Welcome to another episode of the Worthy Physician for physicians by a physician combating physician burnout through awareness to ignite passion for medicine.
Dr. Shah-Haque:Well, good morning. And Elisa, thank you very much for, being here. So for the listeners, I'm Dr. Sapna Shah-Haque and I have, I'm pretty excited about having you on here. Will you please introduce yourself to our listeners
Dr. Chiang:Yes. Hi. Thank you so much for having me. Um, I'm Elisa Chiang and I am an occuloplastic surgeon as well as a life and money coach. I. Primarily have the motivation to help physicians be able to gain financial literacy just so that we can have financial freedom. We can practice medicine because we want to, not because we have to, because I see so many physicians feel handcuffed to their job because of things like loans and just lifestyle creep and maintaining their current lifestyle and providing for their families and. Just the knowledge that 24% of physicians have a net worth of less than$1 million by the age of 65 after having a career as a physician. Which is just, you know, so sad in so many ways because most physicians do not have pensions that are going to keep them, you know, able to continue to live throughout their retirement. And we deserve to build to retire at 65 or earlier or later, or whenever we want to, and still build to maintain, you know, The lifestyle that we've been living, or at least you know, a, a lifestyle beyond what a million dollars of net worth will get you. So just, uh, for an idea, if you have a million dollars in just stocks and bonds, then you can basically live on$40,000 a year, which is less than a current resident makes. And since most of us talk about how little money we have in residency, we certainly don't wanna have less than that when we're looking at our retirement years.
Dr. Shah-Haque:And so just, but then perspective. For many people, residency is, a small apartment or living with family, so it's very minuscule. So that would be taking a huge step back compared to what they already have and not, and not everybody always has their house paid off by that time or a lot, or taking on a bigger house or maybe even downsizing. So you have to consider that. What would you tell physicians that are looking to downsize maybe right before, retirement? Is that, is that
Dr. Chiang:smart? Well, I think it all depends on your current financial position. And there are physicians who have done very well for themselves and they can continue to live their current lifestyle or even expand their lifestyle and still never, you know, run out and always have enough. And then there are physicians where they really can't continue their current lifestyle without down sizing is they decrease any actual work that they're doing, anything that's bringing them.
Dr. Shah-Haque:But you're here to help us try to plan not to be that last scenario. Yes,
Dr. Chiang:definitely.
Dr. Shah-Haque:what is your passion as far as finances?
Dr. Chiang:Yeah, my passion is really, I mean, finances are a tool. I've just been someone who've, you know, even as a child, kinda love money and love having money and not just spending money. So I was that kid where like I had this really pretty embroidered wallet and I'd like to put money in there and I just would like to count it and see more money going in there and eventually have a savings account and see like that that was growing like that. Gave me a rush. Like I wasn't the one, and it's not that I didn't spend money as a kid. I certainly liked, you know, getting ice cream or going out with friends to movies or, uh, books were actually the thing I liked to buy the most when I was a kid. uh, funny thing, but I. You know, I think there are a lot of kids, or even teenagers where they make money to spend money. My sister was certainly one of those people who, she wanted nice things. She wanted brand new clothing. She wanted to wear Aberam and Finch. I remember that very specifically. So my parents, you know, they gave us everything we needed, but they were not about giving us, you know, brand name clothing. And so my sister had to go out and work to buy those things, that that's what the things that she wanted and. I think that was, I think that served all of us children well actually in my family with the sense of like, okay, like, you know, we have the basic needs. Our parents love us. It's not like we have to work as a child. Um, but if there were things that we really wanted that were not, absolute necessaries, that, that were really things that were just for fun or for, you know, essentially lifestyle choices that we had to go out and earn it.
Dr. Shah-Haque:I've turned into my parents. I have young kids, you know, the four year old leaves every, all the lights on because the monsters are gonna get'em. And I'm going behind, turning off the lights, saying, honey, we're not made outta money. It sounds like you were brought up with that awareness. would you agree?
Dr. Chiang:Yeah. And it's funny cause now I look at my, I don't have children myself, but um, my sister has three boys and my brother has three boys. And they both parent very differently, especially when it comes to money with their children. And my sister does have this sense of like, oh, I didn't have all these things when I was growing up. I wanna give my children all these things. And my brother is really much more on the opposite end of like, I wanna give my kids what they need, but you know, they don't need to have all these extra things. And it's funny cuz you know, we grew up in the same environment, but just the way that changed how they wanna treat their children.
Dr. Shah-Haque:you're a physician and you're kind of doing the same thing now, but instead of putting that in a wallet, where are you putting that money now for investment and to watch it grow?
Dr. Chiang:Yeah, so, you know, I do have money in stocks and bonds, uh, especially in my, uh, retirement accounts, but I also invest heavily in real estate, both passively in syndication projects as well as I do currently have an active short-term rental or what people c sometimes call like an Airbnb that, you know, brings in positive cash flow. I also invest, uh, somebody in like private equities, meaning, uh, companies. Shares of companies that are not publicly traded. So when you buy a stock, you're buying a small piece of a company that's publicly traded. You can also buy shares of companies that are not publicly traded. You do have to be what's called an credited investor. Do that. Most of us physicians actually do qualify as an accredited investor.
