Denise (00:07):
Myth, Magic, Medicine and everything in between, two doctors talking... Hii, this is Denise Billen-Mejia with Myth, Magic, Medicine and my guest today is Elisa Chiang who is an MD/PhD and an ophthalmologist/oculoplastic surgeon. So I'd like for her to introduce herself to you and explain exactly what it entailed to get there and why she's pivoted slightly in doing something a little bit different these days. So over to you
Elisa (00:43):
Thanks for having me. So I guess just to start with, even earlier, I did my undergraduate training, I don't know why I call it training. I went to college at Caltech, which is a very research-heavy institution. And in all honesty, you almost get a graduate education as an undergraduate at Caltech. So my junior/senior year classes were all with the graduate students at Caltech. So that I think really developed the idea of doing the PhD with the MD. Honestly my first thought wasn't necessarily to go into medicine. I was pre-med when I was in college, but it was kind of lik, it wasn't necessarily the entire goal. I actually got an engineering and applied science. I majored in engineering and applied science, and I did a concentration kind of essentially in neuroscience and so that there was some biology bridge to that.
Elisa (01:34):
So I did take a lot of biology classes for the neuroscience component and I did really enjoy that aspect, but I also did a lot of programming and more technical side. I graduated undergrad in 2001. So right after the tech bubble, not a great time to get a job, I did apply for jobs. I actually applied for jobs in like management consulting and, investment banking and didn't get any of those jobs. I did get a job as an engineer, essentially as a programmer and then I decided that, looking at the economy, that maybe being a physician would be a nice, safe, secure job where I could really serve people. And, you know, I did volunteer at hospitals. I mean, I had awareness of what it was to be a physician. And I think part of that even probably made me think, I remember there was a resident that I was kind of working, or shadowing for, a little bit, and he was like, you know, if there's anything else you'd love to do, you may wanna consider that first.
Elisa (02:35):
So, so I did consider it, and then I decided to just go ahead and go to medicine. So I ended up doing a year of research while I was applying for medical school. And I applied for that MD/PhD partially because I didn't want to take on the loans for medical school. Medical school was, you know, quite expensive. I had taken on loans for undergrad. Those were manageable and again, I had a very research-heavy background and I thought, well, you know, it would be great if I could try to combine some research with the medicine and so I applied for MD/PhD programs, was accepted in two, ended up going to Case Western Reserve, and spent eight years there. And during my graduate years, it's the first time, in retrospect, where I actually experienced some burnout. I had a principal investigator (PI) that's the first thing you're going to work for when you're a graduate student who was, who micromanaged, quite a bit.
Elisa (03:25):
And so I didn't feel like I had as much autonomy and that, that is why that loss of autonomy in retrospect was kind of some burnout. So I started reading a lot about personal finance and investing. I read Rich Dad, Poor Dad. I actually ended up finishing my PhD a little off-cycle. So I finished it in like three years and three-four months and so I could have gone back to med school, off-cycle, but then given up a whole bunch of elective time. But instead I chose to just take the rest of the year off, go back to med school in July, the normal time you go back to year three. And I spent that time actually flipping houses. I bought a bank-owned foreclosure and fixed it up and got that sold and then did it a second time. And so that really taught me a lot about Investing and, and it was exciting, but, you know it, I won't say it was easy, necessarily, and I did feel like I was also a little lucky.
Denise (04:24):
And I'm assuming you weren't bashing down doors and putting up cabinets. You, you were,
Elisa (04:27):
No, I hired stuff out, but I painted, you know, did, kind of some landscaping. I mean, I kind of did all the things I could do, which isn't a ton, a lot of it was hired out. The roof was hired out, the furnace, the kitchen and bathroom remodel, the refinishing of the wood floors. Yeah. All of that was hired out, but just learning how to hire contractors, get bids, you know, all of that was a lot to learn.
Denise (04:54):
Yeah.
Elisa (04:54):
And so I ended up going back to med school and I actually, I remember during the core rotations, I was kind of like, oh, I don't know if I want to do this. And what I realized in retrospect is I'm really not a fan of in-patient medicine,
Denise (05:07):
The break is you do two preclinical two years, then you do the PhD portion and you go back into third year.
Elisa (05:16):
Yes.
Denise (05:16):
So you hadn't really done any clinical stuff before that.
Elisa (05:16):
Yeah. I mean, there's, you know, some minor, it's
Denise (05:18):
A little bit stuff,
Elisa (05:19):
But yeah, the, the real clinical stuff's not 'til third year for sure.
Denise (05:22):
Yeah. Okay. Sorry. I interrupted you. You're are back at medical school
Elisa (05:28):
And, and again, going through rotations being like, oh, I'm not sure I want to do this. But what I found was I, I really loved fine delicate surgery. And so I started doing electives and I did ophthalmology kind of early on. And I really did love not just the ophthalmology, but because there's a huge wide variety of surgery. And it was just very fine and delicate that, you know, we use tiny sutures.
