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Physicians, on average, graduate with approximately $200,000 in student loan debt, and so many of us shoulder the weight of those loans for many years after becoming an attending. How do we get that weight off our shoulders and achieve financial success?
Episode 54 of the Hope4Med podcast features Dr. Cory Fawcett, a retired general surgeon who now spends his time coaching, speaking, and writing books and blogs to improve the financial and personal lives of physicians. Dr. Fawcett shares the key things he has learned about choosing the right job, managing debt early, and achieving financial success. We discuss how getting out of debt and managing finances effectively positively impacts our practice and our family life.
Connect with our guest, Dr. Fawcett
[00:00:00] Dr. JB: Welcome to Hope4Med.
[00:00:04] Hi, welcome everyone back to the Hope4Med podcast. I’m your host, Dr. JB and today’s featured guest is Dr. Cory Fawcett. Dr. Cory S. Fawcett is a general surgeon who retired at the age of 54, after 23 years of private practice. He now spends his time coaching, speaking, and writing books and blogs to improve the financial and personal lives of physicians. Welcome to the show, Dr. Fawcett.
[00:00:34] Dr Fawcett: Well, thank you for having me. It’s a pleasure to be here.
[00:00:38] Dr. JB: So let us start from the beginning. Please, share with my listener your origin story.
[00:00:44] Dr Fawcett: You know, I always wanted to be in healthcare somewhere as far back as I can remember. And it all started with how the Grinch Stole Christmas. I saw that show is a little kid, and I remember thinking that the Grinch has those terrible teeth. If he just had good teeth, maybe he wouldn’t be so mean and so I’m going to become a dentist so I can fix the Grinch’s teeth and he’ll be happy again. And that was kind of the start of the whole thing.
[00:01:12] And then later on, I wanted to be a physician, kind of morphed into that. I went on to medical school and the first two years of medical school, I was kind of disillusioned and I get into the third year and I did the first three rotations, and those were nothing like. I had dreamed that I would be spending my life in medicine. And I came this close to quitting medical school near the end of my third year because I just I didn’t like what was happening. And so I was kind of thinking about what would be the consequences if I quit when I took a general surgery rotation, and I absolutely fell in love with general surgery. That was so much different than all the other rotations that I had been on in that we actually fixed things.
[00:01:59] When I didn’t like, for instance, when I was on the medicine service at the VA, which was my first medicine rotation, was that all those people just kept coming back with the same thing. They have a diabetic crisis, I fix it. They come back two months later with another diabetic crisis and I got to fix it again. And it’s like this never ending thing, kind of like, my wife talked about changing diapers when the kids were little, it just never ends, and I didn’t like that. And then when I got on the surgery, the difference was that when I took out somebody as appendix, they were never going to have that again, problem solved. And I realized I was a fix-it man and general surgery answered that.
[00:02:39] Dr. JB: The appendix didn’t grow back or the gallbladder doesn’t grow back?
[00:02:42] Dr Fawcett: No, no, those were, I mean, when I fixed that problem, it was over. And so I was really frustrated also in general surgery, there are a few problems that are chronic and those chronic problems were a little frustrating to me because I was in at heart a fix it, man. Maybe that’s why I got into real estate because I love fixing stuff, but that’s how I ended up in medicine. And then I went into private practice. Actually even think about becoming an employed doctor back in 1993 was when I started practice. There were people who were employed, but I never even thought about that. I mean, I was a physician, I was going to be in charge, I was going to own that business. It was my business, not somebody else’s. I should get paid for all the work I do and I’m going to work pretty hard, there’s a lot of hours. And so I never even considered being an employee.
[00:03:37] And I searched, decided where I wanted to live. My first book about starting your practice right kind of covers that whole thought of first decide where you want to spend the rest of your life. You hate snow, don’t go to the mountains of Colorado to be there to start your practice, find out where you want to live. And my wife lived, her family was in Northern Oregon and my family was in Southern Oregon, so the only place I wanted to work was on interstate five between our two towns. I wanted to be close to each family. And so, I sought out to find a practice there. I went door to door talking to every practice in that area looking for who wanted somebody, and I found uh, I think it was six practices that were not advertised, the, the recruiters didn’t know anything about these, but I interviewed at six places nobody knew about because I had knocked on all the doors and I found my dream job and I stayed there for 20 years in that practice.
[00:04:33] And then when I hit my retirement age, which was 50, and I had known I want to retire at age 50 since I was in medical school, I actually laid out that plan in medical school that I would be retired at age 50. And when 50 hit, I wasn’t actually ready to give up medicine, I still wanted to do this, it was fun. And I talked to my partners about going half-time, instead of retiring, they didn’t like that option, wasn’t part of the plan, and so I had to actually retire from my practice. And then I worked as a locum surgeon in order to work part-time and I did that for three years until fully retiring, and I’m spending my time now is a doctor who helps other doctors.