Dr. Shah-Haque:I'm familiar with what that term is, but just in case the listener is not, can you please expand on what that is? Yeah,
Dr. Chiang:so accredited investor right now, the definition is that you've earned$200,000 for the last two years and that you will continue to, earn$200,000 a year. For a single person. If you are a couple, then it's you and your spouse,$300,000 for the last two years, and they'll continue to make$300,000 a year. The alternative is that you have at least$1 million of net worth, not including your primary residents. But basically to protect your, uh, person who doesn't have a lot of money from maybe gained an investment that could bankrupt them. So the idea is that if you have a certain level of income, then even if you were to put a lot of money in one investment and lost it all, that it wouldn't bankrupt you.
Dr. Shah-Haque:So, for, you know, for somebody, for example, I'm 40, I'm about 10 years, uh, out of residency. How would I get into either syndication or real estate? What are the, how did you learn about it and what would you tell a beginner like, like me,
Dr. Chiang:Yeah, so I guess to even go back a little bit, I first got interested in real estate when I read Rich Dad Poor Dad, which is when I was a grad student. I did uh, M S T P or Medical Science Training Program, which is a joint MD PhD program. So I had kind of a longer education and I read Rich Dad, poor Dad, and it just kind of opened up my eyes to what. Building wealth was really about, and what building wealth is, is about buying assets and buying assets are gonna produce more money so that your money is making money. That's what, what building wealth is, because if you always have to work for money, then if you stop working, then the money stops. But if your money can make money for you, that's how you really build wealth and. When you buy pieces of a company like stocks or uh, in private equity, then you're kind of buying some of their profits, right? You get a share of their profits with real estate. When you buy a real estate as an asset. Then you get cash flow in terms of rent, right? So you buy a piece of property, you rent it to someone else, they're using it, and then they, um, and they pay you rent so that you have cash flow coming in that way. And that real estate continues to appreciate. So it's not necessarily like, oh, real estate is better than, um, stocks or private equity is just different. And, uh, and so I started. So during grad school, I was kind of got to this point where I was really unhappy as a graduate student and I decided, like, I, one of my kind of outs was like, okay, I don't wanna a boss, I don't wanna have to work for money. What's the fastest way to create wealth? You know, I know I'm gonna be a physician. Um, but you know, once I, like I said, after we reach support, it's not about how much money you're making your job. It's like, okay, how can I, you know, learn to take that money and build to wealth? So I actually started real estate investing as a graduate student. Um, and I actually essentially ended up borrowing money, bought a house at um, that was a foreclosure, fixed it up, and then sold it, which is something called a flip. And at that time I didn't know about like, oh, I could refinance it and then put a renter in and get my money out. But because I had borrowed the money in order to do this, I like needed the money back to pay it off. I also did take real estate courses in order to kind of learn how to do this. And I did spend a lot of money real estate courses like a Rich Dad, poor Dad Academy. Uh, you know, came advertising themselves and they, they, they do the classic model, okay, come for a free night session, come for a free night. The free night, you know, three hours they sell you on their weekend course was, which, which was a few hundred dollars, I don't remember, three for$500. So you go to that course and then, What you don't realize is essentially two days of selling you, they're big real estate courses, right? So, but I got sold, I bought$18,000 real estate courses as a graduate student. I mean, I'm making$20,000 a year, put this on my credit card. So now I had to pay this off, right? So I had to just, I hustled and hustled and tried different things until finally I actually ended up those courses from Rich Dad Poor Dad Academy, uh, real Estate Academy, um, weren't really enough for me. Be successful in real estate, but I was networking with many other real estate investors and going to, uh, what's called RIA meetings, real estate investor association meetings. And then at those meetings, other people come and sell their real estate courses. I finally actually bought into another real estate courses that included mentorship and that was really the, the key that I needed. I needed someone to actually talk about the deal. Present numbers present, like, this is what I'm looking at, this is what I'm thinking. You know, will this work? How does it work? Both to ask questions to someone. And I purchased, of course, included that mentorship and that's how I was able to do that first flip. And then I, once I sold that, I saw success and now I had paid off. Some of my real estate courses, but I still now had, you know, other real estate courses to pay off, um, and wanted to make a profit as well. So I did it again and at that point, um, was now back in my third year of med school. So after the two, um, Flip projects, you know, I got into a place where like, okay, I know I have the skill, I know I'm gonna use this again. But I went kind of back to focusing on, uh, my medical education intern year residency. But amazingly, there are some residents who are doing real estate investing. the easiest way for a resident doing is probably doing something called a house hack. So buying a property, and it depends on, you know, where you're living in your personal situation, but. If you're in a more lower cost of living area, if you can buy something like a duplex and you live on one half and you get a tenant for the other half, you can get it to the point where the tenant is essentially paying for your rent as well. And maybe you are not, you know, making a lot of money. But if you are kind of living rent free, then that's still essentially money that you would've had to spend towards rent. And it also teaches you a lot about just how to get started in real estate. So I've seen residents, uh, do that as their first foray into real. Um, Actually, I talked to this one fellow who did a whole development project and that's how she paid for medical school. I don't even know how she got the, um, backing or the information or knowledge or drive to do that. But I mean, it's amazing what we physicians can do, but when we put our minds to it, I mean, we're among the smartest people in the world, right? Like, and real estate is not med school hard. It's not practicing medicine hard. So if you go out and seek the knowledge and seek the people and seek the mentors, then we can be successful. pretty much anything in certainly real estate.
