Docs Who Cut Back #5: Wealthy Doc

crispydoc Uncategorized 15 Comments

Wealthy Doc was possibly the first physician finance blogger, generously helping us learn financial literacy back when Al Gore had barely invented the internet.

In those days, the White Coat Investor had not yet started his blog, skinny ties were all the rage, and we docs were doing stupid things with our money.

Nearly a decade later, WCI might clear a million dollars on his blog alone this year, skinny jeans are all the rage, and we docs continue doing stupid things with our money.

I had the pleasure of meeting Wealthy Doc at FinCon18, and was struck by his intensity and passion for serving to others – he’s a workaholic with his heart in the right place. As his story will demonstrate, sometimes a physician’s deep commitment to making the world a bit better can unintentionally create resentment when the family feels they are paying the price for a doctor’s good works.

1a. How old were you when you began to cut back?

I cut back to three days a week at age 50.

1b. How many years out after completing training was this?

I worked full time for 20 years in clinical medicine.

2. What did your parents do for their livelihood?

My mother “stayed at home.” My Dad worked odd jobs in sales or as a DJ but never made much money.

2b. Would you characterize your upbringing as financially secure or insecure?

Well we were dirt poor, so I guess that means I was “financially insecure!” My dad liked to point out that I had food in my belly and a roof over my head and thus was better off than much of the world’s population. He encouraged us to be grateful for everything we have and so I didn’t realize how destitute we really were.

2c. How did your upbringing affect the money blueprint you inherited – both positive and negative?

Positive – That focus on gratitude makes me appreciate life as I live it. I know I can survive on little. I determined when I was a teenager that I wouldn’t grow up to be destitute, so it provided me a drive to learn, grow, and make prudent financial decisions.

Negative – I still have a burning drive within me. If I’m honest it may keep pushing me beyond what is needed. Why do I keep adding to my retirement plans when a CFP told me I will likely never need to spend money from my traditional retirement accounts let alone all my Roth money? I like to think it is my devotion to service and productivity, but maybe some is out of fear of becoming impoverished again.

3. What motivated you to cut back?

Multiple factors came together:

  1. I realized I had reached FI and didn’t need to keep pushing so hard.
  2. I became a bit disillusioned with my administrative roles of my job (then 30% of my time).
  3. My wife and I had health conditions that needed more attention and time.
  4. In retrospect I was also heading into burnout but didn’t realize it at the time.
  5. The last straw was some of the heartbreaking quotes from my family, such as:

From my wife: “I feel like a single mother!” “Even when you are here, you are not here!” “What days will you be here for dinner this week?” “When will things get better for us?”

From my kids: “Daddy I love you and miss you.” “I will see you tomorrow if you are here and not at work!” “Yikes you scared me, what are you doing here?” (Quote at 5:30 pm during the week).

4. What were the financial implications of cutting back?

There were changes, but nothing significant. We live on so much less than my salary that we literally didn’t even notice the pay cut. My income went down, and my benefit costs went up but I also pay less income tax. I have more time to boost my other investments, so things are fine for us. I may ultimately end up with fewer millions later in life, but maximizing wealth to huge numbers has never been a goal of mine.

4b. Did you downsize home or lifestyle?

Nope, not at all.

4c. Slow your progress to retirement? Describe your thought process in making these tradeoffs.

Nope. I’m FI. My wealth would likely continue to grow even if I stopped working completely.

5. How did colleagues react to your decision?

With shock and surprise. I’m known as a workhorse, so they were concerned I had gotten demoted or was facing imminent disability or retirement. I mean who voluntarily takes a big pay cut? There must be more to the story. Once things stabilized and became reality some jealousy has appeared. Others are wondering if/how they could do something similar.

5b. How did you respond?

I reassured them that I wouldn’t be significantly reducing my clinical work. I dropped three separate medical directorships that were taking a lot of my time and making for long days. I also found and helped hire another doctor to keep growing our practice.

5c. Was your family supportive or critical? Partner? Parents? Children?

They didn’t believe me. Literally. I have apparently talked about cutting back for awhile but didn’t have the guts to do it. They didn’t think I knew how to say the word “No!” I had to show them with actions rather than tell them what I was going to do.

6. What have been the main benefits of your decision to cut back?

Lots of benefits! Mostly, I feel like a human being again. I feel more connected to friends and family. In retrospect, I may have been heading for burnout or divorce – since work had crowded out other important things in my life. That pattern wasn’t sustainable. I’m so glad I made the change when I did.

7. Main drawbacks?

The transition has been slower and more difficult than I thought it would be. I wasn’t used to unstructured time. I mean what does a doctor do when not seeing patients? It isn’t that I get bored. Far from it. Actually, the opposite. It is just that other people know I’m “off work” that day and think nothing of expecting me to be available for some activity. Being in clinic at 1 pm on a Wednesday is a socially acceptable way of not being somewhere else. It can be a challenge to juggle my priorities with those of work and family.

