Any retired boglehead doctors out there?

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hmw
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Re: Any retired boglehead doctors out there?

Post by hmw » Sat Dec 02, 2017 12:41 am

staythecourse wrote:
Fri Dec 01, 2017 10:00 am
hmw wrote:
Fri Dec 01, 2017 1:00 am
gasdoc wrote:
Wed Nov 29, 2017 9:19 am


Perhaps as you get into your 50's, and the call becomes truly onerous, you could sell some of it to any junior partners. There is always a price that can be negotiated. At some point, the money might entice a younger surgeon. Having just recently given up my call weekends for the price of $X,000 per weekend call day, I can tell you that just having the weekends off makes a big difference in both burnout relief and prevention, and in finding the time to get to know your spouse again.

gasdoc


I currently do about 15 ED calls a month but don’t get called in much. I will be happy if I can go down to 1 in 4 calls in the future but will require a job change. I actually spend lots of time with my wife and my son. I have dinner at home every night and always takes Friday pm off. I probably work 40 to 50 hours a week on average. I used to be in a larger group of 6 surgeons. Selling calls to junior partners didn’t happen in my old group. Seems to be more common among anesthesiologists, and ER docs.

I know there are quite a few physician BHs on this board. Does anyone know any part time surgeon who is not working as a locum?
Nothing is going to be as well paid as just doing the clinical work otherwise everyone would just quit clinical work. :D

Personally, the only surgery folks I have seen doing part time are those really old guys who just do the clinic stuff for the other surgeons which frees them up to be in the OR. I know a couple of orthopods like that. Of course, they were senior partners/ founders in their group so they could basically do whatever they wanted so not sure if other folks in the same group would be able to do the same when they get to that point.

Good luck.
[/quote]

I have heard some arrangement like semi-retired surgeons doing clinics only and feed the operative cases to the younger guys. I don’t know if the old surgeons just want to get out of house and do something or they really need the money. Honestly, doing clinics is the least favorite part of my job. I’d rather be operating. :happy

hmw
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Re: Any retired boglehead doctors out there?

Post by hmw » Sat Dec 02, 2017 12:44 am

TheNightsToCome wrote:
Fri Dec 01, 2017 10:43 pm
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm
White Coat Investor wrote:
Thu Nov 30, 2017 1:47 am
darrvao777 wrote:
Sun Nov 26, 2017 11:31 am
Not even close to retired (I'm aiming for another 30+ years of practice, health-willing)

But I've already opted to go part-time

I love what I do and I'm already in a lifestyle-friendly specialty. But I find going part-time further improves my quality of life. Hoping to stay healthy and happy enough to continue working
I have yet to meet a doc who regretted going part-time. In fact, most docs would be dramatically happier if they would just cut back to full-time.
"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
Maybe, but if you're a sub-specialist in private practice, then you have to be available to your referring physicians and patients or they will go elsewhere and you will be left covering overhead with no revenue.

If you're an employee, then you have to find an employer willing to hire you for 40 hours per week. That means a limited clinic and no call, but of course, an employer will always prefer to hire someone who will take call and a full clinic load--and there is always someone willing to do that because it is just the normal, expected workload.

It's possible for many specialties. I'm sure plenty of derm, Psy, and path physicians manage this. Any shift-based specialty can manage this (e.g., ER). But I don't know any cardiologists who have an arrangement like this, except for the occasional senior partner who works part-time for a limited period at the end of a career. Such opportunities are rare. They're just not available to anyone who wants the arrangement.
I agree with Thenightstocome on this one.

arsenalfan
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Re: Any retired boglehead doctors out there?

Post by arsenalfan » Sat Dec 02, 2017 1:01 am

Early 40s, 2MD couple. Both work 0.5 FTE starting this year. It is great. Kids are just finishing lower school; now free ALL weekends to coach and be around. I am a full partner x 10 years, and wife is an employee in a great group.

I see us doing this until our mid-50s. It's a very easy lifestyle, which lets us workout everyday, cook, and be around for homework/carpools, but still lets us afford an au pair & housecleaner for the mornings/scutwork of house management.

Once mid-50s hit, I think we'll sell the big house in HCOL area, and start some international medical travel before coming home to roost/help out with grandkids.

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Ruprecht
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Re: Any retired boglehead doctors out there?

Post by Ruprecht » Sat Dec 02, 2017 8:18 am

White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm
White Coat Investor wrote:
Thu Nov 30, 2017 1:47 am
I have yet to meet a doc who regretted going part-time. In fact, most docs would be dramatically happier if they would just cut back to full-time.
"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.

staythecourse
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Re: Any retired boglehead doctors out there?

