What is your relationship with money?  I know that sounds weird, but money is always a touchy subject, and it’s especially so when it comes to doctors. On the one hand, doctors are some of the highest-paid professionals in the country. On the other hand, we also have among the highest levels of student loan debt. And then there’s the fact that, as healers, our primary focus is on helping people, not making money.  It’s a wonder why the relationship can also be dysfunctional!

Here to help us navigate this is Dr. Elisa Chiang, an ophthalmologist, and physician life and money coach and a member of PhysicianCoaches.com. Elisa primarily works with physicians to master their money mindset so they can build wealth and practice medicine on their own terms. Elisa is here to help if you’re someone who needs help overcoming the mind blocks towards investing!

Dr. Elisa Chiang’s Website

www.GrowYourWealthyMindset.com

Dr. Elisa Chiang’s Physician Coaches Profile

https://www.physiciancoaches.com/coaching-category/elisa-chiang

Transcript:

Mike Woo-Ming: Hey guys, this is Dr. Mike. welcome to another edition of BootstrapMD from time to time, we love to highlight physician coaches that are in the trenches, helping our fellow doctors. And our next guest is someone that I got to finally get out, post COVID. I started going to conferences again, and we met at a conference at the white coat investor conference in.

And she’s actually one of our physician coaches and our physiciancoaches.com site. And she’s a really interesting backstory that I wanted to share with you. And I think you’ll be really inspired by her story. She’s a life and money coach. She’s also an ophthalmologist. She is a oculoplastic surgeon and she decided she wanted to become a coach to help physicians. master their money mindset so they can build wealth and practice medicine on their own terms. That will, that’s what we all want. She’s a certified coach through the life coach school and she offers one-on-one coaching on overcoming burnout, achieving new goals, understanding personal finance and overcoming the mind blocks towards investing, which I know there’s a lot of us out there.

We have these blocks that prevent us from investing in things. And you have to be ready to take a leap on those things. And she said, teach her how she was able to. Come that I want to welcome to the program. Dr. Elisa Chiang. How are you doing Elisa?

Elisa Chiang MD, PhD: Thanks for having me. I’m doing great. I’m so happy to be here!,

Mike Woo-Ming: Did I totally butcher your name or did I get it close?

Elisa Chiang MD, PhD: No, you did a great job.

Mike Woo-Ming: So I’m going to talk about your journey because I think it’s always fascinating. There are some people who are listening to this are coaches already. Most of them are thinking about hiring coaches and some of, just saying maybe coaches is right for me, but they want to know more. So tell us about your story. How did you journey from being an ophthalmologist to becoming a coach and doing both things?

Elisa Chiang MD, PhD: I was working at a big hospital system, the only level one trauma center in Cleveland, Ohio, and I was on call 24 7 as the only oculoplastic specialist, which I agreed upon when I accepted the job. But the way my That’s supervisor wanted me to take call was not what, something we agreed upon.

So not to get into all the details, but essentially I know discussions that happen before you signed become totally forgotten. Right? Got to get it all in writing. So for me, it wasn’t really about the hours working that gave me burnout. It was really the complete loss of autonomy and, make decisions and just have control over, life.

Like I would spend a day just waiting to go to the, or, and getting. Case after case because something that’s affecting your eye or bed, doesn’t take, a gunshot wouldn’t obviously takes precedence over. No vision. Vision is very important, but life is more important and there’ll be days where I just be waiting to try to go to the oranges, get bummed after case.

And yeah, that was not how I wanted to continue spending my times. The pandemic was actually a blessing because it actually gave me more time off to think and figure out what I really wanted. And it’s also that time probably discovered coaching the leverage and growth summit, Sonny Smiths spoke at it.

And that was hosted by Peter Kim. And I’d been following Peter Kim for a long time. And that was when I first heard about coaching and she Sonny Smith had chained at the life coach school. So I started listening to life, coach school podcast, and really just got hooked. I binged it joined self coaching scholars.

And when the coach certification came up in September, I thought, wow, I’m not traveling, which is probably the biggest use of my income or, my discretionary budget. And, had a lot more time on my hands because I wasn’t getting together with people and doing a lot of social things.

So I went ahead to do the certification in order to just actually built a self-coach myself better. And I had heard other people who did the certification program. And just found a transformational because obviously it’s part of learning and being a coach, you pure coach. And so you get coached a lot and you also coach a lot.

And so you really learn how to coach yourself as well as coach. But I really just found, I love coaching. In a way I think physicians are attracted to coaching because it gives, what we are looking for in that patient doctor, patient relationship. You really also find in the coach client relationship and you can really develop very deep bonds that way and really help people.

And, I think, the idea of helping people is underlying for, most of us, most people who go to medical.

Mike Woo-Ming: Now I got to know you a little bit when we went to Phoenix and from understanding, you came from a pretty academic background, straight into sciences.

And, there were a lot of doctors who come from that, they’re going straight from pre-med to med school, straight into residency, and let’s face it. They view coaching as woo or, way in opposite direction. We learn as doctors. Did you have struggles with that or was that something you embraced?

Elisa Chiang MD, PhD: Pretty quickly, it’s funny, I tried reading quotes health books before, and the practice of gratitude and that really never. Struck a chord with me. I like never finished those books. But when I heard about the model that Brooke Castillo, uses, it really just made a lot of sense to me.

And when I really broke it down and thought about it, I was like, yeah, that really actually works. And it’s essentially a lot of like behavioral cognitive therapy. That’s in that. It wasn’t actually wooed to me the way that it was presented. So I didn’t have that dissonance when. The kind of life coaching, the life coach school does.

Mike Woo-Ming: For those who aren’t familiar with her teaching, maybe you could talk a little bit more about that.

What, in particular, in terms of the cognitive behavioral aspects of it that you could share with us?

Elisa Chiang MD, PhD: Yeah. So there’s something we call the model and basically there are circumstances in the world and these are things we can’t change. And these are actual facts, you can go to a court of law and this would be after.

And then there’s our thoughts about those circumstances and different people are going to have different thoughts about the same circumstance. It’s our thoughts, and actually create how we feel about, all the feelings that we have and how we feel about the world. And from those feelings actually is what pushes us to take whatever actions we take.

And then that gives us the results that you know, that we see that we get. You can’t even take something like… 9/11. Most Americans would say 9/11 was a terrible strategy, but if you’re the Taliban, 9/11 was a great win. So that’s so the circumstance of 9/11, but the thought could be, it was tragic.

People die like horrible loss of life, or it could be like, “oh, this was a big win.” This was sticking it to the Americans. Like just from different views and depending on how you’re thinking about it, that, if you’re thinking like it’s a tragedy, then you might be sad or angry or, but if you’re thinking it’s a big win you’re elated, so that really makes sense.

And our brains are really wired in order to protect us from a primitive standpoint. So basically in general, we want to see pleasure, reduce pain and be as lazy as possible.

Mike Woo-Ming: So when you were in your peer coaching, how did that help you with your career? You said you suffered burnout. How did, how were you able to help turn that around?

Elisa Chiang MD, PhD: Yeah, so it really actually got me out of my burnout. What I realized is, okay, there are circumstances, but how I’m thinking about these things at the time, everything basically went to a thought that just brought frustration. And I learned that. You can actually change your thoughts and it does take work to change those thoughts, but, I can actually modify things to be like, okay how, how can I look at the same situation and make it into something more positive or efficient?

Or what can I, what do I have control over? What can I do for a better outcome? And that really didn’t make a huge.

Mike Woo-Ming: So many of us, we do feel powerless, which is often an ingredient for anxiety and burnout. And if we were able to achieve that power, that’s just one thing that we’re where we have, we can, empower us to accomplish our goals and our dreams.

So you were, you mentioned you were your job was affected by the pandemic. They reduce your hours. How was it affected?

Elisa Chiang MD, PhD: Yeah. So there was a time where we basically shut down and I only saw patients once or twice a week. And it was really just the patients that were deemed urgent to see.

And luckily, because I was on call 24/7. I was technically working all the time, so I didn’t get furloughed or have to use up my vacation and sick time, which other people did have to use up. But yeah, there were a few months where it was really reduced time at work. And then, eventually the clinics did reopen and it’s, at some point there was just actually a flood of patients because of all the backlog from patients not being seen for some time.

Mike Woo-Ming: So what made your decision? Now you’re getting busy, again, most of us would just go back to what we were doing. You decided to explore coaching. How were you able to do that?

Elisa Chiang MD, PhD: So I decided, after actually getting better and getting out of burnout I did not want to stay at that hospital.

I decided in doing the certification program, it’s six months of actual coaching training and then six months of kind of additional training, either an entrepreneurship or more coach training, depending on what you do.

So to back up a little bit… I had started thinking about even before the pandemic hit, leaving the hospital and starting my own private practice, but in doing the coaching and really enjoying the coaching. And then also just thinking about the pandemic and then thinking about how much regulation there isn’t medicine. I basically thought, I think I’d rather start a coaching business and start my own private practice just in terms of like with the coaching business, there is total location freedom, and when you start a private practice, now you’re building a practice just in that area.

And now you’re still restricted to the location that you’ve started, your practice. It the overhead, obviously for coaching way less than having to get a brick and mortar lease and equipment and staff and know all that from the get-go. I didn’t want to leave medicine and starting a coaching business was also something I thought I can do kind of part-time well, if I go to working as a physician part-time whereas if I start my own private practice, that’s a full-time thing to start.

But then in the beginning you don’t necessarily have a full load of patients and but you have a lot of expenditures that you’re putting out and it’s a lot of work to get patients in the beginning and it can take quite some time to actually become established. So basically, I already had that entrepreneurial spirit.

My father is actually a business professor and my mom was an entrepreneur. She at one point that started her own computer business. It wasn’t a foreign concept to me of starting a business. And I’ve actually been investing in real estate since 2008. And, the way you invest in real estate is you really need to think of your real estate investments as a business, as well as if you’re going to be successful at.

Mike Woo-Ming: Yeah. So let’s talk about it because you’re not only life coach, you’re also a wealth coach or a money coach. So talk about how did that shift, you mentioned you were, you did real estate A decade ago. Tell us about your cutting your financial journey as well.

Elisa Chiang MD, PhD: I’ve always loved money even as a kid. And I really credit my parents for kind of teaching good money habits of understanding the value of money. Understanding money comes from. No, as a kid, I did do like side jobs in order to earn money babysitting. I actually taught people how to use their computers and made $15 an hour at that, which was actually pretty good money.

But I would say I was still in that self-employed mindset as opposed to a business owner mindset as a kid and, At some point during, so I did a MD-PhD program, which is eight years. And, in retrospect, I realized that during grad school I was burning out too.

