Part-Time Medical Career Update from Hawaii


The Journey Into Part-Time Medicine Begins, and So Does the Budget…

Part Time Medical Career Track Update After negotiating a part-time track in my practice I experienced a period of uncertainty and stress.  On the one hand, I felt like I was on a hamster wheel; on the other hand, that running pays very well.  Some physicians spend every last penny, and others save every last penny.  I come from a very generous family and have always enjoyed sharing my blessings with friends, family, and charity so I would say I am somewhere in the middle.  Since I have a solid financial plan I have never really worried about spending and all my saving get withdrawn from my paycheck and never see my bank account.  As a result, I don’t really budget beyond looking at my bank account balance which despite spending way more than I should, stays the same.  Now that I am part-time I still send the same amount of money to my investment accounts but I suddenly I am worried about spending.  I have used Mint.com for years to look at my spending and every year I would say the same thing- “I need to follow a tighter budget.”  So now that I am making 25% less, I now have a new job and need to devise a new plan.  My goal will be to cut back the spending to keep from depleting my bank account.  Over the next several weeks I am going to not only submit all my spending into Mint I will also create a spreadsheet to track and measure my results.  I will then share these results with you and also provide the spreadsheet I used.  Since I have taken a pay cut, I also have taken a tax cut placing me in a lower bracket.  This should offset some of my income loss and I calculated that my reduction in pay will look more like 19%.  So now I have a new challenge. Either I cut spending somewhat drastically or supplement my income with Locums work.  Either way making a large change like this will involve some additional work.  Unlike driving to work, fighting traffic or dealing with some difficult call days this work should be very rewarding with much less liability assuming I don’t take on excessive Locum work.

Spending my New Currency in Hawaii

Napali Coast

One of the advantages of going part-time is I am getting paid in a new currency – time.  Since this precious commodity is of very little supply, I feel well compensated.  In fact, I am just returning from a 10-day vacation in Hawaii.  Hawaii can be very expensive but during the trip, my family and I were very modest in our choices of dining and family excursions.

 

Waikamoi Falls, Road to Hana, Maui

We rented a car, and went hiking to some amazing places on the islands of Oahu, Maui, the big island of Hawaii, and Kauai.

Most of the hikes were free except for some parking or national forest fees but the entertainment value was second to none.  Our favorite post-hike treat was and will always be the shaved-ice (the size your head) for a few bucks.

Hawaii Brain Freeze, Hilo Hawaii

The second most popular activity included beach activities like snorkeling (with our own equipment), boogie boarding (borrowed from car rental company) or just swimming in the warm, crystal clear blue ocean.

Hapuna Beach Bodyboarding

We read on various travel blogs that food would be expensive but we found plenty of cheap and excellent eats all over the islands.

 

Coconut Shrimp and Milk from Blue Water Shrimp, Oahu

 

We skipped the helicopters, ATVs, tours, boats, submarines or any other excursions pushed by the touring companies.  Instead, we rented a car and drove to some of the most amazing destinations at our leisure without any time limits.

Road Trip to Hana Hawaii
Ke’Anae

Before I practiced part-time medicine, I had only been one other trip that lasted longer than 7 days.  Knowing that I will be doing this regularly continues to bring joy and excitement, not only to my life but also to my wife and children.  Since the hiking and adventuring went so well this time around we are planning on other trips to Yellowstone, Colorado, Alaska, and any other places with a beautiful landscape.  Both of my sons participate in Boy Scouts which as an added bonus will fulfill many of their requirements on their way to Eagle Scout.  I am very happy to be part of this process since the time I will have with them will not last forever.  Many fathers realize this far too late and end up like lyrics to the “Cat’s in the Cradle” song, by Harry Chapin. I am truly blessed and continue to count my blessings.  I wish the same for you and your family.  With a good plan, it can be yours too.

