Category: lifestyle

Smart Money MD Poll Results in Infographic form!

Smart Money MD Poll Results in Infographic form!

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The following posts are referenced in the survey results above:

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Creating Success in the Face of Adversity

We’ve all been there in every single stage of our career. Forgetting to study one of the chapters before your chemistry exam in high school. Going into your organic chemistry lab without preparing beforehand. Staying out a little too late before a medical school exam that you thought was going to be easy. Not matching at your first choice residency. Getting rejected on a job prospect. Getting paid less than a guy that you had to convince your administration to hire?

You probably get the point.

The guy who does everything by the book never gets a break.

Sometimes it seems like we never get a break. Thinking about the negative outcomes and situations that could have or should have gone in our favor impacts our psyche. Believe it or not, many of our shortcomings probably aren’t even in our control, yet these are the events in our lives that are most difficult to shed.

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I’m a strong believer in turning misfortune into success. I probably spent the last fourteen years hearing variations of this blasé quip before I actually started believing it—yes, I am a very slow learner. We see and hear this all the time. Look at @PatFlynn. @JohnChow. These are guys that fell flat on their butts and were able to build up empires of financial success and balanced lifestyle.  Sure, these are the mega-success stories. Your story doesn’t have to be in the front headlines to qualify as a success.

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I had a classmate who did everything by the book in order to become a Dermatologist—this specialty is one of the most competitive areas in medicine—but still couldn’t match into a residency. I don’t remember how many times she ended up applying but she is now a successful Dermatologist. If you want it badly enough, you can [probably] make it happen.

We can all develop our own success stories.  All it takes is the desire to find success. Really. If you want it badly enough, you can get there. Fortunately there is no shortage of failures in life to learn from. Work at it long enough and you might find your own strategy to be a winner. Here’s mine:

Rejection

Something bad happens. Let’s say you get rejected from Harvard. Okay, you are a slow learner, so by the time you actually figure out how to reflect on this failure, you’ve already been rejected twice. Hey, I’ve seen it happen.

Look, you worked hard and yet you still failed. The world is still against you. If only you can conquer that demon fighting you every step of the way. Blow out some steam.

Reflection

Why are you upset with this instance of failure? Why did you want go to Harvard so badly anyway? Ego? Fame? Fortune? How would your life be different if you had succeeded?  Would your life be complete? Would that have guaranteed that you would have met your future wife? Is this the next step in your game plan for a successful career? Knowing why the setback was disappointing can help you figure out the next step.

Application

Flip the switch. The failure now becomes a challenge. What do you truly wish to accomplish? It may take numerous attempts to even figure out what you want in life. Then figure out what to do to reach that goal. Perhaps Harvard wasn’t the best idea if you hoped to build up a nest egg to quit your job by age 26 to roam the world. Going into a fast-paced IT environment would have probably  been the better option. Regroup. Make a new game plan and go for it. Maybe there is something that you’re really good at?

Failure

You’re going to keep losing. Don’t forget about that. However, at some point you will get in a win. That is what counts. Delayed gratification makes the victory so much sweeter. You started with being a Harvard reject. Then you transitioned as an IT consultant while starting your own sprocket business in the evenings.  You find your niche in building sprockets for water heaters. You sell your patent to the plumbing industry and become an industry giant overnight. Easy peasy, right?

The moral of the story is as simple as how you make it to be—if you are hungry enough in this world, you will be fed.

What was the last time you made success out of failure?

What situations do you exchange money for more time?

The fundamental tenet in building wealth is to save more than you earn. Easy enough. At some point, there is a threshold in which you pull the trigger to exchange those hard-earned dollars for goods and services. Most of the us who espouse responsible financial practices have streamlined what goods we consider to be suitable for our needs. Yachts, McMansions, and other extravagant material wealth or experiences should be logically put in check until we’ve reached a certain financial stability.  Cooking at home instead of hiring a private chef is another example (yes, I know a surgeon who does that).  Fair enough.

