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Ultimate Frugality

There is frugality and ultimate frugality. I’m not sure mainstream frugality is effective in getting us to our goals. So let’s supercharge it and see what it can do.

I am potentially the right person to listen to on this topic because I’m not frugal by nature. I like spending and if left to my own nature, I would spend anything and everything I have. Having money to track and save takes energy and foresight which drains me.

At the same time, I’ve found some salvation in frugality. Probably not the kind of frugality that comes to mind when thinking about the term. Rather, it’s ultimate frugality. As in, cutting out all of the fluff and reinventing the wheel.

Here is one of many shitty analogies to follow; there is college level studying and the kind of studying it takes to make it through medical school or dental school or vet or pharmacy school. The former is mainstream frugality and the latter is ultimate, supercharged frugality.

It’s important that I distinguish this from being cheap which is destructive and doesn’t take value into account. I’ll also add that frugality is a good tool and technique but it’s not necessary for everyone. You don’t have to be frugal to be wealthy but it sure doesn’t hurt.

Ultimate Frugality and Medicine

If you are miserable practicing medicine, as in, you are stuck in this profession earning a very high salary but don’t enjoy the practice of medicine, then ultimate frugality is a way out. Alternatively, you could give up and give in and feel stuck.

Some of us are able to carve out that ideal career in medicine but not all. If you’re reading these words and thinking to yourself, what the fuck is this dude talking about, it’s probably because you have a dual household income or you have the kind of job in medicine you love doing.

I enjoy seeing patients in the Urgent Care because I love the puzzle piece of figuring out what they have. I appreciate the gratification of helping someone out. But I get disillusioned too easily when I get a silly patient complaint. Or when I have to deal with medical board investigations, have to fight with HR to get my paycheck, or have to argue with a patient over antibiotic prescribing.

Idealism in Medicine

This level of idealism in medicine isn’t healthy, I realize that. It’s the only way I can justify practicing medicine, however. I am working on resetting my mindset but haven’t been successful.

It would be healthier if I developed a more realistic attitude towards the practice of medicine rather than forcing the healthcare system to conform to my individualism.

Nevertheless, it’s ultimate frugality which has allowed me to practice medicine the way I wanted for those short few years. I could stand up to patients and supervisors and didn’t feel like I was selling myself out.

Ultimate frugality offers the ultimate escape; you have such little reliance on the income that if it’s gone, no big deal. This gives you a lot of power and a lot of options.

Traditional Frugality

What I love about frugality is that it is also good for others, not just yourself. Being frugal means you are more resourceful, you become independent, and you preserve precious resources in the world.

As high income earners and high spenders we have a profound impact on the rest of the world. Some of us don’t realize how resource-intensive our lives are and the kind of footprint we have on our environment.

If I’m frugal and can build a sustainable lifestyle for myself then I don’t have to depend on the government for support. I can then maybe become a source of support for someone else, or my community as a whole.

This isn’t to say that someone who spends as much as they earn, at any level, is wrong for doing so. In fact, if you love the work you do, then the income really is just a desirable side effect. And it’s not like every single person has to be frugal in order for a net positive effect on the world to take place.

To be mainstream frugal you just have to spend a little less than you normally would. You save a little more than another person; you just do a touch more. You don’t look at the things you want, but the things you need.

Modern Day Minimalism

Obviously I’m making an argument that conventional frugality is a little ineffective but still sustainable. Certainly better than making it rain da’ club. It’s exemplified by modern day minimalism.

This form of minimalism gives the illusion of negligible possessions. In reality the household still owns a lot of shit but it’s all neatly hidden away in cabinets and drawers. The colors of the displayed items are muted in order for them to blend into the background, giving the appearance that there is less stuff in the room.

The Tesla has a minimalist design for this exact reason, to appeal to those who want more from less. But that’s not ultimate frugality or extreme minimalism; in these latter 2 scenarios you are owning less and spending less while fully aware that you’re going to have less in return.

