MtoM #206: Urologist Becomes a Millionaire and Finance 101: Changing Your Family Tree

This is the White Coat Investor Podcast, Milestones to Millionaire. Celebrating stories of success along the journey to financial freedom. This is Milestones to millionaire podcast number 206. Urologist becomes a millionaire. One of the most underrated financial moves in medicine is working Locum tenants. It pays significantly more on average, and you can work Locums full time or on the side of your full time. When you work with Comp Health, the number one staffing agency, they cover your housing and travel costs, which on top of higher pay really adds up. Locums also gives you more control of your career, allowing you to go where you want, when you want, with a schedule that works for you. It's the perfect way to get ahead financially while getting focused on what you love. Whether it's locum tenants or a regular permanent position. Go to whitecoatinvestor.com comp health to build your career your way with the power of Comp Health. All right, welcome back to the Milestones Podcast. This podcast is all about you. We wanna celebrate your milestones. Use them to inspire somebody else to do the same. The other thing we do to inspire White Coat Investors every year is we put on a conference you may not have heard of. It's called the Physician Wellness and Financial literacy conference, or WC Icon. And WC Icon 25 this year is is going to be in San Antonio February 26th through March 1st. However, you only got a week until the hotel block is going to close. Okay, so if you want to get a discounted room at the conference hotel in San Antonio, it's actually outside of San Antonio in the Hill country, then you only have until the 27th to book that. So it's really a good time to book now if you want to come in person to the conference. So I'm going to bribe you to do it. $200 off. Using code SAVE200, you can come to the conference for $200 off. Now if you just can't make it, you know, you got clinical stuff or family stuff or whatever, but you want to take a sampling of the conference you can attend virtually, we'll give you $100 off that. Use the code VIRTUAL100. Either way, you can use your CME dollars to pay for this, or if you're self employed, you can write it off as a business expense. And we think it's a great, great conference. We do this every year. Not because it's dramatically profitable. It is not. In fact, it's the biggest business risk that we take here at the White Coat Investor because I got assigned for like 1500 room nights every time we put the conference on. So far, I haven't had to buy very many of those rooms every year. But we want you to come because we know this is the closest thing that exists to burnout insurance. You can't buy burnout insurance, right? It's not like disability insurance or life insurance. All you can do is you can learn the ways in which you can beat burnout. So this conference does two things, really. One is wellness, and it has a big focus on wellness. I mean, we knock off the academics about 4 o' clock, and we go play together. And so even if you don't go to a single academic session the entire time you're there, it's still a worthwhile conference to come to because you go home feeling better about your career and your life and with additional skills, et cetera, that can help you to be successful with that. The other half is financial literacy kind of stuff, right? We teach you how to be financially successful. And the truth is, once you're financially successful, it's way easier to deal with burnout because that gives you the tools and the ability to do things like cut back at work, you know, tell your boss to shove it, change jobs, change your career, whatever, right? Because you're financially stable, right? You don't have these huge debts hanging over your head. They don't have you right where they want you because you got to make the next mortgage payment and car payment and student loan payment, right? Okay, so the discount codes again, save 200, virtual 100. You sign up wcievents.com It's February 26th through March 1st. First night's a reception, right? And then three days, we got academics and fun, other activities. We'd love to see you there, but the hotel block closes on the 27th, so make sure you book your room by then. Those of you who are already planning to come, if you haven't gotten your hotel, it's time to get your hotel. All right? So make sure you get that. All right? We have a great interview today, but I'm kind of excited about it. Not just because it's a urologist that became a millionaire, but because this doc has two physician parents. And I want to talk afterward a little bit about changing your family tree. In the words of Dave Ramsey, when it comes to financial literacy. Our guest today on the Milestones podcast is Rich. Rich, welcome to the podcast.

Thank you, Jim. Happy to be here.

Tell us what you do for a living, how far you are out of training, what part of the country you're in.

So I'm a urologist. I am about four and a half years out of training now, and I live in New York City and work in a suburb outside New York City.

All right. High cost of living area. Did everybody hear that? I mean, we've. I think. I think next week, actually, I just recorded an interview for next week with a rural dock. This is not a rural dock. Right. We're. We're in an expensive place to live.

