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  • Physicians who work their entire lives

    One of my worst fears is that I'll develop a terminal illness while still working full-time, and thus not get to enjoy a real retirement.  Intellectually I understand that if I punch out too soon, I could regret it, though emotionally the possibility of being free of the burdens of clinical medicine sounds blissful.  My parents retired at age 55 and 60 and seem happier in their retirement than they were while working.

    On the other end of the spectrum is one of the doctors in our group, who is planning to stop full-time practice next year at 75.  Mainly because of his sluggishness and inefficiency, but also because he goes above and beyond what most of us do, he works at least 12 hours every day, and often does paperwork on the weekends.  He's even stuck out the implementation of a terrible EMR in the last year that has been miserably difficult to adjust to for even the docs who aren't as technologically impaired.  I don't know how, let alone why, he does it.  He will still continue to work part-time for us and otherwise "keep doing what I'm doing now, except not get paid for it."

    I have colleagues who work with doctors over age 80 who continue with their jobs even when they don't seem physically capable of keeping up with the demands any more.

    It is pretty much impossible for me to get my mind around this.  I would understand it if someone can't stop working because they can't afford to.  That's not the case with the doctor in my group, so I can only imagine he does it because he has no idea what else he'll do.  I know a huge portion of us have a FIRE mentality and probably can't relate to it either, but do any of you know docs like this, or even plan to keep practicing full-time until your health makes you quit?  If so, for what reason(s)?  Undimmed love for clinical practice, fear of cognitive decline, fear of boredom, and sense of moral obligation seem to be the most likely of these.  I also wonder if there is a big difference in generational mentality and the number of physicians who choose to do this will dwindle accordingly.
    “Work” is a four letter word for good reason.

  • #2
    When I talk to senior colleagues, being a physician was a calling. They have a sense of social obligation to work until the end. It is literally who they are.

    Huge difference in mentality.
    However the aches and pains of Emr appear to be more troubling to middle aged physicians than to kill rials who have never handwritten a note or a prescription.

    They anticipate a certain amount of busy work and don’t have the desire to be independent or run their own practice, by and large. The current environment is all they have ever known. Not judging, just describing.
    Ymmv

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    • #3
      It's tough to know isn't it? Obviously everyone here is focused on FI/wealth in addition to our practices.

      Clearly retirement isn't good for some people. Work provides meaning and we do some of the most meaningful work in the world. I know very very few docs in their 70s who are still at it.

      I do wonder about that generation of MDs who went through a huge change in the way medicine was practiced and billed etc. My parents (late 60s, both MD) talk about how back in the day the nurses used to stand when a doctor walked onto the ward. Not sure that was a better world but it was a different one for sure. They did not adjust particularly well to EMR and view it as a major negative if they want to keep working.

      I'm sure lots will change in my career but I think the inflection point of going from a world of paper where docs made the rules (think 70s/80s) to a our current system was the big one and I think stuff that changes in my career will be more around the margins.

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      • #4
        OP, your hunch is correct. It is absolutely better to retire early (even from medicine), then it is to work until 50 or 60.

        If you disagree, you haven't traveled enough, read enough, met enough people to know what is out there. Soo much more richness and beauty out there, most of it you won't have the time to experience if you keep working.

        I plan on retiring in my mid to late thirties. I absolutely love my job and my specialty, but I have traveled enough, immersed myself into enough cultures and languages, hiked enough mountains and seen enough sunsets, to know that there is just too much to see in life.

        Looking at digits on a screen as your net worth accumulates isn't what I would consider enriching or perspective-altering. There is so much more out there.

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        • #5
          It's a balance of good of self vs good of others vs good of society.   Only the individual will determine the weight of these and its importance that will often dictate the road traveled.

          The 'greatest generation' and probably the Boomers -- medicine and society was a very different place.   Like MPMD said, people used to stand up when a guest enters the room.  I do still after my father gave me a finer point of proper behavior during my teens.  They even arranged their home furniture and a barrier to the open layout from the living room since it was in clear line of sight of the foyer -- creating an uncertainty of behavior for them on 'when to stand' when guests arrived and made their way to the living room where everyone was sitting.

          To Re3iRtH's point -- absolutely, there's great beauty out there from nature to man's own accomplishments to interaction with humanity; and we should embrace that in whatever balance that is to each own's desire.

          For myself, we plan to slow down as we launch the kids but stay very much engaged in my medical practice as it gives us balance in our lives.  It's always been much more than financials -- that's just been a nice perk.

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          • #6
            I went to dinner last night with a friend whose husband died a week ago of ALS.  He worked until he could not.  He was not a doctor but a PhD in EE who founded a company that employs 1500 people.  He enjoyed solving problems and research.  Some people love what they do and thrive on it.  A friend who is a GYN is still practicing and doing surgery at 84.  He believes he will have cognitive decline if he quits.  I have a psychiatrist friend who is working 3 days per week at 72.  She is very selective about what patients she takes.  She takes no insurance.  She was originally a pends heme-onc and went back to residency at 59.  The people that I see retiring early are usually government employees or teachers.  I can't think of a single doctor that I know that retired prior to 60.  I hear people talking about doing it but it seems few do.  I always thought I would retire at 50 then 55 etc.  I like part time work with no call.

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            • #7
              I am certainly envious of anyone whose vocation is their avocation. Unfortunately, I can't say that medicine is that for me. It has been a great career choice with much personal satisfaction and financial reward, but not something that I hope or plan to be doing into my 60s.

