Mastering Real Estate Investment As A Medical Professional. #458

And number two , this idea that owning a home is the American dream , that you haven't made it until you own a home , and I think it's even more prevalent among physician spouses than it is among the physicians . I have been putting up with living on student loans for the last four years and I want a freaking house .

You don't need me to introduce you , Jim , Everybody knows you . So let's jump right into this , right , Because this episode is about it's very kind of you . I don't know if it's true , but it's very kind of you . This episode , guys , we always talk about from experience .

So about several years ago , we got a property in Pennsylvania and then since then we've gotten several other properties with that and we've seen some successes and we've seen some you know , not so successes . I wouldn't go as far as saying failures right , Because we haven't failed .

Interest rates are close to 7 percent , student loans are through the roof , and so forth , in terms of , you know , interest rates .

The plan was for me to practice medicine and actually I did all our projections , with me making $225,000 a year , because that's what emergency docs were making back then . That was the plan and that plan was working fine and would have worked fine even if White Coat Investor had never made a cent .

But you know , I got all excited in 2011 about passive income , about a side gig , you know . And yes , I felt very passionate about the white coat investor mission .

I'd already been doing that for four or five , six years online on various online forums , but I decided to want to start a business doing it and and my goal was very modest it was I wanted to be making a thousand dollars a month within a couple of years .

And if I didn't make that goal , the backup plan was actually to just go start a direct real estate investing empire . So you know , we never got beyond one property and it was an accidental rental . All my other real estate investments and about 20% of our portfolio is real estate . All of my other real estate investments are passive investments . You know .

They are syndications , they are private real estate funds . They are , you know , vnq , the Vanguard real estate ETF . So I've opted to put my active time into White Coat Investor rather than a direct real estate investing empire .

But I certainly thought about it , and I even think about it still from time to time , and then I got to remind myself I'm trying to simplify my financial life .

So if you want to be in the private real estate investing world which I think is perfectly fine , it has lots of advantages over public real estate . I think funds are better for the vast majority of people .

You've really got to want to be able to do the due diligence on that single property before buying it , to be interested in a syndication rather than a fund that's going to get you 10 or 15 different properties for your 50 or $100,000 .

You know what's going on out there , if you know what I mean . Anybody who knows the reference , you know you can really get out there and kind of have a voice out there . And I'm just very interested in , like , the bad stories about syndications and I just remember you know there was a lot of investments .

You know we got approached by several companies in the past and so forth . But I'm just really interested in the public sentiment about syndications right now . And I think you know one of the things , particularly for the young doctors who are out there right now , because obviously we are just recording right after match day , right .

So you got a whole host of young doctors who are transitioning to becoming residents . They're going to be used to getting a certain amount of money that they've never had before .

There's going to be , you know , maybe a little bit of some lifestyle creep from being a med student to now having some cash and so forth , but basically they're going to be targets , right , whether it's some type of financial product or some type of real estate product .

What's advice that you're giving to these students , or actually to these medical residents who are maybe in a high cost of living area , are considering a should I just get like a , you know ? Should I rent ? You know I'm living in New York , or maybe I'm living in Cali or I'm living in Atlanta . Should I rent ?

Or , you know , should I just get like a duplex ? But with these interest rates , I mean it's hella high .

If you look at the historical data , you got to be someplace three to five plus years for it to appreciate enough to overcome the transaction costs of buying and selling , and residency tends to be three to five years long . So it's always been a gamble to buy as a resident . Now there are times when it pays off .

Right In the last five years it's mostly paid off . If you bought a house when I started residency in 2003 in Arizona and you sold it when I left residency in 2006 , you did just fine . You might've doubled your money .

is what people need to understand . Now , I can't talk most medical students out of buying a house as a resident . It doesn't matter what I tell you , you're still going to buy the house . I can't talk you out of it . And that's fine , because sometimes it works out . It doesn't matter what I tell you , you're still going to buy the house .

I can't talk you out of it . Um , and that's fine , because sometimes it works out . It probably works out about a third of the time for a three-year residency and about half the time for a five-year residency . And the truth is your income is going to go up so much anyway that you can bail yourself out of your bad decision .

You know , and uh , so yeah , you lost money , but it doesn't matter , because now you make $350,000 a year . You know that's the truth for most doctors is they do okay because their income bailed them out .

