lifestyle | Smart Money MD

Category: lifestyle

A Successful Doctor Needs To Be A Healthy Doctor

Posted on July 27, 2015 by SmartMoneyMD

Doctors are in the healthcare business. That means that we either make recommendations to prevent or fix health problems. Ideally all doctors should listen to their own advice, but that is not the case. I’ve seen wide range of doctor lifestyles that range from health addicts to downright gluttons. Some examples of real people who I’ve met:

Surgeon who wakes up at 4am, swims several miles, and then goes through a day in the operating room. He eats mostly raw grains during the workweek, but the a “normal” diet on the weekends.
Dual income ER doctor family with no kids (not planning to have any either) dining out at Michelin star restaurants several times a year. They appear to be in good shape, so probably balance out their caloric intake well.
Independently wealthy internist who eats out at least twice a day in NYC. She Instagrams most of her meals, which sometimes look healthy but definitely budget busting.
Family medicine doctor who eats fast food daily in the hospital cafeteria and local chains. His BMI is likely over 35.
Anesthesiologist who runs an alternative medicine clinic. Firm believer in alternative medicine supplements. I frankly don’t know what his health is like, although he appears to be fit.

I have never been hugely athletic, before, during, or even after my medical training. However, after practicing medicine and aging with experience, I’ve come to terms that nearly every single aspect of our careers are dependent upon our health. If you’ve gotten far enough to become a doctor, you might as well become a healthy one.

Health and Exercise Improves Sleep Hygiene

Many doctors sleep soundly simply because their work is grueling. If you are a Hospitalist who admits and discharges patients for 12 hour shifts while running around the hospital, you will be exhausted. Likewise, if you are a surgeon who operates from 7am until 3pm three days a week, you will also be tired and burned out.

I doubt that either of these doctors will have trouble sleeping, but it is likely that both of them currently have or have had back pain or body aches. I have seen quotes that 60-80% of everyone in the United States have or have had back pain! A doctor who spends most of his day hunched over in the operating room is not only exhausted enough to sleep well, but also likely to have neck pain.

I used to experience recurrent back pain throughout medical school, residency, and fellowship. When I started my first job, I finally wizened up and started a rudimentary exercise and core strengthening routine several days a week. My job was just as stressful, but any somatic aches seemed to vanish. I even slept better and woke up more refreshed in the morning. Is it fitness that cured my musculoskeletal problems or was there simply a psychological component? Frankly it doesn’t matter as long as your aches are gone.

You Will Look More Convincing If You Look Healthy

What do you think goes through your patient’s mind if you’re trying to get his A1c below 15% and you look as if your BMI is 35? How about telling your patient to increase her cholesterol medication while your breath reeks of the sweet smell of McDonald’s fries you ate during lunch? How likely is your patient going to listen to anything health related if you look as if you’ve just escaped from the grim reaper?

People can and do judge you based on your appearance. It doesn’t matter if you’re the most competent surgeon in town if you look as if you need 4L of oxygen to make it through the day. You will lose patients if you don’t look the part. You will feel more confident as a doctor and better equipped to care for others if you are healthy yourself.

You Have The Option To Prolong Your Working Career if You Are Healthy

One would hope that health confers a longer life and working career. No chronic back pain to force you into early retirement or other disability that can shorten your career. While you might decide to retire early anyway, but wouldn’t be nice to have the option?

Exercise Will Help Improve Your Cognitive Ability

As doctors, we have to remember a boatload of information. Surgeons have to maintain their dexterity and clinical and intraoperative judgment. We are expected to be able to do this our entire careers. It is well accepted that physical activity is associated with improved cognitive function. It behooves us to stay fit and keep our mental sharpness as long as possible. Being healthy does just that.

Conclusion

There are plenty of reasons to be healthy—and plenty not to. You can decide what works for you. If you are like me and never truly was in good shape your entire life, go ahead and try exercising. You might like it.

What are your thoughts on health and exercise? What strides have you made to get in shape?

[showads ad=responsive]

Living in Rural America Can Make You Richer

Posted on July 22, 2015 by SmartMoneyMD

I’ve gone from living in a town with a population smaller than that of most major medical centers to living to the most populous city in the United States. I can see the appeal of both. The small towns offer an intimate connection with the community. You have the typical hangouts, stores, and venues that everyone visits, and it is seldom that I’d go somewhere in town and not run into someone I know. It seems as if everyone is your neighbor. The problem is, however, that everyone does seem to be your neighbor. There is no place to hide. As far as intellectual and cultural opportunities, there is no comparison with the large cities. If you enjoy having a breadth of cultural and intellectual diversity, living in a small town is torture.

