[Editor's Note: Today's WCI Network post is from the Physician on Fire. That means I did not write it. I am definitely not retired from medicine. But today we're going back to visit the most important moment on the Physician on FIRE blog. The apex and crux of the entire story. We watched him achieve FI and then surely but slowly move toward RE. Well, when he published this post he actually did it. He left medicine. I guess he wasn't bluffing after all. Enjoy the post and maybe even dream a little bit about your last day at work.]
On Monday, August 12th of 2019, I woke up in a call room, gathered up my belongings, and stepped through the back door of the hospital out into the world for what may very well be the last time.
I wasn’t fired. I simply FIREd.
As in, I realized several years beforehand that I was Financially Independent (FI), and I chose to Retire Early (RE) from medicine.
At age 43, I should have been in the prime of my career. It was a position 25 years in the making when you factor in four years each of college, medical school, and residency along with the 13 years as a practicing anesthesiologist, and I probably could have practiced for another 25 years if I desired.
However, I decided to deviate from the usual script.
In these last 25 years, and even before then, I’ve chased many goals. Get the best grades. Beef up that application with research and volunteering. Impress your attendings. Receive glowing letters of recommendation. Make the surgeons happy; make your patients happy. If there’s happiness left to be had, it’s yours.
Cross over one hurdle and prepare for the next. There were a lot of hurdles on that track, and they’re all behind me now.
Now, I get to chase a different goal — to live a happy and meaningful life while raising our boys and enjoying our days at a less-frenzied pace. It’s a goal with no discernible endpoint and no hurdles to jump over or trip over. A life I’ve been looking forward to for some time now.
Why Retire in My Forties?
Some early retirees have dreamed of this day and planned for it for decades. Some are so burned out from their jobs that something has got to give. Some got lucky and won the lottery or got unlucky but received an inheritance.
None of these describe my situation.
The simplest explanation is that I retired because I discovered that I could.
Late in 2014, I was studying for a bogus recertification exam and I started wondering if I’d have to do it again in 10 years. Spending time at the library studying irrelevant academic minutiae when I had two pre-schoolers at home wanting to play Lego and build puzzles with me didn’t seem right.
I revisited this blogger that had retired early, ran some numbers myself, and realized that we were already in a position to continue living our lives as we were without the income from my job.
I messed around with some spreadsheets and came up with a potential five-year plan. I didn’t know if or when I might actually follow through with it, but we started to dream about what we would do if I actually pulled the trigger. I had lots of ideas.
It’s so Hard to Say Goodbye to Yesterday
This was the best job I’ve ever had. Among anesthesia jobs, the one I just left was easily my favorite. Comparing this line of work to other non-anesthesia jobs I’ve worked, I feel privileged to have been an anesthesiologist.
In the past, I’ve mowed lawns, stacked wood, worked basically every lower-level position available at a grocery store, and even “donated” bone marrow for money (and stem cell research), not once but six times. Some of those jobs were hot and sweaty. Some were boring. And one hurt like the dickens.
The anesthesia job, by comparison, was always in a climate-controlled environment, paid very well, came with some level of prestige, and not once did I experience the sting of negative pressure inside my pelvic bones.
It could be stressful at times, but I did get to do some amazing things and I helped thousands of people survive surgery safely with the fewest side effects possible. I will miss many aspects of this job.
Still, it was a job. Many physicians refer to their careers as a calling. They approach their workdays with passion, and feel empty when away for too long. I respect and envy those dedicated doctors.
That’s just never been me.
While it was an excellent way to make a living, a job is still a job, and there’s usually someplace I’d rather be. Don’t get me wrong; my mind has always been fully committed to the necessary tasks at hand. Patient safety and comfort were always top priorities, and I believe I served my patients well.
But I can’t say my heart has been fully in it. I’ve always enjoyed my days off more than my workdays and my weeks off more than my workweeks. I’d say that’s true of any job I’ve had; to say otherwise would require some intellectual dishonesty. I’ve enjoyed work, but I’ve enjoyed doing whatever I choose with my free time even more.