Cause I know there's always that well , you're paying somebody else's mortgage and you know what's mortgage and what do you notice for residents to jump on that I mean there's two industries working against you here , right , there's the realtor industry , there's the mortgage industry .

That's throwing money away just as much . That's number one . And number two this idea that owning a home is the American dream . Right that you haven't made it until you own a home . And I think it's even more prevalent among physicians' spouses than it is among the physicians , If you like .

I have been putting up with living on student loans for the last four years and a few years before that in undergrad . I want a freaking house and I think that's what drives it quite honestly .

But I've been working with her for several years and during the time she's a non-traditional pre-med , during the time that she was kind of trying to get herself together to get into medical school , we had a conversation one day and she goes I think I want to buy a house . And as a pre-med I said are you crazy ? Now she was what , 27 .

At the time all of her friends were getting married , having children , buying houses , and I said your trajectory is not their trajectory and you can't . You know this is apples to oranges . So the other day when she got into medical school , we just had a conversation on Friday and we absolutely laughed about that previous conversation , about her getting a house .

But I think you're right . You know it's this idea of the American dream and I'm going to be missing out if I don't do it . So certainly when I become a resident and now I'm making some income I deserve this house . So it's just very interesting .

They're like oh well , the mortgage payment is less than rent , so I must be coming out ahead . They forget all those other expenses of homeownership and until you've owned a home or two , you don't realize that sometimes you got to spend $14,000 replacing the roof .

So I've really done lots of roofs . They are more expensive now than when I paid 14,000 for sure Solar panels . You got to make sure it pencils out and most of the time it doesn't pencil out without the big tax break from the government . If you're not getting a big tax break , it's probably not going to pencil out .

It's very easy to overpay for solar panels to be sold a way too expensive solar panel system and come out behind on it . If it's going to take you decades to recoup your cost , it probably doesn't pencil out . You might want to still do it . You know , maybe you just care that much about being solar and saving the planet or whatever that it still makes sense .

But you've got to make sure it actually pencils out . There's actually quite a bit of shopping around you need to do to make sure you're buying a system designed to be bought , not sold , and paying a fair price for it . You know where you live matters . What direction your roof faces matters . You know your weather matters .

You know how much you're paying matters . What you're doing with the electricity matters . You really got to run the numbers on this one .

But if it looks like you're like , oh , this is going to take 22 years to pencil out and I might only be here for six more years and maybe the person buying it's really going to value these solar panels , well , maybe they won't . You know , and don't expect that you're going to get the money out of the solar panels you're putting in .

You really need to get the money out yourself while you own the home , not count on being paid more from the next buyer .

You know what's going on with us Two physician couple right , renee OB I'm trauma surgery . We podcast , we have other businesses , but we also have a real estate business that we're pretty proud of , right . But also , at the same time , there's a lot of work that goes along with it .

You know , so we have investments in there , we have a syndication , but keeping track of all of that , like you said , is like a second job in itself are you giving them , because there's always this craze of , yeah , you're a full-time doctor , right , and then you still got home life , and then you also have these side hustles .

There's got to be a way to prioritize all of this stuff . What's your advice in terms of prioritizing , making sure that you don't get too over-leveraged in real estate making ?

? What's the right balance for us ? And I think there's a few concepts that are worth talking about . The first one is real estate investing in general . Right , a real estate investing is a viable pathway to wealth , right . In fact , it might be one of the fastest pathways to wealth with the reasonable amount of leverage and reasonable amount of work .

In fact , I think maybe the fastest way to financial independence is actually to come out of residency . Do all of your physician work as a locum tenens and put all the money you can scrape out of that that you're not spending , because hopefully the locums company is paying for most of your living expenses .

Take all the money you can scrape out of that and build a short-term rental empire . I actually think that's the fastest way to financial independence . I think it could probably be done relatively reliably in about five years . I really do , but it's a lot of work . It's not the lifestyle most of us would choose . There's a lot of downsides to it .

There's some risk there . You're going to have some leverage risk as well , but that's probably the fastest way out of medicine that I can think of . That said , I don't think that's what most people do . I think most people are like you . They get all excited about real estate .

They're like , look at all these cool people doing all these cool things with real estate . Let's get us some of that real estate . And then they're forced to try to decide how they're going to invest in real estate . And there's all these different ways to invest in real estate that are totally reasonable . Right At one end of the spectrum is VNQ .

