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At what net worth did you start to cut down on your clinical schedule?

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  • #46
    Originally posted by CordMcNally View Post

    To be fair, that's a similar sentiment that you'll find in pretty much every aspect of life. Even in our immediate family we'll be nearly forgotten after 3 generations. Life has a way of moving on with or without us.

    My grandfather used to send me money on random occasions during college and med school. Usually a check for $20 with a note that said “go buy yourself a pizza”. The money was always useful and the fact that he sent it meant a lot to me. Then one day when reminiscing about how he hitchhiked across the county as an 18 year old to go to college prior to becoming a pilot and serving in WWII he made a comment about how his grandfather would give him money for the journey and for random things. Obviously I never met my great great grandfather but that story made him real to me. I’m looking forward to sending money to my great nieces and nephews someday and working in the story of how their great great great great grandfather helped their great great grandfather achieve his dream of being a WWII pilot and how he later helped me achieve my dream of becoming a doctor and flight surgeon.

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    • #47
      I have considered going to part-time now but when I take random days off I come back to lots of messages/in box requests etc so I question whether I would enjoy the part time schedule more or just have more stuff to do on the days I’m there. Right now I plan to work until the bad things at work overshadow the good (right now there is still a positive balance although there has been a downward trend over the past year) and then say sayonara. That being said, my full time is 40-45 hours/week and I never work nights/weekends/take call, and haven’t since residency.

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      • #48
        Originally posted by Anne View Post
        I have considered going to part-time now but when I take random days off I come back to lots of messages/in box requests etc so I question whether I would enjoy the part time schedule more or just have more stuff to do on the days I’m there. Right now I plan to work until the bad things at work overshadow the good (right now there is still a positive balance although there has been a downward trend over the past year) and then say sayonara. That being said, my full time is 40-45 hours/week and I never work nights/weekends/take call, and haven’t since residency.
        This. Full time work at a steady level is relatively benign and taking time down further really results in compressed inbox stuff that simple builds up from days off so efficiency is lost.

        We just launched the youngest to college and spent the first weekend with a free schedule. Wow. cant' imagine adding 8-16 more hours to this near term being only 49.

        Probably when GKs arrive, then will seriously back off time and even retire to pickup new granparenting skills and shift focuses.

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        • #49
          Originally posted by StarTrekDoc View Post

          This. Full time work at a steady level is relatively benign and taking time down further really results in compressed inbox stuff that simple builds up from days off so efficiency is lost.

          We just launched the youngest to college and spent the first weekend with a free schedule. Wow. cant' imagine adding 8-16 more hours to this near term being only 49.

          Probably when GKs arrive, then will seriously back off time and even retire to pickup new granparenting skills and shift focuses.
          I work Monday-Wednesday only, and find plenty of things to do in my extra 8-16 hours a week, but it’s true, if you don’t have enough interests/hobbies to fill that time it might bore you. As Anne said above, the one disadvantage is that I have to log into the computer on Sunday and do 1-2 hours of work to make up for not being there on Thursday and Friday, but to me it’s worth it.
          Last edited by HikingDO; 09-26-2021, 05:20 PM.

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          • #50
            My job was never that time consuming. About 30 hours of real work a week so no complaints there.

            When I reached my FI number we talked about future options and going part time and doing locums. Once the time came to pull that trigger I quickly got to my fatfire number and don’t even need to work part time anymore.

            I’m late 30s and enjoy my new ‘job’ and routine. I thought I would miss my old life and routine but I think the secret is to keep your mind and body occupied with something you enjoy.

