Fight Burnout with Both Saving and Spending

Career burnout is becoming increasingly common and is a hot topic lately, particularly for physicians and other healthcare workers.

DDQThe causes are many. Increased demands. Decreased reimbursement and recognition. Longer hours and lower benefits. The feeling that you’re just another wheel in the cog.

In medicine, it’s the ever-thickening red tape. Clumsy electronic health records (EHRs). Prior authorizations. In-baskets that fill up with dozens or hundreds of messages any time you’re away for more than a few days. The corporatization of medicine.

While numerous strategies are being employed by both employers and employees to fight burnout, I don’t hear many strategies involving personal finance. I believe there is a role for prodigious saving and targeted spending to help keep burnout at bay. While these two strategies may appear to be at odds with one another, let’s examine how saving and spending can both play a role in decreasing burnout.

 

Fight Burnout with Both Saving and Spending

 

Efforts to combat burnout don’t seem to be stemming the tide. I welcome the existence of Chief Wellness Officers, resiliency programs, and the like, but I have yet to see significant progress in the burnout data.

It may be that we’re more willing to admit we’re feeling burned out when we know about half of our colleagues have reported feeling that way. Studies and surveys on burnout vary in how burnout is defined, but most that I’ve come across show increasing rates that approach or exceed 50%.

A 2015 Mayo Clinic study found that 54% of physicians showed at least one symptom of burnout, a rate nearly double that of the 28% rate from 2011. More recently, the 2018 Medscape Burnout & Depression Report reported a 42% burnout rate among physicians, a decrease from the 51% rate found in 2017, but it’s hard to draw any firm conclusions from a voluntary survey as much as I’d like to hope the recent focus on burnout is having a positive impact.

Interestingly, the Mayo study reported that men and women were happy outside of work at a rate of 69% and 67% respectively, while only 45% of men and 39% of women report being happy at work. I’ve said many times that my interest in early retirement is not due to hating my job. I often like it, but I’ve always preferred my days off.

Clearly, I am not alone in my assessment. Most physicians, and I would bet most people, are happier spending their time as they please away from their job than they are while on the clock.

Burnout prevention can and should begin at the highest levels. Many of our frustrations stem from regulatory burdens put in place by certifying bodies, insurance companies, and governmental programs. Our hospitals, clinics, and health systems often create additional systems that only increase the demands on our time and patience.

Removing some of the barriers to effective patient care and restoring some physician autonomy could go a long way towards reducing burnout.

On an individual level, efforts are primarily focused on maintaining or improving both our physical and mental health. Many programs focus on improving physician resilience, which is pretty comical when you consider how resilient one must be to make it through the rigors of a medical school education and the multi-year gauntlet that is residency.

These efforts are laudable, but we should also consider how our finances play a role in career burnout.

 

 

How Saving Money Can Reduce Burnout

 

It’s faint, but it’s there. Far, far in the distance is a sliver of light. It’s the light at the end of a long, dark tunnel. The tunnel walls are built of student loan debt, societal expectations, peer pressure to look rich, and even our own desires.

At the end of the tunnel is financial independence and a bright, sunny sky. On your way, you vanquish the student loan debt and the walls start to crumble. Some light shines in and you can better see things for what they are.

Those societal expectations to look the part of a successful professional were based more upon what you imagined would be expected of you. It turns out no one’s keeping score nearly as closely as you. Other people are too focused on themselves and what they think other people think of them to actually pay much attention to you.

The peer pressure you felt to have the grandest home or the most opulent vacations starts to wane as you realize those that chase those items aren’t seeing any light at the end of their tunnel. They’re making little progress on the debts that are holding them back, and in some cases, they’re only adding to them.

As you defeat your debts and grow your net worth and passive income streams, you can see that you have career options. If burnout creeps its way into your life, you are not stuck doing what you’re doing indefinitely.

lucidityOn firm financial footing, you can afford to drop the parts of your job you don’t enjoy or find a new job altogether. You may be able to work the same job at a slower pace. You may appreciate the job more when you’re not putting in 60+ hours a week 48 weeks a year.

What would having every Friday off do for the burnout you’re experiencing? Could you stop taking call or working night shifts? Are there procedures you just don’t want to do anymore? Could you take that teaching position you’ve always wanted but never thought you could afford? How about a one-year sabbatical?