Oh, yeah.

All right. Despite that expense, you've accomplished an impressive milestone. Tell us what milestone you accomplished.

So I am celebrating becoming a millionaire.

You're a millionaire. Awesome.

Yes.

And only four and a half years out. I mean, I was seven out, so you beat me by two and a half years. You're way ahead there. Very cool. All right, well, let's break it down. Tell us about your assets to start with.

Sure. So I have about. I would say $275,000 in a 401k, about $50,000 in a Roth IRA, and the rest is basically intaxable. I have a very small solo 401k with about $5,000 in it from my medical survey money. But everything else is intaxable.

So it's all investments?

Yeah. Yeah.

Okay. And what about on the liability side? You got anything there?

Nothing.

Nothing. How'd you pay for school?

I was very, very blessed to have my parents pay for school for me.

Parents helped with school. They paid the whole thing. Undergrad and graduate.

Yep, they paid it all.

Very cool. Thank you, mom and dad. If you're listening to this, you're the best.

Yeah. Eternally thankful.

Yeah. How did they pay for it? Did they cash flow? Did they save it up in a 529? How'd they do it?

They cash. Well, they had a 529, but they cash flowed. A lot of it. So my parents are both physicians, and I went to medical school where my mom was a faculty member. So we got a slight tuition break to go through.

Yeah, yeah. Take advantage of the advantages you have. For sure. Now tell us a little bit about your parents. Obviously, they saved something. Right, because they just helped you at school.

Yeah.

Good with money, not good with money. Okay, with money. What do you think? Did you just get all kinds of awesome financial literacy from your physician parents?

So, to be honest, at the time, I didn't know if they were good or bad with money. Clearly. Now I know that they were good, but I would say they both grew up middle class, and I think one of their goals was to not have their Kids have the kind of financial worries that they might have experienced growing up, and they were very successful with that. So, like I said, I lived a very blessed childhood and upbringing. The flip side of that is that I never really developed any financial literacy until I was a resident.

Yeah. I gotta explore more of this, though. I don't get very many people on here whose parents are both docs. How'd they pay for their medical school? Was it back when it was cheap enough that they had a side job and worked their way through, or how'd they pay for it?

They came out with a small amount of debt, but back then, debt was not what it is now.

They just paid it off when they got out.

Yeah, very cool.

Okay, so you still had to become financially literate yourself. How did you do that?

So I did most of it through you, to be honest. So when I was a chief resident and the pandemic started, there was no urology cases to do. And so I had a lot of.

For about two to three, four months in New York, I imagine.

Yeah. And I was kind of. I trained in the Bronx, which was right. Right in the center. So we were doing a one week on, one week off the COVID unit schedule. So I had weeks where I had nothing to do, basically. And at that time, I was having a growing amount of anxiety, actually, about my ex wife's medical school debt. So she had about $450,000 in debt, and I had no idea what I was going to do to. We had no plan, basically. And so I took that time during the pandemic. Your book had been on my to do list probably for like most of my residency, and I never quite got around to it. And the time came, so I kind of dove in, and by the time the hospitals opened up for elective surgery again, I read the book and probably burned through like 80% of the podcast that had been published to that time. So I had a very quick catch up.

Now, you trained, not in the pandemic, basically came out of training into the teeth of the pandemic. And you said, I mean, you're in New York to make things worse. I mean, it's not Italy and it's not, you know, eastern China or whatever it was, but it's about the next best thing, Right? I mean, I guess it's not quite Seattle either, but.

Yeah.

They had you on the COVID unit as a urologist.

Yeah.

What was that like?

Everyone, every. Every single resident, every trainee, the whole hospital was a Covid unit. So everybody was doing it. I Helped with intubation for the first time in my life. Um, it was. It was. You know, it was weird to go back. Obviously, it was harrowing to see the rate of patients that were dying. And, you know, as a trainee, it was tough because we didn't really know what we were getting into, and we were just kind of going in there and doing our best. Certainly for me, I kind of went. You know, I was a chief resident a couple months from graduation, and then I basically became an intern on the teams that were run by the internal medicine docs. And so, yeah, I went back to being an intern doing the floor work and stuff like that. It's actually funny, I just ran into, at my hospital I work at now, one of the guys who was a PGY2 on my Covid team, who's now an attending at my hospital.

