Plan B if things go down the drain?

[deleted941485]

Which is worse dying before you run out of money or wishing you were dead when you outlive your money?

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[namethatsmell]

Which is worse dying before you run out of money or wishing you were dead when you outlive your money?

Your incessant positivity is impressive.

But perhaps you’re painting too rosy of a picture for the premeds reading this thread?

 

[cyanide12345678]

Make hay while the sun shines. Smartest thing anyone told me.

In the end the SWR doesnt matter because no one has any earthly clue on returns or inflation. Much of SWR depends on your timeline. Simply 4% is 25 years at 0 return. If you are 70 you are incredibly safe. If you are 25 much more risk. Also, and maybe this is me and my FatFI ideas than even if I withdraw 4% I will leave some contingency. Lastly, if you have $3M in cash you should be able to live well on 120k/yr if you have no loans or mortgage.

Depending on longevity, 3M may run out if you're withdrawing 120k/yr, so a 4 percent withdrawal rate. Who knows where modern medicine will be in 30-40 years from now and what the average lifespan will be. We're starting to see people live beyond 100 far too frequently.

If we retire in our 50s, it might be another 40-50 years that retirement fund may need to sustain.

 

[deleted941485]

Depending on longevity, 3M may run out if you're withdrawing 120k/yr, so a 4 percent withdrawal rate. Who knows where modern medicine will be in 30-40 years from now and what the average lifespan will be. We're starting to see people live beyond 100 far too frequently.

If we retire in our 50s, it might be another 40-50 years that retirement fund may need to sustain.

If you can live that long then you probably shouldn’t retire that early.

At some point living longer makes no sense no matter how healthy you are.

 

[cyanide12345678]

At some point living longer makes no sense no matter how healthy you are.

Can't necessarily just jump off a cliff after 80

 

[GeneralVeers]

Fortunately for us, the Wealth Tax being discussed will drain our savings an additional 1-2% every year just cuz.

 

[deleted941485]

Fortunately for us, the Wealth Tax being discussed will drain our savings an additional 1-2% every year just cuz.

It’s to make up for all the injustice others have suffered. So you better pay up.

 

[hundreddaysoff]

Yeah people always use the most optimistic numbers like 4% but honestly they are setting themselves up for disappointment. And early bankruptcy

Nah, I agree w/ Bird that there's no real safe withdrawal rate. I wasn't saying that $1M in the bank would net me $40k/y necessarily. I *would* expect it'd net me at least $10k/y on average. Combined w/ my wife's income, goes a long way toward paying $50k/y living expenses + a little fun, or even further if I can convince her to go Mr Money Mustache style and cut our expenses to $30k. In any case, it'd be a nice little cushion that we could draw down in order not to need to work for ~20y at least.

By "pretty good relative to the average American", I guess I just meant that the average American needs to work in order to eat, and I wouldn't need to.

 

[GeneralVeers]

It’s to make up for all the injustice others have suffered. So you better pay up.

An interesting article in Forbes about wealth protection under a hypothetical Warren presidency: Protect Your Assets From President Warren

In short, don't hold a bunch of cash or any other easily-valued asset. Pre-pay taxes and convert to Roth IRA. Hopefully they won't be taxing retirement accounts.

I tend to agree with the author. They won't be going after only estates worth $50 million or more, it simply wouldn't generate enough revenue. Likely $1 million or more will be their target as they are "getting" the millionaires.

 

[namethatsmell]

Another plan B general thought: if you're going to put any time into more training, avoid fields that would require you having to work at a hospital (ie critical care). The inability to potentially hang one's own shingle and go cash-only will continue to chain you to many of the current issues that are plaguing EM.

 

[deleted941485]

By "pretty good relative to the average American", I guess I just meant that the average American needs to work in order to eat, and I wouldn't need to.

I see what you are saying.

If there’s one thing that doesn’t concern me in the least, it’s what the average American has or needs to live.

I didnt get to this point by being a average and I sure as **** am not going out that way either. Lol

 

[GeneralVeers]

I see what you are saying.

If there’s one thing that doesn’t concern me in the least, it’s what the average American has or needs to live.