Depending on your specialty and work arrangement, some of these choices may not be sensible or available to you, but having substantial savings and the ability to walk away for an extended period of time is a valuable bargaining chip.

How do you earn that chip? Simply widen the gap between your earning and spending. Earn more, spend less, or both. Live on half your takehome pay, and you’ll go from broke to retirement-ready in about fifteen years.

It’s true. Consult a compound savings calculator. If you spend about $100,000 a year and invest about $100,000 a year, in 15 years you’ll have $2.5 Million with a rate of return between 6% and 7%. Earn a paltry 2% on your investments and it will take about 20 years.

Once you’ve met or exceeded retirement savings of 25 years worth of expenses, you’ve got an excellent chance of your money outlasting you if you never worked another day in your life based on an initial withdrawal rate of 4% or less.

The knowledge that you can walk away or create the job of your dreams is some serious burnout-fighting power.

 

How Spending Money Can Reduce Burnout

 

The more you spend, the less you save. So how can spending money fight burnout?

You’ve got to be smart about how you spend. Putting a little extra money in the right places while saving money on the biggest-ticket items (housing, automobiles, dining out) can help stave off burnout in a variety of ways.

You’ve heard that time is money. The inverse is also true. Money can buy time, and a lack of personal time is a frequent factor in career burnout.

You can outsource some of the more painful parts of your away-from-work life. Lawn maintenance, house cleaning, and handyman tasks are among the most common. Sure you can do them yourself (and I do two out of those three), but if someone can do it for $25 an hour in half the time it would take you, you’ve bought yourself 8 hours of free time for $100. That’s a burnout-beating bargain.

Consider grocery pickup or delivery services. The money spent on the service will likely be offset by the decrease in impulse purchases.

Take a vacation. You don’t have to stay at a five-star resort to have a wonderful time. A year ago, we spent three weeks with our children in Mexico at a total cost of about $1,000 a week. It was one of our best trips ever, and we’ve taken many.

Before you head out, pay the $100 for five years of Global Entry which also gets you into the TSA Pre✓ line. Trust me; it’s so worth it. You’ll save both time and hassle.

Better yet, let Chase reimburse you for the $100 Global Entry fee as one of the benefits of their Sapphire Reserve card or United Explorer card (but never, ever keep a balance on a credit card).

 

 

A $15 Uber ride might get you across town in ten minutes whereas the $3 public transportation option would take closer to an hour. A $15 an hour babysitter buys you more time for restorative date nights.

Stanford has recognized the benefit of time-saving and task-saving services. Their “time bank” rewards physicians for what might otherwise be unrecognized teaching, service, and clinical activities with credits good for housecleaning, laundry, and meal services or academic support work such as grant-writing, lab management, or speech coaching.

In a clinical practice, a little money spent can go a long way towards improving efficiency and morale. Scribes who tackle most of the documentation work while the physician focuses on the patient can be a Godsend. Updated computer hardware or a more user-friendly EHR may cost money but can make life much easier.

Small investments in something as simple as weekly donuts (is it Thursday yet?) and holiday parties or summertime picnics can boost morale and help foster a more collegial work atmosphere. Burnout is less prevalent when the workplace culture is supportive and people work well together.

 

 

Fight Burnout with Money

 

Money may not buy happiness, but good money management can help reduce burnout in your career.

Save as much as you spend, and when you do spend, spend wisely.

Take care of your mind. Take care of your body. Do what you can to influence change at higher levels.

Burnout needs to be addressed from all angles. I encourage you to take a look at what you’re doing with your money. Can you put it to use to prevent burnout in your own career?

I teach people how to achieve financial independence with the option to retire early, but I’d love to see people continue doing their life’s work with joy and purpose. Please do what you can to avoid burnout while putting yourself in a financial position to have good options if burnout rears its ugly head.

 


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What are your biggest frustrations in your career? How have you used money to prevent or escape from the clutches of burnout? What are your top burnout prevention tips?

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27 comments

  • You are speaking my language 🙂

    I think that fighting burnout out with the tools provided by financial independence is key. It would be great if burnout was fought from the top down by administrators that run the departments and hospitals in which we work… but, at the end of the day, the most sure-FIRE way (pun intended) to deal with it is to provide our own options. This is exactly what financial independence does.