The Timing Was Right
On a very cold January day in Brainerd, Minnesota, I received an email from a young man in the middle of his second year of a four-year anesthesia residency at my alma mater, the University of Florida. He had gotten my email address from an alumni contact list.
It turned out that Brainerd was his hometown, I had been working with his uncle for years, and I would later learn that my father graduated from dental school with another uncle of his.
Even though he had two and a half years left in his residency, he was inquiring very early on about the possibility of a future opening in our small group of five employed anesthesiologists. It’s a good thing he reached me and not one of my partners. We seemed like we might be set for ten years or longer at that point.
Can you tell we’re both happy? (that’s me on the right)
What my partners didn’t yet know was that I was contemplating an early retirement, and this resident’s email gave me a good excuse to let them know. I had been writing about the possibility of retiring early for nearly a year on this website, and it was time to be more open about it.
Later that year, the young doctor was interviewed and hired as my eventual replacement. I dropped to part-time, and patiently awaited his arrival as he advanced through those grueling final two years of residency.
I spent most of my final workweek getting him oriented, watching him work, and trading stories about the fifteen or so anesthesiologists who trained us both. It was great to get to know him and pass the baton.
He’s an excellent physician, and the job seems to be a perfect fit for him and his family of six. I felt good moving on knowing that my shoes will be filled by a very capable doctor, and that my departure created an opening in what I figured was an ideal job for this young man.
How I Could Afford to Retire Early
This is the “how” that people really want to hear. How can a person afford to retire at age 43, just 13 years after starting a career as a full-fledged attending anesthesiologist?
If you’ve read Drs. Stanley and Danko’s The Millionaire Next Door, you know the “secret”. If you know me in real life, you’ve seen it. Dr. Stanley wrote a follow-up book called Stop Acting Rich, and that’s what I’ve done, embodying a “stealth wealth” lifestyle for the most part.
My wife and I have lived a life of relative frugality, at least as compared to most of my physician peers. We’ve settled into a spending pattern where we’re both comfortable. We weren’t trying to achieve any particular goal — we just spent with intention on the things we value, donated generously, and saved and invested the rest.
Almost all of our income has come from one source — my job — although my wife has done a little bit of teaching, and I make money online now, too. It’s all gravy, and half of my profits from this endeavor are donated.
Before I had a website, we had attained financial independence by virtue of retirement savings equal to at least 25 times our anticipated annual spending. We eventually hit the “financial freedom” number I calculated to be 36x spending, and the markets have continued to be kind to us. When I left, we had between 40x and 50x our anticipated annual spending.
My investment strategy has not been anything special; I didn’t get lucky with one particular stock. Most of our money is in passive index funds.
It certainly helps to have a high income, especially if you want to do the fatFIRE thing, that is, retire with an above-average level of spending. However, FI is possible even on modest incomes. If you can learn to live on half of your takehome pay, even if you’re currently flat broke, you should be able to retire in 15 to 20 years at the most.
What Now?
Location Independence
For the first time in my life, I have this thing called location independence. I don’t have to be in any particular place at any particular time. This is huge, and we took advantage of this newfound geographic freedom while we could.
Our first big family trip was supposed be a two-month visit to Ecuador. My wife and I visited the country in 2011 when we toured the Galapagos Islands, and we were excited to return with our boys for an extended stay. Friends who have spent many months in Ecuador have had nothing but great things to say about the place (see here and here).
Civil unrest made that trip impossible, so we “settled” for two months in Mexico, instead. We had a splendid time splitting time between three beautiful and historic cities.
We returned to the states for a few weeks to celebrate the holidays with family and get just enough of a taste of winter to be grateful that we were not around to enjoy all six months of it.
In early January, we were off to Spain for another two-month adventure. We spent time in Valencia, Barcelona, and Madrid, welcoming family from both sides who were able to visit and stay with us.