Dr. Shah-Haque:I think you hit two major things. Number one, you have to have the drive, and then number two, you have to go out and seek. you're right, it's not med school. Hard. I, I know what is intimidating for, for me it's like, okay, well there's so many things, right? So how do you get the initial backing? Who do I go talk to for that piece? and then if I were to do a duplex, how is that finance just, would it be under a, for example, if that's my primary residence, would I finance that as a primary residence versus an investment property? how do I protect myself from the tenants? so I think there are so many moving pieces, you know, like where do you.
Dr. Chiang:Great. And when we think about medicine, so I'm an oculoplastic surgeon. When I start medical school, I had no idea how to do surgery. I had no idea how to do an eye exam, right? Like it's, it's daunting. I didn't know how to use a slit lamp. Like all of it seems daunting, right? It's like, oh, how do I start? Like how do I, you know, and if you think about a physician starting their own practice, like, you know, how do I get staff? How do I get employees? So your questions are totally normal and. First thing to do is start is just talk to other people doing it. There are a lot of physician real estate investors or. Real estate investors. They don't have to be physicians where you can get out and talk to them and ask them how they get started. And that provides a great way to also find a mentor in the area. The other thing is just books. There are a lot of great books. Bigger Pockets actually has a book series, uh, where they have, uh, books and different topics. And a lot of those books have been great, but there are a lot of other real estate books by lots of other publishers. There's a lot of blogs out there, there's a lot of podcasts, so there's no shortage of information. It's really. Starting out and using it. And then there are courses, some courses specifically run by physician real estate investors for physician real estate investors. And those courses obviously have a higher price tag, but they consolidate the data so you don't necessarily have to spend as much time reading so many different things. You can get exactly what you need and then also get your. Answered. So, you know, just in terms of answering the few questions that you presented. Now you know, if you are house hacking, so it is gonna be your primary residence, then you do wanna go ahead and use, uh, you know, borrow with a mortgage as a primary. Uh, Residents, because that's gonna give you the best mortgage rates. And there's no, there's nothing wrong with doing that. If you're actually gonna live there, then that's totally fine. if you are buying, if you already have a primary residence and you're thinking of buying, buying a investment property like a duplex or, triplex or quadplex or even a single family house, and it's strictly going to be as investment property, then you would get a mortgage. Letting your mortgage broker to the bank know this is an investment property, and for that, you're gonna need a larger down payment than a primary residence, and the interest rates are gonna be higher. So you're gonna factor that that in into your cash flow and whether or not this piece of property is gonna make money before you buy it. So that's all information that you need. One thing that a lot of people talk about real estate is like, well, I don't have like big sums of money to invest in real estate. I don't have money to put 20, 25% down on property. I will say in real estate that if you can find a great enough deal, you can find someone with the money to go back that deal, right? Like I said, for my first deals, I borrowed money in order to, to do that, that I borrowed money, uh, off my home equity line of credit. So I had equity in the house that I had bought, I had bought for my parents. and I started real estate investing kind of back in 2008. Where? Well, so I bought my first primary residence from my parents when I was, uh, um, doing the MD PhD program. So, just for people who don't know, before 2008, anyone could get a mortgage. Your dog could get a mortgage. I mean, this is what caused that 2008 crisis is the fact that mortgages were so easy to get. There is a little bit of caveat there. When I started investing and got my HeLOCK, I got my HeLOCK before the whole crash. So I don't even think they really, they, there was no official appraisal or anything. Like literally the bank was like, oh, you have a house. Oh, you only have this much loan on it. We'll loan you more on it. It's fine So I'm not saying it's necessarily, it's easy to do that now, but it is certainly possible and as physicians we do have income. We generally have good credit. So there is money out there that could be borrowed. Let's say you don't want to borrow all of it. If you find a great enough deal, there are investors who will just give you the money to cover all of the cost and you are doing the work. So generally with investing in the beginning, you're either gonna put in time or you're gonna put in money. Right? And, and generally, You're always gonna put at least a little bit of time, but if you have no money, you're gonna put in more time. So in this case, you're gonna put in more time to find that great investment that's so worthwhile that someone who doesn't have time is gonna say like, oh yes, that does look like a great investment. I don't have time to, you know, find those investments. I don't have time to fix up those properties, but I have enough time to give you money and you do it, and you give me a piece of that profit. So just keep that in mind. And then you're saying, I'm a new real estate investor. How am I find that great enough deal? Well, you're gonna spend the time learning how to find a great deal and looking around and talking people, and there are always situations where someone who owns a piece of property might wanna dump it for some reason. Imagine. Someone who just inherited the property from their older relatives, lives acro, uh, in a different state, and again, doesn't have the time to want to go to the house of, you know, their parent or grandparent or great-aunt or whatnot and fix up or clean up or whatever. They just want to get rid of the, the property. And of course, they want some money off the, but they're willing to take the whole lot less to not deal with a headache. Right? You know, you're solving a problem for them. So now you can potentially acquire this piece of property for pennies on the dollar. And then now you are gonna take it, clean it up, fix it up, get it ready to be sold at top dollar. And that's how you're gonna make, that's the value you are bringing. So that's how you make your money off the deal. That's
Dr. Shah-Haque:a really ingenious way that, um, I didn't even know existed.