[00:05:16] Dr. JB: That’s awesome. So I had a couple of questions for you in terms of your story, so when you say you had decided in medical school that you’re going to retire at the age of 50, was that before the general surgery rotation that you did or was it after?
[00:05:35] Dr Fawcett: It was after, because I had already met my wife-to-be at that time. So, and I was working, I would say I was working part time during that time, at a doctor’s office at night as the receptionist. So they would call, people would call after hours, and they would actually get a medical student who answered the phone, and that way I could go look up medical records in the office when, if the doctor needed something and I could actually reliably translate what I was reading to them. And so when I did that job, I had a lot of downtime, one call an hour or something. And so during that time, one of the projects I did was to sit down and pencil out what I needed to do, how much I would need to save, in order that at age 50, I will be able to retire, and then go off and do some other things that I like to do, right? I’m a real Renaissance man, I like doing lots of different kinds of things, and I thought that age 50 was going to be enough of this project and then I would move to something else.
[00:06:44] Dr. JB: And so what made that first position that you got, which you stayed at for you said 20 years?
[00:06:50] Dr Fawcett: Yes.
[00:06:51] Dr. JB: Man, that doesn’t happen all that frequently anymore, somebody staying at one job for 20 years.
[00:06:56] Dr Fawcett: Yeah, I think a lot of people– and that was part of why I wrote that first book to help the resident find that first job and to find the right one the first time– I think a lot of residents do not think in those terms. They look at their dad and they say, I’m just going to go find a job that pays the most, and I want to get, make some money. Okay, and so they just take a job that pays a lot of money and a couple of years later, they figured out that they’re unhappy with this. And then they leave to the next shop, but when they leave to the next job, they do the same thing. They picked one thing that they were unhappy about with their current job and they go find a job that doesn’t have that one thing and then they’re still unhappy.
[00:07:37] I think, like what I said about learning where you wanted to live, I imagine if I had to just pick any old job that the recruiter showed available and I started working in Texas, that pretty soon I would want to be back in Oregon, and I would’ve left that job. So making the decision that I wanted to live in Oregon close to my family, I wanted to be in private practice, I wanted to live in a small town. I mean, making these decisions ahead of time before seeking my job, increased immensely the chance of I would find a job that I would stay at for the rest of my life. But residents today aren’t doing that. I met one, we were interviewing for somebody, I remember this distinctly because it just blew my mind. This resident was he interviewing for us to become a partner with us, and he was interviewing another place to become an employee, and he had mentioned to me he was leaning towards being the employee and I asked him, well, why was he leaning that way? And he said, well, because as an employee, it’s really easier to leave and go somewhere else. And it just blew my mind that as he was looking for his first job, he was already planning how he would leave that first job, and he was looking for a job that was easy to leave.
[00:08:59] How are you ever going to find a job you’re going to be happy with if your goal is to find a job that’s easy to leave? And I actually, we didn’t take this guy. We did not want that attitude in one of our partners that they were looking for a stair-step. ” I just want to get my first job out of the way so I can get onto the real one”. Well find the real one in the first place, and you can do like I did and stay there for 20 years because you’ll enjoy where you live, your wife will like where you live. You’ll like the environment you’re in and the schools your kids are going to be. I mean, if you like all of those things, you’re not going to leave.
[00:09:41] Dr. JB: So at what point during your training should you start thinking about these things?
[00:09:45] Dr Fawcett: I think you should begin thinking about that the year before your final year in residency. Okay? Until then, it doesn’t matter because it’s during your final year that you will begin your interviewing and trying to narrow down where you’re going to go. Now, interviewing costs a lot of money and costs a lot of time, so you should be very effective when you’re doing this. And the way to be effective is to know exactly what you’re looking for. So during the year before the end, before all this starts, you have, you’ve got to have that nailed down. I, I go through in that first book, a lot of criteria that you want to do, that go through this and answer this question for yourself.
[00:10:29] For one of those, for example, is do you want to be an academic doctor or in practice, out in practice? Are you going to be doing bread and butter work or are you going to be doing those esoteric things that they do at tertiary hospitals? Which of those kinds of work do you like to do? Do you like doing research or do you hate doing, if you hate doing research, you do not want to even interview at a job in an academic place because they’re going to require you to do research. And so, there are a lot of categories that you should think about first, and you think about those in the next, the last year, and I think it would be really good for you to actually in that next to last year talk about these things with your attendings. What do they think about living in a small town?
