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There is a debate throughout the physician financial blogs regarding physicians who have expressed a desire to retire early (the RE component of FIRE).
Several have reported being shunned by their peers when they do express a desire to make an early exit from medicine.
Common themes are that there is a moral and social obligation to continue a career in medicine till a more standard retirement age. That because part of our residency salaries were subsidized by the government, we somehow have a debt to society which can only be paid by serving out a long medical career.
Is this all what FIRE docs care about?
These people imply that doctors who leave medicine early are greedy and were only in it for the money and never to help people (because if you did have a true calling to help people, why would you ever want to shorten that aspect of your life?).
Some people even argue that an early retiring doctor stole a spot in medical school/residency from another candidate who could have enjoyed a full medical career, not an abbreviated one.
Just like in personal finance, this decision is PERSONAL. Until you walk in that person’s shoes I feel that you cannot judge that person’s motives for a FIRE lifestyle.
There is increasing public awareness of physician burnout as well as much higher rates of suicide in this profession. Perhaps gaining financial independence and retiring early could have saved these individuals.
To summarize points from my Burnout Continuum post, there are a lot of external factors that slowly erode away a physician’s desire to continue clinical practice:
- Decreasing reimbursements forcing one to increase practice volume just to stay afloat
- Increasing oversight/government regulations including EHR mandates and multiple Medicare hoops to jump through to get maximum reimbursements
- Growing resentment towards the Specialty Boards as many are viewing this as just revenue generating requirements rather than truly improving a physician’s performance or improving patient care.
- Constant threat of malpractice and increasing malpractice insurance costs, forcing individuals to practice defensive medicine rather than good medicine.
- Ongoing battles with insurance companies to get approval for appropriate medical interventions.
- Media often vilifying doctors with perception that doctors are paid too much and responsible for the out of control healthcare costs this nation faces
Although the government does subsidize residency programs and is responsible for a component of a resident’s salary, I strongly feel that this does not imply that resident is indentured to society for any period of time because of it.
If you look at a typical resident’s salary and the amount of hours they put in each week, you realize that they average far less than minimum wage.
No other profession requires all the additional training a student requires to receive an MD or DO and then proceeds to pay them less than minimum wage for 3-5 years afterwards.
By voluntarily choosing to accept this, I feel a physician has more than compensated for any subsidies received.
A key to the FIRE philosophy is that it opens up options, allowing one to maximize one’s happiness.
There are many tragic stories of people whose lives were cut short before the chance to enjoy their “golden years”.
Physicians are notorious for always having a Type A personality and tend to work hard now so that they can enjoy later. Unfortunately that later is not a guaranteed thing.
An individual who has FIRE’d can make the most of what remaining time is left, exiting the rat race early.
By achieving financial independence you can tailor when and where you choose to work as well as how much. Physicians who have taken this path have reported increased satisfaction with both their work and home life.
You can eliminate components of your practice that you no longer like (for example many ObGyn docs have removed the Obstetrics component of their practice to improve their lifestyle).
For those physicians who anticipate having a full career in medicine, there is still nothing wrong with achieving financial independence early on.
Financial independence simply means that you no longer have to rely on working to support your annual living expenses, which can now be covered entirely by your investments, passive income, etc. It does not imply you have to retire early.
S
uperpower Take-home Points:
- A physician should not have to undergo shame by wanting to become financially independent and/or retire early.
- The amount of sacrifice he or she has already undergone to practice medicine has already repaid any perceived obligation to society
- Becoming financially independent does not automatically require early retirement
- Many physicians continue to work after becoming financially independent having greater job satisfaction in the process as they can tailor their work
- Time is not guaranteed
- Achieving financial independence or retiring early will help make the most of what time remains.
Have you told colleagues of plans to become financially independent or even retire early (or are you afraid to share)? And if so were you greeted with a positive or negative response?
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I haven’t discussed early retirement much with my colleagues, but I would hope there wouldn’t be any push back over someone making such a personal decision as whether or not to retire early. Most of the people I work with seem generally content, but the growing issues you mentioned above (frustration with MOC, EMRs, decreased compensation, increased regulations) have created a good deal of empathy for anyone who decides he or she just can’t handle it anymore. Medicine is a calling, and I don’t believe you can continue to provide high quality care if you have reached a point where… Read more »
I appreciate the comment Ray. My colleague and I are both on the fast track to leaving medicine early but really haven’t advertised it to anyone yet. I figure about a year before I really want to jump ship I will start letting people know so that they might be able to recruit a replacement (and honestly I have no problem working beyond that year until they find an adequate replacement). Ideal situation for me would be transitioning to a part time job (3 days a week sounds like bliss to me (and I’m already at a 4 day work… Read more »
Hello XRV, The first time I heard someone say to me that I owed society to keep working, I could not stop laughing in their face. I think that I must be wired differently since some girlfriends have expressed how upset they were when people say that to them. It’s all rather odd. If anyone told me that I had to work for X number of years, I’d NEVER do it to begin with. I could care less if anyone wants to stop working except that I really hope they have saved enough since life tends to have things that… Read more »
Thanks MB for the comment. Yeah I honestly don’t think if I had negative comments about leaving medicine early it would effect me at all. And you hit the nail on the head. You only have one go around so do what brings you the most happiness and if that means retiring early and you are able to do it, by all means go for it. Society survived before you were working. It will survive after you leave too.