Post by staythecourse » Sat Dec 02, 2017 9:31 am

hmw wrote:
Sat Dec 02, 2017 12:41 am
staythecourse wrote:
Fri Dec 01, 2017 10:00 am
hmw wrote:
Fri Dec 01, 2017 1:00 am
gasdoc wrote:
Wed Nov 29, 2017 9:19 am


Perhaps as you get into your 50's, and the call becomes truly onerous, you could sell some of it to any junior partners. There is always a price that can be negotiated. At some point, the money might entice a younger surgeon. Having just recently given up my call weekends for the price of $X,000 per weekend call day, I can tell you that just having the weekends off makes a big difference in both burnout relief and prevention, and in finding the time to get to know your spouse again.

gasdoc


I currently do about 15 ED calls a month but don’t get called in much. I will be happy if I can go down to 1 in 4 calls in the future but will require a job change. I actually spend lots of time with my wife and my son. I have dinner at home every night and always takes Friday pm off. I probably work 40 to 50 hours a week on average. I used to be in a larger group of 6 surgeons. Selling calls to junior partners didn’t happen in my old group. Seems to be more common among anesthesiologists, and ER docs.

I know there are quite a few physician BHs on this board. Does anyone know any part time surgeon who is not working as a locum?
Nothing is going to be as well paid as just doing the clinical work otherwise everyone would just quit clinical work. :D

Personally, the only surgery folks I have seen doing part time are those really old guys who just do the clinic stuff for the other surgeons which frees them up to be in the OR. I know a couple of orthopods like that. Of course, they were senior partners/ founders in their group so they could basically do whatever they wanted so not sure if other folks in the same group would be able to do the same when they get to that point.

Good luck.
I have heard some arrangement like semi-retired surgeons doing clinics only and feed the operative cases to the younger guys. I don’t know if the old surgeons just want to get out of house and do something or they really need the money. Honestly, doing clinics is the least favorite part of my job. I’d rather be operating. :happy
[/quote]

And there lies the rub. As you already know if you are going to be operating then you will be doing the call, doing in patient consults, and getting all the postop calls. Hard to have one without the other. Guess it all depends on how much you love it. Personally, I would rather be home with the wife and kids then in the hospital in any fashion. We have structured our lives that way. Both our parents were docs as well and don't fault them, but we never saw them and basically grew up with a father around. I understood, but refuse to allow my children to feel the same way when they get to my age.

I'm sure you will figure out a good medium. My advice, is keep networking and slowly dropping hints as you get to being 5 years from your exit and see if someone will bite. Just because it hasn't been done before doesn't mean it can't. When you are ready to slow down offering to do the part that most don't and occasional call would be advantageous for you and the group's finances.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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White Coat Investor
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Re: Any retired boglehead doctors out there?

Post by White Coat Investor » Sat Dec 02, 2017 11:07 am

Ruprecht wrote:
Sat Dec 02, 2017 8:18 am
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm
White Coat Investor wrote:
Thu Nov 30, 2017 1:47 am
I have yet to meet a doc who regretted going part-time. In fact, most docs would be dramatically happier if they would just cut back to full-time.
"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

DTSC
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Re: Any retired boglehead doctors out there?

Post by DTSC » Sat Dec 02, 2017 6:38 pm

White Coat Investor wrote:
Sat Dec 02, 2017 11:07 am
Ruprecht wrote:
Sat Dec 02, 2017 8:18 am
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm
White Coat Investor wrote:
Thu Nov 30, 2017 1:47 am
I have yet to meet a doc who regretted going part-time. In fact, most docs would be dramatically happier if they would just cut back to full-time.
"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.
I can't say I've seen too many part time primary care (IM and FP) doctors. I've seen plenty of patients defect from my partners, even if they took 3-4 weeks off after a medical illness. Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days.

HIinvestor
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Re: Any retired boglehead doctors out there?

Post by HIinvestor » Sat Dec 02, 2017 6:48 pm

One of my allergists and my dermatologist works P/T. I know a few P/T internists and some that fill in for other MDs when they go in vacation.

TheNightsToCome
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Re: Any retired boglehead doctors out there?

Post by TheNightsToCome » Sat Dec 02, 2017 8:15 pm

DTSC wrote:
Sat Dec 02, 2017 6:38 pm
White Coat Investor wrote:
Sat Dec 02, 2017 11:07 am
Ruprecht wrote:
Sat Dec 02, 2017 8:18 am
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm


"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.
I can't say I've seen too many part time primary care (IM and FP) doctors. I've seen plenty of patients defect from my partners, even if they took 3-4 weeks off after a medical illness. Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days.
"Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days."

