Finance – Physician In Numbers

Choices And Their Results

In my work, I sometimes prescribe weight loss medications.

They are not currently covered under many local insurance policies. Although the hospital insurance plan was covering them for a short time, coverage will end very soon. However, for the cash-paying patient, they can now cost “only” $500 per month.

I don’t particularly want to talk about whether or not injectable medication for weight loss is a good or a bad thing, or about the cost of medications in the US, or whether or not healthcare coverage for obesity management meets your favor.

What I do want to talk about (briefly) is the wiggle room in some budgets.

Future Me, May 2025

Not long after the start of this blog, I cut my hours very slightly, and wanted to make sure I didn’t waste the extra time I was paying dearly for. I had started reading about preparing for retirement in non-financial ways, and I realized that it was time to start (re-) building a life that didn’t revolve solely around medicine.

I started this series of posts at the end of October 2018 with lots of big goals, but even at the beginning, knew that I couldn’t follow all those dreams all at once.

Every few months, I try to look at what I have accomplished, and see if I can adjust course to focus my free time in the directions I wish I would go: increasing fitness, building (or maintaining) connections with friends, family and community, engaging with the arts, and, lately, keeping up with financial tasks.

My last update was in January 2025. I had hoped to write an update a little sooner, but travel got in the way. (An excuse that made me happy to skip blogging.)

This is a good time to review how well I have been pursuing those goals, as it I will soon have significantly more time out of the office to work on them.

5 More Mondays

It’s a beautiful spring Sunday, my first day off in several weeks, and I can’t quite say that I am excited to wake up early to go into the office tomorrow morning.

However, this will be one of my last early Monday mornings. I have 5 more until I will no longer have Monday morning clinic. Ever, if things work out well.

I’m realizing that I probably need to make some tentative plans for how I will use my extra time out of the office.

FIRE vs OMY, Redux

I’m just back from a national meeting, my first in 6 years.

Spending time away from the office and the inbox, while attending educational sessions, was invigorating. Returning to a week’s worth of messages and to-do’s is not.

Right now, looking at my work load, retirement sounds mighty attractive. However, while I was away, the stock market decided to jump off a cliff.

Why I Won’t Sign Up For An HSA Again

I made a comment a ~~few months~~ year ago on a post offering financial advice to younger people on finances. The writer advised signing up for an HSA (health savings account) and I advised being careful about one.

A quick back and forth earned me the comment that I should write about my experience, so here it is.

Just to be clear: I am not saying that HSAs are bad; in fact, for many people they are great vehicles for saving (and investing!!) for the future.

I’m just saying that an HSA was a bad idea for me.

Below I will go through why the HSA and accompanying HDHP (high deductible health plan) didn’t work for me and my husband, and point out a few things to think about before deciding on the HSA route for you.

To Those About To Match

Match Day is coming up, and soon 4th year medical students will find out where they will be training for the next several years.

Best of luck to those waiting to hear the news, I hope any senior medical students reading are happy with their result.

A woman holding a bouquet and reading a letter. — A wish: You should look this happy opening your Match Day results.

From a financial standpoint, making the transition from a tuition-paying, negative income flow state to working (and paycheck earning) is huge.

Making better decisions during residency can really set you up for financial success as an attending.

I don’t like to imply that if you don’t get it right now, you’ll be doomed, because that isn’t true. However, you can really make your attending life easier based on habits you build earlier.

One More Year (Or Two), Here I Come

As I wrote two weeks ago, I had a meeting with my boss to discuss what my job might look like going forward. Actually, it was a pretty easy conversation, and all the changes I asked for were approved.

It’s very exciting, if a little scary, to contemplate cutting back significantly. I was able to put off thinking about it for a week, as my sister-in-law’s visit was quite a distraction. (Nothing bad, it’s just time consuming to have a house guest.)

Now I am starting to put the changes in action, talking to people at work about making those adjustments to my schedule and my paycheck.

What changes am I looking at?

FIRE vs OMYS (one more year syndrome)

Just a short post today, as my thoughts have been darting all over the place in the past week.

I am meeting with my boss (one of my many bosses) this week, to discuss what my position might look like going forward.

Even though I think I know what I want, I’m torn between joining multiple friends in retirement, and continuing to practice medicine at my current institution.

A woman in a long white dress holds a large sketchbook in her lap as she sits in an empty studio. In the window behind her, a couple stands on the balcony of a distand building — This woman is literally at the drawing board.

Of course, what I want and what my boss can agree to may be very different things. Especially given the uncertainty these days with government funding.

I hope to have, as we say, some clarity about my future by the end of the week.

What’s new with you?

Future Me, January 2025

I started this series of posts at the end of October 2018 with lots of big goals, but even at the beginning, knew that I couldn’t follow all those dreams all at once.

My last update was in May 2024.

Life got pretty crazy since then, and I apparently failed to update my progress for over 7 months.

Not only is it time to review how well I have been pursuing those goals (probably not all that well…), but there is a little more urgency to reconsider what I want. I will be meeting with (one of) my bosses soon, to discuss how I envision my clinical goals going forward.

It’s hard to ask for what you want, when you haven’t really considered the question.

If I’m FI, Now What?

As I figured out in my last post, I think the PiN household is financially independent (FI).

This leads to the next question: will I retire early(-ish), the RE in FIRE?

Although I wasn’t sure about financial independence until I calculated our numbers for 2024, I have had a strong suspicion since the spring of 2024, when my taxable investment account hit, and then blew by, a very interesting round number. For several months, I have been kicking around the idea of stopping work vs. cutting back vs. continuing as I am.

With the financial excuses for why I can’t retire yet out of the way (mostly), I now have to seriously consider whether what I get out of work is worth what I give up to practice medicine.