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Category: lifestyle

Occupational injuries among doctors are more common than we realize

Posted on May 16, 2016 by SmartMoneyMD

occupational injuries among doctors are common Success in our careers can be defined by a number of criteria. Two of the most important qualifiers in my book include both financial and physical/mental health. After all, your pool of money serves you no good if you are not healthy enough to enjoy it. Interestingly, I came across an article published in the 2010 issue of the Journal of the American College of Surgeons that surveyed health of surgeons. One of the key findings was that 86.9% of respondents reported symptoms of physical discomfort! The group of oncologic surgeons surveyed stated that the bulk of the physical ailments come from cervical spine pain, musculoskeletal fatigue, and vertebral disc injuries.

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This is a frightening finding that is unfortunately true and common. After a long day at work, I come home with various aches and pains. As doctors, we all are subjected to repetitive tasks whether it is operating on patients, clicking through the electronic health records, or simply examining patients. We are all subjected to higher volumes of patients as reimbursement levels decline. I think the stress of our workplace contributes to the physical ailments we experience.

How to reduce the likelihood of injury

The best way to insure your health for the future is to prevent injury. I keep a handwritten list of reminders at my office to help me step back and reassess what I need to focus on, especially during a tough day:

Don’t forget to breathe. This means that no matter how chaotic your workday is, make time for yourself. Take that extra 3-5 minutes to go to the restroom, eat your breakfast, and find sanity. The sky will not fall if you take care of yourself first. If you are ill, then you won’t be able to care for others.
Meditate. Yoga and meditation exercises are great to clear your mind. Sometimes you need that extra 10 minutes in the evening to unwind, clear your mind, and reset. It doesn’t hurt to pause.
Make time to stretch and exercise. Repetitive task-related injuries are most common in the workplace. The best way to prevent these is to reduce the repetitiveness. Stretch. Strengthen your core.
Improve your core strength. The stronger your central muscles are, the less likely you will become injured. Moreover, the stronger you are, the faster you will likely recover from injury.
Find a balance between work and relaxation. If you are a surgeon, limit the number of surgeries that you perform in a reasonable manner. If you are employed by a large corporation, make sure that you have the appropriate negotiation strategy to justify your worth. If you are self-employed, ask yourself how much money is worth it to you. Is it worth risking your well-being to perform an extra few appendectomies? Don’t be so sure.

What other strategies do you employ to maintain your mental and physical health?

(Photo courtesy of Flickr)

When does owning a fancy car no longer seem special?

Posted on May 11, 2016 by SmartMoneyMD

when_does_owning_a_fancy_car_no_longer_feel_special Most of us want to be different. Some like to have the latest fashion accessories or gadgets. Others want to have nice clothing, cars, and houses. Those of us who are financially aware will agree that material wealth does not represent actual wealth—many people who sport the latest Apple Watch may have a net worth substantially lower than what it should be for an Apple Watch owner. In fact, it’s the ones who practice stealth wealth who may actually have the greatest net worth to material wealth ratio.

While stuck in traffic on Highway 101 (“The 101”) last week, I tried to entertain myself by counting the number of luxury automobiles I could see in a ten-mile stretch of highway. It was frightening how many there were: over 50 Mercedes including at least 5 AMG’s, 11 Tesla Model S’s, one Tesla Model X, another dozen Maseratis, one Lamborghini, another 30+ BMW’s, and a similar number of Lexus and Infiniti’s priced over $50,000 MSRP.

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I think that there were more Mercedes than Honda Accords on the highway! In this case, does driving a luxury automobile actually distinguish you from the working masses? Does leasing a 5-series BMW or an AMG even show that you are a class above the rest? I don’t think so.

If you happen to live in a city or region with large numbers of wealthy residents, you might actually be fortunate that you might be priced out of wealth portrayal! If everyone around you drives a Mercedes, Hummer, Beamer, or Tesla, you don’t have many other options leftover to be unique. Maybe if you decide to splurge $2000 a month to lease a Bentley Continental GT, you can join the masses and still be stuck in traffic, but in style.

