WCI #148: Finding Balance in Your Life with Dr. Dawn Baker

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White coat get a fair shake on Wall Street. We've been helping doctors and other high income professionals stop doing dumb things with their money since 2011. Here's your host, Dr. Jim Dali. This is White Coat Investor Podcast 148, Finding Balance with Don Baker. Now, I hope those of you coming to the conference next week are super excited. We're excited for it. You know, we're pulling our hair out, of course, because we don't ever know how everything's going to go and what exactly isn't going to go well. Anytime you bring 800 people together, something's got to not go well. So we're a little nervous about it and maybe losing a little bit of sleep, but we're going to have a great time down there and we hope you do as well at WCICON 20. As a white coat, you have valuable knowledge. Various companies want that knowledge and they're willing to pay you for it. That's why we put together a list of recommendations for companies that pay you to take surveys. If you're looking for a profitable side gig for not too much effort, getting paid for surveys could be the perfect solution for you. You can make extra money, start a Solo 401 and use your medical knowledge to impact new products. One of the WCI columnists makes an extra $30,000 a year just doing these surveys. Sign up today and use a fraction of your downtime to make extra cash. Go to whitecoatinvestor.com mdsurveys you can do this and the White Coat investor can help. All right, let's do a quote of the day. This One comes from J.L. collins, who said the market always recovers and if someday it really doesn't, no investment will be safe and none of this financial stuff will matter anyway. And isn't that the truth? So, I mean, while you can't expect, you know, an individual stock to always come back, you know, the overall market is a pretty good bet. You don't know when, you don't know how well, but the likelihood of it all just tanking and disappearing forever is awfully low. And in the event that that occurs, well, we got big problems. Thanks for what you do. Medicine is not easy, as we'll discuss today in this podcast. It's difficult to find a balance and sometimes we feel guilty trying to find a balance. And so I just want to thank you for what you're doing, for being willing to go through all that training and for being willing to be on call and to work such long hours on behalf of your patients. So if they haven't said thanks today, let me say thanks to you. I assume you're probably on your way to work, your way home from work, maybe working out after work, whatever you're doing as you listen to this podcast. Thank you. After the conference, we're going to have conference videos available. This is basically we're going to package up all the presentations from the conference with their slides and with the audio and video from it into an online course. It's going to be awesome. It's going to be way cheaper than going to the course. And obviously it's not quite the same experience. It's a little bit hard to network with an online course, but all the material and all the learning will be available there from the great speakers that we're having at this conference like Rick Ferry and Phil demuth and others. And you'll be able to have access to all that material afterwards. So watch for that. It'll be coming up hopefully within a couple of weeks of you hearing this podcast. We have a special guest today on the podcast. Let's bring her on the line. So our guest today on the White Coat Investor podcast is Dr. Don Baker, who is coming also to the White Coat Investor Conference. She'll be giving a talk there. So I'm looking forward to that. I actually met her at the first WC icon in Park City and it was a pleasure and I'm excited to have her come into the White Coat Investor Conference this next year. So welcome to the podcast podcast.

Don hi Jim, thank you so much for having me on.

So to start with, can you tell us a little bit about your upbringing and how that affected your views on money?

Yeah, I was brought up in what I would say a privileged middle class type of household. My father was kind of on that upward mobility track and my mom mainly was kind of a stay at home mom and then did some part time work. But I would say that I never was really worried about money. I never saw them worry too much about money. But what I did see was them spend a lot of money and work a lot. My father worked quite a number of hours. He wasn't a physician, he was just doing the kind of executive ladder, corporate ladder, if you will. But I didn't really understand the concept of money equaling life energy, though. I would say I don't think that I thought about the finiteness of money and how if you spend it on one thing, you don't have to spend on Another thing, until I got into college and I met my husband, we started doing rock climbing. And at that point, that was when I saw people working part time or choosing to cut back at work so that they could support the hobby that they loved and have enough money basically to do it, but have also enough time to do it. And that changed my whole outlook on money.

The dirtbag lifestyle a la Alex Honnold. Moving out of a van, spending your days on the wall.

Yep. And now here I am with a van. But it's not my only vehicle.

It's interesting that you mentioned that, because I wonder how much of an effect that has on my own views on money. Just that exposure to that dirtbag kind of culture. We'll talk about that more, I think a little bit later in the podcast though. First, tell us a little bit about your education and career to this point.

I was a non traditional medical student. I went through engineering school and did a bachelor's in chemical engineering and a master's of science in chemical engineering as well. And I worked for a while in industry. I just knew that when I was getting out of engineering, mainly at the undergraduate level, that I didn't exactly want to lead that typical engineering lifestyle. I wanted to do something more service oriented. And at the same time I was doing the rock climbing and doing some world travel and just saw different cultures and realized that I wanted to expand the kind of people that I worked with or served in my career. So I decided at that point to go to medical school. And I'm really glad that I waited. I think it was really good to not go straight away because it did give me more life experience, it gave me more maturity. And then also financially it was a little bit better because we were able to support my medical school tuition somewhat with some of our money that we had saved at that point.

And how about your career since then?

Yeah, so now I did my training in anesthesiology and I have been practicing as an anesthesiologist for maybe about eight years outside of residency now.

Your training was interrupted by medical issues. Can you tell us a little bit about that?