Ditto for my cardiology practice. I've got "PDO" 12/1 and 12/4, but I need to log in from home, read stress tests, holter monitors, event monitors, and echoes, review labs and write orders regarding results as needed, and answer inbox messages from the nursing staff. I'll walk into a backlog of things piled on my desk on 12/5 despite this, and there is no way that I'll get through that day if I don't keep up with day-to-day chores on my "off" days.

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White Coat Investor
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Re: Any retired boglehead doctors out there?

Post by White Coat Investor » Sun Dec 03, 2017 1:04 am

DTSC wrote:
Sat Dec 02, 2017 6:38 pm
White Coat Investor wrote:
Sat Dec 02, 2017 11:07 am
Ruprecht wrote:
Sat Dec 02, 2017 8:18 am
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm
TheNightsToCome wrote:
Fri Dec 01, 2017 2:27 pm


"In fact, most docs would be dramatically happier if they would just cut back to full-time."

+1

Many don't have the option.
I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.
I can't say I've seen too many part time primary care (IM and FP) doctors. I've seen plenty of patients defect from my partners, even if they took 3-4 weeks off after a medical illness. Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days.
Really? FP and IM are pretty easy ones. I expected more challenges from general surgeons and cardiologists. I know LOTS of part-time FP and IM docs. Urgent care and hospitalist can do shift work. I've known many primary care docs on the mommy track working 2 or 3 days a week. As more and more of these jobs become employed, I think part-time is very doable there.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

bubbadog
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Re: Any retired boglehead doctors out there?

Post by bubbadog » Sun Dec 03, 2017 1:08 am

I work 3 days a week in occupational health. I have been doing that since age 42. I am never going back to 50-60 hours a week. I have gotten so lazy I am not even sure I could.

DTSC
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Re: Any retired boglehead doctors out there?

Post by DTSC » Sun Dec 03, 2017 7:31 am

White Coat Investor wrote:
Sun Dec 03, 2017 1:04 am
DTSC wrote:
Sat Dec 02, 2017 6:38 pm
White Coat Investor wrote:
Sat Dec 02, 2017 11:07 am
Ruprecht wrote:
Sat Dec 02, 2017 8:18 am
White Coat Investor wrote:
Fri Dec 01, 2017 8:58 pm


I disagree. Where there's a will, there's a way. You might not be able to work in your desired city or hospital or make what you want or need (based on your chosen lifestyle or debt burden) to make, you can work for 40 hours a week somewhere.
That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.
I can't say I've seen too many part time primary care (IM and FP) doctors. I've seen plenty of patients defect from my partners, even if they took 3-4 weeks off after a medical illness. Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days.
Really? FP and IM are pretty easy ones. I expected more challenges from general surgeons and cardiologists. I know LOTS of part-time FP and IM docs. Urgent care and hospitalist can do shift work. I've known many primary care docs on the mommy track working 2 or 3 days a week. As more and more of these jobs become employed, I think part-time is very doable there.
I should have qualified my remarks a bit better: I meant going part time as a mid-career sole or principal earner PCP who is expected to provide continuity of care. Sure, there are plenty of mommy track folks (I have yet to see a daddy track individual) but it seems they are almost always married to a high income individual such as another doc, a lawyer, or engineer. In my employed group, the penalty for doing so - a significant hit to $/WRVU in addition to the drop in WRVU's due to working fewer hours provides such a big income drop that only late-career individuals who don't care as much about income have been able to go part time successfully. I wonder how this is handled in other groups.

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PhysicianOnFIRE
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Re: Any retired boglehead doctors out there?

Post by PhysicianOnFIRE » Sun Dec 03, 2017 12:07 pm

DTSC wrote:
Sun Dec 03, 2017 7:31 am
White Coat Investor wrote:
Sun Dec 03, 2017 1:04 am
DTSC wrote:
Sat Dec 02, 2017 6:38 pm
White Coat Investor wrote:
Sat Dec 02, 2017 11:07 am
Ruprecht wrote:
Sat Dec 02, 2017 8:18 am


That's not true for everyone. Some of us MDs are originally from very modest means and are responsible for supporting extended family, not just spouse and kids. And as mentioned by TheNightsToCome, some specialties are pretty much full-tilt or quit.
You name the specialty and I'll find someone doing it less than full-time. No doubt it's easier in some specialties and some areas than others. But if part-time is a priority, you can make it happen.


