About Me

Mission Statement


Physician on FIRE is a personal finance website created to inform and inspire both physicians and our patients with insightful writing from a physician who has attained financial independence and the ability to retire early. The site has a triple aim to leave visitors enlightened, educated, and entertained.





Hi! My name’s Leif. I also go by PoF, the Physician on FIRE.  I’m a former anesthesiologist, a family man, and a supposed outdoors enthusiast who spends way too much time indoors.


I have a lovely wife and two lively young boys. I enjoy writing, I enjoy photography, moderate exercise, spectator sports, background music, craft beer and homebrewing (also in moderation, of course).

I attained financial independence (the F.I.) at age 39, meaning I could afford to retire comfortably after a 9-year career.  I continued to work for various reasons, and I mostly enjoyed my job, but I did choose to retire early (the R.E.) from medicine at the age of 43. 

To learn more about this was possible, please navigate to  My Story or My Path to FI. 




PhysicianOnFIRE.com is a web log a.k.a. blog site dedicated to the discussion of issues pertaining to personal finance, early retirement, medicine, and miscellany.  I will post new material every week as long as I have something to say, and readers to read.




The seeds for the blog were planted in my mind in 2014, I formulated a specific plan in 2015, and created the website with my first post on January 9, 2016. I typically publish several blog posts a week, including a popular Sunday Best round up post every weekend.


Learn how to better manage your student loan debt, and explore refinancing to a lower rate with cash back offers up to $1,000! Student Loan Resource Page




I live, work, and write Up North, but I’ve lived and worked both north and south of the Mason Dixon Line, and east and west of the Mighty Mississippi. Most of the writing is done in a corner office on a solid walnut desk that was once used in a surgeon’s front office.

I’ve lived most of my life in Minnesota, and we now call northern Michigan home. I was once a Gator Sedator as an anesthesiology resident at the University of Florida, and I completed my internship at Gundersen Lutheran in La Crosse, WI, a city known for having the most bars per capita in the whole country.

My numerous locum tenens stints (before, in between, and sometimes during my “permanent” jobs) took me to hospitals in southwest Florida, central Wisconsin, northern Minnesota, Pittsburgh, PA, many parts of Michigan from near the Indiana border to the U.P. I also worked regular anesthesia jobs in northern Michigan, eastern South Dakota, and northern Minnesota.


my other office



I created this blog to enlighten, educate, and entertain fellow physicians and other people who may have similar circumstances (high-income, late start, educational debt, etc…). My aim is to help those who want to help themselves and share some unique insights from the perspective of a practicing physician. I hope to leave you informed and inspired to look at life a little differently than you might have before.

Physicians, on average, are notoriously bad with money. We are singled out in The Millionaire Next Door as being the worst accumulators of wealth among high earning professionals. Meanwhile, the demands of our jobs are increasing, bureaucratic requirements are stifling our ability to practice autonomously, and burnout is on the rise.


I want to help my fellow physicians and others to understand what it means to be financially independent, how to achieve that goal, and why it will benefit you. Some, like me, will contemplate an early retirement. Others will use their FI status to practice in a way that suits them. It could be part-time or in a way that is less focused on salary, but more fulfilling.

Personal finance will be prominently featured in my writings on this blog. Being a physician, I will also discuss some physician-specific issues on occasion. You can also expect to find some stories and perspectives that are personal, or as personal as you can get from an anonymous writer.

You will see ads on the site. One of my goals is to build up a sizable donor advised fund, and half of all my profits from this site will be diverted to charitable causes.

Thank you for your interest, your support, and for helping me realize the site’s charitable mission. If you like what you see, consider joining the e-mail list to receive notification of new posts and quarterly progress notes from me.


All the Posts


In reverse chronological order. Start your binge reading at the bottom and work your way up to the present day here.



57 thoughts on “About Me”

  1. Love your story Leif, thanks for sharing. Look forward to reading future posts! Hope the weather is great up your way, we are heading to northern Michigan tomorrow from Tennessee!

  2. Subscribe to get more great content like this, an awesome spreadsheet, and more!
  3. Hey PoF,

    With the bill in congress that may eliminate backdoor Roth access, what are your thoughts on doing a mega Roth conversion while it’s still possible? (I did recently re-read your post from your mega conversion with a somewhat similar scenario)


    • It’s certainly reasonable to consider doing so in the 24% tax bracket if you can.

