Many people were interested to see how John spends his money. Why? Well, the headline for his article, written by the people who write headlines for national media outlets, states that he retired in his early fifties with a net worth of $3 Million. Those headline writers know how to grab people’s attention!
Expecting to see how much it costs to get a Lamborghini detailed or the going rate of caviar-stuffed truffles, readers were treated to the costs associated with a man who goes to the neighborhood gym most days, picks up the occasional Chick-Fil-A or pizza slice, and travels with his daughter to drop her off for college.
Who Cares? Why Write About It?
When most Americans think of rich people, they picture a life filled with designer clothing, pimped-out rides and cribs, private jets, and house staff to attend to every need.
There are people like that, and they’ve got more than a few million dollars or at least they’d better or they’ll run out of money right quick. But there are also rich people who live like everyday people. Because they are everyday people. Everyday people with above-average salaries and pretty average spending. That’s precisely how they became rich.
John sent me a message and told me his article reached quite a few people, and other than a number of people being concerned about his fast-food intake that week, the article was well-received. The article also sent a number of new readers to his blog; that fact helps answer the question of “why write about it?” but that’s just part of the answer, as I will elaborate below.
At his suggestion, I reached out to the editors of Business Insider and offered to write my own article for their Real Money series that also featured a mutual friend Brandon (the Mad Fientist), Jerry (the Peerless Money Mentor) and several other men and women in various places and professions. My offer to record and relate my own spending habits was accepted on a Thursday and we started our week of detailed tracking the following Monday.
I wrote an introduction and accounted for our activities and daily expenses as we traveled to our second home and had some family fun for a week in northern Michigan.
The resulting article, given the catchy run-on sentence of a title “I’m a part-time doctor earning $250,000 a year and I plan to retire next year at age 43 — here’s what a week of my spending looks like” was published on Business Insider, picked up by Doximity, and shared by The White Coat Investor to his 20,000 email subscribers.
The Average Indebted Medical Student Has About $200,000 in Student Loan Debt at Graduation
Med students rack up serious debt in eight years of schooling, and for most, that debt will only grow despite making income-based payments in residency. It’s not uncommon for a graduate of private schools to have a half-a-million dollars in debt, and a $1 Million in student loan debt is not unheard of.
Thankfully, Business Insider does not have a comment section. Doximity, on the other hand, does. When my weekly spending article was featured there, there were some less-than-complimentary responses. I responded to some of the comments in a recent post, but there was one flippant comment that I felt deserved more than a one-liner. What was that comment, do you suppose?
“Who Cares? Why Write About it?”
I shared my budget from one random week as an example of what life can be like spending “only” a five-figure sum each year. With a similar budget, most physicians with six-figure student loan burdens can be debt-free within five years or less.
I write about it with the hope that younger physicians may be inspired to get out of debt more quickly.
A Quarter of Physicians Over 65 Are Worth Less Than a Million Dollars
According to a Medscape survey of over 20,000 doctors, the average physician earns about $300,000 a year. Yet, 24% of those 65 and over are not worth $1 Million. 71% of those in the 35-49 age bracket are not yet millionaires, either. Note that net worth includes equity in your primary home (and any other home you own).
45% of physicians feel they cannot afford to max out workplace retirement savings plans, such as a 401(k) or 403(b), according to one Fidelity study, and 71% are not contributing to a 457(b).
I hear divorce can do some serious damage, as can failed business ventures or really expensive children. So can spending nearly as much as you earn, and I fear that’s an issue for far too many people.
But who cares? Why write about it?
The Correlation Between Spending and Happiness is Weak, at Best.
Don’t get me wrong, I know that money can buy some happiness. Vacations are great, good food makes me happy, and with the glaring exception of Jay-Z, no one has ever looked unhappy on a jet ski.
There’s this thing, though, known as hedonic adaptation or the hedonic treadmill. It’s a very real psychological phenomenon that prevents us from having the same exuberant result each and every time we repeat some grand experience or acquire a better gadget.
When we continually upgrade our lifestyle and the objects that accompany it, what was once sufficient becomes inadequate and what was once amazing becomes… well… adequate. When a treat becomes the norm, living without that treat becomes uncomfortable. Enjoy that thing rarely, and you can keep it a treat.