From strictly a financial position, your occupation will likely determine the more financially advantageous location. Someone in the tech sector, investment banking, or finance will fare better in San Francisco or New York. Doctors, however, will likely do better in a rural area or small city.

Larger Cities Have More Doctors.

More doctors may mean more competition. Unless your insurance company belongs to an HMO, you have the option to see any doctor who accepts your insurance. Yes, there are also patients for doctors to recruit, but competition is fierce. In general, the more established doctors tend to see the bulk of the desired patient population (read: good private insurance or cash pay). Medicine is a service industry. We acquire new patients from word of mouth. The doctors with the best results, biggest billboards, and happiest patients get the bulk of the patients. In larger cities, private doctors will have difficulty building a practice due to the dynamics. It can be done, but it will take longer. In the process, you may end up earning less.

The Cost of Living Is Higher In Large Cities

Most essentials like housing, food, utilities, and transportation will cost more in large cities. Most of the time, this increased cost of living is not reflected in reimbursement adjustments. For instance, according to PayScale.com, an income of $200,000 in South Bend, IN will need to increase to $480,088 in New York City in order to maintain the same standard of living! I can’t think of any medical specialty where income more than doubles with regionality. Clearly, income has to be sacrificed in order to live in a metropolitan area.

Some Rural Areas Compensate Doctors More

When I was first looking for jobs in Los Angeles, San Francisco, and New York City, many practices lowball their new hires with insultingly low salaries. Some places guaranteed only 6 months of income, whereas 12-24 months was the norm in the rest of the country. Hospitals offered salaried positions (for Hospitalists and ER docs) that were often consistent with most starting salaries but had limited growth potential. Reimbursement schedules in a state like California are horrendous as well, which makes it difficult establish a stable practice. You pay a price for good weather!

In contrast, job postings from “less desirable” areas like North Dakota, rural Iowa, and the rural Midwest often advertise incredible income potential. I inquired to some of these positions, and they offer up to 80% higher guaranteed salaries for an internist position. For more specialized fields like vascular surgery, the compensation packages are up to 150% higher! It pays to be rural!

New Doctors In Significant Debt Should Consider Working Outside of Metropolitan Areas

Working outside of the major metropolitan cities is a financial no-brainer for doctors looking to eliminate debt. You will command a competitive income while saving on cost of living. The savings can be put towards debt repayment and retirement investing. Sure, you may not get the culture and accessibility of a metropolitan area, but you can always vacation in the larger cities while you are still repaying debt and move to your desired region after you’re debt free.

Do you agree on this philosopy? Is it worth it to strengthen your financial health for a few years before moving to your desired part of the country?

[showads ad=responsive]

How To Identify Physician Burnout — And How To Prevent It

Posted on July 10, 2015 by SmartMoneyMD

Physician burnout is becoming increasingly common, especially for new physicians. The combination of changing healthcare environment and debt burden has made medical practice less desirable to practice medicine. If you want to find whining doctors, go no further than Sermo. You will find plenty of disgruntled doctors.

How Does Physician Burnout Occur?

Burnout typically stems from an undesirable work environment. This might mean taking excessive call compared to the senior partners, getting dumped with non-revenue patients, handling scutwork, taking more hospital calls, or not getting compensated for your effort and time. For outpatient specialties, I’ve seen junior employees getting dumped with uninsured patients or taking care of non-revenue postoperative patients. This means that you end up being busy without being credited with revenue. Some practices do not openly disclose their books to their employees and hit them with overhead charges that should not be allocated to the junior doctor. For inpatient doctors, burnout can come from dealing with sick patients, demanding families, and high stress levels. Moreover, many inpatient doctors work for hospitals or larger groups that certainly can control the amount of revenue that is distributed to the doctor.

The practice of medicine is both a healthcare service AND a business. The Hippocratic oath doesn’t say anything about running a business, but it does us no good to care of patients if we can’t keep a roof over our head while doing so. Purists are going to scoff at this mentality, but this the cold, hard truth. Likewise, if you were to argue the financial ramifications of a cosyntropin stim test in your medical school endocrinology class, you’d be viewed as a heretic.

