Doctors and retirement

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
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Toons
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Re: Doctors and retirement

Postby Toons » Sun Jan 08, 2017 2:39 pm

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"One does not accumulate but eliminate. It is not daily increase but daily decrease. The height of cultivation always runs to simplicity" –Bruce Lee

cookymonster
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Re: Doctors and retirement

Postby cookymonster » Sun Jan 08, 2017 2:49 pm

afan wrote:One need not travel to get CME for MOC. Nearly all professional societies offer CME online. If you belong to your specialty societies you have already paid for this. One could get 50 hours per year by investing the time, but never leaving home. Go to one or two national meetings a year and actually participate, not hang out at the beach, and you could get almost all your CME without travel.

People who do not keep up are dangerous. It would be better if you could get CME for reading your journals every week, but no one has figured out how to police it to prove it happened.

For those who teach, they contribute a lot more than 50 hours of instruction every year, but usually that does not count.

MOC is not a scam. But self assessment is silly and a waste of time. Again, one needs a way to prove one is staying up to date.

The president of my board makes $843,000 a year (4.5x what the average doctor in my field makes) and does not do MOC. It is ridiculous to suggest that MOC is motivated by anything other than greed. If they really gave a hoot about patient safety they would not "grandfather" doctors who are most removed from their training, and thus in most need of "staying up to date." Of course they have to present it as essential for patient care for it to be mandated by payers and employers.

On the approved CME activities for my specialty that I do, the answers to the multiple choice questions are actually listed (in small upside-down font) at the bottom right of the test. I wish I were kidding. These aren't supposed to actually take a lot of time or accurately assess your knowledge. They are just coming up with creative ways to fleece us out of our money that most of us aren't going to bellyache over as long as they're easy and relatively painless. MOC is an expensive waste of time that teaches me nothing, and I try to get through those activities in as little time as possible so I can spend time on non-approved activities that are actually instructive.

mac808
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Re: Doctors and retirement

Postby mac808 » Sun Jan 08, 2017 4:34 pm

From what I've seen in my own family the main advantage doctors seem to have is job/income security in that they are rarely unemployable, which allows the fiscally prudent ones to chug along for 30 years, through market disruptions, recessions, depressions, and other macroeconomic ups and downs, and end up comfortable with less variability than other professionals might experience.

toofache32
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Re: Doctors and retirement

Postby toofache32 » Sun Jan 08, 2017 5:30 pm

mac808 wrote:From what I've seen in my own family the main advantage doctors seem to have is job/income security in that they are rarely unemployable, which allows the fiscally prudent ones to chug along for 30 years, through market disruptions, recessions, depressions, and other macroeconomic ups and downs, and end up comfortable with less variability than other professionals might experience.


Most physicians are employees these days.

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Artsdoctor
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Re: Doctors and retirement

Postby Artsdoctor » Sun Jan 08, 2017 8:02 pm

Quite a meandering thread. Everything from retirement planning, MOC, patient expectations on how many hours a week/month a physician should work . . .

Editing out all of the tangential thoughts and emotions, doctors are like anyone else. At the end of the day, it's all about expenses. How much are your expenses now and how much will they be in retirement (when the income stops). Take a look and see what would make you happy. Would you be happy to live on $75,000 per year? $175,000 per year? $250,000 per year? More? We're not like anyone else in that regard. Once you figure out how much you need, you try to guess how much you'll need.

What's with all the judgment here? Does it really matter if you're a doctor, an attorney, a successful business owner, a CEO?

Cruise
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Re: Doctors and retirement

Postby Cruise » Sun Jan 08, 2017 11:34 pm

qwertyjazz wrote: MOC is great in theory but no psychometrics behind it -


It is only psychometrics if is for psychiatrists. All others have metrics. :happy

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unclescrooge
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Re: Doctors and retirement

Postby unclescrooge » Mon Jan 09, 2017 7:24 am

afan wrote:
lthenderson wrote:...more than half the doctors now work less than six months a year....


I would not want a doctor who practiced six months a year taking my blood pressure, let alone delivering medical care. Either you take it seriously, putting in the time and effort to be excellent, or you should retire. Maybe flip burgers or something, but not take peoples' lives in your hands.


Many hospitalists jobs are set up such that the physician works 7 days on and 7 days off. This is effectively 6 months a year, but it's not like they're goofing off for 6 months straight.

qwertyjazz
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Re: Doctors and retirement

Postby qwertyjazz » Mon Jan 09, 2017 8:25 am

Cruise wrote:
qwertyjazz wrote: MOC is great in theory but no psychometrics behind it -


It is only psychometrics if is for psychiatrists. All others have metrics. :happy


How about psychometric vs psychotic metrics? You would have to be psychotic to believe they are any good
G.E. Box "All models are wrong, but some are useful."

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JDCarpenter
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Re: Doctors and retirement

Postby JDCarpenter » Mon Jan 09, 2017 8:45 am

We are OBG/JD couple retiring this year in mid-50s. High compensation as a couple and we have been blessed with careers that we truly enjoy. In return we have taken, max, three weeks off in any year since DW started private practice in 1990. Combination of our jobs has always made coordinating vacations a challenge; thus, only three trips of greater than one week in that time. She has been in practice with 1 to 3 partners over the years, so has had the typical small practice OB night and weekend duties (last week was the latest 36+ hour no sleep stretch). For the past 8 years, we average maybe 10 weekends a year where neither of us is working--and my job tends to have "emergencies" popping up from clients with little warning. Luckily, we both enjoy what we do and will miss many aspects of it...

