WCI #271: Physician Online Advocacy with KevinMD

This is the White Coat Investor Podcast where we help those who wear the 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.

This is White Coat Investor podcast number 271 physician online advocacy with Kevin, MD. If you're finding our podcasts informative and helpful, we would encourage you to sign up for our monthly newsletter. It is totally free and includes useful, actionable information not available on the regular BL posts or this podcast. It's almost like being in a secret club. The kind of club that can boost your knowledge and enhance your wealth at the same time with no strings attached. Sign up today@whitecoatinvestor.com newsletter. You can do this and the White Coat Investor can help. Welcome back to the podcast. It's wonderful having you here. I appreciate everything you're doing out there. Your work is important. The day to day a droning work that just seems like a job just seems like you're on a factory assembly line. Assembling widgets matters. It matters in people's lives. It matters in the lives of your patients. They might be waiting for months to get in to see you for 15 minutes and even though they're only one of 20 that you'll see today, it's important to them and it makes a big difference in their lives. So thank you for doing what you do. As you know, if you've been listening to this podcast for any length of time, there are lots of things you can do in the world that will make more money than practicing medicine or practicing law or whatever it is you do as a high income professional. But somebody needs to do these important jobs and I appreciate you dedicating your life to do it. Let's do our quote of the day today since we'll be having an interview later on. This one is from Helen Gurley Brown. She said money, if it does not bring you happiness, will at least help you be miserable in comfort. A lot of truth to that, even if said tongue in cheek. We'll be talking a little bit today about a lot of different subjects about advocacy online, about combating misinformation, about managing your online reputation. We'll also be talking a little bit about burnout and I'll get more into this at the end of the podcast, but I want to make sure you're aware of a program we've created in conjunction with the Happy MD called Burnout Proof md and this is a treatment program for Burnout which lots of docs have. More than 50% of docs have. It's essentially a six month support system with a number of different components including content that you work through on your own, including one on one coaching, including group coaching meetings, including being in a community with other physicians also struggling with burnout. It will give you the tools and skills to give you the hope you need to get back to your best life. So pay attention. At the end you'll be able to learn more about how to get access to that. If you can't wait that long, go ahead and look@whitecoatinvestor.com physician burnout coaching and it's also under our recommended tab on the website. All right, let's get our guest on here. This is a guest I've been looking forward to having on somebody that's done a ton for physicians, patients and medicine in general online over the last 18 years. Let's get our guest on the line. All right, our guest today on the White Coat Investor Podcast is Kevin Poe, who you probably know better as Kevin, M.D. he is an internist by training, however, probably best known as the founder of KevinMD.com, social media's leading physician voice. Welcome to the White Coat Investor Podcast, Kevin.

Jim, it's great to be here. Thank you.

So let's let people get to know you a little bit at the beginning of this podcast just so they can relate to you a little more. Tell us about your upbringing and how it affected your views on money.

Sure. So I grew up in Canada in Toronto and upper middle class upbringing. My dad was an engineer, my mom was a medical technologist. And I guess I was raised not to have any debt, pay off your credit card in full and all that. And then as you know, higher education in Canada is significantly cheaper than it was in the United States. I think that if I stayed in Canada, undergraduate education was measured in the thousands, whereas in the United States it's measured in the tens of thousands. I think undergraduate education now is something like 50 to $70,000 a year. And I applied to an American university, Boston University, one of those combined undergraduate MD programs that I got accepted to. And for me, my family, it was a shock. And that was really the first time I was exposed to the fact that I had to take significant educational debt. And the decision I made at that time when I was a teenager would have significant financial ramifications going forward. And I think that was really the first time that I had to be in significant debt, the first time I had to take loans. And it was really the first time that I was really attuned to how finances was going to affect my life then and, and going forward. And I have to be honest, being in debt, even though it was educational debt, even though it was debt for medical school and undergraduate studies, it was certainly needed, wasn't a good feeling. So I think that instilled at the very beginning that I never wanted to be in debt if I didn't have to. And that's been a guiding principle for me going forward.

So tell us about your education and training. Sounds like you did a combined program and then obviously an internal medicine residency. Tell us about that.

So like I said, I went to Boston University when I was 17 years old, three years undergrad, four years at Boston University School of Medicine. I stayed there for residency, internal medicine, and that I wasn't quite sure what I wanted to do. You know, I always said, you know, I'll practice, you know, as an attending doing primary care for a few years and maybe I'll go back for a fellowship. And I'm sure as you probably know, once you get a taste of the attending life and attending salary, you don't go back. So I graduated back in 2002 and decided to do primary care. I am in Nashua, New Hampshire now, which is about 45 minutes north of Boston. And I've been here since so 22 plus years doing primary care after my training in Boston.

And you do primary care clinic and is that halftime? I mean, you're putting a fair amount of time into Kevin md, as near as I can tell. What's your career look like as you've blended those two?

So currently I do primary care halftime, 0.5 FTE. When I first started out, I was a full time regular primary care doctor. At that time there weren't many hospitalists, so we had to see patients in the clinic, we had to round at the nursing homes, we had to round in the morning at the hospital to see inpatients. So a traditional internal medicine practice and as that's evolved, certainly as medicine has become more siloed with hospitalists, I did, I transitioned to strict outpatient primary care. And then as Kevin MD grew, and we'll certainly talk about that later on, it's given me the opportunity to cut down my practice. So I went from full time 1.0 FD, 2.75 FTE, 2.67 FTE and gradually to where I am now at 0.5 FTE. So I see patients Monday, Tuesday and half day Wednesdays and the rest of the time I do A podcast like you are here and work on Kevin md, do some speaking coaching. And it's been a fantastic blend of doing medicine in the exam room and just exploring interests outside the exam room as well.