Dr. Chiang:And the more you talk to people who invest in real estate, the more you read books, the more you're gonna hear about things that, oh, like I never even thought that was possible. And that's gonna get your brain going like, okay, what else is possible? You know, what could I do? And then that's where opportunity will start to show up for itself.
Dr. Shah-Haque:in addition to Rich Dad Poor. what other books that you have read or listened to do you think have been game changers for you or even even podcasts?
Dr. Chiang:I think life coaching actually has been, uh uh, I mean like it's certainly been life changing for me, and that's because the other piece of it is not just getting all the knowledge, it's also getting your mindset in the right place, right? There's a lot of fear that people will have when it comes to investing in general, like even investing in stocks. Like I've met physicians where unfortunately they have not invested any of their money in their retirement accounts. It's literally just been sitting in treasuries because they're afraid of losing money in the stock market. So overcoming your fear by, you know, getting the information. I mean, we're physicians so you know, we can go collect data, we can analyze data, and we can look at, you know, what the actual situation is most likely going to be and not just look at complication and only complications happen, right? Because we know that. Everything does not always go perfectly all the time, but in general, if we do these steps, if we prescribe these medications, if we do this procedure, the patient's gonna have a good outcome. But the that good outcome's not guaranteed. It's the same as investing. If we do all the right steps, if we do our due diligence, then. Generally there's gonna be a good outcome, but that good outcome's not guaranteed. And actually, the more actively you're involved in investing, the more you have the ability to tweak things and to change things and to redirect things as opposed to when you're on the complete passive side where, you know, when you buy a stock, you don't have any say in how that company is run. So you really can't tweak the course of how that company is moving. But if you go and vet, purchase your own investment property, you certainly have full control over. What property manager you use or what tenants get in place, or what screening you use for tenants, what screening you use for contractors, how you fix things up. So again, that takes more time, but with that expertise and you do have more control and, and that's not for every physician. I'm not saying every physician needs to get that involved, but if you have, the desire is totally there. And just having the mindset around being able to get your place. Sense of like, I have the time to do this. I want to do this. My drive is strong enough to do this. I can learn this. You know, as physicians we can do hard things. All that is mindset. And so I think that's really the other key to it. And one of the real estate courses I took, uh, zero to Freedom by, uh, Kenji Letti, they realized how important the mindset pieces is. That that's actually the first module of their real estate course is all just talking about mindset. So the Life Coach School podcast is a great podcast to start getting into that mindset work. Um, so I, you know, I really, that that is one I, I truly recommend as well. And I'm one of those people who, you know, in the past used to read books, you know, quote self-help books, where it was like, okay, how can I be happier and. Things of like, oh, practice gratitude, meditation, you know, all these, not that, those things were bad. I, I don't knock them at all, but it didn't hit home the way. Looking at your thoughts and how your thoughts are creating the world around you really set in, because I could really see, it's like, yeah, if I'm thinking all these thoughts of like, I can't do this, this is too hard, then I'm not motivated to do anything. But to realize like, yeah, those thoughts are optional, and to look at, well, this is all I've accomplished. Why wouldn't I think I could accomplish something else, even though I haven't afraid in that area? That's, you know, there was a time where, I was a first year medical student. Right. And just revisiting that. Yeah. We can still learn. And you know, you might say, well, you know, but I was in my early twenties when I went to medical school, but you probably had some colleague who was in their thirties or even forties in medical school. Right. It's not that we're so old that we can't learn new things. We can certainly continue to learn new things. I mean, even
Dr. Shah-Haque:as physicians, we have continuing medical education. So I mean, I think that we're very able to learn new things and. Um, let me ask you this. What, what if, uh, what's the difference between syndication and, you know, an investment property maybe in the same state or same or maybe the state over? What's the difference between that? So what's a syndication and how does that differ from, um, like. Like a house hack or a a, you know, secondary residence or an
Dr. Chiang:investment property. I'm glad you brought up that, um, in, uh, that topic of lingo. So that is one of the reasons why personal finance and investing does seem difficult when you first get into it, is that there is a lingo to it, right? There is its own language. There's all these different terms that you're not gonna know. But again, I. Compare that to medicine that we have our own lingo, right? We have so much of a language and even between different specialties, we have a lingo. And so we learned the lingo of our specialty and we don't even necessarily know the lingo of other specialties. So I'm in ophthalmology and we use OD for right eye and OS for left eye, right? And. You know, you could be a great cardiologist. You're gonna have no idea. You look at ophthalmology, you know, you're like, what does this mean? I don't understand any of it. It looks like Greek. And you're looking at other physicians note. Well, like I said, real estate is not medicine hard, but it does have its own lingo. Uh, and, uh, personal finance investing is not that hard, but it has its own lingo. Lingos, like syndication house hat, you know, Burr, which is by, um, uh, rehab, refinance, and, and rent. So, You can learn all this lingo, and