WCI #46: The Happy Philosopher

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. Here's your host, Dr. Jim Dahli.

Welcome to episode number 46, an interview with the happy Philosopher.

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Thank you so much for what you do. Your daily work matters. I had an interesting case in the emergency department just this week. It was a guy who was frustrated. You know, these cases we get all the time in the er. The people come to us because they think we're the diagnosologists. You know, they're seeing specialists, they've had all kinds of tests, but they think coming into the ER we're going to somehow be able to diagnose this condition they've had going on for months or years. This case was kind of like that. It was a fellow who came in with basically intermittent chest pain and dyspnea that he'd been having for a year. And he told me all the workup he'd had done, which is just about everything that could be done. And I tried to provide a little bit of, you know, reassurance at the beginning of the visit that maybe I wouldn't come up with a diagnosis for him today and that we'd have to refer him out to some specialists. And then as part of his workup, we ended up finding a pretty substantial pericardial effusion, which was almost surely the cause of his symptoms. You know, this pericarditis he had with the effusion. And we were able to get him on some treatment that would get that taken care of. And it was fun to see how grateful he was after a year of bouncing around in the medical system trying to find an answer. So that stuff matters. It really affects people's lives. I mean, he was in danger of losing his job because he was missing so much work because of his symptoms. He and the opportunity to be with him and really make a profound change in his life in just a couple of hours in the emergency department is really a privilege. Our quote of the day today comes from Brigham Young who said, life is best enjoyed when time periods are evenly divided between labor, sleep and recreation. All men, women and children should labor. All must sleep. And if mental and physical balance is to be maintained, all people should spend one third of their time in recreation, which is rebuilding voluntary activity, never idleness. Eight hours work, eight hours sleep, and eight hours recreation. I think that's so profound and it's perfect for our podcast today. Giving who our guest is going to be very special guest with us today we have Jeff from the Happy Philosopher, who is a radiologist and has been writing about all kinds of interesting topics over at his blog that you can find@thehappyphilosopher.com and I've got a number of questions I've been wanting to ask him, as well as some that have come from you guys via Twitter that we'll be asking him during this episode. But mostly I just want to get to know him a little bit better and give you a chance to get to know him and his philosophy and see if you can use some of that in your lives and use that to improve your happiness and reduce your burnout and to improve your finances as well. So, Jeff, welcome to the show.

Thanks, Jim. Great to be here.

Great. Well, can you, let's just start with you a little bit. Can you tell us a little bit about your upbringing and what led you into medicine?

Sure. My story before I became a radiologist is actually pretty typical, pretty boring and unexciting. I grew up in a typical middle class life, nothing unique or any crazy stories. And in retrospect, I just kind of backed into medicine. It seemed like a good fit for me. I didn't know I wanted to go into medicine. You know, when I was in elementary school, I never had this dream of being a doctor from as early as I can remember. But when I went into college, I enjoyed science. I wanted a career where I had impact, where I would be helping people. And medicine seemed like a logical fit. So I went to medical school, did a radiology residency and started practicing at the young age of 31 or 32 whenever a radiology resident fellow gets out and goes into the real world and early on in my radiology Career. It was pretty typical as well. I was just in a pretty standard private practice job and my life was great until about five years more or less into my, into my career. I found myself completely burned out and unhappy. And I was pretty distressed by this and utterly confused because on paper everything, everything in my life was perfect. I had a really great, well paying job, stable job. My family life was, was wonderful. I wasn't going through any crisis, no medical disasters, no divorce, no sick family. And of course I was completely miserable and didn't really know how to, how to dig my way out of it. I didn't have the skills or tools to figure out what was happening to me. And to get out of burnout.

That is probably not an uncommon place to be. I've run into a lot of docs and I think the statistics I've seen are that it peaks at around 40,000 patient encounters. And I think for a family practice doc, that's about 10 years into your career. I imagine for a radiologist that number comes up a lot faster because you're reading so many studies. And I don't know that that number applies in radiology, but I wonder if that was about the point where you hit that. You said you were about five years in.

About five years in. Yeah, I don't think that number would apply to radiology. From the, the numbers I see, it's anywhere from 10 to 20,000 studies a year.

Yeah. So you'd hit 40,000 pretty darn fast.

Yeah, probably in residency.

What do you attribute that, what do you think caused you to feel burned out really just a few years into your career with everything going well, seemingly?

