May 10, 2024
Ask yourself these 7 questions about money
We might be academics; but our financial health is still important. In today's episode, we discuss 7 key questions to take control of your financial present and future.
Key Points Discussed:
- Understand how you earn money.
- Identify the areas in which you work for free vs. working for pay.
- Consider your long-term financial goals.
- Explore strategies to reach your financial goals sooner.
- Address potential inequities in salary
- Seek out the needed financial information to make informed decisions about your financial health.
Links and Resources Mentioned:
- www.coagcoach.com
Call to Action:
Take a moment to reflect on your own financial situation. Consider the seven questions posed in this episode. Start a conversation with a trusted friend about your financial health.
Sponsor/Advertising/Monetization Information:
This episode is sponsored by Coag Coach LLC, a leading provider of coaching resources for clinicians transitioning to become research leaders. Coag Coach LLC is committed to supporting clinicians in their scholarship.
Looking for a coach?
Sign up for a coaching discovery call today: https://www.coagcoach.com/service-page/consultation-call-1
1
00:00:00,000 --> 00:00:05,860
Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
2
00:00:05,860 --> 00:00:11,260
to build their own research program, whether or not they have a mentor.
3
00:00:11,260 --> 00:00:17,340
As clinicians, we spend a decade or more as trainees learning to take care of patients.
4
00:00:17,340 --> 00:00:22,380
When we finally start our careers, we want to build research programs, but then we find
5
00:00:22,380 --> 00:00:27,780
that our years of clinical training did not adequately prepare us to lead our research
6
00:00:27,780 --> 00:00:29,200
program.
7
00:00:29,200 --> 00:00:35,480
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
8
00:00:35,480 --> 00:00:40,580
However, clinicians hold the keys to the greatest research breakthroughs.
9
00:00:40,580 --> 00:00:46,200
For this reason, the Clinician Researcher podcast exists to give academic clinicians
10
00:00:46,200 --> 00:00:51,800
the tools to build their own research program, whether or not they have a mentor.
11
00:00:51,800 --> 00:01:01,160
Now introducing your host, Toyosi Onwuemene.
12
00:01:01,160 --> 00:01:03,660
Welcome to the Clinician Researcher podcast.
13
00:01:03,660 --> 00:01:08,720
I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you
14
00:01:08,720 --> 00:01:09,720
today.
15
00:01:09,720 --> 00:01:11,720
Today, I'm talking about money.
16
00:01:11,720 --> 00:01:18,320
Specifically, I'm talking about questions you should be asking about money.
17
00:01:18,320 --> 00:01:22,680
And the reason this topic is fresh on my mind is because I'm part of a coaching group, so
18
00:01:22,680 --> 00:01:30,920
I work with Dr. Latifat, who has a money school for women in medicine, for physicians specifically.
19
00:01:30,920 --> 00:01:33,960
And so we meet once a week, and we talk about money.
20
00:01:33,960 --> 00:01:39,840
And we talk about strategies, and we talk about what people are doing, and what syndication
21
00:01:39,840 --> 00:01:43,280
deals people are looking at, what investments people are making.
22
00:01:43,280 --> 00:01:47,460
And it's just so phenomenal because I have to tell you, I've never been in circles where
23
00:01:47,460 --> 00:01:49,560
we just talk about money.
24
00:01:49,560 --> 00:01:55,360
And every time I'm in these meetings, my awareness has just expanded.
25
00:01:55,360 --> 00:01:59,840
I learned things that I'd never understood before, because there I am at today's meeting
26
00:01:59,840 --> 00:02:04,580
saying, but what is a syndication deal?
27
00:02:04,580 --> 00:02:10,040
And I don't think I'm ready to do one today, but what I am is informed, because now I have
28
00:02:10,040 --> 00:02:12,160
information that I didn't have before.
29
00:02:12,160 --> 00:02:18,360
But yeah, so this particular conversation prompted me to decide to record today's episode.
30
00:02:18,360 --> 00:02:22,520
But before that, there was another story that prompted my thinking a little bit more about
31
00:02:22,520 --> 00:02:24,280
money than I usually do.
32
00:02:24,280 --> 00:02:30,840
Okay, so a couple of days ago, I was representing my society, the American Society of Human
33
00:02:30,840 --> 00:02:33,640
Technology on Capitol Hill.
34
00:02:33,640 --> 00:02:36,480
And I am a member of the committee and practice.
35
00:02:36,480 --> 00:02:43,520
And once a year, the committee and practice will go to their legislators on the hill and
36
00:02:43,520 --> 00:02:49,280
will present issues that the society has decided are pressing issues.
37
00:02:49,280 --> 00:02:56,660
Okay, so one of the issues that we had on our list is the issue of physician payments.
38
00:02:56,660 --> 00:03:03,240
And so if you are aware, the system regarding physician payments is broken, and I'm talking
39
00:03:03,240 --> 00:03:09,640
about physician payments from Medicare, such that even though every year, inflation is
40
00:03:09,640 --> 00:03:14,040
increasing, physician payments are decreasing every year.
41
00:03:14,040 --> 00:03:19,080
And there have been some stopgap measures to try to decrease the amount by which it's
42
00:03:19,080 --> 00:03:20,080
decreasing.
43
00:03:20,080 --> 00:03:23,240
I will tell you that it's an interesting phenomenon that it's decreasing every year.
44
00:03:23,240 --> 00:03:29,440
I'm sure that there are some more economic strategies to share exactly what's going on
45
00:03:29,440 --> 00:03:31,280
and the specificities of that.
46
00:03:31,280 --> 00:03:38,080
I cannot tell you, but simply the money is going down every year.
47
00:03:38,080 --> 00:03:42,000
And the strategies that they have to fix it right now are to decrease the amount by which
48
00:03:42,000 --> 00:03:43,760
it decreases every year.
49
00:03:43,760 --> 00:03:48,080
That's better than it decreasing by a more significant amount every year.
50
00:03:48,080 --> 00:03:53,520
But the issue is that while inflation is increasing, physician payments are decreasing.
51
00:03:53,520 --> 00:03:56,360
Okay, so that was one of the issues that we brought to Congress.
52
00:03:56,360 --> 00:04:00,260
And what's interesting is that, so we're a hematologist and we had one representative
53
00:04:00,260 --> 00:04:05,240
from Indiana, one representative from Illinois, and I was representing North Carolina.
54
00:04:05,240 --> 00:04:09,800
We were sitting waiting for our next appointment and we looked across the table beside us and
55
00:04:09,800 --> 00:04:13,080
there is a group of rheumatologists.
56
00:04:13,080 --> 00:04:16,560
And we're like, oh, what issues are you taking to your legislators?
57
00:04:16,560 --> 00:04:19,400
And they're talking about, guess what?
58
00:04:19,400 --> 00:04:21,760
The Physician Payment Act.
59
00:04:21,760 --> 00:04:28,120
In fact, the graph that shows how physician payments are decreasing while all other things
60
00:04:28,120 --> 00:04:32,560
on a fee schedule are increasing is a ubiquitous graph.
61
00:04:32,560 --> 00:04:33,560
Everybody has this graph.
62
00:04:33,560 --> 00:04:37,120
In fact, the graph is so ubiquitous, all the legislators know the graph.
63
00:04:37,120 --> 00:04:39,240
It's like, oh yeah, yeah, we know about this problem.
64
00:04:39,240 --> 00:04:41,280
It is a problem everybody knows about.
65
00:04:41,280 --> 00:04:45,280
And so then the question in my mind is like, well, if the problem is known and has been
66
00:04:45,280 --> 00:04:49,860
known for so long, why hasn't it been fixed?
67
00:04:49,860 --> 00:04:53,600
And I know that there are some of you who are legislative wizards out there and you
68
00:04:53,600 --> 00:04:59,200
can tell me exactly what's happening, but from my very simple understanding, it's like
69
00:04:59,200 --> 00:05:05,440
if payments should be increasing over time, but instead they're decreasing while inflation
70
00:05:05,440 --> 00:05:12,080
is rising, which means they're significantly decreasing, why can't it be changed?
71
00:05:12,080 --> 00:05:14,280
And what are the big barriers for change?
72
00:05:14,280 --> 00:05:18,720
Anyway, so I'm not here to answer that philosophical question because that's a huge question and
73
00:05:18,720 --> 00:05:20,760
not one that I believe I can answer.
74
00:05:20,760 --> 00:05:27,680
But the question I do want to answer is, well, if they're not going to fix it, what are you
75
00:05:27,680 --> 00:05:29,800
going to do about it?
76
00:05:29,800 --> 00:05:36,560
And I'm asking that question of me because if over time the reimbursement to physicians
77
00:05:36,560 --> 00:05:42,480
from Medicare, one of the largest payers in terms of the healthcare system, most of our
78
00:05:42,480 --> 00:05:47,780
patients are older and on Medicare, then what's going to be happening?
79
00:05:47,780 --> 00:05:52,800
So what's happening over time, and we're feeling the pinch of the need to do more clinical
80
00:05:52,800 --> 00:05:56,360
work just to make the same amount that used to be made.
81
00:05:56,360 --> 00:05:59,960
And so if you're an academic medical center, you may not feel the pinch as much, but if
82
00:05:59,960 --> 00:06:03,920
you are in private practice, for example, if you have a small practice, you're going
83
00:06:03,920 --> 00:06:07,520
to feel the pinch because this is money that helps you pay yourself.
84
00:06:07,520 --> 00:06:13,600
And so I think it made me stop and say, hey, who's in charge of the finances?
85
00:06:13,600 --> 00:06:19,560
Who's asking the questions about whether I'm able to be independent financially ultimately
86
00:06:19,560 --> 00:06:20,920
or not?
87
00:06:20,920 --> 00:06:22,400
So it got me thinking.
88
00:06:22,400 --> 00:06:26,680
And that's why having this meeting that I just stepped away from where we're really talking
89
00:06:26,680 --> 00:06:32,560
about taking ownership of our finances was huge, right?
90
00:06:32,560 --> 00:06:38,120
Stepping out of this meeting where we're all talking about taking ownership of our finances
91
00:06:38,120 --> 00:06:40,680
is a big deal.
92
00:06:40,680 --> 00:06:44,840
That's why I wanted to come talk to you about it today because I want you thinking about
93
00:06:44,840 --> 00:06:45,920
it too.
94
00:06:45,920 --> 00:06:49,680
I think one of the challenges for us, especially as academic physicians, is that we are so
95
00:06:49,680 --> 00:06:55,800
focused on all the stuff, seeing patients, writing our manuscripts and submitting grants
96
00:06:55,800 --> 00:06:59,720
and just doing all the things that are associated with being an academic physician.
97
00:06:59,720 --> 00:07:05,320
But here's the thing about being an academic physician, it will end.
98
00:07:05,320 --> 00:07:07,400
A day is coming when you're going to retire.
99
00:07:07,400 --> 00:07:12,440
You're going to walk away from the hallowed halls of the academic institution.
100
00:07:12,440 --> 00:07:14,200
And then what are you going to do?
101
00:07:14,200 --> 00:07:17,720
And will you be financially prepared for that moment?
102
00:07:17,720 --> 00:07:21,640
Some of us will not wait until retirement before we leave the hallowed halls with the
103
00:07:21,640 --> 00:07:24,700
academic institution for better or for worse.
104
00:07:24,700 --> 00:07:27,720
And are we prepared for that moment when it comes?
105
00:07:27,720 --> 00:07:28,720
Okay.
106
00:07:28,720 --> 00:07:30,460
So that's what I wanted to share.
107
00:07:30,460 --> 00:07:33,840
But I want to talk about seven questions you should be asking.
108
00:07:33,840 --> 00:07:34,840
Okay.
109
00:07:34,840 --> 00:07:36,120
About money specifically.
110
00:07:36,120 --> 00:07:42,280
This is about money and it matters because although really I'm really big on you being
111
00:07:42,280 --> 00:07:48,480
kind of the academician, the scholar, the clinician scientist, the clinician researcher
112
00:07:48,480 --> 00:07:55,320
that you need to be, I also recognize that if you cannot afford your life, that's a problem.
113
00:07:55,320 --> 00:07:58,760
And so I'm not here to talk to you about budgeting, not even really here to talk to you about
114
00:07:58,760 --> 00:07:59,760
investment.
115
00:07:59,760 --> 00:08:03,800
I just want to ask seven questions that I'd like you to consider asking yourself.