I can't say I've seen too many part time primary care (IM and FP) doctors. I've seen plenty of patients defect from my partners, even if they took 3-4 weeks off after a medical illness. Since we don't do shift work, it's pretty painful to catch up even if you're gone for more than a few days.
Really? FP and IM are pretty easy ones. I expected more challenges from general surgeons and cardiologists. I know LOTS of part-time FP and IM docs. Urgent care and hospitalist can do shift work. I've known many primary care docs on the mommy track working 2 or 3 days a week. As more and more of these jobs become employed, I think part-time is very doable there.
I should have qualified my remarks a bit better: I meant going part time as a mid-career sole or principal earner PCP who is expected to provide continuity of care. Sure, there are plenty of mommy track folks (I have yet to see a daddy track individual) but it seems they are almost always married to a high income individual such as another doc, a lawyer, or engineer. In my employed group, the penalty for doing so - a significant hit to $/WRVU in addition to the drop in WRVU's due to working fewer hours provides such a big income drop that only late-career individuals who don't care as much about income have been able to go part time successfully. I wonder how this is handled in other groups.
Locum tenens work is available in pretty much every specialty, too, although some specialties like mine (anesthesia) are better suited than others. That doesn't fit the requirements of providing continuity of care and often requires travel away from home. But it can be a great way to practice part time, as much or as little as you want, really. One benefit is that you're generally paid by the hour or day, so the amount of pay is directly commensurate with the amount of work you choose to do.

I did locums exclusively for the first two years of my career, and at other times since, and shared my experience with The White Coat Investor.

:beer
-PoF

newtoseattle
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Re: Any retired boglehead doctors out there?

Post by newtoseattle » Sun Dec 03, 2017 12:48 pm

Yes. Surgeons can be part time. Many busy hospitals now have acute care surgeons. These are often shift type jobs with a group that feels confident enough in each other to do quite a bit of hand offs. Its a change from the traditional surgical model, but I think its here to stay. It provides quicker care and consistency to the emergency patients and the elective guys (and gals) don't have to worry about how to fit in unplanned cases into their day. Care for both sets of patients (the emergency ones and the elective ones) is better. If your local hospitals don't have it, you could get educated on it (ie visit some programs that do) and approach the local folks about starting such a program. There are ortho groups and OB/gyn groups that work this way. Probably not for some of the other subspecialties...

In terms of keeping up skills - I think surgery would be a hard specialty to start part time - just not enough experience. But after 10 years in practice, I have no hesitation going part time.

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ram
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Re: Any retired boglehead doctors out there?

Post by ram » Sun Dec 03, 2017 1:01 pm

hmw wrote:
Fri Dec 01, 2017 8:10 pm
I know there are quite a few physician BHs on this board. Does anyone know any part time surgeon who is not working as a locum?
I work for a healthcare group which covers about 50 clinics, 6 rural hospitals and one tertiary care hospital. At the smaller rural hospitals we expect 1:3 call, which means we employ at least 3 surgeons at that location. But there is elective work for only 1.5 to 2 surgeons.
This means that the workload is fairly low on an average day. Calls are not anywhere as busy as at a tertiary care center. This means remuneration is on the lower side but not strictly only on RVU's.
A 50 to 60 yr old surgeon whose kids are out of high school and who wants to slow down is a good fit for such job. PM me if you want more details.
Ram

staythecourse
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Re: Any retired boglehead doctors out there?

Post by staythecourse » Sun Dec 03, 2017 1:11 pm

DTSC wrote:
Sun Dec 03, 2017 7:31 am
I should have qualified my remarks a bit better: I meant going part time as a mid-career sole or principal earner PCP who is expected to provide continuity of care. Sure, there are plenty of mommy track folks (I have yet to see a daddy track individual) but it seems they are almost always married to a high income individual such as another doc, a lawyer, or engineer. In my employed group, the penalty for doing so - a significant hit to $/WRVU in addition to the drop in WRVU's due to working fewer hours provides such a big income drop that only late-career individuals who don't care as much about income have been able to go part time successfully. I wonder how this is handled in other groups.
Are you expecting a mommy or daddy track that allows one to be a primary bread winner? Forget about medicine is there any job in the WORLD that one can expect to get high pay and less work? The less you work the less your employer makes so if they paid the same their profit margin decreases. It is not reasonable to expect the company to lose money just because person x wants to cut down on their hours for whatever reason.

Just like any part time job you are exchanging time for pay. That is a reasonable expectation for employer and employee. The issue has become employers especially corporate medicine has always realized (but does not like to acknowledge) that the only avenue for them to generate revenue is with doctors seeing patients and generating downstream revenue. With profit margins shrinking they are not in position to allow any docs to see LESS patients.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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ram
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Re: Any retired boglehead doctors out there?