As we’ve talked about before…being “financially independent” gives you *options*. FI, and want to take Q2 call for the rest of your life?….go ahead, be my guest. FI, want to put up with incredible BS in a bad system, because you “owe it to society”? Sure, have at it. FI gives you options, and the power of “no”. FI lets you avoid the fate of the 70 year old OB/Gyn I once worked with….whose trophy wife (no longer a trophy, more of a white elephant) was spending out of control, creating a situation where he literally would work until he… Read more »
Thanks planedoc for another insightful comment (really appreciate them by the way). I love Dave Ramsey’s quote, “Live like no one else so you can live like no one else.” It definitely applies to the FIRE community. We are a rare breed of docs that have taken on the FIRE movement and as such are able to do things that a majority of docs won’t. I have tried to spread the word to my colleagues as much as I could when I first heard of FIRE. Some have changed because of it. Most have not. But those who did not… Read more »
I didn’t know that there was so much FIRE-shaming in the physician community. I guess I could see how other physicians shame FIRE’d physicians due to supposed “moral obligation” but I just don’t buy it. A part of me thinks that some of them are just making up excuses and, in a way, psychologically projecting. Perhaps they themselves wish that they could FIRE too, but can’t (due to their extravagant lifestyle and inability to pare down expenses). So maybe these high lifestyle “Dr. Jones'” try to shame the FIRE’d docs out of envy. Just a thought 🙂
Great point for sure. I have read on some other blogs on Physician FIRE and there were a couple of comments (not sure if they were made by physicians or not though) about how government subsidized our training therefore we owe society and that a FIRE physician took a spot away from another student who would have practiced longer if given a chance (and that was hypothetical too, who knows if that replacement student would have just as easily FIREd).
When my colleagues heard I was retiring, the most common response I got was:
“Congratulations. I wish I could do that.”
I had practiced 20 years in the same office so most of them felt I had a good career in medicine.
Live your life, not theirs. It doesn’t matter what anyone else thinks about your retirement date, except your spouse. Go for it. You only live once.
Dr. Cory S. Fawcett
Prescription for Financial Success
Hey Cory. Awesome your colleagues were happy for you. I certainly would be if someone I worked with did that too. I’m a few years away from doing it myself so hopefully have same experience
“The amount of sacrifice he or she has already undergone to practice medicine has already repaid any perceived obligation to society”
Yes that was my thought! When I first heard of RE in physicians I thought..oh that’s odd, they don’t want to heal people anymore? But really it’s more like the amount of debt and good they’ve done to society should warrant them an earlier and better retirement. Med school costs are riii-dunk-ulous.
Thanks Lily for the comment. I think if you ask any physician, the desire to help people will always be there at any age. It is a struggle between this ideal scenario and reality. I have gotten disenchanted with the system for awhile now. Do you know that if a doctor orders a thyroid ultrasound and a carotid ultrasound (both in the neck but looking at different items), the insurance company will not allow it? So we basically make the patient come in on a separate day so we can rightfully charge for both studies. It is inconvenient for the… Read more »
When I got out I went into the Navy for a few years. I was a cardiac anesthesiologist getting paid a $32K per year LT salary plus a bonus taking care of the troops and retired. It was my pleasure to be their physician. I raised my right hand and pledged to protect your sorry ass with my life. Later in private practice I was the guy who showed up at 2 AM to attend your C-section or gun shot wound usually for free or maybe getting paid enough for a cup of coffee. “Society” got their due in spades… Read more »
I agree. Any physician who has practiced any amount of time has performed services for free or little money and that is indeed another way the perceived debt to society is erased quickly
I’m actually happy my fellow physicians get to FIRE. Good for them. As I’ve gotten older, I’ve slowly cut down on calls and no longer work weekends. I’m much happier and still enjoy work. Happy 4th XRV!
Hope you had a great 4th as well VP. Glad you are able to tailor your work to something more tolerable with less call and weekend.
I am spoiled in that regard, working 4 days during the week only and no call. Even so I look forward to cutting back even more.
Most of my colleagues seem to assume FIRE is unobtainable. I have been FI for some time, but I discuss RE only in the abstract with them.
I do think a lot of my colleagues feel the same way too. It really is achievable for a physician to do so within 10-15 years of being an attending. However majority don’t because of lifestyle inflation etc.
Many doctors leave medicine early. FIRE is no different than leaving the work force because you have children. Gender is a social construct so it is completely acceptable for a gender neutral doctor to be in medical school and residency and decide to leave after one year of practice. It does not matter the reason- EVERYONE should be able to quit without worrying that you are contributing to the shortage of physicians in the US (assuming this is talking about the US). I have just as much respect for a doctor leaving medicine due to FIRE as any other reason.… Read more »
I agree 100% with this take. A doctor should be able to leave medicine without judgment from peers, family, or the general public.
If there is a debate on the doctor shortage it should not be based on attacking the doctor who chooses to leave early but on the reason doctors are leaving and why burnout in medicine is so prevalent. Address that topic and fix it and perhaps doctors won’t want to exit early