Post-FI Notes 021: A Super Successful Surgical Subspecialist

This Northeastern surgical subspecialist has cracked the eight-figure mark in net worth, with the majority of it in index funds. He started around 30 and in the ensuing 20-ish years, with a successful career and prudent (if not titillating) investing, has made his family quite wealthy.

Our guest today shares his story of career success and soul-crushing EMR and response work, and how “one more year” can manifest itself even as one’s wealth grows past abundance and into…well, yes, it’s safe to say, rich.

If you’re interested in participating in one of three interview series, please download the most appropriate form for your life situation: FIRE Starter, FIRE Crossroads, or Post-FI Notes. To see other posts in the series, visit our Q&A archive.

 

Getting to Know You

 

You’re financially independent. About how much does your household spend in a typical year? How much could you spend while still abiding by the 4% rule?

My current net worth after the recent stock market decline is about $10 million.  That consists of about $8,000,000 in investable assets, and about $2,000,000 in real estate, like our practice real estate, house, cottage, and timberland.  I am not including three classic cars, an extensive firearm collection, and other personal items.

We are debt-free and own our house, cottage, timberland, and all vehicles free and clear.

I would estimate we spend $150,000 per year.  By the 4% rule, we could spend $320,000.

 

Tell us about your household. How many people and at what ages? Are you supporting anyone outside of your home? Where do you live?

My wife and I are in our mid-40s and have three children, ages 10, 8, and 7.  My wife stays at home with the kids.  We are not supporting anyone outside the home.  We live in the Northeast.

Are you still working? In what career? Did your work schedule or attitude towards work change once you knew you were FI?

Yes, I am still working as a heavily procedure-oriented surgical subspecialist.  As my net worth increased, I decreased my schedule to four days per week.  I also pay my partners to take my weekend call.  

Once I realized I was FI, I feel it actually increased my burnout, believe it or not.  

It has become much more difficult sitting through work meetings and dealing with hospital and administrative nonsense. I have very little tolerance for any unproductive activity that wastes my extremely precious time.

 

Was financial independence a long-term goal of yours? Did you think you might retire early or be able to do so when you first got started in your career?

It was never a long-term goal until about age 40.  The stresses of my medical career just kept building up, and when several children came along, it became very difficult to balance everything.  

I remember studying for my board recertification at age 40 while on vacation and saying to myself, I am never doing this again.

I pledged to myself I would be done at 50 when my next recertification was due at the latest.  Unfortunately, I am finding it very difficult to finally pull the plug, and I continue to suffer from “one more year syndrome.”

 

Investing

 

How is your nest egg invested? Approximately what percentage is allocated to stocks, bonds, real estate, and alternatives?

My brokerage account is 80% stocks and 20% bonds — all invested in very low-cost index funds through Fidelity. Everything I have left over after expenses each month is very boringly invested in these funds, month after month after month, year after year.  

We also max out I Bonds each year ($25,000) and have for many years.

We also own our house, a lake cottage, and several timberlands and recreational properties amounting to several hundred acres free and clear.  I paid off all my debt years ago.  

The timberland is largely used for hunting and other recreation.  However, timber harvests every 10 years or so, as well as significant price appreciation, have made this an excellent investment.

Are your investments primarily in tax-deferred, Roth, or “taxable” post-tax accounts?

75% is after-tax.  I have the remainder in Roth IRA, 401(k), and cash balance plans.  I max my 401(k) ($61,000) as well as a cash balance plan ($105,000) each year.  I continue to do the backdoor Roth each year for both my wife and me.

 

Do you have investments in an HSA? How about 529 Plans?

Yes, I max out our HSA each year.  I contribute $10,000 per child each year to our state 529 plan.

 

What has been your best investment?

It was coming out of training and joining a private practice rather than remaining in academia.  I simply cannot stress enough how important this was.  It would have been very easy and comfortable for me to stay at the university at which I trained, and they made it very tempting with a signing bonus and a nice salary.  

In contrast, my salary for private practice was initially about $100,000 less with no signing bonus.  I believed in myself, took a leap of faith, and built my practice from scratch, and it paid off tremendously.  

