Retired from Medicine at 43: Why, How, and What Now? | White Coat Investor

[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.

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!