Alternative sources of income

[Technorino]

What are some of your other sources of income besides doing EM shifts, if any?

Small business owner?
Day trader while in the ER?
Youtuber?

Curious to see what all of your lives (social or financial), outside of working in the hospital, are like

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[OccupyTheED]

I think at our level of incomes, unless it's something you genuinely love doing, your best bet is almost always gonna be to work another shift


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[Hercules]

I think at our level of incomes, unless it's something you genuinely love doing, your best bet is almost always gonna be to work another shift


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Yes and no. You can't scale yourself so your best bet may be to spend the time needed to develop passive income streams. Those will compliment your active income and allow you to make more money without spending more of your time. It can also be nice to have some active income that's not clinical. Here are my non-clinical incomes (not counting anything from stock market):
Active:
EMR consulting
Expert witnessing
Administrative stipends

Passive:
Timber income
Small business owner (urgent care)
Commercial real estate (separate LLC for the property; also had an extra building that gets rented out)
Residential rental income (currently adding some single family homes)


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[RoyBasch]

Passive:
Timber income

What is this? investment in lumber futures? Own land and sell the lumber that grows there?

 

[Hercules]

I own a couple hundred acres of timber property in a neighboring state that has cost-sharing plans to subsidize some of my expenses. I like timber as an alternative investment that isn't correlated with the stock market and also has a pretty good inflation hedge built in. Here's an older article but decent overview of timber as an investment if you're interested: Alternative Investing: Investing in Timber | Stock Investor




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[Vandalia]

I own a couple hundred acres of timber property in a neighboring state that has cost-sharing plans to subsidize some of my expenses. I like timber as an alternative investment that isn't correlated with the stock market and also has a pretty good inflation hedge built in. Here's an older article but decent overview of timber as an investment if you're interested: Alternative Investing: Investing in Timber | Stock Investor

Just keep in mind that it is an asset that someone can cut down and carry away in the space of a weekend. "Timber pirates" are a real thing. It doesn't necessarily mean it is a bad idea, but it is something you need to plan on. (I assume Hercules has done that, I am just pointing it out for others.) We lost a couple of dozen of prime oaks on timber land that I am partial owner of (along with 50+ of my closest relatives.)

 

[RoyBasch]

I own a couple hundred acres of timber property in a neighboring state that has cost-sharing plans to subsidize some of my expenses. I like timber as an alternative investment that isn't correlated with the stock market and also has a pretty good inflation hedge built in. Here's an older article but decent overview of timber as an investment if you're interested: Alternative Investing: Investing in Timber | Stock Investor




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Thank's I'll look into it! I'm trying to find out more about unconventional investments to maximally diversify and hedge against whole market downturns where even the most "diversified" portfolios of stocks, bonds, funds, indexes, and real estate lose.

Also, and feel free not to answer this question but; ballpark, how much additional income are you earning each year with all these non-clinical activities and passive income sources?

 

[mauricekenter]

I play poker

 

[bashwell]

I play poker

For me that's sadly an alternative source of lost income because I ain't any good!

 

[The White Coat Investor]

Passive income is a continuum. Things like blogging and real estate investing have some aspects that are passive and some that aren't. If I have to look at it more than once a year, it's not passive.

 

[Apollyon]

We lost a couple of dozen of prime oaks on timber land that I am partial owner of (along with 50+ of my closest relatives.)

Wow - you lost a couple of dozen of prime oaks AND 50+ of your closest relatives to timber pirates?? That is tragic!

(Yeah, I get you - I work in the Allegheny National Forest. It was just the way you wrote it!)

The ANF is one of only two national forests that makes a profit - mostly from cherry wood sales.

 

[Vandalia]

Wow - you lost a couple of dozen of prime oaks AND 50+ of your closest relatives to timber pirates?? That is tragic!

(Yeah, I get you - I work in the Allegheny National Forest. It was just the way you wrote it!)

The ANF is one of only two national forests that makes a profit - mostly from cherry wood sales.

We suspected they were the pirates. Justice is swift, certain and final in the mountains. (Not to mention my logic and grammar aren't too good after a night shift and a morning of meetings.)

