A Physician Blog of Ice & FIRE
“Night gathers, and now my watch begins. It shall not end until my death. I shall take no wife, hold no lands, father no children. I shall wear no crowns and win no glory. I shall live and die at my post. I am the sword in the darkness. I am the watcher on the walls. I am the shield that guards the realms of men. I pledge my life and honor to the Night’s Watch. For this night and all the nights to come.” – The Night’s Watch Oath, George R.R. Martin.
Well, you can scratch the first few lines for me. I have lands, a wife, and children. All of which I have no intentions of giving up. However, I have decided to start this blog to try and help the Free Folk (or Wildling) Physicians who live “North of the Wall” in Canada to weather the coming financial storms. White Walkers Wynne and now Night King Morneau are on the move.
Like a shuffling undead army, governments need life (in this case money) to fund their political agendas.
They seek to extract it from the rich successful professionals and entrepreneurs of this country. Sadly, the winds behind the politics of envy blow strong and this group is a perfect target. Make no mistake – Winter is coming…
The environment in Canada for physicians has a lot of parallels to the seasons in Westeros, the fantasy setting of Game of Thrones. There are bountiful Summers of variable multi-year lengths. These are usually long enough that many forget the equally long and brutal Winters that intercede.
I trained towards the end of a Winter in the late 1990s.
There had been a little over a decade of vilifying physicians as greedy whilst cutting their pay and their ability to provide quality care by starving the healthcare system. Sounds familiar. The government had also discovered that since physicians ordered expensive tests and treatments for patients. Logically, money would be saved if there were fewer docs to do that. So, they cut medical school enrollment drastically. Predictably, these moves led to a doctor shortage due to the “brain drain” to greener pastures in the USA coupled with the decreased production of new doctors.
Ultimately, it reached the point where there was a public outcry and Summer returned.
There was a doubling of medical school/residency slots over a few years. Doctor fees increased over the course of the ensuing decade to help recoup some of the lost ground. This eventually worked and the brain drain was reversed around 2010. Since then, we have been heading back into Winter. The most Stark example being Ontario where there have been unilateral government clawbacks to fees of about 5-10%. There have not been any real good faith negotiation for several years.
This cycle of seasons will no doubt continue as governments think in 4-year terms and react by over and undershooting the longer term target as the pendulum of public opinion swings.
With this latest Autumn over the past few years, I found myself becoming burnt out and cynical.
Not a good place to be only 11 years into my practice at the tender age of 41, but not uncommon. A couple of Canadian surveys done in 2006 showed about 50% of doctors have symptoms of burn out. Perceived lack of control over one’s situation is a strong risk factor for burn out. That certainly described how I felt due to the unilateral government actions, associated media campaign, and challenges within our hospital from continually tightened budgets.
My case was relatively mild with largely some irritability and a bunch of bitching-moaning-feeling-sorry-for-myself.
This gave me significant internal conflict because, by any measure, I really have it made in the shade. I have built a rewarding career and I am usually a glass-half-full kind of guy. I also strongly subscribe to the mentality that you should be proactive and act on your environment. If you do not, then it will act on you. You’ll be stuck reacting. Or even worse, take on a victim mentality. My bitching-moaning-feeling-sorry-for-myself was definitely incongruent with my stated values.
I’d like to say that with my awesome inner-awareness and powers of self-mastery that I diligently embarked on a process of evaluating my priorities in work and life, and explored my options (eg. retire, move, change up my practice or career). What really happened is my wife gave me a kick in the ass (she’s great for that) and told me to do just that.
If she were a Game of Thrones character, she’d probably be Daenerys Targaryen – not only is she the “Mother of Dragons”, but she is also really hot and has a similar temperament. Sadly, I identify most with Tyrian whose self-described role is to “drink and know stuff”.
These factors led to the final conclusion that I should start this blog:
Physician burn-out is hurting physicians and their patients.
There are many others with similar feelings of burn-out who are critically looking at what makes them happy, re-evaluating their priorities, and examining their options. The Financial Independence Retire Early (FIRE) community online has already been doing so.
It is easy to feel isolated as a professional who is thinking about FIRE when popular culture is still very much one of consumerism. Further, your colleagues are (or seem to be) very career focused or “workaholics”. Anything less than medical martyrdom can be scorned as being a sign of weakness or lack of dedication. Reading the stories of other doctors in the FIRE online community like Physician on FIRE, Happy Philosopher, or Dads Dollars Debts was like hearing my own story. They resonated deeply with me and were inspiring and affirming. I hope this blog, with both my story and those of others that participate, provides this comfort and motivation to others.
I had actually already pretty much achieved FI.
It was not intentional because I didn’t know FI was “a thing”. The journey was simply living and managing my finances how I was taught by my parents (who retired in their early 50s) and my aunt and uncle (who retired in their early 40s). Reflecting, I took for granted the wisdom that they passed on to me. Apparently, it is novel enough that you can now call it something cool like “FIRE” and there are people who still need to learn about it. I think that I can contribute, particularly within the Canadian context.
Having FI within grasp, I still don’t want to retire early (RE).
I have found a fulfilling career using symbiosis. Many professionals have done the same. Some are struggling because they need to pause and recalibrate the career aspect with the rest of their lives. However, achieving FI and recognizing that the ability for professionals to do that. For my purposes would consider the RE more for “Re-focusing” work to my priorities.
Extremes attract attention, but a balanced approach is better. The FIRE concept has been in the media lately, but not in a way that resonates with most professionals. It often showcases people that through a combination of living on nothing, working like a beast, starting side businesses, or having benefited from a very long bull market have achieved FI at a young age. They then RE from the job they have grown to hate and live on a shoe-string budget.
The central issue for FIRE is spending our time and money wisely with the right balance between the present and the future. Physicians are in a fortunate position to do this without extremes if they pay attention.
When physicians decide to attend to their finances can vary, but the sooner the better.
During medical school and residency, we are focused on building our medical knowledge and skills. However, we also need to become educated about our financial health. It enables us to perform at our best and we need physicians teaching physicians about finance as part of our training.
New attending physicians need to take care of some basic major personal finance to get off on the right foot and avoid traps. Early career behaviors and choices can also have a disproportionately large impact longer-term. My hope with this blog is to help fill this educational void to help early career physicians to launch on the right trajectory. Or to help those already in flight to course correct.
I will also benefit from doing this by learning more as I research and organize my thoughts to write posts and receive feedback on them.
With Winter coming, the night is dark and full of terrors.
I hope this blog will help provide some light for Canadian professionals in the icy north to proactively take charge of their financial lives and work towards FIRE and the power it provides. Hopefully, my blog lifespan will exceed that of many of the main characters in Game of Thrones.