Right , it's the Vanguard real estate ETF . Right You're buying 120 or 140 companies , all this publicly traded real estate . You're very diversified , it's very liquid , it's very passive , it's very easy .

Right At the other end of the spectrum , you're buying properties with nothing on them and you're getting permits from the county and you're building the place and you're renting the place and you're managing the place and when you decide to sell the place , you're exchanging it for another real estate .

You know property and you know and there's all this other stuff in between . You know private funds and syndications and turnkey properties and short-term rentals and long-term rentals and all this stuff in between . The most important thing is to match you and how you want to invest in real estate to where you fit on the spectrum .

And in my case , I'm a busy guy . I'm doing white coat investor stuff . I'm still practicing medicine . I want to be out adventuring in the world . I'm living this post-financial independence life . I don't want to spend all my time working . I chose the very passive side of that spectrum . I don't want to spend all my time working .

I chose the very passive side of that spectrum . Right , I'm in some passive private real estate funds . I have a few syndications that I'm just waiting to go round trip , mostly private funds and VNQ . That's my real estate investments . You know , I thought about putting together a real estate empire but I just decided it wasn't worth the additional work for me .

So I think you've got to match your desire , your ability to invest in real estate to where you should be on that spectrum . And I think a lot of people kind of shotgun and they own a little bit of this and a little bit of that and a little bit of this .

Well , that's fine in the beginning , but after you have two or three or four of those , I think you got to dial in what you like , right ? Would you like running short-term rentals ? Do you like , you know , getting landlord style calls ? Do you hate having not having the control with a syndication or a private real estate fund .

Does that lack of control bother you ? You know you got to look at all those factors and decide where you fit on the spectrum and I think if you match yourself well on that spectrum you'll be happy with your real estate investments . But your place on that spectrum is not the same as somebody else's place .

And so , you know , I was talking with a colleague of mine and she does full scope OB and she was just at her wit's end because the day was busy and she just could not see , you know , in the future , when she was not going to be this busy again , whereas I'm coming in and relieving her doing locums .

And you know I tell her listen , you know she had some . She had some notes that needed to be done . That was some nursing notes . I'm like you know what , go home , I can do those things . And she's like oh , my God , thank you so much . And I said well , you know I work a month at a time .

So you know it's going to be a hard weekend , but I have a month to recover . You don't just go home . And so we started talking a little bit more about just kind of the lifestyle .

And it sounds like it's kind of the same thing with real estate , right , you have to figure out what you want your life to look like first and then start cherry picking the things that actually work for you .

So if syndication is a thing that works for you , then fine , understand that there are going to be pros and cons to anything that you do , but you have to be able to do that , and so Nii is . He asks me if I want to get those phone calls because we have a property right now which our property manager is .

I won't call her a nightmare , but she's not a dreamy . It's the hardest thing to hire . It's the hardest thing to hire .

, going away ? Is that something that I want to do ? Because if I get that call in the middle of the night and my husband is away and I have my kids at home , what am I going to do ? So , yeah , this this has been a really good topic to discuss , because now you've got me thinking , jim .

And , property manager , it's hard to get a really good one and they charge so much , and I can still do it myself . Well , that's a hard space to be in , right ? When you have 15 doors . Or you have 20 doors , you're like , of course I can't manage this myself . Right , it's a no brainer . Of course I have to have a property manager .

And now you're going to a property manager with 20 properties . All of a sudden , they're much more interested in your business . You end up with a better property manager . You end up , you know , just , you got some economies of scale . You have to put some systems in place that reduce your hassle , whereas you were just winging it with two properties , you know .

And so I think that's a really a bad spot to be in with just a couple of properties . I think what you want to do is either go okay , this is what we're going to do . We're going to build this empire and we're going to get it to 15 or 20 or 30 properties and uh or or or . You just don't do it . You do private stuff , you know you do .

You do syndications , you do private funds , you do VNQ , you do whatever . I think that's a tough place to be , and I think that's where a lot , a lot of docs end up is , with one or two or three properties , and then they have these dilemmas that you're facing now .

So I think you guys just got a decision to make one way or the other either got to build a bigger empire , or or you got to realize that real estate's cool but you're not direct real estate people .

I'd be buying a property in Florida and they build the house to rent . Then they put a tenant in it , they sell it to me and I own the property . So I have control of when it's sold and any big upgrades , the big decisions , but none of the small decisions . They handle all that . They do all the management . When I'm ready to sell , they sell it .

