How to coast as a hospital doctor

[frugledoc]

Hello friends. I fucked myself up by working in a very understaffed department for the last 2 years, culminating in burnout.  I’ve been off work for a few months (on full sick pay).  My mind is much clearer now and I have managed to get my head sorted, although I still have complete apathy to going back to work.  I am in my 40s, married with 2 kids under 8.  We are FI not including my DB pension which I can take from age 50.

I want to just coast to retirement now.  That bit of my brain that anyways went above and beyond has been damaged beyond repair.  I am a public sector worker. 

There is a provisional plan to go back to work in March with a gradual phased return. I would like yo that coast to retirement from here, but the job remains the same and so does my manager.

Anybody managed to go back to an intense job but just sit back and go slow?

[nereo]

Have you come across the White Coat Investor? 
The guy who started it (Dr Jim Dahle) was also an ER doctor.  Contains lots of information and advice that's very specific to your profession

Not everything there is terribly mustachian, but I think you'd find it useful

https://www.whitecoatinvestor.com

[Another Reader]

My take on this as someone that has spent too much time in the hospital as the result of almost three years of Long Covid is you need to get out of hospital work.  I have seen more than a few coasters, including some future coasters disguised as interns and residents, during my visits.  Your patients don't like or trust you and neither do your coworkers.  The nurses, especially.  Find a lower stress job in a clinic or other environment where your hours and workload are set.  Then get on with your life.

[Omy]

I can't imagine coasting as an overworked doctor. I know a retired nurse who does nothing but give people vaccines all day...that seems more like a coast job.

[JGS1980]

Do you have to continue working there to get the pension?

If not, it's time for a change of scenery.

I'm assuming you are in Internal Medicine.

Try Locum Tenems for a private group. Try outpatient internal medicine clinic at 2 days per week. Try NOT WORKING at all for 6 months and see how you feel then. Covid19 burned out plenty of people, you are not alone.

JGS

[Photograph 51]

Maybe get into occupational medicine and do DOT and pre-employment physicals all day.

[LifeHappens]

You have all my sympathy. I have neighbors in hospital health care and the last three years they have all gone through the wringer.

If you do want to stay in hospital care, the quickest solution would seem to be working part time.

[mistymoney]

since your FI, why do you want to go back?

If you want to stay in medical practice, maybe look to take 2-3 shifts/week at an urgent care center.

[Extramedium]

Teach at a PA or NP school?

[MoseyingAlong]

My take on this as someone that has spent too much time in the hospital as the result of almost three years of Long Covid is you need to get out of hospital work.  I have seen more than a few coasters, including some future coasters disguised as interns and residents, during my visits.  Your patients don't like or trust you and neither do your coworkers.  The nurses, especially.  Find a lower stress job in a clinic or other environment where your hours and workload are set.  Then get on with your life.

As a nurse, I want to push back on this.
It depends how you are defining coast.

If it's slacking while at work, yeah, find something or somewhere else.
If it's working reduced hours and call, more power to you. I thought the people who limited their time and stress were wise and usually better to work with.

Don't have suggestions for the OP but hope you find something that works for you. And am glad you recognized the burnout and are taking steps to prevent a recurrence.

[frugledoc]

Thanks all for the replies.  I have thought about just quitting/locum but because I have two young kids I feel I need some job security.  Yes, we are FI, but I worry about additional costs of my children I haven’t factored in (for example, university and health care are currently free in my country, but if that changes I would need 100s of thousands extra)

[Tester]

You are FI. You don't have to go back to the same work.
More, as a medic, if you make a mistake in the hospital it might have a bigger impact than a mistake done at a different place (PCP?). If I would be FI right mow I would try several jobs, one of them being to work at a dicks burger place. And my work can't impact lives the way your work can.

Just think about working where you can have an impact without the stress (and perhaps without the full pay you are getting in the hospital) and see if that works out.
Or just take part time work in the hospital?


I understand that medical work is important/satisfying I am just trying to say "do it because it js satisfying not because you need the money" - especially as you are FI.

[former player]

Sorry to hear about the burnout.  It seems that the job, the manager and the understaffing are all going to be the same as they were? And I bet both the hospital and the manager think that "a gradual phased return" means that they expect you to go back to full-time work at some point, and probably that they will be doing everything they can to turn a gradual phased return into an accelerated return.

