Retired from Medicine at 43: Why, How, and What Now?

On Monday, August 12th, I woke up in a call room, gathered up my belongings, and stepped through the back door of the hospital out into the world for what may very well be the last time.

I wasn’t fired. I simply FIREd.

As in, I realized several years ago that I was Financially Independent, and I’ve now chosen to Retire Early from medicine.

At age 43, I should be in the prime of my career. It’s a position 25 years in the making when you factor in four years each of college, medical school, and residency along with the 13 years as a practicing anesthesiologist, and I could probably do this for another 25 years if I desired.

However, I’ve decided to deviate from the usual script.

In these last 25 years, and even before then, I’ve chased many goals. Get the best grades. Beef up that application with research and volunteering. Impress your attendings. Receive glowing letters of recommendation. Make the surgeons happy; make your patients happy. If there’s happiness left to be had, it’s yours.

Cross over one hurdle and prepare for the next. There were a lot of hurdles on that track, and they’re all behind me now.

Now, I get to chase a different goal — to live a happy and meaningful life while raising our boys and enjoying our days at a less-frenzied pace. It’s a goal with no discernible endpoint and no hurdles to jump over or trip over. A life I’ve been looking forward to for some time now.

 

Retired from Medicine at 43: Why, How, and What Now?

 

Why Retire in My Forties?

 

Some early retirees have dreamed of this day and planned for it for decades. Some are so burned out from their jobs that something has got to give. Some got lucky and won the lottery or got unlucky but received an inheritance.

None of these describe my situation.

The simplest explanation is that I am retiring because I can.

Late in 2014, I was studying for a bogus recertification exam and I started wondering if I’d have to do it again in 10 years. Spending time at the library studying irrelevant academic minutiae when I had two pre-schoolers at home wanting to play Legos and build puzzles with me didn’t seem right.

I revisited this blogger that had retired early, ran some numbers myself, and realized that we were already in a position to continue living our lives as we were without the income from my job.

I messed around with some spreadsheets and came up with a potential five-year plan. I didn’t know if or when I might actually follow through with it, but we started to dream about what we would do if I actually pulled the trigger. I had lots of ideas.

 

It’s so Hard to Say Goodbye to Yesterday

 

This was the best job I’ve ever had. Among anesthesia jobs, the one I just left was easily my favorite. Comparing this line of work to other non-anesthesia jobs I’ve worked, I feel privileged to have been an anesthesiologist.

In the past, I’ve mowed lawns, stacked wood, worked basically every lower-level position available at a grocery store, and even “donated” bone marrow for money (and stem cell research), not once but six times. Some of those jobs were hot and sweaty. Some were boring. And one hurt like the dickens.

The anesthesia job, by comparison, was always in a climate-controlled environment, paid very well, came with some level of prestige, and not once did I experience the sting of negative pressure inside my pelvic bones.

It could be stressful at times, but I did get do some amazing things and I helped thousands of people survive surgery safely with the fewest side effects possible. I will miss many aspects of this job.

Still, it was a job. Many physicians refer to their careers as a calling. They approach their workdays with passion, and feel empty when away for too long. I respect and envy those dedicated doctors.

That’s just never been me.

While it was an excellent way to make a living, a job is still a job and there’s usually someplace I’d rather be. Don’t get me wrong; my mind has always been fully committed to the necessary tasks at hand. Patient safety and comfort were always top priorities, and I believe I served my patients well.

But I can’t say my heart has been fully in it. I’ve always enjoyed my days off more than my workdays and my weeks off more than my workweeks. I’d say that’s true of any job I’ve had; to say otherwise would require some intellectual dishonesty. I’ve enjoyed work, but I’ve enjoyed doing whatever I choose even more.

 

The Timing Was Right

 

On a very cold January day in Brainerd, Minnesota, I received an email from a young man in the middle of his second year of a four-year anesthesia residency at my alma mater, the University of Florida. He had gotten my email address from an alumni contact list.

It turns out that Brainerd is his hometown, I had been working with his uncle for years, and I would later learn that my father graduated from dental school with another uncle of his.

