Anesthesiology ranking near the bottom for both burnout and job satisfaction

[anbuitachi]

Do you invest in an S&P500?

My account was up > 20% last year.

target fund. yea it was up around 20% in 2023, but it also went down around 20% in 2022, so very little change. we literally just surpassed the peak from 2021

---

Members don't see this ad.

 

[anbuitachi]

Are you saying you can't invest 60k/yr on a 550k salary?

Do you invest in an S&P500?

My account was up > 20% last year.

i dont make 550k consistently. i can make 550k if i work a lot of hours. my base salary is in the 3s. the 550k thing was in reference to the rad onc guy.

also i just started attending job less than a decade ago. not much savings. paid off my student loans though and i am now maxing 401k. My employer doesnt offer HSA. i do backdoor roth, which like my retirement, barely budged, due to when i started investing.

 

[Splenda88]

target fund. yea it was up around 20% in 2023, but it also went down around 20% in 2022, so very little change. we literally just surpassed the peak from 2021

What is your net worth?

Few of my colleagues have been hospitalist for < 5 yrs and are paying 400k+ home cash.

 

[anbuitachi]

How long you have been an anesthesiologist?

What is your net worth?

Few of my colleagues have been hospitalist for < 5 yrs and are paying 400k+ home cash.

my household net worth is around 1M. most of it is from the apartment im living in. i live in expensive area. expenses with wife making currently 0$, and kid.. drastically reduced my annual savings

 

[Splenda88]

i dont make 550k consistently. i can make 550k if i work a lot of hours. my base salary is in the 3s. the 550k thing was in reference to the rad onc guy.

also i just started attending job less than a decade ago. not much savings. paid off my student loans though and i am now maxing 401k. My employer doesnt offer HSA. i do backdoor roth, which like my retirement, barely budged, due to when i started investing.

Your compensation is low for an anesthesiologist.

I am a hospitalist and my base is 350k/yr with the ability to make ~450k/yr without killing myself.

 

[anbuitachi]

Your compensation is low as an anesthesiologist.

I am a hospitalist and my base is 350k/yr with the ability to make ~450k/yr without killing myself.

yea nyc doesnt pay that great. the hospitalists here make 200k

 

[Splenda88]

my household net worth is around 1M. most of it is from the apartment im living in. i live in expensive area. expenses with wife making currently 0$, and kid.. drastically reduced my annual savings

You are at least in the top 10%. Will likely be at the top 3% in 5 yrs, which is good IMO

The Making Of A Millionaire, And Why $100K Is No Longer The Benchmark Salary For Wealth In America

Despite the recent economic challenges, the U.S. economy has been growing steadily for years, creating new jobs and opportunities for people to earn more.

www.forbes.com

 

[Splenda88]

yea nyc doesnt pay that great. the hospitalists here make 200k

One of my former classmates make low 200k (I think it's 225k) in NYC as a nocturnist. I told her she can come to my shop and spend 1 wk here and spend her week off in NYC, and she will still come out ahead even if she maintains an apartment in NYC. Nocturnists at my shop make 405k/yr.

I could see why people want to live in NYC. The city has a lot to offer for rich people. If my net worth were > 5 mil, I probably would have an apartment there.

 

[anbuitachi]

Most doctors have the ability to have a net worth of 11 mil after 30 yrs of employment if they live within their means and have had no divorces etc...

Maxing out 401k, IRA, HSA and also invest another 2.5k/month in an S&P500 for 30 yrs will net someone 11 mil.

The issues are most of us don't do that.

The Top 1 Percent: What Jobs Do They Have?

Explore the occupations and industries of the nation's wealthiest households.

archive.nytimes.com

oh and this is using todays salaries, maxing out retirement accounts, and 30 years later having 10m in account. though, post tax will be way less. and top 1% wealth in 30 years will be much higher than the 10M you get

 

[coffeebythelake]

yea nyc doesnt pay that great. the hospitalists here make 200k

Meanwhile floor nurses in NYC make 130 - 150k per year

 

[vm26]

Meanwhile floor nurses in NYC make 130 - 150k per year

Bc nurses actually "care" about their pts. 🙄. Us doctors on the other hand are all about $ apparently

 

[Nocturnist]

have the ability... i guess so? you never know.
live within their means... so basically dont live like a top 1%, live like a resident? like bottom few percentile?
have had no divorces... i dont think doctors enter marriages with plans to divorce lol.

maxing out 401k, ira, hsa, and another 2.5k? i dont even have a hsa. my employer doesnt even offer HSA!.

yea stars have to line up, and you have a chance.

reminds me of those articles i read online about how people in normal jobs like teachers can retire with millions.

---
looking at my retirement account is pretty depressing. its up like 10% TOTAL in the past 5 years since i started contributing

Let's say all you do is max out a single retirement account at 23k a year starting at 30. Lets say your employer is cheap and only contributes another 7k to your 401. At 50, you add another 7k catch up contributions. Let's assume you get a very conservative 8% interest.
At 65, you'll have 6M invested.

Add 7k to a single roth IRA for 35 years, and now you're at 7.5M.

Add the equity and appreciation on a decent home 30 years from now and your net worth is north of 10M.

Are you telling me there's any doctor out there that can't max out a single retirement and one Roth account? If so, they have a spending problem.
No stars need to line up.
Just consistency and trust the process.

I have no idea why every single doctor doesnt retire with more than 10M NW.

