Some clues for Doctors retiring early

[ls99]

Tough not said anywhere in the linked artilcle of Docs retiring early. Good showing of stress encountered by practitioners. Hint: the stress source it is not necessarily the patient(s).

How doctors treat doctors may be medicine's secret shame | Ranjana Srivastava | Comment is free | The Guardian

A psychiatrist colleague observes that a common reason why doctors see her is to figure out how to coexist peacefully with other doctors. She jokes that researchers hate clinicians as people who feed off their intellect. Clinicians scoff at lab doctors who don’t inhabit the real world. And clinician-researchers, derided for being too much of one or the other, are never sure where they belong. General practitioners are sick of the condescension from specialists. Specialists tussle among themselves and with entrenched hierarchies.
Research, here and abroad, points to increasing levels of anxiety, depression and burnout among doctors. We traditionally invoke factors such as long hours, demanding patients and unending bureaucracy as the cause but perhaps it is worth asking what role doctors play in harming each other, however unintentionally.

Edit: the topic I mis spelled "fro" should be for

[rodi]

I fixed the subject for you.

[Meadbh]

I am confused by the title. How does this relate to retiring early?

As for internecine conflict within the medical profession, that's old news.

[Travelwanted]

"Do doctors argue, fuss and fight? Do they have trouble working with each other in genuine collaboration? Absolutely. The medical profession as a whole abounds with fragile egos and deep vulnerabilities."

+1000

No different than any other profession: mix ego and greed and boom!

[ls99]

Quote:

Originally Posted by Meadbh I am confused by the title. How does this relate to retiring early? As for internecine conflict within the medical profession, that's old news.

Seems most doc's cite stress for getting out early. If I dig through the RE forum I am reasonably sure I can find a few examples.

As for the old news, I am sure it is for the insiders. For the rest of us the various internal rivalries and one up(wo)manship and resulting patient getting caught in middle is not. But we suspected it.

Edit add: A positive story of a Doc's ER, though in the next to last paragraph the final straw stressor is explained.
http://whitecoatinvestor.com/how-and...retired-at-53/

[ERhoosier]

Quote:

Originally Posted by Meadbh I am confused by the title. How does this relate to retiring early? As for internecine conflict within the medical profession, that's old news.

All FIREs are, or will be, affected by the 'health' of the health care system which includes the health of those working in it. Do most folks really want to be cared for by docs (and nurses, etc) whose main life goal is FIRE?
FWIW- Most feel the "internecine conflict" between docs has grown much worse over the past decade or so....likely due to the added stress of system changes most feel are too often counterproductive to the efficient delivery of good care. The enforced use of poorly designed and unreliable electronic records cited in Is99's last link is a good example.

[aja8888]

Quote:

Originally Posted by Meadbh I am confused by the title. How does this relate to retiring early? As for internecine conflict within the medical profession, that's old news.

Seems to me it fits in the forum subject matter along with the thread on assisted suicide becoming legal in Canada.

[marko]

Quote:

Originally Posted by ERhoosier ....likely due to the added stress of system changes most feel are too often counterproductive to the efficient delivery of good care.

My doc (40-ish) had had enough of being forced into giving what he felt was substandard care in order to meet insurance guidelines. He was not only stressed over that, but from having to see 20 patients a day and only being able to see them for 15 minutes. Exhausting. He was spending most of his time and billing income just to pay people who could keep track of his billing.

Four days ago, he opened a new practice that takes no insurance at all. He charges a reasonable monthly fee that includes X visits, X lab tests etc etc. Can spend up to a half hour with you and will even make house calls. Instead of paying a half dozen people to code and track insurance, he has one receptionist.

I'm sure for him, its a form of RE!

[Gatordoc50]

Quote:

Originally Posted by marko My doc (40-ish) had had enough of being forced into giving what he felt was substandard care in order to meet insurance guidelines. He was not only stressed over that, but from having to see 20 patients a day and only being able to see them for 15 minutes. Exhausting. He was spending most of his time and billing income just to pay people who could keep track of his billing. Four days ago, he opened a new practice that takes no insurance at all. He charges a reasonable monthly fee that includes X visits, X lab tests etc etc. Can spend up to a half hour with you and will even make house calls. Instead of paying a half dozen people to code and track insurance, he has one receptionist. I'm sure for him, its a form of RE!

I actually use a specialist as my GP. I ask him to just charge me a fair fee and I will gladly pay what my insurance doesn't cover. I think my out of pocket expenses were about 350 bucks last year or roughly 150 dollars an hour for 3 or 4 visits. I am seen on time and have all of my questions answered and feel well cared for. He also has just one staff member.

[Rich_by_the_Bay]

Quote:

Originally Posted by Gatordoc50 I actually use a specialist as my GP.