116
00:08:03,800 --> 00:08:04,800
Okay.
117
00:08:04,800 --> 00:08:09,040
So number one, how do I make money?
118
00:08:09,040 --> 00:08:11,380
How do I make money?
119
00:08:11,380 --> 00:08:13,280
Why is this question important?
120
00:08:13,280 --> 00:08:17,960
This question is important because whether you know it or not, how you make money drives
121
00:08:17,960 --> 00:08:21,000
your experience in the academic medical center.
122
00:08:21,000 --> 00:08:27,160
For example, when I first started, I was fully clinical, which meant it was 80%, but I was
123
00:08:27,160 --> 00:08:29,440
seeing patients five days a week.
124
00:08:29,440 --> 00:08:35,280
But how I made money actually is seeing the patient and writing the note, closing the
125
00:08:35,280 --> 00:08:36,280
chart.
126
00:08:36,280 --> 00:08:38,040
Until the chart is closed, money is not made.
127
00:08:38,040 --> 00:08:41,800
Or at least there's no bill generated so that money can be made.
128
00:08:41,800 --> 00:08:47,080
And so every time I was not very good at closing charts, every time I got the notification
129
00:08:47,080 --> 00:08:53,080
that, hey, you didn't close your charts, that was the sign that someone was like, hey, you're
130
00:08:53,080 --> 00:08:54,720
seeing patients, but we're not making money.
131
00:08:54,720 --> 00:08:55,720
Can we fix that?
132
00:08:55,720 --> 00:08:57,600
And it was a source of stress to me.
133
00:08:57,600 --> 00:09:02,440
I just thought that there was this principle they had and charts needed to be closed.
134
00:09:02,440 --> 00:09:08,280
What I didn't realize is that charts being closed means the institution makes money or
135
00:09:08,280 --> 00:09:11,920
at least can generate a bill so that money comes in.
136
00:09:11,920 --> 00:09:16,400
And so when I didn't close charts, I was playing with somebody else's money.
137
00:09:16,400 --> 00:09:20,040
Mine too, but mostly somebody else's money because they get more of it than I do.
138
00:09:20,040 --> 00:09:21,040
Right?
139
00:09:21,040 --> 00:09:25,640
But if I understood that, then it makes sense that I'm being badgered, I'm being bugged
140
00:09:25,640 --> 00:09:27,160
and people are like, you haven't closed your charts.
141
00:09:27,160 --> 00:09:28,160
You haven't closed your charts.
142
00:09:28,160 --> 00:09:29,360
You haven't closed your charts.
143
00:09:29,360 --> 00:09:31,560
Because what I realized is that that's how I make money.
144
00:09:31,560 --> 00:09:36,240
The moment I close a chart, money is made and it goes somewhere and there's some credit
145
00:09:36,240 --> 00:09:40,240
that comes to me, but that is the final denominator.
146
00:09:40,240 --> 00:09:42,000
But what goes into closing a chart?
147
00:09:42,000 --> 00:09:43,760
Well, first of all, you got to see a patient.
148
00:09:43,760 --> 00:09:44,760
Right?
149
00:09:44,760 --> 00:09:48,400
So prepping my notes before clinic doesn't earn me money.
150
00:09:48,400 --> 00:09:53,760
Seeing the patient is part of earning money, but it doesn't earn me money.
151
00:09:53,760 --> 00:09:57,080
I can see patient, charts not closed or money is not earned.
152
00:09:57,080 --> 00:10:05,200
Or I can see the patient, write the note, close the chart and then money is earned.
153
00:10:05,200 --> 00:10:06,200
Okay.
154
00:10:06,200 --> 00:10:07,200
Why is this important?
155
00:10:07,200 --> 00:10:13,480
This is important because you will live a happy life and no one will ask you questions
156
00:10:13,480 --> 00:10:17,960
as long as the math equation works between where all your funding comes from and your
157
00:10:17,960 --> 00:10:21,240
clinical revenue such that your salary is covered.
158
00:10:21,240 --> 00:10:22,240
Okay?
159
00:10:22,240 --> 00:10:25,320
The moment something happens and your salary is not being covered, let's say you haven't
160
00:10:25,320 --> 00:10:28,560
seen the requisite number of patients, you will hear about it.
161
00:10:28,560 --> 00:10:29,960
You absolutely will.
162
00:10:29,960 --> 00:10:31,360
Somebody will let you know.
163
00:10:31,360 --> 00:10:33,960
In academics, we talk about money indirectly.
164
00:10:33,960 --> 00:10:37,420
And so people will talk about charts being closed and your professional responsibility
165
00:10:37,420 --> 00:10:41,440
and it's not okay that you saw 50 patients and you've only closed three.
166
00:10:41,440 --> 00:10:45,000
They will talk about all that and you'll feel guilty because you're very good at feeling
167
00:10:45,000 --> 00:10:46,000
guilty.
168
00:10:46,000 --> 00:10:52,120
But the bottom line is that, hey, CES, if you did not close charts, that means bills
169
00:10:52,120 --> 00:10:55,760
were not generated and you are not making your salary.
170
00:10:55,760 --> 00:10:56,760
Okay.
171
00:10:56,760 --> 00:11:00,480
So I just wanted to talk about that in the context of the clinical picture because I
172
00:11:00,480 --> 00:11:05,520
think we understand it a little bit better in the context of writing grants.
173
00:11:05,520 --> 00:11:09,000
No funding means no protected time.
174
00:11:09,000 --> 00:11:10,920
It's very simple.
175
00:11:10,920 --> 00:11:13,540
But understand how you make money in terms of funding.
176
00:11:13,540 --> 00:11:15,040
So what gets you funding?
177
00:11:15,040 --> 00:11:21,120
Well, you have an idea and then you write a grant and you submit the grant.
178
00:11:21,120 --> 00:11:25,320
Great idea, grant not submitted, no money can come.
179
00:11:25,320 --> 00:11:30,800
Great idea, grant submitted, opportunities for money can come.
180
00:11:30,800 --> 00:11:34,240
But it's important for you to understand how do you make money?
181
00:11:34,240 --> 00:11:38,560
What part of your salary is covered by grants or part of your salary is covered by clinical
182
00:11:38,560 --> 00:11:43,480
effort and what aspects of those things actually bring you money?
183
00:11:43,480 --> 00:11:44,480
Okay.
184
00:11:44,480 --> 00:11:49,120
So if I have 300 meetings and some of them may be related to research, some of them may
185
00:11:49,120 --> 00:11:55,480
not, but if any of them, of any of those meetings don't move my research forward, don't increase
186
00:11:55,480 --> 00:12:01,320
my ability to write the next funded grant to write for more money, it's not helping
187
00:12:01,320 --> 00:12:02,320
me make money.
188
00:12:02,320 --> 00:12:03,320
Okay.
189
00:12:03,320 --> 00:12:04,880
So I'm not trying to be mercenary here.
190
00:12:04,880 --> 00:12:07,060
Why is this question important?
191
00:12:07,060 --> 00:12:10,240
This question is important because it helps you focus.
192
00:12:10,240 --> 00:12:12,400
It helps you align your focus.
193
00:12:12,400 --> 00:12:15,160
It helps you really think about the 20%.
194
00:12:15,160 --> 00:12:20,280
What are the things you do that create the highest value for you and the highest value
195
00:12:20,280 --> 00:12:22,880
for your employer?
196
00:12:22,880 --> 00:12:26,960
Because your employer needs you to generate money.
197
00:12:26,960 --> 00:12:29,200
It's the only reason you've been hired.
198
00:12:29,200 --> 00:12:30,200
You're a physician.
199
00:12:30,200 --> 00:12:34,200
Physicians are good generators of money and they leave you alone to the extent to which
200
00:12:34,200 --> 00:12:36,120
you're actually generating the money you're supposed to.
201
00:12:36,120 --> 00:12:37,400
You can generate excess money.
202
00:12:37,400 --> 00:12:41,400
They won't tell you too much about that, but if you generate too little, they want to know
203
00:12:41,400 --> 00:12:44,440
and they will let you know indirectly.
204
00:12:44,440 --> 00:12:48,480
So what it allows you to do, understanding how you make money, it allows you to prioritize
205
00:12:48,480 --> 00:12:53,560
what is it about what I do that creates the most value and you focus on that.
206
00:12:53,560 --> 00:12:58,000
A lot of things might fall by the wayside, but the things that fall by the wayside will
207
00:12:58,000 --> 00:12:59,960
not be the highest priority things.
208
00:12:59,960 --> 00:13:00,960
Right?
209
00:13:00,960 --> 00:13:05,640
So to be honest, I didn't used to think that writing notes was an important priority, but
210
00:13:05,640 --> 00:13:09,920
once I understood that, oh, it's not about the notes, it's about generating bill, then
211
00:13:09,920 --> 00:13:14,040
I can clarify, okay, how do I increase my efficiency?
212
00:13:14,040 --> 00:13:18,800
So I can close charts and people don't bother me because this is a thing that creates value
213
00:13:18,800 --> 00:13:20,680
in this space.
214
00:13:20,680 --> 00:13:25,880
So question number one is ask the question, how do I make money?
215
00:13:25,880 --> 00:13:31,860
And that gives you opportunity to maximize it so that you spend less time doing stuff.
216
00:13:31,860 --> 00:13:36,320
If you know that calling a prior authorization doesn't make you money, well, now you can
217
00:13:36,320 --> 00:13:39,400
negotiate who helps you call that prior authorization.
218
00:13:39,400 --> 00:13:42,600
And I'm glad that there are a lot of people working towards helping us so that we're not
219
00:13:42,600 --> 00:13:48,400
doing that kind of stuff all the time, but recognize that the more you understand how
220
00:13:48,400 --> 00:13:54,040
you make money, the more you can prioritize what is most important and see how you can
221
00:13:54,040 --> 00:13:56,240
delegate the things that are not important.
222
00:13:56,240 --> 00:13:57,240
Okay.
223
00:13:57,240 --> 00:14:00,560
I feel like I beat that one today.
224
00:14:00,560 --> 00:14:02,400
I've beat it enough.
225
00:14:02,400 --> 00:14:04,200
How do I make money?
226
00:14:04,200 --> 00:14:05,200
Okay.
227
00:14:05,200 --> 00:14:11,280
Question number two, where am I working for free versus where I'm working for pay?
228
00:14:11,280 --> 00:14:12,800
Why is this important?
229
00:14:12,800 --> 00:14:17,960
In our lives, we will not always be paid for the work we do and that's okay.
230
00:14:17,960 --> 00:14:23,880
Like I'm a mom, nobody pays me for that work or my pay is kind of more in kind, you know,
231
00:14:23,880 --> 00:14:28,560
like the joy that I get from serving as a mom, but it's not something for which anybody
232
00:14:28,560 --> 00:14:30,240
writes me a check every month.
233
00:14:30,240 --> 00:14:33,000
Would be nice, but it's not something I get a check for.
234
00:14:33,000 --> 00:14:38,120
But whether I get a check or not for being a mom, I love being a mom.
235
00:14:38,120 --> 00:14:43,800
I'm good with doing that work for free because the benefits I get are intangible.
236
00:14:43,800 --> 00:14:45,400
I value that.
237
00:14:45,400 --> 00:14:46,400
Okay.
238
00:14:46,400 --> 00:14:47,760
What else do I do for free?
239
00:14:47,760 --> 00:14:53,200
Well, I'm giving a talk to students who are interested in medicine and they're in high
240
00:14:53,200 --> 00:14:56,720
school and all they know about medicine is that you can be a nurse or a doctor.
241
00:14:56,720 --> 00:14:59,480
I'm going to come talk to them about being a hematologist.
242
00:14:59,480 --> 00:15:02,680
I found out I'm the only hematologist on the panel to talk to these students.
243
00:15:02,680 --> 00:15:05,280
I'm super excited because I need them to know about hematologists.
244
00:15:05,280 --> 00:15:07,680
Am I getting paid for this talk?
245
00:15:07,680 --> 00:15:12,960
No, but I'm choosing to do that because it is meaningful to me to pour into the next
246
00:15:12,960 --> 00:15:14,760
generation like that.
247
00:15:14,760 --> 00:15:15,760
Okay.
248
00:15:15,760 --> 00:15:22,920
Now, as a physician, I get paid for a certain amount of work that I do and I'm on a salary.