You know, I think in retrospect it was a combination of a lot of different factors. The way I frame burnout now, the way that makes the most sense to me is that it's a problem of energy balance. So really in anybody's job, there are stresses of the job and things that you don't like about them. And then there are things that are satisfying about your job and that you do like. And it seems to me that when I was going through burnout, all of the things that brought me joy and happiness in my job, you know, the making a great diagnosis or interacting with patients and, you know, doing, doing a good job on a procedure, none of that was, was bringing me happiness anymore. It wasn't, it wasn't fulfilling. But all of the negative things about the job were still there. You know, the stress, the pressure to go faster, do more while maintaining accuracy, things like that. And there Was also this new element superimposed upon all of that. And it was tedium. And I think we all face this in medicine and really most jobs that aren't completely different and creative and you're doing new things every day. But as a physician, I think nobody tells us that our jobs can become quite tedious. Making the same diagnoses, everything every day starts to look the same. And of course, I think some specialties are more susceptible to this than others. So that was one part of it. And the other part was that I was allowing all these other negative influences outside of medicine to seep into my, my being. So I was paying attention to all of the negative things that were going on in the world. I was worrying about things that were not really in my control. This around this time there was. This is sort of the time of the financial crisis. This is all happening all at the same time. And you know, I was. It was just too much. It was too much for. Too much negative, not enough positive. And I just felt depleted all the time and didn't have the energy. And I knew something had to change at that point.

Now, it's interesting, one of the things you mention is, you know, a loss of enjoyment or a loss of fulfillment from activities that you previously enjoyed. And I think that's straight out of the DSM as a definition of depression. Do you think some of this was clinical depression?

You know, I thought about that while I was going through this and actually I didn't feel depressed. I felt more anxious and worried and stressed out than depressed. And I felt more like I couldn't recharge. I think that that had more to do with burnout because I've gone through episodes in my life where I've been depressed. Not sort of severe clinical depression, but they felt much different than this. Interesting, but it's a good question. I think all these things overlap. We tend to try to put a label on something. This is burnout, and this cluster of symptoms is depression. And this cluster of symptoms is something else. But I think that our brains are a lot more complicated than that. And sometimes it's hard to really ascertain exactly what's going on.

Now, speaking of complicated, burnout is almost always applied to our work. Do you think burnout applies in other areas of our lives? I mean, can we get burned out in our marriage? Can we get burned out in raising kids? Can we get burned out from household chores? I mean, is burnout really just a work specific thing, or can it be applied in a lot of areas of our Lives.

Well, I think it can be applied to a lot of things because I burned out on other things. I used to do a lot of triathlon and racing and this is before I went through burnout in my job. And I had a couple years where I just did too much and I got tired of it. I couldn't do it anymore. So I think we can burn out from anything. You know, it's all about balance. And when things get out of balance and some activity takes more from us than we get from it, we run the risk of burning out. We have limits.

Now, you referenced this episode that happened almost a decade ago. Now, from the way you're talking back with the global financial crisis, do you feel like this is still something you're battling? Do you feel like you've worked your way through it? Can you bring us up to date and give us the rest of the story with your burnout?

Yeah. So let me talk a little bit more about sort of how I got through it and how I came to. I think that'll explain some of my philosophies on finance and financial freedom. So at some point I decided that I needed to retire early and just get out of medicine. I knew I couldn't. I couldn't do this long term. It wasn't sustainable. And one bad stretch of call or a couple bad weeks, I'm not sure. Looking back, I can't really remember the details, but I've been researching the math and the philosophy behind early retirement. And I came home one day and I told my wife that I had five years left in medicine and that's. And then I was just going to pull the plug and I figured back in the napkin calculations I'd have enough and that felt good to get that off my chest and have this sort of defined endpoint. But after I sat with that decision for a while, I realized that I was still burned out and I still had five years left. And I needed to make changes to my life to get through those five years. So I started doing a lot of self exploration, experimenting with various aspects of my life, trying to figure out how to be happier, how to get rid of a lot of the negative things that were causing me this anxiety, stress and burnout. And a few years later I actually went part time. But in those few years I actually felt a lot less burned out, even working full time, even though nothing had changed with respect to the job. So my long term solution to battling this burnout was to just do less of what was burning me out. And that's Been a great part of my life, but also before I went part time because it took me several years to engineer a job share that I'm currently doing. Now. I had emerged from burnout before I got to that point of going part time. So I think there are things that you can do to your life that have nothing to do with your job that can help you get rid of burnout. But I also think that for a lot of people, it is their job and they either need to do less of it or find a new job or change something with respect to that.