Well, thanks for doing that. Obviously, that's above and beyond. Most of us in most parts of the country did not have to do that. But I can remember going to work, going, is today the day I bring something home that kills somebody in my family? So it's very real. So thank you for doing that, particularly in that part of the country. By the time the virus got to Utah, it was not the same virus you were facing. So I appreciate you being out there on the front lines. Okay, let's talk finances here. Four years. Four years, you're a millionaire. Even without the debt to start. That's not unimpressive, Right? I mean, that's a quarter million dollars a year increase in your net worth. What's your income been approximately, on average, over the last four years?

So it was around 300,000 for the first two years that I was in practice and then has kind of steadily risen. So in 2024, it was. It was about 800,000.

Yeah, that's quite a. Quite a serious increase. Did you become a partner or something?

I did, yeah. Okay, so I'm in. In a private practice pre.

Partner years. Then you made partner.

Yeah. So salaried for a couple of years and then became partner.

Okay. But we're still talking like you made less than a million and a half bucks or so, and you still have a million dollars of it. That's really impressive. Tell us how you did that.

So it was, you know, kind of a slow and steady approach, I would say. The biggest. The biggest thing for me was I haven't really changed my lifestyle at all since I became part. So I think, whereas I was doing pretty well, you know, I certainly gave myself a big raise when I Became an attending. Certainly, you know, to live in New York City, you kind of have to. After you leave resident, subsidized housing, did.

Your hospital actually provide you housing of some sort or.

Yeah, yeah. In medical school I lived on. I went to residency, the same place that I did medical school. So in medical school I lived next door to one of our hospitals, and in residency, I moved to the other campus to resident housing. I lived across the street from the main hospital. And I think the most I ever paid in rent was maybe $1,000 a month, which in New York City is wildly subsidized.

Yeah, you don't even. You don't even buy a fire hydrant to sleep next to for that.

Oh, definitely not. So the biggest raise, obviously, I gave myself was getting.

Getting out of resident housing.

Yeah, exactly, exactly. So, you know, I think I was doing pretty well when I was making 300, and then my comp got much, much larger, and I haven't really changed all that much.

What about going forward? Do you anticipate an end? Is this the equivalent of a live, like a resident period that's going to end at four years or five years or something, and you're planning on spending more money or are you kind of comfortable where you're at?

Yeah, yeah. So I would say, you know, in line with my next goal is saving for a down payment. I am getting remarried this year.

Congratulations.

Thank you. Thank you. And so, you know, down payments in this part of the country are not cheap. So, you know, it's. It's a several hundred thousand dollars endeavor, so I'll be probably funneling a lot more money towards that than I've been doing the past year or two.

Now, we probably could have brought you on this podcast to talk about a surviving divorce milestone. I mean, you mentioned that you were married not that long ago and there's been a divorce or something here, right? I mean, I assume there hasn't been a death or anything, right?

No, no.

So financial implications of that and what you learned from that?

Yeah. So I would say, thankfully for me, the financial implications were pretty minimal. We had both just finished training, didn't really have anything of note, didn't have property, didn't have much money, didn't have assets. So financially, it was probably as simple divorce as you can get. And in the process of the divorce, my first couple of months. So basically between starting as an attending and then separating, I paid quite a bit into my ex wife's student loans. Learning from what I learned through, you got to get those loans paid off quickly. So I certainly made that a priority, which obviously didn't work out in my favor, but certainly the finances of it were quite simple. So I'm thankful for that.

Anything you learned in your first marriage financially that you're going to carry to your second marriage that you think you're going to improve on, financially speaking?

Yeah, yeah, absolutely. Being on the same page is vitally important and having conversations about things before they happen. So just I think good communication, good planning, I think some of it, you know, in my first marriage, we met when we were young in college, so these were, you know, talks of finance were kind of way in the future. And like I said, my financial literacy was just very minimal. So it was not something top of mind as being important in a relationship, which obviously I don't feel is the case now and is a major lesson that I've taken into this new relationship and will into my new marriage.

