PFFAP-PYP-23-0503-Medscape Lifestyle & Happiness Report
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Welcome to the Physician Family Financial Advisors podcast, where physician moms and dads like you can turn today's worries about taxes and investing into all the money you need. For retirement in college.
Ben: Hello, physician moms and dads. I'm Ben Utley, a certified financial planner and the service team leader here at Physician Family Financial
Nate: Advisors.
And I'm Nate Rennicke, certified financial planner and primary advisor here at Physician Family Financial Advisors. Thank you for joining us today. We are going to ask the question, is Physician Happiness even a thing?
Ben: Is it even a thing? Is it, is it even a thing? Physician happiness. Yeah.
Nate: Um, and Ben, we're going to just discuss this [00:01:00] Medscape Physician Lifestyle and Happiness Report of 2023.
Ben: Discuss it. Break it down. Yeah. Analyze it, put it back together. Reassemble it. Mm-hmm.
Nate: Yeah. How, how long have you been looking at this report?
Ben: Oh gosh, about five minutes, I think. No, just kidding. Uh, I don't know. I, I think I became aware of it about, it feels like about 10 years ago, but I can't, I can't say for certain, and they change it a little bit every year.
You know, Medscape's a pretty good source for information about physicians. So, yeah. I just,
Nate: I've been following it. Yeah. Well, this one was an interesting one. Because of the pandemic. So a lot of, you know, new information coming out because of that. And to be honest, I was, we were both, we had both talked about this quite a bit before it came out more than in past years.
We had just been thinking about when is it gonna come out? And I was trying to figure out why. And I think the reason why is that we're starting to worry about our physicians.
Ben: Honestly. Yeah. Yeah. Yeah. It feels like [00:02:00] things have changed and shifted and, uh, moved around in a, in a different way. Mm-hmm.
Nate: Yeah.
I, I speak with people and are physicians and, um, I'm just, I just, at the top of the call, I try to think like, is, is everything okay? And a lot of times it's okay, but it's not great. So, yeah. Um, Let's, uh, let's, I, I kind of chose just a few. Of the most interesting or more, most telling, uh, pieces of information.
It comes out in slides, I'm sure. Yeah. The listeners have, a lot of them have seen it. But, um, and, and basically answer some questions. It takes a poll and I thought we could just talk about it today. Let's break it down. Correct. So I'm gonna describe the first picture for, for the listeners, which is, it's essentially, the question is, how happy are you as a physician?
And it, it says people's answer from today and then [00:03:00] people's answers from pre pandemic and basically 25% more physicians are. Unhappy compared to pre pandemic. So happiness at work has shifted quite a bit. One fourth of the physicians out there are more unhappy than they were pre pandemic.
Ben: So break this down for me.
What, what percentage of physicians were happy pre pandemic and, and what percentage are, are happy now? Yeah,
Nate: so pre pandemic, um, 75% of physicians were very or somewhat happy. Oh wow. And now 48%.
Ben: Yeah, it's about half and half now. Yeah.
Nate: So 27% swing
Ben: or so, I'm sure there's a lot of, a lot of answers to the big why behind the unhappiness.
What are you hearing when you talk with our clients about, uh, what, what [00:04:00] causes them dissatisfaction with work? Yeah.
Nate: Um, I hear a lot of. So I'm, I, I wanna say overworked. Mm-hmm. But I think that for a long time physicians have been overworked. Mm-hmm. And what I believe now is sort of overworked and undersupported.
Hmm. Yeah.
Ben: So
Nate: undersupported maybe that there, yeah. There's maybe a lot of respect that came at work, but also a lot of support that the physician had and now it's like you're overworked and undersupported.
Ben: Yeah. Yeah. When I, when I ask, uh, in our annual progress checks, one of the questions I always ask, which is, how, how does it work for you today?
And the answer I've been hearing lately is Too busy. Mm-hmm. Like, uh, I talked to a doc yesterday and they were super busy and they're looking at, uh, as a radiologist and they're looking at the contracts that they, they do. And they're beginning to pick and choose which [00:05:00] contracts to discontinue because they're just, they're just buried.
Nate: Yeah. That that can work, um, as far as being compensated for that busyness and for, for some physicians or some specialties if you own your own practice. I hear the same thing from people who work at the big hospitals and don't get any more money.
Ben: It's almost like there are, I wanna say they're less physicians, but Yeah, I'm pretty sure there are less healthcare workers.