 

[psychbender]

Let's say all you do is max out a single retirement account at 23k a year starting at 30. Lets say your employer is cheap and only contributes another 7k to your 401. At 50, you add another 7k catch up contributions. Let's assume you get a very conservative 8% interest.
At 65, you'll have 6M invested.

Add 7k to a single roth IRA for 35 years, and now you're at 7.5M.

Add the equity and appreciation on a decent home 30 years from now and your net worth is north of 10M.

Are you telling me there's any doctor out there that can't max out a single retirement and one Roth account? If so, they have a spending problem.
No stars need to line up.
Just consistency and trust the process.

I have no idea why every single doctor doesnt retire with less than 10M NW.

I'll probably be ok, but my serious contribution to retirement was delayed until I was 38. The military had an all-or-nothing retirement system, so could only do backdoor Roth while I was active duty. I then went back for a fellowship, so had no 401k option for that year, either. My first job fell apart within the first year, when the hospital closed, but I was able to get some money to a 401k, and fund a little more through a solo-401k via locums. I quickly joined a new group, but for the first year, I was ineligible for retirement contributions. Since then, I get max contribution, and continue to do backdoor Roth contributions, but that's nearly an extra decade without any real savings in a tax- deferred retirement account. My wife and I only just got to 1M total between savings, retirement, and brokerage accounts within the past year, and we don't spend on much at all, nor live in a high cost area.

 

[Nocturnist]

I'll probably be ok, but my serious contribution to retirement was delayed until I was 38. The military had an all-or-nothing retirement system, so could only do backdoor Roth while I was active duty. I then went back for a fellowship, so had no 401k option for that year, either. My first job fell apart within the first year, when the hospital closed, but I was able to get some money to a 401k, and fund a little more through a solo-401k via locums. I quickly joined a new group, but for the first year, I was ineligible for retirement contributions. Since then, I get max contribution, and continue to do backdoor Roth contributions, but that's nearly an extra decade without any real savings in a tax- deferred retirement account. My wife and I only just got to 1M total between savings, retirement, and brokerage accounts within the past year, and we don't spend on much at all, nor live in a high cost area.

Your specific situation is atypical.
And even still, you're looking at 27 instead of 35 years. So retire with 7-8M instead of 10M or put an extra 1-2k a month and make up for lost time.

But my example was for a family maxing out one retirement account and one roth for 35 years. The vast majority of doctors with a spouse can, should, and generally do max at least 2 retirement accounts, or at the very least- one retirement and 2 roths. My example was super conservative and still got you to a 10M nw.

Yet stats show a vast minority of docs retire with a NW >5M. It's baffling, and a real shame.

 

[abolt18]

Your specific situation is atypical.
And even still, you're looking at 27 instead of 35 years. So retire with 7-8M instead of 10M or put an extra 1-2k a month and make up for lost time.

But my example was for a family maxing out one retirement account and one roth for 35 years. The vast majority of doctors with a spouse can, should, and generally do max at least 2 retirement accounts, or at the very least- one retirement and 2 roths. My example was super conservative and still got you to a 10M nw.

Yet stats show a vast minority of docs retire with a NW &gt;5M. It's baffling, and a real shame.

Also not accounting for increasing contribution limits as time progresses. What rate of return are you assuming for these projections?

 

[coffeebythelake]

Bc nurses actually "care" about their pts. 🙄. Us doctors on the other hand are all about $ apparently

Yep we're just a bunch of greedy doctors. That's why CRNAs with a whole lot less training get paid as much per hour as me.

 

[Nocturnist]

Also not accounting for increasing contribution limits as time progresses. What rate of return are you assuming for these projections?

I've listed my assumptions in my post, a conservative 8%. I'm not accounting for increased contributions because I'm also not accounting for inflation, and as two are directly correlated and would tend to cancel each other out over time.

 

[abolt18]

I've listed my assumptions in my post, a conservative 8%. I'm not accounting for increased contributions because I'm also not accounting for inflation, and as two are directly correlated and would tend to cancel each other out over time.

I see it now. Missed the 8%.

 

[sevo00]

I've listed my assumptions in my post, a conservative 8%. I'm not accounting for increased contributions because I'm also not accounting for inflation, and as two are directly correlated and would tend to cancel each other out over time.

8% actually is an accurate assumption. Because over the last 30 years s%p 500 has returned 10% average annually and if you account for the goal of 2% yearly inflation, that puts you at 8%

 

[Nocturnist]

8% actually is an accurate assumption. Because over the last 30 years s%p 500 has returned 10% average annually and if you account for the goal of 2% yearly inflation, that puts you at 8%

Partially true but you can't subtract returns from "real" returns like that when talking about compounding numbers. Because 10% compounds exponentially faster than 2%, subtracting 2% inflation from 10% returns after 30 years is much greater than an 8% return.

Same reason why you should max out your 457 deferred compensation retirement account if you can- Tax deferred growth will grow much, much faster than any after tax money at the same yield and same tax rates.

Nonetheless, the point I was trying to make is literally any physician should retire a multimillionaire.

 

[aneftp]

Partially true but you can't subtract returns from "real" returns like that when talking about compounding numbers. Because 10% compounds exponentially faster than 2%, subtracting 2% inflation from 10% returns after 30 years is much greater than an 8% return.

Same reason why you should max out your 457 deferred compensation retirement account if you can- Tax deferred growth will grow much, much faster than any after tax money at the same yield and same tax rates.

Nonetheless, the point I was trying to make is literally any physician should retire a multimillionaire.

Agree. Any contribution matters. The earlier the better in the game.