I didnt get to this point by being a average and I sure as **** am not going out that way either. Lol

I like you

 

[deleted941485]

Another plan B general thought: if you're going to put any time into more training, avoid fields that would require you having to work at a hospital (ie critical care). The inability to potentially hang one's own shingle and go cash-only will continue to chain you to many of the current issues that are plaguing EM.

Ie

Surgery
Gas
Rads
EM
Hospitalist LOL
Cards
GI
ID

Probably 75% of medicine right there

 

[namethatsmell]

Ie

Surgery
Gas
Rads
EM
Hospitalist LOL
Cards
GI
ID

Probably 75% of medicine right there

Several of the above fields have the option of flexing into non-hospital work (private ASCs, outpatient only work, etc).

That said, the specialty with the greatest ability to weather whatever healthcare storms may lie ahead is psychiatry. If you can tolerate being a psychiatrist.

 

[deleted941485]

Several of the above fields have the option of flexing into non-hospital work (private ASCs, outpatient only work, etc).

That said, the specialty with the greatest ability to weather whatever healthcare storms may lie ahead is psychiatry. If you can tolerate being a psychiatrist.

Probably true. I mean something like 40% don’t even take insurance.

 

[Groove]

The problem is that there's so much risk in branching out trying to obtain financial independence. Docs notoriously overestimate their business acumen and will take some alarming risks in the hopes that they can land a pot of gold on the side and wean themselves off a medicine career. I was chatting with a colleague of mine a few years back about cosmetic boutique clinics that offer botox, cosmetic procedures, lipo, lasers, etc.. and the next thing I know he's taken out a loan, bought millions worth of equipment and opened up shop trying to start a cosmetic business on the side. He dug himself into a gigantic financial hole and has been struggling to get out of it for a few years now. Last I spoke with him, he just wants to be able to get the business at neutral cash flow so he can sell it and move out of state. I can still remember how stressed he was that night and he confided in me "Dude...I'm living paycheck to paycheck and I make half a million dollars a year! How sad is that?!" Another of my colleagues just told me other night he had taken out a million dollar loan to start a franchise restaurant in his hometown and I'm like..."So, do you have much restaurant business experience? Have you done this type of thing before?" No to both. I'm just too risk averse for decisions like that however I'll admit that some people strike it big simply because they are willing to take risks the rest of us wouldn't consider. However, I'm perfectly happy retiring on 5 million versus 15 million. It makes no difference to me and the kind of lifestyle that I want to enjoy. I'd rather do something with less risk (work hard, sock money away in good investments) versus do something that although it has the potential to make me rich sooner, also has the potential to destroy my wealth. To each their own.

 

[namethatsmell]

The problem is that there's so much risk in branching out trying to obtain financial independence. Docs notoriously overestimate their business acumen and will take some alarming risks in the hopes that they can land a pot of gold on the side and wean themselves off a medicine career. I was chatting with a colleague of mine a few years back about cosmetic boutique clinics that offer botox, cosmetic procedures, lipo, lasers, etc.. and the next thing I know he's taken out a loan, bought millions worth of equipment and opened up shop trying to start a cosmetic business on the side. He dug himself into a gigantic financial hole and has been struggling to get out of it for a few years now. Last I spoke with him, he just wants to be able to get the business at neutral cash flow so he can sell it and move out of state. I can still remember how stressed he was that night and he confided in me "Dude...I'm living paycheck to paycheck and I make half a million dollars a year! How sad is that?!" Another of my colleagues just told me other night he had taken out a million dollar loan to start a franchise restaurant in his hometown and I'm like..."So, do you have much restaurant business experience? Have you done this type of thing before?" No to both. I'm just too risk averse for decisions like that however I'll admit that some people strike it big simply because they are willing to take risks the rest of us wouldn't consider. However, I'm perfectly happy retiring on 5 million versus 15 million. It makes no difference to me and the kind of lifestyle that I want to enjoy. I'd rather do something with less risk (work hard, sock money away in good investments) versus do something that although it has the potential to make me rich sooner, also has the potential to destroy my wealth. To each their own.

