The X-ray Beam: The Physician Philosopher
For an audio version of this post, please click on the speaker icon (top left).
Just like the original Star Trek series spawned the Next Generation, there has been a 2nd wave of Physician Financial Bloggers that have burst on the scene recently from the White Coat mothership.
On this episode of the X-ray Beam, we go behind the scenes and get an in-depth look into a fellow next gen physician blogger who runs the website, The Physician Philosopher (TPP).
Looks like TPP is already gowned up and lying uncomfortably on the hard table, so let’s not cause him any more delay and commence the study.
If you can please give a brief introduction of yourself (age, medical specialty, years of medical practice))
I am 32 years old and just finished training in July of 2017.
I work in academics as an anesthesiologist after completing medical school, residency, and fellowship – in regional anesthesia and acute pain medicine – all at the same place.
1) Please tell us how you ended up choosing The Physician Philosopher as your moniker and website. What were some of the other names you considered before going with this one?
The name for the website comes from the fact that I was a philosophy major in undergrad and then later became a physician. Hence, The Physician Philosopher, or TPP.
I thought it was catchy, but it posed a potential problem.
Many people confuse me with The Happy Philosopher, another physician blogger who writes on physician wellness topics.
I hadn’t heard of him yet, but White Coat Investor was more than happy to point that out to me.
After I started my site, the very first comment I received was from Jim Dahle who made me aware of HP.
I kindly asked the happy philosopher for permission to keep my site name, and – like a genie in a bottle – he granted my wish.
I can’t remember the other names I was considering at the time, but I guess that’s why my nickname at work is “Dory.”
I have some memory loss issues. I wish I was kidding!
2) When did you know you wanted to become a doctor? Were there any influential people or events that made you embark on this career path?
The realization that I wanted to be a doctor came to me in high-school when I joined a health academy of sorts.
It trained me to be a certified nursing assistant, though I never held a formal job as a CNA thereafter.
I grew up around medicine as well because my father had a devastating gunshot injury five years before I was born in a hunting accident.
The bullet hit his lumbar spine – amongst several other things.
He now has chronic regional pain syndrome, atrophied calves, and has several other resulting medical problems from his injury.
I grew up seeing the good and bad of medicine and the chance that physicians had to have a profound impact – or consequence – on someone else’s life.
This made me want to change things for the better.
3) What were some of the deciding factors that led into choosing the medical specialty of anesthesiology? Were there any other specialties that you considered?
Man, I was so confused in medical school.
I thought about anything from pediatrics to ENT to emergency medicine, and then finally found anesthesiology.
I loved the technical aspects of anesthesia from placing tubes and lines to peripheral nerve blocks.
I also loved the cerebral part of the job where I get to make a plan that has the highest chance of success for the patient while placing them at the least risk.
This kind of thinking might come from my days playing as a goalkeeper for my college soccer team.
It also summarizes my investing philosophy.
4) If you had to do it all over again, would you choose the same medical profession/specialty?
The advice I give to my medical students is this:
Your job in selecting a medical specialty is to find a field where you absolutely love the good aspects of the job while you are able to put up with the bad parts.
Every specialty has good and bad to it.
If you haven’t found the problem areas of your chosen specialty, dig harder.
That said, I love anesthesiology.
I am in love with my job, and what I do every day.
The clinical aspect is different every single day and research and educating my trainees still brings me great joy.
I can still deal with the problem areas at this point.
I’d definitely choose it again.
5) If you were not a physician, what alternative career would you have gone into?
My double major in undergrad was chemistry and philosophy.
I liked philosophy much more than chemistry.
If I hadn’t ended up in medicine, I likely would have followed in my grandfather’s footsteps as a trial lawyer turned superior court judge and receive a law degree.
I likely would have used that to work with families in need in some way.
I still think about going back and getting my JD someday, but I just don’t see how it would be of much use to me now.
The other alternative I would have considered is going into counseling of some kind.
People have gravitated to me for advice my whole life.
That would have been a natural job for me.
6) You have chosen the academia pathway.
What were some factors that led you to choosing a career in academics rather than the private practice route?
This one is simple.
I wanted to help shape the lives of future generations of doctors and to change the way anesthesiologists practice medicine.
It has always been my goal to be a “triple threat” in academics.
In other words, I wanted to excel in all three pillars of academia – research, clinical work, and education.
You have to be good in two of these areas to succeed in academics, but few people are good at all three.
This remains my goal.
7) Do you feel you may have prolonged your path to FIRE by not taking the private practice path?
