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USAFMD ejecting in 2012
Old 06-24-2010, 06:41 PM   #1
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USAFMD ejecting in 2012

As a lurker for quite a while, I decided to write up an intro at the time of registering. Although USAFMD is my handle, it has been two decades since leaving the service, having had a great time serving this great country. In about two years, I will be 51 years young, my two children either off-to and well-along in college. Personality wise, I've found myself to be the archetypal INTJ, like many of you here.

The financial end is nothing Iím worried about as we will be able to draw out $120k/year at a rate of 3% from our nest egg, hopefully not eventually leading to any future dog food diets. The recent healthcare legislation has made uninsurability a future nonissue. While I have many tinkering projects going on at any particular time, I am most concerned about future activities, friends and how it will play out with my wife.

While she jokes that she has been long since retired, she has a well-established, local network of friends where we live. While I like Upstate New York, the scenery and locale, I have a strong dislike for the governance, onerous level of taxation and have a bleak outlook for the long-term. I'd like to move to a lower tax state with less prolonged winters, (although summers up here are wonderful), maybe Delaware, which will also put us closer to relatives. My wife is not as enamored with this idea since she likes the winters having discovered cross country skiing. I am not adverse to going overseas to a low-cost country for a while, although my children might need a place to go or support for a few more years. Our parents are doing fine for the time being.

Like many working physicians, my traditional title, social and collegial network has been within the hospital and among my peers. Although I have not desired to fill the role of a high 'n mighty doctor, I am entirely not sure how that will sit after stepping down from my present role as a hospital based physician.

I have a younger colleague who can take over my duties but the practice will need to hire someone new. I've never had a period greater than two weeks when I did not work. While I do not dislike working, the hassle factor has been increasing over the years and the number of things which I find particularly rewarding less frequent as time goes on. While it might be a fantasy, I've thought working in the Third World might be more rewarding, free of documentation, thoughts of litigation and government regulators. The grass might be very well greener on the other side; I donít wish to acquire an incurable tropical parasitic diseases, get caught up in political unrest or suffer in a prop plane crash in the jungle.

I'm not entirely sure about how to make the transition without losing a good situation. Taking a few month sabbatical might be a good option to try out doing nothing, travel or practicing medicine abroad for a bit. Another idea I had which I've investigated is teaching at a Caribbean medical school part-time. Once control of the practice is relinquished, it will be very difficult to find a similar situation without starting out at the bottom again.

There are projects which I've worked on outside of medicine over the years which I've found totally engrossing. The feeling of being totally in the moment is what I want to recapture for most of my life. I want to go more biking, hiking, sailing, traveling, woodworking and workshop tinkering.

I'm pretty sure I will want to engage in some business, maybe medicine related projects in the future, but don't want any of the "hassle" factor. Perhaps those of you can give me some pointers how you made the transition without losing your circle of friends or comfort zone. Thanks in advance.
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Old 06-24-2010, 11:05 PM   #2
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Welcome.

You mentioned a sabbatical - that's always been a fantasy of mine.

It sounds like your youngest is a rising high school sophomore or junior. During the school year is probably not a good time for you and DW take off for the other side of the world for a couple of months of adventure, with or without your children.

Summer would be better? Perhaps you could work a plan where you take a month+ off from your practice next summer and 2 or 3 months in 2012? (Warming up yourself and your practice partner for the transition to come later in 2012 or 2013.)

Maybe there's a summer adventure / opportunity that the whole family could share. Or tell the kids you and the wife are climbing Kilamanjaro and training some local doctors next July. If they would rather not come along then their part of the plan is to find their own adventure, i.e. a summer job where they can be on their own, but not completely independent and unsupervised. Summer camp counselor, au pair in Europe, living with a trusted relative in another town, etc.
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Old 10-15-2010, 09:36 PM   #3
Confused about dryer sheets
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Thanks Harry, another retired MD also recommended taking 2 months off. It is a good thought which will let me test the water without jumping in.

With the rise of the stock market recently, quite unexpectedly I have reached my number a year and half early. There is nothing I can do since my youngest is still in school, but it is exhilarating and bewildering at the same time. I still and not sure how much of my physician work I want to retain. Recently I read on BH's that three years after you retire, no one cares what you did, including yourself. That's a bit scary.
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Old 10-15-2010, 10:24 PM   #4
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DW is a VA Physician and we get our health care from Kaiser Permanente. Both organizations are full of MDs who hate the hassle but love medicine.

