Job/pay satisfaction

[gruemd]

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I don't really have anyone I can bounce this off of so I'm posting it here instead. Warning, kinda whiny brain dump ahead.

I can't seem to shut out the siren song of money, of wanting more, or maybe it's just wanting something different. I just left a job where I was making about $275 an hour W2 for a job that makes about $250/hr 1099, on a partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, so not bad at all. Very fair and equitably group. Didn't just leave for the potential of more money, but also because my prior group was too small and scheduling was too stressful - if one person took a vacation everyone felt the strain. New group is much bigger and scheduling is much easier, plus holidays/weekends are completely equitable, more so than the previous group. In a bigger city with relatively more stuff to do, restaurants, a university, etc. Plus, the old hospital had so many staffing problems. There were plenty of reasons to leave despite the pretty decent pay, so the most recent switch was not just motivated by money.

But every time I see a job posting, or someone talking about their unicorn job on reddit making $450 an hour with scribes and residents seeing 2 patients in 24 hours right next to ski slopes and ocean I just can't help but think "well what the hell am I doing at this job, let's move the family across the country so I can retire earlier!" and that mindset is driving myself and my spouse nuts. Or a coresident recently posting a job where they are that can be 400+ but is associated with a CMG and is strictly RVU based, and I know myself well enough to know that the constant push to see as many PPH as possible is not good for my mental health or longevity.

Any ideas on finding contentment with the pay I have? I'm so acutely aware that even if I was making 100/hr that we are so much better off than basically everyone in this country, and I have relatives that struggle with money, so I feel grateful for what I have, I really do. At the same time, I know my time of doing this job is limited because, well, US healthcare is a nightmare hellscape.

Compounding this is that my job isn't near my family or my spouse's family. Both of those are in very tight markets where even if I could manage to get a job it would be an immediate 1/3 or so pay cut and also both are higher cost of living. So those don't feel like options. Problem being, I don't feel particularly tied to the areas where we've lived and it just feels like why not live in that random area over this random area if the next random area pays more. The only thing that keeps me from moving is that my kids are in school and making friends, but I just don't feel "rooted" in these areas yet and making friends has proven difficult, so I just feel somewhat adrift. I'm not writing off the new job yet for that as I'm just getting started.

I don't know. Just throwing this out into the ether. Happy to hear any thoughts. Not trying to be a whiner when realistically I have so much to be thankful for, just wondering if anyone is in any similar situation and can relate. Thanks for reading.

 

[RustedFox]

Stop reading plebbit. There's the real problem.

 

[WhatJobDoIPick]

Spend less, save more.

 

[Porfirio]

The direction of the field is not good. You will likely get more out of this career in the long run by being in a good/stable SDG. Your pay $250 per hr pay is good, and it will grow to an excellent long term rate that has good coverage and work-life balance.

Many of the places that you see high hourly rates are dumpster fire places.

The places you want to be are off limits for exactly what you said (bad job market, HCOL). Do not worry about this.

Focus on: Work hard, make money, save money, limit spending, and have some fun. You are in a good place.

 

[EMdoc235]

I don't really have anyone I can bounce this off of so I'm posting it here instead. Warning, kinda whiny brain dump ahead.

I can't seem to shut out the siren song of money, of wanting more, or maybe it's just wanting something different. I just left a job where I was making about $275 an hour W2 for a job that makes about $250/hr 1099, on a partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, so not bad at all. Very fair and equitably group. Didn't just leave for the potential of more money, but also because my prior group was too small and scheduling was too stressful - if one person took a vacation everyone felt the strain. New group is much bigger and scheduling is much easier, plus holidays/weekends are completely equitable, more so than the previous group. In a bigger city with relatively more stuff to do, restaurants, a university, etc. Plus, the old hospital had so many staffing problems. There were plenty of reasons to leave despite the pretty decent pay, so the most recent switch was not just motivated by money.

But every time I see a job posting, or someone talking about their unicorn job on reddit making $450 an hour with scribes and residents seeing 2 patients in 24 hours right next to ski slopes and ocean I just can't help but think "well what the hell am I doing at this job, let's move the family across the country so I can retire earlier!" and that mindset is driving myself and my spouse nuts. Or a coresident recently posting a job where they are that can be 400+ but is associated with a CMG and is strictly RVU based, and I know myself well enough to know that the constant push to see as many PPH as possible is not good for my mental health or longevity.

Any ideas on finding contentment with the pay I have? I'm so acutely aware that even if I was making 100/hr that we are so much better off than basically everyone in this country, and I have relatives that struggle with money, so I feel grateful for what I have, I really do. At the same time, I know my time of doing this job is limited because, well, US healthcare is a nightmare hellscape.

Compounding this is that my job isn't near my family or my spouse's family. Both of those are in very tight markets where even if I could manage to get a job it would be an immediate 1/3 or so pay cut and also both are higher cost of living. So those don't feel like options. Problem being, I don't feel particularly tied to the areas where we've lived and it just feels like why not live in that random area over this random area if the next random area pays more. The only thing that keeps me from moving is that my kids are in school and making friends, but I just don't feel "rooted" in these areas yet and making friends has proven difficult, so I just feel somewhat adrift. I'm not writing off the new job yet for that as I'm just getting started.

I don't know. Just throwing this out into the ether. Happy to hear any thoughts. Not trying to be a whiner when realistically I have so much to be thankful for, just wondering if anyone is in any similar situation and can relate. Thanks for reading.

