Financial Planning for Doctors

You have suffered sorrow and humiliation. You have lost your wits and have gone astray; and, like an unskilled doctor, fallen ill, you lose heart and cannot discover by which remedies to cure your own disease. ~ Chorus from Prometheus Unbound

These words were published in 1820. They come from a Greek mythological play, and they could not ring more true today. The medical world is filled with burned out doctors and nurses.  Many feel that they have lost heart and have become unskilled in their ability to treat their own disease.  This is certainly a part of my burnout story. Yet, the root of this passage in Prometheus Unbound can actually be found elsewhere in the phrase “Physician heal thyself!”

Physician heal thyself comes from the Bible. Specifically, it can be found in Luke 4:23 where Jesus quotes a common Jewish phrase of the time, saying, “Ye will surely say unto me this proverb, ‘Physician, heal thyself’.” (KJV).

What exactly does Physician heal thyself mean?  How has that meaning changed in today’s modern medical world, and what can we learn from this important idea?

What does “Physician Heal Thyself” mean?

In Biblical times, it was common among the Jewish culture to use the phrase “Physician heal thyself”.  This had a nuanced meaning. They believed that before a physician could adequately cure the disease that others were experiencing, they must first heal themselves.

It is the idea that you cannot fill the cup of others unless your cup is full, too.  This makes sense.

Physician heal thyself could be extrapolated to mean that before you venture out into the world to heal others, you probably ought to heal you and your own town first.  In fact, this is exactly how Jesus meant it in the passage in Luke.  At the time, he was being accused of healing acts that seemed to occur everywhere; except for in his home town.

This idea also stretches to the crucifixion of Christ.  On the cross Jesus is implored to save himself.

Those who passed by hurled insults at him, shaking their heads and saying, “You who are going to destroy the temple and build it in three days, save yourself! … In the same way the chief priests, the teachers of the law and the elders mocked him. “He saved others,” they said, “but he can’t save himself! ~ Matthew 27:39-42

It was a strong belief in those times that if someone was powerful enough to save others, they must be powerful enough to save themselves, too.

Do physicians need healing?

Physicians must be fiercely hard-working, intelligent, resilient, and self-sufficient.  That’s how they became doctors.  Yet, because of the very characteristics that got them into medical school, they often don’t ask for the help they need.  Doctors often try and fix things themselves, even when outside help would be best.

Due to a myriad of reasons, physicians cannot heal themselves, though they desperately need it.  In fact, physician suicide rates are alarming.  In fact, Pamela Wible maintains a list over 1,000 physicians who have committed suicide.

Is Physician heal thyself the right idea?

The burnout and mental illness that is pervasive in the physician community is alarming.  In part, this comes from an expectation for physicians to fix their own problems.  Physician, heal thyself!  Because of their personalities and this expectation, doctors have a hard a hard time seeking help.

In truth, physician heal thyself can be an inappropriate ideology.  Like any other human, physician healing from burnout, depression, and suicidal thought requires others to help in the healing process.

The causes to physician burnout, depression, and suicide are many.   Many causes are systematic in nature.  These include insurance company demands, administrator expectation, and electronic medical record difficulties. All of these problems lead to physicians who feel unable to provide the care their patients require.  They are left seeing traumatic events in the lives of those they are meant to serve.  Ultimately, this results in a phenomenon called moral injury.

Personal Causes for Burnout

Of course, the medical system isn’t completely to blame.

There are personal aspects to burnout, too.  Physicians are human.  We have challenging marital and family situations. Our average student loan debt graduating from medical school is around $200,000.  We also struggle with health problems, mental illness, work-life imbalance, and demands outside the workplace.

Financially, physicians are like professional athletes. We often turn to money to find happiness.  Yet, no matter how much money a doctor earns, our profession has shown time and time again that doctors are financially illiterate.  We are notorious for financial decisions that make our burned out and morally injured situations worse.

It turns out that big houses, fast cars, private schooling, and expensive gadgets… do not make you happy. It is the tale of two doctors.  Most follow Dr. Jones by taking the financial road to burnout.  Yet, it doesn’t have to be this way.

If physicians want to continue on and provide excellent care to their patients, it seems that Physicians do need to take part in healing themselves.  Though, this needs to occur with the help of others as well.

Can Physicians Heal Thyself?

If the medical system – which produces burned out and depressed physicians refuses to change – it seems that the doctor must heed the advice to heal themselves.  What options exist for this?

Of course, there are the typical methods that are often spouted in this arena.  Things like meditation, exercise, deep breathing, counseling/therapy, and medications.

Some of these help.  Yet, these items treat the symptom; not the disease.  They are a bandaid when we need an operation.

How Can Physicians Find Healing?

The tool that provides the most help and hope is financial freedom through financial independence.  Physicians who free themselves from the financial shackles that bind them to their dedicated road to burnout can follow the call to heal thyself.

