Docs Who Cut Back #25: Doc To Disco

Doc 2 Disco is a refreshing new voice in the physician finance blogosphere, urging her readers to "tackle the burn through personal finance and hustle."

A highly-trained, dual-boarded specialist within a niche area of medicine, on the surface she might seem the unlikeliest of candidates to walk away from her career. Like many of us, an accumulation of ever-increasing aggravations began to detract deeply from the ability to enjoy her clinical practice.

She stumbled into financial freedom with the realization that her largest consumption item held the secret to unleashing financial freedom.  If only she sold her home in a high cost of living area she was not deeply connected to and put that equity to work, she would immediately arrive at financial independence number.

Complementing her remarkable story, it's tremendous fun to read a blog that comes with its own curated disco soundtrack. Listening as you read provides insight into a blogger in a deeply personal way.

It also brings back fond childhood memories of Ponch and John in the more memorable roller-skating scenes from CHiPs.

While I am including her in the Docs Who Cut Back interview series, it would be more accurate to categorize her as a Doc Who Cut Out - she retired completely from medicine just shy of her 48th birthday.

Might her decision reflect the old medical/surgical divide? Do internists choose to slowly weaken a tumor, while surgeons prefer to just cut it out all at once? Before I get carried away speculating, let me turn the story over to the doc who lived it:

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

• Dual specialties of Maternal-Fetal Medicine and Medical Genetics
  • Ob/Gyn Residency - 4 years
  • Maternal-Fetal Medicine Fellowship - 3 years
  • Medical Genetics Fellowship (well officially it’s called a residency) 2 years

I went from straight full-time to retiring early at age 47 years, 11 months and 24 days. I worked in my specialty for almost 13 years.

2. What did your parents do for their livelihood?

For the first 15 years of my life I was raised by my single mother.  Over an  inconsequential misunderstanding, she kicked me out and I was homeless for a very short while.  This had a VERY consequential affect on my life.  By age 16, I was living with my maternal uncle and aunt, who were very loving and supportive.  They saved my young life.  My mother worked as a home health aid caring for children with disabilities in a group home setting.  My uncle worked in a factory as a machinist and later as a landscaper who owned his own business.  My aunt was the Director of our local Head Start and then later she worked as a Probation Officer where most of her clients were teenage children.

I guess my mother was very financially unstable when I was younger and we were on welfare.   Later she got a job that she eventually retired early from due to an illness which she died of shortly after.  I guess, my aunt and uncle taught me to always save for a rainy day.  But mostly, I would say my money blue print was feeling like I was on my own financially since the age of 15.   For as long as I can remember, I always had at least one job and a healthy respect for money and how to manage it.

3. What motivated you to cut back?

It was a combination of things.  I joined a practice that was owned by a hospital, however we had much more autonomy at the beginning.  Then the practice was incorporated into a “foundation” that continually whittled away at our control of every single aspect of the  practice.  Continual cut backs with staff and crescendoing work loads broke me.  One of my partners retired and I inherited all the work due to my very specific specialty.  Also, I was sued, which put the last nail in the coffin for me.

[Ed.: Dealing with a malpractice lawsuit is a statistical guarantee for anyone who stays in practice long enough, yet it remains one of the lowest points in any physician's career. It's not surprising that this pushed D2D out of practice.]

4. What were the financial implications of cutting back?

We are selling our house because we live in one of the most expensive areas in the country.  I have very little family in the area and since I don’t work at the hospital anymore, we can live any where we desire. 

For many years, my husband and I have owned rental property and done occasional flips.  We now own a home in Barbados right across the street from the beach.  We renovated it and added 2 extra units for a total of 3.  We rent out 2 as short term rentals and we keep one for ourselves.  We will always own passive-income properties as part of our retirement plan.  My financial lifestyle hasn’t changed at all, however my lifestyle has changed tremendously since I retired!

5. How did colleagues react to your decision?

Whew! Did someone say awkward?  Most people were shocked with amazement to the point of silence.  Many physicians older than me were skeptical and borderline angry at me.  Physicians my age were a mixed bag and younger physicians were eager to learn how I could walk away “so early”.  If colleagues were genuinely interested in “how do I do this too”  I honestly pointed them in the right direction.   But unfortunately, most people were just jealous and nosy.  