[00:11:14] You know, like, so I’m a general surgeon, what’s the difference between a general surgeon in a small town and a general surgeon in a big city? Well, in the big city, that general surgeon is going to be highly specialized. He’s going to be maybe only abdominals surgery and everything else goes out the window and it goes out the window because they already have vast other surgery specialists in town. They have thoracic surgery specialists in town. They’ve got a burn specialist in town. They’ve got a breast specialist in town. They’ve been a thyroid specialist in them. So if you go to the big city, count on having a very narrow focus of your practice. But me I’m kind of a Renaissance man, I kinda like everything. To be in a small town, all of those other specialties don’t exist there. So when you need help with those things, you’re going to come to me, a general surgeon in a small town. And so I was so much happier being able to do lots of little things rather than honed into just one thing. So you’ve got to answer those kinds of questions of what it is you really want in your life, before you start your interview process. Then you’re going to find your dream job. It’s just going to fall on your lap.
[00:12:27] Dr. JB: And you have to be honest with yourself, cause sometimes, you can say, oh, I trained that all these powerhouse, academic institutions, I personally hate academic medicine, but it would look good for me to stay you know what I mean?
[00:12:44] Dr Fawcett: Yeah, you can’t be doing this to please other people, you got to please yourself. You’ve got to pick things and you need to speak to, take your spouse. If you’re married, you must take your spouse in on this discussion as well, because one of the big things that drove– so I lived in a small town. There were a lot of physicians who moved into town and two years later they were gone. Yeah. And very frequently, the reason they were gone is because their spouse did not like being in a small town. So both of you together have to find something that you will like. If your spouse doesn’t like a small town living, she wants to go to Neiman Marcus and it’s a four hour drive to get to the closest Nieman Marcus, she’s not going to be happy there. And if you know that ahead of time, and then you’re not interviewing in those places. You’ve got to find a happy medium that you both like, for example, what if your spouse is an oceanographer and that’s her degree, then you should only be looking at places that are on the coast. So that your wife can also live her dream, or his dream as your husband. You, you’ve got to take both of you in consideration, not just what you want, not what your parents want, not what you think would look really cool on your resume, not–
[00:14:07] When I first started in private practice small town, we actually did pancreatectomies. And I thought it was cool ’cause I like doing these big cases and we had good results. And after two or three or four of them there in a small practice, I realized that’s an awful lot of work for a really big case that happens to have a very high morbidity and mortality associated with it. I think I would be better off if I just sent those to the tertiary hospital, let them do those weird big cases, even though they were fun and it was cool to do and, and it felt challenging, you go to realize that that’s not the best choice I should make for my patient. I ought to send those guys away, whether I get good results or not, I still should send those guys away. It shouldn’t be something I’m doing in this small town.
[00:14:58] Dr. JB: Yeah. So, it just really just reinforces that you really need to do a deep dive in yourself to really figure out what it is that you’re passionate about, what aligns with your values and then finding a job that aligns with those same values.
[00:15:16] Dr Fawcett: And even if you’re not a resident, if you’re currently unhappy with your job and you’re ready to move, and most doctors leave– you know, I think it’s half of all doctors leave their first job in the first four or five years. If you’re at that crossroad where you think I’m, I’m going to get a new job, then you better stop right then and have those conversations with yourself and your spouse that so that you do a better job of picking your second job, and maybe it will be your final job as well, because it is super expensive for a position to change jobs. We had somebody that, a friend of mine, I changed jobs and in the book I actually. Listed out all of his expenses. This is what it costs him to trade jobs, and it costs him in excess of $175,000 to swap jobs. Wow. That is a very expensive mistake. And that’s just kind of an average that he, there was nothing super special in there about his change in jobs. Physicians do not realize just how expensive it is for you to trade jobs, that’s a big deal. And so if you can nail that down in the first place, you’re going to save yourself a fortune, not to mention the headaches. Your kids get to change schools, you got to find new friends, you need to find a new personal doctor, you know, you need to find a new dentist, you got to find a new church, got to find a new favorite store to shop. I mean, everything that you learned about your life and got all set up where you’re at, gets thrown away and you’ll start all over again. Why go through that? You don’t have to.
[00:16:55] Dr. JB: So, you mentioned that in terms of residents, oftentimes they go after the highest paying job. Why do you think that is?
[00:17:02] Dr Fawcett: I think it’s because they stare at that huge debt number that they have. And a lot of people think that doctors are rich, including doctors. A lot of us think we’re rich and we really aren’t, most of us start out broke. I remember going to a lecture I was given in a big city and as I was just about to get there, I drove right past the soup kitchen, and there was this long line of guys, and it done on me as I was looking at those guys that most of those guys at the soup kitchen line have a higher net worth than the doctors I’m about to talk to. And yet those doctors consider themselves rich, but many of those are, they have a negative net worth. It will be years before they get up to the point where they’re, they’re equal with the guy at the soup kitchen line, where he’s got a net worth of 0. A lot of doctors spend a lot of years getting back up to a net worth of zero because they started with these huge debts. And then as soon as they go into practice, they borrow more money.
