Jorge Sanchez: Path to FIRE

The moment you are born, as opposed to the moment you enter this world, may be different.

I was born the moment I realized that I wanted to make an impact on other’s lives. I believe that helping others through the practice of medicine is a noble calling.

But that is the beginning of my journey. But what is the destination? After all of these years, I realized that the real journey is about freeing ourselves from things that distract us from attaining happiness. But I am getting ahead of myself.

Of the many journeys we make in life (personal, educational, emotional, spiritual, etc.), my entrepreneurial journey was mostly accidental. Yep, accidentally, since there was no aha moment here. No shaft of light lighting up my path to show me the way. The realization only came years later. I am pretty sure many physicians also stumble upon entrepreneurship just like I did.

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I attended William Paterson University, New Jersey in 1995 and later graduated from the Rutgers New Jersey Medical School with a Doctor of Medicine in 2003. I suffered the usual inundation syndrome most docs suffer when attending medical school.

I became a patient rather than a doctor caring for patients when my mother went into renal failure and I decided to donate my kidney to her while a 3rd year med student. This was a life-changing experience that would change my attitude towards patient care. Once you are a patient empathy comes much easier when you become a consumer of this country’s healthcare rather than someone who delivers it. 

Fast forward past residency and some work in academic medicine at my medical school where I was asked to go to Florida and start a medical group by some friends. I joined 2 friends and started a hospitalist group in southern Florida. We also entered primary care out of sheer necessity to reduce our liability. Those years were fast and furious and we learned painfully from our mistakes in a market that took no quarter. Medical groups were born around us and perished overnight in this environment. Hospital systems became our friends and turned into active competitors.  I quickly learned that this healthcare landscape consumed physicians and spit them out should they make any mistakes. Unenforceable restrictive covenants were still used to prod my fellow physicians into avoiding contract disputes. Many of these contract disputes were sadly led by physician-administrators into what I now call “doc-on-doc crime”. The sheer stress of fighting healthcare systems to keep our company afloat was too much and we decided to exit. We sold to a large national Emergency Medicine group. The sale opened my eyes and introduced me to the tip of the iceberg which would later be called “The Corporate Practice of Medicine”. 

The most bizarre event in the sale was that they tried to enforce an “unenforceable” restrictive covenant that was too much to fight (usually when lawyers go after you it’s a matter how much stomach you have to fight the good fight). I moved to Arizona in 2010 with my future wife because of my love of photography and the outdoors (in addition to getting away from the legal entanglements in Florida).

While in Arizona I entered the world of independent contractors and 1099 employment. It was freaking lucrative with a 2x increase in my yearly income. I was convinced I would never be a salaried physician (today about 75% of all physicians are employed by a hospital system). It was stressful though, corporate medicine made sure I had a bull’s eye painted on my back, and getting predictable, steady work as someone outside of the employee model was a challenge. It was then that I discovered the world of Locums tenens which opened even more possibilities and opportunities. It was a chance to travel and explore the beautiful country that we live in. I am a landscape photographer and these side gigs (or main gigs) were a gift. Some of the best images I captured while working a side gig. 

It was during one of these trips that I met Nirav Shah, MD while shooting a waterfall in the misty Pacific Northwest. We quickly became friends and soon he presented this crazy idea (back in 2017 it was). He had this vision of remote management of hypertensive patients via a cloud-based platform. If you Googled these terms back then you got crickets. I called it “B.S.” because the evidence then was that it took a long time to normalize someone’s BP per the guidelines. We bet a  Nikon camera on a study with 48 patients to control BP via a cloud-based digital platform. We bet on a number of patients who would have improved BP by the end of the study – no improvement  (Jorge gets a Nikon Camera) or improved control (Nirav gets a Nikon camera). To date, I still owe Nirav a camera. We decided to publish and ultimately AHA published it and we were off to the races. We raised venture capital without even knowing that the idea we had would eventually be called Remote Patient Monitoring (RPM) which is everywhere today. 

During our periods of raising capital, we had hundreds of meetings -pitching our idea and vision to investors (many of whom had no clue how healthcare worked). Every Monday morning we would get a handful of rejection emails. Nirav would say during these difficult times, “We eat failure for breakfast.” Thankfully, many believed in our vision, our team, and our business model.

I did realize that to be an entrepreneur you have to have a unique mindset. You have to create this “reality-distortion field” where others see your vision and align to walk with you toward this horizon of success.

Sadly, during our travels in the world of start-ups and founders, it was rare to find a physician entrepreneur (doctorpreneurs as we called ourselves). What blew my mind was that despite the paucity of physicians in the founder space we are uniquely equipped to become excellent founders. So what is stopping us from entering this space? I have a strong conviction that as a profession many of us as bogged down by the very same “golden handcuffs” our jobs place on us. Student loans, overspending, poor tax mitigation, and super specialization that restricts professional mobility all keep us looking for jobs with security and that Q2 weekly paycheck.

This is the time when we came across the website Physician on FIRE. The idea of helping physicians take control of their personal and professional destinies resonated with Nirav and I, and we started a new journey by joining Physician on FIRE.  In this new venture, my goal is to advance the financial knowledge of physicians to help them successfully control their financial (and eventually personal) destinies.

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