What do you do for a living?

I am a registered nurse in the emergency department at a hospital.

How would you describe what you do?

I care for and treat the ill and injured patients and manage their care while they’re in the department and transfer them either home or they get admitted to the hospital.

What all does your work entail?

There’s the physical element of it as far as standing on your feet for twelve hours a day, whether that be walking, moving and rescuing patients, moving stretchers, equipment, things like that. There’s a mental or cognitive element where you have to apply your training and education as far as administering medications and making decisions for a patient’s care.

We do technical things as far as IV’s, blood draws, EKG’s. We hang intravenous drips and medications and manage and titrate those. We perform CPR and life saving measures. We communicate with our physicians in the department, letting them know and updating them on the patient’s condition and changes that occur while they’re there.

We transfer patients to the floors, we discharge them, we transport them around the hospital to where they need to go as far as having a CT scan or whatever.

when you have a good outcome with somebody, you really feel like your direct care of them has made them better in some way, and they tell you that they appreciate the care that you’ve given them. That’s very satisfying and rewarding.

We administer, medications and monitor pain levels and do dressings and all that stuff.

And then there’s kind of an emotional aspect of it too as far as you’re dealing with people that are very sick and sometimes it’s not a happy place to be, and you’ve got angry people so it’s kind of a roller coaster place to be.

What’s a typical work week look like for you?

Well for me, I’m not a full time right now. When I was full time I would work thirty-six hours a week.

Most hospitals now have 3 twelve hour shifts, three days a week, with thirty-six hours a week, and that’s considered full time. But I’m an as-needed employee so I can work thirty-six hours a week or I can work no hours a week, it just depends on what they need. Right now I’m working probably twelve to twenty-four hours a week. It just depends on when they need me and when I want to work.

How did you get started in this career?

Well, I was actually a senior in college getting my psychology degree and I thought I wanted to do that. I was looking into graduate school options because I was finding out that there’s not a lot of options in psychology without a graduate degree.

About that time my grandfather was really sick on my mom’s side and I was spending a lot of time in the ICU in the hospital with him. And something kind of spoke to me about it and I started looking into nursing programs, and found one. The good thing about it is that if you already have a degree in something else you can get a nursing degree in about 1 ½ to 2 years. So that’s what I did, and really, I guess it’s because my grandfather was sick that I was inspired.

What do you like about what you do?

I like the fact that I can make a difference in people’s lives immediately, and I can see the effects of what I do. I have skills that a lot of people don’t have and I feel like I can really make a difference in the outcome of my patient’s illnesses directly. I get a lot of reward from that.

What do you dislike about the job?

I guess in a nutshell I dislike the fact that hospitals are being owned more and more by big corporations and those corporations are being controlled by medicare insurance companies as to what they will and won’t pay for and all that trickles down to the nursing.

We are limited in how much input we can have over our practice, where pretty much they just tell you how things are going to be and you have to do that..

the most challenging thing is when you have something that you can’t fix…something tragic has happened and you can’t help, there’s nothing that you can do..it’s a challenge to figure out how to deal with it emotionally and not take that stuff home with you and let it affect your family life.

And it’s really just the policies and procedures like, charting, computer systems, etc. There are a lot of things that we have to use every day that slow us down and make things a lot less efficient. It’s not really anything to do with your clinical skills or your judgment, it’s just infrastructure and things like that we’d like to see improved, and with the larger companies owning the hospitals it’s seems to be harder to make changes or improve.

How do you make money or how are you compensated?

It’s hourly.

How much money do you make as an RN?

I make $27.05 an hour. And again, I don’t have guaranteed hours, so whenever I work I just get paid that much hourly.

How much money did you make starting out as an RN?

My first job, my base rate was $15.00 an hour. That was ten years ago.

Would you say there are any perks associated with what you do?

Yes, definitely. The biggest perk that I can say right now is that the three twelve-hour shifts give you a lot of free time during the week. You can have four days off and most places will allow self-scheduling, which means you can pretty much say I want to do my three days in a row and be off the rest of the week, or I want to work mostly weekends, or whatever works best for you.

There’s a lot of scheduling flexibility. That’s a big perk. You get pretty good benefits too, usually paid vacation and health insurance and all that.

What education or skills are needed to be an RN?

Well right now to be an RN like I am you can either have a two-year associate’s degree or a four-year bachelor’s degree, and you can function in the same capacity in the hospital or in any RN setting. There is a push nowadays for the bachelor’s to be the standard for all nurses. I have the bachelor’s degree but that’s just because the program I went to was accelerated, but you have to have either the associate’s degree or the bachelor’s degree and then you have to pass the national certification exam to get your nursing license.

As far as skills, I think that somebody should be very flexible. You have to be flexible as far as making decisions and changing things on the fly, you can’t be somebody who doesn’t deal with change well. You have to be able to be around people and deal with people and the public, have people skills, and physically be able to do the job, because it is somewhat physically demanding. I think people forget about that, you’ve got to lift patients around in beds and stuff like that, it can probably be pretty tiring.

What is most challenging about what you do?

Probably the most challenging thing is when you have something that you can’t fix, like you have somebody that’s dead or dying or something tragic has happened and you can’t help, there’s nothing that you can do.

So I think that when that does happen, that’s hard, and it’s a challenge to figure out how to deal with it emotionally and not take that stuff home with you and let it affect your family life.

What is most rewarding about what you do?

Well, I guess kind of the opposite of that is when you have a good outcome with somebody, you really feel like your direct care of them has made them better in some way, and they tell you that they appreciate the care that you’ve given them and that’s very satisfying and rewarding.

What advice would you offer someone considering this career?

I would say it’s a good career to choose right now because there’s been a nursing shortage for as long as I can remember and it’s just going to get worse because we have an aging population.

I think that people just need to really understand that it’s very important to talk to some nurses that they know and that they can find and ask them what it’s really like, because I think some people go into this job not really realizing how it’s really going to be.

How much time off do you get or take?

Well, when I’m working full time four days a week is the regular scheduled time off. And then usually you get about two or three weeks of paid vacation a year. Every pay period you might earn three+ hours of paid time off. And once you accrue enough of that, then you can use it. So if you’re a brand new person in the hospital it probably adds up to two weeks a year, and as you gain seniority in the hospital and are there for more and more years, you earn that time off faster.

The biggest perk…is that the three twelve-hour shifts give you a lot of free time during the week.

What is a common misconception that people have about what you do?

I don’t’ think people really have an understanding of how involved nurses are in the care of patients. You know, we’re definitely not doctors, I totally understand that, it’s very different than medicine but I think there’s kind of a lack of respect for nurses, at least in my experience.
Not always, but I think the misconception is that we’re kind of blue-collar, you know, we work shifts, we get paid by the hour, but it’s really not, it’s much more complex than that, but I don’t think the general public really knows that.

What are your goals and dreams for the future in this career?

Well, right now I’m pretty good where I am. I’ve gotten my bachelor’s degree already. I did go back to school for a semester and do a semester of the Master’s program because I thought I wanted to be a nurse practitioner, but I’ve changed my mind. I think I want to remain at the level where I am for now. I don’t want to go into management, I don’t want to go into higher practice, I just want to be a staff nurse in the ER.

What else would you like people to know about what you do?

I guess I would want people to know that nurses provide a critical element to any hospital stay. Patients spend most of their time with nurses when they’re in the hospital.

Dr. Randy Cole of the Boozman-Hof Eye Clinic was kind enough to share about his career as an ophthalmologist.  You can find his clinic and services here.

What do you do for a living?

I’m an ophthalmologist or an eye surgeon.

How would you describe what you do?

I’m generally working as a cataract and refractive surgeon.  So I do cataract surgery.  I do refractive surgery.  I see patients too, but the majority of what I do is related to providing cataract and refractive surgical services.

What does your work entail?

It entails being in the operating room during cataract surgery, doing refractive laser surgery, and seeing patients in the examining room.  And taking general ophthalmology call covering the emergency rooms of a couple of area hospitals.

It really is quite remarkable in terms of what we can do to improve people’s quality of life, ability to function, and restoring the precious sense of sight to a level better than they’ve ever experienced.

What’s a typical workweek look like for you?

We’re busy.  We work hard.  I’m taking call every second to third weekend and I operate all day Monday.  I’m in the clinic seeing patients all day Tuesday, Wednesday morning, and all day Friday.  I’m off Wednesday afternoon but in a typical week I’ll have about a 170 patient encounters.  Of those, about 40 are surgery encounters.

How did you get started as an ophthalmologist?