[00:18:03] And so I think doctors just get disillusioned with living on a low income for so long and having so much debt that they begin to worry about the debt itself as being a problem in their life. It’s rarely going to be a problem in your life, you’re going to make a lot of money as a physician, and you’ll be able to handle that just fine, but you’re not going to be living the lifestyle of the rich and famous like you might have in your mind. And until you get that nailed down, you’re going to be looking for money. And I think the pay is probably the last thing you should select. If you choose the job simply because it paid the most or because they offered the bonus, sign-on bonus, I think you’re going to be sorry, especially if you go for that big sign-on bonus, because if they’re offering a big sign on bonus it’s because they need to offer a big sign-on bonus to get you to show up here. There’s a, there’s a reason that they’re offering a really big sign on bonus to come to their hospital or their town.
[00:19:05] Dr. JB: And there’s a catch too.
[00:19:07] Dr Fawcett: And there’s a catch. No, there’s no free lunch in this stuff. So when you just see those things, and they count on you seeing that huge bonus and going for them, that’s why they have that bonus there, but if you just ignore the money and realize that any job you get in medicine is going to pay well. Even the lowest paid doctors are in the top 5 to 7% of the nation in income. So you’re going to do well no matter what they pay you. So why not pick the job you’re going to look, in the town you’re going to love, and that your spouse is going to love? You will be so much happier if you do that instead of thinking about the money. And I get that pool when you first get started, when you see a job offering you 400,000 and another one offers you 300,000, that extra a hundred thousand sure sounds good, but it will come at a price. And if that extra a hundred thousand happens to be in a real high cost of living area, you’re not actually going to make more money when all is said and done, the reason they’re paying more is because it costs more and you’re going to come out about the same. So pick the job because that’s where you’d really like to be. And I think the money they pay you should only be a tiebreaker. If you have two equal jobs and you really can’t decide between the two, okay, maybe use the amount they’re going to pay you as a tiebreaker.
[00:20:33] Dr. JB: But you find sometimes that even when you start working and you’re making money, that some healthcare professionals are working, are living paycheck to paycheck.
[00:20:42] Dr Fawcett: Most healthcare professionals when they get started are living paycheck to paycheck, I believe. The problem is that– okay, take me for example, I went to medical school on a Naval scholarship. Okay, so I ended up leaving medical school with only $18,000 of debt. During my residency, I paid down some of that stuff, so when I got out of residency my debt was down to less than $6,000. Okay. So now I started my high pay, high paying job, and a doctor has a big target on their back and everybody was willing to loan me money. A few years later, I was more than half a million dollars in debt. Oh, I bought a motor home, I bought a house, I bought into my practice, I bought a piece of land so that I could build a future house. I started spending my money. I started going on some nice vacations. And pretty soon I was way in debt and my wife didn’t, she didn’t like that, and she convinced me that maybe we should get out of debt, and so we turned that around and six years later, we had our final house payment and we became debt free, and we’ve stayed that way ever since. Our personal budget doesn’t involve debt.
[00:22:04] And I think when you get started, that stuff just surrounds you. I mean, you see the brand new doctor who just came into training, comes and parks his new Tesla in the parking spot and I think, why did he do that? I remember seeing somebody on social media asking a question about how to handle his student loans, and when he was talking about his situation, he mentioned that he and his wife just purchased two cars and they just assumed $120,000 worth of automobile debt. Now, if he’s concerned about his student loan debt, why did he just jump an extra $120,000 in debt with cars? That was a real dumb move. And we just get caught up in this stuff when we see it happen and I think we start doing stuff that’s just not as smart as we are. I mean, we’re smart guys, smart gals, we’re smart people. And yet, we go out there and we see the money and we start doing things that we probably shouldn’t have done.
[00:23:12] Dr. JB: And how does this excessive debt affect your mental health and wellbeing?
[00:23:18] Dr Fawcett: I think it has a big prob– there was something that happened with me that I did not see coming. Okay, so I had half a million dollars in debt, and I told you I was kind of, I was in a small town, so I was doing all kinds of surgery and as things got going, there was two areas of surgery I did not like. I did not like doing vascular surgery and I did not like doing thoracic surgery, and mainly because the patients are sicker, are in the ICU, they generate more phone calls, and I just wasn’t enjoying doing that, but they were the highest paid things I had. And when I had that debt hanging over my head, I did not want to give up those high paying things cause I was afraid, what if my income dropped and I can’t pay my house payment? And so I was, my practice was being effected by my debt. When I made my final house payment and I became debt free and I, and it was like there was a weight lifted off my shoulders I didn’t even know was there. I’m free. And all of a sudden I realized I’m not worried anymore about losing my house if my income drops and I finally had the courage to drop those two procedures from my practice. I had a partner who loved vascular surgery, I had another partner who loved thoracic surgery. I went to the office manager one day and I said, listen, I’m not doing those anymore, send all of my vascular referrals to this partner, send all of my thoracic referrals to this partner, and I don’t want to see those patients anymore. And I was not willing to make that move until after my debt was gone and the debt was continuing to make me have a practice that I wasn’t enjoying.
