Author Topic: Healthcare professionals who'd like to FIRE?  (Read 3994 times)

freemonk

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Healthcare professionals who'd like to FIRE?
« on: July 25, 2018, 05:23:45 AM »
Curious how many other practitioners in healthcare would like to get out ASAP?

I have spent over a decade training, and loathe going to work for several reasons. It's probably the good ole' 80/20 rule where the 20% could be described in a short summary below:
*A google degree is worth more than many years of training.
*Humans lack the responsibility to take care of themselves and what they have procreated (their children) and think that since they show up in your clinic, it's now your responsibility and they have done you a favor.
*Expectations that are impossible to be met.
*In the rare chance of a post operative complication, it is now blamed on the provider, but the human body does unique things sometimes.
*Parents and grandparents, because grown adults cannot fathom going to their appointments by themselves, will leave the most interesting patient reviews (didn't have the right flavor coffee in the waiting room, etc.), which impacts the digital reality of your practice image.

The other 80% are the great, loving mustachians like you all!





jjandjab

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Re: Healthcare professionals who'd like to FIRE?
« Reply #1 on: July 25, 2018, 07:28:03 AM »
I would have to say, similar to your 80/20 rule about patients - 80 percent of the days I'm fine, the other 20 percent I would rather leave healthcare.

But typically I come back to the schooling and dedication required to become a physician followed by the fact that the pay is good and I can always find a job somewhere, even in "bad" job markets. Many of my business and executive friends put up with crap of a similar nature - demanding clients, difficult staff, threat of company mergers, tons of travel, poor online reviews, etc... Now if I could go all the way back to college and know that if I had chosen engineering or biochemistry or similar and could have started my career earnings/retirement savings at say 22-23 with a masters vs 32 in my medical career, that would be an interesting what if... Sometimes thinking about that 10 year delay, combined with the expenses and meager pay during that decade, gets me a bit down for sure...

But overall, I don't see hopping out of my career anytime soon, even though I could be FIRE'd by many folks MMM criteria. Maybe in a few more years. Medicine careers can be hard to restart once you leave as well. So I just control what I can control and don't stress too much about the rest.

TheWifeHalf

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Re: Healthcare professionals who'd like to FIRE?
« Reply #2 on: July 25, 2018, 10:24:25 AM »
To healthcare professionals in the US, has the ACA affected you?
I saw an ophthalmologist after my car accident because my eyes were affected and I had to wear a patch for awhile. Before going to an appointment, after I had been seeing him for a few years, I decided that I din't need such a specialized eye doctor any more(he had a bunch of other letters after his name.)
I could tell he was overworked and remember him saying that he was glad I was there, I was an easy one! He said the paperwork had just gotten unbelievably more difficult after the ACA.
A couple of months ago I got a notice from him that he was retiring. He was probably in his 50's.

honeybbq

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Re: Healthcare professionals who'd like to FIRE?
« Reply #3 on: July 25, 2018, 10:39:45 AM »
I'm a health care professional who'd like to FIRE. BUT, bound by the golden hand cuffs AND by the feeling that I "do good" in the world despite the fact health care is broken and the perpetual red tape and bureaucracy that ruin it.

It's hard. I love my work, but I hate the job.
Love caring for patients and helping people. Hate being strangled but politics.
Love the paycheck. Make way too much money for too little effort. It's too easy.
The idea of a temp job paying minimum wage if I fail FIRE... abhorrent idea to me. It's too easy to make massive amounts of money now.
 
I used to think I'd retire when I was 50. I just checked SSA, I'm 4 years to the second bend. I might make it 5 more years. We'll see.


Abe

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Re: Healthcare professionals who'd like to FIRE?
« Reply #4 on: July 25, 2018, 08:26:39 PM »
I'm in my last year of fellowship and some days things drive me nuts with how irregular my schedule can be. However, one of my mentors had said "If you can't handle uncertainty, don't be a surgeon". Overall I'm planning on working full-time for 20 years and semi-retire / assist after 55. That's early for a surgeon, based on the hospitals I've trained at. My friends who are middle to upper management at companies have the same or higher level of paperwork burden for less pay, so I can't really complain about that. I do have to concur with most of the OP's statements regarding the 20%. For some reason, a lot of people think that because they're an expert in one thing, they are automatically an expert in everything else after spending a day Googling it. Oh, and I'm secretly in it for the money but the homeopath down the street who only takes cash really cares about their whole person. <gag> Usually I then have a very nice patient afterwards who balances things out.

nancy33

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Re: Healthcare professionals who'd like to FIRE?
« Reply #5 on: July 25, 2018, 10:11:11 PM »
I'm a physician and I could FIRE now...I always thought I would want to retire ASAP but now I'm realizing I enjoy my career. I sometimes wish I could try something altogether different since I've been doing this for half my life now. I would like to go back to school and become a naturalist/wild life biologist, maybe in my next lifetime LOL. Knowing I have a CHOICE to retire now is awesome, takes a lot of stress away. Definitely has not been an easy path and the huge amount of debt after graduating medical school was very demoralizing. I would not recommend becoming a physician if it means going into debt for hundreds of thousands of dollars to anyone.

