I go back and forth with my sentiments towards my current lifestyle. On one hand I don’t want to work anymore and on the other hand I love feeling productive. Regardless of my emotional roller-coaster, I have a radical appreciation for the luxury of free time.
The last time I was employed was in 2017. I did some sporadic per diem telemedicine work in early 2018. So for nearly 2 years I’ve been living a relatively unstructured lifestyle with a lot of unstructured free time.
I started working at this locum tenens gig just 3 weeks ago. Iit feels like I’ve been here 5 months. And before I will get used to the schedule, I’ll be on a plane back to Santiago de Compostela (Youtube link).
The Guilt of Unemployment
I go through feelings of guilt some days; my little gremlin inside me tells me that I should be productive, that I should be working, making money.
Productivity = Employment… right?
I know that I’m conditioned to believe that productivity is synonymous with employment. It’s not some universal truth. I wasn’t born believing that. It got imprinted on me.
It’s this same belief which makes me look down on a homeless person. On someone who gets disability checks or SSI. And it’s what modern societies use to oppress women who stay home to raise kids.
The fact that I feel guilty about not working full-time, feel guilty about leaving money on the table – that’s capitalism. It urges me to earn money which creates jobs, which feeds the gov’t tax accounts, and supposedly makes the world go around.
I am not anti-capitalism, I am not pro-capitalism. I just want to practice my trade (medicine) on my own terms and be a productive member in my community. And I don’t want anyone else defining that for me. Gracias!
Full-Time Work
Today I woke up at 4 am and couldn’t go back to sleep. So I got out of my plastic wrapped mattress, walked across my crusty floor, out to the shared hallway, into the common shower, and back to my room for some yoga on the splintered wood floor.
I grabbed my badass Briggs & Riley bag with my, laptop and rock climbing gear and went for a walk, waiting for Groundworks Coffee to open.
On my walk I listened to a 2006 book by Julia Cameron, The Artist’s Way, which I rented from my local library using the Libby App.
Aside from the hairballs in the shower drain and the wood splinters, this has been a lovely morning. I’m sitting at this cafe, enjoying my espresso, watching the sun come up.
But this day isn’t mine. From 8 am onwards my time belongs to the Community Health Clinic, where I’m doing my locum tenens work.
I’ll be running around the clinic from 9 am until 6 pm, slapping on the keyboard, looking for supplies, chasing down medical assistants, calling pharmacies, and trying to understand my Spanish speaking patients.
By 6 pm I’ll be braving the streets of South Central LA trying to find my Uber driver in the dark.
The Luxury of Free Time
Free time isn’t promised to everyone but I think anyone who is reading this website in 2019 is able to engineer unstructured free time.
I think it makes sense to give up the luxury of free time in medicine those first few years out of residency. You need to cement your learning and develop your own style of practice. For that you have to see a high volume of patients and discuss those cases with your colleagues.
Those first few years are also important because you can pay off your debt, invest in solid long-term investments, and buy your future free time.
What you’ll buy with your early investment is the ability to go the coffee shop early in the morning. To relax and read a book or journal or work on your own project.
Then you get to walk back to your home, make a healthy breakfast and maybe take a nap. Then get up and go to the gym or do some yoga at a park.
When you’re ready, when you’re feeling like you want to be productive, then you can head to the clinic for a few hours. Or you can see some telemedicine patients. Or you can do some healthcare consulting or whatever makes you feel clinically productive.
Why should I be at a clinic from 8 am – 6 pm when I’m only feeling productive and clinically motivated from 2 pm until 4:30 pm? Who decided that the workday should be 8 hours? Not me.
The Luxury of Freedom
I’m deeply aware of how unbelievably fortunate I am to live in a world where I can be free. Not everyone has this luxury of freedom. Many are oppressed because of their nationality or their family or friends. And many oppress themselves in their own minds.
If I didn’t take advantage of this freedom I might as well be oppressed. I might as well be a hijabi young woman in Iran, a gay man in Israel, or a black person in America.
But I also don’t have to just piss away this luxury, either, spending my days watching Netflix or reading depressing news.
I choose to spend my free days learning something worthwhile. I can use my free time to volunteer with an organization or to help my family and friends.
I definitely won’t retreat back into employment out of fear – or at least I’ll constantly be battling that urge to not do so. I’ve seen too many physicians regress in that way; worrying that they aren’t being productive, or fearing judgement by their colleagues.