In medical school I just started thinking about what I wanted to do, what I like to do.  I knew some ophthalmologists who had been in practice while I was in high school and college in particular.  They seemed to like what they did and so really early on in medical school it became apparent to me that that’s the specialty that I wanted to go and try to get a residency position in.

In fact, I applied and got the position in the middle of my junior year while in school.  I had a position already nailed down at Little Rock so I didn’t even bother to apply to any other programs or residencies.

What do you like about what you do?

It’s challenging and extremely demanding.  I’m dealing in terms of microsurgery, millimeters, and having to be extremely precise.  There’s a lot of challenges and stress but it is very gratifying. I tell the people I work with over here it’s difficult but we need be realizing that really we’re in the business of miracles.  Doctors and nurses treat, only God heals, but at the same time I feel that we provide a valuable service in helping people in the precious sense of sight.

And modern cataract surgery and modern refractive surgery are truly remarkable in restoring vision to a level that’s better than people have ever had in their lives.  Younger people are having refractive surgery and they are not needing glasses anymore.

We’ve been using implants for older people, lens implants now that you can correct for astigmatism and can help them read so they’re seeing like 20 year olds and don’t need glasses.  It really is quite remarkable in terms of what we can do to improve people’s quality of life, ability to function, and restoring the precious sense of sight to a level better than they’ve ever experienced.

So that’s very gratifying.  At the end of the week you can be tired and be stressed and have some worries but you don’t ever get to the end of the week and wonder, “Did I really accomplish anything or do anything worthwhile?”

What do you dislike about this job?

Well, honestly there’s not any other job that I would rather do.  There’s not any other profession that I would say I wish I had not missed.  The only thing—like any work, the only thing that’s sometimes unpleasant is there’s stress. You’ve got to try to make people happy.  You’ve got to satisfy needs and expectations.  You’ve got to deal with insurance companies, medicare.  There’s rare lawsuits, so like with any work there’s just stress involved.

How do you make money or how are you compensated in this career?

Well, I’m an owner of the businesses that I’m involved in and I have partners as well.  But being an owner in this entity means I have ownership in the clinic and within the clinic I’m paid based on productivity.

And so I’m paid a percent of the profits or distributions of that entity that is derived directly from my productivity in the clinic and indirectly from the profits and percent of my ownership in our optical business and in the surgery center.

It’s all based on fee for service.

So it’s not like being a passive owner of a business.  If you park there, you’re working, doing surgery, doing exams, seeing patients then you’ll generate income.

So unlike somebody who may own a factory or a car dealership, they keep on making income whether they are there or whether they’re spending the winter in Florida.

How much money do you make as an ophthalmalogist?

The average income of an ophthalmologist is around $250,000-$300,000 and that income will vary depending upon how busy or productive an ophthalmologist might be.  The average productivity in a clinic or a benchmark productivity for an ophthalmologist is producing around $800,000 a year gross and he might keep around 40% of that.  And then busier ophthalmologists may produce two, three, or four times that much.

And if the ophthalmologist owns an optical clinic or surgery center that’s profitable, which they aren’t at all profitable, that income can also be supplemented between those other ancillary businesses.

And there are ophthalmologists that go bankrupt.  I bet there’s half a dozen I can name in in the last 10 years just in this state that actually have gotten into a bankruptcy and maybe they had to restructure or have their practice closed.

You’re going to have to finish high in your medical school class to get a residency position[in ophthalmology]. So you need to expect and understand that you’re going to have to be in the top 10% of your class to have a shot at getting a position which is real hard because medical school is not easy to get into in the first place.

The dynamic is changing in health care industry.  About a half of the new physicians are really not owners but employees of either clinics or health care systems. And so those doctors still make a reasonably good percent of their production but they don’t have a lot of autonomy.

The good news is you don’t have part of the ownership and the risk of going bankrupt and having to have a lot of administrative support people and put in extra hours in terms of leading a company or leading, managing and directing an entity.  So it can be that you may work less and have less stress in terms of the business administrative aspects of owning a business but you have less autonomy and you have less decision making latitude.  And essentially it’s somebody else who technically tells you what time to come in, what you need to do, and what’s expected of you.

How much money did you make starting out in this career?

Well, I started as an ophthalmology resident making around 25,000 a year, maybe a little less than that back when I first started.  I supplemented that by moonlighting in emergency rooms and then my first job in 1983 as an ophthalmologist in Florida was probably base salary of 75,000 with some production incentives.

Would you say there are any perks associated with your job?

Well, I think this job’s biggest perk is just the gratification of doing something really dramatic and helping restore sight and helping improve people’s life.

And that’s essentially life changing service you’re providing for people.  So the biggest perk or reward is the gratification of doing dramatic things to improve their vision and their quality of life.

What education and/or skills would you say are needed to do this job?

To become an ophthalmologist, you have to go to college.  I actually got accepted to a few medical schools before I got my undergraduate degree after just three years of college.

But generally you have to have an undergraduate degree and go to medical school and become an M.D.  And then there’s somewhere between 3 to 5 years of training to be an eye surgeon.

And it requires a certain amount of dexterity and hand-eye coordination to be able to do microsurgery.

And the uncertainty about that is you just never know when you could lose that.  If you come down with tremor, a neurological problem, Parkinson’s Disease, arthritis, or have a stroke, you’re done.

As far as determining if you have what it takes, there’s not really a process in this country or sort of an obstacle course or hand-eye testing to see if you can become a surgeon.  A lot of it just comes in the training, and in the process of the training, finding out if they can do it and if not they can become just a medical specialist rather than a surgeon.

So when you get in your internship training you kind of find out if this something you’re really cut out for or if you have to do more of a medical specialty in ophthalmology like a medical ophthalmologist.  You don’t necessarily have to do surgery.

There are certain specialties in ophthalmology that are less surgically inclined like being an neuro-ophthalmologist or being a specialist pediatric ophthalmologist.  They do less surgery and will do more of children’s exam and just some surgeries on the eye muscles.

This job also requires the ability to be able to interact well with patients.

And a successful ophthalmologist has a fairly high overhead with lot of employees in their practice.  So they have to have the energy and drive to see a lot of patients and to be able to manage all that.

What is the most challenging about what you do?

I’m a perfectionist and I can’t have complications so the most challenging thing is to try to maintain concentration and diligence to a point that I essentially avoid any complications in surgery at all.  So I’ve got to have zero tolerance for ever making a mistake or having a problem or complication related to an error on my part.  And that just takes a lot of attention to detail and experience.  And it’s mentally taxing and fatiguing. So I’m real hard on myself to avoid problems errors and complications.  Number two, people’s expectations as such that even if things go well they aren’t always uniformly happy, so that can be frustrating.

What is the most rewarding about what you do?

Well, the rewarding thing is that we are in the business of miracles and being able to restore the sense of sight to people who are really blown away.  Being able to see that is very gratifying.

What advice would you offer considering this career?

My advice would be it’s a good career.  I think it’s something worthwhile to do.  I would recommend it—for myself, over many other surgical specialties.  But you’re going to have to finish high in your medical school class to get a residency position.  So you need to expect and understand that you’re going to have to be in the top 10% of your class to have a shot at getting a position which is real hard because medical school is not easy to get into in the first place.

You got to be in the top 5 or 10% of your medical school class and that makes it even tougher.

So ophthalmology, dermatology, radiology, and orthopedics still are very highly sought after residencies.

And the nice thing about ophthalmology also is you’ve got a little more control over your time.  The surgeries are not emergencies so you can schedule them out in advance.  Not like in appendicitis or a gunshot wound that has to be fixed right now.

So you have a little more control that when you leave work you don’t often get called back at night and when you’re on call on the weekend it doesn’t mean you’re going to have to spend the whole weekend in the ER.

It’s not easy. It’s exacting. It’s stressful. There’s no margin for error but you get to the end of the week and you’ll know that you’re in the business of miracles and you’re not going to reach a point of the week or point in middle age where you look in the mirror and go, “Have I done anything with my life?”

It’s not like as a general surgeon.  If they get called on the weekend, chances are they are going to be spending sometime in the O.R. over the weekend.

And that’s not to say there aren’t emergencies. There could be perforating eye injuries, blood eye injuries, trauma, laceration of the eye lids, so there are a lot of things that can require us to have to come in and do surgery or just see somebody in the office for some medical eye problem.

How much time do you get off or do you take off?

Six weeks a year for meetings and vacations.

What is a common misconception people have about what you do?

Let’s see… People probably think that since I’m an ophthalmologist I prescribe a lot of glasses.  But I really don’t do much in a way of prescribing glasses because I’ve got a group of optometrists that I work with who take care of the glasses and the contact lenses.