So because the MD-PhD program is on average eight years and I did in Cleveland, Ohio, which has relatively low cost of living for housing. A lot of MD-PhD students actually do purchase their own home. And I ended up purchasing the house from my parents actually because my father took a new job.

And so Kim moved out and my parents were actually getting ready to sell the house when I moved back to Cleveland to go to that school at case Western reserve university. And so I started just reading about personal finance in order to like, get the mortgage and understand all that and just really getting fascinated and reading more and more reading about investing. I started following the Motley Fool. I started investing in stocks and individual stock picking. I never did like options or like day trading, but, actually like reading business reports At some point, I read rich dad, poor dad, which then got me interested in real estate. And then by that point I was in grad school and I’m not really a happy grad student.

So I started thinking about investing. Okay. In order to try to get to financial freedom as soon as possible. So I was thinking that even before becoming a physician and actually graduating med school and so I started going to the local real estate investment groups. I actually purchased real estate courses and I flipped two houses. Got to know a lot of other people did some I had a friend that we partnered on some deals together. So yeah, I really started at the real estate investing as a grad school.

Mike Woo-Ming: So you said your first property was for your parents?

Elisa Chiang MD, PhD: I bought the house. I grew up in from my parents. That’s the one we ended up in.

Mike Woo-Ming: And so your parents, your tenants, are you charging rent?

Elisa Chiang MD, PhD: So that was our primary residence. So my father had already moved to California for his new job and my mom was getting ready to sell the house. And then we were, so I got to move home for a little bit, and live free for a little while.

And then we started looking to buy a place since we knew we were going to be there for at least eight years. And, as we were looking around, then I started discussing with my parents. No, could we work something out so we could just buy the home? It would make it so that they didn’t have to go through the hassle of actually putting the house on the market and we get to stay in the house.

So that was I wouldn’t consider that being in investment. Your primary home is a place to live, but really it’s still a liability, right? Like it costs you money every month and doesn’t bring in any money or cashflow. But that was at least the impetus to start really reading about personal finance, just the, getting the mortgage and, understanding we actually ended up getting a seven one arm.

So just understanding the different kinds of mortgages when. You know how they all work, what the library index was like, all that was like banging to me like that.

Mike Woo-Ming: Yeah, it’s learning. I can, I never nomenclature as we do in medicine, and you have to understand all of those different temps. So you started to do flipping, you started to do some rehab. Sounds like some flipping. And then did you tell us about your real estate portfolio now? Did you increase it or you just continuing to flip or what’s it made of.

Elisa Chiang MD, PhD: Yeah. So when I started buying it was so the flip side did I bought foreclosed houses. So bank owned, foreclosures fix the up, sold the, did it again. And and then I said it with a partner and we actually bought some houses and those were rentals. And so I helped manage, I helped her find them and manage them. Went back to med school. I actually found that I really did enjoy ophthalmology.

And so I did do residency and fellowship and I didn’t move to Chicago for residency and then Milwaukee for fellowship. So at that point I wasn’t doing any real estate investing just because now I’m in a different market. And you’re pretty busy as a resident. Chicago is a whole different price range than Cleveland.

But I always had, in the back of my mind, I would get back into it. In fact, there was a part of me that just thought, like all doctors invest in real estate because all wealthy people invest in real estate. That was the way to build wealth. I don’t know if that was just from reading that gave me that thought.

But yeah cause I didn’t really know a lot of doctors, there aren’t many doctors in my family. I only have one cousin who’s a doctor. But that’s really it. Yeah. And she actually doesn’t invest in real estate. So I don’t know why I thought all doctors investment real estate, but my first job was out in Virginia and I did actually start looking into real estate investing there.

Learning that market was like completely different. And so when that job didn’t work out, We’re turning Cleveland was one of the reasons was actually like I knew the market in Cleveland, I know the different areas and I really want to get back into the real estate investing.

And, I have some contacts who are likely still around in Cleveland and then also was, returning home. I had made friends during the MD-PhD years that were that are still in Cleveland and no, it’s a little hard to make friends in your adults. So a lot of things that were driving us to come back to Cleveland.

And so that’s where I am now. And so this is, so I do real estate invest in Cleveland. I have long-term rentals in Cleveland, and I have a short term rental in the Hocking Hills area, which is in Ohio about two and a half hours away.

Mike Woo-Ming: And do you have a game plan? Do you say, ” I’m going to get out like 180 a year, two properties a year?” Do you have any goals for that or you just see what opportunities are out there?

Elisa Chiang MD, PhD: I think of looking at different opportunities, looking at ways to diversify. So I also invest in syndications as well.

Mike Woo-Ming: And tell me about your syndications for those who may not know we’ve done a program, we’ve had a few people talk about syndications, but for those who don’t know, can you tell us about syndications?

Elisa Chiang MD, PhD: When you’ve essentially got a real estate investment. Say, if you think about a large apartment complex, like a 300 unit apartment complex, typically you don’t have just like one person owning that. It takes a lot of capital in order to do that. So you typically have, what’s called a sponsor who finds the deal and then needs to get some investors to work together in order to have the down payment and potentially money to rehab or fix up their property in order to buy.

300 unit apartment complex. So that’s what becomes the syndication. So when you invest in syndication, basically you’re investing in the company, that’s buying whatever real estate, this large real estate property. So it might not be just an apartment complex big commercial buildings or self storage or a development like building a whole bunch of, townhouses or no, any big development projects.

So these can all be syndication projects. And basically you, as an investor are investing, with the sponsor, who’s leading the deal. And and then, when you can, depending on the syndication, you may have cashflow that comes back to you paid out through the time that you’re involved in syndication.

And at some point they’re going to sell the property or refinance, and you’re going to, get back your initial investment and hopefully a good return.

Mike Woo-Ming: So you decided to teach about money mindset or a money coach. Can you tell us about what exactly is a wealth coach or a mind coach or a money coach and why should someone go out and seek these types of coaches?

Elisa Chiang MD, PhD: So a lot of times physicians are smart, right? Like it’s hard to get into medical school and, get, we do amazing things as physicians, but a lot of physicians really don’t. We don’t learn anything about finance and in any part of our education, right? Not in high school, not in college, not in in medical school, not in residency.

And, as we alluded to earlier finances has its own in some jargon, its own language. And so it can be really difficult to understand. And, lot of times we’ll see… talking to, someone who knows about finances or like a financial advisor, and they’ll use all these terms.

And, we, as physicians, don’t like to actually quote, “look dumb” and sometimes we’ll just agree and think okay. And we also, as physicians think, okay, like we’re the expert of our specialty. So now I’m going to go to an expert of finances and they’re going to do right for me and do.

What, what should be done. But the reality of the situation is that most financial advisors are not truly, what’s called fiduciary and doing what’s best for you. Most financial advisors are really glorified salesman of financial products. And a lot of times those are not financial products are actually good for you.

They’re ones that pay a really nice commission to the financial advisor. And I’m not saying that financial advisors are necessarily evil. And some of them really believe these products are really helpful and there are situations where the products are helpful, but I think a lot of times they get sold more to people who it’s really not that helpful.

And really, I think most physicians who do a lot better managing their money themselves, then leaving it to, a financial advisor. Or if you are going to use a financial advisor, you don’t get one that’s fee only get a plan, and then you really execute. And a lot of physicians feel like “I don’t have the time for that. I don’t have the time to learn that.” And it really doesn’t take that much time or effort to make a huge difference on your wealth and your ability to really build wealth. And so working in that money mindset, I think it’s really important to understand like, Any physician is smart enough to learn enough about their finances to manage their money, to really build wealth. Even generational wealth so that their kids and their grandkids are successful. I’m going to retain that wealth of it that is built.

Mike Woo-Ming: Yeah! I can give you a first example. When I graduated residency I was given two financial advisors. One was someone that, the guy ahead of me used and he seemed more interested in selling his particular product than actually helping me.

And the other one was really, it was a disguise networking opportunity. So I didn’t get the best. I didn’t get the best financials. And you talk a lot, especially on your website, going through it about the mindset. And I think for many of us too, who are physicians and especially now I know how it was for me was, usually we have a lot of loans.

And when we’re in medical schools, I remember medical lids and residency, we sign paperwork, we don’t know exactly what we’re signing, but we know that, somewhere down the line, we’re going to have to pay this off and we keep pushing it away and pushing it away. And I think too, it wasn’t until I actually like, sir, wrote down and like circle that number and made that a target to actually confront it, for me, that’s what helped me.

And I think, there’s a book out I’m reading right now called The Psychology Of Money and it’s almost all mindset. It’s almost on mindset. And I think when I work with doctors who have issues with money is they feel like they can, I work with a lot of practice owners.

They feel like I hired this person and they can deal with it. And when I’m actually understanding, like, when I find out like why their practice isn’t doing well, it’s because they’re not willing to confront. Is that just some of the things that you try to do as a money coach?

Yeah, definitely. So a lot of times people, they don’t want to look at their finances.

They just, see that they’ve got money coming in and they spend the money and. There’s at least enough money to in their bank account to actually pay for whatever they spend. But they’re not necessarily thinking long-term, they’re not necessarily thinking about like their investments and how to grow their wealth.

And what’s the best way to do that so that eventually everyone wants to retire. You may not want to retire early lifespans are becoming longer and you probably don’t want to be working when you’re a hundred. And if you’re a surgeon, you probably can’t really me safely operating when you’re a hundred.

They have pilots who have, they have to retire. I think I get 58, but for medicine, Hey, you can keep going. So I never did understand that. So talk about some of the things that you talk about as a money coach, how you help your doctor clients.

Elisa Chiang MD, PhD: That’s a lot of it was investing is overcoming fear, especially people who want to get into real estate investing. You look at how many people will take a real estate investing course, but then, all of them never even get through the course or if they do get through the course, they never buy that first property.

And once you get over the hurdle, the first poppy and there’s always going to be some quote failures, someplace where you lose some money or things weren’t optimal. But the more you learn, the easier it becomes to just keep doing it.

Mike Woo-Ming: Yeah, for sure. My thing is somebody has figured it out and, you’re.

I don’t think you can be, if you want to be do well, you’d want to be the best surgeon. You need to follow and shadow gonna work on your surgeon. So if you want to study financial success is to find out people who are already successful in what they’re doing. And I think, it’s funny.

Cause when we talk about mindset, That’s usually what the part is. I don’t want, I’m not really interested in that, that I want to know about this hot new stock or this hot new cryptocurrency that everybody wants to buy and that’s going to solve my issues. Now it’s having to deal with the mindset if that crashes, or it goes down and really understanding what your risk tolerance is.