Post by ram » Sun Dec 03, 2017 1:17 pm

newtoseattle wrote:
Sun Dec 03, 2017 12:48 pm
Yes. Surgeons can be part time. Many busy hospitals now have acute care surgeons. These are often shift type jobs with a group that feels confident enough in each other to do quite a bit of hand offs. Its a change from the traditional surgical model, but I think its here to stay. It provides quicker care and consistency to the emergency patients and the elective guys (and gals) don't have to worry about how to fit in unplanned cases into their day. Care for both sets of patients (the emergency ones and the elective ones) is better. If your local hospitals don't have it, you could get educated on it (ie visit some programs that do) and approach the local folks about starting such a program. There are ortho groups and OB/gyn groups that work this way. Probably not for some of the other subspecialties...

In terms of keeping up skills - I think surgery would be a hard specialty to start part time - just not enough experience. But after 10 years in practice, I have no hesitation going part time.
The tertiary care hospital in our group has trauma surgeons on 12 hour shifts.
Ram

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Re: Any retired boglehead doctors out there?

Post by White Coat Investor » Sun Dec 03, 2017 2:38 pm

newtoseattle wrote:
Sun Dec 03, 2017 12:48 pm
Yes. Surgeons can be part time. Many busy hospitals now have acute care surgeons. These are often shift type jobs with a group that feels confident enough in each other to do quite a bit of hand offs. Its a change from the traditional surgical model, but I think its here to stay. It provides quicker care and consistency to the emergency patients and the elective guys (and gals) don't have to worry about how to fit in unplanned cases into their day. Care for both sets of patients (the emergency ones and the elective ones) is better. If your local hospitals don't have it, you could get educated on it (ie visit some programs that do) and approach the local folks about starting such a program. There are ortho groups and OB/gyn groups that work this way. Probably not for some of the other subspecialties...

In terms of keeping up skills - I think surgery would be a hard specialty to start part time - just not enough experience. But after 10 years in practice, I have no hesitation going part time.
I wouldn't recommend anyone be part-time right out of residency. I think it takes a few years to solidify skills. Ideally, a decade I think, but everyone is different and all situations are different. One year better than none. Two years better than one. Ten years better than five, etc.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

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Re: Any retired boglehead doctors out there?

Post by White Coat Investor » Sun Dec 03, 2017 2:39 pm

staythecourse wrote:
Sun Dec 03, 2017 1:11 pm
DTSC wrote:
Sun Dec 03, 2017 7:31 am
I should have qualified my remarks a bit better: I meant going part time as a mid-career sole or principal earner PCP who is expected to provide continuity of care. Sure, there are plenty of mommy track folks (I have yet to see a daddy track individual) but it seems they are almost always married to a high income individual such as another doc, a lawyer, or engineer. In my employed group, the penalty for doing so - a significant hit to $/WRVU in addition to the drop in WRVU's due to working fewer hours provides such a big income drop that only late-career individuals who don't care as much about income have been able to go part time successfully. I wonder how this is handled in other groups.
Are you expecting a mommy or daddy track that allows one to be a primary bread winner? Forget about medicine is there any job in the WORLD that one can expect to get high pay and less work? The less you work the less your employer makes so if they paid the same their profit margin decreases. It is not reasonable to expect the company to lose money just because person x wants to cut down on their hours for whatever reason.

Just like any part time job you are exchanging time for pay. That is a reasonable expectation for employer and employee. The issue has become employers especially corporate medicine has always realized (but does not like to acknowledge) that the only avenue for them to generate revenue is with doctors seeing patients and generating downstream revenue. With profit margins shrinking they are not in position to allow any docs to see LESS patients.

Good luck.
Yes, of course. Part-time work comes with less pay. I thought that was a given. The good news is that thanks to the progressive nature of the tax code, you can work half-time and make much more than half of what your take home previously was!
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

cutterinnj
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Re: Any retired boglehead doctors out there?

Post by cutterinnj » Sun Dec 03, 2017 5:55 pm

I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.

hmw
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Re: Any retired boglehead doctors out there?

Post by hmw » Sun Dec 03, 2017 8:21 pm

newtoseattle wrote:
Sun Dec 03, 2017 12:48 pm
Yes. Surgeons can be part time. Many busy hospitals now have acute care surgeons. These are often shift type jobs with a group that feels confident enough in each other to do quite a bit of hand offs. Its a change from the traditional surgical model, but I think its here to stay. It provides quicker care and consistency to the emergency patients and the elective guys (and gals) don't have to worry about how to fit in unplanned cases into their day. Care for both sets of patients (the emergency ones and the elective ones) is better. If your local hospitals don't have it, you could get educated on it (ie visit some programs that do) and approach the local folks about starting such a program. There are ortho groups and OB/gyn groups that work this way. Probably not for some of the other subspecialties...

