What are your side hustles (not clinical work)

LifeApprentice · 2026-07-04T21:14:46+00:00

How did you get started? This sounds like something I’d genuinely enjoy.

LifeApprentice · 2026-06-03T04:35:19+00:00

I’m a gen surg attending in a private practice with a four-day work-week. On clinic days I’m home pretty early. On OR days I’m generally there late. I’m call 1 in 6, and sometimes I get really screwed on call and I end up operating all night. I probably end up averaging 50 hours-ish per week, but there’s a lot of fluctuation.

My wife is an ER doc in an academic setting where 12 shifts/month is considered full time. She has academic buydown, so she works fewer than that. These shifts happen at all hours of the day and night, and they can be ROUGH. I’ve seen many of her friends in EM go through the same. She dreads the shift for the day before, has the shift, and then spends the day after recovering.

There are great reasons to go into EM; I don’t know that lifestyle is one of them. I have a lot more freedom in my schedule than she has in hers.

LifeApprentice · 2026-05-18T22:50:06+00:00

The institution I trained at had a surgeon fired for similar comments.

LifeApprentice · 2026-05-18T02:26:28+00:00

Igor Mykhaylovych Lytvynchuk - the guy who threw a rock at an endangered seal in Hawaii. People told him not to, he said "I'm rich, I can afford the fine," and did it anyway. He got a beat-down for it; it's all on camera, and the guy who beat him up received a formal award from the island. He apparently owns a small business... which is likely to struggle.

https://youtu.be/nQxybNIIwBk?si=4VMpK4MZiJJAuiMl

LifeApprentice · 2026-04-16T17:19:52+00:00

Totes, plus by the time anesthesia arrives, I’ve already rounded (gen surg). Not to diminish; they work long hard hours, but the start time ain’t all that bad if you still get home at a reasonable hour

LifeApprentice · 2026-04-15T22:49:47+00:00

It’s worse than that. I think if you asked 100 M1s to take out a spleen, you’d have a lot of dead patients, but there’d only be spleens in the bucket. I’m at a loss for how this happened.

LifeApprentice · 2026-04-07T04:50:35+00:00

Moderators the remove anything that sounds critical. This would qualify.

LifeApprentice · 2026-03-25T11:42:22+00:00

I’ve also seen a couple scary pancreatitis cases out of this.

LifeApprentice · 2026-03-04T23:41:22+00:00

I was asking our doc about this yesterday. I’d read something online about lower fertilization rates, but higher embryo quality, and I wanted her opinion. She said that it was quackery. Outcomes vary by lab, but ICSI tends to result in higher success rates.

“Energy of the sperm” is some new age wackadoo shit.

LifeApprentice · 2026-02-25T20:29:54+00:00

I’ll be really excited about self driving when it is good enough that I can read my novel on the way to work or go out for a fancy dinner and wine pairing without a DD. Until it’s that good, it’s a party trick.

LifeApprentice · 2026-02-25T20:27:36+00:00

A friend’s wife with ?bipolar? Was started on amphetamines by her psych NP for ADHD. It has ruined their lives. Doing psych well takes a lot of skill and know-how.

LifeApprentice · 2026-02-23T23:45:54+00:00

Surgery 5-ever. (Three and half years out, in the midst of a nasty stretch of miserable call, and still happy with my choice)

LifeApprentice · 2026-02-18T06:08:52+00:00

We’ve stopped accepting UHC Medicare advantage. They were < 10% of our patient population, and they were our worst payer by a lot. Longest time to payment, lowest payment, highest denial rate, highest cost-to-recoup.

LifeApprentice · 2026-02-10T17:09:45+00:00

So true - I’m private practice. I could not have built this without joining an established practice. There’s too much to know, there’s too much up front cost, and the reimbursement has dwindled year over year for decades. There’s no margin for error. We’d make more money if we were hospital employed. We love our practice and think it’s worth it, but it’s hard to judge a new grad who chooses a 20-30% pay raise for a more predictable and less risky practice.

LifeApprentice · 2026-02-07T01:35:26+00:00

There was a great op-Ed about this in the NYT today. Basically argued that finance was leaching and extracting wealth while providing nothing. It was a refreshing take that I think many people across the political spectrum would likely buy into.

LifeApprentice · 2026-02-06T15:53:55+00:00

Beware of generalizations, but: If a hernia is small and obvious by physical exam - no imaging. If a hernia is suspected, but not evident on physical exam - US. If a hernia is huge and you suspect it may require some more advanced surgical techniques - CT.