Yeah, let's talk about that. I mean, I mean you're famous, right? KevinMD.com gets two times the page views of white coat investor. You have a popular podcast, you do coaching, you do public speaking. Clearly you could make enough money to make practicing medicine optional. Tell us why you're still practicing.

I love being a doctor. That's really the simplest answer to that. I went into medicine, you know, to cliche answers to help people make a difference in patients lives. But as a primary care internal medicine physician, you're really needed. There are a lot of people who are looking for primary care physicians. You know, I feel bad sometimes I see a patient for like 15 minutes and they've been waiting on this appointment for six months to see me. You know, I guide them through our dysfunctional healthcare system. You know, they come in with, you know, lab tests, they go out for an emergency department, no one's getting back to them. And in primary care you're definitely needed. So I do love being a doctor. I love taking care of patients. I love having that long term relationships with patients in primary care. So everything that is positive for primary care I love. But as a lot of doctors probably would say, you don't like a lot of the other stuff that goes along with it, right? You know, the bureaucracy and all the other issues that face primary care today. So ironically, by cutting down doing primary care, by working only 0.5 FD, it's probably lengthened my career, it's probably kept me longer going to where I am. So I love being a doctor, I love seeing patients and then of course with my activities outside of the exam room, talking about social media to other doctors. Being a practicing physician also gives you that credibility, right? Because as a lot of your listeners know, physicians tend to listen to other physicians and they can tell if you're a physician in name only and you're not seeing patients regularly. So whenever I talk about social media and I talk about my experience as a practicing physician, there's that certain credibility and relatability. So my message I think resonates more with other physicians because I am a practicing physician.

So how long do you expect to practice and when you eventually hang that up, what do you expect retirement to look like?

So I don't know. I thought about that question. I have a daughter who's a junior in high school, so she's going to be going to college soon. I have another daughter who is in seventh grade, so there's going to be a few more years before she goes to college. So I'll be probably practicing until then. Not knowing exactly how the cost of higher education is going to continue to skyrocket. Who knows how much undergraduate education is going to cost. Like five, 10 years from now is probably going to break six figures. And I think that what I have now is a great blend. It's one of the things that I like to talk about is that we are more than our MDs and we have a lot of control in terms of how we shape our professional careers. We're no longer confined to seeing 30 to 40 patients in the exam room from 9 to 6pm And I think that what I have now in terms of doing part time clinical medicine and doing part time KEVIN MD and exploring entrepreneurial interests and kind of filling that cup outside the exam room, I'm pretty happy where I am. So I don't plan on retiring anytime soon. So I certainly don't have a set date. But when it comes down to a point where whenever I feel like I work because I have to, that's probably no. 1, that's probably a good sign. That's a good time to stop. You know, you only want to work because you want to do it, because you want to go in, and you certainly don't mind going in. And whenever it comes to a point where work feels like work, then that's probably a good sign that, that it's a good time to retire or come back.

Let's talk a little bit about something you said. You've mentioned a couple of times, the cost of higher education. And I've always been surprised how regional this can be. You live in the Northeast. Education's really expensive at a lot of these college and colleges in the Northeast. You know, you go into Boston, everything's 50, $60,000 a year. This is shocking to me because I live in Utah, right? My daughter's going to a college next year where the tuition is $6,000 a year. The state schools here are seven to nine thousand dollars a year. You know, what do you make of that difference in different areas of the country between different schools? And what should people think about that as they, as they plan to send their kids to college?

I think that going to college is not an issue. I think that there are so many undergraduate options in the United States that just going to a college is certainly not a problem. I think the issue is that everyone tends to apply to the same 30 to 40 colleges in the United States. And they can, you know, those colleges, especially now with them being test optional, they're getting inundated with applications and they can pretty much charge whatever they want. So I think that, yeah, if everyone wants to apply to those same 30 to 40 colleges, and especially here in the Northeast, we're looking at an Ivy League education without any financial help to be at least $75,000. And that's pretty much how much it costs to go to medical school when I was going to medical school. And I think it's just simply unsustainable. So I think it's a matter of expectations. I think that you could have a wonderful education at any undergraduate institution in the United States if you want to go into medicine. Course that's something that I'm familiar with. I think that really any undergraduate institution can prepare you for medical school. And, you know, it's certainly not needed, but it's just a matter of expectations. Who knows, maybe it's family pressure, maybe it's peer pressure, maybe people want a prestige. But I think that the cost of education is driven by the fact that everyone's really applying to the same, you know, few dozen colleges that everyone wants to get into.

I think our listeners would be really interested in hearing about the founding of Kevin MD. I mean, this started in 2004. That was seven years before the White Coat investor. It was the same year Facebook was started. It was a year before Reddit, two years before Twitter, six years before Instagram, seven years before Snapchat. You subtitled it social media's leading physician voice. As near as I can tell, when you started, it was just about the only voice. Tell us about that founding.

