What is your rich life like?

[Brigade4Radiant]

Through my palliative care practice I have spent hundreds of hours with people on their death beds. I'll give you one guess how many of them said "I wish that I'd worked more".

True but the fact is if you sent them back with good health they would probably still work more for money.

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[miacomet]

I look at the other forums, where people actually enjoy their jobs, and ugh, what a waste this has been. That would be my rich life.

 

[miacomet]

Through my palliative care practice I have spent hundreds of hours with people on their death beds. I'll give you one guess how many of them said "I wish that I'd worked more".

Ok, now I want more words of wisdom...what else?

 

[WilcoWorld]

Ok, now I want more words of wisdom...what else?

Gosh, maybe I should just start a thread with lessons I learn from dying patients. Folks like @dchristismi and @Frazier could add to it. Here's another:

We die how we live. People who raise their families with love and care tend to be surrounded by love and care at the end of their life. People who raise their families with anger and abuse tend to either die alone, or die surrounded by angry family members who are fighting with one another.

 

[miacomet]

Gosh, maybe I should just start a thread with lessons I learn from dying patients. Folks like @dchristismi and @Frazier could add to it. Here's another:

We die how we live. People who raise their families with love and care tend to be surrounded by love and care at the end of their life. People who raise their families with anger and abuse tend to either die alone, or die surrounded by angry family members who are fighting with one another.

I would love this thread. @dchristismi? @Frazier?

 

[Welvere]

Time Freedom: Having control over one's time is a common goal. This includes having flexibility in work hours, spending quality time with family and loved ones, and having the freedom to pursue personal interests and hobbies.

 

[Brigade4Radiant]

People spend too much time thinking about a fictional death bed.

Mostly dying at home is a good death. Also it will depend on how mentally with it you are. When you’re older most people have the more fondness over a care taker then distant family

No one wished they worked more but no one wished they had less money. Money is a big factor in life your family will fight over your will and inheritance. When your children find out that you would rather give to charity than them see how comforting they are at your “ death bed”

Also a lot of people are in for a shock when they get older. Many will not have a caretaker.


Most relationships would not survive a 40k loss. Meaning give them the money first then say they will lose the money if they would rather pursue the relationship or never spoke to that person

 

[Birdstrike]

Most relationships would not survive a 40k loss. Meaning give them the money first then say they will lose the money if they would rather pursue the relationship or never spoke to that person

That would be an interesting experiment.

 

[HoosierdaddyO]

I guess I’m not rich yet lol (being only 4 years outside of fellowship)… but doing well enough where I can shop at Costco and not even have to think twice. Or going out to dinner with friends or family and picking up the tab, without even flinching at grabbing the check. It’s the peace of mind knowing that when my car needed 2500 dollars in repairs after the rotary belt destroyed everything in its path… I knew all my other expenses would not take a hit because of this car cost.

Little things here and there that with growing up in a low middle class family where I saw my parents who busted their behind having to count all the Nickels and Dimes to budget. It’s the sense of comfort that comes with unforeseen costs, getting to enjoy a little bit of the nice life (getting that surf and turf), and also the hope that over time… I’ll be able to use my finances to buy free time.

 

[Fox800]

Mods: how can I *plonk* this thread before it turns into Cyanide and Emergent just giving each other a handie?

Guys, take it easy - I do my excrementposting on here.

Lmao, ah yes. Invest in the Austin-area real estate 10+ years ago and have an ownership stake in a chain of Texas FSEDs before there there was one on every corner in the big cities. Then hire a bunch of burned out EM docs and pay them $150/hr 1099 with no benefits while you rake in the dough. It's so easy, just invent a time machine!

 

[Fox800]

I used to think i would keep working in EM. Now I dont know. 15-ish years into this I dont know. That being said reaching coastFI/FI etc makes life and work so much more enjoyable. I truly enjoy 99% of my shifts. They are busy, I grew up working, my parents instilled work in me. As one of my childhood friends said to me recently when asking about why my 65+ year old mom who is by her standards FatFI still works 60-70 hours a week as an ED and ICU nurse (2 FT jobs), you guys love to work.

The main change I would make would be to try to spend more time with my kids. I make a major effort to be present with them, some of my non clinical ventures limit that time when added to clinical work. Other than that I would push harder to get out of nights/weekends.

I still enjoy work and my comp is well above EM avg which makes it easier to tolerate hospital admin incompetence.

