5 Job Titles Instead of Saying You Are a Doctor

Don’t tell me you’ve never done this: deliberately avoid revealing that you are doctor. Whether it is like White Coat Investor, who rightfully thinks that he may get a better deal if the sales person doesn’t know he’s a doctor, or it is awkward at a dinner party after a crowd just made a series of doctor jokes (not suspecting that there is a doctor in their mist.)
I’ve deliberately concealed the fact that I was a doctor while shopping for houses.
So here you go, I think these job titles are ring true to much of what we do. Technically, we are not lying when we saying, “I am a __________” from choices below. I’m sure you’ve come up with more creative and funny alternate job title for practicing medicine.


Ø  Customer satisfaction specialist
More and more nowadays, especially with the health care provider ratings all over the internet, patient satisfaction is paramount to compliance, health outcomes of patients, and ratings and corresponding reimbursement for doctors.


Ø  Teacher
Doctor means teacher in Latin. We teach ourselves, each other, and our patients’ day in and out. We are in the business of life-long learning, and teaching.


Ø  Solutions Specialist
We diagnose problems, and then propose solutions. We solve problems all days. We love the challenge of identifying and solving problems.


Ø  Secretary
The amount of paperwork required by insurance company is ever-increasing, eating up 1/6 of doctor’s time. We can pretty much call ourselves paperwork junkies by slang.


Ø  Indentured servant
Medical students today have 3 choices, pay medical student loans for 25 years on IDR (income driven repayment) and receive taxable forgiveness for the remainder, for 10 years on IDR (income driven repayment) while working PSLF-eligible job and receive tax-free forgiveness for the remainder, or refinance to a lower interest rate and pay it off aggressively.

Regardless of which way they chose, it’s a lot of money before the debt is paid off or forgiven. When 5k per month of income go towards paying off student loans, or 10k+ monthly if one’s more aggressive, it does approximate indentured servitude.


 If you like this article, you might enjoy other DWM articles on Personal Finance, Investing, Retirement, Practice Management, & Lifestyle.

All articles by DWM are for informational purposes only and not intended as a substitute for professional advice. Please consult a professional accountant, financial adviser or lawyer, before making financial decisions.

5 Lessons a Harvard-Stanford Trained Radiologist Taught Me

I recently had to see a dear mentor off, as she leaves UA medical imaging to join her family on the East Coast. She was a gem in our program. Many people were really sad to see her leave, but we are happy for her choice to be closer to family.

She has been an inspiration to me the day I started radiology residency in July 2015. Not only is she incredibly knowledgeable, but her empathy and her work ethic are among the best that I’ve ever come across in my personal and professional life.

I’d like to share the top 5 things she taught me by example.

1.       Work hard.

Given her academic/professional stature and shear intellectual prowess, she can choose the path of hardly working rather than working hard. Yet she persists to work the hardest she can. Her work ethic inspires and reminds me that effective leaders lead by service and example. The best way to increase the efficiency of your team is to increase that of your own and thereby setting an example/standard for others. Because of her example, I decided to become more aggressive with grabbing studies and working harder than ever. When any resident who “likes to take it easy” is on service with me, instead of complaining about additional workload, I see it as a golden opportunity for me to work harder, grab more cases, and learn more. She was totally right, working hard in the end benefits me more than anyone else because the more I do, the more I learn, and the better/stronger I become as radiologist and an individual.

2.       Don’t take kindness and generosity for granted.

As I began to furnish my 2nd/dream home (while my partner keeps our first home in Tucson), she gifted me so many things. I felt so grateful when we picked up the wonderfully cared for household items/furniture from her home. During our last trip to her home the night before her flight, she even made dinner for us. By all standards, she went above and beyond to help and nurture me, one of her 36 residents at University of Arizona during 2015-2016. I was speechless to receive such undeserving acts of kindness from her. Seeing how she has given so generously to me and many others, I also see how not everyone realizes how lucky they are to receive her graciousness. So this taught me to appreciate those rare creatures like her. Before I take someone else’s kindness for granted, I will remember her, and remember to pass on and reciprocate acts of kindness.

