MtoM #234: Psychiatrist Opens a Private Practice and Still Manages to Pay Off Her Student Loans in 2 years and Finance 101: How to Invest at All Time Highs

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 234. Psychiatrist opens a private practice but still manages to pay off student loans in less than three years. His podcast is sponsored by Bob Baiani at Protuity. He's an independent provider of disability insurance planning solutions to the medical community in every state and a longtime White Coat Investor sponsor. He specializes in working with residents and fellows early in their careers to set up sound financial and insurance strategies. If you need to review your disability insurance coverage or to get this critical insurance in place, contact bob@whitecoatinvestor.com today. You can also email inforotuity.com or you can just pick up your phone and call 973-771-9100. The Physician Wellness and Financial Literacy Conference 2026 speakers have now been announced. Head over to whitecoatinvestor.com WCICON to see the full lineup and session topics. Whether your career is just getting started or you're planning your exit strategy, this group of finance and wellness experts will help you get closer to the life you actually want. Mark your calendar to join us 3-25-28 at the JW Marriott Las Vegas Resort and Spa in beautiful Summerlin, just west of the Strip. It's a peaceful desert retreat near the Red Rocks, one of my favorite places, but still close enough to all the action on this Strip. Early board registration opens September 1st. Sign up for a reminder to register with the lowest prices@whitecoatinvestor.com WCICON we have a great interview today. I think you guys are going to really like this one. I enjoyed doing it. Stick around. Afterward we're going to talk about how to invest at all time highs. Our guest today on the Milestones to Millionaire podcast is Danielle. Danielle, welcome to the podcast.

Thank you for having me, Jim.

It's so awesome to have long term white coat investors on the podcast. You mentioned before we started that not only had you listened to a few of these milestones, you think you'd probably listen to all of them. It is not that unusual for our guests actually. But this is your chance. We're celebrating you today so it's pretty awesome to have you here.

Yeah, I'm thrilled to be here. I think this has been a huge part of my journey is listening to your podcast and feeling inspired to accomplish these goals, so I'm excited to share mine.

Cool. Well let's introduce you a little bit to the audience. Tell us how far you are out of training, what you do for a living and what part of the country you're in.

Yeah, so I'm a child adolescent and adult psychiatrist. I graduated from my child adolescent Fellowship in June of 2022, and I practice in Southeast Florida.

Okay, and what have you accomplished recently that we're going to celebrate with you?

Yeah, so two goals. One is paying off my student loans in less than three years and then opening a private practice.

Cool. Well, the first one, we celebrate on here all the time. The second one, not that often. And it feels like less and less and less often among doctors these days. So let's do the student loans first. First, tell us about where you were at when you graduated from med school. How much did you owe when you came out? Do you remember?

Yeah, I owed about 200,000. So I went in state for medical school. Unfortunately, the tuition costs were on the lower end. And then during residency, I was in an income driven repayment program. Probably accumulated another 10 to 12,000 in interest. And then Covid hit, and it actually worked to my advantage because my payments were put on pause for a good chunk of my training, which actually served me well in the long run.

All right, so you owed 210, 215, 220, whatever it was, which is pretty close to average. If you survey medical students coming out of an MD school, it's like 200, 205,000 is what they have coming out. So you had basically an average burden and you came out of residency. And for some crazy reason, maybe because you've been listening to a bunch of these podcasts, I don't know, you decided, I'm going to take this in the corner and drop an anvil on it. Right. So tell us, tell us what you did for income the last few years in training.

My income was probably average for most residents around 60, 55, 60,000, a little bit more. In fellowship, I did moonlight and could earn up to 70, 75,000. When I graduated in June of 2022, that first kind of year out of practice, my total income was only about 55,000. I had just opened my practice a few months out of training. I was trying to accumulate patients, so a good portion of that was actually just from my fellowship income. And then the following years, the income grew as the practice grew. So I think my second year of being open, I made about 315,000 gross. And then last year made 377 gross.

So. So really you paid off the student loans in two years because that's when.

You were making money, I guess. Technically, yes, if you want to say that, yeah.

Very cool. Well, this is going to be a fun story to talk about opening the practice, but bottom line, you didn't make that much money and you decided to dedicate a couple hundred thousand dollars of it to these student loans. Why was that an important goal for you?

