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Articles

It’s Wrong for Doctors to Retire Early

By Jimmy Turner, MD
The Physician Philosopher

Physician Disability Insurance

When Jason Kilar graduated from college he experienced tremendous personal and professional adversity.  Three days after graduation, Kilar’s father ended his own life after battling Bipolar disorder.

Kilar also battled professional valleys. In the months after graduation,  the work life he had long envisioned couldn’t have seemed further from the reality he faced.

After building shelves at a local store and hustling to find a job that he actually loved, this is what Jason says about that time right after graduation during a commencement speech at UNC-Chapel Hill.

“Upon graduating from business school…with a debt level that approximated Slovenia’s gross domestic product… I jumped into a modestly salaried role at a relatively small private company in the Pacific Northwest that was trying to sell stuff over the internet… My friends and family thought I was insane to go there given the uncertainty and the traditional opportunities I was forgoing…”

The company Kilar is referring to is Amazon.  Little known at the time, but I bet you’ve heard of it now.  He learned under the wings of one of the best growing companies of our time, and after leaving went on to create Hulu.

However, none of this would have happened if Kilar hadn’t ignored the naysayers. If he had listened, Jason might still be stocking those shelves at the local store.

Doctors pursuing Financial Independence & Retiring Early (FIRE) can probably relate to some of Jason’s story.  Whether you and I like it or not, there are people who would argue that chasing after FIRE is wrong, particularly when it comes to doctors.

Let’s take some of the most common arguments – one by one – and see if they hold any water.

“If You Plan to Retire Early, Medical School Should Never Have Let You In”

“Well, if you were only planning on working for ten or fifteen years, maybe your medical school shouldn’t have wasted a spot on you!”

It’s this sort of inflammatory rhetoric that makes me wary of sharing FIRE principles with other (non-trainee) people in real life.  People get so passionate about the topic that discussing FIRE has burned many bridges.

The reason that these people are sippin’ so hard on their hater-ade is that they feel you took a medical school spot from someone else that would have spent more time in their life furthering “the cause.”

It’s wrong for doctors to retire early! Right?

They view the FIRE movement as inherently selfish.  Clearly, you can’t FIRE and be thinking about anyone else except yourself.  I never knew that there were so many mind-readers out there!

A Reasonable Answer

The idea here is preposterous.  How many years of working in medicine would be acceptable?  Twenty? Thirty?  Til you die?

Oh, and by the way, some of us also plan on using our medical skills long after our full-time work is done.  When I finally FIRE, I’ll be spending ample time on the mission field teaching others how to provide safe anesthesia.  Hopefully, all over the world.  So selfish.

While I am on my rant, let me point out the fact that our medical training perpetually fails our trainees.  I don’t see any major movement by the “establishment” to fix physician suicide, burnout, or poor financial literacy.

For the record, I don’t teach FIRE to trainees for various reasons, but I also don’t blame any medical professionals who are planning to FIRE.

“You Are Not Dedicated To Your Patients”

This one is pretty cut-throat.  Telling a doctor that they don’t care about their patients is cold.  Even still, I’ve heard people say it.  Sometimes this is said in softer tones about being “weak”.

The premise is that if you are trying to achieve early financial independence, you must be trying to retire early. And, if you are retiring early, you will be hanging all of your potential patients out to dry.

Finding a good doctor is already hard enough for most patients.  Why would you leave them in their time of need?

A Reasonable Answer:  

Simply because some of us are trying to achieve financial independence, does not mean that we are trying to retire early.  We might not be leaving our patients at all.

In fact, I would argue that a financially independent doctor is a better physician.

Taking care of the doctor helps take care of the patient.  In a crashing airplane, you put your oxygen on first so that you can help others.  It’s no different here.

“What About the Doctor Shortage?”

The argument made here is a bit more complicated.

“Aren’t you worried about the doctor shortage?  If you retire early, won’t that make the doctor shortage worse?”

But are we really creating a worse doctor shortage?

A Reasonable Answer:

First of all, let’s point out that this problem exists not because too many board-certified docs retire, but because not enough are created.

There are loads of people who apply for medical school every year.  Many of those that finish medical school get sent into perpetual rounds of internship, because they cannot match into a residency after becoming a doctor.

The bottleneck is not created by early retirees, it is created by the limited number of available ACGME residency slots. (Editor’s Note: previously attributed to be “caused” by the ACGME – the limited number of spots in the cause regardless of the source).

