Category: lifestyle

How would wealth impact your life trajectory?

I frequently wonder how my career trajectory would have mapped out if I knew at a very young age that I’d be financially set no matter what I did. Would I have busted my ass to get a high paying job if I were already financially independent?  Would I have dedicated my life to philanthropy?

Who knows. I’ve met plenty of people in my life who clearly have had various degrees of family wealth. Like the guy I knew in college who was neither a genius nor a hard worker who still got into medical school. I didn’t realize that he came from serious means until his parents cut him a $2 million check when he got into medical school.  Sometimes you can’t actually tell whether someone’s lavish lifestyle is due to wealth or simply egregious extension of their credit lines.

I always figured that if I had the preordained luck to be born into wealth, I wouldn’t have tried so hard in school.  Over the years, I’ve come to realize that the answer may not be as simple.  If I were fortunate to have inherited a family fortune, would I really want to feed off the fat? Or would I have the ambition to build on that wealth to make a name for myself?  Should I just work just as hard and find my true passion? That is a much higher level decision to make than simply working hard to put a roof over your head.  There is a reason why some of the wealthiest people I know still chose a challenging career in medicine.

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You can work and play to you true ambition if money is out of the equation.

I tend to view our life choices as a conglomeration among three needs: (1) fortune, (2) fame, and (3) happiness.  It’s challenging to have all three, but coming into the world with fortune will get you a head start on life.

You can’t have it all.

If money were not a problem (fortune), I probably would have ordered take-out a lot more often and saved myself hundreds of hours of cooking during medical school (happiness). Those hours could be been better spent studying, exercising, or even socializing.  Perhaps that would’ve enabled me to pursue a different specialty in medicine. Would I have chosen a less lucrative profession? Would I have chosen a lower paying but intellectually stimulating job (fame) in a higher cost of living city?

I think that the wealth factor definitely influences how one goes through life. I like to look at it in phases:

Money is awesome phase: This is presumably realized in childhood. Any toys, vacations, foods, or material goods can be had without consideration of cost. This is where bad habits can be ingrained.

Money is a tool phase: As you get older, you start to realize that you can purchase favors or amenities to get ahead in life. Private tutors. Exchanging cash for other people’s time.

Seeking purpose: Everyone experiences this. You try to figure out what you want out of life. Careers. Wealth influences your career choices too. This is where you try to figure out what you ought to be doing to become happy.

Money is a tool again phase: You go about your career with highs and lows. Wealth can be used to ease the daily grind.

It’s clear that wealth can certainly put in an advantageous position to be happy, but wealth can’t guarantee happiness. Had my financial situation been different in childhood, my life trajectory would have been different, but I think that my level of content with my life choices would likely be the same.

Have you pondered these scenarios before?

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Insuring your future through your health

As a healthcare worker, I should also practice what I preach. That means eating healthy, exercising frequently, and following sound lifestyle habits.  Unfortunately I’d be lying if I were to tell my patients that I adhered to all healthy behaviors. I actually see quite the contrary in the workplace.

Overweight healthcare workers.

Fast food establishments in walking proximity of the hospital.

Vending machines with credit card readers or “Flex” spending through hospital ID cards.

Fluorescent lighting in medical buildings.

Good health for healthcare workers isn’t completely a bust. I see many medical practices implement discounted gym memberships for its employees. Other incentive programs include “free” Apple watches for employees who reach certain activity milestones (but additional withholding of paycheck when you don’t meet those goals). Some hospital systems discount your medical insurance premiums if you have normal cholesterol, blood pressure, and hemoglobin a1c levels. Good for them.

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I’ve come to realize that good health habits are probably learned in childhood. My parents emphasized that I should take walks and play outdoors, but there was never any emphasis on regular exercise to become more fit. I was never athletically gifted, so I never focused my energy on getting fit.  Who knew that weak core muscles would start haunting your future self?

My eating habits were horrendous essentially up until the end of the fellowship.  Long work hours combined with limited time and money to took a toll on my health. I never felt physically “bad”, but youth was probably the only advantage I had on my side. I remember there were instances where I strained my neck, back, or arm muscles that left me aching for weeks. Yes I was in bad shape.

Jillian Michaels probably saved my career.