Yeah, during my anesthesiology residency I was having some problems which just to make a long story short, we'll just call hormone related. And I was chalking it up to stress and age being that at that point Now I was 35 years old and I was really neglecting my health and doing the bare minimum to address these problems for a couple of years, just trying to keep my head down and do my training but it started to affect my academic performance. And there were some times where I remember some attending saying to me, like, what is wrong with you? And I said, well, I have no idea. I don't know what you're talking about. But it turned out that I had a large pituitary tumor and was compressing my optic nerve. So it took a long time to diagnose this. But once it was diagnosed, then it made much more sense because I had had trouble interpreting ultrasound and doing some of the procedures that are required for anesthesiology training. So I had to have surgery for this tumor, and it required some time off during my training. Obviously, it was a slow recovery. I had a lot of electrolyte and hormone imbalances that had to be taken care of after the surgery. And, you know, in the end, I would say that it was something that I'm grateful for, even though it was a dark time in my life and it prolonged my training to a certain degree. It gave me some clarity on my life direction and where I wanted to go in my career. And it made me know what it was like to be a patient and what my patients experience when they're going through surgery. And I was really grateful that it was something that was benign and fixable and that it wasn't the diagnosis of some sort of a malignant tumor that, you know, you have six months to live type diagnosis.

Yeah, you know, a lot of people say their hormones are off, but yours really were. And it really was affecting things. Aside from the effects of just the mass pushing on nerves, et cetera, I mean, that. That can be pretty debilitating. So congratulations on all your hard work getting through all that. It would not be an easy road, for sure. And I think things that happen to us early in our careers really can have a profound impact on the life and career decisions we make. For instance, I had a couple of lawsuits in my first two months of residency. One from my first month of practice and one from the second. They were both eventually dismissed because they really didn't have any merit. But from very early on, I was very cognizant of documentation and medical legal issues. And I think it's affected my practice the whole way through. And I suspect having that experience during your training has also affected your career in a lot of ways. And certainly this thing that you do on the side that we're going to talk about next. So can you tell us the origin of practice balance?

So practicebalance.com is the blog that I started toward the end of my residency training. And it was something that came to me as an idea of what I wanted to do when I was experiencing and suffering from the symptoms that were later attributed to my tumor. But I was thinking that they were all related to stress and burnout. I really felt that I was burned out. And there was a period in residency where every day I would wake up and say, I want to quit. But I read books, I went on a silent retreat. I learned about how to manage my stress during that time. And I learned a lot about me and a lot about stress management techniques in the process. And being that I love to write, I decided that I really wanted to share this information with doctors. And so I started out the blog kind of on an informational type of basis where I was sharing articles and things that were related to the topic of stress management and burnout. And as my symptoms change and my surgery happened and then my career changed and I evolved into being an attending anesthesiologist, I'd say the blog evolved as well. Then I ended up going on the quest to become a mother. So I talked a lot about infertility on the blog. And nowadays I would say that my main focus is still back in the self care and self knowledge for high income professionals, not just physicians. But it's just become a lot more general and a lot more about trying to find simplicity in life and trying to find balance and know yourself and how to figure those things out for yourself.

Now, you were never anonymous on this. You've had your name out there from the beginning, is that right?

Yeah, that's right. I thought about it in the very beginning and then I decided that I didn't really want to share anything that I wouldn't want people to know. So I just went with my name straight from the beginning.

And has that had any repercussions in your career or personal life?

No, it hasn't. You know, and actually now that I have a daughter, I do put her on the blog and I put images of her on the blog. And different people have different comfort levels with that, as you know, because I know that you've discussed that and about having your children be, you know, models. But I haven't had any kind of professional repercussions either, I think because I tend to kind of stay in neutral political areas and I just talk about important issues that are relevant to everyone and I don't tend to do really controversial things, I would say.

Now you also blog at Mothers in Medicine. Can you explain how Practice Balance and Mothers in Medicine, the two blogs interact and what the deal is with that connection.

Yeah, so I had my blog before I joined the Mothers in Medicine group. It is a group blog, so a lot of the people that are regular contributors, you have to be selected for it by a head person. But most of them have their own blog as well. Not every single person does. But I joined it basically when I was pregnant. And at that time I really wanted to share some of the information that I had learned about being pregnant and working in anesthesiology and working in an operating room. And also just some of the issues that I had gone through with infertility and what it's like to go through the process of infertility treatments when you're a busy physician. And so that was kind of my pitch to joining Mothers in Medicine. And since then it was about like 2014, maybe 2015 that I joined. I've been a regular contributor and so I write there periodically in addition to writing on my own blog.

So what were some of the issues you had being in the OR while pregnant? I mean, did you have to step out when they shot films or you had to keep your baby bump out of the sterile field? Or what were the issues you found that you ran into?

Well, there are a few different things. Mainly, I think as an anesthesiologist, one of the big difficulties with the fertility treatments was the scheduling aspect of it, because our schedules are not in our own control. And when you do fertility treatments, anyone who's done them know that they're also kind of short notice. So it's a day to day change in plans that was difficult. And then once I was pregnant, then I did write a little bit about being exposed to fluoroscopy, being in the room where they do orthopedics, and if you want to step out for like when they mix the bone cement and those kind of things. So kind of environmental factors. Yeah. And then also just scheduling. It's difficult to be in a really long case if you are pregnant because you usually have to go to the bathroom more frequently. And you know, if you're in an eight hour case or something, that's really hard. So you have to lean on your colleagues a little bit more. So I discuss those issues and if anyone's interested in reading those, they can search my name on the Mothers of Medicine website and you can actually just read all the posts that I've written and it's an easy way to find those.

Yeah, I can certainly relate to that. I think a lot of medical students can where they wondered if they should put a Foley in before they go into some long case, you know, just because for some reason the surgeons seem to have a bladder of steel, you know, and go for hours and hours without. Without going. But maybe they just deliberately dehydrate themselves before the case. I don't know.

I think they do. Yeah. It's pretty scary, actually. It's pretty unhealthy.

I wonder what the rate of kidney stones is among, you know, spine surgeons and others who do long cases.