However, once you are out of the protected training environment, you end up dealing with the reality of a medical practice. Even in protected HMO practices like Kaiser Permanente, you still deal with cost containment, busy clinics, and budget cuts.

Take that work stress back home, and you’ve got a recipe for burnout. At home, you are too exhausted to deal with household chores and family. Fights will bound to arise. You not only have an unhappy doctor, but also an unhappy family.

How To Prevent Burnout

There is hope to escape and avoid burnout. The key is to identify what the offending routines that make your job intolerable and get rid of them. Is it the incompetent front desk that your practice has sustained for the past decade? Find a way to replace them. Are your senior partners giving you all of the holiday call? Justify to them that in order for you to be a productive doctor, these responsibilities need to be divided equally. Are you being charged overhead for a surgical center that you have no hope of owning? Make an argument with your employers that whatever policy that is imposed on you is not commensurate for long-term success for the practice. This is obviously a dicey topic since many of the senior doctors in your practice may have gone through the same process that you are going through (except that income was likely better for them). If they are truly committed to your success, they should be amenable to some change.

Do you keep getting overnight shifts at your hospital? Do they only pay you an extra $4/hr for taking those shifts? Find out what the problem is. Are there other doctors in your group who are willing to take the graveyard shift? If so, negotiate an arrangement with them. If not, then your administrators need to pay you more for working undesirable hours. If you know exactly how much revenue or charges that you bring in per shift, then you have negotiating power. Remember, administrators need facts. They aren’t going to pay you more simply because you are saving lives and deserve it. You bust your ass in the office to earn $200,000, and they bust their asses going to meetings the entire day for their $240,000. To the objective business mind, the two jobs are identical.

Do you simply hate going to work? Perhaps condensing your hours to four days a week can help reduce the stress by simply reducing the amount of time you spend at work. If you can accomplish five days of work in four days, by all means go for it. If you are fortunate enough to have a working spouse and have finances amenable to a part-time job, go for it. This is why alternative income streams are so important. You need that f-you money.

If all else fails, you need to find a new job. Most doctors cringe at the thought of picking up their families and moving, but sometimes that is all you can do. Remember, if you are stuck in an unfavorable financial and emotional job, you have to live with it daily. Most doctors change employers and jobs at least once during the first five years of their careers. This is more reason why you should not be buying a McMansion right out of residency.

Remember, there is hope. Thousands of doctors have been in your shoes and have survived. Some have struggled through burnout, but remember that you don’t have to in order to be a successful doctor.

What strategies have you applied to avoid burnout? What has work, and what hasn’t?

[showads ad=responsive]

How To Become A Rich Doctor – Ride The Wave

Posted on June 28, 2015December 22, 2017 by SmartMoneyMD

how to become a rich doctor ride the wave Easy money does not exist. It does not matter if you are an entrepreneur, lawyer, doctor, or TV personality, you still have to apply effort to generate income. The days of doctors opening up a practice and expecting millions of dollars rolling into your bank are over. I sadly discovered that I was 15 years too late coming into practice.

All is not lost if you’re just finishing your medical training just now. You can still become a rich doctor if you work hard, set realistic goals, and adapt as needed. That’s what I tell myself when I’m two hours behind in my clinic full of angry patients or when I keep hearing at my medical staff meetings that my department is STILL losing money even though I put in more hours at work than I ever have. The following are principles that I try to live by to grow my net worth as a doctor in the 21st century:

Do Not Let The Apparent Wealth of Your Peers Distract Your Goals

It does not matter if your co-resident owns a yacht or just bought the latest iWatch. You don’t know if they maxed out their credit lines to buy rent space at the dock for the boat that they use twice a year. She may belong to old money. It’s also not like that you will benefit from their apparent wealth or if you will magically become successful if you owned the same material wealth. One of our friends recently finished his radiology fellowship, drives a BMW 5-series, and also owns a $1+ million apartment in Manhattan. It is easy to be fixated on the success of others, but it is clear that a self-starting doctor in the first year of medical practice is not capable of living such luxury without the help of pre-existing wealth. It doesn’t happen in the third year of practice either.

Who cares if you drive a 1991 Honda Accord and your front desk lady drives a Lexus? As long as your car gets you to where you need to go safely, it does not matter. Once you build up a strong velocity of money, you can loosen the reins.

Focus on your goals. Don’t try to keep up with the Joneses.