What are your goals and dreams for the future in this career?

It’s hard to believe I’ve been out of medical school now for 33 years.  But I’m still young.  I’m 58.  So I would hope to have the health to be able to continue to work for at least another 10 years.  And I had planned on slowing down some and handing over things to one of the newer doctors but that didn’t work out so ironically I’m probably going to be the busiest in my life for the next 10 years doing more surgery than I have ever done before.   

What else would you like people to know about what you do?

I would just say that it’s not easy.  It’s exacting.  It’s stressful.  There’s no margin for error but you get to the end of the week and you’ll know that you’re in the business of miracles and you’re not going to have to reach the point of the week or point in middle age where you look in the mirror and go, “Have I done anything with my life?”

I think that it’s also worthwhile for people to know what we do in terms of cataract surgery is probably as high a level of service of cataract surgery as is available anywhere in the world.  Furthermore, I like them to know that there are a lot of options now in terms of the refractive lens implant where people can elect for distance vision.

They can elect for getting their stigmatism corrected.  They can also do what’s called a multi focal implant that they could actually also read through.  So there are a lot of options along the lines of the technology.  And I want them to know that we’re a team and staff extremely conscientious who wants to deal with everybody like it’s a family member.  And we have some measurable outcomes that are evidence of that.  For instance, we have the best record in the world on preventing infection after cataract surgery for example.

What do you do for a living?

I’m a medical oncologist.  There are several different types of oncologists. There are radiation oncologists who deliver the radiotherapy in the end of cancer care and medical oncologists oversee the overall care of the cancer patient and run the drug end of cancer care.

What does you work entail?

It entails primarily seeing patients in the office and seeing patients in the hospital.  We also do hematology because most oncology fellowships are combined with hematology, which is the study of cancers of the blood and benign conditions of the blood.  The oncology part of it is the cancer part.

We do consultations in the hospital and we run an outpatient cancer center where we give the drug cancer care. We primarily give chemotherapy but it can also be hormonal therapy. There are other types of drug treatments that we use for cancer as well.

What’s a typical workweek look like for you?

We work very hard like most physicians.  We probably work at least from 8 to 5 and we’re on call at night and we’re on call on weekends. I have a partner now so we switch weekends off but I would say your average medical oncologist probably works at least every other weekend and 5 days a week so there are a lot of work hours there.

I wouldn’t recommend going into this career if you’re doing it just to make money…You need to follow whatever your passion is, otherwise you’ll be miserable…If you’re doing something just to make these little rectangular, green pieces of paper you’re never going to be happy.

How did you get started in this career?

Well you have to go through medical school and get either an M.D. or a D.O. in order to go into either medical oncology or hematology/oncology.  You have to be board certified in internal medicine so you have to do an internal medicine fellowship and then after that you have to do the hematology/oncology fellowship. It’s 4 years of medical school and there’s 3 years of internal medicine and then another 3 years after that.  So it’s 6 years of training after medical school.

The reason I chose oncology/hematology is because it’s more my personality type.  There’s certain personality types that gravitate towards orthopedics or certain personality types that gravitate towards general surgery.  We deal with a lot of end-of-life care and end-of-life issues and there are some people who just can’t deal with those kinds of issues at all. It depends on their personality type. I think it ends up being someone who can deal with uncertainty better whereas the surgical type people I think have a difficult time dealing with uncertainty. Either something is black or white. There’s no shade of grey whereas people in our field end-of-life issues are all shades of grey.

You do a lot of hand holding and a lot of compassionate type care and issues and I just think certain personality types gravitate that way.

What do you like about what you do?

I think what I like most is what I just mentioned. It’s such an honor to be involved in patient’s care when it’s end-of-life because that’s a very personal, very sacred kind of thing.  And you develop strong relationships that way with your patients which is one of the things that makes the job hard as well.

There is another part of medical oncology that is so exciting now too, and it really fits people’s personalities that are into research too.

There are people that do this but don’t do patient care at all, they do just research.  There’s a huge amount of research in the molecular biology and new drug field.  In the last 10 years that we’ve had so many new drugs and so many new ways to treat this.  Many cancers used to be 100% fatal and some of them are now being rapidly cured.  There are all sorts of new things coming down the pike and that’s another exciting part of Oncology.

What do you dislike about the job?

I think probably what most people dislike about all of the medicine jobs now is just the amount of government intervention.  And that’s just going to get worse and worse over the next several years. We used to be much more autonomous and it’s just hard now dealing with both insurance companies and governments.  So dealing with the paperwork and government red tape is probably the worst part of the job.

How do you make money or how are you compensated as an oncologist?

I’m fee for service. I’m in private practice. Certainly there are hematology/oncology people that are employed by other organizations, but I’m fee for service.

How much money do you make as a hematologist/oncologist?

The median salary for medical oncologists in my region(Southeast) is right around $400,000 a year if you just take a median salary.

Certain regions of the country might be slightly higher than that.

How much money do you make starting out as an oncologist?

The starting salary for most oncologists is probably somewhere in the $300,000 range now.

What education or skills are needed to be a hematologist/oncologist?

Well like I said you have to have a college degree and then you have to be accepted to a medical school or a D.O. school and then you have to do another 3 year internal medicine fellowship and then you have to do a 3 year Hematology/Oncology fellowship so it’s a very big commitment of 10 years after college.

The hope would be that we’ll find treatments that work for a lot more of these diseases that we don’t have much in the way of treatment for. Many cancers used to be 100% fatal and some of them are now being rapidly cured.

What would you say is most challenging about what you do?

I really think the most challenging thing now is just all of the bureaucratic paperwork that we have to fill out. I probably spend 3 hours a day just signing forms. You know several years ago it wasn’t anything like that. It’s going to get nothing but worse with our current government situation.  But the patient care part of is still great and that’s still the reason we all do it..

What would you say is the most rewarding about what you do?

I think when you get a card from a patient or family saying how much they appreciated your care.  That’s very rewarding.

What advice would you offer someone considering this career?

I think you’ve just got to do it for the right reasons. I wouldn’t recommend going into this career if you’re doing it just to make money but of course that’s good advice no matter what you decide to get into to.

You need to follow whatever your passion is, otherwise you’ll be miserable the rest of your.  If you’re doing something just to make these little rectangular, green pieces of paper you’re never going to be happy.

How much time off do you get or do you take?

I take about 10 weeks off a year.  I take about 8 actual weeks of vacation and then two weeks of continuing education and medical meetings.

What is a common misconception people have about what you do?

I think the misconception that people have about all physicians is that money just rolls in and that we don’t work that hard. That’s a big misconception, we all work very hard. We all make good money but we all work very hard. So I think that’s probably the biggest misconception.

What are your goals and dreams for the future in this career?

The hope would be that we’ll find treatments that work for a lot more of these diseases that we don’t have much in the way of treatment for.

For example, there’s a new drug that came out a few years ago that treats CML which stands for Chronic Myeloid Leukemia. That disease used to be a disease that was 100% fatal in everybody within 2 years and now it’s 100% curable just by taking this capsule.  So there are a lot of cancers that we don’t have something like that for right now our goal would be there will be more of those treatments coming down the pike.

What else would you like people to know about what you do?

You have to be committed to going to school for a long time. A lot of it is about delayed gratification. Going into the medical career you really have to be willing to go the long haul and realize that it’s going to take a while.

What do you do for a living?

Hospital medicine, and it’s a new division of internal medicine which focuses on patients admitted to the hospital only.  The term hospitalist is now often used to describe this career.

How would you describe what you do?

I’d just say we take care of adult patients that are sick enough to be in the hospital, and that ranges from one-night stays to some element of critical care.

What all does your work entail?

Basically, it involves, at this point, shift work – where we’ll work several days in a row for the sake of continuity in managing people’s illnesses while they’re in the hospital.  Most patients are in, on average, three to four days, that we take care of them.

One part is managing people with medical illnesses that we manage by ourselves or with specialists consulting on our patients, and then maybe the more desirable part of our work is doing consults for surgeons.  So while surgeons, be it orthopedic, or general surgeons, or plastic surgeons, or ENT etc manage the surgical aspects of care, we manage the people’s chronic and acute medical problems.

What does a typical workweek look like for you?

We actually are on a rotation of nineteen days on and nine off.  Formerly, we did fourteen on and seven off.  In the nineteen on/nine off, there are fourteen days where we manage a census of in-patients, admits, and consults..  Then there are five days of night coverage at the end to round out the nineteen, we cover five 12-hour night shifts, and then have a weekend, the intermittent week and the following weekend off, to make nine days off.  But the customary hospital schedule is turning into a seven days on/seven days off, or ten days on/ten days off kind of thing, so that it’s becoming more in vogue for you to have about the same amount of work days as you do days off.