I don't know.

So not everything you write goes on the Mothers in Medicine blog. Is that totally new content you put there or is that republished content from your regular blog or what is it you can do?

Either one. I sometimes will write original posts there and then sometimes I'll also take an idea that I wrote a blog post on my personal blog and then I'll riff on it a little bit differently to change just for the audience. Because mainly the audience there is Mothers in Medicine, as the description goes. So you can kind of do whatever you want. There aren't really rules on there, but I've done both.

And who do you see as the audience for Practice Balance? What's the avatar if the person you're writing for?

My personal audience, they don't have to be physicians, they don't have to be women, just people who are achievement oriented and they don't necessarily have to be high income either. But I would say people who are high achievers, who are looking for ways that they can have more balance and have a little bit more simplicity in their life and slow down.

Do you consider yourself a physician finance blogger?

I've definitely been lumped in that category before. I would say that my main finance related content is more of the mindset finance, the kind of the psychological stuff. But that is not the only topic that I cover. So yeah, I would say that I'm a finance blogger, but it's definitely not the more quantitative stuff that is seen on a lot of the blogs.

Okay, so you write a blog called Practice Balance, so presumably you're an expert in balancing our lives. So can you explain why it's so hard for hard charging high income professionals to find balance in their lives?

This is why I like the name of my blog, because it's Practice Balance. It's a continuous practice for everyone, even me, who has a part time job and who's very cognizant of the issues and always thinking about it. The thing I think for physicians and other high income professionals is that they're used to keeping their head down and things tend to get into a snowball effect for us. Life gets more and more complicated. The older we get, the more responsibilities we get, the more accolades we get at work, the more responsibilities we take on, the more money we make, the more complicated life gets. Then you end up having to outsource all sorts of things, and then you have to manage the outsourcing. So a lot of people in our field are just used to putting their nose to the grindstone and hustling. And we started this early on. I mean, that was how we got into medical school. Even back to grade school, we were hustling and getting our good grades and just trying to pay attention to that. And we got into that kind of that snowball effect for all of our lifestyle factors. And then we sometimes don't pause to think about them and look at them and examine if they're serving us.

I feel like I need you as my life coach now. There's no way I could call my blog anything about balance. You know, I'm the worst at trying to find balance in my life continually. I let something overwhelm everything else. What tips do you have for a doctor who feels her or his life is unbalanced?

The most important thing, I think, in trying to figure out balance for you, because it's different for you than it is for other people, is trying to know yourself better. And you have to pause and figure out what things that you're doing are serving you and what things you're doing you don't really like. And then you maximize the parts of your life that you like and you minimize the parts that you don't like. It's kind of like what a lot of finance bloggers talk about budgeting, and they have pie charts, and this amount of money allocates to this, and this amount goes to this other area. It's the same with balance. I feel like that the term gets dogged a lot. People say, oh, there's no way to get balance. Well, balance isn't an endpoint. It's a continuum, and it's very individual. So the first thing to do is to learn more about yourself, figure out your personality and figure out your likes and dislikes, and actually think about it and be intentional. Because a lot of people, like I said, they just aren't paying attention to themselves and they're not taking care of themselves. And so they get just in that mode where they're not really thinking about what they're doing.

You know, a lot of doctors have been told that they can't do it all, that they got to choose what they want to do with their lives, that they can't really focus it and they push back a little bit on that they want to do it all. And what advice do you have for somebody like that that wants to do it all? They want to have a power career, they want to have a big family and be there for the family event or to raise the kids or whatever. They got some other goals. They want to go climb el cap or whatever. Should they try to do it all? Are they likely to be happier trying to do it all or would they be better off figuring out what is most important to them?

I think it's okay to say that you want it all and to try to do it all. But the one big caveat with that is that you can't do it all in a good way all the time. So yeah, you can exercise and you can be a parent and you can be a spouse and you can be a physician. But some of those different areas in your life are going to come to the forefront at certain times and then some of them are going to go to the back seat. And so you have to be okay. And a lot of us are perfectionists, so it's hard. You have to be okay with not being the best at everything. Like for instance, I am not the most productive and prolific physician in my group and that's okay with me. I'm all right with not being the prestigious academic anesthesiologist that other people are because I care a lot more about being present with my daughter at the age that she's at. Or I care a lot more about traveling or I care about doing certain types of exercise. But you're not going to be the CrossFit champion while you're the most productive person in your group, while you're present for your family and have six pack abs all at the same time. It's just not going to happen.

It's too bad because I keep trying to do it and it's just not working out.

Yeah, you just have to put some stuff on the backseat at different times and then rotate them.

I think that's a good tip. I like that idea of rotating your focuses in your life from time to time because there are times when your kids just need more of you and other times when they're kind of on autopilot for a few weeks or a few months or whatever. And so I think there are times you can do that and, and I think some of us are better at saying no than others. And sometimes that's what you have to do to rotate and focus on something else is you have to say no to what you're doing. Now, why do you think that's so hard for so many doctors to say no? Is that a personality thing that correlates with people going into medicine or what?

I do think that. I think that when you're a high achiever type of person who is used to being self reliant and is used to searching those gold stars, you have a hard time saying no. It's hard to turn down when you get accolades for being successful in your field and then someone involved at work wants to have you take on more responsibility. It's really hard to say no to that. But I do think that it's important. It's a very important skill to learn.

All right, let's turn the page a little bit. I want you to tell us about Christy Reynolds and why maybe we all need a Christy Reynolds in our life and household.

