Need Ownership

[Pudortu]

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate it.

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[deleted813736]

if you are interested in telecommunications/cellular stores, I recently opened one along the east coast and expanding to a second and third by the end of this year. I have worked ER for now almost 2 years, not really interesting to me anymore so im moving on.

DM me if thats something that interests you and we can chat.

 

[Birdstrike]

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate it.

I want to help you. But please clarify something. You say you are debt free, have paid off your house, have a $1.7 million nest egg and just got a promotion. All at age 35. And to top it all off, you "love practicing emergency medicine." Nothing about that suggests anything other than success, financial security and career superstardom. This life as presented, does not require advice and isn't lacking in direction or hope. Yet, your post is absolutely dripping with desperation and hopelessness.

Why?

I can't offer any advice unless you fill in the gaps between being super successful loving your job, and being desperate and needing direction. Something isn't adding up. I have my suspicions, but it's best if you tell your story rather than we make guesses.

 

[Groove]

I want to help you. But please clarify something. You say you are debt free, have paid off your house, have a $1.7 million nest egg and just got a promotion. All at age 35. And to top it all off, you "love practicing emergency medicine." Nothing about that suggests anything other than success, financial security and career superstardom. This life as presented, does not require advice and isn't lacking in direction or hope. Yet, your post is absolutely dripping with desperation and hopelessness.

Why?

I can't offer any advice unless you fill in the gaps between being super successful loving your job, and being desperate and needing direction. Something isn't adding up. I have my suspicions, but it's best if you tell your story rather than we make guess.

This.

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate it.

Dude. Looking at your past posts, you were an intern in 2013 which means you couldn't have graduated before 2016. How on God's green earth have you saved 1.7 million in 5 years and paid off your entire mortgage? That far exceeds your entire taxed income. Did you have some of this nest egg before starting in EM? Surely you couldn't have saved all of that in 5 years. I kept reading your post and thinking....damn, I'd love to trade places with this guy at 35. Your life sounds incredible. Why not just learn how to play the admin game, take the CMG stipend, continue saving and partially retire in another 5 years? You could probably fully retire with your current lifestyle in 10 if you make good investments. Nobody said life and practicing EM was supposed to be a glorified "pie in the sky" experience. If I were you, with your level of success so far, I'd hate to invest in something non EM related that you have limited experience with and risk losing such a great head start on retirement.

 

[Pudortu]

I want to help you. But please clarify something. You say you are debt free, have paid off your house, have a $1.7 million nest egg and just got a promotion. All at age 35. And to top it all off, you "love practicing emergency medicine." Nothing about that suggests anything other than success, financial security and career superstardom. This life as presented, does not require advice and isn't lacking in direction or hope. Yet, your post is absolutely dripping with desperation and hopelessness.

Why?

I can't offer any advice unless you fill in the gaps between being super successful loving your job, and being desperate and needing direction. Something isn't adding up. I have my suspicions, but it's best if you tell your story rather than we make guess.

Absolutely I don't mind clarifying. And thank you for the "career superstardom" complement. It actually means a lot coming from you.

As far as my financial situation, as soon as I graduated residency I took the biggest sign on bonus I could find with a very high $/hour, and moved to BFE. I went to medical school with a partial scholarship, lived very much within my means, and attribute a lot of hard work and sacrifice to getting where I am financially.

I do love the actual practice of EM, as I suspect many of you all do as well. I practice in a very high acuity hospital and love seeing this rare disease or doing that crazy cool resuscitation. It's the BS that comes with it like sepsis measures, patient satisfaction, MIPS, justifying everything, going from covid heroes to zeros etc. Maybe I am burnt out. Maybe I need more resilience training. Maybe I need to see a therapist.

When our new CMG took over not too long ago, they ramped everything up to the max. They hound us, cut our pay, and honestly treat us like garbage. Several of the doctors who were my friends are quitting, or have been fired. I guess I hate the CMG and the hospital an incredible amount for letting us suffer. I also hate the admin work, but am worried if I resign I will have a big target on my back. If I didn't have a permanent home here with an established network of friends locally, I would possibly consider leaving although the local market is saturated.

