Job/pay satisfaction

[bougiecric]

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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.

Will you elaborate on how you achieved this?

 

[miamidoc101]

Will you elaborate on how you achieved this?

500-550k each year for first 2 years. 300k for 6 months of 3rd year attending. There’s about 1.3mil after tax around 900k. Spent about 100k total first 2 years out, made over 200k in stock market. That gets you to over 1 mil net worth. No student loans is the big kicker.

 

[Splenda88]

500-550k each year for first 2 years. 300k for 6 months of 3rd year attending. There’s about 1.3mil after tax around 900k. Spent about 100k total first 2 years out, made over 200k in stock market. That gets you to over 1 mil net worth. No student loans is the big kicker.

You will basically win the game in another 5 yrs.

As much as we complain about medicine, it's arguably the best career path for someone with just an above average IQ (115+) to make it to the top 5%.

 

[Mount Asclepius]

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

I would challenge you to fully consider leaving EM. If you spent as much energy on a new life pursuit, I think you would find greater fulfillment. Take the leap. I flirted with a critical care fellowship for years all the way since residency, but I found a great job in a SDG and have never wanted to leave. I eventually realized EM isn’t all bad despite its negative aspects. SDN seems to attract the jaded, but you are extra crispy compared to most with many of your posts.

 

[miamidoc101]

You will basically win the game in another 5 yrs.

As much as we complain about medicine, it's arguably the best career path for someone with just an above average IQ (115+) to make it to the top 5%.

Assumption is no loans. If you have 500+k in loans before becoming an attending it’s tough sledding to get even net positive.

 

[WhatJobDoIPick]

I would challenge you to fully consider leaving EM. If you spent as much energy on a new life pursuit, I think you would find greater fulfillment. Take the leap. I flirted with a critical care fellowship for years all the way since residency, but I found a great job in a SDG and have never wanted to leave. I eventually realized EM isn’t all bad despite its negative aspects. SDN seems to attract the jaded, but you are extra crispy compared to most with many of your posts.

There are no opportunities near me, I've looked.

I'd rather work 5 more years then have the freedom to pursue my hobbies and other interests, rather than shift gears to another avenue of medicine or a normie M-F.

EM has given me a lot. It's also taken a lot. It's not all bad. I come here to B and M.

 

[emergentmd]

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.

Great Job especially in only 2 years. I don't think many with NW over 1M would have the same mindset when it comes to gas/grocery/restaurants but this really depends on what the 1M NW means. 1M NW in your home is much different than 1M cash in the bank.

5 yrs ago, I was prob at 3-5M NW and felt cash poor as most of it was in RE. Very little extra money to spend on expensive things. Fast forward to now and I have 2M cash liquidity. Completely different mindset now. I don't worry about any costs under 100K now. $2K first class ticket, $3K/night VRBO, $50K family trips, 5/10 No limit tables, $100 tip to my hair cutter doesn't bother me. Went to Tiffany with the wife, she saw a $70K piece of Jewelry. She was shocked when I told her to just get it if she likes it.

My goal is to have $10M liquidity in the next 5 yrs. 10% return is $1M a year spending and still would never need to touch investments.

 

[FrustratedFamDoc]

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.

And smaller town is generally where the $$ is. It doesn’t have to be truly rural. My county has about 100k people in it.

I’m 13 years out from residency, full panel, see about 85 patients a week working for ‘the man,’ outpatient only, and I’m well over the 90th income percentile among my peers doing nothing fancy. I’m wRVU with a very generous base.

Unicorn gig? In a lot of ways, yes, I suppose it is… but if it breaks you and/or your spouse, what’s it all for? I’ve made my peace with where I live because my circumstances dictate that I do. I’m content, but money is not why. If I stayed because of the money alone and could move but didn’t, I would be bitter daily which would spill over in to every aspect of my personal and professional life. Just not worth it.

 

[Tiger26]

Great Job especially in only 2 years. I don't think many with NW over 1M would have the same mindset when it comes to gas/grocery/restaurants but this really depends on what the 1M NW means. 1M NW in your home is much different than 1M cash in the bank.

5 yrs ago, I was prob at 3-5M NW and felt cash poor as most of it was in RE. Very little extra money to spend on expensive things. Fast forward to now and I have 2M cash liquidity. Completely different mindset now. I don't worry about any costs under 100K now. $2K first class ticket, $3K/night VRBO, $50K family trips, 5/10 No limit tables, $100 tip to my hair cutter doesn't bother me. Went to Tiffany with the wife, she saw a $70K piece of Jewelry. She was shocked when I told her to just get it if she likes it.