360/hour is incredible. I make like 260-270/hour. Be happy with what you have. Look at that Michigan coach who seemingly had everything. Minimize time on reddit since it can be toxic, especially the healthcare subs. Don't worry about retiring early in your 30s. Have FUN. Living in a nice area is worth the decrease in pay. Me and the fiance threw a party last night. Got super intoxicated. People loved our house. Slipped on ice at one point and busted my lip. Woke up around 1 PM and saw all the photos from last night. After a couple ibuprofens and carton of Vita Coco the hangovers gone. Early 30s are the best.

 

[Saddleshoes]

Long ago, I had a wise old Doc tell me...
"As long as you make $$$ your highest priority you will never find a job you enjoy."

 

[Janders]

I would be unhappy if was making POOR pay and also working hard. Like if my pay was bottom quartile and the job was actually moving meat and not well staffed. That would be unhappy.

But if I made solid money and the job was solid? I’m set. The enemy of good is perfect.

Don’t go chasing waterfalls.

 

[Emapp20177]

360 at 1.5pph is amazing. The buy in time hurts, but even so it's a reasonable starting rate. Must have a great payer mix or something. Well above the norm per patient. Unless you're signing loads of mid-level charts or something.

 

[Pinner Doc]

I don't really have anyone I can bounce this off of so I'm posting it here instead. Warning, kinda whiny brain dump ahead.

I can't seem to shut out the siren song of money, of wanting more, or maybe it's just wanting something different. I just left a job where I was making about $275 an hour W2 for a job that makes about $250/hr 1099, on a partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, so not bad at all. Very fair and equitably group. Didn't just leave for the potential of more money, but also because my prior group was too small and scheduling was too stressful - if one person took a vacation everyone felt the strain. New group is much bigger and scheduling is much easier, plus holidays/weekends are completely equitable, more so than the previous group. In a bigger city with relatively more stuff to do, restaurants, a university, etc. Plus, the old hospital had so many staffing problems. There were plenty of reasons to leave despite the pretty decent pay, so the most recent switch was not just motivated by money.

But every time I see a job posting, or someone talking about their unicorn job on reddit making $450 an hour with scribes and residents seeing 2 patients in 24 hours right next to ski slopes and ocean I just can't help but think "well what the hell am I doing at this job, let's move the family across the country so I can retire earlier!" and that mindset is driving myself and my spouse nuts. Or a coresident recently posting a job where they are that can be 400+ but is associated with a CMG and is strictly RVU based, and I know myself well enough to know that the constant push to see as many PPH as possible is not good for my mental health or longevity.

Any ideas on finding contentment with the pay I have? I'm so acutely aware that even if I was making 100/hr that we are so much better off than basically everyone in this country, and I have relatives that struggle with money, so I feel grateful for what I have, I really do. At the same time, I know my time of doing this job is limited because, well, US healthcare is a nightmare hellscape.

Compounding this is that my job isn't near my family or my spouse's family. Both of those are in very tight markets where even if I could manage to get a job it would be an immediate 1/3 or so pay cut and also both are higher cost of living. So those don't feel like options. Problem being, I don't feel particularly tied to the areas where we've lived and it just feels like why not live in that random area over this random area if the next random area pays more. The only thing that keeps me from moving is that my kids are in school and making friends, but I just don't feel "rooted" in these areas yet and making friends has proven difficult, so I just feel somewhat adrift. I'm not writing off the new job yet for that as I'm just getting started.

I don't know. Just throwing this out into the ether. Happy to hear any thoughts. Not trying to be a whiner when realistically I have so much to be thankful for, just wondering if anyone is in any similar situation and can relate. Thanks for reading.

For me, where I live is paramount. I’ve always been a work to live, not live to work sort of gal. And I need to be somewhere where I can do the sorts of things that are important to me. (Basically, mountains and snow.)

A while ago I realized my husband and I live a pretty crush lifestyle at well under our means, so I don’t really think about the money.

Just my $0.02. Pun intended.

 

[thegenius]

I don't really have anyone I can bounce this off of so I'm posting it here instead. Warning, kinda whiny brain dump ahead.

I can't seem to shut out the siren song of money, of wanting more, or maybe it's just wanting something different. I just left a job where I was making about $275 an hour W2 for a job that makes about $250/hr 1099, on a partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, so not bad at all. Very fair and equitably group. Didn't just leave for the potential of more money, but also because my prior group was too small and scheduling was too stressful - if one person took a vacation everyone felt the strain. New group is much bigger and scheduling is much easier, plus holidays/weekends are completely equitable, more so than the previous group. In a bigger city with relatively more stuff to do, restaurants, a university, etc. Plus, the old hospital had so many staffing problems. There were plenty of reasons to leave despite the pretty decent pay, so the most recent switch was not just motivated by money.

But every time I see a job posting, or someone talking about their unicorn job on reddit making $450 an hour with scribes and residents seeing 2 patients in 24 hours right next to ski slopes and ocean I just can't help but think "well what the hell am I doing at this job, let's move the family across the country so I can retire earlier!" and that mindset is driving myself and my spouse nuts. Or a coresident recently posting a job where they are that can be 400+ but is associated with a CMG and is strictly RVU based, and I know myself well enough to know that the constant push to see as many PPH as possible is not good for my mental health or longevity.

Any ideas on finding contentment with the pay I have? I'm so acutely aware that even if I was making 100/hr that we are so much better off than basically everyone in this country, and I have relatives that struggle with money, so I feel grateful for what I have, I really do. At the same time, I know my time of doing this job is limited because, well, US healthcare is a nightmare hellscape.

