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Physician Financial Independence – What I Would Do Differently

1. Recognize that burnout is possible

Why wasn’t Dr. Oz talking about burnout on TV? I would have believed him, I swear. When I got married I signed a prenup because I know divorce was possible. Burnout? Condom? What?!

2. Develop an FI game-plan as early as residency and stick to it

I could have come up with a financial game plan as early as residency – but way too many moving parts, I was overwhelmed. I placed way too much emphasis on my income, not realizing how short it would fall. Money grows exponentially, the longer you wait, the slower the growth.

3. Budget using YNAB

Wish I knew about YNAB sooner. Budgeting is math. Math isn’t color-blind and doesn’t care about X or Y chromosomes. Assign every dollar a job as soon as it hits your checking account.

4. Get a financial advisor whom I can work well with

I didn’t master medicine on my own. I couldn’t have mastered personal finance on my own. You should only advise physicians to stay away from a financial advisor if you’re making money with that recommendation. Ehem.

5. Don’t buy a home

I read everywhere that real estate is one of the best investments out there. And yet nobody around me – nobody – has profited from the purchase and sale of their home. I gotta get new friends.

6. Make debt payoff my #1 priority

Everyone said that I’ll have my debt for the next 30 years. So I believed it. I didn’t think it’s possible to be debt free in as little as 5 years. I assumed debt was the only way to live as a physician.

7. Don’t get married

Ehh… yea, don’t get married. It cost me a knee to enter marriage and an arm and a leg to exit that fucker. Oh, don’t have kids either – don’t worry, your neighbors further east will pop out plenty to keep the earth populated.

8. Get a mentor

I had great medical mentors – they knew every clinical study out there. But I didn’t have a mentor who had my back when it come to the lifestyle of medicine. I needed frugal minded, early retired, and financially independent mentor. These individuals are best found reading at the library, working in their garage, hiking, or somewhere under a rock.

9. Live in the most liveable cheap city possible

Portland isn’t cheap but it’s far cheaper than San Diego. Denver is cheaper than Los Angeles. The coast is great if you’re making tons of money but tons of people who make tons of money are douchebags.

10. Worry a lot less about taxes

I thought taxes was the main reason I didn’t have enough money. No, it was because I was buying too many fancy shoes and spending $1,008 a month on my H2 Hummer. Tax cutting doesn’t create millionaires but millionaires can cut the shit out of their taxes.

11. Invest as early as possible, as much as possible

The investment curve of your money isn’t linear. It’s math dude, go read a fucking book. I was too busy reading GQ magazines.

12. Get rid of my car ?

I can’t yet get rid of my cell phone but I can live without a car and have far less headache. My sexy Brompton isn’t gonna get me laid but at least it allowed me to retire early.

13. Don’t trust my employer

It’s not personal, it’s business. Your employer will kick you to the curb as soon as you become a headache for them. They will do what’s best for the entire system and are less worried about the individual physician. If your employer lies about you, what you gonna do? Get a lawyer? Sue?

14. Build an emergency fund and never touch it

It’s tempting to get a boob job with the money you have in your emergency fund – don’t – especially if you’re a guy. An emergency fund isn’t just there to cover emergencies, it also gives you an indisputable feeling of security.

15. Simplify the shit out of my finances

14 credit cards, 3 checking account, 3 brokerage accounts, CD’s, savings accounts, and a dozen different investment funds. Fuck that. With less financial complexity I could have achieved my financial goals faster and with less fluff. 1 checking account, 2 brokerage accounts, 4 individual investments.

16. Stay away from the big spenders

It’s easier to spend your way out of problems and you can even spend more in order to free up more time. The problem with big spenders is that you have to spend like them to be part of the team. Try to order just club soda then next time your homies are eating toe-ja… I mean, uni at the hottest new sushi place in town.

17. Network with other like-minded physicians

There are other frugal doctors out there. Some are autistic. The rest are just flying under the radar. They’ll open up if you get them talking. May I suggest whiskey and/or roofies?

18. Live like a minimalist

A minimalist owns less but does more with what they have. They are more about function than form. It’s hard to be a minimalist and be wasteful with resources. Minimalism is like veganism – it’s good for you and the environment and puts more money in your pockets.

19. Live like a tree-hugger

Tree huggers don’t buy a lot of stuff and don’t spend much on experiences because everything creates waste. Too much electricity usage, gadget orgies, flying places, fancy furniture, driving, personal hygiene – all against the code of ethics of a tree-hugger.

20. Recognize stress and don’t come up with excuses to justify it

Job stress won’t magically disappear. You’ll often find ways to cover it up by working or drinking more. Pay down debt, save more, spend less, and enjoy early retirement. Let your Tesla driving colleague worry about the stress.

