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Put up or shut up time

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  • Avatar FIREshrink 
    Participant
    Status: Physician
    Posts: 844
    Joined: 01/11/2017
    Disability Insurance

    After a lifetime of pursuing FI, I have the opportunity to make some big changes to my practice.

    Admin would go from 0.15 FTE to 0.4 FTE and be paid at about double the previous hourly rate.

    Clinical would go from 0.85 to 0.4. I’d still take my share of weekend calls. All work combined I’d be around 0.8 FTE.

    The admin and clinical work I keep would make my net hourly pay about 20% higher, so my total comp might go down minimally or no more than 10%.

    Best case scenario I’m working three full days a week plus one weekend per month. Worst case scenario the admin time bleeds into everything else and I’m seeing fewer patients but working just as many hours.

    If new admin doesn’t work out I won’t be able to get my old admin back. I’ll then have only 0.4 FTE clinical but could likely bump that to 0.6-0.8 within a year. Would be a low pay year though and I’d have to pay a share of health care premium.

    I’m mid 40s, two kids, we’re very busy. We have retirement assets of 30x expenses even though our expenses seem outrageous to me. College is saved for separately. I don’t think finances are a reason to avoid this change but I tend to be very conservative and worry if this doesn’t pan out I won’t be able to get back into a busy and lucrative practice without major life upheaval (locums pays well but obviously being away from my family at this point is not an option).

    Do you see any financial/professional reasosn this would be a bad move? Anyone made a similar decision?

    (I know admin is not for everyone but this position is appealing to me as I’ll be given broad latitude to strategize across multiple states and hospitals to develop a comprehensive BH platform and brand. I will have a full time operations partner so I don’t have to do most of the legwork. The chance to elevate the needs of my patients and communities to the highest levels of an organization is very exciting and doesn’t come around for shrinks everyday. We are used to working in the trenches and being underresourced in every way. We could lead the way in integrating BH into the rest of medicine, as it should be.)

    #150328 Reply
    Avatar AlexxT 
    Participant
    Status: Physician
    Posts: 897
    Joined: 01/13/2016

    You could retire today if you wanted to , so there’s really no serious downside.  You’ll still have a job if this doesn’t work out, and it sounds like it’s something you really want to do, so go ahead and do it.

    Based on the thread by the guy who made $1 million in a year in psych, it sounds like you could have plenty of other jobs available if you needed them.

    I didn’t like admin work at all, so this doesn’t appeal to me.  If I were in your position, I would probably maximize my income for the next year or two and then retire, but that’s just me.

     

    #150331 Reply
    Liked by adventure, Zaphod
    Avatar Kamban 
    Participant
    Status: Physician
    Posts: 2123
    Joined: 08/01/2016

    Do you like the current 0.15% FTE. Will it just be the same admin job but three times longer or more challenging job or just more boring job. Your last paragraph might turn out to be true or be a pipe dream of a CEO with lofty statements and nothing much.

    If you are already 30X expenses you have nothing to lose. Even if you give it up and become a 0.4FTE that is a slow steady FiRe which you might enjoy. The only issue is health care premium costs.

     

    #150333 Reply
    Liked by Anne, Zaphod
    Avatar DCdoc 
    Participant
    Status: Physician
    Posts: 359
    Joined: 06/14/2016

    You’re already FI. I’ll retire when I get there. And there’s no way I would be doing weekend work. But that’s me, not you. If you’re already FI and talking about changing to a different tract that pays 90%+ of your current salary, it’s not a numbers thing. You don’t need any imcome, much less 90% of a currently highly salary, it comes down to what you want, and your goals. It sounds like the new position is something that could make a huge difference on a population level. You only give glimpses of your thoughts, but it seems like you want to do it. And you financially certainly can handle a slight pay drop. Good luck.

    #150338 Reply
    Liked by Zaphod
    MPMD MPMD 
    Participant
    Status: Physician
    Posts: 2037
    Joined: 05/01/2017

    (I know admin is not for everyone but this position is appealing to me as I’ll be given broad latitude to strategize across multiple states and hospitals to develop a comprehensive BH platform and brand. I will have a full time operations partner so I don’t have to do most of the legwork. The chance to elevate the needs of my patients and communities to the highest levels of an organization is very exciting and doesn’t come around for shrinks everyday. We are used to working in the trenches and being underresourced in every way. We could lead the way in integrating BH into the rest of medicine, as it should be.)

    Click to expand…

    Congrats on your well deserved and hard-earned control over your life!

    My only concern reading your otherwise inspiring post is that this seems like a very pie-in-the-sky administrative goal and I hope you are prepared for much more mundane and trivial work without becoming burned out by it. Does that make sense?

