In the first part of this series, I unpacked financial lessons from my early career and how my wife and I built a strong financial foundation. Next came The Wonder Years of my first decade in practice. An exciting time, when we finally started building our business, investing for our future, and spending some money feeding the delayed gratification beast. We felt like we were finally reaping the rewards.
My perspective on that changed after a few kicks that caused me to wake up from my reverie. We had overshot in some areas requiring re-examination and recalibration. In particular, what I was giving up to earn and spend more. Everyone will have their own story, and hopefully awakening. Then, recalibration using that financial awareness. In the next installments, I will share some of the lessons I learned from mine, hoping that it helps some of you stop hitting the snooze button.
My Financial Awakening
My Career Was Going Well
Up to that point, I didn’t pay much attention to my pay beyond looking for efficiencies. I was working really long hours, but I felt like I was making progress and that the work I was doing was important. As I showed graphically in my previous post, I spent about five years putting extra work towards improving how our practice functioned. That gradually improved outcomes for our patients and yielded a better quality of work-life for our staff. Around 2011, it also started to pay off financially. Despite the hours and stresses associated with it, I was quite happy with my career.
My career didn’t exist in a vacuum.
Outside of my clinical practice, there were some minor annoyances. On the financial side, there was a provincial tax increase. There was little fanfare, and I didn’t realize it until I was kicked awake a few years later. The first kick came from unilateral fee clawbacks. In itself, that wasn’t going to change what I did. However, the blatant disregard for fair processes, the misleading information about physician “salaries”, and the inflammatory rhetoric from the politicians bothered me. The cheerleading by some of the public that I was working so hard to serve upset me. Still, I rolled over and went back to sleep.
Waking up.
I remember exactly when I bolted upright and started looking around. It was May, 2015. I had made it home for an evening during a heavy few weeks of on-call. My wife and I were sitting on the couch watching the news. I was exhausted. I then watched Justin Trudeau “asking that I do a little bit more” via a tax increase. The tone and delivery were like fingers on a chalkboard to me, but objectively it was an increase to a 53.53% top marginal rate. I felt like I was working hard, and contributing already. “Asking” me to do more and telling me I should be grateful to do it because of my good fortune rubbed me the wrong way.
I reflected on why it bothered me so much, besides being tired from working hard for my good fortune. The source of my visceral response became clear when I did the math. That increase would be added onto the Ontario fee clawbacks and a tithe paid to fund our University Department (to enable teaching and research not paid for by the government). Put together, I would only keep 34% of my income for working the second half of the year. Plus, pay HST whenever I actually bought anything. And I was being told that I wasn’t doing my fair share. What would “fair” look like? That caused my wife and I to ask ourselves why we were doing this.
This caused us to re-examine and take action on some important aspects of our financial lives. Our return on work effort. Our return on spending. Taxes impact both, but we hadn’t paid that much attention to that either. We figured taxes were just part of paying for the society we enjoy. Since we were going to be painted as not doing our fair share, we wanted to be doubly sure that we weren’t paying more than we had to.
Return for Effort
It is easy to point to how much money someone makes. However, that does not capture the effort and sacrifices that went into making it. We even do that to ourselves. It is easy to ignore your income when you are enjoying your career, have no problem paying the bills, and feel like you are doing valuable work that is recognized and rewarded. However, it only takes a problem in one of those domains to make you stop and reconsider the return for your efforts. At the risk of using “admin-speak”, that problem can be an “opportunity” to examine the exchange you are making of time/effort for money.
Know the after-tax value of your time
The first step is to figure out how much spending power you get for working. You can only spend after-tax money. So, take your after-tax income and divide it by the number of hours worked. I made the TiMER tool to help.
Knowing that can help you in a couple of ways. You may discover that some jobs around the house that you don’t mind doing pay you more than you make working. Even as a physician. Managing your portfolio is an easy example. Done simply and effectively, it pays more per hour than brain surgery. Or even reading pulmonary function tests.
Diminishing Return For Working More
You will also quickly figure out that your most valuable hours worked are early in the year. Working additional hours has a diminishing return on your time due to bumping up tax brackets. This was the math that I did when I was jolted awake. In addition to taxes and tithes, there may be other expenses that come with working extra. Some are fixed, like office rent. However, others scale or are added with increased workloads. For example, child care, travel, administrative support, or lost income due to a spouse cutting back their work to support yours. Different careers and family circumstances will have different challenges and options.
