Gratitude, stock market gains, and GOMERs

It’s that time of year again. Holiday gatherings, work parties, and thankfulness fills up the calendar.  This also means that it’s time to reflect on the year’s accomplishments and failures.  Perhaps we can learn from our mistakes and strive to be a better form of ourselves the following year.  
It’s time to run through the three G’s, Finance-Edition:


We are lucky to have great hospital support staff, an electronic health record that only crashes intermittently, and a nice parking spot at the office.  This time of year also translates to gifting. For the finance-minded folks, here is a list of reminders to keep track:

Gift tax – Suppose that you’ve hit the jackpot with your medical practice and are sitting on a cool $20 million in your estate.  Maybe you decided to forego that living trust option and just want to spend down your stash.  The annual gift exclusion amount for 2018 is $15,000 per person.  You and your husband can each gift $15,000 per person without getting hit with a gift tax.  This means that you can gift out quite a few $15,000 increments without having to pay a gift tax.  Get your checkbook ready, or mail them online checks if you’re computer savvy.

Gifts to employees — There are certain rules to how you can rewards your employees.  Be sure to reference the IRS’s de minimis guidelines to make sure what you do falls under the rules.  In general, throwing an occasional holiday party to your staff will be perfectly fine.  Giving them cash equivalent gifts will not.

Gatherings — It’s not uncommon for doctors to throw holiday gatherings for their staff in their homes.  That’s very nice, but make sure you have an adequate amount of umbrella insurance. You’ll never know when someone has a little too much to drink and ends up hurting himself in your swimming pool or trampoline.  Be sure to consider buying a rider for libel or slander as well, if that applies to you.

You might also like: Umbrella insurance 101 for new medical graduates

Stock Market Gains

My last weekly e-mail from Personal Capital appeared like this:

Negatives sting

Across the board, the stock market has performed poorly in 2018.  The gains from 2017 have quickly vanished, and these are times that I feel fortunate that I have a stable income to fall back upon.  Do I wish that I had alternative income stream from real estate or side gig? Sure.  But it still isn’t necessary.  The beauty of being a highly-compensated professional allows you to have more options to control your lifestyle, expenses, and ultimately, your net worth.  Set your savings rate on autopilot, and make it a goal never to lower your savings rate  unless some catastrophic life events occur. 

You might also like: How much money do doctors make?

Bear market?  Healthcare is here to stay, whether or not we like the direction of it.  Some calculations project a physician shortage of up to 100,000 doctors by 2030!  Even including doctors who trained outside of the U.S., it is inconceivable that we’d be able to sustain the physician shortage dilemma.  We’ve seen automation, physician extenders, flowchart medicine, and all of the strategies to find ways to care for illness with minimal direct physician input.  What this means for you, the doctor, is that you have job security.  Use that to your advantage. Work hard and keep up with the bear market. You don’t have to do any more to win the game.  


Anyone who has read Samuel Shem’s The House of God will understand the reference. We all have GOMERs in our medical practice, whether we work in inpatient or in ambulatory medicine.  That one patient who we can never discharge because some snafu prevents us from doing so.  Or the patient who keeps coming back unhappy about the seventh cosmetic surgery revision he’s had, and wants another one. 

For free.

On a Saturday afternoon. 

GOMERs are the one constant in the medical field that sometimes puts me at the edge of dislike for my profession.  But whenever this irritating experiences occurs, I remind myself that we are still lucky to be in a well-paying profession that allows us significant freedom to heal.  No matter how negative our workplace can be or how annoying certain hospital regulations are, don’t forget that we are still healers.  We have a skill that allows us to provide services that even to this day I am still amazed that we are able to bring people back from the dead.

Happy Holidays!

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