Thursday, November 21, 2013

Here is Your Box, Climb Inside, Make Yourself Comfortable

One of the things that I find so frustrating in my life is that despite trying to live "outside of the box", my decisions seem to be putting me firmly inside the box. It's almost as if someone else has created the box, lead me to it, sold me on the benefits of living in the box, and then shut the lid on me all the while giggling that they caught another one.

But, I know that is a lie. I am the only one responsible for the box. There might be enough of us living in the box, that we think someone else created it - but it is ours alone. The choice then becomes will you make the most of living in the box, or will you try to escape? Escaping takes more courage than you think.

We weren't going to be those doctors. We weren't going to be the ones living at the cusp of their income. We weren't going to be the ones that make minimum payments on their student loans. We weren't going to be the ones that drive new cars. We weren't going to be the ones that had to work past retirement age. We weren't going to be the ones that still had a mortgage payments and student loan payments 15 years after starting practice. We weren't going to be the ones that .... fill in the blank.

There is a reality that I don't think I can impress upon upcoming doctors and their families enough, and it is this:

What you thought was waiting for you at the end of the rainbow, isn't what you think it is. 

The TRUTH is that your disposable income, the amount that you actually get to use for your day to day living and saving, isn't going to be as great as you thought it was and everything is more expensive than you imagined. Both are influenced largely by what part of the country you live in.

The TRUTH is that your husband, despite being his own boss, is still ultimately at the mercy of his patients and the hospital and their needs. He is a well-paid servant in a highly bureaucratized system. He carries a pager and jumps when they say jump.

The TRUTH is that you are not done sacrificing. Hard decisions still await you. Long hours and nights don't disappear. Loneliness may still be your friend.

The TRUTH is that your friends and family will still misunderstand your situation in terms of finances, time, and abilities. They will always think you have more of all three.

The TRUTH is income guarantees have expiration dates and so do contracts.

The TRUTH (especially for those of us on the 40 side) is that time isn't your friend. If you want to pay off your house before you retire you have 20 years, not 30. If you want to retire at a normal age you have 20 years to save, not 40.

These are hard facts to face. But they must be faced at some point. Sooner than later. Every one's variables are unique. Do you know yours?

My family has always joked that my mother was the original Debbie Downer. She can't help but interject something like "did you hear so and so passed away, so sad, bless her heart" in the middle of an otherwise pleasant conversation. I may have inherited some of that from her.

There are plenty of things that are great about being done and getting a paycheck this is commiserate with your husbands skills, talents, and education. This post in no way is meant to diminish that. Your situation is probably different, they all are. I guess that may be the point. Just because you know a doctor that ........ doesn't mean that it is going to work out that way for you.

If you are expecting magic, you may be disappointed.  Know what your priorities are. Know what you want today to look like and what you want your future to look like. Know what you have to work with. It's never to early to start making a plan.

Don't be disappointed, be prepared. That means having a trusted financial advisor who will tell you the TRUTH about what your unique situation for the present and future look like. The plain and simple truth. You might not want to hear it, but we all need more of it.

I understand the phrase "the truth hurts" much better now.



  1. We are in fellowship now and I must say life is so much better after residency. For me, the pot of gold (figuratively) was there at the end of the rainbow. It varies greatly by specialty and area of the country I do agree. But his level of confidence, respect, and monetary compensation is so much better. I just tell everyone keep living life in the present no matter where you are in the residency/school journey, but that I promise things will get so much better once training is complete. Looking at it realistically like you did is smart, but its also sometimes the only thing that gets people through.

  2. I love how honest you are, I think it's necessary.
    Even though we have a plan and my expectations are low when it comes to fellowship and thereafter, there is still a part of me that thinks ," oh things will be so much easier when..."
    I agree with Kelly, we need to live in the present instead of just "getting through," regardless of what stage we are in.

  3. Pay off your debts aggressively, try to look at the cup half full and remember to live IN the moment as others have said. I often find people who lived so cheaply in training aren't much farther along than those that went deep in the hole in training and lived a middle class lifestyle. One way or another everyone "gives in" to temptation of "spending". We spend in training. We were not raised poor nor do we want to be poor in our 20's and 30's and we don't want our kids to feel poor. We arent' excessive but we have a nice hole to crawl out of. Our lifestyle as attendings won't be much more glamorous than what we have NOW. Financial planning is important but the most important financial planning is PAY OFF ALL DEBTS ASAP. To think you WILL live in that house as a recent grad the rest of your adult life is wishful thinking, I feel. I'm sure it can be done (especially if you don't have much choice on the financial end of things) but truly your needs WILL change, your TASTES will change and it's good to remain flexible. Nothing lasts forever and the only guarantee's in life ARE death and taxes. I love reading your posts.

  4. My husband completed training 25 years ago. It was tough. Prior to his residency he was in the military (ship board duty) and I had thought that tough. Then residency outside the military and a fellowship and that was lonelier and even harder financially and emotionally given we were 2000 miles from family. Our children were born and grew to toddlerhood then. (I met and made some terrific friendships that have endured thru the years.) Once training was complete we moved and purchased an established solo practice and skipped the associate part. You might say its still a solo practice except it didn't take long to find we'd gone from the pot into the frying pan. I say "we" because its unfortunately hardly possible to expect an outside advisor, accountant, bookkeeper, office manager, consultant to keep your business afloat and representing 'you' and direct you as a couple towards an efficient retirement. Its very easy to become misinformed while raising children and focusing on patient and various hobbies and interests one enjoys. Know you are headed towards a bigger responsibility and an enduring loneliness than one can imagine.

  5. this is so true because much of medical training is so "future oriented" from the early part of your training. in 1st year , its 2nd year is better, in 2nd year its 3rd and 4th year will be better. In intern year, its 2nd year will be better. While its true that things are relatively better, I enjoy your realistic posts about what life AND finances in medicine is about. Its better to learn from other peoples experiences than make the same mistakes. I really enjoy your advice.


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