I am already starting to cut back from work. I used to work 180 hrs per month of average without blinking an eye and feeling great. With these new changes, I dread every shift. I just hate the thought of the opportunity cost, especially while our pay is still relatively high. I suspect within 3 years the market will tank. I look at these owners of FSEDs and UCs with envy for having the balls to take a risk and control their own destiny. As I was reflecting on my situation this morning, I realize I can now also take a risk from a position of financial strength. So I wanted to branch out so I have "something else" so that if something happens to my job, I can fall back on something else. I see that people with ownership at least have that sense of satisfaction and that control.

I'm sorry for my rant. It was somewhat therapeutic to type that out and I appreciate you reading this. Either way, I'm looking for an opportunity to branch out and try something new.

 

[Pudortu]

This.



Dude. Looking at your past posts, you were an intern in 2013 which means you couldn't have graduated before 2016. How on God's green earth have you saved 1.7 million in 5 years and paid off your entire mortgage? That far exceeds your entire taxed income. Did you have some of this nest egg before starting in EM? Surely you couldn't have saved all of that in 5 years. I kept reading your post and thinking....damn, I'd love to trade places with this guy at 35. Your life sounds incredible. Why not just learn how to play the admin game, take the CMG stipend, continue saving and partially retire in another 5 years? You could probably fully retire with your current lifestyle in 10 if you make good investments. Nobody said life and practicing EM was supposed to be a glorified "pie in the sky" experience. If I were you, with your level of success so far, I'd hate to invest in something non EM related that you have limited experience with and risk losing such a great head start on retirement.

Thank you very much for your kind words.
I actually graduated in 2015. I graduated with minimal debt (scholarships in college and medical school) and am blessed for that to have happened. I also made some very good investments in the market. Everything is essentially in index funds now. Your statement regarding partially retiring sounds promising actually. Yes, you have put some things into perspective for me. For that I want to thank you as well.
Even though financially things look good, I still have that feeling of wanting something else.
Thank you again for your post.

 

[bravotwozero]

Try looking into wound care, and see if that's for you. If you like the work, you can pick up a wound care gig that will train you in it as an employee - there are a good number of these opportunities out there. Once you've learned enough, you can open up your own practice. This way you avoid the opportunity cost of having to do a fellowship.

 

[Pudortu]

Try looking into wound care, and see if that's for you. If you like the work, you can pick up a wound care gig that will train you in it as an employee - there are a good number of these opportunities out there. Once you've learned enough, you can open up your own practice. This way you avoid the opportunity cost of having to do a fellowship.

Do you have any good books for wound care I can browse through?

 

[bravotwozero]

Do you have any good books for wound care I can browse through?

Unfortunately I don't. I have no exposure to the field aside from what shows up in the ED. I just know that this is an opportunity that exists for any EPs that want a way out.

@Dakota might be able to give you more info/resources, as he is actively involved in the field.

 

[Birdstrike]

1:

I do love the actual practice of EM,...

2:

...It's the BS that comes with it like sepsis measures, patient satisfaction, MIPS, justifying everything, going from covid heroes to zeros etc. Maybe I am burnt out. Maybe I need more resilience training. Maybe I need to see a therapist.

When our new CMG took over not too long ago, they ramped everything up to the max. They hound us, cut our pay, and honestly treat us like garbage. Several of the doctors who were my friends are quitting, or have been fired. I guess I hate the CMG and the hospital an incredible amount for letting us suffer. I also hate the admin work, but am worried if I resign I will have a big target on my back.

l
l
l
l
l
l
This sounds exactly like I felt 10-15 years ago, although I was much further behind in my finances. The problem is, your second paragraph is what EM is, not your first paragraph. We are fed this lie, and willingly believe, that what we think EM should be, is what EM is. Emergency Medicine is not "emergency medicine" any more than dropping a grain of sand in a bowel of pea soup, makes it a beach. Anyone that say it is, is lying.

The cognitive dissonance can be devastating: I signed up for paragraph 1 (nursemaid's elbow, repairing lacerations, intubating, defibrillating, challenging diagnoses) but every time I'm at work, it feels like paragraph 2, not paragraph 1.

If you are able to change your mindset so that you can ignore the negatives and allow the positives to dominate your headspace, then EM may work for you in a sustainable way. My guess is that if you were able to, you would have by now. I wasn't. If not, then looking at a career change may be what you need. That's what worked for me and those feelings of doom, gloom and desperation went away and have not returned in 10 years. Fortunately for you, you're slightly younger and in a much better financial situation than I was, to do so.

The good new is, this are going to get better for you, because you're going to make it happen.