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            • #51
              Originally posted by HikingDO View Post

              I work Monday-Wednesday only, and find plenty of things to do in my extra 8-16 hours a week, but it’s true, if you don’t have enough interests/hobbies to fill that time it might bore you. As Anne said above, the one disadvantage is that I have to log into the computer on Sunday and do 1-2 hours of work to make up for not being there on Thursday and Friday, but to me it’s worth it.
              Absolutely can occupy my time with going full Lego building and finally crack into backlog of gaming since hanging up my addiction during medical as school. Then again two days maybe not enough if I slide back into those hthoses in earnest .x🥰

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              • #52
                Originally posted by mitochondria View Post
                I really struggle with this issue. I'm married (age mid-50s) with no children. House paid off and we have no other debts. 5.5M (with 1.3M in Roth included) in retirement. I am not sure if it is a genuine financial concern issue or a "I'm actually thinking about walking away from everything I've built in my career, such as, co-authoring high impact journals, professor with tenure, guiding young professionals and watching them successfully advance through the years, etc..." issue. What message do I send to the young faculty if I walk away in my late 50's? I am constantly telling young folks to please educate themselves on financial management and save, save, save. Thus, it should not be a surprise to them if I decided to retire before 65. Most folks my age think of moving into leadership positions. I have seen very few physicians who are happy as administrators.

                What am going to do? My whole life has been the hospital and university. My wife retired a few years ago (also a physican) and she says that she has no regrets. It's hard for me to reflect in a contemplative manner on what it will be like leaving medicine when it seems that I am always in crisis management mode with regards to the university and hospital.

                I have this magic number of retiring at 60, but my body is telling me that the calls (I'm an ICU doc) are taking a considerable toll and it is getting tougher to recover as I age. Mother nature may make the decision for me. I will be eligible for an university subsidized health insurance in a few months if I retire early (this means I would be allowed to purchase the health and dental insurance insurance at university rates out of my own pocket until age 65 if I decide to retire). At the moment, I feel that I must stick this out because the COVID-19 pandemic is wearing everyone (physicians and nurses) out. This is complicated by the fact that we are losing nurses who are getting ridiculous offers that I can not blame them for taking. The perfect scenario would be for the pandemic to calm down, our nursing core gets re-established and I give an 8 month notice so my colleagues have plenty of time to recruit someone. I don't know if that perfect scenario is consistent with reality...
                Resonated with me as I literally just finished reading “Die With Zero” by Bill Perkins. HIGHLY recommend for all who’ve posted (or read) this stream. A very empowering argument for rethinking a traditional “I’ll work hard and some day retire and enjoy it” philosophy.

                Soon cutting back to few d a week, far past FI. And per the book, spend majorly the next 15 years!

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                • #53
                  Originally posted by SpacemanSpiff12 View Post

                  Thanks for sharing. I agree with the sentiment you expressed. These two articles (one by @VagabondMD) resonated with me and touch on many of the points you made.

                  The Hospital Will Not Love You Back: https://thephysicianphilosopher.com/...-guest-post-2/

                  Understanding Academic Medical Centers: Simone’s Maxims
                  https://clincancerres.aacrjournals.org/content/5/9/2281
                  Thank you SpacemanSpiff12 for the links. Greatly appreciated!

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                  • #54
                    Originally posted by ScopeMonkey View Post

                    Resonated with me as I literally just finished reading “Die With Zero” by Bill Perkins. HIGHLY recommend for all who’ve posted (or read) this stream. A very empowering argument for rethinking a traditional “I’ll work hard and some day retire and enjoy it” philosophy.

                    Soon cutting back to few d a week, far past FI. And per the book, spend majorly the next 15 years!
                    Thank you ScopeMonkey. I'll read "Die With Zero"!

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                    • #55
                      Originally posted by ScopeMonkey View Post

                      Resonated with me as I literally just finished reading “Die With Zero” by Bill Perkins. HIGHLY recommend for all who’ve posted (or read) this stream. A very empowering argument for rethinking a traditional “I’ll work hard and some day retire and enjoy it” philosophy.

                      Soon cutting back to few d a week, far past FI. And per the book, spend majorly the next 15 years!
                      I'm listening to a podcast interview featuring Bill Perkins now. Some of his arguments are interesting, but I have to ask before committing to reading his book... is the advice he gives relevant considering it comes from a guy worth $65MM?

                      It just seems like the concept of "spend now, die with zero" is much easier when you're rich enough to buy an island, a private jet and a yacht, and still have Scrooge McDuck piles of money leftover.

