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Career burnout has been increasingly common and problematic for both physicians and those in many other fields.

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The causes are many. The solutions are challenging. We’d love to see improvements that start at the top, but the truth is we’re often left to fend for ourselves. No one cares about you more than you (and maybe your mother), and corporations don’t have feelings.

A lack of autonomy is a major factor in burnout, and one thing you can control is your finances. Is “F U” money or FI money a key component in the battle against burnout?

Dr. James Turner seems to think so, and I agree. He spells out four ways financial freedom benefits us in the fight against burnout today. This post originally appeared on The Physician Philosopher.

 

Four Ways Financial Independence Counters Career Burnout

 

Burnout has been in the headlines recently.  First, the World Health Organization (WHO) made burnout an actual medical diagnosis.  Second, another article published around the same time by TIME highlighted research showing how much physician burnout costs the medical field.

Of course, very little of the media put the two pieces together to realize that burnout, which is now an official diagnosis, disproportionately impacts physicians.  Today, I thought I would dive into these recent articles, and describe how we – as physicians – can fight burnout with financial independence.

 

WHO Burnout Diagnosis

 

According to the WHO, The diagnosis of burnout in the ICD-11 codes applies specifically to occupation related context, and should not be applied to other portions of our lives.

The diagnosis is stated as follows in the ICD-11,

Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.

They go on to describe the three classic ways that burnout manifests in a burned out individual.

First, they describe the exhaustion.  People who are burned out lose passion for things at work that used to fire them up.  This might look like apathy, or it could also look “lazy” to others who aren’t paying close enough attention.  Either way, exhaustion is a key hallmark of burnout.

Second, they describe the “distance from one’s job,” which is an interesting way to describe Herbert Freudenberg’s original description of depersonalization.  In medicine, this classically presents as doctors who treat their patients like objects rather than living, breathing human beings.

The third and final classic finding of a burned out worker according to the ICD-11 is “reduced professional efficacy”.  Again, I think they have strayed a bit from the original idea, which is that a burned out worker typically feels incompetent at their job.  Even if that is not the case.  Now, that is not to say that burnout hasn’t been shown to impact medical practice, because it certainly does.

 

Burnout is Costly

 

The TIME article helps us connect the dots a little better.  Yes, burnout is a problem.  (And apparently it is a “real” problem now that carries a diagnosis).  However, burnout is particularly problematic in the medical field.

We know from other surveys that physician burnout is prevalent.  Approximately 40-50% of all physicians are burned out.  Our rates of burnout are almost twice as high as the general population who work in other fields.

In fact, the research being highlighted in the TIME article estimates that burnout costs the U.S. people $4.6 billion each year.  And they say that this is a conservative estimate.

On an individual doctor level, we know that replacing a physician costs hospitals $250,000 – $1 million to replace a physician.  And we also know that burned out doctors are more likely to seek change and to transition jobs.

Given the numbers above, you would think that the medical community – and the administrators that run this community – would be all over fixing this problem.   It would save them a lot of money, right?  Unfortunately, this is not the case at most hospitals.

As working physicians, we realize that the hospital often won’t love us back.  And they certainly don’t seem particularly interested in proposing systematic solutions to a systematic problem that causes moral injury among our physicians.

 

 

Individual Solutions to Systematic Problems

 

Despite the fact that surveys show that physician burnout is caused by a lack of autonomy, electronic medical records, bureaucracy, and a plethora of other systemic problems… the proposed solutions most of us hear from our hospitals involve individual solutions like praying more, gratefulness mindsets, meditation, yoga, deep breathing, and aromatherapy.

So, here we are…. burned out, morally injured, and often left to fend for ourselves.  Despite the fact that these causes are most often systematic, we must find our own solutions.

What are we to do?

We fight burnout with financial independence.  Financial Independence is our escape hatch to burnout. Here are four ways that financial independence may be the best solution.

 

 

1. Finding Our Work-Life Balance

 

It is my contention that most major causes of burnout can be distilled down into two causes.  The first is a lack of autonomy to practice medicine how we see fit.  The second cause involves poor work-life balance.

Money has an intrinsic relationship with burnout.  You can either choose the road that makes burnout worse, or you can choose the road less traveled where money can fight burnout.

We can use our financial decisions to work as often (or as little) as we want, if we stay the course with a solid financial plan.  In fact, the majority of physicians can reach financial independence 10-15 years into their careers.

 

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2.  Financial Independence Creates Courage

 

We have all had the experience of sitting in a faculty meeting of some kind while we watched people sit silent despite their current misgivings about the system.  Some of this likely comes from the apathy associated with burned out doctors.  However, a lot of it comes from the fact that people are dependent on their paycheck and afraid to speak up.

What if we all lived in a world where people had their financial lives in order?  What if people could actually say what was on their mind without having to worry about lost income or retribution?

In such a world, real change might happen because intelligent, educated, and hard-working physicians would be able to speak their mind about a complicated system that refuses to change.  We have created this road destined for burned out doctors.

We can also change it if we have a critical mass of doctors who have the courage to speak up.  And financial independence can help provide that courage for many who are afraid of losing their livelihood.

