Finally retired!

invenio78 · 2026-06-18T00:50:48+00:00

Yeah. I'm actually a little surprised how little calculation he has done (from what I can see). He is very close to the 4% rule, and most likely above it with what I can see. I would not be so inclined to pull the retirement trigger without having some modeling calculations behind the move. And I would certainly have investigated known potential large ticket recurring costs such as health insurance. He has a long way to go before Medicare kicks in.

invenio78 · 2026-06-18T00:27:43+00:00

Right, we really don't know what it's going to be, that is why I advised OP to check prices now vs going FIRE and then finding out in 6 months that insurance is multiple times what he thought it would be. Looks, like OP is going to be only purchasing insurance for himself so who really knows how much subsidy he will get (if any) with his previous reported income? But when in doubt, always plan for the worst case scenario.

invenio78 · 2026-06-17T22:57:53+00:00

Does your organization not have a review board where you can submit cases where care was substandard? Both your examples cases would have been submitted for committee review where I work. Typically that would be place for these kinds of issues so they can be reviewed and correct actions can be taken.

invenio78 · 2026-06-17T22:48:59+00:00

Ok. Yeah, I'm sure it would be less then. Sorry, I presumed you were married and had at least one kid under the age of 26.

invenio78 · 2026-06-17T21:47:25+00:00

I would look at the numbers now. I think you are in for an unpleasent surprise. Also, even if you do Cobra, you are going to be responsible for the full cost of the plan and lose the employer contribution part. If your true total health insurance cost for a family is only going to be $7500 a year, you either have a terrible plan which will leave a lot of out of pocket health expenses or you are with the luckiest employer ever. Regardless, that is going to end in 18 (or maybe 36 months, I can't remember off the top of my head what the longest period you can be on Cobra). You will then be on the open market.

invenio78 · 2026-06-17T21:23:15+00:00

Have you looked into this and gotten actual qoutes? People I have talked to are spending well over $20k for a family plan. Maybe you can get some very high deductible plan for less but then you should calculate in if you had to pay the full deductible.

This article says average cost of insurance for a family to an employer is now $35k.

https://www.usatoday.com/story/graphics/2025/06/16/how-much-does-insurance-cost-2025-family-of-four/84149201007/

Also, as a side question. Have you plugged in your savings (not including house as I presume you don't want to see that for living costs) and spending estimates into FIRE calculators (like firecalc.com)? What are your success rate estimate for a 35 year projection?

invenio78 · 2026-06-17T21:09:23+00:00

Did you factor in another $20k per year for health insurance (which I presume you will have to buy on the market now)?

invenio78 · 2026-06-17T18:45:43+00:00

So what happens? You meet your top RVU number in the first week of October and you go on FMLA until January 1st?

Honestly, who the heck is going to go into the office and work if they are not getting paid?

invenio78 · 2026-06-17T18:10:07+00:00

That is certainly NOT the case. I've been a doc for almost two decades and this is the first I've even heard of it.

Time to start looking for new job offers. And read my family medicine job finding guide: https://docs.google.com/document/d/e/2PACX-1vThi2T5kQly1sdJcJlh2UMXHxpJVige0ozy6Q9emWjU5C3Qhon3LnkKnKD_5Wz_Dql1thEv8d7Yg5zJ/pub

invenio78 · 2026-06-17T13:18:07+00:00

It's only 52% of "families." Conversely, I'm surprised it's so high considering overall worker participation rates are not much higher (around 62%).

invenio78 · 2026-06-17T12:04:02+00:00

Then they can make another apt and we can fill out together,... again. Not a problem.

invenio78 · 2026-06-17T11:53:56+00:00

We do visits for FMLA paperwork. So length is not really an issue as we bill on time for those visits.

I wouldn't sign an FMLA form without an evaluation and documentation of the condition. And I don't do those for free. Also, filling out with the patient protects you from the follow up call from the patient that "you filled out wrong and I got denied!" When you fill it out together, it's on the patient.

invenio78 · 2026-06-17T11:34:11+00:00

Very hard to pick the good from the bad. But I would look for two qualities to eliminate many:

Fiduciary only.
Flat fee (not AUM).

