Jump to content

Had enough? What is your exit plan?

Recommended Posts

So, I am closer to retirment then starting out

have a nice nest egg, just rolled a 1/2 century, and pretty unhappy (atleast locally) with where primary care medicine in heading.   I am thankfully in one of the last private PCP offices in our whole county and doing everything I can to make it successful and it appears to be so.   

 

But if in the next few years this practice closes I am not sure what to do?  Anyone else have a plan ?  

The big thing is ALL the local 'IM/PCP practices are owned by one of 2 entities both with large corp structures whom I think interefer with the delivery of care.  As well they treat PA as hourly employees (your not a doc) but salary you and expect you to ring work home (deal breaker)

 

So the question

What would I do if y practice closed?

 

Vermont is only a few hours away and I have a dream of moving to a tiny town and hanging a shingle but I can't do this with a family

Local system is not great to work for but they are local

driving stinks

 

 

 

 

I honestly think I would find a Geri job in a state owned nursing facility or VA and work for them, even if it stinks atleast it is providing good ethical care for the right reasons??????

 

What would you do??

 

 

PS I had this solved with a 2x24 hour shift in Northern Maine at a substance abuse/MH hospital - but they are not hiring...

Share this post


Link to post
Share on other sites

I would retrain and try and get into sleep medicine.  It's always fascinated me.  Unfortunately you and I are the same age and no one wants to hire and train a 50 year old LOL.  I do have fantastic bedside manner with patients (I know shocking considering I can come off a little "strong" here lol) which is something I guess.  One thing I have really been thinking about is going to a sleep clinic and offering to work for $35 an hour while they train me...6 months to a year etc.  It's about the only way I think I can get my foot in the door.  Working for corporate UC's is behind me.  I just couldn't take the meat grinder for one more day.

Share this post


Link to post
Share on other sites

I had a medical technology degree before PA school.  Went back to the lab in 2019.  Plan to cruise into retirement with this.  I still want to get my waiver for Bup to fall back on.

Share this post


Link to post
Share on other sites

Whenever you think it's time to go, then it's time to go. It's your life and your decision. Still, not all jobs are really the same and you only need one that you would like.

I wouldn't be telling yourself that no one will train you because you're 50. I was a brand new graduate when I was 60 and was lucky to find a doc willing to hire and train me. He has stayed independent and I'm still there 14 years later, though just part-time now by my choice. Maybe a sleep med gig is not out of the question for you.

 

 

Edited by UGoLong

Share this post


Link to post
Share on other sites

Applied to, and was accepted into, law school.  I hope to focus on Employment law as I am completely burned out from Primary Care (patients/admin/docs/expectations).  The breath of air I can take now is wholesome and refreshing - looking forward to school.  

Edited by 6oo6le
  • Like 2
  • Upvote 3

Share this post


Link to post
Share on other sites
On 1/12/2020 at 5:18 PM, Cideous said:

I would retrain and try and get into sleep medicine.  It's always fascinated me.  Unfortunately you and I are the same age and no one wants to hire and train a 50 year old LOL.  I do have fantastic bedside manner with patients (I know shocking considering I can come off a little "strong" here lol) which is something I guess.  One thing I have really been thinking about is going to a sleep clinic and offering to work for $35 an hour while they train me...6 months to a year etc.  It's about the only way I think I can get my foot in the door.  Working for corporate UC's is behind me.  I just couldn't take the meat grinder for one more day.

Good grief... Sleep Med pays at least as well as family med.  Join AASM and do their Midlevel CME, then go shop yourself around.

You may be bored doing sleep apnea day in and day out, but it's a safe, low-risk gig that really helps the people involved.  Lots of patient ed, coaching, motivational interviewing... Only time anyone in a sleep clinic needs gloves is to use cleaning products.  There are no stirrups anywhere in the clinic..,

  • Upvote 4

Share this post


Link to post
Share on other sites

Oh, and my exit plan has always been as a HIPAA auditor/consultant.  I maintain several of my infosec certifications, including an HCISPP.  I don't ever expect to pull that trigger, however, I'm not a fan of living out of a suitcase and wearing ties daily--I'll do one or the other, but not both.

Share this post


Link to post
Share on other sites

Man. I’d love to fly, lecture, and say “Bye Felicia”. Right now it’s sit on butt, drive in a couple of weeks nearby to lecture, suck down a comp cup of coffee, and have them say “Bye Felicia”.

 

Share this post


Link to post
Share on other sites

Taking a seasonal Alaskan Oilfield job saved me from losing it completely as a PA as I slide into retirement. Low stress, autonomy, supportive SP, site management doesn't second guess my decisions, nice paychecks. I still use my clinical skills and have an appreciative patient population. 