Cause I know that. The pandemic drove a number of healthcare workers, particularly nurses out of the field and continues to drive 'em out of the field. Uh, did the, did the survey say anything about the number of physicians that were polled this year versus before the pandemic? And, you know, I, I don't think you and I have this between us, but I'm curious to see if the, if the number of physicians has changed dramatically.
Pre pandemic and post pandemic.
Nate: Yeah. I didn't see, um, let's see. [00:06:00] It says 9,200
Ben: were in prospective clients. I'm, I'm hearing from, uh, more that are older and more that are getting ready to leave retirement. I don't know if that's a natural, just a natural thing that's happening, or it doesn't seem to be pandemic related, but mm-hmm.
Yeah,
Nate: actually there's been
Ben: a shift. Yeah.
Nate: So 9,200 were pulled this year. Mm-hmm. 10,000 were pulled last year. That's not pre pandemic, but. Hmm. Um, that's one year between,
Ben: yeah. Okay. Hmm. So less,
Nate: less happy. Less happy. And, and the, the, the, the problem I have no idea how to solve, but I think about all the time is how are we gonna keep good physicians working?
Yeah. And that is just scary for the country. If, if it's such a, Tough job. [00:07:00] How? You know, it used to be, I think the feeling that I get is that great physicians never did it for the money in the first place. Right? But at least it helps. And now it almost seems like you have to be really careful with your specialty if you want the money to even make sense.
Ben: I'm hearing that there's some bureaucracy that's causing physicians to be unhappy at work. Like maybe before the pandemic they were, they were, uh, self-employed, you know, maybe it was a large clinic or something like that. But then the large clinic got bought either through private equity or maybe, uh, Optum rolled 'em up or something like that.
And they seem to be less happy on the, on the other side of that because they're, um, I'm hearing they have less freedom to practice. Mm-hmm. And. You know, like you say, uh, some of the great doctors don't do it for the money and they're, you know, but they, they do have the freedom to practice. And so I've, I've recently seen 1, 2, 3 physicians, uh, start up [00:08:00] concierge medicine practices, uh, because they, they didn't like what was happening in the, in the clinics where they were.
So they left and they said, Hey, I'm gonna, I'm gonna roll my own and, uh, have freedom to practice.
Nate: Yeah. You know, I, I see some things like that happening too, and my thought as an economist is always like, oh, it'll swing in the other direction because mm-hmm. Physicians won't stand for it for forever.
Mm-hmm. If it's, but the problem is those swings can take a decade. Right. You know, or longer, you know, who knows how long it'll take for people to. Or I guess the big business side of things to get their act together. Yeah. And we
Ben: still haven't quite hit the gray of America that's supposed to come with the baby boomers.
Yeah. You know, we're, it's, we're at the, the leading edge of it, but not, not in the, the bolus in the middle of it.
Nate: Mm-hmm. So, Okay. Well that is a disappointing number, but I'm glad to see it. Just so you, the discussion can be started. Yeah. How do we keep [00:09:00] physicians in the workforce or something on my mind.
Another really interesting question that was asked was, would you take less pay for a better work-life balance? Hmm. Before I give you the answer, what do you hear people say? What do you hear physicians say when you ask them? Would you take less pay for better, for better work life
Ben: balance? Honestly, I haven't asked that question.
Mm-hmm. And uh, and it's, it's a loaded question too. I mean, work life balance, like really, are we, yeah. What, what does that mean? Do we come up with that in the eighties and are we still banging that drum? Because Yeah,
Nate: I call bull. I know. And, and sometimes I, I'm guilty of sort of, I wouldn't say forcing in other people, but when I see them struggling, I sort of at least.
The conversation ends up going down this path of, mm-hmm. Are you working too much sort of thing? Yeah. You know, I'm sort of setting the stage for them to say yes cuz they're physicians. So it's almost always a yes. I, I hear them say a little bit [00:10:00] like they would be willing to work less or that they would like to, um, but then sometimes I do flat out get a cry for help.
You know, it's just too much. And I've had that, that quite a bit too. But the answer that they got with a simple question of, would you take less pay for better work-life balance was 53%. Yes. And I beat the drum of certain specialties not making enough money. Mm-hmm. But this sort of set paints a different picture.
Like if they're willing to take less, then maybe they do make enough money, at least a lot of physicians. 53%. Yeah. What do you think about that?
