Why I Gave Up Obstetrics at Age 43

(Today’s guest post comes from a very thankful reader. Her life was changed by reading my book, The Doctors Guide to Smart Career Alternatives and Retirement. She was kind enough to send me a thank you note and I asked if she would be willing to tell her story to all my readers. She agreed, as long as she could do it anonymously. I hope you enjoy her story as much as I did. It’s great to see a transformed medical career and a joyful doctor.)

 

Just before my 43rd birthday, I resigned from our OB/GYN call group, walking away from my Obstetrics practice and my role as Chief of OB/GYN. This was one of the hardest but best decisions of my life. I wouldn’t have been able to make this move without the support of Dr. Cory S. Fawcett’s book, The Doctors Guide to Smart Career Alternatives and Retirement, his website, Prescription for Financial Success and other similar websites.

This decision was years in the making. Married to an OB/GYN doctor 20 years my senior, who plans to retire in two years (but who’s counting), I have long been contemplating what my career life would look like after my husband’s retirement.

Fortunately, I’ve always been a saver. Because I worked my way through school, which included a stint at a chicken processing factory, I was able to pay off my student loans during my second year of residency.  Despite a brief foray into fine dining, fast cars, and designer purses, a move from the city to a quiet waterfront community made for a significant lifestyle change that meant major savings. Life now is dinners at home, Netflix binges, and lots of hours in our home music studio, where my husband plays the drums and I play a variety of other instruments.

Even factoring in travel every other month to places like Italy, Mexico, and our vacation condo in Banff, we were able to pay off our seven figure mortgage in just over eight years. We simply looked at what we were making each month, subtracted our household needs, travel expenses, and fixed monthly retirement investment contributions, and made sure that every remaining penny went to the mortgage. Admittedly, we were a bit obsessed, but both of us were committed to the goal of becoming debt free.

We reached that mortgage milestone in March, 2018.  Some number crunching with our financial planner lead us to realize that we were now beyond financial independence (the process being sped up by our lack of children). After 13 years of NEVER giving away a single call shift, barring emergencies such as funerals, we began giving away every single call shift. There was some initial guilt, but month by month I realized that I wasn’t missing taking call.  Not one bit. In fact, it was heaven!

In the meantime, I enjoyed a busy but minimally stressful office practice.  This summer we only worked three days a week and took three weeks off. Compared to our prior year’s schedule, it almost felt like being teachers with a summer off! 😊 The crazy thing was that my income didn’t even drop that dramatically.

In 2016, I made a commitment to my referral base that I would expedite all IUD insertion consults.  Having established my reign as “IUD queen” of our area, my office business has been booming with straightforward, not very time consuming but very satisfying referrals that required minimal paperwork. Although I wasn’t “saving lives”, what could be more productive than ensuring five years of unwanted pregnancy in a sexually active 14 year old?  Busy enough with non-surgical gynecology, I gave up my elective OR time in 2017 and have never looked back or regretted it.

Our call group has always had a fairly relaxed policy on giving away call shifts. After 13 years of doing every assigned night shift, every weekend, every holiday weekend and Christmas shift, I thought that it was our turn to give shifts away and enjoy our financial freedom. Ironically, the group members that had themselves given away more than half of their shifts for their entire careers were the ones to complain that we weren’t being “collegial.” This attitude was ironic given our track record of always taking our call and my contribution as Department Chief for more than a year, which we all know is a poorly subsidized and thankless job.  

Why such unhappiness for our decision? Hard to say.  When they were mystified by our sudden lack of appetite for call, we did let them know it was a financial decision.  I suspect they didn’t like that we were in a position to make such a decision and they weren’t.

With a goal of transparency and collegiality in mind, I decided not to pretend for another moment that I had any further interest in providing call coverage. I resigned from the call group.  Hospital Administration told me that with this decision, I was no longer “allowed” to stay on as Chief of OB/GYN. Hooray!!!

My colleagues in every sub-specialty, at every level, were baffled and horrified by my choice. “What a waste!” “All those skills!” “But you’re so great at forceps!” “Won’t you miss delivering babies?!” Even my husband needed convincing and was stressed at the thought of what I was giving up, knowing first hand all of the “financial facts” and how dramatically my quality of life had improved since giving up being on call. And frankly, I needed convincing also.