There have been studies that suggest people earning big-time doctor money aren’t much happier, if any happier, than those earning a wage of about $75,000. The research is imperfect and in need of an update, and the definition of “happiness” may vary from one person to another, but based on what I’ve lived and seen, a lot more money doesn’t tend to make people a lot more happy.
It’s counterintuitive, I know. But who cares. Why write about it?
Physician Burnout is at an All-Time High
Prior authorizations.
Pay based on performance-based metrics and patient satisfaction scores.
More face time with the computer screen than the faces of your actual patients.
A beeper that won’t stop beeping.
Declining reimbursements for increased efforts.
All work and no play make Dr. Jack a dull physician.
As Dr. Peter Kim said, a common solution to this frustration is to work even more in order to get ahead so we can find our way out of this mess.
A better solution might be to spend a bit less so we don’t require the income that results from the sometimes soul-crushing work.
Yeah, but who cares. Why write about it?
Physicians are More Than Twice as Likely to Die from Suicide
Compared to the general population, medical doctors kill themselves at a rate more than double that of the general population. It’s tough to know exact numbers, but on average, we lose a physician to suicide nearly every single day in the United States.
I’m an anesthesiologist. We excel at lethal injection; in fact, I give most of my patients enough medication to kill them. None of them have died under my care. Those having a general anesthetic survive because we breathe for them after giving enough medication to cease all breathing or muscular activity. Those receiving sedation live because we typically don’t give the dose all at once; we titrate to effect. And occasionally, we breathe for them.
We’re also experts at finding veins and cannulating them with intravenous catheters, allowing for swift drug delivery.
When the anesthesiologist doesn’t respond to multiple pages and phone calls, and is later found dead in the call room with a tourniquet and an empty syringe, will we know the motivation? Was it an attempt to escape reality with a quick high, or was it an attempt to escape life with a quick but permanent solution to a temporary problem?
In many cases, we’ll never know. In some cases, I doubt the doctors wielding the needle actually knew. They were just looking for an escape.
I do know that in her tally of over 1,000 physician suicides in recent years, Dr. Pamela Wible has found that male anesthesiologists are at the highest risk for suicide death. I am a male anesthesiologist.
September is suicide awareness month. According to Melanie Lockert, those who die from suicide are eight times more likely to be in debt. As highlighted above, many physicians transitioning into practice have massive levels of debt.
Earning a high income clearly doesn’t solve all of our problems. The joy of spending on luxury tends to be fleeting. Financial independence is one luxury that can offer a safer way to escape.
Who cares? Why write about it?
Financial Independence is the Escape Hatch
When you achieve financial independence, or are making good progress towards it, you have the power to live your life differently. You can afford to work less and earn less. Taking a different job with fewer demands but lower compensation can actually improve your life; the money doesn’t matter much anymore.
If you’re truly financially independent, you don’t have to work at all or can work solely on a volunteer basis at your own discretion. You can venture out on your own and take risks that you never could have considered when you were reliant on a paycheck. You can be your own boss instead of answering to a dozen bosses.
The way most of us achieve financial independence is by spending a lot less than we earn, year in and year out. The bigger the gap, the quicker the path. Live on half your takehome pay, and you can expect to reach your goal in about fifteen years if you’re starting from scratch.
I write about my budget because it’s a big part of what helped me become financially independent by my 40th birthday. I write about money and investing because they play a meaningful role in our lives and our pursuit of happiness.
I’m not saying money is everything — OK, I did say that — but it is a fact that money is the key component of financial independence. Financial independence gives you autonomy, and lack of autonomy in our profession is a leading cause of burnout. I’m trying to help others find more autonomy in their personal and professional lives.
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I’m not saying this venture is 100% altruistic. I’ve been transparent about the way this site earns money for me, my shareholders, and the site’s charitable mission. I may not be saving lives, but I’m trying to help people live better lives. Between the financial educating and donating tens of thousands of dollars to no-kill animal shelters, the local food shelf, and the Salvation Army among other charities, I feel I’m doing some good here.
But who cares?
Why write about it?
38 thoughts on “Who Cares? Why Write About It?”
From a cardiologist of similar ilk who read your original article and many of the sad, cynical, misguided, and defamatory comments on Doximity: touché, right on, and thank you, Sir.
Would going concierge be an alternative? My PCP went concierge and won’t accept Medicaid. What do you think about this?