 

[Hercules]

Thank's I'll look into it! I'm trying to find out more about unconventional investments to maximally diversify and hedge against whole market downturns where even the most "diversified" portfolios of stocks, bonds, funds, indexes, and real estate lose.

Also, and feel free not to answer this question but; ballpark, how much additional income are you earning each year with all these non-clinical activities and passive income sources?

I'll be happy to PM it to you and anyone else interested.


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[EctopicFetus]

Hercules I am interested..

 

[EMIM2011]

@Hercules, I am interested too, thanks!

 

[HunterGatherer]

Hercules, I'm also interested.

 

[deleted859535]

I'll be happy to PM it to you and anyone else interested.


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Also curious about how the non-clinical and passive items break down.

 

[Venko]

I have been trading stocks since I was 16 years old, and at times in my life I have functioned as a day trader and others like now, I'm more of a long range investor. I can make significantly more money in trading than I have in medicine, however, it's not nearly as rewarding. I can certainly teach more if you'd like on how to begin to learn the methods but I would take many years I expect before you're making huge amounts of money in day trading. The long range diversified investing is a considerably safer and less time consuming though still has some risk. The rewards are more tempered as well.


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[Atlas Shrugged]

Someone doesn't read WCI. I am curious as to how much you made day trading.

 

[The White Coat Investor]

I have a post on day trading coming up. Funny how people start talking about day trading years into a bull market where I haven't heard much about it for years. I assure you there was very little online chatter about day trading being a good thing in 2002 or 2009. Lots of docs who got burned there.

Here's the question to ask yourself- if you honestly believe you can beat the market, why are you doing it with a mere million or two? Why aren't you running billions? Your skill is so rare that you should be. People will gladly pay you ridiculous sums of money to trade their money if you are truly skilled at doing this in the long run.

 

[Venko]

Someone doesn't read WCI. I am curious as to how much you made day trading.

I stopped day trading after I started EM residency. I had made enough that I have no student loans. Wedding and rings paid off. Saved enough that I have put about an additional $50k of day trading earnings in long term investments.

That was while I was a full time student and finished undergrad with twice the normal course load. I had small funds to work with and little time. If I used our savings now and devoted more time, I hope but cannot guarantee it would be much more earnings.


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[Venko]

I have a post on day trading coming up. Funny how people start talking about day trading years into a bull market where I haven't heard much about it for years. I assure you there was very little online chatter about day trading being a good thing in 2002 or 2009. Lots of docs who got burned there.

Here's the question to ask yourself- if you honestly believe you can beat the market, why are you doing it with a mere million or two? Why aren't you running billions? Your skill is so rare that you should be. People will gladly pay you ridiculous sums of money to trade their money if you are truly skilled at doing this in the long run.

I was a day trader through much of those years (I stopped when I started EM residency in 2007). I did not make money every day and I did lose big on some days. Worst day I lost 15k in two hours. However, over the long haul I had a very positive outcome.

I only use my own money not anyone else's. I would crumble under be pressure of possibly losing someone else's money or that which is on loan. I didn't want the risk. Many Many people and some businesses asked for me to manage their money, my wife asked me to manage her money when we were dating but I couldn't handle the pressure and repeatedly said no.

In general, as a college and medical student and psych intern, I aimed for and routinely hit on making $250 dollars per day the market was open. Once I did, I stopped for the day. It was a great system, and served my life very very well. I paid for a good portion of my education, and my living. Roughly 40-60k per year. The savings were invaluable and when I had open heart surgery (Congo bicuspid ao valve repair) and needed to pay roughly 10% of that too...well this savings was my savior.

I know that I am and have been blessed in many ways. I am Gifted with numbers (back then at least), and was exposed to the principles of the market from a very young age. I studied and did simulation trading through high school and read many many books on the topic. I have invested significant amounts of time and life experience in the market and various ways to trade stocks. This was money for hard work and discipline. It was not easy and is not a given.


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[docd888]

@Hercules, I am also interested. Thanks for sharing!