There are an abundance of allopathic and osteopathic physicians out there looking for meaningful work after medical school.

Holding on for a later retirement isn’t going to fix this problem. Fixing the bottle neck will.

There is a much more pragmatic and rampant problem happening in medicine though.  It’s called physician burnout, and I am here to tell you that financial independence can help fix that even if it can’t fix the doctor shortage.

Take Home

Like Jason Kilar, I encourage you to ignore the naysayers. Pursuing financial independence is not wrong. And it just may save you.

Instead, make it a goal to achieve early financial independence for the right reasons: decreasing burnout and increasing autonomy… both of which lead to better care for our patients.

That’s what I call putting our patients first.

Has anyone ever given you a hard time about pursuing FIRE?  What was your response?  

TPP

25 Comments

  1. Xrayvsn

    A recent Doximity post on Physician on Fire’s article on retiring at 43 really opened my eyes to how much hate is coming from the medical community itself.

    There really were some nasty comments directed at POF which I felt were unwarranted. I wrote about the conflict as well in my post, The Great FIRE debate (which I also put in the comment section for them to read).

    There will always be haters. No one is going to live in your shoes so no one has a right to tell you what to do with your medical degree.

    Reply
    • ThePhysicianPhilosopher

      Man, I can’t believe that. I just read some of the comments. The venom was flowing.

      I guess it’s easier to cast stones than to fix the broken system that is leading to disproportionate amounts of burnout.

      Reply
  2. VagabondMD

    If “society “ did not want to push docs out of practice, “society” would create a medical environment that docs would not be motivated to leave.

    Reply
  3. Physician on FIRE

    Thank you for this. I’ve been thinking about generating a response to the naysayers who are quick to make false assumptions and egregious accusations without thinking to ask questions or give someone the benefit of the doubt.

    When you assume the worst in everyone else, what does that say about you?

    Best,
    -PoF

    Reply
    • ThePhysicianPhilosopher

      I am sorry that you had to deal with that, POF.

      I just saw some of the comments and many of the were simply absurd. People are quick to judge and guick to jealousy.

      For the record, I greatly appreciate all the help you’ve provided along the way and the awesome example you have set.

      Don’t let the naysayers get you down.

      TPP

      Reply
  4. Mrs. Groovy

    I had little idea there was so much hater-ade! I think a lot of the hate is based on envy for those like you who are nimble enough to take a nontraditional path. The haters are stuck but they’re not willing to do anything about their situations. They’d rather take you down. Misplaced anger is what I’d call it. They seriously need to look in a mirror.

    Reply
    • ThePhysicianPhilosopher

      Misplaced anger is a great way to desrcribe it. So many doctors are stuck and have no idea how to get out. Because of that they can’t acknowledge it as a viable way of life.

      Denial can be strong.

      Reply
  5. A Financial Savvy Doc

    What an eye-opener.

    The envy and misunderstanding of individuals that allows them to develop a fatalistic attitude towards doctors and what they “should do” is disappointing.

    The sad part about these people is that they are adamant in their opinions and no sense of logic will change their minds. It’s not worth arguing with them because they will just dig their heels deeper into what they already believe.

    I easily get lost in the supportive FIRE community (that we have amongst fellow bloggers) that there are people out there that hate us and what we are trying to accomplish.

    -FSD

    Reply
    • ThePhysicianPhilosopher

      I agree that the community here is outstanding. My blog and the community have made it easy to get off of social media and the “whatsitaboutism” (a real thing) that is so prevalent there.

      Reply
  6. Johanna Fox Turner

    You make such rational and well-considered points, TPP. Thank you. Your thoughts and others’ comments will help me, the “outsider”, be a better planner to clients who express ambivalence about contemplating the ability to FIRE early in their careers. It is important to be encouraging while understanding the dynamics at play in this goal.

    You are so right that physicians don’t want to FIRE (actually, for the significant majority of clients, just to be FI) to simply live a life of luxury, but to be liberated from making decisions based solely upon continuing to receive a paycheck.

    Reply
    • ThePhysicianPhilosopher

      Thanks, Johanna. That’s what makes you a great advisor (in addition to your reasonable way of doing business!). You care to know the ins and outs of how we tick.

      Thanks for the support!