And as doctors, we’re pretty much risk averse. That’s part of what we do. The thing that’s important, for us to maintain it, just so it’s so surprising that many aren’t willing to to look at directly in the eye and feel it and say, this is what I need to work on. Do you see the same?

Elisa Chiang MD, PhD: Yeah. And so certainly you talked about cryptocurrency or even the stock market. There are fluctuations, there are ups and downs and yes, the stock market has been doing amazingly for the last few years, but as we’ve seen recently, what goes up will come down and that’s just a natural part of the stock market, but when you think about it, you want to buy things when they’re on sale, right? Like you don’t want to pay top dollar. Like we understand this when we go buy material items, but when it comes to stocks, like just because the stock price is down, doesn’t mean the intrinsic workings of the companies that represent that stock are actually down, there’s always going to be some kind of perceived value in fluff, and then there’s the value of the company itself. And so if you can actually buy, when stocks are going down, when it goes back up and grows again, like that’s when you’re really going to, grow some more wealth cryptocurrency, lots of up and down. And so if you can stomach the ups and downs and you end up selling low and then it like, blows up and you essentially will never create wealth out.

Mike Woo-Ming: Now I want to talk to you too. And I appreciate your time here. I’m curious about your your stocks investing, many of us say, we should invest in what we know.

Is that a philosophy that you do, do you do invest in stocks that you do, or do you allow to do a lot of speculation?

Elisa Chiang MD, PhD: For stocks, I mostly invest just in index funds. I do have some individual stocks that I still own from back when I first started learning about investing and was reading lot of the Motley fool and actually reading like business statements. So I’ve just held on to some of those stocks. One of them being like Starbucks, which, has significantly grown since I bought it in like 2005.

Mike Woo-Ming: I invested in a company every day!

Elisa Chiang MD, PhD: Addictive substance, right?

Mike Woo-Ming: Yes. Yes. That’s right. It’s my… it’s my pusher so I think it really depends. On, where you are in your journey, for me, I am like, I’ve got some conservative stuff when I’ve gotten my index funds, I’ve got those that I don’t even look at them.

I look at them like once a year, and then I’ve got my, individual stocks. I tend to do more, I like, I tend to do stocks that are things that I believe in, I have a Tesla, so I support Tesla. You have Apple, I’m an Apple ecosystem. I have Apple dividends from that.

And then I just have, a small portion. I did a talk on cryptocurrency, but that’s a very small portion of what my net worth is. And, I see. I see too many doctors who want to do, like what’s the newest and hottest thing. And I think you’re just going to get wrecked after a while, unless you can tolerate those that the volatility, sure.

One crypto currency might go to the moon. It might even be in the next Ethereum Sheba, whatever it is, but for every shoe, but you knew it was there like 99 other coins that, that can wreck you. But it has to do with the mindset. Can you. How do you react to when those things go down and like you said, the often will go down even real estate.

We all know that real estate’s on a high, but we also know too that, things can level off and you may not get the returns that that you’ve had before. What are some tactics that you help your clients with in, in their mindset and.

Elisa Chiang MD, PhD: I think one really important thing.

When working with my clients about investing and where they want to go is really talking about their why. And if they have a really strong why that can pull them through the hard times. Especially if they’re interested in doing something like real estate investing, which while passive is really… if you’re doing direct ownership from real estate, it is nothing but passive in the beginning.

It is definitely a lot of work, especially right now, the market has been really hot. So even finding deals in may just take offer after offer. And, sometimes you just want to bite and just go for something and get it. But, you make your money when you buy.

And if you buy too high, like you’re, it’s possible to salvage that with, time and appreciation, but you really want to be smart when you buy the property and do your due diligence. And there’s a lot of upfront cost to that, right? You’re paying for inspectors or paying for other, expert opinions to come in.

We’ve got to look up all the regulations of the city that you’re investing in and those regulations can change, right? The city can pass a new ordinance, which could, really cut into your cashflow and you have to be prepared for that. And that’s why I’m got to make sure that any property you buy is positive cashflow.

And then you’re not just banking on appreciation because yes, while you’ll see appreciates over time, and it’s been appreciating a lot recently, back in 2008, there was a time where real estate really didn’t appreciate. So that primary residence I bought… I bought my home for my parents.

So we bought that in 2003, and when we sold in 2016 and basically was essentially the same value because the value had dropped in 2008 and, basically took till 2016 to level out. And then now, so 2016 is when I went to Virginia, I came back in 2019, and sadly, in those three years, that’s when all the appreciation happens.

Mike Woo-Ming: Yeah. It tends to happen that way too. You never know. But on the other hand too, you might experience some like really big numbers just because you are more active, you are taking more of a risk and let’s say perhaps it’s indication, you could argue whether or not that is there’s always a give and take, right?

So it really comes down to, where you are and what you’re willing to. For lack of a better term stomach or what going to able to do. But for the most part, I think, the best thing to do is to do the best thing not to do is just to do nothing, because I think we all learned that, one of the most scariest things I believe in is just having one job. And I think you would agree with that as well. Yeah. That’s, for me, that’s the most scariest thing.

Elisa Chiang MD, PhD: Because if you think about it. People feel like, oh, my physician job is secure. If you lose your physician job, like it can take quite a while to get a new one and you may have to move for that.

And maybe you’re not in a position to easily move, right? Like your spouse has a job. Your kids are in school. Your family is nearby. But you may have a non-compete and now you’ve got to drive like an hour or two hours away. To work somewhere else.

Mike Woo-Ming: Yeah. You never know what can happen, you never know what can happen. I learned from a a hand surgeon who it was during my rotation and one night after call, he put his hand under his his bed and he ended up having a permanent nerve palsy and he could not operate. Again don’t know if you had, some type of insurance, disability, insurance, but you never know what could, what could happen.

We can walk down the street, we could get in an accident. There’s always things and that can happen. And, we’re only, don’t want to get metaphysical on this, but, we’re, we only got one time that we’re on this earth. We want to make the best of. How are we going to do it?

I think it’s through. And I think you agree through multiple streams of income, start looking at different avenues and realize, that there are no assurances in life

Elisa Chiang MD, PhD: And even tomorrow is not guaranteed.

Mike Woo-Ming: Tomorrow is not guaranteed. Eliza, this has been wonderful. If somebody wanted to find more information about what you do, maybe a search for your coaching services, working with.

Elisa Chiang MD, PhD: So probably the best place to go is my website, which is grow your wealthy mindset.com. There, there are links to all my other social media. I have I’m on Facebook. I am on Instagram. I have a YouTube channel. And I often do webinars and even free coaching sessions. So take a look for that.

Mike Woo-Ming: Take a look at that. Thank you, Elisa. It was very illuminating. Thank you for everything that you do and keep helping more doctors out there cause we definitely need it.

Elisa Chiang MD, PhD: Thank you so much.

Mike Woo-Ming: Thank you again. And as always guys don’t stay stagnant. If you only have one income, start thinking about there’s other sources it’s investing could be real estate. It could be the stock market, whatever you deal. You need to start thinking about these things. The worst thing you can do is not do anything. It always keep moving forward.

When I first saw a blog several years ago, I couldn’t believe it!  Here was a blog, written by an anesthesiologist,  that made many of us believe that as physicians it was possible to retire early.  Today I got to interview the man, behind the Physician on Fire website, Leif Dahleen MD.

We’ll discuss whether it is still possible to retire, in light of a bad economy and crippling medical school loans.  If you aspire to retire early as well, do not miss this interview!

Dr. Leif Dahleen’s Physician on FIRE Website

https://www.physicianonfire.com

Physicians on FIRE Facebook Group

https://www.facebook.com/groups/physiciansonfire

Transcript:

Mike Woo-Ming: Hey guys, this is Dr. Michael Woo-Ming welcome to another edition of BootstrapMD. I’m so excited for this next interview. I’ve been hunting this man down. I’ve been a big fan of his for years, and I’m so excited to finally get him on the program. If you have been in the. This kind of weird space that we’re in for physicians doing other things, investing.

I’m sure you’ve come across his website. This gentleman retired from medicine at the age of 43. Can we achieve financial independence actually several years earlier, he started the website physician on fire to enlighten, educate and entertain other high income professionals while discussing money matters of all sorts.

He’s happily married with two kids. He lives in the Northern Michigan and he travels frequently as a family. We had to. Hunt him down because he was traveling to all these incredible countries and just living that life of fire. So I’m so happy to have on the program. Dr. Leif Dahleen! Leif, how are you doing my friend?

Leif Dahleen MD: Hi, I’m doing great, Mike. And thank you for the incredibly kind introduction. And yeah, you did hunt me down and we found each other in Phoenix you a month or two ago. Happy to see your smiling face once again.

Mike Woo-Ming: At the time of the recording, it is Doctor’s Day. So Happy Doctor’s Day!!

Leif Dahleen MD: Happy Doctor’s Day to you!

Mike Woo-Ming: So is there a Doctors On Fire Day? Are you going to, is that something that’s coming up? I haven’t seen that just yet.

Leif Dahleen MD: In my Facebook group, I put an image up, one of those happy doctor’s day things that are. Yeah, Google. And I said, this JPEG is the only thing you’re going to get most likely so enjoy it. Yeah. Yeah.

Mike Woo-Ming: That’s pretty much, I haven’t gotten any gifts today, but who knows, I think, I’ve been in this, I’ve been retired for medicine in 2004. And when I saw your blog, like I knew about white coat investor and then your blog came out and then.

I really didn’t know how to react, to be honest with you when it, when I saw it or you’ve gotten the same response, because here was a physician who, who claimed, we didn’t know, your name wasn’t out, that he had retired from medicine, whichat a young age, which was almost, I’m thinking of a better word for this, like heresy?

Yeah. I know when I retired and my story is I retired and then now back in as a practice owner, but I had been out for several years and I knew how my response was for my family and just from my colleagues. And so seeing a blog like this was. It in retrospect, it was really illuminating and I’m thinking of a better word, but it… represented freedom for many doctors who are out there who didn’t know that it was even possible. And I and leave and be honest with you. I don’t think we would be in a situation where these days with all of these Facebook groups and we’ve got Peter Kim’s side and Mike could investor. You guys being pioneers in that. So I do want to commend you on that.

Leif Dahleen MD: Thank you.

Mike Woo-Ming: But, so tell me, how did this all start from you? T tell me your background for those who haven’t heard it before. How did we end up, how did you become Physician on FIRE?

Leif Dahleen MD: For. Yeah, sure. That’s a great question. I didn’t plan on retiring early necessarily. I’ m a my Minnesota guy went to undergrad and med school at university of Minnesota.

Now I’m a Michigander and I understand you were a Michigander…

Mike Woo-Ming: You’re actually, are you up here or?