Ben: You know, my experience with this is, um, I, I don't ever get the chance to ask the question because usually when physicians are unhappy, they're just, they just move, you know?
Mm-hmm. It, it's, it's almost like unhappy, unhappy, unhappy. And the tension just grows and grows and grows. And then one day, something snaps, uh, makes me think about during the pandemic, I had a physician who [00:11:00] called me and was like, Hey, I quit my job two days ago, and they're making like seven 50 or $800,000 a year.
And they're like, now what I do? I was like, uh, could you, could you go back in time and call me like a week, a week ago so that we can kind of talk about this and make a little, a little plan for the transition? Mm-hmm. But, uh, I've seen a number that have just snapped. I. And said, I can't take this anymore.
It, it's, it's almost like there's not a nice smooth transition between the unhappy workplace and what follows, I don't know if it's the Boiled Frogs syndrome, you know, where work sucks and then work sucks harder, and then one day, you know, they're, they're almost boiling alive and somehow they manage to find a way to jump out of the pot or mm-hmm.
Or what it is. But it, it seems like it has to come to a crisis before physicians that are unhappy in the workplace will. Make a move now and in in watching these physicians make this transition [00:12:00] universally, universally, they're happier. Once they leave, and you know, I, I saw that physician that was making almost $800,000 a year go to making $200,000 a year, and they're way happier.
I mean, just got more time with their child, got more time with their spouse, had some time to read and take care of their themselves. Uh, we found out that they didn't actually need all the money that they were earning. They'd done a really good job of saving, they're on track with their plan. College was under thumb.
Uh, you know, they're able to relocate, be closer to family, and I, I've seen that a few times, but it seems like something has to actually break before a physician's willing to make that transition, which I, I think is sad because I, you know, if the transition's gonna happen, you can ease the transition.
Sometimes you can change the way life is before you move. So, I mean, I, I'm interested in having that conversation with physicians, but like I say, for some reason, it's not something that, uh, it's not something that we usually hear about before it
Nate: happens. Yeah, with family [00:13:00] dynamics and usually the physician being the breadwinner in the family, it's, it's very difficult, I think, to even think about changing things up and uprooting people, but I think it's very human of physicians too.
The, um, it, it's very common and just human nature that the, the pain of staying has to be worse than the change. Yeah, the pain of changing and, and so they deal with that a lot.
Ben: I don't know if it's physician culture or if it's just the culture in the United States that, uh, you know, you have a job, you're making a certain amount of money and unwilling to make less money for a better environment.
It's, it's that thought that less money is just a terrible thing. Nate, do you, do you see
Nate: that? I mean, I see that, um, With physicians and with everyone else in this country. I think physicians need to realize, or it would be probably better for, for them and their families to realize that they're in a unique position.
Like they [00:14:00] are weird. I have to tell physicians they're weird all the time. You're weird. Yeah. You make more money than everyone else and you actually have this choice. Yeah. For some people they. Maybe they do have some element of choice, but it's, it's really not as big as for physicians. So we're, we're, we're talking about, uh, weird stuff.
We, yeah, we went there. So I'm gonna say, I want to say something that many people, they don't talk about this because it's just weird, but, um, I don't even see the reason that people, so the question is, why don't they, if, if half these people, half these physicians, Would take less pay for better life, let's say.
Why don't they? And I think they, they blame it on saving a retirement or financial freedom a lot. And that's an admirable thing to, to be aiming for, but it's actually not the reason that I see that they act, they don't do this or mm-hmm. The reason that it's the thing that's keeping them from doing [00:15:00] this.
The thing that is keeping them from doing this is an expensive lifestyle. Mm-hmm. True. That is the, that is actually the thing. Yeah. And I mean, if we're talking about weird stuff, I'm, I'm going to suggest trying to simplify your life. Mm-hmm. Because every single time I see a family simplify their life, they aren't happier cuz they make less money, they're happier because a simpler life is, is tends to feel better.
Yeah. Less stuff, you know, less obligations.
Ben: It's a natural experiment. It is. Um, you and I don't see physicians consciously make this choice very often where they go from making more to making less, and maybe they're, they're happier and have better quote unquote balance. But we do see physicians in a, in a natural experiment doing this all the time when physicians choose academia.
Over, uh, you know, being in the for-profit sector, you know, uh, yes. And widely academics make less than, than those that are in the for-profit sector. [00:16:00] So that choice is being made and people are making it consciously. Uh, but it's, it. Seems like that once that happens, that people are locked in and it's hard to, it's hard to look at going the other way.