I do care. I have been practicing saving and live below our means all my life. Now I am FI but still working part time but much happier knowing we will be ok without work. My question to you PoF is what about health insurance? That’s my biggest concern for future.
Bravo, PoF. An instant classic. Keep up the good work.
Powerful post! It’s time physicians stop tearing and putting each other down and instead start supporting and helping each other. Keep up the great work you do!
Standing up and applauding(loudly). Well said and I’m not a physician or a blogger, keep up the good work PoF. JD
Yes, it is important. And you are awesome at it.
Write about it, teach about it, talk about it, show how it can be done.
I will too. Our colleagues can use all the help they can get.
But as for now, I’m off to go give a lecture and workshop on personal finance and investing to my physician peers. We’ll see how their questions and feedback goes. They are usually more polite in person than online.
I will be heading to FinCon18 tomorrow AM. See you soon.
Nicely said! Thank you!
I can understand where a lot of the naysayers and negative reactions are coming from. I’m an academic cardiologist on the coast from an ethnic minority who makes less than your part-time salary, and I don’t have the luxury of a stay-at-home wife (my wife works and we pay for daycare). On the surface, your lifestyle, culture, privilege as a white male in the upper Midwest, salary level and spending are simply not relatable to a lot of readers, myself included. Because of that, I think readers make the gigantic mistake of discounting everything you have to say.
I point many people to your site, because you have done a wonderful job of laying out the numbers, the choices you make, and the consequences of your choices. I’ve followed your advice to live on half ever since I finished training, and I’m somewhere between your Dr. A and B on your 4 Physician series despite my lower salary, and I am well on my way to FI. You have done the physician community a huge service, and I personally thank you for what you’ve taught me and congratulate you on your achievements.
My only suggestion is that your message may reach many more people if you feature guests/writers from very different backgrounds from you who have also been able to achieve similar financial goals. The vast majority of your bloggers in this area are white male physicians – your site could be so much more if you could reach the huge swathes of minority physicians who have very different cultural and economic perspectives. As an example, I used to live in Minnesota myself, so I understand firsthand know the power of geoarbitrage as well as its breathtaking natural beauty; but I also remember how isolating it was to be in a community without people who understand my native culture and the sad state of affairs for Native Americans in the reservations there, which nobody ever talks about. The choice to move to a higher cost of living was not just about money – it was so my children don’t ever have to live without a community of people from the same background. (Don’t worry, I’m finding plenty of other ways to make up for it so I can still become FI far sooner than the vast majority of my colleagues!)
Dr. King was right, that the focus should be on the content of character, of which PoF has plenty. The beauty of FIRE is that the math and numbers supporting it is agnostic to background, skin color, or gender. To shift the focus otherwise misses the mark on so many levels. To assume that others cannot relate to PoF due to their background is to patronize them unfairly. The FIRE community is full of people from all walks of life and backgrounds, showing that people’s differences play a lesser role to that of behavior and math.
Wholeheartedly agree that the math and the numbers is what makes FI beautiful and universal, and I have full respect for PoF’s character. I’m not patronizing anyone – I included myself in that group that finds it hard to relate to POF’s particular career/life/culture, and I have to look past that to focus on the math that is the core of his message. The FIRE community and blogosphere is not homogenous, but it is full of people who have benefited from privilege and education that led them to be able to exercise that math and numbers to the fullest extent possible (often since youth) who often don’t recognize that privilege. To pretend there is no difference in culture and background between people who are able to understand and practice FI and those who are in direr financial straits is frankly naïve – there is no question that ethnic minorities in this country are less likely to be financially literate, let alone FI. One of my own personal goals as an educator is to better get this message across to women and minorities for whom this message has a much harder time reaching since I happened to grow up with significant privilege and opportunities, but am very well aware of those who didn’t. My hope is that the message can reach them too, even if they don’t relate to the wonderful messengers like PoF, WCI, etc.
The focus of the WCI network isn’t for those in dire financial straits. Occasional guest post? Why not? But I felt like the insinuation of racial or gender privilege came across like a backhanded barb to take away from the great accomplishment of PoF reaching FIRE.
