This profile is part of the "People of Giving What We Can" series.
The following profile is provided by Forrest Wells, a doctor in Colorado. He explained his commitment to helping people through medicine and effective altruism and provided helpful advice to fellow healthcare workers. Thank you Forrest for your commitment to Giving What We Can!
I have been blessed with many gifts—growing up in a developed country, having supportive parents, and doing well in school, to name a few—and have long felt that I should use those opportunities to good in the world. This belief helped lead me to a career as a physician, where I felt I could do beneficial work while playing to my academic and interpersonal strengths.
Both of my parents are doctors, and that influenced my career path in a very roundabout way. Growing up I wanted to do something different, to set myself apart—and medicine was the one path I was sure I wouldn’t take. But with time I grew to recognize that the same factors that inspired my parents could motivate me as well. They are both general practitioners who have worked their entire careers in safety-net clinics primarily serving people who might not have otherwise had access to medical care; I got to see first-hand how intensely challenging and rewarding that was. Walking around town we’d occasionally run into their patients and I’d hear about the ways my parents made a tangible difference in their lives, which was pretty powerful. During my university studies at University of Oregon, I found myself very successful in science courses but pretty uninterested in spending time in the lab, and I realized that a career in medicine would allow me to leverage my aptitude for science in a very human-focused way that involves a lot of teamwork and interpersonal interactions. I went to medical school at Oregon Health & Science University, where I decided to specialize in Emergency Medicine: it was a good fit for my personality, an opportunity to set my own path, and a chance to provide a sort of social safety net in a different way. I did my residency training in Emergency Medicine at University of Utah and now practice at St. Mary’s Medical Center in Grand Junction Colorado.
Throughout my medical training, I grew to understand the importance of cost-effectiveness of interventions and realized that while I could use my profession to do good, it wasn’t the way to do the most good. With over seven years of effort and six figures of student loan debt invested into becoming a doctor, I didn’t feel that I could make a career change, but I wanted to do more for the world than just care for the patients in my emergency department.
At around the time, I started making a modest salary as a resident physician, my wife and I listened to the Sam Harris interview with Will MacAskill and were inspired by the ideas of donating a fixed portion of income and critically evaluating the effectiveness of charities. We started donating 5% of our shared income right away.
Within a few months, we realized that we didn’t miss the money in our budget. We actually felt more financially secure while making donations, so we increased to 10% and decided to make additional donations to account for inflation-adjusted “missed philanthropy” from our earned income prior to making the pledge.
I think the key truth here is that people tend to spend whatever money they have. As our incomes increase, so do our expenditures: both on things that feel obviously discretionary (I’ve got a nasty habit of buying skis and bikes) and on things that seem like bare necessities (such as food and housing.) Those fixed expenses really are necessities, but we often spend more on them than is necessary. For example, the house I’m living in right now is much nicer than the one I lived in throughout university, but is a far cry from what people would think of as a “doctor house”. I could buy a new house, a new car, and more expensive groceries, but I don’t think those things would make me truly happier and if I let my lifestyle creep up to my income then I too would start living paycheck to paycheck. The secret to financial security isn’t making more money, it’s spending less money relative to what you have. Setting aside 10% of my income for philanthropy helps me keep my personal spending in check without feeling like I’m deprived of anything truly important to me, and provides a sense of stability when I recognize that if I were to experience a financial catastrophe I could essentially increase my income 10% overnight by not donating. Finally, there is an important psychological piece concerning relative income. Most of what makes us feel like we have “more” or “less” is relative to who we are comparing ourselves to, and in an era of social media and wealth inequality it is easy to find people who look like they have “more”. Donating 10% of my income each month is a tangible reminder that I have “more than enough”.
I’m generally sympathetic to longtermist views and interested in environmental causes. I believe that most non-human species deserve moral weighting and that there is an intrinsic value to natural systems and non-human species’ right to self-determination—but we pretty quickly get into some moral grey areas here and I still have a lot of uncertainty around how these things should be weighted. There is also significant instrumental value to preserving our environment. Climate change is a key cause area for me because mitigating its effects has positive impacts across a wide range of values: improving human and animal well-being in both the short and long term, preserving natural ecosystems, and reducing existential risk to name a few. The funding space is obviously pretty crowded, but I think Johannes Ackva and his team at the Founders Pledge Climate Fund have been doing a good job of applying a scale/tractability/neglectedness framework to target important interventions missed by mainstream funding; they’ve been receiving about half of my philanthropy and will continue to do so. I’m a little unsure of where the other half will go in the future and am currently saving it while researching options. I’d be very interested in ways we could apply an effective altruist framework to goals of ecosystem preservation: conservation groups attract a fair amount of philanthropy globally (albeit much less than humanitarian philanthropies), but I suspect that there are important interventions that are being missed by mainstream nonprofits.
It has been very fulfilling to incorporate philanthropy into my life. The approach of taking the pledge has unburdened me from a lot of the cognitive and emotional work that might otherwise have come with deciding how much and where to give. It has left me with a framework for giving that has been very helpful and that I intend to build on over the years.
To my fellow healthcare workers: our work is hard, emotionally draining, and often all-consuming. We’re burning out left and right from the moral injuries of working in a system that often separates the services we can provide from the reason we chose our careers in the first place: to help people. We have to find ways to connect our work to a sense of doing good in the world if we’re going to keep giving so much of ourselves to it. For me, philanthropy is the answer. We can all agree that at least 10% of what we’re forced to do has no bearing on helping people, and it’s that part of our job that makes us question whether we want to keep doing it sometimes. If you can mentally connect the 10% of the time you spend jumping through administrative hoops with the 10% of your income you donate to charities that you care about, you can feel like everything you’re doing is important. Do yourself that favor, because we can’t afford to lose you.
One of the things that I love about the effective altruist movement is the range of possible levels of commitment. From donating a tiny portion of one's income to an EA-focused fund to donating the majority of one’s income and making a career out of researching key issues, there are so many ways to contribute. I’m not yet sure where I’ll fall on that spectrum, but I think it is really important that the EA community remain open to a wide variety of individuals and ideas. It is really encouraging to see the work and the resources people are putting into this. Sometimes I get discouraged when I look at all of the bad ideas and atrocities still circling the world in the 21st century. Yet, when I think about how far we’ve come as a species, it gives me hope that we could continue to improve if we set our minds to it—and that is exactly what the effective altruism movement is doing.