    Even if we are on a glide path to FI, we might be able to cut back and just extend that path a little bit. Often times, burned out docs learn that they still like their job – they just want to do less of it to have a better work-life balance.

    All of this is predicated on living a lifestyle that allows us to get to early financial independence, and not dig ourselves deeper into a hole that we cannot scale.

    P.S. We recently bought a house, which has a side lot of about an acre with a pretty steep hill. Looking at the thing, I realized it was going to take me 2-3 hours to mow my entire yard with our push mower. Faced with two options (to buy a much more expensive mower or to outsource lawn care for the first time in our 10 years or marriage), I decided to outsource the lawn care. I made a deal with the guy to continue to blow my own leaves and to prune my own bushes. So, all he is doing is truly the lawn care. I think it’ll be worth every penny.

    • VagabondMD

      TPP,
      We cannot rely on the system to assuage the propensity for burnout among MDs. Everything that I have seen, up to this very day, moves the ball in the wrong direction. You are wise to make decisions to solve this for you and your family.

      VBMD

      PS I have never mowed a lawn in my life (mostly true, I mowed half of my yard, once, in 1998 – long story) and have no regrets.

    • A different take on lawn care is to embrace it. Use it as a source of pride and escape. We do that here. Not everyone truly has the time for it, and others may call using a service is a sign of “success”. With that said, I bet more people would enjoy it than they think.

      • Appreciate that perspective, Toby. I’ve mowed my own lawn for the last 9 and 1/2 years. I actually enjoy it.

        The new property has a steeply inclined hill that would require 2-3 hours of mowing (weekly in the summers) and a large investment in a good mower.

        So, I am calling my mowing career quits. At least for now.

        TPP

      • FWIW, I started mowing lawns at age 9 and still mow my own. I’ve got a nice quiet electric push mower (Ryobi 40v) and I put music or a podcast in my ears and it’s a great way to spend an hour outdoors getting a little exercise.

        Cheers!
        -PoF

      • M

        I mow my own lawn, and it takes a little more than an hour. The greatest thing about it is nobody ever bothers you when you’re mowing—time to myself!

      • Mom MD

        I’ve mowed many a lawn, conned my children into mowing until they rebelled or gained other employment and finally have given up and paid for lawn care in the last few years. With near or above 100 degrees for most of the summer growing season in south Texas and humidity that you cannot believe, that is the best money I’ve spent in self care in ages.

    • My first job was mowing lawns 😛

      I saw it as a great way to exercise, get some vitamin D, and earn some cash!

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  • It is wild but I came out today with a very complimentary post to this one about how I have essentially reduced my path to burnout after I decided not to keep chasing the “Least Valuable Dollar.” It is only because I have been on the financial independence path that I have developed passive income streams to allow me to cut down my clinical time.

    Just taking 1 day off a week has shown quite a benefit to my overall well being, allowing me to give my batteries more time to recharge. I was truly on the path to burnout before I did that and because of savings and target spending I avoided falling into its complete grip.

    I love the concept that Stanford has in place (didn’t know about it till read this post) off a time bank. This is a wonderful concept and hopefully it can spread throughout medicine. Part of combating burnout is making physicians feel appreciated rather than the current feeling of just being a “cog in the very large medical machine,” and this time bank reward system seems to be a great way to do so.

    I also like your suggestion for spending money to improve quality of life and give time savings. Yes FIRE people tend to be super frugal and try to minimize cost, but hopefully they reach a point financially where they can reward themselves for the prior sacrifices. Anything to decrease the amount of material taxing your mental bandwidth will improve your quality of life and it will carry over into work, reducing burnout.

    I was surprised at that medscape survey at several things, burnout can strike at any age (you don’t have to be that grizzled medical doctor to feel it) and any specialty (including what was previously deemed the lifestyle specialties, often called the “ROAD (Radiology, Opthalmology, Anesthesiology, Dermatology) to success”

  • Lack of control over one’s work environment is one of the big causes behind physician burnout I think. Here, there is an increased push from our government for physicians to be accountable for performance while at the same time micro-regulating what we do. With increased accountability, there needs to be increased freedom to perform. The players may vary, but I think this is an underlying issue in the USA also.

