“You do not rise to the level of your goals. You fall to the level of your systems.”
– James Clear, Atomic Habits
I had a bit of a revelation recently when I brought my dog in for grooming. Some background: My dog is ten years old and has a double coat from hell (although very pretty). She also had a spinal cord injury in November 2019 and has residual weakness in …
Groomers at PetSmart have more autonomy than physicians
Your income doesn’t matter. What you do for a living doesn’t matter. If you want to keep from being broke, none of these things matter except for this: When you’re dealing with money, you’ve got to understand how to do simple math.
I hear stories about people that don’t understand what broke means. It could be the person that recent graduates from dental school with $400K in debt that buys the $80K BMW for instant …
How not to be a broke doctor (5 ways)
As another autumn pulls the pages off the 2021 calendar, it’s already time to start planning for the end of the year. The days get shorter but often busier as the weather cools down. This can be a vital time when preparing for taxes, and it’s good to know what the best savings strategies are for you to implement now, which will put you in a good spot for your …
12 year-end tax planning tips for physicians
Health care workers understand that workplace violence, cognitive overload, and burnout have been challenging their safety and wellbeing long before COVID-19 added to their trauma. Bias and inequities in health care environments were also present well before this novel virus began making headlines. The time is now for us to determine what it will take to keep people in their chosen profession and then rapidly make these changes. Failure to …
End the trauma, stop health care’s great resignation, and protect care teams now
Even though their incomes often exceed the phaseout threshold for funding Roth IRAs, physicians have been utilizing loopholes in the tax code to fund Roth IRAs for the past decade or more. Converting IRA funds to Roth IRA funds allows a taxpayer to change a tax-deferred IRA to a tax-free Roth IRA. In doing so, the taxpayer must pay taxes on the balance of the account that is …
Backdoor Roth conversions may be going away: What this means for physicians
I am an avid medical blogger. Without a doubt, the most common theme I’ve encountered during the past several years is embodied in the following op-ed: “We must help physicians at the brink of burnout, depression, and high stress,” followed by: “Health care has crossed into a realm of moral injury and systemic collapse.”
I tackled the second essay first. I wrote a no-holds-barred response …
This article and podcast are sponsored by CityVest, providing investors with insider access to pre-screened, institutional real estate investments historically unavailable to individuals.
Alan, please tell us about your background.
My name is Alan Donenfeld, and I’m …
A physician’s guide to the best way to invest in real estate
An excerpt from Physician Underdog.
When investors make the decision to invest, there is something deeper that occurs outside of the capital. A foundation of empowerment is built, and the founders have an edge now over others that didn’t get investment. This comes back to how powerful venture capitalists can be, because they have the ability, through their endeavors, …
Bringing the Hippocratic Oath into the field of venture capital and entrepreneurship
My 13-year-old daughter inspired this article. If you parent a middle school volleyball player, you know that overhand serving is the holy grail of the game at that level. My daughter has a solid underhand serve that works well for her, but a consistent overhand serve would give her a big boost. To my consternation, she prefers to practice passing, i.e., bumping the ball back and forth. Why would she …
What change are you resisting? What should you deliberately practice?
My mother died 18 years ago today. It has probably taken me that long to be able to talk about it because, as survivors of suicide, our culture teaches us to live in shame.
However, as I grow older, I have learned to let go of that shame. If you mention your experience with suicide to others, you will usually always find that they were affected by a similar loss in …
How I learned to let go of perfectionism: a lesson from my mother’s suicide
I tend to size people up pretty quickly. Adult ADHD? I can diagnose it in about two minutes. Borderline personality disorder? About one minute. Bad actors on the Dr. Phil show? About 30 seconds (with the benefit of Dr. Phil’s preamble). I can’t help it. I attribute my habit of analyzing people to my training and practice in psychiatry. After a 40-year career in medicine, I can no longer delineate …
As resident physicians, many of us are overworked, underpaid, and trying our best to make it through. While this time has its ups and downs, we can’t lose sight of the bigger picture. One of the best things we can do during residency is laying the foundation for the life and career we desire. This means doing a few things during our time in training to set ourselves up well …
This article is sponsored by Masterworks, the art investment platform.
Updated March 15, 2022.
The Power Law dictates that 1% of the world’s population holds 45% of the wealth.
And they’re only getting richer thanks to the rise of consumer technology during the global health situation.
In fact, the total …
One unexpected way physicians invest like billionaires (and how you can too)
Medicine is not a business
You fools.
Healing is your blueprint, activated
to complete itself.
A doctor does not broker it,
The best anyone can do is align you
With what you should be,
And stay out of the way.
(Like a teenager setting off an illegal firecracker.)
Mostly, you pay the doctor for the alignment,
And the nurse
To keep the doctor out of the way.
If you’re not ready,
to get on with the business of what you should be,
You come …
Medicine is not a business: a poem
The U.S. Department of Education recently announced some major changes to the rules and qualifications around the Public Service Loan Forgiveness (PSLF) Program. Now, for a limited period of time, borrowers may receive credit for past payments made on loans that would otherwise not qualify for PSLF.
The good news is that public service loan forgiveness is now available to more people. The bad news is that there will be more …
The Public Service Loan Forgiveness waiver and its impact on physicians
About 4 months after emergency medicine physician Jessica (a pseudonym used out of fear of retaliation from her employer) joined a Michigan hospital in 2014, the department’s staffing group was bought out by TeamHealth, a staffing firm backed by the private-equity behemoth Blackstone.
Ever since Emergency Medicine Specialists (EMS) — which touts itself as one of the oldest emergency physician groups in Michigan — was acquired by TeamHealth, “it’s been …
Why private equity is a dangerous employer
Remember the dark days of the pandemic, when the true risk of caring for COVID patients started to become clear? Remember when you could be censured by a nursing supervisor or administrator for wearing a mask in public areas lest you frighten patients or visitors?
Right around then, a third-year resident at UCLA decided to wear a mask wherever he went in the hospital, as testing wasn’t readily …
Why it may be time for doctors to unionize
Over the last 32 years, I have been following the literature concerning money, investing, and debt. In the last few years, I started writing about the topic as well as sharing my knowledge with other physicians through one-on-one financial coaching. Through the years, I have seen many people make the same mistakes when projecting financial goals, and they make them year after year.
When all of the answers are at our …
4 money mistakes everyone makes
When I decided to leave practice and explore non-clinical career options, I found no shortage of opportunities, ranging from the pharmaceutical industry to the health insurance industry and many points in between. I chose to work in the health insurance industry because jobs were plentiful, and the focus of work remained on the patient.
A typical entry-level job in the health insurance industry is that of utilization …
For doctors leaving clinical practice: Do not consider utilization review jobs
I was recently coaching a bright, energetic primary care physician in her first few years of practice. She was working through her Life’s Purpose statement, an exercise we often recommend. At the end of her admirable statement, she tagged on “with efficiency.” Naturally, we explored this a bit. Our conversation meandered toward an interesting conclusion: the more she focused on efficiency, the more likely she was to feel overwhelmed and …
The inverse relationship of efficiency and resilience
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