Denise (05:52):
I remember those, right. I was an ER doctor for a while, so I did sew up a few eyelids in my time -with thread I couldn't see
Elisa (06:04):
So then I, you know, I decided to go ahead and pursue ophthalmology, which actually was a little nerve-wracking, because it's a hard residency to match into.
Elisa (06:12):
And I actually matched into my first choice, which was great and I went to Northwestern. Absolutely loved it there. Did oculoplastics fellowship, Actually oculoplastics is probably even harder to get into than ophthalmology, there are not very many fellowship spots. I actually got a fellowship position that was outside of what's called the ASOPRS, match. It wasn't an official ASOPRS fellowship when I started it, it became an official ASOPRS fellowship while I was in it, but I don't get grandfathered in, unfortunately, so, it's fine, I got equivalent training. So basically what it was that,
Denise (06:51):
So that doesn't make you eligible for the board. Is that the issue?
Elisa (06:54):
No, so, well I'm board-certified in ophthalmology now. ASOPRS has its own membership and there are two pathways into it. So if you went to ASOPRS fellowship, you can apply for membership straight upon completion of fellowship. If you didn't go to ASOPRS accredited fellowship, now you have to wait five years and then apply. I did start the application process, but then they put it on hold during COVID, which is when I got to my five years. So I'm, I'll apply once, once it's
Denise (07:27):
When it's ready. "When it's good for me, I'll come back to you". Yeah. Okay.
Elisa (07:31):
So, but basically my program was so busy. We had five full-time ocular plastics people and one fellow and the one fellow couldn't handle covering five attendings so they started just taking a second fellow. So it was equivalent training. It was great training.
Denise (07:45):
Good. Yeah. So you were loving that and presumably you went out into practice. Did you join a group or did you set up by yourself?
Elisa (07:54):
I joined a, so I decided that I was going to still do general ophthalmology and oculoplastics because I actually really loved cataract surgery and I didn't realize how much I loved cataract surgery until my last year of ophthalmology residency when I was already like you know, already like
Denise (08:11):
Half-way through...
Elisa (08:12):
accepted to fellowship. So I had done an oculo, I'd done a plastics rotation as a med student and then during my intern year. So ophthalmology, back then was a one year intern year. Either. you could do an intern year in medicine or a transitional year or intern year in surgery and then do three years of ophthalmology residency. That's now transitioning to just doing a four-year ophthalmology residency. So during my intern year, I actually did an ophthalmology rotation with someone who did comprehensive and oculoplastics and that's why I really kind of decided I wanted to do oculoplastics, very early on. So I went into residency with the idea that I wanted to do oculoplastics and then, during my last year of residency also really loved doing cataract surgery and there are some ophthalmologists that do comprehensive plus oculoplastics. So that's what I decided to try out first. So I ended up at a practice where it was, one ophthalmologist who owned the practice. There was one employed optometrist. And then, I was brought on and he had kind of been working on like a third person. Like he had a few third persons, some optometrists, some ophthalmologists and you know, they didn't work out for various reasons. And, I guess in retrospect,
Denise (09:28):
Was that a red flag somewhere?
Elisa (09:30):
I didn't think it was, because it wasn't like that many people. I talked to the most recent person who left. He was actually let go. And when I found out the circumstances of why was let go later on, it was yeah. But basically, I didn't know at the time I was interviewing, but he basically said it was justified to let him go. So, Susan who, was straight out of residency. her husband was still in training, so she was in the area while they were in training and then they left after he finished training. So that seemed very reasonable. And then I couldn't talk to anyone, like I think even that,
Denise (10:09):
So you stayed in your, what had become your hometown having been there for so many years when you went into practice?
Elisa (10:16):
No. Oh, so no, I, I, so I did my MD/PhD in Cleveland, went to Chicago for Northwestern, went to Milwaukee for fellowship and then went to Virginia
Elisa (10:28):
So no,
Denise (10:28):
And I was thinking somewhere in there, you got married?
Elisa (10:32):
Oh, well I got married actually, upon graduating undergrad.
New Speaker (10:39):
So, your spouse was fine. We're moving here, now we're moving here now, dear He's not in medicine, right?
Elisa (10:47):
No, he's not medicine. He's a high school teacher. So he moved with me to Cleveland. We actually did distance for, residency and fellowship.
Denise (10:56):
That's a long stretch of time.
Elisa (10:59):
Yeah. , I mean, we had been married at that point for, what, 10 years actually already? So it was,
Denise (11:06):
Yeah, it's doable. I mean there are, there are many, many careers that require that in some ways, I mean, submariners tends to be away from home quite a bit too. Did it, , presumably if he was in high school, he had chunks of time that he was able to go and be with...