 

[The White Coat Investor]

I was a day trader through much of those years (I stopped when I started EM residency in 2007). I did not make money every day and I did lose big on some days. Worst day I lost 15k in two hours. However, over the long haul I had a very positive outcome.

I only use my own money not anyone else's. I would crumble under be pressure of possibly losing someone else's money or that which is on loan. I didn't want the risk. Many Many people and some businesses asked for me to manage their money, my wife asked me to manage her money when we were dating but I couldn't handle the pressure and repeatedly said no.

In general, as a college and medical student and psych intern, I aimed for and routinely hit on making $250 dollars per day the market was open. Once I did, I stopped for the day. It was a great system, and served my life very very well. I paid for a good portion of my education, and my living. Roughly 40-60k per year. The savings were invaluable and when I had open heart surgery (Congo bicuspid ao valve repair) and needed to pay roughly 10% of that too...well this savings was my savior.

I know that I am and have been blessed in many ways. I am Gifted with numbers (back then at least), and was exposed to the principles of the market from a very young age. I studied and did simulation trading through high school and read many many books on the topic. I have invested significant amounts of time and life experience in the market and various ways to trade stocks. This was money for hard work and discipline. It was not easy and is not a given.


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What would you have made per day with no trading, just leaving the money invested? And how much of that $250 per day went to taxes, commissions, and fees? And did you subtract out the value of your time from that $250? These are the questions too few traders ever ask themselves and honestly calculate.

But seriously, if you really are gifted (and who knows, maybe you are) it seems a shame not to scale up just because you can't take the pressure. Think of all the good you could have done in the world with billions of dollars. Do you think some of that pressure is that deep down maybe you're not entirely confident that it was skill and not luck?

 

[emergentmd]

The only person I know who beat the market regularly and yearly was Madoff. Oh...... that was a poor example.

I know of noone who consistently beat the market. Everyone made money in the the 1990's. Over the long haul, most went broke or didn't beat the market.

 

[Venko]

What would you have made per day with no trading, just leaving the money invested? And how much of that $250 per day went to taxes, commissions, and fees? And did you subtract out the value of your time from that $250? These are the questions too few traders ever ask themselves and honestly calculate.

But seriously, if you really are gifted (and who knows, maybe you are) it seems a shame not to scale up just because you can't take the pressure. Think of all the good you could have done in the world with billions of dollars. Do you think some of that pressure is that deep down maybe you're not entirely confident that it was skill and not luck?

Good questions.

$8 flat commissions each way. Taxes were paid off as well. Like I said, the proof is that I was able to pay off all my expenses including tuition and healthcare. We paid for the our wedding and rings ourselves.

I can never tell you what would have happened with long term investing at that time because I didn't do it then.

Day trading for me did everything I needed it to do. During a time when many people lost money, had their investments tank etc, I went to bed at night with no money borrowed and with no money tied up in the market. Every night I "cashed out" and slept easily.

As for investing other people money...there is always some luck involved in life. The same is true in trading just as in medicine. I can give a septic shock patient everything I know to do and I increase their chances of living but it's not a guarantee. I can use every analysis I know to do for a trade and I can still lose. I didn't want to risk owing anyone or hurting anyone else. It's not some deep subconscious anything. It's a very transparent and declared thing: there is always risk. I can handle my own risks, I didn't want to handle anyone else's risk.


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[Venko]

The only person I know who beat the market regularly and yearly was Madoff. Oh...... that was a poor example.

I know of noone who consistently beat the market. Everyone made money in the the 1990's. Over the long haul, most went broke or didn't beat the market.

Now you know of two.


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[alphaholic06]

I would like the info as well @Hercules

 

[BoardingDoc]

Good questions.

Like I said, the proof is that I was able to pay off all my expenses including tuition and healthcare. We paid for the our wedding and rings ourselves.

Congratulations, but this doesn't exactly answer WCI's question about whether you feel this was luck vs skill. I'm happy for you that you did well, and maybe you actually have this down pat, but your quip about personal success quickly evokes the mantra that "past performance does not guarantee future results."