Mainstream minimalism replaces the wired keyboard and mouse for wireless ones. The TV cord is routed through the wall. The drapes are replaced with accordion blinds. The truck, naturally, is replaced with a Tesla or, even worse, the truck ends up in storage.

A sleek Nest replaces the clunky, old thermostat. And the normal facial products with colorful lettering on the bottles are replaced with a sea sponge, a dry brush, an exfoliating volcanic rock, a baking soda serum, an apple cider vinegar shampoo, a vegan sugar rub, and a stainless steel microneedling roller.

Ultimate Frugality

The frugal person from above is a little weird for Nevada but super hip for Frisco and Seattle. They can definitely start their own YouTube channel and post on IG, with titles such as:

My frugal dinner, My minimalist pet food, My Everyday Carry, My frugal grocery list, My minimalist toothbrush.

Ultimate frugality is quite a bit more weird. You’re the psycho down the street. Potentially the serial killer next door. Nothing you do belongs on social media. In fact, it’s better that you stay in the shadows (freak!). In fact, you spend a good deal contemplating how to not come across as a weirdo.

Cheapass Bastard

But you’re not cheap. You don’t rip off the restaurant by bringing your own food to their establishment. Though if you are the kind of cheap person who does it, chances are you’d be livid if someone did the same thing to you. You also don’t skimp on the oil changes and transmission oil filter replacement because you know that it’ll cost you the longevity of your car.

It’s okay to skirt being cheap until you find your groove. Eventually you’ll realize when you’re providing value to your own life and the world and when you’re leaching off of it.


Speaking of a car, you don’t have one as an ultimate frugalist. You don’t even want one. There is freedom in not having to maintain a car. It’s heavenly not having to pay the annual wealth tax on it – aka registration.

You know that your wealth accumulation is only going to last a handful of years. You’re not planning on being a work slave for the next 3 decades. That’s why you relocate your home to be within a stone’s throw of your workplace, allowing you to live without a car.

You’ll walk a distance up to 2.5 miles. You will bike anything under 10 miles. And you’ll take the bus for anything over 8-10 miles. These choices not only reduce your footprint on the earth but they increase your chance of living disease-free.

Your monthly transportation budget is something in the $5-10/month range. You can do the majority of work on your own bicycle. You have solid tires so as to not have to deal with repairing flats. And your bike isn’t made of carbon fiber because you’re not competing in the Tour de France.


You make phone calls for free, taking advantage of the companies which collect all that free data off of you, Google or Skype or Whatsapp. That’s how you send text messages, make phone calls, and make your cameo.

You don’t have Spint, TMobile, or AT&T. You can’t justify paying for the name. You instead have Ting or some prepaid plan. And as soon as you can’t justify having cell service, you’ll cancel it. You’ll still carry the phone but will use free WiFi.

You’ll ask your neighbor if you can use their WiFi and pay half the cost. If that fails, you’ll ask them if they’d like to pay half of your bill if you establish service. If that fails too, you’ll shop around for the 3 MB plan which is just enough to watch some YouTube and check your email.

Kitchen Equipment

Matching plates and silverware and cups are great for the White House or in other aristocratic situations. You just want to not have to eat off of your table, if for no other reason than the excess water needed to clean up the mess.

You have 2 sporks, 3 mason jars, a couple of camping plates, a metal cup which can be used as a pot, and you have one wooden spatula. There is a frying pan and a larger pot. You don’t have a sieve, no commercial grade blender, no food processor, no spiralizer.

The ultra frugalist doesn’t like owning shit because anything you own requires upkeep, storage, repair, and has to be carried from one destination to the next.

They are still baking amazing fucking bread! But instead of the bread maker they use their stainless steel frying pan which has metal handles and a thick copper bottom, perfect for the oven and the stovetop.

Gym Membership

The ultra frugals don’t have a gym membership. That’s the kind of luxury you spring for once you are financially independent. After all, that’s what all of this is about – getting to a point of self-sufficiency after which one can loosen the reins.