 

[deleted77919]

…

 

[sloh]

I’m a 35yo yo ER doc, debt free, own my home outright, and have 1.75 mill in investments. Everything is essentially in index funds now.

Man, you're in a great financial position. I'd just bite the bullet, keep your head down, work hard, continue to funnel money into index funds, and truly hit FI very very soon.

 

[GassYous]

Man, you're in a great financial position. I'd just bite the bullet, keep your head down, work hard, continue to funnel money into index funds, and truly hit FI very very soon.

I think he is basically fi

 

[sloh]

I think he is basically fi

True that. I guess he's looking for Fat FIRE?

 

[gutonc]

True that. I guess he's looking for Fat FIRE?

Yeah, if I was in the OP's position I'd power through another year or two in the current situation, then sell my house and f*** off to Costa Rica or Belize for the next 50 years.

 

[hundreddaysoff]

True that. I guess he's looking for Fat FIRE?

That + free and clear house are my personal FIRE criteria. So far I mostly just have the house. Wife for some crazy reason wants to keep working part-time forever though. If that wasn't the case, I'd probably hold out for more like 2.5M.

 

[GeneralVeers]

I'm in a similar position to the OP with enough saved up to quit. Unlike the OP I hate EM at the moment and can't wait to be done. Still getting $300/hr makes it really hard to give it up. Part of me is hoping that the CMG cracks the whip hard on salary and gives me the excuse.

To the OP: The key is to get some sort of non-medical income to pay for your living expenses. Ideally you don't want to touch your investments, and just let them sit there and accumulate. Getting $5000/month of side income somehow isn't difficult.

 

[Dr Mantis Toboggan]

I'm in a similar position to the OP with enough saved up to quit. Unlike the OP I hate EM at the moment and can't wait to be done. Still getting $300/hr makes it really hard to give it up. Part of me is hoping that the CMG cracks the whip hard on salary and gives me the excuse.

To the OP: The key is to get some sort of non-medical income to pay for your living expenses. Ideally you don't want to touch your investments, and just let them sit there and accumulate. Getting $5000/month of side income somehow isn't difficult.

Inflation worries me. Car prices, housing costs etc are rising out of control it seems.

 

[GeneralVeers]

Inflation worries me. Car prices, housing costs etc are rising out of control it seems.

Of course, it's the natural result of printing trillions and trillions of dollars (wastefully) over the past 2 years. I'm not sure there's a good way around it. However remember the economy is cyclical. Real estate is in a massive bubble, and a slowdown and crash are probably inevitable, especially once evictions start up again.

 

[Pudortu]

I'm in a similar position to the OP with enough saved up to quit. Unlike the OP I hate EM at the moment and can't wait to be done. Still getting $300/hr makes it really hard to give it up. Part of me is hoping that the CMG cracks the whip hard on salary and gives me the excuse.

To the OP: The key is to get some sort of non-medical income to pay for your living expenses. Ideally you don't want to touch your investments, and just let them sit there and accumulate. Getting $5000/month of side income somehow isn't difficult.

This is exactly what I want. I just don’t know how to achieve it.

 

[gutonc]

This is exactly what I want. I just don’t know how to achieve it.

Get another half mil to a mil in your accounts, sell your house, move to one of those places with a thriving US/UK/ANZ/Euro expat community with low taxes and COL (CR, Belize, Thailand, Croatia, Slovenia, Seychelles, etc) and buy, invest in or open a bar/restaurant/resort catering to Western tourists and expats and enjoy 50 years of retirement.

Yes, I'm being a little bit glib, but not completely. There are lots of opportunities for things like that. And you'll both get out of medicine AND get into "ownership".

 

[Franzd'Epinay]

You say you're desperate, but the world is your oyster. You own your house outright, owe no student loans, and have almost $2 million in investments. You could do a neurosurgery residency and still be ahead of most of us by the time you graduate. Hell, you could get a whole new bachelor's degree in a completely unrelated field and still be in a great place financially.

You don't need ownership of anything to guarantee your financial future. If you want to be a business owner because that appeals to you, then more power to you. But I think you need a little perspective on how great you have it.

Edit: I just re-read your posts in this thread. Are you single and without kids too? You can move anywhere in the world next week!

 

[Porfirio]

Why not just start a house rental business? I would start with vacation rentals at this point because of the eviction issues. It is something you can do and you own it.

