Five Ways to Leave Clinical Medicine

Paul Simon gave us 50 Ways to Leave Your Lover. Dr. Jim Dahle gives us 5 Ways to Leave Clinical Medicine in today’s Saturday Selection. As always, this post was originally published on The White Coat Investor.

Just slip out the back, Jack.

Make a new plan, Stan.

Don’t need to be coy, Roy, just listen to me.

Hop on the bus, Gus.

Don’t need to discuss much.

Just drop off the key, Lee, and get yourself free.


Five Ways to Leave Clinical Medicine

 

I am frequently asked by physicians who have grown tired of their job for a list of non-clinical options they can do. Upon further questioning, what they often really want is something that pays just as well (or better) than clinical medicine, but that is much easier to do.

thedisabilitydoc
Unfortunately, that can be a very difficult proposition. You see, most jobs pay much less than practicing medicine in any specialty, and most jobs that pay an income similar to that of a practicing physician are at least as hard, risky, and time-consuming. The median physician income is approximately $200,000, and the median household income in the United States is about $52,000 per year, and that often includes two partners working.

In fact, only 25% of American households have income over $100,000 and only 6% over $200,000, with half of those between $200,000 and $250,000. The infamous “1%” starts at just $389,000, less than that of many physician households, especially a two-physician household. The bottom line is that almost all jobs pay less than that of a physician practicing clinical medicine. So if you want a job that pays just as well as that of a physician, your choices are very limited.

 

Five Ways to Leave Clinical Medicine

 

1. Retire Early

 

In some cases, it turns out the physician just doesn’t want to work anymore. They want to be financially independent and be living off their investments. The good news is that physicians are generally paid enough that if they can live a middle-class lifestyle during their career and in retirement, they can retire completely a decade out of residency.

The math looks like this: Make $200,000 per year, pay $50,000 per year in taxes, live on $50,000 per year, and put $100,000 toward retirement. If you earn 5% after inflation, after 10 years you’ll have a nest egg worth the equivalent of $1.25M in today’s dollars, enough to give you an income of $50,000 a year for the rest of your life.

However, I have noticed that very few physicians hate working enough to live on only $50,000 a year for the rest of their lives. Most would rather work at least a little more and spend more. There are real consequences to a very early retirement.

 

2. Fix Your Job

 

contractdiagnostics
The best option for most physicians is simply to fix whatever it is about their job that they do not like. That might mean dropping call, dropping a portion of their clinical practice (like obstetrics for an OB/GYN), cutting back on shifts or hours, or changing jobs to one with a slower pace, a less litigious population, and/or a more supportive administration.

Nearly every physician I’ve ever talked to who has cut back their hours by 20-33% raves about how much more they enjoy medicine than they used to. Yes, this approach often comes with a pay cut, but it’s often not all that large on an after-tax basis, and certainly no larger than what they would see transitioning to a non-clinical career.

 

3. Entrepreneurial Pursuits

 

Perhaps the best pathway out of medicine is becoming an entrepreneur. Unfortunately, there is some risk here. Most small businesses fail, and most small businessmen make less than a physician, anyway.

However, a physician has a bit of an advantage here. She often has significant capital, which eliminates the main reason small businesses fail—borrowing too much money. She also can ease into the business part-time while maintaining her main, stable job as a physician. Plus, physicians are generally intelligent, personable, reliable, and not afraid of hard work.

These traits serve them well as entrepreneurs. It would be impossible to list every possible entrepreneurial pursuit out there, and in fact finding an unserved niche and filling it is part of the fun of entrepreneurship. But the possibilities range from those that often remain “side hustles” like writing, speaking, and consulting, to the relatively competitive field of real estate investing to the design and manufacture of new medical devices.

 

 

Odyssey WCI

WCI leaving medicine for the day

 

4. Non-Medical Jobs

 

Many physicians transition out of medicine completely into a new profession. This often requires another degree or training, such as a JD, an MBA, or a financial advisor certification.

Some physicians wish to leave medicine and do something else that pays much less than medical work. These are the classic “encore careers” where you become a chef, a teacher, or a tour guide. This is a similar issue to retiring completely, but the more you have and the less you spend, the more job options that are available to you.

 

 

5. Medical Jobs

 

The vast majority of doctors who leave clinical medicine don’t have the interest or skills necessary to be successful as an entrepreneur, nor the money required to move into an “encore career.” They tend to go work for healthcare-related pursuits involving a diverse set of interests such as medical writing, resource utilization, health insurance, medico-legal work, pharma, or managed care.

Hospital administration or practice management consulting positions are available to those who have developed non-clinical skills during their career.

bankofamericaCoaching other physicians and working in information systems are other possibilities. As you are well aware, the design of most electronic medical record systems suffers from having little input from actual end users, and doctors with IT skills are highly sought after commodities. Health and disability insurance companies need physicians to do reviews.

Venture capital companies interested in evaluating and acquiring medical businesses may find your expertise very valuable, especially if you can learn to speak their language. Recruiting physicians for drug trials or locum tenens companies is another option.