    Taking control of your finances and then using that to take control of your personal and professional life strikes at the center of that.
    -LD

  • Rachel

    I really enjoyed this post. When I look at our cleaning service as a line item on our budget, it seems like such a frivolous expense. But then I remember that we now get to spend the weekend playing with our kids instead of cleaning the house and that makes it worth it. Plus they do a much better job than we did!

  • VagabondMD

    My burnout was vanquished when I dropped the soul-sucking IR practice, but going to part-time was the cherry 🍒 on top.

    Being in a financial position to spend less time doing things that are draining at work and still take a non-frugal vacation or two every year seems to be the right balance for me. We each need to look within, understand what makes as stronger and weaker, and construct a life that is fulfilling.

    It all starts with having one’s financial life in order.

  • Great article! I like to call this “Protecting Your Most Valuable Asset.” As a physician, by far the #1 factor in reaching financial independence is staying happy, healthy, and productive — you’ve explained this beautifully.

    Another thing strong savings gets you is a feeling that you’re not trapped. Even when work is hard, somewhere in the back of your mind you know that that you could always quit. If you don’t *need* the job, you’re making the choice to be there every day. Which somehow makes it better and easier to stick with it.

    My best spending tactic for career patents / physician parents is getting babysitters. Your week is so hard, you need a break from the craziness of raising young kids too. Consider a Saturday morning or Sunday morning babysitter to exercise or go for a walk with your spouse. It will energize you for the weekend and make your family time even better. Best money you’ll ever spend.

    Great article — loved it!

  • “Time is Money”: I decided last night to turn down a really nice opportunity to work a few days extra a month at a very good pay rate. I wanted the earnings to accelerate payments on my 15-year mortgage, which I’ve already reduced from 15 years to 12 in just a few months. I want to eliminate the debt (thank you Dave). However, I realized that those few extra days of work will consume time I would rather spend with my wife and newborn baby and lead me in the direction of burnout rather than “work/life balance”. So I will rely on “spending less” rather than “earning more” to achieve my FIRE goals for now…

  • Gasem

    So you’re saying burnout is a dopamine thing. Owning a portfolio is a dopamine agonist. You look at that bottom line and it gives you a shot. Spending money is a dopamine agonist, you buy that (fillintheblank) you’ve been hankering for and your eyes glaze over in pleasure. Dopamine and serotonin (different transmitters same nucleus) turn off risk aversion which also feels good. It’s the reason you can convince yourself to jump out of a perfectly good airplane. A lot of burnout IMHO is related to over active risk aversion and the feeling and assault of impending doom (fear response) it produces.

    This kind of analysis actually helped me out. It was comforting to know my emotional state was actually emanating from my keyed up mid brain and not so much an actual threat. A possible solution to burnout at some level is to deal with an understanding of the biology.

  • Bill Yount

    Burnout is pervasive and has many insidious causes and forms of expression. It is a spectrum of short, mid, and long term cause and effect, not all negative by the way. It is in the air that we breath. It is one side of the see saw of Work Life Balance. Systems run by administrators are clunky and slow at implementing solutions to balance the forces of burnout. We must own our lives, our financial, physical, emotional, mental healths. We must choose ourselves, build our resiliance, lengthen our runways and reserves. It is in blaming the system and hoping and waiting that it will take care of us that we can fall into a rabbit hole too deep to scale alone.

  • It’s not just dr’s. I’m going through this now.

    Theres just a lot of bs in the world. And its weighing on all of us. There’s gotta be more to it.

    Knowing that the end of the tunnel is near makes it better.

    • rr

      regarding BS, just saw this today:

      https://www.advisory.com/daily-briefing/2018/11/30/bs-health-care

      As I read through this list of BS items in health-care it seemed to ring true. I was glad to see that economists came up with this list since it seems to that most press about healthcare is mostly about how those us in healthcare are just screwing up everything.