It’d be a huge claim to say that a single person changed my life, but I picked up a Jillian Michaels exercise video at the local library one day. We all know that the first step to better health is to stop lamenting, get off your ass, and put in some time.  Time, at least in my mind, was something that was in short supply.  Like all of my patients, I was looking for a quick fix.  An exercise video that promised great results with only 15-20 minutes of daily work sounded great to me. Yes, exercise videos are notorious for promising results with minimal effort, but I figured that in theory there should be some optimized cardiovascular and weight training in a condensed 20 minute video.

I committed to exercising at least 20 minutes a day on these workouts and failed miserably.  I came home on most days fatigued and too burned out to exercise.  Moreover, I still had to check work e-mails, deal with administrative fires, and whatever else that needed to be taken care of at home.

Don’t laugh. I’m pretty sure that I can actually finish a cardio stress test without dobutamine assist (maybe).

Daily workouts ended up becoming more like two to three times a week.  However, that was okay. I still burned calories. My muscles felt sore every single time I did them (yes I was that wimpy). After a year of doing these workouts, I came to realize that they were incredibly basic. My next door neighbor who was twice my age still had greater endurance than I did. To me, it didn’t matter.

I stopped getting neck and back pain.

At this point, I can confidently still say that I am at or below fitness average for my age, but that is okay. There is still room to improve, but the moral of the story is that you have to put your mind into whatever goals you want to achieve in order to succeed. I did that for medical school and in my career. There should be no reason why I couldn’t apply that to my health. I feel a whole lot better at work because I exercise.  Not a bad price to pay to insure that I can have a long working career if I choose to!

The real secret to getting rich

I wish that I actually had the secret to making a lot of money quickly—I’d sell it in a seven-part infomercial, run weekend retreat courses, and brand my own swag. That being said, I do believe that we can carve our own wealth if we plan our careers strategically.  Some of us are going to come up with great products, skills, and ideas that will change the world.  The rest of us can still do well in our own unique and amazing way.  I’ve come to realize that the one unifying factor that we see in everyone who accumulates substantial wealth is simply time.

We can talk about hustling, hard work, luck, wealth accumulation strategies, but none of these tactics will give you that financially independent wealth overnight. It just doesn’t happen.

Unless you win the Powerball (I have not).

Rome wasn’t built in a day. You’re not likely to become wildly successful overnight either.    And that is okay.

Find that goal.

Somehow we’ve been programmed by society to find ambition, achieve our goals as quickly as possible, and find other goals to tackle.  The average American takes less than two weeks of vacation annually! I was offered a job working in the tech industry that also offered two weeks of PTO annually. They even allowed you to carry-over PTO. We work more than essentially everyone else in Europe. The only countries that work more are Japan and South Korea.

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This is essentially a race to the grave. There is nothing wrong with hustling, but hustling without and end goal is counterproductive. Even worse, you could easily burn out and fail. Step number one in the wealth accumulation process is to figure out your end goal. Is your goal to quit your job by age 50? What about 40? Or is more vague, like creating a situation for yourself that would allow you to venture into other interests or spend more time with the family? The goal doesn’t have to be super ambitious. You can adapt it as you progress and determine what makes you happy.

Set that timeline.

Whether you plan to reach that goal in five years or twenty, you need to have that deadline. A definitive course gives you something to strive for, and aim for a realistic timeline.  Mr. 1500 days set his goals, reached it earlier than expected, and then adjusted his “magic number”.

We have to be flexible. Work situations change. We might end up moving. You never know. These are the cards that we’re handed, and we deal. I’ve encountered three different situations where my job trajectory could be impacted, including losing my job due to my employer shutting its doors. I fortunately have not been dealt the axe, but these instances will force us to craft out a Plan B.

Work hard, sit back, and enjoy the journey.

You life goals aren’t going to be handed out on a silver platter. You still have to work for it, and stay focused. Fortunately the journey isn’t a straight-shot to the moon (or as high risk). It’s more like an extended hiking expedition. Life is more pleasurable if you enjoy the nuances of our daily activities. Is it the espresso shot that you make every weekend? Or the trips to Costco? It doesn’t matter, because this is what it takes to help keep your eye on the prize.

Going fast is useless if you don’t know where you’re going.

Before you know it, that time will come!

(Photo courtesy of Flickr)

How much should you leave to your heirs?

In the asset management world, there is always some discussion on how you can maximize what you leave behind to your heirs. We all want to make sure that Uncle Sam gets the minimum amount of your hard-earned wealth upon your demise. Fair enough.

I think too much emphasis goes into squirreling away your money into various protected vehicles.  Cash value insurances. <shudder> Trust funds. Step-up basis. Sure, these opportunities are worth knowing about, but the main question about all of this is who in this world should benefit from your financial prowess? And how much is enough?