[00:25:01] Funny thing, I was worried about the fallout and that my income would drop. My income didn’t drop a bit because all those holes that were made in my practice by not seeing those patients were filled up with things I liked seeing because my other partners who took those patients on had to give up something to get them in there, and they gave up stuff I liked. And so I ended up with a more enjoyable practice and I would have never made that move had I continued to be in debt. So if you don’t get your finances under control, those finances are going to be a ball and chain that make you do things in medicine that you wouldn’t have done or you don’t want to do simply because you need the money, you need the income. There are doctors who send their family on vacation but they stay home and work because they need the income. They can’t afford to take the week off. And that just shouldn’t be happening. And there are so many things that getting your finances right will affect in your practice. I didn’t realize that until after it happened to me and my practice was so much better once I became debt-free.
[00:26:21] Dr. JB: So, what advice do you have for doctors, either new residents or new graduates or attending physicians to really get control over their debts?
[00:26:32] Dr Fawcett: I think there is a couple of really big things that you need to do. First of all, when you move to that new town, don’t buy a house. Buying a house when you first move someplace is a bad idea, and the reason it’s a bad idea is because 50% of the people when they move to that new town, they’re going to be moving in a few years. That means you’re going to be turning around and selling that house again in just a few years. It costs a lot of money to make the transaction for a house and it takes around five years to break even on the appreciation of the house, covering all those expenses. So if you move in less than five years, usually you lose money on the deal, so don’t buy a house. And another reason to not do that is you’ll live there for a couple of years, you’ll decide, yes, this is where I want to stay, and now you know what part of town you want to live in, what school you want your kids in, and you’re not in a hurry to buy a house. When you’re trying to buy a house and you’re moving there and you need that house before you arrive, you’ve got a deadline, so you can only buy what’s in the inventory right now.
[00:27:38] So you live there a couple of years and say, okay, I’m going to stay here, let’s buy a house. And you look around and say, I want one in that neighborhood right over there, but there’s nothing available right now. Well, just tell the realtor, hey, soon as you see something in that neighborhood, you call me, we’ll get it. And so now you’re not under time pressure, you can end up buying the house you actually want in the neighborhood you want, and it’s so much easier. And when you’re done, you just hand your rental keys over and move into that house. So that’s one big one. The other thing is when you start this new job with a big income, make a budget and the budget should be that you’re only going to spend a little bit more money than you were spending in residency for the first couple of years, so you get a full handle on what’s going on with that new high income. You get the right things taken care of. You start saving for the down payment of your house. You start conquering your student debts. Those student debts shouldn’t take but four years or five years to be paid off, don’t be saying I’m going to be paying my student loans for 20 years. No, get them paid off and get that off your shoulders. But make a plan for that.
[00:28:50] If you don’t do that, what usually happens is you move into town, you buy a big house, then you need furniture for that house. Then you need a boat for the boat dock because you bought a house on the lake. And you want new cars because these cars that you were driving as a resident, these are not befitting of an attending surgeon, or, you know, got to have new cars, you got to have a really nice car for you, your spouse. You didn’t want them to have to drive that old beater. And so pretty soon you’ll find yourself in a lot of debt cause you didn’t have the cash to do any of those things, so you had to borrow the money, and all of that debt comes with it as some penalties. Now you don’t have money to go on the vacation you wanted go on, and so, or a cut back at work, like if you’re feeling burned out and you say, I need to take a little time off, then you can’t because if you do that, your income drops.
[00:29:40] I was working with a lady who got in a bad car accident and she had lots of broken ribs, bruised up real bad, she was hurting pretty bad and she needed some time off. And she was back in at work at the hospital, hobbling around doing her job, and I’m looking at her saying, why are you here? You need to be home recovering. And her answer was, I can’t afford the time off. Here was a doctor who needed time off to recover from this car accident, and she couldn’t afford– she had too much debt– she couldn’t afford to not be at work. And so you end up doing things that you shouldn’t. So when you start this job, this is an incredible opportunity. It’s like winning the lottery. This is a chance to shape your life the way you want it to be. Most doctors don’t take that chance, they just start spending the money and then find themselves in trouble. And then they call me for coaching to help them get out of trouble. How do I get out of this? I don’t know how to get out of this, I’m such a mess now financially, I don’t know what to do. That should never happen because if you start off and you ramp up your spending and you do it in a controlled manner, you will do very well financially and it will reflect in your practice.
[00:31:05] Dr. JB: Yeah. I think it’s really interesting how you recommended that physicians focus on paying off their debt in four or five years or so. In your experience, how many physicians are successful in actually doing that?