Going into private practice is a mixed bag in anesthesiology these days.
The golden days of privately owned private practice groups are gone.
While there are still a select few groups who are owned by doctors, many are now owned by large national organizations.
So, there are many private practice jobs that make the same that I do in academics.
That said, joining a private practice group that makes substantially more than I do would have certainly gotten me there faster.
Unfortunately, private practice would have bored me.
I would have missed the abstract thought involved in research and education.
Would I have been wealthier?
8) Have you personally fallen trap to any of the typical mistakes physicians make, and if so can you name some of your biggest ones?
This was one of the reasons I started my website.
I’ve talked about some of the big ones in a post about my mistakes. That said, I’ll mention the two big ones:
- I got swindled by a commissioned insurance salesman who encouraged me to apply for disability insurance as a med student.
- I have an essential tremor and was straight denied.
- If I had waited until residency to get the guaranteed policy – for which the only stipulation is that you cannot have been previously denied – I would have personal disability insurance.
- To this day, I work without it because no one will insure someone with an essential tremor in anesthesia.
- I used the GI Bill in undergrad from my dad’s service in the Navy.
- I should have either invested that money or – the better option – saved it for medical school.
- I would have finished without any debt since I had a full tuition scholarship as a medical student.
- Instead, I finished fellowship with $150,000 (plus my wife’s $40,000 from grad school). Still much less than average, but $190,000 more than I should have had.
9) What inspired you to start a blog? Were there any surprises along the way? Any advice to individuals who may be contemplating starting one of their own?
Despite my love for the place where I work, I noticed that there was a vast knowledge deficit in my medical students, residents, and physician colleagues – particularly in the realm of physician wellness and finance.
My thought was that I could take the approach of trying to fill the physician wellness hole partly full of pay dirt from teaching medical students, residents, and early career attending physicians how to build wealth and obtain financial independence.
It has been challenging, but probably not more than I expected.
I think that my message would resonate with most of my target audience, if they could only find it.
To this day, I still feel that’s true.
By far, the biggest challenge has been getting traffic to the site.
Some of that will be solved with time and backlinks (thanks for this post, by the way).
Most of it will be solved by people resonating with my message and sharing it with others.
My advice to others thinking about taking the plunge into the blogosphere is that you should expect it to be difficult.
Most people give up before the end of the first year, which makes no sense given that most blogs take 2 to 3 years to take off.
It’s a practice on patience.
10) Complete the following sentence: I would consider The Physician Philosopher website to be a success when I achieve….
I am going to break that sentence up into the following:
- a success in general when I have achieved helping even one person understand more about their opportunity to achieve financial independence.
- a success financially when I can cover the costs of running my blog and give a decent amount of money through my charitable mission (25% of my revenue goes to charity) on the site.
- it will feel like an overwhelming success when I get to 25,000 sessions per month and 1,000 email subscribers.
11) Being in academics you have your finger on the pulse of the next generation of doctors. What are some of the challenges these millennial doctors face that mid-career/late career doctors have not?
The most obvious difference between millennial doctors’ situation and those of mid/late career is the overwhelming debt.
Around 80% of medical students come out of med school with debt with the average burden being around $190,000.
Even some of my colleagues who graduated only six years ahead of me have student loans between 2 and 3 %.
Many of us who have recently graduated are lucky to get 3.5%, and that’s after refinancing.
Before that, state schools were dirt cheap.
Despite all of this advantage, there are still a ton of mid to late career doctors who cannot retire, because no one ever taught them about money.
With the debt stacked against the up and coming millennial generation, they will need even more help to have any success.
There is just a massive need.
12) Asset allocation is considered an important step any beginning investor must determine but it can be highly individualized based on the investor’s personal risk profile.
Can you share with us your asset allocation and what influenced you in making this particular choice?
I like to tout Pareto Principle on investing, which is the idea that if you do the 20% that matters right you can get 80% of the results.
The biggest thing from this perspective is to save a large proportion of your wealth (20-30%) and to invest it in passive or index funds.
There is no need to beat the market and the market has made many people look like fools trying.
That said all of the following is placed into low-cost index funds through my 403B, roth IRA, and my wife’s governmental 457 (public teacher).
- Large cap index fund: 40%
- Mid cap index fund: 10%
- Small Cap index fund: 30%
- International index fund: 20%
You may notice that I am 100% stocks at this point. That’s because I am young and stupid and like taking unmitigated risks.
I don’t recommend this to others as my risk tolerance is high – can’t wait to hear the response from the “you haven’t been through a bear market” people.