    #150340 Reply
    PhysicianOnFIRE PhysicianOnFIRE 
    Moderator
    Status: Physician
    Posts: 1494
    Joined: 01/08/2016
    Do you see any financial/professional reasosn this would be a bad move? Anyone made a similar decision?

    Click to expand…

    I don’t think you need us to tell you to go for it, but I will, anyway.

    Go for it!

    I was in a very similar situation. Forties, 2 kids, busy, about 30x expenses and I dropped to 60% clinical, 0% admin, 80% blog. Or something like that.

    Cheers!
    -PoF

     

    40-something anesthesiologist and personal finance blogger @ https://physicianonfire.com [Part of the WCI Network] Find me on Twitter: @physicianonfire

    FIRE. Financial Independence. Retire Early.

    #150341 Reply
    Avatar wideopenspaces 
    Participant
    Status: Physician
    Posts: 919
    Joined: 01/12/2016

    This feels like a trick question 🙂 Go for it! The money doesn’t matter. If you hate it, you can ramp up clinical time or just quit or anything in between. Let us know how it goes!

    #150355 Reply
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3105
    Joined: 01/21/2016

    Based on previous discussions with you, it sounds like it might be your dream job. Try it, and if it does not work out, you can try something else.

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #150381 Reply
    Liked by E5797, q-school
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 840
    Joined: 11/07/2017

    Admin can be fun for the right personality type, especially if you are patient, can put boundaries on your time and prioritize tasks, enjoy building interpersonal and interdepartmental relationships beyond that required for direct patient care,  are able to delegate, have good support, and know how and when to say no.  Alternatively, it can be a draining time suck that takes over your life, esp if you can’t/won’t establish boundaries and say no appropriately.  One of the best things about admin is that it makes the time spent in direct patient care even more enjoyable…and you potentially have the ability to make life better for both your colleagues and all of their patients (not just yours).  And if you can move the needle even a little bit on some of the larger scale goals, that could be really rewarding, and you will be able to look back on it with a real feeling of accomplishment.  I say go for it.   It sounds like you want to.  I think they say we regret the things we didn’t do the most.

    #150408 Reply
    Avatar StarTrekDoc 
    Participant
    Status: Physician
    Posts: 1703
    Joined: 01/15/2017
    Earnest refinancing bonus

    Life’s too short not to reach out and scratch that itch.    Since already FI, minimal risk if it doesn’t end up what you thought it would be.  Like Anne said, admin is for some, and not for others—you won’t know until you try out the new hat.

     

    #150431 Reply
    Avatar Dont_know_mind 
    Participant
    Status: Physician
    Posts: 782
    Joined: 11/21/2017

    Yes, why not try it out.

    I am taking up a admin 0.1 role next month paying $200/hour. Which is terrible pay but I believe in the organisation and thought I would try to contribute. I figure I can always resign if it’s terrible.

    #150432 Reply
    Avatar FIREshrink 
    Participant
    Status: Physician
    Posts: 844
    Joined: 01/11/2017

    Well I did it. Three months in and having a blast. Officially 1.0 but working more like a 0.8 and being paid that way which is fine with me.

    So far so good, doing cool work and being told to dream big! Very little accountability so far…

    Avatar G 
    Participant
    Status: Physician, Small Business Owner
    Posts: 1387
    Joined: 01/08/2016

    Thanks for the update–and great news!

    #189175 Reply
    Avatar ZZZ 
    Participant
    Status: Spouse
    Posts: 389
    Joined: 06/18/2018

    “Admin would go from 0.15 FTE to 0.4 FTE and be paid at about double the previous hourly rate.”

    So, they’re going to pay you more to work less ( .35 more admin/ .45 less clinical)? Tough call there…

    #189193 Reply
    Vagabond MD Vagabond MD 
    Participant
    Status: Physician
    Posts: 3105
    Joined: 01/21/2016

    Well I did it. Three months in and having a blast. Officially 1.0 but working more like a 0.8 and being paid that way which is fine with me.

    So far so good, doing cool work and being told to dream big! Very little accountability so far…

    Click to expand…

    Glad it’s working! I am not sure I understand the “accountability” comment…

    At any rate, by mid-40’s (or mid-career), docs should be in a position to craft their professional lives to their own liking and not be beholden to some heavy-handed boss, partner, administrator, insurance company, health system, etc. That is the true value of striving for Financial Independence. Yeah, you can walk away if you want, but better yet, you can do the parts of the job you like best and continue to get paid and continue to have purpose, identity, and connections in your life.

     

     

    "Wealth is the slave of the wise man and the master of the fool.” -Seneca the Younger

    #189195 Reply
    Liked by Docbeans

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