5b. Was your family supportive or critical?

I don’t have any children of my own, but I have lovely adult step children who were not shocked (hehehe).  My husband came around eventually and has been extremely supportive since.  When I told my aunt and uncle I was retiring, they responded with “you will always have a room here”- so sweet, makes me melt.

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

Gosh, there are so many.  First of all, my health was deteriorating and I’ve been actively addressing long-neglected issues, including and especially my mental health.  I feel like I am a civilian again with interests and leisure time in which to pursue those interests.  It’s also nice to see friends and family and not be so pressed for time to get it all in.

7. Main drawbacks?

Hmm, say what?  

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

Yes, but I don’t plan on practicing ever again.  So a non-issue for me.

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

I would say being a doctor is a little over 50% of my identity.  I am my same curious self I’ve always been.  But COVID is a big variable.   I’ve been on “lock-down” for over a year.   Minus a few road trips here and there for various reasons, I can’t really gauge how much it will affect me when the world gets back to normal.  I am hoping to fulfill my immediate-post retirement bucket list soon - so check with me later.

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

DJ and/or beat-maker for sure.  I love music!

A close 2nd is oceanographer.  I was lucky to do research at The Woods Hole Oceanographic Institution for two summers in undergrad.   If I hadn’t already been accepted into med. school, I was considering a PhD in Biology-Oceanography.

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

To my surprise, blogging.  Apparently I have a lot to say.  Other than that, I’ve been quasi-helping out with management and renovations for a myriad of projects going on with my husband.  There’s always something to do.

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

Already retired.  But before the pandemic happened, we had planned to slow-travel internationally.  I have always been active in fundraising for my alma mater, so I continue to participate, but just a little more now.  Oh, I did a fun activity last Fall.  I participated in a Healthcare hack-a-thon where I acted as a mentor.  That was loads of fun!  I ended up nick-naming myself “ask a geezer” that weekend (hehehe).

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

Great question!  I did two fellowships, so I was ready to go hard when I finally finished at age 35.  I guess I front-loaded.   Without knowing it, I was setting myself up for early retirement through living well below my means, and investing. 

Regarding my work situation, it was death by 1,000 cuts.  It was really good while it lasted, but when I saw the ship going into a storm, I should have left and looked for another position. I’m not sure if I would have changed anything about my career or it’s trajectory.  I absolutely loved my specialty because of all of the puzzles I got to solve.  I just wished it was much less admin, bureaucracy and subjugation.

There's a lot of great insight here for those who've considered cutting medicine out entirely, a group that seems to grow larger every year. Let's review some nuggets mined from Doc To Disco's (D2D's) life experience:

• "I always had at least one job and a healthy respect for money and how to manage it." Like another of our Docs Who Cut Back, adversity set D2D on a path toward cultivating financial literacy. Childhood insecurity, including a period of homelessness as an adolescent, made D2D pay attention to finances from an early age. Role models taught her to save for a rainy day. Personal accountability and positive habits paid off a few decades later.
  
• A loss of autonomy, increased workload and a lawsuit created the perfect storm for D2D -  familiar realities for most of us.
• Experience with passive income properties helped create income streams that reduced her reliance on clinical medicine. Like many physicians, real estate plays a role in D2D's portfolio, both diversifying risk and potentially increasing returns.
• D2D's experience is consistent with that of others - don't expect support from colleagues in a decision to cut back or, in her case, retire early. Better to plan ahead and diversify your identity so that you know folks outside of medicine who can cheer you on from the sidelines. Having only ~50% of her identity tied up in being a physician, which I'd estimate is far less than most docs would cite, likely prepared her to take this unconventional path.
• Intellectual curiosity, pride in solving difficult puzzles, and interests outside of health care (DJing, oceanography) were pursued before she left medicine. Having passions and hobbies in place to pursue once work is gone is a key element in easing into a big life transition.

I look forward to following D2D's path in the coming years to get a taste for what the future might be like. If you are interested in reading about what her first year of retirement was like or how it was affected by COVID, you can find D2D's summary here.