249
00:15:22,920 --> 00:15:26,920
So usually I think I probably work more than I get paid, which is fine.
250
00:15:26,920 --> 00:15:27,920
That's how salaries work.
251
00:15:27,920 --> 00:15:31,320
It also means on the months where I don't work as hard, I still get paid.
252
00:15:31,320 --> 00:15:34,360
So that's the benefit of the salary.
253
00:15:34,360 --> 00:15:39,600
But then there are parts of the extra stuff that I do, sometimes we'll talk about, is
254
00:15:39,600 --> 00:15:42,520
it a 40 hour work week or a 60 hour work week?
255
00:15:42,520 --> 00:15:46,340
Because if we can make it a 60 hour work week, then we can allow you to work harder and it
256
00:15:46,340 --> 00:15:48,720
not count as extra.
257
00:15:48,720 --> 00:15:56,400
Anyway, I say all that to say that it's okay to work for free if that's what you want to
258
00:15:56,400 --> 00:15:57,400
do.
259
00:15:57,400 --> 00:16:01,600
But if for any reason there are parts of your life where you're like, no, unless I don't
260
00:16:01,600 --> 00:16:06,360
want my work for free, just make it explicit and clarify.
261
00:16:06,360 --> 00:16:11,600
So when somebody says, hey, I'd like you to please take a couple of three weeks of extra
262
00:16:11,600 --> 00:16:14,160
coal because you know, there is nobody to do it.
263
00:16:14,160 --> 00:16:16,720
You know, three people just quit.
264
00:16:16,720 --> 00:16:18,440
You can say, oh, I know the goodness of my heart.
265
00:16:18,440 --> 00:16:19,840
I want to do this.
266
00:16:19,840 --> 00:16:22,040
And how much is it going to be compensated?
267
00:16:22,040 --> 00:16:24,580
How is my time going to be compensated?
268
00:16:24,580 --> 00:16:28,080
And I know that's almost like a math amount because in medicine we don't talk about that
269
00:16:28,080 --> 00:16:29,080
kind of stuff.
270
00:16:29,080 --> 00:16:32,200
But I just need you to know that you might say, I choose to work for free.
271
00:16:32,200 --> 00:16:36,280
I'm going to take these three weeks of coal and I'm doing it out of the goodness of my
272
00:16:36,280 --> 00:16:37,280
heart.
273
00:16:37,280 --> 00:16:38,280
I'm working for free.
274
00:16:38,280 --> 00:16:40,320
And if that's your choice, that's your choice.
275
00:16:40,320 --> 00:16:42,760
Or you might say, I don't want to work for free.
276
00:16:42,760 --> 00:16:46,600
How is this extra time investment going to be compensated?
277
00:16:46,600 --> 00:16:48,820
And then you get to negotiate that.
278
00:16:48,820 --> 00:16:52,400
And it could be that you're like, can I, I want to get paid financially for it.
279
00:16:52,400 --> 00:16:53,400
I want money for this.
280
00:16:53,400 --> 00:16:57,760
Or you could say, hey, if I'm doing three weeks this year, I'm not doing three weeks
281
00:16:57,760 --> 00:17:01,280
next year because these three weeks need to count.
282
00:17:01,280 --> 00:17:06,120
But that's an opportunity you have when you know where you work for free and when you
283
00:17:06,120 --> 00:17:07,680
don't work for free.
284
00:17:07,680 --> 00:17:13,520
So you can be very clear who is paying for this time, who is paying for this time.
285
00:17:13,520 --> 00:17:15,200
And it could be that I'm paying for it.
286
00:17:15,200 --> 00:17:16,200
That's okay.
287
00:17:16,200 --> 00:17:19,040
Here I am up late recording this episode for you.
288
00:17:19,040 --> 00:17:23,360
I'm choosing, I'm paying for this time.
289
00:17:23,360 --> 00:17:29,080
So what question I want you to ask is where in my life am I working for free versus working
290
00:17:29,080 --> 00:17:30,200
for pay?
291
00:17:30,200 --> 00:17:31,200
Make the distinction.
292
00:17:31,200 --> 00:17:36,080
You don't have to do anything with the information, but be aware.
293
00:17:36,080 --> 00:17:40,960
Don't be in ignorance about how you're using and spending your time.
294
00:17:40,960 --> 00:17:42,920
All right.
295
00:17:42,920 --> 00:17:47,640
Number three, what do I want money to do for me tomorrow?
296
00:17:47,640 --> 00:17:48,640
I'm talking about retirement.
297
00:17:48,640 --> 00:17:51,120
What do I want money to do for me tomorrow?
298
00:17:51,120 --> 00:17:53,000
Talking about retirement.
299
00:17:53,000 --> 00:17:56,880
And to be honest, for most of us, we start, actually I shouldn't say most of us because
300
00:17:56,880 --> 00:17:59,760
I don't know where you are, but for me, I'll speak about me.
301
00:17:59,760 --> 00:18:02,520
I started, they told me I had to put money in retirement.
302
00:18:02,520 --> 00:18:03,520
I'm like, sure.
303
00:18:03,520 --> 00:18:05,640
They put it for me in target date funds.
304
00:18:05,640 --> 00:18:06,640
I was like, great.
305
00:18:06,640 --> 00:18:07,640
Okay.
306
00:18:07,640 --> 00:18:09,360
What am I supposed to do with that?
307
00:18:09,360 --> 00:18:13,120
Over time as I began to listen and learn, I was like, okay, let's look at the expense
308
00:18:13,120 --> 00:18:14,120
ratios.
309
00:18:14,120 --> 00:18:15,960
Is this how I want to invest my money?
310
00:18:15,960 --> 00:18:17,240
Let's look at the performance.
311
00:18:17,240 --> 00:18:18,640
Is this how I want to invest my money?
312
00:18:18,640 --> 00:18:20,160
And I've changed my investments.
313
00:18:20,160 --> 00:18:22,040
I no longer invest in target date funds.
314
00:18:22,040 --> 00:18:24,920
I'm not here to say that target date funds are problematic.
315
00:18:24,920 --> 00:18:26,000
They're not.
316
00:18:26,000 --> 00:18:30,880
It's just making active choices because I'm thinking about what do I want money to do
317
00:18:30,880 --> 00:18:31,880
for me tomorrow?
318
00:18:31,880 --> 00:18:32,880
I'm thinking about tomorrow.
319
00:18:32,880 --> 00:18:33,880
I'm thinking about retirement.
320
00:18:33,880 --> 00:18:35,980
And I'm like, what are my plans?
321
00:18:35,980 --> 00:18:36,980
What is my goal?
322
00:18:36,980 --> 00:18:42,520
And now I'm making choices that affect what tomorrow looks like.
323
00:18:42,520 --> 00:18:43,520
Do I control tomorrow?
324
00:18:43,520 --> 00:18:44,520
Absolutely not.
325
00:18:44,520 --> 00:18:50,400
But I'm making the choice I can make because I recognize that tomorrow, the day of retirement,
326
00:18:50,400 --> 00:18:53,340
or leaving this place, is coming.
327
00:18:53,340 --> 00:18:56,800
And it's an opportunity for me to really think about what does tomorrow look like?
328
00:18:56,800 --> 00:18:57,800
When is tomorrow?
329
00:18:57,800 --> 00:18:59,840
Like, when is that day of retirement?
330
00:18:59,840 --> 00:19:00,840
When is it coming?
331
00:19:00,840 --> 00:19:01,840
When do I want it to come?
332
00:19:01,840 --> 00:19:07,520
Am I just going to accept that I'm going to be here until 90 or 100?
333
00:19:07,520 --> 00:19:09,600
All things working well?
334
00:19:09,600 --> 00:19:12,720
Or do I want to be done with this at age 62?
335
00:19:12,720 --> 00:19:14,440
We get to decide.
336
00:19:14,440 --> 00:19:18,880
But part of thinking about what do I want my money to do for me tomorrow affects what
337
00:19:18,880 --> 00:19:21,080
you do with the money today.
338
00:19:21,080 --> 00:19:22,760
Okay.
339
00:19:22,760 --> 00:19:26,600
Question before is what do I want money to do for me right now?
340
00:19:26,600 --> 00:19:28,040
Now you can look at that in two ways.
341
00:19:28,040 --> 00:19:30,960
One you can say, well, if I want money to do this for me tomorrow, what do I need to
342
00:19:30,960 --> 00:19:31,960
be doing with money today?
343
00:19:31,960 --> 00:19:34,400
So that tomorrow it does this for me.
344
00:19:34,400 --> 00:19:35,400
Right?
345
00:19:35,400 --> 00:19:39,080
What do I need to do with my money today so that in retirement it gives me the returns
346
00:19:39,080 --> 00:19:40,080
that I want?
347
00:19:40,080 --> 00:19:41,080
Right?
348
00:19:41,080 --> 00:19:42,080
No guarantees.
349
00:19:42,080 --> 00:19:44,600
But how do I prepare today for tomorrow?
350
00:19:44,600 --> 00:19:48,000
That's one aspect of what I want money to do for me today.
351
00:19:48,000 --> 00:19:50,160
But the other aspect is how do I want to live today?
352
00:19:50,160 --> 00:19:54,360
I mean, you could totally like lock up all your money and just put it into the future.
353
00:19:54,360 --> 00:19:57,920
Actually you couldn't because there are limits on how much you can invest, but there are
354
00:19:57,920 --> 00:20:00,000
opportunities to invest in different things.
355
00:20:00,000 --> 00:20:02,680
So it's not just your retirement accounts.
356
00:20:02,680 --> 00:20:04,800
You can invest in a syndication deal.
357
00:20:04,800 --> 00:20:07,800
You can invest like an active real estate.
358
00:20:07,800 --> 00:20:09,400
There's so many options for investment.
359
00:20:09,400 --> 00:20:14,560
So it's not as if your retirement account is the only place for an investment.
360
00:20:14,560 --> 00:20:15,800
So you could invest all your money.
361
00:20:15,800 --> 00:20:19,280
You just put it all in savings, investments.
362
00:20:19,280 --> 00:20:22,360
You do all that stuff and then you don't have enough money for yourself or you're paying
363
00:20:22,360 --> 00:20:27,000
off your student loan debt and you live like a pauper or maybe not a pauper.
364
00:20:27,000 --> 00:20:28,000
You live frugally.
365
00:20:28,000 --> 00:20:29,000
How about that?
366
00:20:29,000 --> 00:20:30,480
That feels a little bit better.
367
00:20:30,480 --> 00:20:31,480
Frugally.
368
00:20:31,480 --> 00:20:32,480
But is that a choice you're making?
369
00:20:32,480 --> 00:20:37,840
Are you actively making that choice or are you just kind of letting life carry you?
370
00:20:37,840 --> 00:20:40,280
It's like, oh, this is the amount people pay on their student loans.
371
00:20:40,280 --> 00:20:41,800
Therefore, I guess I do this.
372
00:20:41,800 --> 00:20:46,400
Or when you are overwhelmed or feeling like, I don't like the way I'm living.
373
00:20:46,400 --> 00:20:48,280
I can't go on vacation.
374
00:20:48,280 --> 00:20:50,920
But it's just, what do you want money to do for you right now?
375
00:20:50,920 --> 00:20:53,360
And how do you free up money to do that for you right now?
376
00:20:53,360 --> 00:20:57,680
What do you need to let go of so that money can do what you want money to do for you right
377
00:20:57,680 --> 00:21:00,600
now?
378
00:21:00,600 --> 00:21:03,240
What do you want money to do for you right now?
379
00:21:03,240 --> 00:21:08,040
An important question so that you can make sure that you are achieving your goals and
380
00:21:08,040 --> 00:21:14,320
living the life you want while also building your legacy in your research, in your scholarship,
381
00:21:14,320 --> 00:21:17,200
your academic work, and also in your future.
382
00:21:17,200 --> 00:21:21,240
So you're taking care of all those things, making sure that also you're living the life
383
00:21:21,240 --> 00:21:23,560
you want to live today.
384
00:21:23,560 --> 00:21:24,960
Okay?
385
00:21:24,960 --> 00:21:28,720
Question number five, how can I reach my financial goal sooner?
386
00:21:28,720 --> 00:21:29,720
Okay.
387
00:21:29,720 --> 00:21:31,480
You know you love this positioning.
388
00:21:31,480 --> 00:21:33,480
You love this positioning thing.