hops

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Re: Healthcare professionals who'd like to FIRE?
« Reply #6 on: July 26, 2018, 06:41:02 AM »
There have been a few times that my wife's run-ins with the 20% have sent her home in tears. Usually she takes it in stride, and her experiences are similar to Abe's in that bad encounters are often followed by nice ones. Rarely, though, it happens at the worst possible time. Like when a mom got in her face and asked "Are you a parent?" (The mom was apoplectic when her Internet research conflicted with reality.) When my wife said no, the woman roared "GOOD. You'd be a terrible mother!" That was at the height of our private fertility woes, during a very hectic time in her life, and she bitterly mused "Ten years of med school, research, and training for this..."

Is anyone here in academic medicine, and if so, do you find it more agreeable than private practice? For her first attending job, my wife just took a faculty position at her dream school. For this you are paid partly in prestige -- she could've earned a lot more in private practice. But the benefits are very nice and there are some interesting bonus opportunities. What intrigues her the most, though, are research opportunities and access to the toughest cases. She doesn't think she'll ever want to retire completely, but wants early financial independence so she can do whatever she wants professionally.
« Last Edit: July 26, 2018, 06:43:24 AM by hops »

TartanTallulah

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Re: Healthcare professionals who'd like to FIRE?
« Reply #7 on: July 26, 2018, 08:53:06 AM »
Curious how many other practitioners in healthcare would like to get out ASAP?

I have spent over a decade training, and loathe going to work for several reasons. It's probably the good ole' 80/20 rule where the 20% could be described in a short summary below:
*A google degree is worth more than many years of training.
*Humans lack the responsibility to take care of themselves and what they have procreated (their children) and think that since they show up in your clinic, it's now your responsibility and they have done you a favor.
*Expectations that are impossible to be met.
*In the rare chance of a post operative complication, it is now blamed on the provider, but the human body does unique things sometimes.
*Parents and grandparents, because grown adults cannot fathom going to their appointments by themselves, will leave the most interesting patient reviews (didn't have the right flavor coffee in the waiting room, etc.), which impacts the digital reality of your practice image.

The other 80% are the great, loving mustachians like you all!

I am a health care provider and I'm retiring early (whether I can call it FIRE or end up going back to some sort of work remains to be seen) at 54 because over the last three-and-a-bit decades I've gone from, "I love this job enough to do it without pay," to, "I hate this job so much that you couldn't pay me enough to make me keep doing it."

fuzzy math

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Re: Healthcare professionals who'd like to FIRE?
« Reply #8 on: July 26, 2018, 09:58:57 AM »
Getting out when I can. The patient population is a mess. They refuse to take basic measures (diabetes control, quitting smoking etc) to care for themselves and yet the hospital takes the blame for bad outcomes. Hospital administration politics are possibly almost as bad as US politics. Im an obscure non MD clinician (not listing my specialty publicly) and I dream of the day I turn my pager in for good


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honeybbq

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Re: Healthcare professionals who'd like to FIRE?
« Reply #9 on: July 26, 2018, 10:31:50 AM »

Is anyone here in academic medicine, and if so, do you find it more agreeable than private practice? For her first attending job, my wife just took a faculty position at her dream school. For this you are paid partly in prestige -- she could've earned a lot more in private practice. But the benefits are very nice and there are some interesting bonus opportunities. What intrigues her the most, though, are research opportunities and access to the toughest cases. She doesn't think she'll ever want to retire completely, but wants early financial independence so she can do whatever she wants professionally.

I've done academic medicine and I'm currently in private practice.

Benefits of academic medicine:
Networking with like minded individuals, ability to meet & do research with the best and brightest
Better caliber colleagues
Prestige
Benefits - usually professional funds, travel, visibility
Usually more seasoned/developed retention/benefits like life insurance, paid leave, etc.
cutting edge technology, beta testing, etc.

Benefits of private practice:
Salary
In general, less stress
Less hours
More security (IMO) due to more seasoned HR rules - no chasing tenure or funding, etc.

My spouse and I were both in academic medicine with a young child. That didn't work. I washed up and have the private practice job now. The thing I miss the most is the wonderful, smart people I used to work with. But, I get to spend more time with my child and I have less guilt about it. There are definite benefits to both sides and the grass is always greener. I'd love to go back into academics some day, but maybe when my kid is older and doesn't need or want me so much.