 

[EctopicFetus]

View attachment 373135

Facts.

 

[Groove]

"My Rich Life", huh? Ok, If I had 4 million saved, I'd just invest and do stocks all day. I legitimately enjoy investing and am constantly learning as much as I can about the market, economy and all things financial. I doubt I'd live any bigger than I do now. All I really need is a nice house, a few creature comforts. I'd probably still do 2-3 big vacations a year. My wife is about 12 years younger than me and is a workaholic so I'd totally ride the sugar momma train as long as possible. She doesn't cook, whereas I love to cook so I would do gourmet meals 5 nights a week and I don't even mind cleaning. She likes hiring a maid every now and then but I don't really believe in maids, so I'd just do the cleaning myself. I'd work out daily. Get lots of sleep. Work on a few friendships that have languished over the years due to incompatible schedules and working too much. Wake up at 5am each morning, in bed by 9pm each night. Take care of the dogs. It would be lovely.

If I was still pretty young'ish, I might do 4 shifts a month just to keep my license and credentialing active and to serve as insurance for any future calamity in the market or if my wife couldn't work anymore, etc.. That being said, I'm not sure how many local jobs would hire me for only 4 shifts a month but I could probably figure it out.

 

[Splenda88]

How much $$$ people are spending on vacation this year?

I am finding myself spending ~20k this year. I think that is too much.

 

[xaelia]

How much $$$ people are spending on vacation this year?

I am finding myself spending ~20k this year. I think that is too much.

Depends; once you have a couple kids, airfare and sometimes extra hotel rooms adds up quickly. It's not necessarily too much.

And, well, travel and vacation are worthwhile experiences.

 

[Splenda88]

Depends; once you have a couple kids, airfare and sometimes extra hotel rooms adds up quickly. It's not necessarily too much.

And, well, travel and vacation are worthwhile experiences.

I have 2 kids... and you are correct that things add up quickly.

I guess for 3 mini 5-day vacations in NY, Colombia, Bahamas and a quick 2-night stay in LA, that might not be too much.

 

[VA Hopeful Dr]

How much $$$ people are spending on vacation this year?

I am finding myself spending ~20k this year. I think that is too much.

By year's end, probably between 30-40k.

Week skiing in CO, week at Disney, week in London, long weekend at Great Wolf Lodge, long weekend at the Grove Park Inn.

Its been totally worth it so far. Watching the kids ski for the first time was amazing.

 

[dchristismi]

Well... I have parents who now have to take annual distributions who are taking "us kids" on big vacations now... and they are spending 20K on the trip I sort of described earlier that I am coordinating, but its 4 (then 6 when my brother and his wife meet us a week in) starting in London, down to Chichester for an epic weekend of vintage racing at the GoodWood Revival (with fancy tickets that were $$$$), then across France along the Western Front for the battlefields of WWI: Ypres, Lille, the Somme, then a stop in Reims for Champagne, Verdun, then on to the Würstmart at Bad Dürkheim, and on to the Oktoberfest. But I don't really *have* a budget. Dad just waves his hand and says "you have my proxy." And I book it. And the Bank of Mom cuts me a check after I put it all on my credit card because I get the points which then cover my airfare upgrades for the next trip. Or even the airfare altogether. Or the beach hotel for the anniversary getaway. Play the points game - it's worth it when you do travel a lot.

And I'm thinking it's going to be around $20K when all is said and done because we are mostly staying at AirBnBs where you can rent a whole house except Munich because it's packed. But we did Spain and Morocco for much, much less last year because that part of Europe is a lot cheaper.

I'm leaving for the Netherlands and Belgium in 2 weeks with 2 of my best friends from college for the hell of it. We're leaving our spouses behind to binge on art and cheese and culture. It was just going to be a girls trip until one of the guys found out and now it's a buddy trip. But it's a lot cheaper to split costs that way.

I also take stepdaughter to NYC for her birthday every year for a splurgy theater weekend... and we've been talking about taking 9 year old grandson to see the city at Christmas maybe this year.

Get busy livin' or get busy dyin'...

 

[Kryptocoin]

How much $$$ people are spending on vacation this year?

I am finding myself spending ~20k this year. I think that is too much.

I'm close to 50k but I travel large

 

[Splenda88]

By year's end, probably between 30-40k.

Week skiing in CO, week at Disney, week in London, long weekend at Great Wolf Lodge, long weekend at the Grove Park Inn.