Financial Freedom
My flavor of financial freedom comes from having invested a chunk of money which is earning me passive income. Some of it in real estate and some of it in stocks and bonds.
I only have about $500,000 invested, far less than the $5 million I’m told I’m supposed to have. Still, that’s a passive income of $15,000 – $25,000 per year.
When you don’t have to show up to work, when you have the luxury of free time, $20,000 is a lot of money. It can afford you a very nice lifestyle. I don’t think is difficult for the motivated young attending to accumulate this kind of dough.
And guess what, no employment police will knock on your door and take you to jail for working a little on the side to supplement your passive income.
10 Hours A Week of Work
In fact, maybe you don’t care to accumulate a lot of money in a short period of time. Your can design your own financial freedom by working 10 hours a week.
At $200 per hour, that’s $8,000 per month. If you don’t know how to live an amazing life on $8k then you simply aren’t thinking creatively enough. Go read the ERE book for an upside down view on living your life to its fullest, in a the most sustainable way imaginable.
When I worked for Kaiser as an Urgent Care doctor I made $130/hr. When I did telemedicine work as a per diem I made $250/hr. And when I started my own business I went up to $600/hr.
Practicing Your Lifestyle
I have learned that if you want to adopt a unique lifestyle, you have to give yourself time to practice it, so that you can get better at it. Nothing will feel natural about it.
Instead, if you follow a traditional lifestyle then you’ll be a cog in a wheel. You’ll be the fuzzy rat in the work race. You’ll trade your free time in your youth for digital currency which you’ll spend on mostly tangible goods, which you’ll toss in the trash just to purchase the newer version of it.
If you want to live a more unique lifestyle, such as working only 10 hours a week or retiring early or whatever, you’ll have to practice that lifestyle to figure out how to make it work for you.
Emotional Hurdles
Practicing your unique lifestyle helps you overcome the emotional hurdles. Such as, dealing with the family members who think that you’re throwing your life away. Or dealing with your own feelings of inadequacy for not having a house on pill-hill with a Tesla parked out front.
The more you practice this unique lifestyle of yours, the sooner you recognize the hours of slavery you’ll have to commit to in order to afford that Tesla.
You stop seeing the Tesla’s giant window-sized digital touch display and instead see yourself typing away at a dirty keyboard in a clinic full of fluorescent light bulbs, surrounded by burnt out colleagues and unionized medical assistants.
Employment Is Waiting for You
Guess what, employment, as in, wage slavery, will always be waiting for you. It’ll never go away. It’s something you can always come back to.
But you may never get another chance to walk away from a draining job. You may never have the support you have now to go and try out something different.
Apparently, even if you have your medical license suspended for 30 days, you can still go back to full-time employment in medicine.
Your free time truly is a luxury and I would treat it as such. I wonder how many doctors would go back to full-time work if they tasted unstructured free time and found a way to be productive on their own terms.
2 replies on “The Luxury of Free Time for a Physician”
Hi Dr. Mo,
I’m very glad you wrote this article. When you asked, “Who decided that the workday should be 8 hours?”, I felt as if you had listened to a conversation that I had with my peers back in college.
Many people go into medicine with good intentions…but the way Big Medicine is now, I don’t think I’ll be happy in it unless I do something drastically different from the standard employee model.
Thank you again for reminding us that our most important resource is Time.
Whatever it is one plans to do during retirement, I think it’s important to get started on those things NOW, while you’re saving up or paying off debts.
After you retire, the transition from working to playing will transpire more seamlessly because you’ve already started pursuing activities that give you fulfillment.
Sincerely,
1st Year Medical Student With a Vision
Nice. Great insight as a medical student.
The ideal scenario is if you love what you’re doing so much that it’s not work.
As in, for me, when I am talking to a patient about their diet and exercise and helping them overcome their personal barriers, and when I help them assess their individual disease risk, that’s real medicine to me. Done. Check. But that’s not what we get to do – we have to give meds, document what we did for the lawyers and billers … and for that reason, Big Medicine isn’t my jam …
So enjoy the journey, for sure, but don’t fall into the trap of thinking that you need to work any more than 10-15 hours a week. If you love it, great, work more. If not, keep searching and fighting for the perfect clinical setting. There is something out there for each of us. But we lose the vision after becoming attendings because we go the dollar bills waived at us.
When you get that first paycheck that reads $18,000 or $25,000, you’ll see how hard it is to say no to that. As a 3rd year resident I made $18,000 moonlighting in Decemember 2008 … that’s a tough number to walk away from and say no to…