 

3.  Finding Contentment Today

 

The philosophy of financial independence is built on a few simple ideas.  First, earn a decent income.  Second, live a life within your means by learning to live a life of contentment.  Finally, take the difference between your income and your spending and save what is left.

That second step is absolutely key.  The more contentment we find, the more we realize that we don’t need the expensive house, the fancy cars, and the private schools for our kids that lock us into a life that only an attending physician paycheck could afford.  When we decide to follow Dr. EFI instead of Dr. Jones we realize that we have more than we could ever need.

In a roundabout way, this is another tenant of financial independence that helps us fight burnout.  The reason is that it builds two fundamental beliefs that pour gasoline on our FIRE breathing financial independence machine.

The first is that it decreases our spending, because we finally learn how to spend money in ways that actually make us happy. The second reason is that it increases our wealth accumulation rate (i.e. our savings rate).

This then provides the option to continue to work in the current system, to try to change it, or to use the only other “nuclear” option we have left…

 

 

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4.  Leaving Medicine Behind

 

While part-time work is often an adequate solution to many physician burnout problems, sometimes it is not enough.  Things might get so bad that doctors will leave altogether.

Altruism (e.g. the desire to help patients) can keep people going for only so long in a system filled with insurance companies, large organizations, and hospitals that do not let doctors take care of patients the way they know they should.

If medicine continues to refuse to change, there will be a mass exodus of excellent physicians in this country. This is the nuclear option that is on the table, but no one likes to talk about.  Regardless, it is a very real problem.

 

 

 

Take Home: Financial Independence Can Fight Burnout

 

Burnout is not only real, it is costly.  It endangers doctors and therefore, threatens the medical community as a whole.

This is a problem that must be fixed, but if the system continues to propose only individual solutions to something that is a systematic problem, physicians will eventually find a way out of this mess.  Hopefully, financial independence will produce courage and the system will change.

If not, I’m afraid the physician shortage that looms ever larger will only get worse as physicians leave a field that fails to fix a problem that threatens the career and even threatens the life of physicians.

 

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What do you think?  How do you actively fight back against the burnout that threatens your career?  Has financial independence played a part?  Leave a comment below.

9 thoughts on “Four Ways Financial Independence Counters Career Burnout”

  1. The hospital definitely does NOT love us back. Look at these crazy times with the pandemic. How many of us had to fight with our own administration for proper PPE? How many hospitals got this situation right and planned well for an emergency (very very few)? What are we paying these administrators for?

    I hope two major changes come from this pandemic. First, physicians reclaim their role as experts in health care and science. The public is craving real information – they want to be safe.

    The second, bigger change I see coming has to do with time. I have had countless conversations from surgeons, anesthesia etc regarding slowing down (to only 40 hours/week – HA!). With this forced reduction in hours the last few months, so many us can palpably see all we’ve been missing for years. Changes are afoot…

    Reply
  2. Subscribe to get more great content like this, an awesome spreadsheet, and more!
  3. FI Gives you more options, so much less pressure to keep everyone happy. As you know, many people are just not happy people.

    Each time I crossed a retirement flex point (one million in retirement assets) I reduced the difficulty of the procedures I did. It made a world of difference in my stress and happiness levels.

    I finally retired when my livable years, health, and declining insurance reimbursement rates made the decision easy.

    Great times traveling the US and Mexico until covid and the riots stopped this for a while.

    Reply
    • Great post . Glad you fired and the science back you up. Daily stress is a physiologic killer and eliminating can save your life given elevates stress hormones and inflammation. Interesting dual articles came up reinforcing my decision to quit. 1) new guidelines on excercise doubled the amount to 150 minutes of vigorous exercise per week (working interferes with that after a exhausting day in the hospital) 2) they found that 40- 60 year olds are getting more miserable due to stress from being stuck in middle of aging parents , raising kids, financial stress, and work stress. By FI you can eliminate 2 out of the 4 sources and enjoy and not stress out over your kids and parents

      Reply
  4. Agree with all the above. Having some elasticity in my budget helped me with #1. I hired a scribe and go home at the end of the day rather than doing charts.

    Reply
  5. Not a doctor, but was a corporate officer in a Fortune 200 company making specialist MD wages. When I realized I was financially independent it made me a much less motivated employee. My senior management frequently used intimidation as one of their management techniques and once additional money stopped having meaning in my life I became very difficult for them to manage. While becoming FI may well decrease burnout I think it also reduces your value as an employee by removing some of your motivation and reducing your tolerance of corporate nonsense. I just couldn’t care as much about the work.

    Reply
    • Nice comment, though you make is sound like a bad thing that you wouldn’t take poop anymore from an abusive company.
      Sounds like FI gave you the freedom to demand respect. And I am assuming you were successful because you did good work.
      Good work plus employer respect sounds like how things should be.

      Reply
  6. Interesting comment about one of the side benefits of FI is that you become a more free thinking person not beholden to corporate thinking . Since reaching FI at 50 I have become a better employed physician for my patients because I feel I can push back against stupid policies that just increase bottom line for hospitals while not improving patient care and my sanity and compromising my self integrity . You feel more liberated and less stressed.

    Reply

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