Its been totally worth it so far. Watching the kids ski for the first time was amazing.

30-40k seems to be good a good deal for all these trips for a family of 4+. I am just worried I am spending too much on vacation. Lifestyle creep is real.

 

[Brigade4Radiant]

I spend a good amount on vacations as well probably 20 K. This also includes travel to any place outside my main city. Even if I drive there and that’s including food as well. Honestly, it’s probably 50 K with the food expenses.

I do get a good amount of points to the chase sapphire reserve card. I also have the AMEX platinum for my business card.

 

[Splenda88]

I spend a good amount on vacations as well probably 20 K. This also includes travel to any place outside my main city. Even if I drive there and that’s including food as well. Honestly, it’s probably 50 K with the food expenses.

I do get a good amount of points to the chase sapphire reserve card. I also have the AMEX platinum for my business card.

50k would be a lot for someone in my income bracket. Everything is included in my 20k.

 

[BoardingDoc]

How much $$$ people are spending on vacation this year?

I am finding myself spending ~20k this year. I think that is too much.

Probably 25-35k/yr. Some years as much as 50k. Have no desire to spend less. You can't take it with you, and everytime I go on vacation I say some iteration of "oh yeah, this is why I keep working."

 

[Mount Asclepius]

I’ll be the odd man out just to reveal that some do it differently. I spend about $1-2K in vacations per year and usually less. Most of my vacations are free. I live in an awesome state and spend time locally with the family enjoying it for next to nothing. I’ve previously spent a decent amount of time traveling this country and internationally. For the current season of life that I’m in, I’m choosing to spend (save) my money differently. There will probably come a time where I splurge on more travel again. For now though, I’ll revel in my travel frugality. For those that choose to spend a lot on travel, that’s fine. Just remember not to spend a lot elsewhere in your life, or you will work more to make up the difference.

 

[Splenda88]

Probably 25-35k/yr. Some years as much as 50k. Have no desire to spend less. You can't take it with you, and everytime I go on vacation I say some iteration of "oh yeah, this is why I keep working."

I kind of have that mindset to an extent, but I don't have a big nest egg since I am in year2 as an attending; therefore, I gotta be a little more cautious financially.

 

[BoardingDoc]

I kind of have that mindset to an extent, but I don't have a big nest egg since I am in year2 as an attending; therefore, I gotta be a little more cautious financially.

Totally fair. My number would definitely be lower were I not working at my particular job, or if my wife wasn't also gainfully employed.

 

[emergentmd]

Im at the top end of vacation spend for this thread. I know it looks wasteful from the outside but I worked hard to get where I am at.

Just got back from a Maui Vacation and did not even look at prices. Guys, we worked hard and if it fits in your budget then enjoy.

 

[Splenda88]

Im at the top end of vacation spend for this thread. I know it looks wasteful from the outside but I worked hard to get where I am at.

Just got back from a Maui Vacation and did not even look at prices. Guys, we worked hard and if it fits in your budget then enjoy.

Are we taking about 100k here?

 

[emergentmd]

Lmao, ah yes. Invest in the Austin-area real estate 10+ years ago and have an ownership stake in a chain of Texas FSEDs before there there was one on every corner in the big cities. Then hire a bunch of burned out EM docs and pay them $150/hr 1099 with no benefits while you rake in the dough. It's so easy, just invent a time machine!

Our Em docs all do very well and most sites better than any hospital ER with 1/3 pph. We are not predatory like FC or Neighbors so alittle education and less bitterness is always helpful. Docs flock to our group from the hospitals but there just isn't many spots available.

Every generation has different opportunities but takes someone willing to take risks to work outside of the box. Its easy to Monday Morning QB and say the past generations had it easier. In 10 yrs, some of your contemporaries will be exceedingly more successful and you would have had the same opportunity with the next generation saying Fox800 had it so easy.

 

[emergentmd]

Are we taking about 100k here?

More like 60-70K

 

[Birdstrike]

Im at the top end of vacation spend for this thread. I know it looks wasteful from the outside but I worked hard to get where I am at.

Just got back from a Maui Vacation and did not even look at prices. Guys, we worked hard and if it fits in your budget then enjoy.

Agree. Took my whole family to Spain, just got back from the British Virgin Islands with the wife, and took my daughters and their two friends out of town to see Taylor Swift in concert, all in the last 3 months. All three trips were costly, but fabulous and worth every penny.