I have made it very clear how much I respect PoF and what he has managed to accomplish. I’ve made a suggestion that the FI community can do more to reach a wider audience, especially those from backgrounds distinct from those of the popular writers. You are entitled to your opinion about that suggestion, as are any bloggers who contribute to this community. I disagree with you that there are no doctors in dire financial straits, and I think that WCI would too.
I care and thanks for your writings POF. These are the topics that physicians NEED to read, hear, and discuss. The days of being a stoic martyr are over. Why the needless suffering and hardship? Physician bloggers are the conversation starters and the idea planters. You show other physicians and other professionals how there are options to the status quo. Thanks for all you do.
PoF, this is your signature article. “Why [you] write about it”, is why we continue to read about it three times per week on your site!
Thanks for validating what many of us do, for challenging us to look at some things through a different lens, and for making us chuckle here and there along the way.
It was a pleasure meeting you and your family at the home of https://bckrygowski.com/ … I would say “see you at the next ASA meeting in Orlando”, but you’ll be retired by then!
PS – I’ll put the PoF coozie to good use.
Right there with ya. If the writing helps just one person, then it’s served it’s purpose. So many people are out there searching for answers. There’s a reason a leading cause of depression and divorce is finances. This world has an unfulfilled need for good financial information.
Who cares? Why write about it?
Well apparently many people care, and a lot of people want to write about it. Just think of the plethora of physician personal finance bloggers that you and WCI have inspired. This alone answers this commenter’s short sighted, narrow minded question.
There is a big problem with a lot of people nowadays. They just don’t care. They don’t care about the environment, about others, about their loved ones. Many people don’t even care enough about themselves.
If the world was filled with more caring, mindful, thoughtful people… the world would be a better place.
Thank you, PoF for caring and of course for writing about it. Your writing is the medium in which you share with the world your thoughts and ideas. And these thoughts help inspire others to care even more. The added benefit of some profit going to charity is a huge plus. The animals and the impoverished are some of the most vulnerable populations that need help.
Thank you for caring, writing, and making the world a better place 🙂
I had a dream last night. My worst nightmare in Anesthesia would be to have to tell a parent their kid died under my care. Kids are pretty bullet proof. If they have anything wrong it’s usually one thing like Asthma or something, and kids have one genetic goal, to get old enough to reproduce. I did some peds ICU work and it always amazed me how much you could do to a kid and they would just come up fighting. It’s like they didn’t care because they had reproducin’ on their agenda. My dream was I was in the OR on tonsil day when the airway, all the way to the toes, slammed shut. The clue about kids is when the heart rate drops, drain circle time. I did this and that per recipe and experience, 2 hands behaving like 10, and eventually I got about 10 molecules of O2 into the blood stream and the lil bugger turned pink. Kid had reproducin’ on her agenda somewhere in the future. Then I woke up. I quit practice exactly for this reason. I had twice as much money as I could spend in the next 50 years and the projection was I would die with 3 times what I would spend in retirement. Continuing in practice was merely buying risk.
Every day, go to work buy more risk. Eventually your number will come up. There was no more benefit to accrue. It’s like riding a motorcycle. It’s not if but when. I sold my motor cycle. It was neuro rotation and I was spending my 3 AM’s drilling holes in Someone’s head with Sympathy for The Devil blaring on the box. Pleased to meet you, hope you guessed my name… Surreal for most, common for me. The Someone was driving out of the city on the 290 out to the ‘burbs on a crotch rocket at 2 AM after the bars had closed. We were the level 1 trauma that bordered the 290 complete with 2 copters to step and fetch it.
But who cares? Why write about it? What’s puzzlin’ you is the nature of my game.
Homey don’t play that anymore. No future in buying risk
With regards to what income level is required for happiness, I’d agree with that amount of around $75K – and for me, basically it was an income at which I was able to easily pay my bills, have plenty of quality food to eat, ability to add to retirement savings and also to have a cash cushion.
I live fairly frugally, on less than $2,000 a month, but will occasionally splurge on a night out with friends. On rare occasions I’ve purchased some type of durable item that enhances my play time – such as a new to me but used horse trailer, that better suits my needs, and the needs of an oversized and sweet but claustrophobic horse.
Becoming FI is all about having more options – and a perceived lack of better options is what seems to drive many people to suicide. It seemed to be why my stepfather took that path. I’ve always felt suicide is a permanent solution to a temporary problem, and is also one that devastates the loved ones left behind. Anything that can be done to prevent a person from falling into that rabbit hole of feeling trapped beyond escape is preferable to the darkness of suicidal thoughts and actions.
