Cheap Pizza and $3 Burritos

FigureBy now, the end of residency is in sight. Across the country, women and men who have been studying and training for years and who have recently been deprived of the filthy lucre of old-style capitalist moonlighting, can almost smell money on the breeze. Think about it! The years, the effort, the delayed gratification of medical training make the real money of a real job seem like a scaled down version of the winning Powerball ticket. I remember how it felt. Jan and I had been married three years, and had been together for nine. We grew up together in a sense, and along the way learned to love cheap pizza on date night, $3 burritos for college lunches, inexpensive tickets to arts productions at Marshall University and West Virginia University. In residency, in Indianapolis, we enjoyed our combined incomes, supplemented by moonlit dollars, but still knew how to have fun without spending too much. Working vacations sponsored by Marian College, where she was director of student activities, made wonderful memories without deep financial scars. Our greatest extravagance was probably the separate apartment we kept for our stupid cats one year. But that's another story, as they say. When I graduated from the emergency medicine residency at Methodist Hospital of Indiana and took a job in sunny, incendiary South Carolina, we were excited at the prospect of money. We bought a beautiful black Toyota Celica convertible for Jan. When we finally moved, we rented for six months, and then bought more house than we needed on seven acres of land. We were a little spendthrift. The real spending started when our blessed children began arriving on a regular schedule, spaced roughly two years apart. And for the first few years, we were rather extravagant with them as well. It's difficult not to lavish gifts on your children, a fact that has resulted in what may be the largest private collection of assorted, opened, well used, action figures on the Eastern seaboard. ‘Live your life without becoming a slave to money and things — you'll be happier in the end.’ Having lived through all of that, I have a little perspective on money and work. And if I can give any advice to doctors graduating from residency now, it's this: don't spend too much money. I'm not saying that new doctors shouldn't reward themselves. Buy your long-suffering spouse a gift. Find a nice place to live. If your car is circling the drain, buy a new one. But before you do these things, ask yourself how much house you need for the number of people living in your home. Ask yourself if it has to be in a specific, pricey neighborhood, and if you plan to build later anyway. And consider whether a Hummer is really going to be the car for you, especially if your off-road activities are confined to the Taco Bell drive through. But the most important thing I can tell graduating physicians is to add a few facts into every calculation of need and want. For instance, when you work for one hour, most of you will make somewhere around $100 to $150. Period. When you save the life of an insured person, your compensation will be a lot less than the fee for refractive surgery. And when you give complex care to the indigent, remember that your reward will be eternal because it isn't going to come in a check. When some procedural physicians work for an hour, they make thousands of dollars. Lake houses and Mercedes Benzes make more sense for them. Emergency physicians, however, are the medical equivalent of factory workers. Of course, you should be thankful because you will make more money than 99.9 percent of the people on the planet, but you'll make it by your physical presence in the hospital, going from patient to patient, day after day. When you want something expensive, it doesn't just cost money, it costs time away from the people you love. Next, remember in your calculations that your new partners are anxious for you to spend money. The more you spend, the more you need to work, the more likely you are to stay right where you are. Debt makes your life less flexible and less mobile. Locum tenens in New Zealand sounds like fun? Of course it does. But you can't go. The country club fees are coming up, and the insurance on your houseboat is due. Finally, and this is to all physicians, the reason that the government and insurance companies can boss us around is that we need a certain amount of income. We graduate believing that doctors take certain types of vacations, drive specific cars, and live in elegant houses. If we could somehow be more moderate, live on less, need less, then our negotiating power as a profession would skyrocket. Because we wouldn't need to compromise just to protect our piece of the pie. It's funny, really. The only way to make more in the end might be to make less. So congratulations to all those who will soon escape their indentured servitude in hospitals around the country. You have risen above the pack. You are well educated, skilled, and compassionate. Now, use your brains, use your skill and have some compassion for yourself and your family by living your life without becoming a slave to money and things. You'll be happier in the end.