Save some, spend some. Plan for the future, enjoy life along the way. I also live somewhere others travel to for vacations.

 

[emergentmd]

. I also live somewhere others travel to for vacations.

This always is a discussion when we come back from vacation. Our back yard/neg edge pool overlooking the green belt has a nicer view than most high end hotels. family rarely uses it. Our hot tub prob gets used twice a yr.

Our lakehouse property is an hr away with a boat, jet ski, kayaks, paddle board, commercial slide, 20 ft jumping platform that people pay 1k/nt that we prob go to 2-3 times a yr. Even when we go, the kids spend 95% of the time inside doing what they could at home.

 

[Birdstrike]

This always is a discussion when we come back from vacation. Our back yard/neg edge pool overlooking the green belt has a nicer view than most high end hotels. family rarely uses it. Our hot tub prob gets used twice a yr.

Our lakehouse property is an hr away with a boat, jet ski, kayaks, paddle board, commercial slide, 20 ft jumping platform that people pay 1k/nt that we prob go to 2-3 times a yr. Even when we go, the kids spend 95% of the time inside doing what they could at home.

Champagne problems, I know. I type this as I sit looking at my pool and palm trees, all of which are jogging distance from the ocean, from the sterile comfort of my screen porch. Lol

 

[cyanide12345678]

We take 3-4 trips a year. And then some short trips here and there, though i think we probably don’t spend more than 20k. Were on an European cruise 2 months ago, going to iceland in 7 days, and had everything planned out for a week in Paris in august until i started getting really nervous about traveling with a 30 wk pregnant wife on a transatlantic flight. Our last flight together she syncopized. Let’s see what adventures the next flight next week will hold for us 😅 *fingers crossed*

 

[VA Hopeful Dr]

. I also live somewhere others travel to for vacations.

Somewhere out of state idiots travel to for vacations

 

[doctalaughs]

I'm close to 50k but I travel large

I think I spent 55k this year and not like I’m booking the ritz everywhere or flying first class (premium/plus economy at best).

International airfare for a family of 4 adds up quickly. Kids are old enough that I’m just not willing to book 1 hotel room so it’s 2 - and hotel prices in nice places are crazy if you haven’t looked (look at 4 stars like the Hyatts in Tokyo, London ski country etc over spring break or winter break if you don’t believe me)

 

[VA Hopeful Dr]

I think I spent 55k this year and not like I’m booking the ritz everywhere or flying first class (premium/plus economy at best).

International airfare for a family of 4 adds up quickly. Kids are old enough that I’m just not willing to book 1 hotel room so it’s 2 - and hotel prices in nice places are crazy if you haven’t looked (look at 4 stars like the Hyatts in Tokyo, London ski country etc over spring break or winter break if you don’t believe me)

That's the kind of stuff that gets me as well.

4 premium economy tickets to London was right at 9k.

 

[cyanide12345678]

That's the kind of stuff that gets me as well.

4 premium economy tickets to London was right at 9k.

Ouch. My wife and i save a lot of money often by flying from places like chicago that almost always have the cheapest tickets. For example: flying to pakistan is usually $500 more expensive per ticket locally for me than going through ORD which is only a 3 hour drive.

Our flight to reyjkavik next week is only $500/ticket from Toronto, whereas if we flew from locally we would have paid $1300/ticket. Well worth the 5 hour drive to save $2k on 3 tickets. Plus we make a trip out of it, spend 1 day in Toronto and 1 day in Niagara. But i guess I’m cheap and willing to save money in exchange for some inconvenience.

 

[cyanide12345678]

That's the kind of stuff that gets me as well.

4 premium economy tickets to London was right at 9k.

Just looked at tickets for august from ORD to LHR airport. $780/ticket economy. If you preplan it a few months early then October and November tickets are like $620-650 for direct flights on economy.

Y’all are spending the big bucks 😂😂😂

my wife and i only spend 80-90k a year on all our expenses which essentially includes 30k on mortgage and insurance and 20k on day care. Which is probably why our net worth has gone up 50k per month for the last 1.5 years. If we pull our kid out of day care and just retire we are technically leanfire with expenses less than 4 percent of our net worth already.

Our last trip a couple months ago to Europe cost us right around 4k total for everything which included: 3 flights, a 7 night cruise on holland America from rome to sicili to pisa to tunisia to Marcelle france and then finally to Barcelona, all meals, 3 guided excursions through holland America, lots of taxi and uber use for sight seeing in cities we didn’t buy an excursion, and 1 night in Barcelona. It was a luxurious vacation - just didn’t cost luxury prices.