In terms of keeping up skills - I think surgery would be a hard specialty to start part time - just not enough experience. But after 10 years in practice, I have no hesitation going part time.
My hospital uses this model. They contract the trauma and acute care surgery coverage to a separate company which provides around the clock coverage for these 2 services. I don’t know what their schedule are. 7 on and 7 off? But they have to stay in house and sleep there too. :( Personally I would really hate to sleep in a call room again. And I am not a general surgeon, and really have no intention of doing general surgery ever again. I have not heard of any shift type of work for my subspecialty. Maybe it will never come. I think the best option for me is to join a larger practice group when I am ready to slow down.

hmw
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Re: Any retired boglehead doctors out there?

Post by hmw » Sun Dec 03, 2017 8:33 pm

ram wrote:
Sun Dec 03, 2017 1:01 pm
hmw wrote:
Fri Dec 01, 2017 8:10 pm
I know there are quite a few physician BHs on this board. Does anyone know any part time surgeon who is not working as a locum?
I work for a healthcare group which covers about 50 clinics, 6 rural hospitals and one tertiary care hospital. At the smaller rural hospitals we expect 1:3 call, which means we employ at least 3 surgeons at that location. But there is elective work for only 1.5 to 2 surgeons.
This means that the workload is fairly low on an average day. Calls are not anywhere as busy as at a tertiary care center. This means remuneration is on the lower side but not strictly only on RVU's.
A 50 to 60 yr old surgeon whose kids are out of high school and who wants to slow down is a good fit for such job. PM me if you want more details.
Thanks ram for the info. I am in a subspecialty that requires a decent sized population to keep reasonably busy. So rural hospital is out. My impression has been that large health care system or hospitals are really not very interested in hiring part time surgeons, with a few exceptions.

SGM
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Re: Any retired boglehead doctors out there?

Post by SGM » Sun Dec 03, 2017 9:04 pm

I worked part-time for the last 3 years of my practice. I see a lot of physicians continuing to work. well beyond 70 for a variety of reasons. I could have continued to work, but conditions would have changed as the practice I was last in was taken over by a large corporation at the time I chose to work part-time. The corporation was so large they could not easily make changes they need to do for their own benefit. I attend grand rounds twice a month when I can just for the fun of it and I continue to renew my medical license although I have no intention to practice medicine again. I use my free time for exercise, sports, creative and social activities and travel. Although because of family responsibilities we have not been able to travel for more than a week until very recently. We do have a family business that I would like to help the next generation continue.

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Lieutenant.Columbo
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Re: Any retired boglehead doctors out there?

Post by Lieutenant.Columbo » Sun Dec 03, 2017 9:46 pm

cutterinnj wrote:
Sun Dec 03, 2017 5:55 pm
I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.
does your staff also work 4 days? are they ok with it? how many hours a day do you all work?
Lt. Columbo: Well, what do you know. Here I am talking with some of the smartest people in the world, and I didn't even notice!

cutterinnj
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Re: Any retired boglehead doctors out there?

Post by cutterinnj » Sun Dec 03, 2017 10:12 pm

Lieutenant.Columbo wrote:
Sun Dec 03, 2017 9:46 pm
cutterinnj wrote:
Sun Dec 03, 2017 5:55 pm
I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.
does your staff also work 4 days? are they ok with it? how many hours a day do you all work?
I'm the owner. My staff works for me, like any other business. They all work 815-445 5 days a week with a 30 minute break for lunch and the normal holidays, vacation time, etc...

Hired associates (doctors) all work 4 day work-weeks too.
We've found that there is indeed a "Starling curve" to productivity in our field, and the "day off" helps decrease burn-out as well as improves care.

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Lieutenant.Columbo
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Re: Any retired boglehead doctors out there?

Post by Lieutenant.Columbo » Sun Dec 03, 2017 10:55 pm

cutterinnj wrote:
Sun Dec 03, 2017 10:12 pm
Lieutenant.Columbo wrote:
Sun Dec 03, 2017 9:46 pm
cutterinnj wrote:
Sun Dec 03, 2017 5:55 pm
I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.
does your staff also work 4 days? are they ok with it? how many hours a day do you all work?
I'm the owner. My staff works for me, like any other business. They all work 815-445 5 days a week with a 30 minute break for lunch and the normal holidays, vacation time, etc...

Hired associates (doctors) all work 4 day work-weeks too.
We've found that there is indeed a "Starling curve" to productivity in our field, and the "day off" helps decrease burn-out as well as improves care.
interesting
I went from 8 hours/day 5 days/week to 9 hours/day 4 days/week. My staff works the same hours as me and they all were OK when we changed to 4 days.
In a year or so I'd like to change to 8 hours/day 4 days/week, a year later to 10-11 hours/day 3 days/week...
My concerns are whether I can find staff willing to work only on the days I do, or if I can justify their pay longer days than I'd be working...
Lt. Columbo: Well, what do you know. Here I am talking with some of the smartest people in the world, and I didn't even notice!

cutterinnj
Posts: 260
Joined: Wed Jun 01, 2011 10:08 pm

Re: Any retired boglehead doctors out there?

