Too late?

[ENT Doc]

Bbchi wrote:

2 kids, twins, finishing kindergarten. 15K credit card debt approx. have $$ in savings to pay it but then would have no savings. $100k med school debt, 3-4% interest. Mortgage around 500k I think. Good credit score. Ob gyn. Would love to change careers. But feel trapped financially.

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Sorry to hear you're feeling trapped financially.  For the sake of your family I wouldn't suggest tacking now.  Knowing your family total annual income and total family expenses would help.  Kids in private/public?  What fixed payments are going out every month - put another way, how much wiggle room do you have to address these issues, and do you need to reduce the fixed expenses?  How much in retirement - all accounts?

30,000 ft view from what you've told us thus far is that you need to reduce your spending.  This will come as a shock to all parties because people become used to a certain lifestyle.  Married?  If so you'll both need to sit down and discuss this, do budgets, track your expenses (I recommend doing this daily initially for someone in your situation), stick to the budget, and always agree on the budget.  The budget will hold you accountable to each other and yourselves.  I would recommending writing down (with your spouse if married) your overall long-term financial goals.  What kind of retirement do you want?  Funding for college?  Estate left for the kids?  And then analyze whether you're remotely close to achieving those goals.  The short term goals and budgeting are just tools to help you achieve the long term goals.  Begin with the end in mind.

As for budgets, I've found this series on YouTube to be helpful for creating a simple budget in Excel (or Numbers).  It's easy, don't sacrifice info to some tech company, and I can actually parse out different expenses on a given receipt myself instead of lumping all the items under one expense (which budgeting software will be tempted to do).  Hope this helps.  Any more details would be helpful, but it's all good if not interested in going any further.

https://www.youtube.com/watch?v=AZbWLu5zzAo

[jfoxcpacfp]

StarTrekDoc wrote:

Ask away on this board; but really get a local financial adviser to help layout a plan that’s able to be implemented and followed for the next 20 years with short term milestones and a deep dive again at regular intervals.

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Just curious - why local?

[StarTrekDoc]

Sometimes things simply need a good old fashion sit down, come to Jesus moment, for the family and best done face-to-face to show reality of expenses, budgets, scores.

We do a lot of asymmetrical communications and virtual data sharing along with televisits, but the most effective tool in communication and getting our point across is having a patient come in a have a face-to-face visit.   There's something more palpable and value in it than the rest.

I am a techie of all sorts, but at the end of the day, direct human interaction trumps any tech we have.

[Hatton]

I too am an ob/gyn. You can get it together. Now there is moonlighting for ob gyns. Several of my friends work shifts as hospitalists in addition to their private practice. You need to figure out if the problem is low income, too much spending or some combo. You have time but it is critical to start now. I know one guy who did not do well in private practice who works as a full time laborist and moonlights in another town. Like I said is the problem income or spending. Post your numbers or a guesstimate and one of us will help you

[PhysicianOnFIRE]

StarTrekDoc wrote:

Never too late!. Read PoF levels — you’re Dr D. Move into Dr A or B mode.

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He's referring to the 4 physicians series, and I'm guessing he's right -- with a possibly negative or zero net worth at 45, you may be a Dr. D.

Living like a Dr. A or B (well below means) for 10 years has made work optional for me. I'm still working, but transitioning to part-time this fall. With some big-time adjustments and a cooperative market, you could be 10 years away yourself.

As others have said, eliminate the credit card debt with your next few paychecks or a HELOC or something and figure out where your money is going. The whole family will have to be on board. The kids are in kindergarten (hopefully public), so it's mainly the spouse that will have to go along with what I'm guessing will be some pretty drastic changes.

 

 

 

 

 

[BlueMonday]

Bbchi wrote:

2 kids, twins, finishing kindergarten. 15K credit card debt approx. have $$ in savings to pay it but then would have no savings. $100k med school debt, 3-4% interest. Mortgage around 500k I think. Good credit score. Ob gyn. Would love to change careers. But feel trapped financially.

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You need to set goals. Decide today what you want to be doing in 5 years and figure out a way to do it. If you are an OB/GYN, you have the ability to make over $300k/yr. Sell your house, rent a smaller one and focus on paying off your debt and saving money. With your ability to make money, you should notice monthly increases in your net worth of 10-20k. It will quickly go from -100k to 300k. Then, if you want to change careers, you'll have the freedom to do so. You only feel trapped because you don't have a plan!

[mamaham]

It's not too late!  You can do this.  Just wanted to add my encouragement to that already left above.  So glad that you found WCI now instead of 15-20+ years from now!  You can do this!

[jfoxcpacfp]

StarTrekDoc wrote:

Sometimes things simply need a good old fashion sit down, come to Jesus moment, for the family and best done face-to-face to show reality of expenses, budgets, scores.

We do a lot of asymmetrical communications and virtual data sharing along with televisits, but the most effective tool in communication and getting our point across is having a patient come in a have a face-to-face visit.   There’s something more palpable and value in it than the rest.

I am a techie of all sorts, but at the end of the day, direct human interaction trumps any tech we have.