Even though he had two and a half years left in his residency, he was inquiring very early on about the possibility of a future opening in our small group of five employed anesthesiologists. It’s a good thing he reached me and not one of my partners. We seemed like we might be set for ten years or longer at that point.

What my partners didn’t yet know was that I was contemplating an early retirement and this resident’s email gave me a good excuse to let them know. I had been writing about the possibility of retiring early for nearly a year on this website, and it was time to be more open about it.

Later that year, the young doctor was interviewed and hired as my eventual replacement. I dropped to part-time, and patiently awaited his arrival as he advanced through those grueling final two years of residency.

I spent most of my final workweek getting him oriented, watching him work, and trading stories about the fifteen or so anesthesiologists who trained us both. It was great to get to know him and pass the baton.

He’s an excellent physician and the job seems to be a perfect fit for him and his family of six. I feel good moving on knowing that my shoes will be filled by a very capable doctor, and that my departure created an opening in what I think is an ideal job for this young man.

 

Heir Apparent

can you tell we’re both happy? (that’s me on the right)

 

 

How I Could Afford to Retire Early

 

This is the “how” that people really want to hear. How can a person afford to retire at age 43, just 13 years after starting a career as a full-fledged attending anesthesiologist?

If you’ve read Drs. Stanley and Danko’s The Millionaire Next Door, you know the “secret.” If you know me in real life, you’ve seen it. Dr. Stanley wrote a followup book called “Stop Acting Rich,” and that’s what I’ve done, embodying a “stealth wealth” lifestyle for the most part.

My wife and I have lived a life of relative frugality, at least as compared to most of my physician peers. We’ve settled into a spending pattern where we’re both comfortable. We weren’t trying to achieve any particular goal — we just spent with intention on the things we value, donated generously, and saved and invested the rest.

Almost all of our income has come from one source — my job — although my wife has done a little bit of teaching and this website now makes money, too. It’s all gravy and half of my profits from this endeavor are donated.

Before I had a website, we had attained financial independence by virtue of retirement savings equal to at least 25 times our anticipated annual spending. We eventually hit the “financial freedom” number I calculated to be 36x spending, and the markets have continued to be kind to us.

My investment strategy has not been anything special; I didn’t get lucky with one particular stock. Most of our money is in passive index funds.

It certainly helps to have a high income, especially if you want to do the fatFIRE thing, that is, retire with an above-average level of spending. However, FI is possible even on modest incomes.  If you can learn to live on half of your takehome pay, even if you’re currently flat broke, you should be able to retire in 15 to 20 years at the most.

 

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What Now?

 

In the immediate future, I’m taking my time moving into our new $90,00 house. The location is great, the price was right, and some forced minimalism will be good for us. We’ll also spend some time at our lake place while summer is still with us. It will be gone in the blink of an eye!

 

Location Independence

 

For the first time in my life, I have this thing called location independence. I don’t have to be in any particular place at any particular time. This is huge, and we plan to take advantage of this newfound geographic freedom this fall.

Our first big family trip will be a two-month visit to Ecuador. My wife and I visited the country in 2011 when we toured the Galapagos Islands, and we’re excited to return with our boys for an extended stay. Friends who have spent many months in Ecuador have had nothing but great things to say about the place (see here and here).

We return to the states for a few weeks to celebrate the holidays with family and get just enough of a taste of winter to be grateful that we’re not around to enjoy all six months of it.

In early January, we’re off to Spain for another two-month adventure. We’ll be spending a month each in Valencia (I hear the oranges are top-notch) and Barcelona, living on a yacht that second month. We’ve already got family on both sides lined up to visit, and I expect we’ll be welcoming additional company.

In mid-March, I’m off to Las Vegas for The White Coat Investor’s Physician Wellness and Financial Literacy Conference, where I’ll be moderating one panel, participating in another, and sharing some emcee duties.

We may spend more time out west after that, or we may just want to be home for a change. It’s better to return late May than late March, though, when home is in northern Michigan.