There is hope on the road to burnout.

With this new found financial freedom, physicians have the opportunity to pursue partial FIRE where they take less shifts, move to part-time work, focus on locum tenens (part-time) work, or leave a hostile work place.

Many physicians who take this step find the true meaning in “Physician heal thyself.”  Often, they fall back in love with medicine, and find a new-found passion for a job that has become a daily nightmare.

Take Home

If you have found that the light at the end of medical training is not as bright as you anticipated, there is hope. Physicians cannot completely heal themselves.  We need help.  Just like anyone else.

Yet, there are ways that we can make bad situations better.

First, we must become financially literate by reading a good personal finance book for doctors.  Then, we can remove ourselves from the financially paved road to burnout.  This new found financial freedom will allow us to help reshape both the culture of medicine and our individual lives.

Don’t lose hope.  There is a remedy to your disease.  Physician, heal yourself – and, please, ask for help along the way.

Has you ever lost your way in your job?  Have you ever lost your work-life balance, or found yourself burned out, morally injured, or depressed?  How did you find your way back?  Leave a comment below.

TPP

6 thoughts on “Physician Heal Thyself…And Why Doctors Don’t”

  1. Heal thyself for financially illiterate and indebted physicians often starts with heal thy wealth. In order to be free to apply our healthcare training and gifts, it is more than ever imperative that we get on the path to wealthcare and financial freedom.

  2. Hey TPP. Can’t believe I didn’t see this sooner. Feel as if it’s mandatory for me to comment on this one…..given the name and all. Rant warning, ahead.

    I have to say, honestly, that I don’t fully agree with this post. The solution to the problems of “the game”, aren’t just to save money and get out it it sooner. I hope for most, that’s not why they got in “the game” to begin with. Sure there’s huge benefits to that – namely increased freedom, free time, opportunity. And those are certainly things to strive for, and can help you free up the time to do the “healing”.

    But freedom also doesn’t create healing. Doing the things that create healing, create healing. That can be many things. Learning to express yourself more emotionally. More physical exercise. Time spent doing things you love. Improving your relationships. Being more aware of what you spend your time thinking about. Changing the way you practice to be more in line with your values. You’ve still got to do the work. If you don’t have any “time” for that, then perhaps that’s something to consider as well.

    If you’re feeling the pull towards burnout you should start making some changes now. Like, right now. No matter what your financial situation, and not at some future “point” when you’ve acquired enough capital to work less. The future isn’t guaranteed, and the longer you wait, the more ingrained become your patterns. Will you doing things like start exercising, eating right, and sleeping more in 10 years? Is that what you’d tell your patients?

    • PHT,

      First, let me say that I appreciate your honesty and for telling me what you really think. There aren’t enough people like that around. So, thank you sincerely.

      When it comes to burnout and moral injury here is my overarching view.

      First, the cause of these problems is both systematic and individual. You and I cannot fix the vast majority of the systematic causes (think insurance companies, EMR, adminstrators, non compliant patients, tragedy that befalls people before they even get to us, etc). So, in some senses Physicians cannot heal themselves. The system needs to heal itself so that doctors don’t take the brunt of it.

      Second, until the system is fixed there are some individual bandaids that we can use to make things better. And, if we are being honest, sometimes we bring our own problems to the table that make burnout and moral injury worse. Some of these things we can make better, but they often have a limited effect including meditation, therapy, counseling, mindfulness, or even medication depending on the causes. I think the more powerful individual trestment includes finding financial freedom so that we can pursue partial FIRE (part time work), the power to demand those systematic changes I mentioned above, or to walk away completely if medicine refuses to change.

      Again, I appreciate your honest feedback. Personally, I have started doing some of the things you mention, including meditation, taking more time off, exercise (though I’ve done this for two years now regularly), etc. Even with all of that… I am not going to fix the system by myself. That requires a whole bunch of us with enough financial freedom that we can stand up and demand the changes.

      TPP

  3. Great discussion TPP. Thanks for replying so thoughtfully.

    I think we’re on the same page. Just using a different lens to examine it.

    Yes, the system has problems. Big ones. And as much as I believe in mindfulness as a valuable tool, for instance, you can’t change the system by focussing on your breath.

    But you can change yourself. That I firmly believe in and have noticed in my own life. And when you start doing that, you’re in a better place to work to change the system.

    One should pursue financial freedom. It’s a worthwhile goal. But it’s worthwhile if you use that freedom to continue to help improve yourself and work towards helping others/the system. In whatever way that is for you. But if you pursue it just to chill and have more stuff, you’ll be in a no better position in the end of it all. You’ll just get used to that and want more time and bigger things.

    Work starts within. And it’s WORK. Might as well start now.

    Thanks again .

Leave a Comment

This site uses Akismet to reduce spam. Learn how your comment data is processed.