Physicians need to ask the “dumb” questions to gain financial security

Feb 10, 2022

Everyone thought I was crazy. My preceptors and fellow residents shook their heads and laughed.

“That doesn’t make sense.”

“What’s the rush?”

But I didn’t laugh. I was broke and stressed about money.

With three young children and my wife years away from completing her own residency, I was in a rush to pay off our $300,000 in loans.

My accountant didn’t laugh either. He thought it was a great idea.

I incorporated it before my first day of practice.

Then using dividends, I rapidly paid back those loans.

And it all started with the “dumb” question I asked my accountant.

The questions you don’t ask, you don’t get answers to.

As physicians, we are intellectually minded, competitive, and perfectionists.

These traits can propel us to great heights in our careers but can limit our ability to ask “dumb” questions.

It isn’t easy to ask hard questions or the ones that make us self-conscious, but they are...

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Outsourcing: The secret to physician well-being

Feb 03, 2022

Earlier I wrote about how your hourly rate can provide great clarity in how you spend your life energy (time) working to earn.

Outsourcing, when done properly, can greatly improve your personal and financial health.

By stepping back from the most technically difficult or frustrating tasks, we save our energy for key priorities or enjoying life.

It is not possible (or desirable) to outsource everything. We shouldn’t be completely detaching ourselves from our households or practices.

3 key criteria to guide outsourcing choices

But when it comes to making the right choices, here are three key criteria to guide you:

  1. Always outsource critical tasks like accounting and bookkeeping.
  2. Outsource the things you dread. If you hate cleaning your house, you’ll spend more time dreading it than if you just went to work to pay someone else to do it.
  3. Apply outsourcing principles to your tax planning. I’ll share an example with you below:

Realizing how busy she is in her practice,...

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How to calculate your (real) hourly rate

Jan 27, 2022

I don’t price the purchases in my life in dollars. I measure these costs in time.

Before I buy something, I quickly calculate how many hours (a small consumer item) or years (a house) I will have to work to pay for it.

This regularly forces me to think in very concrete terms about how I am using my time and life’s energy.

The base formula is simple:

In what is a typical week for you, divide your pre-tax earnings by your working hours (clinical and administrative).

But there is some subtlety here as you will need to adjust for overhead, taxes, and whether the expense is corporate or personal.

Your Hourly Rate takes practice, but I promise that it will be transformative in your everyday life.

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Are you feeling energized or overwhelmed in your work?

Jan 20, 2022

I mentioned in a previous blog post that everything we do in life either increases or diminishes our life energy.

Therefore it is crucial that we constantly reflect on how we spend our time. Even what we allow our thoughts to drift to.

Our careers are nuanced in this regard.

We all have elements of the job that are less desirable.

Ideally, however, we should be feeling energized in our work. It is great for us and our patients.

But if one is not at that place, then it is crucial we deeply reflect on why.

And here is where I would challenge you to explore whether financial pressure is causing you to labor more hours than you would like or taking on work that is lucrative but unmeaningful.

Is your life energy dissipating to earn money for what might be unsustainable expenses?

In the week ahead, track your work hours—both clinical and administrative—because in a later post, I will take you through a related Physician Empowerment concept: Your Hourly Rate.

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You’re trading more than just time for money

Jan 13, 2022

Typically, I describe time as the most important asset in our lives. But earlier this year, I interviewed Dr. Vu Kiet Tran on the Primary Medicine Podcast and he blew me away.

Vu Kiet highlighted that we are trading more than just time for money. We are spending our life energy.

Looking through this lens, we need to be asking ourselves whether a given use of our personal energy is worth it.

Will this trade be something that adds to the fulfillment in our lives or will it leave us feeling diminished?

Some activities are obvious:

  • Exercise and healthy eating will add to one’s energy
  • Time spent ruminating on the past or in conflict with others dissipates us

Many things, however, are less clear and require some reflection.

The practice of medicine can be deeply rewarding as it is both intellectually stimulating and provides us with the opportunity to serve others.

But there are many stressors—decision fatigue, long hours, the weight of the responsibility we carry—that...