I'm not saying they are perfect, no place is, But the crap factor seems low. I know the VA is understaffed in some very warm places
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Old 10-16-2010, 12:39 AM   #5
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Quote:
Perhaps those of you can give me some pointers how you made the transition without losing your circle of friends or comfort zone.


I think one aspect to consider is making new friends by joining hobby clubs, a church, volunteer activities, environmental groups, etc. - whatever interests you.
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Old 10-16-2010, 11:38 AM   #6
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Interesting background and plans. I'd say you're in the top tier here as far as retirement income. I think those lurking here are more likely looking for ways to RE on much more modest means, if not trying to find a balance from a more uncertain edge.

I note you mention the benefits of recent (Obama) health care legislation in making uninsurability a non issue. Yet a sentence or 2 later indicate a desire to escape the onerous taxation of the locale. Well, as they say in Canada, we don't mind paying because everyone's covered. It's hard to have good social programs that benefit everyone with minimal or no taxation.

But I don't want to sound too critical, as you have some nice plans under consideration in working in the 3rd world or teaching at remote places. And some good time off for sports, hobbies, etc., which sounds like you deserve from a lifelong profession requiring much dedication. So welcome for sure.
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Old 10-16-2010, 01:01 PM   #7
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I'm more or less in the midst of the transition you so articulately described - I cut back to about 30% 8 months ago, and as of 3 weeks from now will have all but stopped practicing outside of volunteering at a free clinic with medical students.

I'm taking a total withdrawal approach at first, then will back fill with the things I find myself enjoying or needing. Oddly, it's not like I set out with that strategy; it just seems to have evolved that way in the last year, as opposed to selectively pruning back my current life right from the start. I'll see what happens.

Best of luck to you and I look forward to comparing notes.

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As if you didn't know..If the above message contains medical content, it's NOT intended as advice, and may not be accurate, applicable or sufficient. Don't rely on it for any purpose. Consult your own doctor for all medical advice.
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Old 10-16-2010, 01:09 PM   #8
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Welcome to the board. You're not alone in having these thoughts & issues, so I'm sure you'll find good company & commiseration, and hopefully advice.

Quote:
Originally Posted by usafmd View Post
.... While I like Upstate New York, the scenery and locale, I have a strong dislike for the governance, onerous level of taxation and have a bleak outlook for the long-term. I'd like to move to a lower tax state with less prolonged winters, (although summers up here are wonderful), maybe Delaware, which will also put us closer to relatives. My wife is not as enamored with this idea since she likes the winters having discovered cross country skiing.
We live in NJ and I fully understand what you're saying. I have the same reservations that your wife does (though for different reasons). The thought of moving is both exhilarating and scary. I think it will be good to re-energize us and get us to socialize more. Moving to a lower cost area (which is just about anywhere!) will free up cash to allow us to do more outside the home.
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Old 10-16-2010, 05:06 PM   #9
Confused about dryer sheets
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Originally Posted by Richard8655 View Post
I note you mention the benefits of recent (Obama) health care legislation in making uninsurability a non issue. Yet a sentence or 2 later indicate a desire to escape the onerous taxation of the locale. Well, as they say in Canada, we don't mind paying because everyone's covered. It's hard to have good social programs that benefit everyone with minimal or no taxation.

But I don't want to sound too critical,
Thanks for the welcome. I am reminded of the quip that I'd like to make my money in a capitalist society and retire to a socialist one.
Without getting into Obamacare details, most Americans agree upon several tenets of change, one of them is no-capping of benefits and the other is removal of denial of coverage.
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Old 10-16-2010, 06:05 PM   #10
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DW is a VA Physician and we get our health care from Kaiser Permanente. Both organizations are full of MDs who hate the hassle but love medicine.
I appreciate your kind thoughts. As a medical student, I spent some time in the VA system decades ago. I hope (for the patients's sake) there have been major substantial improvements since then. In the past, Kaiser Permanente was one of my employers, after the USAF.

How should I put this . . . . this past summer, I ran into a retired physician and we got into this same discussion. I enumerated characteristics of what I thought might be a "great retirement job" for a physician. Upon hearing the list, he replied postions like that exist, but they are not called "great retirement jobs" for physicians but in the common parlance known as "volunteer" positions.
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Old 10-16-2010, 08:21 PM   #11
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I appreciate your kind thoughts. As a medical student, I spent some time in the VA system decades ago. I hope (for the patients's sake) there have been major substantial improvements since then.

You might take a look at
Best Care Anywhere, 2nd Edition: Why VA Health Care Is Better Than Yours Phillip Longman

they win lots of awards in DW's area





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