Elisa (11:19):
That's what I'm saying. I think it worked better because he had all summer off. He had spring break, winter break. He had, you know, a lot of three -day weekends, like, you know, MLK Day and president's day and you know, kind of other three -ay weekend holidays that other people don't get. So I think that really helped it work out in all honesty. It made it so that I could really concentrate, focus on my training, but when I knew we were together, then you know, I, not that I shirked residency at that point, but you know, I, you could, you know, did little less studying and, yeah, and just planned for that time for us to spend that time. So when we were together, it was really quality time in some ways I almost think it strengthened our marriage.
Denise (11:59):
Hmm. Yeah., I did not have that luxury. We were, , I was trained at the time when a hundred and two hour-week was kind of standard for interns. We didn't have hour caps back then. I don't think I was conscious for a lot of the early part of my marriage. It was - I was at work and then I was just in a state of collapse.
Elisa (12:20):
But yeah. So I still trained when we did the 30 hour call, that was the last year to do 30 hour call, but ophthalmology, I would say our average weeks were about 60, 65 hours. We, we didn't hit close to 80 and we were not allowed to moonlight either.
Denise (12:34):
No, if somebody's operating on my eyeball, I would like them to be well rested, thank you very much. Of course. that's true of most parts of my body. I would rather the doctor had had enough sleep. But so at what point, did you start looking again into finances? Did you continue to invest through your residency and fellowship or...?
Elisa (12:53):
Yeah, so because, when, so I did my intern year still in Cleveland and we were used to just living off my husband's salary. He was a high school teacher, he still is a high school teacher, but he was a high school teacher back then. And, so we just continued to live off his salary when I was an intern. And so I actually was able to put almost my, I maxed out my Roth 403-B at the hospital. I did my intern year at both in 2010 and 2011. So that really gave a lot to invest. I actually started a Roth IRA, for my husband and myself, since I graduated college, my parents just told me like, well, now you're an adult working, you need to put money towards your retirement,
Elisa (13:35):
so you need to open a Roth IRA and put money in it. And at the time they didn't actually explain, I needed to invest that money. But then I was, a medical student and started reading about personal finance. So part of that impetus, that we bought a house since it's an eight-year program. A lot of the MSTP students at Case Western Reserve do actually end up buying their own home and so that got me started reading about personal finance, then reading about investing. So then I started investing with my Roth IRA. I also actually invested a little bit of side money in individual stock picks,, like I bought Starbucks, which has done really well over the years,
Denise (14:12):
Over the years. Yeah.
Elisa (14:13):
Yeah. started reading things like the Motley Fool to learn how to like analyze companies. And then of course did the real estate. I did take a hiatus on the real estate because you know, Chicago's a completely different real estate market, a lot more expensive and then the moving around it doesn't make it easy to kind of learn markets and try to do all that. So actually when my job in Virginia didn't, when the writing on the walls said, maybe I should be thinking about leaving. I made, I actually interviewed kind of all over the place again, but I made a conscious decision to go back to Cleveland for a few reasons. One, I had a lot of friends that I made here from the time that I did my MD/PhD program that were not all in medicine, so they're all still in Cleveland. And then my husband also had friends there from, you know, the long time that he was in Cleveland. Right. And you know, it's a little hard as adults to reestablish all that social connection. After nearly three years in Virginia, I felt like I was just making friends. And so I knew by going back to Cleveland, I would have that social base already. And I would also know something about the real estate market and it would be easy to get back into that real estate investing.
Denise (15:23):
And was your husband able to slot back into the same high school or did he get,
Elisa (15:26):
He was, that was very lucky
Denise (15:28):
That's nice.
Elisa (15:28):
It was very lucky, he didn't get his tenure back. He had to a, he now has tenure again, cuz we've been back here long enough but he had to work back towards his tenure. It was abbreviated to get back to tenure and he did get a job back at the same school. I won't say the exact same job. So he was previously a biology teacher and he had gotten to the point where he was teaching the Honors AP biology. When he came back, there was a biology teacher, who had left as well as a chemistry teacher who had left. And he actually was licensed in both biology and chemistry. So he filled in, so two teachers left and they only hired him. One teacher
Denise (16:06):
That sounds familiar
Elisa (16:09):
And you know, and now someone else had been teaching the AP bio. So he kind of got different courses than classes that he was teaching, but yeah, same school.
Denise (16:18):
Yeah. That's good. And do you have children?
Elisa (16:21):
No children. I think it would've been hard to move this much with children, especially, being separate. I don't know how well it would be to be separate for five years of medical training if we had.
