Smart Money MD

We talk about money on this website, and how to make sure that you have enough of it.  In fact, that’s pretty much the entire strategy for the growing crowd of people in the world who are gunning to retire at an age that most neurosurgeons start their careers.

Those of us in the medical field who also have similar ambitions to work our finances intelligently are likely to have similar end-game strategies in our profession, albeit less extreme.  Sure, it’d be great to give your boss the finger, sell your house, and move the entire family down to St. Kitts. What’s not to like?

The reality is that even if pipe dreams like that may not be palatable even if we have the means to do so; family, kids, friends, and our contacts will have to be on board if we expect to continue interactions with them. You know how that will likely end—not well.  The interesting aspect, however, of being a physician is that the public expects you to have money.  Even if you are only rocking a paltry $120,000 a year in a low-paying specialty, you are still a high-earning doctor to your non-medical friends (even if they earn more than you and not realize it).

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In this scenario, walking away completely from medicine may actually be more socially acceptable.  Dr. X, who drives a fleet of Tesla X’s, probably doesn’t even need to cut back on his expenses to afford a third home in Puerto Vallarta.  No one will bat an eye if you hung up your doctor hat.  What you need to be aware of is how attached you are to your profession.

Your self-image will be impacted after your leave medicine

What might be more critical is how you will accept changing your professional identity if you decided to change what you do.  I work with plenty of hospital administrators who have a medical degree, but no longer practice medicine.  These are typically internists, family practictitioners, and emergency room physicians.  These doctors have all rationalized to me that they saw a new calling outside of clinical practice. Many of them found administration to be more interesting than what they did previously and found that they could impact the medical paradigm more meaningfully through other means. Fair enough. They still are contributing to the healthcare system through other means.

Let’s say that you decided to leave your job as an ear, nose, and throat specialist at the age of 45 to work on your woodworking hobbies.  You’ve made your $4 million safe withdrawal fund, sell your wood-turned teak corner tables at the local artisanal market, and maybe earn enough to pay the utilities every month. Can it be fathomable that you had just become a newly minted attending slightly over ten years ago, yet you are now contemplating letting your board certification lapse?

Most of your classmates will still be ramping up their careers, building their practices, and working long hours. They will be working on research projects to present at the next annual society meetings. Would you be ready to transition to a non-practicing status on your board certification? What do you intend to tell your classmates at your ten-year medical school reunion what you ended up doing with your life?  Furthermore what would it feel like to exit a career that you toiled for decades to gain admission into? Can you still call yourself a doctor if you’re no longer practicing medicine or considered a viable practitioner by your specialty?

Prepare for the end goal while you’re working towards it

Several of my mentors are practicing medicine well into their 70’s, only because they cannot see themselves doing anything else outside of their profession. On the other end of the spectrum, millennials and younger doctors have other intentions in mind.  Avocado toast, luxurious honeymoons in Hawaii, baby moons in Bali, and enjoyment of four-day workweeks are all part of the plan.  Whether you are part of this younger doctor generation or cringe every time your potential hires tell you they need to have Tuesday and Thursday afternoons off to pick up their kids from grandma, the principle is to simply find a means to set your priorities and stick with it.  

If you intend to crank through a decade of sleepless nights in your profession to maximize your income, reach fatFIRE, and call it quits, that’s okay. Be sure that you will be okay with what you intend to do hit your goal. Would working 0.5 FTE be adequate to maintain your skills and foot in the door? Is that even possible with your specialty? Would you be completely miserable leaving medicine completely?

Case in point: I had a colleague who retired at least 5 times before finally officially retiring. Even now, he’s anxiously itching to find ways to continue medical work without being officially employed. He’s in his mid seventies.

Whatever you decide to do, do it with a purpose. Remember, no regrets!