Debt can be good

Oct 21, 2021

In previous discussions, we talked bad debt.

Today, we’re covering good debt.

And no, I won’t be trotting out the old adage that educational debt and mortgages are always a good thing. 

It isn’t true and it isn’t relevant. These debts are only a small part of a doctor’s relationship with borrowing. Let’s dive into something deeper. 

Using a simple example of two physicians, let me show you how debt cuts both ways over the course of a decade.

Case 1:
Frank takes out a $100,000 personal line of credit which he promptly maxes out on consumer purchases and never pays off.

Assuming a $3000 annual cost, the LOC has cost Frank $30,000 over the decade.

Worse still, he had to pay additional personal income tax to cover the annual interest by withdrawing these funds from his corporation.

Case 2:
Yasmine came across great opportunities in real estate limited partnerships (RELPs).

To avoid missing out, she decides to use her LOC to cover household...

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Leading with civility: Part 1 of 4

Oct 14, 2021

(Over the next two months, I’ll be sharing a series of posts on the topic of civility.)

I just attended the Global Leadership Summit 2021 and a particular quote struck me:

“We’re defined by how we treat each other.”
Shola Richards - Founder & CEO, Go Together Global; Workplace Civility Expert)

Why bother with civility at work? 

A recent survey showed that when workers were ill-treated by their co-workers or superiors:

  • 25% took out their frustrations on customers
  • 48% intentionally decreased their work effort
  • 78% dropped their commitment to the organization

In medicine, our work culture is so entrenched in accuracy, efficiency, elitism, and intolerance of the slightest errors that we tend to treat ourselves and each other critically, harshly and without grace. No wonder so many frontline healthcare workers—especially in high traffic, high-stress areas like ER, OR, or inner-city outpatient departments—have the reputation of being rude,...

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How to say “no”

Oct 07, 2021

Previously, I shared the power of saying “no” and why we should all be incorporating it more into our personal and professional lives.

Now I would like to explain the how because it isn’t easy…

As I mentioned before, physicians are inherently conscientious. Our first reaction is often to agree to a request without a second thought. We do this because we know that others’ look to us for help and leadership.

But as we realize the importance of the word “no”, we need to use it properly. And despite our fears of alienating others, this honesty brings us closer with colleagues and enhances the therapeutic relationship.

So here are some useful strategies:

  1. Live and practice with intention. You are saying “no” because you mean it.
  2. Never apologize. You are doing the right thing for you and the situation. You have nothing to apologize for.
  3. Be gracious. If it’s true, reply that you are honored to have been asked. Offer to help in...
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It's about to get ugly

Sep 30, 2021

As I write these words, Alberta is approaching a crisis in the pandemic: We are running out of ICU capacity.

For the first time in my career, I am preparing to triage critically ill patients to decide who receives life support. This was not something I ever expected to encounter.
Yet during these times, I reflect.

Today I was reminded of the wisdom of one of the greatest athletes in history – Kenyan long-distance runner Eliud Kipchoge.

Mr. Kipchoge rarely trains at full capacity. He saves his 100% for when a title is on the line.

Over the next several weeks, I will be working at my 100% to serve my patients.
I will be tired but not burnt out because, for years (not months), I have been at working at a healthy pace. Wellness means caring for yourself first. It means living with intention.
But now it is time to step in and get the work done.

I am confident our great province will come through the pandemic. I am confident in the work of our incredible nurses, physicians,...

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From top gun to team captain

Sep 23, 2021

Finishing your residency training is like finally graduating from the US Naval Strike and Air Warfare Center as the top gun.

You might indeed be the best air-fighting pilot out there, but in the war zone, you and your team have to fly in formation, dodging perilous fires while trying to shoot the enemies down.

Now, in everyday medical practice, there may not be as much of an adrenaline rush—except maybe during codes—but we’re definitely not flying solo (not even in a solo practice!).

Being team captain vs. top pilot is undoubtedly quite a different game altogether—something our traditional medical training under-equips us for.

It’s a long and painstaking process to go from being a “me” thinker to “we” thinker, and as the team leader, mobilizing your entire team to progress through the metamorphosis can be a daunting task!

Here are 5 stages of evolution along the “Me-We” continuum:

PRONOUNS

KEY ISSUE

...

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Debt and choice (Part 2!)