it is much easier to learn the lingo of personal finance investing than it is to learn like any specialty in medicine. So what a syndication is, is really when a bunch of investors get together to work on a real estate project. So imagine your big high-rise apartment in downtown Chicago that's, you know, Hundreds of millions of dollars. Like there's not one investor who's likely owning the apartment building, right? I mean, if you were like Bill Gates, you could probably do it. But in general, what happens is that there are real estate investors who have been in the game for a while. You know, they, you know, they may have started at some point just doing things like single family houses and duplex and rentals. But at some point they kind of maxed out, like, you know, kept building up, bought smaller apartments, bought bigger apartments, and I've even seen physicians go through this path. So to the point for their. Very seasoned investors, they find great deals, but now they don't have millions of dollars to put on one deal, especially when they're doing multiple deals a year. So now they go and find other investors, uh, passive investors, to be limited partners. And you know, those are the people who don't necessarily have as much expertise in finding deals or don't wanna spend the time to find deals. And they have money to invest in the real estate deals. So then they invest and they're passive and. Syndicator or sponsor, uh, is the active person. So they're managing the deal. They're the one who figures out the financing to buy the apartment complex. Who figures out property management, who works with contractors to rehab any units who, you know, does all the kind of nitty gritty actual parts of the real running, the real estate investment itself, and then limited partners. Just essentially invest money. So your job as a limited partner is you're gonna vet the deal, you're gonna vet the sponsor because you can have a magnificent deal where you're buying something pennies on the dollar. But if someone who is inexperienced and inept, or you know, just doesn't know what they're doing, takes over the deal, they can still make it flock, right? So you wanna make sure you're investing in someone who really knows what they're doing, who has a track record, who's done it before. Who's not a, a crock or a thief, and, and then you wanna make sure that the deal looks good. Okay. You know, the deal is in this city, that city has a, a growing economic base or a growing population that the rent set this person says they can get, seem reasonable compared to rents of other apartments in the area that the mount. Predict that they have to use to rehab seems reasonable to, you know, cost. And you'll get to know this information as you go. And there are, again, courses and books and podcasts that can help you learn this information. And you're like, okay, this looks good. I'm gonna invest my money. And then basically at that point, you sign the paperwork, you get. To be a, a, a limited partner in it. You wire the money over and, and then it's hands off and hopefully everything goes well and you get your distribution checks either every quarter or every month or however it is. And the sponsor or syn indicator is running the syndication and at some point they're probably gonna sell in order to make even more money. Um, and at that point, You'll get, you know, another, uh, payout. Sometimes they may even refinance. And then you can get money that you put in back and then you still have partial ownership and it continues. So it all depends on the nature of the deal. There are some syndicators who tend to, you know, buy a, a property, you know, fixed up or. Add value to it, add, um, adding value so that they can sell it for more later. And the window for that project is three to five years. And then there are other, uh, people who are more looking like, yeah, when I find a great piece of property, I wanna keep it forever. So, but eventually refinance so that you can kind of get your money out and then when you get your money out, you invest again and you continue to do that to, uh, build up your wealth. Um, uh, when you buy your own piece of property, that's more active investing. And again, there's different things you can buy. You could buy a. Um, you know, residential place where you're renting to someone who's gonna live in it. You buy a commercial property, right? McDonald's is really, in a way, a real estate, uh, company. They own the, uh, property that McDonald's sit on. And then, uh, different people, you know, buy into the franchise at McDonald's and actually run the McDonald's there. So there are other, you know, big companies that, you know, you imagine your malls. Strip malls or, or big malls or shopping centers or, uh, commercial buildings like office buildings. I mean, all that is real estate where someone owns it and other people are renting or leasing that property. And that could be, you know, much long term leases. Um, you can think mobile home parks or self stores, units. So, uh, you know, or even land, I mean, there's lots of different ways to invest in real estate. Um, and then you can also think development where you are actually, you know, buying a raw piece of land and building an apartment complex on, or building a big shopping, um, center on it, or a big office building on it. So the development is gonna have, in a way, a higher risk because there's so much more to do, right? You have to get the, uh, permits and get the contractors and really takes, you know, raw land to having. Building on it. Whereas, um, you know, if you take an existing, uh, property and you're fixing up, that's probably a little less risk, right? The amount of permits you need and the amount of building you need is, is less. So, you know, along that risk reward spectrum should also be about how ma how much returns you're getting. Um, and so all, and all of this is stuff that you can educate yourself on, but you know, just kind of a overall view of the nature of real estate. So
Dr. Shah-Haque:you started this in, when you were in grad school? Yeah. And you've continued it. So what, what is your hope for physicians? And My understanding is that it's increasing their financial literacy so that way they're not, uh, scraping the bottom of the barrel because of poor, uh, retirement, uh, planning.