Well, I'd like to say that I had a business plan back in 2004 and everything went according to that plan, but that's simply not the case. So at that time, there were probably only a few dozen physicians who had blogs. That was when blogs were really just in its infancy. Right. You know, people kept asking me, what the heck's a blog? Right. And I really didn't know what to expect. Right. So I think that it was a format where people can share their thoughts, obviously on a blog, and there weren't very many physicians who shared her thoughts outside the exam room. And at that time, people would read news articles, there'll be studies published in a newspaper, and they would ask me in the exam room, you know, Dr. Po, what do you think about this study? What do you Think about this new medication. What do you think about this recall? And I think there was one medicine that was recalled, and someone was seeing a patient the next day after the announcement of that recall. And she said, you know, I read your blog posts on your website, and now I'm comforted by what you had to say. And I realized that I have other options for this medicine I was taking. And I think that's when it really shocked me that really we can have a voice, not just one on one in the exam with a patient, but with a blog. And now with so many social media options, we have a platform where we can influence patients and other people who may be listening to us outside the exam room. So instead of one to one, we now can influence one to many. And it's evolved, obviously, since then with the platforms and online media and social media, they evolve every year. The landscape now is certainly much different than it was back in 2004. We have so many different platforms that suits everyone's strengths. You know, on video, you, of course, YouTube and Twitter, LinkedIn, Facebook, and, you know, the website itself. You have email newsletters. We just have so many platforms where people consume information. And I think Kevin MD has evolved, you know, to meet those different ways information can be consumed. Now its primary platform, where I built it up to a point where I can share other clinician voices. They're mostly physicians, but I also share voices of patients as well, as well as advanced practice providers where they can share their story and perspective. And it's important to have a. Something that's physician run because I can certainly set the agenda. I can choose the articles that are published. I can choose the articles that I want amplified. I can choose the narrative. And I think that's important because if you look at newspapers or other mainstream media platforms, you know, their agenda isn't necessarily consistent with what's in the best interest of physicians. And as a physician myself, you know, I want a platform where I can. I can drive that narrative. And I've just been very grateful that people trust my platform. People come to my platform if they want to be seen, if they want to be heard, if they want their stories to be shared. And it's just been a fantastic experience, not only sharing those stories, but also learning from them as well, because, you know, there are thousands and thousands of Kevin MD authors that I've just learned from by reading their story and talking them on the podcast. So being what it is today, it's. It's been. It continues to be a work in progress. It's been a fantastically interesting evolution. And like I said, there was no business plan. It's this kind of taking it as it goes over the years.

Now, you mentioned all these places you've been and we've kind of had the same evolution of White Coat Investor. You know, from blog to newsletter to podcast, videocast and all these social media platforms. Do you have a favorite social media platform? If you could only be in one place online, where would it be?

So I want to reframe that. Rather than a favorite, I would say the most powerful platform, right? I think the most powerful platform has to be Facebook. And all the reasons why I think it's the most powerful also has a flip side. In fact, it's also dangerous as well. So I think for every good that Facebook gives you, I think there's a detriment that it gives you as well. I learned so much by connecting with like minded individuals, not only on your boards. White Coat Investor group chats. I have Nisha Mehta's, you know, side gigs and physician community. I have the Kevin MD community. And just talking to other physicians and hearing their stories about what they're going through, how they solve problems, to me is a fantastic learning experience. I do a lot of listening on social media. I don't necessarily contribute my own stories, but I just do a lot of listening. And just listening to what other physicians are going through I think is tremendously valuable. But I think there's a flip side to that as well. I think what makes it powerful also makes it dangerous as well, because you have a lot of dangers that Facebook has given. I think there's a lot of harms that Facebook has in terms of connecting people who are like minded in negative ways. It perpetuates misinformation. It closes people's worldviews. People only are siloed into a specific worldview. So I think that whatever good Facebook gives, however much I learn from Facebook, there's also a flip side to that and I'm very cognizant of that as well. So when you ask what's my favorite one, I would say, you know, the most powerful one that I've learned the most in terms of being where you're at, it has to be Facebook.

Let's talk about your role@Kevin MD. What is your role now and how has that changed over the years?

So I still own and run Kevin MD on a daily basis. I think one of the challenges I've had is scaling because it's something that I've struggled with, letting Go. It's something that I've like my own child, is something that I've grown since 2004, that I've overseen the day to day operations. So currently I still own and run it. I choose the articles that I want published, I edit my own articles, I do my own podcast, I produce my own podcast, I publish everything myself. I do have partners. I have advertising partners with MedPage Today. And then I have other people who use the Kevin MD platform if they want to share their message with my audience. So, but in terms of who runs, who makes the editorial decisions, the technical decisions, it's still me. And it's been like that since 2004.

Now, as a business, how's it changed over the years? I mean, obviously you have some display ads there when you go there. How does Kevin MD make money? How's that changed over the years?

So I think to run the platform, it's in the six figures to run the platform. So if someone were to make money, this is probably not the best way to do so. Content production is very, very difficult. It was difficult back then, even more difficult now. It's very difficult to stand, to stand out because there's just so many people competing for your eyeballs online. Right. And in terms of how we make money, it's at least advertising space. Like I said, I have a partnership with MedPage Today where they use Kevin MD to display banner ads. And then I have also other places, like my podcast newsletters, where I'm able to share sponsored content from other people who are interested in reaching the physician audience.

So having been done this now for not quite two decades, but a long time, would you recommend online entrepreneurship to other positions? Why or why not? I mean, do you think it's still possible to do something like you or I did more than a decade ago, or has this ship sailed?

I think you have to be passionate. You can't go into it because you want to make money. It has to be a passion for you. And talking to other physicians out there. If your passion is seeing patients, if your passion is going to the hospital and operating or doing procedures or working in the emergency department, that's what you should do. You shouldn't go into online entrepreneurship or create a company online or create a create content online if that's not something that you're passionate in. Because it's very difficult to do what you do with White Coat Investor and it's very difficult to do what I do with Kevin md. It takes a lot of hours. I've published however many tens of thousands of articles, running a podcast. And if I didn't have the passion for it, or if I didn't consider it work, or if I did consider it work, I wouldn't do it. Because on top of raising a family and doing primary care and seeing patients, doing Kevin Envy takes up a lot of my hours. It's pretty much a 24 hour day, seven day a week job. So should physicians do it? I think only if they're passionate. And if they are passionate, income will come. I think that if you have put enough hours behind your project, whatever your online business is, and you spend the requisite amount of time on it, nurturing it, watching it grow, I think the money will come. So to answer your question, should physicians do it? I would say yes, but only if they're passionate. And if their passion is not in not 100% into these online ventures, then they shouldn't do it.