Dibbels81

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Re: Healthcare professionals who'd like to FIRE?
« Reply #10 on: July 26, 2018, 02:29:06 PM »
The plus side of healthcare is that there are plenty of high paying, part time jobs available. For someone like me who isn't ready or able to FIRE, part-time work is ideal.  I worked full-time in a hospital for a few years after graduation, and it was pretty brutal. 15-20 hours a week is more my thing.

goatmom

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Re: Healthcare professionals who'd like to FIRE?
« Reply #11 on: July 26, 2018, 03:33:52 PM »
I don't want to FIRE but I want control over my life.   You really need to work hard to prevent burn out.   Get rid of the 20 percent you don't like.  You are a physician - you can design your life/your practice/your career.  There is so much more flexibility.  You also need to get a thick skin and not give much credence to the online reviews.  I stopped taking insurance because I hated the hassle.  I took the risk of walking away from the typical type of job and created something that I felt good about.  Is it always perfect?  No - but I feel in control and most days walk away feeling like I have made the world a bit better.  Also - learn to live like a resident so that you have the freedom to do what you want with your time and think twice before you buy the big doctor house and the fancy car.

gimmi80

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Re: Healthcare professionals who'd like to FIRE?
« Reply #12 on: July 26, 2018, 04:50:25 PM »
Medical professional here, 5 years out, and I've just very recently hit a wall and realized that at very least, I need a break.

I actually have a pretty sweet job, 30ish hrs a week, an amazing clinic where I can have whatever I want (I have some seriously fancy shit), a solid online rating, and very well trained patients.

I'm an asshole-tamer, it's a gift. The other doctors always dump their asshole patients on me because they know I'll magically get along with them. My patients have affectionately described me as "hilariously terrifying." I'm also particularly gifted with phobic patients, my directness is oddly appreciated by phobics, they actually really want to know what the worst case scenario is, and most people worry about scaring them, but I go full on catastrophic with the possible outcomes, and they are oddly reassured by it.

What I don't handle is the softies, the ones who aren't truly phobic, they just need A LOT of TLC no matter what is happening to them. They need special pillows (not because of injuries or anything), and specific temperatures, and always complain about something on their bill. They don't want actual caring, they want to complain and get attention for it, so the more you accommodate them, the worse they get. Those people write nasty things about me online, lol.

So yeah, I've found great balance, an amazing job, and I'm operating at the peak of my industry...and I'm fucking exhausted.

I need a break. It just hit me last week that no matter how great I have it, I'm burnt out and I need a break.
I feel like none of us get a break to recover from the insanity of school, and the first few years of working are so exciting/challenging, and then we finally settle into our groove just in time for our psyches and bodies to be like "FUCK THIS!!! I'M FUCKING TIRED!!!"

My brain is tired, my spirit is tired, my body is really goddamn tired, and I have suddenly started dreaming of running away to the arctic circle and hiding out where roads literally don't go.

So now, I'm trying to figure out how to take a break. I have no idea how it will work, I still have about 100K in debt, I would be jeopardizing my perfect job, and I can't guarantee that I'll be able to go back if I leave, but it's what I've *just* realized that I need to do. Thankfully, I've always been goddamn fearless, so we'll see what happens.
Sell the practice to someone else... look for a payout

startingsmall

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Re: Healthcare professionals who'd like to FIRE?
« Reply #13 on: July 26, 2018, 07:09:51 PM »
Veterinarian here.... some differences from human healthcare (primarily in the insurance/liability department), but many many similarities (especially to pediatrics).

I'm 12 years into this career. (Yikes. How did that happen? I still consider myself a young vet and new-ish grad. Apparently not.) If you had asked me six months ago, I would have said that my goal was to get out of vet med as soon as humanly possible.

A few months ago, though, I switched to only working part-time in practice, spending the rest of my time working from home on my freelance writing/editing side hustle. Now that I'm no longer forced to spend 40 hrs/wk interacting with people, the 15 hrs/wk that I spend at work have become much more enjoyable. I've even taken on a couple of additional days voluntarily (at another location owned by my practice and then at a friend's practice), just for some extra money and the chance to hang out with a different team for a day!

I'm sure I'll eventually get tired of even the part-time thing, but right now I enjoy it enough that I think I may just continue at this pace long-term. We'll see. Sure, I still wish that I could say "screw it" and go back to my original goal of becoming a wildlife veterinarian, but there will (hopefully) be time to volunteer in that sort of work that later down the road, once my daughter gets older and is too cool to spend time with me.

abpa

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Re: Healthcare professionals who'd like to FIRE?
« Reply #14 on: July 26, 2018, 07:58:55 PM »


I'm an asshole-tamer, it's a gift.

Ha!  I thought you were in GI!

BeardedLady

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Re: Healthcare professionals who'd like to FIRE?
« Reply #15 on: July 26, 2018, 08:37:59 PM »


I'm an asshole-tamer, it's a gift.

Ha!  I thought you were in GI!

That was my first thought too! I spit a little of my tea out when I read that description.

I'm in private practice with a large cash-pay patient base and great hours. It is cushy compared to what a lot of those in my specialty are doing, but I still do not foresee doing this for the long-haul. For me it is having to hire and fire staff, paperwork/insurance, and definitely the 80/20 rule with patients. Spouse and I have about 4.5 years to FI, and we are planning to try for a kid next year. I have an associate who would like to be partner about the time we hit FI, so I may try to sell her 100% instead of 50% and work part-time until she finds a replacement for me.

JGS1980

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Re: Healthcare professionals who'd like to FIRE?
« Reply #16 on: July 27, 2018, 05:48:58 AM »
Malkynn, you are cracking me up!!!