What about services? Guys like @Mr1500 are pretty handy and have built bookshelves and flipped houses with their skillset. No need to spend hundreds of dollars at Home Goods for a particle board desk when you can build your own out of cedar.  MMM is able to haul laundry machines on his bike. Strong-willed doctors like @PoF have the ability to bike to work instead of firing up our standard fossil fuel-consuming vehicles. You get your cardiovascular benefit while saving the environment.  Win-win.  Some of us were not meant to be tough, no matter how hard we try.  Mending a skirt? Only under duress.  Hiking down a canyon or starting a campfire? No way.  Some of us are in careers that make us less inclined to become true masters of DIY or machoism. I work with plenty of neurosurgeons, and I don’t know a single one who bikes to work before an anticipated five-hour craniotomy case. (If you do, please send me a note!) However, I do know a neurosurgeon who would rather run marathons and bike on Peloton than to bike to work.  Peloton subscriptions are not cheap either.

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Where is the cut-off? Is there a cost-savings benefit ratio that you look at before you start opening up the wallet? Most of us probably choose not to change our own oil in the car not only because we might not derive much pleasure from it but also because Jiffy Lube will do it for $29.99. For thirty bucks you can get your oil changes and keep your hands clean! I have two basic criteria to look at before I open up the checkbook:

Minimal risk and skill

First, the task has to be something that I don’t hate. I know some people who simply refuse to cook.   Is it the smell, the difficulty, or just the risk of ruining the shellac? (Probably all of the above) That’s fine, but if you have a financial plan to get ahead in life you’d better have other ways to make up for the expenditures.

Secondly, I just look at how difficult the task is and the consequences if I mess up. For instance, I’m not an expert at baking cookies, but I’m pretty sure there is a low chance that I’d burn the house down if I tried.  Check.

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If the task or service is often performed by many other people without much difficulty, then it is a good sign that I could reasonably attempt it myself.

Hourly rate

The hourly rate argument is a touchy subject. Many plumbers I know charge an hourly rate above that of many doctors.  This doesn’t mean that you should go ahead and change out a broken water valve or toilet yourself in order to save a few Benjamins.  But if the task or service meets the difficulty and skill requirement already, it might be worthwhile to tackle a project or service that could save you some money (especially if you have available time).

My experience at the Department of Motor Vehicles

My driver’s license came up for renewal recently, and I was tasked to step foot in a Department of Motor Vehicles office. There was an automated kiosk to get a number for line, and my number was 417.  To my horror, the next customer in line was 333!  It took another ten minutes before the next customer was called, and it was #289!

If this isn’t a representation of reality, I don’t know what is!

I had cancelled some of my afternoon patients and left work early to arrive at the DMV by 2pm. They close at 4pm. It was apparent that I was rolling the dice if I expected to be called up by closing time. There was no way that I be able to reschedule another surgery or clinic day to wait in line again.  I ended up going straight to a commercial motor vehicle outlet, paying an extra $60 to renew my license, and left by 3pm.

The moral of this story? I need to get into the commercial DMV business.

What situations have you encountered where you decided to pull out the wallet to save time?

Working hard for the next generation

The other day I met up with a retired physician and his adult kids for dinner. His (the retired physician) father was also a physician as well but the kids are not. From the looks of their home, it was clear that there was a bit of generational and self-generated wealth—six acre land, fine artwork, sculptures, $200,000 piano—you get the idea. While not professionals, the children were successful in their own right. The daughter was a professional musician on tour. She was a classically trained violinist, pianist, gymnast, and held some history degree. The parents spoke of how gifted their children were like any other proud parents would.

Just like any pragmatist would, I started to wonder what factors influence how we choose our lifestyles and careers.  How much of these factors depend on family finances?  Music lessons are not cheap.  Piano lessons can run anywhere from $50 to $100+ an hour.  These lessons can recur on a weekly basis.  These activities do add up.  If this physician’s daughter went through childhood without those music and sporting lessons, she may not have even realized any potential in a career in artistry.  How do parents even know if their children will have any talent to nurture?  Maybe without those lessons she would have still carved out a career doing the same thing. We’ll never know. What is important is that this physician’s next generation was still able to carve out a successful career, albeit perhaps less financially successful than their father’s.