      If you’re a high earner, Roth conversions could soon be off the table for you. You might wait and see what actually passes, though.


  4. Two questions:
    1) Are you in the UP or LP of Michigan? Cost of living and lifestyle of each are quite different.
    2) How can you say you’ve retired when you have this post and clearly get lots of $ from all the ads? You have simply changed careers from being an MD to being a financial advice and online entrepreneur. Most people who read this site won’t go out and create a PoF type site with lots of ad revenue, so they better fit that into their F.I. equation, don’t cha think??

  5. You figured that it was ‘OK’ for your kids to miss school because they were in grade/middle school? Make sure you budget some of that 50x suplus to go for their future time with the shrink. Selfish move dude—parenting fail.

  6. Hi PoF, Leif! It’s cool to have gotten to work at one time with a famous financial blogger! I am amazed at what you have accomplished, and now that my family is back in the USA from mission work, I realize how much “catching up” there is to do to be ready to retire at a decent age. I will be subscribing and look forward to learning more of your wisdom. God bless you and your family!

  7. Hi Dr. PoF;

    Thanks for the great work. You have educated me regarding Backdoor roth IRA and TLH the best way I could find anywhere. Another area I am trying to seek some education is regarding how to deal with the income from side locums job in addition to your regular job.

    The issues regarding;

    1. Paying taxes; paying estimated taxes( which seems complicated) vs increasing withholdings at regular job.
    2. How to decide solo 401k contribution. Since I already meet social security obligation at regular work, do I need to only apply medicare tax%s ( 1.45% employee + 1.45% employer + additional medicare 0.9% )when calculating solo 401k contribution.


  8. I've got my 2 acres of non-leveraged, crop-producing, cashflowing farmland via AcreTrader. Get yours.
  9. Hello Dr.POF,

    I’m a 2nd year med student in TX and am debating between either EM or Anesthesia for residency. Both have inviting lifestyles and allow me to practice medicine in team based settings. One thing that I have been searching for guidance is in regards to finance (your blog is perfect for this!). I grew up really poor and was able to attain a scholarship for college, but medical school is a different story. I will be in around $300K debt when I graduate and entering a high paying field that allows me to make a big income is very important to me. I did not enter medicine for the money, sir, but I did enter it to hel get my family and I out of poverty. Finally, my question is really simple (but I thought a backstory would help you understand me better): Will EM or Anesthesia allow me the greatest opportunity to maximize my future income? I have been reading WCI’s comments on StudentDoctorNetwork, and he says that depending on where you work you can make between $250-600K. Will anesthesia, or a subspecialty in anesthesia, allow me this type of income? I am hopeful for your response.

    Texas Med Student

    • Howdy, TMS!

      I would try to take both rotations as early as possible and talk to as many attendings as you can about how they like their jobs and lives. I’d go with the specialty that you prefer (or believe you will prefer) after having a chance to see what they’re really like. Of course, the jobs can look very different in an academic setting as compared to private practice.

      You can do very well financially in either specialty (I know a number of anesthesiologists making in and above that range), and there is a fair amount of overlap in the aspects of the jobs. A couple posts that you may find helpful are 4 Physicians Revisited: The Impact of Specialty Choice & Geographic Arbitrage, or Why the Great Plains are Great.


    • Jake, I “retired” from a very rewarding career in EM in 2004 as the Chief of EM at a teaching institution in Texas, so I’m a bit biased. I would agree that rotating in both specialties is paramount in making a decision, but do what you enjoy. The money will be there either way. Since you’re “only” a second year student, you may decide to be an obstetrician or cardiologist or psychiatrist. Good luck, enjoy, the journey, make a difference.

  10. Hi PoF,
    Any update on your progress? Are you still hoping to exit this August? I’m a year or two older than you and hope to finish up this summer as well (emergency medicine), and I feel like daily I’m back and forth with mixed emotions about leaving. I’ve taken a couple of sabbaticals along the way and It’s almost like leaving a relationship in that you only seem to remember the good times. Cool CME rings nostalgic. Then you come back, reality sets in and you’re like ‘Oh yeah, those are the ten reasons I’m leaving’.
    Anyway, just curious how your mindset is in the homestretch.