In mid-March, I was off to Las Vegas for The White Coat Investor’s Physician Wellness and Financial Literacy Conference, where I gave a talk on fatFIRE, moderated one panel, participated in another, and shared some emcee duties.
Before those big trips, I spent a weekend meeting up with old friends and making new ones at the sold-out Camp FI Midwest. I went straight from there to Washington, D.C. for FinCon, the annual must-do conference for content creators in the personal finance space.
My family joined me in our nation’s capital, which will be a great spot for our boys to kick off the “roadschooling” that will be a big part of our upcoming adventures.
Domestic and international travel was incredible when it was a safe and viable option. Since returning from Las Vegas after a pandemic was declared, we’ve been largely homebound although we did purchase a travel trailer so we can do some properly socially distanced exploring of America until it’s safe to travel far and wide again.
Work. Yes, Work.
The title of the post began “Retired from Medicine,” not simply “Retired”. By continuing to educate people and share my experiences here, I think it’s fair to say I’ll be semi-retired at best. Retired Not Retired.
Blogging feels very different from working, and it’s something that I can do from anywhere, as little or as much as I choose.
Still, maintaining the publishing schedule that I currently have does take some serious effort, and the proceeds (the site does make money) are enough to cover our living expenses even after I share the revenue with shareholders, donate half of what’s left, and pay taxes on the remainder.
The fact that I’m not yet implementing our drawdown strategy also makes it feel less like I’m retired. I also end up going to more conferences and meetups related to this blogging business than I ever did for anesthesia. I’m not going to lie; the blogger ones are much more fun.
Regarding anesthesia work, I haven’t 100% ruled that out, either. I will keep an active state license and do enough CME and maintenance of certification to make working the occasional locums opportunity a possibility. I have no plans to schedule any, but I’d like to have that option if I have a change of heart.
Enjoy Some Free Time
Unstructured free time is something I feel like I haven’t had a whole lot of. In reality, free time is just a vacuum and I tend to fill it quickly whenever it arises.
That’s how this blog started. I found myself with a lot more free time once my kids were both in school in 2016. The free time didn’t last, but the blog did, and those two facts are very much interrelated.
Now that I’m not squeezing the rest of life into the time I’m not at the hospital and surgical center, I do expect to have more true free time, and I’ve been busy making mental plans. Three years ago, I published a list of 50 things I’d like to do or spend more time doing in early retirement.
Interestingly, many items on the list involve some sort of work. However, rather than working for a paycheck, the wishlist work involves activities to improve my mind, body, and soul.
Reading, hiking, traveling, writing… working on myself and my relationships. It’s rewarding work.
The Great Unknown
I’m not making plans too far into the future. Five years ago, I would not have imagined my life would look like it does today. Five years from now, I might look back and say something similar.
Ten years from now, our kids will be about to turn 20 and 22 years old, and our “child-rearing” years will be pretty much over. I expect there will still be some “young-adult-guiding” to do, but the time commitment will be less and less. That’ll be a bittersweet sort of freedom that will present both new challenges and opportunities as we navigate life as empty-nesters.
I was listening to David Epstein on the Afford Anything podcast. He said something that resonated with me, as it’s a phenomenon I’ve recognized in my own life.
Essentially, he explained how bad we are at making future plans and prognostications for ourselves. The reason we stink at it is the fact that we’re making plans for someone we know very little about. Future you is going to be shaped by unforeseen experiences and circumstances into someone that may have different desires, beliefs, and skillsets than the current you.
One of life’s greatest joys is the fact that you can continue to learn, evolve, mature, or even regress. That uncertainty can be scary, but also exciting.
Where will I be and what will I be doing in ten or twenty years? I don’t have a clue, but I embrace the open slate that lies ahead.
Are you planning for FIRE? What are your plans to reach your goals? Comment below!