21. Understand everything there is to know about passive income

Passive income is income you can earn without extensive ongoing efforts. Either there is some upfront energy investment necessary or some minute ongoing attention – but money will flow continuously from a passive income source with ease.

22. Spend more on knowledge and less on entertainment

I get more entertainment from a good book than from my H2 Hummer or Canali suit. Freedom to do whatever I want to do with my day is far more entertaining than living in a gated community with stuffy neighbors. But I’ll gladly come visit you and your pool if you go one of those.

23. Realize that it’s possible for a single male doctor to live on $2,000/month

The median household income is $60k in the US. When I look around I see a lot of comfortable people. I was really fucking happy in college and I didn’t spend too much. I’m living in Portland on a very tiny budget.

24. Develop a vision for my ideal life and believe it’s possible

I kept telling myself that I needed to enjoy being a doctor. Finally myself told me to go fuck myself. Once that bubble burst I realized that there was all sorts other shit that I enjoyed doing and that it was 100% possible to live the ideal lifestyle you imagine. Don’t suffer in medicine – there are enough doing that already.

25. Don’t assume that friends and family know what’s best for you

To this day my family would prefer that I work full-time. That I be married with a few fetuses snotting around the house. They prefer me in a 2-story mcmansion with a couple of luxury cars in the driveway. The vision of such a lifestyle is detumescent.

26. Pay for expert advice

I should have consulted lawyers, financial advisers, business consultants, career consultants, and therapists when the need arose. Experts apparently know stuff that I didn’t even know about.

27. Traditional vacationing sucks. Long-term travel is money

Had I known that I could do telemedicine while traveling then I would have most def rented out an apartment and lived there for 3 months at a time. I did that with Barcelona and Seville and loved the experience. With international income I can qualify for most non-lucrative visas. Earn US dollars and spend cheaper overseas currency – brilliant.

28. I don’t have to be a doctor forever

There are all sorts of other professions I might develop an interest in. Who says that I gotta be a doctor for life?

29. I have 1,001 options to earn income in medicine

I can be an RN, an MA, a clinical consultant, or a healthcare executive. Shit, I can be the speaker for a pharmaceutical company. PT, RT, LVN, Pharmacy tech, dietician, COA, CPC, or HIT.

30. Don’t waste my talents for an employer

I was faster and more efficient than most of my colleagues – and incredibly humble! To spend this talent working for a large medical group was a waste.

31. Give more money away, volunteer my time

Giving money and time away feels good. It doesn’t just help others but makes me grow. Furthermore, by giving money away you become less attached to it – it helps you delineate frugality from being a cheapass.

32. Be selfish

Always be selfish. Once you can take care of yourself, it’s in your nature to help others. But you can’t do much for others if you’re drowning in debt or stress.

33. Working overtime rarely makes sense

It takes exponentially more effort to work 2 extra hours at the end of a 10 hour shift. For that you’ll expose yourself to more risk and be taxed at your highest marginal tax bracket. Spend less instead.

34. Buying used is smart

Cell phones, cars, homes, utensils, appliances, and even kitchen cabinets can be purchased used. It’s an immediate 60% discount. Since the item is already used, chances are that it’ll continue to remain functional.

35. I am not good at speculations

I don’t know when Tesla stock will go up. I have no idea when the next market crash will occur (I thought it would happen in 2016 and it’s 2018 now). I don’t know when and by how much, or if at all, my real estate will go up in value. I’ll leave speculating to speculators and capture my nearly guaranteed returns instead.

36. Prepare my own meals

Cooking at home is cheaper and healthier and better for the environment. Cooking is like meditation. It also forces you to slow down and treats workaholism.

37. The hype around medicine is bogus

Medicine isn’t a higher calling. I’m not smarter than others because I’m a doctor. We curing and healing is a very small part of what we do. We are an integral part of society but we don’t deserve more and don’t deserve less. Vote with your presence and leave a shitty job and work somewhere better. Realize it’s just a job.

38. Buy it for life

If you’re not going to buy used, buy it for life. BIFL items might need some maintenance and have a higher initial sticker price but you can keep them for decades.

39. Do my own taxes

No CPA will care enough to save you every last penny. When you do your own taxes you eventually understand where your money goes. It’s on par with cooking your own meals.

40. Get an electric bike

An electric bike can outperform your automobile in many ways. You won’t tire climbing hills, you can pedal and still get exercise, and you’ll zoom past cars in traffic. You’ll use your car far less and maybe go carless.

41. Recognize the risks of being a doctor

Sexual harassment claims, malpractice risk, medical board investigations, risk of becoming a workaholic, and the risk of relying excessively on your income. And even risk of early death.

