Speaker 2 (00:01.816)
Welcome to the Physician Family Financial Advisors Podcast, where physician moms and dads turn today's worries about taxes, investing, and extra money into a comfortable feeling of financial security. I'm Ben Utley.
And I'm Nate Rennecke. Today's topic is about changing jobs. How to make your physician family work better. So Ben, I think there's quite a lot of misconceptions about why physicians change jobs. At least it's not what I expected when I first started working with physicians as to why they would move around and change jobs. What are the reasons that you see physicians changing jobs most often?
Let's see here. The reasons would be cultural fit. Like maybe the workplace isn't conducive to the kind of work environment a physician wants to have. know, maybe management is rough or pushy or demand driven. Sometimes there's a fracas between colleagues, you know, people just not getting along. Other times it's things that have to do with family, like being closer to aging parents or being closer to grandma and grandpa. Trying to think what else.
Occasionally it's like an exterior culture kind of thing, like the area that they live in doesn't have the amenities that they want or maybe they're rural and they kind of have a city bent about them and so they want to live someplace where there's more arts. Or perhaps they're required to live in a city because of some immigration status and they decide to live someplace else. Maybe they land in North Dakota and would rather practice down in Florida where they're closer to family and
you hops to where maybe mom and dad will locate her in another country.
Speaker 1 (01:40.27)
So, yeah, that was actually pretty common. Maybe, maybe not just the Florida one where there's a lot of airports and easy to travel, but a lot of times you'll see physicians, they kind of get put somewhere, whether or not that's for, you know, a lot of times I'll see really high paying jobs and in areas that are not very desirable to live in and the physician will move there to take care of their student loans or something.
And then once they're done with that, they're ready to live in a more desirable area. Do you see physicians changing jobs for money very often?
You know, I don't see money as a huge motivator for physicians. know, the quality of the care, the ability to practice the way they want to practice the opportunity to grow in their profession are drivers that are really work related. in terms of money, I have seen almost no physicians in my 20 some odd years of doing this that moved to make more money. In fact, almost all of the moves that I've seen have either been lateral
Or in many cases, there's been a pay cut, you know, 10%, 20%. I've actually seen a 50 % pay cut and that's what I have found surprising. But yeah, the paycheck has something to do with it. In fact, the paycheck is usually the thing that keeps physicians from thinking outside the box about moving. But ultimately it's, it's not the thing, you know, the higher paycheck is not the thing that keeps stocks in the saddle.
Mm-hmm. You know, I also hear I know that that's the case in my experience as well as that They don't really think about that. But many times I'll hear when a physician is unhappy at their job, but they feel Obligated to continue to earn the same amount for their family and they and they think there's this misconception that They won't be able to have a similar situation somewhere else and I just it's very it's actually very rare in my experience that
Speaker 1 (03:40.45)
to see that, where you actually can't go make similar money with a better situation. They just, for whatever reason, it's almost human nature, outside of physicians, where you assume that what you currently have is about as good as you can get.
Yeah. And there's, there's an assumption that, you know, more money is better, which, know, you talk to financial people and you would think that would be the case, but I've seen plenty of people have really good quality lives, making less money than what they're capable of. You know, just a classic example of this is physicians who choose to go into academia. mean, everybody knows that academic physicians tend to make less than those that are in private practice. And there are legions of physicians that are in an academic setting.
and they have made a conscious decision to earn less than the going rate that's out there and yet they're still happy. We serve tons of academic physicians and they're on track for retirement and college and they live in decent homes. mean it's, you know, just because you're in private practice and you have a high reimbursement rate does not mean that making less money would cause you to not reach your goals.
Mm-hmm Okay, so it's it's easy for us to say You know on a podcast that go make less money, right? Let's give them. Let's give some examples. We got some examples What's something you've seen recently where maybe a physician made less but it was a good situation?
Well, we have a client who is a pediatrician. Okay. So everyone knows that pediatricians earn in the lower half of physician reimbursement, sometimes a lower quartile. And this pediatrician was in the Bay area. And so now you have someone who's earning in the lower half, but in one of the most expensive housing markets in the United States and really wanted to buy a home.