So I wrote a blog post about Christy Reynolds on mothers in Medicine. So that's one that's an example of something that I didn't write about on my personal blog, but I wrote it straight for that website because I wanted to talk about all the roles that as mothers in medicine we sometimes play. However, Christy Reynolds, it's kind of interesting story. So my husband has a virtual law firm and he realized that there were certain things in his virtual business that he really just didn't like doing and that were unsavory parts of his job. And he wanted to maintain kind of an air of professionalism with being a one man farm and then also wanted to have someone else be the bad guy. And what I mean by the negative parts are like collecting bills or like reminding people of deadlines, talking about things that are not very fun to talk to clients about. And so he made up this administrator and he just made her name be Christy Reynolds. I don't know where he came up with this name. So he sends emails to people when he has to collect bills and things like that from this name. And hopefully I'm not giving anything away. I don't think any of his clients are listening to this.

I guess we'll find out.

It's genius. I mean, I was really like, whoa, this is amazing that you thought of this idea. But I think the reason that people do need this idea in their lives is that we can all be Christy Reynolds. If you have some sort of business interaction that you need to do that isn't very savory, you have to separate your personal feelings from that interaction. It's kind of like saying no or being the bad guy. Sometimes you just have to be that person. You may not be able to have the luxury of hiding behind the mask of another name, but we all have to learn that skill.

And has Christy Reynolds found her way into any other aspects of your lives?

Well, what I wrote about in that particular post on Mothers in Medicine was how I sometimes am Christy Reynolds because her duties have expanded not just to sending emails about getting bills, but also to being the voice for the voicemail grieving on his firm and then also going and picking things up. I've been a runner. I've dropped things off at local offices and things like that. And it's just funny. And it made me think about all the roles that we all have. I mean, it doesn't matter if you're a mother or not a mother or a male or a female. I'm a physician, I'm a mom, I'm a chef, I'm a chauffeur. We all take on lots of different roles in our lives.

Yeah, I really like that idea of having somebody else to be the bad guy. And sometimes our businesses are big enough that we can hire somebody to be the bad guy. For example, when Cindy came to work with me in 2014 and I put her in charge of collecting money from advertisers and it was so nice that I could just talk to them about content and talk to them about questions. I don't have to talk to them about when they're going to pay me and how much they're going to pay me. You know, so why not create, you know, a virtual person if you, if you don't actually need the time from somebody else? I just thought it was a genius idea. I thought it was worth talking about today. But something we probably ought to spend a little more time on is part time work. And this has been fascinating to me over the last two or three years. I think I have routinely gotten to the point when I'm talking to groups of physicians, when I poll them, I ask them, I usually start asking them, what would you do if I wrote you a $10 million check today? You know, would you show up at work tomorrow? And they almost all raised their hands, you know, they truly aren't working just for the money. And then I ask them, well, would you still be working for, you know, a year from now? Are you still going to be working? And, you know, maybe one or two people put their hands down, but pretty much everyone's still interested. And then I ask them, would you be working the same number of days a week or number of shifts a month? And almost nobody puts their hands up. It seems to me that almost everyone in medicine wants to do part time work. So the first thing I tell them is, well, you should probably cut back to full time to start with because so many Doctors are working 60, 80 hours a week. But beyond that, I think there is a great desire for docs to work part time, even if it means giving up a significant chunk of their income. Most docs want to work part time. Now you've been doing this for a while, so can you tell us what part time work is like, why these doctors all think it would be awesome, and how doctors of the various specialties could conceivably go part time?

Definitely it is as good as people imagine it to be. I definitely have liked my part time schedule. And there are some trade offs and you have to just be aware of those trade offs. You mentioned one of them and that is the money part. So I am willing to take less money for sure. I haven't succumbed to the huge amount of lifestyle inflation that sometimes physicians get subject to. And you have to be very aware of that and of not getting into that situation where you're in over your head. But also not just money related, but there are social aspects to being a part time that some people may or may not like. I know about myself that I'm a little more introverted on the introverted side. And so it doesn't really bother me that I don't have tons of good friends that are my coworkers now, someone else that they may actually miss that part. But you know, I don't get invited to all the social events or I don't really know everyone at work as much as some of the other people know each other because I'm not there as much. So that's something to think about too. Now the other thing is that I would say as far as part time work goes, a good way to think about it is to streamline your different roles. So we just talked about Christy Reynolds and all the different roles that we all have in our lives. Think about the roles that you have at work. I knew after I had my health scare that I really just wanted to focus on one or maybe a little bit of two roles in my career. And the main one I wanted to focus on was clinical anesthesiology. And so I went out seeking a job that was focused on that. And I said to different employers this is my ideal job. Can you do this? And the one job that I took, it did give me everything that I wanted in my criteria. But I got a couple of other situations that I could have potentially worked at, but they weren't ideal. So you have to know what your non negotiables are and what your negotiables are and then what roles you really like to fulfill at your job and what roles you don't. Because maybe you can just start to strip those roles away and that will naturally help to get you to go down to full time or go down below full time. You're right that a lot of people, even if they're part time, they're still working like a full time schedule. Now I think that it's easier in certain fields to go into part time work and I'm in one of them and you're in one of them, anesthesiology and emergency medicine. So other fields are a little bit harder. But if you're willing to do job sharing, that's another way that people you know who have more of a role in a clinic can do part time work. But you have to know that you're not going to be that golden child person that is always the highest achieving, most producing, most prolific physician in your group. And you have to be okay with that if you're going to go down to part time.

You know, I think it's one of those things that lots of people transition to but very few people start at it sounds like when you went to at least your current job, that was the plan, was part time from the beginning. Do you have any other tips on how somebody can secure a part time job right off the bat without working full time for a number of years for that employer? Is there any things special to do? It sounds like it would have been a pretty tricky negotiation and maybe would cost a lot of money to be able to do that right off the bat. Any tips there?

