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Burnout and Money
In one of the recent physician burnout and depression surveys, doctors were asked to name the causes of their burnout. The typical culprits were listed: lack of autonomy, EMR’s, lack of support from administrators, insurance companies, lack of time with patients, and so on. However, when they were asked what would improve their burnout, getting paid more was the number 2 cause. Apparently, I am not the only one who believes that there is an integral connection between burnout and money. However, I take a bit of a nuanced view on this compared to those filling out that survey.
Today, I’m going to take this a step further and discuss how our relationship with money can both help or hinder our physician burnout.
The Road to Burnout
The road to burnout has been well documented on this blog. Here is the primer for those just now joining the blog. This story should sound very familiar to you.
Many of us sacrifice our 20s or 30s while we pursue an altruistic calling to become healers. This includes medical school, residency, and fellowship for some of us. All the while, we see things humans were not meant to see and often feel helpless in healing patients. This is a system that produces the moral injury that has become so well known to the medical community.
We push through the 80-100 hour work weeks during residency anticipating that bright light at the end of the tunnel. When we finish, we find all of those contributors to burnout that were mentioned at the beginning of the post. At this point, our slow-fading burnout has the potential to turn into a roaring flame.
And, it is exactly at this branch point that money can either make matters worse or it can be used as a tool to wield freedom from the forces that threaten to end our careers.
Making Matters Worse
For those that continue on the road to burnout, this is the point where they make matters worse. When they find that the light at the end of training is not as bright as they thought it would be, and that their autonomy has been stripped from them by various entities… they try to find other ways to make them happy.
At this point, many people buy the big doctor house, nice cars, private schooling, and designer gadgets. Of course, this is all done while 80% of us are wallowing in student loan debt.
These purchases are made in order to improve our lives, but most find that three, six, or twelve months down the road that these purchases led to just the opposite. Our burnout is worse than it was at the beginning. Except now, we are not only burned out. We also feel trapped in that burned out lifestyle.
This is the second leg of the journey that this blog is meant to prevent. There is a less traveled road that can be chosen. And it leads to freedom.
The Road to Financial Freedom
Remember that branch point? It is the point when we are finishing training. This is when we receive our first attending physician paycheck. It is at this point that we will make some of the most important financial decisions of our lives.
The Road Less Traveled
Instead of making the catastrophic financial mistakes mentioned above, let me walk you down that road less traveled. The road that leads to financial freedom.
At the end of training, we sit down with our significant other, if we have one. If not, we find a best friend. We go through the Three Kinder Questions to get the big picture squared away first. For the 80% of us with student loans, the 21% of us with credit card or consumer debt, and the untold number with car loans…we realize that our debt is our number 1 problem starting out.
Doing the math, we realize that we cannot make all of the purchases that we want while we are upside down in debt. We can have them someday, but things need to be put into order first. Medicine has taught us to become experts at delayed gratification, and those on the road to financial freedom choose to exercise this super power again after training.
We make a plan to deal with all of that debt right from the beginning. However, we aren’t masochists. So, though we are going to spend 90% of our money taking care of that debt or investing for our future… we also use The 10% Rule and take 10% of our post-tax increase in pay after training for our own enjoyment.
Then, we do some math to figure out how much we need to save each year to get to the point where we no longer have to work if we don’t want to. This is our path to financial independence.
The Road Less Traveled
For those who are brave enough to limit our lifestyle creep and continue our delayed gratification after training, we find out that the secret to financial success is finding contentment. We understand that studies have shown that buying “things” do not lead to increased long term satisfaction or joy.
After we find this freedom, we realize that this road leads to the one great possibility that can save our careers. It leads to our ability to practice medicine because we want to, and not because we have to. That is the freedom that is provided by choosing the road less traveled.
Fortunately, we do not have to wait to get to the end of the road to experience its power. Once we have spent sometime on this road, we realize that we have other options. We can cut back at work. It opens doors to experience other paths to financial freedom, namely passive income through things like real estate, side businesses, and the like. It also allows provides the courage necessary to make the changes that are badly needed in medicine.
Money has a dual relationship with burnout. It can be used in a way that makes our potential for burnout much greater. However, it can also be used to join the road less traveled, which leads to financial freedom and provides a way out from our burned out future.
Recognize that money does not fix the true problem, which is more aptly called “moral injury”. However, until the system fixes itself, we must provide options to the physicians who feel trapped in a lifestyle and future that they feel powerless to change.
Join me, if you are brave enough, and make that light at the end of the tunnel as bright as it was always meant to be. Take back the freedom you deserve through financial independence.
What do you think? Does your relationship with money impact your burnout or mental health? Does it provide stress or freedom? Leave a comment below.
Your post brought to mind the words from William Bernstein’s forward of Johathan Clements’ book, How To Think About Money.
Bernstein wrote, “On the surface, it all seems so obvious: We need money to buy the stuff that will make us happy. No, no, and no again. First and foremost, money buys time and autonomy. Secondarily, it buys experiences. Last, and least, it buys stuff, and more often than not, the stuff we buy makes us miserable.”
Most of us have been guilty a time or two for missing the mark for what actually brings happiness and fulfillment.
I agree with you that money can either be something that enslaves us (and leads to burnout) or something that allows us greater independence and freedom.
To the road less traveled!
I love Bill Bernstein (and his writing) and How to Think About Money is probably my favorite money book that I’ve read. I bought a copy and gave it to one of my residents this week, actually.
The road less traveled may be less popular, but it has a far better destination in mind.
I don’t think money and burn-out are directly related. However, unremitting stress and burnout are directly related, money and stress can be related and therefore money and burn-out are indirectly related. The ability to create the environment in which one practices is fundamental to a professional, nowhere more than amongst physicians. Medicine is so very personal, such an intimate relationship between physician and patient, that arbitrary constraints, barriers to providing optimal care, interferences of every kind eat at the core of the relationship, leading to chronic frustration. The inability to make these interferences go away, and the inexorable increase in the number and complexity of hurdles put in front of us is what leads to depersonalization, a sense of low self esteem, embitterment, cynicism, burnout and it’s first cousin, clinical depression. Been there, done that. There are only two solutions; change the system or leave it. All the “resiliency training, mindfulness, etc., in the world won’t make it better if what you return to every day is the emotional equivalent to a shooting war. I did what I could to change/protect the environment in which I worked, but when I couldn’t anymore, the only alternative was to leave it. I hate the fact that the “system” won and I was defeated, but in leaving it the constant triggers to frustration stopped. Rebuilding something as lovely as it was when it was good is a conundrum, but far better than enduring what was when it became unhealthy. If I could, I’d be a part of something bigger than a purely a personal recreation of career and meaning, but I don’t see that bigger thing happening at a systemic level.