Post by cutterinnj » Sun Dec 03, 2017 10:59 pm

Lieutenant.Columbo wrote:
Sun Dec 03, 2017 10:55 pm
cutterinnj wrote:
Sun Dec 03, 2017 10:12 pm
Lieutenant.Columbo wrote:
Sun Dec 03, 2017 9:46 pm
cutterinnj wrote:
Sun Dec 03, 2017 5:55 pm
I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.
does your staff also work 4 days? are they ok with it? how many hours a day do you all work?
I'm the owner. My staff works for me, like any other business. They all work 815-445 5 days a week with a 30 minute break for lunch and the normal holidays, vacation time, etc...

Hired associates (doctors) all work 4 day work-weeks too.
We've found that there is indeed a "Starling curve" to productivity in our field, and the "day off" helps decrease burn-out as well as improves care.
interesting
I went from 8 hours/day 5 days/week to 9 hours/day 4 days/week. My staff works the same hours as me and they all were OK when we changed to 4 days.
In a year or so I'd like to change to 8 hours/day 4 days/week, a year later to 10-11 hours/day 3 days/week...
My concerns are whether I can find staff willing to work only on the days I do, or if I can justify their pay longer days than I'd be working...
I have 9 other docs in my practice, so the load is balanced- everyone is off different days.

Even in a solo practice, I’d have to imagine there would be tasks for employees when you’re not there- importing documents, answering tasks, etc

Tachyon
Posts: 57
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Re: Any retired boglehead doctors out there?

Post by Tachyon » Mon Dec 04, 2017 3:30 am

TheNightsToCome wrote:
Sat Nov 25, 2017 11:34 am
me112964 wrote:
Sat Nov 25, 2017 7:43 am
looking to find out what retirement looks like for retired/retiring doctors today. Currently 53 and looking at options for the immediate and distant future. Locum tenen stories, early retirement, part time, consulting. Any stories appreciated.
At 34 I sold my critical care staffing business and took a year off prior to starting cardiology fellowship. During that year I learned to surf (Waikiki and Surfers Paradise), scuba dive (Grand Cayman and Oahu), and ski (Snowmass and Vail). I tried tandem hang gliding at Torrey Pines, and then chickened out of bungee jumping in New Zealand when I looked over the edge of the platform.

I went to London, Paris, Nice, Monte Carlo, Rome, Capri, Santorini, Auckland, Lake Taupo, Melbourne and Sydney. I bought my first desktop and learned how to use it. I tried to write a novel (never completed). I didn't cut my hair for 15 months. I worked out for about 2 hours per day, six days per week and enjoyed all the uninterrupted sleep that I needed. I spent a lot of time visiting family. It was a very good year, and with adequate funds, it could have been a very good life.

***
At 41 I left medicine because I was so burned out that I couldn't stand the thought of working one more day. I had no plan.

As before, I enjoyed the uninterrupted sleep and the markedly improved workouts. I started to feel like a human being again.

I played a lot of fetch with my German Shepherd, Bart, who was very happy with our new arrangement. He and I were best friends.

I spent long, leisurely days reading accounting and finance books at Barnes and Noble. (My idea of fun. :happy )

I got to know the other retired guys who also passed the time at the bookstore. One guy my age sold his chain of Papa John’s stores. Another older fellow had been a Division I basketball coach. We all grabbed Barron’s on Saturday mornings, me with a Venti Mocha Frappuccino. Life was good.

At first I jumped and became instantly tense every time a nearby beeper or phone alarmed (post-traumatic beeper syndrome), but that disorder gradually melted away.

I loved investing so I eventually decided to study for the CFA exams. About that time I began corresponding with an investor who wrote a regular column on his company’s website. He told me that I was his most astute reader and I noticed that his firm had openings for equity analysts and encouraged non-traditional applicants. I told the investor that I would apply and he invited me for an interview.

It was exciting to become an equity analyst. My colleagues were very bright and well-educated and they all loved investing. We had endless discussion/arguments conducted over the water-cooler, or more often, a group email chain (still have many of them recorded somewhere).

My supervisors encouraged me to take some vacation, but I had to laugh inside. The whole “job” was a vacation. Maybe it’s different for derm or path, but once you’ve been a busy solo practice cardiologist, “working” as an equity analyst is like lounging on a beach. I was doing essentially the same thing that I had been doing in the bookstore–but now a company paid me! I sat in a peaceful cubicle all day reading 10-Ks or working with spreadsheets with no interruptions, no beeper, no crashers, no codes, no nothing but glorious peace.