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #17 on: July 27, 2018, 10:27:25 AM »
I had no idea we have so many in medicine here. I dream of the day when I am workin my last week so that I can tell some of my patients exactly what I think.

Generally I like practicing medicine but patient satisfaction ratting and the beaurocracy is killing the joy every day. I hope when I go part time it will feel better. The golden handcuffs are very real though.
« Last Edit: July 28, 2018, 10:49:47 AM by EnjoyIt »

thingamabobs

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Re: Healthcare professionals who'd like to FIRE?
« Reply #18 on: July 28, 2018, 02:54:01 PM »
Out of residency for 5 years, discovered mmm year 1 when I was trying to figure out how to save for retirement. Now working very very part time and hopefully transitioning out of clinical medicine soon.

I talk to every Med student, resident that rotates with me regarding their loans, saving for retirement, putting off the big purchases until those are handled. I think they appreciate it. I’m going to try talking to the med school class.

I think FI can save medicine. Imagine if more docs were FI and are not afraid to stand up to admins, hospitals, CMGs. More docs who can practice the way they want to and not having to meet ever increasing protocols, patients/hr, metrics...

nancy33

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Re: Healthcare professionals who'd like to FIRE?
« Reply #19 on: July 28, 2018, 11:18:29 PM »


I think FI can save medicine. Imagine if more docs were FI and are not afraid to stand up to admins, hospitals, CMGs. More docs who can practice the way they want to and not having to meet ever increasing protocols, patients/hr, metrics...
[/quote]

Yes! Completely agree with this.

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #20 on: July 29, 2018, 04:57:02 PM »


I think FI can save medicine. Imagine if more docs were FI and are not afraid to stand up to admins, hospitals, CMGs. More docs who can practice the way they want to and not having to meet ever increasing protocols, patients/hr, metrics...

Yes! Completely agree with this.
[/quote]

Medicine is fucked in the US and it is going to have to get a whole lot worse before it gets better. I will be long retired by then which is a shame because I would love to practice medicine and not the bureaucratic BS I am forced to do. Though being FI will make it easier to cut some of the crap.  I will let you all know in 6 months when I go part time.  I hope it rejuvenates my desire to keep practicing. 

BobMueller

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Re: Healthcare professionals who'd like to FIRE?
« Reply #21 on: August 05, 2018, 02:42:21 PM »
To physicians burned out with current practice demands, I think in the coming years the technology of AI will sufficiently expand so the things you don't like (sitting on a computer, fighting w insurance companies) will be done automatically in the room so you can just focus on treatment. Basically, each session will be recorded and automatically extracted into a chart and intelligently processed. Sort of like a smart speaker (like, an actually good one). A lot of my family is in healthcare and get burned out sometimes/feel like their profession is being encroached upon by midlevels and technology. I hope the future is better for both patients and doctors.

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #22 on: August 05, 2018, 08:28:44 PM »
To physicians burned out with current practice demands, I think in the coming years the technology of AI will sufficiently expand so the things you don't like (sitting on a computer, fighting w insurance companies) will be done automatically in the room so you can just focus on treatment. Basically, each session will be recorded and automatically extracted into a chart and intelligently processed. Sort of like a smart speaker (like, an actually good one). A lot of my family is in healthcare and get burned out sometimes/feel like their profession is being encroached upon by midlevels and technology. I hope the future is better for both patients and doctors.

Although this may be the future, I fear a little of recording 100% of the interaction which will lead to even more "cover your ass" medicine.  I also highly doubt this will be available in the next 5-10 years no matter how hopeful we wish AI can take over.  Fact of the matter is that the computer has made my job more difficult and not easier.  I will admit looking up information is dramatically easier because everyone else's job is harder by forcing them to input that data so that I can easily find it if/when I need it later.

Abe

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Re: Healthcare professionals who'd like to FIRE?
« Reply #23 on: August 05, 2018, 11:19:45 PM »
I agree that medicine will be greatly benefitted by advances in computer science. We're not quite there yet - remember Watson & MSKCC's AI-guided review of cancer patient records? <crickets>

However, it has already made a huge impact, based on my personal experience:

Education/Research:
1. Pubmed.gov and online journals
2. Online textbooks
3. Google
4. Electronic records for chart reviews.

Practice:
1. Electronic notes/orders. I worked at a hospital with paper charts and it was terrible. Granted, I was the intern writing in the chart, but still.
2. PACS - X ray films were also a giant time suck.
3. Email. I don't understand why faxes exist still, but we get our "faxes" sent to email and turn-around on signing home health orders is ~5 seconds. If it's worth putting in the chart, the clerk uploads it.
4. Telemetry piped to the electronic records for monitoring patients.
5. Secure texting. Pagers were the worst: 2-1325 at 2am = coding patient or itchy patient.


Circling back to FI and medicine: completely agree with the sentiment that physicians who aren't monetarily dependent on hospitals / insurance companies are in a better position to push back at nonsense they peddle as "patient care" improvements that are obviously just to improve profit margins. Maybe we'll just end up getting kicked out, but could volunteer as part-time lobbyists instead.