Just curious: are you up-to-date on your zoster, tetanus, pneumonia vaccines? Last colonoscopy? PSA discussion (if appropriate)?

It can sometimes be difficult for a specialist to stay current and accurate on decisions and interventions outside the scope of their practice. Some compensate by making larger numbers of referrals or not following the latest evidence in the primary care disciplines.

To be sure, some pull it off nicely. Just something to think about.

[HarryL]

I worked in the health care system in a major medical center for 35 years. That work environment along with being on-call for extended periods of time, can be extremely stressful and toxic to ones health.

My wife said that if I tried to work till full retirement age I'd be dead before I reach age 65! The stress was really taking it's toll on me. I heeded her advice and retired at age 58. Best decision I ever made!

[Bamaman]

My physician has 3 other partners, and their office is fairly fast moving. He spends much of his time dealing with administration of the office and fighting insurance companies questioning his ordering necessary tests and medications.

And then the state comes to him to question why he prescribes so many controlled substances. As an internal medicine doctor, the average age of his patients is high. Many have skeletal issues, bad backs and are living in nursing homes and assisted living. They require more pain meds than younger patients.

At 58 years old, he questions why he continues to go through all the hoops to get treatment to his patients. Early retirement should be in his future.

The problem with physicans retiring is that so many have kept up their lifestyle rather than fully funding their pensions. If a doctor's got a $200K lifestyle, he's going to need $4 million-$5 million in retirement funds, and he's had too many kids to put through graduate school, too big of a house, and driving too many nice cars to ever be a real saver. And a doctor is self employed--with nobody putting any matching funds into his pension. And I'm not going to get into the physician not paying off all his student loans until age 50.

[marko]

Quote:

Originally Posted by Bamaman The problem with physicans retiring is that so many have kept up their lifestyle rather than fully funding their pensions. If a doctor's got a $200K lifestyle, he's going to need $4 million-$5 million in retirement funds, and he's had too many kids to put through graduate school, too big of a house, and driving too many nice cars to ever be a real saver.

As my Dr. (see other post) told me: "People say: 'if you're a doctor, why are you driving an old Toyota?'..."

[Gatordoc50]

Quote:

Originally Posted by Rich_by_the_Bay Just curious: are you up-to-date on your zoster, tetanus, pneumonia vaccines? Last colonoscopy? PSA discussion (if appropriate)? It can sometimes be difficult for a specialist to stay current and accurate on decisions and interventions outside the scope of their practice. Some compensate by making larger numbers of referrals or not following the latest evidence in the primary care disciplines. To be sure, some pull it off nicely. Just something to think about.

Thanks. Those are legitimate concerns.

[ERhoosier]

Quote:

Originally Posted by Bamaman ....The problem with physicans retiring is that so many have kept up their lifestyle rather than fully funding their pensions. If a doctor's got a $200K lifestyle, he's going to need $4 million-$5 million in retirement funds, and he's had too many kids to put through graduate school, too big of a house, and driving too many nice cars to ever be a real saver. And a doctor is self employed--with nobody putting any matching funds into his pension. And I'm not going to get into the physician not paying off all his student loans until age 50.

Agree that is the case for many middle-age docs today, but the next generation will have a MUCH tougher time trying to FIRE. Unless they have another source of funds like rich family or a major scholarship, many will finish their residencies with a multiple six-figure debt load.
Medical School at $278,000 Means Even Bernanke Son Has Debt - Bloomberg Business
Most primary care docs (family medicine, internal med, peds) earn roughly $175-$185k/yr.
Medscape: Medscape Access
Fed student loans have interest rates at 6.8-7.9% (ouch!) and private loans are typically higher. Most new docs make far less than the ave when 1st starting in practice. Running the financial numbers shows that for many docs paying off those loans even by age 50 is an admirable goal.
This blog piece is a bit dated (2011 when tuitions were lower), but reflects a growing opinion that becoming a doctor may no longer make financial sense if you have to pay the full way on your own.
Think about medical school tuition debt before becoming a doctor

[6miths]

Quote:

Originally Posted by Rich_by_the_Bay Just curious: are you up-to-date on your zoster, tetanus, pneumonia vaccines? Last colonoscopy? PSA discussion (if appropriate)? It can sometimes be difficult for a specialist to stay current and accurate on decisions and interventions outside the scope of their practice. Some compensate by making larger numbers of referrals or not following the latest evidence in the primary care disciplines. To be sure, some pull it off nicely. Just something to think about.

Agree totally with this. I frequently tell students that the hardest thing to be in medicine is a good GP.

As a sub-specialist, I do sometimes feel like I know more and more about less and less. The other challenge that a GP faces is that most of the patients presenting aren't actually seriously ill. Separating the sick from the not sick can be quite challenging.