When Eliot Spitzer settled with the big banks he required independent analyst coverage for their clients. Our coverage universe tripled immediately and we were often working 7:30 am to 9:00 pm for about 6-9 months. There was much wailing and gnashing of teeth among my colleagues, but these were such easy hours, nothing like the constant push of clinical work. I was stunned that anyone complained. As physicians we become numb to expanding workloads.

I probably should have stayed, but I was already through the CFA curriculum, so I enrolled at the University of Chicago Booth School of Business on the company dime and it was taking too long. I became more interested in school than work so I bolted and just paid full-freight on my own.

I had been managing accounts for friends and family for several years, so after graduation I moved back to my home town and opened a Registered Investment Advisor (but I didn't charge family members or solicit new business).

I was fit and happy and life was good. I thought things would continue that way for decades, but then I was struck with a serious illness.

I was misdiagnosed by a cardiologist and I knew he was less than stellar (although a very nice guy) simply by discussing a couple of clinical problems with him. I knew how to find a better cardiologist once I was out of hospital, and I knew how to direct my subsequent work-up. I think it’s likely that I would be dead now if not for my medical training.

I was suddenly worried about access to good health insurance and good healthcare going forward. I wanted to be back on the inside, and I had a renewed interest in everything medical. I earned over 800 hours of CME and scored in the top decile on my board re-certification exam. I obtained licenses in two states where I had practiced previously and returned to the practice of cardiology at 54, after 13 years away. I've been back for almost 4 years now.

Things are much better than before, but I still work about 60-65 hours per week with one weekend and 10 nights of call per month. Because we have hospitalists now, the call is not as heavy as it was. (Thank you, dear hospitalists.) Also, I'm an employee now, so I don't have to run the business. That helps, too.

My contract is up in two years and I intend to negotiate less call and/or more PDO and/or fewer patients per day in clinic. I don't hate the practice of medicine, I just hate the life. I really enjoy the subject matter. I'd rather read the Journal of the American College of Cardiology than a 10-K, and I enjoy the work if the pace is such that I can take a breath between patients.

I burned out because of the push of racing to keep up all day every day, and then being called all night. If I can arrange a more humane schedule with my employer, I plan to continue indefinitely.
Possibly the best personal story I've ever read. I initially thought you were on track to be like a big time stock broker or something. Then when you returned back to cardiology, I was like "what?!" Lol, thanks for sharing.

staythecourse
Posts: 5732
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Re: Any retired boglehead doctors out there?

Post by staythecourse » Mon Dec 04, 2017 4:01 pm

Lieutenant.Columbo wrote:
Sun Dec 03, 2017 10:55 pm
cutterinnj wrote:
Sun Dec 03, 2017 10:12 pm
Lieutenant.Columbo wrote:
Sun Dec 03, 2017 9:46 pm
cutterinnj wrote:
Sun Dec 03, 2017 5:55 pm
I'm a surgical subspecialist. My job is 4 days a week. This is what all my partners work as well.
Not really "semi-retirement", but not working 5 days a week is absolutely key.

I also mainly do work in the office (including procedures), and rarely do anything at a hospital, which I think is a huge time and soul-suck.
does your staff also work 4 days? are they ok with it? how many hours a day do you all work?
I'm the owner. My staff works for me, like any other business. They all work 815-445 5 days a week with a 30 minute break for lunch and the normal holidays, vacation time, etc...

Hired associates (doctors) all work 4 day work-weeks too.
We've found that there is indeed a "Starling curve" to productivity in our field, and the "day off" helps decrease burn-out as well as improves care.
interesting
I went from 8 hours/day 5 days/week to 9 hours/day 4 days/week. My staff works the same hours as me and they all were OK when we changed to 4 days.
In a year or so I'd like to change to 8 hours/day 4 days/week, a year later to 10-11 hours/day 3 days/week...
My concerns are whether I can find staff willing to work only on the days I do, or if I can justify their pay longer days than I'd be working...
You can find anybody for anything you want. Just look for it. Maybe not the same ones you have now, but there will likely be somebody out there who is looking for that same type of schedule as it works for them as well.

The bigger issue is having someone answering phone calls and dealing with issues when you are not there. So maybe keep one of the MA's full time and the days you are not there she answers calls, refills meds, uploads stuff, coordinates surgery schedules with the hospital, takes care of issues you want done over phone, etc...

At that point if you are making that move to 3 days/ week you should be done/ near done with your financial situation so who cares if you pay a little extra for someone to be at the office while you are enjoying life.

Good luck.
"The stock market [fluctuation], therefore, is noise. A giant distraction from the business of investing.” | -Jack Bogle

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