Even with stock crashes of 40% in 2000/2001 and 2008. Most single income physican colleagues have networth in excess of 10 million by age 60

Duo physican families have net worth close to 15 million (the ones I know) by age 60.

 

[shadowblade]

Partially true but you can't subtract returns from "real" returns like that when talking about compounding numbers. Because 10% compounds exponentially faster than 2%, subtracting 2% inflation from 10% returns after 30 years is much greater than an 8% return.

Same reason why you should max out your 457 deferred compensation retirement account if you can- Tax deferred growth will grow much, much faster than any after tax money at the same yield and same tax rates.

Nonetheless, the point I was trying to make is literally any physician should retire a multimillionaire.

Yeah, its really mind boggling witnessing some of my colleagues and their shocking lack of usage retirement accounts.

So many older colleagues still working/taking call due to spending problems and poor investment decisions.

 

[aneftp]

Yeah, its really mind boggling witnessing some of my colleagues and their shocking lack of usage retirement accounts.

So many older colleagues still working/taking call due to spending problems and poor investment decisions.

Nah. Most of older colleagues (anesthesiologists) who work
1. Either still love their job /hate their spouses or both and continue to work to avoid their spouses
2. Divorce


Very rarely is it poor spending habits or investment choices.

 

[GravelRider]

Nah. Most of older colleagues (anesthesiologists) who work
1. Either still love their job /hate their spouses or both and continue to work to avoid their spouses
2. Divorce


Very rarely is it poor spending habits or investment choices.

I honestly do not believe that anyone loves anesthesia enough to be taking call (especially in house) into their 60s. Every single 60+ year old anesthesiologist that takes call has made some kind of financial decision that keeps them from giving up call.

 

[Splenda88]

Let's say all you do is max out a single retirement account at 23k a year starting at 30. Lets say your employer is cheap and only contributes another 7k to your 401. At 50, you add another 7k catch up contributions. Let's assume you get a very conservative 8% interest.
At 65, you'll have 6M invested.

Add 7k to a single roth IRA for 35 years, and now you're at 7.5M.

Add the equity and appreciation on a decent home 30 years from now and your net worth is north of 10M.

Are you telling me there's any doctor out there that can't max out a single retirement and one Roth account? If so, they have a spending problem.
No stars need to line up.
Just consistency and trust the process.

I have no idea why every single doctor doesnt retire with more than 10M NW.

I agree.

Unless a physician has had divorce(s) or make other bad financial decisions etc..., there is no reason for a FT physician not to have a net worth of at least 5 mil at the age of 60 (assuming he/she completed training at the age of 35 or younger.

 

[aneftp]

I honestly do not believe that anyone loves anesthesia enough to be taking call (especially in house) into their 60s. Every single 60+ year old anesthesiologist that takes call has made some kind of financial decision that keeps them from giving up call.

My former partner. The group president. Age 72 still takes in house call! He simply loves it.

Never divorce. He’s grandpa now.

Again. Guess why? He doesn’t do it often anymore. But he says the more he’s home. The more it drives the wife crazy.

Again. Happy wife. Happy life. That’s how some marriages last 50 plus years. These couples just do their own activities and working is one of them.

And he loves playing golf. Being on the boat as well. But he still enjoys doing anesthesia. And guess what else? He still taking a very low $250/hr rate to work extra some days the former practice (which is under university ownership) pays him to work. And you think he’s money driven?

He donates his time to other causes as well for the community. Some people are just like that. He’s active in the local church.

 

[coffeebythelake]

My former partner. The group president. Age 72 still takes in house call! He simply loves it.

Never divorce. He’s grandpa now.

Again. Guess why? He doesn’t do it often anymore. But he says the more he’s home. The more it drives the wife crazy.

Again. Happy wife. Happy life. That’s how some marriages last 50 plus years. These couples just do their own activities and working is one of them.

And he loves playing golf. Being on the boat as well. But he still enjoys doing anesthesia. And guess what else? He still taking a very low $250/hr rate to work extra some days the former practice (which is under university ownership) pays him to work. And you think he’s money driven?

He donates his time to other causes as well for the community. Some people are just like that. He’s active in the local church.

Sounds like a nice life

 

[triggermaster]

misandry- ‘happy wife, happy life’

 

[GravelRider]

My former partner. The group president. Age 72 still takes in house call! He simply loves it.

Never divorce. He’s grandpa now.

Again. Guess why? He doesn’t do it often anymore. But he says the more he’s home. The more it drives the wife crazy.

Again. Happy wife. Happy life. That’s how some marriages last 50 plus years. These couples just do their own activities and working is one of them.

And he loves playing golf. Being on the boat as well. But he still enjoys doing anesthesia. And guess what else? He still taking a very low $250/hr rate to work extra some days the former practice (which is under university ownership) pays him to work. And you think he’s money driven?

He donates his time to other causes as well for the community. Some people are just like that. He’s active in the local church.

You can still work in anesthesia without taking call. I can 100% guarantee his decision to take call is a financial one. That could be anything like funding a divorce, funding a lifestyle, or funding an inheritance. Call is the absolute worst thing about anesthesia and unless you are some kind of psychopath, no one in anesthesia truly loves taking call.

 

[pgg]

You can still work in anesthesia without taking call. I can 100% guarantee his decision to take call is a financial one. That could be anything like funding a divorce, funding a lifestyle, or funding an inheritance. Call is the absolute worst thing about anesthesia and unless you are some kind of psychopath, no one in anesthesia truly loves taking call.

Agreed

Night call is awful and get worse and worse as I get older. Hate it. But it pays well and the pre/post time off is nice.

