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Mman

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note: I will retire early and be working part time even before then so I am not attempting to judge anybody personally

Given that there is a shortage of physicians in this country, is there any degree of moral dilemma with someone that takes a valuable spot in a medical school class retiring from clinical practice significantly earlier than some normalish amount of time? Similarly should medical schools be biased towards accepting applicants of a younger age that will likely have a longer career in practice than someone older?

On the one hand, I am the one that did the work and took out the loans to pay for my education so giant F U to anybody that wants to tell me how to live my life. On the other hand, from a societal point of view in a valuable profession with significant limitations to people joining it I can see the downside to me cutting short my career by 30 or 50% compared to "normal". I mean if everyone did it you would need nearly twice as many medical school and residency spots to simply break even on the physician workforce.
 
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bravotwozero

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There’s no shortage of doctors in this country, only in certain regions. If you FIRE and leave, it will change nothing and you will be quickly replaced. Nothing even remotely unethical here.
 
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lanzhou_lamian

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There’s no shortage of doctors in this country, only in certain regions. If you FIRE and leave, it will change nothing and you will be quickly replaced. Nothing even remotely unethical here.
Exactly. By OPs logic, it would be "unethical" to choose to work in a major city like NYC or LA (which have plenty of doctors) when there are rural areas in the country/world that need doctors.

My opinion is work where you want for as long as you want. If you feel a desire to work until you're 65+ or go to a shortage area, that's great, but you are in no way ethically obligated to do so.
 
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FutureInternist

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The goal should be get to “F you” money ASAP.

Then one can switch to whatever schedule one prefers while keeping the “F you” bullet in the chamber for the boss when they keep making newer, stupider, more time consuming but ultimately futile policies.

I am 4 years from paying off my house (if I don’t put any bonus $ into it), and then I will have “F you” money… 🤞
 
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Mman

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There’s no shortage of doctors in this country, only in certain regions. If you FIRE and leave, it will change nothing and you will be quickly replaced. Nothing even remotely unethical here.

there is most definitely an overall shortage of physicians in this country. I don't think anybody even debates that.
 

Mman

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Exactly. By OPs logic, it would be "unethical" to choose to work in a major city like NYC or LA (which have plenty of doctors) when there are rural areas in the country/world that need doctors.

No, that is not my logic. If you are taking a job in NYC or LA, there is clearly a need for your service.
 

bravotwozero

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there is most definitely an overall shortage of physicians in this country. I don't think anybody even debates that.
Lots of people are debating that. It’s only a regional shortage because nobody likes working in the boonies. Urban areas are doing just fine. With new medical schools popping up like a Starbucks franchise, even the illusion of a shortage won’t exist.
 
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Mman

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Lots of people are debating that. It’s only a regional shortage because nobody likes working in the boonies. Urban areas are doing just fine. With new medical schools popping up like a Starbucks franchise, even the illusion of a shortage won’t exist.

It's an overall shortage in the country. It's just in urban areas there mostly isn't a shortage. And that's with us importing all sorts of foreign physicians to help plug the gaps.
 

VA Hopeful Dr

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I don't think its unethical, but its kind of a waste. You(generic) took a med school seat that could have done to someone that was going to practice for 30 years and instead only stayed in the job for 15.

My wife feels more strongly about "mommy tracks" in general for the same reason but also a concern that it will lead to potential discrimination against women "why give her a spot, she's just going to become a stay-at-home mom in 5 years anyway?"

Now I will say that I also don't judge anyone for doing this, with the exception of if going part time screws over your partners in some way.
 

Sanman

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Unethical? No, not at all. By that logic a physician or other healthcare provider should never retire or, as others have mentioned, choose to live in a preferred locale. At the end of the day, the FI part gives you options. The RE part depends on what you choose to do with your time. If you choose to go fishing for the next how many ever years, that might be a waste of skills. If it gives you the freedom to pursue interests and projects you could not due to financial insecurity, then it may actually be better for the community in some way.

I actually have a pharmacist friend that partially FI/REd last month and quit their full-time job to spend more time with the kid and build a business around a fitness hobby. The person still keeps a part-time/per diem gig as a pharmacist, but no need to be tied to a boss all the time. Have you thought about donating some time after retirement to lower income/higher need areas of the field?
 

sylvanthus

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If it was unethical, we shouldnt take older med students who have a shorter career length and should consider taking less women into med school who are more likely to go part-time.

You do you man. Dont worry, the midlevels are happy to replace you and society as a whole is cool with it.
 
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emergentmd

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It is more Unethical to NOT do what is right for you and your family.

I switched majors 6 times in college, did I do something unethical by potentially taking a spot from someone? I applied and got a prestigious job but turned it down last minute to go to med school. Is that unethical?

If anyone finds it unethical, then it is unethical to book a hotel room/restaurant reservation to cancel it b/c you likely took that spot from someone.
 
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heybrother

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Its not so much unethical as it is un-American.

Living within your means? Saving money?

You think you better than me?

If you live within your means, 1 house, 1 spouse etc.

Who will keep the divorce lawyers in business?
And the realtors who would have sold your houses?
The decorators, boat salesmen, and exotic car dealerships.

There's a lot of destroyed lives and dreams and businesses who were counting on your long career and excessive lifestyle.

Consider - way back in the day, way, way back my dad bought a $10,000 rug. Pure stupid vanity trying to keep up with other people. This is like 50 years ago - not kidding. Its sitting rolled up in a back bedroom.

If you don't engage in silly vanity like my dad did - who will be there to give your kid a fancy used up old rug they don't need?