Likewise, if all of your coworkers wear Loubs, you might not feel unique if you wore them either. I find it to be an interesting phenomenon that the more blatant display of wealth that surrounds me, the less tempted I am to own expensive material.

Hey, it’s not all bad if everyone around you drives a Mercedes. You know that not everyone can really afford one, and you might not be as tempted to own one yourself.

Does this approach to wealth impact you in the same way?

(Photo courtesy of Flickr)

Why I still shine my shoes

Posted on April 29, 2016 by SmartMoneyMD

For a mere $8, I can have my wedges shined at the airport. Sometimes it will cost $10 or $13 after tip, depending on how generous I feel. It doesn’t break the bank, but it sure isn’t cheap either. I suppose that I could take my shoes to a local street vendor and save a few bucks, but that requires going out of my way to make an extra stop before going home.

This is a chore that I’ve wondered whether there is validity in doing myself. I probably have a pair of shoes shined every few months. The problem is that I have a good number of shoes. Eventually the time and costs add up. How much do I need to earn in my primary job to make this worthwhile? Is it $100/hr, $150/hr, or $200/hr? That’s a tough call. I’d imagine that if I can command $500/hr consistently on a full-time schedule, I probably can’t be bothered to polish my own shoes.

But I don’t.

So Shoe shining can be quite simple. All you need is shoe polish, a rag (old sock), and maybe a brush. Go ahead. Help keep your expensive leather pumps looking new.

why i still polish my shoes

Would you be willing to polish your own shoes?

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How much money do doctors really have?

Posted on April 24, 2016December 16, 2016 by SmartMoneyMD

Previously, we discussed examples of how much wealth an average doctor with aggressive saving strategy can will have after working for five years. There were a few comments that the saving strategy was indeed a bit aggressive, but I think that it is clearly doable. Part of the strategy is to become a good doctor, work hard and hustle, and learning to diversify your income stream.

Medscape recently released a survey on physician net worth, and it provides an interesting snapshot of our profession. Head over to Medscape to read all the details. One graph that I found interesting was the stratification of physician net worth by age:

medscape physician net worth by age

I think this survey reveals a few findings that are reassuring and expected from the profession. The “Under 28” category is not surprising. Most of us are still in residency, and either have a zero or negative net worth. I’m surprised that 4% of the respondents actually had over $1 million in net worth. This demographic has inherited money or other unusual windfall.

Under the age 28-34 category, 12% of respondents already have over half a million dollars in net worth! I’d expect these doctors were unlikely to have incurred student loan debt and have entered specialties with relatively short training periods and moderate to high salaries, such as Emergency Medicine or Internal Medicine. Assuming that the average Emergency Room doctor finishes a 3-year residency at age 28, she will start earning at least $300,000 her first few years on the job. Very few other medical specialties will be able to command such a high salary early on in their working careers in such relatively short amount of training.

What is reassuring is that 12% of doctors before age 40 actually become millionaires. You don’t even really need a working spouse to reach this threshold if you are prudent with your earnings. The White Coat Investor was able to do it with aggressive saving, smart investing, and diversification of income. Imagine that you are a Hospitalist earning a flat $250,000 annually. At age 40, you will have worked 10 years, and $2.5 million in pretax dollars. At a 30% effective tax rate, you have taken $1.75 million home after taxes. If you are very conservative and spend on $50,000 a year, you will definitely have at least $1 million in the bank. Even if you aren’t a frugal, you should still have $1 million in the bank.

Doctors should be able to do well overall.

Based on the Medscape survey results, doctors are still very well off compared to the general population. The sole reason for this is that we as a profession have a good offense in the form of high income. Even if we may not control our expenses as well as we should, we can still survive. About a third of the survey respondents close to retirement age (60-64) reported a net worth above $2 million. Not bad. The other two-thirds of the group have less. While I don’t anticipate seeing doctors out on the streets, we should be able to do better given our 30+ year high earning career. You can take control of your earnings, spendings, and let your money work hard for you.

