A Look Back At My First Few Months As An Attending

I’m back! I can’t believe it has been a month since my last post. Work became a little more time intensive than I anticipated which left me with little time to write for fun and this blog on the side.  Don’t worry,  I do plan on keeping up with the blog and keeping to a regular posting schedule in the future and I’m sorry for the delay. This week I plan on prepping posts so that this does not happen again.

 

It has been a little under two months since I started working with a new group outside of residency. The learning curve has been steep with many more hours put in than I originally thought would be necessary. It was a very eye opening experience which I will touch a little bit on in this post. Being a new attending is stressful and adding to that is that I’m still waiting for my first real paycheck to come in!


Learning Curve

Change can be hard to conform to, especially when the change is going from a resident or fellow to attending. Now that it’s my license on the line it seems that the level of stress has increased much more than I anticipated (The more senior attending physicians can now say I told you so). I am not implying that residency did not prepare me for the real world, in fact I think that I am much better prepared than some of my colleagues who started at the same time as me. What I am trying to say is that I was not anticipating the stress I would feel for the first month or two as an attending till I found my groove in the new practice.

My shifts are usually 12 hours long but have gone as long as 18 hours with me seeing up to almost 30 patients a day. Most of the prolonged time I spend at work up to this point is due to my inefficacy with the system and hospital itself as a result of me being new. Not knowing how to easily reach a consulting physician other than being on hold for the page operator for a long time and not knowing how to work a new EMR really ate up ta lot of my time yielding very long days.  As I collect more and more phone numbers where the physicians are a text message away, it becomes much easier and quicker for me to go through my work day. So hopefully in the near future this reason for a slow down will dramatically decrease.

The largest and most unexpected slowdown was learning the new EMR. Growing up in the generation where it was required to take some computer coding classes in school I figured I would be able to handle any software like a pro. It also helped that in residency I used 3 different EMR’s since we rounded at 4 different hospitals and I used another one during medical school. Soon after starting work, I came to find out that learning where to find something in an old EMR that is not search friendly took longer than I expected to become used to. I finally feel like I’m starting to get this down and my time spent charting per patient has dramatically decreased already. Hopefully with time this will continue to improve as I get comfortable with the computer system.

 

Waiting for a paycheck

Another area that I underestimated is not how but when I would be getting paid. The contract was spelled out quite clear but what I did not expect was the delays with administration and other insurance issues that have lead to an average of 6-8 weeks before payment on patients that I bill for. My contract is based heavily on commission or how many RVU’s I bill for. This has lead to a longer than expected delay before I get to see a real “attending” paycheck. To date, I have not received one yet but I will in the next 2-3 weeks. Luckily, we have recently teamed up with an organization that plans to pay much quicker so the delay should significantly be decreased.

With all the moonlighting shifts that I completed during residency and cash that I stockpiled it looks like at the end of this month my cash will run out and I will have to take a loan to make to my first real paycheck. The idea of taking a loan definitely hurts but I know that this is a very temporary situation.

 

How I plan to get by till the bigger paychecks start coming in

I did something that I never thought that I would, but I took out a credit card to help with the short term loan. The credit card that I applied for has 12 month 0% APR which I plan to use to bridge the gap from lack of finances to when my paycheck arrives in 2-3 weeks. Its not ideal but I have to pay the bills. I also was talking to my father about the situation and he graciously offered to give me a little cash so that my bank account is not sitting with $0 present for the next month in case I need cash for an emergency. My ego took a little hit when I realized that a 30 year old grown man still had to get help from the parents but I’ll get over it.

 

Live extremely frugal till then

Till the paycheck start coming in I’ve been working long hours and taking advantage of any perks that I may have at the new job. The physician dining hall has free food for physicians and I have been using this as my means of nutrition till I can restock the fridge. Driving has been kept to a minimum to keep gas costs low. The “going out budget” has been drastically slashed and air-conditioning only comes on from 10pm to 5am and is turned to no lower than 76 degrees. This has decreased my overall monthly costs of living (excluding rent and my loan) from about $1100 a month to about $300 a month. Of course, I don’t plan on living like this forever but it sure does help in the short term to not spend money that I do not have.

Once my first real paycheck arrives in about 3 weeks, the credit card will be paid off and I plan on eating a little better to keep a healthy lifestyle and maybe even turn the air conditioner a little lower if needed.

Why is there so much fried food in the doctors lounge?
Why is there so much fried food in the doctors lounge?

 

4 thoughts on “A Look Back At My First Few Months As An Attending

  • September 30, 2016 at 8:44 AM
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    “”Welcome to the real world,” she said to me, condescendingly.”

    Are you having fun yet? The pay issue is lame, but once you get through the initial wait, the checks will come regularly. I wouldn’t worry about the credit card issue. I actually used a 0% CC check to finance the purchase of a 6-figure vacant lot when I was short on cash and didn’t want to take on a loan. I was able to pay it off in time, and I have no doubt you will be able to do the same.

    Cheers!
    -PoF

    Reply
    • September 30, 2016 at 11:28 AM
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      Thanks for the encouragement! I am having a lot of fun and learning a lot every day that I am at work, it’s exactly what I want to do and can’t see myself doing anything else. As for the paycheck issue and using a credit card to finance living expenses short term, its nice to hear that this is not uncommon and that the money will eventually start rolling in.

      Reply
  • October 16, 2016 at 10:04 PM
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    The first year will be a blur! Good job on keeping the costs manageable until the paychecks start coming in.

    I would have to second PoF on taking advantage of the 0% interest on new purchases credit cards. As long as you don’t get carried away, which I doubt you would, you will be able to pay it off quickly.

    While I have definitely over leveraged myself with student loans and mortgage, the 0% interest credit card offers can be used very creatively for your own benefit.

    Why DO the doctors lounges always have fried food? I am surprised that they are not more progressive and health conscious in Austin.

    Reply
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