This is Physician Finance Interview #13, which is part of a series of posts is published each Friday. If you’d like to read the other PFI posts, you can find them here.
The focus of the interview is to investigate how other doctors have handled their money, income earning potential, assets, debts, and much more.
Tag along as we discuss success, failures, and advice that I hope will prove useful to many! Please, leave comments below about the answers and your thoughts!
My questions are in bold. The answers then follow.
If you are a medical professional of any kind, email me if you are interested in being interviewed and sharing your stories and experiences. The questions below are emailed to the person being interviewed and responses are returned, formatted, and published.
Your Story Background
1. Take a second to tell us about yourself so that others can see if their story relates.
I am a 58 year old general surgeon living in the Pacific Northwest.
I am married, with one child, and 23 years out of training. My entire medical training ran 12 years, to age 35, yielding board certification in general surgery and fellowships in burn surgery and cell biology.
I am semi-retired as of January 2018, semi-voluntarily and semi-compulsorily due to a marvelous, technicolor version of burnout.
2. What is your financial background?
At age 28, as a second year resident, I bought the only house I could afford on a residents salary with a federal mortgage interest credit program.
Early in training, I was introduced to a full service broker and invested small sums in an after-tax account, as I had no access to a qualified plan until my clinical fellowship in 1994-5. That was my first introduction to investing and I maintained that relationship until 2007. I asked a lot of questions, but didn’t learn much about how to analyze and choose individual equities during that interval.
During my clinical fellowship in 1994-5, I made the maximal allowable contribution with the employer match through TIAA/CREF. I still have that account and it has yielded about 7%/year on a $3000 contribution. That was my first retirement savings at age 34-5. I invested a great amount of sweat equity and earnings from moonlighting into my home, and the home appreciated about 2 fold over my costs in 6 years.
After entering practice, I participated in the practice qualified plan as soon as the contract allowed, and started seriously putting away deferred income in 1997 at age 37. I maximized contributions to my qualified plan until December 2017 (20 years). I intended to do so until age 67, but life happened in spite of my plans.
3. Were you given a head start in the financial world in anyway? Let us know if the opposite is true, too.
My father was a physician, and he supported me through junior college, 3 years of liberal arts undergraduate education and 4 years in a University of California medical school.
The total tab for those 7 years was about $60,000 and I contributed another $15-20,000 in wages from working summers and during the school year when and where I could.
4. What is your current net worth? List the assets that compromise your net worth.
I don’t keep strict track of my net worth, but my net worth is in the neighborhood of $2,500,000
5. When you finished training how much student loan debt did you have?
Dollars & Debt
1. List your current sources and size of debt.
I have a sizable amount (nearly $700k) mortgage debt financed at slightly under 4%, on $1.2 million in property value. I have a secured line of credit with variable debt levels, under 200k, used for two business start-ups and short term support for living expenses between retirement and the subsequent source of income.
We don’t carry any consumer loans and we pay credit cards monthly.
2. If you had/have student loans, what is your student loan repayment plan?
I had a bit of undergraduate student loan debt, but paid it off with wages before graduating.
3. If you have a mortgage, do you plan to pay it off early or invest in the market? Why? If you don’t, why did you decide to rent?
I doubt it will be possible to pay off my mortgage before we sell the place some day, unless one of my businesses succeeds beyond our imagination.
We are mitigating the cost of the property through building on-site rental capacity for in-laws, other close family and either law or medical trainees. We will reduce our monthly carrying costs by half when that capacity has been achieved.
Income & Spending
1. What is your household annual income and will it be changing in the near future?
As I began to realize that I probably wouldn’t make it to standard retirement age as a full time burn surgeon, I began to make adjustments to be able to live on half of my peak earnings.
I have two business start-ups, both started in 2018. Neither will pay me much in 2018. One has the capacity to be profitable within a few months of opening, the other is considerably more risky and wouldn’t be expected to start paying it’s owner in the first 3 years or so.
I am filling gaps with limited amounts of locums contract work.
[Editor’s Note: This section was previously incorrect. It is now correct as stated by the interviewee. TPP]
2. Do you use a monthly budget or track your spending? List your major expense categories for each month in your budget/spending.
We monitor our expenditures and follow category based tracking of checking and credit/debit accounts but have not been strict budgeters.
I maximized my qualified plan, shoveled plenty of money into cash value whole life insurance to the tune of about 100k per year total deferral, then we simply spent the remainder, first on home mortgage, then on private school, and after that on general cost of living categories.
We do not live extravagant lives from the standpoint of material belongings.
3. Does giving to charity or causes you believe in play a part in your financial life? If so, what percentage of your annual income goes towards this endeavor?
Saving & Investing
1. Do you have an emergency fund? Why or why not?
We have always had cash equivalents against which we could easily borrow for emergencies, so we never kept more than 2-3 months of expenses in cash.
We had home equity credit lines, secured lines of credit against assets, cash value insurance loans, but I never let money sit idle in my checking/saving accounts.
2. What percentage of your income do you save towards retirement/investments each year? How did you determine this level of saving?
My pretax savings have been the federal maximum with employer matching since I became a shareholder in my practice. The life insurance savings approximately doubled our overall savings rate above the qualified plan contributions. I chose to put all of my pretax and after-tax investment dollars into tax deferred and tax exempt investments so as not to deal with capital gains taxation, tax on interest and distributions.
[Editor’s Note: This section was previously incorrect and carried forward from a prior interview. It is now correct as stated by the author. TPP]
3. You mentioned your assets above. What is your investing philosophy?
I do not speculate.