Strategize and Build Alternative Streams of Income

Even if you score a killer job that pays you $300,000 a year, it will take years to build up enough wealth to buy substantial luxury. If you take home 55% of this salary and save 50% annually, you’d only have $412,500 after 5 years. Sure, you could work some investment magic on that amount, but you might also end up with less than what you put in. Not all of that is going to be disposable income if they are locked up in retirement accounts.

Build your income. At the workplace, this means learning how to streamline expenses, working harder, and building your worth as a doctor. Ride the wave. As you build your practice, your patient base will grow accordingly. Treat them well, and they will refer their friends to you. Instead of making $200,000 a year, you might earn $210,000. It’s not much, but it is also earned money. That is step number one.

[showads ad=responsive]

Don’t forget that the income wave can rise OR fall. Your reimbursements will go down. You may get deadbeat payors. Remind yourself that as a doctor, you still have job stability. That is one of the few advantages that you traded off after 10 years of no/low income servitude to the medical profession. This is your primary income stream that you maintain in order to find alternative means to grow your net worth.

Think Like An Entrepreneur

Being employed as a doctor will allow you to have a comfortable lifestyle. If you want more than that, you will have to think BIG. The $5 million house with a 7 car garage in the “rich neighborhood” of town is probably not going to be owned by a doctor. Probably not a practicing doctor without alternative streams of income. This may include multiple streams of income:

Passive income – I consider this the best form of income. Money comes in while you sleep. You may have put in work previously, but it continually adds to your net worth. This may be in the form of royalties. If you are involved with investments, growth of your shares will also come passively. In the tech industry, passive income can from from a number of streams, whether it is through referral networks or endorsement fees.
Active income – The sky and your time is the limit. Real estate. REITs. Invited lectures. Perhaps you were a wine connoisseur before becoming a doctor. Maybe your dream job was to run a wine tasting company. You still can as a doctor. It can even provide ancillary income. Do you have other money generating hobbies? Perhaps you’ve always dabbled in photography. Do you want to run a wedding photography studio on the side?

You can generate income through any or all of the methods above. The greater number of income streams you have, the more stable your net worth growth can become.

Plan Your Finances Intelligently

Asset preservation is a key component in building net worth. As a doctor or any high income generator, you have to make sure your finances are in line. This means getting out of debt. The hole you dug yourself into during college and medical school needs to be filled in. I paid off a six figure debt by the time I finished my first year of practice. You can too. Rule number two is to avoid getting into debt. This means you pay off your credit cards every month and make sure that you are not late in payments. Avoid frivolous purchases like the plague. Rent your house while you’re still deciding whether your job will last long term.

Track your investments, spending, and income. I use Personal Capital as an online tool to monitor my finances. From the spending standpoint, Personal Capital tracks all of your purchases and allows you to categorize them. You can monitor exactly how much you’ve spent with groceries, restaurants, entertainment, and other miscellaneous purchases in nice graphs. You can get a quick sense of which categories of spending you can cut back on.

From an investment standpoint, Personal Capital employs advisors (real humans) who can discuss with you how to strategize your portfolio. For portfolio management, they charge 0.89% for the first $1 million invested and a decreasing amount as your assets under management increases. I do not use their advisory services, mainly because my current investment options under my employer are relatively fixed, and my taxable investment amounts are still a pittance. It’s difficult for me to determine whether I’d actually ever have an advisor handle the majority of my investments because I feel that I spend the majority of my educational time allocated to finance. For the busy doctor who has little desire to educate herself (big mistake if you do no self-education), having a low-fee advisory service wouldn’t be the worst thing in the world. There are plenty of stupid things you can do with your hard earned cash.

Conclusion

You can still build a substantial amount of wealth as a doctor in the 21st century. It’s going to be a lot more challenging than what our predecessors went through, but you have more tools at your disposal. Remember that it still will require hand work and a strong desire to build your wealth.

What have you done to contribute to your net worth? How much of your effort in building net worth comes from your medical practice versus other sources of income?

[showads ad=responsive]

(Photo courtesy of Flickr)

Younger Doctors Are Wimps

Posted on June 25, 2015 by SmartMoneyMD

Full disclosure: I consider myself in the “younger” doctor category. The experiences and sentiment expressed in this entry are derived from what I’ve encountered during my training and now current job.