    • Great questions. My final dates will be mid-August this year, and I will renew my current MN license when it comes up in November.

      I’ve been working part-time for most of the last 16 months, with stretches of up to about 5 weeks off consecutively. We’ve done some great traveling as a family, I’ve had some “downtime” to focus more on this site, and I can’t say I’ve missed work much. The people, yes, but not the “ten reasons I’m leaving.”

      I think if I didn’t have this site to keep me busy, the pull of “one more year” would be a bit stronger, but I feel I’ll be ready to walk away when the time comes. In case I’m wrong, I’ll make it easy enough to come back.


  11. Hello PoF, Stumbled across your blog and bookmarked it. Always inspirational to read from the perspective of another who actually did what they talked about. Very informational blog. P.S- Also added your blog as a website to watch out for on my blog.

  12. I enjoyed reading your articles. I came from a family of physicians (most are anesthesiologists) so I can relate. My father used to joke that my forgetfulness was due to an overdose of anesthesia that my mother took when I was being delivered.

  13. Also, I am trying to post in your other blog posts, but there seems to be no way to do that. Do you know anyone else with the same problem?

  14. Just wanted to leave a post saying your views are very well written and balanced. I just found you today and I am enjoying the experiences that you go through and how you write about them honestly and with maturity. Cheers.

  15. PoF,

    Stumbled across your website from the WCI forums and as a fellow homebrewer felt a little more connection with this one! 🙂

    I am just in my research and planning phase right now working on budget and figuring out what my next step is. I am a Navy Family Medicine Physician and just finished my payback of 4 years and signed for 4 more so will begin making more money. I have been maxing out Roth for my spouse and I for the last 7 years and TSP for the last five years off of recommendations from a friend but with my increase in salary and Bonuses I need to figure out the best strategy going forward. I have listened to some audible courses and am currently listening to “The Only Investment Guide You’ll Ever Need” as well as reading “The White Coat Investor”.

    I was wondering if you had any military specific recommendations? I plan on doing 20 years (Currently I have 8 active and 4 reserve) for the pension which I think is a pretty good deal but want to maximize investments along the way.

    BTW this is not a good website to look at during work when there are a multitude of delicious craft brews floating across the top of the screen! It is making charting very difficult!!

  16. I’ve sat at that particular brewery many times!

    Just ran across your blog. So much info, so little time. I’m graduating my ortho residency in June and leaving for a year of fellowship.

    I’ve been reading MMM, WCI and your site quite a bit lately.

    Quick summary: I have about 260k in student loans (7%ish). We will sell our home here and get about 60k cash from that. My wife (engineer) has about 160k in her Roth IRA at this point. I moonlight quite a bit and expect to have roughly 80-100k excess available when we are done with fellowship. I lack any real retirement account at this point. No credit card debt. One newer extremely “cushy” truck with payment.

    I guess my question is, like many others, how to approach my first few years in practice? I fully expect/hope to live well below our means. Middle class home, some fairly cheap hobbies. Tackle the loans outright? Build up retirement? 50/50? Who to refi with?

    I feel like I’m sitting in a pretty average spot as a new grad (outside of the moonlighting and wife’s retirement). Can you give me some general guidelines?


    • Lots of great questions there, asystole. The fact that you’re considering these issues now is a sign that you’ll be in excellent shape in short order, particularly once you start earning an attending orthopedic surgeon’s salary.

      I gotta ask, which brewery? My header images switch up at random, so it could be one of several.

      I’m about to launch a student loan page, so stay tuned for that. I know that SoFi has great rates for those that qualify, and there are several others listed in this recent guest post. I’m assuming PSLF will not be an option for you, so refinancing is a good idea.

      Once you get started in practice, I would certainly invest as much as you can in tax advantaged (tax deferred) retirement accounts available, and do a pair of backdoor Roths. After that, investing in a taxable account versus paying down debt becomes more of a personal choice with no clear cut winner. You can probably afford to do some of both.


      • Oh, gosh. I meant to post this under your “Frugal Without a Cause” post. Sorry for the confusion. That sure looks like Founders Brewery.

