Retired Doctor 1 year anniversary

[urn2bfree]

This post was edited to remove redundant info from an earlier post in this same thread...i meant to use that info in another thread about docs retiring..still this retains the relevant i fo that is cited below...

I do feel the stress of having less money coming in--even though if my wife stopped working I think we are more than comfortable where we are with our usual spending being around 3% of our portfolio (with over two years safety in cash or CD's that combined are earning over 2% interest) and this is without touching the value of our home equity of $700,000 and my hope we will downsize and at least have lower maintenance costs even if we roll our equity into a higher priced but warmer part of the country. The other thing that amazes me is the series of unfortunate and unusual expenses that have befallen us in this first 4 months- each of us needing root canal for the first time, a broken tooth, an ER visit for stitches, frozen broken pipes, a dryer repair, leaky sink, new timing belt needed, some new tires...I am hoping to see these death by a thousand cuts expenses taper off for a while, but who knows? If my wife were not still providing it would be even more unsettling no matter how much cushion I think we have.

 

[longranger]

Sorry to hear of your short term unlucky streak urn2bfree. It is a sobering reminder that there are no absolute guarantees no matter how well you prepare. On the other hand same can be said about your ability to enjoy retirement if you wait another 10 years.

As yet another rapidly burning out MD in practice for 28 years contemplating ER this thread has been therapeutic for me. Although I have never been particularly fond of Kool Aid the evil elixir has affected me. It hurts that I may walk away feeling somewhat defeated by my years in practice. Hope that goes away as my time and energy are reclaimed after FIRE.

Have had 2 colleagues in my group retire in the past 3 years. Actually one of the 2 in process now. One retired at 59. At 2 years out is very happy with his decision. The other retiring now is 75. He has lived life on his own terms, had secure enough finances to retire FIRE several times over 20 years ago, says he has no regrets but has very little left in the tank to enjoy life with. It was sad watching him deal with the changes in medicine over the last 5 years. He waited at least 10 years too long. I can see in his eyes that now he is thinking "AND FOR WHAT"?. He thought that retiring at 59 was a terrible mistake for my other colleague. He has no idea that I will likely not make it to 59 before FIRE. Will not tell him until after he is long gone as it is assumed I will follow in his footsteps for at least 10 more years.

Jackson D. Congratulations. Your blog is now on my short reading list.

 

[EastWest Gal]

This thread is helpful to us me and other professionals, who tend to be pressured to define who we are by what we do. My medical director who was trying to get me to do more stuff said "You're a pediatrician." I never could think of myself as "a doctor." If we think of ourselves as our profession, then retirement is a tragedy, almost a defeat. I'm not there yet but it seems here we treat retirement as a victory, a liberation.


I too have been told I need to retire to something else. Like Jackson D, I'll need to unwind before the something else shows up. I can't wait!

 

[6miths]

Thank you for all of the posts. I am three weeks away from officially packing it in 2 days before my 53rd birthday. I have always enjoyed the patients and teaching but the admin side at the hospital is killer. Looking forward to the garden, cottage, traveling and quality time with the family.

 

[rkser]

A Question for Doc ?

Hi Doc,

I am semi retired, 57 yr old physician , in private practice 3 days a week, yearning for a full retirement one day.

How did you get Medical Insurance as a retired doc ?

Thanks and regards

 

[ERhoosier]

........It hurts that I may walk away feeling somewhat defeated by my years in practice........

No reason to feel that way. Actually, congrats are in order. You have devoted almost 3 decades of your life to the most noble effort of tending to the sick & injured. Thank you for your service!! I would never view a future decision to retire or change directions as a defeat.

 

[longranger]

Most of my feeling defeated or guilty is for not being able to influence the highest levels of the government/megacorp healthcare complex in a rational direction, as irrational as that is. In reality my negative feelings are based largely on the egotistical premise that I SHOULD be part of the good guys that slay the dragons that are making our healthcare system ill. Most of the doctors in positions of leadership I have worked with have a pretty good idea what needs to change in healthcare, are not hostile to realities of the business world. Unfortunately the government and megacorp interests that reap huge financial gain from the systems current structure have an odd mixture of ignorance to the effects of what they are doing and criminal disregard for the negatives they can understand. That may sound overly dramatic but I think you would here the same opinion from most individuals who are patient advocates and have been asked to function as the token MD on boards, in think tanks etc... You can lead the horses to water but..........................