Leif Dahleen MD: A little more on the index finger, but bigger? Okay. Yeah, we’re at, we’re an LP in a Michigan, which is very close to a. Wife’s family is and where she grew up. So that’s how I ended up over here.

Mike Woo-Ming: That’s probably the only few Northern Michigan towns I know.

Leif Dahleen MD: Yeah. Escanaba I’ve been through there many times. Also Marquette and I did some locums work in Ishpeming Michigan, which is just west of Marquette. But those are upper peninsula towns. We’re technically below the Mackinac bridge and below the bridge were known as trolls, because. trolls live under the bridge.

Mike Woo-Ming: You still get access to good fudge.

Leif Dahleen MD: Yeah. It’s close by. Yeah. But back to the question at hand yeah, I went through did an anesthesia residency after medical school and went to the University of Florida for that. That’s where I met. My wife did locums for a couple of years, get to try out different practice types and hospital. Sizes. I was at a VA hospital where they did transplants and everything under the sun. I went to some small community hospital. Found that suited me better. And that’s where I did know most of my positions.

Mike Woo-Ming: Yeah, you didn’t do the traditional thing that most doctors do is “all right. I’m ready to sign a contract with this hospital and I’m going to be there for the next 20 to 30 years.”

Leif Dahleen MD: No, I didn’t. No. I went to the ASA meeting, which is the American Society of Anesthesiologists. Intern, I believe in, and maybe a couple more times before finishing residency and I walked around the exhibit hall and saw these tables. There was a global medical staffing offering locums in Australia and New Zealand, which I thought was fascinating.

And other companies with jobs all around the country that, a lot of them are like a try before you buy type of situation where you go there and you learn what it’s like to work. And often they clearly a hundred percent of the time they have staffing needs or they wouldn’t be hiring locums.

And often times they’re looking for permanent staffing and just don’t have it. Haven’t been able to recruit those positions. It’s a working interview for the most part. And I worked a number of different places for one thing. I didn’t necessarily know what the real world would be like.

Residency is always at this tertiary care center and a. You’re basically in the room doing your own cases. And in the real world, you’re doing a lot of supervision. Maybe you might work with CRNs, you might work with anesthesia assistants, residents, et cetera. I just wanted to try out different places.

And then a very, more practical reason I chose that path was that my fiance at the time now wife was going to match is a dietician into a program. Very similar to the way that we matched into residency. And you don’t know where until you get your letter and open it up. And lo and behold, we were going to go to Pittsburgh for nine months and I say, We were engaged in the newly married.

I didn’t want to live apart. And so I was able to find locals work there in Pittsburgh. And we tried out some other places where we thought we might want to live, including Northern Minnesota and Northern Michigan. And, that ended up being two of the three places that I worked full time for a number of years for each of them.

And we worked other places too. It was a cool way to have our all expense paid trips around the country in as little as one week at a time in some cases. But generally I prefer to work for several months at a time and we’d get a furnished apartment and rental car provided per diem for food and everything.

So my living expenses those first few years were like, like nothing,

Mike Woo-Ming: Now were… you talk about your background, did you come from an affluent background or… what kind of background did you do? You grew up?

Leif Dahleen MD: Yeah, I used to think of it as upper middle-class, but now I’ve come to learn. That means like luxury cars and huge houses. That sounds more like upper-class to me, but I would say we’re somewhere in between middle and upper middle, maybe for the Midwest it’s upper middle, but my dad was a dentist and we had a cabin up north in Minnesota. But we also, My dad liked to be frugal in certain ways.

So we would stop at thrift stores and hit up the garage sales every weekend and look for great deals, things that we could turn around and make a profit on, or just collect. And we’d take vacations. We take long road trips for example, or take advantage of a deal where you fly to Florida in the spring and then drive back a rental car a week later because they would offer a really good deal as the rental car companies wanted to move those cars up north for the summer.

Anyway, things like that where my parents were, good bargain shoppers. Taught us the value of money. We worked quite a bit growing up, mowing lawns when we were too young to get real jobs. And then I worked at a grocery store as soon as I turned 16. Yeah. So again, we weren’t hurting for money by any means, but I also think I learned good money habits in the way that we did grow up.

Now thinking about, working in your job, unlike most doctors they’re out trying to get the, I don’t want to stereotype, but most of them when they come in. They want to get that expensive house. They want to get the the super expensive Mercedes or Lexus or Tesla or whatever you have in there.

Mike Woo-Ming: It sounds like you didn’t follow that path.

Leif Dahleen MD: And no. Oh, it was, two years, like I said, we’d spent next to nothing. I kept my little one bedroom condo in Gainesville, Florida. And we actually started renting that out after a year, just moved what little belongings we had into my wife’s mother’s garage.

And but after. Two years of doing that. And once we were married and expecting our first child, we started to build a very nice home and we did build 4,000 square feet on the water really nice place. Four years later, the hospital went under in a small town and there was no one to buy our what, might’ve been the nicest house in town.

So that, that set on the market for a long time, when we did finally decide to sell it after. Using it as a seasonal rental and that sort of thing for awhile, but yeah, long story short. We did make that one financial move, I guess in hindsight it was a mistake, but it didn’t feel like one at a time.

We really thought that would be where I spent my career, 20, 30 years working in this small town in Northern Michigan about an hour and a half north of where we are now. But yeah, that didn’t happen. So the car. I’ve never been a big car guy. I know some people are just not my thing. I’d rather walk or bike.

If I can, a car is a utilitarian kind of thing. It gets me from point a to point B. I don’t get too excited about the maker model. I drive a new center model.

Mike Woo-Ming: We’ve gone investing in something that’s going to depreciate the minute you purchase it. Exactly.

Leif Dahleen MD: Yeah. And I knew I was poor. I finished residency.

Thing other than, some home equity, because 2006 had gone up, so the condo was set. It mine were pretty small. I went to, like I said, public school, undergrad and medical school had scholarships that more than covered undergrad. And and about 60,000, I think my wife had about 15,000 in student loans.

Now this was back in 2018. To so 20 years ago, so these numbers sound tiny, but the average at the time, I think was around 90,000. So I had less than the average, but I also lived awfully frugally as a as a med student. I had a beat up old car. I lived with roommates and not the greatest apartments, yeah. Then didn’t take out any loans that I didn’t need to pay for it.

Mike Woo-Ming: What was the point of saving? Where were you looking at retiring early or was it just a way that I really don’t need to buy a lot of stuff?

Leif Dahleen MD: Yeah. I’d say it was more of the latter. I didn’t know what I was saving for.

I just knew that I didn’t have any reason to, and I want him to see my net worth grow. Like I, I learned about, again, I mentioned. Parents taught me some good values in terms of money management. And my dad taught me the rule of 72, which is how long it takes for your money to double at a given rate of return or interest rate.

So I knew that if I got, let’s say 8% on my money, it would double every nine years. If I got 12% on invested money, it would double every six years. And even, as a. And resident looking at jobs, paying wow, like $250,000 a year, $300,000 a year. I knew that was on the horizon and I was like, I’m going to save a lot of money and that’s going to double and that’s going to double again and I’ll be a multimillionaire someday.

By the time I actually got out of residency into the real world, the jobs were even better than I had imagined. And so I didn’t necessarily know what I was going to do with millions of dollars. It wasn’t until. 2014 or so that I discovered the concept of financial independence and realized that, oh, I can use this money to buy freedom, to buy back time and, location independence, the ability to travel.

Like you mentioned, in your introduction, taking our kids around the world. And that sounded much more appealing than. 2:00 AM labor, epidurals, and long, long days in the hospital. So that’s the that’s the route that I decided to do.

Mike Woo-Ming: So you could have invested in a lot of things in front of when I read the stock market or a Vanguard is what got you interested to talk about? There’s a lot of places where doctors can be investing. Why was that the best route for you?

Leif Dahleen MD: Again, going back to my parents, one thing my dad did in medical school at the time, I guess I was not thrilled with life. I was in a surgery rotation somewhere on the internet. I found something about swing trading and I was reading about this and I sent my dad an article and he said, he sent me a book.

It was Andrew Tobias’s The Only Investment Guide You’ll Ever Need. And I read that and then. Introduced me to what investing should look like. And to me that means index funds as the bulk of what you invest in. Now, in the back of the book, he mentioned two companies that he believed were excellent T. Rowe Price and Vanguard.

And I thought T Rowe price sounded quite Regal. And he mentioned that Vanguard was kind of a, no-frills sort of a low budget kind of deal. And I actually went those two real price. Sounded, I don’t know. It sounded more appealing in the final chapter of the book when I revisited it, once I had some money and and it turns out after six or seven years, I took a closer look at everything.

And that was in like an S and P 500 fund paying expense ratio of about 38 basis points. If I remember 8.3, 8%, and I realized Vanguard was charging like 90% less. And. And I looked at, and I invented, I invested in some mutual funds that were of funds, but they’re all actively managed.

I didn’t do everything right. From the get-go for sure. But I also didn’t make any really big mistakes. The thing I did right. Was save a lot of money and invest it. I didn’t invest it perfectly. No one does, no one can really do a perfect, but I would’ve done things differently in hindsight.

But again not super costly mistakes. And I do believe and still believe. The US stock market is a great place to put the bulk of your money. And that’s where most of mine is.

Mike Woo-Ming: Even this year.

Leif Dahleen MD: Oh yeah. Oh yeah. Stock market, I think it’s up on the year finally. I’m sure it took a little dive at volatility is part of the price you pay for long-term results.

And I think just understanding, where the stock market has been over many decades and all of the tribulations. It has seen and recovered from gives me confidence that most continues to continue to see strong returns from the stocks. You’re investing in companies that do wonderful things for people and make great products and provide services that we all use.

Mike Woo-Ming: Now, when you invested heavily, what kind of give me an example of what percentage you were actually putting into investing and how much percentage where you go to paying your bills and other expenses?

Leif Dahleen MD: Yeah. Every year is different. There’s no such thing as a normal year. At least it seemed like for us in doing locums for a couple of years, building a big house, I cost a lot of money and that hospital going bankrupt, finding another job, realizing that wasn’t a place we wanted to spend.

Yeah, the rest of our career move, finding another job back in Northern Minnesota. So the percentage wise, I would say anywhere from probably 30 to 60% given, depending on the year, maybe 20% on a year where we had a lot of expenses, I like to pay for cars with cash and it’s when locums made some extra money, even during my vacations, when I had full-time jobs but yeah, towards the end, when things are stable, the last five or six years, we had paid off our house by then we were spending maybe 70,000 a year, not counting certain things like charitable giving, but just food, lodging, travel, bills, utilities, et cetera. That was maybe… 20% of what I was bringing home. When we’re saving maybe a 70, 80%, not counting taxes, I’m talking net not gross because 30, 35% goes to taxes, but from what’s left, I saved most of it. When I didn’t have any other big expenses,

Mike Woo-Ming: Take me to the decision when you. decided you wanted to retire. Tell me, what was your thinking process then? Was it one day you decided, was it that one year decision? How did that work for you and your family?

