Another 25 years?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Newtwo said:
i like emergency cases.
Click to expand...
I like taking call because it is more unpredictable and there are some occasional interesting cases that I wouldn't normally do on a typical 7-5 day.
Members don't see this ad.
 
PlayToWin said:
Seems to me , some people just don’t like being anesthesiologist. Hell it’s not glamorous but you gotta enjoy it somewhat , otherwise you are not gonna last 25 months let’s alone years
Click to expand...
I don’t think most here are complaining DIRECTLY about the art/practice of anesthesia.

It’s kinda like dancing. It’s fun to do when you WANT to....
NOT so fun, when, like the old western movies, someone is shooting a gun at your feet (at 3 am, on a weekend/holiday), and shouting “Dance!!! Now!!!”.

Yes, call is part of the “deal” of some specialties, like ours. However, call for “medical emergencies” is different from call for “surgeon social life/scheduling emergencies” or “hospital throughput issues”.

The “corporatization” of our hospitals, and anesthesia groups, has made this much worse, in my opinion.

Dance, pardner!!!!
 
Last edited:
  • Like
Reactions: 3 users
Members don't see this ad :)
DirtDocMD said:
I don’t think most here are complaining DIRECTLY about the art/practice of anesthesia.

It’s kinda like dancing. It’s fun to do when you WANT to....
NOT so fun, when, like the old western movies, someone is shooting a gun at your feet (at 3 am, on a weekend/holiday), and shouting “Dance!!! Now!!!”.

Yes, call is part of the “deal” of some specialties, like ours. However, call for “medical emergencies” is different from call for “surgeon social life/scheduling emergencies” or “hospital throughput issues”.

The “corporatizion” of our hospitals, and anesthesia groups, has made this much worse, in my opinion.

Dance, pardner!!!!
Click to expand...
you can say that literally for any speciality outside of those who run their own practice .. SOLO and I bet those guys work harder than 95% of physicians. The trade off for dancing when you want to is money, location or both.
I’ll keep on dancing until I get to the point where I don’t need to dance but want to.
 
  • Like
Reactions: 1 user
ryanjmy said:
The worst jobs are the ones that expect you to supervise 4 rooms during the day and then sit you’re own cases after hours. Eff that.
Click to expand...
lol. 4 rooms is a drag for sure. My guess is that the practices that sit cases after hours are the ones that employ the anesthetists though.
 
  • Like
Reactions: 1 users
Arch Guillotti said:
lol. 4 rooms is a drag for sure. My guess is that the practices that sit cases after hours are the ones that employ the anesthetists though.
Click to expand...

Yes. The practice I'm familiar with employed the CRNAs. They made great money but worked hard. Then they sold to an AMC. The AMC kept the same practice model but cut salaries by $200k. The old guys retired and for some reason the AMC wasn't able to recruit replacements. Imagine that. I did some Locums work for them. Made good money but it was pretty exhausting. Run around all day and when things start slowing down have to relieve the CRNAs. Truly the worst of both worlds.
 
ryanjmy said:
Yes. The practice I'm familiar with employed the CRNAs. They made great money but worked hard. Then they sold to an AMC. The AMC kept the same practice model but cut salaries by $200k. The old guys retired and for some reason the AMC wasn't able to recruit replacements. Imagine that. I did some Locums work for them. Made good money but it was pretty exhausting. Run around all day and when things start slowing down have to relieve the CRNAs. Truly the worst of both worlds.
Click to expand...

I wonder how much they made preamc
 
chocomorsel said:
Why do they think you are super rich and don’t need money?
Click to expand...
Because I’m super rich and don’t need money


People assume everyone is the same as they are with regards to finances. They make a hefty ransom every year, spend most, and assume everyone else would too. They don’t understand how you could live without a plane, boat, 3 houses etc.
 
  • Like
Reactions: 3 users
Members don't see this ad :)
Blockit said:
Yes, this is very true. Makes me angry. But, finding *good* jobs in our field ain’t easy.
Click to expand...
Right!!. That is because many ****s in this field's attitude is " At least I have a job". You can't win with that attitude.
 
