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Physicians who work their entire lives

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  • Dr. Mom
    replied




    The idea of working part time out of residency was not one I seriously considered either,
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    Long, long ago in a galaxy that seems now so far away...my husband was diagnosed with Type 1 Diabetes as I entered my second internship year. I had left OB/GYN for Peds. He was starting an employee position as an ophthalmologist.  We had a 6 month old and a 20 month old.  It was quite the existential crisis for us, as it should have been.  Totally changed our priorities and life plan in a good way.

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  • Lithium
    replied
    The idea of working part time out of residency was not one I seriously considered either, probably because a) I'd only ever worked full time or more, b) I didn't realize financial independence would come so quickly and easily as a result of my natural mustachian frugality (easy to say that after a 9-year bull market, I know), and c) part-time jobs are hard to find, I didn't have any mentors that had tried it, and I overvalued benefits at the expense of flexibility.  I would have counseled myself three years ago to go straight into locums and date around rather than sign a contract somewhere far away, which is the equivalent of ordering a mail-order bride.

    Hopefully there are some PGY 3-7's reading this forum who can take this into account.  It can take a while psychologically to accept that as an attending, you're in the driver's seat with finding jobs, and that is the time to really determine your personal and professional priorities.  Of course, it's better to figure that out late than never.

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  • LizOB
    replied
    I don't know how I'll feel about retirement when the time comes.

    All I know is towards the end of my maternity leave I was DREADING going back to work, then at the end of my first day I realized I felt like a normal person again and was going a little nuts being at home all day every day. Granted, maternity leave and retirement are very different things, but it does make me wonder how I'll feel about not working eventually.

    I'm learning more about personal finance because I want to have options later. I may not avail myself of the option of retiring early, but I want the option to be there.

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  • Dr. Mom
    replied
    We are definitely on the medicine is a job not a calling end of the spectrum.  But, having said that, it never made sense to us to push longer hours at the expense of our lives to reach some number before we allowed ourselves to ease off.  We have both only ever worked part-time.  It has allowed us the life we want and jobs we enjoy because they do not take over our lives.  We counsel our son who is a M2 to pursue the same.  The whole idea of early retirement and/or FI never crossed our minds.  I think it might be a generational thing.  Hatton and I were discussing it at lunch a few weeks ago.  I like the balance that Wealthy Doc described of some work balancing some play.  We just chose to have that balance from the start of our careers and not as a reward for hitting some magical number. YMMV.

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  • TheHappyPhilosopher
    replied
    This is such an awesome discussion. Although I think there is a spectrum and shades of gray, ultimately there are people who see medicine as a calling and others that see it as a job/career. The 'medicine is my calling' crowd probably should probably work as long as they can as it is ultimately what makes them happy. The stronger the ego/identity is tied to medicine the harder it is to leave.

    For those of us that see medicine as a job, we should probably work until it stops making sense to trade our time for money. I am on the job/career side of the spectrum. I currently work half-time (as many of you probably already know) which is a much better fit for me personally than full-time. A few things that nudged me in that direction.

     

    1. Massive burnout.

    2. When I hit my mid 30's some of my friends started getting sick, and a few people close to me died (40's, 50's). It brought into focus how short life is and how tenuous our hold on health can be.

    3. My identity and ego were very loosely tied to medicine. If I was unable to practice for some reason I really wouldn't miss it.

     

    I am fortunate that I had a high income coupled with my natural frugality (all relative of course). I have options now. If medicine was my calling or if my identity was more strongly tied I could be very selective about taking another job if I was not happy (fortunately I am in a great practice so I don't have to consider this).

    One thing I often wonder though, what would happen if I left medicine tomorrow? Is continuing to work in a field that is not my calling holding me back in some way? Am I just doing something because it is easy and comfortable not to change?