Should this ultra frugal person choose to have a gym membership, it’s probably because it helps them be more efficient during their working years. They can head straight to the gym after work and shower there. They’ll pay one single annual payment for the membership and forget about it.


There is nothing inherently wrong with dining out except for the shit quality, the insane prices, the wasted food, and having to tip. It’s a manufactured experience which the ultra frugal person doesn’t care for. Sure, they would love to sit at a calm cafe and order a delicious and healthy sandwich but it’s damn near impossible to find such a place in the US.

The amount of salt and burnt oil, the cost of the dish, the pressure to order a drink or dessert, the lack of options for something organic – all of this makes the dining-out experience a chore and less of a treat.

In the kitchen this person has 5 basic spices which they might change from time to time. Brown rice, lentils, beans, and whole wheat flour. Loose passion flower and chamomile for tea. They have a few bags of frozen spinach and broccoli and mushrooms. Everything else they get from their grocery store.

Not much dairy or meat is consumed for the sake of health and the fact that good quality, organic options would be costly.

They don’t have alcohol in the house and don’t have a drinking habit because it adds to the cost of socializing. Explaining to someone that you don’t want to pay $14 for a glass of wine is much harder than just saying that allah forbids you from drinking the devil juice.

The Library

Supporting authors is crucial so that we can ensure more progress in literary arts. It’s one of the best way to support the great thinkers of our time who wouldn’t do well in the traditional employment setting.

Fortunately, knowledge is valued very highly in our American society. That’s why we have access to free books for which we all pay directly through our taxes. So it’s sort of free but not really. Either way, it’s something the ultimate frugalist takes advantage of, until they get to that point of financial security where they can support their favorite authors by patronizing their work.

Buying Used

People find it gross to wear used clothing which has been washed. They are comfortable walking with their shit-stained shoes all over their carpet and floors – but damn, used clothing, gross!

It’s not an easy disgust to overcome but this person can do it. After all, they happen to be a doctor, they’ve had their fingers in far worse. They overcome their negative feelings by reminding themselves that they are doing something good for the world, extending the life of an item that otherwise would end up in a landfill.

By doing so, they gain a new appreciation of quality. They understand what items are well-made and what would be considered cheaply made shit which won’t even stand up to a verbal insult. This helps them make better purchasing decisions in the future. And they’ll pay it forward by donating or selling their used stuff in the future to the same organizations. Cycle of life.

We buy used cars and used houses. Why not used headsets, phones, laptops, and socks? The more people who choose to buy used, the more manufacturers will have to take the longevity of an item into consideration. Of course, the minted price will reflect it but so will that company’s profit margin. And they can add ancillary services such as repair services, and replacement parts, and allow for upgrades. Planned obsolescence is so 1980’s – vote against it with your dollars.


US healthcare is rather advanced. But as an industry it only benefits from a higher disease burden. After all, you don’t pay when you’re healthy, you pay when you’re sick. And even though medications are supposed to make you healthier, the logic is that you still have to pay for them. Oh, and if you get a side effect from one of these medications or treatments, you have to pay for that visit as well.

Ultimate frugality vets the value of a service against its cost. Healthcare is health so why pay for the former when you can have the latter for mostly free?

In fact, it cost more energy and money to become unhealthy. You have to eat more processed food, which is more expensive. You have to eat a larger volume of food, also more expensive. You have to live in a polluted city which is usually more expensive than a less populated one. You have to pay for a car which keeps you hostage during your commute.

Fortunately, you’re a doctor. So even though you’ll play the game, you’re not drinking the Kool Aid. You realize the irony for having to pay for a published journal article when researching a topic. It’s not like you’re buying a book. You’re not buying a rap song by Biggy. It’s as if there is a monopoly on medical knowledge. After all, would you want the public to know that 90% of the data on the health benefits of nuts comes from research funded by the nut industry?