Elisa (16:33):
I don't, I don't necessarily think that would've been,
Denise (16:36):
Yeah, a lot of, a lot of my cohort just, well, I was always jealous of the Indian residents, because they were just bringing their parents over to move in so "here Mom",
Elisa (16:47):
My mom think would've done that actually. Yeah. And I mean, she said many times she's like, you know, I'll help, I'll help in every way I can because she really wanted grandchildren and I am the oldest and I was married, but you know, my sister got married and she's got three kids. Now my brother has three kids,
Denise (17:01):
She's off your back a little bit
Elisa (17:03):
yeah, I've got six nephews, but no nieces. So that's the one thing. No, no girl, ,
Denise (17:11):
I was the eldest of four girls and I had three boys. When they were little, they would do things like climb on trees, get on rooves. I don't understand them. anyway,
Elisa (17:27):
I didn't get on rooves. I definitely climbed trees when I was little.
Denise (17:30):
Well it was, they was the climbing tree with no way down again, and of course coming from, you know, Peds and ER background, I just see disaster. When you see those things, you immediately go to the worst thing that can happen, but, okay, so what did you do when COVID hit? What, did it change or it just continued to grow this interest. When did you start Life Coaching?
Elisa (17:55):
So it was actually a result of COVID and in all honesty, the COVID pandemic was a blessing to me in many ways. So before the COVID pandemic, I was working at a big hospital system, a level one trauma center taking 24/7 call as the only oculoplastic specialist, having my two-week vacation request to Europe denied because who's gonna take call. And I had thought, you know, I had discussed this with the person who hired me before I took the job that, well, if I take 24/7 call, when I'm not around, who's gonna take, you know, cover when I'm on vacation. And their answer was, well, they did have someone to take oculoplastics call before they had an oculoplastics person. Who's very part-time, so he would just deal with whatever he could when he was around. And when he wasn't around, they would be scrambling. And so they said, well, this would be much better than what we had before. So I took them at their word, but then it was like, no, you have to find someone who's going to cover it.
Denise (18:51):
So it's your responsibility.
Elisa (18:53):
Yeah. Yeah. And, they wouldn't let me do the vacation, and the thing is, they wanted me to talk to someone else. So there's no shortage of oculoplastic specialist in Cleveland because we got the Cleveland clinic, we have University Hospital, we've got private oculoplastics people, but yeah, she said I had to actually reach out to Cleveland clinic, or UH so I did reach out to the person at UH, and he was fine with it, but the thing is like, he doesn't actually control if UH accepts the patient, UH, being University Hospital. So anyway, I did actually get that vacation approved, but it ended up not happening because of COVID, but because of COVID I ended up, we had a time where all our clinics were closed and was just going to clinic once, maybe twice, a week to see urgent patients.
Elisa (19:38):
And I only did one surgery during that time, which was a Mohs reconstruction for someone who had melanoma. So since it was, you know, cancer, they let us go ahead and do that during the pandemic. But that gave me time to be at home and reflect, and life was actually a little better. And then Peter Kim had the Leverage and Growth Summit. So I, you know, in my financial background had found the White Coat Investor a long time ago, started following him, you know, follow Peter Kim when he came out, when he was anonymous as Passive Income MD followed the physician philosopher, Jimmy Turner. So it was following all these financial people. And it's funny, somehow didn't get the thought of, "Oh, like, oh, maybe I should actually be putting something out there instead of all these (well, Peter Kim's Korean, but, you know, Jim Dahle and Jimmy Turner are) white men". And so are a lot of the financial bloggers in the physician space, but right. Actually never occurred to me to do that. Much later on,
Denise (20:36):
Is there a gender skew as well? More men than women?
Elisa (20:40):
Yes. There's definitely gender skew with more men than women. There are more women coming on the scene. Bonnie Koo is probably the first of the women's physicians who really started talking about money.
Elisa (20:49):
but now [ inaudible] and myself are also now in that space. Okay.
Denise (20:55):
So that sounds like a good segue for you to start talking about what you do when you're not being a surgeon what is your other job?
Elisa (21:03):
Yeah, so again, so being at that hospital and being on 24/7 call and really not having a lot of autonomy or say, and certainly during COVID, like, you know, there were a lot of things we weren't being told, or even when we went back to clinic, it was like, okay, this is what you're doing. And we didn't get to, I didn't feel like we could even give feedback. I was doing surgery on patients. And when I do surgery on patients for their eyelids, like their whole face is exposed. And so I'm like, you know, a foot and half from them and they're not being tested for COVID. Whereas at the other two big hospital systems they were testing all patients before elective surgery, for COVID, but they weren't testing for me. And I'm like, I'm really just exposed. And I didn't even have someone I could appeal to when I was like asking they're like, well, the committee decided, and that was it.