Compounding this is that my job isn't near my family or my spouse's family. Both of those are in very tight markets where even if I could manage to get a job it would be an immediate 1/3 or so pay cut and also both are higher cost of living. So those don't feel like options. Problem being, I don't feel particularly tied to the areas where we've lived and it just feels like why not live in that random area over this random area if the next random area pays more. The only thing that keeps me from moving is that my kids are in school and making friends, but I just don't feel "rooted" in these areas yet and making friends has proven difficult, so I just feel somewhat adrift. I'm not writing off the new job yet for that as I'm just getting started.

I don't know. Just throwing this out into the ether. Happy to hear any thoughts. Not trying to be a whiner when realistically I have so much to be thankful for, just wondering if anyone is in any similar situation and can relate. Thanks for reading.

I think this is well above average? I suspect this is probably 75% percentile in the country. You aren't getting ripped off.

I can't imagine there are ERs where people make $450/hr seeing 2 patients. And they are only 1 hr from the ski slopes. If they exist they have a long line to get in.

If you like the people you work with, have a reasonably well run ER, and you have a pretty good hospital system, then you got a good gig and just go with it. Feel lucky.

 

[Brigade4Radiant]

One more year till 2027 job crunch

 

[DeadCactus]

I typically remind myself that:
a) There is probably a reason the job pays significantly more
b) The difference is much smaller after taxes
c) Salary variation between emergency medicine jobs is probably the least impactful part in regards to quality of life

I think people in medicine struggle when they finally get to the end of the training pathway and don't have a clear goal in front of them anymore. Then income and retirement fill the void as metrics and goals to define "success". Don't get me wrong, for some people FIRE is an actual goal. But I think for many people it is just sort of a default they fall into and they end up on a never ending delayed gratification treadmill. For those people, some time reflecting on what they actually want out of their career and life would probably be helpful. If you have clear goals, it becomes easier to explore whether other jobs actually move you closer to your goal and weight the benefit against the risk and other negatives of changing jobs.

 

[emergentmd]

partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, Very fair and equitably group

For 120hrs, you are making $532K with all of the tax benefits of being 1099. Benefits may be lacking but tax savings/retirement options greatly outweighs this.

Democratic, fair/equitable group making $246pp. You got a unicorn job that most other specialist would kill for.

This is not directly at you but just in general. I find in life people are just either built happy or unhappy regardless of their situation. You have a great job it sounds like. Not perfect but from your post, I do not think you would consider any job perfect. Figure out why you are not content because it is not the job.

 

[EctopicFetus]

My precise advice to you. The grass isnt always greener. That being said i think if you create realistic goals financially and personally using your current job and work toward that you will be happier. Stop reading about all the other jobs out there. Often times there is a "gotcha" that they fail to disclose. On top of that as someone else mentioned. Some people are built to be unhappy. For some like myself professionally I have a few no goes. I mentally can not accept working for a CMG.

For example I live in a highly desireable city. One of the groups in town is hiring, they need a few docs. Job I think is desirable. But what did they fail to disclose? The hospital is likely to sell/close. If it sells it is unlikely the group keeps the contract. Sometimes you have to dig a little deeper. If you found a job you are happy with stay with it.

If the other job is a CMG once the workforce issues hit pay is gonna drop for them. For SDGs you will be fairly protected. again this is just my 2 cents.

Set some goals, work toward them. Whatever they are financially. Do you want to hit some $$ amount? Do you want to hit FIRE by 45. Whatever it is. If you can measure it you can work toward it.

 

[old_boy]

One more year till 2027 job crunch

Explain please.

Is this because of the potential move to 4 year residencies? If so I still don’t understand.

 

[DeadCactus]

Explain please.

Is this because of the potential move to 4 year residencies? If so I still don’t understand.

Probably a reference to a famous 2021 study that estimated a surplus of almost 7,000 to 10,000 EM physicians (~10-15% surplus) by 2030; 2027 is roughly when we would be expected to cross into having more physicians than jobs. I don't know if there is newer data on how those projections are panning out. The world, the US, society, healthcare, and the profession changed drastically almost immediately after that study was published in ways that could drastically alter attrition and need (and to a lesser extent production).

Edit:

DEFINE_ME

 

[EctopicFetus]

Probably a reference to a famous 2021 study that estimated a surplus of almost 7,000 to 10,000 EM physicians (~10-15% surplus) by 2030; 2027 is roughly when we would be expected to cross into having more physicians than jobs. I don't know if there is newer data on how those projections are panning out. The world, the US, society, healthcare, and the profession changed drastically almost immediately after that study was published in ways that could drastically alter attrition and need (and to a lesser extent production).

Edit:

DEFINE_ME

All true but that study didnt take into account that even more residencies would open since then.. and they have..we are nearing the inflection point. I imagine a new reality is coming. It will be local like most things. Time will tell. I wouldnt want to be in need of a job in 2027 onward. It’s gonna be bad locations, short hours and/or bad pay. The old and established docs wont be immune either.

 

[emergentmd]

I don't know about the job market. I just feel EM docs are doing less clinical shifts either because of work/life balance vs FIRE vs higher pay/locums/less shifts vs other medical fields.

I heard the same from the 2021 study but it seems like I get more locums calls/texts/emails than every before. I have no idea how some even get my phone number to text. Maybe the flood of new EM docs are true, but every year it seems like there are more locums calls.

*edit* I just saw the 4 yr thread and shocked this is going to happen across the board. This will definitely make EM less competitive and some may not even fill but I guess it will go to all the IMGs

 

[alpinism]

I should make a new thread but from talking to current residents its getting harder and harder to find good jobs in a major city.

Hard to believe its true but even in Texas it sounds like Dallas, Houston, Austin, etc are saturated now with the exception of maybe some microhospitals and freestandings that are single coverage for 200/hr rates. Basically residents are having to consider a 1-2hr commute with blocks of shifts at small rural community hospitals if they want to stay in those cities.