How did you get started in this career?

Hospital medicine is simply internal medicine residency applied over a career.  Internal medicine residency is 6 1/2 days a week of managing hospitalized patients and a half a day of clinic, and so all we’ve done is trim out the half day of clinic and manage hospitalized patients.  This is actually, to me, the simplest and purest adaptation for a career from what residency is.

What do you like about what you do?

I’ll answer that 180 degrees to the opposite.  I really don’t like clinic.  I like the fact that there no appointments, people are sick and you can make a difference hopefully.  And I don’t have to worry with the staffing and the major overhead concerns of the clinic practice.

What do you dislike about this job?

I have no control over the time that people come in.  So you may have a day like today, where you go in at 9:00 or 10:00, and you run for three or four hours, and then at 1:00, 2:00, you’re kind of done, sitting around twiddling your thumbs and then you get busy again at 4:30 or 5:00, after you’ve had some down time in the middle of the day.  That’s also common with emergency medicine.  Parts of your shift are hopelessly slow and then all of a sudden, somebody pulls back the curtain and you’re overwhelmed.

And basically, we have a deal where you take what gets put on your plate during your assigned shift.  So on the slow days at the end of your shift, you’re done.  On a very different day, you may stay several hours after your shift. So that’s one of the dislikes, the lack of predictability.  On the other hand, as long as people are sick and needing to be in the hospital, it’s interesting enough to stay. You’re just done when the job is done.

How do you make money/or how are you compensated in this career?

Hospitalists in general are paid two ways.  One, are employees and have a guaranteed salary and benefits package, and then the others are fee for service.  So you show up, take care of what’s there, and you bill and live off the collections, minus overhead.  And then there are a few people that have kind of blended that, and this is us, where you have a guaranteed base, not a whole lot, but then you have a productivity type bonus structure, so that if you see hardly anyone, up to whatever the agreed amount of patients is, then you make the guaranteed minimum.  But if you see more than that, then you share in the profits or the collections for the patients above the minimum amount.  We have a guaranteed amount of money that we’re going to make every year, and then we have productivity model and it’s a month-to-month thing, so for the month of September, if we see X number of patients and X is below the hard deck, then we make a guaranteed amount of money, and if X is above the agreed upon number, then we’ll get paid on the productivity.

How much money do you make as a hospitalist?

The guaranteed is about $250,000 and the productivity above and beyond that is variable depending on numbers, but in this job, I’ve made as little as $180,000 and as much as $450,000.  It just depends on volume.  When you’re making $450,000, you hate your job.

You’re basically working like a pack mule so, there’s a happy medium somewhere between $275,000 and $325,000, where we feel like we’re making a good living and we’re doing a reasonable amount of work, where you can really take care of people.  All those years where we’re making north of $400,000, we’re so busy the quality suffers.

How much money do you make starting out as a hospitalist?

I think you can expect to come out of residency and sign a contract around $200,000.  It’ll be better in competitive markets and a little less in academic markets that are saturated.  As a general rule, you should anticipate or hope for, and not settle for anything that doesn’t have a 2 in front of it.

Would you say there are any perks associated with your job?

Sure.  The flexibility of making our own schedule is a real perk, even though it’s pretty inflexible after we set it up.  We can set it up – with partners, I own the company.  I get the pride and feel of ownership there, so that’s kind of a perk.

What education or skills are needed to become a Hospitalist?

For internal medicine, it’s four years in college, four years in medical school and a minimum three year residency.  As far as skills, it’s mostly a cognitive profession.  It’s not very procedural, so while we do some minor procedures, the skill set is mostly cognitive.

We’re mainly thinking, planning, managing cases, working through diagnostic dilemmas, but not scopes and scalpels and that sort of stuff.

What would you say is most challenging about what you do?

For us, it is how sick the patients are.  The days are gone where you can put someone in the hospital just because they have something minor wrong.  So by the time now that anybody qualifies for admission, they tend to be very sick, so managing a multiplicity of disease and very sick patients is a big challenge,

What would you say is most rewarding about you do?

Watching people get better, absolutely.  Watching a plan come together – making a diagnosis, putting the treatment plan together, and watching somebody get well.

What advice would you offer someone considering this career?

To do dentistry instead. (laughs)

Within the whole field of medicine, don’t pick your specialty based on the hours, the procedures, or the reimbursement.  Pick it based on what you think you can dedicate a lot of time to, because nobody in this profession that does it well, does it a little bit.

How much time off do you get or take?

Basically, we have 12 weeks off a year right now. But that’s 12 weeks, and not weekends on the other weeks.  That’s 12 seven to nine day runs, but you don’t get 12 weeks vacation plus all the weekends and holidays and everything else like a normal job.  So all the days just kind of run together and the calendar day doesn’t really matter.  If I employ you right now, you’re going to work all but 84 days of the year.

And arguably, you get 104 days off if you just take weekends, and then if you take holidays, that’s probably another 14 more, and if you take two weeks of vacation, that’s 10 more, and you get to 140-150 pretty quick.  We work all but 84.

In a small group, trading out a call for a day or two is very, very difficult, so I pretty much say “If it’s important to you for me to be at the wedding, then call and ask me what day I’m off.”  If it doesn’t matter, then just tell me what the day is and I’ll tell if you if I’ll be there or not.

With some of the practice guys, it’s work four days a week, and they might complain about not having much vacation time, and how nice it must be to have nine days off at a time.  I always ask them when the last time they pulled 19 straight days was and tell them I’m going to do that 16 times this year.

What is a common misconception people have about what you do?

That you make a ton of money right out of the gate.  Truth is, they start low on the pay scale with a lot of student debt.  That’s probably one.  Another is that we’re supposed to get it right all the time.  A lot of things are, in my profession at least, are very much trial and error. There’s some diagnostic dilemmas that baffle us and I think people maybe don’t understand sometimes that we have to work through that.

And then maybe a misconception that a doctor is a doctor is a doctor, whereas I know very little about the surgical subspecialties and some of the things like cosmetic surgery and ophthalmology.  Hopefully, when it comes to diabetes, heart failure and internal medicine, I know a whole lot, where the eye doctor doesn’t have any idea. So I think the idea is that “because you all went to med school, you all have the same fund of knowledge” and certainly you learn how to be a doctor in residency, not in med school, and your fund of knowledge is dependent on your residency and experience, not on the anatomy course you took in your first year of med school.

What are you goals and dreams for the future in this career?

I have a couple.  One is to grow my practice to be big and successful, and respected.  Another is to have a management or administrative arm of the practice in the career so it’s not all bedside.  And then, I’d like to be one of those guys who plays his whole career for one team, so I can start and finish in the same place, and that’s really uncommon.  About 50% of the physicians in this specialty switch their place of practice in the first four years.

And I think that’s because for the last ten years, this career has been kind of sexy and so the offers are bigger and better in other places. So if you’re willing to move, you can change your pay scale.  And the other thing is that people change because they start in small groups and the demand of call in a small group is very taxing, and so there is a significant allure of a bigger group, which more shared calls.

What else would you like people to know about what you do?

Specific to the profession, it is the fastest growing specialty in medicine ever.  The next closest is emergency medicine, which was kind of championed in the ‘70s, and we’re really at a clip of 400% faster than emergency medicine grew.  There’s somewhere between 25,000-30,000 hospitalists in a specialty that’s 10 years old and that takes several years to train somebody.  So it’s really, really kind of a rocketship past the moon as far as the growth of this particular sector.

I don’t know where the demand curve is going to plateau, but the supply is being met by a whole lot of people who would normally specialize, but because the money and the lifestyle are fairly attractive, instead of doing a GI fellowship,or rheumatology, or cardiology, if you have the opportunity to get out after three years and become a hospitalist and have a decent lifestyle and decent salary and good opportunities to grow in the field.  So, I have a feeling that the rush to this specialty is probably over.  We’re starting to hear that in some of the big cities, a really desirable job is hard to find. That’s new in the last couple of years. There’s a few markets that are very desirable – jobs in very desirable locations are starting to be full.  But for the most part, there is still lots of need.

What do you do for a living?

I’m a general dentist.

How would you describe what you do?

I do anything that pertains to surgery, cleaning, hygiene, or fillings in someone’s mouth.

What does your work entail?

I do fillings and root canals and surgical extractions, regular extractions, removal of wisdom teeth, removal of canines, soft tissues etc.

What’s a typical work week like?