389
00:21:33,480 --> 00:21:35,960
You're going to do it forever and ever.
390
00:21:35,960 --> 00:21:38,600
Even then a day is coming where you're not.
391
00:21:38,600 --> 00:21:41,040
It's not possible that you want to wait until 90 to retire.
392
00:21:41,040 --> 00:21:46,760
I mean, once you get to age, I believe it's like 73 and some change, you start to make
393
00:21:46,760 --> 00:21:51,880
these, you know, like required distributions from your retirement accounts.
394
00:21:51,880 --> 00:21:53,920
But is that the age at which you want to retire?
395
00:21:53,920 --> 00:21:54,920
Would you want to retire sooner?
396
00:21:54,920 --> 00:21:59,520
Would you want to retire while you still have the great health to do the retirement thing?
397
00:21:59,520 --> 00:22:04,920
Or do you really want to wait until like your old, older, and maybe suffering challenges
398
00:22:04,920 --> 00:22:07,480
that are associated with aging?
399
00:22:07,480 --> 00:22:09,680
You get to decide.
400
00:22:09,680 --> 00:22:13,600
But the question is, if you want to, how can you reach these goals sooner?
401
00:22:13,600 --> 00:22:17,240
Maybe you've resigned yourself to the fact that it's like, nope, I already have $300,000
402
00:22:17,240 --> 00:22:18,240
worth of debt.
403
00:22:18,240 --> 00:22:20,800
I have another couple of hundred thousand in this home that I bought.
404
00:22:20,800 --> 00:22:21,800
I'm going to be in debt forever.
405
00:22:21,800 --> 00:22:22,800
I'm going to be okay.
406
00:22:22,800 --> 00:22:25,200
I've just resigned my life to this.
407
00:22:25,200 --> 00:22:31,040
And I've heard some say that to me, but I'm saying, hey, what if, what if, let's just
408
00:22:31,040 --> 00:22:34,560
imagine for a moment, what if it were possible?
409
00:22:34,560 --> 00:22:38,760
For you to have a different outcome, what if it were possible for you to achieve your
410
00:22:38,760 --> 00:22:40,680
financial goals sooner?
411
00:22:40,680 --> 00:22:43,520
How might that change the way you show up?
412
00:22:43,520 --> 00:22:45,800
Just a thought, just a thought experiment.
413
00:22:45,800 --> 00:22:46,800
Don't get too excited.
414
00:22:46,800 --> 00:22:51,320
But what if you could reach your financial goals sooner?
415
00:22:51,320 --> 00:22:52,320
Would you want to?
416
00:22:52,320 --> 00:22:54,840
And what would you do if you did?
417
00:22:54,840 --> 00:23:01,400
It's a question to ask so that you can take charge and change the way you behave today
418
00:23:01,400 --> 00:23:03,840
to achieve the outcome that you want tomorrow.
419
00:23:03,840 --> 00:23:04,840
Okay.
420
00:23:04,840 --> 00:23:13,080
Sixth question is what's my current salary relative to my position and level of experience?
421
00:23:13,080 --> 00:23:14,080
Okay.
422
00:23:14,080 --> 00:23:15,080
Another one that's a little bit tense.
423
00:23:15,080 --> 00:23:18,920
I like, I can feel the tension building up in my belly even as I talk about it, because
424
00:23:18,920 --> 00:23:21,080
it's like an academic talking about salary.
425
00:23:21,080 --> 00:23:23,480
Oh, no, we don't talk about that.
426
00:23:23,480 --> 00:23:25,600
And I want to say it's time to talk about it.
427
00:23:25,600 --> 00:23:26,800
It is time to talk about it.
428
00:23:26,800 --> 00:23:31,680
For many of us who are underrepresented in the academy in any way, whether we're women
429
00:23:31,680 --> 00:23:38,920
or whether we're a gender or sexual or ethnic minority or racial minority, it is possible
430
00:23:38,920 --> 00:23:44,640
and quite likely that there may be some inequities in our pay.
431
00:23:44,640 --> 00:23:45,880
I'm not saying definite.
432
00:23:45,880 --> 00:23:49,080
I'm saying possible, maybe likely.
433
00:23:49,080 --> 00:23:50,920
You don't know.
434
00:23:50,920 --> 00:23:53,520
You don't know until you start asking questions.
435
00:23:53,520 --> 00:23:56,400
And you may not want to do anything about it.
436
00:23:56,400 --> 00:23:59,240
You may be like, oh, I know there's inequities, but how much is the inequity?
437
00:23:59,240 --> 00:24:01,200
Or you may be like, oh, no, I'm fine.
438
00:24:01,200 --> 00:24:03,640
Yeah, to what extent are you fine?
439
00:24:03,640 --> 00:24:05,960
And I'm not asking you to say, well, what is that person earning?
440
00:24:05,960 --> 00:24:11,280
And am I earning something relative to that person, which, you know, it always starts
441
00:24:11,280 --> 00:24:13,580
its own kind of controversy.
442
00:24:13,580 --> 00:24:18,400
The question is not compared to others as much as it's like, well, for me today, as
443
00:24:18,400 --> 00:24:24,040
an associate professor who has been in this role for the last four to five years, how
444
00:24:24,040 --> 00:24:27,800
much should I be earning?
445
00:24:27,800 --> 00:24:28,800
Ask that question.
446
00:24:28,800 --> 00:24:31,320
And maybe it's not a question that you ask yourself.
447
00:24:31,320 --> 00:24:35,720
As much as it's a question you can ask your division chief, like, oh, I want to make sure
448
00:24:35,720 --> 00:24:39,360
that I am benchmarked correctly.
449
00:24:39,360 --> 00:24:44,040
What are the benchmarks of someone who is at my position and has been in this role for
450
00:24:44,040 --> 00:24:46,520
the past couple of years?
451
00:24:46,520 --> 00:24:49,760
Ask the question and see what answer you get.
452
00:24:49,760 --> 00:24:50,760
It'll be interesting.
453
00:24:50,760 --> 00:24:52,200
It'll definitely be interesting.
454
00:24:52,200 --> 00:24:54,400
But if you don't ask, you don't know.
455
00:24:54,400 --> 00:25:00,160
I want to invite you not to be afraid to ask because information helps you make decisions.
456
00:25:00,160 --> 00:25:02,400
So ask, ask that of yourself.
457
00:25:02,400 --> 00:25:04,160
To what extent can you answer the question?
458
00:25:04,160 --> 00:25:07,200
But then ask that of the people who actually know.
459
00:25:07,200 --> 00:25:10,240
Now see to what extent they can answer the question for you.
460
00:25:10,240 --> 00:25:11,800
Again, you don't need to do anything.
461
00:25:11,800 --> 00:25:12,800
You don't need to put up a fight.
462
00:25:12,800 --> 00:25:14,480
You don't need to be angry.
463
00:25:14,480 --> 00:25:17,560
Just get the information, just the information.
464
00:25:17,560 --> 00:25:19,000
All right.
465
00:25:19,000 --> 00:25:24,920
Number seven, what will it take to get the financial information that sets me free?
466
00:25:24,920 --> 00:25:28,240
This is a question that I actually I'm asking for myself.
467
00:25:28,240 --> 00:25:32,240
I'm already kind of in the process of getting information that sets me free.
468
00:25:32,240 --> 00:25:35,200
That helps me think differently about my finances.
469
00:25:35,200 --> 00:25:40,440
What I find about many of us academics, and I will speak for myself, is I'm so busy going
470
00:25:40,440 --> 00:25:45,520
from one manuscript to the other manuscript, one grant to the next grant, that to be honest,
471
00:25:45,520 --> 00:25:48,080
there isn't really time to stop and think about, wait a minute, what do I want to do
472
00:25:48,080 --> 00:25:49,640
with my financial future?
473
00:25:49,640 --> 00:25:52,040
Because it just doesn't feel normal, right?
474
00:25:52,040 --> 00:25:55,120
In medicine, that's not something we really talk about.
475
00:25:55,120 --> 00:25:57,060
But it is time to start talking about it.
476
00:25:57,060 --> 00:25:59,000
It's time to start thinking about it.
477
00:25:59,000 --> 00:26:03,760
And what will it take to get the information you need?
478
00:26:03,760 --> 00:26:05,600
And I hear some of you say, but I'm so busy.
479
00:26:05,600 --> 00:26:06,960
It's like, yes, you are busy.
480
00:26:06,960 --> 00:26:09,440
And I'm so excited for you that you're busy.
481
00:26:09,440 --> 00:26:13,800
And you can never be too busy to take charge of your financial future.
482
00:26:13,800 --> 00:26:19,060
You can never be too busy to sit and think about, well, what are the financial goals
483
00:26:19,060 --> 00:26:20,060
that I have?
484
00:26:20,060 --> 00:26:21,920
How do I reach them?
485
00:26:21,920 --> 00:26:23,700
How do I reach them sooner?
486
00:26:23,700 --> 00:26:28,160
What will it take to live the kind of life I want to live today and the kind of future
487
00:26:28,160 --> 00:26:29,160
I want to have tomorrow?
488
00:26:29,160 --> 00:26:32,000
What will it take to accomplish that?
489
00:26:32,000 --> 00:26:33,440
These are questions I'm still asking myself.
490
00:26:33,440 --> 00:26:35,520
I'm going to summarize in just a little bit.
491
00:26:35,520 --> 00:26:37,120
Number one, how do I make money?
492
00:26:37,120 --> 00:26:40,680
Number two, where am I working for free versus working for pay?
493
00:26:40,680 --> 00:26:43,880
Number three, what do I want money to do for me tomorrow?
494
00:26:43,880 --> 00:26:46,680
Number four, what do I want money to do for me right now?
495
00:26:46,680 --> 00:26:49,760
Number five, how can I reach my financial goals sooner?
496
00:26:49,760 --> 00:26:55,040
Number six, what is my current salary relative to my position and level of experience?
497
00:26:55,040 --> 00:27:00,320
And number seven, what will it take to get the financial information that sets me free?
498
00:27:00,320 --> 00:27:07,240
I tell you that this journey of academia or scholarship is about your whole life.
499
00:27:07,240 --> 00:27:09,320
It's not about just grants and manuscripts.
500
00:27:09,320 --> 00:27:15,120
And we would be remiss if all we focused on were the things that may not take us the distance
501
00:27:15,120 --> 00:27:16,520
that we need to get to.
502
00:27:16,520 --> 00:27:18,840
I know it's important to focus.
503
00:27:18,840 --> 00:27:22,280
And I'm always a big person on telling you to focus.
504
00:27:22,280 --> 00:27:23,600
It's a thing.
505
00:27:23,600 --> 00:27:25,240
You should focus.
506
00:27:25,240 --> 00:27:30,280
And you should make sure that you do not focus on your career to the detriment of your financial
507
00:27:30,280 --> 00:27:32,760
future.
508
00:27:32,760 --> 00:27:37,920
Both should go hand in hand so that you can work your career to give you the financial
509
00:27:37,920 --> 00:27:39,480
future that you desire.
510
00:27:39,480 --> 00:27:40,480
All right.
511
00:27:40,480 --> 00:27:42,680
I'm going to have more thoughts on it in the future.
512
00:27:42,680 --> 00:27:46,560
But today, thank you for listening to what I do have to share.
513
00:27:46,560 --> 00:27:50,560
As always, if you are looking for a coach, definitely reach out to me.
514
00:27:50,560 --> 00:27:54,880
You can find me on Instagram, find me on LinkedIn, and on Facebook as well.
515
00:27:54,880 --> 00:27:57,040
I look forward to hearing from you.
516
00:27:57,040 --> 00:28:04,240
And I am so thankful that you will, I ask, share this with somebody else who would benefit
517
00:28:04,240 --> 00:28:06,400
from thinking and talking about money.
518
00:28:06,400 --> 00:28:07,480
All right.
519
00:28:07,480 --> 00:28:09,760
Have a great rest of your day.
520
00:28:09,760 --> 00:28:21,000
And I'll see you next time on the Clinician Researcher Podcast.
521
00:28:21,000 --> 00:28:26,360
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic
522
00:28:26,360 --> 00:28:31,600
clinicians learn the skills to build their own research program, whether or not they
523
00:28:31,600 --> 00:28:33,120
have a mentor.
524
00:28:33,120 --> 00:28:39,240
If you found the information in this episode to be helpful, don't keep it all to yourself.