3.       Love and give to others as much as you can.

While we live in a world of competition, exclusion, envy, and scarcity, she builds an oasis of love, inclusion, admiration, and abundance starting from herself, reaching out to those around her. She gives and gives and gives tirelessly. Though it could be disappointing to see some take her kindness for granted, she manages to become an inexhaustible source of positivity. In a tight radiology job market, she got job offers from multiple prestigious institutions within a month when the word got out that she was leaving for Tucson. She was surprised at how much people from all over the country love to have her join their respective teams. Yet it’s clear to me how her loving, positive disposition compounded with her work ethic makes her an incredible asset to any hospital/academic institution.

4.       Respect everyone.

She’s always kind and respectful to everyone: colleagues, technologists, residents, patients, and visiting scholars. Even if she does not agree with a person’s work ethic or decisions, she still treats him or her with respect. I find this the hardest to practice. As I work hard and love working hard, I find laziness/sloth despicable and have low tolerance for it. So I find it amazing that she could accept someone at the other end of the spectrum from her end. I do though understand why she respects everyone. She values each human being intrinsically, regardless of their character traits.  Her respect for others speak greater to her character than those around her.

5.       Always do and be the same even when no one is watching.

She’s absolutely right on this. Whenever she says this, I recall the times when I cut around the corner with a U turn to circumvent a red light and other little acts that I won’t do if the authority is around and I can get in trouble. In the end, I might have saved 1 minute on my commute to work or had some other short term short-sighted small gains, it truly isn’t worth it. It’s just easier to be consistent and hold myself to the same standard whether someone else is watching or not. Plus, I do serve someone greater than myself. My God is always watching; He knows my every act. At the end of the day, being able to sleep at night and be at peace knowing I have done my best with everything is worth maintaining the same standard in all circumstances.

I think the top 5 things she taught me by example will make me happy and successful in all aspects of my life: personal, professional and financial.

6 Financial & Professional Advantages of the Small Fish in the Ocean

While it may seem nice to be the big fish in a small pond,

it is not at all the most advantageous position for rapid progress and ever-climatic serial successes. 


1.       Many to learn from in immediate surrounding.
While I am constantly reminded of how little I know when I surrounded by experienced and knowledgeable attending radiologists, I also enjoy the pleasure of learning from them even in casual conversations.


2.       Perceived value is elevated by the collective average.
This is why I like to purchase lower end homes in a high end neighborhood, rather than the most expensive home in an average neighborhood.
After I purchased one of the cheapest home in a highly sought after neighborhood in 2014 (as MS4), I sold it to family in 2016. (I like the idea of keeping great homes in the family.) I’m now looking for our next home. When I was faced with the most expensive home in a great neighborhood versus a low end home in an even higher tier neighborhood, I’m going for the latter again.


3.       Not perceived as a threat.
It’s unfortunate that envy is real and real at all levels and dimensions of human endeavors.  I notice that those not perceived as a threat tend to receive more collegiate support. Nurturing instead of competition.


4.       Not targeted.
The most luxurious home on the block will likely be the first to be robbed, when all other variables are held constant. Chinese saying goes, “Humans are plagued by fame, and pigs by fatness.” The fat pig is ready for slaughter, so is the famous, illustrious person, unfortunately.


5.       Abundance for all.
While it is more often than not the right mindset to know there’s always someone better than me, it’s also the right and self-fulling to operate on the presumed abundance rather than scarcity. The abundance mindset encourages collaboration rather than competition.
As many of my readers know, I’m big on “living gently on this earth.” I’d love to leave a little footprint as possible behind me, kill as few trees and cows as possible. Being the big fish in a small pond means that I’d more likely to be dumping on others, which I distaste. I much rather to be surrounded by fresh water in the oceanic immensity.