I think I hate having debt. You talk a lot about the psychological burden of debt. And I think everybody has a different threshold of toler. Mine is pretty low. I knew that I wanted to pay it off as soon as possible so I could really work on saving and reaching financial independence quickly. You know, I think I got some advice that as I was paying down the loans and my interest was lowering down to maybe like five and a half percent, that it made more sense to invest it. And I just really didn't like that idea. It felt like a huge shackle on me, tying me to med school, and I wanted to get rid of it. So I was just very focused on dropping as much money on it as possible. And when the COVID pause lifted in October, I think I put like 60,000 towards it, just a lump sum. And then from there it was another five to 12, sometimes 15,000amonth. Whatever I could funnel there.

Yeah, you send them big checks, those debts go away quickly, don't they?

They do. It's sad not seeing your actual bank account number rise. That staying steady is a little discouraging, but seeing the number come down on the loans was really, really motivating.

Yeah. And both of those affect your net worth in the same way, which is really that if you want to keep a score and it's a single player game, of course, but if you want to keep score, that's the score to keep, not necessarily just the bank account balance. So very cool. Well, congratulations on that. Did it end up being easier or harder than you thought it was going to be to pound out those student loans in less than three years?

Yeah, I think easier in kind of the grand scheme of things. I think I've modified my lifestyle to some degree. I went on a couple really big trips. My sister got married in Italy, and I was able to do that. I took another international trip with a friend. I didn't feel like I was wanting for anything. And yeah, I think my initial goal was to pay them off in two and a half years, but taxes were a lot more than I expected in private practice, so I had to delay it a few months. But in the grand scheme of things, that those extra few months don't mean much.

Yeah, that's A common shock that new attending physicians have when they realize they're paying more in tax than they made during their training. So pretty awesome though. Very cool. So you kind of live like a resident. You inflated your lifestyle a little bit, took a couple of trips, but it sounds like you kept things under control pretty well and really prioritized wiping out that debt. Okay, let's talk now about starting a private practice. Something like 3/4 of docs now are employees and the majority of the rest of them are joining partnerships. Right. There's already somebody that's kind of sorted out the business and they're kind of joining it and learning as they go along. Very few people are going into practice on their own, and I would say a pretty good chunk of them are psychiatrists. Probably because maybe the equipment and overhead, I don't know, is a little more straightforward. It's a little easier to do some cash pay kind of stuff. But tell us about your journey of starting a private practice, why you wanted to do that, and maybe some of the surprises along the way.

Oh yes, lots of surprises and mistakes. But I think I always knew I wanted to open a private practice. I like being my own boss, but more so I like being able to provide people with care that I think they deserve. And in training, I felt like the time that I could give to people was so diminished based on regulations by insurance companies. I just didn't like that model of care. So in my fellowship, I connected with a mentor who had a private practice and tried to absorb as much information from her as possible on the business side of medicine, which you don't get any education on in medical school. And she gave me a lot of. A lot of knowledge. I connected with some groups that I got some additional info with and then I just went for it. I think a lot of it was learning as I went. You're right in that psychiatrists don't have a lot of overhead. I really don't even need an office. I have an office, but I need a computer. I could use paper charts if I wanted. An EMR system and a couch to talk to people.

The classic Freudian couch, huh?

Exactly. I think the area I set up my practice in is fairly well resourced, so I don't have to deal with insurance companies. It's a cash based practice. I still do prior authorizations, of course, but that has allowed me to build something that I can feel really fulfilled with. And it's just steadily grown by word of mouth. And I was really lucky to connect with a therapy group for A source of referrals. I hired an assistant to manage the phones and the billing and scheduling, and it just kind of keeps growing to the point where I'm thinking at some point I might want to hire some therapists or maybe another psychiatrist just to be able to provide people access, because it seems like there's a need.

Pretty awesome.

Yeah.

I mean. I mean, I don't want to say it's like an overnight success. It's not. You had at least one pretty hard year, it sounds like. Yeah. This is relatively quick for business success, right? I mean, white coat investor, its second year made five grand. Right. I was working pretty darn close to full time at it. So you've been very successful in this business. What. What was the biggest surprise, you think other than taxes? Sounds like the tax bill, especially when you're paying both halves of the payroll taxes, was a surprise. But what else surprised you?

Honestly, it was really. It was a bit of an adjustment to be my own boss. I think I still had resident fellowship mentality of I have to work as hard as possible. And granted, I had a goal of paying off my loans, so that. That drove some of that. But if I have a really heavy week and I'm feeling burnt out just by the aspects of work and I want to take a day off, I can do it. I can block my schedule and I can have my assistant help call people. And for the longest time, I wouldn't do that because there was a lot of sense of guilt and just this mentality that you have to go, go, go, go, go, always. So adjusting to having control of my life and my schedule and being able to maintain balance, I think was more challenging than I thought and a little bit of a surprise for me now.