Now let's turn the page a little bit. You're an expert in social media. What do you see as the biggest problems with social media and its intersection with medicine?

So I would say two. The biggest problem, number one is misinformation. I think that it's so easy to perpetuate misinformation and we've seen that during the pandemic. I think we're elevating people who have legitimate scientific credentials and putting them on the same platform with your neighbor who maybe just, you know, heard something from someone else and giving them that same platform. And I think that's confusing the audience in terms of what's reputable information or not. So talking, talking to patients specifically in the exam room, you know, there's so much misinformation that they've heard on Facebook that I have to spend time clearing up. So that's the number one biggest problem, is the perpetuation of misinformation. Number two is that I think the silos peoples, and you know what we talked about earlier about siloing people with similar worldviews, you know, that's good and bad, but. And I think that if you look at the negative aspects of that, you only talk to people who share your political viewpoints and just share your worldview and you don't really get exposed to ideas or perspectives that differ from yours. And if you look at how Facebook runs, you know, the algorithm, you only like stuff or you click on stuff that you agree with, right. And that in a sense that self perpetuates because that only feeds more information that you agree with. So I think that's been A real detriment of social media in that it's really adds to the divisiveness of our society by enforcing the worldviews that we already have.

Let's talk about that first one. Because it grows out of one of the things that's wonderful about social media, that's wonderful about the Internet, and that's that you can get your voice out there. Even if you're not a big, huge media company, even if you're not famous, even if you don't have political power, you can get your voice out there. And if people like it, it spreads quickly and it can go viral, et cetera. I mean, that's a great thing. But it also puts a random blogger that started last week on par with CNN or on par with, you know, USA Today or whoever, some big media company. How do you balance free speech with the need to rein in disinformation?

Yeah, and I think that's a question that a lot of social media companies are still grappling with. I think it's really a tenuous balance. I don't have a good answer to that. I think that when it comes to public health, should there be more moderation from the social media companies? Maybe when it comes to deliberate misinformation that harms public health. And I know that a lot of companies like YouTube and Twitter, they post warnings if they know that there is misinformation specific to the pandemic. But I think that you bring up a wonderful point. I think the power of social media in terms of elevating everyone, you know, that, that like I said earlier, is, is indeed a double edged sword. But I want to talk about what our responsibility is as physicians. You know, I think that one of the, the themes that I always try to talk about whenever I give talks on social media to other physicians is that we do have a responsibility to combat misinformation. And you know, one way that we, one of the ways that we can do it is that more of us need to go online and either create content or share reputable content. Because this is really a content game and whoever has that biggest influence is going to change minds out there. So I always encourage physicians to get online and really create a counter narrative of reputable health information to combat all the misinformation that's out there. Because I always talk about how people who perpetuate misinformation, they've had a head start on us. I talk to doctors and they say, you know, why do I need to go on social media? And you know, While I'm convincing doctors get on social media, people who perpetuate, for instance, anti vaccine stances, they've had a five to ten year head start and a five to ten year head start online, you know, that's, that's an eternity. So we're already playing catch up. So that is one of the pleas that I have for physicians is to really go online and you don't have to create content like, like you or I do, but simply share reputable pieces of content. And by creating again, a counter narrative of reputable health information, you're doing your part in hoping that reputable health information reaches patients online. Because we already know they're exposed to a lot of disinformation, misinformation. So we as physicians, we need to also perpetuate reputable source of information so they can reach our patients.

Let's talk about the second issue with social media that you brought, up, the siloing. And we all know somebody, a family member or a friend that is just deep in a silo on the Internet or on Facebook. But how do we combat this for ourselves to make sure we're not just in a silo, but also how do you pull somebody else you care about out of one of these online silos?

Again, a great question. I think that's also been a challenge. I think you have to understand where they're coming from. I think that you cannot talk down to them, you cannot say that they're wrong. But I think you just have to listen and understand. And it's very similar to when I talk to patients in the exam room and they have views on, for instance, the COVID vaccine and they've read something online about how it's dangerous or if they want to take ivermectin or, or something like that. And you have to see where they're coming from. You have to listen to their concerns, you have to listen to their story and you have to take the time to understand. Because a lot of people who believe in misinformation, obviously they're not bad people. They're people who sincerely believe in that and they're doing what's best for themselves and their families. So it's important that we understand that and we have to understand where they're coming from and really have that conversation about what their motivations are. You talk about what you would do or what I would do for my family and my kids, and we realize that we have that commonality, is that we want to do what's best for our families and we may have different ways of doing so. And you just have to find that common ground. And once you have that common ground, I'm not saying that you're going to convince everybody, but I've convinced more than a few where they come in with some type of strongly believe misinformation and we have a conversation about what's their motivation behind it and they have second thoughts. And you know, even some of them have, have, have changed their minds and gotten, for instance, the COVID vaccine. So I think it is important to not talk to them in an us versus them matter and realize that hey, we do have the same motivations and we just have different ways of getting there. And it's important that we just hear each other out.

How about in ourselves? Is it, is it just a matter of making sure we get our information from both CNN and Fox? I mean, how do we make sure we're not ourselves getting into an online or political silo?

