Search Result

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Wow. Shows my age. When I was a resident a lot of the jokes hid the $100 bill behind the EKG. (once a upon a time there were these things called paper...

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I agree with abds. I would do it....

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We cannnot escape our genetics or bad luck, but we can change bad diet, habits, stress, that you parents may have had.
I for one have been pleasantly...

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Disability is easier to get earlier, and group disability can stack on top of it. I favor buying more earlier and then reassess every 5 years.
...

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A lot of us get lumpy income. That us the beauty of an asset allocation and use of broad index funds. Any extra money get dumped in your account according...

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Roth 401k seems reasonable for you. Even though your tax bracket in retirement will likely go down. At least you will have some tax free money, plus a...

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I’m shooting for 50%, one day. Not sure that we will hit that, even in the first couple years of retirement when we go on a traveling binge.
...

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6 months is not enough time to audition a new partner. It is also not long enough to break even. In many practices the employed physician is being subsidized...

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Ok. Business is usually 3-4x and first class, if the plane has it, is more.

not worth it on a per hour basis. Yet. The older I get, the...

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Maybe he read this
https://www.nejm.org/doi/full/10.105...99611283352202...

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What is interesting is that there is a movement to FIRE and escape from employment.

however, when you look at high achievers, those who...

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Don’t try to figure it out now. Go by feel.

when I started my internal medicine residency Cardiology was at the top of my list. Four weeks...

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Moneydance.
quicken for Mac has not had decent tools for investments in the past.

Money dance is now going to a subscription model...

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I don’t even like to give my car to the valet.

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Please provide more details.

- Are you becoming a partner for job 2 on day 1? Or is it employed with a salary guarantee?
- is there...

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figure out your preferred asset allocation and invest excess cash accordingly.

Lump sum is the evidence based answer....

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We bought a house in fellowship, sold it two years later and made money. We moved to a different city, contrary to our initial plans. We got lucky due...

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Schwab is also easy to use and allows lower grant amounts than vanguard....

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So the landscape is complex and is changing.

Hospitals are taking an increasing share of the oncologists, but many of these institutions...

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My accounts are aggregated on a desktop app, moneydance, on my home computer.
so I find I have been checking less and less often the older (and...

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Someone is making a lot of money from the practice.

is there any pathway to becoming a partner/shareholder/owner ?

hospital...

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We used Schwab. Some of their funds have lower minimums.

I think any of these big three are good enough....

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Where I am, the hospital employed primary care practices are heavily tilted toward physicians, believe it or not. The corporate owned practices are heavily,...

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I hope physican PCP do not disappear. As a specialist, I can tell who the good primary care providers are. This includes some NPs , but I can tell you...

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They do.
but except in specific exceptional situations, they should not.

In one move you would increase both your debt and your ri...

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We front loaded the kids 529 plans and the market was kind to us. Number one is three years in at a private college and number two is deciding. In state...

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Definitely a problem, combination of passing the buck, the specialist not straying from his core business, and not straying from his expertise. But the...

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I think the dividend income approach is obsolete. In the past few decades more companies like to focus on growth over income.

so not all...

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15-17% across multiple offices. I feel like it is higher at mine....

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Depends on

current net worth
current age and expected time to retirement ( and length of retirement)

i think the recommendations...

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Impressive. Took me a lot longer to erase less debt....

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Actually, I grew up around a bunch of family and it was a great thing. I moved away for residency and beyond ( where I met my wife) and I took my first...

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I rolled mine over twice, until I was able to find a low cost vanguard run program. Now there are several choices that are good, but if you can get a...

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So it looks like for many on this forum with really big tax deferred compartments, Roth conversions will never deplete their pretax money, if they want...

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Our practice has a non compete for 2 years or with a cash buyout. We have had both versions exercised, in the past 10 years.
I am surprised that...

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Correct. Raw data has to get processed. Large EMR companies have for example, diagnoses prescribing behavior, and a whole lot more.

There...

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Yes. Patient data is big money. Even when fully anonymized. Customers include Pharma, insurance companies, and more.

many of the cheaper...

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Probably depends on the cost and how robust your current disability coverage is. You may be able to get own occupation disability coverage, but I would...

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I think the main reason to have culturally diverse doctors is to have a better connection with those of different backgrounds. But getting the right people...

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My guess would be the year of service, since that is what I would expect the statements to reflect....

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It is a real problem. We can barely get applicants for our RN positions. We try to shift some nursing duties to MAs but we are way down in MA staffing....

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I mostly stopped, because I got the basic education years ago. I always recommend it to my younger colleagues and family.
Imused to frequent some...

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Actually I tried to do the 1035 exchange to an annuity, a MYGA, since I did not want to deal with a fee laden variable annuity that would sit in a marginal...

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I am going to go against the grain a bit, in that I am a little more comfortable with debt.

1. Put aside enough for your primary savings...

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I have to agree. I cringed with the gymnastics anecdote. was that really why she was moonlighting? Of course among doctors who do this it is more often...

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Don’t be bullied by expectations. Take your time and buy when you want where you want. (If you want to)

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Real estate aside, I am sure a few people can hear the market, or augment their returns with some smart bets on tilts or value stocks.

but...

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I used to carry an iPad mini. It WAS great for connecting to Cerner through a Citrix app as well as my office EMR. I could read patients scan results...

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Looks like there are a lot of favorable features for you in the new offer.

I am in a private practice, and over the years, I prefer our...

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Oh. I thought it was a penguin joke…...

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We do not get a state tax deduction on 529 contributions. We front loaded 529 contributions for college and let it ride. We cash flowed private school...

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We have done it the other way around, but more often taken care of employees family members....

