Motivation for Building a “McMansion”

In the article one weird reason why doctors buy bigger homes than lawyers, it explains a seemingly common practice in locations in certain tax protected states that physicians purchase more expensive homes to protect their assets from malpractice liability.

The article states that doctors buy bigger homes than lawyers in general.  Protection of assets by buying an expensive dwelling in place like Florida and Texas is a well-known strategy that many people in the top 5% use very creatively.  There are multiple homes sitting on the coastline with few regular dwellers. A former commissioner of baseball used this strategy quite effectively. 
The sad part is that people have to go to such lengths in our litigious society to protect their lifetime assets and protect the future of their families.

A seemingly simple solution for the medical profession would be to radically alter the malpractice system from a personal fault system to a reasonable no-fault system that compensates the injured appropriately. It would also punish egregious repeated behavior by some practitioners through appropriate sanctions. Other countries like New Zealand have accomplished this with some success.

The ultimate solution is not to get sued either individually or in a group. Unfortunately, the odds are against you. On the other hand, a nice house on the beach is nicer than living in a tent.

Getting the Dread On!

My long-time Emergency department colleagues collectively called the anxiety and anticipation about having to perform perfectly on the next shift "Getting the Dread On".  This implied that the worry about the stresses of the next stint could begin any time from when the last shift ended.  The definition of dread is great fear or apprehension.  Common synonyms include fear, apprehension, trepidation, anxiety, worry concern unease, angst- you get the picture. 

After reading these descriptions, one would wonder why anybody would work at this job.  We'll save that for a another blog.

Some shift work health consequences include:

• Sleep disorders
• Diabetes Mellitus
• Headaches
• Ischemic heart disease
• Fatigue
• Stress
• Poor appetite control
• Substance abuse
• Problems with medications
• Problems with interpersonal relationships

The biggest fear is making mistakes leading to poor patient outcomes.  This coupled with volume and performance pressures, patient satisfaction scores, the ever-looming threat of malpractice suits, and chronic self-doubt can immobilize an individual.

It is probably time to retire or find a less stressful career than Emergency Medicine if getting the dread on is a recurring theme in your life.  Fortunately, most people learn to deal with the stresses and overwhelmingly positive side to the job, and they soldier on!

Should Baby Boomers Retire Already?

Baby boomers are defined as people born during the demographic post-WW II baby boom between the years 1946 and 1964.  As a group, they were the wealthiest, most active, and most physically fit generation up to that time.  They were a generation that received peak levels of income, so they could reap the benefits of abundant levels of food, apparel, retirement programs, and sometimes even "midlife crisis" products. 

Being a member of that group, it is time to think of retirement and all of its trappings. 
When I was 50, my requirement for retirement was a Dow of 20,000, and S&P of 2,000, an end to supporting various universities, winning the lottery, and finally controlling my chronic disease of fixed monthly expenses. 

Time has changed these criteria, but even with a 20% net reduction in the value of the dollar since the "crash" I '08-'09, the stock market has recovered significantly.  This has given more people a chance to consider retirement despite the fear of "running out of money".

Of course, this is all monetary.  The real substance of the issue is within the word retire.  How can I re-tire, when I an not even tired, yet?  Other than finances, then, a more important question is "what am I going to do with myself"?  This is a real issue for hard-working type A personalities who daily have a large number of people under their beck and call.  Another facet of this issue is the concept, long purposed in many corporation, of mandatory retirement.  Have many of us worked alongside a long-time partner who is "slowing down" and whose apparent clinical productivity is not what it use to be?  What should happen to him, if he loves practicing medicine, and wants to work into his 70's?

Start thinking about this, when you are 50.  If your life expectancy is 80 or 90, you probably will have at lease 20 years of retirement. 

Retirement does not mean intellectual, spiritual, and physical death.  It should be viewed as an opportunity.  After all, there are many youths out there that world love to have your job!!  Give the "kids a chance".