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                      • #56
                        I cut back due to the pandemic and do not plan on going back to full time again. My decision was not based on net worth. The pandemic definitely made me think about what was important to me, which actually includes work.

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                        • #57
                          Originally posted by mitochondria View Post

                          Thank you SpacemanSpiff12 for the links. Greatly appreciated!
                          Couldn’t agree more. The rules of academic medicine article is spot on.

                          One nice aspect of academics is that you have the opportunity to leave behind a literature trail (manuscripts, textbooks, patents) that will be leveraged by future generations. Also, trainees form a second type of family that, at least for a couple of generations, may trace its lineage and history. It still ultimately becomes dust in the wind, of course, but in my field the elderly are often celebrated at annual meetings by former trainees or societies in which they were active. They are valued consultants for industry and academia. I think this makes it hard for many to ever retire and they keep that emeritus position and small office until they can no longer physically show up.

                          Maybe it’s ego, maybe it’s wanting to still be able to mentor and influence, but decoupling from that lifestyle seems pretty difficult. And in most cases it’s not about the money.


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                          • #58
                            Originally posted by mitochondria View Post
                            Thank you Tangler for your insightful reply. There is validity to several of the points you are making. What really struck me at my institution is that we had a very hard working successful surgeon. Everyone raved about him and understandably so. He ended up passing away in his 40s. A webpage was created and everyone (staff and patients) left their condolescences and shared their memorable stories. A year later, he was an afterthought to the masses. The organization moved forward.

                            One of my close colleagues at work passed away a few years ago. We had a service for him and it was devastating to the whole staff. Since then, we have recruited his replacement. The hospital administration is new, the medical school leadership is new and 90% of the nurses are new. When I refer to what his approach was to a given clinical situation when I teach residents and fellows, nobody knows who he was. He has only been gone for about 5 years. To their credit, there are 3-4 previous fellows who get together on an annual basis to remember him, but all in all the healthcare and academic system moves forward. The systems did not collapse in his absence, but rather filled his spot with someone else. I continue to look at his absence as a terrible loss to our team, but it has also given me a new perspective on what I should be valuing.

                            A few months ago, I was interviewing a seasoned administrator for a hospital administrative position. When I asked her how she handled difficult situations/challenges in the past, she replied that she had profitable hospital that was doing well. She then smirked and stated, "and then the neurosurgeon unexpectedly died!". She went on to elaborate that it really put the organization in a brief tailspin because "all of a sudden our neurosurgical service line was in crisis" (I paraphrase). They eventually recovered by recruiting another neurosurgeon, but she learned that there will be bumps in the road with staffing and that you just need to focus on the big picture and you'll perservere. Not once did she express any sadness or remore that a highly skilled professional suddenly loss their life in perhaps the peak of their career. That moment solidified my perspective of the system in general...
                            one of the best pieces of advice i ever received from my residency PD: institutions don't love you back.

                            i've seen this time and time again, and never noted an exception yet.

                            it doesn't mean you shouldn't throw your heart and soul into your job, just that you should remember that the most important things in life never happen when you're wearing work clothes.

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                            • #59
                              Originally posted by StarTrekDoc View Post
                              Probably when GKs arrive, then will seriously back off time and even retire to pickup new granparenting skills and shift focuses.
                              Grandparenting skills and parenting skills are completely different. However, daycare and babysitting are services that grandparents can be much preferred to an outsourcing option. Define the skills you are planning to develop. Parents need to grow their skills as well. Be there if needed is a good philosophy.

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                              • #60
                                Originally posted by SpacemanSpiff12 View Post

                                I'm listening to a podcast interview featuring Bill Perkins now. Some of his arguments are interesting, but I have to ask before committing to reading his book... is the advice he gives relevant considering it comes from a guy worth $65MM?

                                It just seems like the concept of "spend now, die with zero" is much easier when you're rich enough to buy an island, a private jet and a yacht, and still have Scrooge McDuck piles of money leftover.
                                Short answer: yes, it applies. Read it, trust me.

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