Docs Who Cut Back #12: Dr. McFrugal

crispydoc Uncategorized 11 Comments

Dr. McFrugal is an anesthesiologist and fellow physician finance blogger who has distinguished himself as my favorite purveyor of food porn – I’ve never seen a photo of one of his plant-based meals I didn’t immediately want to put a fork in. He espouses minimalism, frugality, and the selective pursuit of luxury that provides his family pleasure out of proportion.

I had the privilege of meeting him in person at FinCon18, where he boldly brought a neonate to the conference. (Thanks to the 24 hour party run by the Waffles On Wednesday beneath a giant inflatable flamingo, Dr. McFrugal and his wife still managed to look better rested than most docs in attendance.)

Like the Loonie Doc before him, this interviewee is another example of someone who “cut back” to full time, in this reducing a 65 hour work week to the more sane 40 hours a week.

1. What is your specialty, and how many years of residency/fellowship did you complete?

I’m an anesthesiologist who also practices interventional pain management. I completed four years of residency in anesthesiology and an additional year of fellowship in pain management.

I’m 35 years old, and I just started cutting back in the Spring of 2018 after my first child was born, about four years after completing training.

I need to be up front about one thing though. My idea of cutting back is working 1 FTE (full time equivalent, which is essentially working a 40 hour work week). Currently, my hours are about 7 AM to 3 PM, Monday to Friday. I may pick up one or two weekend or night shifts a month, but not much more.

This is a significant decrease from about 65 hours a week, which is how much I was working four years ago. Hence, I have “cut back”.

2. What did your parents do for their livelihood?

My dad was a pharmacist and my mom was an accountant. Both retired about five years ago and are enjoying life. Currently, they spend a lot of their time traveling.  

I would characterize my upbringing as financially secure. Both of my parents were relatively frugal people. They were classic savers and not spenders. My sisters and I never really had to worry about money.  

More importantly, my parents always made time for us and were always there when we needed them. For example, if we needed help on our homework, my parents would be there to guide us. They were always there for our sporting events, concerts, recitals, graduations, and any ceremonial milestone events in our lives. No matter what, my sisters and I knew that we could count on them for love and support.

Through my parents, I came to understand that while money is valuable, quality time spent with loved ones is even more important. This is especially true if you have “enough” money. Because of this, my upbringing had a very positive effect on my money blueprint, and on life in general.

3. What motivated you to cut back?

Family is the biggest reason why I cut back. My parents were always available when I was a young child and I want to be the same kind of parent for my child(ren).

Cutting back allows me to help my wife raise our daughter. Being a parent can be tough, especially if you have to do it all by yourself. That’s a scenario I did not want my wife to be in. My goal is to be a present husband and father.  

Health was also a big motivator for me to cut back. It’s not like I was totally unhealthy while working 65 hours a week. But regularly working nights and long hours increases your stress load, which can take a toll on your health in the long run. It can also lead to burnout. I didn’t want to become burned out or develop an unhealthy lifestyle. Cutting back just made a lot of sense.

4. What were the financial implications of cutting back?

Interestingly, there were no financial implications from me cutting back. In reality, I’m probably making more money now working 40 hours a week compared to three years ago when I was working 65 hours a week. The only major implication is a huge gain in time.

Sounds strange, but it’s true. Allow me to explain.

But first, a bit of a backstory.

Throughout residency and fellowship I was used to working about 65 hours a week. Meanwhile, I was frugal enough to live on half of my resident’s salary, which is not easy to do in Los Angeles, a high cost of living area. After maxing out my retirement accounts, all of my extra cash went directly to paying off my student loans.

Once I found a job after fellowship, I was determined to earn enough money to pay off my student loans completely in two years. In addition to that, I was also able to earn enough for a down payment on a house. It wasn’t easy. I did it by continuing to live frugally and working many hours. During the first three years I worked about 60-65 hours a week, which is what I had been used to in residency. All of this happened during my first three years of working as an associate physician at a relatively lower pay rate.

Now that I am a partner physician, my pay rate has increased significantly. On top of that, there was a pay raise across the board for all physicians in our medical group. And finally, I just started earning an extra stipend for my sub-specialty in pain management. All this considered, that is why I am currently making more money now at 40 hours a week compared to four years ago when I was working 65 hours a week.   

We didn’t have to downsize our home or our lifestyle at all. In fact, in many ways it has become slightly inflated. We still live a relatively frugal lifestyle and manage to spend on select luxuries, such as travel.

5. How did colleagues react to your decision?

Actually, my decision was well-received. Many of my colleagues expected me to cut down my hours. They thought that working 60 hours a week (1.5 FTE) is not sustainable and would eventually lead to burn out. I certainly did not get any push back at all when I decided to cut back.

