Too late?

[fatlittlepig]

Bbchi wrote:

2 kids, twins, finishing kindergarten. 15K credit card debt approx. have $$ in savings to pay it but then would have no savings. $100k med school debt, 3-4% interest. Mortgage around 500k I think. Good credit score. Ob gyn. Would love to change careers. But feel trapped financially.

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you been working for 10 years and only have 15K in savings? I would love to see what you have spent your money on (seriously)

[hightower]

That credit card debt is nothing to fret over.  You just need to focus on making some extra payments towards it and getting rid of it asap.  What kind of 401k/savings balances do you have?  100k of student loans at 3-4% isn't that bad either.  I mean, of course its not ideal, but its not the end of the world.  Mortgage of 500k at what percentage?  How much do you make yearly?

Sounds like you're burned out.  I've been there.  Its not hopeless and you're not trapped financially.  You just have to be willing to make some changes to allow you to fix things.  I do think its important to first get your finances on the right path before dealing with the burnout issue.  It shouldn't take long, but its important that you see that you're not trapped.  We need to know a little bit more about your financial situation to make specific recommendations though.  Have you ever put together a budget?  Now would be a good time to learn how. Add up your fixed expenses (mortgage payment, car payments?, student loans, etc).  Then look at where the rest of your money is going each month (how much do you typically spend on food, shopping, entertainment, etc, etc).  Then, see where you can make cuts.  If you're spending 2000/month on food, for example, try slashing it down to just 1200/month.  Then see how much money you can start throwing at your credit cards and what can be put into savings.  Set it up so that these amounts are automatically taken out of your paychecks and you are forced to live off of what's left over.  The hardest thing to do will be learning to say no to spending when its not something you've budgeted for.  But, its absolutely necessary if you want to feel better about your finances.  Let us know what your spending typically looks like per month.  That will help us gauge where your problems might be.

In the mean time, while you're learning as much as you can from this site, start figuring out how you can make changes at work to feel less burnt out.  Do you have the option of working part time?  Those extra days off could help.  Do you have any other ideas about what else you'd rather do for work?  Non clinical jobs such as working for an insurance company or something?  Start thinking and researching your options now.  It can help you to see that you have options.

All of us on this site are happy to help

 

[Kamban]

Unless the OP comes back to supply details we are all meandering in the dark.

[Anesthesia84]

DMFA wrote:

The most difficult thing isn’t going to be figuring out what to do; it’s going to be adjusting from your current high-spending self to a low-spending, debt-eliminating, retirement-investing self.  That’s a big psychological switch with a lot of momentum behind it, and you’ve got to get the rest of your family on board with it, too.

Stop spending.

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This was the biggest hurdle for us (and we weren't really huge spenders since luckily we found this website before we both finished residency and didn't have much to spend!).

I have literally stopped going to any stores except for groceries. We buy everything online and only after a waiting period if it is not a necessity. It is too easy to go into Target or TJ Maxx or whatever and see a bunch of things you "need" and end up spending hundreds of dollars accidentally!

 

[DMFA]

The most difficult thing isn't going to be figuring out what to do; it's going to be adjusting from your current high-spending self to a low-spending, debt-eliminating, retirement-investing self.  That's a big psychological switch with a lot of momentum behind it, and you've got to get the rest of your family on board with it, too.

Stop spending. Pay your debts.  Get a cash buffer/emergency savings.  Add retirement accounts.  Bob's your uncle, right?  Just because the concepts are simple does not mean actually being able to follow through with them is easy, but you have to keep telling yourself and your spouse that you can indeed do it.

Fortunately everything's *probably* going to be fine.

[RogueDadMD]

There's good evidence supporting mental health and telemedicine. Given the lack of procedures and not using physical exams, only discussion, it lens said itself better to telemedicine than almost any other specialty. Most of it isn't tears eyed discussion holding hands; also I don't think hand holding is as common as it may have been before.

[Hatton]

OP I hope that you did not get turned off to advice because you might have followed a different path.

[jfoxcpacfp]

I can understand how that could be for mental health patients. You can't reach out an pat a patient's hand and try to comfort them - I often find myself wishing I could hug a client.

Obviously, you are far higher up the techie scale than am I .

[BlueMonday]

adventure wrote:

BlueMonday wrote:

No you are absolutely NOT too late. Let me tell you my story – I was 38, married with two kids. Almost $400k in student loan debt, some of it in default (credit score of 585!), and a house that we bought for $850k that was worth now worth $750k and only about $100k in our retirement accounts. Over the last 10 years we paid off the debt, sold the house and rented a small one for two years, and have accumulated about $2M in savings. To paraphrase WCI, live like a resident until you get back on track.

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Guest blog post would be cool…

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Not worth a blog post, it's all been written by WCI before and there's no secret to it.

1. Reduce your expenses (live like a resident, move to a lower COL area)

2. Make a lot of money (switched from academics to private practice)

3. Work harder

 

 

[StarTrekDoc]

jfoxcpacfp wrote:

\You should try it sometime – you might be surprised at what we can accomplish using 21st-century technology! ?