        Thanks for the info. I will continue to read a little everyday and get myself up to speed!

  17. Great site, thanks for sharing your insights and experience. I am not a Physician, but ironically I work for a boutique electronic health record (and PM) as a Finance Manager. I hope to be hear often to read your articles.

  18. Nice Place POF! I’ll be sure to add your tidbits to my reading list.

    I’ve been following a lot of your posts on WCI and Bogleheads especially since you often ask the same questions that I have(but you ask it so eloquently).
    As for myself and probably like most physicians, tried a few jobs, settled down into a routine and it was busy, intellectual and mostly fun. And the years flew by. This is especially true if you add raising children. The Kids are finally grown, about to go to college and hopefully be productive. My field (IM -hospitalist)as well as healthcare has drastically changed(for the worse – I could go on forever). Thus Mid-life/Mid-career crises! Almost sent in my resignation but after reading all of the insights you guys provided, it helped ground the chaos. The funny thing was I didn’t realize I was already financially independent for the last 3-4 years until my crises. Definitely gave me security and new outlook towards work.

    But hitting the target number for retirement is probably 1/4 of it and retirement actually looked like it would be extra work!
    1) Yikes never knew about capital gain harvesting before pensions/RMDs/SSI kick in.
    2) Roth IRAs – do I want more via backdoor? But I have all those straggling traditional IRAs
    3) What would I do with the extra money if I stay in the game?
    I’m not too materialistic and I haven’t bought a nice toy for myself in 20 years but who’s to say I wouldn’t enjoy a small RV for flyfishing. Our if I can still brave the cold, get a condo in a nice urban environment and a mountain lodge 2 hours away (if only they would build that monorail Denver – Vail).
    4) Actually working/staying in the game has its own risks. Started to re-balance with aim for 60/40 or even 50/50 but WTH, my wife’s practice is thinking of buying a surgical center building. Diversification is fine but I like smaller game like 5-10% REITs preferably in 401K.
    Also I wonder if income generated by this surgical center cuts into my capital gain harvesting in those lean years.

    (No need for responses. The above is just ranting – So many good responses from the various forums already mentioned and articles you and others have provided)

    LOL, the one thing not often mentioned is incorporating one’s spouse on the game plan. I often copy forum threads that pertain to her situation but the interest seems lacking. She nickle and dimes purchases but she doesn’t understand the .5-2%+ savings on tax decisions and other decisions equates to several hundred thousands.

    Again, great questions and responses on forums and thanks for your efforts/website.

    • Thank you Huang Tiger. I’ve only been writing as PoF for a little more than a year, but I’ve been figuring these things out for a number of years. There are many nuances and fine tuning that can be done once you master the basics and pluck the low hanging fruit.

      As with most things in life, the Pareto principle applies. 80% of your results come from 20% of your efforts. If you never have an opportunity to tax gain harvest, you won’t be in dire straits. Same with the backdoor Roth. These are optimization tools that give you extra credit, but you can manage quite well without them.


  19. Pretty cool site. I’m also an anesthesiologist although I have a few years on you. Currently 58. I’ve tried to gravitate more toward dividend growth investing and am doing fairly well. Hope to retire in 1 year.

    • 2018 might be the year for you and me, both!

      At the tail end of your career, dividend investing can make some sense, especially if you plan to be in lower tax brackets in retirement. It will depend largely on how much of your portfolio is in tax deferred 401(k), IRA, and how much you draw on them, of course. In a working career, dividend returns can be reduced significantly by tax drag, which is why I haven’t been a big fan of dividend stocks in general.


  20. Great site!
    I’m a fan of this website.
    I’ll have to direct some of my younger colleagues- who may still be flexible and not set in their ways ( of fears and biases and poor risk management)- to this site for sound practical financial information.

  21. Hi There!

    Do you have any advice or page recommendations for a pre-medical student?
    I’m a non-traditional , full-time student doing post-bacc work for another year before I even apply while working part-time (I have a 401K at this job and one from an old job) with some credit card debt.

    Is there anything extra I can do or get started for when I become a medical student in about 3 years?

    • Hello, Anthony.