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Show gratitude to your mentors

Jan 06, 2022

Reflecting on my own life, I am profoundly grateful for the numerous mentors I have had. Folks who have taken the time to share their experiences and wisdom. 

What I learned from them has been key to who I am today. 

While I have worked hard to get where I am, much of the credit belongs to the incredible people in my life who have guided me along the way.

But in my younger years, I was brash, overworking, and failed to give enough recognition to my mentors. 

I try to do better now and this is my own quick list of tips on how to honor mentors in our lives:

  1. Internalize the fact that someone is your mentor. Whether you tell her or him this fact is less important than how the acknowledgment changes your verbal and nonverbal communication to convey the respect that is owed.
  2. Respect the limits of a mentor. She or he will not be an endless source of answers across your personal and professional life. They, like us, all have their own challenges and will become uncomfortable...
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Relationships matter

Dec 16, 2021

I’ve previously spoken of the power of narrative in our lives.

By sharing wisdom and experience, we gain understanding that is invaluable yet overlooked in our world of constant knowledge acquisition.

Perhaps one of the most important ways to grow personally and professionally is to have mentors.

People often have a mistaken belief that mentorship—especially in the professional realm—should be formal and involve meetings and specific objectives.

Nothing could be further from the truth.

Mentors are simply folks in our lives who share their wisdom and experience. They may not even have any specific guidance for us. They speak and we grow as we internalize what they are saying.

The next time you are mentoring someone or receiving some good guidance, make that conscious effort to practice gratitude and celebrate the moment. Not just on the issue at hand, but on the simple fact that you have that depth of relationship with someone.

Do you have an example of an amazing...

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Team building secret: Awareness

Dec 09, 2021

Historically, physicians have been “lone wolves”, especially in solo practice or rural settings.

Even in community clinics or hospital settings, we tend to be quite independent, minding our own business.

But times have changed: patient care has evolved to be heavily team-based, coupled with EMRs and virtual care platforms. As the team lead, it’s no longer just about your personal performance: it’s a team production now. 

In essence, the practice of medicine is more like a team sport—each teammate with their specific strategic roles following a certain playbook. Alas, most medical schools and residency programs seldom equip us with such skills.

Once we step into the real world of medical practice, we either conform to conventional practice traditions or we “wing it” based on survival instincts. 

Let’s face it: building or rebuilding a team is no easy feat.

However, awareness is the first step of any great adventure.

As a...

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The power of narrative

Dec 02, 2021

With limitless information on our phones, our world is filled with opportunities to learn knowledge.

But knowledge isn’t the same as wisdom.

Wisdom speaks to our own circumstances. It forces us to ask the most important question in our lives: the why?

Wisdom comes from experience.

And while we grow throughout our own lives, it is important to recognize the power of narrative to transform us.

Narrative is the telling of our personal or collective stories. This can be as formal as the wisdom of an ancient spiritual teaching or as relaxed as a chat with a colleague.

In these dialogues, we access another’s past experiences – their struggles, triumphs, and insights.

Looking at your busy week ahead, find space to access wisdom. Start reading a great book or call and old friend or loved one.

Was there a time or moment when you accessed wisdom in an unconventional or surprising way?

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Leading with civility – part 4 of 4

Nov 25, 2021

(This is the final post in a series on the topic of civility.)

The ultimate test of leadership: if your authority, title, or rank were taken away, would your subordinates still follow you?

It’s true with:

  • Your patients—wonder why they refuse to comply with your evidence-based treatment advice?
  • Your staff—wonder why they fail to comprehend the importance of your orders?
  • Your spouse—wonder why, even when you win the argument, you lose the relationship?
  • Your kids—wonder why they’d sometimes “purposefully” defy your instructions, even to their detriment?
  • Your mentees—wonder why they tune out or argue when you share your seasoned professional insights and secrets?

The fact is:

“No one cares how much you know until they know how much you care.”
- Theodore Roosevelt

Reflection of the day: 

When was the last time you openly praised, thanked, appreciated, recognized, or rewarded your staff, or celebrated success with...

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