Retiring, Changing Specialty to lower risk/pay or part time work if you had 11 Million in assets

Jun 20, 2019
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Attending Physician
I am an MD/MBA (obtained MBA later at top institution while working) whereby I specialized in Anesthesiology. I have a trust that I will be inheriting with about 8M and I'm current worth approximately 3M, so the total assets come out to be 11M. Assets are mostly liquid in a mix of stock index funds and bonds, with about 50K in misc Gold holding and 425K in a house that I bought with cash.

When I run the NPV numbers at 7% (assumption for long term returns) for 10.5M in assets (liquid portion), I obtain a negative 4.3M with a 500K cashflow after 30 years. Considering the 500K is "post tax" money, I would need to earn about 800K to obtain 500K post tax. The tax drag on trust assets for post tax assets would only be 15% for Long Term Capital Gains and income on 401K monies (approximately 3.5M of assets). So for the assumption to take into account tax drag, the pre tax income would be closer to 700K to make a fair comparison for NPV.

My questions include:

1) Does it make sense to continue to practice Anesthesiology considering the risk for high cost lawsuits? Even at 90+ percentile MGMA, I would never be able to replace this money if lost in a large malpractice. Is it logical to go to part time?

2) Go back for Pallative Care Fellowship whereby income would be closer to 230K or so but very low risk for malpractice . I could potentially use my MBA to get hospital based administrative positions as well.

3) Go into non medical field with utilization of MBA to get into consulting or related fields in insurance companies.

4) Retire. I would be very nervous to retire at early 40s and it would seem like a waste.


Any thoughts on the goal for this situation?
 
Last edited:

dpmd

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Why not just do whatever job you enjoy. The likelihood of a malpractice judgement that affects your net worth enough to impact your lifestyle is pretty damn small. If it makes you feel better, you could move to a state with malpractice reform and/or get higher than normal coverage.
 
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dpmd

Relaxing
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Still working while having 3 mill and maybe knowing about the trust to come implies one likes to work. Plus the op mentions retirement only to basically eliminate it as an option.
 

mark-ER

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Retire AND do something you want. If you enjoy palliative care / pain medicine at end of life, do that. There's a lot of cool research in anesthesia and sleep medicine, pharmacogenomics, etc. Without a huge overhead headache, you could really customize your job to exactly how you want; you might just need to find an employer who is willing to let you do that (work your network, particularly in academic settings). Heck, if some of the research pans out, you could either start a non-profit or a startup to commercialize and use that MBA.
 

cpants

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If you like anesthesia, why not work at least part time for a while? One idea is to consider working in a government job (ie. state university) or the VA where you are shielded from malpractice liability. I would definitely get a few good attorneys to take a look at your situation (tax, estate, malpractice, etc.) because there is probably a fair amount you can do to shield some of these assets as well.
 

aspiring rapper

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what did you decide? you are in a terrific position! it sounds like you can't go wrong.
 
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