My goal is to have $10M liquidity in the next 5 yrs. 10% return is $1M a year spending and still would never need to touch investments.

Nicely done! I'm at almost $5M NW at 42 and just getting out of the cash-poor stage after buying and renovating about $6M in real estate over the last ten years. Starting to ramp up my brokerage account after putting $1.5 in tax deferred accounts and counting on two very stable and well-funded pensions.

Still, I'm only a year out from having almost no liquidity last January when a cascade of things happened all at once with a rental, so I ended up working about 1.75 FTE in the ED since then.

 

[Apollyon]

about 1.75 FTE

Wow! And, you're still alive? God bless you, brother!

 

[WhatJobDoIPick]

Wow! And, you're still alive? God bless you, brother!

What's the point of all the money if you have no time to enjoy it?

 

[Apollyon]

What's the point of all the money if you have no time to enjoy it?

Leave a zero balance!

 

[miamidoc101]

I think the sweet spot is making just over 500k working 130 hours a month.

 

[WhatJobDoIPick]

I think the sweet spot is making just over 500k working 130 hours a month.

Yes, that is an outlier in EM.

 

[SeekerOfTheTree]

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

I agree with this based on my experience.

 

[SeekerOfTheTree]

Here's a more nuanced take on this topic:

In summary of what you posted
"For people who are not poor, deeper unhappiness is unlikely to be solved by more money alone; nonfinancial factors like free time, relationships, and life satisfaction matter more."

We as docs are definitely not poor but alot on these forums talk about being unhappy. That's a personal issue that is at a deeper level. I would still go with a reduction in unhappiness makes me happier regardless of how they try to split it in the article.

 

[WhatJobDoIPick]

In summary of what you posted
"For people who are not poor, deeper unhappiness is unlikely to be solved by more money alone; nonfinancial factors like free time, relationships, and life satisfaction matter more."

We as docs are definitely not poor but alot on these forums talk about being unhappy. That's a personal issue that is at a deeper level. I would still go with a reduction in unhappiness makes me happier regardless of how they try to split it in the article.

My finances and personal life are great.

Unhappiness at works stems from lack of agency, control and a feeling that what you do doesn't matter. That is why people are unhappy in certain fields of medicine.

 

[AlmostAnMD]

what you do doesn't matter.

Dude. Preach

that was a huge killer for me. It wasn't just my leadership didn't care about me (I was just a "metric") or that the staffing wasn't safe or the nurses couldn't put a ****ing IV to save their own life (or someone else's!), it was that none of it mattered anyway.

In five years of attending practice I can count maybe 30 people I genuinely helped. The rest were all basically trying to kill themself, either directly (GSW to face) or slowly (eating candy bars while their insulin gtt is running). Very, very few problems I encountered weren't somehow self inflicted. Caring more than the patient does about their own health was turbo burnout fuel

Now I thrive on ****ing insurance companies

I literally lay in bed wide awake fantasizing about how I'm going to eviscerate their CMO at a state fair hearing. I get so hyped up I lose sleep over it

They steal our money

I take it back

You could argue both of us are a waste of dollars but as long as there is theft, feels good to punish thieves

 

[Brigade4Radiant]

my net worth is low (student loans family) but when im 60 if i keep with budgeting and investing my net worth should be 35 million

 

[emergentmd]

Nicely done! I'm at almost $5M NW at 42 and just getting out of the cash-poor stage after buying and renovating about $6M in real estate over the last ten years. Starting to ramp up my brokerage account after putting $1.5 in tax deferred accounts and counting on two very stable and well-funded pensions.

Still, I'm only a year out from having almost no liquidity last January when a cascade of things happened all at once with a rental, so I ended up working about 1.75 FTE in the ED since then.

Great job. When I was 42, I was nowhere near where you are. In 10 yrs when you hit my age, you should be well past where I am at.

I have switched from RE investing into mostly brokerage accounts to increase liquidity. In 10-20 yrs when u retire, you can live off your RE refinancing and pay no taxes.

This is my plan

 

[emergentmd]

my net worth is low (student loans family) but when im 60 if i keep with budgeting and investing my net worth should be 35 million

You will see when you hit 10M, budgeting matter very little to you NW. It’s like a snowball/critical mass. Once you hit about 10M, saving an extra 200k/yr is inconsequential.

