I have a confession to make.
Last Wednesday, I spent the entire morning planning my escape from medicine.
I don’t even know how the ball started rolling, but I found myself lost in the math trying to figure exactly how little I needed to live on. I’ve long known the 4% rule – if you can live off of 4% of your total investments, you could presumably retire.
Are you good on $40,000/year? Your number = $1,000,000.
I think people should be able to live more than comfortably on $60,000-100,000/year. That is, unless you read any of the doctor finance blogs. They’re helpful to a point, and then they give someone like me serious FOMO.
How do I not have my real estate crowdfunding investments going yet and why don’t I have rental properties?? Why haven’t I started an aesthetic side gig with botox and fillers?
I think the real question is – do I really want that reality?
As of this moment, I do not so I started thinking:
What could I cut back on to get to my personal number?
I started plotting how to sell our house for a profit, buying a little 500 square foot condo or tiny house and selling all of our possessions. I threw out any dreams of having kids (they’re expensive!), my dream to update my SLR camera for the New Zealand/Australia trip that now is never going to happen. I started to even go down the path of moving to a low cost country to see if I could retire even sooner – hello, Guatamala or Vietnam!
I searched new jobs that could possibly pay me more money so I could get to that number sooner. I was prepared to toss away the relationships I’ve built with my patients over the last 3 years – I mean, if I retired, I’d have to let them go anyway.
I felt excited for the first time in a long time!
This was a goal I could look forward to! I could escape the shackles of this career in less than 10 years if I was diligent enough!
But, it all came to a screeching halt when I started looking at my student loans.. still have $135,000 left to pay down.
This delays my plans significantly. What if I used our emergency fund to help pay that down faster?? Who needs an emergency fund anyway?
OR…. if I flee the country, my lender wouldn’t be able to find me in Vietnam if I got remote enough.
Reality dissolved into fantasy rather quickly.
How sad is it to want to escape your reality when you just spent 11 years to get here?
The grass is always greener
What if I got to retirement and decided I didn’t like that either?
What if having nothing on my schedule started to become too dull?
I have so much inertia to moving forward with something, anything to get me out of this funk, so there I sat, wasting 4 hours of my morning living in fantasy.
Maybe I just needed a vacation.
Vacation mode
As it turns out, a long overdue vacation with my sister was already scheduled for this week. The last vacation I had taken (outside of visiting family in the Midwest last summer, which if we’re being honest is NEVER a real vacation) had been over a year ago.
I struggled with the decision to bring my work computer and whether or not I should check in throughout the week to make sure things were going well. Apparently giving advice versus taking my own advice are two very different things. Ultimately, the computer came and I did work the first two days of vacation until I realized the level of fury I was feeling going through my last 50 documents on Sunday night wasn’t worth it.
The despairing feeling that I would never allow myself to fully disconnect tore through me as I looked at my sister passing the time dominating Quizzup: Star Trek The Next Generation while I worked for 2 hours.
This was not how I was going to spend the rest of my trip.
So, I shut the computer down and got back to doing what I was meant to do – spending time with my sister.
“Sorry about that. I hate having to work on my off time,” fully expecting her to commiserate with me.
“You know, doctors aren’t the only ones who have to work outside of business hours,” she replied nonchalantly.
Of course, logically I know this. I see a lot of patients who deal with high stress and burnout who then come to me requesting Xanax or Ativan so they can just get through their days. I understand lots of people work very high stress jobs for much less pay – I see it every day.
But in that moment, her response was jarring – I was expecting empathy, not a glib retort of,
“Get over yourself.”
What siblings are for…
There is no way I would have let my husband get away with that, but when my sister said it, I had to stop and listen. Also, I was locked into spending the rest of the week with her so we had to get along.
Later, she told me stories of when she worked at an insurance call center where she would listen to people begging her to re-instate their $12/month policies they couldn’t afford. She heard horror stories of children dying in motorcycle accidents to a mother dying in a home fire and listening to their family members trying to pick up the pieces of their loved ones’ lives. When not listening to those stories, she was yelled at for being heartless for not changing decisions that weren’t in her power to do so.