  • Upvote 3

Share this post


Link to post
Share on other sites

I do EM which is a somewhat volatile field: staffing companies can lose site contracts, sites can have declines in census leading to staffing companies cutting hours, etc.  My safety net is to always be credentialed at least 2 sites with 2 different employers.  Finding a new job and getting hired and credentialed can take up to 6 months.  Going from PT to FT at an existing site if they have an opening is easy and usually can be done in less than 1 month.  I try to always monitor the job market in the states where I'm licensed.  If absolutely necessary, I could hunt an UC job for awhile.

Share this post


Link to post
Share on other sites

Real estate is my exit plan. Will work rural ED until I'm sick of it or until it gets in the way of the exit plan. 

  • Upvote 2

Share this post


Link to post
Share on other sites

Any other PAs follow the FIRE (financial independence, retire early) path?  I'm planning my exit strategy from the beginning of my career haha.  

The wife and I both have jobs making good money, we have been working and living with low expenses while investing the difference for 3 years now.  If our projections are correct, we should be able to have flexibility to drop to part time (EM around 4-6 shifts per month!) within 4-5 years from now just to cover our living expenses with the part time work, while the nest egg investments will grow huge with compound interest on its own over the years.  Leveraging compound interest early in our career gives pretty awesome possibilities.  

Effectively only having to work hard and invest hard for 7-8 years then dropping to part time sounds pretty amazing.  Hopefully we can make it happen!  

Would be great if we had others in our community doing the same, sharing the unique pros/cons/challenges for PAs...

  • Upvote 2

Share this post


Link to post
Share on other sites

My plan is to master watercolor and I'm in process.  I just sold a painting today.  I start teaching classes at the city parks and recreation department in June.  I'm taking classes from master watercolor artists  - local and nationally known.  I have 1.5 years to retirement, maybe earlier.  Someday I will be famous and you can all say  "I knew Paula on the forum, wish I would've bought an original when she was just a novice!"    HAHAHAHAHAHAHA. 

 

  • Like 1
  • Upvote 5

Share this post


Link to post
Share on other sites
2 minutes ago, Paula said:

My plan is to master watercolor and I'm in process.  I just sold a painting today.  I start teaching classes at the city parks and recreation department in June.  I'm taking classes from master watercolor artists  - local and nationally known.  I have 1.5 years to retirement, maybe earlier.  Someday I will be famous and you can all say  "I knew Paula on the forum, wish I would've bought an original when she was just a novice!"    HAHAHAHAHAHAHA. 

 

LOL nice, well done.

  • Upvote 1

Share this post


Link to post
Share on other sites

One concern I have with any early retirement is health insurance.  That's why I'm going to keep working FT until both my wife and myself are 65 and on medicare.  Fortunately, at my job that's only 10 shifts/month.

  • Like 1

Share this post


Link to post
Share on other sites
3 minutes ago, ohiovolffemtp said:

One concern I have with any early retirement is health insurance.  That's why I'm going to keep working FT until both my wife and myself are 65 and on medicare.  Fortunately, at my job that's only 10 shifts/month.

TRICARE, VA, Medicare trifecta for me and my wife!

  • Like 1

Share this post


Link to post
Share on other sites

Buy a laundromat. My friend has done it and he’s done really well. Surprisingly recession resistant and requires only a few hours per week of work to manage. Like jmann, I’ll probably continue to do rural EM or if I ever get burned out I want to get into some form of education. 

  • Upvote 3

Share this post


Link to post
Share on other sites
21 hours ago, SERENITY NOW said:

Any other PAs follow the FIRE (financial independence, retire early) path?  I'm planning my exit strategy from the beginning of my career haha.  

The wife and I both have jobs making good money, we have been working and living with low expenses while investing the difference for 3 years now.  If our projections are correct, we should be able to have flexibility to drop to part time (EM around 4-6 shifts per month!) within 4-5 years from now just to cover our living expenses with the part time work, while the nest egg investments will grow huge with compound interest on its own over the years.  Leveraging compound interest early in our career gives pretty awesome possibilities.  

Effectively only having to work hard and invest hard for 7-8 years then dropping to part time sounds pretty amazing.  Hopefully we can make it happen!  

Would be great if we had others in our community doing the same, sharing the unique pros/cons/challenges for PAs...

I'm a fellow PA following the FIRE path for the past year. Spouse also makes pretty good money. Despite living modestly compared to most in our situation and our friends, our house still doesn't quite fit into the FIRE picture anymore so we're looking into offloading it and just renting until we decide to stop moving around and something cheaper comes along. Got a new job and am currently renting in a low COL area making more money, better schedule, better bennies, and saving an hour of commute time each day. Have already started to buy secondhand when able and going to offload expensive household items once we sell the house. Offloaded truck and got a gas-efficient, low cost of ownership car. Spouse has negotiated a remote/telecommute work schedule which has further reduced driving and time spent commuting. Spending less money on eating out, beer, and expensive hobbies/activities and spending more time cooking and being outdoors doing free/low cost things like hiking, parks, and patio BBQ/fire pits. Already cut costs on phone plans, internet/cable packages, insurance, etc. Christmas is spent with fam and friends and we agreed on no-to-low cost gift-giving. Avoid using A/C and heat when able. Putting into retirement and other investment vessels. No debt except for house, which we have been paying down and should be taken care of altogether soon and yielding profit if we decide to sell. Next step is adjusting my schedule further to allow for PRN work that I enjoy and can make additional income. 