Understanding this is helpful if you have some degree of control over how much or what type of work you do. I was fortunate in that regard. I have gradually stopped stepping up to be the first person to fill in service gaps. Even though it was desirable work, I now feel better doing less of it. Getting paid more per hour is a bonus. Instead of extra work, I could spend more time kicking work-life imbalance’s ass. I also gave up parts of my practice that came with high fixed overhead. Even though it paid well on the top line, the net income loss was attenuated by also dumping the associated costs. That was more than made up for by increased flexibility in my work hours.
Our Spending Problem
Even if you are fortunate enough to have a career with the flexibility to change how much and how you work, you cannot make adjustments if you spend everything you make. We spent very little during the first part of our financial journey, but we also had little income. When I started making drastically more as an attending physician, we still spent moderately more for a few years. Those early years of “living like a resident” despite my attending income compounded our increased financial freedom later. However, our spending eventually really took off.
The Earning & Spending Trap
When I had my financial awakening in 2015, we found ourselves in the earning & spending trap. We had gradually adapted and dialed up the speed on the hedonic treadmill. I was earning more and could afford it. However, it was hard to cut back or make adjustments without addressing our spending. Our discretionary consumption was increasingly driving our need to earn money.
There were two major jumps in our spending. One was structural and more difficult to control. The other was discretionary and easier to adjust. Spending is an important skill to develop, and spending synergistically to improve happiness helps. There are also strategies to help you enjoy the process and avoid a lip-skid on the hedonic treadmill. Fortunately, we didn’t have any stumbles on the treadmill, but we were starting to sweat.
Structural Spending
A major factor was building a large home. Ok. A truly massive house with acreage. That created a large ongoing structural cost. Increased taxes, maintenance, and utilities. Tractors make maintenance easier (and more fun), but they also require maintenance. And, of course, a barn to put them in. There was also a baked-in high cost to sell the property. While we did not make money when we did eventually sell it, it did provide value for us.
It facilitated our ability to live surrounded by nature, and exercise regularly. There was plenty of space for our hobbies, and I could bike to work via a rail trail. Even though our property was “a thing”, it facilitated many of the activities and experiences that we valued. Arguably, that could have still been done with less than 10000 sqft and the unintended consequences that came with that.
Like many people, we justified sparing no expense with the premise that it would be our “forever home”. We were overbuilding for the future. However, this was ultimately a lesson in affective forecasting. People are bad at predicting how a purchase will make them feel in the long run. That makes careful and honest reflection even more important before making major increases to structural spending. Real estate is a classic example.
One reason why we are poor at affective forecasting is that we change and our situations change over time. Often, in completely unexpected ways. So, this requires ongoing reflection and recalibration. Preferably before a “cash-flow event” forces it. That can even happen to doctors: health issues, family issues, pandemics. Your lifestyle is more precarious when structural spending dominates your budget.
Variable Spending
The second spending bump occurred after I started paying attention in 2015/16. What happened? Don’t people try to spend less when they pay attention to their budget!?!
In reflecting on what we valued, we adjusted our spending. Initially, that was up. We bought a motorhome and started traveling as a family frequently instead of taking occasional all-inclusive resort vacations. It didn’t save money, but we enjoyed more active trips. The time and money required to learn new skills and develop hobbies were also prioritized. We became more involved with some charities, giving both time and money.
Overall, we did not consistently reduce our spending. However, we could ramp it up or down depending on how much we wanted to work and how our portfolio was doing. That is in contrast to structural consumption costs driving our need to work more or take on excessive risk with our investments.
Recalibrating Our Spending
Trading Our Country Estate For Freedom
Following the election in the fall of 2015, we canceled further renovations to our property. Our landscaper was furious – we had been doing our part to stimulate the economy. However, there was no point in adding more structural costs.
After a few years of finding ways to align our variable spending with our values, we sold the big property. We were also entering a different stage as our kids started high school. We moved to a smaller house in a different city. Its geographic location was more conducive to an outdoor active lifestyle beyond the confines of our property lines. Plus, it was easier for our kids to independently get around without using major roadways. That geographic arbitrage lowered our structural costs dramatically, increased our financial freedom, and enhanced the parts of our lifestyle that mattered most to us.
We value our freedom to work on our terms and the ability to spend more time and money on living The Good Life over having more house than we need. We learned that through trial and error.