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #24 on: August 06, 2018, 07:39:18 AM »
I agree that medicine will be greatly benefitted by advances in computer science. We're not quite there yet - remember Watson & MSKCC's AI-guided review of cancer patient records? <crickets>

However, it has already made a huge impact, based on my personal experience:

Education/Research:
1. Pubmed.gov and online journals
2. Online textbooks
3. Google
4. Electronic records for chart reviews.

Practice:
1. Electronic notes/orders. I worked at a hospital with paper charts and it was terrible. Granted, I was the intern writing in the chart, but still.
2. PACS - X ray films were also a giant time suck.
3. Email. I don't understand why faxes exist still, but we get our "faxes" sent to email and turn-around on signing home health orders is ~5 seconds. If it's worth putting in the chart, the clerk uploads it.
4. Telemetry piped to the electronic records for monitoring patients.
5. Secure texting. Pagers were the worst: 2-1325 at 2am = coding patient or itchy patient.


Circling back to FI and medicine: completely agree with the sentiment that physicians who aren't monetarily dependent on hospitals / insurance companies are in a better position to push back at nonsense they peddle as "patient care" improvements that are obviously just to improve profit margins. Maybe we'll just end up getting kicked out, but could volunteer as part-time lobbyists instead.

Because most physicians are financial morons they become heavily dependent on their paycheck.  Most can not survive having their pay disappear for a few months which is likely the reason why doctors won't ever revolt against the bureaucratic BS that keeps getting thrown at us.  We need to join together and just say NO.  No more press-ganey, no more core measures that add zero value to patient care.  No more useless JHACO regulations that provide no patient benefits. No more useless documentation that adds no value to patient care. We need to demand cost transparency of everything. We need doctors to take over healthcare policy and that policy needs to be malleable to change with research and technology.  Physicians need to join together and say NO.  stop working for 1 week (except on the critically ill) and the key players will beg us to come to the negotiation table.  Unfortunately we are weak as a group and the system will continue to crumble.

abhe8

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Re: Healthcare professionals who'd like to FIRE?
« Reply #25 on: August 06, 2018, 01:16:45 PM »
I'm here... Still here getting loans paid off and caught up on retirement. I'm three years out of residency and already dreaming of FIRE. But I'm also hoping that going parttine will help. I like my work but I want more time with my family.

BobMueller

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Re: Healthcare professionals who'd like to FIRE?
« Reply #26 on: August 06, 2018, 01:17:51 PM »
I agree that medicine will be greatly benefitted by advances in computer science. We're not quite there yet - remember Watson & MSKCC's AI-guided review of cancer patient records? <crickets>

However, it has already made a huge impact, based on my personal experience:

Education/Research:
1. Pubmed.gov and online journals
2. Online textbooks
3. Google
4. Electronic records for chart reviews.

Practice:
1. Electronic notes/orders. I worked at a hospital with paper charts and it was terrible. Granted, I was the intern writing in the chart, but still.
2. PACS - X ray films were also a giant time suck.
3. Email. I don't understand why faxes exist still, but we get our "faxes" sent to email and turn-around on signing home health orders is ~5 seconds. If it's worth putting in the chart, the clerk uploads it.
4. Telemetry piped to the electronic records for monitoring patients.
5. Secure texting. Pagers were the worst: 2-1325 at 2am = coding patient or itchy patient.


Circling back to FI and medicine: completely agree with the sentiment that physicians who aren't monetarily dependent on hospitals / insurance companies are in a better position to push back at nonsense they peddle as "patient care" improvements that are obviously just to improve profit margins. Maybe we'll just end up getting kicked out, but could volunteer as part-time lobbyists instead.

Because most physicians are financial morons they become heavily dependent on their paycheck.  Most can not survive having their pay disappear for a few months which is likely the reason why doctors won't ever revolt against the bureaucratic BS that keeps getting thrown at us.  We need to join together and just say NO.  No more press-ganey, no more core measures that add zero value to patient care.  No more useless JHACO regulations that provide no patient benefits. No more useless documentation that adds no value to patient care. We need to demand cost transparency of everything. We need doctors to take over healthcare policy and that policy needs to be malleable to change with research and technology.  Physicians need to join together and say NO.  stop working for 1 week (except on the critically ill) and the key players will beg us to come to the negotiation table.  Unfortunately we are weak as a group and the system will continue to crumble.
I've been critical of Uber in the past for its "work whenever you want" disguising an erosion of worker's rights, but maybe the same playbook can rescue the physician profession. With blockchain securing patient records and with the lowering of cost of technology, maybe capital costs for independent practice can be brought down significantly, slaughtering all of the middle-men. With overhead down, a primary doctor could probably live quite well on co-pays alone.

abhe8

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Re: Healthcare professionals who'd like to FIRE?
« Reply #27 on: August 06, 2018, 03:00:52 PM »
I'd love Uber for doctors. Log in to the secure site whenever I want to work (or work extra), see patient list of who wants to be seen now, and the price I would make. Patients can do the same. Prices would flux, depending on how many patients and how many providers are available at any given time. Visits would be tele health, from my home to theirs. Or PCP offices and ERs could use the service as well.