Speaker 2 (05:38.25)
So they went to work for an organization that they thought was a not-for-profit organization. And when we really drilled down, we found out that in fact that it wasn't, it's Kaiser Permanente. The Kaiser part is not-for-profit, but they were employed by the Permanente group. And that's a for-profit organization. And our research shows that employment in that does not qualify for public service loan forgiveness. So we ran the numbers and realized that
as a pediatrician working in the Bay area, she was probably never ever going to be able to afford a house as long as she had these huge student loan payments. we discussed with her over course of a couple of years about changing jobs. And ultimately she found a job that's in the area that she really liked and moved. Right? So now she's on track for public service loan forgiveness, but maybe not able to get a house. And through COVID and the waivers that we've seen in student loan payments, she was able to save up those student loan payments and get enough for a down payment on a home.
And today is not only on track for full loan forgiveness, not only working in a job where she's happy, but actually owns a home and is now part of that rising real estate market. And that was just a huge, huge change for her. mean, part of her quote unquote family, she wanted a dog and it's really tough to have a dog in an apartment complex, but she was able to find a space with a small yard and kind of is much happier than she was when we originally met her.
And there's no cut on Kaiser Permanente because I know they're great outfit. just that it wasn't working for her financially. And so we had to kind of think outside the box, but it took her a long time to actually make the decision to change jobs.
Mm-hmm. Mm-hmm. Yeah, and there was multiple decisions in between Okay What about another example that maybe isn't is a lot less money related because that one you know, we we know that making a pediatrician salary and in certain parts of the country you're essentially Kind of in the close to the middle. I mean close to the average earner in those in those parts of the country
Speaker 1 (07:45.344)
We've seen some pretty bad work situations that bleeds into family life and seeing people make decisions outside of money to improve their family life.
Right. So we do serve a physician that was in Florida in a specialist in highly reimbursed professions making, I don't know, $800,000 a year, something incredible like that in cancer care. And through the course of COVID, wound up having a really bad experience, just felt like not supported at work and ultimately decided to leave work and went, found a job in a lower paid portion of the medical world.
and was able to earn enough to still be able to pay for retirement, still be able to send kids to college, but was able to have more flexible hours and spend more time with their children. And her husband picked up a job that he had always wanted, but wasn't employable in the area where they were. They moved from one state to the next. And the thing that she said that really struck me, she said, I did not know what it felt like to live without stress.
She said, I've been stressed for so long and I worked so hard. It's just unbelievable to realize that there's actually another way to live. And when I talked with her, she just sounds lighter and happier and generally more satisfied and still on track for retirement, still on track for college, still able to afford a nice home. So cutting that salary more than in half.
It's a big game-changer, but there's an assumption that you have to make a lot of money to be happy and to be comfortable and to reach your goals. But that's not true. It's really a matter of kind of rethinking life and how things could be for you.
Speaker 1 (09:32.206)
Yeah, doesn't solve all your problems. Once you've solved the money problem, you're left with all the problems that aren't money related, which is most of them. So that's great. I've seen the whole, wow, I never thought life could be different so many times. literally you get so, you kind of, don't, it's kind of a bad word to say, I guess, but brainwashed into thinking this is it.
This is what I this week.
Yeah, yeah, there you go. That's a great word. Yeah
mean if you're working like 60, 70 hours a week, it's hard to have time to think about anything other than what is right in front of you, especially when it's a high stress environment.
Mm-hmm.
Speaker 2 (10:18.574)
I was always on the treadmill this morning. was reading one of my health books. I I hate exercising, right? And I have a love-hate relationship with my treadmill, but I listen to books that cause me to think that I'm going to die. So I listen to health-related books. And one of the things that was in that book that they were talking about the stress and how hard stress is on the body.
And you know, stress can shorten a person's life materially. And I think most cardiologists are aware of this. You know, it's, hard on the heart. I'm, I'm talking to physicians here, so I probably sound like a, like a three year old discussing this topic, but, you know, stress really is a life shortener. And I think that there's, there's a more balanced way to approach life. mean, to kind of back all the way up, there are households where, you know, both earners working.
are making a couple hundred thousand dollars a year, right? These are not physician households. These are just ordinary households. People have been holding down a job for a decade or so, kind of middle management kind of jobs. And those people are on track for retirement, right? So if I'm a physician making 350 or $400,000, I'm not making twice as much as they are because of the tax burden, but there is some room to wiggle there.
and to still have a good quality life and still be happier or perhaps happier. And so, you if you're in a highly paid position where you're making, you know, a million or $600,000 a year, you know, dropping down to 300 or 350 or 400 is not going to be a deal breaker. There can be a better way to live.