Iceland so far for next week is clocking in at $3650 for 6 days for flights hotel and rental car that are already paid for. Probably will end up spending another 1.5k for food, airport parking, and another 2 days in canada where I’m yet to get hotels. Total cost will likely land at ~5k for 3 people.

 

[VA Hopeful Dr]

Just looked at tickets for august from ORD to LHR airport. $780/ticket economy. If you preplan it a few months early then October and November tickets are like $620-650 for direct flights on economy.

Y’all are spending the big bucks 😂😂😂

my wife and i only spend 80-90k a year on all our expenses which essentially includes 30k on mortgage and insurance and 20k on day care. Which is probably why our net worth has gone up 50k per month for the last 1.5 years. If we pull our kid out of day care and just retire we are technically leanfire with expenses less than 4 percent of our net worth already.

Our last trip a couple months ago to Europe cost us right around 4k total for everything which included: 3 flights, a 7 night cruise on holland America from rome to sicili to pisa to tunisia to Marcelle france and then finally to Barcelona, all meals, 3 guided excursions through holland America, lots of taxi and uber use for sight seeing in cities we didn’t buy an excursion, and 1 night in Barcelona. It was a luxurious vacation - just didn’t cost luxury prices.

Iceland so far for next week is clocking in at $3650 for 6 days for flights hotel and rental car that are already paid for. Probably will end up spending another 1.5k for food, airport parking, and another 2 days in canada where I’m yet to get hotels. Total cost will likely land at ~5k for 3 people.

We live near a smallish regional type airport. Its cheaper for us to fly out of here to somewhere like O'Hare then to London than to drive to our nearest major airport (Charlotte) and fly direct. This only works for international flights though, domestic we drive to Charlotte for cheaper.

I'm also 6'6 so regular economy just isn't an option anymore. 10 years ago I could do it, but the airlines keep shrinking the leg room.

 

[cyanide12345678]

We live near a smallish regional type airport. Its cheaper for us to fly out of here to somewhere like O'Hare then to London than to drive to our nearest major airport (Charlotte) and fly direct. This only works for international flights though, domestic we drive to Charlotte for cheaper.

I'm also 6'6 so regular economy just isn't an option anymore. 10 years ago I could do it, but the airlines keep shrinking the leg room.

Yeah even Charlotte isn’t a real major airport. That’s the equivalent of my using my local international airport that sits in a city of 2M sized metro. We only use it for local domestic flights or Mexico flights, anything outside of that chicago is always significantly cheaper for us.

I guess that’s the only time I’m thankful for being 5’ 9’’ 😂😂😂

 

[doctalaughs]

Just looked at tickets for august from ORD to LHR airport. $780/ticket economy. If you preplan it a few months early then October and November tickets are like $620-650 for direct flights on economy.

Y’all are spending the big bucks 😂😂😂

my wife and i only spend 80-90k a year on all our expenses which essentially includes 30k on mortgage and insurance and 20k on day care. Which is probably why our net worth has gone up 50k per month for the last 1.5 years. If we pull our kid out of day care and just retire we are technically leanfire with expenses less than 4 percent of our net worth already.

Our last trip a couple months ago to Europe cost us right around 4k total for everything which included: 3 flights, a 7 night cruise on holland America from rome to sicili to pisa to tunisia to Marcelle france and then finally to Barcelona, all meals, 3 guided excursions through holland America, lots of taxi and uber use for sight seeing in cities we didn’t buy an excursion, and 1 night in Barcelona. It was a luxurious vacation - just didn’t cost luxury prices.

Iceland so far for next week is clocking in at $3650 for 6 days for flights hotel and rental car that are already paid for. Probably will end up spending another 1.5k for food, airport parking, and another 2 days in canada where I’m yet to get hotels. Total cost will likely land at ~5k for 3 people.

Don’t underestimate price differences between peak and off-times though. I remember the days when my kids were in pre and elementary school when we didn’t care about pulling them out. We got some amazing prices on flights and accommodations (I remember about the same prices or less to Iceland, like 600 pp tickets to Thailand etc).

Now in middle/high school we can’t just pull them out and it can literally be 3x more for flights and hotels over school breaks. Summer is a little bit better which is usually where we do our big international trip yearly.