It's turnkey . I literally could buy a dozen of these properties and never see them in my life , never get a call about them in my life , and I think for somebody that really wants the unique tax benefits to owning the properties yourself and having that high level of control over them , but doesn't want a management nightmare , that's something to consider .

Plus , you get out of whatever high cost area you're in . You know I mean buying a local place here in Salt Lake now is starting to get crazy . You know the average home here is six or 700,000 or whatever .

Salt Lake , yeah , it's getting expensive now , and so that would give me a chance to go to a less expensive market where instead of buying one property you could buy three , you know , and have a little bit more diversification that way .

But something to consider I I you know another place on that spectrum is is a turnkey yeah , rental , that's true , that's something we had that .

I don't know how many people defaulted before I did , but I can imagine , though you know , they're getting a guaranteed check , a guaranteed refund check , they're using that to pay him , and so forth , but I'm sure he had to chase them down a couple of times , but the profits could have been that high .

We listen , it gives us the career fulfillment that we need but also , at the same time , it allows us to have the work-life balance that we need to have , right , it allows me to be here to talk to you . It allows me to be , you know , plugged in with my family , my kids , my wife , and still be here and talk to you guys for close to 10 years now .

So listen , let's answer this question from

Dr Kevin . Dr Kevin is a full-time locum tenants emergency medicine physician , and this is what he writes . I love the flexibility of locums , but since I'm not employed by a hospital , I don't have benefits . This is real . Should I really be thinking about disability insurance right now , dr Kevin ? I appreciate the question .

Thank you very much for writing in this question . You know I got all the answers and the short answer to this is 100% yes , yes . And look , if you're already working as a locum tenens ER doc man , you should have had disability insurance yesterday , right , man , you should have had disability insurance yesterday , right ? So let's get to the point .

Like , one of the biggest misconceptions I would say about disability insurance right now if you're listening is that you can worry about it later . Right , I'm gonna worry about it later , I'm gonna take care of it when it comes up , and later you can put whatever time reference , time interval on it . But it's a big deal , right ?

Because , especially as a locum tenens doctor , you are your own safety net , right ? Like ? You don't . There is no HR department if an issue occurs , there's no benefits package , right ? Part of the reason why you get paid so well is , you know there's no benefits , right ?

So you have to purchase benefits on your own right and there definitely is not any type of employer-backed disability coverage . I'm going to be very honest about that .

And even the employer backed disability coverage that you have is not very good , like , even if you are working as an employee doctor , you should have your own private type of disability insurance , and that's real talk , right ?

So if something happens to you an injury , an illness , a burnout related condition and let's be real , that happens more often than you think and let's say you can't work , your income stops . That's it . There's no salary that you get to depend on . There's no work , that means there's no pay , right .

So that is where a private disability insurance plan comes in . And also , if you're looking for a private disability insurance plan , like you got to make sure that it's true own occupation policy . I'm gonna say that again Make sure it is true own occupation policy .

You want to be sure that when you're looking at a plan that it says that lingo in there , right . And that means that if you can't work , I'm gonna be honest . If let's say let's get to the real let's say , as an emergency medicine doctor , or let's say you're an anesthesiologist , if you cannot work in that specific field , right .

Or even general surgery , right , I'm a general surgeon . If I can't do general surgery anymore but I want to do something else , that means I'm still going to get paid , right , and that's a really big deal .

Right , there's a lot of fine language out there that is meant to trip you up , but if you have true own occupation disability insurance , that means that you can do other things . If you can't work in your specific field , right . And since you're a 1099 contract I got a little cheat code here . Right , your premiums may be tax deductible as a business expense .

So not only are you protecting your income as a business expense , so not only are you protecting your income , you're being smart with your taxes also . Now that last caveat I'm going to be honest with you make sure you talk to your tax professional about that . Make sure you talk to your financial advisor about that .

They may give you some additional or a different type of advice . So super important that you run that by them first . Okay . So look , disability insurance , dr Kevin , it's not about fear , um , it's about financial responsibility . You've worked hella hard . You've worked way over 10 years to protect this career , to build this career , excuse me .

So protect that income at all costs , right ? It's super important , right ? So I recommend , if you're looking to get disability insurance you listen , I'm telling you right now I recommend you work with Jamie Fleischner with Set for Life Insurance . All right , we've been working with her personally for over 10 years .