525
00:28:39,240 --> 00:28:41,000
Someone else needs to hear it.
526
00:28:41,000 --> 00:28:45,040
So take a minute right now and share it.
527
00:28:45,040 --> 00:28:50,480
As you share this episode, you become part of our mission to help launch a new generation
528
00:28:50,480 --> 00:29:03,360
of clinician researchers who make transformative discoveries that change the way we do healthcare.
00:00:00,000 --> 00:00:05,860
Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
2
00:00:05,860 --> 00:00:11,260
to build their own research program, whether or not they have a mentor.
3
00:00:11,260 --> 00:00:17,340
As clinicians, we spend a decade or more as trainees learning to take care of patients.
4
00:00:17,340 --> 00:00:22,380
When we finally start our careers, we want to build research programs, but then we find
5
00:00:22,380 --> 00:00:27,780
that our years of clinical training did not adequately prepare us to lead our research
6
00:00:27,780 --> 00:00:29,200
program.
7
00:00:29,200 --> 00:00:35,480
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
8
00:00:35,480 --> 00:00:40,580
However, clinicians hold the keys to the greatest research breakthroughs.
9
00:00:40,580 --> 00:00:46,200
For this reason, the Clinician Researcher podcast exists to give academic clinicians
10
00:00:46,200 --> 00:00:51,800
the tools to build their own research program, whether or not they have a mentor.
11
00:00:51,800 --> 00:01:01,160
Now introducing your host, Toyosi Onwuemene.
12
00:01:01,160 --> 00:01:03,660
Welcome to the Clinician Researcher podcast.
13
00:01:03,660 --> 00:01:08,720
I'm your host, Toyosi Onwuemene, and it is an absolute pleasure to be talking with you
14
00:01:08,720 --> 00:01:09,720
today.
15
00:01:09,720 --> 00:01:11,720
Today, I'm talking about money.
16
00:01:11,720 --> 00:01:18,320
Specifically, I'm talking about questions you should be asking about money.
17
00:01:18,320 --> 00:01:22,680
And the reason this topic is fresh on my mind is because I'm part of a coaching group, so
18
00:01:22,680 --> 00:01:30,920
I work with Dr. Latifat, who has a money school for women in medicine, for physicians specifically.
19
00:01:30,920 --> 00:01:33,960
And so we meet once a week, and we talk about money.
20
00:01:33,960 --> 00:01:39,840
And we talk about strategies, and we talk about what people are doing, and what syndication
21
00:01:39,840 --> 00:01:43,280
deals people are looking at, what investments people are making.
22
00:01:43,280 --> 00:01:47,460
And it's just so phenomenal because I have to tell you, I've never been in circles where
23
00:01:47,460 --> 00:01:49,560
we just talk about money.
24
00:01:49,560 --> 00:01:55,360
And every time I'm in these meetings, my awareness has just expanded.
25
00:01:55,360 --> 00:01:59,840
I learned things that I'd never understood before, because there I am at today's meeting
26
00:01:59,840 --> 00:02:04,580
saying, but what is a syndication deal?
27
00:02:04,580 --> 00:02:10,040
And I don't think I'm ready to do one today, but what I am is informed, because now I have
28
00:02:10,040 --> 00:02:12,160
information that I didn't have before.
29
00:02:12,160 --> 00:02:18,360
But yeah, so this particular conversation prompted me to decide to record today's episode.
30
00:02:18,360 --> 00:02:22,520
But before that, there was another story that prompted my thinking a little bit more about
31
00:02:22,520 --> 00:02:24,280
money than I usually do.
32
00:02:24,280 --> 00:02:30,840
Okay, so a couple of days ago, I was representing my society, the American Society of Human
33
00:02:30,840 --> 00:02:33,640
Technology on Capitol Hill.
34
00:02:33,640 --> 00:02:36,480
And I am a member of the committee and practice.
35
00:02:36,480 --> 00:02:43,520
And once a year, the committee and practice will go to their legislators on the hill and
36
00:02:43,520 --> 00:02:49,280
will present issues that the society has decided are pressing issues.
37
00:02:49,280 --> 00:02:56,660
Okay, so one of the issues that we had on our list is the issue of physician payments.
38
00:02:56,660 --> 00:03:03,240
And so if you are aware, the system regarding physician payments is broken, and I'm talking
39
00:03:03,240 --> 00:03:09,640
about physician payments from Medicare, such that even though every year, inflation is
40
00:03:09,640 --> 00:03:14,040
increasing, physician payments are decreasing every year.
41
00:03:14,040 --> 00:03:19,080
And there have been some stopgap measures to try to decrease the amount by which it's
42
00:03:19,080 --> 00:03:20,080
decreasing.
43
00:03:20,080 --> 00:03:23,240
I will tell you that it's an interesting phenomenon that it's decreasing every year.
44
00:03:23,240 --> 00:03:29,440
I'm sure that there are some more economic strategies to share exactly what's going on
45
00:03:29,440 --> 00:03:31,280
and the specificities of that.
46
00:03:31,280 --> 00:03:38,080
I cannot tell you, but simply the money is going down every year.
47
00:03:38,080 --> 00:03:42,000
And the strategies that they have to fix it right now are to decrease the amount by which
48
00:03:42,000 --> 00:03:43,760
it decreases every year.
49
00:03:43,760 --> 00:03:48,080
That's better than it decreasing by a more significant amount every year.
50
00:03:48,080 --> 00:03:53,520
But the issue is that while inflation is increasing, physician payments are decreasing.
51
00:03:53,520 --> 00:03:56,360
Okay, so that was one of the issues that we brought to Congress.
52
00:03:56,360 --> 00:04:00,260
And what's interesting is that, so we're a hematologist and we had one representative
53
00:04:00,260 --> 00:04:05,240
from Indiana, one representative from Illinois, and I was representing North Carolina.
54
00:04:05,240 --> 00:04:09,800
We were sitting waiting for our next appointment and we looked across the table beside us and
55
00:04:09,800 --> 00:04:13,080
there is a group of rheumatologists.
56
00:04:13,080 --> 00:04:16,560
And we're like, oh, what issues are you taking to your legislators?
57
00:04:16,560 --> 00:04:19,400
And they're talking about, guess what?
58
00:04:19,400 --> 00:04:21,760
The Physician Payment Act.
59
00:04:21,760 --> 00:04:28,120
In fact, the graph that shows how physician payments are decreasing while all other things
60
00:04:28,120 --> 00:04:32,560
on a fee schedule are increasing is a ubiquitous graph.
61
00:04:32,560 --> 00:04:33,560
Everybody has this graph.
62
00:04:33,560 --> 00:04:37,120
In fact, the graph is so ubiquitous, all the legislators know the graph.
63
00:04:37,120 --> 00:04:39,240
It's like, oh yeah, yeah, we know about this problem.
64
00:04:39,240 --> 00:04:41,280
It is a problem everybody knows about.
65
00:04:41,280 --> 00:04:45,280
And so then the question in my mind is like, well, if the problem is known and has been
66
00:04:45,280 --> 00:04:49,860
known for so long, why hasn't it been fixed?
67
00:04:49,860 --> 00:04:53,600
And I know that there are some of you who are legislative wizards out there and you
68
00:04:53,600 --> 00:04:59,200
can tell me exactly what's happening, but from my very simple understanding, it's like
69
00:04:59,200 --> 00:05:05,440
if payments should be increasing over time, but instead they're decreasing while inflation
70
00:05:05,440 --> 00:05:12,080
is rising, which means they're significantly decreasing, why can't it be changed?
71
00:05:12,080 --> 00:05:14,280
And what are the big barriers for change?
72
00:05:14,280 --> 00:05:18,720
Anyway, so I'm not here to answer that philosophical question because that's a huge question and
73
00:05:18,720 --> 00:05:20,760
not one that I believe I can answer.
74
00:05:20,760 --> 00:05:27,680
But the question I do want to answer is, well, if they're not going to fix it, what are you
75
00:05:27,680 --> 00:05:29,800
going to do about it?
76
00:05:29,800 --> 00:05:36,560
And I'm asking that question of me because if over time the reimbursement to physicians
77
00:05:36,560 --> 00:05:42,480
from Medicare, one of the largest payers in terms of the healthcare system, most of our
78
00:05:42,480 --> 00:05:47,780
patients are older and on Medicare, then what's going to be happening?
79
00:05:47,780 --> 00:05:52,800
So what's happening over time, and we're feeling the pinch of the need to do more clinical
80
00:05:52,800 --> 00:05:56,360
work just to make the same amount that used to be made.
81
00:05:56,360 --> 00:05:59,960
And so if you're an academic medical center, you may not feel the pinch as much, but if
82
00:05:59,960 --> 00:06:03,920
you are in private practice, for example, if you have a small practice, you're going
83
00:06:03,920 --> 00:06:07,520
to feel the pinch because this is money that helps you pay yourself.
84
00:06:07,520 --> 00:06:13,600
And so I think it made me stop and say, hey, who's in charge of the finances?
85
00:06:13,600 --> 00:06:19,560
Who's asking the questions about whether I'm able to be independent financially ultimately
86
00:06:19,560 --> 00:06:20,920
or not?
87
00:06:20,920 --> 00:06:22,400
So it got me thinking.
88
00:06:22,400 --> 00:06:26,680
And that's why having this meeting that I just stepped away from where we're really talking
89
00:06:26,680 --> 00:06:32,560
about taking ownership of our finances was huge, right?
90
00:06:32,560 --> 00:06:38,120
Stepping out of this meeting where we're all talking about taking ownership of our finances
91
00:06:38,120 --> 00:06:40,680
is a big deal.
92
00:06:40,680 --> 00:06:44,840
That's why I wanted to come talk to you about it today because I want you thinking about
93
00:06:44,840 --> 00:06:45,920
it too.
94
00:06:45,920 --> 00:06:49,680
I think one of the challenges for us, especially as academic physicians, is that we are so
95
00:06:49,680 --> 00:06:55,800
focused on all the stuff, seeing patients, writing our manuscripts and submitting grants
96
00:06:55,800 --> 00:06:59,720
and just doing all the things that are associated with being an academic physician.
97
00:06:59,720 --> 00:07:05,320
But here's the thing about being an academic physician, it will end.
98
00:07:05,320 --> 00:07:07,400
A day is coming when you're going to retire.
99
00:07:07,400 --> 00:07:12,440
You're going to walk away from the hallowed halls of the academic institution.
100
00:07:12,440 --> 00:07:14,200
And then what are you going to do?
101
00:07:14,200 --> 00:07:17,720
And will you be financially prepared for that moment?
102
00:07:17,720 --> 00:07:21,640
Some of us will not wait until retirement before we leave the hallowed halls with the
103
00:07:21,640 --> 00:07:24,700
academic institution for better or for worse.
104
00:07:24,700 --> 00:07:27,720
And are we prepared for that moment when it comes?
105
00:07:27,720 --> 00:07:28,720
Okay.
106
00:07:28,720 --> 00:07:30,460
So that's what I wanted to share.
107
00:07:30,460 --> 00:07:33,840
But I want to talk about seven questions you should be asking.
108
00:07:33,840 --> 00:07:34,840
Okay.
109
00:07:34,840 --> 00:07:36,120
About money specifically.
110
00:07:36,120 --> 00:07:42,280
This is about money and it matters because although really I'm really big on you being
111
00:07:42,280 --> 00:07:48,480
kind of the academician, the scholar, the clinician scientist, the clinician researcher
112
00:07:48,480 --> 00:07:55,320
that you need to be, I also recognize that if you cannot afford your life, that's a problem.
113
00:07:55,320 --> 00:07:58,760
And so I'm not here to talk to you about budgeting, not even really here to talk to you about
114
00:07:58,760 --> 00:07:59,760
investment.
115
00:07:59,760 --> 00:08:03,800
I just want to ask seven questions that I'd like you to consider asking yourself.
116
00:08:03,800 --> 00:08:04,800
Okay.
117
00:08:04,800 --> 00:08:09,040
So number one, how do I make money?
118
00:08:09,040 --> 00:08:11,380
How do I make money?
119
00:08:11,380 --> 00:08:13,280
Why is this question important?
120
00:08:13,280 --> 00:08:17,960
This question is important because whether you know it or not, how you make money drives
121
00:08:17,960 --> 00:08:21,000
your experience in the academic medical center.
