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Shop Around for Everything

There are always good prices to be had if you are willing to shop around. The bell curve representing how much each of us spends for a particular items is most interesting at the fringes. Having enough time to shop around is ideal but for medical professionals that’s often a luxury.

1. Healthcare

I have spoken to medical professionals who don’t fully understand the cash-system of the US medical system. I had a fellow urgent care doctor who kept coming back to see me for his migraines. Another who kept bringing her daughter to me for her pilonidal cyst which recurred despite two surgeries at Kaiser Permanente.

They were in deep battles with Kaiser’s HMO to get an outside referral. It wasn’t the cost, as they kept repeating. The simple solution would have been to pay out of pocket for an office visit to a neurologist specializing in headaches and pay out of pocket for a surgeon specializing in pilonidal cysts.

All they wanted was the initial consult to see if anything else could be done. This would have cost them less than $300, each – they each had spent far more in time and headache to get these referrals.

The same goes for imaging studies and lab studies. You can find private labs and imaging centers which will charge you $700 for an MRI instead of the $2,500 which your insurance will bill.

2. Transportation

You can pay $2,500 a year for automobile insurance or you can get the same coverage for $1,100. If you don’t bother shopping around, you’ll never know.

Not only should you shop around but also consider all the different options. I paid $2,200/year to get comprehensive insurance for my Smart Car back in 2013. I then realized that liability was adequate and I ended up paying $360 for the entire year.

If you have 2 cars in the house, could you get rid of one and replace it with Uber? Shop around and figure out the costs.

3. Mobile Phone

Not only can you buy an older phone for super cheap but you can buy rebuilt or refurbished ones for next to nothing. There really hasn’t been much technologic innovation in the mobile phone industry for the past 10 years.

As for cell phone plans, Republic Wireless offers $15/month of unlimited talk and text. And an extra $5/month for data. In the US I pay on average $18/month for my Ting cell phone plan. I use Google Hangouts for free phone calls and text messages. The rest is mobile data.

Many of us could get by without a plan whatsoever. If you live in a large city with lots of wifi access, you can use a smartphone with Google Hangouts for phone calls and text messages without paying a dime to a wireless carrier.

4. Dental Care

I pay for dentists out of pocket. I don’t let them bombard me with xrays but I try to be vigilant about dental cleanings and try to stick to the same dentists for continuity of care.

Xrays every 6 months or even every year can be a little ridiculous unless you already have lots of dental work and the dentist needs to worry about cavities forming under old fillings. Or if you grind your teeth a lot then you might be at more risk of enamel damage.

When I need work done beyond a simple filling, I get another quote from another dentist. If this offends your dentist then you should stop seeing them. A dental bridge, a root canal, an onlay, or a tooth extraction can vary widely from dentist to dentist. If you happen to be traveling to a medical tourism destination, that might be the best time to have such procedures done.

5. Glasses

I would love to support my local optometrist. But I used to pay $400 for my glasses which I’d have to replace every 2-3 years. Now, I don’t replace them because I buy higher quality frames at lower prices through online retailers.

I used to wear contact lenses which I don’t anymore. I was able to save quite a bit on those as well but taking my prescription online. I managed to play tennis, surf, and rock climb with my glasses, never needing contact lenses again.

6. Clothing

I buy most of my clothes at thrift stores. The quality of items there is jaw-dropping. Not just clothing – laptops, kitchen utensils, exercise equipment, bedding, and furniture. I pay a premium for certain items – the buy-it-for-life items which are a little harder to come by in the thrift stores. Those are worth buying new.

I have had my exercise socks from Lululemon for over 10 years. Unfortunately, their clothing quality has dropped while their prices have gone up. Some say that other companies like prAna are still good options for a balance of quality, sustainability, and price.

7. Debt

Whatever debt you have, it’s good to shop around and see how you can have them forgiven, refinanced, or restructured. Creditors depend on ignorant consumers to take advantage of us. Remember, the creditor took the risk on you – for that they charged you a hefty premium. If you cannot pay back the debt then you have every right to exercise your rights in your favor.