Initially, all of the good memories of my practice flashed before my eyes; the lifesaving victories, as well as the heart-warming moments. Not the blurry eyed, barely safe, 24 hour shifts fighting a brutal cold. Not the horrifying close calls. Not the worry of an OB case with a bad outcome or a malpractice lawsuit, which I haven’t had but was always a threat.

Then I discovered the online FIRE community.  I found Physician on FIRE. I found Dr. Cory S. Fawcett’s blog and books.  I read old posts and comments obsessively.  I realized that I was not alone.  That I was not lazy.  That it’s OK to admit to being a bit burned out.  That I’m allowed to be proud of the hard work that lead to reaching financial independence. That I am not obligated to work at the same pace for the rest of my life.  That shifting from hospital to office practice does not mean I am quitting, and does not mean I am less of a doctor.

When I was self-doubting, having a mini panic attack, I would turn to “The Doctors Guide to Smart Career Alternatives and Retirement” and read for a bit, devouring all of the re-affirming information.  The first chapter helped me analyze why I wanted to make this change, and I reassured myself that it was for the right reasons. The chapter on clinical career alternatives reminded me of my already established relationship with Bayer (makers of the Mirena IUD) and that I should pursue that further.  Every page reinforced that I was not a selfish person making a reckless decision. I was a hard-working physician who had worked enough weekends and nights to now enjoy working regular “business hours.” 

For now, I will be assisting my husband in the OR one day a week and will see IUD and general GYN patients three days per week.  When he retires, I will go down to 2-3 clinic days per week, depending on our travel schedule. Without OB patients anymore, it’s exciting to be able to leave for more than 5 or 6 days at a time without having to find coverage for them. For those wondering whether I considered doing locum on call shifts… I did, but the malpractice insurance and poor compensation to stress ratio was not worth it. I’m loving my life without call so much now, that the thought of another call shift is too painful.

On my last ever call shift, I was called in emergently at 5 am, three hours before my scheduled shift. The on call OB doctor was tied up in her third emergency C-section and there were two more pending.  I did two back to back C-sections, one on my own patient who was beyond grateful to have me there during such a stressful time.  Instead of lamenting the many life saving moments that might have been in my future, I will celebrate all those that have been in the past, and remember all of the good I’m still doing every day.  I plan to also keep in mind that my own life is worth something too, and it’s OK for me to put it first now.

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14 thoughts on “Why I Gave Up Obstetrics at Age 43”

  1. What a wonderful story and truly inspirational. I too felt a huge weight off my shoulder when I became debt free. It is amazing what having a fully paid home does to your psyche.

    There is always a debate of whether you should put the extra money towards investments or paying down mortgage and even though financially I may have come out behind investing with the big bull run we had, emotionally I am way ahead.

    Very smart decision to design a practice that won’t burn you out. Most OBGyn docs seem to be much happier once they drop the OB part out from the practice as the hours and emergencies decrease dramatically. Being financially independent allows you to do that so you did the smart thing by working hard in the beginning and now reaping the rewards later.

    Thanks for sharing your story.

    • Agree 100% that the decision to max out mortgage payments (rather than our investments) was a very emotional one, and was all about getting to that euphoric feeling of being debt free. Once it was paid off, our bank tried to convince us to use a home equity LOC to invest, but we of course decided against it for the same psychological reasons that we raced to pay it off in the first place (and my financial planner was against the idea, which makes me feel so secure that he has a cautious approach).
      Thanks so much for the words of support!

  2. Congratulations to the author for making a better life for yourself.
    Congratulations to Cory for having such a positive and powerful impact on people through the work you do.
    FI gave me the confidence and ability to transition to part-time clinical work and it has been wonderful.

  3. You’ve given plenty of yourself. There’s no shame in wanting to have a better and healthier life for yourself. No one can question you’ve earned it, not that one needs to “earn” the right to pursue happiness and balance in life.

    Thank you for sharing your story.

    Cheers!
    -PoF

  4. I’m thrilled to read about another doc who has cut back to tilt work-life balance in favor of life. Dropping OB call sounds like a life-affirming choice (as it was for Hatton1), kudos for designing a life that put you in the position to opt out.

    The gift of medicine is that you can lead a wonderfully upper-middle class lifestyle working far fewer hours, and use the balance of time available to regain those qualities that made you an interesting human before your training commenced.

    It’s a shame so few of us ever bother to unwrap that gift!

    Thanks for sharing this story, Cory.