By the same token, I want to acknowledge that there a lot of people out there making a lot of money, and they're very happy with that. And I think that's a really great place to be. But I know that there some listeners who are hearing this and they're thinking, wow, that's me. I'm stressed when I come home. I don't get to spend enough time with my family. I haven't been on the treadmill myself. I feel like my things are narrowing for me, and I need to find a way to expand my life.
Speaker 1 (12:25.87)
For those people, let's talk about what they might be able to consider, maybe to take one little step toward this more sustainable life that we're talking about, just to start considering your situation. I kind of came up with a, it's a small list. There's a lot of things to consider, but the big ones generally are like when you change jobs, you have to consider retirement and your workplace plan. I hear this all the time.
you just have to consider insurance. So have a family and you're worried about your family going off insurance and you think I have this great insurance at this job. Then there's some families that need to consider student loans like public service loan forgiveness. That's a huge one. And then there's some other things there. Let's talk about those.
yeah, so I think if you are a person who has a federal direct student loans, subsidized, unsubsidized Stafford's, those kinds of things, you need to take a very serious look at where you're going to go to work. Don't make any assumptions that you're going to get PSLF out of this employer because they may not be a not-for-profit. It might look like a not-for-profit, but you really have to drill down. you know, it's really, it comes down to whose name is on your paycheck.
You know, which is, which is funny. know that physicians sometimes get paid two or three different ways or they work for a company that owns a company. And I ask, know, whose name is on your paycheck in terms of the payer. And it's not always obvious. So I think, you know, in the early stages of looking for jobs, that'd be one of the first questions I'd ask if I was shooting for PSLF, which, you know, you and I have seen recently that PSLF is real. We've seen actual clients have their student loans zeroed out and
you know, the difference between that and not having it is, can be the equivalent of five extra years of work. You know, that's, and if you love your work, that's no big deal, but it'd be nice to have the option. yeah. PSLF is an option. The retirement plan, that can be a big deal, especially if you're going, maybe you're going to work for Kaiser, which has a nice pension, or perhaps you're looking at going to the VA, which has a fantastic pension. You know, that pension is, it's a game changer.
Speaker 2 (14:38.488)
for folks who are looking at retirement. Let's see what else. I think that the place that you're gonna live will make a huge difference and I think most people look pretty carefully at that. Before you change jobs, you should also think very carefully about the people you're gonna work with. So if these are colleagues and you've had a relationship with them before, then that really takes down some risk.
Mm-hmm.
Speaker 2 (15:00.982)
I had one physician who was in a kind of a forced job change situation, went to work for a group in a place where they wanted to live. They were living close to grandma and grandpa in a nice house, know, two kids, Jack and Jill bedrooms, just storybook, know, picturesque life. And about six months in, this practitioner realized that their colleagues were bilking Medicare and just realized that they had to get out of there. So I think you can't know enough about the people that you're going to work with.
including the support staff. So that'd be a factor that I look at. And you know, if you don't know the area and you don't know the people, you should try to keep your options open. So rather than buying a house immediately, it would be a good idea to rent. And I know that some employers slap on the golden handcuffs. You come in, they give you a 50,000 or a hundred thousand dollar bonus for signing. And that basically becomes a debt if you don't stay there for five years.
So you'd want to be really careful about what you do with that money after you get it.
Yeah, like yeah, I want to retouch on some of those things too because you brought up some thoughts that I see that hundred thousand dollar quote-unquote forgivable aloneness all the time and You know, I'm I'm probably seeing about 50 50 where we recommend a client just hold on to it and in 50 50 Sometimes they just hand it right back. So even a hundred thousand can't keep them
at a job for a couple more years, which tells you something.
Speaker 2 (16:33.036)
Yeah, again, it's really not about the money, you know. You know, I don't think that there's anything about the money that drives physicians into the workplace, you know, where you take a bright geeky kid that loves science and has good grades, you know, ultimately decides to become a physician. Maybe they're thinking about financial security, but I don't think anybody goes into medicine to get rich, you know? So I kind of think that it's not so much about the money with physicians.
No, that-
Speaker 2 (17:02.818)
Though it can be some, but most, I think that they're really in it because that's where their heart is. That's where they want to serve and that's what they feel called to do. And I know this from same physicians who are clearly financially ready to retire and continue to practice another five or 10 years. just in their blood.