She helped me and Renee get rid of our really expensive disability insurance and get to something that was way more cost effective and actually had better coverage , and that actually was the biggest start of us . Paying off our student loan debt was us first realizing that , hey , we're paying way too much to disability insurance as well as to whole life insurance .

Let's get something that's way more economical . And three years later , we paid off over almost $700,000 of student loan debt . So we know a thing or two about working with cost-effective disability insurance Super important . So I recommend Jamie Fleissner with Set for Life Insurance . She specializes in coverage for doctors , especially independents like you and me .

All right , so there's no fluff in what she's talking about , it's just honest advice . And she's got access to multiple top tier carriers . So I want you to take a look at setforlifeinsurancecom or tap on the link in the show notes to set up a free , no-pressure consultation with her .

Super important and remember this is Docs Outside the Box , and outside the box doesn't mean unprotected . Dr . Kevin , thanks for writing in . To Kevin Thanks for

writing in . Hey , let's do a little quick change , real quick , because I want to talk about some of the current policy impacts on student loans , because there's some changes that are being proposed . If I was a med student right now , or if I was a resident , I'd be a little bit nervous as to what decisions to make and so forth .

So there's proposals to possibly end PSLF , possibly proposals to put caps on loan forgiveness . Man , what a time .

You need an hour with an expert in a spreadsheet . And so we hired somebody who actually made this his career , this fellow by the name of Andrew Paulson , who runs this for us , and that's what he does . He meets with literally hundreds of docs every year and helps them walk through this stuff , and so he just sent me a message yesterday .

This is literally yesterday . I got this at 1243 PM yesterday . He's like hey , a couple of big things come down the student loan pipeline that you ought to be aware of , and then talking to people about this is just stuff that happened this weekend before we were , I don't know , crazy Right , I don't know when your , when , your , you know podcast goes live .

It really was a nice program for borrowers . I can't express how nice this would have been for doctors indebted doctors to have access to for decades . But as a taxpayer I go man . That's awfully nice for doctors . No surprise , this one's going away .

It was an IDR program where basically your loans no longer went up in value in residency even though you basically weren't making payments on them . So that thing's going away . What most people are probably going to end up in is the new IBR program . I'm not going to be easy about that .

Up in is the new IBR program , and so repay , pay , save probably all gone . It's interesting . You got to think about this stuff from the perspective of how did it get put in place ? Did it get put in place by executive fiat or by an act of Congress ? And if it went through an act of Congress , it's much more likely to be long-term Okay .

So IBR went through an act of Congress , and that's why that's probably what we're reverting to . All the other stuff was you know that was an executive action . Pslf also went through an act of Congress , so it takes an act of Congress to get rid of PSLF . President Trump can't just sign a paper and PSLF is gone .

That's not how it works , and so I think that's an important thing to recognize . So the save's probably dead attendings are relying on .

But these are things . Should I go into locums ? You know , that's a big scary thing too . If you go into locums , you are out of this Right . So yeah , I'm sorry , but I cut you off , Go ahead .

I think anybody already in the program is going to be grandfathered into any changes that take place . So I would not panic and bail out of PSLF because people talk about it going away . It has not gone away . It is still there .

You might be using a different IDR program to make your payments , but PSLF is still there and , assuming that is your student loan plan , I would stick with it until 100% for sure it's gone .

And if you're really worried about it going away I'm actually not that worried about it going away for people who are already in the program If you're worried about it , what you should do is you should save up what I call a PSLF side fund , right ? This is money you would be using to pay off your student loans quickly .

You know , I tell people live like a resident for two or three years after you finish residency , pay off your student loans , you know . So you're sending them $5,000 , $10,000 a month payments to your student loans .

We don't think that's going away , for those at least who are currently in the program , and for everybody else , the only way to make it go away is an act of Congress . Okay , so that means the president's got to sign it , it's got to pass the house of representatives and it's got to pass the Senate with the filibuster proof majority .

Right , that's 60 senators . Well , a lot of the Republicans will vote to get rid of it , but count the Democrats that will vote to get rid of it , and I bet you can't come up with enough of them . How good is Cory ?