If you have a shitty credit then hire a credit repair company to fix that so that you have better access to creditors who can refinance you. Credit repair does work – it’s worked for me.

8. Retirement

I’ve written pages and pages on this topic. You don’t need $5M to retire comfrotably. You can structure your retirement any way you wish. You can live in any country you like.

Retirement needs are based on math. Math which isn’t sexist, ageist, or racist. But know the math based on whatever investment strategy you’d like to adopt. Work your way backwards using the math and you should know exactly how much you need for retirement.

If you are worried about risk, you can have multiple income streams which means you don’t have to just rely on cash. There is real estate and bonds and stocks and CD’s and even earned income.

9. Taxes

You can pay 10% to California for income taxes or you can pay 0% state income taxes to Nevada or Washington or Florida. We have some control over taxes but that requires major lifestyle decisions.

You can work as an employee and have most of your income go towards taxes or you can become an independent contractor and keep a lot of your gross income. No need for any fancy tax strategies. Having the ability to deduct more against your income and maximizing retirement accounts can keep more money in your pocket and decrease your tax burden.

Another solid way of decreasing your tax burden is to earn less income. Since your income tax goes up exponentially with your increase in earnings, decreasing your income puts more money in your pocket.

10. Home Repairs/Remodels

Some work on your home should be done with a general contractor and others are perfect for a handyman. Many handymen have licenses, are insured, and bonded which makes hiring a contractor and unnecessary expense.

Not only is it helpful to get multiple quotes but it’s a good idea to post the job on various forums and websites to get a more realistic idea of the cost from homeowners who’ve been through this already. There, you will also be informed of any potential hiccups which might be encountered.

11. Housing

I’ve gotten multiple calls through my clarity consulting where physicians have been concerned with living or moving to a high cost of living area such as San Francisco or Los Angeles.

The great thing about these cities is that people move there to have more lavish lifestyles. If you’re willing to live in a smaller place and a little further away from the action, you can save a lot of money while still enjoying the higher income these cities afford.

I found a small studio in San Diego, in the Banker’s Hill neighborhood for $800/month. I had to pay the same for a smaller place in Portland, Oregon – a far less expensive city. It’s not always easy finding these deals but if it’s possible.

12. Jobs

Whatever you might hate about your job, I’m certain there is another job in your specialty which offers you far more upside for a small financial downside. Want more op-time? Want less clinic time? Want lower acuity patients? Maybe more cosmetic medicine?

A burnt out lawyer buddy now represents his lawyer buddies who are too busy to show up to court some days. He just shows up and files motions. He lives in San Diego and earns more than enough to pursue his passions – surfing and weed.

13. Learning

Whether you want to learn to become an IT specialist in healthcare or you want to learn SEO or integrative medicine, you don’t have to pay exorbitant fees for traditional schooling. You can design your own learning course from the information that’s already out there. Often for free or for very little money.

14. Professional Advice

You don’t have to pay a lawyer $15,000 or pay a web designer $2,500 for one project. You don’t need to pay a CPA $4,000 to do your taxes. Most of what professionals do for us is to give us advice. In today’s gig economy, many such professionals are willing to break up their time into affordable portions.

I can go on JustAnswer and ask a lawyer about anything I like and pay only per question. There are other websites where you can retain a lawyer for only a few minutes or hours of their time.

You can go on fiverr or Upwork and pay far less for a certain project than you would if you hired a traditional company. And you can go on entrepreneur websites like clarity.fm and pay an expert for just a few minutes of their time.

15. Your Career

I’m an MD and it’s the career I paid for in medical school. But I am by no means stuck seeing patients in a clinic for the rest of my life. I can look for other ways of earning a living with my medical degree. Even if a governing body takes my medicine license away, they’ll never take my knowledge or my MD degree.

I can do telemedicine, clinical consulting, chart reviews, open my own private practice with an associate, or I go into something related, such as nursing, physical therapy, or dietetics.

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