Before our big trips, I’ll soon be spending a weekend meeting up with old friends and making new ones at the sold-out Camp FI Midwest. I go straight from there to Washington, D.C. for FinCon, the annual must-do conference for content creators in the personal finance space.

My family joins me in our nation’s capital, which will be a great spot for our boys to kick off the “roadschooling” that will be a big part of our upcoming adventures.

 

Work. Yes, Work.

 

The title of the post began “Retired from Medicine,” not simply “Retired.” By continuing to educate people and share my experiences here, I think it’s fair to say I’ll be semi-retired at best. Retired Not Retired.

Blogging feels very different from working, and it’s something that I can do from anywhere, as little or as much as I choose.

Still, maintaining the publishing schedule that I currently have does take some serious effort, and the proceeds (this site does make money) are enough to cover our living expenses even after I share the revenue with shareholders, donate half of what’s left, and pay taxes on the remainder.

The fact that I’m not yet implementing our drawdown strategy also makes it feel less like I’m retired. I also end up going to more conferences and meetups related to this blogging business than I ever did for anesthesia. I’m not going to lie; the blogger ones are much more fun.

Regarding anesthesia work, I haven’t 100% ruled that out, either. I will keep an active state license and do enough CME and maintenance of certification to make working the occasional locums opportunity a possibility. I have no plans to schedule any, but I’d like to have that option if I have a change of heart.

 

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Enjoy Some Free Time

 

Unstructured free time is something I feel like I haven’t had a whole lot of. In reality, free time is just a vacuum and I tend to fill it quickly whenever it arises.

That’s how this blog started. I found myself with a lot more free time once my kids were both in school in 2016. The free time didn’t last, but the blog did, and those two facts are very much interrelated.

Now that I’m not squeezing the rest of life into the time I’m not at the hospital and surgical center, I do expect to have more true free time, and I’ve been busy making mental plans. Three years ago, I published a list of 50 things I’d like to do or spend more time doing in early retirement.

Interestingly, many items on the list involve some sort of work. However, rather than working for a paycheck, the wishlist work involves activities to improve my mind, body, and soul.

Reading, hiking, traveling, writing… working on myself and my relationships. It’s rewarding work.

 

The Great Unknown

 

I’m not making plans too far into the future. Five years ago, I would not have imagined my life would look like it does today. Five years from now, I might look back and say something similar.

Ten years from now, our kids will be about to turn 19 and 21 years old, and our “child-rearing” years will be pretty much over. I expect there will still be some “young-adult-guiding” to do, but the time commitment will be less and less. That’ll be a bittersweet sort of freedom that will present both new challenges and opportunity as we navigate life as empty-nesters.

I was listening to David Epstein on the Afford Anything podcast the other day. He said something that resonated with me, as it’s a phenomenon I’ve recognized in my own life.

Essentially, he explained how bad we are at making future plans and prognostications for ourselves. The reason we stink at it is the fact that we’re making plans for someone we know very little about. Future you is going to be shaped by unforeseen experiences and circumstances into someone that may have different desires, beliefs, and skillsets than the current you.

One of life’s greatest joys is the fact that you can continue to learn, evolve, mature, or even regress. That uncertainty can be scary, but also exciting.

Where will I be and what will I be doing in ten or twenty years? I don’t have a clue, but I embrace the open slate that lies ahead.


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81 comments

  • Stan Davis

    it’s wonderful what you’re doing. one strong warning…i left OB practice for 8 years, i was still in the OB world as an academic and labor and delivery safety consultant, still board certified but that didn’t matter…i could not find a hospital that would help me get back into practice.

    you don’t fall back on OB or anaesthesia. if you don’t intubate anyone for two years, good luck. doesn’t matter if you kept up your state license, doesn’t matter if you’re up on CME. what matters is how much care have you given in the last two years. haven’t given care for two years? you won’t get privileged at most hospitals today. (it’s probably the easiest patient safety question out there…how many of these (X) procedures have you done in the last two years?)

    doctors more and more are finding this out the hard way. they can’t get back in because they can’t get privileges and there is no standard way to get back in. no one will want to take a chance on you because you’re too much of a liability to “train-up”.

