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Greetings from western Massachusetts
Old 07-18-2012, 09:39 AM   #1
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Greetings from western Massachusetts

I have been reading this incredibly informative, opinionated and witty forum (without ever posting--shy!) for many months as I navigated ER from medical practice. I am eager for feedback and advice!

I am 55 years of age, single now for about as long as I was married, with children 21 and 23 who are more-or-less "launched". I worked as an oncologist for almost 30 years before getting real career fatigue/burn-out. I plotted ER for 2 years before exiting in December 2011 (a very difficult transition with unhappy partners and patients, but I HAD to get out or I would have become quite a basket-case!). At the same time as I ER'ed, I moved from a medium city in the midwest (St. Louis) to a college town in Massachusetts. Much of my professional life was spent in St. Louis although I had lived happily until age 34 in the Northeast. My new community has a slightly higher cost-of-living than St. Louis. The best parts of living here are the many things to do both indoors and outdoors (kayaking! hiking! bicycle paths! tons of concerts and museums!), as well as proximity to family (brother, dad). I am so happy with my decision. My stress has melted away.

I have always lived a "moderate" life and saved, even as my physician partners were spending every dollar of our (large) salaries on vehicles, second homes, country clubs etc. My net worth is around $3.1M. I have no mortgage on my primary (only) home and my children's college expenses are/were covered completely. I pay for medical insurance on the Mass state exchange (it isn't cheap!!) My AA is roughly 45/45/10 equities/fixed/other, with a "ladder" of munis/bonds/Tbills set up for the next 8 years (and intended to continue rolling over as I use up each year's monies) to cover all my day-to-day expenses. The remainder is in index and low cost funds (Wellington etc), commodities/real estate funds as well as a charitable trust of 120K (latter not included in NW). I had help from a financial advisor to set all of that up about 3 years ago.

I anticipated ER income to be $96K/year after taxes. I do like to try new restaurants, listen to live music, travel. I still give some financial support ($1K a month, split) to my two children (one is still in college and one is working but not quite making enough to be entirely self-sufficient). I did some renovations on my new home here which are now complete and that was a separate budget (but did run over my estimate of course).

Questions:
1) After 6 months of ER I find I miss the challenge of my work, but not the stress and exhaustion. How to reinvent some form of work as a pleasurable activity? It is extremely hard/impossible to work "part-time" in my field. I have considered a 6 month stint in "Doctors without Borders" to mix adventure with service. Anyone with experience in leaving medicine/ministry/teaching etc who has navigated the loss of self-identity as "someone who serves"? Volunteer opportunities exist here--how has that worked out for those who have jumped in? How to find "meaning"?

2) I seem to keep having unexpected expenses I didn't budget for (high vet bill, new appliance, more $$ than I thought to furnish home...). If I need to re-vamp my budget upwards by 10% does this mean I have "failed" ER? FIREcalc said 99% success at my original budget. Do things smooth out with time? Should I assume this is just "first year" spending or did I mis-calculate?

3)There are some unique challenges to being a single ER person, such as losing some of the economies of scale of having a partner. Any insights from other single folks here?
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Old 07-18-2012, 10:16 AM   #2
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At the same time as I ER'ed, I moved from a medium city in the midwest (St. Louis) to a college town in Massachusetts.
I lived in Northampton, MA for a year and loved it. If I wasn't thinking of ER in the UK, Northampton would be my choice.

As far as budget goes this is what I am planning. I've tracked my spending for the last 2 years, so I know the pattern of my budget. My ER budget is my current budget plus a 10% contingency and I plan to have one year of expenses emergency fund that is completely separate from my asset allocation.

As far as budgeting as a single I find it easier than when I was married. I can control of the spending and forego things that might seem like necessities to others without feeling any hardship. For example, I rarely use milk.......most people must have a couple of pints in the fridge, but I don't like the stuff. As a single I only need one car and many times I use my bike for short trips. With two you'd have to use the car......unless you had a tandem
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Old 07-18-2012, 11:58 AM   #3
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Welcome aboard, Rachel! Sounds like you've managed to pull off a successful early retirement. Congratulations.

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Old 07-18-2012, 01:20 PM   #4
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Welcome to the forum, Rachel.
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Old 07-18-2012, 02:03 PM   #5
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Welcome, Rachel! Good for you on escaping the stress before it got the best of you.