Within 2 years I was making three to four times I would have made in academia and I gained real estate equity on top of it.  In addition, I was able to invest over 6 figures ($165,000) tax-free each year because of our group’s retirement plans in addition to my taxable investments.  There is simply no way I would be anywhere close to where I am now if I would have stayed in academia

A close second was investing only in very low-cost broad-based index funds and managing them myself.  I took a keen interest in investing, and I read financial websites for about an hour each day and accumulated a collection of about 30 of the classic investing books that are often encouraged on this site.  I have read and reread all of them often.

I have avoided all the classic (and many times foolish) doctor investments that have plagued my partners.  

 

Your worst investment?

I really cannot think of any.  I have always lived beneath my means and invested in broad-based market index funds every month. Very, very dull, but doing so has proven extremely effective.  

 


 

 

Post-FI Life

 

What do you like to do with your free time? How much free time do you have these days?

Where do I start?  I have so many interests and hobbies.  I try to exercise two hours each day. I love the outdoors and have loved it since I was a child.  Hunting, fishing, gardening, timber and woodland management, heavy equipment, classic car restoration, shooting and firearms, archery, making maple syrup, biking,  reading…you get the picture.

I have minimal free time.  Medicine seems never ending and this has significantly worsened and continues to worsen since the EMR onslaught began.  I begin my day at 5 am and do two hours of inbox work before 7 am, and this continues on any break in patients during the day.  As soon as it is cleared, it fills back up.  The patient messages are never-ending, and now I am expected to be accessible via phone messages and email messages from patients.  It has completely exhausted me and taken much of the joy out of medicine for me.  It has become truly soul-crushing.

 

 

Do you enjoy travel? Tell us about a favorite trip you’ve taken.

Yes, we are very simple people and enjoy the outdoors and thus most of our trips focus on this.  We also spend significant time at our cottage especially during the summer for the lake and skiing in the winter.

 

Do you incorporate giving (money or time) into your post-FI life?

Not directly.  I give out significant free care to my indigent patients.

 

If retired, do you miss work? Do you get bored?

I am not yet retired, but do not foresee any issues with getting bored.  

I look forward to the day when I can go on vacation and not be checking my inbox daily, or the day I can have carefree time to spend with my kids.  Medicine is never-ending and I want my life back.

 

What advice do you have for others hoping to achieve the financial success you’ve found?

Live within your means, and invest regularly and consistently in low-cost broad-based index funds.  Avoid foolish doctor investments.  

Avoid lifestyle creep until later in your career when you have accumulated significant assets—those first few years as an attending really set the course for the rest of your investing life.  Every dollar you invest at age 30 is worth significantly more than the same dollar invested in your 40s or 50s.

Try to develop an interest in investing.  Even a simple task of taking half an hour each day to read this website and other popular sites will put you far ahead of most of your colleagues

Finally, be humble.  Treat everyone with respect. Do not look down on people because they are not as successful as you.

 

Finally, is there anything under the sun that you’d like some help with? The hive mind would be happy to weigh in.

I have found it very hard to make the decision to retire.  I have worked very hard to get where I am and going part-time is not an option in my group or specialty.  I would need to close my practice and leave my group.  When would you “pull the plug”?

Second, my group is entertaining the idea of building a surgery center.  If I continued to practice, would you invest in this or avoid this?  While this could be a great investment, a large part of me feels that it would be foolish for me to take the risk at this point in my career.

 

Again, if you’d like to partake in a future Q&A, please download a FIRE Starter, FIRE Crossroads, or Post-FI Notes interview form.

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


 

11 thoughts on “Post-FI Notes 021: A Super Successful Surgical Subspecialist”

  1. Dude you da man! I am so jealous I hope to be in your shoes one day! Actually I will likely never attain you net worth my plan was to retire with net worth of $4mil. You’ve bought your freedom just pull the plug and enjoy! Seems you have so many interests you have a lot to retire too. And your kids are still kids! Quit, hang with the kids hunting/camping/exploring etc, and if you feel like you miss work maybe do Locums. You’ve won the game- you can stop playing. Congrats!