There, I’ve said it. My attending physicians said it to me when I was a medical student, resident, and fellow. My coworker who is 30 years my senior doesn’t openly call me a wimp, but we both know what goes on in his mind when I whine about taking call. It gets worse. When I was teaching my medical students, they seemed to elevate apathy to the next level—imagine combining laziness, entitlement, and cleverness together. You end up with someone who will only do what it takes to get the grades and advance to the next level. No more, sometimes less.

Maybe subsequent generations are always wimpier. Doctors in the 1970’s and 80’s were mostly men who belonged to single income households. Many surgeons operated from dawn to dusk and rarely saw their families. These doctors also generated serious amounts of income compared to doctors today. The incentive was good for them to work hard; you put in the hours and the money rolled in.

Times Have Changed.

Economic and social shifts in medicine over the past two to three decades have molded the experiences of doctors.

Economics of Being a Doctor

Reimbursements for professional services have either decreased or lagged behind inflation rates. Some surgical procedures in the 1980’s actually paid three times more than surgeries performed today (not even taking account of inflation). We are constantly pressured to see more patients to keep up with rising overhead costs while the complexity of documentation and regulations have made medical practice much more challenging. I make about forty mouse clicks and type several lines in the Electronic Health Record for every patient that I see in the office—thirty years ago the same could have been documented using one side of a 3”x5” index card! The very technology that was designed to improve communication and quality of care not only slows me down but also digs into my checkbook. There are plenty of physicians who actually bankrupt their practices when they are unable to adapt to the changing financial aspects of medicine.

In some ways, the increased restrictions on how we practice medicine have led many doctors to limit the number of hours they actually spend working. Twenty to thirty years ago, internists typically ran outpatient clinics and saw their patients who end up being admitted into the hospital. A typical week may entail 35-40 hours of outpatient clinical care, another 2-3 hours of managing the business, and 2-5 hours caring for hospital inpatients. Now, the role of caring for inpatients has transitioned to that of Hospitalists—doctors who strictly work on a shift basis caring for inpatients. The doctor who was able to handle his business, hospital patients, and his clinic in 50 hours a week may need 60 hours to do the same thing AND get paid less. From an economic perspective, it is a no brainer to actually put in fewer hours. Yes, the healthcare system is way too complex to be explained solely by this reasoning, but from a practical sense, working less actually makes sense. Ironically, by working less, the new-age doctor by default becomes “wimpier”.

Social Changes in Medicine

One significant social shift in medicine is the increasing number of FEMALE doctors. Most medical schools enrolled nearly a 50/50 distribution of male to female students. What this also means is there has been an increasing number of dual income doctor households. A dual income doctor household confers two advantages: (1) higher earning potential and (2) diversification of income. If one spouse’s job ends up being horrible and he loses his job, the family isn’t going to starve. A dual income household allows flexibility in how much each spouse needs to work. Instead of one spouse working 78 hours a week, you can have both spouses working 40 hours a week to generate an equivalent income. With an easier cash flow, neither working doctor spouse actually has to put as many hours in. With social change, there is now a higher potential to have two wimpy doctors in a household.

Wimpy Doctors Come Ahead Financially

Yes, younger doctors who put fewer hours are wimpy compared to prior generations of doctors. The earning power of younger doctors will unlikely ever compare to that of prior generations due to the nature of the healthcare system. However, the new generation of doctors are savvier. We are resourceful enough to learn the basics of managing our finances and know where and when to seek assistance. Our hours of work will be less, but we can take advantage of increased freedom to broaden our fund of knowledge, prepare ourselves financially, and have more time to our families. Dual income doctor families have an even greater advantage. With appropriate division of earning potential combined with an intelligent savings rate, a dual income doctor household can have a diversified means of building net worth and a higher likelihood of achieving financial independence.

Being wimpy wins.

What have you done to take advantage of the changing face of medicine to improve yourself financially?

[showads ad=responsive]

Doctors Need A Four Day Work Week

Posted on June 16, 2015April 17, 2016 by SmartMoneyMD

doctors need a four day work week Working in the healthcare industry is hard. Stress hits you in all levels. Burnout rates are high. Job satisfaction has slowly declined over the past 20 years due to a number of external factors beyond the practice of medicine.

