tend to be healthy, surgeries are more often elective and are for quality of life, surgeries tend to be done on an outpatient basis or have a 1-2 night stay. (fewer patients staying in the hospital, means fewer rounds, fewer late night emergencies or calls to manage)
- has slightly more of an emphasis in clinic than ortho. Clinic can be more of what you want to make of it. Generally, some variation of 8-5. Clinics offer more reimbursement compared to the same amount of time spent in the OR.
- there are fewer ENT emergencies that have a high incident rate that will require an attending to come in while on call
- malpractice cost is one of the lowest among surgical specialties. ENT's have less litigation in general.
- Ancillary income includes hearing aid sales, speech patholgists, audiologists, allergy, facial cosmetics
- average ENT works 40-50 hours/week
- average income ~$250-325K
General ortho:
- patients tend to be healthy, but pathology tends to be more acute. Surgeries can range from elective to emergent. Fewer opportunities for outpatient surgery. Longer hospital stays for patients (more rounding, more calls in the middle of the night for management issues)
- more emphasis on operative management to generate income rather than clinic. Clinic is busy with a lot of nonoperative management and follow ups though. Same clinic type schedule as ENT with an 8-5 type of variation. Operative days tend to be longer. Calls tend to be busier.
- more acute emergencies that have a higher rate of incidence. Many can be stabilized by the ER and seen the next day as an add on case or clinic patient.
- malpractice cost is high. Prevalence of litigation is higher than ENT.
- ancillary income includes imaging, physical therapy, and medical device design
- average orthopod works 50-60 hrs/week
- average income ~$300-400k
So my big questions: Do orthopods tend to work more by choice, by expectation among peers, or by necessity because of practice costs and declining reimbursement. What makes ortho "hard" as an attending and ENT "Early nights and tennis" as an attending?
I am assuming that orthopods work more and thus they get paid more. If they simply worked fewer hours they could have a similar lifestyle to the stereotypical "Early nights and tennis" while making a comparable income?
I ask all these questions because I love both specialties. I find the challenges of both specialties stimulating. I pick at these nitty gritty differences because ultimately I am having a hard time committing to one or the other. I have already rotated through both specialties. In general, I got along with the people in ENT better at my home program, but enjoyed the surgeries in ortho more.