My allocation will all change once my $200,000 in student loans is gone 10 months from now (20 months after finishing training).
This is what it will look like then, and what I recommend to my readers who have just finished training:
- Large cap Index Fund: 25%
- Mid cap Index Fund: 10%
- Small cap Index Fund: 25%
- International Stock Index Fund: 20%
- Index Bond fund: 20%
15) For a reader unfamiliar to your website, what are three posts you are most proud of that they can gain an insight about you and your philosophies?
Well, since I post on two topics (wealth and wellness) I’ll give a mixture of these:
Physician, Know Thyself: This post is about having an identity outside of medicine. This is a hard task and has led many to disappointment and doubt. It almost led one of my friend’s to end his life.
A Tale of Two Doctors: The First Paycheck. This post shows the power of using those first two or three years after training to build wealth. We follow two doctors who make very different decisions and see how they end up. It also shows the mathematical side of my writing.
3 Ways Financial Independence May Save the Practice of Medicine: This post was actually a guest post that I wrote for another website (Camp FIRE finance). That said, it perfectly encapsulates my philosophy and why I have a website at all. It’s worth the read, I promise.
16) Is there a book or books that has made a major impact in your financial well-being?
Yep. Here they are and why you should read them:
The White Coat Investor Book: An obvious must read for physicians and physicians in training. I read this in my last year of residency and it peaked my interest.
A Random Walk down Wall Street: If you don’t believe in index fund investing – and need some convincing – this book is for you. It will teach you to avoid doing dumb things with your money like speculating on individual stocks, timing the market, and investing in actively managed funds. Or you could just invest in index funds.
The Investor’s Manifesto: Preparing for Prosperity, Armageddon, and Everything in Between. This is written by William Bernstein who is a retired neurologist turned personal finance master. It’s a great primer on investing and the science behind it. Simple enough to understand, but thorough.
The Bogleheads’ Guide to Investing: This book started it all for me, but then I got busy with residency training and dropped it. It’s a great place to start and a must read for beginning investors.
17) If you had a time machine and could go back to any point in time and change just one thing, what would it be?
Come on, I am a philosopher. I wouldn’t change a thing.
Everything that has happened has made me who I am today.
I don’t regret a thing.
Don’t mistake that for meaning that there haven’t been mistakes. There have been plenty of those.
If I hadn’t had made those mistakes, I wouldn’t be as passionate about teaching my students and residents about topics that are vital to their success.
On top of that, I am a God-fearing man married to the woman of my dreams with three kids that adore and respect me.
Even if everything else fell apart, I’d still have everything I need.
18) Can you name 5 things that had the greatest financial impact on you?
- Marrying someone that could get on the same page as me with all of this financial stuff. She allows us to be frugal and achieve our goals. It makes all of this so much easier.
- Mistakes that I made and situations that burned me. There is no better way to light a fire under someone.
- Learning about FIRE and the chance to become financially independent early and the power that provides. It’s a true motivator.
- Reading the books I listed above.
- Having a full scholarship (tuition, room, and board) in undergrad and a full tuition scholarship in medical school. That saved me from being $300,000 more in the whole than I was. That said, all of that education is what is affording me all of this earning potential now. So, it was all well worth it in the end, but had an impact whichever way you look at it.
At this point there was a strange electrical smell coming out of the X-ray Room, the lights were dimming, and the X-ray tube was groaning.
If I wasn’t too careful, this interview subject would transform from The Physician Philosopher into another beloved physician blogger, Crispy Doc, right before my eyes.
I therefore checked my radiation badge (which was glowing) and decided to call it a day.
The 2nd part of this interview will be a rare Friday post tomorrow so please check back in and see The Physician Philosopher continue to philosophize.
(Note to self, next time you examine anyone with the title philosopher in the name, be prepared for an ultra extended exam (and have the physicist test the equipment accordingly)
I would also like to welcome my latest sponsor for this blog: Set For Life Insurance.
You may have seen this company on other noteworthy personal finance blogs and I am glad to have a reputable company like Set For Life choose my site to help spread the word of their expertise in finding the best insurance options for life, disability, and even long-term care.
If you are in the market for any of these services please consider them and as always I appreciate any feedback with your experiences.
NOTE: The website XRAYVSN contains affiliate links and thus receives compensation whenever a purchase through these links is made (at no further cost to you). Although these proceeds help keep this site going they do not have any bearing on the reviews of any products I endorse which are from my own honest experiences. Thank you- XRAYVSN