Typical for me and I would say for most dentists is Monday – Thursday, 8 a.m. until 5:30 or 6. I usually end up working through lunch too, because that’s my personal preference; if I’m going to be there, I want to be there working.  90 percent of my work is with patients, either doing an exam or a procedure, with the rest of the time working on office stuff.

How did you get started?

Dentistry is in my family, and that is how I got introduced to it. I went to school and started taking my science courses and I really liked them, and also I liked the interaction with people and helping them in some sort of capacity; I liked it that dentistry really allowed me to do that.  And it is a trade also.  I wanted a job that required a license because I feel like when you’re licensed to do something, you will always have a job.

What do you like about what you do?

I would say first and foremost, being able to talk to people or getting to be around and help people.  I also like working with my hands. And I’m not an artist, by any means, but you have to have a good eye and be good with your hands.   You have to know what looks natural and what doesn’t, which is really funny because a lot of patients don’t want what looks natural; they want what looks fake, which we hate:).

You have to have good patient interaction because at the end of the day no one knows how good of a dentist you are but they do know how your bedside manner is and how you treat them.

Sometimes they’ll say, “oh my gosh this isn’t perfectly straight” and you tell them,  “look at my tooth, my tooth is natural and it’s not perfectly straight, that’s why it looks good”.

What do you dislike?

I really don’t think there’s anything I don’t like about dentistry. I really don’t. I like it that much. But sometimes I feel like I have to be strict and I feel like I’m giving lectures to patients[when they guidance about tooth care or are doing bad things to their teeth].  I don’t like conflict so that’s kind of hard for me. But, at that same time, when it must be said, it has to be said.

How do you make money/or how are you compensated?

It’s fee for service.

How much money do you make as a general dentist?

I make around $200,000 – $250,000 after taxes. You are very well reimbursed and you can make up to a million. It just depends. It depends on how good you are, where you practice. But, I would say the range is like $200,000 to a million.

Somebody who owns their own practice in a small town can make more than someone in a city, because when you’re in a big city the market is saturated. I just feel like you can do better when you’re in a smaller town and because you end up doing more of your procedures, you can make more. In a city, you end up referring a lot of patients, but  in a small town you can’t, you’re forced to do everything.

How much money do you make starting out?

The average salary, I think, is about $170,000, but that is looking at someone who has not been working for 10 years.  People that have established practices make much more.  On the other hand teachers and professors in dentistry don’t make that much. People in public health don’t make that much. My first year I made $200,000 after taxes.

What education or skills are needed to become a Dentist?

Most dental schools require a four-year undergraduate degree. I don’t think you necessarily have to have that,  but you do have to have the requirements, so that usually means you have a major in biology and at least a minor in chemistry, so you have to take a bunch of sciences. You have to take the DAT which is the admissions exam and you have to have a certain GPA and you have to have a certain score on that to get an interview.  Then dental school is four years. After dental school, you can choose a specialization, and depending on which specialization you decide to take, it’s a two to six-year program afterwards.

As for skills, I would say you have to be good with people, especially as a general  dentist; as a specialist I don’t think you have to be as good;  but you have to have good patient interaction because at the end of the day no one knows how good of a dentist you are but they do know how your bedside manner is and how you treat them.  The better you are at that, that better you are as a dentist. You may have the best hand skills in the world, but patients won’t appreciate that, because they don’t always know.

What is most challenging about what you do?

Working in a very tiny, dark space.  And,  there’s fluids where you have to keep things dry. Sometimes it can be really challenging, especially when a patient can’t open their mouth.

Also, people are very, very, very scared of the dentist and I probably hear that 10 times a day: “it’s not you, I really like you but I just hate the dentist and I’m so scared and I had this one bad experience.” Seriously, every other patient, I get a story like that. It doesn’t bother me, but I’ve talked to some older dentists, and they sometimes get a chip on their shoulder.

What is most rewarding?

I guess, if I’m being completely honest I would say helping people and being financially successful. You’re very well reimbursed for what we do. Also, having the freedom of not being on call. Unlike some other medical specialties, you aren’t in the position where you have someone’s life in your hands. The biggest thing you can do is ruin someone’s tooth, but even then you always have options. Although it can be stressful at times and you do have to know what you’re doing at the end of the day but it’s not like you’re in the middle of somebody’s guts and they’re not going to wake up.

What advice would you offer someone considering this career?

To do well in school and to do a bunch of shadowing to see if it’s something they really want to do; it’s hard to know until you really get into it, because you don’t start drilling and doing all of that until you really start working with patients. You have no way of really knowing if you’re going to get along with it. The other advice is to have a good GPA, of at least 3.6 on science courses.  Your science GPA is what is important.

Are there any perks associated with your job:

You are your own boss, and you make a decent living. I feel like it’s still a respected field. You can choose your own hours, you can work as hard or as little as you want. You are always learning. For the rest of my life I will continue learning about something I like, which I think is good.

I love it, I love dentistry. It’s the best thing in the whole world. My friends and I talk about it all the time. We feel that we’re so lucky.

How much time off do you get/take?

I take every Friday off, which comes to about six weeks a year.

I can also take vacations. Right now I don’t take off very much because I take off Fridays and that’s enough for me. But, later, I’ll probably take two weeks at a time.

What is a common misconception people have about what you do?

A lot of people who have never had a toothache think all we do is exams and cleanings. If they have never had a filling, root canal, or an extraction they probably don’t realize how much we do. And others think we’re scary, which is a common misconception about dentists.  I probably hear that ten times a day “it’s not you, I really like you but I just hate the dentist and I’m so scared and I had this one bad experience”.

What are your goals/dreams for the future?

To be the very best that I can be. Seriously, I want to be the best dentist. I want to know everything; I want to be very well educated. I already own the practice but I still want to go back to school and want to specialize and get the continued education.

What else would you like people to know about what you do?

I really do think it’s the best job in the world. When I was in college, there were six of us that were best friends; three of us were biology majors and one of them wanted to go to medical school and one of them wanted to do research and I convinced both of them to go to dental school; today, they think it’s the best decision they ever made. You don’t have to be on call, and when you have a family you can still work as much or as little as you want, and you are going to be well-reimbursed for your work.

What do you do for a living?

I am a Registered Nurse.

How would you describe what you do?

I take care of patients who are recovering from a wide range of illnesses or from recent surgery.

What does your work entail?

I’m responsible for making sure that the patient’s pain is under control, that they receive their prescribed medicine on time, that their vital signs are stable, that the doctor’s orders are being followed and I act as a liaison between the doctor and the patient’s family.

What is a typical workweek like for you?

I work three, twelve-hour shifts and I’m stuck on night shift right now.  The night shift is really hard.  The money is good but the rest of your family is scared to call during the day because they’re scared that I’ll be sleeping.  But you kind of get used to it and then eventually you get to work days.  So I work 3-twelve hour shifts that usually end up being about 13 or 14 hours because you have to stay late sometimes to finish charting.  It ends up almost being a 40 hour work week.

How did you get started?

I actually started by going to college and getting a psychology degree and with that degree I was only able to get a job as a receptionist.

I knew a psychology degree doesn’t really do anything unless you go for your PhD or Masters so I really wanted to help people but I didn’t feel like I was really getting that opportunity and my sister was in nursing school and loved it so I went too.

I went to a school that offered a one year accelerated Bachelor’s degree in nursing program.

It was twelve months because I had already had my Bachelor’s degree.  I didn’t have to take all the other classes and so I got a second Bachelor’s.

It was a crazy year. It was probably the most difficult year of my life but it was worth it.

What do you like about what you do?

The best part is seeing patients get better and knowing that I played a small role in that. We get a lot of patients who are in a lot of pain after their surgery which can be pretty stressful trying to get their pain under control.  But once they’re comfortable and smiling it does feel really good to know that I helped them out.

What do you dislike?

I wish I had a lot more time to spend with my patients. There are some busy nights where I’ll run into a room to see something and my patient wants to tell me a joke or a story about her grandkids and it absolutely breaks my heart to have to interrupt them and leave because the patient in the room down the hall is throwing up and another patient is crying in pain and another patient has to go to the bathroom.  So there’s sometimes that there is so much going on that I feel like I can’t give my patients the attention that they desire and that I want to.

How do you make money or how are you compensated?

Nurses are all hourly so they’re not a salary. It’s not a salary position unless you’re in management.

How much money do you make as a registered nurse?

In Kansas City it seems like most hospitals for new graduate nurses start around $21 or $22 an hour and then every year the salary goes up by a little bit less than a $1 a year. I’ve been a nurse for 5 years and I’m making $26 an hour.

