Investing, physician, Physician Training, retirement, Uncategorized

Why Physicians Make Big Financial Mistakes….and Should They be “Firing Their Financial Advisor”?

I am not a financial advisor, so please do not make any financial decisions based on anything I write. However, I am a physician who retired early after achieving financial independence and many readers have reached out to know more about this.  In the latter half of this article I also review a popular new online financial literacy course geared for physicians from the “White Coat Investor”  “Fire Your Financial Advisor”

Probably like you, I remember having an investment firm invited to speak at our residency program. They discussed the benefits of own occupation disability and offered a discount to residents wanting to sign up with their firm. I also remember them talking about managing portfolios. I opted to sign up for the disability coverage and continued with this for a few years until I had adequate coverage through my attending job. At this time, I canceled the plan. I never did use them to manage my money.

I since found out that this same group speaks to many residency programs/hospitals in the surrounding area. Makes me wonder, how did they get this monopoly of a captive audience of fledgling physicians?  Is there some incentive to the programs for allowing them to speak to their residents?  I don’t know the answer to that.  Regardless, it makes me nervous that many physicians aren’t getting good/fair advice relating to finance.

business-2089530_1920

Why are we talking about finances again? Its important to everyone, and it doesn’t get enough attention with physicians who are more focused on patient care and family time with little left for anything else. With medical student loans, yet also high income potential, every physician should care about finance.

My goal in discussing these topics is NOT to have physicians leave medicine early by retiring early. However, a benefit of financial success is the ability to have control over your time- and I have found time to be the most precious commodity after a health scare read more here

You may be hearing about the massive rally going on in the stock market and wondering if you are missing out. You may have worries about student loans and whether you should agree to a “doctor loan” when buying your first home.

There are so many financial topics that are specific to physicians but, yet as a group, we do not have the training or interest in managing our own finances to allow us to pay off our loans, fund our kid’s college education, or book the vacation that provides the life experience with our families that we value so much.

Most of us don’t have time to learn in depth analysis of stocks or to research different real estate investment opportunities. Unless you have a specific interest in this, I wouldn’t recommend it.

However, as high income earners,  we make big mistakes by leaving an enormous amount of money on the table by not having a basic understanding of retirement savings plans, and the importance of a financial plan for your family.  It is dry, and sometimes painful, to get a better understanding of these things but I promise its worth it.

You may be investing in CME conferences for your career, reading new journal articles, and paying for an “Uptodate” subscription every year. These are all good things to continue advance knowledge in your medical career. Just don’t forget to invest in yourself and family too.

I wish I could say I was able to retire based on my physician income alone. Its just not true. Unless I had completely maxed out all retirement vehicles early (including while a resident), minimized loans (both student and mortgage), lived modestly, and invested in the stock market, it just wouldn’t be possible. However, your income as a physician puts you in a place where you should absolutely be able to retire when you want to if you make prudent financial decisions.

Take the time to make a financial plan. Read a few books or take a course. It will be worth so much to you over the years and well worth your time investment. Its not fun, but crucial. And no one in medicine will tell you to do this.
End of rant.

In full and complete disclosure, I was approached by the creator of the “White Coat Investor” to give feedback and take his new online course to see if this was something I thought would appeal to my readers. If you end up buying the course through my link, I will get a small portion of the cost for the course (without any additional cost to you- the price is the same regardless).  You can take as long as 7 days to determine if you find it worthwhile, refund is available if not.  WCI “Fire Your Financial Advisor” Course

 

WCI Course _4

I am definitely not running this website as a principle means to make money. This is a hobby for me, but it does have administrative costs. So, if you are going to buy the course for the same price anyway and my review/link helped you decide to do it, I feel it is a win for us both.

All that being said, I did the course. Here is my honest feedback:

1. It is boring, and dry. (Perhaps mostly just a function of the material itself, but some variation in how the information is presented would be nice).

2. It is incredibly useful for physicians.

It deals specifically with topics that are unique and pertinent to physicians. If you have tried to read about finance and found books incredibly boring, or if you don’t know where to find all the important information for physicians in one place, it is likely a good fit. Its all done on videos that you can start and stop when you want. I don’t recommend doing more than a few hours at a time as you will start to lose focus.