“I worked hard so that my son could be in a band.”

Not everyone who pursues a life in art can be financially successful.  I’ve met plenty of gifted musicians whose daily chore consists of struggles to find performance venues along with trying to write their own music.  Many of them have other blue collar jobs in order to make ends meet.  Another doctor who I work with occasionally has a son in a band. I’ve never heard of his band, but I do hear about the struggles of getting discovered by a scouts. Perhaps they will become famous one day, but it sounds like a tough job. I’m not sure how he actually makes a living.  The son drives an M5.

I’ll stop judging now.

I like to think that with proper financial decisions and continual hard work, wealth can be sustained and built upon in successive generations.  However, I can see through my colleagues why sometimes even conscientious families will have difficulty sustaining wealth.

We want the best for our children.

No, I don’t intend to blame our kids for society’s downfall.  But it is tough to withhold opportunities for our children especially if we are able to offer our time, money, or knowledge.  I know that my parents sacrificed their paychecks, savings, and time to help further my fund of knowledge.  With our children, we can often be biased to think that they are more capable than they might actually be. Who knows if your kid has the talent to be the next top professional golfer? Better start those lessons early and get the best set of clubs on the market!

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This not a parenting blog, but rather a financial and lifestyle blog for high income earners. Chances are that if you’ve stumbled onto this website you probably have enough compulsion to prevent your hard-earned wealth from ending after your generation. But many of our coworkers may have a different view of their lifestyle and could be spiraling down a path that they don’t want. I suppose that in the end, it may not matter to you anymore if the next generation struggles.

How much assistance do you offer your kids?

(Image courtesy of Flickr)

Negotiating the Three F’s: Fame, Fortune, or FIRE?

This entry is more of a philosophical debate that I’m sure many of my colleagues (myself included) have contemplated at least once. Ambition can be a powerful motivator in our daily lives, and I’m sure that every doctor is no stranger to ambition. While one would hope that every person who has any authority to dictate our health have good attention to detail, there are doctors who surpass the normal expectations of being a doctor. We all know those people as “gunners”. Some of us might even be “gunners” at heart.

So how does ambition relate to our finances? For the professional who has dedicated her life to delivering excellent healthcare to our society, ambition can be self-defeating.

Fame

Many of us dream of fame. Some of us strive to be famous.  Only a select few in our profession achieve fame. Some of this fame can even become notoriety. Fame in medicine is represented in many forms. Academic medicine is a common route to achieve fame in our field. We work under the auspices of a university or academic setting. By default, there is some prestige from association with higher learning.

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There is a trade-off, however. Are you going to earn a similar amount from working at an academic institution? Probably not. Most academic hospitals will provide doctors with a fixed salary with a small incentive for productivity. By working there you are essentially accepting a potentially lower salary in order to have your name tied to an institution of higher learning. Is it worth it? Some people would agree.

Fame in medicine can come in another form.  There is mass-appeal fame. These are the doctors who are known to be public communicators to the world. Mehmet Oz is a clear example of this. Following in his father’s footsteps as a highly skilled thoracic surgeon, Dr. Oz himself trained to become a famed cardiothoracic surgeon. He tied himself to an academic institution and was willing to accept a potentially lower salary.  He then associated himself to daytime television and established widespread mass appeal. In a way, he was able to achieve the fame of being associated with an academic institution and fortune. In the process, he likely transitioned himself out of truly practicing medicine. I doubt that he’s scrubbing into Milstein OR 23 for any heart valve surgeries with any frequency these days.

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Fortune

Aside from Dr. Oz who has the fame and fortune, doctors can simply go the fortune route. This is most commonly achieved by working at regional hospitals or, better yet, a private medical group. Hard work, long hours, and some business savviness can translate into a nice income. These are incomes that can fund family vacations into exotic regions in the world, all without gaming any credit card points or strategizing hotel stays. I’ll be first to admit that I’m sort of jealous of some doctors who can pull in the annual 7-figure incomes. They may not have the fame of medicine, but they can surely get the fortune aspect of it. Pick your poison.

