Money Talk For ER Docs™

Every professional service is different in terms of the customer and service provider interaction. It tends to be true that the more personal the product or service is, meaning the more tailored it is to the customer, by default, the more involved the customer has to be in the process. Take buying the newest PlayStation as an example. The product is what it is and the same one is universally bought by all. Now consider the opposite end of the spectrum where there's a specific financial planning process, for a specific specialty, for an even more specific person or family. The dynamics are completely different in those two examples.

That's what we'll discuss in today's episode – what it's like to be project managers to ER Docs and the workload requirement, on both ends, to successfully implement a financial plan.

Envision is the 500-lb gorilla in emergency medicine. What happens to them sends ripples through the EM landscape whether you work for them or not. A question we've received of late is: What happens to tax-deferred money under an EDP, or more commonly referred to today as a DCP or defined contribution plan, if a company, like Envision, goes under? Do the same protections that exist for an IRA or 401(k) exist for a non-qualified plan?

If you're at all interested in the business-side, or private equity's involvement in healthcare, today's episode is a good one to tune in to as we'll break down the structure that makes up a staggering 40% of US ER Departments and, ultimately, how that impacts the finances of ER Docs.

The fastest-growing renter segment of our population goes to high income earners. That seems counter-intuitive; high income earners are able to overcome the barrier to entry associated with home ownership – e.g.: down payment, loan qualification, and credit – better than low income earners. So if it isn't a choice, what are the factors at play that are leading to this upward trend? And if it is a choice, why are more and more high income earners, like ER Docs, choosing to rent over buy?

We'll get into that, the tax implications of each as it pertains to the decision, and all of the emotional elements that are at play in today's episode.

The perfect storm of events led to a significant rise in what we call "meme investing." That's where you throw caution to the wind and take a stab at hitting it big through risky or speculative investments. It started with the pandemic – people bored at home; no sports on TV; Vegas shutdown. Then the headlines of GME and AMC stock "get rich quick" stories led to FOMO. All while, waiting there only a download away, were online trading companies, like Robinhood and Webull, ready to accept anybody willing to play the game. Did you take part in "meme investing?" Are you still taking part in "meme investing?"

With recent volatility in the markets, we're seeing more and more ER Docs reconsider having side accounts. But does holding money aside for YOLO'ing really have much of an impact on a financial plan? We'll look into that on today's episode.

ER Docs have a unique characteristic of being "hybrid earners," meaning accepting income both as an employee earning a W-2 and as a contractor earning 1099 in the same year. And we find a large percentage do exercise this ability; if not in most years, eventually at some point in their careers. So that begs the question: is there a perfect mixture of 1099 vs. W-2 that yields specific advantages, like tax savings and retirement deferral opportunities? And is there a point where earning too much of one over the other yields diminishing returns?

Nobody wants to work more to earn less, so we'll look into those questions in today's episode and get into what that hybrid-earning "sweet spot" could look like.

It's apparent that the happiest people in life have learned how to achieve balance. But achieving balance is one of, if not the most, challenging thing in life because it's embedded in every decision we make: our relationship with work; our relationship with food; spending time with family; and the list goes on.

ER Docs have to be masters of balance when it comes to work because if they aren't, the long hours, intense conditions, and high-stress environment, repeated 15+ times a month for 20-30 years will eventually take its toll somewhere over that period. So while it may be a requirement to find balance career-wise, it's another to find it in spending. That's why today's episode is focused on the concept of a "reverse bucket list" and re-evaluating our personal satisfaction equations to make future spending more intentional and fulfilling.

Feeling a never-ending sense of unrest with today's current events? There was COVID that shook our world for a couple of years. We caught some semblance of normalcy with the Winter Olympics. But today, we have the Federal Reserve planning to hike rates in an effort to combat the prevailing high inflation we see all around us… and a war, with an uncertain outcome. While it can feel raw and emotional, we have to be reminded that this time is not different. Events like these have happened several times before. Can we draw upon our past to arrive at logical conclusions for our present?

That's the topic of today's episode: bringing rationale to an otherwise chaotic world we're living in.

"The road to success comes through hard work, determination, and sacrifice." This is a quote from Dolzinski and it paints a picture that we must give up things in order to achieve a better, larger thing eventually. Delayed gratification, if you will. In many cases, that's true, especially when it comes to financial planning. Saving a little bit extra now instead of spending it means longer compounding interest on that investment, as an example. Or, delaying retirement a couple of years means a more comfortable retirement down the road. But does that always need to be the case?

That's the topic of today's episode: two specific non-behavioral strategies available to ER Docs that, when implemented correctly, can impact financial success as much as behavioral changes.

The Godmother of the Emergency Physician recruiting world – Barb Katz – joins Scott on this special edition of the Money Talk For ER Docs podcast. Barb shares her unique perspective on the job market Pre-COVID and her anticipation for what is to come. She gets into hourly rates and sign-on bonuses, where opportunities seem to be popping up, the pay discrepancies from location to location, and what residency programs are, or are not, doing to prepare new graduates entering the workforce. Ultimately arriving at the answer for: Has a new norm been set for the job market and if so, how long will that last?

Everybody will find value in listening to this episode, but especially those who are soon to graduate or those looking for a new job or worried for the security of their current job.

Transition from W-2 to 1099 is a bigger deal than you might first think. So we've set out to create the most ER-specific "how-to" guide we can come up with to help those navigating this change. This is Part 2.

We encourage you to re-listen, or listen for the first time, any prior episodes mentioned as they can assist in giving more details in areas we simply can't fit in this mini-series. And as always, feel free to reach out at [email protected] if you have any questions or need clarification. Enjoy!