Is it Wrong for Doctors to Retire Early?

Is it wrong for doctors to retire early? That’s the question posed by Dr. James Turner in today’s Saturday Selection.

It could be that people have always had strong opinions on this topic (and virtually any topic under the sun), but in this age of social media and comments sections, people can more easily share their opinions with the whole world with the click of a mouse or the tap of a phone screen.

I know there are plenty of people who indeed believe it is wrong for a physician to retire early. As a retiring physician with an interest in physician wellness, it never ceases to amaze me how poorly some physicians are treated by… guess who? Other physicians.

Last summer, an article of mine was shared on Doximity and there were some nasty comments. If you’re a medical professional with a Doximity account, you can see all 171 comments here. Some came to my defense after I called attention to it, but particularly at the beginning, the comments were downright savage.

I can understand a frustrated physician hiding behind a made-up screen name venting, but to post with your name, picture, and credentials to let professionals across the country know what a jerk you can be? Professionalism is supposed to be a core competency in residency, but apparently it didn’t sink in for everyone.

Let’s see what The Physician Philosopher has to say, as he examines some of the arguments and offers sensible rebuttals. This article originally appeared on his site.

 

Is it Wrong for Doctors to Retire Early?

 

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 work life 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 role 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 Kilar hadn’t ignored the naysayers. If he had listened, Jason might still be building and stocking those shelves at the 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.

 

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“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.

 

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“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 limited number of available ACGME residency slots.

There are an abundance of allopathic and osteopathic physicians out there looking for meaningful work after medical school who need residency training

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.

 

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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.

 

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Has anyone ever given you a hard time about pursuing FIRE?  What was your response?

8 comments

  • bill

    There is a more sinister reason to not retire early as an MD. If everyone did it, I suspect the result (no idea how this would be done but i think it would be) might be lower incomes for new docs. Let’s say schoolteachers began retiring at age 30 because they could – the system would begin cranking out teachers in greater and greater numbers until their incomes reached the point where they could not retire at an early age. FIRE docs who retire are relying on most docs being too stupid to stop buying things and work until their first heart attack. We should thank them…

    • I don’t follow. If the argument is that docs retiring early causes labor scarcity, the logical endpoint would be that salaries would rise, not fall.

      • bill

        I agree if all docs retired early MD salaries would rise in the short term. In the long term it is unpredictable. The USA could do with less docs and more paraprofessionals, a situation in which MD incomes could skyrocket. It is also possible that the paraprofessionals could turn professional and put negative pressure on MD incomes, this would require changes in licensing brought on by an MD shortage. Either scenario is possible, there are probably lots of possibilities.

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  • Gary Simms

    Your first duty is to yourself and your family.

    Insurance companies have no concern for you or their clients. They provide minimal coverage designed to satisfy the insured’s expectation, pocketbook , and the insurance company’s profit margin.

    Patients change doctors at the change of every insurance contract if you’re not a contracted provider.

    Where’s the loyalty?

    I’m just a dentist, but no one was ever worried about my finances except me.

    People wondered why I lived here n a modest home and drove modest vehicles.

    Today they wonder how I retired at 58.

    Again, Your first duty is to yourself and your family.

  • jlo

    This is a very provocative and complex issue:
    I first agree your first duty is to your self and your family
    Medicine is a unique profession in which there is an expectation of altruism that is different than almost every profession. We suffer dearly for this expectation.
    All of our eductions are subsidized in one way or another by society and the argument that if we were not not planning to work for a certain span of time could be said about just about everyone who received a public education from K on or who went to a private school of any type that was subsidized by research grants or tax preferred status.
    There are many barriers to having the right mix and number of medical providers and having physicians retire early is very low on the list of things that need to change.
    I am 52 and planning to retire on my 55th birthday. We all have our own story and pathway but as a cardiac electrophysiologist, I really like what I do on many days and would love to work part time but the system is not really designed to allow me to do so. With that said I make almost 7 figures working 4 days a week so it is hard to complain. I am pretty good at what I do and IMHO the world and my community will be worse off if I am not seeing and taking care of many complex patients. I am certain there will be someone to fill my practice with their own skills and attributes. I would love a part time way to offer my services and will look for those opportunities.

    We physicians are an interesting mix of personalities and it does not surprise me the pushback and criticism the FIRE movement receives from many physicians. I think that is why we as a profession have lost control over our profession because we spend most of our time fighting amongst ourselves and no time really advocating for our profession.

    I would like to share a story related to how physicians as a group are so dysfunctional:

    I had dinner with the CEO of one of the major pacemaker companies a few years ago right after the ACA was approved and the medical device industry was hit with a tax on their products. He told me that he was frustrated because he thought as an industry they had spent enough on lobbying to avoid this tax but they clearly did not. He then pointed out that there was no med mal reform in the ACA and he said the trial lawyers outspent 5-10X on lobbying compared to the device industry and that was the cost for them of preserving their stake. He laughed and told me that “you poor doctors are going to get screwed” and pointed out that we had no real voice at the table. He said the AMA and other “doctor groups” have their own self interests that have nothing to do with physicians well being. He said until physicians organize, chunk in some cash and hire your own lobbyists to fight for your interests, you will be patted on the head, get lip service about how the doctors are so important and continue to be abused.

    I will not be critical of what another doctor chooses to do as we all have our own story and path. It is sad to me that we cannot figure out a way to work together to make it better for the profession instead of continuing to fight over a smaller and smaller pie.

  • I think the big question here is who defines and what is the deffiniation of early. When I started medical school, age 50 was my set retirement age. So when I retired at age 54, I retired late. Yet many would say I retired early. So one must first define the right retirement age, in order to say you did it early.
    I’m putting this one in Fawcett’s Favorites this week.
    Thanks,

    Dr. Cory S Fawcett
    Prescription for Financial Success

  • Pingback: Fawcett’s Favorites 7-29-19 – Dr. Cory S. Fawcett

  • NightnightDoc

    First off, congratulations. As a fellow anesthesiologist, I commend you on wanting to share your training after retiring. I would argue that financial freedom is a wonderful thing to strive after. Just because one could theoretically retire say after 10-15 years, choosing to do so is another thing. Working because you want to work not because you have to work is a liberating concept.

    I would believe that patient care would increase. It’s unfortunate that you had so many naysayers and those that were frustrated by your goals. However, it’s not your fault that they choose poor financial decisions (the real reason most of those folks were salty).

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