Elisa (21:47):
So I got coached myself on the burnout and that really helped a lot. And because of COVID, I wasn't traveling and I loved to travel. So that's where a lot of my discretional spending goes to, so I had, you know, a significant amount of savings that, from not spending on travel. And I had thought before COVID to actually leave the hospital and start my own practice, but with COVID and seeing, you know, the fact of COVID shut downs on private practices, I was like, oh, I'm not sure I wanto to do that. Or at least not anytime soon. You know, the Life Coaching industry is not regulated like the medical industry is - highly regulated So I actually, did coach certification, you know, with the thought of like, well, maybe I could entertain this as a side gig or something like that. But, you know, I also told myself that, you know, even if I don't, just the skills I learn will make it will make me more resilient just about
Denise (22:48):
Yeah. You can coach yourself. Yes, exactly.
Elisa (22:51):
Right. Yeah. Um, but you know, of course during training, we do a lot of peer coaching and I really found that I really enjoyed the peer coaching. And in fact, it had some of the aspects of medicine that I was kind of missing that really deep one-on-one connection. You know, I know that there are some doctors who still get that with their patients, but I don't think in ophthalmology and oculoplastics, I really necessarily, there are few select patients where I've developed that. But,
Denise (23:14):
Well, presumably not,
Elisa (23:15):
Not,
Denise (23:16):
You, you don't have a longitudinal relationship with them, do you, they come for a problem and you see them for a few months, but
Elisa (23:23):
For oculoplastics, that's generally the case. Like they come for an issue, I fix it surgically, and then they go back to whoever referred them. There's some issues like thyroid eye disease where I do see them more longitudinally and then in comprehensive ophthalmology. So I would say the patients I got closest with were patients where, I have a few glaucoma patients that I was kind of seeing them much more often. So some glaucoma patients often you'll actually see them every three to four months when they're stable, but when they're not stable, you may be seeing them like really often and then, you know, there are some other kind of eye conditions where you're seeing them super regularly for a period of time. And so there are a few of those patients that I kind of got close to, but it was a very small percentage of my patients who I really felt close to. A lot of ophthalmology patients you just see once a year.
Denise (24:11):
Yeah. Yeah. People like me who just like, "I need new lenses now". Yeah. Yeah. So after you went through the life coaching with all your experience in finance and, and how to invest in real estate, was that what pulled you towards that? Or do you do burnout stuff as well? Or do you think, adjusting how we feel about money is going to help with burnout.
Elisa (24:37):
Yeah. I actually think the two kind of go a little handin-hand, because if you have, you know, a good grasp on your finances and you get to the point where you're even financially free, then you don't necessarily have to work for a paycheck. Now you can really negotiate to do just what you want to do and really build your ideal life. And even before you get to the point where you're financially independent or financially free, once you learn how to kind of manage your money and manage your mindset around money, then you don't feel as, like tied, like I have to work at this job, I need this money. Right, right.
Denise (25:09):
You can see a light at the end of the tunnel.
Elisa (25:11):
Right. You can see how you can build so that you can come financially independent. You can see how you could potentially lower your expenses so that you can, you know, start to cut back at work. And then that might actually make you feel a lot better. And sometimes even cutting back at work, you don't necessarily cut back on your productivity. So if you're paid purely on productivity, it's even possible to maintain a similar income, but working less time when you really manage your mindset.
Denise (25:34):
So that is what you do with your coaching. Your coaching is geared on adjusting people's mindset, helping them adjust.
Elisa (25:43):
I think,, the kind of coaching I do is really working on mindset, because it really all comes [down] to your mindset. So you can create whatever you think you can create. And we say our, you know, in life coach school, we always talk about the model. So our thoughts create our feelings, we act on our feelings and the actions we take produce the results that we have. Right? So it all comes to how you're thinking. And so we are thinking about how you can do things and always coming with a curiosity and a feeling that, you know, the thought that everything is possible and actually feeling that it's possible, then what you can do makes things possible.
Denise (26:18):
So for a physician, well, do you work with anybody but physicians or ...?
Elisa (26:25):
I, some, a few nurses, likenurse practitioners and midwives, I would say like higher level nurses, but, and during my training time, I coached non-physicians, because we did a lot of peer coaching and obviously a lot of coaches aren't physicians, but at this point I mainly coach physicians
Denise (26:43):
so
Elisa (26:46):
I just think that like, my being a physician, like there's just that extra
Denise (26:48):
yeah. Yeah. So if you, if somebody is feeling like they could use some help in this area, what would you advise them to do first?
Elisa (27:00):
So first is really take stock of where you are and what you are thinking, how your life is now and what an ideal life looks like. And are there ways to start bridging that gap? You know, if you want to start kind of low-cost, like just, The Life Coach School podcast, that's essentially where I started. And that is what really kind of started turning around my mindset and got me into the idea of coaching. Because you know, coaching is, it is an investment and it's a very worthwhile investment. And now having invested in coaches, I don't think I'll ever be without a coach personally,
Denise (27:32):
But we don't want all the doctors to suddenly become coaches and you know, some people have got to start staying in medicine.