 

[DeadCactus]

All true but that study didnt take into account that even more residencies would open since then.. and they have..we are nearing the inflection point. I imagine a new reality is coming. It will be local like most things. Time will tell. I wouldnt want to be in need of a job in 2027 onward. It’s gonna be bad locations, short hours and/or bad pay. The old and established docs wont be immune either.

Just to clarify, I'm in no way trying to paint an optimistic picture just an uncertain one. If anything, I'm more pessimistic with how unpredictable life seems to be becoming.

 

[WhatJobDoIPick]

All true but that study didnt take into account that even more residencies would open since then.. and they have..we are nearing the inflection point. I imagine a new reality is coming. It will be local like most things. Time will tell. I wouldnt want to be in need of a job in 2027 onward. It’s gonna be bad locations, short hours and/or bad pay. The old and established docs wont be immune either.

All the more reason to work for a SDG. At least if the ship goes down, you all go down together.

 

[EctopicFetus]

I should make a new thread but from talking to current residents its getting harder and harder to find good jobs in a major city.

Hard to believe its true but even in Texas it sounds like Dallas, Houston, Austin, etc are saturated now with the exception of maybe some microhospitals and freestandings that are single coverage for 200/hr rates. Basically residents are having to consider a 1-2hr commute with blocks of shifts at small rural community hospitals if they want to stay in those cities.

Yep. Same here.

 

[EctopicFetus]

All the more reason to work for a SDG. At least if the ship goes down, you all go down together.

And you are insulated from the work force issues imo.

 

[SeekerOfTheTree]

I don't really have anyone I can bounce this off of so I'm posting it here instead. Warning, kinda whiny brain dump ahead.

I can't seem to shut out the siren song of money, of wanting more, or maybe it's just wanting something different. I just left a job where I was making about $275 an hour W2 for a job that makes about $250/hr 1099, on a partner track of 1.5-2 years where the average partner pay has been around 360-375/hr - with seeing over just above 1.5pph, so not bad at all. Very fair and equitably group. Didn't just leave for the potential of more money, but also because my prior group was too small and scheduling was too stressful - if one person took a vacation everyone felt the strain. New group is much bigger and scheduling is much easier, plus holidays/weekends are completely equitable, more so than the previous group. In a bigger city with relatively more stuff to do, restaurants, a university, etc. Plus, the old hospital had so many staffing problems. There were plenty of reasons to leave despite the pretty decent pay, so the most recent switch was not just motivated by money.

But every time I see a job posting, or someone talking about their unicorn job on reddit making $450 an hour with scribes and residents seeing 2 patients in 24 hours right next to ski slopes and ocean I just can't help but think "well what the hell am I doing at this job, let's move the family across the country so I can retire earlier!" and that mindset is driving myself and my spouse nuts. Or a coresident recently posting a job where they are that can be 400+ but is associated with a CMG and is strictly RVU based, and I know myself well enough to know that the constant push to see as many PPH as possible is not good for my mental health or longevity.

Any ideas on finding contentment with the pay I have? I'm so acutely aware that even if I was making 100/hr that we are so much better off than basically everyone in this country, and I have relatives that struggle with money, so I feel grateful for what I have, I really do. At the same time, I know my time of doing this job is limited because, well, US healthcare is a nightmare hellscape.

Compounding this is that my job isn't near my family or my spouse's family. Both of those are in very tight markets where even if I could manage to get a job it would be an immediate 1/3 or so pay cut and also both are higher cost of living. So those don't feel like options. Problem being, I don't feel particularly tied to the areas where we've lived and it just feels like why not live in that random area over this random area if the next random area pays more. The only thing that keeps me from moving is that my kids are in school and making friends, but I just don't feel "rooted" in these areas yet and making friends has proven difficult, so I just feel somewhat adrift. I'm not writing off the new job yet for that as I'm just getting started.

I don't know. Just throwing this out into the ether. Happy to hear any thoughts. Not trying to be a whiner when realistically I have so much to be thankful for, just wondering if anyone is in any similar situation and can relate. Thanks for reading.

One thing I will comment on is this feeling of being rooted you speak of. I've moved alot and tried to make friends, establish roots, etc....I feel this is something that has become harder since covid. People just aren't the same as they were. Trying to make friends is hard as heck. I feel people have an easier time dating than actually making friends. If there was a Tinder for making friends it would be nice.

Also comparing your pay to others is the the thief of joy. The plastic surgeon I know makes 1.3 mil (public salary info due to non-profit). I was envious till I got to know him and saw that life doesn't change much between 500k-2 mil. Maybe more first class vacations and bigger house? You don't get a private plane, chef, butlers, etc. It doesn't make you happier.

Focus on yourself and you will find fulfillment/happiness in the dumbest ****.

 

[sloh]

One thing I will comment on is this feeling of being rooted you speak of. I've moved alot and tried to make friends, establish roots, etc....I feel this is something that has become harder since covid. People just aren't the same as they were. Trying to make friends is hard as heck. I feel people have an easier time dating than actually making friends. If there was a Tinder for making friends it would be nice.

Also comparing your pay to others is the the thief of joy. The plastic surgeon I know makes 1.3 mil (public salary info due to non-profit). I was envious till I got to know him and saw that life doesn't change much between 500k-2 mil. Maybe more first class vacations and bigger house? You don't get a private plane, chef, butlers, etc. It doesn't make you happier.

Focus on yourself and you will find fulfillment/happiness in the dumbest ****.

The difference between 500k and 2M can determine what neighborhood physicians with families can buy houses in as well as how fast they can hit coast FIRE, not having to really look at price tags when buying groceries/food. These all impact regular daily QOL.

