Medicine – Physician In Numbers

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?

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.

BOARDS Are Coming!

I’m not sitting my repeat specialty boards for a few more weeks, but I’m finding that I have less time to blog these days.

Lava coming down a mountain with billowing clouds. Two small figures look at the lava pool. The bay of Naples is seen on the right. — What my life feels like right now

I will likely continue publishing my Friday Fitness posts, but the Monday posts may need to go on hiatus until April.

See you on the other side!

Pick Your Poison

You may or may not know that US physicians are no longer board certified for life.

Anyone who passed their boards after 1990 has needed to pass more exams (with associated costs and time off of work) in order to stay current.

4 Pieces Of Advice For Those Starting Internship

Another school year has come to an end.

Graduations are pretty much done.

That means the first days of internship are approaching fast.

I thought a few pieces of advice, and encouragement, might be appropriate at this time. As I prepare to meet my new interns on my next rotation through the hospital.

Lessons Learned From My Spending As A New Attending

Match Day has come and gone. It’s time to think about next steps as everyone still in training moves on to the next level.

Fourth year medical students know where they will be going in June.

Residents who are going on to fellowship have known about their next destination for a few months.

Those finishing training in 3 months will (hopefully) be moving on to a practice that excites them. And pays a lot more than a resident salary.

The move from resident to attending salary holds plenty of opportunity: to spend more, to save more, to make plans that can affect your financial life for years to come.

When I graduated residency, I did not have a very clear plan for my finances. There really wasn’t much out there to guide people who were going to see a large increase in income.

I muddled along, making some good moves, and some not-so-good moves. I periodically look back at the choices I made, and I thought I might share some lessons I take away from my spending at that time, in the hopes it helps you make your own plans (or maybe let you know you are not alone if you have made similar choices yourself).

When You Are Ready, You Will Know

I have been thinking a lot about cutting back at work.

The conditions at work have been going downhill (not enough staff, some issues with the physical plant), and I have been tired, and I have other interests I would like to have time to pursue. Some of my patients are not always pleasant to deal with.

On the other hand, I have some patients whose names on my schedule make me smile with anticipation. I love seeing them for their yearly or twice yearly visits.