      The best thing you can do is to get started as soon as possible. If you plan on eventually having a job making $300,000 a year, every year that goes by is another year you won’t get that salary.

      Beyond that, pay off or minimize credit card debt, live below your means, and look to specialties that pay average or above, preferably without an especially long residency / fellowship training requirement.

      Good luck!

  22. We are a two physician family in our late thirties. We will be coming up on a public school vs private school decision for our two kids. Would love to know your thoughts on that.

    • Great question, HF.

      As a product of public schools, I do have a bias. I grew up in a town with a good public school system, and attended undergrad and medical school at a public University. Naturally, I am a fan of public schools, and that’s where my boys are.

      I do realize that not all school systems are created equally, and I hear from other physicians that, in some places, private schools are more or less necessary for a good education. However, I can guarantee that some of the public high school grads in those places are going on to college and better things. Also, I wouldn’t put much stock into data comparing outcomes between public and private schools. The private school kids generally come from a household with higher socioeconomic status, and the willingness to pay shows an emphasis on education in those families.

      Private school tuition can run from a few thousand at a local parochial school to as much or more than college tuition at prestigious schools. I would not want to pay college tuition prices for each child for 13 years prior to college, but that’s just me! Also, consider that there may be more pressure to spend on your kids to have nicer clothes, computers, vacations, etc… to fit in with peers at a private school. Ultimately, it’s your money, and you’re free to spend as you wish.


      • Financially I would say public schools are definitely the way to go. With 3 little ones in private schools I could buy a new luxury car each year with the money I spend on tuition. My wife and I were both publicly educated and received good educations.

        Our situation is different than PoF in that we live in a major metropolitan center where the vast majority of public schools are failing and are schools in name only. There are a few good public high schools that you can test into but there is no good school district you can send your kids in kindergarten all the way through HS. We may switch over once our kids are in high school.

        I do wish the private schools were a little more diverse, A little too much “competition” from all the folks with nothing better to do with their time or money. They do have smaller class sizes, and probably have more balance and non-academic education opportunities.

        We do have nieces and nephews the same grades as our kids in public schools(different city) and they are at the same stage and learning the same thing. If you are bright in public school you will be bright in private school. As some point the difference academically is going to be up to what the kid does with the resources….

        just my 2 cents…. I just chalk it up to an expense associated with my job and living where I do. I have been giving serious thought about looking in a better state for a new job but this is “home” for our extended families.

        • That’s quite a conundrum, doc. Proximity to family is huge, but the cost of many years of private school tuition for three could keep you in debt for a very long time. Do you need to leave the state for the situation to improve? Surely there are suburbs or exurbs that have schools with a decent reputation? Of course, you also have to consider the job prospects of the location as well. I hope you find the best of all worlds!


  23. Hi, a few comments and a question or two. I was actually looking for an e-mail address, but posting here is OK too.

    Really enjoy your blog, well written and the charts/scenarios are well produced. I think I’m in a similar situation as you, i’m almost 40- dual physician family, two young children. Investable assets about 2.8 million, paid off house (approx 900). I suspect we have similar frugal ways, low expenditures (public schools etc) I have been interested in early retirement and recent events have solidified that desire.

    My question- as you know, typical physicians (and I know quite a few who fit this stereotype) are not financially savvy, and tend to have high expenses however there must be quite a few physicians who don’t fit this stereotype. Why don’t we see more early retirement physicians, in fact I do not know a single physician who has retired early, in fact I know quite a few who plan on working until 60.

    I am also curious as to whether this blog has been “profitable” I know you probably would rather keep that private.

    • I’m glad you’ve enjoyed the blog, and you are correct in that we do have quite a bit in common. I do have an email address. The Contact page is accessed at the very bottom of the screen. But this is a perfectly acceptable place to have this discussion, also.

      Like you, we’ve got a couple young children, are mortgage free, and can call ourselves multimillionaires. We’re doing it on one income, so haven’t amassed quite the nest egg that you’ve got. I haven’t revealed my net worth online, but that will change tomorrow when my guest post @ Investment Zen goes live tomorrow.

      I also haven’t revealed our exact annual spending, but I’m working on a post that I hope to be ready by Tuesday that will detail our spending in detail. We spend about triple what the MMM family spends, and far less than most physicians.