Leaving religion aside, one has to realize that you can’t really take any of this to the grave. Anyone other than yourself will get your wealth. Most people are going to give it to their kids, grandkids, relatives, and charity. I’ve seen this in my closer friends. It’s an interesting phenomenon to see on the outside.

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Middle class inheritance.

I have a friend who lost her parents a few years ago. Her family was a quintessential middle class family. She worked as a manager in a local small business. No one in the family had professional degrees, but they all managed well. All of the siblings ended up splitting the savings accounts and the house. As I recall, each recipient received on the order of $100,000 total.

I would take a windfall over nothing on most days, but you realize that an amount like this isn’t going to allow anyone quit their day job. Taking all of this in cash all once would probably trigger a relatively sizable tax amount for the average American too.

I’d want to take back my loved one any day in this situation.

Upper class inheritance.

I have another distant colleague whose parents were in some shipping business. She is a general surgeon who doesn’t seem to practicing medicine anymore (I don’t know her that well, but she stopped after having kids).  Her husband was “in the finance industry”. Now, it was no surprise based on her lifestyle during medical school that she came from serious means. Nice clothing, furniture, apartment, and vacations. If I were in her shoes, I might not have even had the ambition to go into medical school, yet alone become a surgeon. When her mother passed, I recall that people spoke about “serious amounts of money” in the inheritance. Not sure what that means, but the people who spoke about it were all doctors, so I would assume that these amounts were big in my book too.

Thanks to Facebook, I now see vacation pictures from their family almost every other month. They have a nice home in the Bay Area that recently sold for nearly 8 figures.  I think that they are all happy.

How much money are you planning to leave on the table after you’re gone?

Windfalls and their impact on your lifestyle.

The easiest way to ruin any person’s self-initiative is to give them a crazy amount of money before they have established their careers. In this regard, it’s probably a good idea to set up a trust fund if you end up having significant wealth to leave behind.

Fortunately (or unfortunately) most of us will never have enough excess money to ruin someone’s life. But we should consider whether leaving an inheritance should be part of the investment equation. My strategy is as follows:

  1. Work hard and save as much as you can before you have dependents.
  2. Continue to work hard and instill work ethic into your dependents or mentees.
  3. If you are able to contribute to others’ well-being, do so. Invest in their education and work ethic.
  4. If you have excess after helping out your family and friends while you are still alive, consider the charities that you have left out.
  5. Leave behind what amount you feel is adequate after you’re gone.

That’s it. Simple and sweet. If you hustle enough in your working years to fall into the trust fund level, congratulations. You’ve gone above and beyond. Otherwise, there are more pressing matters to deal with in your lifetime.

(Photo courtesy of Flickr)

Work is still bad for your health

Work is still bad for your health

Over the past two months, my work has been on a tear in a not-so-good way.  I’ve been clocking more hours than I ever had in my attending career.  The time I spend in the office and operating room is more intense than ever.  Ironically, I doubt that the hard work will even translate into additional year-end income.  The rationale behind such irrational aspects of medicine can only be partially explained through a PhD dissertation, but this is the life of medicine that we’ve signed up for.  Now, this post isn’t intended to be a rant session, but it does serve as data for me to reflect upon.

Longer/Strenuous Work Hours = Less Time Off

We only have so many hours in a day.  You have to rob Peter to pay Paul. Longer hours for me means that I have less time with the family, less time to clean the house, and less time to devote to the Smart Money MD website. More strenuous hours also mean that I am more exhausted when I get home.  Caffeine can only get you so far, so many of my evenings have been entirely unproductive or degraded into menial tasks like dozing off while having the television on.

Long-term this can’t be good for the psyche.  Unless you really love your job.

Someone else benefits off of your labor.

In the field of medicine, we try to cure diseases.  The more time you spend working in medicine, the greater number of people you will help. Helping people alone is a powerful feeling. I am happy every time I am able to help someone out with my medicine knowledge.

But medicine isn’t all for altruism.  We get paid to help people too.  And that pay isn’t necessarily bad.  A good paycheck is useless if you don’t have the time to enjoy it.  If you spend the bulk of your time at work, who exactly enjoys your hard-earned dollars?

No, we shouldn’t blame stay-at-home spouses or the kids! A physician’s family by default signs up for both the pains and joys of the physician member. I know plenty of partners and spouses of physicians who have equally challenging or more demanding jobs than they do. But family members also have to deal with missed recitals, holiday events, family gatherings, and other joys of being with friends and family.

