Career burnout is becoming increasingly common and is a hot topic lately, particularly for physicians and other health care workers. The causes are many. Increased demands. Decreased reimbursement and recognition. Longer hours and lower benefits. The feeling that you’re just another wheel in the cog. In medicine, it’s the ever-thickening red tape. Clumsy electronic health records (EHRs). Prior authorizations. In-baskets that fill up with dozens or hundreds of messages any time you’re ...

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The telephone rang. Why would he be calling? Must be a misdial, I figured. I  hadn’t worked with him in several years, and we were never known to make social calls back when we did work together. That call was no mistake. What he had to say made me simultaneously queasy, fearful, and angry. It felt like the first couple loops on a rollercoaster ride I didn’t sign up for. I ...

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“It is neither wealth nor splendor, but tranquility and occupation, which gives happiness." - Thomas Jefferson If you are a practicing physician, you need rest. Why do I say this? Because you have gone through an enculturation process which focuses on hyperactivity and super high-level achievement. In training programs and in practice, admitting that you are tired or needing a rest break is a sign of weakness and is discouraged, to say the ...

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I was browsing the Bogleheads forum last night, and my eyes naturally gravitated to the thread titled “What is FI if you love your job?” The short answer is that FI is financial independence. Nothing more, nothing less, and it doesn’t look any different if you love, hate, or feel indifferent towards your job. The long answer, after learning that the man asking the question is about ten years ...

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When I described my drawdown strategy in early retirement, I stated we will “sell from the taxable account first.” I also plan to collect quarterly dividends from my index funds, but if Vanguard were Burger King and I could have it my way, I’d hold the dividends and take bites out of my account only as needed. When I discuss the downsides of dividends, note that I am ...

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In January of this year, I wrote one of my favorite posts after helping a retired couple free themselves from their financial advisor, greatly simplify their portfolio, and saving them more than $20,000 per year in the process. For details, please read "From 28 Funds to 3," then return here for a follow-up. In summary, the couple previously owned 28 funds (with 48 positions between three accounts). The ...

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You did it! You worked, you saved, you conquered. Your investments add up to 25 times your expenses, or 30 times, or whatever your magic number is. You have achieved financial independence (FI), however you have chosen to define it. What’s that low rumbling sound I hear? Is that a bear coming out of hibernation? I won’t pretend to know when it’s coming, but I promise you I haven’t seen my last bear market. It could start ...

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“Can I look at that book?” said the man next to me in an accent I would soon learn to be Pakistani. I had placed the book face down on the park bench intentionally. In a busy, public place, I didn’t want to broadcast that I was reading The Doctors Guide to Smart Career Alternatives and Retirement. The back cover contained enough information to pique the polite man’s interest. “Sure,” I said. ...

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In order to safely plan for a successful retirement, it’s imperative to have a general idea of what your spending needs will be when retired. We cannot calculate whether or not our anticipated withdrawal rate would be considered safe (in the range of 3% to 4%) without knowing the size of the annual withdrawal. That number can be difficult to pin down, as there are many variables. It can be informative ...

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I’ll be the first to admit that I am a frugal physician. Frugality has served me well, and I wouldn’t be financially independent without that quality. Yes, I refer to frugality as a quality, and as far as qualities go, it’s a quality quality to have. While not everyone thinks of frugality as a decidedly positive quality to possess, it just might be that others confuse frugality with its ...

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Innovative technologies and shifting public expectations are altering the practices of many industries, particularly those that provide a service. Medical practices should take heed and recognize these trends or risk losing patients and market share to others more open to adopting new strategies. How does one differentiate a high-performing medical practice from another that’s falling behind? And what are the forces that drive the discrepancy? What strategies can your practice implement ...

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And I don’t love it. When I gained acceptance into medical school, I thought I would one day have one amazing job, or at least one job title where I might get to wear several meaningful hats. I’m a physician anesthesiologist. It’s my duty to play a role in improving the health and the lives of my patients. I studied and trained for many years to have the privilege of understanding the ...

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A couple years ago, I reached the seven-year mark after my initial board certification with the American Board of Anesthesiology (ABA). At the time, it was a significant milestone. I was eligible to take the all-important Maintenance of Certification in Anesthesia (MOCA) exam. Diplomates of the ABA -- that’ right, I’m considered a diplomate -- in other words, a board-certified anesthesiologist. Diplomates were encouraged and incentivized to take the $2,100 exam ...

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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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It’s hard to find time to pay attention to all the messages I receive. There are voicemails, emails (work, blog, and personal), and the nonstop notifications from Facebook and Twitter. Post-it Notes on the desk and the refrigerator. I am bombarded with messages. Urban Meyer, head coach of the Ohio State football team, doesn’t have a lot of time to leave messages. Right now, he’s gearing up for a likely bid in the ...

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You won’t find me at any haunted houses this weekend. I don’t need any costumed creeps jumping out at me when I least (or most) expect it. I’ve never been a huge fan of strobe lights, fog machines, bad makeup, or canned Vincent Price laughter. My day job is scary enough. Some like to say that anesthesia is 99 percent boredom and 1 percent terror. They’re half right. The 99 percent is rarely boring. ...

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The day was progressing swimmingly until the charge nurse announced we had an emergent exploratory laparotomy. These things happen; often there's free air in the abdomen from a ruptured ulcer or diverticulum. Sometimes an exploratory laparotomy is necessary after trauma or a particularly nasty infection. We're prepared to handle them. "Where is the patient?" I inquired. "On the way down from ICU. The surgeon's on his way in," I was told. Hmm … ...

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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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I would like to discuss how I achieved financial independence at age 39, and how it allows me the freedom to practice medicine in a way that keeps me happy. Financial independence is defined as having enough money saved and invested in a way that would allow you to quit gainful employment and continue your present standard of living. The math, based on a 4 percent withdrawal rate, requires you to have ...

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Evidence-based medicine is at the heart of what we physicians do. It is the basis for professional decision-making, and a focus of most journal articles we read. Using solid evidence to practice good medicine has been a foundation of clinical practice for decades. There are consequences for failing to follow evidence-based guidelines. If patient harm results from straying from a more loosely defined “standard of care,” which tends to be evidence-based, ...

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