I cannot describe the relief I felt when I finally reached FI – knowing that if I lost my job tomorrow I’d still be financially OK. My journey through more than two decades of intense work in IT and witnessing the threat of layoffs, and actual layoffs, of myself and others has ended in a place where the actions of company executives no longer has the ability to stress me out. and cause sleepless nights.
Xrayvsn, you expressed everything I was thinking!!! And any time I get annoyed or frustrated about being on the patient end of the insurance company games, I remind myself that a doctor (and his staff) struggle with this (and more) EVERY. WORK. DAY. — ALL. DAY. LONG.
No wonder physician suicide is at an all-time high.
I just felt your budget failed to mention many of the costs we pay every day but do not see. Property taxes, utility bills, insurance premiums, garbage pickup,…….
That specific article was an assignment — track all outflows in one calendar week. About 10 other people have done the same for BI’s Real Money series. I included the association dues that happened to be paid during that week, which does cover garbage pickup, and I also linked to an article that has our full annual spending with breakdowns by category.
Best,
-PoF
Well, POF, I actually don’t know that I would call you a part-time doctor.
When I think of the core competencies of being a “complete physician”: communicator, leader, collaborator, etc. You are checking off the boxes still.
Part of being a physician is caring for patients. Another part, larger for academic physicians, is teaching and developing the next generation of physicians to do it also – only better. This is caring for our colleagues and all of the patients that they will touch in the future.
I actually think that you have shifted to become more of an academic physician with teaching about finance as your academic schtick. While you do make some money at it, it is a pittance compared to clinical practice. Just like the rest of academic medicine. My career has been as an academic physisian. I similarly see what I am doing with my blog as simply a shift to fill a void in medical education. Like most people who are the first to leap into the breach, it takes a while for others to understand why you would do that – and the value of it.
-LD
I am glad that you write about this stuff. Despite me being a complete FIRE failure, you have been an excellent mentor and and have no doubt helped many others. Thank you for doing it, and I hope that you continue writing and teaching. Cheers!
I care and I’m glad you write about it.
I recall that at least one of the doximty commenters who initially left a negative comment, later left an apologetic comment after he had read many of the positive comments and had time to reflect. Hopefully other negative doximty commenters will have similar changes in attitudes after they have time to get over their initial anger and frustration. It is probably much more difficult for an older doctor with low net worth after years of work, to realize there had been another way.
I care and I’m glad you wright about it.
I recall that at least one of the doximty commenters who initially left a negative comment, later left an apologetic comment after he had read many of the positive comments and had time to reflect. Hopefully other negative doximty commenters will have similar changes in attitudes after they have time to get over their initial anger and frustration. It is probably much more difficult for an older doctor with low net worth after years of work, to realize there had been another way.
Keep writing. The world needs to hear that the best things in life aren’t things. A very old message that will always be relevant.
My husband and I both were raised in a very modest lifestyle. We figure you can’t miss what you never had, and easily live on less than half our income, while having a nice home and cars (for us) and tithing. The hedonistic treadmill just never caught on.
Although I did just splurge on a giant bag of chocolate candy at Costco for the office. . . And I might do it again. I felt really rich!
As an “older” doc (63), I find what you write quite useful. Thanks to my frugal parents, I had always saved money, but hadn’t eschewed debt. About 15 years ago realized I was like the rat on a treadmill. I dramatically changed my life…now I’m FI, and live very close to the life I always dreamed of…. (I work part-time as a doc, part-time as a pilot…and never work nights!)
Keep on writing. Well worth it.
Man, POF. This one post is basically the outline of my blog in a nutshell. You hit so many of the salient points that I care deeply about in one post.
In fact, my post yesterday talked exactly about the phenomonen you mentioned today: spending doesn’t make people happier. There is a plateau.
Financial independence can provide a way out if needed and places docs in a great position, because in order to get there you have to learn contentment and spending less to propel you towards FI.
Why write about it? Because there are so many people out there that care deeply about this subject. Those that don’t simply haven’t been exposed – which is the entire reason I created my site. To expose medical students, residents, and early careeer attending physicians to these exact ideas.