Be the spender this country needs.
 
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thesauce

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On the one hand, I am the one that did the work and took out the loans to pay for my education so giant F U to anybody that wants to tell me how to live my life. On the other hand, from a societal point of view in a valuable profession with significant limitations to people joining it…

It costs schools far more than your tuition to train you and that is largely paid-for by the taxpayer
 

kratos99

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No. FI doesn’t mean RE. For me, I’m FI, so I can afford to sit and spend time with patients rather than seeing them quickly in order to bill more. Patients love it cuz it doesn’t seem like you are money hungry but I’m as money hungry as the doc who bills excessively. Just that my money is making money for me. When your investments go up or down 100k plus a month and ON AVERAGE go up by more than you make, you just don’t care anymore.
 
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Dusn

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It costs schools far more than your tuition to train you and that is largely paid-for by the taxpayer
This is a lie perpetuated by hospitals. Schools like to pretend it costs that much to train medstudents and hospitals like to pretend that they lose money off of training residents. Residents and fellows, especially after intern year, are cheap labor for the hospitals and the training program gets paid additional money by the VA and other hospitals that they have the residents rotate through.

If it really costs 100K/year for a hospital to train a resident then why would the VA and other outside hospitals actually pay the primary "training" hospitals to have the residents rotate through the VA -- especially when the VA is where many surgical (at least in ophtho) residents actually get most of their surgical training? Residents are a huge financial benefit to all these hospitals. Most of the teaching attending are essentially volunteering their time to teach medstudents and so even training medstudents should not be very expensive.

Doctors are not responsible for hospital and medschool administrators fleecing the taxpayer.
 
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VA Hopeful Dr

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This is a lie perpetuated by hospitals. Schools like to pretend it costs that much to train medstudents and hospitals like to pretend that they lose money off of training residents. Residents and fellows, especially after intern year, are cheap labor for the hospitals and the training program gets paid additional money by the VA and other hospitals that they have the residents rotate through.

If it really costs 100K/year for a hospital to train a resident then why would the VA and other outside hospitals actually pay the primary "training" hospitals to have the residents rotate through the VA -- especially when the VA is where many surgical (at least in ophtho) residents actually get most of their surgical training? Residents are a huge financial benefit to all these hospitals. Most of the teaching attending are essentially volunteering their time to teach medstudents and so even training medstudents should not be very expensive.

Doctors are not responsible for hospital and medschool administrators fleecing the taxpayer.
Since the word "tuition" is used, I'm guessing that post was limited to medical students. And yes, for public schools much of the tuition is subsidized by the state (ie. taxpayers).
 
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thesauce

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This is a lie perpetuated by hospitals. Schools like to pretend it costs that much to train medstudents and hospitals like to pretend that they lose money off of training residents. Residents and fellows, especially after intern year, are cheap labor for the hospitals and the training program gets paid additional money by the VA and other hospitals that they have the residents rotate through.

If it really costs 100K/year for a hospital to train a resident then why would the VA and other outside hospitals actually pay the primary "training" hospitals to have the residents rotate through the VA -- especially when the VA is where many surgical (at least in ophtho) residents actually get most of their surgical training? Residents are a huge financial benefit to all these hospitals. Most of the teaching attending are essentially volunteering their time to teach medstudents and so even training medstudents should not be very expensive.

Doctors are not responsible for hospital and medschool administrators fleecing the taxpayer.

IOW, it costs the taxpayers more than your tuition to train you.

I didn’t say medical students and residents weren’t financially beneficial to the organizations - just that the taxpayer money used to train them is more than the tuition paid. You crossed a gap to jump on a semi-related soapbox but that point remains.
 

Dusn

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IOW, it costs the taxpayers more than your tuition to train you.

I didn’t say medical students and residents weren’t financially beneficial to the organizations - just that the taxpayer money used to train them is more than the tuition paid. You crossed a gap to jump on a semi-related soapbox but that point remains.
My point is that taxpayers are paying money to hospitals and medical schools needlessly. There is no objective evidence that it really cost more to train a doctor than the tuition paid. Medical schools and hospitals just claim that it costs more and the govt and the rest of us believe them.

For very inexpensive public medical schools i agree that it may cost more. But then we should be arguing that all students, not just medical students, going to public universities owe something to society to continue working at a job that is useful to society until retirement age. Does everyone who went to a public K-12 also owe a debt to society?

My argument is that even if we do owe a debt (which I don’t think we do), it’s been more than paid for by the end of residency.
 
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dpmd

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It is no more of an ethical problem to retire early than it is to take any days off ever and to work fewer hours of the day than your body could theoretically handle without dying. No more of an ethical problem than selecting a specialty that is not as impacted by the distribution problem (not so much a shortage as a distribution problem) or selecting a job in an area already serviced by your specialty instead of going to one that lacks it. No more an ethical problem than deciding to practice medicine in the US rather than a country more in need of physicians and not more a problem than deciding to become a doctor instead of some other career that has a severe shortage and great need. If you feel some residual guilt once you retire you can always volunteer your services here or internationally or donate some of your money to good causes.
 
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RespectTheChemistry

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I'm just a non-physician bystander, but I am inclined to think that the alternative to FIRE - allowing oneself to spend a long time in toxic burnout as such that patient care begins to suffer is the thing that gets into possible ethical murky water. Just my two cents.
 
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Monocles

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100% no. Your first obligation should be to yourself. I always argue that physicians who are here by choice (ex: not forced into medicine by family or financial circumstances) are probably the happiest, and thus provide the best care.
 
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