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Ideal Career Plan For A Doctor

Urgent care as a career is here to say. I say that because primary care is overburdened and the financial engine behind medicine continues to be driven by ‘things done’ and not things ‘prevented’. There wouldn’t be much money in preventing things, after all. Just like there isn’t much money in building a superior product that can last decades with parts that are actually serviceable. For this very reason we will only see a higher demand in patient care with smaller number of clinicians out there being able to satisfy the needs.


Fear Will Drive Our Industry And Keep Us Very Well Fed

As media creates more and more of a health hype through medication advertisement, diet fads, exercise videos and supplements society will act out their fears by visiting doctors more and more and relying on the doctor to keep them healthy. Countless coughs and colds will be seen in the urgent care and treated with antibiotics, thousands of lacerations will be seen that never need a doctor to even look at it much less repair it, and even more abdominal pains and chest pains will be seen that will get million dollar workups in fear of a lawsuit.


6-Step Guide To The Light At The End Of The Tunnel

And yes, many wonderful visits will be had as well. Patients who were petrified of a mass on their body will leave relieved knowing it was something benign. A painful hemorrhoid will be managed, a foreign body in the eye will be removed and an asthma attack will be treated. The urgent care doctor is here to stay regardless of how medicine will change. Primary care providers will get further entrenched in medication juggling and ER docs will see sicker and sicker patients with even more technology that only makes their jobs more complex.

If I were to design an ideal career track for a physician out of medical school who is interested in urgent care it would go something like this:

  1. Start moonlighting early
  2. Pay down your student loan as much as possible
  3. Start investing in tax-deferred accounts
  4. Work hard the first few years out of residency
  5. Then drop down to part-time or per diem
  6. Retire early

All this can be accomplished in under 10 years out of residency, I would say easily within 7 and others have done it in 5. You might be a single dude or gal starting residency or you might be part of a household with dual income. You might start out with $400k in student loans or have had the fortune of having your education paid for. You may think you have it harder than the person who started out with $0 debt, however that person still has to learn the financial lessons of life, they are inevitably going to have to make the same mistakes as you and soon you both will find yourselves on the same path.


The Current System Is Best At Ensuring A Burnout

The way medicine is currently practiced, the way the career is laid out, the hours and the patient volumes are absurd. The system that has been followed is archaic and burns out physicians before they even have a chance to becomes masters in their fields.

There is no need for a physician to work a set ‘schedule’ or work 8a-5p with 5 days on and 2 days off. It is unnecessary for a doc to work well into their 60’s before freeing themselves of this huge time commitment. As a physician gains expertise in their field through the power of time and repetition and having made their fair share of mistakes their time becomes more valuable. A physician who has worked for 5 years generally has more knowledge and experience, they will benefit from having more time with a patient. They also will likely have burnt their candle quite a bit more so they would benefit from shorter hours, less work. Currently, our medical system doesn’t allow for such a system. However, you can create this for yourself.

If you’ve been reading the things that I’ve written you know exactly where I’m going with this. Stop worrying about the principal amount of your student loan debt, whether you should refinance it from 8.5% down to 4.5%, whether you should do that backdoor Roth IRA conversion, whether you should invest in VTSAX or VTTSX whether you should pay the extra $100/mo for that financial adviser… These are not the things you should worry about right now. These are the minutia of your overall financial plan. You first need to lay out a financial plan, write it out on paper and you can then worry about the small steps as you break everything down. Not only that, but first solve the larger problems before tackling the easy problems (yes, the above are the easy problems). But I’ll tell you right now, what matters is that you keep increasing your income to expense ratio. As simple as that sounds it appears that among many of my colleagues this is probably the last point that’s addressed. They are worried about which upgrade they are going to make to their home to raise its resale value, which car they are gonna buy next, which cable company to go with to get the best channels with the cheapest monthly expense… The reason is that it’s far easier to deal with minor details than to tackle the elephant in the room.

A successful business always has a business plan. Your life is a business and you are your own CEO. Get a piece of paper and draw out your personal financial plan. You can do this on your own or you can even pay a financial adviser do it with you for $500-1,500. It will be the best money you spent.


Where are you in your financial journey?
What does your financial plan look like? 

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