I am a huge proponent of the FIRE movement, especially for physicians. For the uninitiated, FIRE stands for “Financial Independence, Retire Early.” However, a lot of physicians I talk to tell me that they are concerned that the growing popularity of FIRE will discourage doctors from practicing medicine. Is this something that we as a field need to worry about?
We already know that the United States, and world at large, is facing an impending physician shortage. That’s why the White House is allocating more resources to train more doctors. This is particularly an issue within primary care specialties like family medicine and pediatrics.
Combined with this impending physician deficit is an ever-growing epidemic of burnout and moral fatigue among doctors. Doctors across specialties are experiencing this due to a myriad of issues including loss of autonomy, decreasing compensation, increasing administrative responsibilities without clinical impact, and patient mistrust, just to name a few.
Will the FIRE movement become another influence on medicine leading to fewer doctors with more leaving the field as they pursue and achieve financial freedom? I resoundingly say, “No!”
And here is why: The problems are everything I just listed. Those are what discourage doctors from practicing medicine. And FIRE is the cure. I know this because I have experienced it personally!
Let’s walk through a thought experiment. Imagine your current medical practice. The good and the bad. Are you happy? If the answer is no, why is that? And why do you stay at that job? The answer is usually because you need the paycheck from your job. This is true of private practice and employed physicians alike.
Now, imagine that you did not need that paycheck. Imagine that you could work and practice medicine because you want to, not because you need to. How amazing would that be! You would be empowered to push for changes needed to improve your job satisfaction. Or you could leave altogether if you were not happy. You would be free to find a way to practice medicine that suits you best. And makes you happy. And guess what? A happy doctor is a better doctor for their patients.
This is the biggest thing that people misunderstand about the FIRE movement. The acronym is all wrong! I look at FIRE as just “FI.” I am pursuing financial independence, but I actually don’t want to retire early. I just started my practice. But I do know that I will be much happier practicing medicine and living on my own terms rather than because I need money to cover my expenses via paycheck.
Sure, some physicians will pursue financial freedom and ultimately leave medicine when they achieve it. And that is perfectly fine. However, I really believe that the majority of doctors would elect to continue practicing medicine with their new freedom. And most importantly, I am adamant that a country of financially free doctors could enact positive change on the health care system in ways we cannot even imagine. Changes like: more space to participate in and enact systems level changes, helping provide more and better-quality research, improving national and international access to patient care, and simply providing better patient care just by being happier and loving their job.
And this is why FIRE is the cure to the physician shortage and not another contributor to it. Also imagine how many more talented young people would enter the field of medicine if a normative system to eliminate debt and achieve financial freedom was established. As a side note, imagine even more if the debt problem associated with medical school was adequately addressed. This would effectively provide a “head start” on the path to FI. More doctors would be practicing because they want to, not because they have to. And health care would benefit tremendously.
In fact, I would argue that the opening of more medical schools through funding from the executive branch will unfortunately not help the physician shortage as intended. More medical schools operating in the current model will only discourage more doctors from going into the fields needed most, such as primary care and pediatrics, due to climbing debt and decreasing reimbursement. This is an anti-FIRE formula.
But again, the prospect of financial freedom would have the opposite effect of this. And that is why I believe it is so important to teach the simple principles and strategies of personal finance in medical school and residency. If the larger issues of increasing debt and decreasing compensation are not as imminently solvable, this is an immediate action to help doctors. It is also very simple to do. All it takes is one interested doctor. It is something that I have begun doing.
So, what can you do if you are looking to start your journey toward financial freedom as a physician? The most important first steps are to educate yourself, learn how to calculate your net worth, develop a spending and savings plan, and learn the simple way to invest your money.
The beautiful thing about FIRE for physicians is that the formula is quite simple. If you save at least 20% of your gross income and invest it wisely in passive index funds, you will practice medicine and ultimately retire on your own terms. And not only will you improve your own financial and overall well-being, but you will inspire others to do the same. Again, financial independence does not mean you have to retire. It simply allows you to live and work on your own terms, because you want to, not because you have to. In fact, FI carries enormous potential to bring more joy into the work you do and how you do it, carrying enormous impact for both you and your patients!
What do you think FIRE will do to the future of health care? Share in the comments.
Jordan is a graduating fellow in plastic surgery at NYU.
Illustration by April Brust