 

[Fox800]

Try looking into wound care, and see if that's for you. If you like the work, you can pick up a wound care gig that will train you in it as an employee - there are a good number of these opportunities out there. Once you've learned enough, you can open up your own practice. This way you avoid the opportunity cost of having to do a fellowship.

I'm actually looking into this right now. There are companies that will train you up, put you through their "fellowship". The pay is a big cut from EM, but the work is like 0700-1600, Mon-Fri. 3-5 days a week. You pick what days you work. No nights. No weekends. Never on call. Some places are W2 and offer typical benefits (401k, HSA, disability).

But you can make $200k/year for working 3 days a week (Mon-Weds or Tues-Thurs or whatever and have a four day weekend every week), with benefits. For working like 27 hours a week. And actually sleeping in your own bed every night.

I've interviewed with two of these places already. My only concern is losing EM clinical currency. I'd still have to work a handful of shifts a month (3-4).

 

[Fox800]

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate it.

You're winning at life, and I envy your position. I'm renting, just made it into the black, with loans on my back, and I just hit 35 (worked for a while before med school).

 

[Fox800]

You could start buying up real estate and managing it (or not - hire a manager).
You could open a franchise business.
You could start a consulting company.
You could start coaching people professionally - like other physicians.
You could invest in an UC/FSED in another geographic market.
You could do a chill fellowship like hyperbaric medicine or sports medicine.
You could reduce your number of clinical shifts.
You could do part-time work for the VA and take care of a different patient population, not have metrics shoved down your throat, and take care of nice old dudes that are probably actually respectful.
You could work from home and do easy telemedicine stuff, consulting, or utilization review.

 

[Airborne Flt Doc]

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate

I recommend real estate & franchise ...at least that’s what I did just in time for the nosedive of EM

 

[Sushirolls]

Go buy some land and build a niche farm.
Bees
Chickens
Goats
Cattle
Hay
some or all of them.

And open up your own tiny restaurant in a random suburb to be the 'market' the place that buys your produce from your farm.

You do the farming, some one else does the small restaurant you own.

 

[sylvanthus]

Dude is winning at life and still unhappy. Im fuxxored with negative net worth. Awesome.

 

[bravotwozero]

I recommend real estate & franchise ...at least that’s what I did just in time for the nosedive of EM

My issue with franchises is that you of course have to pay franchising/royalty fees etc, which can be quite a bit. Does that not eat into your profits, especially when you're likely going to finance your franchise with a loan?

 

[bravotwozero]

I'm actually looking into this right now. There are companies that will train you up, put you through their "fellowship". The pay is a big cut from EM, but the work is like 0700-1600, Mon-Fri. 3-5 days a week. You pick what days you work. No nights. No weekends. Never on call. Some places are W2 and offer typical benefits (401k, HSA, disability).

But you can make $200k/year for working 3 days a week (Mon-Weds or Tues-Thurs or whatever and have a four day weekend every week), with benefits. For working like 27 hours a week. And actually sleeping in your own bed every night.

I've interviewed with two of these places already. My only concern is losing EM clinical currency. I'd still have to work a handful of shifts a month (3-4).

Just curious, but why is not losing EM clinical currency important to you, if you're looking for a way out of EM?

I had the same dilemma, when I got offered a urgent care w-2 position, which was 200k a year with benefits. Mon-Fri 8-5, no nights, weekends or holidays. FT commitment only. I decided I was not quite willing to take the one way street out of EM just yet and turned it down.

 

[Tenk]

Uhh go part time and enjoy life? Nobody ever said on their death bed: “I wish I worked more.”

 

[Fox800]

Just curious, but why is not losing EM clinical currency important to you, if you're looking for a way out of EM?

I had the same dilemma, when I got offered a urgent care w-2 position, which was 200k a year with benefits. Mon-Fri 8-5, no nights, weekends or holidays. FT commitment only. I decided I was not quite willing to take the one way street out of EM just yet and turned it down.

I want to have a backup plan...which is important given how volatile the job market has been. I want to be able to get credentialed at a new place, and you have to have worked recently...

 

[GeneralVeers]

I want to have a backup plan...which is important given how volatile the job market has been. I want to be able to get credentialed at a new place, and you have to have worked recently...

Fox I'm going to quit my full time job and keep my part time job at 3-4 shifts per month. Can you get a part time gig? As long as you have no "gap" in your work history it's easy to get back into full time.