Once a person has been subjected to stress leading to burnout that the likelihood of stress and burnout returning is greater, that it happens sooner at lower levels of pressure and that the health consequences are more severe and long-lasting.  Alongside my day job I was a trades union official in the public sector: I saw this happen to colleagues.  That the courts recognise this and make provision for compensation for people who have not been protected by their workplace after a stress related work injury is still inadequate recompense for the damage it causes.

For you to go back to the same job, manager and understaffing is sending me danger signals.  I think that as a minimum one or more of those needs to change before you go back, otherwise every day you walk into the hospital will be a day when the pressures that led to your burnout will be pressing down on you again, and any limits that you try to set in your own mind will have everything else - the understaffing, the attitude of your manager, your own desire to do a good job and help your patients to the best of your ability - undermining them every minute of every working day.

Sometimes as public sector workers it is hard to be open to other possibilities.  But my advice would be that you should look at every other possibility open to you rather than going back to your old workplace.  Another hospital, including a private one?  Clinic work?  Retraining in a different speciality?  Teaching?  Being FI gives you options.  And if you have a partner then the future security of your children is down to them as well, it doesn't fall all on your shoulders, and if you are not working that frees them up to improve their earning power and take care of those potential future costs that worry you.

If you do stop work altogether, just remember to keep your national insurance contributions going so that you get the full 35 years of contributions.  The pension might not be much but I suspect that if charges do start to be made for things like health care then people with a full record of NI contributions will be the last to be charged and be charged the least.

[lhamo]

Thanks all for the replies.  I have thought about just quitting/locum but because I have two young kids I feel I need some job security.  Yes, we are FI, but I worry about additional costs of my children I haven’t factored in (for example, university and health care are currently free in my country, but if that changes I would need 100s of thousands extra)

I don't quite understand how doing a few days a week/month of locum coverage would not account for this.

Or, if absolutely necessary, you could go back to work for the period you kids are in college -- I am considering this if it turns out DD REALLY wants to go to an out of state school that will cost more than we have saved for her (plenty to cover full costs at an in-state school).

Alternatively, are there less stressful roles that maybe don't pay as much but would allow you to keep/benefit from your medical license?  Chief medical officer at a private school or camp facility?  Medic on a wilderness search and rescue team?  Primary care doctor in a more remote location that has limited access to health care?  Your hospital work may have been more specialized, but perhaps there are ways to be more of a generalist in a less stressful, more enjoyable setting.

In any event you are not doing yourself or your patients any favors by continuing to work FT while burned out.  At the very least step back significantly and focus on recovering, mentally and physically.

[Steeze]

Take more time off -- how easy is it to get a job again later if you need? If you are not ready to go back, don't go back yet... that is the whole point of FI. Sounds like you MIGHT need to make a couple hundred grand over the next 20 years or so, how hard is that without the high paying ER job?

Other adjacent options available that would give you a learning curve and some renewed interest for a while? Medical sales? Starting a private family practice / making house calls? Work remote for a teledoc type service? Teaching at a medical school or university?

Or even other less lucrative options that might just be fun while you repair your soul, like ski instructor or dog walker?

Just because you're a skilled doctor doesn't mean you have to be a doctor.

More money doesn't always mean more better. Plus, if you really needed to go back to work down the road, I am sure you could get back into the field 10 years from now for another few years if you needed.

[lutorm]

Yes, we are FI, but I worry about additional costs of my children I haven’t factored in (for example, university and health care are currently free in my country, but if that changes I would need 100s of thousands extra)

I agree with what everyone else is saying, but I wanted to focus on this: it seems like you might be suffering from some lingering anxiety over financial insecurity. Realistically, how likely is it that university would go from free to just "ok everyone, you're on your own"? Same with healthcare. Yes, there may be gradual changes, but with financial resources and free time you're probably more likely to successfully navigate them than less wealthy people who are still working. In contrast, it sounds like going back to your work would have pretty certain adverse health consequences?

I suggest you read some of the discussions about OMY syndrome around here. It's always possible to invent some worst-case scenario to convince yourself that you need to work more, but think about the flip side: how would you handle involuntary events resulting in your being unable to work?

Of course, you say you're "FI", but that means very different things to different people. Some might consider themselves FI with a 5-6% withdrawal rate, others would feel insecure at 1%. Where you are on that spectrum, and how trimmable your budget is, makes a big difference to you financial resilience. Try to take a holistic view of your financial risks and mitigation strategies.

[gooki]

Assuming you like what you do excluding all the bullshit, I'd just pitch 2 days a week (or whatever works for you) to your current manager. You're in the position of power since they're understaffed.