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You're preaching to the choir   I'm a CES type guy (more yet, alpha tester type) and have championed telehealth and informatics for years.

All those things you said are the advantages of the televisit.  It expands out reach dramatically, information dissemination, and access are all exponentially improved.

That said, there is something from the face-to-face (F2F) visit that just can't be replicated remotely.  We've witnessed it time over again in mental health, subspecialties, primary care--across the spectrum of care.

The first step for OP has been done-- acknowledging an issue.   The next steps are developing OPs goals and reconciling them with Spouse's acknowledgment and goals.

We simply don't know enough information on how the relationship, spend, and goals are between the two.  It can be as easy as back of envelope calculations and goals or need a full-on power point presentation with excel data and interactive calculators to reflect shortfalls.

Our planning mantra - Right time, right place, right person.   -- the order of priority of these is a whole different Oprah show.

[jfoxcpacfp]

StarTrekDoc wrote:

Sometimes things simply need a good old fashion sit down, come to Jesus moment, for the family and best done face-to-face to show reality of expenses, budgets, scores.

We do a lot of asymmetrical communications and virtual data sharing along with televisits, but the most effective tool in communication and getting our point across is having a patient come in a have a face-to-face visit.   There’s something more palpable and value in it than the rest.

I am a techie of all sorts, but at the end of the day, direct human interaction trumps any tech we have.

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With all due respect to a fellow techie, that's exactly what we do, often with the babies being handed from parent to parent and sweet children's noises in the background as we meet face-to-face. It's very gratifying to be able to meet f2f in the comfort of the family's home in their natural surroundings. I realize that, for some, it's more satisfying to fight traffic, coordinate schedules, find a sitter or meet with kids running through the office, get dressed up (clients meet with us in whatever they happen to throw on), pull all kinds of records together (because you don't know what you're going to need to take), and sit in a waiting room drinking stale coffee. Oh, yeah, and limiting interaction only to planners who happen to be in your vicinity who may not be the best fit for you. Not everybody happens to live in a city with lots of choices.

Meeting virtually not only affords f2f but also interactive screen sharing with all of the same information, often more because both of us can access whatever we need on our computers or run to the bedroom to get a particular receipt we need to go over. If the meeting ends early, virtual clients go right back to whatever they need to do at home. And if you and your spouse happen to be in 2 locations, which often happens with locums doctors, it's just as easy to have a 3-way f2f. Actually, because it's so easy to meet, clients can schedule meetings on-the-fly if we need to have a quick chat about a current twist in their situation, i.e., they don't have to wait for the next scheduled quarterly/semi-annual/annual "official" meeting.

I can assure you, we have the same come-to-Jesus experience if that's what's called for. But we also have empathetic, get-to-the root of the problem conversations about the person's history and what the best steps to take are for that couple/individual to achieve their cherished goals and get beyond the self-recriminations.

You should try it sometime - you might be surprised at what we can accomplish using 21st-century technology! 

[mamaham]

It's not too late!  You can do this.  Just wanted to add my encouragement to that already left above.  So glad that you found WCI now instead of 15-20+ years from now!  You can do this!

[BlueMonday]

Bbchi wrote:

2 kids, twins, finishing kindergarten. 15K credit card debt approx. have $$ in savings to pay it but then would have no savings. $100k med school debt, 3-4% interest. Mortgage around 500k I think. Good credit score. Ob gyn. Would love to change careers. But feel trapped financially.

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You need to set goals. Decide today what you want to be doing in 5 years and figure out a way to do it. If you are an OB/GYN, you have the ability to make over $300k/yr. Sell your house, rent a smaller one and focus on paying off your debt and saving money. With your ability to make money, you should notice monthly increases in your net worth of 10-20k. It will quickly go from -100k to 300k. Then, if you want to change careers, you'll have the freedom to do so. You only feel trapped because you don't have a plan!

[PhysicianOnFIRE]

StarTrekDoc wrote:

Never too late!. Read PoF levels — you’re Dr D. Move into Dr A or B mode.

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He's referring to the 4 physicians series, and I'm guessing he's right -- with a possibly negative or zero net worth at 45, you may be a Dr. D.

Living like a Dr. A or B (well below means) for 10 years has made work optional for me. I'm still working, but transitioning to part-time this fall. With some big-time adjustments and a cooperative market, you could be 10 years away yourself.

As others have said, eliminate the credit card debt with your next few paychecks or a HELOC or something and figure out where your money is going. The whole family will have to be on board. The kids are in kindergarten (hopefully public), so it's mainly the spouse that will have to go along with what I'm guessing will be some pretty drastic changes.

 

 

 

 

 

[Hatton]

I too am an ob/gyn. You can get it together. Now there is moonlighting for ob gyns. Several of my friends work shifts as hospitalists in addition to their private practice. You need to figure out if the problem is low income, too much spending or some combo. You have time but it is critical to start now. I know one guy who did not do well in private practice who works as a full time laborist and moonlights in another town. Like I said is the problem income or spending. Post your numbers or a guesstimate and one of us will help you