Yeah, I think it's important to get information from different sources of political worldviews. So when I read editorials on a specific issue, I make sure that I read them from the New York Times, the Washington Post and the Wall Street Journal. So it's important to get a diverse spectrum of perspectives on Kevin md. This is something that I emphasize because I do include political perspectives not only from the left, but also from the right as well because it's important to learn from people who may not necessarily agree with us. So that is something I certainly emphasize. You know, I have my own viewpoints, but you know, I would post things on Kevin MD that I don't necessarily personally agree with. But I think that it is important to have that diversity of opinion that is out there. So like you said, it is important to step outside our silo and listen to people that we don't necessarily agree with. And, and it is possible to have incongruent viewpoints of the same issue. And you just have to understand that and be accepting of people's perspectives that may not be your own.

All right, let's talk about online reputation. So you've co written a book about managing your online reputation, you called it. It's a very descriptive title. Establishing, managing and protecting your online reputation. A social media guide for physicians and medical practices. Why is that a subject important enough for you to spend that sort of time and effort on it?

Yeah. So that book was published a long time ago. It's almost an eternity. It's certainly overdue for another edition, but at that time it was really my call to arms. So to speak for physicians to go online. Because more so back then, physicians didn't really know why they should be online. They just said, I just see patients in the exam room. I don't care what my online reputation is. It doesn't matter how I appear on Google. I don't need to be on Facebook, Twitter and LinkedIn, YouTube. I just want to see patients in exam room. And I was trying to convince them, and we talked a little bit about this before, that we need to go online because that's where our patients are. Not only are they going online to research health information, they're going online literally to Google their doctors as well. And I think that I wanted to, to really share. If we don't take a proactive stance to manage our online reputation, someone else is going to do it for us. Because, like, you know, if you Google your name online and you don't have an online presence, what normally shows up, it's going to be something from health grades, rate, MDs, vitals, Yelp and whatnot. So if you don't define yourself online, someone else is already going to do it for you. So you might as well be a little bit more proactive and control what's how you're presented online, not only for your own knowledge, but patients as well. Because a lot of patients are just going to be Googling you online before they see you. And then now that rationale has certainly expanded. We talked about that misinformation piece, but there's also a third piece that I want to talk about is really advocacy. I think that there's a lot of changes to our profession. A lot of clinicians who are listening to this podcast, they're going to know that sometimes our profession is changing by the day. There's a lot of regulations that are coming up. There's a lot of just bureaucratic influences. There are a lot of things that are going to change how we practice as physicians. And if we don't speak up, people who don't have our best interests at heart is going to make decisions for us. And already we're not going to like the effects of that. So I wanted to also give that third reason that, hey, we have these tools, our powerful tools, whether it's a website or Facebook or YouTube, where we can advocate for our profession, where we could share our stories and try to gain some influence on these policy decision makers that are going to affect our lives and really add that reason to the call of arms, of why physicians should go online, not only for the patients, not only for online Reputations, but for the profession as a whole to really try to take some of that control back and make a difference.

You mentioned proactively getting out there to manage your online reputation. I mean, what do you mean? Should people buy the URL with their name and put something up there so that that's the first thing that hits when people Google you instead of health grades or Yelp? Is that what you're talking about when you're talking about managing online reputation? Or is this just for plastic surgeons to have before and after photos on a website?

So I think it depends on how aggressive that you want to be. Right. So I think the very least you could do something like, you know, LinkedIn. LinkedIn is a fairly common website that gets ranked high. So if you do a LinkedIn profile where you can control what shows up, you know, that can compete with things like health grades or Yelp or a patient review at least. Right. And the more you do, the more effective it's going to be. So once you get comfortable being online with LinkedIn, yeah, you could buy a URL with your name. You can adjust your Google or your Google business profile. So the more of these online platforms that you control and be more proactive and customize, the more you control how your online footprint is going to be. Now that's the first step. You know, there are going to be some physicians who think, you know, that's enough and I think that's great. You know, I think that if people just grab a LinkedIn profile and just change my Google, my business thing, it takes a few hours and that already puts them ahead of the game. And of course there's going to be some physicians who are going to utilize these online platforms to talk about some of the things that, that I talked about earlier, whether it's telling stories, patient education, advocating for the profession, and yeah, they can create a URL for their name and have that online website. And the more visible they are online, the more they're going to control their own reputation. So yes, there are physicians who have their own blogs and really just share their stories and kind of do what I do. Where they use that website is that central repository of content. And then they can spoke out to all the different online social media platforms where people can consume their information. So I think it depends on the physician, it depends on what their goals are, depends on how interested they are in terms of managing and creating an online reputation. But I think that there is a spectrum based on what, what those goals and, and how committed they are to it.

Now Online reviews of physicians are notoriously terrible. You know, some of us really don't care. You know, if you're a radiologist, if you're an emergency physician, if you're a hospitalist, frankly, you don't care what people have put about you on health grades or Yelp or whatever. People don't Google the emergency docs for choosing an emergency department, but obviously that matters for lots of people, lots of practices. If you're trying to build a practice, you know, just about every patient's going to look at your reviews before they come see you. What should doctors do about negative reviews?

The first thing I recommend is really just, you know, read them. And a lot of times when people write a less than positive review, it's not necessarily the physician himself or herself. It's sometimes something to do with their office staff or something that they have no control over. You know, it could be not enough parking. It could be that the support staff, they didn't get back to that patient in time. So there are times where those reviews can point out problems in your practice that you may not even be aware of. So that's the first thing, is just to read it and, and fix whatever you can to fix. The second thing I normally recommend is just asking in general more patients to rate you online. And a lot of medical systems, I believe University of Utah, they already do this. Like they just, they, they use their press gainy reviews and put that on their public website and use that to kind of saturate the public physician reviews. Because in general, patients like their doctors. If you look at Press Ganey scores and Press Ganey reviews in general, they're pretty good for their physicians, more so than say, something on Yelp or so. So I know a lot of medical systems are using these official press gaining reviews as part of your public facing feedback for physicians. But I really think the best way to manage something negative is to again, be proactive because you want to, you know, I don't want to say marginalize, but you want to make negative reviews less visible, right? And by doing, by creating your own content, whether it's a website and controlling how your footprint is online, what that sometimes can do is push down the visibility of negative reviews, maybe onto the second page of Google. So the more online platforms that you can control and you can customize that can hopefully make less than negative reviews that you don't control, make them less visible.