You can also help write, produce, and present continuing medical education courses. Many of these can be paired with a part-time clinical career as well, which might even make you more valuable as you will still be seen as “one of us” among physicians.

If clinical medicine has become less attractive to you, then consider your alternatives. They include retiring completely, modifying or changing your clinical job, starting a business, leaving medicine for another career, or most likely, using the skills and knowledge you acquired in medicine to pursue a non-clinical medical career.

 


You're still not using Personal Capital? That's how I track the PoF portfolio.

 

[PoF: Personally, when I was frustrated with MOC and realized I had enough money to retire, I started plotting an escape of my own. What I thought would be a full retirement is morphing into more of a career transition into a job with infinitely more flexibility and a lot less stress — blogging.

 

It’s not exactly passive income that I’m earning here, but it is what my friend Jillian @ Montana Money Adventures calls passion income. What a great term! For some of you, working in medicine may truly be passion income, and that’s wonderful. Personally, I’ve found something else.

If you’re interested in learning more about non-clinical jobs and entrepreneurial ventures for physicians, join me in the physician-only Facebook group started by Nisha Mehta, MDPhysician Side Gigs. And check out my review of Dr. Cory S. Fawcett’s latest book, Smart Career Alternatives and Retirement for Physicians.]

 

Find FIRE with me.

Get an amazing spreadsheet, new post notices, & a quarterly newsletter.

We won't send you spam. Unsubscribe at any time. Powered by ConvertKit

11 comments

  • Some specialties are easier to start a glide path than others when slowly scaling back clinical hours.

    The easiest ones by far are considered the “shift work” specialties such as ER, radiology, anesthesia.

    Other specialties require a little more planning and logistics to slowly decrease workload (obgyn docs dropping the ob portion for instance).

    But by slowly reducing clinical hours you can potential extend your work career as you won’t feel burned out as much.

    Problem is there will be a point where it doesn’t make financial sense to decrease hours beyond a certain point: fixed expenses start taking a larger proportion of earned dollars

  • Subscribe to get more great content like this, an awesome spreadsheet, and more!
  • snowcanyon

    Seems like the most remunerative way to leave medicine would be to go to Wall Street, which I would LOVE to do. Anyone know a mid career (45-50) doc who has done this? No idea where to begin.

    But that’s where the money is….

    • Dr. Michael Burry ran a hedge fund. Did you read or watch The Big Short?

      From what I hear, be prepared to work like a resident, at least in terms of hours, if you want a chance at making the big bucks. Also, bear in mind that there is no Hippocratic Oath in finance.

      Best,
      -PoF

      • snowcanyon

        All true! But NE physicians are grossly underpaid, which is not something I can fix, and I’m really tired of living elsewhere. I’ve given it over a decade, and we would love to move closer to family. Hence my interest in Wall Street.

        Open to any other thoughts from anyone as to how to accomplish this!

  • PoF,
    Thanks for including my book in your recommendations at the end of the blog. Doctors are very well trained and have a lot of skills, beyond treating patients, that many other employers would love to use. If you really do want out of medicine, there are many options, some are spelled out in my book.

    Dr. Cory S. Fawcett
    Prescription for Financial Success

  • Vivek angadi

    I am not quite tired of my job (mostly want to grow clinically from where I am), but I am concerned about being financially tied to my primary vocation due to the changes in medicine.

    • It can be ugly out there. We’ve certainly lost some autonomy, haven’t we?

      Since we don’t know what tomorrow will bring, I emphasize saving for financial independence at an early age. Options are a good thing to have!

      Best,
      -PoF

  • Gasem

    I made a pile, slipped out the back Jack and dropped off the key Lee. Now living stress free as a retiree. My pile is bigger than when I quit-ee. Had to fudge to make that rhyme

  • The owner of the company my engineering husband works at is a surgeon. Have ideas about what medical devices need fixing in your field? Hire some engineers and write some SBIRs and you have a company. And you’re helping improve the field for others.

  • I’m only a few years out of training, and haven’t really been beaten down by the job yet. Also, it seems like a shame to work for all of those years to prepare for a job, and then only do it for a fraction of the time that you spent preparing.

    I’m more concerned with the future of medicine. As a young doctor with a long time horizon, most of the trends we’re seeing in healthcare are alarming. It would be nice to have a backup plan.

    The problem, as was pointed out in the post, is how much money we make. Finding a couple of side hustles to replace 40k per year is much easier than finding a couple that produce enough to replace 200k per year. Its ironic that making more money can actually make financial independence harder to achieve.
    -Ray

  • One thing that often concerns me with doing less clinical medicine is the loss of the physical and in some cases the mental skills. I’m sure I could go a year or two and still remember how to put in a central line. However, putting a central line in a 2 month old is something that takes some practice to maintain. There’s a certain point where if you’re doing less than a certain amount of clinical medicine you should stop. Also, there’s the concern that if you do something nonclinical that’s less lucrative than your clinical work, it’s hard to step back in later if you want to increase your income.

Leave a Reply

Your email address will not be published. Required fields are marked *