Hospital nurses tend to make more than other types of nurses. At doctor’s offices they only make like $18 or $19 an hour even if you are a registered nurse. So you definitely get more in the hospital and then hospitals usually pay night shift workers a shift differential which for me is $3 an hour so I get my base pay and then for the night hours I get $3 more an hour and I also get additional pay.  If it’s a weekend you get $2 an hour extra.

How much did you make starting out in this career?

I started out at $22 an hour maybe but that was in TX.

What education or skills that are needed to be a Registered Nurse?

Most hospitals require a registered nurse degree but you can do that two ways. There’s actually a Bachelor’s degree which is called a BSN and some hospitals prefer that and pay more; other hospitals don’t distinguish between a diploma nurse, which is an RN without the Bachelor’s, and the Bachelor’s.

What is the most challenging about what you do?

The patient load and the severity of their sickness.

If I have five patients and I have one patient who demands a lot of time because they’re in a lot of pain or they’re really sick then my other four patients might not get the attention that they deserve.  So I’ve learned time management skills are just absolutely critical and even then sometimes I’ll have my whole night figured out and something will come up and throw everything off.  So it’s definitely a skill learning to prioritize and juggle my plans for the night I guess. That takes a long time to learn.

What is the most rewarding for you?

The patients, just getting to know the patients and their families and seeing them get better.

What advice would you offer someone that’s considering this career?

The best advice I could offer would be to contact a hospital in the area and see if there’s any way that you can shadow a nurse for a full shift because I think that a lot of people watch TV shows and see doctors doing all the work and they think that’s the way things actually are and it’s not like that. Nursing is a very, very physical job. It’s a lot of thinking and it’s a lot of work.  I love it but I’ve met a lot of people who I think if they would have actually seen what it was really like before they went to school that they might have chosen something different.

I don’t want to sound discouraging by any means but I think it’s a good idea to actually shadow someone to see what it will be like.

How much time off do you get or take?

Well we technically have a 12 hour shift. It’s only three days a week so every week you get four days off and then it seems like hospitals give you a lot of paid time off because you don’t get holidays paid.  With most jobs you get paid when you don’t have to work on a holiday but hospitals they’re open every day all day so you sometimes have to work holidays so we do rack up a lot of paid time off and so it just seems like occasionally I’ll be able to take a day or two off which is really nice.

What is a common misconception that people have about what you do?

That nurses just give medicine and they don’t do much else.

What are your goals or dreams for the future?

I guess to eventually to try different areas of nursing and just see what is all out there because that’s one of the best things about nursing, there are so many different areas that if you get bored with something or something isn’t the right fit you can try a different specialty, or you can go from being a floor nurse to an operating room nurse and it’s almost like a different profession.  So you have a lot of options I guess. In the future I would like to try out different things and see what the best fit is for me.

What else would you like people to know about what you do?

That’s a good question. To be nice to their nurses! No, I’m kidding.  It’s a very rewarding job, you learn a lot, it’s constantly evolving, that people should only go into nursing if it’s their true passion.

And that if you really do want to help people and you are interest in medicine that it is a very rewarding and exciting career.

What do you do for a living?

I sell medical devices and drugs to hospitals in this area.

How would you describe what you do to someone?

I pick a product and find a need in the hospital to fill. Then I go through the process of educating physicians, pharmacy, operating room personnel, case management and then administration. So it’s pretty complex and you’ve got multiple decision-makers that have to be satisfied before the sale ever takes place.

What does your work entail?

Lots of time on the road. I figured the other day I probably have close to 1,000 different customers within the hospitals that are kind of touch points for me. So I can’t be there all the time with them. I try to dedicate at least one day a week to some of these hospitals and then spend a lot of time on the phone, lots of time emailing back and forth.

Network as much as possible….because you’re not going to see these jobs on Monster

What’s a typical work week look like for you?

I start at the crack of dawn. My typical day starts at 5:00 or 5:30 in the morning. The first hour or hour and a half is usually spent looking at reports, being on the computer, taking care some administrative stuff. I’m usually out of the house by seven o’clock or 7:30 and just continue to make my rounds. Depending on what account I’m working on, I’ll spend most of the day there, working with customers, making sure everything is going smoothly or selling a new product If I have a new product. And then I’m home by about 4:30 or 5:00 and continue to work out of my home office. So a lot of times it about six o’clock before I’m done. But because a hospital is open 24 hours a day, this job can be never ending. So you got to kind of be careful, I guess.

How did you get started in this?

I was in sales selling dictation equipment to medical offices and had a friend that I knew give me a call and said, “Hey, we’re expanding and we’re looking for a Rep in Longview, Texas are you interested in it?” And I had no idea what a pharmaceutical rep did, but it sounded good. And it sounded a little better than what I was doing as far as an income standpoint. So I interviewed for it and took it, and here we are 15 years later.

What do you like about what you do?

I like the autonomy to be able to go create my day, every day. I’ve got a product that I have to sell that nobody really tells me how to get from point A to point B. I have to go create that every day. And so I like the challenge of going out and doing the detective work and figuring out what the problem is and where my solution fits in. And then when it comes to fruition and the product gets used and sales start coming in, obviously, that’s very rewarding. Also, most of the products that our company carries really are kind of life-changing products. And knowing that those patients are getting the best product that’s making a difference in their life really is personally satisfying as well.

What do you dislike about this job?

Some of the red tape in regards to entertaining is tough. It used to be we had free range to do whatever. We could take customers to go play golf. We could go have dinner with somebody and all of that is gone. Anything we do now has to be within the laws of the hospital. It’s got to be documented. People have to sign in. It has gotten real red tapey, for a lack of a better word. We wait for products longer than we used to. It seems like seven or eight or nine years ago there was a product every year that comes out. I think the FDA has kind of slowed down its approval process. So you see a lag as to when new products may come to market. So kind of sitting around waiting on the new latest and greatest product to sell gets to be old.

How do you make money or how are you compensated in this career?

I’m compensated with a salary and, of course, car and gas etc.  And then I have a commission plan that goes along with the products that I sell. It’s paid quarterly.

And how much money do you make as a pharmaceutical sales rep?

Last year I made $163,000.

How much did you make starting out?

Starting out base salary was $32,000. I think I made about $50,000 my first year.

What education or skills would you say are needed to do this?

Four-year college degree is mandatory. What I see now on some of their postings is 1 to 2 years of either prior sales experience or Pharma experience before they are hired by us.
You need to be a great communicator too that can listen and figure out solutions. Also, like I said before, you kind of on your own out here, and if you can’t pull that off every day you’re not going to last very long.

What is most challenging about what you do?

Probably the most challenging is getting the product in the hospital and getting it moving for the first time because of all the different touch points and different personalities and opinions. Sometimes everyone doesn’t align. So when you have one person that is against it, it’s only one versus 10 but they have so much political capital in that hospital, they can stop the process from taking place. That’s very frustrating.

What is most rewarding?

The most rewarding is seeing it get put on hospital formulary, get used, and getting my competitor removed from that hospital.

What advice would you offer someone considering this career?

Network as much as possible. Get involved in many of the groups that are on LinkedIn. There are tons of different pharmaceutical professional organizations, medical device organizations that are listed on LinkedIn. Just get into some of those boards and start talking and networking and figure out what companies may be expanding in the future or hiring in the future. And then if you got two or three recruiters, continue to work with them because you’re not going to see these jobs on Monster. You’re not going to seek them in the classified ads. They are usually filled by word-of-mouth or recommendation from someone that’s already in the industry. And if you don’t know those people, you really don’t have a chance of getting in.

How much time off do you get to take?

Now I get four weeks vacation plus two holidays, two floating holidays. So I get 22 days off of just my own time and then, of course, they’re gracious with company holidays around Christmas and Fourth of July and Thanksgiving and that kind of stuff. So I don’t know what the total is, but it’s a good amount.

What’s a common misconception people have about what you do?

People seem to think that people in Pharmaceutical Sales, as a whole, work about 2 to 3 hours a day and make easy six-figure money for not a lot of work, and this is not true.

What are your goals and dreams for the future in this career?

If I spend another 16 years that will give me 31 years in the industry with a nice 401(k) and pension. I’ve done the projections. I will retire and be just fine. But as far as promoting or moving up to management or to the home office, I’m not interested. I’m a career hospital representative.

What else would you like people know about this career or what you do?

That it’s fun. And if you like sales and like people and enjoy the “windshield”, which you will see a lot of, it’s a great gig to have and the money is great. There is some flexibility but with that flexibility comes a lot of responsibility also. But it’s a very fun and rewarding career.

What do you do for a living?