Feel free to delete since issue is with one of your site mods (and email contact form is no more), but just a heads up there’s a moderator of yours using lots of profanities to other members…
Being addressed.
I am intrigued.
This is a great story. I would hope that the writer would consider using his talents in the future in a charity. Many here and in other countries need his ability.
I heard this idea a lot, but it’s beyond me why someone would want to practice medicine voluntarily when they didn’t want to do it for pay. I mean, maybe if it is a way to do it less or they left medicine not because of medicine but because of a particularly bad job or something.
The reasons I continued to work overseas after retirement were similar to the reasons I worked there prior to retirement. A desire to teach and contribute in a setting where there was great need. Another major factor is that many of the factors that make medicine unpleasant in high resource settings are absent in low resource settings – intransigent hospital administrators, malpractice concerns, unappreciative patients and health care workers, etc. I have heard of studies that suggest that once you start paying someone to do something, their level of enjoyment and satisfaction in doing it decreases.
I’ve practiced medicine on four continents. Developed countries, underdeveloped countries, for pay and as a volunteer. Different hassles in each location, but in the end it was all about the same. You do some good at times. It feels like work at times. It feels like pleasure at other times. But I’ve moved away from the notion that it is somehow dramatically more enjoyable when I’m doing it as a volunteer. More likely I’m under-resourced and can’t get someone the help they need because of it and I’m left to stew on the great inequalities in the world. I can remember managing a STEMI with an ASA and about 12 hours of heparin I collected from heparin flushes.
I’ve donated my anesthesia skills in impoverished Honduras a couple of times before retiring from medicine.
Now, I continue to use my talents to benefit charity, but I’m using the written word rather than practicing anesthesia to do so. I’ve donated over $300,000 in online income to charities (including a donor advised fund) since starting Physician on FIRE in 2016, and we now support the salary of one of the physicians I’ve worked with via One World Surgery. https://www.physicianonfire.com/one-world-surgery/
Cheers!
-PoF
I am intrigued.
I’m a great admirer of both of your blogs and what they represent to many of us.
What I don’t understand is how the POF can afford traveling so much? The way I understand his retirement finances is that he said farewell to tubing in 2019 with more or less 3 mil. Also has a paid off house , which is a huge reduction of his fixed expenses. Also has some income from the POF blog.
Unless I’m missing something, he should have 80k/yr plus (unknown) blog income.
How does that allow traveling for 4-6 months/yr not to great Americana destinations with an RV but to foreign locales? That is, for a family of 4 ?
My credit card bill for a family of 3 in a LCOL area is 6-7k/month with a very frugal lifestyle. That’s not counting housing and health insurance expenses
If you search through his website, he has some posts that have specific breakdown of expenses. I remember thinking on one of those posts that I spent more on a long weekend than he spent for a month; just as I suspect that some could spend in a couple hours what I spent for the weekend. It is all about which options you choose from the menu.
FWIW, 6-7k/mo plus housing and insurance in a LCOL area is not a “very frugal” lifestyle. 😉
I wouldn’t worry about his finances too much. I don’t think he’s ever touched the nest egg and is adding to it every year. That’s what happens when you build a successful business. He’ll be fine.
He’ll walk you through what he spends on those long trips and it’s really not that much. The biggest expense of traveling is airfare. Once you’re there, the expense is usually not much more than at home, especially in many countries.
I’ve got new for you though, $7K a month is far from frugal. The average American household makes $60K. That’s $5K a month TOTAL, not just on the credit card.
Now I spend a lot more than probably either of you so I’m not one to toss stones, but I certainly know how to spend less and would do it if I needed to in order to meet my financial goals. For every one of your expenses there’s a family down the street spending less on that item.
So the 3 mil is just his “safety”. I get it. POF is our hero and a successful businessman.
But it does introduce some confusion for the rest of us (still working) stiffs, who are trying to learn and who don’t have a business revenue coming in to augment or at least not touch your principal.
