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Exit Strategy

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  • Exit Strategy

    I've been working for the same employer for three years since graduation, and with recent changes my current job is getting pretty unbearable due to the workload.  I can't believe how burned out I feel at this stage of my career.  In essence, I don't have a strong work ethic and don't enjoy medicine all that much to begin with, and I have the good fortune of not having student loan debt and have accumulated a decent net worth.  Where I'm "poor" is my personal life, which has been a casualty of my entire school and career track, and it's getting harder to justify working any full-time job, let alone one that is more onerous than most, just to throw more money at taxable accounts and the mortgage.

    The inertia and anxiety of leaving has been hard to overcome, but I'm getting to my breaking point.  A big deterrent has been the prospect of losing a pension I'd have to work another two years to keep, but I'm at the point of giving serious thought to walking away even from that.  I could leave for a better position at a different hospital in the same system and likely keep it, and I would even consider moving (to a less desirable city) just for that.

    The alternative is to seek a less stressful, part-time position within my current department.  I am not sure how that would be received.  So I am wondering if I would be better off scheduling a meeting with my medical director to candidly inform them of this, or if I should just go ahead and start contacting other hospitals to see how receptive they would be to my request.

    On the one hand, I don't want to get expose as a burned out malcontent.  It might just poison the well.  I am also mildly worried it could just backfire and they might tell me they're happy to replace me (administration says they have no problem recruiting for the position I have).  On the other, I wonder if I start contacting directors in other cities to see what leverage I have if it will filter back to the one in my department anyway, so I might as well go to them first.

    I'm not sure if anyone can give me great advice without knowing my administrators or how my hospital system works, but if anyone has experience with dealing with a similar dilemma, I'm all ears.

  • #2
    How valuable would the pension be? It seems like that's one of the main reasons you would be willing to stick around but it's hard to imagine it being worth much after only 5 years in the position and given how miserable you seem from this post it's particularly difficult to imagine it being worth sticking around an extra 2. Why not put some feelers out to see what other jobs are out there, both part-time and full-time, and see if there's something you'd be happier doing.


    • #3
      Go part time.  What's your specialty?


      • #4
        As best I can tell, the pension has about 27k-30k in it right now.  My 401k match is also only 40% vested, which means another 14k or so would be left.

        I'm in psych, doing inpatient work.  I wouldn't want to work in a clinic.


        • #5
          A pension where you accumulate 2.5% of your yearly salary which can be paid in perpetuity (ie after 50 years old like in the CA prison system healthcare providers) can be super worthwhile. Your current pension at 27-30k cash value doesn't seem to have that much to offer. Even Kaiser does 2% of salary a year with 10 year vesting if I recall? Another group with a good tax advantaged retirement system (ie full 54k per year and 30k in defined benefit plan plus 3400 in HSA pretax) will have you exceed that in 6 months. If the pay is higher at the new job then you're even better off. So far I don't see a compelling reason to stay, or at least put out some feelers.

          However, if you are referring to 30k in yearly income from a pension, that has a "real value" of $750,000 or so in cash equivalent which is a whole other ballgame. Stick that out for another 2 years, add in social security and you have a retirement income that most of America would be happy to have right there and the rest of your career to put a little more away as the "cushion." Plus, as unpredictable as their payouts may seem, having a steady monthly cashflow after retirement is attractive as part of a retirement portfolio and I wish that my wife or I had one as at least a portion of our retirement plan.

          On the other hand, it's worth asking yourself what it is you hate so much. Is it a grind of working a lot of hours? If so cutting back even 10% could make a world of difference. I'm working 17 shifts a month in Emergency Medicine which is more than most in my group but compared to residency seems like a walk in the it's all relative. Good luck!


          • #6
            I may just be saying this because I am really burned out, but I want to work the bare minimum to keep my clinical skills up to par and still call myself a doctor.  I do not need full time salary, and while the benefits are nice, if I can't get them with part time work I would rather do other things with my time.  If I didn't take another job in my department or another hospital in my system to keep the pension, I think I would try locums out so I could take months off at a time and have maximum flexibility and minimal commitment.  As it turns out, I am also hoping to sell my house in about six months.


            • #7
              Is the admin serious about being able to fill your psych position? I recently spoke with a physician recruiter on my podcast who said psych was in huge demand right now.


              I also have psychiatrists in my family who are getting multiple daily job offers from all around the country.

              I would think you would have your pick of job options if you are unhappy where you are.