When I hit critical mass, more money comes in than out no matter how much I spend.

 

[SeekerOfTheTree]

My finances and personal life are great.

Unhappiness at works stems from lack of agency, control and a feeling that what you do doesn't matter. That is why people are unhappy in certain fields of medicine.

My point was unhappiness in general, not unhappiness with your job. In regards to "agency, control and a feeling that what you do doesn't matter" you knew that before you picked this field, so did I. I've worked over a dozen jobs now and nothing about this has changed since I picked the field. I am pretty happy with the work and the money I do and the expectations I have of it and myself. I just want more money and an easier job always if I can find one.

 

[EctopicFetus]

Dude. Preach

that was a huge killer for me. It wasn't just my leadership didn't care about me (I was just a "metric") or that the staffing wasn't safe or the nurses couldn't put a ****ing IV to save their own life (or someone else's!), it was that none of it mattered anyway.

In five years of attending practice I can count maybe 30 people I genuinely helped. The rest were all basically trying to kill themself, either directly (GSW to face) or slowly (eating candy bars while their insulin gtt is running). Very, very few problems I encountered weren't somehow self inflicted. Caring more than the patient does about their own health was turbo burnout fuel

Now I thrive on ****ing insurance companies

I literally lay in bed wide awake fantasizing about how I'm going to eviscerate their CMO at a state fair hearing. I get so hyped up I lose sleep over it

They steal our money

I take it back

You could argue both of us are a waste of dollars but as long as there is theft, feels good to punish thieves

Their stock price i think shows they are doing most of the f***ing. They unlike hospitals have long sorted out that playing these games is a net positive for them. I remember years back it was put out there that United makes $1B a year in their profit just based off of float. Aka they collect premiums and delay as long as possible paying that money back out.

I think the move is to earn for yourself. Maximum $$ per time at work inclusive of travel. Some of the locums docs get all jazzed making $350/hr but dont take into account the 4 hours of commuting to get to said job. Suddenly the pay isnt that amazing. Getting an all expense paid trip to a small town 4 hours away from the airport in Minnesota in the dead of winter is all negative to me.

 

[WhatJobDoIPick]

Their stock price i think shows they are doing most of the f***ing. They unlike hospitals have long sorted out that playing these games is a net positive for them. I remember years back it was put out there that United makes $1B a year in their profit just based off of float. Aka they collect premiums and delay as long as possible paying that money back out.

I think the move is to earn for yourself. Maximum $$ per time at work inclusive of travel. Some of the locums docs get all jazzed making $350/hr but dont take into account the 4 hours of commuting to get to said job. Suddenly the pay isnt that amazing. Getting an all expense paid trip to a small town 4 hours away from the airport in Minnesota in the dead of winter is all negative to me.

I was way more excited about these types of rates as a broke new grad. Now that I have money, I see these rates and laugh. You couldn't get me out to a place like this for less than $1,000/hr, and even then likely not worth it to me since gotta get a new state license, go through credentialing, travel, etc etc

 

[retro]

I feel like the infamous 2021 study on the doom and gloom of our specialty fails to foresee one important aspect of our job. The hostile work environment that leads to quick burnout. The study assumes that all ED physicians in the workforce will stick with the job and fulfill the typical retirement age of 60-65 years old. I'm only 6 years out of residency, but even I know this is far from reality. Many ED physicians, including my colleagues get burned out quickly and exit the field. They say they can't stand it anymore. They'll transition to urgent care jobs, ketamine clinic, open up a med spa, run a botox clinic, etc whatever it takes to not work in the ED. So the new grads in the future might continue to see a decent job market. And that's not because we've reached a good supply/demand ratio or because ACEP is doing a good job. It's because many existing doctors are exiting the field, making room for others. I consider myself as someone who enjoys ED work and feels very comfortable in the chaos, but even I'm starting to feel the burnout these days. The burnout mainly stems from having to work with stupidity and ineptitude of admins / leadership, not from the patients. And that problem will come with most ED jobs out there. I'm currently 1.8 M in NW, and my plan is to buckle up and hustle for another 10 years to reach 5 M. As soon as I hit that number, I'm leaving the field without looking back. I'll live off the dividend, spend the rest of my life doing things I love with my family and friends.