Those desired portfolio numbers don't shock me. Our retirement spending is going to be a good bit higher than our after-tax (and after-contribution/savings) spending while working. Basically a whole bunch of delayed gratification. :happy First decade of retirement is planned to be our opportunity to spend quality time together while seeing, experiencing, and doing the things we've put off. (Remember that movie "Up"? We started clipping destination articles in the early 90s....) Selfish and self-indulgent? Maybe, but that's what we want and what we have been planning for since before we had children.

Given our ages, her likely longevity, our desired/discretionary spend rate, and the difficulty either of us would have in getting back into this level of compensation once we leave, it would be imprudent to not have a wide margin of safety.
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arsenalfan
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Re: Doctors and retirement

Postby arsenalfan » Mon Jan 09, 2017 9:12 am

Comparison can cause much unhappiness.
Last edited by arsenalfan on Mon Jan 09, 2017 9:29 am, edited 1 time in total.

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lthenderson
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Re: Doctors and retirement

Postby lthenderson » Mon Jan 09, 2017 9:12 am

afan wrote:
lthenderson wrote:...more than half the doctors now work less than six months a year....


I would not want a doctor who practiced six months a year taking my blood pressure, let alone delivering medical care. Either you take it seriously, putting in the time and effort to be excellent, or you should retire. Maybe flip burgers or something, but not take peoples' lives in your hands.


There is a joke I've heard that asks what you call the person who just barely passed their medical exams? Doctor. I'm not one but I certainly recognize that not all of them are the same and some of the ones who only practice part time in my wife's practice are better than some that are full time. I should also note, none of them take six months straight. Some work one month take one month off and the rest work two and a half days a week.

On a related note, doctors working part time are part of a huge problem in my wife's practice. They have full time nurses and other associated staff which increases overhead dramatically when the doctor is not at work. If it were me, I force them to pair up so that their full time staff actually has full time work year round while one of them is gone.

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Sandtrap
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Re: Doctors and retirement

Postby Sandtrap » Mon Jan 09, 2017 10:12 am

arsenalfan wrote:Comparison can cause much unhappiness.

+1

travellight
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Re: Doctors and retirement

Postby travellight » Mon Jan 09, 2017 11:50 am

sambb, thanks for this very gracious sentiment:

"You gave up the best years of your life, from age 18-35 in libraries, studying, and working >80 hours a week in residencies so you could save my life."

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gasdoc
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Re: Doctors and retirement

Postby gasdoc » Mon Jan 09, 2017 3:12 pm

travellight wrote:sambb, thanks for this very gracious sentiment:

"You gave up the best years of your life, from age 18-35 in libraries, studying, and working >80 hours a week in residencies so you could save my life."


+1. How refreshing!

gasdoc

monsterid
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Re: Doctors and retirement

Postby monsterid » Mon Jan 09, 2017 3:23 pm

gasdoc wrote:
travellight wrote:sambb, thanks for this very gracious sentiment:

"You gave up the best years of your life, from age 18-35 in libraries, studying, and working >80 hours a week in residencies so you could save my life."


+1. How refreshing!

gasdoc


+1. Amazing sentiment.

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PhysicianOnFIRE
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Re: Doctors and retirement

Postby PhysicianOnFIRE » Mon Jan 09, 2017 5:01 pm

Anesthesiologist here. I commented on the WCI thread the OP mentioned. Nearly a year ago, I said I was shooting for $3 Million to $4 Million. This week, I modified that goal to less than $2.5M to $2.8M based on a year of actually tracking expenses and figuring out our "sweet spot." I don't want to regret working too long or retiring too soon, or at least I'd like the likelihood of regret to balance out.

Out of curiosity, I calculated the time it would take to reach $10 Million at my current savings rate. Working full time, it would be another 11 to 24 years at a CAGR of 2% to 10%, or age 52 to 65. Working half time, it would take 14 to 44 years depending on returns (again using 2% to 10% CAGR).

:beer
-PoF

p.s. I won't be working part time 44 years from now. 4 years, maybe. :)

LateStarter1975
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Re: Doctors and retirement

Postby LateStarter1975 » Tue Jan 10, 2017 9:15 am

arsenalfan wrote:Comparison can cause much unhappiness.


This
Debt is dangerous...simple is beautiful

bigred77
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Re: Doctors and retirement

Postby bigred77 » Tue Jan 10, 2017 9:45 am

It does not shock me at all. I am not a doctor and our household income is just a touch under 200k per year. I am aiming for 5M-10M in retirement (closer to 10M, and I'm talking in nominal dollars assuming 2%-3% inflation in roughly 25 years). Saving 25% -33% of our income, which can be done without even maxing out all of our tax advantaged space, and getting an 8% nominal (5% real) return from a 75/25 portfolio will get us there right around 55 years old.

My brother is a doctor (a resident actually). For him to get to the same place, he will have to do more of the heavy lifting via brute force savings. I actually did see the benefit of being able shove money into retirement accounts at age 23. He will be lucky as he's going to probably have his student loans completely paid off before he becomes an attending. Just getting to start from 0 is a huge benefit for him.


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