So I can't really talk for things that aren't the kind of the or anesthesiology type of job because that is harder. It is harder to secure a part time position in a clinic. But for me my days are very clear. I said I really want to just work three days in the operating room and I tried to find a position where that is what they would offer me. And I said this is my ideal situation. What can you do? And I think I got pretty lucky with the job that I am at. But I think as far as tips for other people, you have to be willing to have them say no to you and be willing to walk away. And so this gets to what you talk about a lot on your blog and in your podcast and everything, which is financial literacy. If you're financially secure, financially literate, you know what you can afford and can't afford, you're much more confident to go in to the negotiation for the jobs and the situations that you want and, you know, take no for an answer and go look elsewhere. It's the whole FU money concept.

So how early in your career is it advisable to do this? I mean, do you think there's a period of time when somebody really needs to be full time to consolidate their skills at the beginning before they should even consider going part time? Or do you think that it's reasonable to go part time right from the beginning? And how does that work out for somebody who, for instance, who wants to be home with kids at that part of their career? Because usually coming out of residency you're in your early 30s and you know if you're going to have kids, now's the time to get going on them. How do you reconcile those two things?

Yeah, I think that I'm biased because I went straight out of training and went part time, but I didn't go too part time. You know, I was kind of in that 75% FTE range. I feel like that there is a minimum amount and it's probably different for different fields that you want to do. If you're going to go straight out of training and be part time, that will give you the experience and the exposure to the clinical areas needed to be able to see what you need to see to be a good practicing physician. And it is something that isn't a perfect measurable number that I can just throw out because I do think that it's probably different for all the different specialties. But I felt like for anesthesiology at least half time is important, but probably more like the three quarter time is still enough. And it depends on your job too. So if you are going straight out and you're practicing in an area where you're say you're an anesthesiologist and you're doing supervision of mid levels, you have a different skill set than if you're doing the cases on your own. So you're not actually in the operating room doing every single thing for the anesthetic as an anesthesiologist who works in the operating room by themselves. So I worked by myself. And so I knew that I was still getting A lot of skills and I was still seeing a lot of surgeries. The other thing is that my job is at a tertiary academic center, referral center, so I got to see a lot of sick patients. So I justified my part time work with the fact that number one, I'm doing my own cases and number two, I'm still seeing a wide variety of things including rare clinical presentations and diseases and surgeries because of the practice setting. So it would be a different situation if you were going in and you were number one supervising or number two at kind of a smaller town surgery center or something like that where most of the patients are more healthy.

Okay, so that's the early part of the career. How about later in career, mid to late career? You're thinking about cutting back. How much can you cut back before you really shouldn't be practicing medicine at all? When you're really not staying current, your skills aren't good? How many days a month do you think you need to work in order to be a competent doctor? Be a doctor that you think your patient should trust?

So I think just like all of the different questions about part time, the answer is it depends. As we were just talking about on the practice specialty and the practice settings. I have been thinking about this issue myself because I think that as I get older I will want to cut back even more than I already am. And so with anesthesiology, it's a very procedure dependent field. And so you have to know how much is a minimum amount that you can keep up your skills. And I know that Physician on Fire has talked about, talked about that on his blog too, being that he just recently retired. There is one person that I know has talked about this and he's a surgeon and he blogs. His name is Corey Fawcett and he has a lot of insight and information as to kind of how he cut out different areas of his practice and in what order he did it. So for the surgeons out there, that might be a useful thing to look at. But I think that there's a little bit of an experimentation that has to take place for people. You're not going to know if you're at that level where you're comfortable with the amount that you're working and still being up to date on kind of all of the clinical information that's out there until you get to that point.

Yeah, I know. It's something that I've thought about a lot. Some people cut back because they want to work less. I cut back so I could work more. I actually end up working a lot more than I ever did, at least as an attending. And I was working till 12:30 last night. It's one of these problems of having a job you can do anytime, anywhere, that you have a cell phone connection, essentially. But it's one of those things I have really thought about as I have cut back on my clinical practice over the last three and a half years. Three and a half years ago I went to 75% time, and then a year and a half ago I went to 50% time. And I know that I am spending a lot more time and effort on cme. For instance, I speak at the American College Emergency Physicians Scientific assembly each year. But I am going there and spending the whole rest of the time that I'm not speaking, going to class after class after class and trying to make sure that I'm staying up to date, because I worry about that. And so I think you probably can't coast quite as much when you're part time. I think you have to be a little bit more deliberate about your ongoing learning and about, you know, your practice and maybe take steps, as you mentioned, to make sure that you're seeing the higher acuity patients or that you are, you know, seeing an adequate volume to keep those skills up. But I think about all the different specialties. I mean, obviously you go around the, you know, physician blogosphere and you see all kinds of people part time. You know, you're part time, and, you know, everybody in the white coat investor network has either been part time, is part time, or wants to go part time, you know. And so I think a lot of people are seeing all these docs out there that are doing part time just because they're the ones who have the time to have some other sort of pursuit and have some sort of presence out there that you hear about them and you learn about them. But I wonder how applicable this really is to all of medicine. And I think about the various specialties. For example, OBGYN, you see OB's all the time, drop their OB practice to improve their lifestyle. All of a sudden they're not in the hospital at 3am delivering babies, and they cut back. So the practice is just gyne, or just one aspect of gyne. And I see surgeons stop doing trauma, for instance, or you might see somebody not taking as much call or not taking call. So I think in every specialty, there's different ways to cut back. Certainly in the primary care specialties, you just have a smaller patient panel. Maybe you're only there Monday, Tuesday and Wednesday. Morning, but you have a smaller panel and so you can manage or you do a job share, as you mentioned, and somebody else covers Wednesday afternoon and Thursday and Friday. But I think a lot of people just assume because they're not in radiology or anesthesia or emergency medicine or hospitalist medicine that they can't cut back in some way to halftime. And I think that's probably not true. I think there probably is a way for most specialties to at least be working less. But you're right that you have to give something up, whether it's money or whether it's prestige or whether it's the next promotion or what it is in order to get that. And. And it's just a matter of deciding whether that's worth it to you or not.