    Sorry, feeling very contemplative this morning  :lol:

    Leave a comment:


  • WealthyDoc
    replied
    I haven't been on the forum enough lately I guess because I just now discovered this awesome thread.  I appreciate all of the thoughtful and diverse opinions on this important topic.  Once again, hats off to WCI for establishing a place for this kind of discussion.  Conversations don't happen to this depth in the office, at dinner, or in the doctors' "lounge."

    I am all over the map in my own mind on this issue.  I was a big FIRE guy before there was such a thing.  I read cashing in on the American dream, living without a salary, your money or your life, etc long before blogs and reference books were out there.  I had a plan to retire early.  Once I reached FI I realized I love what I do.  I actually enjoy my work more now that I know I don't have to do it.

    It provides among other things: a salary (inflation-adjusted income), benefits, mental stimulation, growth challenges, deductible (or paid for) work trips, purpose, structure, meaning, and social interaction.  I would do fine as an early retiree since I love to chill and I have dozens of interests.  But I like a mix.  The time off seems, more fun when I also work.  I love Saturday, but do I want every day to be Saturday?  Probably not.

    My work life is pretty easy compared to other physicians.  That likely contributes to longevity.  That is by design though.  I decided how I wanted to live my life and now here I am.  I will go down to three days a week work in January.  That should be even easier.  I would push back on Lithium and others who feel trapped in their life.  We create our own reality.  Our life is what we make it.  We get what we negotiate.  People have control over you and your schedule only if you give them that power.  Be open to considering that I could be right even if you at first think I'm just lucky or crazy (and yes I may be both of those).

    I am grateful to many of my mentors who worked into their seventies, eighties, and beyond.  I had one who worked until 90.  Although that won't be me, I'm glad he kept chugging away.  I learned things from these guys that could only be taught through the lens of decades of learning, growing, and helping.

    Life is an adventure to be enjoyed and lived.  Each of us needs to carve out a schedule and life that works for us.  Although we need to make our own decisions and our own lives, it is cool that we can help each other figure this out together.

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  • wideopenspaces
    replied




    For the people that are saying that you feel as if medicine is your calling and you feel as if its an honor to practice medicine what are your fields of practice? I have a feeling the people that quickly grow tired of medicine would be physicians on the front lines ( hospitalists, intensivits, PCP’s, pediatricians,psychiatry, ER) as opposed to the specialty fields. Maybe because of a high work load with relatively lower compensation than other fields of practice?

    For me there is only so much BS that can be tolerated now and the longer I practice the less patience I have.  Dont get me wrong, I do enjoy my job but in the end I feel as if this is nothing more than a job.  Looking forward to the day where i’m FI and can work part time and do things that I find more enjoyable.

     

     
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    I'm a psychiatrist ? I work part time, which is probably part of the reason I'm able to love what I do. And I'm in academics so the pay isn't great but I get to spend time with my patients- 60 minutes for all new folks and 30 minutes for follow ups. If I have someone that takes longer to see I can schedule them for 60 minute follow ups as well. And I'm outpatient, so I really get to build relationships with people. I love that part the most and I think is where a lot of the satisfaction comes from. Walking with my patients as they navigate life . . .

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  • q-school
    replied







    I was definitely one of those who had planned to work forever until a few years ago.  I just never thought about it any other way.  For a few reasons.  I enjoyed what I did, I made a good living doing it, I took plenty of time off and spent time with family, traveled, etc.  I also never really planned for a retirement.  Fortunately we were just big savers and never got into lifestyle creep.  I also incorrectly thought we had to save enough to live on 80% of what I made.  Then a few years ago, I had some health issues and had to stop operating.  Work became less fun and I took on more administrative duties.  That plus EMR, new rules to be followed, meant I spent more time doing non-patient related activities.  EMR is a good system for record keeping but it stinks for seeing patients.  Being in a very high volume field there is no way you can duplicate the ease and speed of paper.  With that turn of events, I started thinking about retirement and realized we were well past 80% of what we SPEND and then I knew I would be finished soon.  I consider myself lucky that we did ok without a real plan.  I also wish I could go back and tell my younger self to think about retiring early.  I hope to pass that message on to the younger physicians in our group.  Not to retire early but to have a plan in case things change and you want to take that option.
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    I have thought fairly seriously of trying to put together a panel for my residents of docs who had issues like this during their careers. Not to be Debbie Downer but I think it would be a positive thing to put up in front of a bunch of 26-30 year old docs.