6.       The surprise element.
Mom always taught me to keep a little reserve, an art I have hard time of grappling with and practicing. I like to share all I know as quickly as I can and then move on to learning more.
But as I progress through my training from pre-med, to MS and PGY years, I am starting appreciate then surprise element. Instead of spending all my time on tutoring (which is superficially lucrative at $388/hour), I decided to cap the number of tutoring hours and invest the rest in being with my loved ones and advancing my own learning: as a radiology resident, as a personal finance blogger, and as a parent.
Sure I can put out more and make more money today, but I balance that with taking in and building the largest asset I have, my mind. I pace myself in sharing what I know while incessantly expanding what I know.


 If you like this article, you might enjoy other DWM articles on Personal Finance, Investing, Retirement, Practice Management, & Lifestyle.

All articles by DWM are for informational purposes only and not intended as a substitute for professional advice. Please consult a professional accountant, financial adviser or lawyer, before making financial decisions.

 

My Debt is Better Than Hers: 5 Reasons Credit Card Debt Trumps Student Loans

1.       Are you kidding me? Look at the interest rate!

First off the highest interest rate I have ever paid to a credit card company is 1.7%. In fact I have not paid a penny of interest other than that of my student loans (paying interest to department of education) since January 2014. I have been indeed borrowing negative interest money to pay off my student loans and max out my retirement savings. So why would anyone choose, in my shoes (I was class 2014), 6.8% interest rate over negative to 1.7% interest rate debt? I know there’s stigma and fear associated with credit card debt, but to me what’s more scary is debt snowballing at 7% interest rate while I sleep, work, eat…

Federal Student Loan Interest Rates (fixed)

July 1, 2016 to June 30, 2017 July 1, 2015 to June 30, 2016
Direct Stafford Loan – Subsidized
(Undergraduate Students)
3.76% 4.29%
Direct Stafford Loan – Unsubsidized
(Undergraduate Students)
3.76% 4.29%
Direct Stafford Loan – Unsubsidized
(Graduate/ Professional Students)
5.31% 5.84%
Direct Parent PLUS Loan 6.31% 6.84%
Direct Graduate/ Professional PLUS Loan 6.31% 6.84%
Perkins Loan 5.00% 5.00%
HPSL
(Health Professions Loan)
5.00% 5.00%

2.       The origination fees.

Check out the origination fees! It’s higher than credit card balance transaction fees. Now, the balance transfer offers I had gotten throughout medical school included 1% transaction fee for 15 months balance transfer checks at 0% APR. To put in plain language, private banks were charging me 1% up front for me to borrow money up to my credit limit for 15 months interest-free. So what is the true cost/effective interest of such a debt/offer? 1% divided by 1.25 years = 0.8%. You can see it 2 different ways to compare apple to apple.
One, balance transfer has $0 origination fee and effective 0.8% interest annually vs. student loan with 4.27% transaction fee (which becomes your principle the moment your loan disburses) & 6.8% interest rate.
Two, balance transfer has 0.8% origination fee and effective 0% interest annually vs. student loan with 4.27% transaction fee (which becomes your principle the moment your loan disburses) & 6.8% interest rate.

No matter which way you look at it, I can’t see anyone say student loan is a better deal than credit card debt.
Nowadays, my balance transfer offers are either 0% transaction fee for 15 months of 0% interest rate, or 2% transaction fee for 14 months of 0% interest rate. Still beats the federal student loans.

Federal Student Loan Origination Fees

October 1, 2015 – September 30, 2016 October 1, 2014 – September 30, 2015
Direct Stafford Loan – Subsidized
(Undergraduate Students)
1.068% 1.073%
Direct Stafford Loan – Unsubsidized
(Undergraduate Students)
1.068% 1.073%
Direct Stafford Loan – Unsubsidized
(Graduate/ Professional Students)
1.068% 1.073%
Direct Parent PLUS Loan 4.272% 4.292%
Direct Graduate/ Professional PLUS Loan 4.272% 4.292%
Perkins Loan 0.00% 0.00%
HPSL
(Health Professions Loan)
0.00% 0.00%

3.       The rewards/incentives of charge on credit than to ask Uncle Sam.

Now, let’s talk about borrowing negative interest money from credit cards to fund your education rather than paying 4.3% loan origination fee with 6.8% interest accrual on what you borrowed + the origination fee.

