[Today’s post is from The Physician Philosopher, an academic anesthesiologist who writes about financial independence, personal finance, and physician wellness topics. In this article, TPP discusses some of the criticisms of the FIRE movement as it relates to physicians. These criticisms are real – well before I started this blog and FIRE was a term, there was a searing, controversial 2011 op-ed in the New York Times by a female anesthesiologist entitled Don’t Quit This Day Job, where she implored her fellow female physicians to eschew part-time work or early retirement. This article previously ran on The Physician Philosopher’s blog in August 2018. -WSP]
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 worklife 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 roll at a relatively small private company in the Pacific Northwest that was trying to sell stuff over the internet… My friend’s 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 Jason Kilar hadn’t ignored the naysayers. If he had listened, Jason might still be building and stocking those shelves at that 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, then? 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 in preparing them on how to obtain both wealth and wellness. I don’t see any major movement by the “establishment” to fix physician suicide, burnout, or poor financial literacy.
“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.
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 ACGME for limiting the number of nationally available residency slots. There is 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 bottleneck 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.
What do you think? Has anyone ever given you a hard time about pursuing FIRE? What was your response?
Having sacrificed enough to go through medical school and accumulate a large amount of debt and then get underpaid for the amount of hours you put through residency I believe is enough to pay back whatever society thinks a doctor owes them.
No one can know what you have done unless they too have walked in your shoes, so it is easy to criticize someone from afar. If society wants doctors to practice longer, than there better be changes to the system that are causing doctors to want to leave.
Docs complain about the incessant hoops we have to jump through for both insurance companies and government regulations as well as declining reimbursements. Fix those issues and a much larger % of doctors would be willing to work longer.
Make us feel like clerical workers with decreasing clinical work and you will get dissatisfaction which leads to wanting to leave. You can’t have your cake and eat it too. Society wants docs to work themselves to death apparently, but the smart docs are no longer giving up this pound of flesh.
Completely agree, Xrayvsn. People blame doctors for a system that beats them down and no one will fix. Just doesn’t make a lot of sense.
If you want docs to work “full careers” then try treating us with respect and throw in tort reform.
Physician financial health is so important, yes for FIRE, but also for job satisfaction. When we take control of the dollar, get out of debt, and aren’t controlled by the threat of losing our job, we can better advocate for our patients and climb out from under the feeling of being stuck in a broken system that causes burnout. If someone retires early, that’s their choice. Personally IF I retire early, I see myself opening a not-for-profit, income based fee only clinic. I only see it helping my patients.
The most important part of FIRE is the FI part. I don’t usually talk a lot about early retirement, and tend to focus much more on financial independence. The reason? I think a doc who is FI is a better physician for the reasons you outlined. There is leverage and freedom in not having to worry about losing your job.
As opposed to feeling stuck, they can choose to practice medicine because they want to and not because they have to. Powerful stuff.
TPP
If the average worker puts in 40 hours a week and retires 40 years after college (about age 62), then a doctor who puts in 80 hours a week should retire 20 years after college (about age 42) to be fair. Any work a doctor does after age 42 is gravy and they should be thanked for putting in the extra time. Any doctor who retires after age 42 should not be considered “retiring early.”
Dr. Cory S. Fawcett
Prescription for Financial Success
You know, Cory, I’ve never thought about it like that. That’s actually really interesting.
Thanks for pointing it out, and hope you are doing well!
TPP
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