Elisa (27:39):
Yeah. Yes. And, and I think coaching can help a lot of doctors stay in medicine and be happy in medicine. There are some physicians, like myself, who become coaches, but still practice.And there are some physicians who, you know, have left being a physician to just coach and you know, for some people that is the right choice for them.
Elisa (28:00):
Yes, we don't want, we don't want the physicians to think, oh, I'm just gonna become a coach. And in all honesty, like, and becoming a coach is becoming an entrepreneur and that's not necessarily easy as well.
Denise (28:10):
A whole new set of things you need to learn. Yes. Right. But key amongst them is understanding money. Yes. And investment and return on investment, so yeah.
Elisa (28:20):
And that, that part is really important for entrepreneurs to get their mindset around as well
Denise (28:24):
So, so you help people who feel that they're burning out, they need assistance with getting some balance with all of the things of life. What would be the first thing you do?
Elisa (28:35):
No, honestly, I get asked all sorts of questions. So, I'm going to take a tangent now I'm going to talk about kind of the people I've worked with. So I, so I've coached some people just purely on burnout and actually people who are doing financially well and are on the path of financial independence. And so they found me because they do read about finance, they read about personal finances and I'm in personal finance spaces. So then they learn that I'm a life coach and they'll come to me for burnout. I also coach people who, so this is different patterns I see on physicians, so there's the physician who, you know, actually saves, well, doesn't spend all their money, but they're not investing it. And so they're not actually creating financial security for themselves. Because you can't save your way to financial independence, but they just know nothing about money and they just don't even know where to kind of start. Andsome of them have even talked to financial advisors and kind of gotten that like sleaze-factor that you'll find with some financial advisors.
Denise (29:34):
Okay." I told you buy whole life insurance!"
Elisa (29:37):
Yeah, exactly. And that's a big one, unfortunately, less than 90% of financial advisors are truly fiduciary where they're really obligated and actually doing what's best for you. A lot of them are selling these whole-ife, universal life, you know, AVLU whatever you want to call it, you know, permanent life insurance products that is not right for the majority of physicians or people.
Elisa (30:00):
And then I see people who are like kind of financial train-wrecks be honest, they've, they've kind of spent, either they're living almost paycheck to paycheck., so they do have a little bit of savings, but they're not really investing a lot or maybe they're maxing out their retirement accounts. But honestly, as physicians, that's typically not enough because, you know, there's a max of, in 2021 it's $19,500, in 2022 it's $20,500. But even just, I mean, that sounds like a lot of money put away to retirement, but for a physician, um, no,
Denise (30:32):
You need, you want, your aim is to at least maintain a lifestyle you're used to.
Elisa (30:37):
Right. So if you are making $340,000 a year, and you're only investing, you know, $20,000 a year towards retirement, you're not gonna maintain your standard of living when you get to that point.
Denise (30:48):
A rude awakening. Yeah. Right. I get quite upset when I read post in other groups other than L and G, ,other famous physician groups where people say, "Do I really need disability insurance?" And I go argh!, We're doctors. We know that disaster can strike. And unless you're sitting on a big pile you better have some insurance. I can't believe that question is asked, but it is almost monthly asked. And and it terrifies me. I got sick at what I thought was right about the time my kids were going to go to college. And if we hadn't had the independent own occupation insurance that we had,separate from my employer, we probably would've lost the house. It took so long to get the insurance flowing from the other people. It absolutely terrifies me when people ask those kind of questions. Right.
Elisa (31:37):
And sometimes the disability insurance you get from work it's, if you can work at all, it doesn't kick in. Right? Yeah. So if you can flip hamburgers at McDonald's
Denise (31:45):
Exactly. That was, that was actually the point that was raised when my first official boss, when I was an attending said, he practically frog,-marched me in and was like,t his is part of the onboarding process, come and meet my insurance person. And I got own-occupation and I was completely clueless. I just did what I was told. And thank God I did, because we really would've been up the creek if we hadn't had it. And I anyway, sorry,
Elisa (32:09):
Yeah, no, no, I, yeah. It's one of the, the most important things to have. And if you've ever heard Stephanie Pearson's story, I mean, she had disability.
Denise (32:16):
Oh, that's right. Yeah.
Elisa (32:17):
Right. She had disability insurance, she had her own policy. She had a work policy. And yet when it came time that she got disabled on the job, she had to actually even sue to get some of that money and she, she was not covered like she thought she was covered
Denise (32:31):
Yeah. I had to get an attorney for my, for the hospital bit. They wouldn't release the policy. And I got this letter that I almost throw away and it had a funny, almost looked like a bill-due kind of thing. And I opened, it said, are you planning on filing for long-term disability? And I filed it and I had it month later, but the hospital, didn't [help] it's just nuts. And then I had to pay 20% of my income from that policy to the attorney. I really get emotional when I see those posts saying, do I need insurance? Like, Yeah!, And medicine costs money.