I think that is a fascinating intersection. I think I've said before that 50% of burnout is poor financial decision making and the other 50% is a toxic job. But you introduce this third leg of the stool, if you will, that's beyond problems with the job, that's beyond not having your finances lined up to allow you to do what you want to do, particularly with respect to the job, but other things that you can do in your life to reduce burnout. Now, some people deride this kind of stuff as, you know, do yoga and your job won't be as bad. You know, they make fun of it on Twitter or Facebook or whatever. But you're suggesting that there's a role for this third leg of the stool. Can you tell me more about what you think doctors can do without changing their job, without changing their financial situation that will reduce burnout?

Yeah, I think that. I mean, for me, and from what I've seen, a big part of it is getting rid of things. I've written about this before that a lot of times when something isn't right in our life, our baseline thought process is that we need to add something that we're deficient. If I just do this or add this or, or my life will be better. But a lot of times it's about subtracting the bad things. And it's kind of this concept of decluttering, getting rid of all the distractions and all the negative influences and getting rid of things you don't need. And this can be toxic relationships. It can be commitments that don't serve you. It can be things that you're just doing subconsciously and automatically that don't add any value to your life. I mean, you know, good exercise is to pause the podcast and go look at your calendar right now and really scrutinize everything on that calendar and ask yourself, you know, does this appointment, does this meeting, does this, you know, family activity contribute to my overall happiness and well being and a Lot of times these things don't, you know, we can get rid of a lot of negative things from our life. As far as adding things, I think that, I think that optimizing everything in our life is a good idea. So whether that's your health, whether that's practicing mindfulness or meditation or any kind of meditative practice, exercising, eating well, limiting alcohol, I mean, all these things are little nudges in a direction, right? So you may not be able to solve all your problems doing yoga or meditation, but it's probably not going to hurt you. And it might make your life, you know, 4% better. But if you do 10 things that nudge you in a direction, it can really have a profound effect over time.

That's very wise. You're brilliant in many, many ways. Now I see why you're able to match into radiology. But what you're talking about is being intentional. Being intentional, filling your life with those things that bring you fulfillment and eliminating things from your life that don't. I mean, it really is a simple concept, but how difficult is it to do? I mean, both at work and at home, this is, this is tough to get rid of the crummy stuff in your life. You know, I've been working really hard on doing this the last couple of years, two or three years ago, I think after hearing Dyke Drummond give a talk about, or he showed some Venn diagrams, you know, between your ideal life, your actual life and his. His comment was if you could get those to overlap by 80% or more, then you're not going to feel burnt out because you're doing exactly what you want to do. And so we actually drew up what our ideal life looked like at that point and have spent the last two or three years trying to synchronize our actual life with our ideal life, you know, with some success and some failure in that respect. But I agree that being intentional and actually stepping back and looking at your life, trying to figure out the things that are adding value and adding wellness is pretty important.

Yeah, we do so many things on autopilot and I like the way that he, that he frames a lot of things with respect to burnout and you know, how many of us are. One analogy that he uses in either a blog post or maybe his book is that we're on this train track and there's only one set of rails. There's no, there's no decisions or turn offs. And you find yourself at, you know, in your 40s looking back and you wonder how you got here and you just don't remember making these decisions or being intentional and. Yeah, so I, Yeah, I completely, completely agree. And, and just to go off on a little tangent here, you. You mentioned that. That these things are. Are simple, and they are simple. I mean, as you know, personal finance is extremely simple, but none of these things are easy.

Right? Exactly.

And you have to make the distinction between those. I mean, there's so many things that are just really simple when you boil it down to its essence. But we're humans, and we're really flawed, and it's, It's, It's. It's not easy being a human, for sure, navigating these things.

It's a lot like weight loss, right? I mean, weight loss is not complicated, but it's not easy either.

Exactly.

So I think you're exactly right there. Now, you moved in at some point to start a blog. You felt like you had something to share with the world, something to share with somebody else. What, what possessed you to start blogging again?

