Survivor Stories: Factoring how much better it will actually get

by Jennifer Hunt

Today’s topic comes from a post on our Facebook page last week. 

Are there any of you who are veterans at being doctor's wives? Say 10 or 20 years out of residency? What is your life like now? Is it what you expected?

It’s a fair question, and one we see a lot around here. Tell me it’s worth it. Tell me we’re going to be okay. Tell me it gets better. PLEASE.

So here are my observations on what is guaranteed in post-training life:

1. You will have more money than you do now.
2. That’s all.

The questions about how much more you will see your husband, whether or not his stress level (and, by association, your own) will decrease, and precisely how much more money will be in your bank account all depend on a handful of variables. I have been submerged in the world of eyeballs since 2000 (and kids’ eyeballs since 2004), and I have friends and family members in other specialties, but I can only offer you my observations. A definitive, blanket statement is impossible because every doctor’s life will look different. 

Here’s what will determine how much better it gets:

1. Choice of specialty. Surgical specialties are going to demand more time than medical, but they typically earn a higher salary. Additionally, inpatient surgical specialties will demand more than outpatient. If your surgeon has to admit a patient, he will have to round on that patient, which means more time away from home. Some specialties’ call are brutal, some are barely noticeable. But remember that call equals new patients, which is vital to building and maintaining a practice, especially during the first few years.
2. Teaching hospital vs. Private practice. Both have pros and cons. My DrH has been in private practice since 2004, but my best friend’s DrH is on staff at Cleveland Clinic. In private practice, your husband will be part of a small business, and if he is a partner, he will be a small business owner. They don’t teach that skill in medical training, and the learning curve is huge. Lots of additional stress and time, especially during the first few years. But he makes his own schedule, has control over his practice, and theoretically, he will have a practice to sell when he retires. In academic medicine, your husband can let someone else worry about billing and employee benefits, but he may not have as much control over his schedule and how his practice runs. He will, however, have residents to take primary call and field patients. Additionally, he will likely be required to conduct and publish research, attend meetings (in town and out of town), and speak at conferences, which obviously requires more time away from home.
3. Small town vs. Big city (also Small practice vs. Big practice). Besides cost of living, this affects both the patient population and the number of doctors backing him up. This is probably the most varied variable—you can encounter the same problems in both places. If your DrH is one of three specialists taking call for your area, guess what? His call will be q3. This could be mean every three days, every three weeks, or every three months, depending on how the hospital and/or practice structures it. But if you’re in a large group or a large city with fifteen docs sharing his specialty, his call will be less, and you will see him more—which means more free weekends where you don’t have to keep your calendar clear or drive two cars if you dare to actually make plans. Another factor: whether or not his practice requires the doctor to cover his own patients—if he does, he is technically on-call EVERY DAY. If he has a patient who has a problem, that patient does not contact whoever is on-call that night, he or she calls your husband. For us, it’s usually not a big deal...until you receive a 3:00 a.m. phone call for emergency pink eye. I’m guessing an academic doc would never have this issue.
4. His personality and values. If he wants to earn as much money and notoriety as he possibly can, you won’t see him. If he wants to work hard and earn a good living, but still coach Little League, you’re in luck. Talk to him about these things now and set realistic expectations. What is important to him now will be important to him later. He will make time for what he values most.

This is by no means a comprehensive list, but I hope I’ve given you a list to bookmark and return to when your DrH is choosing a specialty and a practice. (Fellow Survivors, please chime in below and add to my list.) Most importantly, talk to your DrH about these things and where he sees himself. Medical marriages and families require team effort, and the best decisions will be made together.