I imagine the first two or three months you had all your overhead, all the expenses you have to run in this business, and you didn't have that many patient encounters. Tell me about the doubts that seeped into your mind in those first few months.

Yeah, yeah, it was scary for a while. I would say the first year, year and a half, there was a lot of anxiety about it. I would have one or two patients a week. And fortunately, with, you know, it being out of pocket type of service, I could get reimbursed a little bit better. But I took a loan, a personal loan from my dad for $10,000, just to be able to pay my bills and make it through. And then once I started getting enough patience to, you know, have a day in the office, one full day, it started to even out Fairly quickly. My overhead is pretty low. It's maybe like 18 to 20% of my total gross income. So it leveled out faster than I expected, which I feel very lucky about.

Yeah, very cool. Is there anybody else? Depending on your income, is it just you, or do you have a partner? Do you have kids? Anybody else depending on you?

Nope, just me. Right now, I am engaged, so I'm going to be getting married next year. And I've had a lot of talks with my partner about finances from the beginning, and he's been.

I bet you have.

Yeah, he's. He's been so supportive, and I think we both felt really excited when they were finally paid off. We had a celebratory dinner.

Good for you. One thing I do regret is not celebrating milestones better than we did. We blew through a lot of milestones. Some of them we blew through very quickly, and I wish we'd celebrated them better than we did. So we try to make a big deal out of milestones these days. Okay. All right. What else should people know? There's somebody else out there. They're coming out of residency, and they're like, man, seems like nobody's opening their own practices anymore. What would you tell that person that would like to but is scared to do it?

Just do it. I mean, learn as much as you can. I think you advocate for learning when it comes to finances. All of this information is out there, and there are people who have done it. Find them and learn from them. I reached out to people. I made a lot of mistakes along the way, and I try to help people learn from my mistakes if they're interested in opening a practice. But we spend and devote so much time and energy learning this field of medicine and then oftentimes ending up in a job that we feel depleted by. I think if there's an opportunity to take control of your job and find something that fits better, whether it is a private practice or whether it's connecting with a smaller group and having a little bit more say in how it's run. I think it's important to look for those opportunities, But I think the knowledge that a lot of us possess and the ability to learn can be focused very easily on business. I think there are a lot of business owners that just picked up a book and learn it, and I think we're really good at picking up books and learning, and we have a lot of resources out there. So put the fears aside and try it.

Amen to that.

Yeah.

So what you're saying is personal finance and investing in Business is way easier to learn than psychiatry.

Yeah, I get confused every day with psychiatry. I do it, the less I feel like I know, to be honest.

Yeah. Yeah, I can relate to that for sure. Very cool. Well, congratulations, Danielle. You've been very successful. You have accomplished two milestones, either one of which you should be very proud of. And we're excited to celebrate them with you and hope it inspires other people to do the same.

Yeah. Thank you so much, Dr. Thale. You are fantastic and provide hope for all of us. So keep doing what you're doing. We appreciate it.