 

[SeekerOfTheTree]

The difference between 500k and 2M can determine what neighborhood physicians with families can buy houses in as well as how fast they can hit coast FIRE, not having to really look at price tags when buying groceries/food. These all impact regular daily QOL.

Doesn't ultimately change QOL or happiness greatly. You might FIRE a few years earlier (if that is your primary driver) but you can't say a person making 500k can't live in a good neighborhood. I don't really look at prices of groceries so not sure how that would factor into this. The QOL to me is a marginal improvement. The problem with us on this forum is that alot of us are unhappiness and our idea of financially well off is a little disconnected from reality. Just my observation.

 

[emergentmd]

I should make a new thread but from talking to current residents its getting harder and harder to find good jobs in a major city.

Hard to believe its true but even in Texas it sounds like Dallas, Houston, Austin, etc are saturated now with the exception of maybe some microhospitals and freestandings that are single coverage for 200/hr rates. Basically residents are having to consider a 1-2hr commute with blocks of shifts at small rural community hospitals if they want to stay in those cities.

I am not sure about this. I get calls from TH for the St Davids system in Austin all the time. I know many docs who have left and told me they are always short of docs so I would be very surprised if the Austin Market is tight.

As for Dallas/Houston/SA, I get calls/emails with job offerings at high volume places in/suburbs so I would be surprised if its saturated.

 

[emergentmd]

Doesn't ultimately change QOL or happiness greatly. You might FIRE a few years earlier (if that is your primary driver) but you can't say a person making 500k can't live in a good neighborhood. I don't really look at prices of groceries so not sure how that would factor into this. The QOL to me is a marginal improvement. The problem with us on this forum is that alot of us are unhappiness and our idea of financially well off is a little disconnected from reality. Just my observation.
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I concur with a lot of this. I will say when you get to the point where money does not matter, life does get easier. Also, when money doesn't matter, that is one less stress/concern in your life.

I am just an isolated example, but I feel much less stress now when money is not an issue vs when I was making 500K/yr early in my career. But I have always been a happy person, and now instead of working 12-14 shifts/month, I now have 10-12 extra days to do what I want such as work out more, play golf often, more naps, etc....

 

[EctopicFetus]

I concur with a lot of this. I will say when you get to the point where money does not matter, life does get easier. Also, when money doesn't matter, that is one less stress/concern in your life.

I am just an isolated example, but I feel much less stress now when money is not an issue vs when I was making 500K/yr early in my career. But I have always been a happy person, and now instead of working 12-14 shifts/month, I now have 10-12 extra days to do what I want such as work out more, play golf often, more naps, etc....

Lots of research about this and what makes people happy. I actually lecture on this topic. It’s not purely the money thats true. Buying crap doesnt make you happy. Buying a 20k watch the “joy” of that lasts very briefly.

however, There are ways to spend money that will indeed make you happier. Specifically, turning money into time. (Aka hiring a housekeeper, a landscaper etc. if you dont enjoy those tasks and use that free time to do something you wouldnt do otherwise or have time to do otherwise). In addition, experiences bring joy when done with those you love and those you want to spend time with.

Brooks isnt my favorite but he is on point here.

How to Buy Happiness

The joys of money are nothing without other people.

www.theatlantic.com

So if you dont use money to buy freedom and experiences and use it for stuff or just save it then you are correct. But look at the article and the data shows you can indeed use money to buy happiness. Where the $$ cutoff is depends.

im not sure im any happier now than I was earlier but I spend 0 time worrying about my finances (#1 cause of divorce in the US, I believe), I spend where it matters, (experiences, health, landscaping, housekeeping etc.).

To do what I want to do costs money. A fair bit.. could I earn less than I do to make all this happen? Sure? If I earned 75k could I do it.. Absolutely not lol.

 

[HemorrhagicShock]

For me Happiness has always been a verb, not a destination or a number.

 

[alpinism]

I am not sure about this. I get calls from TH for the St Davids system in Austin all the time. I know many docs who have left and told me they are always short of docs so I would be very surprised if the Austin Market is tight.

As for Dallas/Houston/SA, I get calls/emails with job offerings at high volume places in/suburbs so I would be surprised if its saturated.

I'll clarify that last post the fact that you can find some jobs but they're all terrible and low paying.

I've never worked at St Davids but its TH + HCA and is well known to be a hellhole that's always hiring because they can't keep docs because the conditions are so bad in the emergency department. The added bonus is the pay is way less than surrounding places in Texas because its in Austin so you have the pleasure of 4PPH for 200/hr rates with all the TH + HCA metrics.

Not really the place I'd want to be for a first new grad job but if you're feeling truly desperate for any job.

 

[sloh]

Doesn't ultimately change QOL or happiness greatly. You might FIRE a few years earlier (if that is your primary driver) but you can't say a person making 500k can't live in a good neighborhood. I don't really look at prices of groceries so not sure how that would factor into this. The QOL to me is a marginal improvement. The problem with us on this forum is that alot of us are unhappiness and our idea of financially well off is a little disconnected from reality. Just my observation.
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Here's a more nuanced take on this topic:

"Does money buy happiness? It’s one of the oldest and most-asked questions in human history. Yet the evidence is mixed. If you believe that money can’t buy happiness, then you might have heard of the research that first popularized this claim.

In 2010, Nobel laureates Daniel Kahneman and Angus Deaton released a paper called “High Income Improves Evaluation of Life but Not Emotional Well-Being.” Their paper found that while a higher income did indeed improve how people rated their life, it didn’t have any significant impact on their emotional well-being after a certain income threshold. In other words, while more money could make you feel better about your life as a whole, it didn’t make you any happier on a day-to-day basis once you earned over $75,000 a year.[1] This was the commonly accepted wisdom for over a decade. Money can buy happiness, but it levels off eventually.