Take, for instance, the daily work of an intensive care unit (ICU) nurse. Patients in the ICU are sick. Many of them die. The nurse is responsible for monitoring these patients for health changes. He is responsible for changing the bed sheets, cleaning ventilator tubing, cleaning the patient, and changing dressings. This job is physically demanding and tough on your feet, back, and arms. It is emotionally and psychologically draining due to the degree of illness you are surrounded by. It is demoralizing when you make mistakes or are yelled at. The fluorescent lights in the hospital are depressing. They do burnout. For the level of shit that nurses deal with, I am grateful that nurses are available to help us out.

However, nurses are almost always contracted on a hourly rate. A standard work week is 40 hours, which can consist of four 10-hour shifts. I have seen options for three 12-hours shifts per week. Yes, shifts can last longer than you expect due to sign-outs and ten-hour shifts can become 11 or even 12 hours. That is the reality of medicine. You want to deliver good care. If you were the patient, you would be thankful that your healthcare worker stays longer to make sure appropriate care is handed off.

Doctors Are Likely To Burnout Even More

The one perk of being an hourly worker is that if you end up taking additional shifts beyond your designated time, you can potentially receive overtime pay. That’s right. Time and a half. You might argue that cleaning up an incontinent patient’s shit is worth more than time and a half, but at least there is additional compensation. Some doctors are paid according to shifts like Hospitalists and Emergency Room Physicians, but they are unlikely to receive a higher hourly rate for extra shifts.

Most doctors are compensated by the amount of care they deliver. That is stratified by the number of patients they care for, and the acuity of the diseases treated. It doesn’t matter how long it takes a doctor to care of the patient; they still get paid the same amount.* With the evolution of the American healthcare system, doctors are compensated less while having to deal with ever increasing regulations that are often not even pertinent to healthcare. Sermo is a good reference forum for doctors to bitch about their problems. It is depressing to see what our profession now has to deal with.

In addition to decreasing compensation, doctors still have to deal with the usual stresses of the workplace. We deal with sick patients who sometimes die. We deal with family members and overbearing parents whose children are in the hospital. We deal with questionable lawyers who advertise on late night television who promise to sue doctors when modern medicine fails to prolong lives or cure all ailments.

Keeping a Sane Work Week May Be A Solution for Doctors

While financial independence may be the ultimate solution to eliminate physician burnout, restricting the number of hours you spend with work may be a temporary solution. One of the best advice I’ve received from several retired doctors was that keeping a four day workweek was one of the best lifestyle decisions they’ve made. Yes, some employers don’t allow this. You might not make as much money. Sometimes working less will prevent you from advancing your career.

But it can make you much happier. I recently experimented with taking one day off a week at the expense of a slightly lower income. I am much happier now. The typical day in the hospital is stressful. Patients, no matter how informed, have questions. Patients are sick. Some misinformed patients are hostile. It is amazing how many personalities exist, and no matter how nice you are, you will be verbally abused by unreasonable patients.

Having a four-day week gives me a break from those stresses. I can actually take care of chores at home and run errands. I avoid losing an hour of my life commuting to and from work. Again, I do have a lower income than the majority of my peers and nearly all of my colleagues in the same field, but I still have enough to sustain a reasonable lifestyle. It will likely take me longer to achieve my F-You Money stash, but it is a sane balance.

Do you cut back on your hours at work to allow for more time with your family? What has your experience been at work? Sound out below!

[showads ad=responsive]

*This is true for the most part, although some billing methods allow for doctors to bill for the amount of time spent to care for a patient to account for those complex cases that require additional discussion. I do find that time-based billing to be somewhat impractical since you end up having to spend a very long time before you can code for high level cases.

(Photo courtesy of Flickr)

Habits and Characteristics of Millionaires

Posted on June 9, 2015 by SmartMoneyMD

I do receive commission from Amazon from the book links listed on this page. I do think that it’s a worthwhile small investment for your financial future. I appreciate your help in sustaining this website!

I finally set aside some time to read the sequel to The Millionaire Next Door, entitled The Millionaire Mind, by Dr. Thomas Stanley. The author had studied the lifestyle and habits of millionaires and condensed them into two best-selling books. As high income earners with a late start on their careers, doctors do have plenty to learn from the rich. The following is a list of focal points that Dr. Stanley emphasizes throughout both of his books:

Millionaires Did Not Get Good Grades in Schools Nor Did They All Go To School

Of the millionaires polled and studied, the majority of them apparently were not seen as intelligent by their teachers and did not achieve good grades in school. Some were condemned by their teachers to a life of mediocrity. Could mediocrity serve as motivation to achieve? The author believes that by not being “book smart”, these future millionaires became more resourceful and chose careers that were less popular and had less competition. These people also learned to work harder and more intelligently than their peers and eventually became more financially successful than their peers who received better grades in school. Examples given included a millionaire businessman who owned a metal recycling company or the salesman who knew how to get widgets sold. Neither of these professions truly required much of any formal education but allowed the resourceful to succeed.