My medical group has hired a lot of new physicians lately. Many are under 40 years old like me. In general, the younger physicians value work-life balance a bit more compared to the more senior physicians. That said, all of my colleagues were very understanding. Those who appreciate a great work-life balance could relate because they have similar values. And those colleagues who want to work more saw my “cutting back” as an opportunity to pick up extra shifts and work even more.

5b. Was your family supportive or critical?

My wife was overwhelmingly supportive of me cutting back. She always wants to spend more time with me and she really appreciates having me home to help take care of the baby. She totally wouldn’t mind if I left work and stayed home with her all the time!

The baby isn’t able to verbally express her appreciation for me spending more time with her. But I’m sure (or at least hope) she’ll thank me later when she’s older.

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

I’ve realized many benefits by cutting back including:

  • Spending more time with my wife and baby. This is time that I can never get back.
  • Getting more quality sleep, which is vital to overall health and wellness.
  • Having more time for hobbies such as reading, blogging, exercising, etc.

7. Main drawbacks?

I can’t think of any real drawbacks.

I guess if I had to pick one, it would be that I am giving up the opportunity to make even more money. But this isn’t a real drawback to me.

Once you have “enough” money, every subsequent dollar you earn becomes less valuable. Not only is every additional dollar that I earn taxed at a higher rate, those dollars become unnecessary after having enough money. Because of this, the opportunity cost of earning more money is not a real drawback.

8. Did you fear your procedural or clinical skills might decline?

Not at all. At 1 FTE, I’m still doing enough procedures and working to the point that I do not think my skills will decline.

In many ways, I think it may even help prevent the decline of my skills. This is because by cutting back (and not becoming burned out), I can better maintain my health and the mental acuity necessary to perform at a high level. In addition, cutting back will help me maintain my zeal and passion for medicine, which would likely translate into me being a better doctor.

9. If you are honest, how much of your identity resides in being a physician?

Being a physician is a big part of my identity. But it’s certainly not everything. More and more of my identity resides in being a husband and father, especially after cutting back. And I’m totally fine with that. My family is, and always will be, my top priority.

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

This is a tough one. If I had not gone into medicine, I probably would have pursued a career in pharmacy like my dad.

Another alternative career I might have pursued would be a travel advisor, agent, consultant, or anything related to travel.

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

Since cutting back, most of my free time has been spent helping my wife take care of the baby. Like I mentioned earlier, parenting can be tough. So I try to give my wife a much needed break from caring for our daughter. When I’m home, I play with the baby, read to her,  and change her diapers.

I have also had more time to exercise, stretch, and meditate.

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

I’m definitely not approaching retirement yet since I plan to work another 20 years or so. While I’m forecasting that we could be financially independent in five years, I am not planning to retire early.

When I do approach retirement, I think it would be an easy transition. I imagine slow traveling with my wife throughout different parts of the world.  

13. Did you front-load your working and savings, or did you adopt a reduced clinical load early in your career?

As mentioned in a previous question, I absolutely front-loaded my working and savings very early in my career (as early as residency).

The biggest advantage of this route is that I paid off my student loans very early. Nowadays, the average medical student graduate has about $200,000 in student loan debt. Psychologically, that is very daunting.

In addition to paying off my loans, front-loading my working and savings allowed me to develop the discipline and habits for future financial success.

I wouldn’t do anything different if I were graduating residency today.  

A few observations about Dr. McFrugal that might be instructive for the rest of us:

  1. He leveraged the benefit of a higher paying sub-specialty at the cost of an additional year of training. That extra year paid a nice dividend in increased salary, helping him to cut back without significant financial sacrifice. In many fields, sub-specialty training can offer either a higher income or an extended runway at the end of a career. I recall a conversation with a friend from residency who did a dual residency in EM/IM that cost him an extra year of training because he considered IM his exit strategy from possible burnout in EM.
  2. Dr. McFrugal obliterated his educational loans as a first priority. He front-loaded his debt elimination to great effect, allowing subsequent years’ earning to go completely toward wealth accumulation.
  3. By continuing to work resident hours as a young attending, he leveraged his human capital (the gifts of youth and extraordinary stamina).
  4. He timed his reduction to coincide with the birth of a child. Seldom does life conform to plans this neatly, but that’s no excuse not to think ahead. When such plans do come to fruition – what an impact!
  5. Selective luxury spending has allowed a high quality of life with overall low costs despite a high cost of living area.
  6. For those so inclined, minimalism and frugality work in tandem to reduce expenses. The less you own, the less space you need , the lower the mortgage, the less space you have, the less you can own, and so on in a virtuous cycle.