Dr. Chiang:Is that correct? Yeah. Yeah, it is. And also for us to live well because, you know, there are people that I met who've discovered the, what's called the fire movement, financial independence retire early, but then they're just putting their notes to a grindstone cake. You know, save, save, save investment, investment, invest and be frugal. And. Don't necessarily live life because they're kind of have this arrival fallacy that, okay, in six years, eight years, I can get out and then life is gonna be great, you know? But I do think it is a balance. I mean, you can make life great now, but just make sure that the, your cash flow situation is such that yes, you are spending money on the things you value now that bring you joy now, but you're also taking care of your future self. Saving and investing for that future self so that you can continue to have the joy, have the money to buy the things that bring you joy. So it, and you know, it's multifold, but I think increasing financial literacy encompasses, you know, all these things. And you know, I, I know we've talked a lot about real estate investing in this, um, podcast episode, but the reason I bring in, uh, real estate investing is partially because. People, uh, generally hear about stock and um, and bond investing, investing in that portfolio. And they kind of hear about real estate investing, but they're not necessarily doing it because of they think that it's just such a big step to go into and it is just something different. Uh, people who use per uh, uh, financial investors, uh, personal finance advisors, those people are not ever gonna talk to you about investing real estate. They're really licensed to talk to you about just investing in stocks and bonds and. There are definite, um, personal finance advisors who are, don't have necessarily your best interest at heart. Um, but there are a lot that do and, and they can really be helpful in helping you create a financial plan. But just realizing that financial plan is never gonna include in real estate investing. And no, not everyone has to invest in real estate, or you could just invest in real estate by, um, vying to REITs, which is basically publicly traded real estate companies. So, One way to kind of invest in real estate, but it's just to know what's available out there. And real estate is also generally a faster way for you to potentially build your wealth. So because we, physicians tend to start later when it comes to looking at our investing, then for some of us going into real estate really helps us kind of make up for lost time. And as long as I've been investing in real estate, I've definitely met physicians who really. Fell into real estate, loved it, like have been gungho at it and in less than five years have done way more than I've done and created, you know, way more cash flow and assets and income than I've done, even though I started so much earlier. You know, and it's not a race, right? Like I'm going at a pace that I'm happy with and I'm spending my time how I wanna spend my time. Uh, but just knowing that it is an option for any physician to.
Dr. Shah-Haque:Thank you for clarifying that because as physicians, we're high driver, you know, we're goal-oriented individuals, we're competitive, so thank you for pointing that out, that you, you're going at a pace that you're comfortable with and you're doing what you're comfortable. that's good for you. You know what's good for another person, great for them. But gotta focus on what you feel comfortable with. And another thing is, is that we're just so used to delayed gratification. Right? We did that during, uh, undergrad, then grad school, then uh, maybe medical school, um, well definitely medical school, but plus remind us grad school right before that or after that, since you have a PhD and then residency. So it's almost like, my gosh, I don't know how to live in the now. and also enjoy them now because six years is not promise, right?
Dr. Chiang:Yeah. And sometimes it goes both ways, right? We don't know how to live in the now and so we don't actually allow ourselves to kind of fully spend money that we can spend in order to happy, right? Like we're still looking at the menu and being like, oh, you know, that stake sounds great, but maybe that's too expensive. I should get the chicken Um, or. You know, I'd really love to go on that vacation, but, ooh, that's, that's a really high price tag to the opposite end of, okay, now I'm an attending. I have this money, I should get all the things I'm gonna buy. The Dr. House, the doctor car, the, you know, uh, you spend money and in and inflater lifestyle. You know, to a high degree, just like all at once, and then not actually taking account. The taxes that we start paying when we're attending and the loans now, you know, that we've taken for our medical education are now starting to, you know, Add up with the interest over time and the fact that we nec, we haven't necessarily been kind of saving, investing for our future for either retirement or if we wanna fund our children's education or you know, anything else that we have on the horizon. And so, yes, when you first buy that, you know, Dr. House or that car, or you know, whatever, you know, expensive things that you've kind of been delaying for a while, that will make you feel great for a little while, but then eventually that just becomes your new norm. And. And now you've got kind of a new expensive norm. So one advice I always have is, especially for new attendings, is to, you know, slowly grow into your income. Yes, you can definitely spend more than you did when you were a resident or fellow, but don't just start being like, okay, I've got this big paycheck, I can now spend it all, um, you know, increase in increments and half amount that you're sending aside for saving, investing for the future. Yeah,
Dr. Shah-Haque:it's. Because we also have to remember now we're gonna start paying back loans if you haven't been, if you've been deferring them during, during residency, because residency paycheck is like this much, and the loans are a lot of times about a third to to a half
Dr. Chiang:the check. and I do encourage anyone to consider, um, uh, public service loan forgiveness PS uh, P S L F. You know, it used to be like that was something where it was very hard to get, but at this point, like lots of physicians have been able to get it, and we are. I don't wanna say privilege, but I mean we are lucky or it is advantageous for us that generally when we're in training in residency and fellowship, we're working for nonprofits for that time counts. So instead of deferring, if you can make those minimum payments that are based on your income, then. You know, like for me, I did six years of residency fellowship training. So then, you know, I didn't have loans because I did the MSTB program, but if I didn't, I could just work four years at a nonprofit and have those loans wiped out. And if you've got$300,000 loans, it could be well worth working however many years to get those loans paid off because you're still making an attending salary while you're working at that nonprofit. You are just, you know, maybe delaying being in a private practice or opening your own practice. And, you know, most people don't really wanna open their own practice straight out of training. So it may, it's not necessarily a bad thing to go ahead and, you know, work for, um, Work for a hospital or work for a nonprofit, uh, work for academic centers when you're in the first few years where you're really learning your profession. And then you'll actually learn all the things that you don't want right? And you'll, you'll learn like how you wanna set things up so that you can actually practice medicine in a way that you enjoy. And I, I'd say probably, More of the people I know are more happy in private practice or even starting their own practice than working, um, in a corporate setting. But having that background in the corporate setting is not necessarily a bad thing, especially if it's gonna get you able to cancel, you know, six figures of student loans.