Weekend day call though. I realized not long ago that now that I'm retired from parenting, Saturdays aren't any different than Tuesdays. I'd be perfectly happy working Wed-Thu-Fri-Sat-Sun *days* every week, especially since the Sat-Sun days are ultimately paid at a higher rate. Routinely having some weekdays off would be useful too.

 

[aneftp]

You can still work in anesthesia without taking call. I can 100% guarantee his decision to take call is a financial one. That could be anything like funding a divorce, funding a lifestyle, or funding an inheritance. Call is the absolute worst thing about anesthesia and unless you are some kind of psychopath, no one in anesthesia truly loves taking call.

Nope. I’ve known the guy for 20 plus years.

Believe it or not. He loves anesthesia.

Does he take q4 regularly call anymore. Absolutely not. He does it every 10 weeks or so. He doesn’t work “full time”. Closely to 0.7% of the time. He doesn’t need health care either. Since he’s Medicare age. So what else do you have for me his motivating factor?

But he still takes calls.

Not everyone is financially motivated. (I am financially motivated up to a certain point to be honest) But this dude has paid off homes in Florida , Georgia and North Carolina. Has 10 investment beach condos (all paid off) netting him 300k a year. I know him extremely well.

But some people love what they do. Im being brutally honest. I don’t love
My job. Just like you don’t love your job

Even my “retired” ups friend who’s worth millions retired age 54 (due to stock options). He goes back during the holiday season and works like 60 hours in ups logistics during the busiest time of the year. He’s not divorced either.

You seem burned out from call. That’s perfectly normal. But to make a blanket statement someone takes calls for monetary reasons when they don’t have. It’s just painting the wrong picture. Some people just love their jobs.

 

[Dr. Rude]

Agreed

Night call is awful and get worse and worse as I get older. Hate it. But it pays well and the pre/post time off is nice.

Weekend day call though. I realized not long ago that now that I'm retired from parenting, Saturdays aren't any different than Tuesdays. I'd be perfectly happy working Wed-Thu-Fri-Sat-Sun *days* every week, especially since the Sat-Sun days are ultimately paid at a higher rate. Routinely having some weekdays off would be useful too.

Not so much in the places I have worked. Lots of stress about not having enough staff on weekend days for concurrent emergencies. On a weekday, no problem just not starting an elective case.

 

[sevo00]

Call isn’t so bad if you’re at a low acuity place. I don’t mind it. Start the day late in the afternoon and the next day totally off. Go to grocery store off peak hours and gym to workout when minimal people there

 

[GravelRider]

Nope. I’ve known the guy for 20 plus years.

Believe it or not. He loves anesthesia.

Does he take q4 regularly call anymore. Absolutely not. He does it every 10 weeks or so. He doesn’t work “full time”. Closely to 0.7% of the time. He doesn’t need health care either. Since he’s Medicare age. So what else do you have for me his motivating factor?

But he still takes calls.

Not everyone is financially motivated. (I am financially motivated up to a certain point to be honest) But this dude has paid off homes in Florida , Georgia and North Carolina. Has 10 investment beach condos (all paid off) netting him 300k a year. I know him extremely well.

But some people love what they do. Im being brutally honest. I don’t love
My job. Just like you don’t love your job

Even my “retired” ups friend who’s worth millions retired age 54 (due to stock options). He goes back during the holiday season and works like 60 hours in ups logistics during the busiest time of the year. He’s not divorced either.

You seem burned out from call. That’s perfectly normal. But to make a blanket statement someone takes calls for monetary reasons when they don’t have. It’s just painting the wrong picture. Some people just love their jobs.

I’m not disagreeing that some people love their jobs. I’m just disagreeing that some people love taking call. I have encountered all types in my travels through anesthesia and I have yet to meet anyone who says “Yay! I’m on call today!”

Agreed

Night call is awful and get worse and worse as I get older. Hate it. But it pays well and the pre/post time off is nice.

Weekend day call though. I realized not long ago that now that I'm retired from parenting, Saturdays aren't any different than Tuesdays. I'd be perfectly happy working Wed-Thu-Fri-Sat-Sun *days* every week, especially since the Sat-Sun days are ultimately paid at a higher rate. Routinely having some weekdays off would be useful too.

I don’t mind weekend days either. Often there are less hassles on the weekend and you can focus just on clinical work. There’s no clipboard warriors making sure every bit of body hair is covered or charge nurse reporting you if the patient is in the OR 30 seconds late. All the stupid joint commission stuff that wastes everyone’s time and patience during the week gets relaxed on the weekend. It’s a reminder of how pleasant our jobs can be.

 

[GravelRider]

Call isn’t so bad if you’re at a low acuity place. I don’t mind it. Start the day late in the afternoon and the next day totally off. Go to grocery store off peak hours and gym to workout when minimal people there

Yes, but you are doing that for a perk…not because you love call. Call is incentivized with money or lifestyle perks or both. Call is basically a gamble…am I going to get paid for sleeping? As I get older, the odds that I win that gamble or the rewards for taking that gamble have to meet a certain threshold until some point where I decide it’s simply no longer worth it to play the game.

 

[DesiredMemberName?]

If the guy is 0.7 and takes one call every 10 weeks, it’s not because he’s financially motivated.

He probably does get some sense of fulfillment from the clinical work, helping his partners, or both. What a sicko

 

[aneftp]

Yes, but you are doing that for a perk…not because you love call. Call is incentivized with money or lifestyle perks or both. Call is basically a gamble…am I going to get paid for sleeping? As I get older, the odds that I win that gamble or the rewards for taking that gamble have to meet a certain threshold until some point where I decide it’s simply no longer worth it to play the game.