However, in 2021 Matthew Killingsworth upended the world of money and happiness research when he published a paper titled “Experienced Well-Being Rises with Income, Even Above $75,000 per Year.” His paper found that both life satisfaction and emotional well-being continued to increase with income, even beyond $75,000.[2] This directly contradicted the findings of Kahneman and Deaton and created a problem for the happiness research community.

After all, if Killingsworth’s paper disagreed with the work of two Nobel laureates, then who was right? Well, Kahneman and Killingsworth decided to team up and dig through their respective data to resolve the discrepancy. The result was a 2023 paper titled “Income and Emotional Well-Being: A Conflict Resolved.”[3] Their joint paper identified two primary differences between Kahneman’s and Killingsworth’s research.

First, they found that Kahneman and Deaton’s original measure of emotional well-being wasn’t actually measuring happiness, but unhappiness. In other words, their paper couldn’t differentiate between higher levels of happiness. For example, imagine I ask a bunch of people to rate how happy they are, from 1 to 10. Then I take that data and replace any value 7 or greater with just 7. All the 10s become 7s. All the 9s become 7s. And so forth. As you can imagine, we would no longer be able to differentiate between those who are extremely happy (i.e., the 10s) and those who are just mostly happy (i.e., the 7s). This is basically what happened in Kahneman and Deaton’s original study. As a result, they weren’t measuring whether happiness rose with higher incomes, but whether unhappiness declined with higher incomes.

These might seem like the same thing, but they’re not. One is looking at whether more money can increase happiness. The other is looking at whether more money can prevent unhappiness. As Kahneman and Deaton found in their 2010 paper, it can’t. No one is immune to unhappiness, no matter how much money they have. Therefore, the conclusion from Kahneman and Deaton’s original paper would be more appropriately stated as “Unhappiness decreases with increasing income, but there is no further decline beyond ~$75,000.”[4]

The second thing that Kahneman and Killingsworth found was that Killingsworth’s data did show a leveling off of happiness as incomes rose above $75,000. However, this was only true for the unhappiest people. When Killingsworth looked at the bottom 15 percent of people in terms of overall happiness, those who earned above $75,000 weren’t any happier than those making around $75,000. Once again, money is not an antidote for unhappiness.

Putting it all together, Killingsworth’s research ultimately won out. Money can buy happiness, but not in every circumstance. Here’s how I’d summarize what he found: If you are poor, more money will probably make you happier. If you are happy, more money will probably make you happier. But if you aren’t poor and you aren’t happy, more money won’t do a thing.

Although “more money” refers to income (not wealth) in this context, we know that income and wealth are correlated (see chapter 2). As a result, we should assume that they are interchangeable when looking at money and happiness. Killingsworth’s latest research seems to suggest this as well. His most recent paper found that those with a net worth between $3 million and $8 million (i.e., Level 4) were significantly happier than any of the income groups that he had previously studied.[5] In other words, wealthier people tend to be even happier than initially imagined.

While there isn’t a lot of happiness research on those with higher amounts of wealth, I can understand why wealth can lead to more happiness. I don’t think it’s the money itself that makes people happier, but what the money allows you to do. For example, I hate cleaning. I’m a tidy person, but I can’t stand periodically dusting, vacuuming the floors, and so forth. So when I finally had enough wealth to justify paying for a cleaning service, I did. And guess what? It’s worth every penny and I’m definitely happier because of it.

Having more money doesn’t just allow you to spend more on yourself, you can spend more on others as well. Researchers have found that those who spent more of their income on others had greater happiness.[6] This result doesn’t surprise me. However, it’s also much easier to spend money on others when you have more money to spend in the first place. Money is like the oxygen mask on an airplane. You must first secure your own mask before you can assist others.

Though there is a strong correlation between money and happiness, I don’t believe the relationship is directly causal. Having an extra zero on your bank balance isn’t going to make you jump for joy every day. But having more wealth can transform your lifestyle and how you are able to impact others. That’s where the additional happiness likely comes from.

In the context of the Wealth Ladder, more money will impact your happiness based on where you are today. For example, if you’re in Level 1 or Level 2, more money is likely to make you happier. This is true whether we are discussing wealth or income. However, if you are in Level 3 or above, more money will probably only make you happier if you are already happy. If you are miserable in Levels 3–6, more money is unlikely to be the solution.

The only way I know of escaping this loop is to shift your focus to the nonfinancial aspects of your life. These are the things that research shows can actually lead to more happiness than money. For example, one source of increased happiness is having more free time or leisure. Researchers analyzed data from seventy-nine different countries and found that “countries whose citizens value leisure more than work report higher subjective well-being at the country and individual level.” This effect was found in both richer and poorer countries.[11] Then again, you can’t enjoy your leisure time if you are constantly working to make ends meet."

 

[emergentmd]

I'll clarify that last post the fact that you can find some jobs but they're all terrible and low paying.

I've never worked at St Davids but its TH + HCA and is well known to be a hellhole that's always hiring because they can't keep docs because the conditions are so bad in the emergency department. The added bonus is the pay is way less than surrounding places in Texas because its in Austin so you have the pleasure of 4PPH for 200/hr rates with all the TH + HCA metrics.

Not really the place I'd want to be for a first new grad job but if you're feeling truly desperate for any job.

HCA/St David's was a great place to work before HCA/TH went into profit mode. Yeah it sucks now, losing docs left/right, poor staffing, etc.

But this is life. You may get 2 but almost never 3 in any job of money, location, work quality.