42. Live like medical assistants do

I know MA’s and RN’s with multiple rental properties, very healthy retirement accounts, and a very small household budget. They still manage to pop out fetuses and have hobbies.

43. Don’t identify with being a doctor

Once you identify with being a doctor, you’ll want to live like a doctor. You’ll expect to be treated like a doctor and forget that you’re a replaceable employee.

44. Find the best fucking dentist there is and don’t change them

Once you find a great dentist, don’t change them – oh, and don’t date them. Much like a classic automobile, maintenance is key when it comes to your grill. And like herpes, prevention is key.

45. Don’t hang out with physicians

Physicians talk about medicine. They spend like doctors and few have interesting hobbies outside of running. Hang out with simpler people who live richer lives. Please leave hate comments in the comment section below.

46. Learn to make everything myself

Bake your own bread, repair your own electric razor, upgrade your own RAM, install your own Unix OS, and fix your own plumbing. It saves you money but also connects you to these physical things on a deeper level. Bleed for what’s valuable to you.

47. Only take on leadership roles to pad my resume

Leadership pays only a slight bit more and comes with a lot headaches. Some decisions will eventually create enemies.

48. Read more books, listen to more podcasts

A lot of people have figured a lot of shit out already. And here I thought I was a fucking pioneer. Pay the author $10 and learn what they spend $1,000’s learning. Sucka’!

49. Worry more about how much I spend and less about how much I make

You income is far less powerful than your spending. How many more TKR’s can you squeeze in a day? How much could you cut from your budget?

50. There is always a cheaper option

House hacking, long-term travel, going carless, living in a cheaper and more progressive city, moving to a zero-income tax state, buying low-cost index funds, buying used shit, going vegan, brewing your own beer, showering less, borrowing ketchup packets, stealing your neighbor’s WiFi, downloading bootlegged movies, growing your own weed. In that order.

51. There are no double digit returns unless you take on a second job

An investment which proposes a 14% return is a pink unicorn – with tits. You might come across it once in a lifetime and brag about it on Reddit but rather than chasing boobed horses, spend your energy on safer and more predictable investments.

52. Real estate is not passive income

Only bloggers tell you that their rental income portfolio is a passive one. All your friends will tell you how much work it is. It’s not a bad option as long as you’re willing to put in the work.

53. Decide sooner that I don’t want kids

I got my balls clipped in my mid 30’s. But I always knew I didn’t want kids and yet the discussion came up with every-single-goddamn relationship I was in. “Sorry, I shoot blanks!” ?

54. If I can’t fix it, I won’t buy it

I spent a lot of money on expensive stuff that I had to throw out once it broke down. If I can’t fix it or have someone fix it then I won’t pay any money for it. It’s the best way to vote with your money and let manufacturers know what you think of their POS products.

55. Move out of a high cost of living area

It’s not just money saved on housing, but your entertainment calendar will shift from breeding Arabian horses to collecting mushrooms off of dead logs.

56. 200 sqft is more than enough

A human takes up 1.25 sqft. An adult mattress is 28 sqft. Your shitter is <1 sqft. I don’t need 3,000 sqft of living space. Fuck you HGTV. I’ve lived in 142, 212, 650, and 750 sqft. I have more than enough space in my 360 sqft studio.

57. The medical board isn’t your friend

The medical board exists to infantilize the patient, vilify the physician, and clear cases off of the books. Should you ever interact with them, pay for a lawyer. They will lie and they will deceive (the medical board, not the lawyer!)

58. You should always have enough time to exercise

If you don’t have enough time to cook and enough time to exercise then you are working too much. Maybe it’s okay for a very short period of time. But these habits will stick with you and soon you’ll have a personal sqft of my entire studio.

59. It’s really easy to get into debt

Debt feels good because it justifies you working like a taxi driver. Debt solves most problems and displaces the burden of worry into the future. But debt is tough to get out of once you’re in it.

60. My primary residence is not an investment

Even if your home appreciates 50%, by the time you pay for the mortgage interest, property tax, insurance, repairs, maintenance, remodels, furnishing, moving costs, and factor in the opportunity costs, you will come out even.

61. Money that’s invested grows stupidly fast

I thought it would take me until age 41 to be financially independent. But money grows fast as fuck when it’s invested and when you don’t touch it. I should have invested more and sooner.

62. Don’t expect any support to live a frugal lifestyle

“Why do you torture yourself? Are you sure it’ll be worth it? Enjoy life.” I am enjoying life. “OMG, I wish I could retire early but … “.

63. It’s okay to be boring

I am boring as fuck. I write for a blog that makes no money. I climb up holds in a gym that lead nowhere. I cook food that has no dairy or meat. I read non-fiction books and listen to life hack podcasts. If you’re okay with being boring then be proud of it. Take your Zika infested Tahiti vacation and go grow a brain.