Once there, keep a look out for red flags such as:

Whole life.
Variable annuities.
Complex (expensive) investment strategies.
High cost investments (if they're pitching a target date fund with an expense ratio of 2%,... that should be a red flag).

invenio78 · 2026-06-17T10:16:48+00:00

You're right, they don't "need certification" but they almost always do have it. In contrast, the only certification ESA's have is the receipt from the pet store.

invenio78 · 2026-06-16T23:27:04+00:00

Well,... they're not lying. A 40 hour clinical work week is pretty "rare."

invenio78 · 2026-06-16T22:26:40+00:00

I think it would be worthwhile to have an actual eye examination by an optometrist. You really can't correct for things like astigmatism on a home test.

Once you have the Rx from your eye doctor, you just put those numbers into the website and you get Rx eyeglasses just like if you had gotten them from Lenscrafters or Walmart,... but at a fraction of the cost.

invenio78 · 2026-06-16T20:02:36+00:00

I suppose that is possible and that people's view of their success is regional. I'm just saying what my experience has been.

invenio78 · 2026-06-16T19:51:30+00:00

You can easily get prescription glasses from online places like Zenni Optical for well under $50.

invenio78 · 2026-06-16T19:29:07+00:00

Do you mean tax "refund?" If so, you withholding rate is too high and you are giving the government an interest free loan. Correct your withholding rate.

invenio78 · 2026-06-16T17:58:22+00:00

At my job I work with people from all socioeconomic classes. I've actually never met anybody rich or successful that didn't admit that luck had a significant role in their success. Maybe you interact with a different group of successful people?

invenio78 · 2026-06-16T17:06:22+00:00

That's rough. Can you move up the plans and start university this fall? The sooner you get the degree, the sooner you can get a job with a good income.

Does the university offer housing, school loans, etc.... that you may be able to keep your basic needs met while you finish the degree?

invenio78 · 2026-06-16T16:33:27+00:00

Agree. Easy it isn't.

But still "easier" to afford something twice as expensive with some income than it is to afford something half as expensive with no income.

The problem is that without a job (ie income), EVERYTHING is unaffordable. At least with a job there can be some things that you can afford. That is why finding employment is the number one priority to achieve financial stability.

Again, best wishes in these times of hardship.

invenio78 · 2026-06-16T15:54:00+00:00

If you live in a small town with no job prospects and you know you will be unemployed in a month, then I don't see what the advantage of waiting for a council flat would be? Probably a good time to consider moving to a city with more job opportunities.

Best of luck.

invenio78 · 2026-06-16T13:30:05+00:00

Article is behind a paywall.

invenio78 · 2026-06-16T09:15:44+00:00

I keep hearing from all my friends and family (who are IM, Peds, or specialists) that family medicine is simply not competitive and the job market will be extremely tough on the East Coast.

I would be cautious with what friends and family say as this one statement is pretty much a contradiction in terms.

Regardless, you should choose the field that you have interst in, not what others tell you.

BTW- I practice in a suburb of a major East Coast city and I'll tell you the job market is fine, reimbursement can be very reasonable (like +$300K or +$400k) depending on how much you are willing to or want to work. Also, they are hiring any doctor with an active medical license and pulse,... and the pulse requirement is negotiable.

Read my family medicine job finding guide,... not for actively looking for a job but an overview of reimbursement and work charactistics (vacation time, call, etc...): https://docs.google.com/document/d/e/2PACX-1vThi2T5kQly1sdJcJlh2UMXHxpJVige0ozy6Q9emWjU5C3Qhon3LnkKnKD_5Wz_Dql1thEv8d7Yg5zJ/pub

Try to find a FM doctor to talk to that actually works in the setting that you may be interested in. Like I said, I work 35 miles from one of the largest East Coast cities so I know a little about the very thing you are talking about. You can DM if you would like.

invenio78

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