I think it's. It was multifactorial. When, when. When I emerged from the burnout, I looked back on. On how I did it. A big part of. Of my healing and the process I went through was reading other people's stories and reading other people's blogs. One of the first ones I stumbled on was Pete's blog, Mr. Money Mustache, and that was instrumental in framing these ideas of financial freedom, his kind of stoic philosophy, and all of the things that he talks about. I stumbled on your blog and learned a lot about personal finance from a physician standpoint. And I realized that I had this unique experience because when I was going through it, there was nobody exactly like me that was describing these things. And I decided to put my. I had all this information in my head, and I just needed to get it out, get it out into the world and see if anybody could use it. And, you know, if somebody reads my blog and can nudge their life in a positive direction, all the better. The other kind of tragic event that nudged me along, too, maybe even more, was that early in the process, before I really started writing, a good friend of mine from medical school died of suicide. And I'm not sure how much of that had to do with being a physician or, you know, the kind of guilt and shame that comes with going through depression or whatever when you're a doc and feeling like you can't quit. But, you know, if my writing could help somebody else not go through that or nudge them in a positive direction, I just. I felt compelled I felt like I needed to get my story out there.

So what is the message? I mean, what's the 32nd elevator spiel for your blog? What's the point of it?

So we should seek to maximize happiness in our lives. And usually this is done by increasing our freedom. Not only freedom to do the things we want to, but maybe more importantly to have the freedom to not do the things that don't serve us. So I look at freedom and happiness and how they're related and mainly write about that. I write about really anything that pops into my head. But those are my main underlying meta messages of the blog.

Now, clearly it's resonating. I mean, I'm looking here at the front page of your blog. You've got over 3,500 people that have given you their email address because they want to read everything you write. So clearly your message is resonating with people and is growing. I find it interesting that you focus so much on freedom because particularly for a doctor, especially at the beginning of the career, there's very little freedom. I mean, you go into this training pipeline as a pre med and then medical school and then residency and then fellowship, and at that point, you know, you owe two or three or $400,000. You're really locked in. Even if you're living like a resident, you're locked in for another two to five years just to pay off medical school, not even getting yourself anywhere near financial independence just to get back to broke. And so we're deliberately locking ourselves in, eliminating a lot of freedom, just as by our career choice. And then to turn around at age, you know, 30, 35, 40, and say, you know, increasing freedom is the way to happiness. I think that's a difficult transition for a doctor to make.

Yeah, for sure. And I think we as physicians self select. I mean, we're not an average population, right? We go through all these things and the training process not only changes us, changes us, but we are a different population that goes into it. You know, we, we do give up a lot of freedom. And we, I mean, anybody who's gone through residency knows that you, you're, you have no freedom in residency. I mean, you're basically all your time is accounted for. And it, it's a little bit difficult to get out of that mindset once you start practicing. But the, the problem is that a lot of docs get into, get into practice and they need the freedom because there's this such, there's this high level of burnout, there's this abnormally high Level of suicide and having freedom and training yourself to cultivate this freedom, I think is really important. I think it's sort of immunizes you to some extent, protects you from a lot of the bad things that can happen to you with respect to your career and burnout and all these complex issues.

So is burnout as simple as taking back that freedom that we gave up when we got into this pipeline?

No, I don't think burnout is simple at all. I think a lot of people try to make it simple and say it's, you know, it's just one thing. It's, you know, if we could just change this, we wouldn't have burnout. I think as a combination of the medical industrial complex, for lack of a better term, kind of what medicine has become, I think it's become a lot less satisfying to be a doctor over the last 10, 20, 30 years. Just kind of working, looking at trends in medicine, there's a lot more things to do that have nothing to do with taking care of patients, measuring things and doing metrics and navigating poorly designed EMRs and things like that. Those contribute to burnout, but also external things to the job. As a physician, we're constantly working sort of on the edge of the danger zone all the time. You know, many of us, not all of us, but we're working in these very stressful jobs and there's very little margin for error. So when something does go wrong, there's a high failure rate, there's high risk of depression and all these other things.

You know, that gives me a good segue to go into one of the questions that I got on Twitter. This one comes in from Jeff Howe, who wanted me to ask you, do you think that the erosion of the patient physician relationship is contributing to burnout and job dissatisfaction? And if so, what's the long term solution to that?