Let's talk a little bit about, about what you're doing with the blog and podcast. The first thing somebody notices when they go to Kevin MD or they look at the PODC is that there's an absolute ton of content. There's a ton of stuff there. Where does it all come from?

It comes from guest authors, other, primarily physicians, but anyone intersect with healthcare. I think the mission I have is to share the stories of the many who intersect with our healthcare system but are rarely heard from. And it turns out there are thousands of people in our healthcare system who want to be heard but don't have a platform to do so. I get dozens of guest articles daily. I publish three to four times per day just over the last 20 years. Almost 40,000 pieces of content and more than I can get through. But I think that it just really speaks to a need where healthcare professionals or anyone intersect with a healthcare system. They just want their stories told and there's nowhere for them to do that. You can go to a place like the New York Times or whatever newspaper and that's perfectly fine. But sometimes physicians may not be the best writers. Right. You may not have a New York Times quality op ed. And that doesn't mean that your story is any less important, doesn't mean that your story is any less poignant if you're not a polished writer. So I create that platform where people can get heard not only just on the website itself and on social media, but I have a lot of television producers, newspaper editors who read my site, and people who've written on Kevin md. They've parlayed that into opportunities to write books, to appear on national and local media, and use Kevin MD as a springboard where they can share their story on a larger platform. So, you know, I've built a platform. It's not easy to start a platform. It takes time and effort. But now that I have that platform, I use that to really share stories from healthcare professionals who want to. Want to either tell their side of the story or just want to share an experience. And I'm just really gratified that people trust me to do that.

So in essence, your content is provided to you free. It's donated to you essentially by people that want to get it out there.

Yeah. And I think that it's, you know, in exchange, certainly the visibility and the fact that it certainly spreads on social media and giving them that opportunity so they're. So they can be heard. Otherwise, you know, as you know, it's very difficult to be heard. It's difficult to cut through all that information clutter that's out there. So I do give that opportunity where they can cut through that noise. So they can not only, you know, at the very least they'll be heard, but sometimes they could even make connections and again, parlay that into bigger media platforms.

Do you worry that that model attracts people with an ax to grind or simply people looking to promote whatever they're doing, rather than maybe the content that is most important to get out there?

Yeah, so I think absolutely so. And I'm sure that you, you feel that as well at white, at the, you know, white coat investor from. You have a lot of people who do want to share their stories with the physician audience, but, you know, that's where being an editor comes in. And by all means, I'm certainly not perfect. You know, I think some things that I've published that I've had second thoughts about. But yeah, that's where the editorial discretion comes through. So I think that everything I do read through, if there's things that are promotional, and I don't think that would benefit my audience, I just simply would decline it. And I've declined many, many pieces. But. But yeah, I do think that is a concern. The bigger you are as a platform, the more people they are going to utilize it, but not in the best interest of my audience.

Now, you've embraced a variety of voices on your blog and podcast far beyond just physicians. You often feature advanced practice clinicians and even patients. Has there been any blowback from going beyond doctors and tell us about that?

Yeah, sometimes. So I sometimes get feedback from physicians. And why are you including perspective of, of perspectives of nurse practitioners? You know, it should be physicians only. Why are you including perspectives of patients? So, yeah, so I do sometimes get some pushback against that. But I think it goes to what we talked about before in terms of siloing our worldview and how we need to break out of that. Because as physicians, for instance, you know, talking about why include patients, for instance, you know, as physicians, we actually don't know what it is. Well, a lot of us don't know what it's like to be in our healthcare system from a patient perspective. And I think it's important to know that. I've learned so much from patient written articles. I've learned so much by talking to them on my own podcast and they share some of their stories and difficulties in our healthcare systems. I had no idea about as a physician, knocking wood. I'm lucky. I rarely use our healthcare system as a patient, but hearing these stories, I think it has made me a better physician. It's maybe more empathetic in terms of what patients are going through. And, you know, I've learned a tremendous amount. And the same goes for people who are not necessarily physicians and, you know, advanced practice providers, you know, physician assistants and nurse practitioners. It's interesting to hear what their journeys are in our healthcare system, because our healthcare system, despite what a lot of physicians think, it's, it's vast, it's huge. And I think that there's so many aspects of it outside of the physician world that we just simply don't know about now.

KevinMD.com has never been one to shy away from controversial topics. What do you see as the top three to five most controversial topics in medicine right now?

Yeah, so I think that it all boils down to really one thing, the future of our profession. And that can manifest in different ways. I know that there's a lot of controversy when it comes to advanced practice providers and independent practice. You know, that's certainly a topic that garners a lot of controversy. Whenever I post an article on that or whenever it's shared on Facebook, you know, it just elevates into a huge shouting match in the common comments. So I think that's the one thing. And I think there's so many aspects in terms of, you know, the role of government in our healthcare system. Anything political, you know, that's going to generate a. A ton of controversy as well, because there is no right answer. And people are so entrenched on each side that no matter what people say, it's very difficult to convince people's minds. But I think it really just boils down to the future of our profession. You know, what does it mean to be a doctor today and what does it mean to be a doctor going forward? And I think that a lot of the controversy really stems from. From that question and exploring that question. And, you know, it's changing as we speak. What it means to be a doctor today is different from what it was 10 to 20 years ago. You have a lot of doctors with these proverbial side gaz gigs. You have doctors now who don't necessarily see patients only in the exam room or go to the hospital. You know, you see a lot of physician coaches. You see a lot of physicians who are practicing not in a traditional manner. And that is one of the things that I am interested in exploring. And it does get some pushback because you have a lot of traditionalists out there and they don't necessarily see side gigs in a favorable light. For instance, you know, they think that doctors who are necessarily see patients 24 7, they're not considered proverbial real doctors. You know, they, you know, they think that what some of us are doing with entrepreneurial ventures, they're distracting from our true purpose as being a physician. So I think that that evolution there, there's going to be a. There's a lot of pushback from people who, who view medicine traditionally versus a newer generation of physicians who realize that medicine shouldn't be all consuming. So it's interesting being on the sidelines and seeing this and seeing the discussion that emerges from this. And really, essentially what we're dealing with is the evolution of what it means to be a doctor. So I think that's garnered the most pushback.