 

[Fox800]

Fox I'm going to quit my full time job and keep my part time job at 3-4 shifts per month. Can you get a part time gig? As long as you have no "gap" in your work history it's easy to get back into full time.

I'm trying to. Talking some recruiters in the area I want to be in. Still on the hunt.

 

[Franzd'Epinay]

Just curious, but why is not losing EM clinical currency important to you, if you're looking for a way out of EM?

I had the same dilemma, when I got offered a urgent care w-2 position, which was 200k a year with benefits. Mon-Fri 8-5, no nights, weekends or holidays. FT commitment only. I decided I was not quite willing to take the one way street out of EM just yet and turned it down.

Mon-Fri 8-5 at $200k/yr is a terrible offer. Was this in Denver or something?

 

[Franzd'Epinay]

I second the franchise idea, specifically Chick-fil-A.

 

[Fox800]

Mon-Fri 8-5 at $200k/yr is a terrible offer. Was this in Denver or something?

It's $200k for 3 days a week. 0700-1600 (roughly), you pick the days.
$200k for 27 hours a week, daytime hours. Plus benefits.

If you do M-F I'm guessing you'd be in the low 300s + benefits. Which some people take for working EM.

 

[Fox800]

Did you want to open your own clinic? Pretty sure that doesn’t need a fellowship.

I’ll open a Taco Bell franchise next door. I bet we could open an entire strip mall!

(I’m kidding…or am I?)

 

[cyanide12345678]

This.



Dude. Looking at your past posts, you were an intern in 2013 which means you couldn't have graduated before 2016. How on God's green earth have you saved 1.7 million in 5 years and paid off your entire mortgage? That far exceeds your entire taxed income. Did you have some of this nest egg before starting in EM? Surely you couldn't have saved all of that in 5 years. I kept reading your post and thinking....damn, I'd love to trade places with this guy at 35. Your life sounds incredible. Why not just learn how to play the admin game, take the CMG stipend, continue saving and partially retire in another 5 years? You could probably fully retire with your current lifestyle in 10 if you make good investments. Nobody said life and practicing EM was supposed to be a glorified "pie in the sky" experience. If I were you, with your level of success so far, I'd hate to invest in something non EM related that you have limited experience with and risk losing such a great head start on retirement.

It's possible to do what this person did. Should actually be the norm for doctors, but it isn't. I'm 3 years behind this person, exactly 2 years out, and have a net worth of 620k and debt free. If the market is as generous as it has been over the last 5 years, i expect to be between 1.5-2M in worth in 3 more years. This should be the norm for doctors if they have any financial sense and understanding.

 

[cyanide12345678]

I need some advice people.
I’m a 35yo yo ER doc and I am desperate for some kind of business, any kind, to get into. I’ve worked hard since graduating and become debt free, own my home outright, and have 1.75 mill in investments. I just got a small promotion to an admin position. And I hate it.
I hate how I have zero ownership of anything. I am desperately looking for something to invest in and become an “owner.” The freestanding Er market and urgent care market where I am is completely saturated. I hate working for the CMG that took over my job. I just want to know that I own something to maybe give me some control of my destiny. To know that I won't be fired at someone's whim.
I have no idea what to do but I am desperate. I’ve asked every colleague I know that I am chomping at the bit to get into anything. However no luck. I wish I could meet another entrepreneurial doc and do something. Anything. I just need to feel like I have some kind of control with all the doom & gloom of our specialty. Im not looking for a side gig. Even though I love practicing emergency medicine, I want it to become an option and not a requirement. If anyone could recommend some direction for my life or point me in the right direction, I would truly appreciate it.

Do you want something active, or would you like to own something passively?

Here are some ideas for you to consider:

Start investing in syndications. You are technically an owner of the entity doing business and receive a k1 from the partnership. Expected returns should be in the 15-20 percent range, with risk of capital loss as with any investment. You leverage The experience of the syndicator in running the Enterprise. I personally just put money in my 3rd syndicate deal yesterday. First one is an apartment complex in Florida, second is an apartment complex in the Washington DC area, and yesterday i put $28k into New Era medical investment fund, at crowdstreet. They are building and leasing inpatient rehab and inpatient psych facilities.

If you want something active, then go through listings on bizbuysell.com or flippa.com. honestly, it's so hard to start something from scratch, much easier to buy an established business with profits. Plenty of bars, restaurants, established franchises for sale there with established revenue and profits.

