When does a fiscally responsible physician dealing with burnout know when it’s time to play the financial independence card? As I’ve said before, it’s often some combination of “I have enough” and “I’ve had enough.”
That’s the position the guest author of today’s post found herself in. “Doc to Disco” was ready to lead a different life, but she wasn’t quite sure she could pull it off until she had a light-bulb moment.
That epiphany led to a relatively quick exit late in 2019, and it came at just the right time. How did she pull it off?
I’ll let D2D explain. Can I call you D2D? I suppose I just did.
Why FIRE Was This Burned Out Doc’s Only Way Out
I’ve had enough, and …….. I have enough
I had the answer to my burn-out and didn’t even know it. It was a hard choice. Sell the house and be done.
- Meditate more – it will fix things.
- Go exercise – you will increase your endorphins.
- Burn lavender or some other random essential oil; it’s guaranteed to relax you.
- Get more sleep – it will solve everything.
We’ve all heard these “solutions” before. The problem with these is that you continue to circumvent the actual burn-out issue by not directly addressing the etiology. No doubt, doing all these things may have an impact, but at least for me, it was fleeting.
Yeah, I meditated on my days off; I got 7 hours of sleep on average if I wasn’t on call, and I love burning eucalyptus oil. However, in the long run, I never felt like anything had changed. I continued to feel like I was on the 24th mile of my marathon, barely keeping the time I had set for myself.
The Burnout was Insidious and Gradual
It did not happen overnight or even over a year.
At the beginning of finishing up my last fellowship, I was eager to see my own patients and finally get to see cases and do procedures I had trained so long for.
After a few years had passed, I gained more and more patients, volunteered (and sometimes was made to volunteer) on more committees, and taught students and residents, which I enjoyed. Enough became making it home for dinner at a reasonable hour and not spending 2 days in the hospital with a very sick patient.
Inexpensive vacations or vacations “sponsored” by my work were top on my list. Since my student loans were paid off by then, our goal was to save up for another rental property or maybe pay off the mortgage early. I didn’t know at the time, but as more and more people in my organization started to rely upon me, I was at the beginning of burn-out.
I remember having a sense of continuously being on “go-mode”; my I/O binary button was always in the “I” position. I looked at my partners 20 years older than me, doing as much work as I was, “no rest for the weary,” they would exclaim, and so I plodded on.
Less time for family, less time for friends, even less time for my husband and what I enjoyed, definitely no time for me. Was this what I signed up for? Damn – still living like a resident, but with sprinkles on top of practice meetings, RVU quotas, and dealing with all the ugly crap of running a small business.
Lazy employees, patient complaints, inner fighting amongst staff, people-pleasing the referring docs, the escalating hoops to jump through for maintenance of certification, hospital privileges, new insurance rules, etc. The only time I felt like I was actually doing what I had trained for so long was about 35% of my time!
I’m a huge percentage partitioner. My brain always puts stuff into percentages. 35% was NOT a percentage I was happy with.
This is NOT enough for me.
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How I Approached FIRE
Living below our means and financial investments was HOW I was able to retire early, but my “WHY” was definitely burnout and being fed-up with “corporate medicine.”
So I started to pay off that big-fat mortgage in hopes of working less eventually. I finagled a few more vacations/conferences on my work’s dime, and I started to hyper-save.
Never did it occur to me to look for another job as I felt in my heart that administration, demanding/needy patients, crescendoing encroachment on my time, especially with EMR and various hospital responsibilities, would be no different anywhere else. Enough became just getting through the next couple of weeks before an overdue vacation. This period lasted the longest.
As the years went by, I slowly realized in bits and pieces that I needed to make hard choices, tough choices, if I wanted to “fix” this. It was a hard pill to swallow as a doc. I am used to picking up a book, going to a course, or reading an article, implementing what I learned, and solving “the problem.”
Not so – for Burnout.