8. Did you fear your procedural or clinical skills might decline? How did you address this concern?

No, since I still do almost as much clinical work. I consolidated my clinic hours and dropped all of my administrative roles to allow me to work only three days a week. I have more time for CME now.

9. If you are honest, what percent of your identity resides in being a physician? How did cutting back affect your self-image, and how did you cope?

Probably more than I would like. Maybe 80%. I’m still a doctor who sees patients though. If I gave it up completely it would be more of an issue. This transition period is allowing me to develop the other parts of me and my identity. I did give up my medical directorships and that has been harder than I thought. I’m glad to not have to sit in passive 2-hour 7 AM meetings, but I miss the comradery of other physician leaders. I used to be the “boss” and making decisions. The new practice medical director politely reminded me recently that I’m no longer medical director. I had been responding to issues that I no longer should be dealing with. I am still learning to stick to just clinical issues that affect my patients and let the new leadership do the rest.

10. If you had not gone into medicine, what alternate career might you have pursued?

I had a friend who taught scuba diving as a dive master. He had a condo on the ocean in Ft. Lauderdale. That sounds awesome right now. Realistically though given my interests and personality, I would enjoy being an investment analyst or CFP/CFA.

11. What activities have begun to fill your time since you cut back?

Unstructured time was a foreign concept at first. As a clinician or administrator my time was always booked solidly. Initially I was not well-organized with my time and didn’t make the best use of it. Now I have clearer priorities and use digital calendars and To Do Lists to keep me on track. Filling time isn’t difficult. Making sure I’m not wasting time is more my focus.

I organize my activities around my 4-5 highest priorities that are consistent with my values. Currently they are: to be more supportive at home; to work on my own health, fitness, and happiness; to be more productive at work when I am there; to build my multiple passive income streams; and to maintain my blog.

12. If approaching retirement, what activities have you begun to prioritize outside of medicine so that you retire to something?

I’m not sure I’m approaching retirement, but I am enjoying part-time work. It is sustainable to me if it continues to be an option with my employer. I am enjoying a lot of activities outside of my clinical practice. I’m volunteering more, active in our church, teaching medical students and residents, improving my blog, going to conferences, improving my health and reconnecting with neglected relationships. It feels wonderful. I still enjoy my work, but it is just a part of my life now, not a substitute for a life.

13. Did you front-load your working and savings, or did you adopt a reduced clinical load early in your career? What was the advantage of the route you chose? What would you do differently if you were graduating residency today?

I wouldn’t change a thing. It all worked great. I didn’t have a grand plan and wasn’t in a hurry to retire or maximize profits. I took plenty of days off, vacations, and CME trips. I didn’t kill myself with extra call or moonlighting to make extra money. I focused on paying off debt and maximizing retirement funds early. I invested any “extra” money like raises and bonuses. I didn’t miss what I never spent. I continue to spend a little more each year, but never had a huge jump in spending. I spent five years in academia and made a lot less but have no regrets about that either. There is much more to life than money. Besides if you are frugal and make reasonable choices you will do well after 20 years in medicine. Physicians in the U.S. are paid very well (currently top 5% and up) in almost every specialty and location.

You can find Wealthy Doc at wealthydoc.org, and follow him on twitter at @Wealthy_Doc.

Observations on Wealthy Doc’s story:

  • The workhorse archetype is immediately recognizable. Wealthy Doc is the first I’ve met who stopped before an external crisis (MI, divorce) forced his hand – no small feat.
  • His ability to ignore colleagues’ reactions is a key trait of folks who can pull this off. His outsider identity allowed him to write his own story.
  • The first responsibilities Wealthy Doc dropped were the shiny brass rings of medicine – three medical directorships! Medicine fetishizes prestige and promotions. WD’s honest accounting revealed them to be the ballast that kept his balloon from soaring. Pursue purpose over prestige! [Sounds like a t-shirt waiting to happen, Accidental Fire]
  • For those of us with families, medicine can be a jealous mistress. The pleas from WD’s wife and kids likely sound familiar to many of us; we ignore them at our peril.
  • “I still enjoy my work now, but it is just a part of my life, not a substitute for life.” May we all reach this inflection point sooner rather than later.

Comments 15

  1. Excellent write up about Wealthydoc. I enjoy these “here is what I did” rather than “it’s my way or the highway”.

    Wealthdoc gives a clear approach to what sounds like a nice career path.

    Fortunately in Canada, many of us laugh at “promotions”. Most of us do not give a wit about any of it. The few who do, spin around in their own little worlds all by themselves.

