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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From independence to interdependence

Aug 12, 2021

As part of the social maturation process, we humans grow from dependence to independence to interdependence.

Professionally, this is also true as we progress from medical students to interns, residents, fellows, and finally, full-fledged clinicians.

Yet, intrinsic to our training is a high level of elitism, skepticism, self-reliance, and a “trust no one” kind of attitude. Unfortunately, many of us get stuck in the independence stage, becoming quite dysfunctional when the world expects us to be interdependent.

Organization-wise, this causes wastage, friction, resistance, obstruction, dispute, and even potential harm to the patient or the clinical entity!

As covered previously, modern-day practitioners can no longer afford to be lone wolves anymore. It’s high time we evolved to be effective team players. 

Here are some hallmarks of mature interdependence:

  • “I serve us so we can serve others” mentality
  • Confidently vulnerable
  • Being OK with what you are...
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Outsourcing less to strengthen your children

Aug 05, 2021

For those of you who have known me personally over the years or attended our live events, you will be familiar with my constant praise of outsourcing.

And as a two-doctor family with four children, we’ve done a lot of it over the years to keep the household and our practices running.

Yet what the pandemic taught me is that our needs evolved.

Now that our kids are older, they can (and more importantly, should) do more.

Janette and I want our children to be independent and resilient hustlers like their parents. But we realized that it won’t happen if daily life is always handled for them.

We need to prepare them not only to live with less money but to be happy in the way we were – broke and driving a $400 car.

So, in addition to talking to the kids about independence and living on a budget, we teach it.

I’m proud that our teens readily scrub bathrooms, cook, change oil on the vehicles, work in the family businesses, and take flights independently.

These skills...

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From 100% of 1 to 1% of 100

Jul 29, 2021

Decades ago, one of my mentors asked me, “Would you like to make 100% of one person, or 1% of one hundred people?”

That question caught me by surprise. I was working around a hundred hours weekly as a solo practitioner, so I knew all about “100% of 1”. But “1% of 100”? I couldn’t even fathom it! What did it mean?

It’s all about leverage.

Archimedes said, “Give me a place to stand and with a lever I will move the whole world”.

In the worlds of manufacturing, finance, real estate, and franchising, there are numerous leveraging success stories.

In healthcare, we’re faced with radical cuts and dwindling resources while clinical and administrative responsibilities rise. Practitioners need to evolve and learn to leverage other teammates' time, effort, knowledge, expertise and technology.

The old adage of “if you want something done right, you gotta do it yourself” is not only obsolete, but detrimental to...

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Bad debt drains life’s energy

Jul 22, 2021

In an earlier posting, I wrote how debts can be a choice. Today I’ll explore the mental toll that bad debts take.

When it comes to issuing debt, banks use formulas based on occupation, income levels, and existing obligations to determine whether a borrower is a safe bet.

And often, doctors are given whatever they request.

But sustainable debt has less to do with numbers and more to do with your mindset.

Because most of us have one, I’ll use the example of a mortgage.

In some markets, it can consume 30% or more of gross billings.

It gets worse: Remember that payments reflect after-tax earnings in top brackets. Your $5000 per month mortgage is now more than $8000 of earned income.

Worse still: you’re paying large personal tax bills just to cover additional thousands in property taxes.

So, is this debt a joy or a burden?

Here are the real questions to be asked about bad debt:

How many clinical hours per month (or years in my life) will I have to work to pay off this...

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From fear to faith

Jul 15, 2021

Fear is an innate instinct to protect us from danger, but it can also be a learnt or conditioned response to less harmful situations (e.g., heights, public speaking, social settings).

Fear of the unknown is a powerful deterrent and roadblock to the path of greatness, personally and professionally.

FEAR equals False Evidence Appearing Real.

With closer examination and confrontation, a lot of such irrational emotions can be chased away like dark shadows in bright light.

How does fear paralyze us? It’s a mental process where our minds fast-forward the worst scenarios, playing them right now.

What about faith? It’s a mental process where our minds fast-forward the best scenarios, playing them right now.

In essence, fear and faith are the same mental process, just one being negative and the other positive. So why is fear so much more prevalent than faith?

It has to do with our natural bend towards negativity versus positivity—like saying “it’s too good to be...

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