My cousin visited me in sunny Cali this past weekend. She lives a life that many in the medical community can appreciate: a stable and successful job for many years, but burnt out. She then decided to take six months to work on her writing and try establishing herself through various pursuits. While successful in some ways, she decided she needed a more stable position. So she found a job, ...

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There has been much talk over the years about resident work hours. How long is a safe shift? With safety being considered for both the patient and the resident. But no one ever discusses attending work hours. If putting in a 24-hour shift is bad for a resident, isn’t it bad for an attending as well? When I was working in critical access hospitals, I usually was on call for ...

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D.J. is a 55 year-old woman with recently diagnosed early-stage left-sided breast cancer. She just had a lumpectomy to remove the tumor, and now has to decide whether to undergo chemotherapy after surgery. Her oncologist carefully discusses the clinical and pathologic data about her tumor, in terms D.J. can understand. She discusses the risks, benefits, and side effects of chemotherapy, and recommends treatment. D.J., having learned about the risks and ...

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Are you a medical resident or fellow?  Do you have a family to provide for?  Do you feel that your biweekly paycheck is not quite enough to justify the hard work you put in?  Luckily for you, your program offers the great benefit of "moonlighting."  Should you take advantage?  Here are some of my thoughts on the matter. What is moonlighting? Like so many other things we take for granted in medicine, ...

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Despite above average intelligence and work ethic, the average physician is an absolute imbecile when it comes to the topics of personal finance, investing, and business. The lack of expertise on these critical life topics is having a dramatic effect not only on the financial lives of physicians but also their rates of burnout and thus their patient care. In past decades, by virtue of their above average income, a ...

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Debt is destroying the lives of doctors everywhere. The cost of getting an education has moved into the ridiculous range. Many doctors are now starting their practice so far in the hole, that they do not see the way out. I would not have been able to start on my debt-free journey (I peaked at more than $600,000) if I had not developed a new attitude toward debt. Putting debt into ...

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Who Retires at 30 to 35? Retiring after a career of zero or a few years may sound ludicrous, but there are a few scenarios that are not so far-fetched. The stay-at-home spouse. A handful of physicians complete residency, but never pursue employment, often choosing to start a family instead. I know one physician who made this choice at age 29, actually. The suddenly wealthy. A large windfall at the beginning of one’s ...

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Most physicians, including me, would fall into the category of type A personalities, always on the go with a constant need to be productive. We cram every minute of the day with productivity and leave little time in our schedule for fun and recreation. Even type A personalities need a break from working to recharge their personal batteries. How often have you been packing for a vacation and included work ...

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If you stay in medicine long enough, you will encounter physicians who seem to care more about the paycheck than the patient in front of them: think Dr. Farid Fata.  You may find those colleagues revolting; I know I did.  I despised these physicians and felt nauseated even to be in the same room as them.  But as time went on, I realized that almost nobody starts a career ...

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As a physician who is planning an early retirement, and is writing about the topic often, I find that retirement is frequently on my mind. It’s not difficult to articulate my desire for an early retirement. I crave the freedom and time with my family. I look forward to restful nights free from the threat of the loathsome pager. Another round of MOC is not for me, and I’m ready ...

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