Some topics (many more available) with their own video segments that I found to have very good coverage that you might also be interested in:

  • What an advisor can do for you
  • What to look for in an advisor
  • Disability Insurance
  • Physician Mortgage Loans
  • Refinancing During Residency
  • Paying off Debt Quickly
  • How Much You Need to Retire
  • Investing in a Taxable Account
  • 529 Plans
  • The Backdoor Roth IRA
  • Stocks, Bonds, and Mutual Funds
  • Why You Need a Will

This course is perfect for people who don’t have time or desire to hang out on investing sites/forums or read tons of books on investing. Can you find all of the information somewhere else (perhaps even free) or other websites/books/lectures? Yes, but you would have to spend an enormous amount of time to track all the information down and compile it. If you want the information highly geared to physicians and spoon fed through videos, this may be a great tool to help you build wealth. The impact over many years can be incredible vs. staying in a static situation where you are doing nothing for your finances.

In the end, my recommendation is to do something. Buy a finance book, hire a financial advisor (after at least understanding the basics of how their fees are collected), write up a financial plan, or lastly buy this course if it fits your learning style. You need to at least know what you don’t know.

This course is expensive at $499. However, if you think about the yearly amount you would pay to an advisor or the amount over the years that you could accumulate by having a better understanding of personal finance, the cost is pretty nominal. In addition, if you are like me, you may be more likely to actually do (and finish the course) since you invested some real money into it. It gives you motivation to complete it as you don’t want to waste that money! Lastly, you can get a refund within 7 days if you don’t find it useful.  I would suggest doing 2 hours every weekend for a month.  If you commit to that you will have a huge improvement over where you are today.

If you are interested here is the link to check it out:

WCI Course _2

White Coat Investor: “Fire Your Financial Advisor” Online Course

By the way, I think financial advisors are generally good people. I even have a close family member who is one, and their expertise cannot be replaced with a single course. The title is a little provocative and misleading because you very well may still benefit from using a financial advisor, but you should know how to pick one and determine how they can best help you. You will get advice on this in the course too, and it may save you a lot in the long run. Ultimately, even if you use an advisor you should have a basic understanding of how things work so that you aren’t taken advantage of by a small minority of bad ones (especially those trying to sell you whole life insurance policies)!

I hope you don’t mind me telling you about this course, but I truly do feel it could be very beneficial to many physicians- especially those in medical school, residency, or 5-10 years into their career. And to answer whether you should be getting into the stock market, the answer is yes! But don’t do it blindly. Whether that is through a 401K, taxable brokerage account, 529 for your kids, etc. depends on your financial situation but you should be making your money work for you instead of relying solely on your paycheck.

If anyone else has tried the course, help our other readers out and let us know what you thought in comments below!

Advertisements
OB GYN, physician, Physician Training, work hours

The Wrist Band Challenge: A Safe “Strike” Against Unsafe Working Conditions That Can Harm Patients (and Physicians)

My shift had finally ended. As a second- year resident, I was driving home after 30 hours awake straight. During this time, I delivered several babies, performed a cesarean section or two, a couple of circumcisions, rounded on many patients the following morning, triaged new patients, and taught medical students. Never during that 30 hours was a 5- minute nap possible; clinical load would not permit this.

I couldn’t wait to get home at the end of the shift as I was completely exhausted. So, I buckled up and prepared to drive the 20 minutes home on interstate 95 so that I could finally get some rest before my next shift started less than 24 hours later.

I could feel my eyes starting to droop as I was driving. I turned the radio up loud, drank a big gulp of my hot coffee, and rolled down the window. I had done this many times previously after these long shifts and had figured out all the tricks to make it home safely, or so I thought.

I must have not been able to fight off my increasingly heavy eyelids, because I woke up suddenly to the jarring bumps on the side of the road- intelligently placed to wake up drivers such as myself who may be drifting out of the lane. This startled me, and I turned the wheel hard to get back on the road. However, I overcompensated, confused, and dazed from no sleep, and spun around 180 degrees so that I was facing the opposite direction of traffic on the interstate. I slammed into the wall of an overpass and my car came to a sudden and jolting stand still.