You can also venture into real estate, buy a small apartment complex and slowly build a real estate portfolio.

Lastly if you truly want to start something on your own, good luck. It's hard to make a business succeed when you already have a full time job and it's only a side hobby. You'd have to truly give it all your time and energy to even have a chance at making more than your day job.

If you haven't read rich Dad poor Dad yet, i suggest you read it. Understand the 4 cash flow quadrants. Being a day to day operator in a business isn't as exciting as being an investor benefiting from the business without putting in the work.

 

[cyanide12345678]

Absolutely I don't mind clarifying. And thank you for the "career superstardom" complement. It actually means a lot coming from you.

As far as my financial situation, as soon as I graduated residency I took the biggest sign on bonus I could find with a very high $/hour, and moved to BFE. I went to medical school with a partial scholarship, lived very much within my means, and attribute a lot of hard work and sacrifice to getting where I am financially.

I do love the actual practice of EM, as I suspect many of you all do as well. I practice in a very high acuity hospital and love seeing this rare disease or doing that crazy cool resuscitation. It's the BS that comes with it like sepsis measures, patient satisfaction, MIPS, justifying everything, going from covid heroes to zeros etc. Maybe I am burnt out. Maybe I need more resilience training. Maybe I need to see a therapist.

When our new CMG took over not too long ago, they ramped everything up to the max. They hound us, cut our pay, and honestly treat us like garbage. Several of the doctors who were my friends are quitting, or have been fired. I guess I hate the CMG and the hospital an incredible amount for letting us suffer. I also hate the admin work, but am worried if I resign I will have a big target on my back. If I didn't have a permanent home here with an established network of friends locally, I would possibly consider leaving although the local market is saturated.

I am already starting to cut back from work. I used to work 180 hrs per month of average without blinking an eye and feeling great. With these new changes, I dread every shift. I just hate the thought of the opportunity cost, especially while our pay is still relatively high. I suspect within 3 years the market will tank. I look at these owners of FSEDs and UCs with envy for having the balls to take a risk and control their own destiny. As I was reflecting on my situation this morning, I realize I can now also take a risk from a position of financial strength. So I wanted to branch out so I have "something else" so that if something happens to my job, I can fall back on something else. I see that people with ownership at least have that sense of satisfaction and that control.

I'm sorry for my rant. It was somewhat therapeutic to type that out and I appreciate you reading this. Either way, I'm looking for an opportunity to branch out and try something new.

I get it. This is exactly how I've been feeling. Tired of being **** on by CMGs who keep cutting staffing. I make great money but i hate my current job.

By the way, i personally am taking a 100k pay cut starting November 1st. Going to go from my single coverage shop that often gets very busy and stressful to a rural shop with 0.8 patients per hour (20 a day). Getting so tired from seeing 4-5 patients per hour for the first 3-4 hours of my shift. I hope that change personally helps my burnout and i can enjoy medicine without the volume pressures and stresses. Maybe you need a new practice environment - a different pace perhaps?

 

[Groove]

I get it. This is exactly how I've been feeling. Tired of being **** on by CMGs who keep cutting staffing. I make great money but i hate my current job.

By the way, i personally am taking a 100k pay cut starting November 1st. Going to go from my single coverage shop that often gets very busy and stressful to a rural shop with 0.8 patients per hour (20 a day). Getting so tired from seeing 4-5 patients per hour for the first 3-4 hours of my shift. I hope that change personally helps my burnout and i can enjoy medicine without the volume pressures and stresses. Maybe you need a new practice environment - a different pace perhaps?

3-4pph to 0.8 is totally worth 100K IMO as long as you were making 400-500K. You may get bored though! My main shop is very high acuity, fast paced, high PPH and I oftentimes will get burnt with too many shifts in a row. Then I'll cover one of our outside hospitals on a slow night where I'm seeing less than 1pph and even though I'm much less stressed, I get so incredibly bored. You can't have it all I guess.

 

[Groove]

It's possible to do what this person did. Should actually be the norm for doctors, but it isn't. I'm 3 years behind this person, exactly 2 years out, and have a net worth of 620k and debt free. If the market is as generous as it has been over the last 5 years, i expect to be between 1.5-2M in worth in 3 more years. This should be the norm for doctors if they have any financial sense and understanding.