I’m a medical doctor. I’m an obstetrician gynecologist.

How would you describe your job to someone?

Labor-intensive. Ha-ha.

Well, number one, it is a very satisfying position. You have the opportunity, from an obstetrical standpoint, to share in the families’ greatest days of their lives. When you look back and ask a family, mother or father, what are the best days of their lives, they’ll say the wedding and the birth of our children or something like that.  I get to share that all the time with every baby I deliver.

Almost every baby I deliver there is a lot of joy and it is a great thing to experience with the family. Also, unfortunately, when you talk about emotion I am with them in their lowest of lows when you tell them that they are having a miscarriage or they have a malformed fetus or maybe a lethal fetal anomaly. It’s the hardest days of their lives and to be able to be there for them at that time, it is very rewarding also.  Fortunately there are far more good days than bad in what I do but even in the bad times it’s rewarding to help them get through it.

From a gynecological part of it, a woman is trusting me with her intimate details and intimate parts of her anatomy that are needing help, whether it’s a cancer screening, pap smear, if it’s for contraception or family planning or problems due to infection or whatever. It’s almost always a very personal matter. For someone to entrust that to you is very rewarding.

What does your work in entail?

A lot of hours unfortunately.  I work 8 to 5, Monday through Friday except the day that I am on call and then on that day I start at 6:30 and go basically until 7 o’clock the next morning, a 24-hour shift. I do that one day a week when I’m on call. And then, because I have good partners, one out of every seven weekends I’m on call from Friday morning until Sunday night so that’s a long weekend.

What I do is fun. It has its hazards. There’s risk associated with it, but the joy that we get with it is immeasurable.

During my 8 to 5, I’m in a clinic checking on obstetrical patients, checking their progress, looking for problems, and also at the same time doing any gynecologic work.  We serve as a family practitioner to many women, just for the routine physicals and blood tests, cancer screening, preventive maintenance exams or regular, for their annual examinations or annual physicals, and then, of course, we uncover problems like cervical precancerous lesions, etc. We also do vaccinations and we do a lot of general medicine too. We are many women’s only doctors so if they have a sinus infection or a urinary tract infections, different things like that, we do that as well.

I also have a pretty busy gynecology practice where we deal with stress incontinence, well, any kind of urinary incontinence and prolapsed vaginal walls, whether your bladder, your rectum has prolapsed into the vagina. We do a lot of surgery. I have a very busy practice regarding minimally invasive procedures where I do hysterectomies with a laparoscope, basically single incision incontinence surgeries. We makes three small incisions in the abdomen and take out large uteruses as large as full term pregnancies through the scopes now. It’s amazing what we’re able to do that’s minimally invasive surgical procedures through the laparoscope. I would say 99% of the hysterectomies that we do now are through the laparoscope and don’t have to have open incisions anymore for those. So that’s rewarding to be able to bring those new surgical techniques in.

How did you get started in this career?

I can’t remember when I didn’t want to be a doctor when I grew up. I always wanted to be a physician. And early in my career, I had a mentor who had a small family practice physician in my town and went to our church.  He knew that I was interested and I went over and worked with him in the clinics in the summers and on the weekends and different things like that. And he piqued my interest and then I decided that’s what I wanted to do.  So I dedicated my collegiate studies to that and then was accepted to med school.  I didn’t know exactly what specialty I wanted to do then. I thought I probably wanted to do family medicine and deliver babies and do all the other things. But when I got into med school and went into my rotations and obstetric and gynecology I knew then that’s really where I wanted to go.

It’s happy, as I told you before, you’re not dealing with a lot of illness. You’re really dealing with a lot of wellness. And I’m a very happy person a lot of the time. I like joy, I like to laugh, and I like to have fun and this is the profession that really deals with all of that as opposed to a lot of physicians dealing with death, dying, morbidity, and mortality all the time.  That was not my cup of tea.

What do you like about what you do?

The joy of it and sharing with families one of the greatest events of their lives.

What do you dislike about it?

The long hours. It takes me away from my family more than I would like it to.

How do you make money and how are you compensated in this job?

We’re basically fee for service. We provide a service and the patients pay the fee for it. Now most of it is through their insurance, and we have contracts different insurance companies, Medicaid, etc.

How much money do you make as an OB/GYN?

I would say median income for an obstetrician gynecologist in the United States is about $280,000.  But those are the guys that don’t work very much.  So I would  probably say median income is about $280,000 or so but there’s years I made over $700,000.

How much money do you make starting out in this career?

Well we’ll be paying our new partner $480,000.  The hospital is paying his salary the first year to bring him in.  It’s a guaranteed salary of $240,000 plus whatever he produces out of that he’ll be able to keep. So probably about $400,000+.

What education or skills are needed to do this job?

You need a college degree and a doctorate of medicine afterwards. Four years of college and then an additional four years of med school and then four years of residency training, depending upon your specialty. Ours is four years. And then if you do a subspecialty, high-risk obstetrics is another three years and then reproductive endocrinology, another two years.  Urogynecology is another two years. GYN, cancer, and oncology is another three years. But the thing that I think is important is you better make straight A’s in college to get into med school. You need to be an A-student and that really is one of the more difficult parts of the whole deal is getting into medical school. You’ve got to push it in college to keep your grade point very high and score well on the MCAT to get into medical school. So it kind of starts early making sure that you’re making yourself a center of excellence in your life because after that you’ve got to do the same.  There’s continued education and practice. You need to be excellent in your practice.

As far as skills, I think it takes a fair amount of manual dexterity. There’s times when you need to be pretty doggone strong and these days I think it takes a fair amount of good hand-eye coordination and ability to work with and being able to see on the monitors what you’re doing. You have to be good at video games kind of. Your hands have to do what your eyes are telling them what to do without touching it. I do robotic surgery as well so we’re literally out of the patient working on a console in 3-D looking in a pelvis and operating.

What would you say is the most challenging about what you do?

Again, the hours. It’s not at all uncommon to have a 100-hour work week. And then second to that is liability. We live in a society that pretty much expects perfection and 3% of babies are born with a natural birth defect that we have no ability to diagnose prior to delivery.  Because you’re dealing with unborn human life, you don’t know a lot of times what’s on the other side when they’re born. That’s one of the more stressful things when you talk about doctors doing obstetrics. The stress of the liability and lawsuits is significant.

What would you consider most rewarding about this job?

The shared experience with the family at the time of birth. It doesn’t get much more rewarding than that. That’s one. The second is now, being able to do surgery in a minimally invasive way where the recovery is very short and the pain is markedly diminished, by doing that it’s a new paradigm.  When most people think of surgery they think of a big knife making a large incision and a lot of pain. And now we don’t do that. We take care of their problems with very little pain, very little downtime. And that to me is very rewarding to be able to stay on top of that technical curve with gynecologic surgery and being able to provide that to my patients.

What advice would you offer someone considering this career?

If you don’t mind working hard it is probably one of the most rewarding careers in medicine and one of the most rewarding specialties in medicine.

How much time off do you get or take in a year?

A lot. I work hard and I play hard. But I don’t play hard until my work’s done. I have a lot of partners and now that I am getting up in age a little bit taking more time off to travel with my family. I’m coaching football teams and basketball teams and really enjoying those extracurricular activities. So I’m taking a little more time off. In a year probably average 8 weeks off.

What is a common misconception people have about what you do?

That I make a million bucks a year because you don’t. Uncle Sam gets a lot of it.

That’s the common misconception about obstetricians probably and also the misconception about physicians. And a lot of physicians really don’t make that much in today’s world. A lot of physicians are employed physicians etc. A lot of people who are physicians are people who have worked hard to get where they are, and I don’t really begrudge them if they do make good money because most physicians are over $150,000 in debt when they get out of school.

And so you have to pay that off and when you’re starting out, it takes a lot of time. So you’ve already deferred your wage making capabilities until you’re 30-years-old, 32, before you’re really out and going. And all of a sudden you’re trying to play catch-up and paying off these huge loans. So many of us really don’t have much disposable income until your early 40s.  So there’s always a delayed gratification that you have to be in medicine because you have to work hard in college to get to through medical school and to get a good residency.

I’ve had friends who got jobs right out of college who were successful and retired by their mid 40’s.  At that point I was just getting ramped up.  So I think people don’t quite understand what we go through to get there.

What are your goals and dreams for the future in this career?

Continue to push the envelope on minimally invasive surgery procedures. To dedicate more of my time to indigent care and doing medical mission trips.

What else would you like people to know about what you do?