              • #8
                Psych is super in demand right now, all across the country. Especially if you want to do inpatient, since most psych's work outpatient. Look into the prison system, VA, state hospital, or academic medical centers, all of which have inpatient psych. Or join a group that provides inpatient work in community hospitals. If you don't like your current job, vote with your feet! There's plenty of opportunities out there.


                • #9
                  I hear what you guys are saying.  Oddly enough, despite my dissatisfaction and the high demand, I think I could be replaced pretty easily, as there's been low turnover in my group and they historically do not have difficulty hiring.  That, on top of forfeiting the 40k, makes me ambivalent about walking out.  So I'm hoping I can somehow stay, at least in the hospital system, and figure out a way to dial the work back.


                  • #10
                    I think more financial detail could be helpful in eliciting feedback.

                    • What is your salary?

                    • What's your net worth?

                    • How much in retirement / taxable?

                    • What are your annual expenditures?

                    Regardless of the answers to the above, I would look for another job before pulling the trigger on quitting.  Getting another job is easier if you already have one.  Sitting on the bench while your net worth bleeds away sucks.



                    • #11
                      Make about 250k a year

                      Net worth about 1.4 mil, $450k in retirement (70% tax deferred, 30% Roth), $300k home equity, rest in taxable

                      age 34

                      I don't even track my spending, maybe 35k a year?  I should probably figure that out.

                      mentally and financially it makes perfect sense to sell the house and go kitesurfing, wallaby chasing, and Peak bagging for six months but professionally probably too damaging to justify.


                      • #12

                        Make about 250k a year

                        net worth about 1.4 mil, $450k in retirement, $300k home equity, rest in taxable

                        age 34

                        I don’t even track my spending, maybe 35k a year?  I should probably figure that out.

                        mentally and financially it makes perfect sense to sell the house and go kitesurfing, wallaby chasing, and Peak bagging for six months but professionally probably too damaging to justify.
                        Click to expand...

                        Congrats on your excellent financial condition.  You could clearly afford to take some time off judging by those numbers.  I am sure you can find a job that would be able to support your lifestyle even if taking time off damages your career.

                        I do think people can overestimate the positive impact on their lives by changing their jobs.  I have had several colleagues move on to different places expecting the switch to make them significantly happier only to find that it makes a marginal difference.


                        • #13
                          Let's be honest, you can definitely take 6 months off if that is what you want/ need at this point (I'm also a psychiatrist). You will not lose any of your clinical skills over that time frame. I was just out for 3 months of maternity leave and nothing new had happened during that time and I picked up right where I left off, but only working 7 hours a week instead of 21.
                          I am very familiar with your situation. While they could easily fill your spot, they would rather keep you. I think it's worth talking to the medical director about your options for part time work. I know they're having trouble filling their new access center, could you do 10 shifts a month there and still keep the pension? And then leave in 2 years? Or if you hate that idea, reach out to the other hospitals in your organization, they would love to have you. Another doc in your group nearly just left for another hospital in your system and didn't get any blowback for it.
                          Ultimately I think you're in too good of a financial situation to let fear hold you back from asking for whatever you want or need. You won't get fired for asking.


                          • #14
                            You're beyond FI at this point if you're spending less than $50,000 a year. Congratulations! That is a remarkable feat.

                            It doesn't sound like the pension and 401(k) vesting are exactly golden handcuffs. Bronze handcuffs, maybe. But it's money you don't really need unless you undergo some lifestyle inflation (which might not be a bad idea).

                            If your position can be easily filled, it's only because it is a very lucrative position for your specialty. I have also heard psych is in high demand. We're losing the one psychiatrist in town who does ECT, and haven't found anyone to take his place. He's going to a practice where do nothing but ECT and TMS.

                            If I were in your shoes, I'd start making plans to leave the job in which you're unhappy without immediate plans to start another job. Obviously, keep licensure and CME active, think about what constitutes a more ideal job for you, and once you've caught your wallabies and you're ready to think about working again, start looking for a job that can most closely approximate the ideal. Or not. FI affords you options.





                            • #15
                              I concur with everyone above in some way or another. If you are unhappy you have to look for change. If it is with the place but not medicine, then look for another job with various changes as opposed to leaving altogether. You can afford to leave altogether though and so consider that an option. If psych is in demand you could do 1-2 months of locums a year easily and make money and keep your credentials valid.

                              You have reached financial independence. Nice work. When I was 34 (3 years ago) my net worth was - $220,000 and I had been practicing for about 2 years. So you are kicking butt man.

                              Either way, as Michael Jackson said, "Its time to make a change"