Comments 11

    1. Post
      Author

      DMF,

      You are a great counterpoint to those of us who had to learn the lesson and play catch up in middle age to course correct. As a young person with a plan and an early commitment to financial literacy, you are a great example of what can happen when the moon lines up perfectly with Venus.

      Strategic debt reduction/elimination + higher than average earning specialty + remunerative subspecialty training + minimalism + work ethic + living like WCI’s proverbial resident in your first years out + understanding the nuances of the tax code (as it pertains to your wife qualifying for PSLF in law) + travel hacking has set you and your family up for an incredible string of successes.

      There’s no doubt you started with a winning lottery ticket (great parents who taught responsible money habits, great spouse on the same page), but your current position is just as much a direct result of what you did with the hand you were dealt. Many more have squandered what should have been winning hands.

      Thank you for showing what can be done when you come out of the gate motivated and eager to work hard.

      With gratitude,

      CD

  1. “Once you have “enough” money, every subsequent dollar you earn becomes less valuable.” — great quote. When I worked in engineering, there were many years I managed 80+ hour weeks and it was very hard to get out of, working for a small company and taking on big deadlines. I admire the way you are managing to cut back to 40. What a weird time we live in when 40 is cutting back, huh?

    1. Post
      Author

      Normal hours are the new black!

      Engineering is another field where overcommitment is the expectation and the norm.

      It is amazing how we can lionize a pathology with utility when it serves our overlords…

      Appreciate your stopping by and your generous support on Twitter, Susan!

      Fondly,

      CD

  2. I’m loving this series. It is great to learn a bit more about Dr. McFrugal.
    It is amazing how many have cut back and still work a full-time 40-hour workweek. Gee, I wonder why burnout is so high in medicine?

    Another thing I notice is most of those who have cut back say they “can’t really think of any” drawbacks to cutting back. That should be encouraging to others who are considering taking the plunge.

    1. Post
      Author

      Couldn’t agree more, Wealthy Doc. Once you achieve that FI threshold, the main drawback – earning less money – is no longer significant enough to dissuade you.

      Come on in, the water feels great!

      CD

  3. Honestly I think DMF probably had the best plan of us all from the moment he finished residency.

    He hit all the right things such as attacking student loans first and getting rid of them (a big mistake of mine not to) and work hard early when young and used to working as a resident to build capital and now prioritizing family life while still incredibly young.

    Cutting back will prolong your career and in the end will make more money over your work lifetime than working hard and killing yourself for a shorter period

    1. Post
      Author

      Xrayvsn, appreciate your insight. DMF is the us we might have been if we’d had our acts together at the outset instead of halfway through the game.

      I think DMF is an example of Evel Knieval (I checked, that’s really how he spelled it) when everything goes exactly right. You meticulously map out the ramp height and angle, determine some vectors, account for gravity, and practice religiously.

      Finally the day comes and you are able to jump the 20 cars, fly over the waterfall, and land your motorcycle ever so gracefully. This is the DMF success story – a difficult task pulled of with great foresight and effort but made to look simple to the outside eye.

      Most doctors try to accomplish the same outcome but with no planning, thumb in the wind and let’s hop on the bike. Is it a surprise that we end up as Evel Knievel in a body cast with multiple broken bones?

  4. I told my husband that if we don’t have enough money later we can work more when the kids are grown.

    Neither of us ever regretted taking time off when the kids were young. And we never missed the money either.

    We knew we would have only one kick at that can.

    I think it is healthy that we all support one another along our respective journeys.

  5. This is a great example of how some focused front-loaded effort for the first few years of practice can pay disproportionate dividends. Kid-timing can be different for different people and is a major influence. However, the concept of the “right start” can really apply to the first 5-10 years of practice I think.

    It may be 5 years for those who have young kids later. More like 10 years for those who have them early since it is difficult to be as intense with little ones around. However, it seems to be somewhere in the 5-10 years out in practice point where the adrenaline wears off.

    In a race, we used to call that the “free energy” and you can’t get it back later. Nicely done Dr. McFrugal. I think you have a commanding lead.

    -LD

    1. Post
      Author

      Appreciate the feedback, Loonie Doc.

      It’s encouraging when a wunderkind like DMF pulls off this sort of start to a career. It’s like Olympic downhill skiing, and despite the hazards DMF has successfully made every pivot around a flag so far. He’s riding that free energy all the way to the bank.

      Your kid-timing estimates gel nicely with my experience as well.

      Appreciate your stopping by,

      CD

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