Dr. Shah-Haque:Not only that, but um, it would also teach you the business side of medicine that we definitely don't learn either in medical school or residency. So it also lets you know about the reimbursement and, and, you know, how would you want to structure that? If, if and when you go out in a private practice.
Dr. Chiang:Yeah, and I encourage everyone to learn about the business medicine cuz you know, you can go into a job being like, okay, I'm just a physician, I just wanna see patients. And you can also not learn it even if you are in a environment where it's actually easy to pick up that information. But everyone needs to know how, how does. The money work in medicine, and it is very complicated. So I'm not saying you're going to become an expert in it, but how are you compensated? Are you compensated based on collections versus VUS versus just straight salary and per diem? Like those are things to kind of know so that you know when you want to negotiate, like what you're negotiating for and know all the different parts of your compensation, right? So your salary or however much you're being paid is not your only compensation. Other things like. The, your retirement accounts, what's available, your healthcare, you know, um, your C m E credits, your vacation time, or any pay time off, that's also all part of your compensation and things that you wanna negotiate for as well. Oh,
Dr. Shah-Haque:what you're saying is music to my ears, because I had this exact conversation with Dr. Ne Darco back over the summer, and, uh, you know that, that negoti, that contract, lawyer is definitely worth the investment for the negotiation.
Dr. Chiang:Oh, and, and just to bring one more point, tail insurance, right? Most doctors need their first job. Yes. Yes. Make sure you find out about your non-compete and your tail insurance, and if at all possible, make it so that you don't have to pay tail. Um, but if you absolutely do, find a way to see, see like how it can be limited or, you know, if there are circumstances where you can get them to pay for it. And then for the malpractice. Uh, sorry, sorry. The tail is the malpractice insurance that generally after residency and fellowship, you don't have to worry about because you have, uh, any type of insurance that covers anything going ongoing. But a lot of times when you go to other jobs, especially in private practice, the kind of insurance they're gonna have is such that once you leave, you have to buy what's called tail insurance to cover anything that might happen that happened during the time you're working there. But someone kind of. you know, later retrospectively. So, um, and then the non-compete, right? If you go to an area and you know you wanna stay there, it's your hometown, it's your spouse's hometown, then you really wanna look at that non-compete because if you end up leaving, if it's, you know, two years and 50 miles from any office of this big hospital system, like you may not build to work there for two years, and those can be really enforceable. So you wanna get that non-compete as small as possible for as short as length of time as.
Dr. Shah-Haque:Oh, thank you very so much for bringing that up. Because if you're in a state where like, uh, say that you're a cardiologist and you're working in a state in one of the bigger health, health systems and that can just completely put you, push you outta the state depending on where they're located. Um, I mean, it's rare, but I've heard of it happening.
Dr. Chiang:Or even that they open a new office, like you leave the non-compete region, you open your own new, new office, and then they open an office like not that far from you. And now like you've put in a lease and now you're in that non-compete area. Like it's just, yeah, this is where you definitely need to get a lawyer and make sure everything is spelled out because if it's not in writing, it doesn't exist. It doesn't matter what you talked about verbal. right.
Dr. Shah-Haque:I was just having that conversation yesterday with somebody. Um, you know, it doesn't matter what you agreed to, when you negotiate something and you get it done on contract, like it has to be, you have to know your points that you agreed to, um, because that's a whole port of, um, a contract under negotiation. Like there's no verbal contract. Like this is not the 18 hundreds when we're just shaking over things and saying, okay. you know, this is, um, this is real business and I think, I think the business side of medicine is always daunting. Again, because we're not taught this, we went to, into medicine to, to help people and to deal with data. So when you start getting into these, into this gray area, again, it's not, it's not difficult. It, I think, but it can be daunting because it's out of our.
Dr. Chiang:Yeah. And it's even out of our norm to like ask for what we want, right? Like during residency and fellowship, it's really like, you know, you, you match into a place. And yes, we had a little bit of choice in terms of like, you know, how we rank places, but mm-hmm then we get there and it's like, okay, these are the rules and we just kind of have to follow these rules, right? But once we become attending, like, you know, the hospital system might say like, oh, that's not possible. We can't do that, but let me tell. There's lots of times hospitals say that, and then if you push, if you are needed, if they really need you, then new things are possible. And if it's really something that you know is important for you and they keep saying it's not possible, then that might just be a red flag of like, okay, it's not possible for you to work at that place.