Thank you. All right. That was a fun interview, right? I mean, how many docs are opening up their own businesses right out of residency these days, opening their own practices and going at it? Right? It's scary. No patients come in that first day and you're like, oh, is this going to work? And you got to go home and explain to your spouse or your parents or your kids that this is worth the risk. This is going to work out eventually. It's scary to open your own practice. Yet Danielle has not only done it, but has gotten her income up very rapidly and been able to use it to meet her financial goals, like crushing her student loans. You can do this stuff. It is not that hard. Other doctors before you have done it. You can learn it. You're an expert at learning. You can learn new stuff and you can learn this finance stuff for sure. All right. I promised you at the top of the hour that we were going to talk a little bit about all time highs. We see questions about this all the time on blog comments by email, on the forums, et cetera. This one came on the white coat investor forum, said, I have absolutely no clue why the s and P500 is within a half percent of new all time highs. Geopolitical, US politics, government policies, micro and macroeconomic theories. And the pundits or prognosticators do not seem to provide any reasonable explanation. Market seems to find its own way simply because that is what markets do. Feel free to answer. Why? Well, here's the deal. What you gotta recognize about all time highs, right? When people try to scare you with the phrase all time highs, what they're really saying is the market's gonna go down, right? And how do they know that? They don't. Because their crystal ball is just as cloudy as yours is just as cloudy as mine is just as cloudy as all the financial advisors crystal balls are. And certainly just as cloudy as the crystal balls of the talking heads on CNBC are. Nobody really knows Very well. What's going to happen in the future? You can guess a little bit, but the truth is you really shouldn't have an investment plan that requires you to know what is going to happen in the future. As far as all time highs, look at a stock market chart, right? Go ahead, look at it. What does it look like? What percentage of the time is the market at an all time high? A very high percentage of the time it's at an all time high. And in fact, if you pick any given point on those stock market charts, you realize that all time high also often means a low never to be seen again. Right? You may never ever, ever be able to invest again at this all time high. Because markets typically go up in the long run, not only for inflation, but also because guess what, people are getting better at generating profits. They're working hard, they're going to work all day long and working for the most successful corporations in the history of mankind. So yeah, no surprise that just because it's at an all time high doesn't mean it has to go down. It can go up from all time high. Now maybe it's a little more likely to go up if you're 20% below an all time high. That's not necessarily the case. Sometimes you can go down from there too. Sometimes it goes to 40% below the last all time high. That happens every few years in the market. So don't assume that looking at a chart you can divine what's going to happen in the future. You know, there's a whole school of thought of people who try to predict future by doing nothing but looking at stock charts. And they look for patterns and all kinds of stuff. Most of it's voodoo, let's be honest. Right? They have no idea what's going to happen in the future. If they did, they'd be making a killing. Right? They'd be gazillionaires. Because if you could predict the future in any sort of accurate way, there's no way you should only be managing your own money. You should be managing billions and billions and charging a high percentage of that additional value that you can provide and keeping that. So the likelihood of somebody else knowing that if they're not a kazillionaire or rapidly on their way to doing so seems pretty low. Right? Okay. So don't be afraid of all time highs. Don't let it keep you from continuing to follow your investing plan, which if you're like most of us, means investing some money every month when you make it. Okay? Sometimes you're buying at lows, sometimes you're buying at highs. Over the long term, the effect of this periodic investing, sometimes actually mistakenly referred to as dollar cost averaging, allows you pick up more shares at lower prices and fewer shares at higher prices. So in the long run, it works out very well for you as an investor. I assure you I've invested a lot of money at all time highs in the past and I'm very glad that I did so. Okay, now let's talk about what causes the market to move. There is an entire industry called the financial media whose job is to write about or talk about why the market moves every day. They have to go on the screen and they have to come up with a reason and they have to tell you that's the reason why it moved. Or they have to write something every day. Whether that's a blog, whether that's an article, whether it's something on social media. This is their job to come up with a reason. Nobody goes back and tries to figure out if they were right. Nobody goes back and says, oh, well, that's not why it moved, it moved for this other reason. Right? The truth is, markets are really complex. A market is the opinion of literally millions, tens of millions, hundreds of millions of people about what something is worth at any given time. That's what a market is. And in general, the market as a whole is smarter than any of the rest of us as individuals, right? And so there's a lot of factors that go into it, whether it's politics, whether it's economics, whether it's, you know, just it's time for something to be different, you know, interest rates, whatever. There are lots of things that cause markets to move. And the market meaning everybody as a whole feels differently about things at a time. Sometimes the market goes start mad crazy, right? Some political event happens and everybody goes, oh, this is going to be terrible. And all of a sudden you can buy things at a pretty serious discount. Sometimes they are totally wrong. They're not always right about what something's going to be worth long term. Sometimes things are bid up way more than they really probably should be. And sometimes things are discounted dramatically more than they should be. But the market's right more often than any of us are as individuals. So don't take too much confidence that just because the market went down that it's going to go up, or that just because it went up, it's going to go down. There's a lot more to it. And if you think it's very simple that you can explain it with one thing on the nightly news. You are probably mistaken. You're probably a novice you don't recognize. There's far more nuance in how markets move than a lot of people give credit for, particularly in the beginning of their investing journey. This podcast was sponsored by Bob Baiani at Protuity. One listener sent us this review. Bob has been absolutely terrific to work with. Bob has always quickly and clearly communicated with me by both email and or telephone, with responses to my inquiries usually coming the same day. I have somewhat of a unique situation, and Bob has been able to help explain the implications and underwriting process in a clear and professional manner. Contact bob@whitecoatinvestor.com gratuity today. You can also email infoortuity.com or you can just call them at 973-771-9100. If you need disability insurance and you don't have disability insurance or you're worried your disability insurance is not very good, get it taken care of now. Don't wait until you develop another medical problem or, heaven forbid, become disabled. All right, we're at the end of a podcast. These milestone podcasts only happen with your participation, so if you'd like to apply to Come on. We'll celebrate your financial milestone with you if you apply@whitecoatinvestor.com milestone and we can use it to inspire somebody else to do the same, I'm sure. See you next time on the podcast. Thanks for being here.

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