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Who writes checks? Seriously. Most of our bills are charged to the credit card. The cleaning people and others take Venmo, and the lawn guy has a quickbooks...

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I think it is higher it higher than these guesses. There was a poster on bogleheads I think who was probably a spine surgeon and lived on less than 100k...

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People talk.
our employee salaries are supposed to be confidential. Somehow they are not.

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Not underwater, but periodic storm surge damage is a real risk, depending on the specific location. Condos might be a different risk. After surfside,...

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Often agents have you sign a contract, and you are on the hook for 3 m after the contract period unless you sign with another realtor. At least that is...

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You can make a lot of money in a any specialty if you are able to make any business decisions, work hard. pick the right location, etc.

...

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We went from option 2 to option 1 a few years ago due to some increasing needs. Expensive, but we get service. Our practice is bigger with much more intensive...

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If you are that uncomfortable then maybe it is time to revisit your asset allocation. Perhaps you should set it to increase bonds or decrease international....

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The only time I have excess cash is in April or May, when we finally get our K-1 and get the final tax tally. I have usually estimated reasonably well,...

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Fortunately, I no longer need the services of a commercial barber....

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I used to use Quicken but then changed to Moneydance. It is OK software and does the job of letting me track my asset allocation. Still do not like the...

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Agree with the others. There is plenty to be unhappy with right now in this stressful time. It is not likely that you will have a simple fix.
...

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What do you have now? How much do you spend annually on insurance? If you are not paying too much then maybe you do not need to make any changes. In...

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We used Utah with all vanguard funds. Was one of the best at the time. We stayed in age based funds and were happy With the program....

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I have an emergency fund. The more I save, the less I need it (since I can sell assets in Taxable) but the less it matters that a little extra cash is...

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Cruise is a good choice. We did that with both sets of parents when the kids were young.
nowadays there are many places to rent a big house that...

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Front load the 529 and then taxable. We never went beyond the annual max, but we opened an account for each parent for each child. We stopped at about...

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This is an excellent way to pay yourself first, Literally!

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Good points. I agree that much of what we do can only be done well if we maintain a certain volume. And at too low a volume, it does not justify the trouble...

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It may make sense to keep Roth 401k as part of your strategy even longer. The longer your time horizon, and the more you expect to accrue outside of tax...

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Corporate culture vs private practice culture. Some private practice is extremely productivity oriented and in the worst cases, greedy and sketchy. Hospitals...

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In the process of doing the same thing except with Schwab. I will do the 1035 exchange and delay any withdrawals until the appropriate age. Or leave that...

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Maybe retirement is overrated. A lot of us love what we do, at least parts of it. Artists, musicians, writers never retire. They pace themselves. Big...

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Tough decisions. I know a couple of people in this situation. One was going to do an MBA after the required years but just retired young instead. Another...

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Call us a flash point for us. A ton of stress but not a huge driver of revenue. Once a senior doc wanted indefinite No call and that caused a lot of strife....

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have a bow flex that we might many years ago. A former NFL player had one at home and told me really liked it. I used it for years but prefer dumbbells....

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But I think that is the problem. Getting into the “right” school is becoming a surrogate goal for life success. In the real world there is not quite...

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Life is not a piece of cake outside the path to medicine, nor is it easy to find job satisfaction and a sense of purpose in a career. Just look at any...

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I let my IM go at the first renewal, more than 10 years ago....

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Slow down and a third partner to handle the load. You will enjoy the job more, your life more, and still be making plenty.

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Every practice is set up differently. Some do not invite you to own the real estate some require it. The price depends on whether they own a fancy building...

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There are surprisingly few things I really need right now. Bought a couple of gadgets, and replacement laptop bag. Trying to decide if I replace a 5 year...

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Make sure you look at a few calculators.

try
cfiresim
firecalc.

market goes up and it goes down, so be prepared...

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Another option is to invest it all now and replenish it over 5 years....

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We get 7 regular days off a year that the office is closed. Of course, the people on call still work.

New hires start at 4 weeks going up...

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I just got out of mine, which is a much smaller policy than you were us. I did not do any fancy analysis, but the cash value is much more than I paid...

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Interesting discussion. I think the concern for welfare, UBI, etc, is based on the concept of “deserving.” I believe that most who get disability,...

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Go used. With three kids a new car won’t look new for long. I know someone who got a used Sequoia with 50k and drove it for 120 more and it still was...

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Stockton California did a UBI of sorts and it was not bad. Not sure how it would scale, or if it would pass the test of time. I am sure like anything...

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I think it is. Currently there is no other reasonable way to incentivize physicians to reduce costs without making everything a constant battle for authorization....

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My FOMO is nicely counterbalanced by FOLMS. Fear of losing my shirt.

seriously. My loss aversion prevents me from taking these big gamb...

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Since I use vanguard, I just stick to index mutual funds. Easy whole dollar amounts, so I convinced myself that I actually invest more rather than going...

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All of the above.
as I approached 50 I also had a rising balance, so I started moving more into bonds.

now I am thinking I am happier...

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The academic answer is to lump sum. Since it only “usually “ comes out ahead, do what you are comfortable with, but keep the investment time as short...

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Do some more pediatric rotations and see how it feels.

My friend initially was surgically inclined but clicked with pediatrics. He did a...

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One nurse can do 8-10 patients a day, more if the treatment is simple. But it will not make a profit unless you are able to have a margin on the infused...

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I have the older generation from 2008. Still sounds good. The smaller bookshelves from earlier No longer do. I have speaker craft in ceiling speakers...

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I don’t have a sound room, after a certain point upgrades won’t count. I have Aperion audio. Maybe a step below what you are looking at....