And, and I'm not suggesting that someone go from, you know, being in a hard charging practice where you're, you know, doing a hundred knee surgeries a week to, uh, going into academia, but it tells you that there are people on the other side of the fence that are making less, that are still physicians and still running families, and still pursuing their goals and, and having a good life.
It, it is possible. It just tells you that it's, it's out there.
Nate: It certainly is. Mm-hmm. This whole work-life balancing, I think it's a journey that people go on and it was a really cool next question that Medscape asked, or at least the way I interpreted it, because I think a lot of times people reach for, before they leave their job, they try to take some measures to, to make themselves feel better about work, and that a lot of times comes in the form of vacation.
Mm-hmm. [00:17:00] So, um, Medscape asked How much vacation do you take? And I mean, most physicians take what looks to be like the average amount of vacation, which is three to four weeks. Mm-hmm. Some one to two, some five to six, but mostly three to four weeks vacation. Yeah. And so my question to the positions who are trying to take vacations to.
To improve their life is why hasn't it improved your life? Yeah. And this is something that I think you and I have experienced too, is vacation is great, you need to rest, but it is no substitute for a life of burnout. Yeah. Like it won't, uh, it won't recharge the batteries like a physician needs it to.
Ben: Yeah. It's almost like, oh, if you're burned out, you need to take more vacation. Well, you can see that physicians are less happy now. Mm-hmm. And they are taking, you know, three or four weeks of vacation a year. [00:18:00] So clearly there's not a correlation between vacation and happiness or vacation and lack of burnout.
I, to me, it sounds like the burnout comes from the thing that you do every day, rather than the thing that you do every now and then. Mm-hmm. Yeah. Interesting observation, and I'm kind of surprised that they even asked that. It's like, what does one have to do with the other?
Nate: Right. Well, at least the way I took it is that they, it was showing that it doesn't, which is just interesting to way to look at the data, I guess.
But I know y you recently went on c you took a couple weeks off for the first, I think the first time I've ever seen you take a couple weeks off Uhhuh. Um, how'd that go? Um,
Ben: I don't know. I mean, I, I'm not wrestling with burnout. Yeah. So, uh, it didn't have an impact on that. I'm the kind of guy who doesn't vacation.
Well, I really like what I do, but I kind of came away from it thinking, you know, that was nice. But if I, if I really had it to do, I would take, uh, I would take longer [00:19:00] weekends and mm-hmm. Rather than traveling at a distance, I would travel more close to home. I'd go to the beach more often, that kind of thing.
Yeah. And I, I think that goes to kind of having a, a more sustainable, uh, balance between, between work and. And other things. You know, when I, when I look at my life, um, the thing that causes me not to burn out is some form of play. You know? Uh, I was just gonna say
Nate: play. Yeah. Yeah,
Ben: play. And, and this is, you know, I've done a little, uh, self-study in this.
I've read some books and, uh, you know, followed some folks in this space. And, uh, play seems to be the key. To burn out. And so it's, it would be hard to ask a whole bunch of, you know, 10,000 physician physicians do you play, right? Mm-hmm. But it, it could say, you know, what activities do, do you do outside of work?
And, you know, exercise would be one, meditation would be another. Um, you know, spending time with your, with your family and, and kids might be another, you know, do you have a hobby? [00:20:00] If so, what are your hobbies? Do you play a sport? If so, what are your sports, you know, to, to get a more granular feel. Of, you know, what happens with physicians outside their work lives and to, to find out if there's any correlation between what happens outside the OR and, and what causes them to feel more happy or more, uh, quote unquote balanced.
Mm-hmm.
Nate: Yeah. Well, um, there, kind of on that same topic, uh, Medscape asked sort of, What do you do to avoid burnouts? Kind of like right in line with the vacations. Like is that what you do? Mm-hmm. And the people who wrote in, like, they actually typed in answers rather than choosing a, you know, a pre-selected answer said what you just said, which was like exercise and, and some, some good play activities.
But another thing they said, or the way I took it, is they set boundaries. Mm-hmm. So, Maybe they do work [00:21:00] a lot, but they've set some boundaries when they took the job, like, um, they do a lot less admin or something. They, they set some boundaries. They, I don't, I don't do any charting at home. Mm-hmm. They, they're setting boundaries that improves their, I guess, mental health so that they can be sharp at work and sharp at home.
