One of the biggest parts of my decision-making for my current practice set up was a work-life balance. Work-life balance can lead to happiness or misery. As a cardiologist it is easy to land a job with long hours and a high pay. In most private practice firms there is a “you eat what you kill” outlook, where the more you do, the more patients you see, the better your income. Besides the potential conflict of interest that can come from this model, this never struck me as a good way to practice medicine and there are a few reasons for this. Also I find that this model does not lead to happiness.
Why happiness is important
Exhaustion leads to dissatisfaction
I am not talking about patient satisfaction scores, though I suspect these would take a hit also, but your own personal satisfaction with a career or life. I imagine that if I was working 11 hour days, then coming home to play with the kids for an hour or two, and then back to working another 1 to 2 hours to finish charting and managing an inbox, that I would be exhausted. This would lead to less enjoyment both professionally and likely personally.
With a 7am to 6pm schedule, if you have a family with which you spend time, there is only the early morning or late night to do the things that keep you sane. If you then take an hour or two more at night to catch up with charting, then forget it as there is no time left for personal needs. This may not be the case for single individuals or those without kids, but anyone with young children will understand how unsustainable this is. Then it becomes easy to resent the job and maybe even the patients, and this can lead to worse outcomes for everybody
There is no guarantee that you will be here in 30 to 40 years
Another thing I often here from physicians is that they will work really hard now so that, in the future, they will retire early and comfortably. While working hard and earning a high income now is a good idea, there are 2 problems with this reasoning. First, with increased income people usually spend more. The mentality is that they worked hard so now should be able to play. This seems good on the surface but if spending goes up, then retirement will not be any closer. The point of working hard was to retire early, and that in part means saving more.
Secondly, there is the risk that something terrible can happen and leave you disabled or dead. It happens and it is always unexpected. If something does happen, then will those 10 years of working really hard matter. I doubt it. Therefore, ensuring you are working hard and saving money while also having time for your self, family and friends. Imagine working 12-hour days and missing out on your children growing or dinner with your partner. It seems like a waste to have all that money but no time.
All that extra money will be taken by the tax man
The current highest income tax bracket is $415,000 for single filers and $466,950 for married joint filers. Incomes above these amounts are taxed at 39.6% on a federal level. That is almost half of what you earn not to include potential state income tax. Therefore, you will be working harder to bring home an extra $100,000 but will only see $60,000 of it. If you want to hustle for Uncle Sam, then go for it. As for me, I think an income below $413,350 is the way to go. It is only taxed at 33% while making a lot of money.
These are just a few reasons why balance pays. By working hard and earning a good wage, but balancing it with a job that allows for you to be home by 6pm you will be able to find a better balance and hopefully minimize burn out. What do you think? Whats more important to you- work, money, family?