 

[Soccer171983]

I play poker

vegas baby!

 

[Venko]

Congratulations, but this doesn't exactly answer WCI's question about whether you feel this was luck vs skill. I'm happy for you that you did well, and maybe you actually have this down pat, but your quip about personal success quickly evokes the mantra that "past performance does not guarantee future results."

If your question is: is it luck or skill? I wrote this in a prior post:

As for investing other people money...there is always some luck involved in life. The same is true in trading just as in medicine. I can give a septic shock patient everything I know to do and I increase their chances of living but it's not a guarantee. I can use every analysis I know to do for a trade and I can still lose. I didn't want to risk owing anyone or hurting anyone else. It's not some deep subconscious anything. It's a very transparent and declared thing: there is always risk. I can handle my own risks, I didn't want to handle anyone else's risk.

So the summary is: there is both luck and skill. I made a net profit every year between 1999-2007. Skill to be consistent, though lucky that during 9/11 attacks for example I didn't have any cash invested.

Listen, I am not telling others to be a day trader if they don't want to be or are too scared. If anyone wants to learn about day- short term, or long term trading just let me know. Otherwise, if you don't...that's okay. Move on and start a business, buy trees, find the mutual fund that makes you feel warm and fuzzy, buy gold coins, do whatever makes sense to you. The OP wanted to hear of ways to earn money outside of medicine while still practicing and well I shared my experience.

I wish you all the very best. Let me know if anyone wants to learn more.


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[Groove]

I can't find anything on the side that I can do for a couple days a month that pays me more than 2 ER shifts. I wish I could...

 

[Hercules]

I can't find anything on the side that I can do for a couple days a month that pays me more than 2 ER shifts. I wish I could...

True but...

We as a specialty get paid incredibly well by the hour. The goal (for me at least) isn't to find more work or better paying work because no matter what work you do, your time becomes the limiting factor. The goal is to develop multiple passive income streams that provide income regardless of what you do with your time. Thus you can convert that great income we have into true wealth and assets that cash flow.


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[deleted206819]

I'll be happy to PM it to you and anyone else interested.


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@Hercules

I'm also interested and was wondering how you can get into EMR consulting?

 

[deleted859535]

True but...

We as a specialty get paid incredibly well by the hour. The goal (for me at least) isn't to find more work or better paying work because no matter what work you do, your time becomes the limiting factor. The goal is to develop multiple passive income streams that provide income regardless of what you do with your time. Thus you can convert that great income we have into true wealth and assets that cash flow.


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Does anyone have a good feel on the actual hourly rate for the PCP folks / surgeons / radiologists on average if you had to break it down? I sometimes wonder about that.

 

[The White Coat Investor]

I can't find anything on the side that I can do for a couple days a month that pays me more than 2 ER shifts. I wish I could...

Me either. Except maybe write another book.

 

[bravotwozero]

So we'll get to see WCI the sequel on the shelves?


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[Hercules]

1) How did you get into EMR consulting?

2) I'm wondering how you set up the urgent care to be passive income. Who hires staff when they turnover? What about inventory, business tasks, and scheduling? Would love to own one passively.

3) For commercial real estate, did you go in to fix up the place, rent it out, and then hiring a manager that deals with all the calls and maintenance?

Pulling this over from the other thread since it seemed to fit here better (hopefully that's ok with the mods--tell me if I'm committing a faux pas).

Got Em,
1) I fell into it. It's with allscripts and our hospital has been a beta testing site for the company for years. They love to bring clients down to see it in action, especially since we have an efficient and high functioning ED. They like to have me there to talk with the ED medical director of potential customers. I bill at the same hourly rate that i do for all expert witnessing/consulting.

2) I have 4 other partners. We worked it for the first 6 months to get it running the way we wanted then hired docs to staff it. We hire MDs. Our manager hires all other staff. Inventory, business tasks, billing, scheduling are all handled either by our manager or our coder.

3) The commercial real estate has our urgent care on it and an extra building that gets rented out. Our manager has that rolled into her duties.