[00:31:21] Dr Fawcett: All of them who try. The problem isn’t that people aren’t successful, it’s that they don’t try. They, they say, well, shoot, I can pay this off over 20 years or they play the game, “oh, but it’s a low interest loan, I got it refinanced at 2.8%.” I can make more money in that stock market, so why would I pay this off? And they started playing these games with their money instead of kind of doing the right thing. I mean, you borrowed that money with the intent to pay it back as soon as your income got big. You don’t have money now, you want to go to med school, they’ll loan you the money, but you pay it back when you started making the bucks. If you pay the money back, now they can loan it to another student. But if you’re dragging it out cause you can play this interest game, I think there’s a moral problem with that. They lend you this money with the intent that you’d give it back to them as soon as you can.
[00:32:19] And the other thing is you don’t realize how great it is to be debt free. When I said I had only less than $6,000 left to pay, the only reason that I still had that $6,000 cause I was in that trap, it was a low interest loan, it was only 3%. Why would I pay off a 3% loan? I’d rather spend the money and do it, it’s only 3%. It’s only 3%, right? My wife kept saying, why don’t we just pay this off? We could just write a check and it’s gone and I’d never have to see this again. Every month she had to write another check and send it in for my $6,000 loan and I kept fighting that because of this whole low interest loan thing. And finally I said, okay, let’s just pay it off. And we wrote the check and that’s when I felt this weight lifted off of me, my student loans are gone. I didn’t even know that my student loan was affecting me. I thought it was cool to have this 3%, but that 3% was affecting me and I felt a relief when it was gone. So I think the people who failed to pay it off quickly are just not, they just didn’t try to pay it off quickly.
[00:33:24] I think almost every– if you imagine, imagine you get out of work and it, you start your first job at $400,000 a year. Let’s just say, throw that one out. You’re a specialist, you’re making $400,000 a year, and you used to live on $60,000 a year as a resident. So what if you just took your income and lifestyle up from a $60,000 resident to a $100,000 a year attending, and you lived your lifestyle $100,000 a year. And let’s say you paid a hundred thousand in taxes, that leaves $200,000 to attack your student loans with. The average physician has a $200,000 student loan debt. If you are average, you’ve paid your student loans off in one year, and now that extra $200,000 is yours to do with whatever you want. And you can start an incredible savings program for your future retirement. You can do all kinds of stuff for your family. You can bump your income now, your expenses up from $100,000 a year and maybe you go to $200,000 a year, and you live on $200,000 and you save $100,000. You can do so well.
[00:34:32] Compare that to the guy who comes out and he bumps his lifestyle up to the $300,000. He paid $100,000 taxes, he’s got $300,000 to spend and he spent it all of it. Now you don’t have any cushion. If something happens, you don’t have the ability to take care of it. You’re not saving for your future. You’re spending it all and you’re going to do that forever. I love the quote that the person who doesn’t learn to make money while he sleeps is destined to work forever. And that’s what a doctor is, we don’t get paid unless we put in the hours.
[00:35:07] Dr. JB: That’s right.
[00:35:08] Dr Fawcett: And if we set ourselves up that we have to put in the hours in order to make ends meet, then we don’t have any wiggle room when something happens. And you never know when something will happen in your life or your child’s life or your spouse’s life. One of those happened to me. My spouse was diagnosed with cancer and I needed to take off the next month to help deal with that, everything that was going to go on, surgeries and appointments and getting everything set up. And I was so thankful that on a moment’s notice, I could just call my office manager and say, I’m taking the next month off. I didn’t have to worry about whether I could make payments on anything. There weren’t anything to make payments on. So, I could freely just take that off and spend the time helping my wife. I dread to think what would have happened to me if I had been living right up to my income and had a lot of debt and I needed to take that month off. What would have been my, I mean, I need to take this to be with my wife, but I need to be at work in order to keep our house and to keep our health payment, health insurance. And I mean, I can’t not work and yet I need to be with my wife. You should never have to be in that position. I was so thankful that I could just take the month off on a moment’s notice and not worry about it.
[00:36:36] Dr. JB: I mean, the sad reality, just like you gave that example of that physician that was in that car accident, is that so many physicians are in that situation of that person that was in the car accident where, like you said, you go to work, you get paid to work. There’s no sick days, there’s no PTO or anything like that, I guess unless you’re like in maybe an academic or some other setup like that. But you’re trading hours for money, and if you’re not working hours, you’re not making money.
[00:37:07] Dr Fawcett: Even if you get those sick time, okay, even if you get that, I want those doctors who are listening to this and they’re an employed physician who say, well, I get sick time, what difference does it make? Even if you get sick time, I bet you, your bonus is paid on RVU’s. And so when you’re not working during that sick time, your RVU’s are going down. So you are the one who’s going to pay for that sick time by having a lower bonus later on. So the hospital’s not actually paying for your sick time, you are, and so you better be ready for that.