Thanks for paving the way,
TPP
Instant classic! I would opine that you are saving people. Saving them from embarking or continuing down the same path that has led to the astounding statistics above. Providing a strong antidote to burnout which improves patient care. If I can paraphrase Jonathan and Brad, “The POF is spreading”. Keep writing about it.
I care. I’m not a physician but we are taught to trust doctors…I take things not on blind trust as an adult. You write clearly with perspective that is applicable to many people. Seeing your reasons and having some in common, I am glad you write about it.
A few years ago I realized I will likely not get to a ‘C-Suite’ without working in a way that would lead to burnout, and life is too short for that. Instead I’m aiming for FI to craft a life I want. You and others show a path, and ways to travel that path. Your exact path will not be mine, but I’m glad you write about it because it shows many how it can be done.
I am glad that you write about it! I found your site googling “how can I retire from medicine?” in the middle of the night. I was a burnt out, cog-in-the-wheel doc who was providing good patient care but missing having any kind of life and really missing my family. The administration kept piling on more demands and I hit my breaking point of just not wanting to jump anymore. Reading your posts was a lifeline for me. It showed me that I was already financially independent and gave me the confidence to quit my job. I am now enjoying my kids and not missing the pager at all! When I was working, it hadn’t been just for the money that I felt caught on the treadmill. It was more about my patients and their care. I think as physicians, we are so used to prioritizing the patient above all else that it is very hard to step back. But all of the patients found care from one of the new docs the hospital hired. They are happy to see me in the community and are glad for me that I am able to see my kids everyday now. I am so much happier. When I think back to how desperate and “stuck” I felt during my last year or so of work, I would never want to feel like that again. So THANK YOU for writing about it. You are helping people and changing lives.
Thank you for sharing, RD. Comments like yours more than make up for 100 negative comments somewhere else. I’m glad you not only found value in the message I’m sharing, but also found a better life as a result.
People are quick to say I’m leaving patients behind, but the fact is I opened up a job for a young man who was hoping to return to his hometown and will now have that opportunity. Moving on from my anesthesia career will be good for me, good for my replacement, and will not negatively impact our patients.
Best,
-PoF
I care too and I am not too different from everyone else.
Anytime a headline be it on television or on the internet, says someone is a millionaire, people will care. It’s just that most Americans will not like the answer when they open up a FIRE-type blog and the person doesn’t have Porsches and a massive house and so on and so on. And heaven forbid if the resulting article talks about saving money, that’s not what people would be clicking for.
I care.
And I am glad you wrote about it.
Jim Dahle wrote a great post about money being a taboo subject among physicians. It’s like we are not allowed to discuss money and keep it under wraps.
If it it wasn’t for sites like you and the rest of the WCI network, thousands of doctors would go on the same path that led to others being heavily in debt and forced to work harder to make ends meet.
The Hedonic Treadmill is a common phrase these days but it wasn’t before you guys started talking about it. And it is a true phenomena. Every materialistic thing I bought has lost its shine and doesn’t have the same effect as the day of purchase.
We all are looking for that dopamine rush which is far too fleeting.
Your statistics are sobering and unfortunately spot on. Physician burnout and suicide (linked hand in hand) are at all time highs as doctors lose their autonomy and the practice of medicine is no longer the same as it was in the golden age of medicine.
Now we have become glorified clerical workers and our judgements are questioned at every turn due to cost saving measures by insurance companies and admin people.
And we are subject to patient scores in order to get the best reimbursements? We are not some restaurant needing a yelp review. Ridiculous.
I for one am glad you write about everything you do, including your budget. Pierce the viel of what a week in the life of a high earning doctor is so that others can follow by example.
And as much as like the idea of Doximity, I am ashamed to say some of these people are my colleagues with the hateful comments that they put out directed to you.
Completely agree about the hateful comments. I can’t believe what some people would say with their own name, face, and address available to all that are watching them say it. They literally have no shame.
This cause is worth defending, and most people that take the other side are either burned out themselves or have no way of getting to FI because of their inflated lifestyles.
Xrayvsn, you expressed everything I was thinking!!! And any time I get annoyed or frustrated about being on the patient end of the insurance company games, I remind myself that an MD struggles with this (and more) EVERY. WORK. DAY. — ALL. DAY. LONG.
No wonder physician suicide is at an all-time high.