My motto is that your home isn’t just the roof you sleep under. It’s your neighborhood, your community, and the people who make up your little village.

Sure, if your neighborhood sucks then you have no choice but to lock yourself into your house. Not like you can just go for a comfortable stroll and chat with neighbors. Not like you can pick up a baguette around the corner for 70 cents. You rush down the stairs, into the sterile garage, into the car, stuck in traffic, past a toll-booth, into another garage, up some more steps, and into your cubicle.

Fortunately you can choose your neighborhood, your city, your state, and country. If you’re an American then you’ll likely spend your working years stateside where income is high and working conditions unmatched. But you’ll choose the kind of state which is favorable to your profession. And you’ll live in a city which is student friendly. And you’ll choose the neighborhood which has a high walking score.


Whether you buy or rent makes no difference because you view your decision as a value decision. You know how to find a good value rental in any city and you’re willing to pay for the right real estate if it makes for a good investment.

The end-stage frugal person might buy a 3-br house and rent out 2 rooms. Or they’ll rent a tiny studio close to work. They aren’t looking for their dream home, they are making a good economic decision first. They will be able to buy their dream home eventually, if that’s important to them.


You don’t dislike your life so you don’t feel the need to escape it. You like where you live and what you do. It’s all part of a bigger plan. Sure, some will warn you that life is meant to be lived and that if you just keep saving for tomorrow and tomorrow never comes, you’ll be sorry. In which case you can reply that there would never be any doctors if students weren’t willing to trade their present for a future.

Instead of sprinting through a city and snapping selfies by a monument, you choose to live in other countries. In Thailand for 3 years, perhaps. Then off to Spain for a couple of years. And then back to the US for a decade. Then Canada and New Zealand.

5 replies on “Ultimate Frugality”

What are some cities you would recommend for people that don’t want to have a car, want low taxes, and want to be able to walk to the grocery store and nightlife?

I’m thinking Miami, Las Vegas, or Seattle. Possibly NYC. I’m getting ready for the match, and I’m sure I want to live somewhere that I don’t need a car, just don’t know where exactly yet.

Would you happen to have other suggestions?

Congrats! I ended up not matching but was surprised to see so many good options with the scramble and landed the Family Medicine residency at UCLA.
As for cities, look for these common facilities nearby:
-public library
-grocery store
-bus/train stops
I like Miami, very doable. Vegas is also good, decent public transport. Atlanta is tougher but you can find good pockets. NYC can be done but the public system is far too congested to make it feasible for someone in residency – though I’ve had friends who managed but usually with a car. SF and Oakland can be doable – pretty good public transport.
Check out the walkability score for each city.
Look on urbanplanning and lowcar subreddits to see what cities people recommend there.
Austin can work.
AZ is impossible.
San Diego is nearly impossible.
Some parts of Colorado are very well connected.
I think I heard that Salt Lake City is a possibility – dunno.
Check out each city individually. It’s better to pay a little more in rent and be positioned in the perfect location and that way you’ll save a ton on not just the cost of owning a car but parking tickets and parking meters and parking permits and broken glass and flat tires and everything else shitty that comes with owning a car. Buy yourself a solid Brompton Electric or any other electric bike and you’ll be flying up and down any hill or street.

Thank you for the suggestions! Didn’t even know that lowcar was a thing, that sounds like it will be a fruitful subreddit to explore.

Hi Dr. Mo, I just fell over your blog when I was researching “telemedicine hacks for physicians”. So refreshing to read your thoughts. I have been practicing family medicine for over 15 years and have always been frustrated with the work/life balance juggling act and find in your words a kindred spirit. Thank you for your inspiring blog. I am finally finding my way and try to live by the words “it’s never too late to be what you might have been.” Thank you!

Happy to hear that from you Jenny. I tried a lot too and don’t feel like I was able to ever figure out a good balance. But I’m so much happier now especially because I need less income and can do the kind of work I enjoy doing.

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