I worked at St Davids before HCA/TH and was one of the best job around. Never an opening. SDG, democratic. Great work quality, good pay, good location and I would say a Unicorn thus rarely an opening.

 

[EctopicFetus]

HCA/St David's was a great place to work before HCA/TH went into profit mode. Yeah it sucks now, losing docs left/right, poor staffing, etc.

But this is life. You may get 2 but almost never 3 in any job of money, location, work quality.

I worked at St Davids before HCA/TH and was one of the best job around. Never an opening. SDG, democratic. Great work quality, good pay, good location and I would say a Unicorn thus rarely an opening.

And now it sounds like CMG and HCA.. 2 devils.. best of no worlds. I guess living in Austin if thats your jam.. but professionally its zip.

 

[emergentmd]

Yeah, all the good docs jump ship is from what I understand. I bet its just all new docs or clock punchers. Sad that they turned the ER into a mess.

 

[turkeyjerky]

But this is life. You may get 2 but almost never 3 in any job of money, location, work quality.

10 years ago when I graduated, it was ‘pick 2’. Now that’s a unicorn and most are lucky to get 1.

 

[dozitgetchahi]

The difference between 500k and 2M can determine what neighborhood physicians with families can buy houses in as well as how fast they can hit coast FIRE, not having to really look at price tags when buying groceries/food. These all impact regular daily QOL.

All depends on where you live.

I make about $850k as a rheumatologist now in a LCOL area. I could buy the biggest house in town if I wanted to (I don’t, my house (which is 2000 sq ft, and nice) cost about $200k…but I live in a locale where a “very nice” house would be like $500k, and the “nicest house in town” would be $800k-1m or so).

I already don’t look at food/grocery prices and go on nice vacations. Working hard on savings, debt and FIRE etc.

 

[dozitgetchahi]

360/hour is incredible. I make like 260-270/hour. Be happy with what you have. Look at that Michigan coach who seemingly had everything. Minimize time on reddit since it can be toxic, especially the healthcare subs. Don't worry about retiring early in your 30s. Have FUN. Living in a nice area is worth the decrease in pay. Me and the fiance threw a party last night. Got super intoxicated. People loved our house. Slipped on ice at one point and busted my lip. Woke up around 1 PM and saw all the photos from last night. After a couple ibuprofens and carton of Vita Coco the hangovers gone. Early 30s are the best.

Seems like an odd way to talk up living in an HCOL area.

There are legit advantages to living in an HCOL area - better cultural opportunities, better cuisine, etc etc.

If you just want to get wasted while you show off your house, you can do that in my area for a 50% discount on your mortgage payments. But I digress.

 

[Splenda88]

All depends on where you live.

I make about $850k as a rheumatologist now in a LCOL area. I could buy the biggest house in town if I wanted to (I don’t, my house (which is 2000 sq ft, and nice) cost about $200k…but I live in a locale where a “very nice” house would be like $500k, and the “nicest house in town” would be $800k-1m or so).

I already don’t look at food/grocery prices and go on nice vacations. Working hard on savings, debt and FIRE etc.

According the the wealth ladder by Nick Maggiulli, once your net worth reaches 100k, you don't worry about grocery prices anymore. I think he is correct for the most part.

• Level 1. Paycheck-to-paycheck (<$10k): You are conscious of every dollar you spend. This includes people with crippling debt.
• Level 2. Grocery freedom ($10k–$100k): You can buy what you want at the grocery store without worrying about your finances.
• Level 3. Restaurant freedom ($100k–$1M): You can eat what you want at restaurants.
• Level 4. Travel freedom ($1M–$10M): You travel when and where you want.
• Level 5. House freedom ($10M–$100M): You can afford your dream home with little impact on your overall finances.
• Level 6. Impact freedom ($100M+): You can use money to have a profound impact on the lives of others (e.g., buy businesses, engage in large-scale philanthropy, etc.)

The Wealth Ladder (Out Now!)

On my 2nd book, The Wealth Ladder, and its proven strategies for every step of your financial life.

ofdollarsanddata.com

 

[TeddyBoomBoom]

According the the wealth ladder by Nick Maggiulli, once your net worth reaches 100k, you don't worry about grocery prices anymore. I think he is correct for the most part.

• Level 1. Paycheck-to-paycheck (<$10k): You are conscious of every dollar you spend. This includes people with crippling debt.
• Level 2. Grocery freedom ($10k–$100k): You can buy what you want at the grocery store without worrying about your finances.
• Level 3. Restaurant freedom ($100k–$1M): You can eat what you want at restaurants.
• Level 4. Travel freedom ($1M–$10M): You travel when and where you want.
• Level 5. House freedom ($10M–$100M): You can afford your dream home with little impact on your overall finances.
• Level 6. Impact freedom ($100M+): You can use money to have a profound impact on the lives of others (e.g., buy businesses, engage in large-scale philanthropy, etc.)

The Wealth Ladder (Out Now!)

On my 2nd book, The Wealth Ladder, and its proven strategies for every step of your financial life.

ofdollarsanddata.com

I’ve never seen this but I like it. I don’t necessarily agree 100% but it’s food for thought.

 

[sloh]

I’ve never seen this but I like it. I don’t necessarily agree 100% but it’s food for thought.

It's a great book. One of my favorite interviews with Magiulli is this one:



At 50:26 he talks about how starting at Level 5 (10M), you kind of have enough money to solve anything that can be solved with money. And also getting to 10M is almost impossible just grinding away at a job and regular investing.

 

[miamidoc101]

Im finally above net worth 1 mil (just over 2 years out). Im at point now where gas/grocery/restaurant costs dont really matter/I dont even look at what it costs. Pretty much any reasonable vacation (not staying at the 4 seasons every night) is extremely comfortable.

