I can retire---and my doctor can't?!?

[sgeeeee]

sgeeeeeeeeee,

Maybe she's not telling you the whole truth.  I'll bet she always wears rubber gloves when she's around you.  It's possible she doesn't want to to leave anything behind that you've touched -- even money.

I think you might be right. I am repulsive.

 

[sgeeeee]

SG, why not give a gift to the clinic?

That's a good idea. DW and I have started talking about this recently and are looking for the best way to do it.

In addition to being a good doctor, we have great respect for what this woman is trying to do. :

 

[gtmeouttahere]

Why not give her a gift certificate, in the amount of the money owed, to a spa or some other place she could enjoy and relax after a tough work week.

You should just say on the certificate that you are "trying to keep her healthy so she can continue to keep you healthy in the future." "Thanks so much for your continuous and undying care." Or something to that effect.

 

[roadkill]

Interesting article..........



http://www.marketwatch.com/News/Sto...1CE-4754-A6B4-1C69D6761DEF}&siteid=mktw&dist=

 

[Rich_by_the_Bay]

Interesting article..........

Ouch. That's 10% absolute reduction in income over 8 years, even worse in real terms.

When I left private practice to return to an academic career many years ago, my colleagues were pretty skeptical about the financial penalty I would pay for my decision.

I did it for personal reasons and career satisfaction, but it turned out to be one of the best career decisions I made. Other than a flat year here and there, my income has more than kept up with COL, I have a 403b with employer contributions, a 457, and paid malpractice, health, life, etc. like any corporate wonk. I get to practice, teach, and do research; now that I'm old, I also get to be the boss (at least that's what I'm told). Lastly, I will get to retire a little early.

Many of my former colleagues who didn't adapt are cynical, making less than I, and have limited retirement savings or options. We were all in primary care which, in the 70s, seemed a fascinating, noble, and challenging specialty.

Dodged a big bullet.

 

[justin]

Went to the doc's office yesterday and saw a magazine in the waiting room - Medical Economics or something.

When I flipped through it, I was surprised to see an article on finances. Very basic stuff like spend less than you make. Have a rainy day fund. Set up 401k's or IRA's (and participate!). Don't get tricked by the "latest and greatest" investments opportunities out there.

 

[roadkill]

Rich.....

NPR did a story this morning regarding a primary care doc in DC. Although she loved the work, her net income dropped to $54K per year due to increased office overhead and reduced insurance payments.  She closed her practice and took a $125K salaried job with Georgetown medical center.........as yogi might say..."the future ain't what it used to be"......

 

[Rich_by_the_Bay]

NPR did a story this morning regarding a primary care doc in DC. Although she loved the work, her net income dropped to $54K per year due to increased office overhead and reduced insurance payments. She closed her practice and took a $125K salaried job with Georgetown medical center.........as yogi might say..."the future ain't what it used to be"......

Pains me to hear stories like this because on a numeric basis, primary care docs (internists, family practitioners, pediatricians) are probably the most important hinge on the system.

Health care in the good ole US of A is in a painful stage of transition.

 

[xmanz3]

I live in Atlanta (Brookhaven). In which part of Atlanta do you live? I have seeing how real estate prices have increased tremendously in my area. I was lucky enough to purchase a townhome $20k less from what they are selling now.

 

[Dawg52]

Here's another story of a doctor unable to retire early.

http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/07/01/8380770/index.htm

 

[Sarah in SC]

And also from Money Magazine, the words we've been waiting to hear all along....Why men don't know jack about retirement by Walter Updegrave
http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/07/01/8380769/index.htm

Sarah

 

[roadkill]

Here's another story of a doctor unable to retire early.

http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/07/01/8380770/index.htm

Well, I don't know what level of income a typical pulmonologist generates, but this guy is 57 and only has $336,000 in financial assets?  geeez..................

 

[Dawg52]

And also from Money Magazine, the words we've been waiting to hear all along....Why men don't know jack about retirement by Walter Updegrave
http://money.cnn.com/magazines/moneymag/moneymag_archive/2006/07/01/8380769/index.htm

Sarah

I saw that one too but didn't feel as compelled to share it. 

 

[spideyrdpd]

I dont know why you single out doctors. Dont they say most americans are one paycheck away from being bankruptcy.
As they say its not what you make its how much you keep
to add in another cliche
Its also a lot easier said then done

 

[sailaway]

As a physician that has retired early at 55, I actually agree with most everything that has been stated. Interesting and few other forums of people would understand what this one knows. My wife and I were lucky enough to recognize early on the importance of saving rather than spending but it was hard just as it has been for everyone on this board.

My fellow physicians no longer laugh at me for driving that old old pickup. But I practiced in a small town where it was not important to keep up with Dr. Jones.

"I love my truck"

Sailaway

 

[Rich_by_the_Bay]

As a physician that has retired early at 55, I actually agree with most everything that has been stated. Interesting and few other forums of people would understand what this one knows. My wife and I were lucky enough to recognize early on the importance of saving rather than spending but it was hard just as it has been for everyone on this board.

Maybe you'd agree with me that another problem faced by many of our colleagues is a deficient sense of "life outside of practice." That can make the prospect of retirement a little scarey even if you have the finances in place.

 

[cute fuzzy bunny]

The millionaire next door covered this syndrome.

High end white collar professionals often come from well to do families with higher end lifestyles. They spend a long time in school fraternizing and becoming lifetime friends with other kids that are well to do that also enjoy higher end lifestyles.

