Financial Planning for Doctors

I’ve reached my limit.  I didn’t know that I had one until this year.  In fact, I’m seen by many people as the person who has an everlasting amount of energy and ability to achieve.  In my first two years in practice, I’ve won teaching awards, published randomized control trials, published a personal finance book with a 5-star review, and worked 1.3 FTE as an academic anesthesiologist.

Lawrence B. Keller

Oh, and I run a blog (subscribe here!) and have a nightly basketball competition with my kids. [My two oldest kids play basketball with me each night on their “hanging on the back of the door” basketball hoop.  Let the record show that daddy is currently the undefeated champ.]

 

Catharsis

At some point in the last six months, I hit a wall.  That is when I found my limit.  

As I’ve continued my process of catharsis on this blog, I’ve realized that some things matter and others simply don’t.  Things that matter include my faith (as weak as that may be at times – I am thankful that God is faithful even when I am faithless), my family, and my friends. 

Some of the things that don’t matter include other peoples’ opinions on my career trajectory.  Where my career goes from this point forward is up to me.  That is a disappointing prospect to some who had other ideas of where my seemingly “successful” career was heading.

I’m done trying to achieve other people’s views of “success.”

When I go to the grave, God is not going to ask me how many papers I authored.  He is going to ask me if I looked out for those around me and helped them when they were in a time of need.

What some fail to realize is that I have an insatiable appetite for freeing people – freeing them from their seemingly predestined road to financial despair.  Freeing them from the financial decisions that will later entrap them.  And freeing them from having to subscribe to other people’s expectations so that they can design their dream life and live it each day.

This has become a big part of my career path.  In fact, outside of clinical medicine, addressing the problems that I talk about on this site is my biggest career goal.  It is the legacy that I want to leave.

There is Hope

Teaching others to find contentment and to avoid the lifestyle inflation that shackles so many doctors is an important message.

Some on a more traditional path might think that I am crazy, but I think that it is crucial to provide hope to others so that they can perform a three point turn on their road to burn out.

Financial independence is a key aspect in that turn.

We can change this medical education landscape, if some of the other attending physicians can find the courage to join in the battle.  We must prevent the burnout process before it starts by educating medical students and residents.  

Thankfully, the medical school where I work (Wake Forest) is brave enough to take on this challenge, and they have empowered me to create a personal finance curriculum to help combat this problem.

Let’s Stop Pretending

How about we do ourselves a big favor and stop pretending that there isn’t a problem in medicine.  Let’s stop pretending that physician burnout isn’t an issue.  Let’s stop pretending that we don’t know that most physicians (and most other medical professionals) aren’t financially illiterate

And can we please stop pretending that the systematic beat down doctors face each day isn’t leading to the secondary PTSD and suicide that kills a doctor a day?

Instead, let’s be open and honest about the problems we face.  We are all in this together, and we cannot expect our employers to fix things.  Sometimes the hospital will not love you back.

We must recognize that the significant debt burden and financial jail that doctors encase themselves in is a big part of the problem.

The sooner that we can face the reality that many physicians live paycheck to paycheck despite earning hundreds of thousands of dollars each year, the better we will be.

This all takes a certain amount of honesty and transparency, but I believe we are tough enough to endure it.

Stopping the Trend

With the ever increasing debt burden our trainees face the burnout epidemic is only going to become a bigger problem – unless WE stop it. Yes. You and me.  

We can make this path better for each and every doctor that is being trained behind us.  I would argue that this is a moral imperative for those of us who interact with trainees on a daily basis.

Otherwise, these future physicians will be left to their own devices, and we know where that leads. Just like many professional athletes, our future doctors will spend every dollar they make in order to find the fleeting happiness that money can buy.  

We must educate our physicians in training that there is a better way. 

Take Home

Finding my limit is what freed me to pursue my true passions.  I’ll continue my two pronged approach to this battle (through this website and the curriculum I am building at Wake Forest).  

I hope some of you will join me in this battle.  

We can work to fix the physician burnout that exists.  At the same time, we can empower our doctors to take their financial lives into their own hands so that they can fight back when the system doesn’t fight for them.

Have you ever found your limits?  Are you burned out or feeling the heat?  Are you willing to be a part of the solution to this rampant problem?  Leave a comment below.

TPP

 

12 thoughts on “There is Hope on The Road to Burnout: Will You Join Me?”

  1. Realizing you are hitting the wall is important in recognition for developing burnout.

    Besides my very smart decision to choose a practice that featured lifestyle (no nights, no call, no weekends) over other jobs that offered money, I was fortunate that I was never driven by titles/accolades.

    Some might call it lack of ambition (which I find is funny because in order to become a physician and on top of that get into a pretty competitive specialty field you have to have a lot of ambition) but I call it sanity. I never wanted to be the chief medical officer or president of any organization I belonged to. I did not desire to see my name in a book or publication.

    Because of this I did not feel it necessary to do the extra things to stand out and catch the eyes of those higher above me. I just concentrated on my clinical responsibilities (which despite the decreased clinical hours can still flame some fires of burnout here and there).

  2. What is this “burnout” that you speak of? 😉

    My husband likes to tell me that doctors are extreme people. We only have two settings: Go and Go FASTER.