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              • #8
                It's a balance which is a personal choice. Most people seem to choose to keep going part time into their 60's.
                I recently saw an old mentor that I hadn't seen for over 10 years a few weeks ago. He looked much frailer than I remember him, but was still very sharp. He is in his late 60's and said he was retiring. He told me it's probably better to retire on top of the game and before you get dementia or something like that. He certainly had contributed a huge amount to patients and to mentoring trainees, including myself, for many years.

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                • #9
                  I personally choose to work. I grew up in a culture that puts the stay at home mom on a bit of a pedestal so it certainly would have been easy to choose that route, but I knew that was never the right path for me. So I guess I have a different perspective. Not saying I want to work until I die but I do understand the value in meaningful work and why some would choose that. I also think it's a little, I don't know, naive or something, to think life is going to be SO MUCH BETTER once you are retired. If you die at 50 while still working and think you were cheated, I submit that maybe you weren't doing life right. I just mean that life is a journey and you should strive to find happiness along the way, not at the end, as some sort of reward. If I die at 50 I'll be sad for the future I missed out on but not because I didn't have enough joy and happiness in those 50 years. Hope that makes some sense.

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                  • #10
                    I love what I do.  It's awesome.  But I want to do it when I feel like it and not *have* to do it.  If I work a few days a month when I'm in my 60s, I don't want it to be because I jerked my portfolio around or need to pay some bills.

                    If I decide I want another luxury/sports car or add to my guitar collection, or want a first class transoceanic flight instead of flying coach, meh, whatever, I'll consider doing a bit more than what I otherwise would.  And I hope to have a purpose well beyond my profession, especially with my family, and to have a good amount of passive income to help get me there...but I don't anticipate walking out of a clinic/hospital (as a practicing physician) for the last time until I'm simply physically incapable of doing so.  I mean, even then, I could probably read PFTs from home, if they're still having humans do it by then.

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                    • #11
                      If I truly enjoyed my career I wouldnt mind doing it until I die. Unfortunately I do not. I hope to find more meaningful work after I stop being a doctor. I wish it were a career I loved but I really dont like it.
                      I truly envy those who have found work that they love and are good at. That would be better to me than being ultra wealthy.

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                      • #12




                        OP, your hunch is correct. It is absolutely better to retire early (even from medicine), then it is to work until 50 or 60.

                        If you disagree, you haven’t traveled enough, read enough, met enough people to know what is out there. Soo much more richness and beauty out there, most of it you won’t have the time to experience if you keep working.

                        I plan on retiring in my mid to late thirties. I absolutely love my job and my specialty, but I have traveled enough, immersed myself into enough cultures and languages, hiked enough mountains and seen enough sunsets, to know that there is just too much to see in life...


                        Retiring in my thirties is something I did not even contemplate since I did not make my first $1M till I was just 40. My most productive life academically, monetarily and private practice growth was in my forties and fifties.

                        But one thing I did do was travel in my twenties and thirties and forties and fifties. I have worked in three continents. I take vacation twice a year, often abroad. I read quite a few books, mostly non fiction. I have met enough people but some of the most interesting people are not those in Cambodia or Australia but my very own patients. I work four 6-hour days a week. I think this is a good balance in keeping my mental faculties sharp while at the same time not getting burned out. If my mental abilities are still up to par, I plan to work at least 2 months a year even at age 70.

                        Off to Central America in three days time. Adios.

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                        • #13
                          I have gone back and forth on this issue. When I was acutely suffering from burnout, I wanted to get out ASAP and I could not help but think about my two fellow fellows who were dead by the age of 50 and what a pity it was.

                          Now that I have crafted my job and career more to my liking, particularly as I approach part time in January, I feel that I might want do this for quite a bit longer. Maybe. (Warning, guest blog on PoF site coming soon.)

                          One thing I have observed, American professionals beat themselves up in their careers quite a bit more than they do elsewhere. Last week I was in Spain and talking to people of all kinds, there was a great sense that life was much more than working and piling up dough. I have found that Europeans seem to live much better than we do, appear healthier, and seem happier. Or maybe that is just the rose colored glasses of vacation.

                           

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                          • #14




                            It is absolutely better to retire early (even from medicine), then it is to work until 50 or 60. If you disagree, you haven’t traveled enough, read enough, met enough people to know what is out there. Soo much more richness and beauty out there, most of it you won’t have the time to experience if you keep working.
                            Click to expand...


                            .




                            I also think it’s a little, I don’t know, naive or something, to think life is going to be SO MUCH BETTER once you are retired. If you die at 50 while still working and think you were cheated, I submit that maybe you weren’t doing life right.
                            Click to expand...


                            .




                            I know a huge portion of us have a FIRE mentality and probably can’t relate to it either, but do any of you know docs like this, or even plan to keep practicing full-time until your health makes you quit?
                            Click to expand...


                            .
                            Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

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                            • #15




                              When I talk to senior colleagues, being a physician was a calling. They have a sense of social obligation to work until the end.
                              Click to expand...


                              .




                              It is literally who they are.
                              Click to expand...


                              .




                              However the aches and pains of Emr appear to be more troubling to middle aged physicians than to kill rials who have never handwritten a note or a prescription.
                              Click to expand...


                              .
                              Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried (many) bags for a lovely and gracious 59 yo Cyd Charisse. (RIP) Hosted epic company parties after Friday night rehearsals.

                              Comment

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