YHD

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Re: Healthcare professionals who'd like to FIRE?
« Reply #28 on: August 07, 2018, 09:30:54 PM »
Love this thread.  We need more physicians to see the light.

I used to want to FIRE--I have the stash.  Academics, tenured.  Landed the sweetest gig and drastically cut back on clinic to 2 days/4 half days a month.  I can vouch for diminishing number of fucks to give in direct proportion to stash size.  Prolly contributed to current gig.

Immune to handwringing over job elimination from AI--if that happens, I really will just FIRE. 

And, oh yeah, fucking cancer--need me some high quality employer provided ppo insurance until medicare or single payer.  Consider this a golden handcuff.

CalmSeas

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Re: Healthcare professionals who'd like to FIRE?
« Reply #29 on: August 07, 2018, 10:22:08 PM »
I'm one year out of fellowship and really enjoying the work. I hope to save up enough to be financially independent over the next 5-10 years at most, and I'm not sure what I will do from there. Maybe scale back, maybe donate more, or maybe by then I will feel differently about the work and will want to get out entirely (though that's hard to imagine now)!


Slow2FIRE

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Re: Healthcare professionals who'd like to FIRE?
« Reply #30 on: August 07, 2018, 10:38:17 PM »
The Doctors who are getting tired of medicine really should FIRE if they have the means.

I feel as if close to 1 in every 4 doctors (primary care physicians) I've met either didn't care about you other than as another number to ring up a "sale" trying to push you through everything in 5 minutes or less or thought pain killers were the answer to every issue (no, I don't want narcotics and I don't want 800mg motrin - how about a *real* plan to correct my issue instead?).  Never had an issue with specialists and I can't say that I've met more than a few dozen doctors (military as a dependent and active duty and kept moving around even after the military).

nora

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Re: Healthcare professionals who'd like to FIRE?
« Reply #31 on: August 08, 2018, 01:04:54 AM »
The Doctors who are getting tired of medicine really should FIRE if they have the means.

I feel as if close to 1 in every 4 doctors (primary care physicians) I've met either didn't care about you other than as another number to ring up a "sale" trying to push you through everything in 5 minutes or less or thought pain killers were the answer to every issue (no, I don't want narcotics and I don't want 800mg motrin - how about a *real* plan to correct my issue instead?).  Never had an issue with specialists and I can't say that I've met more than a few dozen doctors (military as a dependent and active duty and kept moving around even after the military).

So you have come to a thread for healthcare professionals to criticize healthcare professionals? Seems a bit off.

nora

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Re: Healthcare professionals who'd like to FIRE?
« Reply #32 on: August 08, 2018, 01:09:28 AM »
I would like to be FI so I can choose to work much less. I already work part time due to heavy working hours and saving well for five years in the past, and my aim is to be FI by Christmas 2020. Some of my doctor friends think it is strange to want to retire after all the training, but I would like to have the option anyway. After two or three days off, it is hard for me to go back even for half a day. I still enjoy it though -the best part is talking to patients. Worst part is the after hours phone calls, followed closely by the paperwork.

Retire-Canada

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Re: Healthcare professionals who'd like to FIRE?
« Reply #33 on: August 08, 2018, 07:08:25 AM »
My GF was a RN and is now moving up the management chain at her hospital. She's just waiting until 55 so she can draw enough pension to FIRE with her investments. If her investments tripled today I'm pretty sure she'd FIRE ASAP and forget about the pension. Since we both started working towards FIRE late the pension is a set of golden handcuffs at current investment account levels.

She has talked about going back to nursing picking up the odd shift here and there after FIRE just to stay in touch with the profession, but without the stress and physical demands being too much.

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #34 on: August 08, 2018, 11:08:56 PM »
Though being FI will make it easier to cut some of the crap.  I will let you all know in 6 months when I go part time.  I hope it rejuvenates my desire to keep practicing.

lol, or you could end like me and after 2 years of 3 days a week start thinking "hmm...I think 2 days a week would be nicer", then eventually I'll probably end up with two half days a week, and so on and so on. Cutting hours can be addictive.

I'm fine with that.  In all honesty if we downsized our idiotic doctor house we would be able to likely FIRE today or at least within a few months of savings.  So if after 6 months of 8 shifts a month is too much I will go down to 6 and so forth.  Hopefully by the time I am working 0 days we can either afford to FIRE in this home or if not move into something a bit smaller.

EnjoyIt

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Re: Healthcare professionals who'd like to FIRE?
« Reply #35 on: August 08, 2018, 11:09:52 PM »
BTW, for those docs who have never met this neurologist/psychiatrist Slo-mo please watch this video.

https://www.nytimes.com/video/opinion/100000002796999/slomo.html

I find it inspiring in a way.

india dark ale

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Re: Healthcare professionals who'd like to FIRE?
« Reply #36 on: August 14, 2018, 05:20:29 PM »
Hey guys! My first post.