Yup this a reason why psych is pretty bullet-proof. A shrink's main start-up cost is their medmal policy which is cheap since their liability is so low. They can rent a small office without the regulatory burdens and costs most physicians deal with or just do tele. Their other startup costs can be covered by an amazon gift card.

 

[deleted941485]

Biden-Linked Firm Tests Messages to Undercut ‘Medicare for All’

A new poll by a firm linked to Joe Biden is testing messages designed to undercut support among Democrats for Medicare for All, one of the most contentious issues splitting the party’s top presidential contenders.

www.bloomberg.com

70% in favor...this is what you are up against.

 

[GeneralVeers]

Biden-Linked Firm Tests Messages to Undercut ‘Medicare for All’

A new poll by a firm linked to Joe Biden is testing messages designed to undercut support among Democrats for Medicare for All, one of the most contentious issues splitting the party’s top presidential contenders.

www.bloomberg.com

70% in favor...this is what you are up against.

It's always how you frame the question. People like to virtue signal and want to believe that they are "good people". They support healthcare as a right, unless it costs them money, and decreases the quality of their own healthcare. They want to help other people, but only if it means not giving anything up.

 

[deleted941485]

It's always how you frame the question. People like to virtue signal and want to believe that they are "good people". They support healthcare as a right, unless it costs them money, and decreases the quality of their own healthcare. They want to help other people, but only if it means not giving anything up.

Idk demos are pretty dogmatic when it come so to their own sense of morality. Everyone else is a criminal or worse if you do t go along.

 

[deleted941485]

It's always how you frame the question. People like to virtue signal and want to believe that they are "good people". They support healthcare as a right, unless it costs them money, and decreases the quality of their own healthcare. They want to help other people, but only if it means not giving anything up.

In 14 months were gonna have the election of a lifetime. There’s a ton on the table to lose.

 

[GeneralVeers]

In 14 months were gonna have the election of a lifetime. There’s a ton on the table to lose.

Agreed. Possibly the most important election ever. Hillary Clinton was never a true believe as far as M4A and socialism were concerned, and possibly wouldn't have been too damaging to our profession. This new crop of candidates (except Biden) really believe this stuff.

Fortunately any nonsense they enact won't likely go into effect until 2022 at the earliest which gives us all a bit of time to plan.

 

[deleted941485]

Agreed. Possibly the most important election ever. Hillary Clinton was never a true believe as far as M4A and socialism were concerned, and possibly wouldn't have been too damaging to our profession. This new crop of candidates (except Biden) really believe this stuff.

Fortunately any nonsense they enact won't likely go into effect until 2022 at the earliest which gives us all a bit of time to plan.

It takes ALOT of preparations. Not just forgoing nice things but rethinking your whole career trajectory and even when you have a plan you have to have the right connections to really make it happen. Living in interesting times.

 

[TooMuchResearch]

Write Clinton in?

Agreed. Possibly the most important election ever. Hillary Clinton was never a true believe as far as M4A and socialism were concerned, and possibly wouldn't have been too damaging to our profession. This new crop of candidates (except Biden) really believe this stuff.

Fortunately any nonsense they enact won't likely go into effect until 2022 at the earliest which gives us all a bit of time to plan.

 

[GeneralVeers]

Write Clinton in?

Trump is still better than Clinton for us, regardless of what you think of him personally.

 

[deleted941485]

Trump is still better than Clinton for us, regardless of what you think of him personally.

As much as he tries to scramble to put together a coherent health policy. Id take him over whatever nonsense weekend at bernies, or 0.8% native american has planned. Biden is whatever but the public option would still be a death blow too.

After what Clinton did in the 90s to Health Care, she is honestly the is the closest thing to the modern obsession with controlling medicine.

 

[cyanide12345678]

Trump is still better than Clinton for us, regardless of what you think of him personally.

The amount of fear mongering this guy does against minorities, it's hard to bring myself to vote for the guy, even though he's better for my personal financial situation.

 

[deleted941485]

The amount of fear mongering this guy does against minorities, it's hard to bring myself to vote for the guy, even though he's better for my personal financial situation.

I honestly don't care if he calls me every name in the book just as long as he keeps his small hands off my livelihood and what i earn from it.