It wraps around and it can tell what your heart rate is , it can tell how long you sleep if you go to bed with it , and like he released that and it showed , like , how , like he was becoming tachycardic at certain points , oh my gosh , you know , you know how much dehydrated he was and it was really interesting to kind of follow , like starting at hour one ,

all the way Can you not drink when you filibuster and then ? You probably shouldn't .

So that's good . But there's another thing that's like a bombshell this weekend that people ought to know about . There are a bunch of people that used to be , you know , filing their taxes married , filing separately to try to get some advantages with their student loans .

Right , because you basically , if you're married to an attending , you were trying to show that you had this really low resident income .

So this is this is breaking news and and people ought to be aware of this If you're using that technique , it might be time to rethink your technique . You might need a new plan . Maybe it's worth going and spending a few hundred dollars with Andrew and getting some specific student loan advice , but you know , be aware of that change coming up .

They're getting forgiveness on loans . They should be paying back . Or they getting these sweet deals on their income driven repayments . And why are doctors getting $400,000 forgiven if you know they make so much money ? It's kind of pushback against that .

So now , with Republicans in control of the House and the Senate and the White House , you're seeing some of that come back into student loan policy .

Will it shift people ? Which specialties they're going into ? Um ?

no-transcript . I've always talked about how this is an individual decision and it's very interest rate dependent . So maybe for somebody early in their career , maybe taking some additional leverage risk in their life is a reasonable decision to help them meet their financial goals , and they've got a mortgage at 2.75% .

Well , shoot , maybe it makes sense for them to invest with additional cash they have rather than pay off the mortgage . I think the calculation changes when you have a mortgage . That's 7.5% , though .

7.5% is a very attractive guaranteed return for an investment , and if that's what you can get by paying off your mortgage , well , that might be worth doing rather than investing that money . So , in that respect , I think interest rates have changed .

Obviously , people's personal situations and personal lives change and over the years , you know , maybe carrying that debt's not so necessary . So much for you to meet your financial goals , and it's time to , you know , drop a bomb on your mortgage and get rid of it . You know we paid off our mortgage in 2017 . It was a 2.75% mortgage .

At that time , money market funds were paying 1% .

Eventually those mortgages either get paid off or people move , or they refinance them or whatever . But for those who have them , man , it makes a lot of sense to borrow money at 3% and make 4% in a money market fund , or maybe make 7% or 8% or 9% in the market . You know , it makes a lot of sense .

But that's a very individual decision of how much debt to carry and when to pay it off and what you do with your extra money , whether it goes toward investments or paying off debt . A lot of variables there and I wouldn't say there's one right answer for everybody by any means .

money ? And for me it was just I don't want the psychological burden of owning this or of owing this student loan debt , like it was just way too much . And I think that that's the factor that a lot of people don't necessarily consider .

When they're just looking at numbers and saying , hey , this is what you should do , because this is what makes sense , it's like , yeah , but how successful am I going to be at doing that if I have this other thing that's just eating away at me ?

And we haven't taken out debt since . Right , we don't miss it . We can always go out and get another mortgage if we want to . We don't miss it . We're not going back to get it by any means , and uh . So there is this whole other way to live and um , and we have definitely taken business risks we would not have taken if we still had debts . Um and uh .

And they paid off . So it's not just a simple looking at your rated projected rate of return and the interest rate on your debt . There's more to it than that .

Uh , there's just so many factors that go into it and so many individual aspects to it . If you think this is an obvious answer all the time , you don't understand how complicated it can be .

I think it's a white collar job . It's a professional job .

It was just a duty of being a doctor and you were on the medical staff and so you were on the call list and now everybody wants to be paid and so it means you got gaps in your call list and that has effects on patient care for sure , absolutely . And the bottom line , and that has effects on patient care for sure .

So I went ahead and kind of just condensed all these different questions into like just one sentence type quotes Is it too late to get into real estate with interest rates so high ?

There are better times than others , of course but sometimes you can only recognize those retrospectively .

If I go invest in Florida , I'm not going to have to do a Florida return because there's no income tax in Florida , but I still have to pay Utah state taxes on that income . So it doesn't necessarily get me out of it .

So I don't know that the state taxes should drive a lot of decisions , other than if you're trying to keep the number of state tax returns you filed down . Um , you know , a couple of years ago I filed in . I filed in 12 states . That's a pain , right . I'm like I can't even figure out what states I got to file in .

That's what drove me to actually hire a professional for the first time to file my taxes . Oh yeah , you've done them always by yourself . I had always done it by myself until then . I couldn't figure out which states I had to file in .