She also knew what it meant to be emotionally burned out in ways she didn’t anticipate.
If you’ve been reading this blog for a while, it must sound like all I have to sell you are stories of how doctors have it so bad.
That couldn’t be farther from the truth.
I am so incredibly lucky to live the life that I live. My life right now is what people speak of when they say, “The grass is always greener.” To be able to even go on a week’s vacation with my sister and explore the San Diego Zoo and Safari Park to see gems like this is more than some people can even dream of:
Many people are dealing with their own struggles through burnout – I speak of mine as a doctor because this is the story I know. This in no way has been an attempt to diminish any one else’s experience.
Work culture in this country is reaching a boiling point. According to The Workplace Is Killing People and Nobody Cares in Insights by Stanford Business, job engagement is low, distrust in management is high, job satisfaction is low and is continually declining all across the board.
This isn’t just a doctor problem. This is an everyone problem.
In the meantime, I’m going to continue restocking my Joy Fund and appreciating my life as it is right now instead of plotting my escape.
Perhaps another moment of clarity to move me forward will come along while I stare into the eyes of a lizard.
Now, back to vacation mode 😎
***
Photo taken in the Badlands, South Dakota. You know, where Scar from the Lion King lives.
If you want to see more from the San Diego Trip, feel free to follow me on Instagram where I’ve been restocking my Joy Fund on my first 30 Day Challenge!
The headline got me. Well done. Thank goodness the rest of the post paints a brighter picture. Love the way “home” brings us down to earth with a thud at times. Good that you heard your sister!
When I see a post that hits so close to home, that I have to leave temporarily and then come back to read it in its entirety.
I see a lot of me in this post, it’s kind of scary. There’ve been many a time I’ve come across the fact that a lot of the things I don’t like about medicine are in many other industries as well. But it’s good because I can take stock of it and make decisions going forward that are more in line with what I want.
I’m always daydreaming about my escape plan, it’s one of the things that gets me through the day sometimes. I’m also guilty of trying to get through x amount of time to get to my happiness at point z, whereas it’d be better to focus on how to make the now a bit better.
Hope you enjoyed your trip!
Thanks for reading! The trip was lovely, but unfortunately it didn’t relieve the dread I had when I returned to work. But, I’m taking this as a good thing – something to push me into action, and just this weekend I brushed up my resume.
Daydreaming is nice and wonderful, but at the end of the day, it’s just escapism and eventually you have to return to reality. The good news is that physicians are doers and fixers – we have the ability to change what needs to be changed, and sometimes that means instead of putting our heads down and biding our time until things magically get better, we need to go through some growing pains and make things happen!
It’s a little terrifying and I’m not sure what’s on the other side, but I know right now what I’m doing is not sustainable. I’m glad to see you wrote another post on your blog and hope your journey back is going well!
Good for you for moving beyond fantasizing and escapism. I also went through that phase early in my burnout adventure. It was appealing for the moment, but in retrospect, not very productive and possibly an impediment to moving forward.
It is better to figure out how to reshape the current version of your life to make it more sustainable and rewarding. Peeling the onion, removing layers of discontent and frustration.
I am enjoying your Instagram photos,
-R
I spent so much time and effort pushing forward to getting to my big girl doctor job that I never stopped to think about what I wanted my life to look like beyond that achievement.
I also wasn’t prepared for the fact that my priorities would change and shift over time – the possibility that one day I wouldn’t want my career to be the only thing that defines me didn’t even register.
Hopefully starting these sorts of conversations will help and prevent the next generation from growing the onion in the first place!
Thanks for following me on Instagram! I love your hiking adventure photos as well!
The average household in the United States makes about $58,000/year before taxes. Even with massive educational debt few physicians are living on that amount of money. Most educational debt can be paid off within 10 years with a 6 figure salary. I think if you are willing to live on the US average salary then retire. Most physician are not average and are unwilling to live the average lifestyle.
Your sister is right– Get over yourself. You are living the dream.