Lots of my colleagues just leave the kids and travel off-times with spouses but I figure having the kids see the world and spend vacation time is worth the extra $.

 

[GassYous]

I use going. Used to be scotts cheap flights. I pay for the medium version about 50$ a year. I've been to spain, japan, france for less than 600$ per ticket. Got hawaii tickets for about 100$.

 

[ERMudPhud]

The most interesting, thing, though, is the lavender survived the winter, and is regrowing right now!

One of the most magical things is when the sedum is in bloom, and there is the low hum of a bunch of bees at once pollinating. It's reminiscent of "Atmospheres", by György Ligeti.

Jeez I go away for a few years and I come back and Apollyon's turned into a poet, GeneralVeers has been banned, and almost everyone else seems like they are unhappy in their work.

I would say my life is pretty rich. Maybe not the richest possible life, somewhere out there in the "Everything Everywhere" multiverse I have a life where I own Tesla(the company not the car), CMG's are banned, and I'm married to Michelle Yeoh, but other than that my life is pretty rich. My family is healthy(now), my kids are pretty cool, and I'm still getting out of bed every day. Actually my wife is better than Michelle Yeoh but it fit with the "Everything Everywhere" reference.

Last 5 years I probably averaged 120+ hours per month seeing patients and preferred the busiest places. Now I work 4 days per month at a small critical access ED in a place where people from all over the world go to vacation. I get to do everything there. I work another 4 days a month in an academic inner city level 1. I never get to actually do anything there but I see cool pathology and learn from really smart residents, smarter than me. The rest of the month I can pick up extra shifts at either of the two part-time gigs, do locums if the price is right, travel, or just play in paradise.

I still think EM is fun. There is nowhere else in medicine where you get to see a completely undifferentiated patient, figure out what is wrong with them, and then do something about it. It's what we all probably thought all doctors did when we were kids. Every single patient is a black box, a mystery, a puzzle to be solved. Sure, often the solution to the mystery is "You are doing too much meth" Frequently the answer to the puzzle is "I'm sorry, there is nothing wrong with you I can fix" But sometimes you open the black box and find Churg-Strauss, methemoglobinemia, post-partum eclampsia with PRES, deep water oxygen toxicity or ehrlichiosis.

Sure there are entitled crazy patients and annoying families but every room you enter is a chance to meet someone new and interesting. I've met a guy with a Stanley Cup ring that looks like it hasn't left his finger once in the 50+ years since he won it. I've met actors, politicians, CEO's, diplomats, and rocket scientists. I've also met plumbers, electricians, commercial divers 1000's of miles from the ocean, and grateful refugees just starting a new life in America. I learned from all of them. I can put up with the annoying and entitled to meet the rest of them. Plus its easier to forgive the annoying and entitled when you realize that's just their response to fear.

I've worked a lot of nights, weekends, and holidays over the years. More than I would have in a 9-5 clinic or surgical subspecialty. My kids were sometimes pissed about that but I gained a lot too. I remember a lot of weekday mornings with the kids at a nearly empty zoo or aquarium when they were little. Everyone else's parents were working. Same with afternoons at the park or ice cream parlor. I remember pulling the kids from school for ski days or backcountry hut trips before we got more uptight about not missing school as they got older. I once worked 17 straight shifts at the beginning of June and 14 straight at the end of July. Took the 4 weeks off in the middle and the whole family went to Borneo and saw pygmy elephants and orangutangs in the wild and climbed Kinabalu. Didn't miss any work. I remember week long float trips and multiple weeks of vacation every year. More weeks a year than 9-5 America offers. Couldn't do that easily and keep an outpatient clinic running. Later we took an 8 month sabbatical from work and travelled all over Asia and the south Pacific. Still had a job when I got back. Couldn't have done that with a 9-5. So everything in life has trade offs but I like the ones I made in EM. You can still make those trade offs today if you want.

I tried some other things over the years. At one point or another I was a biochemist(maybe more fun than EM), Chief of staff(not fun), interim CMO(hated that one), director of informatics(interesting), COO of an SDG(engaging), C something or another of a start up(not the right person for that job), and even briefly a USACS regional VP(really hated that one). I realized that if I woke up in the morning and had a day full of meetings I just wanted to go back to sleep. If I had a day full of zoom meetings I wished I had died in my sleep. If I had a day, evening or night shift coming up I generally had a good feeling about the day. So, I quit all that other **** and I've just been seeing patients full time for the last 5 years and I'm happy. Hopefully I have another 5-10 years left. Staves off the dementia.