122
00:08:21,000 --> 00:08:27,160
For example, when I first started, I was fully clinical, which meant it was 80%, but I was
123
00:08:27,160 --> 00:08:29,440
seeing patients five days a week.
124
00:08:29,440 --> 00:08:35,280
But how I made money actually is seeing the patient and writing the note, closing the
125
00:08:35,280 --> 00:08:36,280
chart.
126
00:08:36,280 --> 00:08:38,040
Until the chart is closed, money is not made.
127
00:08:38,040 --> 00:08:41,800
Or at least there's no bill generated so that money can be made.
128
00:08:41,800 --> 00:08:47,080
And so every time I was not very good at closing charts, every time I got the notification
129
00:08:47,080 --> 00:08:53,080
that, hey, you didn't close your charts, that was the sign that someone was like, hey, you're
130
00:08:53,080 --> 00:08:54,720
seeing patients, but we're not making money.
131
00:08:54,720 --> 00:08:55,720
Can we fix that?
132
00:08:55,720 --> 00:08:57,600
And it was a source of stress to me.
133
00:08:57,600 --> 00:09:02,440
I just thought that there was this principle they had and charts needed to be closed.
134
00:09:02,440 --> 00:09:08,280
What I didn't realize is that charts being closed means the institution makes money or
135
00:09:08,280 --> 00:09:11,920
at least can generate a bill so that money comes in.
136
00:09:11,920 --> 00:09:16,400
And so when I didn't close charts, I was playing with somebody else's money.
137
00:09:16,400 --> 00:09:20,040
Mine too, but mostly somebody else's money because they get more of it than I do.
138
00:09:20,040 --> 00:09:21,040
Right?
139
00:09:21,040 --> 00:09:25,640
But if I understood that, then it makes sense that I'm being badgered, I'm being bugged
140
00:09:25,640 --> 00:09:27,160
and people are like, you haven't closed your charts.
141
00:09:27,160 --> 00:09:28,160
You haven't closed your charts.
142
00:09:28,160 --> 00:09:29,360
You haven't closed your charts.
143
00:09:29,360 --> 00:09:31,560
Because what I realized is that that's how I make money.
144
00:09:31,560 --> 00:09:36,240
The moment I close a chart, money is made and it goes somewhere and there's some credit
145
00:09:36,240 --> 00:09:40,240
that comes to me, but that is the final denominator.
146
00:09:40,240 --> 00:09:42,000
But what goes into closing a chart?
147
00:09:42,000 --> 00:09:43,760
Well, first of all, you got to see a patient.
148
00:09:43,760 --> 00:09:44,760
Right?
149
00:09:44,760 --> 00:09:48,400
So prepping my notes before clinic doesn't earn me money.
150
00:09:48,400 --> 00:09:53,760
Seeing the patient is part of earning money, but it doesn't earn me money.
151
00:09:53,760 --> 00:09:57,080
I can see patient, charts not closed or money is not earned.
152
00:09:57,080 --> 00:10:05,200
Or I can see the patient, write the note, close the chart and then money is earned.
153
00:10:05,200 --> 00:10:06,200
Okay.
154
00:10:06,200 --> 00:10:07,200
Why is this important?
155
00:10:07,200 --> 00:10:13,480
This is important because you will live a happy life and no one will ask you questions
156
00:10:13,480 --> 00:10:17,960
as long as the math equation works between where all your funding comes from and your
157
00:10:17,960 --> 00:10:21,240
clinical revenue such that your salary is covered.
158
00:10:21,240 --> 00:10:22,240
Okay?
159
00:10:22,240 --> 00:10:25,320
The moment something happens and your salary is not being covered, let's say you haven't
160
00:10:25,320 --> 00:10:28,560
seen the requisite number of patients, you will hear about it.
161
00:10:28,560 --> 00:10:29,960
You absolutely will.
162
00:10:29,960 --> 00:10:31,360
Somebody will let you know.
163
00:10:31,360 --> 00:10:33,960
In academics, we talk about money indirectly.
164
00:10:33,960 --> 00:10:37,420
And so people will talk about charts being closed and your professional responsibility
165
00:10:37,420 --> 00:10:41,440
and it's not okay that you saw 50 patients and you've only closed three.
166
00:10:41,440 --> 00:10:45,000
They will talk about all that and you'll feel guilty because you're very good at feeling
167
00:10:45,000 --> 00:10:46,000
guilty.
168
00:10:46,000 --> 00:10:52,120
But the bottom line is that, hey, CES, if you did not close charts, that means bills
169
00:10:52,120 --> 00:10:55,760
were not generated and you are not making your salary.
170
00:10:55,760 --> 00:10:56,760
Okay.
171
00:10:56,760 --> 00:11:00,480
So I just wanted to talk about that in the context of the clinical picture because I
172
00:11:00,480 --> 00:11:05,520
think we understand it a little bit better in the context of writing grants.
173
00:11:05,520 --> 00:11:09,000
No funding means no protected time.
174
00:11:09,000 --> 00:11:10,920
It's very simple.
175
00:11:10,920 --> 00:11:13,540
But understand how you make money in terms of funding.
176
00:11:13,540 --> 00:11:15,040
So what gets you funding?
177
00:11:15,040 --> 00:11:21,120
Well, you have an idea and then you write a grant and you submit the grant.
178
00:11:21,120 --> 00:11:25,320
Great idea, grant not submitted, no money can come.
179
00:11:25,320 --> 00:11:30,800
Great idea, grant submitted, opportunities for money can come.
180
00:11:30,800 --> 00:11:34,240
But it's important for you to understand how do you make money?
181
00:11:34,240 --> 00:11:38,560
What part of your salary is covered by grants or part of your salary is covered by clinical
182
00:11:38,560 --> 00:11:43,480
effort and what aspects of those things actually bring you money?
183
00:11:43,480 --> 00:11:44,480
Okay.
184
00:11:44,480 --> 00:11:49,120
So if I have 300 meetings and some of them may be related to research, some of them may
185
00:11:49,120 --> 00:11:55,480
not, but if any of them, of any of those meetings don't move my research forward, don't increase
186
00:11:55,480 --> 00:12:01,320
my ability to write the next funded grant to write for more money, it's not helping
187
00:12:01,320 --> 00:12:02,320
me make money.
188
00:12:02,320 --> 00:12:03,320
Okay.
189
00:12:03,320 --> 00:12:04,880
So I'm not trying to be mercenary here.
190
00:12:04,880 --> 00:12:07,060
Why is this question important?
191
00:12:07,060 --> 00:12:10,240
This question is important because it helps you focus.
192
00:12:10,240 --> 00:12:12,400
It helps you align your focus.
193
00:12:12,400 --> 00:12:15,160
It helps you really think about the 20%.
194
00:12:15,160 --> 00:12:20,280
What are the things you do that create the highest value for you and the highest value
195
00:12:20,280 --> 00:12:22,880
for your employer?
196
00:12:22,880 --> 00:12:26,960
Because your employer needs you to generate money.
197
00:12:26,960 --> 00:12:29,200
It's the only reason you've been hired.
198
00:12:29,200 --> 00:12:30,200
You're a physician.
199
00:12:30,200 --> 00:12:34,200
Physicians are good generators of money and they leave you alone to the extent to which
200
00:12:34,200 --> 00:12:36,120
you're actually generating the money you're supposed to.
201
00:12:36,120 --> 00:12:37,400
You can generate excess money.
202
00:12:37,400 --> 00:12:41,400
They won't tell you too much about that, but if you generate too little, they want to know
203
00:12:41,400 --> 00:12:44,440
and they will let you know indirectly.
204
00:12:44,440 --> 00:12:48,480
So what it allows you to do, understanding how you make money, it allows you to prioritize
205
00:12:48,480 --> 00:12:53,560
what is it about what I do that creates the most value and you focus on that.
206
00:12:53,560 --> 00:12:58,000
A lot of things might fall by the wayside, but the things that fall by the wayside will
207
00:12:58,000 --> 00:12:59,960
not be the highest priority things.
208
00:12:59,960 --> 00:13:00,960
Right?
209
00:13:00,960 --> 00:13:05,640
So to be honest, I didn't used to think that writing notes was an important priority, but
210
00:13:05,640 --> 00:13:09,920
once I understood that, oh, it's not about the notes, it's about generating bill, then
211
00:13:09,920 --> 00:13:14,040
I can clarify, okay, how do I increase my efficiency?
212
00:13:14,040 --> 00:13:18,800
So I can close charts and people don't bother me because this is a thing that creates value
213
00:13:18,800 --> 00:13:20,680
in this space.
214
00:13:20,680 --> 00:13:25,880
So question number one is ask the question, how do I make money?
215
00:13:25,880 --> 00:13:31,860
And that gives you opportunity to maximize it so that you spend less time doing stuff.
216
00:13:31,860 --> 00:13:36,320
If you know that calling a prior authorization doesn't make you money, well, now you can
217
00:13:36,320 --> 00:13:39,400
negotiate who helps you call that prior authorization.
218
00:13:39,400 --> 00:13:42,600
And I'm glad that there are a lot of people working towards helping us so that we're not
219
00:13:42,600 --> 00:13:48,400
doing that kind of stuff all the time, but recognize that the more you understand how
220
00:13:48,400 --> 00:13:54,040
you make money, the more you can prioritize what is most important and see how you can
221
00:13:54,040 --> 00:13:56,240
delegate the things that are not important.
222
00:13:56,240 --> 00:13:57,240
Okay.
223
00:13:57,240 --> 00:14:00,560
I feel like I beat that one today.
224
00:14:00,560 --> 00:14:02,400
I've beat it enough.
225
00:14:02,400 --> 00:14:04,200
How do I make money?
226
00:14:04,200 --> 00:14:05,200
Okay.
227
00:14:05,200 --> 00:14:11,280
Question number two, where am I working for free versus where I'm working for pay?
228
00:14:11,280 --> 00:14:12,800
Why is this important?
229
00:14:12,800 --> 00:14:17,960
In our lives, we will not always be paid for the work we do and that's okay.
230
00:14:17,960 --> 00:14:23,880
Like I'm a mom, nobody pays me for that work or my pay is kind of more in kind, you know,
231
00:14:23,880 --> 00:14:28,560
like the joy that I get from serving as a mom, but it's not something for which anybody
232
00:14:28,560 --> 00:14:30,240
writes me a check every month.
233
00:14:30,240 --> 00:14:33,000
Would be nice, but it's not something I get a check for.
234
00:14:33,000 --> 00:14:38,120
But whether I get a check or not for being a mom, I love being a mom.
235
00:14:38,120 --> 00:14:43,800
I'm good with doing that work for free because the benefits I get are intangible.
236
00:14:43,800 --> 00:14:45,400
I value that.
237
00:14:45,400 --> 00:14:46,400
Okay.
238
00:14:46,400 --> 00:14:47,760
What else do I do for free?
239
00:14:47,760 --> 00:14:53,200
Well, I'm giving a talk to students who are interested in medicine and they're in high
240
00:14:53,200 --> 00:14:56,720
school and all they know about medicine is that you can be a nurse or a doctor.
241
00:14:56,720 --> 00:14:59,480
I'm going to come talk to them about being a hematologist.
242
00:14:59,480 --> 00:15:02,680
I found out I'm the only hematologist on the panel to talk to these students.
243
00:15:02,680 --> 00:15:05,280
I'm super excited because I need them to know about hematologists.
244
00:15:05,280 --> 00:15:07,680
Am I getting paid for this talk?
245
00:15:07,680 --> 00:15:12,960
No, but I'm choosing to do that because it is meaningful to me to pour into the next
246
00:15:12,960 --> 00:15:14,760
generation like that.
247
00:15:14,760 --> 00:15:15,760
Okay.
248
00:15:15,760 --> 00:15:22,920
Now, as a physician, I get paid for a certain amount of work that I do and I'm on a salary.
249
00:15:22,920 --> 00:15:26,920
So usually I think I probably work more than I get paid, which is fine.
250
00:15:26,920 --> 00:15:27,920
That's how salaries work.
251
00:15:27,920 --> 00:15:31,320
It also means on the months where I don't work as hard, I still get paid.
252
00:15:31,320 --> 00:15:34,360
So that's the benefit of the salary.
253
00:15:34,360 --> 00:15:39,600
But then there are parts of the extra stuff that I do, sometimes we'll talk about, is
254
00:15:39,600 --> 00:15:42,520
it a 40 hour work week or a 60 hour work week?