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With all due respect to a fellow techie, that's exactly what we do, often with the babies being handed from parent to parent and sweet children's noises in the background as we meet face-to-face. It's very gratifying to be able to meet f2f in the comfort of the family's home in their natural surroundings. I realize that, for some, it's more satisfying to fight traffic, coordinate schedules, find a sitter or meet with kids running through the office, get dressed up (clients meet with us in whatever they happen to throw on), pull all kinds of records together (because you don't know what you're going to need to take), and sit in a waiting room drinking stale coffee. Oh, yeah, and limiting interaction only to planners who happen to be in your vicinity who may not be the best fit for you. Not everybody happens to live in a city with lots of choices.

Meeting virtually not only affords f2f but also interactive screen sharing with all of the same information, often more because both of us can access whatever we need on our computers or run to the bedroom to get a particular receipt we need to go over. If the meeting ends early, virtual clients go right back to whatever they need to do at home. And if you and your spouse happen to be in 2 locations, which often happens with locums doctors, it's just as easy to have a 3-way f2f. Actually, because it's so easy to meet, clients can schedule meetings on-the-fly if we need to have a quick chat about a current twist in their situation, i.e., they don't have to wait for the next scheduled quarterly/semi-annual/annual "official" meeting.

I can assure you, we have the same come-to-Jesus experience if that's what's called for. But we also have empathetic, get-to-the root of the problem conversations about the person's history and what the best steps to take are for that couple/individual to achieve their cherished goals and get beyond the self-recriminations.

You should try it sometime - you might be surprised at what we can accomplish using 21st-century technology! 

[StarTrekDoc]

jfoxcpacfp wrote:

\You should try it sometime – you might be surprised at what we can accomplish using 21st-century technology! ?

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You're preaching to the choir   I'm a CES type guy (more yet, alpha tester type) and have championed telehealth and informatics for years.

All those things you said are the advantages of the televisit.  It expands out reach dramatically, information dissemination, and access are all exponentially improved.

That said, there is something from the face-to-face (F2F) visit that just can't be replicated remotely.  We've witnessed it time over again in mental health, subspecialties, primary care--across the spectrum of care.

The first step for OP has been done-- acknowledging an issue.   The next steps are developing OPs goals and reconciling them with Spouse's acknowledgment and goals.

We simply don't know enough information on how the relationship, spend, and goals are between the two.  It can be as easy as back of envelope calculations and goals or need a full-on power point presentation with excel data and interactive calculators to reflect shortfalls.

Our planning mantra - Right time, right place, right person.   -- the order of priority of these is a whole different Oprah show.

[BlueMonday]

adventure wrote:

BlueMonday wrote:

No you are absolutely NOT too late. Let me tell you my story – I was 38, married with two kids. Almost $400k in student loan debt, some of it in default (credit score of 585!), and a house that we bought for $850k that was worth now worth $750k and only about $100k in our retirement accounts. Over the last 10 years we paid off the debt, sold the house and rented a small one for two years, and have accumulated about $2M in savings. To paraphrase WCI, live like a resident until you get back on track.

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Guest blog post would be cool…

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Not worth a blog post, it's all been written by WCI before and there's no secret to it.

1. Reduce your expenses (live like a resident, move to a lower COL area)

2. Make a lot of money (switched from academics to private practice)

3. Work harder

 

 

[jfoxcpacfp]

I can understand how that could be for mental health patients. You can't reach out an pat a patient's hand and try to comfort them - I often find myself wishing I could hug a client.

Obviously, you are far higher up the techie scale than am I .

[Hatton]

OP I hope that you did not get turned off to advice because you might have followed a different path.

[RogueDadMD]

There's good evidence supporting mental health and telemedicine. Given the lack of procedures and not using physical exams, only discussion, it lens said itself better to telemedicine than almost any other specialty. Most of it isn't tears eyed discussion holding hands; also I don't think hand holding is as common as it may have been before.

[DMFA]

The most difficult thing isn't going to be figuring out what to do; it's going to be adjusting from your current high-spending self to a low-spending, debt-eliminating, retirement-investing self.  That's a big psychological switch with a lot of momentum behind it, and you've got to get the rest of your family on board with it, too.

Stop spending. Pay your debts.  Get a cash buffer/emergency savings.  Add retirement accounts.  Bob's your uncle, right?  Just because the concepts are simple does not mean actually being able to follow through with them is easy, but you have to keep telling yourself and your spouse that you can indeed do it.

Fortunately everything's *probably* going to be fine.

[Anesthesia84]

DMFA wrote:

The most difficult thing isn’t going to be figuring out what to do; it’s going to be adjusting from your current high-spending self to a low-spending, debt-eliminating, retirement-investing self.  That’s a big psychological switch with a lot of momentum behind it, and you’ve got to get the rest of your family on board with it, too.

Stop spending.

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This was the biggest hurdle for us (and we weren't really huge spenders since luckily we found this website before we both finished residency and didn't have much to spend!).

I have literally stopped going to any stores except for groceries. We buy everything online and only after a waiting period if it is not a necessity. It is too easy to go into Target or TJ Maxx or whatever and see a bunch of things you "need" and end up spending hundreds of dollars accidentally!