  • Like
Reactions: 2 users
Aheadbyacentury said:
Right!!. That is because many ****s in this field's attitude is " At least I have a job". You can't win with that attitude.
Click to expand...

It’s more than just “at least it’s a paycheck”.

Even within this thread, I can feel there’s really no “pride” in medicine anymore. In our field, “pride” and/or ego was never the driving factor for me, nor most of anesthesiologists. On top of that, selling out to crna to make a few quick dollars then AMCs to make even more. This is not a field to protect each other….

One of the story I heard in training was at a near by practice, senior partners would literally walk away when their cases are done, no matter what. You’re about to code a patient, goodbye. You need a quick bathroom break, bye. You’re in a difficult airway… you get the gist. Our unofficial motto was, “at least we come to help…..”

I think the softening of training, the focus on life-work balance, the mental and physical stress are all factors. Some of us are from less developed country originally. The attitude is very different. I also know without the education and working hard, I will never be part of the higher echelon of ‘Merica. But seeing the recent suicides with FMGs at Lincoln, certainly also challenge my own beliefs.

/rant
 
  • Like
Reactions: 1 user
pjl said:
Because I’m super rich and don’t need money


People assume everyone is the same as they are with regards to finances. They make a hefty ransom every year, spend most, and assume everyone else would too. They don’t understand how you could live without a plane, boat, 3 houses etc.
Click to expand...
How do they know how much you make and how you spend in order to make that judgement is what I meant.
Is it common knowledge? You may have a family member that you take care of that people don’t know. Other responsibilities that take up your money and not just houses and boats. Just because one isn’t overt with their spending doesn’t mean they don’t spend.
Anyway. I don’t know if you were being sarcastic with that line.
 
IMGASMD said:
..........................I can feel there’s really no “pride” in medicine anymore. I

/rant
Click to expand...
They do not want you to have pride in medicine anymore. They dont want you to have pride in ANYTHING. When that happens then they can have control.
If you have pride, you cannot allow what is happening to happen.
 
  • Like
Reactions: 1 users
Aheadbyacentury said:
They do not want you to have pride in medicine anymore. They dont want you to have pride in ANYTHING. When that happens then they can have control.
If you have pride, you cannot allow what is happening to happen.
Click to expand...

They being who? Medicare? Midlevels? Ourselves? I’d say all of the above but I agree.

“They” want cogs that take orders, accept crappy working conditions, and never speak up.
 
  • Like
Reactions: 1 user
RadsWFA1900 said:
They being who? Medicare? Midlevels? Ourselves? I’d say all of the above but I agree.

“They” want cogs that take orders, accept crappy working conditions, and never speak up.
Click to expand...

All of the above. That’s why we are al fu(king “providers” now. Provide what?! A service? Healthcare?

Saaaaddddd
 
chocomorsel said:
How do they know how much you make and how you spend in order to make that judgement is what I meant.
Is it common knowledge? You may have a family member that you take care of that people don’t know. Other responsibilities that take up your money and not just houses and boats. Just because one isn’t overt with their spending doesn’t mean they don’t spend.
Anyway. I don’t know if you were being sarcastic with that line.
Click to expand...
My partners all know my income. They tease me about needing time off, since I’m apparently a wuss. It is good natured. The surgeons probably have no idea since I don’t talk about it.

I fully understand people spend differently, my point was that others assume (often incorrectly) I either make more or have a lot of money from some outside source.

At the end of the day, I am rich and I do have lots of money, I just work less because I don’t need the “more” that a lot of others do. I have multiples of my “fire” number for my desired lifestyle and realistic spend.
 
  • Like
Reactions: 3 users
IMGASMD said:
All of the above. That’s why we are al fu(king “providers” now. Provide what?! A service? Healthcare?

Saaaaddddd
Click to expand...

It’s confusing when they say provider but then I realize that’s how they like it

You don’t know who they’re referring to all you know is that they don’t like you
 
RadsWFA1900 said:
It’s confusing when they say provider but then I realize that’s how they like it

You don’t know who they’re referring to all you know is that they don’t like you
Click to expand...

“What do you like to be called?” Is one of my favorite questions now.

Dr. IMGASMD. That’s how.
 