Leif Dahleen MD: Yeah the first, it was that realization like a, is this really possible and spent a lot of time reading, all the safe withdrawal rate studies and. .. Kind of verifying in my mind that this was a real thing. We had enough money to make it work, and then did some spreadsheet work to project out because I had just moved about a year earlier to Minnesota and I was happy to be back home and it was the best job I’d ever had. So I was in no hurry to leave.

I thought maybe we’ll come up with a five-year plan. And our kids just started at this a really good grade school at a gifted program. And we figured well about the time they’re in middle school, I will have been here five or six years and it might work out just really well. I want them to have a nice cushion and it turns out that we had, at some point, double, what I had five years early by the time I actually did leave my job. So I felt very secure by then. And of course, as we’ve talked about a little bit, I did start a website too, and that as turned into a source of income as well. And yeah, it was just a lot of conversations with my wife, like what we wanted life to look like.

She was excited that the idea of traveling. Yeah, weeks and months at a time, rather than quick vacations, where you hit up all the tourist spots really quickly and then race home, and then you’re supposed to be here. Now, my wife didn’t work much. She did teach a nutrition class like one night, a week kind of thing for a couple of years.

And now she probably works now more than ever. She does all the verification for our physician. Only Facebook group. There are a lot of people trying to sneak in that are not physicians that want to have access to us. So she spends an hour, maybe an hour or two some days just working on that for me.

But no, she’s stayed home to take care of our kids. We have two boys they’re now 11 and 13 years. When I retired now almost three years ago, I guess they would have been eight and 10. So yeah, she was home with them until they went to school and they were in public schools until I left my job. And since then we’ve taken over. Primarily my wife has taken over their education.

Mike Woo-Ming: Now I know when I first retired, I have that conversation with my wife and. A lot of, I did have spreadsheets back then I had to do a lot of convincing. And then they were on board. Then the conversation with my parents was another thing.

And my mom still, to this day thought, “you’re nuts” that, “you’ve got some mental things” and just from many doctors out there, cause I’m not the only one where we are. Being a physician is so in wrapped what we do and I’m sure you’ve come across this as well. How old are those conversations?

And even now these days, you’re a doctor and why aren’t you working? Why aren’t you. For me picking up my kids or, why aren’t you doing this? Or what kind of doctor are you who doesn’t work even, college roommates, so that I’ve had say, I’m not sure what exactly what you’re doing now, or at least when I was retired, how are those conversations going?

Leif Dahleen MD: The one that I was most concerned about was the one with my parents. I remember when I was accepted to medical school, they offered a percentage of the class and I think it was somewhat merit-based. They asked if we wanted to take early summer anatomy and then we could be TAs and help teach anatomy to the rest of the class.

And at first I accepted. But then it was like my last summer freedom before what I knew would be a long, difficult slog of medical school and residency. And I was having a great time and I just don’t let parents I think I don’t want to do this summer anatomy program. It’s just, I don’t really need to I can take anatomy with everybody else.

And I remember my dad was like, do you even want to go to medical school? You want to be. Yeah. I just want to have a little fun this last summer before it gets crazy. So when the time came 20 years later to tell my parents that I was considering retiring early I didn’t know how that would go, but it went really well.

Actually, my dad had retired by then. I think he had a different outlook on, how much time you get on this planet and everything else and said, “Hey, if you can afford it, Do what makes you happy.” And we had conversations about finance. Like before, before I started a blog, he was probably the only are they, my mom and dad were the only people I talked to about, money matters.

And no, I’ve found a lot more people that I can talk to about that. But yeah, no, it actually went well. And then as far as other people, friends, distant relatives Maybe some have found my site and read a lot of things or listen to podcasts or whatnot. But I don’t get any real pushback.

No one seems to be particularly upset by what I’m doing so that a lot of people know I have this other thing that I do, on the website and that, so I don’t know if they really realize or get the facts. That’s all just bonus just to, it’s gravy. I didn’t need to do that in order to retire from medicine.

And I think that’s the question I get most often is yeah, you retired, but that’s because you have this thing. Oh no. I had probably more than twice as much money as I needed to retire, with a high five figure, low six figure annual spend, which has plenty of money in Northern Michigan.

But yeah, no I’ve been very pleased with the reaction. Like public with my name and decided not to be anonymous. There was, it was like crickets, no one really cared or noticed, which was how I wanted it.

Mike Woo-Ming: So let’s talk about that because I was interested too, is first off you to, why did you decide to create the website and two, why did you go anonymous at the beginning?

Leif Dahleen MD: Yeah, but circling back to that question, I never really answered it earlier, but I had read about financial independence realize that was something that we had. Gave us amazing opportunities to retire. If I wanted to, or take a lower paying job or work less, or, basically when money is no longer a concern that opens up a world of possibilities and it was a concept that isn’t taught in schools.

It wasn’t anything I really thought about retirement is something to do when your kids leave the house and they’re on their own. And. You’re getting older and don’t like working all those hours. But no, I just wanted to share the message on people to know what it means to be financially independent and what that can do for you.

So I read a blog called Mr. Money Mustache. That led me to a handful of others, including one by a physician Dr. Jim Dolly, who writes the white coat investor. And. I saw what he was doing. I saw what other people are doing. I didn’t really see anything in the fire space. Financial independence retire early from a higher budget, higher spend approach.

Not that we’re, among doctors, very high spenders, but among the, fire crowd, I guess I would say. More of a quote-unquote fat fire where lean fire means you are very low budget. If that fires on the other end of that spectrum. And we do like nice things. We spend more than the average American household, but less than the average American doctor.

So we’re somewhere in this kind of odd place. But I found out that I enjoyed writing and I initially set out to write like once or twice a month and it ended up being once or twice a week. And. And it just has taken off from there.

Mike Woo-Ming: What I like about it too, is you’re very transparent. Some of the little pushback you get, you actually, I know about it. Cause you actually leave it on your website. You left a few of the comments that may not be as flattering that are on there was that was a conscious choice.

Leif Dahleen MD: I’ve deleted very few comments. I delete the spam, there’s just random stuff that links to garbage, but yeah, if someone’s critical, that’s good feedback in general. And I can usually explain why I think that perspectives is a little off and maybe they don’t know my whole story don’t know exactly what I’m doing. I had a post about donor advised funds not long ago, which is a vehicle where you donate.

To an entity that holds the money and it can remain infested that entity is a charity. And once the money is there, it can only go to other charities. They have to be 501c3 registered IRS charities. But I like to use that as a mini foundation. We’ve been building up the balance in that while donating from it.

We only donate maybe five to 10% of the balance, but the balance is now inaccessible like a half a million dollars. And I got shit for that from some random comment or as “oh, you guys just do rich people. It’s just a tax write off.” It’s okay. Yeah. I get to deduct maybe 37 cents for every dollar I give to it.

And I can’t give that money back and it will go to charity. That’s the only destination for it, and I’m like, I don’t think he knows that. No, we pay the salary of a physician now donated like a bunch of money to COVID causes Ukraine more recently, we’re trying to do good with the money I’m making online.

And a bulk of the profits end up being donated and I think that’s a good thing, but yeah. So if someone’s gonna write some hate, I’ll be like, okay. Yeah. But here’s the other side that maybe you didn’t realize.

Mike Woo-Ming: Exactly. And following up on that one question about when you decided to tell us the decision when you decided to out yourself, is it just like continuing, just just being transparent,

Leif Dahleen MD: It wasn’t my decision. It was Jim Dolly’s. He said, so we partner pretty early on. He liked what I was doing, and I liked the exposure that you would be able to give me. He bought a small piece of my company and we’ve been working together in some cross promotional ways and different things since 2017. And he had his first white coat investor conference in 2018 and he said, you’re going to be on the big stage.

Leif DeLeon MD. This’ll be your coming out party as I got I. Okay. I’m like first, let me make sure I let my colleagues at work know that is part of my plan. So that was one of the factors that went into my being anonymous initially, I didn’t know for sure that I would truly follow up and retire early.

It was an idea I had that I was exploring and writing everything out really helped me… firm up, what I wanted out of life and what I wanted early retirement to look like. But of course I had to let my colleagues know and I didn’t want to be writing the site about, “Hey, I’m gonna retire in a few years. And I saw this thing online about you not working with us anymore pretty soon. What’s this about?” So I wanted them to be the first to know. Once I talked with my chief and some of my colleagues there. Then I felt comfortable putting my name out there too. You always worry about what are people gonna think.

And most people don’t think much.

Mike Woo-Ming: And usually are not thinking about you at all.

Leif Dahleen MD: They’ve got their own things going on. Like I go, huh? That’s good. That’s cool. All right. Whatever.

Mike Woo-Ming: You’ve got quite a big following and many, you probably get a lot of questions. I want to be like, do you leave?

How can I get started? What are some, maybe three or four things that you could recommend for someone coming out, they want to retire early.

Leif Dahleen MD: Yeah I would start with not having that attitude, right? I would hope that you can enjoy because no matter what, unless you get a big inheritance or, get really lucky with a moonshot kind of investment, you’re going to be working for a decade or two minimum.

And so figuring out how to enjoy the job. Are doing, you went to medical school for a reason, went through residency. This is supposed to be the good part. It gets better and it really does. So that would be the first thing, but to put yourself in a position to become financially independent then you just need to focus on growing the gap between what you earn and what you make.

And honestly, over the first five, 10 years, how much money you have invested. Is going to be depend much more on how much you saved and invested in much less on your investment returns. Now over 20 to 30 to 50 or a hundred years, your investment returns make a huge difference, obviously. But initially it’s just brute force savings and you’ve got to pay off debt.

You’ve got to invest, you’ve got to live and you’ve got to have some fun. And I think there’s a tendency among. Many people and physicians are certainly not immune to this, to equate expensive experiences, expensive items with just being happier. And that’s not always the case, and you can look at big studies on happiness from country to country.

There was a study and this is now 10 or 15 years old. So inflation has changed the numbers, but making more than about 70 grand a year, didn’t seem to make people a whole lot happier, maybe a little more life satisfaction. So people have equated that to maybe spending more than about 70,000 a year.

Does it make you all that happy? Maybe it’s a hundred thousand now after inflation. And obviously there are easy ways to, refute that anecdotally, but also when you think back on some of the happiest times in your life and the things that have brought you the most joy, was it hanging out in college meeting, your future partner, camping trip, playing games with your kids, all these things that really don’t cost a lot of money necessarily.