Still able to go out and go on vacation, but just keeping it in check now. Current goal to FIRE is 5 years barring any unforeseen circumstances or changes. May or may not have a paid-off house by then but that is TBD. 

  • Like 1

Share this post


Link to post
Share on other sites
11 hours ago, ohiovolffemtp said:

One concern I have with any early retirement is health insurance.  That's why I'm going to keep working FT until both my wife and myself are 65 and on medicare.  Fortunately, at my job that's only 10 shifts/month.

A valid concern for us too. Goal is to shift to a job that offers insurance but requires only minimal shifts per month to maintain FT status. 

Share this post


Link to post
Share on other sites

I'm trying to keep my wife teaching so we can use hers.  I figure that since we've been out the same amount of time, though she's been teaching for ~10 years with extended holiday breaks and summer breaks, that should allow me to get out first (which I did).  It'll be interesting to see if anything changes between now (60) and age 65 when Medicare kicks in.

Share this post


Link to post
Share on other sites
On 1/14/2020 at 2:09 PM, SERENITY NOW said:

Any other PAs follow the FIRE (financial independence, retire early) path?  I'm planning my exit strategy from the beginning of my career haha.  

The wife and I both have jobs making good money, we have been working and living with low expenses while investing the difference for 3 years now.  If our projections are correct, we should be able to have flexibility to drop to part time (EM around 4-6 shifts per month!) within 4-5 years from now just to cover our living expenses with the part time work, while the nest egg investments will grow huge with compound interest on its own over the years.  Leveraging compound interest early in our career gives pretty awesome possibilities.  

Effectively only having to work hard and invest hard for 7-8 years then dropping to part time sounds pretty amazing.  Hopefully we can make it happen!  

Would be great if we had others in our community doing the same, sharing the unique pros/cons/challenges for PAs...

I have been following the FIRE path since I graduated a year and a half ago. My wife is a teacher, so although her salary is low, we should be able to have health insurance provided through her school district for the rest of our lives after retirement. I'm currently 31, hoping to fully retire at 50 but my wife will have to work for another 5-7 years after that to meet her 25 year mark. We live in a very LCOL area so as soon as our collective school debt is gone ($130k for me and $30k for my wife) we will be flying pretty. I'm hoping to have our loans paid off in the next 5 years and then invest, invest, invest after that.

  • Like 1

Share this post


Link to post
Share on other sites
On 1/15/2020 at 2:43 AM, LT_Oneal_PAC said:

Buy a laundromat. My friend has done it and he’s done really well. Surprisingly recession resistant and requires only a few hours per week of work to manage. Like jmann, I’ll probably continue to do rural EM or if I ever get burned out I want to get into some form of education. 

I found a nice laundromat deal near where we will eventually retire to in NW Florida. It's listed for $700k right now so is a little rich for me! Did a little looking and asking and the owners gross 700k/yr and net around $200k- $250k/yr with rent and electric being the biggest costs. Not quite the 3x/yr you'd likely need to quit the regular gig, but darn close. If I had a spare $250k to invest right now I'd already be offering! Could always pick up at urgent care part time for some extra $$ down there I guess. 

  • Like 1

Share this post


Link to post
Share on other sites
7 hours ago, JMann said:

I found a nice laundromat deal near where we will eventually retire to in NW Florida. It's listed for $700k right now so is a little rich for me! Did a little looking and asking and the owners gross 700k/yr and net around $200k- $250k/yr with rent and electric being the biggest costs. Not quite the 3x/yr you'd likely need to quit the regular gig, but darn close. If I had a spare $250k to invest right now I'd already be offering! Could always pick up at urgent care part time for some extra $$ down there I guess. 

what about just building your own??  700k seems like a lot for a bldg and some washer and dryers....

Share this post


Link to post
Share on other sites

We are close but our goal is to have f-u money. Meaning any day of the week we can tell our employees f-u and walk out. 

Military pension helps. TSP since it became available. She is fed and fully vested but the pension isnt much yet. The last statement she will qualify for $1k a month so far. Plus her tsp. Pension for her doesn't start until she gets older. Tricare for health coverage is $600/year. 

Sell house, cars, etc. Move to a condo or something cheaper near a beach and transition to liveaboard sailboat is the plan. 

Kids have 4.5 years till both are in college. Both have half my GI bill and some college savings. Hoping to have most of thier undergrad covered. Once they get into or done with college we want to pull the rip cord and jump. Maybe work part time at first. 

I only wish I had more in the tsp before this last market run. Might have said f-u already. 

Edited by bovineplane
  • Upvote 1

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.


×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More