Like any other pending issue in my life, I wanted a tangible and obtainable solution—# goal (in my high school cheerleader voice at the championship). But as my burnout got worse, I felt defeated. This was not going away as easily as I assumed it would. I could not deny that I had enough of the gut-wrenching conversations with patients conveying bad news. I was done with the futile discussions about yet another way we could lower our standards, see more patients and save more money for “corporate medicine.”
I had enough of feeling pulled in 8 different directions all at once and expected NOT to skip a beat, not miss a meeting, and for everyone around me to continue NOT to value my time or my well-being. To make things worse, then I got sued. I was warned for many years that it would make me depressed and maybe even paranoid if I got sued. I could anticipate second-guessing every clinical decision I made for the foreseeable future, etc.
My reaction was one of anger. I was so angry.
I had global resentment towards the chronology of events, other colleagues involved in the case, the patient dynamics, the system that made me vulnerable, and especially myself. I traded in my youth for good grades to be the best physician I could be; I sacrificed having children because I knew my patients would come first, and just having a daily life – culminated into getting sued? Really? It was just too much for me.
Then it became crystal clear. Enough for me was – I WANT OUT and right now!
It was like a meteor had blown up my entire notion of what I thought my life would be. I had taken off rose-colored glasses, and the world was now in crisp “portrait mode” on the new iPhone. I discovered FIRE shortly after this revelation. I dove deep (in my James Earl Jones voice).
Making FIRE Happen
Almost immediately, I re-configured my budget in Y.N.A.B. and increased the amount funneled to my taxable account; my F.U. money. I was laser-focused on getting my savings percentage up.
I used FIREcalc to determine my FIRE figure – I used to update my net worth as frequently as monthly. By age 41, I was a “millionaire” (mostly due to my HCOL home’s equity). At age 43, we were out of all debt except for the big-fat mortgage (via all the traditional methods – living below our means, saving, and investing- I was a total YNAB fanatic).
I did lots of internet searching and came across the Choose F.I. Podcast. From there on, I went down the rabbit hole, devouring many blogs and podcasts. Eventually, we attended the JL Collins Chautauqua in Europe a few months before I retired. I had already planned to retire before we got there, so to meet like-minded people was not only great timing but life-affirming for me
IT WAS ON!
My new revelation had a serendipitous pebble effect too. The next thing to go was 90% of the committees I was on. I only participated or sometimes ran committees I felt were meaningful for my patients or me. I no longer participated in frivolous nonsense.
Finally, I went natural; YES, after 40+ years of straitening my hair, I came into the office with my natural hair. It was long overdue. I didn’t care anymore what patients thought; I had long not cared about what staff or my partners thought. I was a caterpillar who metamorphosed the night before into a butterfly!
It was uncomfortable, oh yes, and quite awkward for me and the people around me, but liberating none-the-less. Ironically and somewhat to my surprise, I found myself fantasizing about what my life would be like if I were a “civilian” meandering in the world of endless time on my hands.
Even after studying for as long as I did, seeing cases that were so rare most docs would never see in a lifetime of practice, I felt really blessed that I had enough of that too. Contributions to my field through collaboration and teaching, most importantly, the help I provided my patients who needed me the most was satisfaction for me.
It was enough.
Every day, I was getting braver, more comfortable with the reality of not practicing medicine. But how were we going to pull this off financially? Sure, I was a good saver, and we had some rental property, but we live in one of the most expensive cities in all of America.
How could I possibly retire now? And then it dawned on me… Holy Crap!
I am already F.I. (insert surprised emoji here)! I have enough equity in my home to retire!
It was like a ton of bricks came tumbling down, but not onto me, on the construct of what I used to value, what I used to hold in high regard; I was F.I. and didn’t even know it. Woot woot, I would put that equity to use, baby (insert sunglasses emoji here)!
Yes, to the contrary, an HCOL area put me over the hump. I was F.I., in fact, Fat F.I. because of the equity in my home, and I HAVE ENOUGH!
I decided to leave medicine, but when? Just like that, it came to me, if I get dropped from the case, I will quit shortly after.
