There is a lot written about the cost of healthcare and how it affects retirement. In this post I want to talk about a few things regarding health, healthcare, and being retired.
My patients each have their own definition of health. Being pain-free is high up there and having more productive days comes in a close second. Diet, cholesterol, blood pressure, stress, and emotional well-being are very low on the list for many though they shouldn’t be.
Relationship Between Health & Retirement
To enjoy retirement one needs to be healthy and in order to enjoy health in retirement a person needs a feeling of financial security. Physicians shouldn’t have a problem amassing a gang of cash for their retirement years but our health often suffers because of this.
One of the main problems is that we start working late, we then accumulate a bunch of date or delay paying the debt off, then we start saving even later, and don’t know shit about investing. By the time we learn investing and combine saving/investing we’re in our 50’s.
Health & Stress
The body is like an engine and it can handle quite a lot of insults but there are both cumulative and compounding insults from which the body cannot recover.
We can stress our body out quite a bit and as long as we’re getting enough sleep, eating healthy foods, breathing in clean air, and have time to let our bodies recuperate then we’re likely not causing any permanent damage.
Switching from a stressful household to a stressful job, then not getting enough sleep, and eating on the run while stuck in a shitty commute breathing in the fumes of other cars allows for no restoration.
Many physicians will spend their golden years having to navigate the same shitty medical system in which they worked in. They have to argue with their insurance company, figure out drug costs, schedule surgeries, and get lab tests done.
To enjoy health in retirement it’s necessary to manage our health well before that. I know this, I’m a Family Medicine physician and though I may not know how to use a stethoscope, I know all about prevention.
Many physicians will have a hard time reprogramming their minds once they enter retirement. 3-4 decades of being constantly on the go has that effect on human beings.
It’s common for the transition from employee to retiree to cause as much stress, if not more, for us workaholics.
When you look at poverty in other countries, it’s their lack of feeling secure that creates the biggest stress and havoc in communities. Not knowing if they can afford food the next day or if they will have enough gas in their car to drive their ill family member to the doctor a few towns over.
If your retirement feels insecure then you’ll feel emotionally insecure. Unfortunately, we’re brainwashed into thinking that we need millions of dollars in order to enjoy a halfway secure retirement which only adds to the problem.
Tricking Us Into Health
My personal definition of health is staying the fuck away from western medicine and doctors. I’m healthy if I’m able to enjoy my life on a daily basis despite pains, injuries, digestion issues, vision problems, etc.
How many people will spend their last few weeks in miserable hospitals just so the medical system can make a little more money? How many of us physicians will die in nursing homes and SNF’s, or in ER’s?
Multiple surgeries, chemo medication, 7 meds to keep our livers from falling out – that’s not health, that’s tricking us into thinking we’re healthy. The poor consumer doesn’t know any better – but we do, we’re doctors damn it.
Ever wonder why you can’t walk on the sidewalk of a busy street without choking from the exhaust of passing cars but you can sit comfortable in fucked up traffic and not smell a thing? It’s because you have a carbon filter in your car’s A/C system.
Unfortunately you are still breathing in the carcinogens – ya just can’t smell them. And your cortisol level is up from being in traffic so you are adding compounding insults to your body.
You can’t walk into a home these days and not see particle wood and all sorts of different paints and sealers and surface chemicals.
All these mass-produced, low-quality products such as particle wood cabinets and shitty plastic art pieces bought at World Mart are giving gasses that you don’t want to be breathing.
Your fake wood floor, your carpets, your sofa that was chemically lined for stain resistance are all insults which we expose our bodies to. Even mattresses and pillows aren’t free from these off-gassing.
The meat in the store isn’t brown in color and the fruits look like someone just painted them. Well, they technically did. The meat passes through a gas cloud which prevents it from browning and the fruit gets a healthy wax covering.
Is this bad? Does it cause cancer? Does it lead to diabetes? I don’t know. But I know that whatever country starts living off things like that seem to have a population who suffer worse health.
You go to work and there is immediately a fire to put out. Your coworkers are stressed but you just feel this aura of negativity that you aren’t even aware of. Then you have a meeting where your piece of shit boss who is orders of magnitude dumber than you tells you how you should do things.
You go to do your work but your negativity is now palpable and every patient in the room is picking a fight with you. You assume it’s them and not you so you keep butting heads. Your awkward day just went from not-so-great to horrible.
But it’s okay, because your job puts on these weekly and monthly meeting and strategy sessions where you supposedly get to provide input. Yet, for whatever reason, when you leave those meetings you’re scratching your ass wondering why you just got burdened with even more responsibility.
Healthcare Cost & Retirement
You would think that the topic of health insurance and healthcare cost would belong in this post but it doesn’t. Follow me into retirement and I’ll show you that you won’t have to worry about healthcare costs nearly as much as you’re led to think.
Not only can you get your healthcare much cheaper than others by being savvy but you aren’t going to pursue useless or unnecessary medical interventions.
Medicare. Medical tourism. Your neighborhood private physician. These are ways you can afford affordable health care. Health care is much more important than health insurance.