And I learned to be selectively frugal, spend. Bringing the most joy and as far as investing, yeah, I like VT, sax and chill. I don’t have the t-shirt, but I’ve seen it. That’s a good one. Which would be the Vanguard total stock market. Like I said, index funds and and I think it’s all right to use a little bit of play money.

Whether it’s for your own business, someone else’s, an individual stock. I just wrote a blog post on this that published the other day. I think, maybe up to 5% of your invested dollars could be in that moonshot deal. When you have a little bit more, you can take some more chances.

Mike Woo-Ming: What’s your opinion on cryptocurrency?

Leif Dahleen MD: I don’t know where it’s going. Some brilliant people have said that it is the future. Some equally brilliant people have said that it should be worthless. Really doesn’t have any intrinsic value and the use cases are difficult to find. So I am somewhere in the middle and I don’t profess to know which way it’ll go.

But I don’t want to miss out entirely. So I do have some investments in companies that will do well as crypto does. Cracking is an exchange and I was able to invest in that pre it’s still pre IPO because that’s still, I don’t know, in the future, if at all. And I invested in a company called Republic, which republicans.com does.

A lot of funding for startups helps attract investors to different types of startups. And they also do crypto and tokenization of assets and whatnot. They’ve got a pretty diversified kind of. Business model now. So those are companies that will be well as crypto does. As far as directly owning it, I don’t have Bitcoin.

I don’t have Ethereum. I did invest a small amount, a few thousand dollars in a pre-seed round for a token that apparently is worth 10 times what I put into it. Although I don’t have liquidity options at this point in that yet. So I’m dabbling, and. We’ll see where it goes. I’m as curious as anyone, I read a lot about it, but I don’t have any strong opinions because people that know more than me have very strong opinions in very different ways.

Mike Woo-Ming: Okay. Gotcha. This has been amazing. So what’s the plan for a Physicians On Fire for 2022?

Leif Dahleen MD: The same as always, thankfully we’ve been able to travel again and that’s been good. We go to Europe for a month in January. We spent part of February and most of March and Florida and south America.

And we’re doing a two week cruise after spending about a week in Texas. And. Some time in New York city, Boston, Maine. So I’m not sure if you’re asking about me or the website, but it’s one in the same sometimes. Yeah. Yeah. So just continue on putting out, content four or five days a week, something for just about everyone we’ve got interview series.

My original thoughts stuff on investing taxes travel, you name it. Yeah. We’ll keep an eye.

Mike Woo-Ming: Yeah, you’ve got the really great stuff, guys, if you want a good read too. I love what you wrote about when you were traveling during COVID than in history or experiences. That was that was really enlightening and Leif the great writers.

Go to his website, physicianonfire.com. Check out if you’re a physician you can get on his Facebook group. If you’re not. His wife is going to kick you out. So don’t even try. It’s a great place to put up some good posts and inspiring, and as a great community. If again, thank you so much for joining us on the program today.

Leif Dahleen MD: Thank you, Mike. I appreciate the introduction and the the invite and the conversation was quite good. Appreciate you sharing my story with your readers and watching.

Mike Woo-Ming: Thank you so much and thanks all of you. And again, if you want to be inspired, don’t just read it. If you want to start implementing these things, learn about finance, go and study all these things.

Whether it be stocks, whether it be crypto, whether it be real estate, invest, find mentors are actually doing it. And don’t just read about it. Keep moving forward.

More doctors are learning the benefits of becoming a practice owner and starting their own direct primary care (DPC) practice.  DPC is a primary care model where patients are not billed by insurance, but instead charged a flat recurrent membership fee.  Dr. Cynthia Villacis is a direct primary care physician and one of our life coaches at PhysicianCoaches.com. She opened her DPC over 5 years ago after getting burned out as an employed physician, and then opened her life coaching business a year ago to help physicians who are stressed and want to make a change in their personal or professional lives but feel stuck. You’ll be energized by Dr. Villacis’ inspiring story!

Dr. Villacis’ e-booklet: How to Beat Physician Burnout

https://www.coachcynthiamd.com/Burnout

Transcript:

Mike Woo-Ming: Hey guys, this is Dr. Mike Woo-Ming. Welcome to another edition of BootstrapMD. As this is the podcast for physician entrepreneurs, and I love to spotlight doctors who are in the trenches. Becoming their own boss. And I’ve got another one here and I’m so glad she’s on the program. She has a direct primary care physician as well as a life coach.

She opened up her direct primary care practice about over five years ago, after getting burnt out as an employed physician at a federally qualified health center or FQHC. She then started her life coaching business about a year ago to help physicians who are stressed and want to make a change in their personal or professional lives, but feeling stuck.

So I’m super excited to have her. She’s one of our physician coaches on our physician coaches.com website, where you can find over 200. Physician coaches, but you can pick four in a 12 different specialties. So I love to bring into the program here today, Dr. Cynthia, via VSCs. Cynthia, how are you doing today?

Cynthia Villacis MD: I am doing great!

Mike Woo-Ming: Thank you! Thanks for coming on to the program, I was mentioning just prior to us coming onto the call, I know doctors who started up their own DPC practice and they’re super busy just trying to manage the business and doing all the things that we often don’t think of when we were employed physicians.

And then you decided, you know what? I want more stuff. I want more stress in my life. I’m going to take on more things and I wanted to become a life coach as well. So I want to hear about your journey. We talked about it. We’re probably gradually. Graduated residency, but at the same time, you’ve had those turf wars.

You’ve probably got them experiences, but when they take about your journey from getting into the medical school, then get into residency and then deciding to start up your own DPC.

Cynthia Villacis MD: That’s going back quite a ways. So I am 19 years out of residency. So going into as far as the going into med school part I was a little bit late in terms of coming to the decision that I wanted to be a doctor.

So I graduated back in 1993 from Oberlin and stayed up there and worked a couple of years finishing up my pre-recs and then came down to Wright state. And Dane for med school, I was interested in doing primary care and I had applied to and gotten into two med schools in the state of Ohio. And I had gotten married and undergrad and the other school that I got into.

Was new Yukon. I was one of two people who had gotten been accepted and I didn’t want to be like the only married medical students and I’m right. Stayed had people coming from all different backgrounds. And I had a focus in primary care. So that’s how I ended up down at Wright state. And then I had my first child fall of my fourth year of.

Med school. And I was looking at residences at west. I made it out to Seattle with my husband and a two month old. And yeah, we were like, oh, we love Seattle, but his family is in Ecuador. My mom was in Cincinnati and We just decided that we wanted to be at a place where we’d have more support. And then as we went through med school and I had my second kid at the end of residency at the, my second kid at the end of residency we just decided to stick around the greater Cincinnati area.

My kids would at least to get to know one side of their grandparents. So that’s how we ended up here. So actually on the other side of the river, I’m in Northern Kentucky and family is very important and when we can be starting to raise, yeah, sure.

It is so. Ended up coming back here, figure, we could always go to Seattle on vacation if we wanted to, but we didn’t have to live out there.

Mike Woo-Ming: So you went into residency and this was a time too. It was like, cause I was in that same time, a lot of people say you gotta go into primary care was a lot of your colleagues going into primary care that time because now it’s the, I think, it’s definitely shifted everything now is about specialties and primary care is off after thought. It sounds like at least I perceive it that way.

Cynthia Villacis MD: There was but… Set up with a focus on primary care. I’d helped remember helping organize like primary care day and, we had a family practice interest group and stuff like that coming up. So me and it was the only practice was definitely recognized and encouraged.

And we had great mentoring as far as going towards primary care. And I remember working. Doing some rotations, as far as at the us and the community health centers, up there with Dr. Gala Roy at east Dayton health center. And just really got encouraged to go in that direction. Okay.

Mike Woo-Ming: So you’ve graduated, you completed your residency and now you’re looking at a whole different job offers, I assume. Or did you have a. A place in mind where you wanted to practice, what was that for you?

Cynthia Villacis MD: For me, I was wanting to stay in the greater Cincinnati area, at that point in time. I was pregnant with my second kid and my husband was in school at Northern Kentucky.

We were wanting to stick around the area and yeah, I ended up initially working At a hospital owned group for a couple of years. And as a hospital owned group, you don’t really have much control over what’s going on. And they ended up moving a physician into my office that had a problem with prescribing and it just, it was not a good match at all.

I ended up leaving there. I did urgent care for a year. And then I started working in a community health center systems. I had gotten exposed to community health centers through medical school and really wanted to be able to try to help people from different backgrounds and the community health centers have a way of having sliding scale for folks that don’t have insurance and tend to have reduce fees for labs.

And sometimes for medicines also, but they’ve got this weird thing where the way they get reimbursed by the government, they would get reimbursed like for the same amount, for a level three and a level five. You have the thought that, it’s a more complicated patients that you should get more time with them.

It doesn’t really work very well. But I stayed at a community health center system for a number of years. I was at neighborhood healthcare for three years. And then I was with another community health center system in the greater Cincinnati area for eight or nine years. And I love that.

Mike Woo-Ming: Which one kind of worked better or what was the reason for switching?

Cynthia Villacis MD: But the CEO, to be honest the CEO at the first place I always wanted to provide. Quality care as far as to the patients. And she was more interested in how timely everything was, but didn’t give me support to help make it more timely. My ma had to do the blood draws as well as from the patients.

And. It just it was a very dysfunctional system. There was one time where she came down and knocked on my exam door and told me to hurry things up. This is a community health center system where people like literally would get off the bus, before their appointment and after their appointment, all of a sudden you’d have a waiting room full of patients, that was the way the saran, you just saw whoever was next, but yeah, it wasn’t a physician. No. Oh no. She was definitely not a physician. And what kind of made me move me towards leaving is when they were having economic fit financial problems.

And I was trying to think through, as far as what other things we could change, how I could change things once again, wanted to try to have some influence on how things happened. And the only answer she could come up with to get me about how things were going to get better is that I was not seeing more patients and I was already seeing.

Literally I was like, how about this? This, yeah, no, the only thing that she came up as I would see more patients I’m like, yeah, I can’t do that. I’m already doing 10 to 15 minute visits on the patients and yeah. That wasn’t gonna work. So I left from there and went to another community health center.

And this can be health center. They looked at me house number was not having the same kind of financial problems. But once again, I think it was in that committee health center system when we switched to EHR. So it was a very dysfunctional EHR system. At what point in time I counted, there were over 20 clicks that I had to make to get lab results into my inbox and send it to my nurse. 20 clicks! You can imagine primary care, how many times over and over that had to be happened, and just add to that.