Right. You know, you know, it seems to me like you should set up your life so that you could work a little less, even though it means like working the same hours but not at home and play more. And that's one, one way to not completely change jobs and just see if it
Ben: helps you or not. This, this word burnout comes to us from some research that was done, I believe it was back in the eighties.
Um, gosh, I can't remember where I read about this, but essentially there's a, a healthcare worker who was on the streets and, uh, he or she was working with people that were drug addicted and. The word burnout comes from when you have taken so much of a drug that you have [00:22:00] basically completely saturated your, your dopamine receptors.
You know, basically you've, mm-hmm. You've let out all the dopamine that your brain has, you go to seek the next high, and there's, your brain doesn't have any dopamine to release. And so no matter how much drug you take, you, you don't get the high again. And that's, that's burning out. And, you know, I, I think.
Uh, you know, the good feeling that comes from work only comes if you have time off of work and, and, and you find a place for that in your life. If it's, if it's all work or there's too much work, then you don't, you don't get that good feeling. And so the mm-hmm. You know, it's funny cuz they, people talk about recreational drugs, you know, that's, that's where you get a different feeling.
I think that the key to it is recreation and, and recreation means re recreating the life. And I'm sure that's gonna be different for, for everyone, but, Uh, I think that there, there's gotta be a place for that, for those things that a, uh, physician was interested in be before they went into medicine. You know, the, the callings that they had, like maybe playing guitar [00:23:00] or whatever it happens to be, to kind of go back to that and rekindle it.
Uh, I think that work can be all consuming and when it's all consuming, it's, it's like a drug, you know? It's a drug is all consuming and it makes it difficult to continue on with life. So I, I didn't really think it would be talking so much about burnout, but I guess it's hard to talk about, uh, physician lifestyle without really talking about burnout.
Nate: Yeah. Yeah. I'm, I'm curious what, what physicians do to play. I mean, or if they play. Maybe we, maybe
Ben: we need to run our own, our own survey. Yeah. Call it P scape.
Nate: Yeah.
Ben: Hey, if you're out there and you do something that looks like play, play a guitar, play a sport, play with your kid, play with your cat, um, write us at [email protected] and tell us what you're doing to play.
Nate: Cuz we wanna know. I actually really love to know that. Yeah, same. All right. Well those are the interesting pieces of data that I got. Nice. Nice. Any final [00:24:00] thoughts? Good.
Ben: Any, any other good stuff in, in there? Any, any other interesting questions?
Nate: The only other one was, um, that I think we, we recently did an episode about mom guilt and there was one, um, little piece of information in there that basically said, Women feel conflicted, women physician feel really conflicted with, with parents as parents as well.
So like they've feel conflicted between work and their family. Yeah. Men do too, but more so women. And I think that, uh, something, I mean, it's, it's, I expected it because that's kind of what the data has said for years. Mm-hmm. But obviously, um, still hard to see.
Ben: Did they show that longitudinally? Was it, was it year over year or was it just like, are you conflicted at work
Nate: today?
Yeah, it was just, are you conflicted at work? And 80% though, said, uh, or at least somewhat conflicted. Uh, 50% [00:25:00] were very conflicted. Yeah. So one little piece of, uh, encouragement would be that. While everyone's burnt out in the survey, we're also seeing, uh, you and I are seeing that physicians are really, really needed because they're burning out.
Mm-hmm. Which gives physicians leverage and maybe you can't leverage yourself for more money for whatever reason, but you can leverage yourself for more life and set boundaries at work. Mm-hmm. And, um, if your place of work won't let you set boundaries and work a little bit less, you know, maybe that's a sign that.
They're not taking care of you well enough and you can look elsewhere.
Ben: It might, might be time to go somewhere else. And, and, you know, that is, that's one of the bright spots that you and I have seen. We've seen physicians change jobs or change employers, and it, it has been a very effective way, you know, doing the same, doing the same thing, even to the same extent.
You know, same kind of practice, uh, you know, similar number of hours. Sometimes just the work environment is toxic [00:26:00] or the management is toxic, or the incentive system is toxic. Switching has been something that we've seen work quite a bit. It's, it's very effective. Once, once a, a doc gets to that, gets to that point.
Mm-hmm. Yeah. Okay. Well, I'll take us out. So that's, that's all we have for you today. If you're interested in our physician retirement investment checklist, you can get that in the show notes by clicking the link. And, uh, we hope you'll join us, uh, for our next show.
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