Elisa (33:05):
Yeah. Medicine costs money,
Denise (33:06):
Why isn't this in the curriculum probably should be in high school curriculum. But anyway,
Elisa (33:12):
So, and that's why I'm on a mission now to really get more physicians, to get, you know, financial literacy so that they have their disability, own-occupation, you know, policy that really will help them in case they need it, that they have the proper life insurance, term, if they need it. And, you know, maybe not even need it at all, depending on their situation. So like my husband and I, we don't have any children. We don't have any dependents. We do have life insurance, but we , we wouldn't necessarily have to, I have life insurance for myself because I do real estate investing and my husband wants no part of it. So I want him to be able to, essentially fire-sale off our real estate and not worry about it and not worry about any kind of debt that I've taken on for our investment and just pay that off with the life insurance policy I have on me. And then I have a life insurance policy on him because I actually depend on him for my health insurance and, as a physician, I like just being part-time at this point, so I can also do the life coaching and that means having to have my own healthcare. And we all know about how expensive healthcare is,
Denise (34:20):
Which is unfortunately the other part of it though, I think like, because you're a doctor doesn't mean you don't get sick, there's, there's a lot of bad stories -you need to read more.
New Speaker (34:29):
And I actually have a medical condition that I'm really lucky that I was able to get a full own occupation, policy and the so, and the reason I was able to get it is because at Northwestern, for any person in training, the last year of their training, they can get an own-occupation policy from Standard, that's a pretty good policy, without medical review.
Denise (34:52):
Yeah.
Elisa (34:53):
And, and so that's so important to know that.
Denise (34:55):
So we, we need to get
Elisa (34:56):
If a residency program has that, like every resident who has any medical condition should be picking up their disability insurance at that time.
Denise (35:02):
Right. And, and, and even if they don't have a disability, you might get one, two years later. So get it now, while it's cheaper.
Elisa (35:08):
Yes, definitely yeah. I mean, if you are totally healthy, you may be better off like, just doing the medical exam and, and, as opposed to the Standard policy, but right.
Denise (35:19):
But for every year you wait a, the risk that you are not as healthy the next year, but for every, even just being older, it, it costs more. So get on board when it's reasonable, especially in the last year residency.
Elisa (35:32):
Yeah. Actually I remember meeting, when I was a medical student, there was an ED resident who was like, always telling everyone, get disability insurance, because he actually, got a heart condition during residency, did not have disability insurance, and now can't get it.
Denise (35:48):
Yeah, exactly. Yeah.
Elisa (35:50):
So you don't want to get disability insurance when you're a medical student, you want to get it after, I think you can get it after you've matched to residency, but basically you need to know what specialty you're going to be in before you apply. So there is a downside to actually applying too early. So there's so many nuances to learning about disability insurance. You know, if you're women, you definitely want to get it before you get pregnant. But then of course, if you're just deciding to have children during medical school, then it's like, do you get it before, you know, you have your specialty and pay much higher premiums, but risks having something happen to your pregnancy that like, you can't get it afterwards. It's...
Denise (36:27):
There's a lot, there's a lot to think about, which is why there are people who spend their entire lives teaching about this stuff. So what,in the links, below this invisible place, I will put, links to Pearson too, because I think that's that's really important,
Elisa (36:44):
Yeah, no, I like to send everyone to where I'm like, go get a second opinion. Make sure that, I mean, even if you have it, like just make sure it's rock -solid.
Denise (36:51):
Right. Somebody look at it. Yeah. Yeah. So after you've talked to somebody back off the cliff, when they realize how much money they've been losing, where would you suggest ? Do you suggest everybody -real estate or are there other options that you would come up with? Do you like real estate? Because you enjoyed the gardening and things? Presumably I love houses, but I hate the headache of owning houses.
Elisa (37:19):
And so there is a way to invest in real estate, completely passively, through syndications. So what I I do is actually I talk about all the different options and then really work with the client on what appeals to them, what they want to do, what their goals are. So if you want to achieve financial independence, quickly, direct ownership from real estate probably is the fastest way to do it, but it is a lot of work and it is a lot of learning. And you know, you are going to make mistakes along the way. You will likely lose money on the way. Hopefully it's small chunks of money as opposed to larger chunks of money, but it there's, you know, we talk about passive income and a lot of people who get into direct real estate invest are like, this is not passive.
Denise (38:02):
That's not, it's not passive.