Aheadbyacentury said:
Right!!. That is because many ****s in this field's attitude is " At least I have a job". You can't win with that attitude.
Click to expand...
Well, I certainly don’t view myself as a “****”. And I certainly have a lot of pride in my specialty. The fact is I can have all the pride that I want, but if the culture of a place is such that administration has set the precedent that you are just a service provider who is there to say yes to everything, then there’s nothing you can do about it.
Go ahead and try to aggressively change the culture at one of these facilities. They will discipline you, or maybe even terminate you, and label you with a scarlet letter that you have to explain for the rest of your career.

This is why in another thread on this forum I have been inquiring about where the good jobs actually are. No better people to ask than the people on the inside.
 
  • Like
Reactions: 2 users
1628382412422.png
 
As long as the income remains solid, and that means over $350K per year plus additional benefits/bonuses, the vast majority of Anesthesiologists are NOT going to retire; even in my age group the majority want to keep working at some capacity albeit less than full time. We have all spent so much time and energy to get to this point that most of us don't just walk away even after we "hit our retirement number." Sure, if you have real money (20+ million) maybe you walk away completely but for the rest of us the regular paycheck is a source of security and hedge against worst case scenarios where the dollar is worth 1/3 to 1/2 less in 10 years.
 
  • Like
Reactions: 1 user
Among the top 5% of earners, the average income was $309,348 in 2018, according to the Economic Policy Institute, a nonprofit think tank; among the top 1%, the average income was $737,697. Meanwhile, the average income in the U.S. in 2018 was $55,412.


A net worth is the sum of an individuals’ total assets, minus any debt, including loans, mortgages or credit card balances.

To be considered in the top 1% of net worths, a household needs combined assets totalling over $11 million
 

More Definitions Of Rich​

The risk-free rate (10-year bond yield) is currently around 1.7%. Therefore, one needs a net worth of roughly $27,700,000 ($470,000 / 1.7%) to be able to generate $470,000 a year in top 1% income!

As a result, I highly recommend people reconsider the 4% Rule and reduce their safe withdrawal rate in retirement. The 4% rule is outdated and dangerous to follow in this permanently low interest rate environment.

$27.7 million can therefore be considered the upper band for the definition of rich in today’s environment using this methodology. Given a top 1% net worth is at least $10 million, $27.7 million can be used as a top 1% net worth for a couple.

Another calculation is using the ideal income for maximum happiness. I think that ideal income is $200,000 per individual and $300,000 per couple. Therefore, using the same 1.7% divisor, we can get $11.7 million and $17.7 million. In other words, a top one percent net worth amount based on happiness can be between $11.7-$17.7 million.

www.financialsamurai.com

The Top 1% Net Worth Amounts By Age

Getting to the top 1% net worth by age is a very impressive goal. But how much money do you need to get there? Overall, to have a top 1% net worth in 2021 requires having at least $10 million. $10 million is also the ideal net worth amount for retirement. People like to throw around random net...
www.financialsamurai.com www.financialsamurai.com
 
Now I don't want anyone to misconstrue my posts above about FIRE. My point is that for those of us wanting to maintain our lifestyle at around $300K per year (yes, I can live on less) the minimum number is $11.7 Million. If you factor in inflation and devaluation of the US Dollar that number could be as high as 17.7 Million.

Now, I don't think I will achieve 17.7 million before my retirement but I wouldn't want to retire early (before age 60 for example) without a significant nest egg. That nest egg needs to be even bigger if you won't be working from age 55-65 as you will withdrawing funds that could be compounding growth over that decade. Thus, unless you want to live a simple lifestyle, which is just fine, and reduce your spending to around a 2% withdrawal rate due to your early retirement I suggest you keep working at least part time.
 
1628384960233.png


The author states this is per person. So, if you have a spouse then possibly factor in a multiplier to the net worth goal if you need more spending money. The less you spend the less money you need. People forget about healthcare and income taxes when planning for FIRE. I suggest you look into the cost of healthcare prior to cutting back on your fulltime gig. Also, factor in taxes to your "net" income during FIRE.
 