I have learned many lessons as a self directed retirement investor in the last 11 years. Now, I am a dividend and income investor, with my eye on total return with a significant “pay me now” and dividend reinvestment component to my strategy. I put all my effort on the buy side and rarely sell.
I rarely re-balance, except to supplement positions as new money becomes available. Nearly without exception, I purchase mid-to large cap, blue chip equities that pay above the market median in quarterly or monthly dividends. The metric to which I pay the most attention is the growth in cash flow through the portfolio from all sources.
I have dabbled in selling cash-covered puts and selling calls as well. However, this is a labor intensive hobby and I participate in that hobby very sporadically. I hate funds in general, but use them selectively in areas where I have no insight into market leaders and with international equities.
Emerging market bond funds have done well for me in addition to deeply discounted corporate mini-bonds between 2008 and 2013, which I liquidated when their values approached par value.
Alternative Investments Outside of the Market
We have owned real estate in the form of rentals, have been a limited partner in in-fill development, but my favorite and only current form of real estate investing beyond my home is in equity REITS. 15% of my retirement portfolio is spread across the REIT sector. I also let Schwab have a modest stake in my portfolio for their dividend-growth EFT (SCHD).
I consider social security to be the fixed income component of my portfolio. It will amount the equivalent value of about a $600-700k bond component to my retirement portfolio.
I continue to keep a substantial balance in cash value life insurance, although I have reduced the death benefits over the years to cover a steadily shrinking future earnings estimate as I approach retirement. The cash values have caught up to the declining premiums and I no longer have to feed these entities and they will grow from this time forward as dividends pay the premiums.
I have never looked at them as “investments”, rather as enforced savings and a safety net for my wife and son should they lose my earning capacity through an early demise.
4. If you could tell other doctors about one thing you’ve learned about saving and investing, what would it be?
To embellish on that theme, I much prefer tax deferred or tax exempt vehicles. I believe the earliest savings should go into index funds or very low risk, widows-and-orphans style equities, as they will have the longest time to work and should be protected from the shifting winds of markets.
5. If you have kids, are you saving for their college education? Describe where and how. For those with kids who don’t plan on saving for their college, please tell us why.
I consider my cash value life insurance to be my son’s 529-plan equivalent. My mother, at age 90, will not outlive her assets, and is likely to leave an estate which will result in somewhere around 250-400k windfall to my family within the next 5-7 years.
My wife’s folks are in their 80’s and increasingly frail, and we anticipate some degree of support, but to our good fortune, they have 4 children, 3 of whom have adequate means to provide meaningful support without a major sacrifice.
Retirement Goals & Gaffes (Mistakes)
1. What is “your number” and your age that you feel will allow you to retire? How’d you arrive at this number; give us some details.
Well, I guess I have already “retired”, as I am no longer doing what I was trained to do.
However, I never had a view of retirement as a life of leisure, filled with travel or golf or fishing. Retirement is more like redefining my contribution to others by taking what I have learned and transforming it into new ways of continuing the mission that are compatible with my age, energy, and tolerance for the business of medicine.
My first questions about every engagement are “is it fun?”, “Would I do it for free?”
We have lived relatively modest lives to this point and have little desire to change our habits in retirement other than spending more time tending the homestead together and working for our souls rather than our pocketbooks.
2. How much will you be spending annually in retirement? Give us some details.
We’ll spend just enough to cover living expenses and favored activities.
My goal is to live on social security, dividends and distributions, rental income and part time employment until my eyes, ears, hands and back are no longer able to support my motivation.
3. If you plan on retiring early (before age 65), how do you anticipate handling health care costs?
I can cover expenses on 7-10 days of work per month as a surgeon. That lives 2/3 to 3/4 of each month free to pursue other interests.
At the moment, Locums are filling that need, while a super-subspecialty, outpatient-only part time clinical practice start-up is about to go live. If it is successful, I’ll stop traveling to take work assignments, but I don’t plan to do any more than 8-10 days/month of clinical work and hopefully NO hospital-based care going forward.
4. If you plan on retiring early (before age 65), how do you anticipate handling health care costs?
Covering health insurance costs is the single most uncertain factor in the years between full time employment and Medicare eligibility. We have to solve that in another 12 months when our COBRA coverage is no longer available.
Advice & Farewell
1. What advice would you give to The Physician Philosopher readers who may be a younger (or current) version of you?
Unless you want your epitaph to be “wish I had worked some more”, find ways to deploy your knowledge, skill and experience to have adventures of your own, rather than crash and burn at the salt-mine.
2. What is the toughest challenge facing physicians who are just finishing training?
Maintaining optimism and altruism in a world where there is less and less autonomy and more limited rewards for the hard work.
3. What is the top financial mistake you see your colleagues making that you would advise our younger physicians and trainees to avoid?
They are very risk adverse on behalf of their patients, and almost recklessly naive about how their retirement assets are being managed. There is educational content everywhere, but you have to pick it up and read it.
4. What are the top two-three resources you would recommend to a reader outside of The Physician Philosopher website (book, blog, podcast, etc)?
Chuck Carnevale, David Van Knapp on Seeking Alpha and elsewhere on the web; Sure Dividend blog.
5. What questions do you have that TPP readers might be able to answer?
Thanks for taking part in the Physician Finance Interview Series!
For anyone interested in taking part, shoot me an email.
[Editor’s Note: A prior version of this interview had two mistakes in it that were not originally caught due to carrying forward the interview questions: The income of the interviewee and the interviewee’s response to question #2 in the Savings & Investing section. It is now correct as states by the author. TPP]