You should share more specifics about how you've gotten successful financially. I know plenty of us would be curious. I know you were into "safer" options trading awhile back. Is there something else you've been studying and found success with?

I consider myself a pretty savvy traditional investor and am luckily beating the market (ATM) but there's noway I could create the kind of wealth so quickly through investing. I also consider myself a fairly educated investor. What's your secret?

 

[cyanide12345678]

3-4pph to 0.8 is totally worth 100K IMO as long as you were making 400-500K. You may get bored though! My main shop is very high acuity, fast paced, high PPH and I oftentimes will get burnt with too many shifts in a row. Then I'll cover one of our outside hospitals on a slow night where I'm seeing less than 1pph and even though I'm much less stressed, I get so incredibly bored. You can't have it all I guess.

Im making 450k currently, working 12 x 12s. As a nocturnist, i get killed from 7 pm to 11 pm. It's one of the busiest times, sometimes dangerous. The new job pays 360k w2 plus full University benefits. I've made my money and I'm at peace with a paycut especially since my family income still goes up with my wife becoming an attending in family medicine. The first 1 million is the hardest, after that compound interest just takes over.

Boredom I'll take over stress. Career longevity matters.

 

[bravotwozero]

Mon-Fri 8-5 at $200k/yr is a terrible offer. Was this in Denver or something?

We’re talking about urgent care here, not EM!

 

[cyanide12345678]

You should share more specifics about how you've gotten successful financially. I know plenty of us would be curious. I know you were into "safer" options trading awhile back. Is there something else you've been studying and found success with?

I consider myself a pretty savvy traditional investor and am luckily beating the market (ATM) but there's noway I could create the kind of wealth so quickly through investing. I also consider myself a fairly educated investor. What's your secret?

Family income of 500k-ish over last 2 academic years, 450k was mine, 50k was my wife's as a resident. Paid $150k of loans during those 2 years. The rest went to savings after taxes and expenses.

The success really has been through earnings and investing mostly.

Massive investments into the market after the March crash helped significantly. A lot of tax benefits through being s corp have helped lower tax bill, especially with my solo 401k contribution of 57k and the 199a deduction.

350k of my net worth is in options now. I used to Target 12-15k/month in profits monthly. I had 1 rough month where i lost 24k, mostly because i folded my positions instead of holding in perpetuity, now i play even more conservatively - aim is to get 6-7k/month (roughly 1.5-2% of what's in the account). Because of the loss of 24k of my profits, I basically have the same return as sp500 right now - about 45 percent since November 2020 when i started options. It's a strategy I'm sticking with.

Plan is to diversify 30-35 percent into physical real estate. Illiquid assets that do not correlate with the markets. All of that will be in private real estate syndications essentially. Doing it all through crowdstreet for now.

I plan on being at 1M net worth in 1-1.5 years, so 33 age. Shouldn't be hard with 600k in family income starting November, though my wife and i are taking a 2 month hiatus from working after August and just traveling.

 

[wamcp]

I'm in a similar position to the OP with enough saved up to quit. Unlike the OP I hate EM at the moment and can't wait to be done. Still getting $300/hr makes it really hard to give it up. Part of me is hoping that the CMG cracks the whip hard on salary and gives me the excuse.

To the OP: The key is to get some sort of non-medical income to pay for your living expenses. Ideally you don't want to touch your investments, and just let them sit there and accumulate. Getting $5000/month of side income somehow isn't difficult.

Get into securities trading/stock investing. Futures, stocks, crypto, bonds whatever you want. Just learn it well.

Eventually, getting +62K gain in a single day isn’t so exciting anymore.

I’ve hit 2 mil net worth and looking to exit medicine to switch maybe into tech. That being said i’m not EM and I do find my nocturnist hospital gig pretty chill, just boring at this point

 

[cyanide12345678]

Get into securities trading/stock investing. Futures, stocks, crypto, bonds whatever you want. Just learn it well.

Eventually, getting +62K gain in a single day isn’t so exciting anymore.

I’ve hit 2 mil net worth and looking to exit medicine to switch maybe into tech. That being said i’m not EM and I do find my nocturnist hospital gig pretty chill, just boring at this point

View attachment 339782

Damn. Impressive.

 

[Birdstrike]

My only concern is losing EM clinical currency. I'd still have to work a handful of shifts a month (3-4).

Losing my EM clinical currency is one of the best things that ever happened to me.