Docs Who Cut Back #5: Wealthy Doc

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.