Mike Woo-Ming: Yeah. I love that because I’ve simulated done these kinds of passive aggressive ways of explaining things. And I love that it’s constantly 20 clicks to do something that I could just write down for yes, 20 clicks.

Cynthia Villacis MD: Yeah. And the person that they had in charge of the HR implementation I think she was very overwhelmed. And there, I remember one point in time, I was trying to ask her to change the wording on one of the orders that we had to do, because we’re getting called from the radiology centers, asking us what they were supposed to be doing.

Because there was one of the codes was for an extracranial ultrasound. Which a crowded Doppler, but, apparently, it was confusing everybody, but it’s just like something that would go in and you could just change the words really easily, in terms of I knew how to do it, but I couldn’t do it because I wasn’t the person that was supposed to be doing it.

I didn’t have authorization. But it didn’t want to make changes like that, so it’s, it was it was a struggle there in terms of the computer system and I just ended up working longer and longer hours. I had 36 patient contact hours a week, but was probably working more like 60 ish. At least, for all those extra hours. Yeah.

And I remember talking about wanting to cut back on my hours at one point in time. Because I’m like, this is too many hours. But then I was going to be part-time and wouldn’t call it for the benefits that I needed. So I just felt really stuck, and I, got burned out I still wanted to provide good care for the patients, but I really ended up feeling like I couldn’t, I just couldn’t make the system work. I was running behind. I didn’t like being behind, but I thought it was more important to take care of the patient in front of me than to get them in and out the door.

Mike Woo-Ming: Who did you were able to talk about these things? Did you talk about this with your husband? You have to plan for dots at work?

Cynthia Villacis MD: Yeah. I talked to my husband about it. I was on the leadership team. I talked with the medical director of. Oh, yeah. I brought up, my concerns, my issues.

I made some suggestions, I was having problems with charting and I was like Hey, can I have a scribe? Could I have Google block? Could we try the Google goggles? Could we try the way scheduling? And it was like no. And I’m like, okay. I basically just end up getting really burned out and it didn’t I feel like it was it wasn’t sustainable.

And I was trying to figure out how to make it change or what to do differently. Cause I, I didn’t know what to do. I thought it was me. I didn’t burn out. Wasn’t a thing that people were talking about in the early the night. Not nineties, but it’s 20, 2010s, right? Whatever year that is. Moving people, weren’t talking about that back then. At least not people that I knew. So I thought it was just me. I didn’t understand that I was getting burned out or whatever else was going on, but I know I needed to change.

Mike Woo-Ming: There were no internet discussion groups back then.

Cynthia Villacis MD: No. Don’t remember any of that. Anyways, I was reading a medical economics journal and I wrote about this thing called direct primary care. And I Googled direct primary care near me and found a lady that was about an hour and a half away. And then a little Dr. Molly Rutherford, and she had opened a direct primary care practice. So I went down and visited her software office, went to a conference with my husband and came back and was like, “Hey, this is what I want to do. How are we going to make this work?”

Mike Woo-Ming: And I’m curious, how did that conversation, did you just email her or pick up the phone and say, Hey, I want to do the same thing. Can I shout at you? How did that happen?

Cynthia Villacis MD: I don’t remember, this is those like six or seven years ago, but I either called her, emailed her, but she was, super helpful, very open to, yeah, come on down and shadow me and I’ll show you what my offices like. And that’s one thing I really appreciated about the DPC community is there’s a lot of.

Helping each other that’s going on? I think part of it comes from being a relatively newer practice style and not being quite so many of us, there it’s, that’s, it’s been a good community. But I still felt stuck. It was hard to make a change. One of the things that helped me move towards making a change though, is I also do addiction medicine yet.

I forgot to tell you about that half. So I started doing. Started doing that year or two before I opened my DPC and I was as an employee And I had seen what people were able to do to change their lives, to improve their lives and to get back on their feet. It was all these things against them.

They were able to make things better, and I’m like, whoa, I don’t have any of that stuff going on. I’m just talking about, opening a business and even if the business has problems, I can go get another job. As an employee someplace, if that’s what I want to do, so worst case scenario is I go back to doing what I’m doing now or to urgent care.

And you know what I’m saying? It’s so that you put things in a whole different perspective, and helped me move forward. And I think that, and seeing that there were other people out there. That we’re doing something different. That, that probably was, that was super huge. I think if I had just read about it and hadn’t gone to the conference and met these people who were doing things other than being an employed physician, I, that would have been so much harder for me to move forward.

Mike Woo-Ming: You saw some people who were actually implementing it. Wasn’t just a pipe dream,

Cynthia Villacis MD: Exactly. It wasn’t a pipe dream. And everybody was happy. It was like the only medical conference I think I had been to, at that point in time where people were actually like, happy about what they were doing. There were hopeful, and I think it’s the whole. Being able to have some control over your practice or how you do things. Yes, you’ve got the responsibility for it. You have to make payroll, there’s certain things you have to, do. But to be able to decide, if you want to do something or not that was one of the things that I had challenges with as far as an employed physician, is that.

I felt that I had all these responsibilities over the outcomes. I had all these boxes that I had to check all these criteria, but I didn’t have any control over the process. And so here I am, I’m like, okay. Yeah, I agree. Those are great ideas. We should do things. We should make sure that people have their

But if you only have 10 or 15 minutes to do it, And you how was all that supposed to happen? I don’t want to not educate them on their diabetes medicine so I can ask them if they have gotten that at all these other things done that. Anyways, so try to do PHQ cycles around that.

But it never got things working well enough that I felt I could do what I wanted to with the patients.

Mike Woo-Ming: I read this somewhere and it was a great description of why we were anxious or why we have anxiety. And it wasn’t, it was simply a math equation. It was anxiety equals uncertainty plus.

Powerlessness. So in the future, we can, when you’re an entrepreneur, you’re always going to have uncertainty, but you have power. You empowered yourself. And often times as employees, we have both, we have this uncertainty and we feel powerless. Does the DPC, you found a way to empower yourself. It’s

Cynthia Villacis MD: Perfect.

Yeah. Yeah. And that’s the empower. Yes. You hit it right on the nail.

Mike Woo-Ming: Yeah. So you just, you go in you go to this conference, you’re surrounded by like-minded individuals. They seem really happy. You tell your husband, I want to do this. What was that timeline like? And when did you actually, like, how did you work on your business, working your practice while still probably work in, full-time schedule I assume. And your FQHC?

Cynthia Villacis MD: How did I do that? Actually I, I told them a little sooner than I was planning to. They were asking me to start up a new line of service for the company doing addiction medicine services. And I was like, oh, I have to tell them because I can’t be responsible for starting a new line of services and then leaving.

Yeah. So it was. Basically evenings and weekends, and it was hard to find the time to do some of the things that I was wanting to do. I did have a brief period of time where I wasn’t open yet after I had left. The employed position, but that was really because I outed myself earlier than I planned to in terms of letting them know what’s going on.

That was actually really helpful because it is hard to make calls and find out about things during the day. It’s hard to look at commercial properties that, if you’re not getting home until eight o’clock at night, how are you going to go look at the properties?

Mike Woo-Ming: If you do have to, when you’re looking for a place, did you want to make sure or where they’re like non-compete clauses or anything like that? I know it’s probably a different type.

Cynthia Villacis MD: No they’re told they’re totally were non-compete clauses. So my community health center that I was working at with was over in Ohio. And that was part of the reasons why I came back over to Kentucky besides the fact that I lived here. There was a non-compete.

So it was really irritating because, I’m working at a community health center with patients with Medicare, Medicaid and our insured. And there, there are more people there, more patients needing those sorts of services, and there are places for people to get it, and I just honestly personally have a philosophical issue. People having non-competes I understand as a business owner, why you’re concerned about losing your patients, but from a patient perspective, people should have the right to follow their physicians.

They should be able to, have their physicians tell them where they’re going, some of my patients got their letters and some patients just had me disappear on them because not all my letters were sent out appropriately and there wasn’t anything I could do about that, but yeah, so I moved to a base of basically I was starting from scratch, over here in Kentucky. And one of the big things I had to figure out though, was how was I going to finance it? ’cause, I’m not independently wealthy. I’m the primary bread earner, so a lot of those things were things that had kept me stuck before.

But it’s one of those things that you have to, if you agree to move forward before you have all the details figured out, you’re more likely to figure out the details, So initially, I increased the number of hours that I was doing the addiction medicine. So I was doing that with twice a week and in part to our money part, because I like it.

I’m there one day a week still at this point in time. But also in the practice, once I was talking to more people about, the practice and what I wanted to do, and I found other things that I could do in addition to seeing the patients as I was trying to get more patients come in physicals, for vets. I could do telemedicine. There, there was all these other opportunities that I wasn’t aware of. Immigration physicals. I do those. I started doing those actually like right before the pandemic. So I didn’t deal with this initially. I love doing immigration. That’s actually one of my favorites.

Things just because I love meeting people from different backgrounds and cultures. And I’m mean, you can see that looking back that I was an exchange student for a year. I remember, back in 88 and I speak Spanish as a second language. That’s something that. I like and I also haven’t brought my husband through the immigration process.

He came over on a FIA fiance visa back in 91. So I have some experience that way, but being able to do the immigration physicals for patients who speak Spanish in their native tongue. That’s. That’s really nice, to be able to actually have a conversation with somebody, as opposed to having them have to do everything through an interpreter.

Yeah, it’s fun.

Mike Woo-Ming: We have a number of people who listen to our podcasts. You want us to set up their direct primary care practice? What are some like two or three things, advice that you can give them? Lessons that you’ve learned after starting a beer DPC.

Cynthia Villacis MD: Let’s see. I would say network, both with other people who are doing direct primary care with people in the community so they can know you’re there and know that your services are something that they want.

And with other physicians who are doing things outside of employed medicine, both to learn of opportunities as well as just to get support, cause it really helps mentally when you are working with and talking with. I have support with other people who are also trying to do something different.

Mike Woo-Ming: Now, when you signed up, did you there’s a bunch of DPC companies out there, like MD VIP and some other things like that. Did you go with one of these companies or did you just do this on your own?

Cynthia Villacis MD: Yeah, no. MD VIP is really concierge more so than DPC I was wanting to provide something that’d be more accessible, coming out of the background, the community health centers then MD VIP was and yeah no, I did it on my own.

With, support and talking to friends and stuff, but it was a lot of learning, but I think being open to learning and I think that’s another big thing as far as learning when you’re starting your own business realizing that. If you make a mistake, you didn’t kill anybody.

And it’s actually a good thing cause that’s how you learn. You know what I’m saying? And there’s, it’s much easier to fix things somewhat and in business if you miss something on the lease that you should have found that you stopped well, the next time you see it, at least you’re not going to miss it.