For 99% of the population. A job is a job.

But to say call is a punishment. I tend to disagree.

1. Do you want to work 7-3pm (5 days a week)?

2. Or work 3p-7am Monday call
Wednesday call 3pm-7am
Friday 7-3p

I’d take option number 2

Why?
Have more time off for option 2.

 

[GravelRider]

For 99% of the population. A job is a job.

But to say call is a punishment. I tend to disagree.

1. Do you want to work 7-3pm (5 days a week)?

2. Or work 3p-7am Monday call
Wednesday call 3pm-7am
Friday 7-3p

I’d take option number 2

Why?
Have more time off for option 2.

I never said call is a punishment, but it sucks and if it weren’t compensated with money or perks, people wouldn’t do it. Again, this conversation began when we started talking about taking call into your 60s and 70s, not comparing general working options. As I age, taking call at a reasonably busy hospitals where I am doing some kind of work late into the night and early morning hours most nights takes a larger and larger toll on me. People who are of typical retirement age and continue to take call at these reasonably busy hospitals are 100% making a financial decision. I don’t care what people say about their love of anesthesia or love of their partners. I just don’t believe it. I’m also not talking about some sleepy rural hospital where a case occurring after midnight can be counted on one hand annually.

 

[ucsfgaspain]

Call blows when you are old (if you work at a busy big hospital). Call is manageable when you are young. How do I know? because I'm old now (As an aside, never understood what a pain in the ass presbyopia is until it happened to me). I pay my younger colleagues to take my call allotment. It's a win/win. They get more money in their pocket and I get more sleep IYKYK. It's the rare old guy that doesn't get dinged up from sleep deprivation. I'm hyperaware of the effects of sleep debt since I'm an endurance sports guy (head nod to gravelrider and ane ftp if I read that handle correctly) and have always been interested in the whole lifespan and healthspan field. $$ is a tool to avoid the bad things of life, and i deploy it as such.

I also think the "utility" of life is front loaded i.e. a year in your earlier decades is so much more valuable than a year in the later decades. So I want to utilize my resources to front load life. That is often forgotten in our society which just wants to accumulate $$$ without putting too much thought as to what the end goal is. But to each their own. Do what floats your boat.

BTW to circle back to the main topic, I graduated from Stanford in the early 90's, Yeah my dumb a$$ went into medicine. So I have a very clear concept of what the alternative could have been. But I did get a good consolation prize. I married tech So that cushioned the blow a lot

 

[aneftp]

I never said call is a punishment, but it sucks and if it weren’t compensated with money or perks, people wouldn’t do it. Again, this conversation began when we started talking about taking call into your 60s and 70s, not comparing general working options. As I age, taking call at a reasonably busy hospitals where I am doing some kind of work late into the night and early morning hours most nights takes a larger and larger toll on me. People who are of typical retirement age and continue to take call at these reasonably busy hospitals are 100% making a financial decision. I don’t care what people say about their love of anesthesia or love of their partners. I just don’t believe it. I’m also not talking about some sleepy rural hospital where a case occurring after midnight can be counted on one hand annually.

If you ask my 72 year old colleague if he likes covering 1:4 and doing 10-12 blocks a day running around vs taking night call solo when things die down at 7/8pm. He’d take the call.

Same thing at super busy trauma one center. The 3 dudes who do the night float 7p-7am at 58/62/64!! Day shift and night shift are paid the same. They all average the same hours. But night float docs get more time off.

The old kids all want the night float slot. Cause all the damage from the work load comes from daytime work.

Once you start separating 24 hours into 12-18 hour work load. Take the night call slot.

The work load decreases tremendously

I’m not saying it’s for everyone.

Calls work for some people.

For your situation it seems like you need to move towards more day shift or your practice needs to get with the modern times and move towards night float system.

 

[aneftp]

Call blows when you are old (if you work at a busy big hospital). Call is manageable when you are young. How do I know? because I'm old now (As an aside, never understood what a pain in the ass presbyopia is until it happened to me). I pay my younger colleagues to take my call allotment. It's a win/win. They get more money in their pocket and I get more sleep IYKYK. It's the rare old guy that doesn't get dinged up from sleep deprivation. I'm hyperaware of the effects of sleep debt since I'm an endurance sports guy (head nod to gravelrider and ane ftp if I read that handle correctly) and have always been interested in the whole lifespan and healthspan field. $$ is a tool to avoid the bad things of life, and i deploy it as such.

I also think the "utility" of life is front loaded i.e. a year in your earlier decades is so much more valuable than a year in the later decades. So I want to utilize my resources to front load life. That is often forgotten in our society which just wants to accumulate $$$ without putting too much thought as to what the end goal is. But to each their own. Do what floats your boat.

BTW to circle back to the main topic, I graduated from Stanford in the early 90's, Yeah my dumb a$$ went into medicine. So I have a very clear concept of what the alternative could have been. But I did get a good consolation prize. I married tech So that cushioned the blow a lot

Dementia is real with lack of sleep as we age. Newer study confirms what we already know with lack of real sleep.

I’m not saying taking calls is great especially older folks. But not everyone works at super busy hospitals with regular q6/8 calls and lack of sleep.

If your hospital is busy. Consider a true night float call system. Some one will do it. Especially if the reward is extra time off.

https://www.ajpmonline.org/article/S0749-3797(23)00009-0/fulltext#:~:text=UP%20to%2044%25%20of%20patients,bodies%20or%20Parkinson%20disease%20dementia.