Attachments

  • 1628384903316.png
    1628384903316.png
    161.9 KB · Views: 58
BLADEMDA said:
Now I don't want anyone to misconstrue my posts above about FIRE. My point is that for those of us wanting to maintain our lifestyle at around $300K per year (yes, I can live on less) the minimum number is $11.7 Million. If you factor in inflation and devaluation of the US Dollar that number could be as high as 17.7 Million.

Now, I don't think I will achieve 17.7 million before my retirement but I wouldn't want to retire early (before age 60 for example) without a significant nest egg. That nest egg needs to be even bigger if you won't be working from age 55-65 as you will withdrawing funds that could be compounding growth over that decade. Thus, unless you want to live a simple lifestyle, which is just fine, and reduce your spending to around a 2% withdrawal rate due to your early retirement I suggest you keep working at least part time.
Click to expand...

So I couldn't imagine how someone could spend 300k a year but then I found out that it's very easy. Take a bunch of trips first class to high cost areas and money just evaporates.
 
  • Like
Reactions: 1 user
GassYous said:
So I couldn't imagine how someone could spend 300k a year but then I found out that it's very easy. Take a bunch of trips first class to high cost areas and money just evaporates.
Click to expand...
Let's say Southpaw wants to retire at age 55. He needs a net income of $250K after taxes to travel, play golf, enjoy life etc. That $250K is only 60% of what he was earning prior to FIRE but he is okay with it. How much will Southpaw need in gross income to net $250K per year? Remember, Southpaw doesnt'have access to his 401K/IRA at age 55. He also needs to pay for healthcare. So, in order to net $250K he needs a gross income around $300-$305K. That money must come from his nest egg and if he withdraws at a rate of 4% per year then Southpaw could run out of money by age 80. Instead, southpaw "sucks it up" and works 1/2 time from age 55-65 which completely solves the issue of running out of money. Now he can withdraw at 2% or less annually due to his 1/2 time FTE income without worrying about depleting his nest egg.


thephysicianphilosopher.com

Partial FIRE: The Solution to Your Problems? - The Physician Philosopher

There has been a lot of focus on FIRE (Financial Independence Retire Early), but I am here to tell you that you can experience a lot of the benefit of FIRE before you get there. In fact, I'd argue FIRE can be detrimental to your life, and that partial FIRE could prove to be a better...
thephysicianphilosopher.com thephysicianphilosopher.com
 
Last edited:

$10 Million Dream - Physician on FIRE

This calculator, developed in the post about a $10 Million dream, determines the number of years to reach a savings goal based on a variety of market returns.
www.physicianonfire.com www.physicianonfire.com

The above link has a calculator for hitting your number. The gray box on the left says "zero" but you can enter your current net investments into that box. Then, the calculator will show you how long in years to hit your desired number based on the expected rate of return. You can change the last number to any number like 15,000,000 instead of 100,000,000.
 
BLADEMDA said:
As long as the income remains solid, and that means over $350K per year plus additional benefits/bonuses, the vast majority of Anesthesiologists are NOT going to retire; even in my age group the majority want to keep working at some capacity albeit less than full time. We have all spent so much time and energy to get to this point that most of us don't just walk away even after we "hit our retirement number." Sure, if you have real money (20+ million) maybe you walk away completely but for the rest of us the regular paycheck is a source of security and hedge against worst case scenarios where the dollar is worth 1/3 to 1/2 less in 10 years.
Click to expand...
Your idea of real money is someone’s else’s idea of stupid money.
I know damn well I don’t need 20 million to retire as I live cheaply. That’s insane. I can retire comfortably with a fourth of that. I don’t care for fancy crap except for flying business on long haul flights. And since I plan on living in another country in within the next few years it may be even less than that.
So for me, I would walk away from American Medicine pronto if I had my idea of real money.
I make excellent money but these damn patients, midlevels, administrators and families often work my nerves. And these Antivaxxers aren’t helping a bit.
I get so tired of being called a “Provider.”
Only in America where every damn thing is political and money driven.
 