(Photo courtesy of Medscape)

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Do you want to be a winner? How to win in life

Posted on February 23, 2016February 23, 2016 by SmartMoneyMD

I tend to stay out of politics and out of political discussions in all situations. However, it’s impossible to avoid hearing about the political discussions if you watch the news or read anything online. It’s also interesting to learn about each candidate’s personalities. I found it particularly entertaining that one candidate called himself a winner.

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What does being a winner mean?

A “winner” is generally construed as a successful person in life. This certainly has different definitions depending on who you ask. In medical school, I had classmates who somehow considered not getting AOA (generally the top 5% of your graduating class) to be a failure or not getting one’s first choice in residency a failure. If that is the case, then most doctors are failures.

I know plenty of foreign medical graduates and doctors who were horrible students who run departments in well-known institutions, and an even greater number of them who earn more and work less than some of the most successful graduates from top medical schools and residencies. Are the lesser qualified doctors winners?

In order to become a winner, you must define the term for yourself.

Does being a winner mean that you are the most knowledgeable physician in your field or subfield? Does it mean that you have maximized your understanding of a particular subject? Or does winning mean that you are outrageously rich?

Make sure you want to be a winner.

Once you’ve established what your perception of what a winner means to you, you have to ask yourself if that is an achievable goal and that it is something that you want to accomplish. Be prepared to lose some sleep in the process. Map out a plan, and work at it every day.

Go become a winner.

Start early and go hungry. Time is your biggest ally. If you want your savings and investment accounts to grow, you must start early and let compound interest work its magic. The sooner you figure out your goals, the more time you have to make mistakes and learn.
Out hustle your competition. If you spend enough time on a subject, you will become an expert at it. If you spend more time on it than everyone else, you’ll likely become the definitive resource for others.
Sleep less and work more. No pain, no gain. One hour less of sleep in exchange for work will undoubtedly result in increased productivity. It may not happen every day, but do it for a year and I bet that you will accomplish more.
Rinse and repeat. Keep adapting, and roll with the punches.

What other strategies have you implemented to become a winner?

Should I buy the BMW X5 xDrive 40e Hybrid luxury SUV?

Posted on February 17, 2016February 3, 2021 by SmartMoneyMD

I previously assessed the economical merits of driving a hybrid car. The vehicles I reviewed were more wallet friendly and not frequently seen in communities whose annual income exceed $200,000. Mazdas and Priuses aren’t typically considered luxury cars. If you cruise down Highway 101 in the greater Los Angeles area, the luxury cars you see are Teslas, Mercedes AMGs, Hummers, Maseratis, and high-end SUVs. If you stroll down any of the tree-lined neighborhoods of Boston, you’ll see Range Rovers galore. Among this wide range of luxury vehicles, only a handful reflect consideration to the environment. This leads up to our next question: if you can afford to splurge on a luxury car, should you aim to be environmentally responsible as well? After all, wealth and environmentally conscious is always morally superior, right? ? This is where hybrid vehicles and electric cars come in. Is it worth it to buy a luxury environmentally conscious vehicle?

I recently received a flyer in the mail advertising the new BMW X5 xDrive 40e Hybrid SUV from our local BMW dealer. They were willing to deliver the SUV to your doorstep to test drive! Business must be tough these days, especially with sub $2/gallon gasoline in most of the country (not in California!) This level of service for luxury vehicles is actually not rare at all—Ferrari dealers will deliver your vehicle and pick it up for service from your doorstep. However, I never considered BMW’s to be in that league. Nothing screams more of moral superiority than a 5000 lb luxury hybrid SUV delivered to your doorstep.

I looked into the specifications of this monstrosity: luxury German parent company, assembled in South Carolina, $63,000 base price tag, with fancy Bang & Olufsen speakers. Acceleration from 0-60 is less than 7 seconds, and the electric motor can clock in somewhere between 13 to 18 miles. Prominent logo in the rear hatch that proudly reminds others on the road that this monstrosity has an electric engine as well.

Does this car save you gas?