    1. I remember one mandatory 7 AM meeting that was a turning point. I was tired. I skipped my normal meditation and exercise. I didn’t spend time with my kids. I raced to work. About 2 hours into the meeting I was still sitting in the conference chair passively listening. I looked around at the tired faces of physician leaders. Many looked stressed and not in the best shape. That vision and realization helped crystalize my decision to drop the admin part and go to part-time.

      1. Post
        Author

        Your story is incredibly relatable, WD. My wife and I began our careers with academic aspirations, and it was precisely what you saw – a lack of role models whose lives we’d want to emulate – that prompted our decision to take an alternate track. We miss the teaching, the residents and the intellectual rigor – but our experience uncovered as much pathology among the successful academicians as there was among the patients.

        I’m so glad you veered away before hitting the brick wall.

      2. I had a similar epiphany in one of those meetings. All of the the Admins were earnest about solving the problem du jour, the Hospital-employed docs were just killing time, and I was fuming as my work was piling up, my cellphone was exploding, and I wanted out of there.

  2. I hardly think to go to WD website I should go more. I just read a great article on SS over there. I think this interview is a prime example of how you can tailor your life in medicine. Rather than divorce your wife you have to divorce your obsession with maximizing income by moving out of the tail of the bell curve to some place more rational, or you will have an MI and the decision will be made for you. Might just as well build it into the plan. I think too many are bang bang in their careers. They either are balls to the wall earners or trying to make it on $15K per year from a blog with the belt so tight the eyeballs are bugging out. It’s not either or. If you hate your practice figure something out. I did, then I got old and pulled the plug. In the mean time I had a GAS.

    1. Thanks for the kind words about my blog. I try to write just very high-yield content. You are not alone in forgetting to go there. As Jim Dahle has pointed out I “suck at marketing!”
      I have noticed a diminishing utility with higher incomes. My first few salary doublings boosted my subjective well being a lot. $15K to $30K was huge. $30K to $60K helped. $60K to $120K was amazing. After that subsequent doublings had minimal effect on my life. I mostly just paid a lot more taxes.

  3. Excellent interview WD and another great addition to the series CD.

    You are right that there are certain physicians that want to get titles like medical director to have even greater prestige in the community. Having gotten to that level, it is even more impressive that you withdrew from it but it probably saved you your sanity.

    People have pushed me to go on the medical board of directors but I know a few colleagues who basically got eaten up and spit out by that process. For me it’s a bit of ignorance is bliss how I practice medicine. I do not think I would enjoy knowing more of the machine even if it did carry prestige.

    1. Being a physician leader wasn’t all bad. I made great friends and learned a lot. I also was given more influence than I probably deserved. If the hours were more manageable I might have continued. When I was looking to cut back on my hours, the admin work was the obvious choice. Particularly because in order to accommodate physician leaders most of the meetings are before or after an already long workday.

  4. Another excellent post in a fascinating series. As I sit here in an ED reading this at 2AM, I can’t help but think that Crispy and Wealthy Doc are onto something.

    I think this interview may have been your most compelling case for cutting back yet. Although I actively flee from admin roles, I otherwise identify with WD’s drive. My wife and kids wouldn’t believe I was cutting back unless they saw it with their own eyes.

    Thanks Wealthy Doc for once again setting a good example for the rest of us!

    1. Post
      Author

      Workaholism is a pathology with utility. It’s hard to treat because the patient can point our benefits (Greater opportunities conferred on the progeny! Perks and luxuries! Financial security!) where the family derives benefit in spite of the pathology. The puritan work ethic further extols disease as virtue.

      I’d consider starting the inaugural chapter of Workaholics Anonymous, but I know how it would go: nobody would show up – they’d all have a little bit of extra work to catch up on.

    2. Thanks for your kind words, SideHustleScrubs
      I definitely had to prove it to my family with my actions that this time I meant business and was really cutting back.
      My life is definitely more enjoyable and balanced. I took a pay cut. But as PoF and others have pointed out those highest marginal dollars are basically the work hours when I’m paid the least. Your employer won’t point out to you that you will be taking home less and less per hour with each extra promotion or role at work.

      I also have more time to build up my passive and portfolio income streams. That is all going much better now than ever since I have more time.

      Again, it isn’t all about the money at this stage in the game. I spend more time working out, sleeping, volunteering, teaching, mentoring, etc. But it is nice to know that the financial hit is minimal when taken into the whole context of taxes and time for investing.

    1. Thanks, B,

      This has been a great series that CD put together.

      We doctors are used to following a “cow path.” Get good grades. Go to college. Take science courses. Get into medical school. Get a good residency and a good job.

      If later, we want to do something a little different or if we are overwhelmed and need a change, it helps to know some people and read stories of mentors or colleagues who have done it.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.