Major Spending Recalibration
Our lifestyle spending decreased dramatically when we downsized houses in 2020. However, it did eventually increase again. This time the increase was from flexible expenses more aligned with our values and rather than structural costs from excessive stuff. Our structural costs are now similar to the Canadian average, but our spending on travel, skill development, physical activity, and giving is massively more.
Don’t Get Mad. Just Wake Up.
While it was negative feelings that caused me to wake up and take a harder look at our earning and spending, it resulted in our family making positive changes. The reason why I shared the personal negative aspects that were the impetus for my financial awakening is that I have been hearing a lot of those feelings coming up again. The recent capital gains tax increase was not surprising from a fiscal policy standpoint. However, the tone and delivery were almost exactly the same as in 2015. The political rhetoric, misinformation, and hyperbole from all political parties are unlikely to change. Try not to waste your emotional energy getting caught up in it.
Instead, use it as a wake-up call to examine what you are exchanging your time and efforts for. You can change that. The right balance of financial and non-financial costs and rewards will be different for everyone. However, reflecting on that can help you find a time/effort exchange rate that suits you. There are diminishing financial returns for working more. Particularly at higher income levels.
Controlling your spending gives you the flexibility to make more changes. This is particularly important with purchases that come with ongoing structural costs. Reflect on how you spend vs what you value. Recalibrate your goals to match that to get the most satisfying return on your spending. It took us years to work that out and is still a work in progress. As we change and our situation changes, it will continue to change. However, we are now awake and recalibrating deliberately. We now have more flexible spending and lower structural costs enabling us to be nimble.
The other way to get the best exchange rate for your time and effort is to tax plan. Prior to my awakening, I largely ignored tax planning. Pretending to “ask me” to “do a little more” ultimately resulted in me “doing a lot less” on multiple fronts. Working less and spending less is two of them. However, paying attention to tax planning also resulted in my paying less tax despite the tax increases. More on that in the next installment of my wealth journey.
Love it. Yes , it’s already been 9 years since 2015. Seems like yesterday. I agree totally. I’ve cut back on work but my total wealth has increased thanks to less spending and more investing.
Even better, it’s allowed me to cherish my now 7 year old daughter more and follow her adventures and develop my skills and experiences
Hey Dad MD. A couple of reasons why people have a hard time recalibrating and scaling back in medicine is because they love it and feel irreplaceable. However, medicine won’t really love you back and you are definitely more replaceable as a doctor than as a parent or other family member.
Mark
Which benchmark did you use for your specialty’s average annual income? I’m not sure OMA lists ICU-specific as opposed to the individual sub-specialty of the practitioner.
Also, how to account for ICU weeks that are more typically 80-100 hours, but with “full/time” being markedly fewer than 48wks/year ?
Cheers
Hi JB,
There wasn’t good data from the OMA or elsewhere. However, back then I actually spent a lot of time doing analysis of the income (billing plus stipends) per week of ICU, CCRT, and our lower acuity critical care units amongst our attendings. Plus, the associated hours worked (we were pretty standardized). That relatively open discussion and review was part of how we were able to make our practice more efficient and fair at our site. As part of that, I also did an “environmental scan” speaking frankly one-on-one with the other ICU heads of service within our LHIN and some neighbouring ones. It was pretty consistent overall, with a few major outliers. I used that to come up with a rough guess of income per hour worked for each of our services and we made them fairly even so that there wasn’t winners and losers. As you mention, ICU is typically 80-100/wk for relatively few weeks out of the year. There is also often work in other specialties that is highly variable. So, for this analysis, I just took my total hours worked and normalized it to 2496 hours per year as one FTE (48 weeks of 52h/wk). I adjusted the income by roughly the rate of inflation, although physician fees haven’t really tracked that well and vary by practice patterns. My practice pattern got some nice catch-up bumps in the mid-to-late 2000s and then the usual sub-inflationary increases or clawbacks afterwards. So, the income FTE certainly has some drift. The biggest ways that my pre-tax income per hour bumped over time was due to improved collaboration and cross-coverage of our units. That got rid of some low-utility redundancy and gave use more flexibility for surges or illness etc. The other big improvement came when we became recognized as a formal department and I started getting paid something for all of the admin work that I had been doing.
What I was most interested in with this data and analysis of my career over time was more the relative changes over time rather than the absolute numbers per se. There will always be variability between practices. Including ICU, especially when coupled to work in other specialties. I had some respirology and GIM in the mix during my early years.