The truth is that I’ve seen plenty of physician households that enjoy luxuries that probably don’t afford a significant increase in happiness and otherwise wouldn’t have been chosen if it weren’t for a good income.

Things like getting a $120,000 car instead of a $30,000 car for a four-person family. It’s bad when your trunk release in your expensive car fails to open and all of your fancy groceries spoil (yes, true story).

Image that your $100,000+ car is holding your $150 steaks in the trunk hostage in the dead of the summer.

Or getting a house so large that you need three hot water heaters in order to supply all of the faucets.

Or buying into a subdivision that requires a well-maintained lawn with grass even though you live in a drought-stricken area?

You end up throwing money unnecessarily to solve problems.

In keeping along the lines of the scenarios above, I’ve seen busy doctors throw money at their problems simply because they don’t have time to deal with them.  Ordering take-out more than four times a week is one example.  I’ve had another colleague who ended up paying for an entire hot water heater system (his was like 4 years old) because the first plumber told him that replacement was the only fix!

All of these scenarios have played through my mind as I’ve stayed late at work these past few months.  Is that something that I truly want to deal with long term?

It does, however, sound like a reminder how important maintaining your financial health is to our future.

(Photo courtesy of Flickr)

Should you encourage your kids to attend college?

College is an experience that most parents encourage their kids to consider. It is a means to advance in society, get a good job, and become financially stable.  Likewise, my parents fortunately emphasized college as a necessity in life—you need to get into a good college in order to succeed in life. Period.

But should college be an option for everyone?

As a physician, it would be hypocritical for me to even suggest that kids should consider bypassing college completely.  I certainly encourage students whom I mentor to get the best grades possible and challenge themselves in any way they can.  If college is a possibility, I encourage them to go for it.  The problem is that many people end up in careers that don’t necessarily require a college degree. You might have “wasted” several years of your life in college for naught.

College is not necessarily free.

The problem with implicitly mandating college is that someone has to pay for it.  You. Uncle Sam. Your parents or family. Everyone.

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It seems like most students become involved with student loans at some point in their lives.  I certainly was.  I am sick of hearing about student loans.  They’ve been a necessary burden for many of my colleagues, and some of my colleagues are still repaying their medical school loans from a decade ago.  College is no different.  Last I checked, tuition at Stanford University in 2016 was around $45,000 a year.  Room and board will tack on another $14,000.  Big numbers add up quickly.

I view colleges in the same light as I do with medical school.  There is a trade-off between cost and perceived quality.  Top-tier schools are difficult to become admitted into. Many of them are also expensive.  Many parents whose kids are admitted into a top-tier school will likely make sacrifices for their kids to attend.  Even if your daughter’s art history degree from Yale cost you $260,000 and delayed retirement, it might still be worth it to you.  Your kid will have gone to one of the top Ivy-league schools in the country.  A top college will likely have high cost, high prestige, and likely high quality education.

The problem with an expensive degree is exacerbated if neither you nor your child gets anything out of it.  An art history degree from a no-name private college may still cost you $260,000 after all is done.  As a parent, you’ve go no bragging rights for your child. If your child doesn’t find a decent job, she is also stuck without a means to build her own financial future.  You don’t want colleges with high cost, low prestige, and low-quality education.  Everyone loses.

College does not guarantee a secure financial future.

A college diploma certainly doesn’t guarantee you a means to generate income, but your experiences in college can certainly create opportunities for you to acquire a job.  Fortunately for our society, the unemployment rate for college graduates over age 24 is lower than 5 percent (perhaps 2-3%).  By going to college in the U.S., you’ve putting yourself in a good position to become employed.  Not bad, but someone should compare income rate to the cost of obtaining the education. I suspect that it is lower than one would expect.  Sure, going to college may help you get a job but it still might not be enough to pay your bills.  Someone needs to solve that conundrum.

You’ve still got to play your cards right even if you go to a good college.

You life still isn’t set if you go to a good college even at a good price.  Not everyone is suited to learn in a classroom.  Not everyone will be able to take advantage of the social interactions in college.  Some kids who opt to live at home during college in order to same money may even miss out on some of the experiences they would have otherwise gleaned from living in a college campus.  There are many variables at stake. No one will be able to offer you or your child a clear strategy to win in school.  That’s what makes life so unpredictable.

Who should actually go to college?