Yeah. I do think that people, they don't want to ask for what they really want. It's a hard thing. They don't want to be told no. They're worried about what the other people in their profession or in their group are going to think of them. And that's unfortunate because a lot of people will go in the motions that they're doing all the while. They want to work less or they want a slightly different role in their practice.

Right. It's almost like I don't want my partners to think I'm weak because I don't work night shifts, but at the same time I don't want to work night shifts. And so you got the fact that you don't want to look weak. And yet at the same time most of your partners are probably jealous that you're now halftime. And so I think there's a lot of weird things that happen in our mind when we start talking about not being. And it's not even just full time, it's time and a half kind of doctor that you're weak and I don't know, maybe that's trained into us during medical school and residency or maybe even as a pre med, you know, trying to compete to get into medical school. But I think it's hard to overcome for a lot of docs.

Yes, for sure.

All right, let's turn the page a little bit again and let's talk about the power of a phrase that you have used. The phrase is I get to. Can you talk about that?

Well, even though we're talking about part time work and oh, I must have this perfect setup of balance in my life, I still get overwhelmed too. And I have used the phrase I get to as a practice of gratitude when I'm Getting overwhelmed or I get into a state that's a woe is me like state. I think that stress, even if you have what a lot of people would consider to be the perfect situation with jobs or work life balance, it can eat at you no matter what your situation is. And so I use this to help to turn things around. And what I mean is, like, I'm up late at night doing something tedious, like I'm making lunch for my daughter to go to school, and I really want to just be watching Netflix. But instead I say, like, I get to do this. I get to make healthy food for her so that she doesn't have to eat junk food or, you know, just other kind of tedious things that you have to do or things that seem mundane. I get to do this thing and reframe it as opposed to I have to, I have to go plan, blah, blah, blah. And a lot of us fall into that category of saying, I have to do this, this and this. And really they're just first world problems. It's like, well, I have a house and I get to go clean my house. I actually have a roof over my head. You know, that kind of thing. It can really help to feel better about what's going on in your life.

It's a little bit like that technique. They tell people to smile when you pick up the phone because it goes across the line to the other person. You know, it's just a mindset change. In a lot of ways, the people who are happiest in life are those who choose to be happy. And so I think there's a lot of wisdom there for sure. All right, let's talk about your recent trip to the Virgin Islands and what you learned about locum tenens from it.

I'm actually on a sabbatical from my part time job and this was something that there was precedent in my group for doing. And I wanted to do it now when my daughter was not quite kindergarten age so that things weren't more complicated with school responsibilities and such like that. So I took nine months off and during part of that time, I wanted to do something clinical that was different and branch out. And you were just talking about keeping up to date in your field. And there are a couple of things in my practice of anesthesiology in the current job that I have that I don't really get to do on a regular basis. So I wanted to do either a medical mission or a locum tendons position so that I could get my hand back in those and Also just see what it was like to be a traveling physician. And I found this position at a community hospital in the U.S. virgin Islands. And I thought that that would be a good one because part of my time off is really the main primary reason is to travel with my family. So they came along with me and I felt like that that was a good destination to go to. And I would say that this locum tenens position wasn't your typical locum tenens position. It was kind of odd. I mean, I haven't done any other ones, so it's hard for me to compare. But just based on talking to other people about what their locum tenens experiences are like, this was a little bit untraditional. It was a little bit like working at a VA in a third world country. Of course, it's a US territory, but it's still, they have limited resources. It's an island that was devastated by a hurricane just less than two years ago. Well, about two years ago. And things are still being rebuilt. So you can imagine that in general, things move at a very slow pace over there. So I got to see what it was like to work in an environment with very limited resources. And I know that you have done that with some of your travel work. But then also at the same time, kind of the politics that go along with a government run hospital and some of the inefficiencies that you see, money is thrown in certain directions and then there's such a scarcity mindset when you look just in the opposite direction. So it was an interesting experience. I'm glad I did it.

And what'd the family think of the trip?

They liked it. They stayed mainly near to where our Airbnb was on the days when I worked because we didn't want to have to rent two cars. But you definitely need a car to be in the US Virgin Islands. It's actually ironically, very hilly. You think of an island and you think, oh, you can just walk along the beach to go anywhere. But it's not like that there. It's very steep hills. And so my daughter is at the age where it takes very little to entertain her. So they built a lot of sandcastles and did a lot of ocean things. And then after my time that I was working, it was kind of an intense period, a little longer than a week of work. Then we had some days where we moved on to one of the other islands called St. John. And we did some just relaxing stuff. We did a lot of snorkeling and going to the Beautiful, beautiful beaches that were there. So we all got to enjoy the area as a family too, in addition to me working there.

So did your husband take a sabbatical as well, or did he just continue on with his virtual law practice?

So my husband, because it's a virtual practice, is able to still do his work, and he has to do some flights here and there to do some depositions and things like that. But mainly his work is done on the computer and on the phone, and so he's able to continue that as long as we have an Internet connection.

Yeah, it's a wonderful thing how the economy has changed. Back in the 90s, we all kind of thought the Internet was going to change the world, but I think it was 15 or 20 years later when we actually saw the real changes that came from it. And there's so many of us that are just working online from home or from the U.S. virgin Islands. And it's pretty amazing how the economy's changed that way.