 

[Meadbh]

Longranger, it's very frustrating to know what needs to be done but to be powerless to implement it. Healthcare is highly politicized and there are multiple agendas and power structures that are much bigger than individuals, even leaders in healthcare. That's not to say that leading and facilitating improvement is not possible; indeed it is, within one's scope of practice and influence, and that is very satisfying. But there comes a time when it's OK to step off the treadmill and forget about saving the world. You've earned it.

 

[ERhoosier]

Agree with Meadbh, but no reason stepping away from day-to-day clinical medicine requires forgetting about "saving the world". In fact, many docs have deliberately left at the top of their clinical games in attempts to have a greater impact on improving peoples lives (e.g. becoming legislators, lecturers, authors, volunteers, etc.). Others just get so burnout by the frustrating, often irrational bureaucratic overhead of 'modern' clinical medicine that they need major time (months,even years) to decompress & recharge before finding new pursuits. There are many ways to have positive impact on the world beyond clinical medicine.

 

[longranger]

Thanks for the understanding and advice ERhoosier and Meadbh. Sorry to all for my earlier rant of sorts. Your observations and advice hit the nail on the head. Hopefully after Fire and time to recharge I will find pathways to be more at peace, contribute to society or feel at ease doing nothing in particular at all. That why I have been reading every post on this site since I found it and will continue to do so as my FIRE plans progress.

 

[Brett_Cameron]

.... The other thing that amazes me is the series of unfortunate and unusual expenses that have befallen us in this first 4 months- each of us needing root canal for the first time, a broken tooth, an ER visit for stitches, frozen broken pipes, a dryer repair, leaky sink, new timing belt needed, some new tires...I am hoping to see these death by a thousand cuts expenses taper off for a while, but who knows? If my wife were not still providing it would be even more unsettling no matter how much cushion I think we have.

Similar things happened to us coupled with daily swings in the markets of -7 to +5% swings. It caused extreme short term anxiety for the first 4 or 5 months. Enjoy!

 

[ERhoosier]

Similar things happened to us coupled with daily swings in the markets of -7 to +5% swings. It caused extreme short term anxiety for the first 4 or 5 months. Enjoy!

That's why I'm focusing more on buying stocks (inc via funds) as, to use John Bogle's term, "income streams". So long as the dividend/income stream is stable to increasing, those short-term market swings become pretty meaningless.

 

[urn2bfree]

Hi Doc,

I am semi retired, 57 yr old physician , in private practice 3 days a week, yearning for a full retirement one day.

How did you get Medical Insurance as a retired doc ?

Thanks and regards

Right now my spouse still works so we get coverage from her employer, but if she quit tomorrow, I included the expense in our possible needs when seeing if we have enough to retire. In other words, You have to budget for insurance. With the ACA guarantees of no denial for pre-existing conditions (like being in your 50's) Retiring Early became possible. Without it, I would worry that we could not get insurance at any cost. In fact, both sides of the political spectrum have noted this effect of the ACA on freeing people,to,reitre early, but of course each emphasizes it quite differently. ("Freeing up workers to retire early and opening opportunity for younger workers!" Or "Allowing lazy louts to not work and lowering employment!" Whatever.)

 

[ERhoosier]

......You have to budget for insurance. With the ACA guarantees of no denial for pre-existing conditions (like being in your 50's) Retiring Early became possible. Without it, I would worry that we could not get insurance at any cost.....

Agree, and not just for premiums. THE issue here is and will remain overall HC costs. Guaranteed issue is worthless if total costs, (inc premiums, copays, deductibles, & OOPmax), are so high folks cannot afford it. For most ER's, generous budgeting for HC remains critical (excuse the pun) to avoiding medical bankruptcy. Full Silver Exchange plan HI premiums for pre-Medicare ER's often exceed $12k/yr and couple/family OOPmax is $12,700 (PLUS any non-covered &/or out of network care). According to Kaiser's Subsidy Calculator, a 60yo ER couple with chronic HC issues & MAGI of $62,500/yr could spend a budget-busting 42+% of their PRE-tax income on HC costs (even with unlikely assumption of NO non-covered or out-of-network care).
Subsidy Calculator | The Henry J. Kaiser Family Foundation

IMHO guaranteed issue is here to stay even if ACA is repealed (unlikely) or modified (almost certain). Bank on it. It already existed pre-ACA in many states (if only in hi-risk pools). During HC reform debate the concept was NOT unique to ACA, but had (& continues to have) widespread bipartisan support. It was included in almost every other serious competing HC reform bill (Ryan's HR 2520, Price's HR 3400, Coburn's S1099).

 

[rkser]

Thanks Urn2bfree & Erhoosier for the info and insights.

One can buy the Obama HC Plan but finding doctors and hospital to accept it is a problem in our town.