I am absolutely living the dream! The fact that I have enough that an unexpected car repair won’t through me into financial straits puts me ahead of the more than 50% of Americans who have less than $1,000 in savings.
I will say after taxes, $70,000+ going to paying off student loans, and maxing out our retirement accounts, HSA’s and IRA’s, we’re living on about $65,000 a year which is more than enough. I recognize our privilege in being able to max out all of our retirement vehicles, something that is out of reach for many people.
I’m not the only doctor who’s doing this – I think there is a movement of many physicians realizing they don’t need to buy into that doctor lifestyle, allowing them to live comfortably and work less.
With that being said, for me, all this griping really isn’t about the money. I didn’t go into medicine to become rich. It is more the mourning of 12 years of my life dedicated to a career that I’m finding is not what I had hoped it would be. It is the realization that all of the time I spent away from my husband, family and friends, missing out on evening dinners, holidays, birthdays and vacations because I was working 80 hours a week or on call for 28 hour shifts may have been spent in vain. It is the regret of knowing I closed doors to other opportunities that may have been better suited for the life that I would have been happier in.
Sure, we are compensated with money at the end of it all. But it is time lost, and that’s something you can’t get back.
Okay, you are correct you have made a sacrifice. The career of medicine is not about you —-the doctor. It is about providing medical care and helping fellow human beings have a healthy quality of life. It is loaded with personal sacrifice of the doctor. You take your time and energy that you will never recover to help others in exchange for money. Money that you could have made if you had chosen a different career. As a millennial, it is not too late for you change careers or at least a less demanding schedule.
I am a female physician for 38 years. I predate the 80 hour work week. Residents then worked over 100 hours a week. I raised 3 children and took care of an elderly parent. I have missed holidays, birthdays, dinners travelled to the hospital in weather above 95 degrees and 25 below zero. There will be no cornerstones or plaques on any buildings with my name, few awards for service and never made enough money to retire early. I have had a full life— no time lost. l am forever grateful for the opportunity to be a physician.
Remember the cliche “Chose a job you love, and you will never work a day in your life.”—-Confucius
Thank you for trailblazing for us female physicians who have followed in your footsteps! Medicine and life in general for you is much different than what it is for me, no doubt about it.
However, though we have followed your lead, many of us who come behind you and certainly those of us in the millennial generation are starting to forge onto very different paths because quite honestly, we don’t want the life that you just outlined above. And, because of the work women of your generation put in to challenge the status quo, we don’t have to.
It’s not necessarily better, but it is different. There will be issues we run into along the way I’m sure. And I’m sure the women after me will pursue their own paths as well.
What one considers a full life for themselves will invariably be different from one person to another, and it can change several times over a lifetime.
I actually tried to choose the job that I’d love, but come to find out, the job keeps changing because of the current healthcare environment.
I’m now of the mindset, “The grass is greener where you water it.”
I totally agree that “The grass is greener where you water il.” What I find most interesting is that most do not know the path they should take. I know what I don’t want but …….I have not determined what I really want.
M, while I think it’s wonderful that Happy1 has no regrets about her long history of sacrifice and her satisfying career, that does not diminish the validity of your disillusionment with medicine. There are clearly no magic bullets for improving physician satisfaction nowadays, but one thing I’ve found to be helpful is: work less. Even shaving 1-2 hours off the end of each day could help you leave the office just 70% depleted instead of 95% depleted. You will make less money, but you may extend your career longevity.
I 100% agree with you! I have been cutting back over the last 6-8 months. Initially I cut back from 50-60 hours/week to “just” 40, and am considering another change, but one in which I’ll change the job itself to work for me.
I think the biggest killer of satisfaction and happiness is the lack of control over our lives. I’m working on gaining that control back 🙂 Thanks for the comment!
M.
No one has “control” over their lives. Murphy’s law is strong and enforce at all times. I would suggest that you take time and write down 1) what is important to you and 2) what do you think is your purpose or goals in life. After you have identified these two things then develop a plan to achieve #1 and #2. Keep in mind that it is not about the money. If money could solve problems ,so many rich and famous people would have not committed suicide. Look for the daily positive small things that you accomplish not the Big Bang goals.