By the time you’re nearing retirement you’ll have your own little side business where you’re writing off your health insurance premiums on your taxes like I have done.
If you’re going to a doctor who is throwing antibiotics and blood pressure meds at you for every new ailment you experience then you’re fucking with your health.
Antibiotics and blood pressure medications are relatively new – 1980’s is when these things started going viral. They are crutches and do much less good than the medical community would have you believe.
Find a competent physician who wasn’t just a good test taker in medical school but understands how to maintain your health. And listen to them.
In order to enjoy a healthy retirement it’s important to not only be emotionally and physically healthy but it’s important to feel financially secure.
Interestingly, financial security has little to do with the size of your bank account and retirement stash. There are plenty of docs out there who wallow in self-pity because they only have $2M saved up and they are in their late 60’s.
My PA colleague has $2M saved up and is hustling for another $400k even though he’s old enough to retire – his financial adviser told him he doesn’t have enough. He lives in a stupidly low cost of living state.
Feeling financially secure has to do with knowing and, more importantly, understanding that your overhead will be covered with your invested assets.
One of the best tools of oppression is keeping people in the dark. This being the information age it’s that much harder to do but people even in the US still manage to enslave themselves without the big corporations needing to do much more than write a few fear mongering articles online.
It’s important to understand where your income in retirement will come from. How much you can withdraw from a certain portfolio size. It’s helpful to understand the tax implications of such withdrawals.
A savvy retiree knows that they can still invest while retired. They can still capitalize on their assets in unique ways. They can still earn an income doing something they love.
Coming To Terms With Death
Morbid right? But shit, we are one of the most death averse societies. There is nothing wrong with death – it’s as fucking natural as birth. Some cultures celebrate death.
The good news is that despite what we see as healthcare professionals, the majority of us can die happily in our own beds with little pain and with dignity.
Some of us unfortunately catch the longevity fetish and become more preoccupied with living longer instead of just living in the moment. 1 year spent doing exactly what you want with your time is the same as tacking on an extra forced decade at the end of your life.
You will die. It is okay.
You have 100% control over how dignified of a life you’ll live and with how much dignity you’ll pass. Let’s give our death’s the same loving attention that we give our pets.
Stress affects your health and it negatively affects the chance of a successful retirement. Poor health will make for a shitty retirement and poor retirement planning will add to your stress.
There are 2 kinds of stress, the self-imposed stress which is 95% of the stress we feel and external stress.
The stress that fucks with your health which is out of your hands is economic decline, wars, angry people getting in your face, theft, and oppression.
How we respond to these inevitable stresses is critical but I’ll leave that for other brilliant bloggers to address.
It’s the joke of the doctor telling the patient to stop pressing on a spot that hurts every time they press on it. Why do we constantly expose ourselves to self-imposed stresses?
It has partly to do with how much we are suffering in our lives. The more shitty our lives are the more we’re likely to make ourselves and everyone around us suffer.
We work too much, we don’t party enough, we fear death too much, we fear cancer too much, we worry about our kids too much, we watch too much news, we get under too much debt, we depend on the government too much, we fear the IRS excessively, and we don’t give ourselves enough options and don’t build enough redundancy in our lives.
“I have no choice, I gotta do what I gotta do” – the irony. Not only are you a healthcare professional – cream of the crop – but you also live in one of the most wealth abundant nations.
You have options, you choose not to take them. Whether so that you can keep feeling sorry for yourself or have a reason to blame your lack of progress on. Maybe you want the pity of others. But you have options my dear doctor!
Action Steps for Physicians
Enjoying Health In Retirement
To enjoy health in retirement the biggest bang for the buck for a physician is to decrease the amount of stress they put themselves through. It’s an incremental process.
Shave a little off of your to-do list every day.
Stop trying to do too much for others which includes your parents, partner, and kids.
Worry less about what others say and what people think of you. When you’re all dead none of that shit will matter so why would it matter now.
Prioritize exercise, meditation, and fun over your job.
This is the hardest thing for many healthcare professionals to do but here is my recommendations for living your life in order of importance:
- your emotional well-being
- your body’s well-being
- your financial stability
- your partner
- your children
- your friends
- your career
Enjoying Financial Security in Retirement
Completely ignore financial news. Of course, you should completely ignore all mainstream news unless you enjoy being depressed but baby steps.
Become financially knowledgeable, it’s very little information that you need to master but repetition helps.
- get rid of debt
- increase your investments
- decrease your reliance on your income from a job
Hire a good financial adviser. The reason you’re working as much as you are is so that you can eventually not have to work and enjoy financial security. Do you think it’s better to spend that couple hundred a month on a new laptop or a financial adviser in order to achieve that?
Understand that whoever is telling you to not have a financial adviser is financially incentivized to tell you that. I’d love for someone to prove me wrong.
Remember that even your financial adviser can’t help you if you were spending like Dr. Mo ca. 2009. You need to learn budgeting. Guess what, it’s free to learn how to budget. You can do it with a spreadsheet like a hobo or you can do it in style with YNAB.