On your questions:
1) Although I was not in the "service to others" world, my identity was still wrapped up in my w*rk. I have found volunteering to be very rewarding and helpful in providing a sense of worth, purpose, and usefulness. I do have one acquaintance who is a retired OB/GYN who goes on medical mission trips regularly (mostly South / Central America). He did a couple of short (2-week) trips before he retired and now I think goes for about a month at a time several times a year. You might want to try a short stint first with one or two organizations before you commit to an extended tour. Also, with your background, I would expect local nonprofit medical clinics or organizations such as LiveStrong would value your expertise as a volunteer.

2) If you've always lived moderately, my guess is the extra spending is some "pent up demand" that's related to your move and/or your retirement, possibly also combined with not enough "contingency" allowance in your budget. I suggest tracking your expenses closely for at least a year before you decide which it is. And no, it doesn't mean you "failed" if you have to adjust things - it sounds as though you have a decent amount budgeted for discretionary items so worst case is you need to cut back a bit on that to cover the contingency when needed.

3) Sorry, can't help on this one since I haven't budgeted as a single person for many moons.
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Old 07-18-2012, 06:49 PM   #6
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Welcome Rachel. I'm almost 49 and would like to ER like you at about 54 or 55. I am an interventional radiologist and have been burning the candle at both ends for way too long, all by my choice of course. And I'm on call right now actually. We have a very busy oncology service and I really enjoy working with all the onc patients (placing ports, biopsies, etc). I found this site looking for some help with winding down this dog and pony show, since I have gone from loving my work to "liking" my work. I'm so grateful for the wisdom on this site and I appreciate your willingness to share your finances b/c the specifics give me a better gauge on where I am relative to desired lifestyle in retirement.
I could add "amen sista" to your description of partners engaging in the fast moving treadmill of lifestyle creep. Kind of scary.
1. I have thought about volunteer work and teaching part time (very part time) but I don't really have a strong desire to practice medicine after ER. I have partners over age 70 still working 10 hour days and they are NOT happy. The fear of ending up like this scares the bejeebies out of me.
2. Agree with MBAustin, your post tells the story of someone who knows how to live within their means and adjust when necessary. Quite frankly I'm very impressed...your financial status after divorced and raising two kids is pretty awesome.
3. I have three children (only one in college so far) and a wonderful wife who is a pretty frugal gal, so I can't comment on the economics of singlehood.

Look forward to hearing more about your post ER life.
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Old 07-18-2012, 07:43 PM   #7
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Welcome Rachel! I a also a single MD, a neonatologist. I'm still w*rking but moved about a year ago to my desired ER location. I was saving furiously prior to the move but found that I needed to spend more on new furniture, decorating, etc, etc., mostly one time purchases. When all was said and done, if one time expenses are excluded, expenses were not unreasonable, and this year I am back to my previously frugal ways. So give yourself some time to settle in. You are in great financial shape.

Oncology is a highly stressful field and I totally understand why you wanted and needed to move on. For some physicians, dealing with that stress means buying expensive toys. This morning I parked my 17.5 year old Accord next to a really cool Porsche convertible, which I admired, but realized it had no appeal for me personally. So I went out and put a deposit on a new Honda CRV at a fraction of the price.
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Old 07-18-2012, 08:21 PM   #8
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Welcome Rachel , I worked as an RN for forty years before retirement & burn out . I love Northampton . My daughter went to U of Mass and I fell in love with western mass especially during fall foliage .Take time to relax before you consider the next move .
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Old 07-18-2012, 08:27 PM   #9
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I went out and put a deposit on a new Honda CRV at a fraction of the price.
Wow ! Congratulations !
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Old 07-19-2012, 12:57 AM   #10
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Welcome, Rachel, from an another clinician. Same ballpark net worth numbers than yours, maybe a bit less if I exclude my home. I am 47, not ER'ed yet. Planning on 70k-100k annual withdrawals, with an average of 92k until age 95. Not financially savvy and useless at budgeting, but learning from this website. Totally burnt out with insane hours and sometimes very difficult patient situations. Most of my posts here are between 1am and 4am... I never sleep more than 4 or 5 hours in a row.

Q1 - Very active also in Central America where I provide healthcare services in a couple of clinics a few times a year - next trip takes place in September. You may wish to do something similar, it's a great feeling to give back.

Q2 - yes, unexpected expenses are part of life.