    Reply
  2. Subscribe to get more great content like this, an awesome spreadsheet, and more!
  3. Congratulations on your success. My husband and I met ‘our number’ several years before retiring but kept working anyway since he was close to receiving full retirement benefits (non-physicians). My picture of health husband was diagnosed with PD and found himself only able to work about 2 more years. At the same time my career also became ‘soul crushing’ and we both retired. Best.Decision.Ever!

    To me, once FI if you describe your work as soul crushing that signals it’s time to go. My husbands diagnosis just reinforces that tomorrow isn’t promised. Take your money and enjoy the time you have with your family. and your hobbies. Just my opinion.

    Best of luck in whatever you decide to do!

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  4. Congrats on your success! I suspect your desire to stay in medicine is due to the fact it is a large part of your identity. Who are you outside medicine? You have many interests, sure, but you are Doctor “X”. That matters and it is tough to let go of that. You will still be a Doc, of course, but once you leave practice, it’s different. You’re “retired” not you’re a “doctor”. I think you have to decide if that’s acceptable. BEST of luck!!

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  5. To me, retirement isn’t about sitting around to do nothing. I see retirement as freedom to do whatever I want.

    Sometimes that’s a challenge though. What DO I want?

    I feel if you were able to find something you enjoy, even if it earns a fraction of what you earn now, it could be a good move.

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  6. Joining the chorus of – why is there no outsourcing of the inbox? Even if it cut your profit margin by 20%, if you enjoy your job much more and get multiple hours in the day back, wouldn’t it be worth it?

    I feel like either doing that OR just ending your clinical journey for now makes far more sense than continuing to work in the manner in which you describe.

    Reply
  7. Sounds like you are good to pull the plug….you have plenty of hobbies and will keep busy. Maybe you can do locums if you want to do some occasional medical work. Financially – you are all set. I wouldn’t invest in the new surgical center.

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  8. Agree with comment just above. Over 90% of your messages should not be reaching you. Invest the time and have a PA or a super medical assistant manage this for you. I bet you are too into the forest (too busy) to take the time to come up with a solution to this problem. This situation is exactly what PAs can handle. Hiring one can be a step before ever cutting back, going part time, or retiring early. As a PA I am always encouraging the surgeons in my group to push these things down onto the PAs. Surgeons should be operating.

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  9. Congratulations on your hard earned success! Never forget that your hard work and wise choices have placed you in this position. Regarding pulling the plug: the one more year syndrome is real. I reached financial independence several years ago, but could not pull the plug. That is until I unexpectedly received a rare cancer diagnosis. My life stopped, then turned on a dime. I pulled out of work the day after my diagnosis to concentrate on saving my life. I am doing well now, but I surely do wish I had those yours back when I was carefree and completely healthy. Even as physicians who live with life and death every day, particularly in my specialty, you cannot imagine your own mortality until it happens directly to you. You have enough money, but I suspect you would agree that you can never have enough time. My best wishes as you move forward and congratulations again on your success!

    Reply
  10. This is amazing. Love your journey. We are dual physician earners with very little kids, early 40s. Started investing only 4-5 years ago and half your networth. Quick question on your RE portfolio, do you invest as a completely passive/LP partner or perform many active roles as GP or JV.

    Thank you.

    Reply
  11. Congratulations on reaching FI! If you do decide to retire and sell everything off, make sure you have something to retire to. Everyone needs structure to their lives.
    For now, it looks like you need to find a solution to all the things that’s bothering you at the practice. It’s no fun waking up at 5am to do something you hate.
    Hope you can come to a decision. Thank you for sharing.

    Reply
  12. Congratulations on a very successful career! It sounds like you have a choice to make – either pull the plug to retire since you clearly don’t need to keep working or find some solutions to your headaches at work. It sounds like you need a nurse or PA or someone to delegate the inbox management to. Once you train them in the common issues it should take away a lot of the burden. For meetings and committees and so forth, just simply refuse to attend. If you need to hire a practice manager or someone like that to handle administrative issues, then do it. Ultimately, you have the “F-U” money at this point so if the solutions don’t come then it is time to walk away. As far as the surgical center, I would look at the classic words “when you have won the game, stop playing.” Would you rather be managing a surgical center or attending to your hobbies and other interests?

    Reply

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