Examine your skill set exclusive of medicine. What would you do if you had all the money and time you needed? Do a little of that activity on a regular basis. Happiness is not a goal or destination… it is a state of mind. Famous quote “People are about as happy as they make up their minds to be.”
One of my favorite Wayne Dyer quotes is “If you change the way you look at things, the things you look at change.” I share these quotes because as you live this life you will find they are true.
Absolutely – I can’t control everything but I can control the way I react to different things in life and the things I choose to focus and dwell on. Ultimately that is what I had intended my “taking control of my life” statement to me.
I agree, doing more of the things that I enjoy outside of medicine is important, but at the end of the day, the majority of my week is still spent at work. If I don’t change what takes up 45 hours of my life every week, that’s a significant amount of time to be in a toxic work environment. Currently, half of the office has come to me asking if I would be willing to be a reference for them because they are planning on quitting in the next 3 months. I am choosing to try to make it work and plan on discussing the issues with management next week, and if nothing changes, I will then choose to leave.
I am cautious with trying to mollify myself with quotes in the vein of “Happiness is a state of mind” because sometimes that just keeps people stuck in a bad situation. I see it all the time with my patients who are in soul sucking jobs, unhappy marriages and even domestic violence situations.
Sometimes you need to change the environment altogether or leave.
Found your post via POF’s Sunday Best. It felt like I was reading something I wrote myself. As a fellow millennial doctor, I feel very similar to how you feel a lot. Especially your comments on the realization that I made an enormous personal sacrifice to get to a job I found out I really don’t enjoy very much and is not really what I thought it would be. When I first came to this realization a few years ago I was quite negative minded about it and that led to a lot of negativity in my personal life and relationships. Since then, I’ve learned to be more positive. I realize how fortunate I am compared to so many people in this country. I realize that even though I wouldn’t choose this career again, it’s a privilege to have served as a physician at all. I’ve gained an appreciation for life that I don’t think I would have understood otherwise. It’s afforded me the opportunity to travel with my wife all over the world with many more trips hopefully in the future. We live a comfortable life and don’t really have to worry about having enough to meet all of our needs and most of our wants.
I still desire a path out from under the enormous responsibility that comes with being a physician. It can be challenging some days to stay positive. But, I have to keep reminding myself that it could be a heck of a lot worse in so many ways. Just from a health perspective alone, every day I’m not sick and dying like the patients I see in the hospital every day, is a day worth celebrating.
You are absolutely right – we are very fortunate. I think I got sucked into the black hole that is catering to the middle/upper class worried-well population, where sometimes the only complaint that is listed for reason for visit is “tired” – just thinking about it makes me tired!
I don’t round in the hospital anymore, so I don’t have that perspective to keep me grounded. I used to volunteer at the free clinic until my burnout consumed me, and that was helpful to getting over myself 🙂 I have looked into medical missions to help get my mojo back, but until I can find something I can commit to, ultimately, less time at work seems to be the answer for right now.
I’m glad to hear you’ve been able to surround yourself with more positivity! It’s encouraging to hear other people’s success stories. Thanks for the comment!
Hi M,
You are right to choose your direction on the Financial Independence. Financial Independence gives you the options to do things which are of interest to you. I think that the most pressing task for you is to clear up your existing debts with remuneration from the profession whilst not adding more debts. In addition, I am of view that you will be able to clear your debt faster, given that you are in the profession which makes high amount of remuneration. Stay the course and I believe that you will be able to achieve your dream in shorter time to come.
Good luck.
WTK
Thanks! I’m on track to be done with my student loans in a year and half.. not too shabby considering I really only started seriously paying them down in 11/15. It will totally open up a whole new world of possibilities once the shackles of debt come of!
Good luck in your endeavor. Enjoy the journey along the way.
I agree with firewtk. The road to FI really can only be a positive move. Everyone can benefit from losing what does not serve them and saving for an ulitmate goal.