FIRE

Okay, some of us just don’t have the fortune to amass a fortune or fame through medicine. We’re not doomed. In fact, we might be the luckiest of the bunch. These are guys that worked hard to enter a career in medicine and are able to earn a relatively comfortable salary. There is perhaps some flexibility in our schedules and we aren’t necessarily burdened by the perils of crazy-high incomes or fame. We can still achieve some financial independence in the process.

Sipping a cup of ‘joe on a weekend morning at home probably isn’t the worst thing in the world.

Having a relatively high income, saving up a decent amount of our earnings, investing in some real estate, and counting up our pennies isn’t necessarily a bad arrangement. You’re not going to be in any extreme category of medicine, but the lifestyle probably isn’t too much to gripe about either.

I’ve struggled to identify myself in one of these three F’s in medicine. The ego in my psyche wants to achieve the first F. The ambition side of me wants the second one. The rational side of me realizes that I probably belong in the third F, and that is okay. If I play my cards right, I’ll still turn out okay.

Which F do you belong to?

Replacing the flammable vapor sensor in your hot water heater

Part of the toils of home ownership is the hassle of repairing appliances and fixtures. In the financial freedom world one could rent or even live like a digital nomad. But that doesn’t work if you plan to enroll your kids in traditional schooling or even hold a professional job. The nomadism comes after financial freedom, unfortunately.

This leads us to today’s DIY review. My five-year old hot water heater decided to act up last week and punished the household with cold water. Fortunately with many modern hot water tanks have a gas control kit installed. This control unit helps maintain the pilot light and allows you to adjust the temperature of the water.  In layperson’s terms, this device keeps the water hot, whether through natural gas or electricity.

The beauty of these controls is that they also provide error codes for troubleshooting. My device has a light that flashes and and chart for reference. Think of it like a diagnostic system in ICU ventilators:

Everything is getting computerized these days.

My control unit produced a sequence of 7 flashes, which indicates that I have a faulty flammable vapor sensor (FVS).

The FVS is a relatively newer’ish invention that consists of a silicone type sensor that detects flammable vapors outside of the hot water tank. If you have a gas leak, you certainly don’t want to have an open flame feeding off that fuel. The downside of the sensor is that it can be trigger by other fumes in the vicinity such as paint fumes.

Check to make sure that you don’t have a gas leak.

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The most critical reason why your gas control valve triggers an FVS error is that it might actually be doing its job. Do you have a gas leak somewhere? Make sure that you don’t smell fumes from natural gas, garage off gasses, or even open paint cans in the vicinity. Vent the area where your water heater is located. Only when you are certain that there is no dangerous situation should you proceed to make changes.

Reset the FVS.

Let’s say that there was a temporary trigger to the sensor. Maybe there was a spider that built a nest right on your water heater. Perhaps your dog had a loose bowel movement. Whatever. You can reset your control panel. Every device is going to be different. The user’s manual should have a section on resetting the device. Or try Google. That’s what I did.

I have a Honeywell type control panel. There is one on-off switch, plus a dial to control the water temperature. To reset my controls, I did the following:

  1. Flip the switch to ‘off’.
  2. Unplug the unit.
  3. Turn the temperature dial to ‘low’.
  4. Plug in the unit.
  5. Flip the switch to ‘on’.
  6. Modulate the temperature dial from ‘low’ to ‘very hot’ about 3-5 cycles.

At some point, you will hear a spark. The pilot light will subsequently light, and you will likely hear a whoosh where the flame ignites underneath the water heater. If your hot water heater stays on, then you’re home free.

You might have a bad vapor sensor.

Unfortunately after I performed a reset on the control unit, my water heater shut off after five minutes. My FVS is situation on the edge of the water heater in a plastic cover.

The sensor looks like a power socket plug.

25VS. The little guy that stands between hot and cold showers.