Competition ensues, and the spending escalates.

You're conditioned to earn and spend and keep up with the Jones's.

Certainly not the case with all or maybe even most, but their observation was that the average "millionaire" profile was a blue or slightly white collar worker who started their own business after receiving little or no higher education past high school, drove a pickup truck and lived in a middle class neighborhood.

I get this from the "helpers" at the Dentist I go to. He hires "unretired" dentists all the time to pick up his slack. One guy keeps coming back. First thing he says when I sit in the chair is a question designed to setup a one hour monologue on his multiple airplanes, his surgeon sons multiple exotic cars and huge house in southern california, and the mid five figure family vacations in exotic locales.

Sounds like a nice life. Except for the part where he's in his mid 70's and still has to take on part time work.

He actually asked me once what I did. Told him I had been retired for 5 years on my investments. "Whadda ya invest in?". "A variety of mutual funds at Vanguard". "Huh. So my sons looking at getting rid of his porsche and ferrari he's had for two years and getting a..."

 

[sailaway]

Maybe you'd agree with me that another problem faced by many of our colleagues is a deficient sense of "life outside of practice." That can make the prospect of retirement a little scarey even if you have the finances in place.

That was the major problem I anticipated, realized, and am somewhat successfully working through.  This forum helped in all the above three.  It helped that I live in a small community where I was just somewhat another fellow friend.  It helped that I had few ego problems, a successful marriage, and kids with only the "usual" problems.  This goes the same for others on the board.  I think more people on this board have problems than they want to readily admit or discuss.  But personlly I have found general truths.  It has not been easy but the benefits of having my own life far outway the drawbacks and I have no regrets to my decision.

Headed to Pamplona, Spain on Friday.  Wish me luck on staying ahead of the bulls.

Sailaway

 

[Nords]

Headed to Pamplona, Spain on Friday.  Wish me luck on staying ahead of the bulls.

I've seen what happens to the Pamplona "man in the street" during that event... Physician, heal thyself!

 

[Meadbh]

Rich is correct; physicians in general miss out on a key advantage of people who enter the workforce early: the time value of money. In addition, particularly in North America, physicians tend to begin their careers with enormous debt loads. The mean is over $100K.

Also true is the perceived need of (some) physicians to keep up with the Joneses and maintain conspicuous consumption. Not mentioned so far is the fact that most physicians are, in fact, small business owners, and many have high overheads that may amount to 50% of their gross revenues.

I recently met an 81 year old doctor who told me he couldn't afford to retire  because he needed the income to pay for his wife's personal care home expenses (she has Alzheimers). What a terrible way to end a career! Of course I also know another MD who is in his eighties and works full time because he loves it.

I'm a physician too, but my situation is different. I grew up an only child in Europe where people save more. My parents paid my tuition. As an intern I was saving for a deposit on my first home. I didn't really get into tax efficient retirement savings till I became an attending physician at 33, having lived and worked in 3 countries and settled in Canada. I definitely live a more conservative lifestyle than most of my colleagues.

My total annual income is <$200K, most of which flows through my medical corporation, allowing me to defer a significant amount of tax. I save ~$60K a year, mostly in the corporation. My net worth doubled last year due to an inheritance and is now ~$2m. My assets are allocated approximately 30:60:10 apart from my home, vacation property, pension fund and some VC. Ialso have a significant global focus. By the time I am 55 I expect my NW to be $3m assuming I have an average ROI of at least 7%, and my corporation to be worth $1m of that. If it is, I will take ER. If not, I will wait till it is. I plan to live on corporate dividends until I can access my retirement funds at 69.

I did take a sabbatical some years ago and used it to do an MBA. After that I completed the Canadian Securities Course (www.csi.ca) as I my MBA sparked an interest in finance. Anyone can take this course and it's well worth the effort if you want to learn how to invest more intelligently. Provided, of course, that you don't have a problem with Canadian content.

 

[macdaddy]

As someone headed to medical school, it scares me how some of my classmates shrug off the debt burdens they will graduate with. I have friends who chose a private school over a state school and will graduate with 200k-250k or more of total debt. The worst thing is that the medical schools and loan companies even grant generous loans for living expenses, meaning poverty no longer forces someone to LBYM. To me that borders on criminal behavior, enslaving someone who doesn't know any better in debt for the next 20 years of their life. They think that they will be able to consolidate their loans at the 2%-3% rates of the past few years. And besides that, even at 60k/year for 4 years, "student loan debt is good debt"... what a misunderstood black hole blank check concept. They really believe that they will all have cushy 200k per year jobs in primary care in the city of their choosing. I think they will be in for a rude awakening, having been scewed by the system.

 

[Meadbh]

Macdaddy, you may want to check out this link, as well as some previous issues:

http://mdm.ca/md/Strategy/index.asp?url=/content/md/strategy/05/2006/Strat02.asp&language=E

 

[jclarksnakes]

....Last week I talked to a very frustrated and very tired first year resident who said she had $300,000 in student loan debt. I was thinking that she will have to work hard to pay off the debt and then save very aggressively to retire as young as many of us.
jc

 

[Meadbh]

That financial pressure is one (but not the only) reason why suicide is much commoner in physicians than in the population in general. See

http://ajp.psychiatryonline.org/cgi/content/abstract/161/12/2295

 

[kcowan]

Another problem for GPs is that they are not trained to run a small consulting business such as their practice. Nor do they get any training on investing. These are both problems for many of them. Bad investment choices then lead to financial pressures later in life.