    just as an example, i have a friend who developed breast cancer, after a year of treatment she decided to stay home with the kids for 2 more years. she can’t find a job now. she assumed that with a physician shortage they would be available. what she found out is that ACOG and ABOG (the professional society and the board for OB) don’t have a program for re-introduction to practice. the incredible thing about this story is that one of the hospitals she applied for has family practice residents who do OB, yet they felt uncomfortable helping her get back into practice.

    i got lucky, a practice that needed someone knew of me, we came up with a program just for me that the local hospital accepted and i was back. however that required a willing group and a willing hospital…very hard to find those two variables working together…both have liabilities for your work, and you know how risk-averse clinics and hospitals are these days. having said that, even employed physician hospitals are not bringing people on who haven’t worked enough in the last two years.

    so while i applaud you, wish i had the freedoms you have, i will tell you you are not as free as you think. plan accordingly.

    • Thank you for sharing these stories.

      I am well aware of the one-way street this is, and have said time and time again that I will maintain a medical license and board certification for a year or two, but if I haven’t practiced medicine at the two-year mark, I would not feel comfortable with my skills, would have a difficult time obtaining privileges and malpractice insurance coverage, and will be officially done at that point.

      I’ve been contemplating this move for nearly five years and have been writing about it here for the last three and a half years. This is not a willy nilly decision on my part.

      Cheers!
      -PoF

      • Joe Morgan

        I’ve seen a few docs like the OB and yourself who wind up struggling in later years and with no physician skills to get back into the game.
        Not keeping up skills by some locums or other work periodically is job killing and often becomes critical at a time finances are critical also.
        Good Luck!
        But somehow I don’t think it will last till death do you part.

        • Struggling in what way, Joe?

          I can see struggling for purpose, not knowing what to do, etc… I think I mitigated that risk away by working part-time for a couple of years and taking some lenghty trips as FIRE trial runs.

          If you’re referring to money struggles, we’ll have to agree to disagree. I could have left work with a 4% withdrawal rate nearly five years ago, and our net worth has approximately doubled since then. If that’s not safe, I don’t know what is.

          Cheers!
          -PoF

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  • Unlike you, I did not start working as a physician until I was 43 but my wife and I both had PhDs in medical research and had travelled the world starting at age 27 (55 countries) and lived in 5 countries. So now we are making up for lost time. I am almost 70 now and still working as a hospitalist-nocturnist 7/7 midnight to 8am.

    We now have 3 freehold houses. One for our son and daughter-in-law, our main home in TN Appalachian mountains, and a vacation home and car in New Zealand where we still have family. OK so why don’t I retire. We have savings about 10x my salary but we think it doesn’t matter how much capital you have you cannot live on 0% interest. Although my wife has done extremely well with investing (starting by buying Apple shares when they were $2.75 each – adjusting for splits) we feel the stock market is getting too risky now and pulled out a large part of our investment. But is it even possible to keep your savings safe.

    I plan to live to 100, and to make it last I will probably continue to work, part time. I am lucky to have a contract that allows me to take at least 2 months vacation every year and we plan to continue to travel to New Zealand (where I love to work on my engineers lathe) every year, plus other trips to Europe etc for several weeks. This is only possible because nocturnists are in demand. But the zero interest rate problem is a serious concern.

    Like you my wife and I run web sites and online databases for voluntary organizations (genealogy archives) but do not make any money out of it. That is our hobby.

  • Anna Sell

    Congratulations. Hoping to retire from anesthesia soon but what is holding me back is the thought of health insurance. We had an Obamacare plan for several years and it was expensive and restrictive. I’m 12 years away from Medicare. How are you handling your health insurance.?

  • Dr. Kathryn Duplantis,MD

    Semi retired all ready and will transition to teaching residents cosmetic and reconstructive surgery one day per week!

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  • JH MD

    Dermatology here and same at 45! I’ve learned to ski and mountain bike this year, finding some consulting and real estate on the side to be fun, fulfill my “customer service” mindset. Loving it but a bit fearful at times so very glad to read this article and many of the comments.

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