Mark
I thoroughly enjoyed reading today’s post. The majority of mid-career MD’s who have been through the current political landscape would relate to the emotions you described. The moment the capital gains inclusion rate increase was announced in April, I reduced my hours from 35h/week to 30h/week. If it weren’t for the solid financial footing I was able to develop with the help of this blog, I doubt that I would have been able to do so. Thank you for all the work you do!
Thanks SY. I still experience the emotions from time to time, but can move on faster knowing that I have the financial freedom to adjust. Great to hear that you have put yourself in a similar position to adjust and find the balance. It is why I have been doing this.
Mark
Great article Dr. Soth
Great post. I’ve got a question on income smoothing. As a very rough rule of thumb, not getting into the “it depends” style of answer:
What’s the best salary to take that will optimize how much money I can out of my corporation while not overexposing myself to the higher marginal tax brackets?
For example, does $172,000 make more sense than $200,000?
I don’t really have a specific plan for the money in the future, but I know that I want to enjoy my money and not keep it all in a corporation. So, I want to start taking it out over a long period of time.
Thanks! Love the blog.
Hey Dr. J,
What I do is start with are there any major splurges that I foresee in the next 3-5 years. I divide that by 3-5 and add it to my annual expenses. I then figure how much dividends I need to pay to release the RDTOH from corp investments (generally 80% of interest or foreign dividends received plus 100% of the amount of eligible dividends received by the corp). Then, how much salary do I need to pay out to have what I need to cover my expenses plus RRSP and TFSA contributions. My corp optimal compensation calculator basically runs that algorithm plus some other nuances. Paying extra beyond that when not needed generally is worse off due to the loss of corporate tax deferral. Ben & Braden tested an algorithm very similar in their compensation/IPP paper to show that. I re-evaluate my spending and progress every 3-5 years to make adjustments, but find it hard to plan concretely beyond that. Also, over longer time frames the corporate tax deferral also becomes quite powerful.
Mark
Thanks Mark for the detailed response
Thank you for writing this LD. This certainly resonates with me and was also my motivation to learn about personal finance in the first place. It is really disheartening that the government is using the same tactics once again to berate and dishonour hardworking people just so they could save a few dollars on their budget. A big blow in recent days seems to be from comments the public made online in response to articles about us. One of them wrote “we need to pay doctors less so they have to work more”. Unfortunately as a physician relatively early in my career, I have no option to scale back my work, but what I can do is to be more mindful of my spending towards things that bring joy and meaning to me and my loved ones. It really is a learned artform and your posts have been a source of inspiration in my financial journey. Keep up with the good work!
I was in your shoes during the 2017 tax change furor, spending loads of time reading every article, scanning comments etc. One tip i would have provided to myself in retrospect: despite how thick skinned you think you are don’t read public comments, be it globeandmail.com physician articles or ratemds, usually nothing good comes out of it mentally! cheers, Tim
That is definitely good advice!
Mark
interesting read, thanks. Yeah there was something about the “a bit more” phrase, as an early career MD at the time struck a cord, then the first corporate tax changes… yikes , this time I’m a fair bit more calm.
I am a bit confused about what you mean by diminishing returns of working more. there are still deferral benefits of the the CCPC long term. For most incorporated MDs earning an extra 200-300k/year and saving it, especially early on, is a great idea if it doesn’t lead to burnout. Are you talking about later stage physicians with a fairly large portfolio already and reasonable withdrawal rates would lead to annual spend well into top tax bracket?
another point that i’ve been thinking about. for those of us running an office, might be beneficial to fully utilize the fixed overhead costs for x number of years and go very part time/locum for y years, then it would be to work a light load in the office for x+y paying full overhead the whole time.
Hey Tim,
I agree that a corporation can smooth out the income so that the progressive taxes are not as bad. However, that hinges on not spending so much that you have to take out income at the highest rates. We were doing both. So, we needed to cut back spending and that enabled us to draw less, and work less. I was working extra, but also spending extra. There were diminishing returns from both, and I needed to cut back on both.
I think if I had fixed overhead costs and was cutting back, I would be trying to find someone to job share to maintain service, transition, and cover some overhead. I don’t think I wrote about it in this post, but that is basically what I did as I wound down my outpatient practice. It was a pretty quick transition for me and I got really lucky with a great physician to phase into my work, but it seems to be a viable option.
Mark
Yeah if i can make it work job sharing would be a great plan. I’m a ways off still but its lease renewal time so it always gets me thinking about the future.