 

crash-test-1620604_1920

My heart was racing, my hands were shaking, and I tried to get my bearings to understand if I hit someone, or if I was still in danger and needed to get out of my car. I quickly got out, unbelievably unharmed (and miraculously no one else either) and called my husband with trembling hands. I was only 5 minutes from home.

A man with his wife and children in the car quickly pulled over to see if I was ok. He could see how shaken I was an offered to sit with me until the police and my husband could make it.

My car was totaled. I walked away fine, without a scratch, but with a new understanding of the inhumane conditions expected of physicians.

Ultimately, I believe patients have the right to know if they are receiving care in optimal situations that promote safety and decrease preventable medical errors. Physicians have an incredibly strong, important and powerful ally in our quest for humane working conditions- our patients.

We’ll call it the wristband challenge. It works like this:
Physicians take call for any varying amounts of time. I propose physicians start wearing rubber wristbands (like those commonly seen promoting the “LIVE STRONG” campaign) signifying to their patients how many hours straight they have been responsible for patient care without a break

 

Green: 0-24 hours
Yellow: 24-30 hours 
Red: 30+ hours

                                                                                                                      
Think this could never work, or that nobody would do this? Guess what, its already been done. Please see how the South African Medical Association came to bring this project to fruition in their country. https://www.samedical.org/campaign “The SAMA campaign makes it easier to identify doctors who have worked longer hours. It is also a visible reminder that South Africa should employ more doctors to manage their workload”.

wristband

This is a way to promote transparency with patients. They should have a right to know if their obstetrician is on their 30th hour awake and about to deliver their first born child. Or if their physician is admitting their father with congestive heart failure and writing detailed medication orders without sleep for over 24 hours.

Physicians want to have humane working conditions that promote patient safety, but it is complicated for a profession such as ours. We have been told it is illegal to form a union. We are threatened that going on strike puts patients at risk. We can’t just all walk out of an ER at the same time, and therefore we don’t, out of respect for our patients and concern for their well-being. However, this puts us in a trap of beneficence where “do no harm” compels us to continue working in unsafe conditions not only for our patients but for ourselves.

A physician can wear their wristband and not have to fear speaking out or arguing with an employer or worry about being labeled a “trouble maker”. If the bands become standard, hospitals who are employing safe practices can use this as a bragging tool that their physicians are well rested and rightfully claim to be advocates for their patients. It is a silent tool of protest for physicians who will continue working without going on physical strike and allow our patients to do the fighting. In the end, it is the collective voices of our patients that matters most and will get the most promise for change to a dysfunctional system.

As a patient you may ask, “well, why don’t you just not schedule yourself for more than 24 hours on call”? If you are a physician in private practice you can. However, the trajectory of medicine now has more physicians employed through a hospital or HMO. The loss of autonomy in these positions does not allow a practicing physician to dictate the amount of time on call thought to be “reasonable” or “safe”. This is especially true for resident physicians and medical students who are bound by their teaching programs rules. Importantly, the number of residency spots has not sufficiently increased each year to allow for enough doctors to fill in the patient needs that continue to increase in number.

Up until now, no hospital or CEO of an organization wants their patients to know how long their doctors have been working straight. It isn’t posted on websites like C-section rates, repeat hospitalization rates, or complication rates. The government isn’t mandating reporting this statistic that directly impacts the safety of patients AND physicians. Perhaps if the public knew and could see first-hand, in real time, the types of hours the doctors caring for their family members were working, they would demand change.

It would no longer be an abstract concept. I don’t blame current residency programs- they are simply trying to meet patient needs with the limited number of physicians employed to fulfill this demand. This would mean increasing the number of residency positions so that we have enough doctors to provide required care. This in turns means there needs to be increased funding for residency positions from the government.

we can seek meaningful change in our profession without going on “strike”. Patients will see wristbands turn from green to orange, and ultimately red. Patients will begin to speak up. Not only out of concern for themselves, but out of care for their physicians.