In medical school, when I charge my trimester tuition of 15k every 4 months, I make anywhere between $150-300 cash back, even more if I redeem the points for gift cards, flight mileage rather than cold cash. If I were to borrow from Uncle Sam the same 15k for 4 months of medical school education, I would have been charged $600 origination fee, and have a debt principle of $15,600 snowballing at 6.8% interest rate the minute the loan disburses (it is a few days later when I get the check and cash it.) So $900 difference up front, then either I ride the 0% interest on credit cards for 18 months, or I let the 6.8% interest from Uncle Sam crush me for the same 1.5 years.

What would you choose if you were I?

4.       Banks compete, you win.

Discover, Bank of America, Wells Fargo, Chase, Citibank, American Express, just to name a few were competing for my debt, hoping to bait and switch on me (i.e. bait me with introductory promotional interest rate of 0% then switching to 17% after promotion ends.) When bank competes, borrowers win.

Now, do you know how many competitors are against Uncle Sam? Nada, zero, zilch.

As Uncle Sam monopolize “federal” student loans market, they charge whatever they like. While private banks can borrow 0% interest rate (prime rate for a while as you recall), from feds/ (tax payer dollars from you and me), Feds decided arbitrarily to charge those who want to advance their education 6.8%. You see where our national value lies, clearly in business, not in education.

Because of all the banks competing to bait and switch on me, I never ran out of offer. As I write right now, I have $0 student loans, $0 consumer/credit card debt, and the only debt I will have in a few weeks is the mortgage of my 2nd/dream home. I still get 10+ credit card balance transfer offers, as the banks hope that I will bite their bait and stick around for the switch.

While these banks are the same faceless corporations who charged my dad 30% interest rate when he missed a payment 10 years ago, I don’t feel bad to fund my education with their negative to 1.7% interest rate loans.

5.       When things goes really really badly, student loans stay, credit card debt is discharged in bankruptcy.

What’s the message here? Don’t mess with Uncle Sam. While I paid back every penny I owe (principle + interest) to Uncle Sam and private banks. White Coat Investor raised a good point… “I even thought to myself, well, what if you just left all that debt on the credit cards and just declared bankruptcy at the end of medical school? Student loans don’t go away in bankruptcy, but credit card debt sure does. By the time you get out of residency 3-5 years later, that bankruptcy is almost off your record. Unethical? Of course. But geez, I can’t say it wouldn’t be tempting when staring a $400K student loan in the face.”

While per my personal moral standards, I will not advise anyone to do the above, neither did WCI intended to encourage intentional bad debt. What I do see though if a PGY3 gets disabled and no longer can finish medical training or practice medicine at all, yet he/she has 400k of student loans at 7% interest rate from the feds. He indeed would have been better off to have these debts on credit cards and file bankruptcy.

What do you think?

In short, I’m way more scared of borrowing from Uncle Sam, the monopolizer of government issued student loans, than borrowing from credit card companies/private banks in a highly competitive market, favoring consumers.

Tax-Sheltered Savings Beyond 401k, Roth IRA, & 529-Expert Sessions with Johanna Fox CPA,CPF,RLP

It was a pleasure to have “sat” with Johanna Fox CPA,CPF,RLP this early Saturday morning (via face time, in the comforts of our respective home offices.) As I need more tax-efficient space to save money beyond (my Roth IRA, Roth 401k, pretax 401, Mini’s 529 and Mini’s Roth IRA, tax-sheltered saving space totaling $45,000) 2016, I needed Johanna’s expert help on where to put my additional savings. Johanna’s comments are in blue below. Disclaimer: Johanna Fox is a sponsor of this site.


These are the things I learned during our session.