64. Drop down from full-time gradually

Once you’re financially independent or close to it, don’t go from full-time to unemployment. Transition to part-time, taste it, feel it, swish it around in your mouth. Then go per diem and see if it pairs nicely with your vegan salmon dinner.

65. I can retire as early as I want

65 is as arbitrary as a retirement age as an 81mg ASA tablet. You can retire at any age for which you’ve planned. The earliest I can imagine a doctor retiring is age 35. The youngest doctor I know retired at 37. I retired at 39. I hope you work for however long you’re happy working – but at least you’ll know your retirement is set by you and not by congress.

66. Understand what it means to be financially independent

Financial independence is a math equation and so there is no reason to argue about it. You either save enough acorns to last you all your life or you grow an acorn tree and take good care of your leafy friend to have acorns forever.

67. Don’t aim to stop working, find the work I love doing

If you’re paid to play with kittens all day then you’re not gonna bitch about that one kitten who wouldn’t stop playing with the feathered mouse toy. You also wouldn’t be fantasising about quitting that job ASAP.

68. It’s easier to fix spending problems with overtime

Ah damn, that vaca got expensive – I’ll pick up some overtime. I really wanna afford that nicer house with the view – I’ll pick up an extra shift. Do you have the same model with an M in front of it? – I’ll do some weekend rounding and maybe trick on the geri wards.

69. Go under the radar at all times

The best doctor on the wards is a target of the haters. The worst doctor on the wards earns the same pay but lacks job security. Be Dr. Incognito at work. Haters gonna hate – picture me rolling.

70. House hacking could be brilliant

Buy a house and rent out the spare room(s). Once it’s paid off, kick the bums out and move in your main squeeze.

71. Don’t limit your location to the US

The rest of the world isn’t backwards. Health insurance in the US costs $300/month for a healthy 30-yo man. You can live in Spain, Portugal, Australia, and Scotland for a lot less money. Earn $200/hour from the US doing telemedicine and spend it overseas.

72. Understand that a $300k income is not a $300k income

You don’t pay your student loan payments and your mortgage payments with pre-tax dollars. You don’t earn $300k/year – you earn 60% of that, at best.

73. Stress and debt both lead to more spending

Debt causes stress and stress leads to spending, which eventually leads to debt. Break both habits and become wealthy as fuck.

74. It’s okay to start over from scratch

Have you dug yourself into a big financial and lifestyle mess? No prob’ Bob. Start over – sell the house, ditch your expensive partner, get rid of the pet hamster, move to a cheaper state, and downsize drastically. Escape misery, your patients will thank you. So will your staff.

75. The credit card game is a waste of money and time

The more money you spend the more miles you get. The more traveling you do the more money you spend. In the end, you’ll be spending more money. You’re not ‘hacking’ shit! The credit card company knows what they are doing and they partner up with airlines and hotels and restaurants to hack your wallet.

76. Financial independence and early retirement is a real possibility

You can complain and suffer in a miserable career or take the cow by the utters and take control of your flatulent medical career.

77. You can outspend any income

$300k is only amazing when you come from earning $45k as a resident. By the 3rd year you’ll be complaining why you’re not earning $1M. While the $1M neurosurgeons is pissed that the hospital exec is making $3M.

78. Don’t cash out my retirement accounts… twice ?

So I guess there is a 10% penalty in place to prevent you from accessing your money early. Well, I sure showed you, IRS! Ha! ….fuck….

2 replies on “Physician Financial Independence – What I Would Do Differently”

Wow. That was a really long detailed list for sure (proud of myself I got through it).

Fortunately a lot of your advice I have already incorporated into my life and it has allowed me to get me where I am after I had to pick myself off the ground after a brutal divorce at the age of 40 (I didn’t know you were divorced as well).

I like the statement you had about travel hacking with credit cards. It’s true, these big companies are not fools and don’t offer things that in the long run line their pockets with more money. Any analysis that they lose money would stop that program in a heartbeat so the fact that it continues must mean it is a good money making offering for them.

I had a marriage that lasted like 8 months. We’re still friends to this day and didn’t have an ugly breakup – I think the prenup helped that. It just put everyone on the table and there was nothing to fight or argue about. It was tough on her because we were both spendy when we started dating in 2012 and suddenly I had the holy vision of financial independence and set out to change my lifestyle which really complicated things us … she wanted to shop and spend and I wanted to save and invest. We didn’t reach a middle ground because I’m one of those all-or-none people.
I know you have kids right? That really complicates things, doesn’t it? Kudos for you to have figured it out – and your blog is amazing so I hope a ton of residents and medical students read that.

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