 

[Sriddymopboi]

Dementia is real with lack of sleep as we age. Newer study confirms what we already know with lack of real sleep.

I’m not saying taking calls is great especially older folks. But not everyone works at super busy hospitals with regular q6/8 calls and lack of sleep.

If your hospital is busy. Consider a true night float call system. Some one will do it. Especially if the reward is extra time off.

https://www.ajpmonline.org/article/S0749-3797(23)00009-0/fulltext#:~:text=UP%20to%2044%25%20of%20patients,bodies%20or%20Parkinson%20disease%20dementia.

While I don't doubt your claim that lack of sleep can probably lead to dementia, the article you posted discusses how sleep disturbances is correlated with development of dementia. Lack of sleep from the job isn't classified as a sleep disturbance per se.

 

[anbuitachi]

Let's say all you do is max out a single retirement account at 23k a year starting at 30. Lets say your employer is cheap and only contributes another 7k to your 401. At 50, you add another 7k catch up contributions. Let's assume you get a very conservative 8% interest.
At 65, you'll have 6M invested.

Add 7k to a single roth IRA for 35 years, and now you're at 7.5M.

Add the equity and appreciation on a decent home 30 years from now and your net worth is north of 10M.

Are you telling me there's any doctor out there that can't max out a single retirement and one Roth account? If so, they have a spending problem.
No stars need to line up.
Just consistency and trust the process.

I have no idea why every single doctor doesnt retire with more than 10M NW.

Your specific situation is atypical.
And even still, you're looking at 27 instead of 35 years. So retire with 7-8M instead of 10M or put an extra 1-2k a month and make up for lost time.

But my example was for a family maxing out one retirement account and one roth for 35 years. The vast majority of doctors with a spouse can, should, and generally do max at least 2 retirement accounts, or at the very least- one retirement and 2 roths. My example was super conservative and still got you to a 10M nw.

Yet stats show a vast minority of docs retire with a NW >5M. It's baffling, and a real shame.

A lot of doctors cant do it. And if a lot cant do it, then those situations are no longer atypical. Its similar to what I said to another post. You are saying if stars line up. If there are no divorce, no medical emergencies, no career issues ,etc then yes you should reach 10m if you dont spend like crazy in 30 years, and assuming past performance equals future performance.

Also also you are including pretax money in that 10M number. Most of this in your example is from 401k. That's pretax. So take a few M off that number.

And you underestimate expense in VHCOL areas, especially with the student loans we are graduating with today and home/rental costs.
And you are using present 10M because you are using present contribution #s. No one knows what 10M is worth in 30 years from now. In the past 3-4 years, the value of your money went down significant.


Assuming 3% interest rate, your 10M today is worth 24.3M in 30 years. To enter the top 1% in wealth today, you need ~15M today.


Lets ask again, how many doctors can save 24.3 M post tax for retirement?

 

[aneftp]

A lot of doctors cant do it. And if a lot cant do it, then those situations are no longer atypical. Its similar to what I said to another post. You are saying if stars line up. If there are no divorce, no medical emergencies, no career issues ,etc then yes you should reach 10m if you dont spend like crazy in 30 years, and assuming past performance equals future performance.

Also also you are including pretax money in that 10M number. Most of this in your example is from 401k. That's pretax. So take a few M off that number.

And you underestimate expense in VHCOL areas, especially with the student loans we are graduating with today and home/rental costs.
And you are using present 10M because you are using present contribution #s. No one knows what 10M is worth in 30 years from now. In the past 3-4 years, the value of your money went down significant.


Assuming 3% interest rate, your 10M today is worth 24.3M in 30 years. To enter the top 1% in wealth today, you need ~15M today.


Lets ask again, how many doctors can save 24.3 M post tax for retirement?

I agree with your post. It’s extremely hard to save even 5 million by age 50 (those people went through the housing crash and stock market crash) with kids and high cost of living area.

Anyone who is under age 42 /43 out in practice less than 14 years) really hasn’t experience a crash.

Anyone who purchased a home 2010-2021 is pretty much sitting pretty with both home values and 401k values never knowing a true prolong downturn like 2000/2001 tech stock crash 40% that didn’t recover for many (some out of business)

Housing stayed flat for 10 plus years 2010-2020 as well

Same thing happens in the 1990s. The Cold War ending and places like high cost places like dc and San Diego experience housing decreases 1989-1991 and didn’t recover for a decade either.

 

[Nocturnist]

A lot of doctors cant do it. And if a lot cant do it, then those situations are no longer atypical. Its similar to what I said to another post. You are saying if stars line up. If there are no divorce, no medical emergencies, no career issues ,etc then yes you should reach 10m if you dont spend like crazy in 30 years, and assuming past performance equals future performance.

Also also you are including pretax money in that 10M number. Most of this in your example is from 401k. That's pretax. So take a few M off that number.

And you underestimate expense in VHCOL areas, especially with the student loans we are graduating with today and home/rental costs.
And you are using present 10M because you are using present contribution #s. No one knows what 10M is worth in 30 years from now. In the past 3-4 years, the value of your money went down significant.


Assuming 3% interest rate, your 10M today is worth 24.3M in 30 years. To enter the top 1% in wealth today, you need ~15M today.


Lets ask again, how many doctors can save 24.3 M post tax for retirement?

Me: you can have a normal BMI. All you need to do is literally just exercise regularly and burn more calories than you consume.