      Reply
  7. Teeth92

    Just a dentist here , but when I sold my private practice after 24 years my staff and patients were mad. I thought they would be happy for me. I think it’s just some people’s human nature to be self absorbed . Everyone was concerned about how the changes would effect them.
    This post is akin to the heated discussions among dentists concerning how many female dentists “should” be admitted to dental school. For years , some dentists felt that because women were less likely to own their practices and become employees or work part-time that preference should be given to men who would presumably own and work longer careers. Thank you for writing this article. It made this dentist who sold after 24 years feel validated.

    Reply
    • ThePhysicianPhilosopher

      It really is crazy how people view this same topic so differently. I don’t preach early retirement on this site. I focus more squarely on financial independence.

      That said, I fault no one who wants to leave medicine early with the way everything is now, or if they want to go focus on something else that they are passionate about.

      Good for you for putting the work in and leaving after 24 years. Impressive stuff.

      Reply
  8. Ed

    Just want to say thank you for well-written answers to the ridiculous arguments made by those who don’t get it. FIRE should be taught at an early age and in medical schools. I strongly believe society could benefit greatly from your message.

    Ed

    Reply
    • ThePhysicianPhilosopher

      I really appreciate that! It’s comments like this that keep me going.

      Stop back by anytime!

      TPP

      Reply
    • thestockmd

      Ed, I’m not sure I agree that FIRE should be taught at an early age. I struggle with this periodically as I FIREd and have young kids that see me at home during the ‘work day’.

      Perhaps a better way to approach this is to teach financial literacy in general and transition to a more nuanced discussion as the student matures.

      Reply
  9. M

    I really liked your comment on fixing the bottleneck of residency slots. While I’m not a physician, its my opinion that this is the root of many problems with our medical system and extends to doctor burnout, doctor’s crazy hour, the growth of huge medical groups, high medical costs, etc.

    There is clearly a need for more doctors, and we need to allow supply/demand to work more freely.

    Reply
    • ThePhysicianPhilosopher

      Yeah, it’s definitely an issue. It’s a classic argument or shifting the blame to individuals (doctors) instead of fixing the broken system.

      Reply
  10. Ob Doctor Mom

    I, too, experienced the haters when one of my articles about the ethics of retiring early was picked up on Doximity. Luckily, there were also quite a few physicians who had my back. Regardless, I stopped reading the comments. In the end, I am learning to worry less about what is “expected” of my life, and instead leading it the way that feels right…and I am learning it is an ever evolving path. Great article.

    Reply
    • ThePhysicianPhilosopher

      Thanks, OB Doctor Mom.

      After watching the same thing happen to Passive Income MD and Physician on FIRE, that doesn’t surprise me.

      I, too, think it’s important to set your own expectations and worry very little about those that are placed on me by society, my adminsitrators, or other individuals.

      I am sure my goals will change and evolve just like yours. That is part of the fun, though.

      Thanks for stopping by,

      TPP

      Reply
  11. Jeff P Tarola D.D.S.

    There was a time when doctors would practice for many, many
    decades. But that was before insurance companies, and PPO’s,
    and massive paperwork and government regulations and
    massive malpractice practice premiums and having to get
    permission from insurance companies before you could order
    tests or do procedures. A time when a doctor could actually spend
    time with their patients. But those days died in the 1970’s and early
    1980’s when doctors were no longer in “private practice” but
    became cogs in the insurance business and government Medicare.
    Medicine is a very noble way to earn a living but the doctor
    patient relationship has been destroyed by insurance companies
    and government regulation. When an MD sees his local plumber’s
    income is equal to his/hers with none of the hassles of running
    a medical practice then getting out early looks very appealing.

    Reply
    • ThePhysicianPhilosopher

      Yeah, it’s a tough spot to be in… Going into a something as a calling to later simply be treated as a number or employee that doesn’t matter to those in control.

      Reply
  12. Psy-FI MD

    This is an excellent post! After becoming financially woke, I’ve encountered folks who think a physician should work until their 70’s. One or two have sited that medicine is a calling.

    Some naysayers forget that many of us spend a minimum of 3 years (in my case 5 years) serving the poor and underserved. It’s called residency (and fellowship) training. There was someone (WCI I believe) who mentioned that we pay back society’s (monetary) investment in us in 1 or 2 years of attending service.

    Becoming financially independent and working a lifetime makes the calling real. Being financially dependent while working a lifetime is just indentured servitude to your financial obligations.

    Reply

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