 

[GeneralVeers]

The amount of fear mongering this guy does against minorities, it's hard to bring myself to vote for the guy, even though he's better for my personal financial situation.

Low on my list of priorities. He certainly does make good (although inarticulate points) about illegal immigration and its problems.

 

[gro2001]

Fortunately for us, the Wealth Tax being discussed will drain our savings an additional 1-2% every year just cuz.

Warren's wealth tax is for net worth over 50M. Bernie's plan is over 32M. I must be doing EM very wrong if this is a concern for any working EM doc.

 

[deleted941485]

Warren's wealth tax is for net worth over 50M. Bernie's plan is over 32M. I must be doing EM very wrong if this is a concern for any working EM doc.

Nah. But they just throw out these numbers because the higher you go the less people worry about it actually affecting them. When they realize that it’s just a gimmick and they actually start going after people with 2-3M in the bank then you’ll start to hear some extra complaining.

Everyone with a brain can see it for what it is. It’s a sales push. Just like when they first introduced the income tax. It’s all just the same nonsense over and over again. People keep buying it because they think they are getting something for nothing and punishing people they don’t like.

 

[GeneralVeers]

Warren's wealth tax is for net worth over 50M. Bernie's plan is over 32M. I must be doing EM very wrong if this is a concern for any working EM doc.

They all pretend they don't want to tax the middle class, because it sounds good. In reality most of the wealth is concentrated in the middle class because simply it's the largest demographic. In order to fund their fantasies, they will have to go after everyone to some degree. If you have 2-3 million in assets, which is reasonable for an EM physician mid-career, they will certainly view that as rich, and evil, therefore it's justified to steal.....I mean tax that wealth.

I'm going with the guy who doesn't state he is going to take my money, or make me a government employee. For the purposes of this discussion, I'm trying to keep politics limited to things that affect our careers, and or financial well-being.

 

[Brigade4Radiant]

An interesting article in Forbes about wealth protection under a hypothetical Warren presidency: Protect Your Assets From President Warren

In short, don't hold a bunch of cash or any other easily-valued asset. Pre-pay taxes and convert to Roth IRA. Hopefully they won't be taxing retirement accounts.

I tend to agree with the author. They won't be going after only estates worth $50 million or more, it simply wouldn't generate enough revenue. Likely $1 million or more will be their target as they are "getting" the millionaires.

How will going after estates not worth 50 mill not generate enough capital?

Also most of the wealth isn’t concentrated in the middle class sorry

 

[BoardingDoc]

In reality most of the wealth is concentrated in the middle class because simply it's the largest demographic.

This is inaccurate. In terms of wealth, the top 10% controls ~70% of the entire nation's wealth as of last year. This trend has only been increasing over the past several decades. This information doesn't come from MSNBC or some left wing think tank BTW. It comes from the Federal Reserve.

https://www.federalreserve.gov/econres/feds/files/2019017pap.pdf

 

[GeneralVeers]

This is inaccurate. In terms of wealth, the top 10% controls ~70% of the entire nation's wealth as of last year. This trend has only been increasing over the past several decades. This information doesn't come from MSNBC or some left wing think tank BTW. It comes from the Federal Reserve.

https://www.federalreserve.gov/econres/feds/files/2019017pap.pdf

You are right I am wrong.

I should have re-phrased. The middle class makes up about 50% of the country. Interestingly "upper class" has actually increased over the past 20 years, as the share of middle class has decreased. So while politicians claim the middle class is shrinking it's not because they are moving to lower incomes but higher.

My point on taxes should have been that it's not reasonable to fund a government by taxing the top 10-20% of people alone. There simply isn't enough income even if you took 100% of it to do that without also increasing taxes on the middle class.

 

[deleted941485]

You are right I am wrong.

I should have re-phrased. The middle class makes up about 50% of the country. Interestingly "upper class" has actually increased over the past 20 years, as the share of middle class has decreased. So while politicians claim the middle class is shrinking it's not because they are moving to lower incomes but higher.

My point on taxes should have been that it's not reasonable to fund a government by taxing the top 10-20% of people alone. There simply isn't enough income even if you took 100% of it to do that without also increasing taxes on the middle class.