I'm 58 and FI. But I really love my job. As a specialist, I get plenty of free time and weekends. I take 8 weeks of vacation a year. The job is easy and the money is good. I'm planning to keep saving so as to leave a pile of money for my wife when I'm gone, and she can pass on the rest to our only child when she dies. Even 1% SWR would be a lot for us to spend as we are very frugal people.

MrThatsDifferent

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Re: Healthcare professionals who'd like to FIRE?
« Reply #37 on: August 14, 2018, 06:11:42 PM »
Damn. I feel bad for healthcare professionals, as you’re probably the only people who your clients and the public need you far more than you need them. And there still isn’t enough of you. That’s a hard profession to walk away from. Most of us can be replaced in a heartbeat but doctors and nurses? You’re needed. Hopefully those part-time and flexible options become more available.

india dark ale

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Re: Healthcare professionals who'd like to FIRE?
« Reply #38 on: August 14, 2018, 06:59:29 PM »
That's one of the reasons I want to keep working. I feel it is a waste of my knowledge, talent and experience to quit and walk away.

DocMcStuffins

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Re: Healthcare professionals who'd like to FIRE?
« Reply #39 on: August 14, 2018, 07:01:25 PM »
Started my own practice and built it so I wouldn’t be needed. Now I could retire from the income from my other employees but I continue to stache away. Enjoy the patients still and have delegated a lot of responsibilities. I plan on seeing patients for another 5 years with the plan I have in place. All the changes going on in healthcare are tough from a business standpoint but to be honest I love the challenge. When I stop seeing patients I will change fully  into the COO/CEO role because I love growing my business.

Mesmoiselle

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Re: Healthcare professionals who'd like to FIRE?
« Reply #40 on: August 15, 2018, 08:48:58 PM »
I dunno if this thread is mostly for doctors.

I'm in Imaging and the MMM blog entry about if the cost were $0 and the pay were $0 would you still do this?

And due to the chronic pain from repetitive motion injury I suffer with 75% of others in my field, the answer is no. 

If I just break myself for 7 more years, I'd be FI. But I may break permanently, so what would FI bring me?

Patients don't kill me (their stupidity mostly amuses), but management understaffing and Nurses/Doctors who treat me like a mouth breather do.

The thing that got me into healthcare was that feeling I got when I had the time to sooth a patient, and educate them. Now I'm so swamped, I honestly hope they STFU so I can get through their exam without missing something important and get on to the next one.

Sad day.
« Last Edit: August 15, 2018, 11:15:36 PM by Mesmoiselle »

SpareChange

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Re: Healthcare professionals who'd like to FIRE?
« Reply #41 on: August 16, 2018, 12:15:38 PM »
I dunno if this thread is mostly for doctors.

I'm in Imaging and the MMM blog entry about if the cost were $0 and the pay were $0 would you still do this?

And due to the chronic pain from repetitive motion injury I suffer with 75% of others in my field, the answer is no. 

If I just break myself for 7 more years, I'd be FI. But I may break permanently, so what would FI bring me?

Patients don't kill me (their stupidity mostly amuses), but management understaffing and Nurses/Doctors who treat me like a mouth breather do.

The thing that got me into healthcare was that feeling I got when I had the time to sooth a patient, and educate them. Now I'm so swamped, I honestly hope they STFU so I can get through their exam without missing something important and get on to the next one.

Sad day.

Also in imaging. Curious what your end game is. I'm leaning towards going permanent PT next year with benefits, after hitting minimum 300k. Then coasting along for another 10 years or so. Don't think the race to FIRE category would be optimal for me. 

Mesmoiselle

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Re: Healthcare professionals who'd like to FIRE?
« Reply #42 on: September 19, 2018, 01:18:18 AM »
I dunno if this thread is mostly for doctors.

I'm in Imaging and the MMM blog entry about if the cost were $0 and the pay were $0 would you still do this?

And due to the chronic pain from repetitive motion injury I suffer with 75% of others in my field, the answer is no. 

If I just break myself for 7 more years, I'd be FI. But I may break permanently, so what would FI bring me?

Patients don't kill me (their stupidity mostly amuses), but management understaffing and Nurses/Doctors who treat me like a mouth breather do.

The thing that got me into healthcare was that feeling I got when I had the time to sooth a patient, and educate them. Now I'm so swamped, I honestly hope they STFU so I can get through their exam without missing something important and get on to the next one.

Sad day.

Also in imaging. Curious what your end game is. I'm leaning towards going permanent PT next year with benefits, after hitting minimum 300k. Then coasting along for another 10 years or so. Don't think the race to FIRE category would be optimal for me.

Well, I contract travel now, so the money is good. My very specific plan is to save 80k in "old people retirement" and then 350k in stocks saved over next 7 years. I'm on the fence about going back to school to get a bachelor's degree in almost anything since most jobs and even teaching in imaging requires that- because it would slow down my FI but I also have to consider that an injury could take me out permanently anytime.

The contract work means I can run my arm ragged and then take a month or two break to recover before I run out and moderately injure myself again. The breaks slow FI as well but their is no way round them.