Dr. Shah-Haque:No, I agree 100%. And again, it's, you have to ha stay. I think it goes back to, I think the life coaching where you were saying you have, you know, mindset, but also part of that, what are your core values and ensuring that that place is going to honor you as a, not just a physician, but as a person. And if you really need that, for example, um, I need time with my family. And when I've negotiated this contract, it was, I have a family. I want to raise my kids. I want to work part-time. You know, that's, that was important to me. And that, that was, there was a win-win for.
Dr. Chiang:Both. Yeah. We, we, physicians are in demand, right? There's a coming shortage of physicians and hospitals can't really operate without physicians as much as they're trying to they, they still need us.
Dr. Shah-Haque:You're speaking to the choir. I, I, I love it. I love this discussion. I, I, I've, um, I get silly excited when I can talk about these things, so thank you for bringing the nerd, you know, bringing that side out. I, I really appreciate this conversation. Yeah. um, what services do you provide to physicians? What, how do, how do we get ahold of you and what, what services do you provide?
Dr. Chiang:Yeah, thanks for asking. So what I do is I work with physicians one-on-one. I do one-on-one coaching where we really work on your mindset in order for you to get whatever really your goals are. And I know that's really broad. So just to kind of go more into it is, you know, I have clients where I've helped them just. Look at their current situation and look at like, how much can they be spending? How much should they be investing? You know, where are they really with their money? And even to the point of like, okay, where would they like to look into investing? Do they wanna invest in real estate? If so, what kind of real estate investing actually looks like something that they would find funds, something interesting for them, something they do actually wanna spend the time to engage. I've helped physicians through different, like job transitions and career transitions. Um, but really what it comes down to is like if you have any issues where like money is an object, where like you've got thoughts of scarcity, thoughts of like, I don't know that I can do this because of the money I feel tied to my job because of the money. Um, those are all things I help physicians with. Um, I help physicians also just through my podcast, the Grow Your Wealthy Mindset podcast. So that has a mix of episodes that. Purely just even informational about learning how to invest or learning how to take care of your personal finances as well as episodes on mindset and you know, having a growth mindset, getting over your limiting beliefs. Basically being able to achieve whatever goals you want. So, you know, I, my. Purpose, like I've said, is really to help empower physicians to take control of their money and their finances so that they can build wealth, that they can have financial freedom, they can practice medicine as we want to, and really shape our medical careers to be doing the things that we love and as much as possible, not doing the things that, you know, we don't like. And you know, I mean, obviously everything's, there's never a quote. Perfect job. You know, I love my spouse. We've been married for 23 years. We still get into arguments, right? So, but y you know, you should have a, a career like that where like, generally you love going to work. You wanna go to work, and it's not just something you have to do because you need that paycheck and, and cash flow.
Dr. Shah-Haque:Yes. Thank you very much for that. And I'll make sure to include your podcast and your, uh, website and any social media links
Dr. Chiang:in the show notes. Yeah. My website is Grow Your Wealthy mindset.com. So if you wanna, uh, set up a consultation with me, if you just, I mean, it's totally free. If you wanna just talk about how I can help you, then you can go to the website and just schedule a time for us to meet. Um, if you're not ready for that, you can get on my email list. Um, and you know, Get information from me, get to know me or start listing my podcast. Um, I also have just a freebie on my website. It's the Financial Independence Workbook. And so it really steps you through actually how to crunch the numbers to figure out how to get to financial freedom from a pure number standpoint.
Dr. Shah-Haque:Oh, no, that's, that's, uh, definitely something I'm gonna be downloading this weekend. That's, that's great.
Dr. Chiang:Um, well,
Dr. Shah-Haque:thank you. I'm, like I said, I'm, I'm nerding out right now. I just, this is, this is invigorating to me. Um, so what last pearls of wisdom would you like to leave for our listen?
Dr. Chiang:Yeah, so really we as physicians, I mean, like I said, we're the smartest people in the world. We can do whatever we set our mind to. And right now you may feel bogged down, you may feel stuck, you may feel like you just don't have time for any of this, but let me assure you that like. That you can find time for this. You can find a way to really be happy in your current life now. And it doesn't necessarily mean making huge changes at this moment. It's about making incremental changes. And that begins with that shift in the mindset and asking your brain questions like, you know, how can I make each day a little better What it is? What is it that I need to have some joy in my life today? You know, what delights me and how can I incorporate more of that? And just taking it step by step. Sometimes it's really not about money. right. A lot of times, you know, I talk to physicians and really, you know, what they say they want is more money, but really what they want is more freedom, more time, more joy, and they think that money can get them. All these things. Yes, money can help you with these things, but money isn't the be all, end all to get these things. Money is just a tool to help you get these things. But in the i in the end, your mindset, your brain is so magical. It can actually produce all these things for you. That is so beautifully
Dr. Shah-Haque:said again, Elisa, thank you so much. I really, really appreciate everything that you've brought to the table today.
Dr. Chiang:Yeah, thank you so much. It's been so fun having this conversation with you.
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