A driving range of 13-18 miles on electric power sounds absolutely horrible. While I hate commuting, I still ended up living about 13 miles away from my workplace. If I owned that car, I’d still have to eat some gas on every roundtrip commute. If I travel between offices and the hospital, I’d run out of electric power halfway through the day. You have to recharge your charge every single night to make sure the battery stays charged.

BMW says that the average errand involves running to the grocery and department stores and is less than 10 miles so the X5 Hybrid is covered. While this may be true, why should anyone ever need to haul 5000 lbs of vehicle to buy groceries? No one should ever lug around that much weight to buy groceries even if you’re buying 100lbs of dog food!

You’d be better off driving a smaller, more fuel efficient car if your sole aim was to save gas.

Who should own this car?

All practicality aside, the BMW X5 is actually a very nicely designed SUV. The engine under the hood and the interior design exudes luxury. This car makes one of two statements about its driver:

I am filthy rich and enjoy luxury cars or
I am in over my head and paying for this car’s lease through my biweekly pay check.

I’d say that if you’re going to drop $60+k on a luxury SUV, there are far worse vehicles (read less reliable and less practical) to spend your money on. The hybrid aspect of the car isn’t going to save you much money, but sounds a whole lot more practical than driving a hybrid Porsche.

Since I am a firm believer of stealth wealth, I would probably not own this car under any circumstance. With a fancy car, I’d want to make sure to keep it in the garage to protect it from the elements. I’d be wary of it being in the supermarket parking lot, lest some careless customer slams their car door onto mine. I’d worry about people breaking into the car, since a luxury car attracts attention.

If this car does strike your fancy, make sure that it represents a relatively minor portion of your wealth. Any luxury splurge like this shouldn’t exceed 1% of your total net worth. For a $60,000 car, this means that you should have at least $6 million of net worth. I understand that this is an incredibly conservative assessment, but this is a pricey splurge.

Would you buy a BMW X5 Hybrid?

Maintain interest in your job to minimize burnout

Posted on February 10, 2016 by SmartMoneyMD

I previously discussed strategies to avoid physician burnout and that a four-day workweek will help keep your stressful job manageable. A second approach to maintaining your drive in your work is to find one aspect of your job that you find interesting and challenging. Focus on conquering it. If that challenge is compelling enough, it will keep you going.

What interested you in childhood?

Did you ever have one skill or interest that you mastered during childhood? Remember how many hours you spent learning about a particular subject? You found a means to improve your understanding of this topic, whether or not the material was easily accessible. The key to success is the hustle, motivation, and drive.

This is no different in any job you do. The magic in becoming good at your job or career is to find a topic or area that you are passionate about. This can include simply clinical practice, practice management, or administrative duties (meh!). In my experience, there is always an unmet administrative role in every medical practice that needs additional manpower (or woman power). If any of these roles suits you, you can make a side career out of hospital or medical administration.

What if you hate your job?

How can you find a challenge in your workplace to conquer if you simply hate your job? I certainly do know physicians to passionately hate their job, but those people are few and far in between. The most common reasons why people hate their jobs involve coworkers, subordinates, the income, or the environment itself. I have plenty of malicious subordinates who try to undermine the success of my department. Office politics and mounds of paperwork are also common topics that make our jobs miserable.

The most important step in finding a resolution is to consider what aspects of your workplace or coworkers that make your experience unpleasant. What variables can you influence or change? Consider the negative factors and whether improving on these issues will make you happier. For me, there were dozens of issues that need to be corrected. I made a priority list and started tackling them. It certainly made the workplace more manageable as we fixed glaring mistakes and inequities.

What if your job cannot be salvaged?

It is possible that your job still wakes you up more frequently than your newborn no matter what you’ve tried to do to salvage it. At this point, you have to decide whether you will still be able to support your family if you stopped working and start looking elsewhere if you don’t have an alternative stream of income. This is a great time to brush up on some passive income stream options and create a plan to allow yourself to retire early if you find yourself in the same situation in the future.

What other options have you considered to make your job more pleasant?