 

[miamidoc101]

my goal is get to 5M net worth then live off investments and work 1 shift a week. can make 150k a year 1 shift a week, maintain brain stimulation. I think I can get there by age 40. Ride off into the sunset after

 

[Splenda88]

Why is 5M the goal for most people now? It's a lot of money.

Can people aim for 2M and then drastically reduce the number of shifts they work? Like from 12 to 6 shifts per month.

 

[sloh]

Why is 5M the goal for most people now? It's a lot of money.

Can people aim for 2M and then drastically reduce the number of shifts they work? Like from 12 to 6 shifts per month.

Personally knowing docs in HCOL with house and kids, 5M seems about right before coasting with the lifestyles they want.

 

[Porfirio]

Why is 5M the goal for most people now? It's a lot of money.

Can people aim for 2M and then drastically reduce the number of shifts they work? Like from 12 to 6 shifts per month.

Depends on how you want to live. For me, it is not enough.

You can definitely get to 2 million and coast to retirement. I would personally not live off the 2 million and instead live off the 6 shifts a month. Let the 2 million grow.

 

[Splenda88]

Personally knowing docs in HCOL with house and kids, 5M seems about right before coasting with the lifestyles they want.

If house is owned outright, 2M is a good number to coast.

 

[Splenda88]

Depends on how you want to live. For me, it is not enough.

You can definitely get to 2 million and coast to retirement. I would personally not live off the 2 million and instead live off the 6 shifts a month. Let the 2 million grow.

Not live off 2M, but have 2M and then work to cover your lifestyle. For instance 2M into a brokerage with 10% return will turn into 5M in 10 yrs. However, if you contribute 10k/month to that, it will be 7M. There is definitely a difference, but is it a substantial one?

 

[WhatJobDoIPick]

Why is 5M the goal for most people now? It's a lot of money.

Can people aim for 2M and then drastically reduce the number of shifts they work? Like from 12 to 6 shifts per month.

My goal is 2M invested and paid off house.

Then I will coast with 4-5 shifts / month.

I think I can get there in 5 years or so. Maybe 6.

I do not have an expensive lifestyle.

 

[emergentmd]

I was way more excited about these types of rates as a broke new grad. Now that I have money, I see these rates and laugh. You couldn't get me out to a place like this for less than $1,000/hr, and even then likely not worth it to me since gotta get a new state license, go through credentialing, travel, etc etc

Preach. I remember in The past moving my life around for $500/hr. I don't know what the number would be for me to do locums but it they would need to add another digit to that.

 

[EctopicFetus]

I feel like the infamous 2021 study on the doom and gloom of our specialty fails to foresee one important aspect of our job. The hostile work environment that leads to quick burnout. The study assumes that all ED physicians in the workforce will stick with the job and fulfill the typical retirement age of 60-65 years old. I'm only 6 years out of residency, but even I know this is far from reality. Many ED physicians, including my colleagues get burned out quickly and exit the field. They say they can't stand it anymore. They'll transition to urgent care jobs, ketamine clinic, open up a med spa, run a botox clinic, etc whatever it takes to not work in the ED. So the new grads in the future might continue to see a decent job market. And that's not because we've reached a good supply/demand ratio or because ACEP is doing a good job. It's because many existing doctors are exiting the field, making room for others. I consider myself as someone who enjoys ED work and feels very comfortable in the chaos, but even I'm starting to feel the burnout these days. The burnout mainly stems from having to work with stupidity and ineptitude of admins / leadership, not from the patients. And that problem will come with most ED jobs out there. I'm currently 1.8 M in NW, and my plan is to buckle up and hustle for another 10 years to reach 5 M. As soon as I hit that number, I'm leaving the field without looking back. I'll live off the dividend, spend the rest of my life doing things I love with my family and friends.

One quick point on that study.. It also didnt take into account more residencies opening.. that has happened. What i have seen is that it is hard to get a job in or near a city. When i was coming out of residency you could literally get a job in any city in the US. Denver - check, San Diego - check Seattle -check. Literally anywhere.

Now try getting a reasonable job in those cities. Frankly even tier 2 cities are tough .

 

[EctopicFetus]

Preach. I remember in The past moving my life around for $500/hr. I don't know what the number would be for me to do locums but it they would need to add another digit to that.

closest i got to locums.. Job about 2 hours from my house. 12 patients a day.. Offered me 275/hr. I said i would do it if i could do 72 hour shifts. Was a no go on the 72s. I said im good. My main job pays very well. I figured for 20k i would do it and handle a bunch of my admin type stuff while there.