When I got out of residency the old guys all told me, "Its too bad you really missed the gravy years by a few years" Even though that was 20+ years ago it seems like we just keep telling the new grads the same thing and to an extent its true. But, I am incomparably more fortunate than my grandparents or parents. I'm not wealthy enough to fly first class on those trips I mentioned but my life is financially fine. Helps that we are still in the same house we bought when I was in residency and the average age of the cars in the garage is over 15 years.

Medicine is cyclic. I remember when people thought radiology was saturated but then imaging boomed and we needed way more radiologists. Maybe AI swings it back the other way, maybe not. I remember when Psych was the lowest paid specialty and almost no one, except for the people you knew were born to be psychiatrists, wanted to do it. Not any more. Anesthesia was so moribund that a friend got an interview and then a position outside the match at Harvard just for sending a postcard asking for an application. Then with pain and the increase in all sorts of interventions Anesthesia boomed. It will change again. I can't say it will necessarily change for the better for EM but it wouldn't surprise me. For now a lot of those residency spots created by private equity or HCA are going to go unfilled and there are tons of EM jobs out there. I'm getting emails every day with openings. I get texts about locums every week. If you graduated from an American medical school and went to one of the better EM residencies you will have dozens of places looking to hire you when you finish. The residents I've been working with all got to be pretty choosy about where they decided to work in the last few years. If they settled for less then their dream jobs it was often because other factors mattered more in their choice.

So here is the thing. If you like seeing patients and you like meeting new people you will always have a job in EM. The country isn't getting younger or healthier. You may not get paid as much as you would like or as much as you think you deserve but you will always have a job you like that allows you to live fairly well. If you hate EM, even if the pay doubles you will still hate it. If you enjoy the work you will be fine.

So, you can live a rich life in EM and I'm pretty sure that will continue to be true assuming you actually like what we do. If you don't like what we do you really should do something else. Less than a third of my residency class are still doing EM so you can do other things. As others have pointed out there are lots of other ways to make a living and you are only limited by your fear or your imagination or your work ethic.

 

[Apollyon]

Jeez I go away for a few years and I come back and Apollyon's turned into a poet

And I burned out hard 3+ years ago. UPMC chewed me up and spit me out. They have my eternal animus. However, now, I'm finally back to work, and I'm working with veterans. Boy howdy, leaps and bounds above the ED clients that simply can't "adult".

 

[miacomet]

And I burned out hard 3+ years ago. UPMC chewed me up and spit me out. They have my eternal animus. However, now, I'm finally back to work, and I'm working with veterans. Boy howdy, leaps and bounds above the ED clients that simply can't "adult".

As an ER doc?

 

[Apollyon]

As an ER doc?

What? Burned out? You know my story. Now, I'm doing comp physicals. But, the PTSD with them is real. I feel a moral imperative to look them in the eye, and tell them, "I see you, and I hear you." The psychic injury greatly outspeaks the physical.

Look up "Vietnam Requiem" on YouTube. "8 to 10 years after coming home, almost 800 thousand men are still fighting the Vietnam War".

EM is done for, permanently.

 

[deuist]

I'm checking back in for the first time in a long while, too. I'm crispy from working 180-200 hours a month for CMG's and am trying to cut back. The problem is that I'm tied to the area and can't leave, so there are not any good choices. The other options for EM docs---like hydration clinics and urgent care---are not appealing.

 

[bravotwozero]

I'm checking back in for the first time in a long while, too. I'm crispy from working 180-200 hours a month for CMG's and am trying to cut back. The problem is that I'm tied to the area and can't leave, so there are not any good choices. The other options for EM docs---like hydration clinics and urgent care---are not appealing.

Why are you working so many hours?

 

[BoardingDoc]

I'm checking back in for the first time in a long while, too. I'm crispy from working 180-200 hours a month for CMG's and am trying to cut back. The problem is that I'm tied to the area and can't leave, so there are not any good choices. The other options for EM docs---like hydration clinics and urgent care---are not appealing.

Whaaa? That's so many hours. Why? I mean, that's an absurdly unhealthy amount of hours. When I was fresh out of residency and trying to make as much as humanly possible I worked ~155hrs/mo. Now, I'm tied for most hrs worked in my group with one other person and we're both at less than 130/mo.