Elisa (38:03):
Yeah. The idea of passive income is that the amount of income you're getting is disproportional to the amount of work you're putting in now direct
Elisa (38:10):
Real estate in the beginning. It's a lot of work, but eventually it can become much more passive. Right? You, you put in a lot of work in the beginning. There are some people, if they're, if they're still enjoying practicing medicine and they're coming to me like relatively young, especially like residents or fellows or, you know, attendings within their first five years, you can actually still just get to financial independence by doing the old-fashioned invest in, you know, the stock market and just invest really regularly. But you just have to invest enough and keep investing and not sell when it goes down.
Denise (38:43):
Yeah. Not panic.
Elisa (38:44):
Yeah. Not panic. Yeah.
Denise (38:46):
But of course the housing market does that too, right? You have lots of panics with that. Do you, do you yourself invest in rental stuff or do you just buy to flip?
Elisa (38:56):
I, you know, I do have, well, I, actually recently just sold my long term rentals. I had a duplex and a triplex and I sold them partially because of a new ordinance that was passed in Cleveland that I just didn't want to deal with. I do still have a short-term rental that I self manage and actively manage. And of course the short term rentals, probably even more work than a long term rental when it comes to actual property management.And then I have investments in different real estate syndications.
Denise (39:26):
Right. So really the best advice is find somebody that already knows this stuff and go and talk to them. And you are one of you are one of the them. Yeah. So, so all of your information you sent me before will be in this. Is there anything you'd like to say in addition?
Elisa (39:45):
Yeah, so really, so important that all physicians get at least a basic level of financial literacy and there's so many great resources out there. So I started my own podcast, the Grow Your Wealthy Mindset podcast, so I'm hoping that will be a great resource for people for years to come. I also have a YouTube channel where I've got kind of shorter little clips of videos. I'm trying to make my podcast a little bit more organized than the YouTube videos are, kind of like, well, what do I think people need to know? And I just kind of record a little clip, and I've been doing that for over a year, but there's also a lot of other resources. There's the White Coat Investor., who's been around a long time. I mentioned him earlier and he's got several books that are great. There's the White Coat invester Conference that is now held every year, it's gonna be next year, I believe the beginning of March. It'll be in Phoenix, Arizona at the JW Marriot there, really nice place. That's where it was held last year.
Denise (40:40):
I'm really, I'm really at the end of, you know, I'm post retirement age. So, that a lot of it won't be pertinent to me, but I have a son that's just moved to Flagstaff. So maybe there's a good reason I should go there.
Elisa (40:54):
It's a Wellness Conference too.
Denise (40:57):
There's excellent reasons to go there.
Elisa (40:58):
Yeah. A lot of life coaches give talks there too, so hopefully I will be a speaker there as well. They haven't chosen the speakers yet, but I am applying
Elisa (41:07):
Andyou know, I mentioned Passive Income MD, Peter Kim, who was a founder of LGA, so, I don't remember who actually said this, but yeah, the Leverage and Growth Summit. I mean, that was really kind of the beginning of my transformation for sure, because that's when I first found out about coaching through Sunny Smith. He had Sonny Smith's talk on and then I started listening to Life Coach School podcast from that. And when I talked to the physicians at the hospital as an employee, that none of them were interested in anything extra, whereas you go to LGA and yeah, there's people starting all sorts of different things.
Denise (41:42):
Do you think the people who aren't interested is because they're burned out and they can't, like "let me keep being in my silo? I don't wanna think." Or are they just,
Elisa (41:50):
Not, all of them are necessarily burnt out. Some of them just, I think, are in that mindset of like, I just want to practice medicine. I don't want to know the business part of it. I want to just do my job and go home. And, you know, if I'm, you know, I get paid well enough just to do this, and part of it may be that like, I don't want to have to sit and think about the business stuff because I want to spend the time with my family, you know? And they're okay with not having the autonomy or, I mean, and I would say there are probably different hospital systems that are, you know, better to work for than others that might, you know, for me, it's, I crave too much autonomy. I really want things to be efficient, and you know, I could see in the hospital system was at just like how much inefficiency there was in terms of like billing, in terms of streamlining things, in terms of like having the doctor do all these tasks that you could really have someone at a much lower pay rate do.
Elisa (42:48):
Not collecting money that's owed. I mean, it's,
Denise (42:53):
Yeah. So we will have links down below for people to go and look at all those resources. And I thank you so much for joining me today
Elisa (43:03):
And yeah. Thanks so much
Denise (43:03):
Maybe we'll think of things we can talk about again and you can come back
Elisa (43:07):
I would love to.
Denise (43:09):
Thank you. Bye bye.
Denise (43:12):
Thank you for joining us at Myth, Magic, Medicine. If you have found this episode useful, you can apply for free CME credit for the link provided. If you're not a medical professional, please remember while we're physicians, we're not your physicians. So please consult with your own healthcare professional. If you think something you have heard might apply to you or a loved one until next time.
