Career Satisfaction & Balance: Stick It To “The Man” & Play Your Banjo

Attending a music recital is a common right of passage for the more affluent parents in our area.

For those unfamiliar, these events usually take place in a church (for the concert hall acoustics) or an old-age home (since the patrons are mostly deaf). It is a pretty homogenous affair with kids playing the same classic songs on either a piano, violin, or clarinet. In the hands of children, the clarinet is a wind instrument that looks and sounds like a Canada goose being strangled. That just won’t friggin’ die.

For the most part, these kids are following a script laid out for them by their parents.

The parental reasons for the script can vary, but there are some common threads. There is the popular belief that children’s minds are opened and developed by music. For some parents, it is driven by how playing an instrument was part of their own development and success. Since they have been successful and it worked for them, it is applied to their offspring also. Other parents wish they’d had that opportunity and want to see their kids have it.

For some, it is how their kid is a prodigy and a better instrumentalist at age 8 than most adults. I felt that kind of pride watching my son at his music recital. Not because he is a musical prodigy, but because he stood out from the crowd for being lively and boldly blazing his own way. Amidst the classical melodies on classical instruments, he got up and rocked it out on his banjo.

You want to play the banjo?!? Uh.. OK.

While we were happy that our son decided to take up a musical instrument for the same reasons as most parents mentioned above, we were very careful to avoid imposing our will. He had to really want to play an instrument and he could choose which one (if he decided to).

We would facilitate his desire as long as it proved to be consistent over several months. He had to really want it. One of our family rules is that you finish what you start and we didn’t want to have daily battles due to a change of heart.

Several years later, he came to us wanting to play the banjo. As you can imagine, it took a while after that to find a banjo teacher and to order a banjo. Apparently, banjos are not a standard stock item in music stores ’round these parts and we didn’t have any banjo players amongst our “kinfolk”.

What the heck does this all have to do with finance or physicians?

A lot actually. We want our children to be resilient, happy, and contribute positively. This is also what we want from our medical careers, and financial health is one of the aspects that underpins that.

Like a kid forced to play a musical instrument with the best of parental intentions, physicians are pressured by the professional scripts of those who have gone before us.

Financially, we also face cultural scripts. Both from our colleagues and the society that surrounds us. Some may be helpful, but many are detrimental. We need to consider the career and financial path that works for us. Play our banjos with energy and joy rather than just be another pianist in the crowd (no matter how skilled). Or if that is too warm and fuzzy for you, think of it as stickin’ it to “The Man”.

What? You don’t know who “The Man” is? Look up.. That’s his thumb holding your down, man. Let’s look at some specific examples of what I am talking about.

Common Scripts For Physicians

  • The Academic Script
  • The Altruism Script
  • The Image of Success Script
  • The Ambition Script
  • The Bad With Money Script (the antithesis of Financial Independence)

The pressure for trainees to pursue academic medicine.

“Anyone can be a clinician, but only the elite group of super-ninja doctors can do research. Pursue research and bring honor to the clan.”

Unidentified Grandmaster Of A Shadowy Academic Medical Syndicate, circa 2000 A.D.

For residents and medical students, this is a commonly promoted script within academic centers. Particularly when a learner shows great promise. This brings pressure to bear. You feel flattered by the praise from a superior and don’t want to let them down.

The academic physicians and leaders (like parents) do mean well by encouraging this. It is both what they know and it is true that academic medicine is a hard (but vital) road that few follow. Since the road is long and difficult with few financial rewards, there is a fear of missing even one potential future academic due to “lack of encouragement”. However, a true desire and happiness from the intrinsic rewards of academic medicine are required to pursue this career track successfully.

Medicine is about self-sacrifice and altruism. Don’t be a greedy doctor.

Medicine is a helping profession. This is central to why it is a rewarding career path or even “a calling”. Further, medical martyrdom is even valued by many (who of course look down on those that don’t martyr themselves). Anyone who goes into medicine simply for the money won’t last very long. This is all true, but too much imbalance between effort and reward may also lead to a sub-optimal result.