If your kids want to enter professions that require college degrees, they don’t have much of a choice.  In actuality, if you attended professional school there is a strong likelihood that your kids will end up going to college.  Most parents who went to college will at least encourage their children to go to college.  Unfortunately, not every child whose parents went to college will actually benefit from a college degree.  That’s a fact.

Better to burn money on a less expensive education if you’ve really got to burn it.

The problem is that no reasonable parent would actually discourage her kids from attending college, no matter how poorly suited the kids are for the classroom. In these cases, you just have to cut your losses. Lay out the facts, offer options for your child, and what you would be able to contribute to their education. For instance, if your child got into NYU and has her mind set on attending (even though your parental instinct tells you that it’s a six-figure mistake), make it clear what you can contribute to their education.  Give them the freedom to make their life choices.  You might be pleasantly surprised.

What are your thoughts on college?

(Photo courtesy of Flickr)

How much do you love money?

This is a loaded question.  Most of us opted for a career in medicine not because of the money.  I knew that doctors made a decent living when I considered applying for medical school, but my main goal for becoming a doctor was to be able to do something really cool.  Cool stuff like saving lives or eradicating disease.  Activities related to money were not on the radar.  Tax lost harvesting? Indexing? No way! As a doctor who went through the hellish initiation process of medical school and residency, I should be immune to dealing with the toils of real life!

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Boy I was so wrong.  You can lose out in life if you don’t know how to control your finances. Guys like RootOfGood, Retireby40, and FinanciallyAlert are the smart ones who got it right early so that they can enjoy life.

You can make a lot of money as a doctor.

Herein lies the fallacy.  Just because you can make a lot of money in the medical profession doesn’t mean that you will.  It certainly doesn’t mean that you will get rich either.  I’ve met too many middle-aged doctors who have taken one too many fancy vacations and funded their kids through one too many private schools.  I’ve met plenty of doctors who end up taking poorly compensating jobs in highly desirable places. Both of these situations aren’t conducive to building a solid net worth.

I blame the salary bump that we all get after residency.  I tripled my income after fellowship.  Sounds amazing, but I probably should have increased it by a six-fold instead if I had picked a smaller town to live in.  Nonetheless, this significant jump in income plays tricks on you.  It makes you feel really rich even though you are not.  You have to pay taxes to Uncle Sam for having such a high income.  And Uncle Sam doesn’t really care if you have a negative net worth either.  It hurts to pay high taxes on everything while you still have a negative net worth.

Realizing that the medical system puts doctors at a huge financial disadvantage has actually helped me pay more attention to finances and money.

Doctors generally work pretty damn hard.

This is also a problem.  The nature of medicine puts doctors at a financial disadvantage. The long hours that doctors have limits what can be done outside of work.  If you work from 6am until 8pm—my friend Moe often works even longer hours—you aren’t going to have time to shop for discount groceries or cook dinner.

As much as I like Tikka Masala, I will rarely have the time or energy to cook it myself like Justin @RootofGood is able to.  (j/k)

All joking aside, most doctor lifestyles aren’t conducive to saving money.  And we all know that savings rate is a key component in building net worth, especially early in your working career.  The doctor with long hours is more likely to order take-out, have a housemaid, hire out lawn services, and take fancy vacations to compensate for the challenging lifestyle. That’s human nature. It’s not possible to run at high gear all of the time.

For these reasons, I’ve learned to respect money. We work long and strenuous hours. It’s easy to burn through our earnings relatively easily due to the stress of our work.  My long term goal has been to find a work arrangement that is conducive to a reasonable work-life balance with adequate compensation.  Not easy, but it should be a goal that all of us strive for.

You can work as hard as you want.

There are a lot of ambitious people out there. The great thing about our society is that ambition, hard work, and a bit of luck can get you far in life. Without a doubt, you can earn more if you work more. I know some doctors who work two jobs.  They like it. I know surgeons who operate while they are on vacation (they are licensed and take some locums opportunities). I know some who take time to do more medical work in charity. If the money is good and your health is good, you can theoretically work until you croak.

Don’t keep rolling that rock up the hill if you don’t know what’s going to happen next!

Make sure you have an end goal in mind.

It’s important to reassess your goals frequently. If money is what you want, then just work harder and spend none of your hard earned money. Otherwise, figure out what you really want out of your day, week, year, and life. Where does free time come into play, and how much of this can you control? When you are considering your financial goals, think about how much you actually need, and how much your heirs would get out of your excess earnings and whether that would even be beneficial to them.

(Photo courtesy of Flickr)