Hopefully the networks will evolve and increase the number of participating doctors and tertiary care hospitals.

That is the main deterrent in taking the early retirement for many, including myself.

Best

 

[urn2bfree]

How Being a Doctor Became the Most Miserable Profession

http://www.thedailybeast.com/articl...tor-became-the-most-miserable-profession.html

The title of the article tells you what this is about

 

[iac1003]

Yes to the article above.

I'm already halfway out, working 3 days a week, but still have to "make my productivity numbers" and it is still stressful.

In one year's time I won't be entirely free but will be on COBRA before Medicare kicks in and will just supervise nurse practitioners and work one day a week, and if that's too much, I will just ship out of medicine (licensed, 1983).

I already have a lot of interests, stepped down from leadership positions many years ago - in a hospital, it is all politics and CYA without any non-MD administrator wanting to effect real positive change imho. BTDT as the lone wolf trying to improve care, systems, blah, blah. I was just a cog in the wheel. Plus they refused to pay me what a male department chair would get paid.

It's been a great profession but 30 years is long enough doing one thing!
I may not be as financially secure as all of you but I'm pulling the plug on this work thing anyway.

 

[Rich_by_the_Bay]

It saddens me to hear of all this burn-out, though I certainly understand it after 35 years of patient care.

I'm no mentor for anyone but myself but here are some solutions that have helped me remain engaged and content (semi-retired for 5 years, academic internist):

1. I have a 10% telemedicine gig which I enjoy tremendously. It pays pocket change but motivates me to read, keep up CME credits, licenses, and so on. IOW, it makes me feel like I am still a doctor. Amazing what even video medicine can provide.

2. I have commitments as a volunteer teacher of English as a Second Language. Great way to give back to my new community and meet some true heroes with fascinating stories to tell. Stimulating, interesting, socially rewarding.

3. I am writing what passes as a pathetic piece of fiction. Occupational therapy for me.

4. I meditate (have for decades) and that helps keep me centered and nonreactive.

5. I have given myself permission to sleep late, not work when I don't have to, and to enjoy even trivial chores like food shopping. Probably a side-effect of meditation.

6. Maintain a satisfying and loving 43-year marriage by being more compromising, etc; moved near the kids and grandkids.

7. Recognizing that my choice of profession isn't really that important to people I meet. It is incidental to most of them, negative for a few and god-like to, well, just about nobody.

8. Retired neither too wealthy nor too poor to support a comfortable lifestyle. We are a one-car family, entertain modestly, etc. but live in a high-cost area near San Francisco. Only time will tell on this one but for now it looks like we got it right, more or less <knocking on wood>.

It's not nirvana but we want for little else.

 

[steelyman]

Rich_by_the_Bay - I never took your name to be boasting (weren't you "Rich_in_Tampa"?) but that sounds like a very rich life

 

[ERhoosier]

How Being a Doctor Became the Most Miserable Profession

How Being a Doctor Became the Most Miserable Profession - The Daily Beast

The title of the article tells you what this is about

Sadly, here's some evidence to support that view-

How many doctors contemplate suicide?

 

[Meadbh]

This is a significant problem internationally. Here are some links on the problem in Ireland, where working conditions have deteriorated significantly in recent years:

Inquest into junior doctor death told of long hospital hours - Courts | The Irish Times - Mon, Nov 18, 2013

http://www.suicidology-online.com/pdf/SOL-2013-4-92-95.pdf

I have personally known two Irish doctors who committed suicide (one by insulin overdose) and two residents in Canada who committed suicide, both using pills. One of them in particular was considered the "cream of the crop" with excellent career prospects and a loving family.

Edited to add: I have just become aware that a wonderful oncologist that I used to know recently died by his own hand. He was ~ 60 years old.

 

[Jackson D]

I just got back in town and noticed that this thread was active again and it made me sad to read about suicide, depression, and PTSD among doctors. I am now almost 2 years out and can tell you that I still think about the intensity of the work and stress that made me think: This is no way to live. In my case it was figurative and I was able to get out, but in the described cases, people literally ended their lives. I will post a 2 year update in a few weeks but here are a couple of pictures from what I was up to this past week. Life in early retirement is great. I wake up and look forward to what the new day will bring rather than dreading what I face at work.

The pictures are of Point Lobos State Park and the waterfall at Julia Pfeiffer Burns State Park, taken on a driving trip along California Highway 1.

 

[longranger]

Wonderful pics Jackson. Wish i lived closer to you. Would love to chat about your experiences as I plan my own FIRE adventure.