When you are successful, it is easy to believe that you are special, your ego stroked by a seductive inner dialogue.  I did this.  I built this.  I am a physician, an entrepreneur, a real estate investor, a business owner, and an educator.  I am financially independent.  I built this.  

     While confidence is necessary, and a certain amount of ego is helpful, when you start to believe your personal narrative a little too much, it spills into narcissism and is counterproductive.  And it just makes you an asshole.  As we strive to improve ourselves, to be better at medicine, business, and personal finance, we all need an ego check from time to time.  This is mine.

     While I write primarily in the first person, I want to clearly acknowledge that I did not get to where I am alone.  I did not pull myself up by the bootstraps.  Nor did I not lock myself in a room somewhere and invent a new product that revolutionized the world.  I worked hard but also had a healthy amount of assistance, good fortune, and privilege.  This is not false humility nor an attempt to be woke.  It’s simply my acknowledgment that I had a tremendous amount of help getting to where I am today.

    My mother was a schoolteacher who constantly pushed education on me, loved me unconditionally, and encouraged me.  We weren’t rich, but I always had food to eat, and there was always food for my friends, which my mother was very proud of.  My parents never divorced.  I always had a roof over my head.  I always had books to read, and I always had hugs and kind words.  These things are intensely, enduringly important, and their impact on my life should not be underestimated.

Lady Luck

    Lady luck has smiled on me throughout my life and has played an outsized role in my financial fortunes.  I was blessed enough to be born to a middle-class family in the world’s most prosperous nation, raised without experiencing famine or war.  While it’s not lucky that my father died when I was in high school, it allowed me to qualify for Pell Grants, which paid for a large portion of my undergraduate education.  During the time he was alive, we were in that grey zone, as my parents made too much money for me to qualify for aid but too little to help me pay for college.  While I still needed some loans, I accumulated less debt than had he lived. 

I was fortunate to get accepted to an in-state public medical school and to receive a general assembly scholarship, which paid all the tuition my first year, allowing me to keep my student loans to a minimum.  My first job out of residency was lucky because I could work as much as I wanted, which is not the case everywhere.  I started my career during what I call the golden age of emergency medicine.  There was a high demand for my services and a low supply of qualified doctors.  ER salaries rose quickly during the first decade of my career.  Contract management groups had not completely overtaken the industry, and insurance companies had not utterly ruined reimbursement. 

Business Luck

I was also fortunate to be invited to help start an ER group just two years after graduating from residency.  It would be foolish of me to believe that I did anything special to deserve that.  I was simply in the right place at the right time.  I was also lucky in the timing of my investments.  While I started investing in real estate just before the market collapse of 2008, I did the bulk of my real estate investing after the great financial crisis, which allowed me to purchase many properties at low prices and with historically low mortgage rates.  A historically bad stock market crash a year after you begin your career is also, paradoxically, a wonderful stroke of luck.  There are many, many other examples of my good fortune, but you get the point.

personal finance business

    I have partners in all my businesses.  The ER group would never have been successful without them.  The main thing I contributed at the outset was labor and enthusiasm.  While my business acumen and influence have grown over time, there is no doubt that the group would have been successful without me.  The same goes for the urgent care business.  While I have certainly played a leadership role, one of my partners has done the lion’s share of the work.  The UCs would have never been successful without her dedication and sacrifice.  Additionally, dozens of others have contributed to the businesses’ success that usually receive no credit.  The APPs in the ER, the business managers, the billers & coders, the front desk staff at the UCs, and the back-office staff all have played a significant part.   

Personal Acknowledgement

    Finally, I got two critical things right.  I believe the two most important decisions you make in this life are #1, with whom you choose to procreate, and #2, with whom you marry.  Fortunately, I hit a bullseye with my wife.  I have benefited from her advice, flexibility, dedication to our family, and, most importantly, patience.  

personal finance journey

     Acknowledging that I did not get here alone was only the first step.  I have always felt strongly that I could be placed into any situation and thrive through sheer hard work.  That ego served me well in my youth but has been tempered with age and experience.  Hard work is probably the only part of my story I could control and replicate if needed.  Pretty much everything else has been heavily influenced by circumstance.  I have seen a lot during the last 20 years in the ER.  I’ve seen people get shot in the head and be discharged.  I’ve seen others get shot in the leg and die.  I know now that the wheel of fortune could have stopped in a different position at many points in my life, and if it had, I wouldn’t be here writing this as the same person, if at all. 

Future

That is why the next step on my path is to teach medical professionals about business and personal finance.  Through the years, I have found that these topics were sorely lacking in my formal education and that I would have benefitted tremendously from learning them earlier.  I have informally taught colleagues and formally lectured to residents and fellows about this topic.  Now, I am writing to a larger audience.  This is one way I can give back but a fraction of what I have received.  Please join me as we explore the topics of business and personal finance as medical professionals.  I’m excited to teach and learn with you.