FWIW, I stopped publishing our net worth when we were at about ~$3M.
When I left my anesthesia job, we were at 40x to 50x anticipated annual spending (of $80k to $100k per year).
I would attribute about 5% of the income that helped grow our net worth to my online endeavors and > 94% to my anesthesia work. My wife contributed the remainder with very occasional teaching.
Best,
-PoF
many thanks for clarification. It makes more sense to me now, when you walked away from your job with 4-5 mil with expected expenses under 100k/yr.
Keep writing , please!
G & WCI make some excellent points.
When I look at the cost of travel, the only new costs you have are transportation (the costs of getting there and getting around once you’re there) and lodging. Everything else (food, entertainment) are costs you’d incur whether traveling or not. You might also save some money that you don’t spend on things like work-related expenses (commuting, work clothes, etc…). It’s true that you might spend more on entertainment than normal, but the longer you’re away, the more spread out those expenses will be.
A one-week trip could easily cost a family $5,000, but a month-long trip might only cost a few thousand dollars more.
When looking back at our 2 months in Mexico late in 2019, I figured it cost us about $3,000 in additional expenses, plus the airline miles we used to get there and back (https://www.physicianonfire.com/slow-travel-in-mexico/).
For 2 months in Spain, we spent $2,500 on airfare, a few hundred on trains, and about $4,000 on 3 and 4-bedroom Airbnb flats. So maybe $7,000 that we wouldn’t have spent if we had stayed home.
Cheers!
-PoF
Thanks for the post.
I do think what you have achieved is amazing and you are to be congratulated.
Coming from a family that embraced a strong work ethic, I wonder what the impact of your FIRE decision will have upon your children. Of course your children will benefit from the experiences of double parenting, travel, and home schooling.
Will they miss out on the lessons of grit, determination, perseverance, and hard work that are often associated with “work” and a “job” in the traditional sense? In my opinion, there are so many good lessons for children (and adults) to learn from “work” and the implications for self worth and reliance. Having a “job” can be a good thing.
PoF, I was surprised to see an old classmate of mine was your “replacement.” (Couple years ahead of me). I had no idea where he and his family ended up after florida. Pretty cool to see!
Notably, I found that I had to stop reading your blog a year+ ago because it made me more focused on finishing when I haven’t even started yet and that focus made me feel miserable doing what I do, when I normally love what I do. Nevertheless I learned a LOT and I am grateful to you. FI is at the top of my bucket list. My goal is debt-free by 40 and FI by 50.
Very cool to hear that. He got to come back to his hometown, and it felt serendipitous when he reached out to me. The timing of his arrival and my departure seemed just right.
And I feel for you. I have stated that I was happy to be blissfully unaware of FI and the FIRE movement for the first decade or so of my career. If I had known what could be, I might have gotten to FI a little quicker, but not much, and it would have felt like a long slog.
I think debt-free by 40 and FI by 50 are great goals, especially if you’re able to enjoy the journey.
Cheers!
-PoF
Congratulations! Always good hearing stories like this. I hope to join the club a few years from now.
That was a great read to be able to FIRE in your 40’s. Was wondering, what do you do for your health insurance coverage in the US and outside the US, do you have a particular catastrophic plan that you would recommend? Also, your strategy to get monthly inflow of income from your savings, is it from your 401k/SEB/HSA, please share your plan to put money aside to allow for a steady monthly income. That would mean around 7 million to put aside for retirement, would be 500k/year for around 14 years in savings alone, please excuse these noob questions, but would really help some of us plan. Thanks
Here are his thoughts on health insurance: https://www.physicianonfire.com/cost-of-healthcare-in-early-retirement/
As far as his strategy, I think he pretty much lives off his blog income and is still saving some of that. Not sure what you’re talking about with $7 Million.