So I do think that that's a factor, definitely. I may not be the expert on that because as we establish I'm a radiologist, I don't have a lot of patient contact anyways. So my interaction with the patient hasn't really, hasn't really changed. But, but what I have seen change over the course of my career is my role and my interaction with referring physicians. You know, it used to be that there was a lot more one on one interaction, people coming down to radiology to look at films. And now of course, everything is on packs and people are too busy to come down to radiology anyways, unless it's something, you know, really necessary.

It's interesting you say that. You know, I mean, I think I'd been at my job for a couple of years before. Before I knew where the radiologist sat.

Yeah.

You know, and oftentimes they're not even in the hospital.

Yeah, you probably know all of their voices, but you may not recognize them if they were, you know, sitting next to you at a restaurant or something.

That's exactly right. That's exactly right.

Another question.

Go ahead.

Go ahead. Yeah, go.

I was going to give you another question from Twitter. This comes in from Doc G and it's a little more specific to your blog, but he wanted to know how come you didn't use use your status as an MD in any of your blog branding. It's called the Happy Philosopher. There's really nothing there that says you're a doc. It doesn't seem dramatically aimed at docs. How come?

Well, it's a good question and it's relatively simple answer. When I started blogging, my intention wasn't really to write a blog that was specific to physicians. The goal of my blog was really for me just to get my thoughts out there onto the Internet and let people do what they want with them. And it wasn't until later in the blog that I really started writing about more physician specific topics and telling my. I mean, it was a while before I even told my story on the blog. And the reason I keep writing about that stuff now is that it resonates with people. You know, some of some of my posts that get the most traction that are physician specific. So the blog sort of evolved into what it is. I mean, I have a lot of readers that aren't physicians and you know, just read the blog because, you know, they want to hear my thoughts on whatever random thing is bouncing between my skull. But then there's a lot of people that come on there just to, to sort of relate to me as a physician, hear what I have to say with regards to that. So it. I didn't start out with the intent of being a physician blogger. I just wanted to get better at writing, get my ideas out and have fun.

Now as I look over the blog and I think as my listeners here check out Happy Philosophy, the happyphilosopher.com they'll notice that this is what I call a pure blog. You know, I've told people a lot of times that blogging is not a business, that blogging is sometimes associated with a business, you know, some sort of online entrepreneurship thing. But yours is a pure blog. It doesn't appear that you're really monetizing at all here. Is that intentional? Is that something you plan to do in the future with the blog, or you just really haven't decided what you want to do with that yet?

I think it's a. I think it's more of the latter. I just haven't decided what to do with it. I've, I've thought a lot about where I want to, where I want to take this. And, you know, I thought about doing things like, like speaking, for instance, or coaching or consulting. And I have a lot of ideas that are bouncing around in my head, but I, I, yeah, I haven't, I haven't done any, any serious monetization just because I'm, it doesn't interest me. It sounds like, it sounds like added work and added stress and for, for probably not that much, especially for somebody.

Already working as a radiologist.

Right. Yeah. I mean, I mean, I make, I trade my time for money at an infinitely higher rate doing, you know, reading MRIs than I, than I would blogging. Unless for some reason, you know, my audience grew by leaps and bounds.

So do what we can to help with that. And you worry about that later.

Yeah, I just want people to read it. As long as people are reading it and getting something out of it and improving their lives, that's enough payment.

I love to see that. As my listeners know, my blog's basically been a business from day one. I had ads up on it the first week before anybody was ever reading it. And so I always find it interesting to. About talk, talk to other bloggers that, I don't know, I guess I just view it as more pure. They're literally blogging just to get their ideas out there and just to help people. I think it's awesome. I think I'm just not quite selfless enough to do it so well.

I mean, you know, it's, it's. There's nothing wrong with, with monetizing a blog. I mean, if that's what keeps you motivated and you believe in the message and, you know, I can see, I see both sides of it, and it's a, I think it's a very personal, just a very personal decision. It's not a right. Right or wrong way.

Yeah, for sure. Now, you've been blogging a lot lately about not buying anything at all this year. How come you're doing that and how's that going?