So let's talk about what people aren't talking about. What do you think is not getting enough attention in physician focused social media?

You know, it's difficult because I think the talking to people like yourself and people in our world who blend clinical medicine with entrepreneurial ventures, we like to think that that's what it is everywhere and it really isn't. I think that what we're doing in terms of you with White co investor and what I do with Kevin MD is actually not norm. Right. And I think that even though we talk about this a lot on both of our platforms, I don't think it gets talked about enough in terms of we are more than our MDs. I think that if I talk to physicians who are not plugged in on Facebook and you know, don't read Kevin MD or the White co investor and you know, they're, they're just spending whatever, 80 hours seeing patients every day, they think that's all there is to medicine and they're burning out. And I think that even though we, I talk about it a lot on Kevin MD about burnout and what it means to be a physician, I don't think that we talk about it enough. I don't think it's normalized quite yet. And I think we do need to address that issue of clinician burnout. You know, we both know what the numbers are. It's like more than 50% or something like that. Physicians are burning out. And to let them know that there is hope out there, that there is a solution to this. And we talk about burnout a lot. But I don't think that. I think it needs to be normalized in terms of the solutions to burnout, whether it's either, you know, cutting back or, or doing things outside the exam room or doing things out of clinical, outside of clinical medicine. So you're just not working because you have to. I think that that's something that even though we talk about it a lot, I think it needs to be just normalized and. And make people realize that, hey, there are other ways to be a physician than what's traditionally thought of.

Let's turn the page to finances a little bit. A few years ago, Kevin MD started incorporating financial content onto the site. Yeah, why? And what have you learned about teaching finance to doctors by that experience?

So I think I was inspired by what you're doing in terms of. I think one of the things that I mentioned when I had you on my show a couple weeks ago is that you created a whole new asset class of content, which is like the health care personal finance space. And I think that there were a lot of Kevin MD audience members who don't necessarily read the White Coat Investor. And I wanted to really just expose them, to say, hey, you know, this is important information. You know, almost important what you know clinically. Because if you as a physician aren't financially literate, you are going to struggle going forward. You know, you are going to be burnt out from your job. You are going to feel like you have to work because you have to pay off debts or you bought that expensive doctor car or house, and that's only going to contribute to your burnout. So I thought that it was important not only to share the traditional Kevin MD stories about medicine whatnot, but really to kind of share a little bit of the financial aspect as well. Because I think if you are financially literate, it is actually going to help with the burnout prices that's affecting the medical profession today. So that's the main reason why I wanted to include some financial pieces on Kevin MD and that it's still a minority of the content. But I do have physicians who contribute financial stories, you know, financial tips and advice. And I think that those stories are just as poignant and relevant as the clinical stories that I share on Kevin md.

Now, you have interacted with lots and lots of docs, both online in real life. What are your general thoughts on the financial situation of physicians?

I think it's better than it was. But I. I read on your Facebook group some of the questions that people have. For instance, as we're speaking today, the S and p is down 20%, and people still ask, should I wait for the bottom? When should I time the market? And I think there are a lot of basic financial questions that people are still asking that people need answers to. I think that it's better than it was, certainly thanks to what you do. But I think that there's certainly room to improve in terms of financial literacy of physicians. And that's certainly what I continue to try to do a little bit on Kevin MD by sharing these articles. And I think that everything that your audience is familiar with in terms of the unique issues that physicians face, I think they're continuing. But slowly but surely, hopefully we'll narrow that gap.

Let's get a little bit more personal. Do you feel like you've got your financial ducks in a row? And if so, how did you do that?

I don't know if I have my financial ducks in a row. I think that certainly there are a lot of things I can do better, but I think, think overall it's pretty good. And what I mean by that is really, I don't have any debt. And I think that if you just follow that one rule and just really try to minimize or eliminate any unnecessary debt, I think that you already, you'll be ahead of a lot of the other clinicians who are out there. And you know that that value that was instilled in me early on, that's really something that I've lived by. And if I didn't do anything else, that's not having any debt, I think that, that I would, I would be fine. Yeah. And then in terms of what else did I do to get my financial ducks in a row is really reading A White Coat Investor and, and just following your tips and advice. And you know, specifically, I think that one of the things that was very helpful was this. When I was just learning about investing, you know, I would start by writing, reading that, that book, you know, the Dummy's Guide to Mutual Fund Investing. Right. Those, that yellow and, and black book. And you have Eric Tyson. Yes, Eric Tyson. Yes. I'm sure that's the first book that a lot of physicians would read. So I would read that. But then it wasn't until I read, you know, information by, by John Bogle and White Cloud Investor that, you know, investing doesn't have to be complicated. Right. You just have a three fund index fund portfolio, and that's really, really good enough. And I think that just, just reading, you know, from a, you know, what White Coat Investor does from a physician perspective as it relates to personal finance, you know, I, I've learned a lot that, and you know, investing and managing money, it doesn't have to be complicated, even if there's a lot of exotic ways to invest, but it doesn't have to be complicated if you stay out of debt. And just do index funds, you know, you'll come up way ahead.