[00:37:43] Dr. JB: That’s very important point to highlight, I think that’s something that a lot of people don’t realize.
[00:37:50] Dr Fawcett: Yeah. They think that the just cause they’re an employed physician that somehow they’re guaranteed things, but I guarantee you that if your production drops off, you won’t be an employed physician for long, because the only reason they’re employing you is because they’re making money off of you. If they stop making money off you, they’ll find somebody else. And so if you need sick leave and you’re not working and your RVUs fall down, that’s going to affect things. You’re going to see it happen. I remember one doctor who was just so mad. He was an employed doctor, he had six weeks of vacation and he went to put in his final week of vacation and they said, “no, you don’t have any vacation time left.” He says, “yes I do, I went to these five weeks. I don’t have another…” “Oh no, you forgot your CME week.” “What are you talking about?” Well, they had required him to go to a special training seminar for a week to learn this new piece of equipment that the hospital was bringing in, they wanted him to be the one to do it. They required him to go to this thing and they counted it against his vacation, and he was ticked. He thought he still had another week of vacation, but his employer said, no, nope, we counted that as your vacation. So, you do not have a lot of the things that you think you have when you’re employed. If you don’t keep your production numbers up things are going to change for you.
[00:39:14] I had a bunch of doctors in my own town, they were buying up doctors right and left. And then one day, the hospital just realized that all these doctors we own aren’t making us enough money, so they just turned them loose one day. They just said, okay, you guys are all in private practice now and they didn’t have their own offices. They didn’t have their own staff. They were working for the hospital and just immediately, a bunch of them were suddenly on their own. Okay, as of today, you guys are on your own. That was a tough one. Some of them did fine, some of them left town. And it was a pretty big shock to just suddenly find out we don’t need you anymore. At least not on the payroll, you go to earn your own keep. And it was because they weren’t producing enough for the hospital.
[00:40:02] Dr. JB: Wow. So I think I might know the answer to this, but I’m curious to see what you have to say in terms of, what is the number one thing physicians can do to maintain their happiness and their mental health?
[00:40:17] Dr Fawcett: That’s an interesting question, because just recently an actual survey came back to ask that very question and the answer was spend time with your family and friends. That is the number one thing on the survey that physicians are doing to improve their mental health. They’re spending time with their family and friends. But the thing that really bugs me is, when times get tough, that’s one of the first things that you cut out.
[00:40:49] Dr. JB: That’s right.
[00:40:49] Dr Fawcett: When something, let’s say something happens and times get tough, do you cut out going fishing with your kid or do you cut out being on a committee at the hospital?
[00:41:01] Dr. JB: Going fishing with your kid.
[00:41:02] Dr Fawcett: Do you– yeah, you should be calling the committee and say, right now, I just don’t have enough time to be doing this, I’m going to have to bow out of the committee so that you can go fishing with your kid. But no, when something bad happens in your life and it’s going to eat up a bunch of your time and you have to cut something out for this, it’s often your family and friends that get cut. Or sleep or exercise, two other things that are needed for your mental health. And it’s a sad thing that the first thing that we cut out is the thing that we need the most. And we can’t be doing that. You can’t be in a position that it’s your family that gets sacrificed when something happens, rather than these other things that you’re doing that aren’t even your job. Being on the committee isn’t actually part of your job, that’s extra.
[00:41:52] And if you’re missing your kid’s soccer game because you had to go to a committee meeting, your kid knows that you chose to do something else rather than come see him. Your kid knows the difference between I’m sorry I missed your soccer game, there was a big car accident and I was working to save two people’s lives. Your kid understands that is really important and more important than a soccer game, but your kid doesn’t really understand why you chose to go to a committee meeting instead of coming to see him score two goals today, because they know the difference between what you have to do and what you choose to do. And many times we get too many of those things in our schedule. We’re on too many committees, too many board meetings, things like that, that really hurt our home life. And it comes back to that home life, the time with your family and friends, is the number one thing that we do to improve our mental health, and we’re sacrificing that.
[00:42:52] Dr. JB: You know, but sometimes you just feel like you’re just too busy for your family, right?
[00:42:57] Dr Fawcett: Yes. And this is a really funny thing because the doctors who say they’re too busy, a lot of people who come to me for coaching or coaching because they want to do something different because they think their job is a problem and it’s ruining things at home, but here’s the thing, there’s 168 hours a week. If you spent seven hours a night, seven days a week sleep, and that’s 49 of them. If you work 60 hours a week at your job, that leaves 59 hours a week for you to do things with your family. That is plenty of time. You actually, if you don’t work a 60 hour week, if you work a little less than a 60 hour week, you’ll have more family time than you have work time. It’s not your job that’s causing the problem of you being too busy, it’s all the other things that you add to your life on top of the job that makes you too busy. You’re helping out at the church, you’re the president of this, you’re the vice president of that. You’re on these two committees. You’re the chairman of this committee. You’re on these two boards. You’re on this thing with your kids at school, you’re on the PTA. I mean, it’s all those other things that you’re doing that you’re blowing that 59 hours that you have to do stuff with your family.