You: most Americans are obese. And if they can't be in shape, then I can't do it either. You're underestimating the difficulty of 20 mins of exercise and my inability not to snack before bed.

Yup, it sounds that ridiculous. You can stick to your victim mentality, or you can just max out one retirement account and one Roth for 30 years, and retire a multimillionaire.

Few notes:
- I'm not underestimating the expenses, I live in a HCOL area myself. I'm not frugal by any means.
-I have kids
-i had loans, paid them off moonlighting through residency.
- Inflation historically is 2.4% in last 20 years and 2.2% in last 100 years. If you're going to use a 3% inflation rate over the next 30 years, I'm going to use a 10% historical s&p return rate and blow your numbers out of the water.
-nobody uses after tax money when calculating or talking about NW. First its not practical, because everyone's tax rate varies widely. Second, capital gains taxes are a bargain compared to income taxes.
-I don't really need to enter the top 1% wealth or care where it's at. It skewed by the likes of pro athletes, hollywood stars, entrepreneurs, billionaires, trust fund babies etc. I just need to accumulate enough to provide me steady returns that allow me to replace my income so I can maintain my QOL indefinitely.
-the contribution limits of retirement accounts are increased proportionally with inflation by the IRS, specifically to account for erosion of purchasing power by your retirement age. So just continue maxing your retirement account and inflation is accounted for.

I'm just a hospitalist, all you anesthesiologists supposedly have a much higher earning potential than me. I'm on track to have a NW of 5M around age 40. I don't think there's anything special about me. If I don't contribute another penny and just don't touch my nest egg, I'll have over 25M by retirement age. If I can do it, you can do it.

 

[aneftp]

Me: you can have a normal BMI. All you need to do is literally just exercise regularly and burn more calories than you consume.

You: most Americans are obese. And if they can't be in shape, then I can't do it either. You're underestimating the difficulty of 20 mins of exercise and my inability not to snack before bed.

Yup, it sounds that ridiculous. You can stick to your victim mentality, or you can just max out one retirement account and one Roth for 30 years, and retire a multimillionaire.

Few notes:
- I'm not underestimating the expenses, I live in a HCOL area myself. I'm not frugal by any means.
-I have kids
-i had loans, paid them off moonlighting through residency.
- Inflation historically is 2.4% in last 20 years and 2.2% in last 100 years. If you're going to use a 3% inflation rate over the next 30 years, I'm going to use a 10% historical s&p return rate and blow your numbers out of the water.
-nobody uses after tax money when calculating or talking about NW. First its not practical, because everyone's tax rate varies widely. Second, capital gains taxes are a bargain compared to income taxes.
-I don't really need to enter the top 1% wealth or care where it's at. It skewed by the likes of pro athletes, hollywood stars, entrepreneurs, billionaires, trust fund babies etc. I just need to accumulate enough to provide me steady returns that allow me to replace my income so I can maintain my QOL indefinitely.
-the contribution limits of retirement accounts are increased proportionally with inflation by the IRS, specifically to account for erosion of purchasing power by your retirement age. So just continue maxing your retirement account and inflation is accounted for.

I'm just a hospitalist, all you anesthesiologists supposedly have a much higher earning potential than me. I'm on track to have a NW of 5M around age 40. I don't think there's anything special about me. If I don't contribute another penny and just don't touch my nest egg, I'll have over 25M by retirement age. If I can do it, you can do it.

Again. You have not felt the pain of a crash stock market or housing crash.

As anything in life. Some luck. Some good timing

Image being a pretty new grad in 2004/5. The wife wants a new home. You become a big attending making “real money” aka 220k on a partnership track in 2005. Partners make 500k. 3 year partnership track.

You buy that fancy new home for say 700k stretch your budget a little knowing you will make big money in 2006.

That home value goes down to 450k by 2010. The bank won’t let you short sale because you are a physician. You don’t become partner in 2008. They string you along.

Oh. The 401k tanked in 2008. All those gains you made 2005-2008 wiped out in a matter of months.

This my friend is a set back many doctors face. Both the housing crash and stock market crash.

Than guess what? The anesthesia market tanked with mega mergers in your market. Further depressing salaries. Many salaries are in the low 300s range for another 5-7 more years due to amc squeezing everything

That’s what I mean by anyone who’s been out less than 10-12 years hasn’t felt the true pain of how capital markets work.

Yes. That doc still survived. But a setback of 200k plus on a home and depressed salaries for over a decade is painful.

Their net worth after almost 20 years in the real world is probably less than 2-3 million and they are approaching or past age 50 now. Kids get more expensive as well and now they are having to pay for college.

So since you are only 40 or less. You haven’t felt real pain.

Any idiot who’s been in stock market since 2010 should have double or triplet their profolio. Same with housing prices up a staggering 50% in the past 5 years

Oh. Hospitalist salaries have more than doubled in the past 15 years. My sister in law is a hospitalist. She was making a lowly 130k a year with 10 weeks off in a very high cost of living area. Now she makes 270k with 26 weeks off. Big difference.

 

[Splenda88]

Again. You have not felt the pain of a crash stock market or housing crash.

As anything in life. Some luck. Some good timing

Image being a pretty new grad in 2004/5. The wife wants a new home. You become a big attending making “real money” aka 220k on a partnership track in 2005. Partners make 500k. 3 year partnership track.

You buy that fancy new home for say 700k stretch your budget a little knowing you will make big money in 2006.

That home value goes down to 450k by 2010. The bank won’t let you short sale because you are a physician. You don’t become partner in 2008. They string you along.