Yeah, I think it's true. Although, as you know, being a physician, you can't just see patients over a computer all the time. I mean, I know some people do telemedicine, but not all fields of medicine can be done virtually. So there has to be some time that we're really in the hospital. So it's a little different for us.

As doctors, although I'm amazed how much that is creeping into our practices. For example, at one of my hospitals, after 10 o', clock, when we admit a patient to the hospitalist service, it is not a doctor that's even in town that we are admitting to. And then the regular hospital comes back in in the morning and takes over care on them. It's really pretty interesting. Yeah, they're putting in the orders and they're taking the calls from the nurses. And so I was surprised to see that. But that's a change in our hospital just in the last month or two. So who knows how it's going to change? You wouldn't have expected, you expect radiology be outsourced to Switzerland or Australia, but you don't necessarily expect that from the hospitalists. So maybe things will change more than we think. All right. We hinted earlier in the podcast that we were going to talk about climbing. Now, a lot of people might not realize this when they look at your blog, but the header image on your blog is Red Rock National Conservation Area, just outside of Las Vegas, where we're going to be having the conference coming up in about a few weeks from the time this runs from the Time people are listening to this, but a few months from when we recorded it. Tell us about rock climbing and how you got into it and what kind of climbing you do.

So I started rock climbing back in undergraduate days. I was maybe about 20 years old. Now I'm 45. So I've been climbing quite a bit, quite a long time. Off and on for all those years. I would say lately for the last few years it's been more off, but we still do climb a little bit. I got into it because my husband has a geologist father who had taught him how to rock climb a really long time ago when he was a kid. And it was one of our first dates and it became part of our lives, just an integral part of our existence for those kind of early years, in the mid to late 20s especially, it dictated all of the travels that we did all over the country, all over the world. All of the time off that we would have in between jobs or schooling or any kind of training that we were doing was always taken up by rock climbing. And we have climbed quite a bit in the Red Rocks Preserve there that you're referring to on the photo. And we have a home in the Las Vegas area, so we do frequent that area.

So what kind of climbing do you do? Are you a sport climber? Are you a trad climber? You climb ice? You done big walls? What are we talking about?

I've tried it all except for big walls, which is pretty gear intensive. But my main focus has always been sport climbing. So clipping bolts and doing single pitch type routes. But I've tried all of those different things. Ice climbing. I'm so easily cold that that was just so unpleasant. I definitely didn't like that kind of climbing. But the sport climbing is something that is very easy to do in a short day or a long day or even at the climbing gym. It's very athletic. It's very kind of focused on the movements and not so focused on the gear, which is nice. The gear is kind of an afterthought. And I have really liked that kind of climbing the most.

So what's the hardest you've climbed?

The hardest route that I have done without taking any kind of rest or falls is a 512A. So that, you know, the rating goes from 50 to 5. Now they have 515 something. So up there in the kind of the higher levels, it's been a little while since I've climbed. That hard?

Yeah, that's hard climbing. People don't realize that is difficult climbing. That's impressive climbing. I'm really impressed with that. Do you have a favorite route?

I have a favorite. A couple of favorite areas. I don't know. That's kind of like asking for a favorite child, I think, when you love climbing so much. But I would say that my favorite areas that I've been to and I have been to a lot of climbing areas are Maple Canyon, which is in central Utah near the town of Nephi. You may be familiar with that. But it's a conglomerate type cobblestone climbing, and it has all different grade levels, and it has routes that are more kind of vertical and technical. And it has really overhanging, dynamic, gymnastic routes. And then as far as out of the country goes, my favorite climbing can be found in the island of Kilymnos, Greece. And it is limestone tufa climbing and kind of pinching these weird tufa runnels and a lot of overhanging climbing there. So those two places are my two favorite places.

How about Red Rock? You got a favorite route at Red Rock?

Oh, my gosh. Favorite route at Red Rock? Have you climbed there?

I've been. I've spent entirely too much of my life in the Red Rock National Conservation Area. I don't know, I probably spent a month to two months of my life in that area just, you know, putting together a whole bunch of different trips.

We used to do that a lot, too. And that was part of why we ended up buying a condo down here when there was the real estate kind of bust in that late 2000s, was because we were always coming down here to go climbing anyway. But I think my. Probably my favorite. One of my favorite sport climbing routes at the Red Rock area is at the gallery, and there's one wall that kind of has a bunch of 12s on it, and they're pretty hard. They're actually really thin. But there's an 11 called the yak Crack that is really challenging and goes up kind of on the side. It's kind of an arete. Arete is where there's a lot of exposure. So you've got your legs kind of hanging out in the air and not necessarily on the rock, and it's quite challenging. I both love and hate that kind of climbing, so that's probably one of my favorites.

Yeah, I think I've hung. Dogged my way up that one at some point.

Yeah, well, me too.

Probably hanging on all the bolts, but awesome. Good stuff. All right, well, we're boring everybody with all this talk about rock climbing. I'd rather have a Rock climbing podcast, but I can't get anybody to listen to that one, so we'll have to talk about finance and stuff. But you said you consider yourself a financial blogger. What do you see as the intersection between finances and wellness?

So I feel like that in order to have good stress management and wellness, we need to have a good handle on our finances and have good financial literacy. So they go hand in hand in the aspect of preventing burnout for physicians, preventing that overwhelm, and being able to have the space to pick and choose what you want to do at work. Like we were talking about. Minimize the things that, that you don't love about your job and maximize the things that you do. And the only way that you're going to do that and not be in that trapped, overwhelmed position is by having a good handle on your money and being able to know where you stand and how to live a comfortable life by your standards and minimize your debts and pay off your debts quickly and those kind of things. We all accumulate a lot of debt in medicine. And then also as far as just wellness goes in general, having good self care is having a good handle on your finances and being able to know what enough is for you and being able to not just spend money in order to numb yourself from the bad things that might be happening in your life, but finding out other good ways to take care of yourself that aren't involving buying Maseratis or, you know, spending money on fancy bags or something like that. Yeah.