“And, when you want something, all the universe conspires in helping you to achieve it.”
― Paulo CoelhoThe Alchemist

Challenges for Part-time Medicine Practitioners

After speaking with a fellow surgeon, I also realize this may not necessarily be a reality for others not practicing anesthesia, emergency medicine, or family practice.  Going part-time for surgeons can be particularly challenging.  Cory Fawcett speaks about this in his book, The Doctors Guide: Smart Career Alternatives.  He decided to transition into part-time medicine by leaving his permanent career for a locums tenens career.  For him, it was very rewarding but for others like my friend the idea of frequent travel does not sound appealing.  Since she not only has patient obligations from her clinic, she also has to fully manage her post-operative patients properly to have the best outcomes.  Alternatively rather than working 100 hours a week she has decided to back off of taking call and set boundaries with the administration on expectations for RVUs, office hours etc.  The problem as Cory has pointed out, other members of the department are not usually willing to go along with these plans since they would, in turn, have to work more.  No standardized system exists in surgical practices to share and distribute work.  Understanding this before signing up for a practice cannot be stressed enough and sometimes money seems like the most important factor until it isn’t and then navigating out a busy practice is challenging.

Keep Dreaming, take Action and you will find your Treasure,

Haleakala Sunset

DOAT

6 thoughts on “Part-Time Medical Career Update from Hawaii

    1. Thanks for the comments and the visit. I started out really loving my work. As a resident, I would go the extra mile or take the volunteer for the extra challenging case and loved every second of it. As I became an attending I also enjoyed my work immensely and took on many challenges to enhance my career like taking the advanced echo boards when they were not required(whew!). Then I decided to become the medical director of the department after much prodding by my colleagues. Not realizing it I doubled my work and had two jobs. After losing my hair and burning the candle at both ends for too long I became burned out with both. Now that I am part-time I have relearned to love practicing medicine and you are right, LESS is MORE!

      Thanks again for the comments! DOAT

  1. Got your link from PoF, great post. At 26 with 2 young kids, I see myself in your photos in a few years. Just got back from Kauai x 10 days so I am pretty loose with time off now that were FI.

    You are sensitive to the patient continuity of most specialties, and seem to be grateful for the flexibility your specialty affords. Many docs I meet that have side hustles, take time off, cut back are in these fields that lend that.

    As a Radiation Oncologist I am tied to the Linear Accelerator and taking lots of time off would mean getting permanent locums. Not impossible but I’m always looking for solutions as I consider transitioning to part-time in the next decade plus minus.

    I wonder, do you feel any sense of loss aversion due to lost income? Do you feel some of your “doctor identity” slipping away? I look forward to future posts.

    1. Wow, you are a young guy to have so much going for you! I wish I had half of your “Goodlife” sense when I was younger! I did read all the books as a resident, but I just didn’t follow them as well as I should have. I have many friends in your situation and I am working with them to find some potential solutions. If you find any that work please share and I will in turn share with them, we are all in this together.

      As far as “doctor identity” goes, I am not sure I ever took on the identity to begin with? As an Anesthesiologist, I have little “awake” patient interaction and in the operating room, the Surgeon is the captain of the ship. Just as any Anesthesiologist which Spotify track is played and the answer is obvious. I am not sure in other practices but I one of us shows up late for 1 minute we get a phone call from a deranged nurse manager yelling at us. If a surgeon shows up 30 mins late that same manager with the sweetest voice will say, “Doctor, don’t worry about it. We will wait for your arrival.”

      Honestly, I received more respect as a Medical Director. I would warn anyone not to fall into this trap since it places us as practitioners in an ethically difficult position at times and can strain relationship with peers. In retrospect, I would have rather been a clinician and focused on my clinical practice, instead of getting torn between two different worlds.

      Loss aversion was well covered by Passive Income MD , an I see you commented on it :). My position remains that it depends on what you are loosing. Currently, I am working on the financial bottom line and so far it doesn’t look that bad. I have lost about 17% of my salary(ouch) but have gained 25% of my time back thanks to the new tax code which places me in a lower tax bracket(a future post). So in a way, I have the best of both worlds. I have way more time than I ever dreamed of and I still make plenty of money for covering my expenses and current investments. If anything I feel embarrassed that I have so much but I will get over that once I master the ukelele. Also, I plan on never missing another kid’s play or competition ever again. That loss aversion was killing me back then.
      Malaho! DAOT

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