Yeah. Now the other thing that's a little bit unique about you is you're in a high cost of living area. What hope, what advice can you give to other docs that are training in a high cost of living area, want to stay in a high cost of living area? How can they be financially successful too?

The first piece of advice I would give people is you can do it, it can be done. There's definitely a pull for geographic arbitrage reading your site and other sites, and it's so real and it does make such a big difference. But if you have good reasons to be in New York City or LA or San Francisco or one of these high cost of living places, it can be done. I think it's like everything else, it takes a little bit of additional planning, it takes a little bit of additional determination. But physician income can cover a lot of ground. And so I think that it kind of takes the same things that we've displayed in all of the steps to becoming a doctor. You know, we wouldn't study for a test in medical school or the boards without having a study plan. You know, you can't complete this difficult task without having a plan. And I think, you know, the best advice I feel like I learned from you is before you get your paycheck, have a plan for it. And that has been supremely helpful.

Very cool. So what's next for you and your financial goals? I mean, obviously on the personal side, you've got a marriage coming up, but what's next financially? What's your next milestone? You're going for?

So first wedding and then house down payment. So that'll probably take a couple of years, both before we're ready and before it's saved up.

Have you decided yet how much you're going to spend on a wedding?

Yes, because it's coming up in a couple months, so that part has all been hammered out.

That's the classic expense where you can spend as little $150 at the state courthouse or you can get the Indian wedding and spend $500,000 on flowers.

Right.

I'm curious what attendings in New York these days think is a reasonable amount?

Well, as someone who I had a wedding in New York previously, but I was a resident at the time, I wasn't really paying for much of that. So this time around, inflation aside, it's been astonishing what things cost and what you can spend if you want. I think probably in New York City, you can't really have much for less than 20 or 30 thousand dollars. And a lot of times that's a family only small event. So.

No, I, I just asked somebody this question 45 minutes ago and, and listeners aren't going to hear the answer to that for two more weeks because it's a podcast in the future and, and they came up with almost the exact same number. So maybe that's what doctors are spending on weddings these days. I was very, very curious about it.

I don't think that's what doctor. I think doctors are spending a lot more. You know, depends if, if that's what you want to spend it on.

Exactly. Okay, very cool. Well, what advice do you have for, for that person out there that, that wants to be like you? Right. They're like, wow, four years out, already a millionaire, you know, a partner in hard working urology group, doing really great. What advice do you have for that person?

My advice would be not only pay attention to the details both at work. You know, working hard and increasing your income is doable in most practice settings, and I've been lucky enough to be in a position to do that. And then on the other side, keep track of the expenses. The first thing I did when I became single was do a budget. Daily budgeting look every month and get those pieces in place and then slowly but surely build on top of that.

Very cool. All right, well, thank you so much, Rich, for coming on the podcast. Sharing your experience, sharing your milestone, letting us celebrate it with you, and using it to inspire somebody else to do the same.

Thank you for having me. An honor to be here. And thank you also for the major impact you've had on my financial life.