It’ll work for like 5-10 years and then we will be having this discussion again about how to pay for all these new entitlements.

You can soak the rich but eventually they either tap out or get smart move the money elsewhere. Then you gotta go after lower and lower earners to keep it going.

 

[GeneralVeers]

It’ll work for like 5-10 years and then we will be having this discussion again about how to pay for all these new entitlements.

You can soak the rich but eventually they either tap out or get smart move the money elsewhere. Then you gotta go after lower and lower earners to keep it going.

Also taxes suppress economic activity, which means less tax revenue, which means more taxes. It's a spiral these people don't get.

 

[nimbus]

I suppose...if you don't mind violating federal law with every Rx you write.

When medical marijuana was a thing in my state, the doctors would provide “recommendation letters” that stated that medical marijuana could be helpful for whatever condition the patient had (99% anxiety or migraines). The letters were sufficient to buy weed at a medical marijuana dispensary, but they were not technically prescriptions. Now that recreational marijuana is legal in my state, the marijuana docs have all gone out of business as have the medical marijuana dispensaries. 99% of all billboards in my city are now for marijuana stores all of whom offer delivery.

As an aside, I know some very good pain doctors who recommend it to their patients for chronic pain management. The patients just order it retail. Insurance doesn’t cover.

 

[enalli]

Also taxes suppress economic activity, which means less tax revenue, which means more taxes. It's a spiral these people don't get.

There's a sweet spot. If you assume 0 revenue at a 0% tax rate (because you collect no tax) and 0 revenue at a 100% rate (because why would you work at that point?), then there is, by definition, a tax rate at which you will have maximum revenue somewhere in the middle. If you're to the left of that spot, then raising taxes will absolutely raise more revenue.

 

[enalli]

Idk demos are pretty dogmatic when it come so to their own sense of morality. Everyone else is a criminal or worse if you do t go along.

"Generally, the people on the opposing side make too many generalizations about the people they oppose."

Imagine the absolute lack of self-awareness needed to make this statement.

 

[nimbus]

You are right I am wrong.

I should have re-phrased. The middle class makes up about 50% of the country. Interestingly "upper class" has actually increased over the past 20 years, as the share of middle class has decreased. So while politicians claim the middle class is shrinking it's not because they are moving to lower incomes but higher.

My point on taxes should have been that it's not reasonable to fund a government by taxing the top 10-20% of people alone. There simply isn't enough income even if you took 100% of it to do that without also increasing taxes on the middle class.

Both Sanders and Warren talk more about taxing wealth than income affecting people with net worth over $16mil. It’s an easy sell.

Bernie Sanders Proposes a Wealth Tax: ‘I Don’t Think That Billionaires Should Exist’ (Published 2019)

Mr. Sanders is embracing an idea at the center of Elizabeth Warren’s presidential campaign. His proposal goes further in who would be taxed and how much money would be raised.

www.google.com

 

[nimbus]

Nah, I agree w/ Bird that there's no real safe withdrawal rate. I wasn't saying that $1M in the bank would net me $40k/y necessarily. I *would* expect it'd net me at least $10k/y on average. Combined w/ my wife's income, goes a long way toward paying $50k/y living expenses + a little fun, or even further if I can convince her to go Mr Money Mustache style and cut our expenses to $30k. In any case, it'd be a nice little cushion that we could draw down in order not to need to work for ~20y at least.

By "pretty good relative to the average American", I guess I just meant that the average American needs to work in order to eat, and I wouldn't need to.

You’re at huge risk assuming $30k/yr. I’ve had $10k plumber bills. When you have tree roots in your sewer main, it’s pay or live with toilet paper and **** in your house.

 

[deleted109597]

You’re at huge risk assuming $30k/yr. I’ve had $10k plumber bills. When you have tree roots in your sewer main, it’s pay or live with toilet paper and **** in your house.

I've got credit cards for that.

 

[hundreddaysoff]

You’re at huge risk assuming $30k/yr. I’ve had $10k plumber bills. When you have tree roots in your sewer main, it’s pay or live with toilet paper and **** in your house.

That's why we're gonna be real careful in choosing our house. Working on my real estate license for this reason and others, in fact.