  1. There may be an after-tax 401k component available to me from Banner (checking as we speak, the SPD “Summary Plan Description” is not completely clear on that), which allows me to save $53k total (including my 401k Roth, 401k after tax, & Banner’s employer contribution.) This would be really exciting because it will provide me an additional $33k after-tax space to save for retirement which I can then Mega-rollover into my Roth, ideally on an annual basis!
  1. For my business/1099 income from blogging, writing, book royalties, if I choose to set up SEP-IRA, I actually have until 10/15/2016 to fund my 2015 SEP-IRA contribution. You read that right! So I can actually reach into the space (which I thought was lost to me) back into 2015, here in 2016 as we speak if so desired.
  1. DWM LLC can pay Mini Wise Money up to 6,300 without Mini having to pay a penny of taxes, and that would work perfect to fund her Roth IRA. [You may have to pay state income and unemployment taxes, depending upon where you live.]
  1. If I pay Mini above $6,300, she will pay taxes when she files her tax return, but the taxes will be way cheaper than mine! Since Mini already does so much work for DWM LLC, on the blog, might as well pay her more and pay Uncle Sam less in taxes. [As long as you are not incorporated and Mini is under age 18, there are no FICA taxes due on wages you pay her. Best to have an employment contract in place specifying duties and pay. Be sure to document work done. See “How do I hire my child?”]
  1. If it comes down to 529 vs. Roth IRA for Mini, it’s more important to max out her (Mini’s) Roth IRA instead of 529. Which I don’t understand why parents don’t do more often. I’ll be writing a post on why I think Roth IRA is way better than 529 for savings for children regardless of the purpose. But the gist is,

One can withdraw money from Roth IRA (the principle investment) without any penalty or additional taxes for any reason or at any age.

529 is earmarked for higher education. You get a penalty of 10% plus taxes if you withdraw the money for non-educational costs. (What if Mini decides to not attend college and be a YouTube entrepreneur instead?) [Or what she gets a full ride scholarship?) Or what if you save too much? I am one of the few who believe college costs will eventually begin to decline in our internet-saturated world. We are already seeing students turn to less-expensive community colleges and trade schools. Did you see this debate I had with WCI?]

FAFSA counts 529 against financial aid at a higher % than it would count dollars in a Roth IRA. Since I pay plenty of taxes as most physicians do and paid a grand price/cost for my ½ dollar medical school education, I’d like to get as little EFC (expected family contribution) on FAFSA as possible when it comes time to pay for Mini’s college.


While points #1 and #2 are completely new ideas to me, the rest of the ideas are further solidified and clarified by Johanna’s expertise.

It was a wonderful session, if you are interested in seeking Johanna’s service, you can reach her here. I highly recommend her. She’s knowledgeable, personable, and most importantly she’s authentic and has her heart set in service rather than pure monetary gains, quite refreshing to find in a money-expert like herself.

Thanks for the kind words, DWM. One more point to consider on the SEP v. 401k issue: when you become an attending, you will make too much money to contribute to a Roth IRA. Actually, you are bumping up against the threshold now. But you will pay taxes on a back-door Roth contribution if you have money in a pre-tax IRA, which includes the SEP. That is why for this year (2017) you should set up a SOLO-401k and roll any pre-tax IRA money into the SOLO-k. A 401k does not keep you from contributing to a tax-free back-door Roth IRA. On the other hand, if you don’t have the funds to contribute to a SEP OR a SOLO-k this year, you have until 10/15/2017 to save enough money to contribute to your SEP for 2016! Then you could set up the SOLO-k in 2017 for the year 2017 and roll the SEP into it. Hope this makes sense – I’m sure it will to you, but you may have to sort it all out for your readers J. Looking forward to future discussions.


Final-01
You can seek out Johanna’s expertise and service by clicking here. I’m sure you’d be glad to learn to maximize your tax efficiency and to optimize your investment plan for your family and your future.

 If you like this article, you might enjoy other DWM articles on Personal Finance, Investing, Retirement, Practice Management, & Lifestyle.

All articles by DWM are for informational purposes only and not intended as a substitute for professional advice. Please consult a professional accountant, financial adviser or lawyer, before making financial decisions.