[00:44:10] Or maybe you live an hour commute from the hospital. An hour each way, two hours a day, five days a week, 10 hours a week. Okay. What if your boss told you that, hey, we’ve decided we’re going to give you a full day off, 10 hours. We’re going to give you a full day off each week, but we’re not going to drop your pay. You would go for that in an instant. And yet, that’s exactly what you’d get if you stop commuting and you move your family close to the hospital. So you didn’t spend 10 hours a day in your car, instead of 10 hours a day with your family.
[00:44:43] So the doctor will be doing all of these extra activities and saying he’s too busy and then blame it on their job. Well, it’s my job that’s causing the problem. It’s not your job that’s causing the problem, it’s all these other activities that you’ve taken on that are making you too busy. Your kids probably shouldn’t each be playing two separate sports and be having two separate music lessons. You’re teaching them to be too busy. Pick one sport, pick one instrument and concentrate and then spend the rest of your time enjoying your life. But we don’t do that enough. I think it’s cause we’re type A people in general, physicians are generally a type A, go, go, go people. And so when we have a blank spot in our schedule, rest or spending time with our family isn’t what pops up, it’s what project can I get done? I got a blank, I got a two hour blank spot. I had a partner who, if he had a two hour blank spot, he was having the office staff call in patients from next week, so he could see him now cause he didn’t want that two hours to go. But me, when I had a two hour sudden blank spot, like an operation got canceled, I got a two hour opening, that was a chance to go for a bike ride, go see my wife, or take her out to lunch, or go home. Take advantage of those things and live your life. Don’t just crowd it with so many things that you think I’m just too busy. If you say that, then fix it ’cause it is in your control. It’s not your job that’s making you too busy, it’s all the other pieces you’re throwing in.
[00:46:20] Dr. JB: And so, it sounds to me that there is a way for you to be able to work, pay out, pay off your debt, and still have that quality time with your your friends and loved ones and family.
[00:46:33] Dr Fawcett: Yes. That is very possible, if you plan that to happen. If you just fly by the seat of your pants, I guarantee you, that stuff is not what your life’s going to be like, but if you plan that to happen, I like to say plan your white space, that white space in your calendar that’s empty, plan that, but plan for fun. Here’s a cool lesson for you to do. If you think that family is important to you, and if you ask almost every doctor, how important is family, they’re going to rank it one or two, right? That’s the, that’s the pat answer, they’re going to rank at one or two, family is right up at the top. Okay, then I would say, let’s pull out your calendar for last month and show me where your family is in your schedule. And many doctors can’t find any time they actually scheduled to do something with their family. Their family only gets any leftover emptiness that they couldn’t get scheduled.
[00:47:38] I say, schedule your family on purpose. Right here, we are going for a bike ride. Then, not only are you looking forward to that moment, but all your family is looking forward to when we’re all going to go for a bike ride on this time. Put it on this schedule. For most of us, if it’s not on the schedule, it’s not going to happen because your schedule is what keeps reminding you what to do next. And if you think your family’s important, I challenge you to go back and look at your schedule for January, and you show me how many places your family shows up in your schedule.
[00:48:18] Dr. JB: So Dr. Fawcett, this has been such an amazing conversation. And the question I have for you is if my listener wanted to get in touch with you, learn more about what you do, how could they do so?
[00:48:30] Dr Fawcett: Go to my website, financialsuccessmd.com. You can email me at firstname.lastname@example.org, but all of the resources are there at the website. You can find my books, I’ve got a couple of courses that you can take, read the blogs, are free to read, there’s blogs on all kinds of topics about making your life better, getting out of debt, buying real estate, making passive income in addition to your income, so there’s lots of references. There’s a contact page there. It all starts with finding me at Financial Success MD, and I’m on Twitter and Facebook and LinkedIn and Doximity, you can find me all over the place. If you just look for me, just Google my name, you’ll find me. And you can get started down that journey to making your life better too.
[00:49:16] Dr. JB: Perfect. And so in closing, do you have any pearls of wisdom from my listener?
[00:49:22] Dr Fawcett: Life isn’t about making the most money you can, life is about making the most life you can. You should be going out and having fun. As a physician, you’ll make a lot of money. The money will take care of itself, but your family won’t. You’re going to have to take care of them on purpose. So don’t make your life about the money, make your life about the life.
[00:49:50] Dr. JB: Who says a doc can’t rap? D O C T O R J B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or prerecorded. Come learn some. Each one, teach one. I’m done.