When the sensor detects a sensitive fume its resistance increases and closes the circuit. On average the working range of these resistors is somewhere between 9-45 kilo-ohms. I was able to test the resistance of my FVS using a multimeter, and mine was somewhere around 196,000 kilo-ohms! (196 mega-ohms). Clearly the FVS had simply gone bad.

Mega amounts of resistance indicates a bad vapor sensor.

One hack to get your hot water heater going in a pinch (DON’T DO THIS) is to install a resistor in the circuit. If you have access to a Radio Shack or electronics store, you can pick up a 15k-ohm resistor. Tie it into your hot water heater, and you will have bypassed the safety mechanism of your hot water heater.

Replace the vapor sensor.

If you have a bad sensor, the fix is easy—get a replacement and install it. Many of the big box chains like Lowe’s and Home Depot will unlikely carry these parts, but a specialized plumbing company might.

You can also find replacement parts on eBay or Amazon. I have a Whirlpool water heater, which is actually made by American Water Heater Company, whose parent company is A.O. Smith.  This is important because many of the replacement parts are interchangeable. Through some detective work, I found out that my flammable vapor sensor was also manufactured by Rheem. The part online was $25 with free shipping.

How much did I save?

Plumbing is a specialized profession (like gastroenterology). It may not be the most challenging line of work, but it can be dirty.  The local plumbing chain charges $150 per visit ($300 on weekends), $150/hr for labor, plus parts. This probably would have been about a $450 job. Plus the agony of calling the plumbing and potentially taking a day (or half day) of work off.

Not a bad trade-off, especially in post-tax dollars.

Priceless.

How much home maintenance do you deal with?

Five Reasons to quit a career in medicine

Rough days in the office or operating room take a toll on you. Mentally. Physically. Cognitively too. Sometimes you get distracted by your work and put your family as priority number two. I can see why some doctors just quit. On my evening commute, I was mentally paging through some reasons why some of my colleagues choose to leave such a career. Here are five of those reasons:

  1. Regulations in healthcare have always been annoying, but are only getting worse. Some rules are made with the intention of protecting those we care for, but I’ve become quite skeptical about the hoops that we jump through just to get reimbursed by the medical insurances. The claims that we submit get denied for the most asinine reasons (or often without explanation).  Those who deny our medical claims often think twice when they’re on the receiving end of denied claims.
  2. Medicine is actually a service industry.  Yeah, some of us clearly did not realize this when we decided to enroll in medical school.  Some of us still didn’t realize when we chose our specialties either.  People can be nice. People can be rude. Some people are downright mean. Doctors are glorified service workers that have to cure diseases and make people happy.  Imagine doing that for thirty years, with demands increasing every year.  Get out of medicine to escape the pain.
  3. Our profession can be bad for your health. I know a surgeon who still practices at age 74, and is on the top of his game. But guys and gals like him are few and far between.  Imagine zapping your hands under fluoroscopy every day on the job when you’re a vascular surgeon or interventional radiologist. Yeah, looking at you @FutureProofMD. You might get some arthritis sooner or later.
  4. Medicine is an ever changing profession.  Some of the ways I treat patients have changed quite a bit even over the past few years.  If you’re not able to keep up with the technology and practice of medicine, get out. Do yourself and your patients a service.
  5. Medicine can be a boring career.  I hope that most doctors don’t think that medicine is boring, but sometimes it just is.  I do get tired of the daily grind, but there are doctors I’ve met who clearly hate practicing, teaching, or research. Perhaps they are just hateful people in general. If that describes you, get out.

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I wouldn’t mind having one of these every morning before reading the newspaper…

Note that financial independence is intentionally left off the list above.  There are physicians who are FI who still practice medicine. That’s the beauty of a career that has traditionally been gratifying.  Having enough money to choose how to live your daily life is a luxury that not many people have, but that reason alone should not be why you ought to leave medicine.

If you plan to leave your career in medicine, what are your reasons? (Don’t become an auditor for an insurance company!)

(Photo courtesy of Flickr)