    • rr

      MrWow didn’t have a way to respond to your last comment, but yes I can see the irony of #7 for this sheet re Excel spreadsheet planning for readers of this site. But even though I can see the appeal of Excel spreadsheet planning if I imagine myself as a hospital administrator, I think I see what these economists mean. Our hospital is in the midst of a cost-cutting initiative, but while administration touts the cost savings of many things that will be eliminated I think the budget numbers (presumably on Excel spreadsheets) fail to account for things that may suffer with some cuts such as job satisfaction for doctors, nurses, etc. I have sympathy for the fact that these folks have to make the numbers add up, but sometimes that seems to be the over-riding focus. Hopefully administration has given some thought to these trade-offs, but it isn’t always clear that is the case.

      Obviously using Excel spreadsheets for personal finance won’t capture all relevant factors related to whatever goals you are using said Excel spreadsheet, but I think as long as you keep these limitations in mind it’s okay. Plus hopefully most of our finances are more predictable and less complex than that of a large hospital organization.

    • Yep, I agree. Building my plan for financial independence actually pulled me back from the edge of burnout simply because I saw an end. And, of course, when things feel in control your stress levels are reduced.

      Having a financial plan, and an end, helped me have some energy to get back to the job I’m passionate about.

  • Great post. My first career as a telecom engineer certainly burned me out. Not so much the work I did but the never ending obligation of carrying a pager 24X7X365. I felt powerless over my own life. I did use FI to retire early and I had a great burnout free encore career. I do believe that taking financial control and having the financial strength to stand our ground and demand balance from both ourselves and our task masters is the answer to burnout free work.

  • Actually, we do have a Chief Wellness Officer in our organization. And I am the wellness champion of our anesthesia department.

    I think a good tip to prevent burnout is to create a culture of gratitude. Sounds silly, but gratitude is the key to happiness and therefore a key to preventing burnout.

    When you start with gratitude, you become more grateful for what you do have and less resentful for what you don’t have (as well as less resentful for what others may have). Once this is realized, it is much easier to stop spending. After realizing that what we have already makes us happy… there’s no need to run on the hedonic treadmill chasing the things we think will make us happier, but ultimately won’t. So this helps us save money with a clear purpose that we have enough and we don’t need more to satisfy our needs.

    The problem with extreme frugality and saving just for savings sake… you can get burned out from that because there may not be a clear purpose. And if we are just saving just to retire early… then what. Happiness isn’t guaranteed. Happiness only comes when have gratitude and are grateful what we have. And it makes it easy to turn down shifts because you don’t need the money! So being financially independent definitely fits into the picture, but I think it has to come from a place of gratitude.

  • JSC

    I love all of this. Agree so much on saving more and spending in ways that buy you time. Additionally, really distilling life down to the things you desire most. I don’t love a big lawn and so moving to a little house with less upkeep means I get more time (less lawn work) and more money (don’t need to outsource).

    The crumbling tunnel of student debt is just everything… knocking mine out of the park really made the future more tangible.

  • So many good aspects pointed out in the article and in the comments. I couldn´t agree more.

    Just two little tweaks:

    Lawn maintenance : I do the opposite lately and feel some kind of budhism-like relaxation in doing that myself. I even opted for a fully manual driven english retro mowder. Fitness training included 🙂

    Regarding 5 * hotels. Sometimes you can turn this around in your favour, if there´s an option to book deep-off-season (Seaside hotels in January, “bad weather” environment) Often the weather isn´t so bad at all and with some warmer clothes you can experience great holidays. Less stress, fewer people, less waiting – same luxury Spa, for a fraction of the money.

    Best way against burnout : Fight against all these smart ass corporate administration MBA PwC consultants – or leave the Fightclub altogether with FIRE….

    “Diethylparaaminotannadol ?
    No. First rule of crime: Keep It simple.
    What’s simple?
    Carbon Monoxide.”

    Coma (1978) 🙂

  • Burnout is epidemic, and cutting back on your clinical load is the new black.

    1) Assuming control over your finances grants you greater control over your time.
    2) Doing less, more humanely, can help you fall in love with medicine all over again.

    Appreciate your modeling both so well PoF – you are the FIRE movement’s Cindy Crawford, sans mole. (Also, Minnesotans are known to be awfully pale, although Cuba might have offset that.)

    Fondly,

    CD

  • Real nice blog! My first visit here. I have only been blogging myself since July at age 67 (yes that is not a typo). So maybe I am a bit out of place here among these young people. Although I have no hope of matching anything like this site, I do enjoy blogging!

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