Q3 - single here too. Never been happier.
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Old 07-21-2012, 09:15 PM   #11
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Rachel, I am a Rad Onc age 46 (married, children ages 13 and 12) hoping to work full time for another year and a half then transition to locums. I am not burned out with rad Onc, but am burned out with the medico politics and increasing burden of stuff I have to do during the day that has nothing to do with taking good care of patients. Like you, I have been relatively frugal, which give me the opportunity to escape the rat race while all the other docs live more or less paycheck to paycheck paying for Porsches and 5000sf homes and 2nd homes. Have you thought of locum work? The appeal of locums vs. complete retirement is I figure if I really wanted to take that exotic vacation, I can work a couple of extra weeks (without the hassles of my own practice) to pay for it.
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Old 07-22-2012, 12:26 PM   #12
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Originally Posted by Rachel View Post
I have been reading this incredibly informative, opinionated and witty forum (without ever posting--shy!) for many months as I navigated ER from medical practice. I am eager for feedback and advice!

I am 55 years of age, single now for about as long as I was married, with children 21 and 23 who are more-or-less "launched". I worked as an oncologist for almost 30 years before getting real career fatigue/burn-out. I plotted ER for 2 years before exiting in December 2011 (a very difficult transition with unhappy partners and patients, but I HAD to get out or I would have become quite a basket-case!). At the same time as I ER'ed, I moved from a medium city in the midwest (St. Louis) to a college town in Massachusetts. Much of my professional life was spent in St. Louis although I had lived happily until age 34 in the Northeast. My new community has a slightly higher cost-of-living than St. Louis. The best parts of living here are the many things to do both indoors and outdoors (kayaking! hiking! bicycle paths! tons of concerts and museums!), as well as proximity to family (brother, dad). I am so happy with my decision. My stress has melted away.

I have always lived a "moderate" life and saved, even as my physician partners were spending every dollar of our (large) salaries on vehicles, second homes, country clubs etc. My net worth is around $3.1M. I have no mortgage on my primary (only) home and my children's college expenses are/were covered completely. I pay for medical insurance on the Mass state exchange (it isn't cheap!!) My AA is roughly 45/45/10 equities/fixed/other, with a "ladder" of munis/bonds/Tbills set up for the next 8 years (and intended to continue rolling over as I use up each year's monies) to cover all my day-to-day expenses. The remainder is in index and low cost funds (Wellington etc), commodities/real estate funds as well as a charitable trust of 120K (latter not included in NW). I had help from a financial advisor to set all of that up about 3 years ago.

I anticipated ER income to be $96K/year after taxes. I do like to try new restaurants, listen to live music, travel. I still give some financial support ($1K a month, split) to my two children (one is still in college and one is working but not quite making enough to be entirely self-sufficient). I did some renovations on my new home here which are now complete and that was a separate budget (but did run over my estimate of course).

Questions:
1) After 6 months of ER I find I miss the challenge of my work, but not the stress and exhaustion. How to reinvent some form of work as a pleasurable activity? It is extremely hard/impossible to work "part-time" in my field. I have considered a 6 month stint in "Doctors without Borders" to mix adventure with service. Anyone with experience in leaving medicine/ministry/teaching etc who has navigated the loss of self-identity as "someone who serves"? Volunteer opportunities exist here--how has that worked out for those who have jumped in? How to find "meaning"?

2) I seem to keep having unexpected expenses I didn't budget for (high vet bill, new appliance, more $$ than I thought to furnish home...). If I need to re-vamp my budget upwards by 10% does this mean I have "failed" ER? FIREcalc said 99% success at my original budget. Do things smooth out with time? Should I assume this is just "first year" spending or did I mis-calculate?

3)There are some unique challenges to being a single ER person, such as losing some of the economies of scale of having a partner. Any insights from other single folks here?
I live in western mass also but not Northampton. sounds to me like you are doing fine. Just don't overthink it. stay relatively frugal and you will be fine.
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Old 07-24-2012, 09:37 PM   #13
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Great to hear from others in medicine facing similar challenges. The ideas of locum tenens and mission work are right on the money for me. Thanks especially for the support to not overthink things and continue to live frugally (with joy).
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Old 07-25-2012, 08:49 AM   #14
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Welcome Rachel. You've done well and seem to be well positioned for ER. Congratulations. I retired in Dec 2011 as well at 56.

Sounds like some volunteer work, at first locally and then beyond, either in your field of work or in a related field would be fulfilling for you. I haven't gotten to that point yet but I recognize that it may come someday.

Given your recent move, I wouldn't fret about the new appliances, furniture, etc. It seems to me that these are just a part of moving and getting settled into a new place. Besides, at your level of new worth and spending I suspect that if the higher level is not an anomaly that you could adjust as needed.