Yes. So I tend to just like to do crazy experiments every now and then. I think that, I think that doing these quote unquote extreme experiments can really allow us to learn something about ourselves. And I've done a few of these. I've done, like, for instance, I did an experiment where I abstained from alcohol for six months. And I really learned a lot about myself and about society and the interaction between the two by doing that experiment. And I don't actually know why I started this experiment. I think I was a little bit sort of disappointed or disgusted by looking around my house and still seeing all of this stuff, even in spite of decluttering and getting rid of a lot of things. Maybe I'm romanticizing kind of the minimalist movement of owning, like 20 things or whatnot, but I decided to just see what it would be like to not let any new clothes come into my life for a year and wrote that post. And then, you know, like, with most. Most of my posts, a lot of the comments are supportive and, oh, hey, that's great, and I'm gonna try this too. But there was one on there that, that said, you know, that's. That's not a challenge. I mean, look at you. You've documented all your clothes here, and you have enough clothes to last, you know, multiple years and multiple lifetimes for most of us, right? And I said, you know, this. At first I was a little bit defensive and kind of like, whatever. And then I thought, this guy's absolutely right. I mean, it's kind of like saying, you know, having a wine cellar with a thousand bottles of wine saying, you know what? I'm not going to buy a single bottle of wine this year. You know, that's just not a challenge. So I decided to expand it to stuff. Not buying any quote unquote stuff this year. And of course, there's a lot of caveats and, you know, things that I don't consider stuff like, you know, grocery store items and, you know, not going to stop buying toilet paper and toothbrushes and things like that. But I wanted to challenge myself and just see what it would be like not to let any new things into my life and just be really intentional about the sort of stuff that I was letting into my life. And I'm only about a month and a half into the experiment, so it's really not. It's not very hard yet. But, you know, check back with me in November and I might be quite, quite distressed by this experiment. We'll see how it goes. It's gonna be a fun one.

It's fun to watch, for sure. You wrote a different blog post not that long ago about the cult of productivity. And I think once I read the post, it kind of got more into medicine and how we're always being pushed into being more productive in medicine. But I thought about it both in regards to medicine as well as in our regular lives outside of medicine, and I suspect that my wife and I are card carrying members of the cult of productivity. Tell us why this is bad and what can and should be done about it.

Yeah, well, I think, you know, in this country we're all, you know, pushed to be more productive. It's sort of a virtue that we hold, that we hold on a pedestal because the opposite of it is unproductive. And I mean, who would want to be less productive? And productivity is good and bad. I mean, we need it to get things done. But when we sort of worship productivity and it becomes an end instead of a means to an end, then I think it can become really destructive because we always have to, I think, go back to first principles and ask ourselves why, you know, why are we, why are we being more productive? And why do we, why do we have to do more and be more efficient and do more. I mean, some is good, but it's like this whole concept with finance of enough, you know, at some point we just have to be satisfied with being productive enough. Because when you focus too much on productivity, I think it can lead to stress and anxiety and burnout and all these other negative things. And then it becomes counterproductive because you're actually less productive and less efficient when you're going through burnout, when you're unhappy. I mean, that's, that's one of the things I noticed about my burnout is that one of the big symptoms was I just wasn't as productive. I had to take more time, I couldn't go as fast, I was more distracted. So trying to be more productive was actually making me less productive. So yeah, I think it could be dangerous. But of course, everything in moderation.

All right, my next question is going to be very general, very free flowing. I'm going to let you take it any direction you want to. But if you had to name three things that you think physicians get wrong most of the time, what would they be?

Three things. So I think the first thing that physicians often get wrong or trap, not get wrong, but a trap they fall into is they, they think that they are their job, that their, their identity and ego gets tied up with being a physician. Like it, like it does with few other careers with, with the level of intensity. And I mean, this isn't necessarily bad. Again, in moderation, because we need, we need our ego to get us to do things. And, you know, we identify with all sorts of things. But when things go wrong, as, as a physician, you know, if you go through. So you go through a malpractice lawsuit or you're going through a tough time in your life, or you're going through burnout, when, when you are your job, you, you feel a lot of shame when, when, when that fails, when that falls apart. And shame is such a toxic emotion. And if, you know, I think that's a lot of time, what leads people to suicide and to not being able to detach and change because they just can't. They can't leave it. It is them. It's leaving medicine or quitting or unwinding or healing is destructive to their ego. So I think that's, that's a big thing that can go wrong. Of course, it doesn't go wrong for, for a lot of people, but it can.

Okay, so number one is don't be your job. What would number two and number three be?

Let's focus a little bit more on the personal finance side of things. I think that when docs come out of training and they get those big doctor paychecks because there's this huge difference in, in the amount of money you make as a resident and usually as an attending, and it's jarring, I mean, to see the difference. And it's so sudden because you just start and you have all this money pouring in and you get this idea in your head that you don't really need to worry about money anymore. You don't need to be frugal, and you really do. I mean, if you want to have some degree of freedom in your life, you. You really do need to be. Still be efficient and frugal and, and mindful of your money.