Burnout is very hard to explain to non-medical peers. Even when they know how many years we sacrifice and how much debt many of us come out with, it is difficult to explain how emotionally exhausting some days can be. As we are encouraged to see a higher and higher volume of patients, (many of whom are very entitled and disrespectful) there are days when I come home and don’t want to talk to another human, period. Some days it feels as though they dump all of their emotional baggage on you to absorb and then you leave the room feeling defeated. Then there are the high rates of insurance denials dictating our patient’s care, ever increasing regulator paperwork… the list goes on and on. I worked in a medical mission scenario for 1 year prior to medical school. It is an absolutely inspiring life experience and may help you reboot. In all honesty though, I don’t think it will take much time back in the US medical system before your lifted spirit is weighed down with the same familiar burdens. (sorry, cynicism has crept in)
Chose your number, save like mad, optimize as many aspects of your life as you can to find joy, and have an exit plan. Even if you decide to say in medicine part time, once you hit that number and realize that you have the choice to practice how you please or leave at any time, you may find yourself feeling more empowered and rediscovering what you liked about medicine in the first place!
AG
I have found myself down the financial independence rabbit hole and I 100% agree with you. I’m still settling on my number but realistically I think I’ve only got another 12-15 more years of this left in me as it stands right now. Perhaps if I ultimately decide to do something other than primary care, my career’s lifespan may be longer, but I too am very cynical about the course of healthcare in general moving forward in this country. Just today I was watching something about how telemedicine is going to kill private practice and primary care.
At any rate, half of my take home pay is going toward the student loans and once those are done (hopefully by the end of 2019), that will then be funneled into my retirement/F-U fund a la Physician Philosopher.
Unfortunately paying off the loans is the only thing keeping me employed right now.. even after taking a girls’ vacation again this weekend, I am dreading returning to work tomorrow. The emotional baggage you speak of is crippling. In the Pacific Northwest, depression/suicide/anxiety are so prevalent, probably consuming half my appointments EVERY DAY. Counselors and therapists have 6 month waiting lists, so it falls within the purview of primary care, meaning me. Can’t wait to see what dumpster fire is waiting for me tomorrow!
I have been contemplating doing a medical mission, but I really haven’t been able to find a non-faith based one for me to join. Not that I’m opposed to them in principal, it’s just not my scene. Any recommendations?
The volunteer mission I did was non-faith based. I stumbled on it while traveling in Ecuador. It was purely surgical, but I’m positive there are medical groups out there with similar missions. It will bring back your faith in humanity when you take care of really sick people who walked for days to see you and waited in line for a similar time period without one complaint.
I just paid off the last of $270K student debt last month. I did side hustles (medical and not-medical), and worked like crazy to get productivity bonuses to slap down on my loans. A huge weight has been lifted off, and now the real savings begins. I don’t know how many years I have left in me at this pace either.
Have you considered concierge medicine? It may not pay more but you have more liberty to chose you patient population and not feel rushed with them….just a thought.
I’m happy to chat off line as well anytime. I strongly believe that it helps to get frustrations out with objective friends and not dump in all on our poor spouses/partners.
Hang in there. Start a gratitude journal. Get outdoors and hike it out whenever possible. Nature has a way of balancing negative vibrations:)
AG
AG,
Sorry for the delay in my reply – things have been crazy with the holiday weekend!
I decided to be open with my concerns/complaints with my current practice, and it turns out we’re all in agreement – we can’t continue at this pace for much longer. We’re considering possibly doing a concierge practice vs DPC, and there are plans to flesh this out after things settle down after the holiday. This has been encouraging, but I’m a skeptic – I’ll have to see if this actually turns into anything or if it is just going to be a gripe session without any changes.
In terms of the gratitude journal, I have one of those journals that you write a line in every day for 5 years – it was great the first 2 years I did it… but then even more depressing when I realized I couldn’t think of anything positive to put in toward the 3rd year at the peak of my burnout. To see the slow decline of my mental health directly related to my career is eye opening. I find getting outdoors is where I’m the happiest, and my photography has been therapeutic.
Thanks for the offer to chat off line! I’ll email you outside of this reply 🙂
M