  5. I am happy for the author for finding happiness her own way. For me, I needed the OR and the Birthing room in addition to the office. I retired from OB and GYN at 66. I took day call but I did get night call relief over the final 3 years. I was FI in my 50s but loved the work until Catholic Corporate America took over.

  6. Keeping yourself safe and secure financially was the first step to having a choice. Simply having that choice reduces stress dramatically for active physicians. You will still do great ‘post-medicine’ because you have lost no skills and have a world class education. Many, if not most, doctors are natural teachers. Your next 20 years will be full of opportunities to teach others from your experience and education. Perhaps you may even find a voice in teaching OB/Gyn residencies on professional development and work-life balance to reduce stress and burnout. Great story!

  7. I have such admiration for those that have been able to keep up with the pace of OB and the OR into their 60’s- and sometimes beyond… the “grandfather” of our residency program operated into his late 70’s and saw office patients until his mid 80’s (a bit extreme and a tough act to follow, he would be mystified and mortified by my decision). With the shift in GYN practice to more medical and less surgical management, it was easier to give up my OR time than I would have thought. I considered just keeping my Mon-Fri day shift on calls, but the compensation (without after hours codes) turned out to be far less than I was earning in the office (not that it’s just about the pay…) I agree about the Corporate takeover issue- our hospital feels more and more corporate every day (as Chief, sitting in on all the meetings and listening to the “business-speak” I felt like I was working at one of the big banks, not a health care facility).

    I hope you’re enjoying retirement, you’ve more than earned it!!

  8. Congratulations on dropping OB and for making the tough decisions associated with it.

    Been 20 years in private practice and I still love delivering babies, but it does get harder to wake up at night, or to put up with the silly calls at night (ex: been bleeding for 2 weeks but now I’m concerned about it, etc.).

    You finding that balance will allow for longevity in your Gyn career. That is inspirational as I’m trying to figure out my transition strategy….

  9. Sorry that I missed this post when it was first published. I saw it on POF today. I too am a former OB/GYN now doing just GYN. I did OB until 56. I am now working 3 days/week in a hospital owned practice. No call. Some OR. I also am a Mirena queen. I see all the ER follow ups. Figuring out financial security is so critical to being able to make the decision to quit OB. Several docs at my hospital >65 still doing OB. One doc over 80 still doing GYN surgery. I also did my time as department chief. Very thankless job. The problem as I see it with a total office GYN practice is the encroachment of nurse practitioners. I get asked all the time if I miss OB. In all honesty I doubt anyone does after they quit and start sleeping. Feel free to PM me on the WCI forum if I can help you.

    • Sending my thanks out for all of the support and thank you to hatton1 for sharing your experience. Since my goal is to work only 2-3 days per week, I know I’ll be busy enough with office gyne. In our community, very few nurse practitioners insert IUD’s and so I think the flow of patients will continue (not to mention repeat patients every 5 years…)

      It’s been just over a month since I made my announcement to my group, and every day I am happier (almost giddy!) more certain of my decision. The sense of dread has lifted. I’m loving my new “niche”. Last week I even started a YouTube channel about Intrauterine Contraception! Totally embracing my new role, and feeling that my career has been resuscitated.

  10. So glad you could find away to keep enjoying practicing medicine without having the high stress and burn out. As a patient I don’t look forward to when my specialty Dr’s retire but I care about them as people and don’t want them burned out at my expense. Good to know there are options for Docs who still want to use their training in different ways.

  11. Great post. Would the author be willing to share what she means by “fixed monthly retirement contributions”? I find it hard to strike the balance between paying off mtg and investing. Did you max your tax advantages space and then put the rest to the mortgage butdid not pay taxable? Or did you decide to save 20% and then put the rest to mtg? I can think of a half dozen variations here. Curious what worked for the author.

  12. To answer West Coast MD:
    About 35% of my monthly take home pay went to retirement contributions, 40+% to mortgage, remainder for all other life expenses (including a small mortgage on a second property) and travel. For the retirement savings, about 40% of each month’s contribution was “tax advantage space” (RRSP- I’m Canadian, not sure if that means anything to American readers…) Many docs in Canada also took advantage of Incorporation as a further tax advantage space, but my personal situation didn’t allow for that.

    In terms of how I came up with these numbers… we basically set a goal of paying off the mortgage in less than ten years (because both my husband and I had very anti- debt mindsets) and did the math from there.

    Not sure if this helps, happy to answer any other questions!

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