A well-balanced practice nourishes our heart (compassion), our mind (mentally stimulating), and our spirit (a sense of purpose). However, it also involves money. Money is like the body of our practice. Our heart, mind, and spirit won’t survive very long if we neglect the reality of our physical needs. Conversely, focusing on the physical/finances alone will lead to a shallow and unsatisfying career. Balance.

We are also not in this alone. The demands of medicine are potentially infinite and can push out others in our lives. We need to avoid selling out our families for medicine. This includes both our time and money – which are really interchangeable. If you don’t get paid for your time now, then you can’t buy time later. Medical culture glorifies self-sacrifice, but should that include sacrificing our families too?

The financial aspect of the altruism script is still enforced.

Sadly, from within medicine, this can still occur through money shaming. However, it is even more strongly enforced by those outside of medicine. That becomes particularly acute during contract negotiations or when politically expedient.

Doctors can make a lot of money compared to the average person. While everyone acknowledges that medicine is a long tough road, it is far enough outside of the average person’s experience that they don’t really understand that. Or how it may justify income. Opportunity cost, business expenses, and the other nuances of being a self-employed professional are also, at best, abstract concepts to most people.

You should look like a doctor. The image of success.

Doctors are admired as successful people in our society.

Our materialistic culture also naturally looks for an open display of that success for corroboration. That means nice clothes, a nice car, exotic vacations, and/or a doctor house. It is pervasive for everyone in North America and causes people to spend beyond their means to project that image.

This can be especially acute for physicians as they enter independent practice.

There is a mix of delayed gratification (for over a decade), expectations from ourselves and family (who have also sacrificed), and the headline number on the cheques rolling in (large and pre-tax). Our “means” is suddenly large and concretely in our face. Our debt may also be in our face, but we have had it so long that we have become numb to it.

For some physicians, a display of wealth may be important.

Most people seeking cosmetic surgery would be more likely to go to Dr. Nicecarfancypants than Dr. Subaruwalmartwear. Regardless of their actual skill level. For the rest of us, as long as we look professional on the job, it doesn’t matter.

In fact, overspending could make us bad doctors.

If we become trapped on the hedonistic treadmill, then we are more likely to burn out. Burn-out is characterized by undoctorly attributes like cynicism, inattention, lack of empathy, and lack of energy. Good medical practice requires the opposite of that.

Feeling trapped and lacking control are major contributors to burn-out. Those feelings are also the natural consequence of needing to work too much or at things you don’t find rewarding – solely because you need to pay the bills.

You should be ambitious. Always.

People don’t get into medicine without being ambitious. Ambition to improve how we practice and how we live our lives outside of our career is laudable. Developing in these areas also gives us a sense of meaning and purpose which is protective against burn-out. However, this is not always how ambition is defined in a medical career.

These scripts are very similar to the academic medicine script, except that they occur after the training period. The pressure to follow these scripts is usually applied by more senior physicians who have succeeded in a non-clinical domain of medicine. Physician leadership in its various forms is the most common realm. Again, it is well-intentioned to help encourage promising younger colleagues to travel the path that worked for them. The potential danger of these scripts is that there are many options and success lies in you finding roles with meaning to you. This is different for everyone.

My own shifting ambitions.

For example, in my own career, finding areas of need that I could build something to fill it gives me a sense of purpose. Early on, that was curriculum development and educational leadership in my medical subspecialties. The script would have been for me to progress to a residency program director position.

Instead, I shifted into hospital administration as the curriculum stabilized and development of our clinical services became where I was needed more. Our team made amazing changes over the course of a decade. As a side effect of that, we grew into a department and I became a Department Chief at a very young age. The script would have me gunning to be a Chief of Staff or lead a larger department somewhere. However, I have no desire to pursue that at this time.

Each time that I have made one of these career shifts, my mentors in those areas have been baffled by my deviation from the script.

The biggest needs that I see presently, that require my skillset, are at home as a parent and as a physician teaching physicians about finance.

Financial Independence Is Like Playing The Banjo

You will need to play your banjo to obtain financial independence

The main pillars of developing financial independence are earning money, spending wisely, and investing without having mistakes eat up your returns.