Can this apply to doctors? Hell no. Doctors succeed by working hard but also getting good grades. We survived through college organic chemistry and repeated testing of material that ultimately has little to do with our final daily routine. This hazing process was important because it filtered out the less compulsive and less determined—after all, you’d want a compulsive doctor who does not miss diagnoses. Medicine is a mesh of inexact science with art; patients can become ill and even die under the most skilled physician (and get wrongfully sued too). Can a doctor be skillful but received poor grades in school? It’s possible, but less likely.

With these conflicting conclusions, can doctors still be millionaires? Of course, but it certainly is much harder. One of my neighbors who is a retired small business owner likely has more wealth that I will ever accumulate constantly remarks how rich doctors are. Yes, doctors have good salaries, but we still need to be smart about our money and convert a high income into high net worth.

Millionaires Contract Out Tasks To Others

Apparently the typical millionaire is not the DIY-type. Home repairs, plumbing, cooking, yard work…all of these routine household tasks are either left to the spouse (the wife, according to his book) or hired help. Millionaires spend their free time relaxing with their family, playing golf, or focusing their attention to earning more through their profession. This approach allows them to enjoy their hard work, and maximize their earning potential. A jack of all trades is a master of none.

I’ve seen this mentality with my colleagues to a certain extent. We’ve trained such a long time to practice our profession; we should use that to our advantage to earn more. I recently heard that one two-physician couple hires a chef to cook for them, and each meal costs $120! It certainly is impressive that one could afford this long term, and I suppose you can interpret this to be that they are successful in their careers. Need additional income, let’s pick up a few more shifts in the ER. I know doctors who don’t know a single bit about cleaning floors, car maintenance, or how to operate their food processor. But they do know how to intubate a patient, and that’s where the easiest way for these people to obtain income.

Frequent visitors to this website know that I approach net worth as a balance between savings through lifestyle modification and income (whether from your career or alternative means). I have discussed low-risk household maintenance tasks like changing the headlights to your car, replacing toilet parts, and cleaning your toilet. By means of branching out your fund of knowledge, you can become more self sufficient and invest your hard-earned post-tax dollars for other needs. You can be smart about your money without being totally useless in practical life.

Does limiting the number of outsourced tasks mean that I will never become a millionaire? I sure hope that there’s no corollary between hiring help and becoming wealthy in today’s times.

Millionaires buy lasting furniture and older, well-built homes

One interesting statistic that Dr. Stanley found was a millionaires rarely buy new furniture but rather resurface their existing furniture. The premise is that quality solid wood furniture should last forever, and wasting money purchasing new furniture every decade is not practical. Frankly, I don’t even know any local furniture dealers who reupholsters furniture. This fact might be reflective of outdated trends. Most modern furniture (even the expensive ones) contain particleboard.

He also found that millionaires target older, well-built homes in established neighborhoods to live in. These homes tend to save their owners more long term. I don’t really know how to interpret this finding in present times. There are plenty of affluent neighborhoods especially in the northeast that undergo cycles of tear-downs and rebuilds. Some owners do it simply because they want updated floor plans or extra bathrooms. I haven’t noticed any correlation with the upper-middle class or the ultra-affluent.

Whether you upholster your old furniture or live in well-established “older” homes probably has some connection with being a millionaire or ultra-rich. Not following these statistics probably doesn’t prevent you from being a millionaire either.

Conclusion

After reading both The Millionaire Next Door and The Millionaire Mind, I do think that the author brings up goods points that apply to all of us who are trying to build up a stable net worth. There are plenty of millionaires and billionaires who were not pegged by their teachers to be successes and some who did actually receive good grades. The one unifying aspect of the wealthy is that they think differently. Everyone works hard, keeps their eye on the goal, and finds ways to reach that goal. The billionaire factory widget maker worked hard to reach his clients and sell products. The wealthy doctor needs to do the same.

[showads ad=responsive]

Do you have any experiences with any of the qualities of a millionaire? Comment below!