Thank you for your reply. The $ 7 million i am talking about is the average target number posted on bogleheads by physicians looking to retire and made an assumption that to FIRE in early 40’s you would have that number. And to retire by 44 years if you start earning at 30 would be an average of 500k/year in savings alone other than annual income.
How much can we make off a blog to support a monthly income, curious as this could be something to pursue in the long haul, and that probably would have to have many internet clicks.
Ha ha. Just because someone says they need $7M to retire doesn’t mean YOU need $7M to retire. It’s all about what YOU spend. POF spends a lot less than you and I do, so he needs less to retire.
For health insurance, we have an UNsubsidized Bronze HSA plan purchased via the exchange. Costs just under $1,000 a month.
I’m not sure where you got $7M, either, but I have written about our drawdown plan (https://www.physicianonfire.com/drawdown/) and how and when one can easily access different accounts during the various “epochs” of early retirement (https://www.physicianonfire.com/epochs/)
I hope that’s helpful, RR.
Cheers!
-PoF
Thank you for your reply. The $ 7 million that i am talking about is the average target number posted on bogleheads by physicians looking to retire and made an assumption that to FIRE in early 40’s you would have that number. And to retire by 44 years if you start earning at 30 would be an average of 500k/year in savings alone other than annual income.
Thanks for your reply. FI is also on my list and your achievement is inspiring.
Also, was wondering as you are keeping your license active and your CME, what are your suggestions to
if you want to keep your options open in case you would want to return to practicing medicine?
Do you volunteer at a hospital or how do you plug your CV even for locums work, again this is a noob question as even if you decide to do locums work at some point? How many months or years gap in your clinical work is ok or are you keeping up with credentialling at your previous work place to do intermittent locums work? Thanks again, just trying to plan when i stop working for an income.
I can’t imagine you’re going to be able to go back once it has been 2-4 years, but it probably depends on how desperate the employer is. At the time of quitting medicine most of us have a license, DEA, board certification etc that is going to last another year or two. That’ll probably do for most. I have another FIREd colleague who has kept his license for 7 years now since he quit practicing. He finds it useful to write scripts for trips, family etc. But I don’t think he’s going back to really practicing.
Thank you very much for your reply.
Most physicians i know mostly academics have practiced to 70’s and 80’s of age with some still doing some intermittent work once a week, and was wondering if the inclination to practice medicine again or rethink the decision would bother some after puting in so many years of training in a field. But from the post, it seems that that once you quit, you have made a choice.
I don’t think those docs who FIRE are all that interested in working into their 70s and 80s. Going back is pretty tough. I’ve got a guest coming up on the podcast soon that is like the exact opposite of someone who wants to FIRE. Different strokes for different folks, but I’m trying to help all of them with their finances.
Thank you for your reply.
I realize it would be difficult to get back to an emplyed position, but if someone want to do primary care or outpatient medicine and open their own practice with low overhead or join a larger pvt practice group and work one day a week to be involved in medicine, would it be a liability or difficult to get malpractice insurance coverage for such a physician.
There are some physicians who quit pvt practice and do volunteer work in Africa/Haiti and do intermittent locums work in the US. Just wondering if you FIRE but still want to keep up your clinical skills to do volunteer work, would it be a hassle in today’s medical litiginous environment.
It could be done. Not particularly cost efficient, but it could be done.
It’s true than in academic medicine you can find sprightly 70-75 year olds. Typically they are ID/endocrinology etc. You’ll be hard pressed to find 65 yr ED doc, even in academic medicine, with somewhat full clinical load. You’ll see more older physicians in administration/med school offices- DIO, dean’s office etc.
Thank you. Great posts, i think physicians should start thinking about finances once they start getting a paycheck and plan for no debt to FI early irrespective of when they retire.
Sure, medicine doesn’t have to be a calling.
It can indeed be “just a job” from which you retire.
A close relative ended up attending medical school starting in his mid-30s thanks to the US military.
Given his prior military service he ended up retiring less than 20 years later.
Now he works only when he wants, on a contract basis.