    It took a while for me to be ok with slowing down. My mantra in the last 2 years has been, “You can do anything you want… you just don’t need to do it all right NOW.”

    Perhaps that will be of benefit for you since you seem to also be afflicted by the need to everything all at once!

    Take care of yourself.

    M

  3. Recognizing there is a problem is the first step to fixing it. You’ve detailed the factors leading to burnout in physicians: the increased debt burden (both educational and consumer) that leads to an ever-increasing hedonic treadmill. Declining reimbursements/increasing administrative burdens placed on physicians have also contributed to the burnout as well. I’ve realized myself that I hit the wall when trying to pursue the recognition title. Let me know where to sign up in the battle to fight physician burnout.

    • Yeah, the recognition part is where I stopped, too. If I get promoted, great. If not, oh well. No one is going to remember what my academic rank was when I die. They most certainly will remember whether I stood up for others that can’t.

      Glad to have you on the team!

  4. for me there’s no “on the road to” . I traveled it to the bitter end, walked into the outback and am still on the path to a new steady-state. My overt battle with the forces of burnout started around 2009, peaked in 2017. Recovery started about when the overt battle started, but I couldn’t recognize it at all for a while. The path to recovery was in full force as early as 2013, but I still didn’t recognize that things I was doing for survival would become my “next career” until literally 3-4 months before I bailed out and pulled the ripcord on my primary career. The free fall and then arrested drift to a landing was no piece of cake, but I’ve “rolled up my parachute” and am now clearly on the road to “what’s next”. I’m what happens when there is no recognition or external intervention along the pathway to burnout. I will never go back to the scene of that slow motion crash, but I’m beginning to understand some ways that could have altered my trajectory in that first career for the better.

    • Nathan, that sounds bitter and hard. I am glad that you eventually sorted it out. I’d love to hear more of your story if you are willing to write a guest post? I think that might prove helpful give your story above.

  5. Financial independence does not seem as much the answer to burnout as it the answer to escape

    If I might suggest a slightly different direction to guide the road to financial independence and what it really means, in every medical school and certainly in every competitive private university, you will find the children of privilege. Some can be identified by their names, some by the private schools they attended from kindergarten onward. Among these is a Rockefeller granddaughter who did psychiatry and arguably the most famous being somebody with a common name who would have escaped public recognition had his hardware and software not become a lurid public trial, that would again be unnoticed were it not for his close Kennedy ancestry. It might be useful to peasants like me who started with little but retired with no financial concerns this year or to those with debt to see how those with no financial impediments handle the challenges of the modern medical workplace. Do they burn out differently, or at all? That might better define the true role of financial security and the ability to cope with a set of working conditions that everyone of all economic strata wished were better.

    • The answer to systematic and systemic problems are systematic solutions. This would involve changing the health care system and the hospitals where we work.

      That is unlikely to happen for now until their are physicians who are free enough to buck back against the system. So, while financial independence won’t solve the problem directly it will empower people to change the system or to escape it if they find it unwilling to change.

      Your hypotheticals about those who have experienced generational wealth are interesting. I don’t come from that background either. I came through bankruptcy as a kid, and poor financial decision after poor financial decision… Until I was made aware of my financial illiteracy.

  6. Once you stop reaching for the shiny brass ring that your mentors set out for you, you realize the one you are wearing is made of gold.

    There’s a great deal of pleasure to be found by diversifying your identity into more than the doctor asset class.

    You knew this entering medicine, but you sacrificed so much to reach your particular pinnacle that the job became justification for neglecting the other facets of your life.

    Hitting that wall reminds you of the accumulated wealth you had banked in the less prestigious areas (Father! Husband!) and that’s what ultimately carries you over the wall to set goals that fit only your needs and expectations.

    It lets you start over and reinvent what medicine will mean to you, and that’s a tremendous freedom.

    • You are so right about walls putting things into perspective. That’s certainly what happened to me. I’m constantly trying to figure all of this stuff out, and it is a learning process as I go.

      Thankful there are those (like you) that have gone before me on this journey.

  7. You just summarized everything I felt in the last 3 years of residency. Lots of people were “disappointed that I did not pursue a fellowship because I was their “super star” resident.
    I simply told myself the truth, running my career on that trajectory will send me to an early grave literally especially as a subarachnoid hemorrhage survivor. I don’t enjoy sleep deprivation, I don’t enjoy being miserable. (Lots of miserable people trying to sell their opinions).
    My faith, my family & I and my friends are the only things that matter. I am my own competition. I have no point to prove to anyone in and outside medicine. By all rational standards I m a success.
    I see the constant push to “do more”, “publish more”, “impress more” as a race to the bottom. In the end, you realize that you have been on a treadmill, going nowhere.
    Just get off the treadmill, enjoy the people and things that matter.

    • Being open and honest about it is the first step. Props to you for being bold enough to admit where you were at. It takes a big person to do that, but you’ll be better for it in the end

      Getting off the treadmill for me has included being vocal about my time expectations, considering part time work, and asking for shifts that help me fulfill my work life balance while also requiring my skill set.

      Some of it has worked. Other methods have not. It is a constant work in progress, but I have faith that it will work out over the next year or two.

      For now, I am working on being content with where I am and enjoying my family and friends as often as I can.

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