Mm-hmm. Yeah, the the other one was the the PSLF for the public service loan forgiveness I've seen too many times where physicians are getting their advice kind of from the wrong person So their recruiter might tell them yeah Yeah this this place qualifies because they think they know what they're talking about and they don't really realize that they're getting paid from a physician group that is not Technically, you know qualified. So there is a level of you know
If this is a really big decision for you, like you're moving your family across the country, you should get some kind of third party advice about your contract, about whether or not it actually qualifies for PSLF. You should get to know to the best that you can the area and the people you'll be working with. And then get some specific advice about, some professional advice about the insurance and the retirement and all that.
Even if it's not, you know, even if you're not moving your family 2,000 miles away from where you started, it's a big decision for everybody. you know, just imagine a doc who makes even a quarter of a million dollars a year, okay? Making a quarter of a million dollars a year and you're making a decision to move and you could be at that job for 10 years or 20 years, maybe even 30 years. I mean, 20 years at a quarter of a million dollars a year is a $5 million.
combined lifetime paycheck. Now, I have people who contact me and they're like, I'm thinking about buying a lease on a car. You what kind should I get? And we'll spend hours on the phone talking about financing, what kind of car to get. But I don't have very many people who contact me and they say, hey, I'm thinking about making this $5 million decision that's going to impact my family and what I do for the rest of my life. What do you think?
Speaker 2 (19:07.852)
I'd love to have that call so we can drill down and look at it because we're prepared to have that conversation. But it is a huge decision.
Yeah. Okay, so what's the bottom line here?
Well, the bottom line is to think outside the box when it comes to the box that you're working in, right? And I'm gonna take us out on one story. This is a happy ending story. So there's a guy who's practicing down in Georgia.
He wasn't from that part of the country. He moved down there for the job opportunity. He loved the job. His wife was miserable. She didn't have any, any friends in the area. This was during COVID. So it was really difficult to get out and make friends. She's raising young children. There's not a lot of support. And honestly, from what I heard, the romance was, was just waning, right? I could tell it wasn't going well. And I said, well, you know, where would she like to live? And he said, she'd like to live close to her parents.
And I said, well, where do they live? And he said, well, they live up in Michigan. And I said, well, why not move to Michigan? He said, well, I'd have to get recertified. And he said, and then I wouldn't, there's not very many jobs in the area where, you know, her family lives. It's kind of rural and I'd have a hard time getting on there. And I said, well, what about this? I said, how long does it take you to fly to see her parents? And he said, well, it's about a, it's about a two hour flight.
Speaker 2 (20:30.582)
And I said, well, no, how long does it really take you? said, you you've to get to the airport an hour early. You got to pack. You got to get a rental car when you get there. said, what's the total time? And he said, maybe six hours all told. And I said, what if you lived an hour or two hours away from where her parents live? I said, what if you moved to a place in that state where you could definitely find a job and definitely get your credentials? And that way you'd be close to your mom and dad.
And then while you wait for a job to open up, you can, you can be close by. So that's, that's even closer than being on an airplane. He's like, you're right. He says the total travel time is less. just seems like more. And so he began the job search and lo and behold, as he was doing a job search, a job opened up in the hometown where she lives and they moved. And last time I heard, he said she was a lot happier. The kids are a lot happier. They actually had more time together because they had a little built in babysitting with grandma.
he was still able to, to achieve at the level in his profession that he wanted. I don't remember exactly how the money turned out. I think he made a little bit less, but the cost of living was a little bit less too. And was kind of a wash and you know, still on track for college and retirement, still got to have a nice home, but it was a major life upgrade in terms of their, of what their family was able to get. So it really did make their family work better.
Mm-hmm. Great.
Yeah. So I think that's, that's all we, how we have for today. Just, you know, it comes to your job for, if you're not feeling it, they're taking you for granted. If you're not getting supported, if you're feeling burned out, you know, it's time to look around a lot of people changing jobs and there's a lot of openings for good physicians. So I want to thank everybody for listening. I'd like to thank everyone who's sent comments and email and left questions for us. So if you'd like to reach out to us, you can write us at podcast at physicianfamily.com.
Speaker 2 (22:22.734)
You can visit us at physicianfamily.com slash podcast, or you can drop a question on the physician family answer line at 503-308-8733. That number once again is 503-308-8733.
Thank you for listening to the Physician Family Financial Advisors Podcast. Is there a question you would like answered on our next episode? Go to PhysicianFamily.com to record your question. While you're there, send your our newsletter and ask to use tools you can use to turn worries about taxes into a lifelong feeling of financial security. That's PhysicianFamily.com.
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Speaker 2 (22:57.228)
investing in extra money