Long time married so I can't comment on the single thing other than to say that I'm sure there are dis-economies of scale but it sounds like you are used to dealing with them.
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Old 07-25-2012, 09:52 AM   #15
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Hi, Rachel!
I am the fellow MD who told you about this site. I hope to be joining you in ER about 17 months. Fear and apprehension about having "enough" are still stalking me. Being married makes it tougher, as I would be happy living a much simpler lifestyle than my wife may, somI have to be confident we have enough to do so. As you know , she is not interested in ER and is passionately involved in her work. Oddly I do not at present have any concern about missing this life at all, but in reality it may happen.
One of our colleagues -a gastroenterologist who recently moved his group from my hospital to your old hospital-goes to Peru every year with a medical mission so you may want to contact him. Then you could be with some folks you already know. Call me if you don't know whom I am talking about- I don't want to post his name on here. (INITIALS PB)
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Old 07-29-2012, 04:13 PM   #16
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To all of you medical folks who are early retirees.. Great... and Congratulations on getting there... A long and happy life!

On the other side... what are all of us oldsters going to do, when the doctor shortage gets worse?
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Old 07-29-2012, 04:31 PM   #17
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Don't worry, most docs have to work until a ripe old age to maintain appearances. Also, there are more medical students enrolled than ever before, even though the number of applicants have been trending downward since 2002. Now access to those docs.... That's a loaded political issue I won't try and answer!
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Old 07-29-2012, 05:08 PM   #18
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Don't worry, most docs have to work until a ripe old age to maintain appearances. Also, there are more medical students enrolled than ever before, even though the number of applicants have been trending downward since 2002. Now access to those docs.... That's a loaded political issue I won't try and answer!
+1. ER for physicians, IMHO, is uncommon. I would think both identity and lifestyle issues come into play. I imagine the OP's partners flipped out when she announced she was going into "operation ER"!
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Old 07-29-2012, 11:34 PM   #19
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Forget early retirement. In my experience most MD have zero plans for retirement- period. Many have gotten on the never ending lifestyle escalator. Many have planned poorly to pay for their children's education. Many are defined by their job and would not know what to do with themselves if not doctoring. These latter types are very common in the older generation. One still sees them hanging around at Grand Rounds lectures. They always make a point to ask a question or more typically just raise a hand as if to ask but actually just to make some comment they think is profound, but strikes me usually as a pathetic cry to remain relevant. Also they show up in the doctors lounge. Is it for the free coffee and donuts because they also planned poorly to provide for their retirement? Or just another sad effort to somehow stay connected to what once made them feel important? Finally there are those who absolutely love what they do and keep doing it as long as the system lets them whether they are any good at it or not. Ultimately I still think many of these love it as much for how it defines their identity as much as any joy in the actual work. Even those most enthused about the best of medicine complain about how it is changing for the worse. Most studies on this subject find that close to half of current MD would quit if they had the dough to do so. Count me in that half that want it and the much smaller fraction who have planned well enough to do it.
Is there a doctor shortage coming? Almost certainly, whether I quit or not. But with that impending shortage, those unable to quit will be suffering worse than the situation that had them wanting to quit in the first place. I would expect extremely unhappy doctors will be common place.
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Old 07-30-2012, 01:04 AM   #20
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Originally Posted by urn2bfree
Forget early retirement. In my experience most MD have zero plans for retirement- period. Many have gotten on the never ending lifestyle escalator. Many have planned poorly to pay for their children's education. Many are defined by their job and would not know what to do with themselves if not doctoring. These latter types are very common in the older generation. One still sees them hanging around at Grand Rounds lectures. They always make a point to ask a question or more typically just raise a hand as if to ask but actually just to make some comment they think is profound, but strikes me usually as a pathetic cry to remain relevant. Also they show up in the doctors lounge. Is it for the free coffee and donuts because they also planned poorly to provide for their retirement? Or just another sad effort to somehow stay connected to what once made them feel important? Finally there are those who absolutely love what they do and keep doing it as long as the system lets them whether they are any good at it or not. Ultimately I still think many of these love it as much for how it defines their identity as much as any joy in the actual work. Even those most enthused about the best of medicine complain about how it is changing for the worse. Most studies on this subject find that close to half of current MD would quit if they had the dough to do so. Count me in that half that want it and the much smaller fraction who have planned well enough to do it.
Is there a doctor shortage coming? Almost certainly, whether I quit or not. But with that impending shortage, those unable to quit will be suffering worse than the situation that had them wanting to quit in the first place. I would expect extremely unhappy doctors will be common place.
How true!
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