Oh. The 401k tanked in 2008. All those gains you made 2005-2008 wiped out in a matter of months.

This my friend is a set back many doctors face. Both the housing crash and stock market crash.

Than guess what? The anesthesia market tanked with mega mergers in your market. Further depressing salaries. Many salaries are in the low 300s range for another 5-7 more years due to amc squeezing everything

That’s what I mean by anyone who’s been out less than 10-12 years hasn’t felt the true pain of how capital markets work.

Yes. That doc still survived. But a setback of 200k plus on a home and depressed salaries for over a decade is painful.

Their net worth after almost 20 years in the real world is probably less than 2-3 million and they are approaching or past age 50 now. Kids get more expensive as well and now they are having to pay for college.

So since you are only 40 or less. You haven’t felt real pain.

Any idiot who’s been in stock market since 2010 should have double or triplet their profolio. Same with housing prices up a staggering 50% in the past 5 years

Oh. Hospitalist salaries have more than doubled in the past 15 years. My sister in law is a hospitalist. She was making a lowly 130k a year with 10 weeks off in a very high cost of living area. Now she makes 270k with 26 weeks off. Big difference.

What's your salary now and what is your monthly expense?

Your 700k fancy new home in 2006 should at least worth 1.3 mil now and should be paid off.

I just calculated it. Contributing 5k/month (or 60k/yr) into an S&P500 at 10% historical return should net one ~3.5 mil in 20 yrs.

If you count other assets, 4.5-5 mil net worth is not that extraordinary.

 

[aneftp]

What's your salary now and what is your monthly expense?

Your 700k fancy new home in 2006 should at least worth 1.3 mil now and should be paid off.

I just calculated it. Contributing 5k/month (or 60k/yr) into an S&P500 at 10% historical return should net one ~3.5 mil in 20 yrs.

If you count other assets, 4.5-5 mil net worth is not that extraordinary.

Again. Judging by 88 name. You are under age 40.

You have not felt pain. And no. That 700k home is worth around 1 million now. Because the real value was around 500k for over 12 years since the crash. So people purchased from 450-500k from 2010-2019.

Anyone who says it’s easy to save 5k a month in a high cost of living area is either single no kids or married and duo income.

Not many people can contribute 20k into retirement plus another 5k a month post tax into sp 500.

When I had no kids. I saved 10k a month easy. And I was only making 390k at the time. Plus putting 20k plus into retirement.

Kids and their activities and savings for 529 etc. cost at least $1500 pe

Car insurance for new driver age 16 can ran from $300-500 extra per kid per. It all add up.

I made 450k plus whatever I make on my side gig (it can vary year by year). Almost 250k last year.

Depends if I find the right gig to do extra work.

 

[GravelRider]

A lot of doctors cant do it. And if a lot cant do it, then those situations are no longer atypical. Its similar to what I said to another post. You are saying if stars line up. If there are no divorce, no medical emergencies, no career issues ,etc then yes you should reach 10m if you dont spend like crazy in 30 years, and assuming past performance equals future performance.

Also also you are including pretax money in that 10M number. Most of this in your example is from 401k. That's pretax. So take a few M off that number.

And you underestimate expense in VHCOL areas, especially with the student loans we are graduating with today and home/rental costs.
And you are using present 10M because you are using present contribution #s. No one knows what 10M is worth in 30 years from now. In the past 3-4 years, the value of your money went down significant.


Assuming 3% interest rate, your 10M today is worth 24.3M in 30 years. To enter the top 1% in wealth today, you need ~15M today.


Lets ask again, how many doctors can save 24.3 M post tax for retirement?

$24.3M to retire? WTF? I guess I should plan on living in a homeless shelter when I retire. The numbers quoted in these forums are insane sometimes.

You also didn’t account for pay increases (well maybe not for you). I’ve been in practice less than 10 years and I am making more than double what I was making when I first came out. My expenses have increased, but they haven’t doubled…not even close. If your projections for inflation are correct, but anesthesia salaries don’t keep up with inflation then you are going to hear a lot of crickets in the OR instead of the pulse ox. If you increase your spending proportionally with every pay increase then you will have a hard time saving.

It is absolutely within the ability of every physician to save $10M or much more in 30 years (whether you need that much is another topic). If priority #1 is saving $10M by X age, it is doable, so long as you make certain other choices. If you CHOOSE to live in a VHCOL area or collect Ferraris then you are making a very specific choice where accumulating wealth has no longer become a top priority for you.

 

[Splenda88]

Again. Judging by 88 name. You are under age 40.

You have not felt pain. And no. That 700k home is worth around 1 million now. Because the real value was around 500k for over 12 years since the crash. So people purchased from 450-500k from 2010-2019.

Anyone who says it’s easy to save 5k a month in a high cost of living area is either single no kids or married and duo income.

Not many people can contribute 20k into retirement plus another 5k a month post tax into sp 500.

When I had no kids. I saved 10k a month easy. And I was only making 390k at the time. Plus putting 20k plus into retirement.

Kids and their activities and savings for 529 etc. cost at least $1500 pe

Car insurance for new driver age 16 can ran from $300-500 extra per kid per. It all add up.

I made 450k plus whatever I make on my side gig (it can vary year by year). Almost 250k last year.

Depends if I find the right gig to do extra work.

I am in my mid 40s and have been an attending (hospitalist) for over 2 yrs now. Salaries have been 400k.

I got what you are saying regarding the housing market. I purchased a townhome in 2005 for 225k and it's only worth 335k now. I also purchased a house in 2011 after the crash for 150k, and it's worth 500k.