 

[emergentmd]

I invest in real estate. Have 7 properties bringing in 200k/yr. Most go to P&I now, but once I get them all paid off, I will clear over 100k/yr on top of the appreciation. I hope to have 15 by the time I retire and just let people pay for my lifestyle.

 

[KGflyboy]

I invest in real estate. Have 7 properties bringing in 200k/yr. Most go to P&I now, but once I get them all paid off, I will clear over 100k/yr on top of the appreciation. I hope to have 15 by the time I retire and just let people pay for my lifestyle.

Commercial or residential?

 

[emergentmd]

Commercial or residential?

Residential but been offered commercial but that requires having to lose control over any decision making.

I am not looking to get rich, but always looking for a way out of medicine. Not b/c I don't like EM (I actually love EM), but everyone's goal is to work if they want and not b/c they have to.

 

[slurpy15]

Residential but been offered commercial but that requires having to lose control over any decision making.

I am not looking to get rich, but always looking for a way out of medicine. Not b/c I don't like EM (I actually love EM), but everyone's goal is to work if they want and not b/c they have to.

SFH? Apartment buildings? What region? Good for you, BTW!

 

[emergentmd]

Texas, SFH/Duplexes/Lakehouse

 

[slurpy15]

Smart. Texas is cheap with great cap rates. Didn't know duplexes were popular there, cool.

 

[Hercules]

I invest in real estate. Have 7 properties bringing in 200k/yr. Most go to P&I now, but once I get them all paid off, I will clear over 100k/yr on top of the appreciation. I hope to have 15 by the time I retire and just let people pay for my lifestyle.

That’s awesome and same plan here. So total revenue of $200k and a NOI of $100k? What kind of annual cash flow right now?


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[emergentmd]

That’s awesome and same plan here. So total revenue of $200k and a NOI of $100k? What kind of annual cash flow right now?


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Lakehouse is as much for personal usage but rented short term to defer costs. This is my first year to rent short term rental with revenue likely to be 40k with NOI 20K. Maybe put 5k in my pocket. Not bad as we use the lakehouse for 30 dys a year which would cost about 20K if I rented it.

My SFH/Duplexes takes in about 130K/yr with a NOI of about 70K. Likely take home 30K this yr after all costs including P&I. Not bad as this is a 10% return on my initial down payment of 300K.

I only had these properties for 3 yrs and given the appreciation, I could sell them all and walk away with about 700K after all selling fees. But I plan to keep this and pass this onto my kids.

Once these properties are paid off/close to being paid off (hopefully in 3-5 yrs), I am going to leverage them all and hopefully double my portfolio.

 

[emergentmd]

Smart. Texas is cheap with great cap rates. Didn't know duplexes were popular there, cool.

Cap rates are not great in the major cities in Tx given the rise in property value and property tax, but beats California which is an appreciation play.

Duplexes are super easy to rent, mitigates vacancy risks but added headache of two renters vs one. But I have a property manager that deals with all of these headache. I think Over the past 3 yrs, I have spent probable 20 hrs total dealing with them.

 

[slurpy15]

Cap rates are not great in the major cities in Tx given the rise in property value and property tax, but beats California which is an appreciation play.

Duplexes are super easy to rent, mitigates vacancy risks but added headache of two renters vs one. But I have a property manager that deals with all of these headache. I think Over the past 3 yrs, I have spent probable 20 hrs total dealing with them.

Amazing. It's hard to research remotely. Good for you! It's hard to get a good cap rate in my area, too. I'm impressed that you found a great locale that gives you such a great return.

 

[emergentmd]

Amazing. It's hard to research remotely. Good for you! It's hard to get a good cap rate in my area, too. I'm impressed that you found a great locale that gives you such a great return.

I lucked into my duplexes and got a great deal. But in a place with a low Cap rate today will be a good Caprate in 3 yrs once the rent goes up.

 

[KGflyboy]

Ok, quick questions for me and any others not down with the lingo.

1. What does NOI stand for?
2. What is "cap?"

It's probably super obvious, but I'm not catching on yet. Help me out.