You learn something, and don’t beat yourself up about it. Take it as a lesson and go on,

Mike Woo-Ming: Tell us about your practice now. Is it a small practice? Micropractice how many hours are you working on your business right now? And, yeah,

Cynthia Villacis MD: so I have gone back to forth between being a small practice micropractice I had an ma with me for a bit.

A year and a half and then COVID. So then I would, then I had no MNA for quite a while. Probably about a year and a half, and then I just hired her back in January. And I also have a virtual medical assistant that’s with me two days that answers respond Tuesdays two days a week. So I’m currently working in my DPC.

Four days a week combination of practice stuff, seeing patients syndrome. You’ve seen direct primary care patients doing immigration physicals, and then the business part of it, it’s obviously a mixture of all of it. But I’ve really been able to, I think, grow a little bit more again, these last couple of months since I’ve had Danielle back, because it’s hard to answer the phone in a schedule appointments when you were working with patients,

Mike Woo-Ming: What surprised you, is there anything surprised you after you’ve launched your practice?

Cynthia Villacis MD: I’m trying to think one thing there were lots of surprises.

Mike Woo-Ming: I would assume. So we knew everything before it happened.

Cynthia Villacis MD: Yeah. Yeah. Yeah, I was going to say honestly, I can’t think of one thing that was a surprise. It’s just been an ongoing learning experience. Which is good because, I like learning and trying new things, but Yeah, I’m sorry, I can’t think of one thing.

Mike Woo-Ming: In terms of a physician who wants to do this kind of practice, what type of skills do you think should they have, if they want to take this on?

I think being willing to learn about the business aspect as well as the medical aspect. I think being not being as scared to make a change, if something isn’t working.

Being willing to put your out yourself out there in terms of talking with people about your practice because you do have to go out and find patients they’re not just going to magically appear on your doorstep and that takes word of mouth and networking and it’s different than when you are.

If you’re an insurance-based practice, people, a lot of times would show up because your name was on their card or they look to see, where, who is the doctor that’s close to them, or that has the, the reviews when you’re starting from zero and you don’t have an insurance feeding your patients, you have to get them from someplace.

So you have to be willing to be a person to get out there and put yourself out there.

So how do you put yourselves out there doing community talks? Are you marketing online? What are some ways that you market your practice? I’ve done a variety of things. COVID mess with some of them, but things that I have done, like over the last five to six years I was in BNI for, at one point in time.

Cynthia Villacis MD: I gave different health talks as far as to the library on different topics. I have had open houses. I have done cold calls and showed up at people’s offices. Hey, why don’t meet you? Also like in the like the local, like physicians, mom group, so like putting that out there and then they I guess I’d like to say obvious, but maybe it isn’t obvious.

Cause I don’t know that it’s obvious to me originally just like having a website and a Facebook page and then that kind of stuff. I’ve done different forms of marketing, but really the. Word of mouth has done the biggest

Mike Woo-Ming: return. Yeah. That always is the best.

It just word of mouth and let’s add your name of your practice is

Cynthia Villacis MD: health connections, direct

Mike Woo-Ming: primary care actions. Okay, great. And we can put a link to that too, in our show notes. You’re also a life coach and we were joking. I was like, sounds like you don’t have a lot going on right now. So tell me how that journey started being a life coach.

Cynthia Villacis MD: Yeah. I you had brought up is it not stressful? Like doing all those different things and actually, I think coaching helps me with stress as opposed to adding stress. So it goes on the other side of the equation, but I was struggling with some things, my practice in terms of.

The ability to pivot and make changes and let myself do some of those things. And also having some issues in my relationship. I’ve been married for a long time now. I think anybody who’s been married for 30 years be lying. If they didn’t tell you, they didn’t have some things that they wanted to work on.

And I was at the lever nigger, some that back in 2020, and there was a physician on there and she was talking about what she was doing with coaching. And I was like this sounds like this could be really helpful. And I signed up for her summer coaching program and just fell in love with coaching.

And it was a really deep dive, was like, at least four days a week, I was doing something related to coaching. And either, one-on-one coaching or the group coaching or having a guest speaker coming on, it was pretty awesome. And then I went on and I did. Enrolled in the life coach school.

As far as for training to be a life coach, I had actually I had heard of coaching before and that I’ve been listening to Brook’s podcasts for a number of years. I knew that I knew that it was out there. I had done self coaching scholars at one point in time. But I had never been in a coaching program.

I had never invested in myself that way. And it’s definitely different when you are. Really investing in yourself and doing a deeper dive than when you’re meeting with rotating people, for 20 minutes, it’s a very different experience. So I signed up for the life coach school and that was my start.

Mike Woo-Ming: So tell us about your experience. Now you’ve been doing this for about a year or couple years.

Cynthia Villacis MD: Yeah. So I’ve been certified for about a year now. So the certification. Yeah. So I’ve been doing this for probably about a year and a half, as far as from the beginning of the coaching program, but the business for about a year.

Yeah, so basically I. I have worked with different groups of people, but probably the group that I worked with the most and who I probably relate with to the most is other physicians who are. At a place where they want to do something different, but they’re feeling stuck, and they’re trying to make decisions in terms of how to make things better for themselves.

Mike Woo-Ming: So you didn’t have that?

Cynthia Villacis MD: No, I did not have a coach just want to, would have been so helpful. Because there are some things. That, we can change internally about things about the way we think about things about whether things are stressful or not. And there are other things that just need to get changed in terms of the circumstance, and just having somebody to talk through.

About what kind of a change that I wanted to make and work through some of what we call limiting beliefs that would have been super helpful. And I think I would’ve been able to move faster, in terms of towards making a change in a way that was healthy and helpful for myself, if I’d had somebody to work through those lists.

So limiting beliefs are beliefs that we have that we are like, we really believe are true, that whole is back from moving forward, So so that’s something that I work with folks on and that can be really helpful.

Mike Woo-Ming: So why do you think it just seems, I was reading a thread on physician coaching. There’s definitely people who have gotten benefit from coaching. It’s still a majority or maybe just my perception of docs or say, you know what, this is a bunch of bologna. I could just do it on my own. What do you say to those folks who feel that coaching is a bunch of woo woo and stuff?Cause I’m sure you’ve seen this too.

Cynthia Villacis MD: Yeah, no, absolutely. I think there are a couple of different groups of people you mentioned. There are people that thinks the whole thing is blue and blue. And those people make well, they obviously have a closed mind against coaching. They haven’t probably tried it themselves.

And that’s too bad, I would love to talk with them and, have them see what coaching is like if that’s something that they’re interested in, but then there’s the other group that I can just do it myself. And I think a lot more people are in that camp, and what I’d say to that is, yeah, you probably could do some of that.

Absolutely. That’s why Brooke has the self coaching scholars program is, there is a way to go and self-coach on things, you can look at the circumstance and look at the thoughts that you’re having related to her circumstance and what feelings you’re having related to those thoughts and and try to work through as far as the model yourself absolutely. And I do encourage people to do that, but it’s really hard to see. In your own mind, the same way that somebody else can see in your mind? I know for myself, there have been lots of times where I have been stuck on something and I’ve been like, it’s been like, I’ll be trying to figure out, the model for myself okay, I’m trying to coach myself.

And I’ve been like hitting my head against the wall and then, I’ll have a session with my coach and it’ll be like, Something we’ll just click, or sometimes it’s not even right. Then I remember there was somebody that I would…. had done coaching with and I was like at a stop light and it was like, we’d have this conversation like two or three weeks earlier.

And all of a sudden I was like, oh, it was like something just shifted or clicked. And it was just really where it’s I felt the clump, like mentally a clunk. And it was like sometimes when you see things like that, you can’t unsee them. And the problem I had been talking with her about was something that I had been trying to work through for like 10 to 15 years.

I talked to the counselor on and I was still having the same issue. It was a, and it was. It wasn’t in the moment, the conversation with a coach. So the different set that clunk happened, but it got the wheels turning and think about thinking things in a little different way.

And with that, I was able to. The shifts, how I was thinking about something and it really altered a relationship that I had been struggling with. So

yeah, I think too is because as physicians, we are usually the decision makers. We are usually the buck stops here. When our nurses come to us or men come to us, we have to make, hundreds of decisions, if not thousands of decisions, weekly and.

Those same people who say, who are closed minded with coaching also, they don’t really have a solution. They tend not to have a solution to their problems. And they’re in the same situation that they were, three or six months ago. Yeah. Yeah,

go ahead. I was just thinking one thing that I think is, can be a misperception sometimes is that people think that the coaches are going to tell them what to do, we don’t tell people what to do, but we help them figure out what they want to do. It’s a very different mind shift mindset in terms of being a coach versus being a position, in a, as efficient as a physician, when I’m working with a patient, I have certain things that, they should do this, they should do this, they should do this.

Whereas with a coach, it’s really, it’s more inside that person in terms of what is right for them. And it’s more me working with them for, to help them decide what is right for them and decide to have them decide how to move forward and what is going to work best for. I don’t know if that makes sense.

Mike Woo-Ming: It does perfect sense. And Sophia, this has been amazing lots of great information work or they go, if they want to get more information about your practice, about your your coaching practice, where can they go to find out. Yeah.

Cynthia Villacis MD: My webpage for the coaching practice is www.coachcynthiamd.com.

And I do have a freebie on there that they may be interested in talking about overcoming burnout or some things that they can do questions that they can ask themselves if they are looking at trying to make another change in their life to try to help them decide what direction they wanna move.

Mike Woo-Ming: All right. So we’re going to leave that link here too. And again, if there are anybody who’s interested in DPC, are you open to absolutely open for content as well?

Cynthia Villacis MD: Awesome. Totally open for contact. I’ve definitely talked with folks about DPC in the past.

Mike Woo-Ming: All right. Thank you so much. Any final words before we end the call today?

Cynthia Villacis MD: No, just thanks for having me on here. And I think the more people talk about other things that they can do Other things that more than people talk about things that other people are doing out there besides being an employed physician. I think that gives people hope and it gives them ideas in terms of other directions that they may want to move for themselves.

So thanks for having me.

Mike Woo-Ming: Yeah. And again, we’re at a special time now where I go, just like Cynthia, I didn’t see any of this stuff. 10, 15 years ago. Now we’re seeing doctors who are doing different things outside of their typical clinical employee practice, opening up their own practice, starting out on their own online business, coaching business.

What have you. So there are never feel that there’s no. There’s no opportunities out there because the more we talk about it, the more we learn from each other. And as always guys, don’t get too stuck in a rut that you can’t do anything. There are people out there like Cynthia who are willing to help.

And again, thank you so much f and as always keep moving forward.