I think I need to tell the listeners that I didn't prompt him to say that before this started, but it's so important to live like a resident. It's so important to grow into your income as slowly as you can, because it really is the big financial change of your life. And, and if you don't manage it well, it'll swallow up the whole rest of your financial life. All right, what's number three?

Number three, again, this is maybe related to number two. And I know so many docs, just so many that know absolutely nothing about personal finance. And I think that they, they just assume that they, they don't need to know. But docs make the same mistakes with with respect to personal finance that a lot of other people do, but they have bigger piles of money to do it with. So it has, it has a big effect on them. And yeah, I think that just having a basic financial education is very important for docs. And I just, I see so many that just don't even understand really simple concepts.

That's a great segue. And since this is a financial podcast, we probably ought to talk a little bit about finances during this time. Tell us what your financial philosophy is.

So my financial philosophy is pretty simple and so I'll liken it to the book you, money or your life. I imagine that a lot of people are interested in personal finance have read this book. It basically equates time with money. For most of us, we trade our time for money. So money is this tool, trade our time for it, and then we use this money later on to spend it to bring us necessities, comfort, happiness. So my philosophy is to try to be as efficient as possible with your money, which is just another word for frugality. Although frugality has more of a negative connotation than efficiency, especially earlier in your career, because most docs are not going to go through burnout to the extent that I did. But if you do hit something tough, your life, burnout or anything, it's really nice to have a financial cushion, to have some degree of freedom, maybe not financial independence, but, you know, at least being solvent and having, you know, some backup plan, some, some escape route if you need it. And then, of course, spending more usually doesn't bring you more happiness. In many of the instances that we try to spend our money to buy happiness, and a lot of times that doesn't work. So my philosophy is to figure out what makes me and my family happy and how can I spend money to increase those things. And then all the other stuff, you know, I really don't need to spend money on that. I can direct my money towards things that, that make me and my family happy. That's really it.

Yeah, I think that cushion is so important. In fact, I was just finishing up a shift yesterday and our managing partner was taking over for me at the end of the shift and we had a short discussion and it turned out that we just switched into a new EMR at the beginning of the month and somebody screwed something up. And the bottom line is none of our charts have been sent to the billing company in the last month. And so our business literally is going to have no income whatsoever for about a month long period here in about a Month, you know, and, and what does that mean for us as partners? Well, that means we're probably not getting paid that month. And in fact we've got to come up with a solution to cover our expenses, our overhead, our employee physicians and PAs and you know, all this other overhead that we have, whether that is us contributing money to the pile or whether that is borrowing money. And it was nice to be able to sit there and go, this is a purely academic decision discussion for me. It won't affect my lifestyle at all. And part of that's because I got the side income from the white coat investor, but part of it is simply because I have an emergency fund, you know, a month's worth of expenses for us. We've got six months worth of expenses sitting in a money market fund. You know, literally not getting paid for a month is, does not affect my life in any way, shape or form. And I think that's a place that more docs ought to be at, at least by the time they're a few years out of retirement residency.

Yeah, yeah, absolutely.

So let's talk about your investments. What do your investments look like? I mean, what's your asset allocation? If you had to explain it in 20 seconds, pretty boring.

I imagine. I do the same thing that a lot of other docs do, as much as I can in retirement accounts and tax protected stuff. Mostly I invest in low cost index funds. I would say, I don't know the exact allocation, maybe, maybe an 80, 20, 75, 25, something like that.

Now like many finance, I guess you're not really a financial blogger, but like many bloggers, physician bloggers, you're in a specialty that makes pretty good money. What message do you have for the pediatricians, family practice docs, military docs, academics, other low paid physicians with regards to, to finances?