It’s fun. What I do is fun. It has its hazards. There’s risk associated with it, but the joy that we get with it is immeasurable.  It truly is. Literally, just recently I had a patient who had a very difficult first delivery. The baby was born with an extremely rare lethal abnormality.  And when the baby was born, nobody would have had an idea that this would happen. There’s nothing you could pick up on and so they were devastated with the first delivery.  We worked through and got them through a second pregnancy, and we found out this baby did not have this problem.  And getting them through that delivery was extremely, extremely gratifying.  To work with them through the worst day of their lives, through a long process of years and then to enjoy then the best day of their lives.

What do you do for a living?

I’m an allergist and immunologist.

How would you describe what you do?

We treat and diagnose diseases that are produced by disorders of the immune system.  And they include conditions such as respiratory allergies, which are allergic and non-allergic rhinitis and asthma, acute systemic allergic reactions known as anaphylaxis, and also patients who have immune deficiency disorders.  So it is a very broad based sub-specialty of the specialties known as internal medicine and pediatrics.

What does your work entail?

It entails seeing patients on a daily basis who suffer from the above diseases.  90% of our work is in office, and perhaps 10% is involved in hospital for the majority of allergists and immunologists.

In our discipline….we have very little to do with our hands, but a great deal to do with our minds.

We do have emergencies, we do admit asthmatics, and people who go into anaphylactic or allergic shock, and we do get called for consultations in hospitals as well when we are on call.

What does a typical workweek look like?

A work week can vary from anywhere about forty hours to a maximum of seventy to eighty hours a week, depending upon the work load and the number of consults that we receive.

How did you get started in this career?

Going into this career one has to follow the following path.  First of all you go to college and take pre-med courses, and then you are accepted into medical school.  The usual time that it takes to complete that stage of your training is about eight years.  After medical school, one then enrolls in an internship and a residency and that usually is three to four years.  To get into allergy one has to do either an internal medicine residency, or a pediatric residency.  My own personal duration in residency was four years.  After completion of residency, one enters what is called a fellowship program.  The fellowship program runs for another two to three years.  After completion of the fellowship and passing ones board examinations in internal medicine, pediatrics, or both and then allergy and immunology, one becomes a board certified allergist immunologist.

I chose immunology because it is a fascinating subject and it covers diseases of all organs.  For example, there are immunologic diseases of the heart, lungs, kidneys, and the skin.  So it is a fascinating disorder, and allergists are trained in all of these disciplines.

What do you like about what you do?

What I do is great fun.  We have a chance to deal with people in an intimate environment in office where we have all the tools that we need to help them in a very efficient manner. We deal with diseases that impact people’s lives and we have a great opportunity to lesson the burden of disease on these people’s lives and improve their quality of life.  And in addition, the basic science that underlines what we do is fascinating and constantly changing, and there is never a day where there is a dull moment.

What do you dislike about what you do?

I assume there is no job that you can have where there isn’t some aspect that is a nuisance.  In my job, dealing with regulations set by the government, regulations set by insurance companies, and the paperwork involved in getting through this mass of rules is something that I think no one likes to do.

How do you make money or how are you compensated in this career?

90% of our compensation comes directly from insurance companies, either private insurance companies or the government, and a small percent comes from direct payments by patients.

How much money do you make?

The minimum is usually low hundred thousands and goes up to maybe $300,000.

How much money did you make starting out in this career?

The usual starting salary is close to $100,000.

What education or skills would you say are needed to do this?

You have roughly thirteen or fourteen years of your life devoted to learning the discipline, and during that time of course the intellectual activity is extremely vigorous; medical school, the residencies, passing ones board exams, and then subsequent to that one has to re-certify every ten years.  So you have to have the desire to be constantly studying and learning new things.  In our discipline, the entire difficulty is the intellectual.  We have very little to do with our hands, but a great deal to do with our minds.

What would you say is most challenging about what you do?

Well the most challenging is clearly the intellectual aspect.  We see challenging patients which require research on our part and the work therefore extends far beyond the actual work day.  Most of us spend nights and weekends learning about problems that we see during the day.

What is most rewarding about this?

Most rewarding thing is when you have been successful in helping someone through their health care difficulties.  I think all of us in medicine find that to be the most rewarding aspect.  But also rewarding to me is the fact that not a day goes by when we don’t learn something new, so we are kept on our toes and I find that a very gratifying way to live.

What advice would you offer someone considering this career?

I think it is important to understand that you have a long way to go before you are going to be, for lack of a better term, hanging up the shingle.  Therefore you will see your friends who have taken shorter paths to earning a living already out and enjoying a full capacity life, so they should prepare themselves for that marathon that you go through, and one has to want to work hard.  One has to be prepared not to work only during the day but to work at night and be on call, both in their training and perhaps to a lesser extent in their final practice, but still it does exist. And then finally, one has to want to help people.

How much time off do you get or take with this career?

Most allergists practice five days a week and take call on the weekends and nights.  Time off varies tremendously on whether or not you work in a large group or whether or not you have a single practice or whether or not you are employed by a very large clinic.  If one works, for example, in a five man/woman group you will take call roughly every fifth weekend.  If you work by yourself you may take call every weekend that you practice, so the time off varies considerably depending on where you work, how many people are employed by your group and whether or not you are an individual practioner or work for a large clinic.

What is a common misconception that people have about what you do?

I think the most common misconception that I see in my own practice is the lack of understanding between what a dermatologist does and what an allergist does.  Dermatologists take care of multiple skin diseases. Almost 90% of allergy involves internal diseases and are the internal organs, and only a very small percent of all practices see skin diseases per se.  So each day in my practice I am referred a patient or two who really belongs at a dermatologist who takes care of the vast majority of skin diseases.

What are your goals and dreams for the future in this career?

You could not believe the advances that have occurred in our field since I began practicing, which is well over thirty years ago, and I think it is not unreasonable to assume that the same degree of advances will occur in the future.  When I began practice I had at least ten people in the hospital each and every day.  My hospital practice now is usually never more than one or at maximum two people in the hospital, and most of the time it is zero.  So we have been able to almost stamp out hospitalizations for the majority of diseases that we treat, and in the future I think we will make the same advances, because our knowledge is expanding along the way.

What else would you like people to know about what you do?

I think that people should understand that we are a very capable sub-specialty, which can exert profound changes in people’s lives for the better when they suffer from allergic and immunologic disorders.

What do you do for a living?

I’m a speech language pathologist in a skilled nursing facility.

How would you describe what you do?

I work with geriatrics who have been in the hospital but need therapy before they’re able to go home to live independently. Most of the people I work with have trouble communicating in some aspects, communicating or eating etc.

What does your work entail?

I keep a case load usually around seven to twelve patients at a time and I treat the various communication disorders or communication or swallowing disorders.

How did you get started in your job?

I knew I wanted to be in health care in some way and just ended up choosing therapy and stuck with it.

What do you like about your job?

I like that I interact with people all day long. I like helping people become more independent. I like the flexibility that my job offers. I like the ability to make my own schedule. I like not sitting at a desk all day long.

What do you dislike about your job?

I can’t think of anything I dislike offhand.

How do you make money or how are you compensated?

I get an hourly rate and I get full benefits and paid time off.

How much money do you make as a Speech Language Pathologist?

About $80,000.

What education or skills are needed to be a speech language therapist?

It requires a master’s degree which is a five semester program. Other than that you have to have state licensure and national licensure. You also need to enjoy working with people and be able to get your stuff done and get things turned in on time to Medicare so you don’t get denied.

What is most challenging about what you do?

Working with people that may never fully recover. Like if they had just a massive stroke and won’t ever be back to where they were. You know you can help them make improvements but they won’t be able to live like they were before the stroke. And that’s very tough sometimes.

What is most rewarding?

Just helping people to regain their independence and the lives that they had before they went to the hospital before they had a problem.

What advice would you offer someone considering this career?

Let’s see I would say if you know if you want a career that you’ll be interacting with people, helping people, and one that’s at the same time still challenging and one that you learn a lot every day then this would be a good one because you work in healthcare alongside other medical professionals and you get to learn a lot about other disciplines as well.  Other advice is a good graduate program will go a long way.

Also, go to an undergraduate program with lots of different clinical opportunities.

How much time off do you get or do you take?

I get three weeks off per year.

What is a common misconception people have about what you do?

That I only work with kids who can’t say their “R”s or that have lisps.

What are your goals or dreams for the future in this career?

I’d like to continue working with adults and maybe even get into doing some work in a variety of settings like the hospital or maybe private practice. I’d also like to get experience with different populations of adults with different disorders.

What else would you like people to know about what you do?

It’s a very rewarding job. It’s a lot of school but in the end it’s worth it.