Now you're going to be one of our speakers at WC Icon, which I think may be next week by the time for the people hearing this, in fact, they might be listening to this on their way there, I don't know. But why did you apply to speak there?

Well, when you had the first conference in 2018, I saw the advertisement and definitely wanted to go. And I reached out to you by email, basically with the argument that I was a local and would be happy to fill into the conversation if needed. In your bloggers panel, I think you said something on your advertisement for it like, oh, we're going to have a bloggers panel. And I said, hey, I'm a blogger and I'm right here and I can drive there and that kind of thing. And it just opened a can of worms for me. Not only was the conference awesome and unlike any conference that I had ever been to, with very practical information that was important for everyone and every specialty and all levels of training, but when I did that bloggers panel, it introduced me to a whole community of bloggers that I've stayed friends with and made contacts with since that time. And the panel and the conference really got me thinking about how money and lifestyle balance issues relate to each other. And it even had me to start another blog. I have a new blog that only has a few posts on it, but it's called stealthwealthfamily.com and we hope to use it for participation from my daughter as she grows up and also as we travel a little bit more. But I really wanted to participate in the follow up conference because of how indebted I felt to your initial conference, opening me up to this whole new community. And I came up with a few different ideas of things to speak on and you chose one of them and so it's going to be awesome. I'm taking a deep dive into the topic of self knowledge and how it can help physicians to better manage their stress levels and their finances. So we'll be talking about why and how and resources to gain self knowledge and the possible effects that it can have on you. Cool.

Now we're running out of time, but you've got the year of shoot. Probably 30,000 people, mostly docs similar high income professionals who are eventually going to listen to this podcast. What would you like to tell them that we haven't talked about yet today?

We haven't really talked about outsourcing too much. And one thing, I'm in a lot of different social media groups for especially women physicians and physician moms and I see so much that is kind of thrown to outsourcers and I'm not anti outsourcing. But I would like to say that just because you're a physician or a high income professional, that doesn't mean that you have to lead this super complicated life or you have a morning nanny and a night nanny and a cleaning person and a person that makes your meals or and a meal service and blah blah blah. You have to think about the things that you really enjoy doing and the things that you don't enjoy doing. And if you really don't enjoy doing any of that stuff, then go ahead, by all means, outsource everything. But I think that people nowadays outsource too much and don't think about what they really want to spend their time doing. And you can lead a more simpler life than what you're doing now.

So it's okay that I still mow my lawn?

Yeah, that's like a perfect example. I still clean my own house even though at times I had someone clean it. I went Back to doing it myself.

Yeah.

So yeah, an example.

Interesting. You know, Peter Kim, the voice behind Passive Income md, just shakes his head every time I tell him I mow my own lawn. You know, he just thinks I'm crazy for not outsourcing more than I do.

But yes, I know. I've had those conversations with him too, actually.

Yeah. Dr. Baker, thank you so much. I think this will be really helpful to listeners and they can learn more about you at practicebalance.com@stealthwealthfamily.com at let's see, what's the other blog? Mothersinmedicine.com so they can find you all over the place and certainly are going to have an opportunity if they're coming to the WCICON conference that they'll be able to meet you there. So I'm looking forward to it. Thank you so much for agreeing to do it and I'll see you at the conference.

Yes, I look forward to it too. Thanks.

So that was great having dawn on. She has got a great perspective. I feel like I need to hire her as my life coach though. She'll help me have a little bit more balance. So certainly I hope you get a chance to see her speak at the conference. It should be a great talk. As a white coat, you have valuable knowledge. Various companies want that knowledge and they're willing to pay you for it. That's why we put together a list of recommendations for companies that pay you to take surveys. If you're looking for a profitable side gig for not too much effort, getting paid for surveys could be the perfect solution for you. You can make extra money, start a Solo 401 and use your medical knowledge to impact new products. One of the WCI columnists makes an extra $30,000 a year just doing these surveys. Sign up today and use a fraction of your downtime to make extra cash. Go to whitecoatinvestor.com mdsurveys you can do this and the white coat investor can help. Now the conference is coming up next week. Within a couple of days of you listening to this, I will be heading down to Las Vegas. We're hauling, I don't know how many bucks, 4,000 books or something. 5,000 books. How many is it? 5,000. I think books were taken down to Las Vegas that are going to be included in the swag bags. We got to fill up the day before the conference and so. So we're looking forward to it. It's going to be great to see everybody down there. If you are not able to go though you can still get a piece of this. We are going to package up the conference into an online course and we will be getting that up and ready for you to purchase hopefully within a week or so of the conference ending. I have great hopes that our tech folks can get that turned around quickly after the conference ends, but it's obviously a lot of material to get incorporated into an online course very quickly. But hopefully within a couple of weeks of you hearing this, this will be available on the website. So watch for that and get your chance to participate at a far lower price than flying across the country to Las Vegas to participate in person. Thank you for leaving us a five star review on itunes and for telling your friends about the podcast. Keep your head up, keep your shoulders back. You've got this and we're here to help. We'll see you next time on the White Coat Investor Podcast.

My dad, your host, Dr. Dalle, is a practicing emergency physician, blogger, author and podcaster. He is not a licensed accountant, attorney or financial advisor. So this podcast is for your entertainment and information only and should not be considered official personalized financial advice.