The Sunday Best (2/10/2019)


The Sunday Best is a collection of articles I’ve curated for your reading pleasure.

Expect most of the writing to be from recent weeks and consistent with the themes presented on this website: investing & taxes, financial independence, early retirement, and physician issues.

 

Presenting, this week’s Sunday Best:

 

 

Six or seven years ago, I spent most of my 17 weeks off from my primary job working locums three states away. That’s where I met Dr. Eric Larson, the President of the group at the time. We reconnected on his podcast, The Paradocs in Episode 033: Walking Away From It All. The FIRE Movement with Dr. Leif Dahleen.

 

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I maintain that the FIRE Movement is Here to Stay in some form or fashion. Joe’s not so sure. From Retire by 40, Is the FIRE Movement a Fad?

 

Either way, I’ll keep washing out my Ziploc bags. Just kidding — I don’t do that (but I do reuse the ones I use for sandwiches). And why not? According to Beyond the Dollar, People Who Wash Their Ziploc Bags are More Likely to Be Millionaires.

 

With a name like Debt & Cupcakes, you wouldn’t expect them to be into fasting. Surprise! They are — but it’s not the kind of fasting you normally hear about. 3 Financial Fasting Challenges to Help You Become Debt Free.

 

Side Hustle Scrubs challenged the White Coat Investor’s readers to Stop Whining About Job Satisfaction. He followed that up with 10 Things More Productive Than Whining About Job Satisfaction (and the doctors who did them).

 

One “productive” thing (depending on how you look at it) some of those docs did is cut back, like Crispy Doc did. I featured the first four in this insightful series a couple months ago. Learn from four more like them:

 

Dr. Miko of Mind Body Miko cut back. Waaaaaaay back. Who knew that surgical training in Australia could be rougher duty than here in the states? The Ugly Side of Becoming a Surgeon. Ugly is a gross understatement.

 

Cutting back or quitting are not your only options. There are other career paths for physicians, almost all of which don’t involve blogging. From Enzyme HealthAlternative Career Ideas for Burned Out Physicians.

 

If you and your special someone aren’t on the same page financially, how can you find harmony? My friend Andy has been known to Budget Party and Cubert convinced his wife to join him in Early Retirement BlissWhitney Hansen has some additonal ideas. 4 Steps to Get Your Partner on the Same Financial Page.

 

This topic has much narrower scope, but it’s a question I hear often. From Laura of Every Day by The Lake, writing for Women Who Money (yes, money’s a verb now): What Can I Do With an Old 401(k)?

 

I reviewed a couple of FIRE books published in 2019 earlier this week. Financial Freedom and Playing with FIRE in Financial Freedom for Millennials. Congratulations to JHL and Kathy S who won copies of the two books signed by the authors!

 

Speaking of books, The White Coat Investor book is selling at the lowest price I’ve ever seen. At $10 a pop, you might want to pick a few up for your favorite med students or residents.

 

Thursday’s guest post was quite popular. Rachel Hernandez explained The Reality of Real Estate Investing: It’s Not as Easy as It Seems, and I introduced a real estate investment from CityVest that would be much, much easier.

 

Yesterday, Passive Income MD proved that ladders aren’t just for firefighters, house painters, CDs, and bonds. How to Build a Real Estate Crowdfunding Ladder.

 

Gain access to a hard money lending fund with the minimum investment reduced 90% and substantially lower fees.

Twenty Nineteen

 

The year 2019 will be a memorable one for me, but that’s not what the heading is about. When I wake up post-call tomorrow, I will have 20 hospital shifts and 19 surgical center shifts left to work.

Not that anyone’s counting.

In reality, the 20 hospital shifts are 24 hours apiece and strung together 3 to 5 days at a time, the latter over the 4th of July holiday. Yes, Independence Day will be my final working holiday. In a way, I only have six hospital call shifts to go, but I don’t like to think of a 72-hour or 120-hour stretch as one shift.

So 20 and 19 it is. I reserve the right to work in anesthesia again if the desire hits me, but I’m making no particular plans to do so. I want to see how it feels to have a calendar with no workdays scheduled, and what it’s like to months on end without putting on a pair of scrubs.

I just finished reading Tanja Hester’s Work Optional, which I’ll be reviewing on Tuesday, and it’s given us a good framework to use to better envision what we want life to look like on the other side of this career.

In the short term, after waking up post-call and all done on August 12th, I anticipate spending about a week and a half in Michigan keeping tabs on the construction of our new home, returning back to Minnesota to visit friends, maybe having a retirement party, catching the Golden Gophers’ season opener at TCF Bank Stadium, chilling for a weekend at Camp FI Midwest over Labor Day Weekend before heading out to FinCon19 in Washington, D.C.

Like retired people tend to say, I’m not going to know how I ever found time to go to work!

 

A 1-Star Physician

 

Knowing that my name would eventually be associated with this site, I would occasionally Google my name to see what came up.

On the first page, there I was. A 1-star (out of 5) physician. One of the online physician rating sites had garnered one review of my performance and it was a complaint, of course, with a 1-star rating. I’m not going to name names, but the site rhymes with wealth glades.

The rating was from a person in Florida who, in 2016, complained about my office staff and waiting room time. Note that I haven’t worked in Florida since 2006 and have never had a clinic, office staff, or waiting room.