As you think back over your career to all the financial advice you've been given by docs, colleagues, et cetera, what do you think is the most helpful thing you've been told?

I mean, I want to just, yeah, expand what I say. It doesn't have to be complicated. Right. Like I said. And sometimes I don't even follow that advice. Right. So you, you read about the latest cryptocurrency and I've invested in cryptocurrency and you read about real estate and I've invested in real estate. And I think back to myself, you know, if I just stuck with like a, a three fund index portfolio and not get into that, would I be better off than I am now? Right. And I think the biggest piece of advice is really just to keep it simple. You know, you don't necessarily have to follow whatever the latest trend is or whatever your colleagues may be investing in. And if you just resting principles, simple and stay out of debt, you'll come out way ahead. And I think that probably is the most powerful piece of advice that was given.

Well, you now have the ear of 30 to 40,000 listeners and our time is short. What have we not talked about yet that you want them to know?

Yeah, I want to talk about clinician burnout. I know we mentioned that earlier and how if you have your financial docs in order, if you're financially literate, that's really going to be a solution to burnout. And it's not necessarily you can be financially independent, quit medicine altogether, but you can do similar to something I did, and it gives you the opportunity to cut down to halftime and lengthen your career in clinical medicine. So that, to me, I think is the biggest message is that I think that we are more than our MDs. We don't necessarily have to be in the exam room seeing patients 24 hours a day, but if you can find a way to follow passions, if you have them outside of the exam room, that to me is going to be the strongest solution to the burnout crisis that's affecting a lot of physicians today.

You know, it's interesting you mentioned that the first thing I tell somebody when they tell me they're burned out is why don't you cut back to full time? Because so many docs are already working far beyond full time. But you're right, it's really hard to get burned out when you're working half time or quarter time. You know, it's hard to get burned out when that's all the more often you're going into work and it takes financial know how to get your life to that level. That's not necessarily the solution for everybody, but it certainly is a solution for many, many docs that are burned out is simply to work a little bit less and all of a sudden they love their jobs again. So good tip. All right, well, what's the best place for people to learn more about you? Or if they want to hire you as a coach or a speaker, where's the best place for them to go?

Sure. KevinMD.com has everything that you need there as my content and information on speaking and coaching. And of course you can search for my podcast. It's a daily podcast. We're going almost 800 consecutive daily episodes and just go to your favorite podcast platform and search for the podcast by Kevin MD Awesome.

Well, it has been great having you on here. Dr. Kevin Poe, MD, founder of KevinMD.com thanks for being on the White Coat Investor podcast.

Thanks for having me.

Hope you enjoyed that as much as I did. One of the best parts about having a podcast is you get to bring people on that you want to talk to. And I like talking to Kevin. He's got a lot of insight into medicine. He's been online for a long time and you learn a lot when you're online interacting with a lot of people. So well spoken and so knowledgeable. It's always great to hear from him. You know, he's right about the burnout. Burnout's a huge problem, right? 50% plus of docs have some burnout and if you look at the percentage of whom it's having a severe effect on their life, I mean it's in the 10 to 20% range, right? If you multiply that by a million doctors in this country, that's hundreds of thousands of doctors whose burnout is severely affecting their life. So we partnered with the Happy MD to create something called Burnout Proof MD that you should check out if you go to whitecoatinvestor.com physician burnout coaching. This is one of the things we offer. We have kind of a spectrum, ranges from private coaching all the way to online courses. But in the middle of that is this product that we think is really great. It's called Burnout Proof md. You get a six month support system of weekly two hour group coaching. You get three one on one personal coaching calls. During the program. You join these other like minded physicians in a private community. You get access to 29 plus hours of burnout proof training materials that you get CME for so you can use your CME funds to pay for this. Most importantly though, you get the tools, you get the skills you need to live your best life. To overcome burnout. You've got to optimize for longevity. You can insure against death, you can insure against disability, you can't insure against burnout. So you need to prevent it. You need to treat it when you get it. And that really is one of the most important financial steps you can take in your career. All right, thanks. For those of you who have been leaving us a five star review and telling your friends about the podcast, our most recent one comes in from Iswar Sankar says Fantastic Jim Dali is the perfect balance between Dave Ramsey and Robert Kiyosaki. If you know, you know. Enough said. Well, that's very kind of you. I appreciate that five star review. If you're finding our podcast informative and helpful, we would encourage you to sign up for our monthly newsletter. It is totally free and includes useful, actionable information not available on the regular blog posts or this podcast. It's almost like being in a secret club. The kind of club that can boost your knowledge and enhance your wealth at the same time, with no strings attached. Sign up today@whitecoatinvestor.com newsletter. You can do this and the White Coat Investor can help. I love doing this podcast. I love getting feedback from you. Positive feedback is best given publicly. Negative feedback. Please shoot us an email editorwhitecodeinvestor.com this podcast really is driven by what you want on it. So if you like stuff, let us know. If you don't like stuff, let us know. Keep in mind that other people often have different opinions. Like our most recent podcast about Bitcoin a few weeks ago, right? Lots of people loved it. Lots of people hated it. It's a controversial topic, no doubt about it. But we appreciate getting the feedback and we do use it to guide this podcast. We also put your questions on the podcast as you know. If you want your questions answered, you can leave them@whitecoatinvestor.com speakpipe and we'll get you on the podcast. We'll answer your questions. Till then, keep your head up, shoulders back. You've got this and we can help. We'll see you next time on the White Coat Investor Podcast.

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