We remain a team, with health and healing at the core of our mission. With enough help from our patients I do believe we can see a change in the culture of medicine. I believe this should start with our teaching institutions and residency programs that are treating our most vulnerable of patients.

Uncategorized

Taking Risks: Getting Comfortable in an Uncomfortable Spot

It’s hard to believe it has been one year since I retired from medicine.

It was a big leap to make that decision and a scary one at that. However, if I have learned nothing else over this past year, the one thing that has proven itself over and over is the value in pushing myself into uncomfortable and unknown scenarios.

Fear of failure has held me back from opportunities in the past. I think most people can agree with this statement. We may make excuses for why we didn’t apply for a certain job, try a new fitness class, or learn how to invest. In addition, it’s easier to stay where we are in the comforting cocoon of understanding the “rules”. We know what to expect and what is expected of us. It makes us anxious to go into an unfamiliar setting.

My goals for 2018 will include pushing into more unknown but exciting endeavors. I may certainly fail, but I’ve learned to be ok with that.

Some positives from the past year:

1.  Writing

It was terrifying to put my first article on a public forum, but I attended a writing conference that pushed me to try it. Since I wrote that first piece, I have since started a blog (accumulated over 260 Regular Followers- thank you readers!), accepted a position as a Doximity Fellow (I am a contributor for this “Linked In” for physicians website), wrote a couple of guest posts for other websites, was interviewed for 2 different podcasts

http://www.doctormoneymatters.com/episode-17,

thumbnail

(Link up today for “Doctor Money Matters” Podcast! This physician led podcast is more finance related, so if interested- please check it out- and follow his podcast!)   This is something new for me- pushing into an unknown again, hoping I don’t sound too foolish…

…. Lastly, I had had several interviews with reporters leading to quotes in articles published on Yahoo News, SELF, and STAT regarding topics important to me in health care. It still seems crazy to think that one year ago I had never written anything! Apparently “good things happen to people who write” as a wise person once told me.  If you ever thought about writing or have something to say, Go for it.

2.   Coaching a youth sports team.

Sure it may just be 4 year old girls soccer, but its harder than it looks to keep 4-year-olds entertained for an hour! Plus, I haven’t played soccer in over 20 years. This was a fun endeavor that both my daughter and I enjoyed immensely.

3.   Investing.

I jumped in head first, all while soaking up as much information as I could. It proved to be a lucky year to get involved. I would encourage other readers to learn about the stock market and get the courage to learn about something new, like personal finance. It can be quite empowering and beneficial to your ability to retire early if you so choose.

Some failures:

You may remember from my post back in May, soon after retiring You Retired From Medicine- Now What? ,where I where I discussed wanting to learn how to cook. I really did try but haven’t quite figured this one out. Perhaps its just a lack of passion but when it comes down to it, I really don’t like cooking. I have been unable to manage to make more than 1-2 homemade meals a week. We still tend to eat out way more often than we should, or my husband will sometimes cook. Until I can get 5 people on the same page about whether to eat steak/salmon and broccoli, as opposed to dinosaur chicken nuggets, I just don’t think it will happen.  So, macaroni and cheese/pizza/nuggets it is for now!

Plans for the future:  hold me accountable!

1. Continue my quest/love for travel. Scheduled for 2018 so far:
I’m a big believer in the value of experiences instead of things…

Orlando, FL (Disney World with the kids)
New York, NY (“Frozen” on Broadway with my oldest),
San Francisco (conference)
New Orleans (celebrating a friend’s 40th)
Boston (conference),
Punta Cana, Dominican Republic
Kiawah, SC
Outer banks, NC

2. Continue learning more about finances/investing.
On my book shelf:


3. Grow the blog
I will have a regular posting schedule in the future- expect more content!

4. Continue to speak my mind regarding Health Care in our country and topics of importance to both physicians and patients.

I’ve learned that the more risks you take, the easier it becomes. So, this year I will be pushing the limits even more. I am not sure what my life will look like 1 year from now, but if the dramatic change from last year is any indication of the unpredictable twits and turns life can take, I know one thing for sure- I have no idea where I will be.

I would love to hear what risks you are thinking of taking in 2018.  Any ideas?