Sep 16, 2021

Last month I went through the first three of six quick wins on your path to avoiding consumer debt.

Now I want to share three more of my favorites:

1. Opportunity Cost.

How much would this $50,000 be worth if I bought more real estate/equities with it instead of a new vehicle? (This is why I’m still driving the same truck five years on).

2. The Tax Bill.

As an incorporated professional, you have the choice to withdraw personal income at top marginal rates or keep it within your corporation to invest. Over years and decades, the spread can be astonishing.

3. Life Energy.

My favorite and the last line of defense! How many hours of my life energy will I spend in clinical work to pay for this? Often when I ponder on this one, I’m out. The big purchase never seems to be worth the night shifts.

 

 

While each of these facets appear small, they can add up to accumulated wealth of millions over the course of your career.

 

More importantly, reduced spending...

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From critiquing to good-finding

Sep 09, 2021

A Harvard Business team found that from a database of 50,000 leaders, both positive comments and constructive criticisms were important in promoting team success.

While criticism was most effective in correcting serious mistakes, praise worked better overall.

Positive comment examples included: “I agree with that,” and “That’s a terrific idea”.

Negative comments included: “That’s a dumb idea,” and “Why would anyone even consider doing that?”.

The praise-to-criticism ratio was 5.6:1 for top-performing teams, and 0.36:1 for low-performing ones.

Incidentally, this finding is echoed by a study on wedded couples’ likelihood of remaining married, with the optimal ratio being amazingly similar at 5.0 (vs. 0.77 to 1.00 for the divorcees).

In medicine, our high standards of accuracy and low tolerance of mistakes make us harsh, even difficult bosses.

You may find it hard to utter wholehearted compliments unless someone does an...

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Outsourcing Less and Getting Lost in Your Thoughts

Sep 02, 2021

Previously I explored how the affluence of a physician household can make life too easy for kids.

But there are negative effects on us too.

The pandemic forced us to dial back some of the outsourcing and I felt happier in unexpected ways:

I was more physically rested. As net cashflow improved, I worked fewer shifts and my patient volumes fell again this year – which left me feeling my best in years.

Interestingly too is that other, unrelated household costs also fell: Gone was much of the impulsive meal delivery, consumer purchases, and over-priced “service appointments” at the dealership.

At Physician Empowerment, we don’t talk just money, we talk hourly rates. By reducing costs, I was working fewer clinical hours (and using less of my life energy) to pay the bills.

But shouldn’t the extra work create its own fatigue?

Actually, it didn’t.

Another realization I came to in this process is that much of the exhaustion of medicine isn’t the just...

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From mending weakness to fostering strength

Aug 26, 2021

Many of us grew up heeding criticisms and corrections from superiors while downplaying praises (lest it go to our heads).

As such, we gravitate towards negative comments on ourselves.

Studies on work evaluations have shown that employees recall more negative comments than positive ones, in the ratio of 4:1. We can probably recall all the feedback and countless rebukes on how we underperformed during our long, gruesome training days.

But we’re not referring to basic levels of competency for safe practice here—in real life, many shortcomings are more personality-based than aptitude-based.

Research has shown that focusing on mending one’s weaknesses seldom yields impressive bottom-line returns compared to companies focusing on identifying and fostering employee strengths.

We as medical professionals already have very high intrinsic standards; atop numerous professional evaluations, peer reviews, and public scrutiny, we ourselves are the worst critics.

Maybe it’s...

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Debt and choice

Aug 19, 2021

In an earlier post, I alluded to the notion of choice in most consumer purchases.

Below, I’ll briefly highlight the first three strategies I use to avoid consumer debt:

1. Cash, Paper, Scissors

Cash always wins. At Physician Empowerment, we emphasize that cash reasserts control over personal spending by forcing us to evaluate the true cost and triggers an important mental pause in that path to buying.

2. Now or Never?

The sacrifice of becoming a physician is one of modern society’s biggest exhibits in delayed gratification as we forgo countless hours, lost income, and youthful energy to reach careers that start well into our thirties. If you’re a doctor, then you’re a pro at delayed gratification. So go ahead and give it a try with your next big or small purchase!

3. Buy Smaller.

Do I really need this trim level, location, or size of purchase?

Whether your techniques to regulate spending are similar to these or different is irrelevant.

The key message is...

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