  • Like
Reactions: 1 users
BLADEMDA said:
View attachment 341766

The author states this is per person. So, if you have a spouse then possibly factor in a multiplier to the net worth goal if you need more spending money. The less you spend the less money you need. People forget about healthcare and income taxes when planning for FIRE. I suggest you look into the cost of healthcare prior to cutting back on your fulltime gig. Also, factor in taxes to your "net" income during FIRE.
Click to expand...
Look at this chart. Your number is based on how much income you need. If you only need 150k then that number is around 6 million. 6 million with a 3 percent withdrawal rate so you can have money to pay taxes and buy health insurance leaving you $150k per year. The earlier you retire the more likely you will run out of money so the bigger cushion you need
 
It’s interesting to me what people’s own definitions of rich are. My personal definition is the ability of a portfolio to safely maintain the median annual income of whatever size family you have without lifting another finger for the rest of your life.
 
I posted these links and charts because many of you are delusional in thinking you can retire on a few million dollars and live like an attending or the way many of you live now. Most of you will be forced to work 25 plus years if not 30 years at your gig in order to retire with that $250k income.

Unless you hit it big with real estate or stocks your retirement number is rather large based on an income of $400k. Hence, most of you will indeed be working for 25-30 years as an Anesthesiologist.
 
  • Like
Reactions: 1 users
ERRES2288 said:
It’s interesting to me what people’s own definitions of rich are. My personal definition is the ability of a portfolio to safely maintain the median annual income of whatever size family you have without lifting another finger for the rest of your life.
Click to expand...
That’s fine. The chart I posted shows the less you spend the less you need to retire. If you can live on $80k per year (I can not) then your FIRE is clearly a reality by age 50.
 
chocomorsel said:
Yes, we are. Have you seen the news lately? But please do expand of what it is you mean.
Click to expand...
Millions of dollars to retire? Needing 300k per yr to just live? Y'all feeding caviar to yere dog or wha?
 
  • Like
  • Haha
Reactions: 4 users
Newtwo said:
80k is nearly double the average right?
Click to expand...
Most professional advisers recommend at least 60-80 percent of your pre-retirement income for the golden years. That means $400 x 0.6 is $240k. In order to actually generate a net $240 your gross income will need to be closer to $280k. If you feel $80k is enough that makes you the rare exception.
 
Newtwo said:
80k is nearly double the average right?
Click to expand...
$78,500

The national median family income for the United States for FY 2020 is $78,500, an increase of almost four percent over the national median family income in FY 2019. Twice this change is 7.9 percent which is greater than five percent, so this higher value is used as the cap on increases.Apr 1, 2020
 
I cannot live on 80k per year either. I’m just saying that I don’t think it’s necessary to have a portfolio that generates 250-300k/yr in passive income to be considered rich in my eyes.
 
Newtwo said:
Millions of dollars to retire? Needing 300k per yr to just live? Y'all feeding caviar to yere dog or wha?
Click to expand...
Yes, it takes millions of dollars to retire if you want 60 percent of your current income level. The less you need to live on the less you need to retire.
 
ERRES2288 said:
I cannot live on 80k per year either. I’m just saying that I don’t think it’s necessary to have a portfolio that generates 250-300k/yr in passive income to be considered rich in my eyes.
Click to expand...
I respect your point of view. Figure out what you need to spin off each month to live comfortably then multiple by 12. The rest is easy to calculate in order to arrive at your Number. I choose to use a 2.5-3.0 withdrawal rate but you can use 3.5. The earlier you retire prior to age 65 the more conservative you should be with the withdrawal rate.
 
The cold hard truth is that most of you will be working for 30 years. That Said, save up and invest so you can drop down to part time after 25-30 years.
 
You must log in or register to reply here.
Next unread thread

Similar threads

G
So What's Wrong with the 25 year repayment plan
Replies
44
Views
3K
thinkorswim
thinkorswim
TheLoneWolf
Complications spiked 25% in hospitals bought by private equity
Replies
18
Views
2K
nimbus
nimbus
coffeebythelake
Yet another dental sedation death
Replies
20
Views
2K
coffeebythelake
coffeebythelake
coffeebythelake
Another Geoffrey Kim?
2
Replies
51
Views
5K
coffeebythelake
coffeebythelake
G
Another anesthesiologist behaving badly
2
Replies
52
Views
3K
anbuitachi
A
Top