I think the key is to remain flexible. Keeping living expenses low is just one part of this. In a crappy enough economic situation (eg hyperinflation scenario if we keep voting ourselves the treasury), even $2M in the bank might not be enough to stay afloat if one can't find a job. I do plan to keep my hospital credentialing and licenses current and maybe pull 1-2 shifts/mo even after declaring FI. I also have some programming chops and other random skills from before med school that could probably pay the bills in a pinch. Hell, I'd go back to bagging groceries if I had to. I did that in HS and it was actually pretty fun.

 

[miacomet]

That's why we're gonna be real careful in choosing our house. Working on my real estate license for this reason and others, in fact.

I think the key is to remain flexible. Keeping living expenses low is just one part of this. In a crappy enough economic situation (eg hyperinflation scenario if we keep voting ourselves the treasury), even $2M in the bank might not be enough to stay afloat if one can't find a job. I do plan to keep my hospital credentialing and licenses current and maybe pull 1-2 shifts/mo even after declaring FI. I also have some programming chops and other random skills from before med school that could probably pay the bills in a pinch. Hell, I'd go back to bagging groceries if I had to. I did that in HS and it was actually pretty fun.

Realtor? That seems extremely ripe for automation....

The biggest threat to our livelihoods (maybe not outpt psych) are VC/CMGs, not government takeover. Unlike government takeover, which may or may not happen, VC and CMGs are already ruining many of our jobs at this very moment.

 

[gro2001]

Realtor? That seems extremely ripe for automation....

The biggest threat to our livelihoods (maybe not outpt psych) are VC/CMGs, not government takeover. Unlike government takeover, which may or may not happen, VC and CMGs are already ruining many of our jobs at this very moment.

Also physicians have at least some political capital. There is a constituency and some donor money at stake. And although physicians are not as well liked as nurses or teachers, people still generally have a positive view of the profession and generally don't mind physicians earning a high income. The public is generally sympathetic. Not to the exclusion of other interests, but all else being equal most people have at least some positive experience with physicians. CMG executives share no such sentiments and would cut every physician job out if they could do it somehow without affecting their bottom line.

 

[Angus Avagadro]

I've got credit cards for that.

At 22%. Good luck with that.

 

[EctopicFetus]

Depending on longevity, 3M may run out if you're withdrawing 120k/yr, so a 4 percent withdrawal rate. Who knows where modern medicine will be in 30-40 years from now and what the average lifespan will be. We're starting to see people live beyond 100 far too frequently.

If we retire in our 50s, it might be another 40-50 years that retirement fund may need to sustain.

I’m familiar with the models. Reality is no one knows or can predict. IMO 4% is failry safe if you retire in your 50s. again just my opinion. some people do 3% or 2.5% but reality is those people are doing that simply because they can. Frankly I hope to retire where my withdrawal rate will be under 2%. that has more to do with my spending and amount I hope to have when I retire than how much I think I need. I also will then be able to leave a huge chunk of my money invested in the market cause I can withstand the ups and downs. Lets say you believe in the 80/20 stock / bond split. Lets say you needed 500k to retire. This split could look like 400k stock 100k bonds today. If you got to $1m you could leave the 100k in bonds and 900k in stocks. I am not a believer in getting ultra conservative as i near retirement with my investments but I think thats cause I believe I will have more than enough. Time will tell.

The gloom and doom on here has a good place where it is coming from but we always fret when change is in front of us.

In the end M4A would decimate insurers, big pharma etc. Keep in mind thats 17% of our economy. we would have a collapse if this went thru as a full bore m4A model. IMO there is nothing to it. The BB legistlation is the real scary and more likely event which will negatively impact us. Something will pass. It will hurt us. The question is how bad.

Again, may hay while the sun is shining. Clouds are on the horizon.

 

[VA Hopeful Dr]

At 22%. Good luck with that.

You have a crappy credit card if that's your interest rate. Also its not hard to fine ones that give you a several month grace period for major purchases. Mine has, in order, 10% and 60 days.

 

[bravotwozero]

Can also sign up for new credit cards that will give you 0% APR for a year to a year and a half ...