Developing financial independence requires you to play your banjo while everyone else is playing their pianos and violins.

Or, if you want to be uber-frugal, you can play a wash-tub or empty moonshine jug.

The thing is, when you achieve financial independence, you are then free to play however you like.

Play your money-maker banjo.

You can maximize your income by finding areas of need to fill. These could be shifts/jobs/locations that are “undesirable” (but well-paying to attract people). Some underdeveloped areas, that don’t pay well, can be improved and made more lucrative by doing things differently (and better). That requires more upfront effort, creativity, and taking the risk that it won’t work out. However, risk and potential reward are usually linked – just as with investing.

Even if not financially rewarding. Even if it fails. There is value in having faced the challenges of trying to tackle a problem or fill a need that most have shied away from.

The traditional doctor-script doesn’t allow time for much else. However, breaking from that to pursue some money-making side hustles can boost your income. The skills honed and challenges faced in these side-interests may be reward in their own right.

March to your own tune with spending.

With our progressive income tax system, spending less money yields out-sized benefits compared to earning more.

Don’t increase your spending because you are trying to fit in with everyone else. Spend it on what is important to you. For doctors, that may mean breaking from the doctor house, luxury car, private school, Club Med Vacation script. Conversely, it could mean spending extra money on things that aren’t generally associated with doctors. Play your banjo, drive your tractor, or even your big honkin’ motorhome.

The point is, spend deliberately on what makes you happy and advances your goals. Not on what others expect.

Consider ripping out a badass-banjo-solo with your investing.

The vast majority of physicians use investment advisors. That may be the best route for some. There are potential advantages and costs. If shopping for a financial advisor, just make sure that your are getting good value for the money you are spending. For those willing to put in some effort, maybe stretch their comfort zone, and with the discipline to follow simple plans – DIY investing can save millions over the span of a career.

etf investing canada

Join the financial independence band.

If you decide to DIY invest, you aren’t really playing solo. You have to strum your own banjo, but there is a growing community on the internet that likes to jam together. There is the Physician Financial Independence (Canada) Facebook group that is full of colleagues and mentors. Physician finance blogs. I have even made portfolio building tools on this site (in the right sidebar on a desktop or bottom on a mobile device) to help. There are even some financial professionals that have great material to help DIY investors get started, like the Canadian Couch Potato and Canadian Portfolio Manager Blogs.

Whatever routes you decide to take in career, life, and finance – just be sure to write your own song.


  1. I got into medicine to have a good time and write scripts not live scripts. Here’s my man singing my song, imagine your “girl” is medicine.

    Now I’m done. Did all I want to do. My girl treated me right and I treated her right. Now I stepped into a different river. That’s the thing about writing scripts, you get to call the tune and write the ending.

  2. LD, this piece speaks to me, especially how you played the banjo within your institution.

    I can tell you that I’m the outlier wherever I work, but I’ve found a tribe of doctors and friends who cheer me on instead of covering their ears, and that’s priceless.

    Congrats on another all-time-favourite article.

    Good on you, Gasem, for forming such a healthy relationship with medicine. I’m trying to keep my girl healthy. ๐Ÿ™‚

    1. Thanks Melissa. Being an outlier is more interesting. When you have friends and colleagues cheering you on, it is definitely more fun. Plus, if things get stale you have no difficulty changing the tune knowing that you have done it before and that you will still have your groupies along for the ride ๐Ÿ˜‰

  3. Loonie Doc,

    Reading this cues that nostalgic surge of warmth rushing through me, as if our mom must have given us up for adoption to different families in different nations all those years ago only for us to find one another via physician finance blogs and recognize our shared DNA in what is destined to become an after school television special that airs just before reruns of DeGrassi Junior High.

    Thanks for writing something so authentic to my experience. Like you, Gasem and Melissa, life 2 standard deviations out has been richer for the eccentrics inhabiting these fringes at my side.



    1. Thanks CD. Maybe we were part of an intergovernmental nature bs nature experiment and there will be a documentary. Seriously though, going your own way has been made way better by being able to find others of similar ilk via blogging. My wife thinks it is hilarious (and a little scary) as I keep finding others to jam with.

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