255
00:15:42,520 --> 00:15:46,340
Because if we can make it a 60 hour work week, then we can allow you to work harder and it
256
00:15:46,340 --> 00:15:48,720
not count as extra.
257
00:15:48,720 --> 00:15:56,400
Anyway, I say all that to say that it's okay to work for free if that's what you want to
258
00:15:56,400 --> 00:15:57,400
do.
259
00:15:57,400 --> 00:16:01,600
But if for any reason there are parts of your life where you're like, no, unless I don't
260
00:16:01,600 --> 00:16:06,360
want my work for free, just make it explicit and clarify.
261
00:16:06,360 --> 00:16:11,600
So when somebody says, hey, I'd like you to please take a couple of three weeks of extra
262
00:16:11,600 --> 00:16:14,160
coal because you know, there is nobody to do it.
263
00:16:14,160 --> 00:16:16,720
You know, three people just quit.
264
00:16:16,720 --> 00:16:18,440
You can say, oh, I know the goodness of my heart.
265
00:16:18,440 --> 00:16:19,840
I want to do this.
266
00:16:19,840 --> 00:16:22,040
And how much is it going to be compensated?
267
00:16:22,040 --> 00:16:24,580
How is my time going to be compensated?
268
00:16:24,580 --> 00:16:28,080
And I know that's almost like a math amount because in medicine we don't talk about that
269
00:16:28,080 --> 00:16:29,080
kind of stuff.
270
00:16:29,080 --> 00:16:32,200
But I just need you to know that you might say, I choose to work for free.
271
00:16:32,200 --> 00:16:36,280
I'm going to take these three weeks of coal and I'm doing it out of the goodness of my
272
00:16:36,280 --> 00:16:37,280
heart.
273
00:16:37,280 --> 00:16:38,280
I'm working for free.
274
00:16:38,280 --> 00:16:40,320
And if that's your choice, that's your choice.
275
00:16:40,320 --> 00:16:42,760
Or you might say, I don't want to work for free.
276
00:16:42,760 --> 00:16:46,600
How is this extra time investment going to be compensated?
277
00:16:46,600 --> 00:16:48,820
And then you get to negotiate that.
278
00:16:48,820 --> 00:16:52,400
And it could be that you're like, can I, I want to get paid financially for it.
279
00:16:52,400 --> 00:16:53,400
I want money for this.
280
00:16:53,400 --> 00:16:57,760
Or you could say, hey, if I'm doing three weeks this year, I'm not doing three weeks
281
00:16:57,760 --> 00:17:01,280
next year because these three weeks need to count.
282
00:17:01,280 --> 00:17:06,120
But that's an opportunity you have when you know where you work for free and when you
283
00:17:06,120 --> 00:17:07,680
don't work for free.
284
00:17:07,680 --> 00:17:13,520
So you can be very clear who is paying for this time, who is paying for this time.
285
00:17:13,520 --> 00:17:15,200
And it could be that I'm paying for it.
286
00:17:15,200 --> 00:17:16,200
That's okay.
287
00:17:16,200 --> 00:17:19,040
Here I am up late recording this episode for you.
288
00:17:19,040 --> 00:17:23,360
I'm choosing, I'm paying for this time.
289
00:17:23,360 --> 00:17:29,080
So what question I want you to ask is where in my life am I working for free versus working
290
00:17:29,080 --> 00:17:30,200
for pay?
291
00:17:30,200 --> 00:17:31,200
Make the distinction.
292
00:17:31,200 --> 00:17:36,080
You don't have to do anything with the information, but be aware.
293
00:17:36,080 --> 00:17:40,960
Don't be in ignorance about how you're using and spending your time.
294
00:17:40,960 --> 00:17:42,920
All right.
295
00:17:42,920 --> 00:17:47,640
Number three, what do I want money to do for me tomorrow?
296
00:17:47,640 --> 00:17:48,640
I'm talking about retirement.
297
00:17:48,640 --> 00:17:51,120
What do I want money to do for me tomorrow?
298
00:17:51,120 --> 00:17:53,000
Talking about retirement.
299
00:17:53,000 --> 00:17:56,880
And to be honest, for most of us, we start, actually I shouldn't say most of us because
300
00:17:56,880 --> 00:17:59,760
I don't know where you are, but for me, I'll speak about me.
301
00:17:59,760 --> 00:18:02,520
I started, they told me I had to put money in retirement.
302
00:18:02,520 --> 00:18:03,520
I'm like, sure.
303
00:18:03,520 --> 00:18:05,640
They put it for me in target date funds.
304
00:18:05,640 --> 00:18:06,640
I was like, great.
305
00:18:06,640 --> 00:18:07,640
Okay.
306
00:18:07,640 --> 00:18:09,360
What am I supposed to do with that?
307
00:18:09,360 --> 00:18:13,120
Over time as I began to listen and learn, I was like, okay, let's look at the expense
308
00:18:13,120 --> 00:18:14,120
ratios.
309
00:18:14,120 --> 00:18:15,960
Is this how I want to invest my money?
310
00:18:15,960 --> 00:18:17,240
Let's look at the performance.
311
00:18:17,240 --> 00:18:18,640
Is this how I want to invest my money?
312
00:18:18,640 --> 00:18:20,160
And I've changed my investments.
313
00:18:20,160 --> 00:18:22,040
I no longer invest in target date funds.
314
00:18:22,040 --> 00:18:24,920
I'm not here to say that target date funds are problematic.
315
00:18:24,920 --> 00:18:26,000
They're not.
316
00:18:26,000 --> 00:18:30,880
It's just making active choices because I'm thinking about what do I want money to do
317
00:18:30,880 --> 00:18:31,880
for me tomorrow?
318
00:18:31,880 --> 00:18:32,880
I'm thinking about tomorrow.
319
00:18:32,880 --> 00:18:33,880
I'm thinking about retirement.
320
00:18:33,880 --> 00:18:35,980
And I'm like, what are my plans?
321
00:18:35,980 --> 00:18:36,980
What is my goal?
322
00:18:36,980 --> 00:18:42,520
And now I'm making choices that affect what tomorrow looks like.
323
00:18:42,520 --> 00:18:43,520
Do I control tomorrow?
324
00:18:43,520 --> 00:18:44,520
Absolutely not.
325
00:18:44,520 --> 00:18:50,400
But I'm making the choice I can make because I recognize that tomorrow, the day of retirement,
326
00:18:50,400 --> 00:18:53,340
or leaving this place, is coming.
327
00:18:53,340 --> 00:18:56,800
And it's an opportunity for me to really think about what does tomorrow look like?
328
00:18:56,800 --> 00:18:57,800
When is tomorrow?
329
00:18:57,800 --> 00:18:59,840
Like, when is that day of retirement?
330
00:18:59,840 --> 00:19:00,840
When is it coming?
331
00:19:00,840 --> 00:19:01,840
When do I want it to come?
332
00:19:01,840 --> 00:19:07,520
Am I just going to accept that I'm going to be here until 90 or 100?
333
00:19:07,520 --> 00:19:09,600
All things working well?
334
00:19:09,600 --> 00:19:12,720
Or do I want to be done with this at age 62?
335
00:19:12,720 --> 00:19:14,440
We get to decide.
336
00:19:14,440 --> 00:19:18,880
But part of thinking about what do I want my money to do for me tomorrow affects what
337
00:19:18,880 --> 00:19:21,080
you do with the money today.
338
00:19:21,080 --> 00:19:22,760
Okay.
339
00:19:22,760 --> 00:19:26,600
Question before is what do I want money to do for me right now?
340
00:19:26,600 --> 00:19:28,040
Now you can look at that in two ways.
341
00:19:28,040 --> 00:19:30,960
One you can say, well, if I want money to do this for me tomorrow, what do I need to
342
00:19:30,960 --> 00:19:31,960
be doing with money today?
343
00:19:31,960 --> 00:19:34,400
So that tomorrow it does this for me.
344
00:19:34,400 --> 00:19:35,400
Right?
345
00:19:35,400 --> 00:19:39,080
What do I need to do with my money today so that in retirement it gives me the returns
346
00:19:39,080 --> 00:19:40,080
that I want?
347
00:19:40,080 --> 00:19:41,080
Right?
348
00:19:41,080 --> 00:19:42,080
No guarantees.
349
00:19:42,080 --> 00:19:44,600
But how do I prepare today for tomorrow?
350
00:19:44,600 --> 00:19:48,000
That's one aspect of what I want money to do for me today.
351
00:19:48,000 --> 00:19:50,160
But the other aspect is how do I want to live today?
352
00:19:50,160 --> 00:19:54,360
I mean, you could totally like lock up all your money and just put it into the future.
353
00:19:54,360 --> 00:19:57,920
Actually you couldn't because there are limits on how much you can invest, but there are
354
00:19:57,920 --> 00:20:00,000
opportunities to invest in different things.
355
00:20:00,000 --> 00:20:02,680
So it's not just your retirement accounts.
356
00:20:02,680 --> 00:20:04,800
You can invest in a syndication deal.
357
00:20:04,800 --> 00:20:07,800
You can invest like an active real estate.
358
00:20:07,800 --> 00:20:09,400
There's so many options for investment.
359
00:20:09,400 --> 00:20:14,560
So it's not as if your retirement account is the only place for an investment.
360
00:20:14,560 --> 00:20:15,800
So you could invest all your money.
361
00:20:15,800 --> 00:20:19,280
You just put it all in savings, investments.
362
00:20:19,280 --> 00:20:22,360
You do all that stuff and then you don't have enough money for yourself or you're paying
363
00:20:22,360 --> 00:20:27,000
off your student loan debt and you live like a pauper or maybe not a pauper.
364
00:20:27,000 --> 00:20:28,000
You live frugally.
365
00:20:28,000 --> 00:20:29,000
How about that?
366
00:20:29,000 --> 00:20:30,480
That feels a little bit better.
367
00:20:30,480 --> 00:20:31,480
Frugally.
368
00:20:31,480 --> 00:20:32,480
But is that a choice you're making?
369
00:20:32,480 --> 00:20:37,840
Are you actively making that choice or are you just kind of letting life carry you?
370
00:20:37,840 --> 00:20:40,280
It's like, oh, this is the amount people pay on their student loans.
371
00:20:40,280 --> 00:20:41,800
Therefore, I guess I do this.
372
00:20:41,800 --> 00:20:46,400
Or when you are overwhelmed or feeling like, I don't like the way I'm living.
373
00:20:46,400 --> 00:20:48,280
I can't go on vacation.
374
00:20:48,280 --> 00:20:50,920
But it's just, what do you want money to do for you right now?
375
00:20:50,920 --> 00:20:53,360
And how do you free up money to do that for you right now?
376
00:20:53,360 --> 00:20:57,680
What do you need to let go of so that money can do what you want money to do for you right
377
00:20:57,680 --> 00:21:00,600
now?
378
00:21:00,600 --> 00:21:03,240
What do you want money to do for you right now?
379
00:21:03,240 --> 00:21:08,040
An important question so that you can make sure that you are achieving your goals and
380
00:21:08,040 --> 00:21:14,320
living the life you want while also building your legacy in your research, in your scholarship,
381
00:21:14,320 --> 00:21:17,200
your academic work, and also in your future.
382
00:21:17,200 --> 00:21:21,240
So you're taking care of all those things, making sure that also you're living the life
383
00:21:21,240 --> 00:21:23,560
you want to live today.
384
00:21:23,560 --> 00:21:24,960
Okay?
385
00:21:24,960 --> 00:21:28,720
Question number five, how can I reach my financial goal sooner?
386
00:21:28,720 --> 00:21:29,720
Okay.
387
00:21:29,720 --> 00:21:31,480
You know you love this positioning.
388
00:21:31,480 --> 00:21:33,480
You love this positioning thing.
389
00:21:33,480 --> 00:21:35,960
You're going to do it forever and ever.
390
00:21:35,960 --> 00:21:38,600
Even then a day is coming where you're not.
391
00:21:38,600 --> 00:21:41,040
It's not possible that you want to wait until 90 to retire.
392
00:21:41,040 --> 00:21:46,760
I mean, once you get to age, I believe it's like 73 and some change, you start to make
393
00:21:46,760 --> 00:21:51,880
these, you know, like required distributions from your retirement accounts.