So, trying to cover bases, be flexible. Perfect world is 9 months a year for the next 7 I save hardcore. Back up plan takes longer.

What I'm willing to do for $0 is draw and write so the "bachelor's degree in whatever" will probably be related.

What I want to do in early retirement is volunteer. I've wanted to do big brother big sister for years. I've wanted to go abroad and donate my sonographer skills to ACTUALLY Ill people for years. I want to create beautiful things with my own hands. Spend time with friends and family with no time constraints. Hmm. Got off on a tangent. Somewhere in there answers your questions, I'm sure.

Incidentally, I've been doing a lot of internal thinking about the balance between making yourself miserable to achieve FI and delaying it some normal age, like 50, and enjoying life now. Not in an insane spendy pants way but like... I want to go to Hawaii WITH my husband. Not for 3 months alone on a job.  3 weeks with husband is better than 3 months alone even if former is big $$ and the latter would net a profit.
« Last Edit: September 19, 2018, 01:32:54 AM by Mesmoiselle »

Freedomin5

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Re: Healthcare professionals who'd like to FIRE?
« Reply #43 on: September 19, 2018, 05:40:08 AM »
I'm....uh...pretty direct with my patients. They usually already know what I think.
I've had some of the things I've said to patients repeated back to me and I'm like "What??? No! I didn't actually say that, did I? OMG"

Surprised I didn’t see this thread earlier. I’m also in healthcare and plan to FIRE next year, after five years (2 years building my practice, 3 years running full force and diverting as much of the firehose of cash into investments).

Just wanted to comment on being direct with patients. @Malkynn You must be an empathetic, caring, and high EQ practitioner. Your comment reminded me of a psychiatrist who told a patient that her husband left her because she “didn’t take care of her appearance” and that “all men strayed so why are you so upset about your husband’s infidelity?” Needless to say, within a few weeks he suddenly “was not currently available for appointments”. Sometimes, it’s better not to speak your mind, especially if you’re burned out and have uncharitable thoughts.. I think he was burned out. And I don’t think he ever took courses on bedside manner.

On the other hand, I’ve met several wonderful wonderful physicians who do great work in a caring, kind, competent, and efficient manner. They make me proud to be associated with them.

Sorry...just had to share. Back to our regular program now...

hops

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Re: Healthcare professionals who'd like to FIRE?
« Reply #44 on: September 19, 2018, 09:28:08 AM »
I've done academic medicine and I'm currently in private practice.

Benefits of academic medicine:
Networking with like minded individuals, ability to meet & do research with the best and brightest
Better caliber colleagues
Prestige
Benefits - usually professional funds, travel, visibility
Usually more seasoned/developed retention/benefits like life insurance, paid leave, etc.
cutting edge technology, beta testing, etc.

Benefits of private practice:
Salary
In general, less stress
Less hours
More security (IMO) due to more seasoned HR rules - no chasing tenure or funding, etc.

My spouse and I were both in academic medicine with a young child. That didn't work. I washed up and have the private practice job now. The thing I miss the most is the wonderful, smart people I used to work with. But, I get to spend more time with my child and I have less guilt about it. There are definite benefits to both sides and the grass is always greener. I'd love to go back into academics some day, but maybe when my kid is older and doesn't need or want me so much.

The academic pay cut bugs me at this stage in the game, while we're still paying down her student loans and plotting an eventual move closer to her office. But the benefits are stellar and it's impossible to argue with how happy she is now. We'll see if that's still the case in a few years when it's time to line up more funding.

Her schedule has been a lot more agreeable as an attending than it was in residency, largely due to the protected time she's given as part of a grant. Not all of her friends have been as lucky, and a few have left in recent years for the same reasons as you. That's the one thing that finally got her interested in FI, wanting the freedom to dictate her own schedule.

Much respect to you double doctor couples raising kids, by the way. A lot of our friends are in that boat and even those with plentiful help (whether paid or volunteered by local family) still find it very difficult at times.

I'm....uh...pretty direct with my patients. They usually already know what I think.
I've had some of the things I've said to patients repeated back to me and I'm like "What??? No! I didn't actually say that, did I? OMG"

Just wanted to comment on being direct with patients. @Malkynn You must be an empathetic, caring, and high EQ practitioner.

You’re not wrong.
I put an absolutely exhausting amount of emotional energy into my highly empathetic relationship with my patients,

I have the luxury of a lot of time with my patients, 1.5 straight hours with every new patient. The first 15-20 minutes is reserved for them to just talk about themselves and their personal life. I won’t let them talk about anything clinical until I’ve got a sense of them. They share A LOT of personal information with me. There’s a lot of tears, laughter, joking etc.
I handle a lot of fear and phobia, it closes people off and clams them up and I use a bit of disruption to pry them open and get them to engage.

That's remarkable for dentistry; so many of the offices I've been to as an adult kind of work like assembly lines. I hear radio ads for sedation clinics that basically say "Afraid of us? We'll drug you!" From what you've described in this and other threads, "Afraid of us? We'll listen to you!" seems like it might yield more, and happier, patients.