 

[Splenda88]

Im finally above net worth 1 mil (just over 2 years out). Im at point now where gas/grocery/restaurant costs dont really matter/I dont even look at what it costs. Pretty much any reasonable vacation (not staying at the 4 seasons every night) is extremely comfortable.

You can do it if this is your thing, especially if it is short vacations (< 7 days). It won't affect much your net worth retirement trajectory.

 

[FrustratedFamDoc]

What good is the extra $$ if you’re too damn depressed to enjoy it? Compound in family/marital strain because she is now with someone she no longer recognizes (you) and a town she despises (because of you)…. You’ll need the extra $$ for alimony and child support. If mama ain’t happy… Don’t become just another rich but broke alcoholic doc who resents everything.

I’m not EM, but we all (physicians) eat the same soup. Sometimes it’s a delicious lobster bisque, other times it’s the most unspeakable hep b infested piss from a Chinese restaurant in Boaz, Alabama. The bisque will naturally cost you a ton more.

Chose sanity above all else man. I’m FM and stayed in the same town I did residency 16 years ago. It’s a surprisingly good town for healthcare, but no situation is perfect. I’m in a small town in the SE (I’m from the South so no biggy culturally) and the weather is depressing as hell 4 months out of year. Substance abuse is high and you can frequently feel the malaise in the air. We can’t keep a good psychiatrist more that a couple years and they closed what was a very good, very large, inpatient psych facility, because well, you know, screw those ‘crazy’ people, right? Get a job? As expected, it’s worked out swimmingly.

My wife is a local, and our very significant family ties are such that we’re not going anywhere for the foreseeable future. She and I often say we’d leave tomorrow, but It just wouldn’t work… but I live in a freshwater fishing paradise. I can be in Nashville, Atlanta, Chattanooga, Birmingham, Huntsville, Asheville in 1-3 hours. I’m 6 hours from the gulf. I make a **** ton more $ since the big fish ate our group a few years ago and find myself buying more stuff, but I can say that am 0% happier for it, even though my salary basically doubled.

I made my peace with my circumstances years ago, and that’s really what it’s all about. The order of operations is:

contentment leads to peace leads to happiness. It’s the only way it works.

 

[EMdoc235]

Im finally above net worth 1 mil (just over 2 years out). Im at point now where gas/grocery/restaurant costs dont really matter/I dont even look at what it costs. Pretty much any reasonable vacation (not staying at the 4 seasons every night) is extremely comfortable.

Grats, join the club. I don't think I'd want to stay in the 4 seasons until I'm like 50. I don't spend much time in hotels or spas and it would be a waste.

 

[Groove]

I need 10M to 100M to afford my dream home? Say what? Whoever made that list has been watching too many of those French Chateau renovations where normal peeps buy these French castles and get state/country financing to help restore it and then pretend they are kings and queens.



(I do love watching that channel though, lol. I'd love to retire and do something like that as a full time job. The wife cut down that idea pretty quickly though.)

 

[Porfirio]

I need 10M to 100M to afford my dream home? Say what? Whoever made that list has been watching too many of those French Chateau renovations where normal peeps buy these French castles and get state/country financing to help restore it and then pretend they are kings and queens.



(I do love watching that channel though, lol. I'd love to retire and do something like that as a full time job. The wife cut down that idea pretty quickly though.)

Rich dude, younger wife, dog, French country side, not a kid in sight… Definitely a millennial dream.

 

[Saddleshoes]

...
My wife is a local, and our very significant family ties are such that we’re not going anywhere for the foreseeable future. She and I often say we’d leave tomorrow, but It just wouldn’t work… but I live in a freshwater fishing paradise. I can be in Nashville, Atlanta, Chattanooga, Birmingham, Huntsville, Asheville in 1-3 hours. I’m 6 hours from the gulf. I make a **** ton more $ since the big fish ate our group a few years ago and find myself buying more stuff, but I can say that am 0% happier for it, even though my salary basically doubled.

I made my peace with my circumstances years ago, and that’s really what it’s all about. The order of operations is:

contentment leads to peace leads to happiness. It’s the only way it works.

FrustratedFamDoc has just shared the secret to success in going rural!!!!!
Any healthcare professional that goes to the "Big City" for schooling and marries a city girl/boy, they meet in school, is not ever going to small town America to practice.

 

[WhatJobDoIPick]

Speaking of pay, I recently was presented with an "opportunity" for 1099 locums paying $320 for "high volume overnights."

Man...stick a fork in EM... it's done.

 

[Groove]

Rich dude, younger wife, dog, French country side, not a kid in sight… Definitely a millennial dream.

Well, they are both actually Gen X and in their 50s. The husband is an ex Australian politician. I don't think they are "rich" in the common sense of the word but no doubt had enough money to commit to the project. He had a normal politician salary which wasn't anything extravagant but she comes from money and is heiress to some sort of brick company I believe. The entire Chateau cost about 870K USD or roundabouts if I recall correctly but watching the restoration from the get go when they got there and had like one room that was habitable is pretty cool to watch how far they've come. Obviously the restoration is costing millions if not tens of millions and they have lots of heritage organizations and state assets, crowd funding, etc.. that they are using to pay for it. It's kind of a cool commitment. They'll be working on this thing for most of their ordinary lives. But hey, not a bad place to retire and live out the end of your life. I love watching them discover historical stuff in the attics and on the grounds, etc.. It's a super cool show and I think she does the YT videos and the editing is great. They're a good team and both obviously have good work ethic as they'll be cranking out labor intensive stuff all day long and never seem to complain. (on camera!)