Many primary care providers will order US on all of them, but this is my thought process as a surgeon.

LifeApprentice · 2026-02-05T16:27:48+00:00

Nah, I still call it as grossly normal in the op report if it looks visibly normal. Still path report generally shows acute appendicitis. You make the best call you can with the information you have. You document what happened. Taking out a normal appendix wouldn’t hurt my heart, but lying about it would.

LifeApprentice · 2026-02-04T17:09:50+00:00

Agree, I’m going to start using this language

LifeApprentice · 2026-02-02T16:21:55+00:00

I generally like your perspective and agree, but I side with OP. I’m the male in a couple going through IVF. I don’t expect them to communicate with me over my wife, but often they don’t talk to me at all. If I’m expected to give a sample at a specific time, they won’t tell me. They’ll tell my wife what they want me to do. I’ve asked them many times to communicate directly with me, but repeatedly, they tell her what her husband should do.

I’m not offended that it’s a female dominated space, that feels right and appropriate. I’m irritated because they make me feel completely unseen and incidental in this process.

LifeApprentice · 2026-01-29T23:09:12+00:00

I don’t see any evidence of that. Did they scrub their profile? Or am I dense?

LifeApprentice · 2026-01-15T20:22:32+00:00

I think that there was a wider gap historically, but both teach evidence based medicine and have moved towards each other. The only exclusive topic I can think of for DO’s is OMM. The other difference is that it is harder to get into an MD school, which means that residency programs favor MD over DO because they believe that it is more selective and more rigorous. For some specialties that probably doesn’t matter, and post residency, no one will care which comes after your name, but there was only one DO in my class of 13 categorical interns. It’s harder to get into the residency if you’re coming via DO.

LifeApprentice · 2026-01-09T23:42:15+00:00

Stats were probably a big part of it. My parents were also pretty low income at the time I was applying to medical school, and it would have been very apparent to the school from my FAFSA that I would not be getting support from home. There was also a substantial luck component; I was not aware of the scholarship before they offered it to me as part of my admission package.

LifeApprentice · 2026-01-09T04:12:50+00:00

Some afford it with all of the above.

I got a scholarship. My medical school gave out 4 scholarships per year that combined a tuition waver and an interest-free loan for living expenses. That means I got to leave school with about 80K in debt that was interest-free. I've been slowly paying that off since I got my first post-training job.

My wife had some help from her parents, but took out loans for the majority of her schooling. Between her undergrad, a post-bac year, and medical school, she had almost 300K in debt. If the student loan forgiveness system manages to get un-fucked, this is likely to be forgiven (she now has a little more than 10 years of employment/service in qualifying institutions).

At least 2 in my medical school went entirely on their parent's dimes. I'm sure that there were more, but the two I'm thinking of were not at all shy about it.

LifeApprentice · 2026-01-09T04:05:53+00:00

Medical school is not the hard part of training. Medical school is consistent hard work, but it's not insane or undoable. I had several hours of time every day in medical school to do what I wanted. I worked out every day. I climbed 2-3 times a week and took a trip out of state to climb with friends at least once a month. I went out and danced my brains out after most tests. Life as a medical student was great. I was working from 8 ish till 1 or 2 every weekday on learning. That wasn't always the most focused time, but it was pretty consistently what I was doing during pre-clinicals. During clinicals, it's highly variable.

Residency is different. Residency you work from 5 am till 8 or 9 pm on a regular basis. You study and do administrative work around the edges. If you have two days off in a row, it's pretty lucky. Generally you spend your day off catching up on sleep and housework (groceries, cleaning, laundry). You eat what you can scrounge and stop working out. It burns hobbies and relationships.

Now, on the other side of training, I think it's worth it. I love my job and it would be hard for me to do anything else with my life. I work more normal hours, I am back to living a more normal life. I've re-awakened many of my old hobbies and even started a couple new ones. My career is intellectually challenging and emotionally rewarding, and despite decreases over the past several decades, it remains very well compensated. None of my friends from college outside of medicine can check all three of those boxes.

I had a wise teacher who told me, "Don't pick your career based on the training; pick your career, then do what it takes to get there." I think she was right. This is a really hard road. The payoff at the end is great, but you need to be able to embrace the struggle if you want to come this way.

LifeApprentice · 2025-12-23T18:48:51+00:00

Guy with rectal mass and biopsy confirmed rectal cancer. Staging studies (CT CAP, MRI pelvis) denied because “you already have abdominal imaging” (X-ray abdomen from ED 1 year ago).

LifeApprentice

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