    Seeing things like this happen to colleagues over my short career helps keep me on track financially. I think we all know cases of the opposite where health issues hit when someone is not on track for FI, truly a scary event. Thanks for your story.

     
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    youth is wasted on the young.

    everyone has to travel down their own path.  you can't always help people avoid trouble.  I'm constantly fascinated by energy spent by academics (on many boards) in these quasi gray areas of resident education when my experience has been that many of the residents still haven't learned medicine (or at least could learn more about related areas--even public health care policy or practice management seems more on point than this area, with all due respect).



     

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  • CM
    replied


    I have thought fairly seriously of trying to put together a panel for my residents of docs who had issues like this during their careers. Not to be Debbie Downer but I think it would be a positive thing to put up in front of a bunch of 26-30 year old docs.
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    It certainly couldn't hurt but I wonder how much it would help.

    When I was a 20-something resident, the idea of being a 40- or 50-something physician with health problems was incomprehensible to me. I expected to maintain robust health until my 80s or beyond when I would die of cancer. That was true even though I knew a surgical resident who developed lymphoma.

    I was no more worried about poor health than a lightning strike or a fatal accident on the highway. I suspect that a panel of docs with health issues would have caused me as much concern as a panel of lightning-strike survivors.

     

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  • MPMD
    replied




    I was definitely one of those who had planned to work forever until a few years ago.  I just never thought about it any other way.  For a few reasons.  I enjoyed what I did, I made a good living doing it, I took plenty of time off and spent time with family, traveled, etc.  I also never really planned for a retirement.  Fortunately we were just big savers and never got into lifestyle creep.  I also incorrectly thought we had to save enough to live on 80% of what I made.  Then a few years ago, I had some health issues and had to stop operating.  Work became less fun and I took on more administrative duties.  That plus EMR, new rules to be followed, meant I spent more time doing non-patient related activities.  EMR is a good system for record keeping but it stinks for seeing patients.  Being in a very high volume field there is no way you can duplicate the ease and speed of paper.  With that turn of events, I started thinking about retirement and realized we were well past 80% of what we SPEND and then I knew I would be finished soon.  I consider myself lucky that we did ok without a real plan.  I also wish I could go back and tell my younger self to think about retiring early.  I hope to pass that message on to the younger physicians in our group.  Not to retire early but to have a plan in case things change and you want to take that option.
    Click to expand...


    I have thought fairly seriously of trying to put together a panel for my residents of docs who had issues like this during their careers. Not to be Debbie Downer but I think it would be a positive thing to put up in front of a bunch of 26-30 year old docs.

    Seeing things like this happen to colleagues over my short career helps keep me on track financially. I think we all know cases of the opposite where health issues hit when someone is not on track for FI, truly a scary event. Thanks for your story.

     

    Leave a comment:


  • Arkad
    replied
    I was definitely one of those who had planned to work forever until a few years ago.  I just never thought about it any other way.  For a few reasons.  I enjoyed what I did, I made a good living doing it, I took plenty of time off and spent time with family, traveled, etc.  I also never really planned for a retirement.  Fortunately we were just big savers and never got into lifestyle creep.  I also incorrectly thought we had to save enough to live on 80% of what I made.  Then a few years ago, I had some health issues and had to stop operating.  Work became less fun and I took on more administrative duties.  That plus EMR, new rules to be followed, meant I spent more time doing non-patient related activities.  EMR is a good system for record keeping but it stinks for seeing patients.  Being in a very high volume field there is no way you can duplicate the ease and speed of paper.  With that turn of events, I started thinking about retirement and realized we were well past 80% of what we SPEND and then I knew I would be finished soon.  I consider myself lucky that we did ok without a real plan.  I also wish I could go back and tell my younger self to think about retiring early.  I hope to pass that message on to the younger physicians in our group.  Not to retire early but to have a plan in case things change and you want to take that option.