I contacted “Weatlh Glades” support, informed them that the rating was clearly in error and couldn’t possibly be about me, but they didn’t seem to care. After repeated attemps, I finally got a response. I was told that they had confirmed the review had met their criteria for display.

Really? Must be some really stringent criteria.

However, I was given an option for my “special situation”, which I imagine is an all-too-common situation.

“I contacted our Product Management team and asked them if we could deactivate your survey page. This is not a normal option but they are open to the idea in your case due to your specialty’s ethical responsibilities and constraints. It will allow the display of your profile it just takes away any option of surveys and of course all previous survey data would be gone as well.”

So now I don’t have any stars, but I’d rather have no reviews than one bad one that arose from somebody’s extended wait time in some random clinic in the Sunshine State.

There are other things you can do proactively to improve your online ratings. Have you ever listened to a podcast and had the host not ask you to leave a 5-star review? Think about it.

The impact of physician rating sites and social media are becoming more important than ever. These are frequent topics on sites like KevinMD, but where do you start? Dr. Jay Sridhar of the Retina Podcast and Dr. David Almeida asked me to preview a course they created to help physicians understand how to use social media and online branding to their advantage.

I thought the content was solid with a number of actionable tips, but as a frugal physician, I didn’t like the price point. Before offering the course to you, I asked them to cut the price in half.

Not only did they do that, but they gave me a $10 off code for my readers to use (discount codephysicianonfire), making the course a justifiable $39 business expense. If, after taking the course, you’re unsatisfied for any reason, you can request (and will receive) a full refund.

Check out Online Strategy for Physicians: Digital Media, Online Branding, and Online Strategies for Physicians

 

 


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Have an outstanding week!

-Physician on FIRE

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8 comments

  • Online reviewing of a doctor is another absolute farce.

    My daughter came to me and showed me a 1 star review of me when she Googled my name.

    I got 1 out of 5 stars across the board from an angry patient who basically was upset that she had a followup CT scan she did not want to do (but was convinced by her ordering doc to do so). Apparently I read it out as normal or benign finding (it was an anonymous review so I couldn’t research it) which apparently confirmed her belief it was not necessary.

    She went on to accuse me of being greedy and I should have canceled the study. By the time I am aware of a study it is already done and on my screen to review. It just is not part of a normal radiologist work flow. On rare occasions a clinician will call me and ask me what study to order and that is pretty much the only time to influence it.

    It is absolutely ridiculous that some reimbursement levels are tied to patient satisfaction ratings. Sometimes the best medical thing to do does not conform to what the patient wants and you can get dinged with a bad review.

    Congratulations on your upcoming independence. Perfectly timed to coincide with July 4th. Those 24 hour shifts seem brutal so I’m sure it will make you appreciate your freedom even more when you complete them.

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  • Dr. P

    PoF- I’d be interested in hearing more about your new home build and what strategies a frugal doc like yourself are using to keep construction costs in check. It might make a good blog post as many high income professionals build a new home sometime during their career…

  • Barney

    Your anecdote about the 1-star rating illustrates what college teachers (many of whom get anonymous reviews every semester) have known for decades: the credibility of anonymous reviews is always questionable. Third parties looking at these reviews have no idea how factually accurate they are. And, as your experience illustrates, they are sometimes completely inaccurate.

    It saddens me that so many people rely so much on these reviews.

  • I just checked. Thankfully I have no reviews anywhere!

    My wife has a few, 4.5 Stars!

    This is all so crazy. Patient satisfaction is not correlated with health outcomes. Medicine isn’t about satisfying people. It’s about making them healthy and encouraging them out of their unhealthy habits and beliefs.

    There is plenty of advice that no one wants to hear and when you start going down that path you are bound to anger people.

    Say that kind of stuff to patients and see how well your ratings hold up!

    Tying reimbursement to a popularity contest is how you get perverse incentives that lead to things like an opioid epidemic.

  • Thanks for highlighting the Crispy Doc series. He is doing the important work of giving us role models outside of the standard issue one that we are enculturated with.

    Thanks for the tip on the $10 WCI book too. I should stock up on a few more copies. I have given mine all away – again. You and Jim are changing lives for the better.

    Good luck with your job countdown. You are a five-star doc in my book!

  • As someone who is inpatient based and on a team I think it’s hard for someone to single me out for a review (either positive or negative). I think one issue that applies to us that doesn’t apply to others types of professionals who are reviewed is confidentiality. For example on some sites when a hotel or restaurant gets a bad review there is often a response by the business. However, given HIPAA we cannot rebutt any bad reviews. (Also I think the overwhelming majority of us value patient confidentiality, even for those patients whom we do not have a good relationship with).

  • Thanks for highlighting my controversial article. Docs don’t have to accept being miserable, but whining won’t solve much. Luckily there are physicians like yourself who have set a good example of how to change. Thanks for all you do.

  • Gasem

    Just leave a review of the review stating the person came in seeking narcotics and was refused. One thing to note on “reserving the right to practice anesthesia” About 2 years after your last day with no ongoing clinical practice, you will no longer be insurable. So if that’s your long term back-up plan you need to consider that and be doing a few locums stints a year.

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