I recently attended a conference on Physician Wellness, during which we were asked to do an exercise in pairs. Alone, we were to write down three goals at our job. Then, we were to ask our partner about a time when their work aligned with those goals, and how they felt.
My partner for this exercise was a hospitalist, who talked about the joy in finding time to really talk to a patient. When you don’t have to rush off to the next emergency or phone call, and can have a longer talk about who they are when well, or what has been happening, or just listen to someone who is sick and needs support.
For me, I thought about a visit I added on during the holidays, with no one scheduled afterwards. We had time to talk beyond the allotted 15 minutes, and to cover a few more problems, to build a stronger connection. I even had time to write the office note, while my house staff took care of business in the hospital.
In both cases, what we wanted was enough time to do our jobs well.
Medicine isn’t an assembly line, where if you just crank up the speed a bit more, you can get more done each day. It takes time to do some things properly: get an old lady from her wheelchair to the exam table; manage an interview with someone who needs a translator; break bad news; think about an uncommon problem.
Unfortunately, the way to get paid more (or plenty), is to see more patients. So if we want a raise, or just to maintain our income as doctors, we have to see more people each day. At least, that’s what I hear as an employed physician. That means either longer hours or shorter appointments.
This is fine with easy appointments: you have a sore throat, your kid has strep, let’s check a strep test and make sure you aren’t allergic to penicillin. Or, we started you on a BP med last month, are you doing OK? Your BP today is 118/72? Done! You can crank through plenty of visits, and make some good money doing so.
It’s not so easy with some of our other appointments: you know that CT scan we got to look for kidney stones? Well, it looks like you have a spot on your liver… is not necessarily a short visit. Nor is the visit talking with someone on chronic anticoagulation about their recent hospitalization for a bleed, and deciding what to do next. That’s a day when you don’t want a lot of visits, and maybe you don’t bill enough to be a star performer. But maybe you feel like a star doctor, and that all your training was worth it.
FI, Retire Early
My introduction to the financial independence movement was, as for many people, Mr. Money Mustache. As you may know, he saved a very high proportion of his salary for his first decade out of school, and then retired as a computer engineer. He is happy living an inexpensive life, and, for him, whatever sacrifices he made in his early career (living cheaply, working long hours) appear to have paid off in his early retirement.
I have been following a number of other blogs over the years, where again, hard work and tight budgets led to an early retirement, and the freedom to pursue other dreams.
It’s true, if you put the work in early (work hard, save hard), you can reap some amazing rewards later. The idea behind financial independence/retire early seems to be work very very hard and stay focused, so you can quit your job young and start your real life.
On the other hand, these rewards are not 100% guaranteed. What is guaranteed is that you have to work hard and save a lot of money, which means denying yourself pleasures now. You hope you will be able to enjoy them later.
FI, Retire Slow
I have been reading more and more blogs writing about slow FI, which seems to be more about setting yourself up for success over time (save a good deal of money, be selectively frugal) but making sure to enjoy yourself along the way. Starbucks is OK, maybe savings get reduced for a few years so you can stay home with family.
Some posts I’ve saved over the past few months:
- Why we stopped chasing early retirement for a happier life. From Mad Money Monster.
- If personal finance feels like punishment, you’re doing it wrong. From She Picks Up Pennies.
- Self-deprivation on the journey to early retirement. From Abandoned Cubicle.
Coming back to medicine
Talking with my new hospitalist aquaintance, I thought about the treadmill of 15 minute visits as a medical version of FIRE: work hard, very hard, which will suck some of the joy out of work. However, your reward will be a big pile of cash that can finance your early exit from your hated job.
Whereas, going the Slow FI way might mean changing your schedule to allow for more time connecting to patients [i.e. cutting back]. It would lead to hitting financial goals later, but maybe finding more meaning in your time and work along the way.
A fair compromise would be to work hard in your first few years out of residency, when that feels more normal; and then slow down once you have cleared a few hurdles: a good start to your retirement funds, paid off student loans, a down payment for an affordable house. [This sounds suspiciously like advice from the White Coat Investor.]
I think the Slow FI movement is calling out to a number of people because it gives us permission to make changes that are less remunerative, but make life more enjoyable. It allows the option to find a joyful and meaningful career, instead of rushing to end one and start another. Slow FI certainly is sounding more appealing to me, after being asked to consider when I am fulfilling my personal goals at work.
Which option is more appealing to you? Rushing ahead to an early retirement, or meandering a bit more slowly?