    Leave a comment:


  • fasteddie911
    replied
    I know multiple MD family members or family friends who have worked, or will work well into their 65+ years.  Some are due to financial reasons (sending multiple kids to private college, HCOL area, etc.), but others enjoy the work, are dedicated to their patients, or just wouldn't know what to do with all their free time.  These docs include generalists as well as specialists, all in the private practice outpatient setting (as opposed to academics, inpatient, shift-work or employed setup), which may have something to do with it as well.  I think partially what keeps them going is the relationship with their patients, many of whom they've known for years.  Patients whom they exchange gifts with, attend events for/with, etc.  People talk about the importance of social interactions in life and retirement, and while it's atypical, I think the doctor-patient relationship can sometimes be a legitimate form of this.

    While I aspire to FI asap, I'm not sure what I'd retire to, especially early retirement.  If it's a life of leisure, it may be wonderful for a little while, but not sure about doing it for 40+years.  Despite being in medicine, I don't feel like I'm missing out on anything in life and there's never really been anything I'd rather be doing in its entirety.  I feel like I live a pretty good life outside of medicine, I get to spent time with others, experience things I'm interested in, and have traveled pretty well.  Likely it varies by person, as I also don't have many wants or needs.  I read about others' desires beyond work and I often can't relate.  I don't desire to socialize more than I already do, I don't have many interests or hobbies (despite trying many things), I'm not particularly interested in many of the experiences that others enjoy/crave, and my travel bucket list isn't particularly long.  I imagine my ideal setup at some point would be part-time work, which would still give me ample time to pursue other things in my life and provide a nice sustainable work-life balance.

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  • Antares
    replied




    For the people that are saying that you feel as if medicine is your calling and you feel as if its an honor to practice medicine what are your fields of practice? I have a feeling the people that quickly grow tired of medicine would be physicians on the front lines ( hospitalists, intensivits, PCP’s, pediatricians,psychiatry, ER) as opposed to the specialty fields. Maybe because of a high work load with relatively lower compensation than other fields of practice?

    For me there is only so much BS that can be tolerated now and the longer I practice the less patience I have.  Dont get me wrong, I do enjoy my job but in the end I feel as if this is nothing more than a job.  Looking forward to the day where i’m FI and can work part time and do things that I find more enjoyable.

     

     
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    I’m a psychiatrist, and I am definitely one who feels it’s an honor and a privilege. However, there are many other things I love and are worth doing, so I will be stopping when it is financially reasonable to do so, having already committed 30+ years to this starting with medical school. (I suspect I’d be much more burnt out if I were not in private practice however.)

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  • FIREshrink
    replied
    Happiness is overrated. If everyone just did what felt good we'd be in a world of hurt. Making the world a better place, touching people's lives, creating peace matter more.

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  • gadoc
    replied
    For the people that are saying that you feel as if medicine is your calling and you feel as if its an honor to practice medicine what are your fields of practice? I have a feeling the people that quickly grow tired of medicine would be physicians on the front lines ( hospitalists, intensivits, PCP's, pediatricians,psychiatry, ER) as opposed to the specialty fields. Maybe because of a high work load with relatively lower compensation than other fields of practice?

    For me there is only so much BS that can be tolerated now and the longer I practice the less patience I have.  Dont get me wrong, I do enjoy my job but in the end I feel as if this is nothing more than a job.  Looking forward to the day where i'm FI and can work part time and do things that I find more enjoyable.

     

     

    Leave a comment:

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