I think I would tell them the same thing that I would tell a higher paying, higher paid doc is that, I mean really personal finances is very simple. You make money, you spend less than you make, you invest the difference wisely and you try to avoid or hedge against catastrophe. I mean the only thing that really matters is your savings rate and that can be influenced by the amount of money you're making or the amount you're spending. I mean the median income, household income in this country is what, like 59,000. So even the lowest paid doc in practice is making usually a lot more than the median income. So you know, stay, stay the course. Let, let the capital markets and, and work for you or whatever you're investing in. Let the Time value of money and compounding do its thing. Be frugal, you know, but don't, don't, don't be cheap, but be frugal. As far as the more tactical things, I mean, you know, there's quite a bit of variability in, within the specialties, you know, the pediatrician, you know, the variability in income from a pediatrician can, can be wide. So you can always seek a job where you can maximize your income within your specialty. You know, don't live in a high cost of living area, but you know, there's a lot of things you can do. And ultimately life comes down to decisions. You know, you can have anything you want, but you can't have everything you want. If you want to be a single household income pediatrician in a lower paying job in New York or San Francisco, I mean, there's decisions to be made. It's going to be tougher to save money and become financially independent for sure.

Now you've said that news is toxic and should never be consumed willingly. How come?

It's a pretty, pretty bold statement, isn't it? So, yeah, I kind of rail against news and the reason I do is because I realized that when I was consuming a lot of news and a lot of information when I was in burnout and before burnout, and I realized that, that it didn't really, it wasn't healthy. News is not really designed to inform us. And I know some people are going to think that that is a crazy thing to say, but it's designed to cause anxiety and want us to consume more of it. I mean it's, it's, it is, you know, most of it wastes our time, most of it is not actionable and it doesn't make us happy. So I'm not advocating being uninformed. I certainly think that being informed is important. But consuming news is probably the worst way to do it. The really important stuff will filter to you through other people or just kind of living in society and reading deep, deep work and books and things like that. But you know, 24 hour news cycle is 99.9% useless.

That is so profound. I think I get sucked into the news cycle all the times and all the time and it's gotten shorter. You know, it's less than 24 hours now with Twitter and Facebook and that sort of thing.

Yeah, do a 30 day fast. Just cut yourself off from news for 30 days and see what it does. It's a great experiment to do. It's low risk, it's amazing.

I bet it would make me happier, quite honestly. Which brings me to my last question for you. I think we're going a little bit long here, but that's okay because this is such great stuff. But my last question for you is what can doctors do today to be happier?

So there are a lot of things I think, think that we can do. I'm a big believer in trying a lot of little things. So let's first talk about the things inside your job. So I think it's worthwhile trying to figure out what your pain points are in your job and then taking little steps to try to fix them. And you won't be able to fix all of them, but there are really a lot of things that you probably can fix and figure out what the worst part of your job is and try to fix it. Whether it's the emr, whether it's your schedule or whatever, I don't know, I can think of a dozen examples. But try to fix something in your job. Start by saying no to things that don't add value or make you happy. Look at all of your commitments, look at your calendar and really sit down and think about the things that are adding value to your life and the things that are not adding value to your life and try to get rid of them. That will probably make one of the biggest differences. It's all about just decluttering things that are negative. The last category I think is take care of yourself, take care of your mind and your body. These things are not miracles. But you know, if you're in a toxic job, you're going to do better with a healthy diet, getting some exercise, you know, doing some meditation or yoga or all, you know, those things that people make fun of on Twitter. You know, take some vacation, take some time off. All those little things, just self care stuff is going to help. It's going to help. It's not, it's not going to cure a toxic job, but it's, it's going to help. And I think lastly, if you're in a really bad place, you know, if you're depressed, if you're severely burned out, if you're having thoughts of suicide, get help. I mean, you know, figure out a way to get help. Talk to, you know, coach or a therapist. You know, it's complicated because physicians I think have a lot of fear of seeking help and sometimes rightfully so, because they get, you know, they can be punished in some ways for seeking help, but if it's severe enough, you need to do it, especially if you're suicidal.

Jeff thank you so much for coming on today. This has really been an incredible interview and I think is going to end up being one of our most popular podcasts. I really appreciate you coming on today.

Oh yeah, thanks. Pleasure's all mine.

Wasn't that wonderful to have Jeff on? I thought that was really a profound podcast. I mean, I learned a lot from it and I thought of a few things that I could really do in my life, stuff that I could toss out of my life that honestly would make my life happier. I hope you felt the same way about the podcast.

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Thank you for leaving us a great rating on this podcast that really does help spread our message across the country and across the globe to other physicians. I've been surprised. I'm starting to get a little bit of feedback from UK doctors who have been reading the book blog and the book and so on and so forth. And so it really does have more reach than sometimes we know. Head up, shoulders back. You've got this. We can help. We'll see you next time.