[Today’s post is from Crispy Doc, an emergency physician who lives and works in sunny California. Burnout is real in medicine, especially among residents and young attendings. In this post, Crispy Doc describes how the workaholic culture of American life (including in medical training) has been adopted in some Japanese work environments. Crispy Doc argues that a solution to the burnout in either case is to pursue FIRE (financial independence, retire early). This article previously ran on Crispy Doc’s blog in October 2017. -WSP]
In the years following WWII, the U.S. helped Japan rebuild infrastructure and institutions. From that time onward, the relationship has been mostly a bromance. Our nations have arguably become the Vince Vaughn and Owen Wilson of the G-8, putting one another in playful headlocks when negotiating Pacific trade agreements or playing wingman when a cute vulnerable bachelorette country finds itself in need of rescue from a douchebag regional bully with nuclear capabilities.
Journalists in recent years have highlighted the fact that little brother has started to beat big brother using the latter’s original playbook. Japan is taking American cultural trends and icons and raising the stakes, developing a respectable mastery that arguably refines classics like bourbon, denim, and burgers.
Unfortunately, Japan has not just adopted, but raised the stakes on American workaholic culture. A recent article in the NY Times drew attention to a 31 year old woman who, after putting in 159 hours over overtime in her job at a state-run broadcasting agency, died of heart failure.
The cause has become common enough to have been assigned a name: karoshi, “death from overwork.” The condition first appeared in the 1980s, and it cuts across all income brackets, affecting blue collar factory workers and white collar executives alike.
Work culture in Japan considers exhaustion a positive sign of a respectable work ethic, placing junior workers (especially those under 35) at particular risk as they earn their stripes to climb the ranks.
Physician readers may find their spidey senses tingling with recognition because residency training for physicians has an awful lot in common with the potentially toxic culture that enables karoshi. Elders in the field who shrug off legitimate concerns by stating they took their hits as a rite of passage, disparaging the latest generation of residents as whiners. At around the time I graduated from medical school, hospitals dependent on low-cost labor and federal subsidies to maintain their entrenched interests opposed the right of residents to unionize; change was ultimately imposed from the courts.
While the right to a less abusive work environment continues to trickle (slowly and unevenly) into medical training, the available resources to help resident physicians to avoid financial abuse is at an all-time high. The physician financial blogger community is in the midst of a renaissance, with the White Coat investor leading a mainstream educational movement toward financial common sense on the one hand, and Physician on Fire demonstrating how thoughtful investing and a frugal disposition can enable even late starters like doctors to reach financial independence in a decade.
Karoshi is an extreme example, a symptom of a sick work culture. When medical residency ends, FIRE offers young physicians a path to take control over their financial destinies, putting them in a position to eventually decline unreasonable work obligations. For Japanese workers, FIRE gives the young and exploited an offramp from a potentially dispiriting future of continual (occasionally fatal) work-related stress.
[If you liked this post by Crispy Doc, consider subscribing to his e-mail list (as I have). What do you think? Do you think working excessive hours is still considered a badge of honor in the medical profession? Is pursuing FIRE the best way to combat work-related stress and burnout? -WSP]
It really is an important lesson!
There are a lot of us trying to tie these two important topics (physician wellness and financial independence together). That’s definitely my niche. I am glad for anyone else out there sharing the same message! After all, a rising tide raises all boats.
Thanks for spreading the word.
TPP
It is sad that it has become a badge of honor to be put through the rigors of residency in order to practice medicine.
Low pay and long work hours is a recipe for disaster. It is no wonder when people come out of it they want to blow all their money at once as a new attending as a reward for surviving.
I think every generation has a bias saying the older generation had it easier and the younger ones are whiners. In a few decades people might be referring to my generation as practicing in the golden age of medicine when I personally think it is doctors that practiced a few decades before me
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