394
00:21:51,880 --> 00:21:53,920
But is that the age at which you want to retire?
395
00:21:53,920 --> 00:21:54,920
Would you want to retire sooner?
396
00:21:54,920 --> 00:21:59,520
Would you want to retire while you still have the great health to do the retirement thing?
397
00:21:59,520 --> 00:22:04,920
Or do you really want to wait until like your old, older, and maybe suffering challenges
398
00:22:04,920 --> 00:22:07,480
that are associated with aging?
399
00:22:07,480 --> 00:22:09,680
You get to decide.
400
00:22:09,680 --> 00:22:13,600
But the question is, if you want to, how can you reach these goals sooner?
401
00:22:13,600 --> 00:22:17,240
Maybe you've resigned yourself to the fact that it's like, nope, I already have $300,000
402
00:22:17,240 --> 00:22:18,240
worth of debt.
403
00:22:18,240 --> 00:22:20,800
I have another couple of hundred thousand in this home that I bought.
404
00:22:20,800 --> 00:22:21,800
I'm going to be in debt forever.
405
00:22:21,800 --> 00:22:22,800
I'm going to be okay.
406
00:22:22,800 --> 00:22:25,200
I've just resigned my life to this.
407
00:22:25,200 --> 00:22:31,040
And I've heard some say that to me, but I'm saying, hey, what if, what if, let's just
408
00:22:31,040 --> 00:22:34,560
imagine for a moment, what if it were possible?
409
00:22:34,560 --> 00:22:38,760
For you to have a different outcome, what if it were possible for you to achieve your
410
00:22:38,760 --> 00:22:40,680
financial goals sooner?
411
00:22:40,680 --> 00:22:43,520
How might that change the way you show up?
412
00:22:43,520 --> 00:22:45,800
Just a thought, just a thought experiment.
413
00:22:45,800 --> 00:22:46,800
Don't get too excited.
414
00:22:46,800 --> 00:22:51,320
But what if you could reach your financial goals sooner?
415
00:22:51,320 --> 00:22:52,320
Would you want to?
416
00:22:52,320 --> 00:22:54,840
And what would you do if you did?
417
00:22:54,840 --> 00:23:01,400
It's a question to ask so that you can take charge and change the way you behave today
418
00:23:01,400 --> 00:23:03,840
to achieve the outcome that you want tomorrow.
419
00:23:03,840 --> 00:23:04,840
Okay.
420
00:23:04,840 --> 00:23:13,080
Sixth question is what's my current salary relative to my position and level of experience?
421
00:23:13,080 --> 00:23:14,080
Okay.
422
00:23:14,080 --> 00:23:15,080
Another one that's a little bit tense.
423
00:23:15,080 --> 00:23:18,920
I like, I can feel the tension building up in my belly even as I talk about it, because
424
00:23:18,920 --> 00:23:21,080
it's like an academic talking about salary.
425
00:23:21,080 --> 00:23:23,480
Oh, no, we don't talk about that.
426
00:23:23,480 --> 00:23:25,600
And I want to say it's time to talk about it.
427
00:23:25,600 --> 00:23:26,800
It is time to talk about it.
428
00:23:26,800 --> 00:23:31,680
For many of us who are underrepresented in the academy in any way, whether we're women
429
00:23:31,680 --> 00:23:38,920
or whether we're a gender or sexual or ethnic minority or racial minority, it is possible
430
00:23:38,920 --> 00:23:44,640
and quite likely that there may be some inequities in our pay.
431
00:23:44,640 --> 00:23:45,880
I'm not saying definite.
432
00:23:45,880 --> 00:23:49,080
I'm saying possible, maybe likely.
433
00:23:49,080 --> 00:23:50,920
You don't know.
434
00:23:50,920 --> 00:23:53,520
You don't know until you start asking questions.
435
00:23:53,520 --> 00:23:56,400
And you may not want to do anything about it.
436
00:23:56,400 --> 00:23:59,240
You may be like, oh, I know there's inequities, but how much is the inequity?
437
00:23:59,240 --> 00:24:01,200
Or you may be like, oh, no, I'm fine.
438
00:24:01,200 --> 00:24:03,640
Yeah, to what extent are you fine?
439
00:24:03,640 --> 00:24:05,960
And I'm not asking you to say, well, what is that person earning?
440
00:24:05,960 --> 00:24:11,280
And am I earning something relative to that person, which, you know, it always starts
441
00:24:11,280 --> 00:24:13,580
its own kind of controversy.
442
00:24:13,580 --> 00:24:18,400
The question is not compared to others as much as it's like, well, for me today, as
443
00:24:18,400 --> 00:24:24,040
an associate professor who has been in this role for the last four to five years, how
444
00:24:24,040 --> 00:24:27,800
much should I be earning?
445
00:24:27,800 --> 00:24:28,800
Ask that question.
446
00:24:28,800 --> 00:24:31,320
And maybe it's not a question that you ask yourself.
447
00:24:31,320 --> 00:24:35,720
As much as it's a question you can ask your division chief, like, oh, I want to make sure
448
00:24:35,720 --> 00:24:39,360
that I am benchmarked correctly.
449
00:24:39,360 --> 00:24:44,040
What are the benchmarks of someone who is at my position and has been in this role for
450
00:24:44,040 --> 00:24:46,520
the past couple of years?
451
00:24:46,520 --> 00:24:49,760
Ask the question and see what answer you get.
452
00:24:49,760 --> 00:24:50,760
It'll be interesting.
453
00:24:50,760 --> 00:24:52,200
It'll definitely be interesting.
454
00:24:52,200 --> 00:24:54,400
But if you don't ask, you don't know.
455
00:24:54,400 --> 00:25:00,160
I want to invite you not to be afraid to ask because information helps you make decisions.
456
00:25:00,160 --> 00:25:02,400
So ask, ask that of yourself.
457
00:25:02,400 --> 00:25:04,160
To what extent can you answer the question?
458
00:25:04,160 --> 00:25:07,200
But then ask that of the people who actually know.
459
00:25:07,200 --> 00:25:10,240
Now see to what extent they can answer the question for you.
460
00:25:10,240 --> 00:25:11,800
Again, you don't need to do anything.
461
00:25:11,800 --> 00:25:12,800
You don't need to put up a fight.
462
00:25:12,800 --> 00:25:14,480
You don't need to be angry.
463
00:25:14,480 --> 00:25:17,560
Just get the information, just the information.
464
00:25:17,560 --> 00:25:19,000
All right.
465
00:25:19,000 --> 00:25:24,920
Number seven, what will it take to get the financial information that sets me free?
466
00:25:24,920 --> 00:25:28,240
This is a question that I actually I'm asking for myself.
467
00:25:28,240 --> 00:25:32,240
I'm already kind of in the process of getting information that sets me free.
468
00:25:32,240 --> 00:25:35,200
That helps me think differently about my finances.
469
00:25:35,200 --> 00:25:40,440
What I find about many of us academics, and I will speak for myself, is I'm so busy going
470
00:25:40,440 --> 00:25:45,520
from one manuscript to the other manuscript, one grant to the next grant, that to be honest,
471
00:25:45,520 --> 00:25:48,080
there isn't really time to stop and think about, wait a minute, what do I want to do
472
00:25:48,080 --> 00:25:49,640
with my financial future?
473
00:25:49,640 --> 00:25:52,040
Because it just doesn't feel normal, right?
474
00:25:52,040 --> 00:25:55,120
In medicine, that's not something we really talk about.
475
00:25:55,120 --> 00:25:57,060
But it is time to start talking about it.
476
00:25:57,060 --> 00:25:59,000
It's time to start thinking about it.
477
00:25:59,000 --> 00:26:03,760
And what will it take to get the information you need?
478
00:26:03,760 --> 00:26:05,600
And I hear some of you say, but I'm so busy.
479
00:26:05,600 --> 00:26:06,960
It's like, yes, you are busy.
480
00:26:06,960 --> 00:26:09,440
And I'm so excited for you that you're busy.
481
00:26:09,440 --> 00:26:13,800
And you can never be too busy to take charge of your financial future.
482
00:26:13,800 --> 00:26:19,060
You can never be too busy to sit and think about, well, what are the financial goals
483
00:26:19,060 --> 00:26:20,060
that I have?
484
00:26:20,060 --> 00:26:21,920
How do I reach them?
485
00:26:21,920 --> 00:26:23,700
How do I reach them sooner?
486
00:26:23,700 --> 00:26:28,160
What will it take to live the kind of life I want to live today and the kind of future
487
00:26:28,160 --> 00:26:29,160
I want to have tomorrow?
488
00:26:29,160 --> 00:26:32,000
What will it take to accomplish that?
489
00:26:32,000 --> 00:26:33,440
These are questions I'm still asking myself.
490
00:26:33,440 --> 00:26:35,520
I'm going to summarize in just a little bit.
491
00:26:35,520 --> 00:26:37,120
Number one, how do I make money?
492
00:26:37,120 --> 00:26:40,680
Number two, where am I working for free versus working for pay?
493
00:26:40,680 --> 00:26:43,880
Number three, what do I want money to do for me tomorrow?
494
00:26:43,880 --> 00:26:46,680
Number four, what do I want money to do for me right now?
495
00:26:46,680 --> 00:26:49,760
Number five, how can I reach my financial goals sooner?
496
00:26:49,760 --> 00:26:55,040
Number six, what is my current salary relative to my position and level of experience?
497
00:26:55,040 --> 00:27:00,320
And number seven, what will it take to get the financial information that sets me free?
498
00:27:00,320 --> 00:27:07,240
I tell you that this journey of academia or scholarship is about your whole life.
499
00:27:07,240 --> 00:27:09,320
It's not about just grants and manuscripts.
500
00:27:09,320 --> 00:27:15,120
And we would be remiss if all we focused on were the things that may not take us the distance
501
00:27:15,120 --> 00:27:16,520
that we need to get to.
502
00:27:16,520 --> 00:27:18,840
I know it's important to focus.
503
00:27:18,840 --> 00:27:22,280
And I'm always a big person on telling you to focus.
504
00:27:22,280 --> 00:27:23,600
It's a thing.
505
00:27:23,600 --> 00:27:25,240
You should focus.
506
00:27:25,240 --> 00:27:30,280
And you should make sure that you do not focus on your career to the detriment of your financial
507
00:27:30,280 --> 00:27:32,760
future.
508
00:27:32,760 --> 00:27:37,920
Both should go hand in hand so that you can work your career to give you the financial
509
00:27:37,920 --> 00:27:39,480
future that you desire.
510
00:27:39,480 --> 00:27:40,480
All right.
511
00:27:40,480 --> 00:27:42,680
I'm going to have more thoughts on it in the future.
512
00:27:42,680 --> 00:27:46,560
But today, thank you for listening to what I do have to share.
513
00:27:46,560 --> 00:27:50,560
As always, if you are looking for a coach, definitely reach out to me.
514
00:27:50,560 --> 00:27:54,880
You can find me on Instagram, find me on LinkedIn, and on Facebook as well.
515
00:27:54,880 --> 00:27:57,040
I look forward to hearing from you.
516
00:27:57,040 --> 00:28:04,240
And I am so thankful that you will, I ask, share this with somebody else who would benefit
517
00:28:04,240 --> 00:28:06,400
from thinking and talking about money.
518
00:28:06,400 --> 00:28:07,480
All right.
519
00:28:07,480 --> 00:28:09,760
Have a great rest of your day.
520
00:28:09,760 --> 00:28:21,000
And I'll see you next time on the Clinician Researcher Podcast.
521
00:28:21,000 --> 00:28:26,360
Thanks for listening to this episode of the Clinician Researcher Podcast, where academic
522
00:28:26,360 --> 00:28:31,600
clinicians learn the skills to build their own research program, whether or not they
523
00:28:31,600 --> 00:28:33,120
have a mentor.
524
00:28:33,120 --> 00:28:39,240
If you found the information in this episode to be helpful, don't keep it all to yourself.
525
00:28:39,240 --> 00:28:41,000
Someone else needs to hear it.
526
00:28:41,000 --> 00:28:45,040
So take a minute right now and share it.
527
00:28:45,040 --> 00:28:50,480
As you share this episode, you become part of our mission to help launch a new generation
528
00:28:50,480 --> 00:29:03,360
of clinician researchers who make transformative discoveries that change the way we do healthcare.