If you want to avoid that sort of situation , well , only invest in real estate in states you already have to file in , or in tax free states , or in states where they do a composite return , you know , and they just pay the taxes for you . The investment pays the taxes for you to the state , so you don't have to file a return there .

Um , but , uh , that that can be complicated for sure If you're investing out of state in real estate .

Should they avoid PSLF ? Should they just pay it off on their own , or would you always just recommend going into PSLF ? Does it make mathematical sense to do PSLF ?

I mean , if you can get PSLF , yes , it pencils out . If you can't get PSLF , you might as well pay them back . Now the next question , of course the follow-up , is should you deliberately take a job you don't want to get PSLF ? Right ? That's a different question . You got to run the numbers .

I mean , if this thing's paying you $100,000 less than you'd make at the other job , just so you can get PSLF , that's not going to pencil out , right ? I mean , it's like when I was in the military , I left residency in 2006 . And emergency docs then were making about $225,000 a year . My job in the military paid 120 . That's what I was making .

I can pay off a lot of student loans with the difference between 120 and $225,000 . Right , and so if you're not getting similar income at that PSLF providing job , or you don't otherwise like that job for some reason because you want to be an academic or something . You know that doesn't make sense to take a much worse job just because it gives you PSLF .

But if you want the job anyway and it qualifies for PSLF , shoot , you know , go for .

So yeah , um , but yeah , I mean I think we're seeing a lot more doctors striking um residents striking you know things that I have . To be honest , I just never thought that I would see .

I think this is a big reason why burnout rates are higher . Because we have less control over our jobs . We think that doesn't matter as much when we first come out of residency 10 years out .

I think it matters a lot to have control over your work environment and who you work with and how you get paid and how you divide up the money and all that kind of stuff . I think it matters and , um , and I , I think , uh , we ought to push as much as we can for docs to still own their jobs as much as possible .

I think it's good for docs , I think it's good for patients .

Not to say that the other spectrum is bad , it's just that this works for us .

And , you know , in some form or fashion I do think doctors should have some portion of their medical practice , either be as an independent contractor in some form or fashion , where they are like directly in control , where they're not employed to have to perform that practice and so forth . So you know , locums is growing bigger and bigger .

Now I don't know what's going to happen

with private practice . I don't know if there's ever going to be a resurgence with that , with the rate at which these hospitals are purchasing private practices and so forth . But that's kind of where we stand on it . Your thoughts on locums . Will there ever be a time ? That's what I want to know . Yeah , do you think there will ever ?

Is there a tipping point ? Right that there will be more locums right because there's always , there's always a , there's always a swing right , and sometimes that swing could be really like to one complete direction , right . Like could that happen ?

They were getting paid so much more to be a travel nurse that they were doing that , and in a lot of places that's how locums for physicians has worked out that way . They were getting paid so much more to be a travel nurse that they were doing that , and in a lot of places that's how locums for physicians has worked out .

They've treated the doctors that are there locally so badly that they've left and they got to bring in locums docs and pay them so much more , pay so much more , you know , to the locums company and the docs in combination that they're actually coming out behind if they just treated the docs well in the first place .

You either didn't appreciate someone , you didn't reimburse them in a way that you should , you didn't give them retention the way , how they needed , or you know , like you said , when you bring in a locums nurse or a locums PA or a locums doc , you know you have the person who's employed and they're doing the same shift and this person is bringing in 10 times ,

20 times more than what you're bringing in Absolutely . That could be frustrating .

And way too much locums opportunities are coming up just because of short sightedness of employers that they have not treated the doctors they could have had long term . They haven't treated them well and so they've lost them , and now they have to hire locums because they have to have somebody in that slot .

You know how to handle your finances while you're in med school as well as you know some of the things that could happen if you're not really paying attention to your finances once you become a resident or once you become an attending . So , dr Dolly , is there a way ?

Can you just let people know real quick what's the best way for people to I don't know why I'm even saying this , but to even go and find out more about your writings and so forth ? Let them know all the ways they can follow up with you , please .

And you know , however you want to , you know , learn this financial information . You do need to learn it . Pick the way that you learn best and we put this information into that format for you Excellent .

So let's talk about the blue collar , white collar thing , because I think this is a really interesting debate , right , that was a really interesting debate .