      Why don’t more physicians retire early? The luxury lifestyles are one reason. Some physicians truly love their jobs, and can’t imagine life without them. There are certainly plenty of financially independent physicians still working full time. Maybe its because they love the job, or maybe they want to grow their net worth further.

      For me, I like my job for the most part, but it can be quite demanding and stressful. I also have family plans that are not compatible with a full time job. For more information on my plans and thoughts on retirement, I can recommend the following posts if you haven’t seen them yet.

      Top 5 Reasons I Chose Not to Retire at 39

      Top 5 Things I’ll Miss When I Retire Early

      The Top 5 Reasons I Want to Retire Early

      50 Ways I’d Like to Spend My Time in Early Retirement

      Announcing My Retirement

      There will be plenty more to come!


        • Hi POF, I wonder what ‘multimillionaire’ means from the community of FIRE seekers’ perspective. Does net worth of $2 million qualify or do you need much more? Mainstream financial community seems to use $5 million or more as minimum to qualify as multimillionaire. What is your definition?

        • Is that the same Mainstream that says you need to replace 80% of your pre-retiremnt income to retire? There can be many different definitions of what it takes to be considered wealthy, and I can understand why it might take $5 million for some to truly feel wealthy.

          As far as a definition of multimillionaire? 2 is a multiple of 1. If you have 2 things, you have multiple things. So, yes, in my mind, a $2 million net worth qualifies someone as a multimillionaire. As does $Ten Factorial.


  24. My I ask a funny question? How “easy” or hard is it for a patient to never wake up after getting anesthesia for surgery? For example, could I inject the patient with X ML of fluid in the IV then count on her to wake up in 3 hours after I inject her with something else?

    I remember watching Nip Tuck and wondering this. 🙂

    Thanks for sharing!


    • Not a bad or funny question, Sam. The short answer is that the drugs we use are relatively short-acting. Unless you are actively dying when you enter the operating room, there is an extraordinarily good chance you will wake up shortly after the surgery is done. I recently wrote about a patient who didn’t wake up, but this was a patient who wasn’t expected to see the afternoon, let alone another day.

      As far as waking up on time, the good stuff we give through the IV only lasts a few minutes. We maintain anesthesia continuously with a steady infusion of IV medication or inhaled volatile gas for the duration of surgery. As the final sutures go in and the bandages go on, we titrate down and turn off the continuous flow and you tend to wake up in a matter of minutes. There are rare outliers, such as the patient with an unknown homozygous pseudocholinesterase deficiency who receives succinylcholine and remains weak for hours rather than minutes, but those are beyond the scope of this website.

      There is also regional aneshesia, where we can give a one-time dose of local anesthetic next to nerves to make one or more body part numb for a few hours or more, but longer lasting numbness is a good thing, since patients can be awake and have reduced / no pain at the surgical site for awhile.


  25. Hi, I’m looking forward to reading your posts and learning more about your charitable mission. I’m sure your educational material fills a void in the physicians’ community. Congrats on your FI!

  26. Compliments for Your article, of retiereing the docteur of anaestesiologist.My life is the same, in this case i.m working with 71 activ like rheumatologist and internal medicine. Thank You ! I recomended for every Collegeus!

  27. PoF, great stuff here! My cousin is also an anesthesiologist and making a pretty penny these days. However, I was surprised after meeting some of his other fellow anesthesiologist friends that not all of them are taking the steps you’d think towards an early retirement. Some in fact were still swimming in hefty debt. Cash flow is the key. It just goes to show you that all types of individuals need extra help. So, kudos to you for helping to educate your fellow physicians! Congrats on your ability to FIRE by 39.

  28. I think this is a wonderful website. Congrats on your accomplishment, achieving FI after 9 years means you were deliberate but from the most recent post it sounds like you are still enjoying a good quality of life.

    • Thank you, Dr. Mo! I’m glad you’ve found my site to e useful. I suppose I have been deliberate in my savings over the years, but it wasn’t until fairly recently that I knew why. I’ve gone from “frugal without a cause” to a full fledged fan of FIRE.

      If you truly enjoy the site, be sure to sign up for e-mail updates, or follow on Feedly.com, and don’t forget to tell your friends!



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