Luckily for me, I did get dropped from the case, and I was so relieved. If you are reading this and contemplating quitting medicine, you know exactly what I am talking about.
I didn’t have to make a Pros & Cons list. I didn’t have to speak to my mentor about it; I didn’t doubt that THIS was enough.
Currently living off savings and some Roth IRA funds I accessed and the proceeds from a rental property we recently sold. We plan to put most of the proceeds into a much cheaper home for ourselves in the U.S. and a different rental property w/ better weather – most likely in Gainesville, Fla., which of course, is much closer to Barbados than the West Coast.
Do I Regret Retiring?
N-O-P-E, and it sucks that some people comment that I should – hence one of the reasons for starting my blog – I didn’t want other colleagues, especially women internalizing this judgment.
The main fears that I had about retiring early were not having enough money, fights with my husband, changes in friendships, and becoming lazy; none of this happened.
As physicians, we often stay in our tunnel and can’t imagine living a different way, as I did for too many years. I want to help fellow docs navigate out of the tunnel to see the light, whatever that light may be.
11 thoughts on “Why FIRE Was This Burned Out Doc’s Only Way Out”
Thank you for your post. We stopped at Barbados during a cruise years ago and always thought it would be nice to go back and make that our destination for a vacation.
All the best!
Great read. And Gainesville rocks. But I’m biased 😉
The author does not say what her specialty field within medicine was. One thought that comes to mind is the potential for switching to a DPC model. My personal physician has done this and it has changed his life. Quality, not quantity. He sees fewer patients, spends more time with them, and the model is more efficient as many minor issues are handled by phone or text. Plus all your patients want you and choose you as evidenced by the yearly or monthly membership fee. This could be a compromise for some physicians which could allow a third choice in addition to continuing as you were or full retirement.
Thank you agile101 for your suggestions. Yes, I did think of this model however at the time I wanted to pursue other interests besides medicine. Also, with the economic downturn I know a few physicians who are struggling a bit with this model. But this is certainly a solution for many of us.
Very nice and well written story. I really enjoyed it and I am happy that you had the courage and insight to make this transition. One thing I would add is that when physicians leave clinical practice, they remain physicians the rest of their lives. This is not an achievement that disappears the minute you stop seeing patients. There is absolutely nothing wrong for any of us to pursuit other interests during our lifetimes even if this occurs during our traditional “working” years. Again, congratulations and thank you for sharing your experience.
Thank you so much Ron. Yup- I just put on those “big-girl” pants and took the leap. NO REGRETS!
Thanks for sharing your story! I can identify with all of it. I especially share your obvious detest for the presented “solutions” for burnout to include mindfulness, meditation, exercise, wellness, etc. None of these things are bad of course, but none of them deal with the real causes of burnout. They are just poor bandaids. American medicine is broken. I am not sure how to fix it, but I cannot let its brokenness break me too. I also wish my job was more about helping people instead of meeting silly demands, maximizing RVUs, avoiding lawsuits, taking overnight/weekend call answering to shift worker hospitalists who could care less what time it is, etc. I just cannot do it anymore….
Agreed @introvert investor MD! I’m glad it resonated with you. Re: helping people- yeah- it wasn’t enough of my day anymore and something had to change. I hope you find your solution that fits you best Introvert investor MD and please keep us posted.
Thanks so much @Introvert Investor MD. I hope you find something that works for you, even if it means taking a real break from medicine.
“I especially share your obvious detest for the presented “solutions” for burnout to include mindfulness, meditation, exercise, wellness, etc.”
These things, especially exercise, are essential (in my opinion) for a good and happy life, but I agree they’re never going to fix a situation this bad. Meditation especially, the real benefits are years down the line, what are you supposed to do in the meantime?
(to Leif: the css on this page and some others is broken by the way)
Thank you Introvert Investor MD, I think I replied before but some type of tech glitch, any whoo I am glad to hear you chose to exit. Can’t wait to see how it goes, keep us updated. Congrats!