It's our pleasure. Okay. I hope you enjoyed that interview. It's a lot of success in a high cost of living area. That's not easy. I just did an interview a few minutes ago with somebody from a low cost of interviewing, low cost of living area, and we're going to run that interview next week. But it's interesting to compare and contrast, right? I mean, here's somebody living in resident housing. Next week you're going to find out how many acres this doc bought for what essentially the New York docs are using for a down payment. It's impressive, the difference in geographic arbitrage, but I promised you at the top that we're going to talk a little bit about changing your family tree. And Megan was just commenting between episodes here as we record this morning how fun it's going to be to have a second generation white coat investor come on this podcast and share their milestones with us. And this was about the closest thing we've had yet, right? The white coat investor has been around since 2011. It's now 2025. Right. We're 14 years into this. This doc was the child of two docs and they saved up enough to pay for med school. You know, between saving in advance and cash flowing it. And imagine those of you out there who are like me who had some sort of contract with the military or contract with an MD, PhD or Indian Health Services or, or whatever, or those of you who borrowed 200, 300, 400, $500,000 to go to med school. Imagine your kids want to be docs, your kids want to be dentists. Whatever they want to do, imagine them being able to come out debt free. How much different would their life start if not only they start at a net worth of zero, but maybe they start with a 20s fund, too. Maybe they start with an HSA that you funded for them for a few years there. Just imagine how that changes going forward. Now, when their kids come along, they're financially literate because you taught them right. Their kids come along, they're not starting out in debt. They're starting out with a few assets. You know how big of a difference a few assets can make in your 20s, you know, when you really can use some money. We're talking about changing family trees for two generations, three generations, four generations. You know, it's not just about, you know, leaving legacy wealth, know, generational wealth. It's also what you're teaching them, not only through your example, but, you know, deliberately. I sit down with my kids all the time and we talk Money this year during our giving meeting, we didn't get around to doing it until the first week of January. In fact, we barely got the money into the daf still in December, but they sat on it for a week or two and so we couldn't distribute it. And then we got busy through the holidays. And so we actually had a giving meeting the first week of January this year. But as part of that, I did a couple of things. One, I read a letter, you know, some information that one of my aunts put together about her upbringing, you know, my mother's upbringing. They grew up on this little tiny farm, you know, 12 kids and some, you know, basically a two room house on a farm. The boys slept out in the barn year round. You know, it was the way it worked out. And comparing and contrasting their lives with the life of my mother and my aunt was pretty dramatic contrast. And so we read that before. We talked about who we were going to give to this year, which charities we were going to support. And I think that put them into the right mindset to realize that the advantages they have with their 20s funds, with their 529 saved up, you know, with their Roth IRAs that are funded with every dollar they've ever made as teenagers, you know, the advantages they have, the advantages I had, you know, my father was the first one in his family to ever go to college, became an engineer. And then most of their kids have advanced degrees. So you're changing your family trees as the years go on. The other thing we did is we read together the blog post that I ran on the first of the year. I think it was called Investing that thing Rich people do. And it talks a lot about the basics. And a bunch of comments on it said, oh, I'm going to share this with my kids. And I'm like, I haven't even shared this with my kids, so I thought I better share it with my kids. The idea being that my kids are never going to be able to claim that they weren't financially literate when they left home. They've been taught about retirement accounts, they've been taught about index funds, they've been taught about how real estate investing works. They've been taught about the importance of budgeting and insurance and those sorts of things. And do they know everything? No. Do they still have lots of questions? Yes, but it's something we talk about regularly in our house. Not only do we lead by example, but we actually try to sit down and teach them something about it from time to time. Right. My kids have done their own tax returns, for instance, there's no reason that your kids should be leaving home financially illiterate, right? Don't handicap them that way. Help them to be successful, even more successful than you were. Now, maybe they won't have your income. Maybe they're not a urologist making $800,000 a year. That's okay. With the start you give them in financial literacy, they're still going to be successful. You know, unless they make deliberate decisions not to be, there's nothing you can do about that. But you can make sure they're financially literate when they leave, and I think you'll be glad you did. Now, earlier we mentioned working locums with Comp Health, the number one staffing agency. But Comp Health isn't just a locums agency. Comp Health staffs regular, permanent positions across the nation as well. They also offer telehealth, medical admissions and more, and that's what makes them unique. They can look at your situation and offer multiple solutions to build your career the way you want it and meet your financial goals. And they know their stuff, especially when it comes time to negotiate contracts, which they're willing to do for you. So whatever career move you're looking for, go to whitecoatinvestor.com CompHealth use the power of Comp Health to build your career your way. All right, this is the Milestones to Millionaire podcast. We'll see you next Monday. Check out the regular White Coat Investor podcast. It drops on Thursdays. Keep your head up and shoulder back. Shoulders back. Not just one of them. I feel like I got one of them these days, but it's healing quickly. Keep them both back. You've got this. We'll see you next time on the podcast. The hosts of the White Coat Investor are not licensed accountants, attorneys, or financial advisors. This podcast is for your entertainment and information only. It should not be considered professional or personalized financial advice. You should consult the appropriate professional for specific advice relating to your situation.