Physician Empowerment

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Physician Empowerment is an organization dedicated to transforming the lives of Canadian physicians through education in finance, practice management, wellness, and leadership.

Kevin Mailo, Wing Lim, Dimitre Ranev

May 30, 2025 LATEST EPISODE
every other week NEW EPISODES
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69 EPISODES

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Latest episodes from Physician Empowerment

68 - Part 2: Hiring, Firing, and Employee Retention with Kate Post

Play Episode Listen Later May 30, 2025 24:48

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67 - Part 1: Hiring, Firing, and Employee Retention with Kate Post

Play Episode Listen Later May 15, 2025 27:13

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66 - Thriving Workplaces Have Gravitational Pull. Effective Hiring and Retention with Jayna Amadasun

Play Episode Listen Later Apr 30, 2025 42:11

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65 - Medical Entrepreneurship with Dr Marc-Emile Plourde

Play Episode Listen Later Apr 15, 2025 27:14

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64 - Insurance: The Why What Who When & How with Galen Nuttall at Maxim Advisory Group

Play Episode Listen Later Mar 30, 2025 38:44

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63 - Indentured Servitude: The Wrong Way to Fix a Broken System. Featuring Jayna Amadasun, MD

Play Episode Listen Later Mar 15, 2025 42:46

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Want to dive deeper into topics like this? Master your journey with Physician Empowerment's Masterclass Membership—your gateway to exclusive content, expert-led sessions, and actionable strategies to elevate your personal and financial well-being. Learn more and join us today! https://www.physempowerment.ca/masterclass—In this episode, Dr. Kevin Mailo welcomes Dr. Susannah Ward to the show to talk about self-acceptance and her work in changing the culture of medicine. Dr. Ward is a fellow with the College of Physicians, a specialist in rehabilitation medicine, and the Founder of Ataraxia Collective which promotes the well-being of doctors. Susannah and Kevin discuss the pressures and demands of medicine and how awareness around taking care of ourselves first should become a priority. Dr. Susannah shares some of her stories and reflects on the stress, lack of autonomy, sexism, and constant pressures of her journey through training and work. She points out that doctors face the reality of burnout around the world and it helps to understand they're not alone. Susannah and Kevin talk about what can be done when someone identifies their burnout: everything from seeing their own GP to avoiding numbing coping mechanisms like alcohol and taking care of personal nutrition and sleep. Susannah and her work shine a spotlight on the importance of identifying our need for self-care, allowing ourselves to be human and prioritizing our own well-being.About Dr. Susannah Ward:Dr Susannah Ward qualified as a rehabilitation physician in 2018 with the Basmajian Award for best fellowship clinical exam performance. She has over 15 years of experience working in public and private hospitals across Australia. She has diverse clinical experience including general medical and surgical care, palliative care, geriatrics and rehabilitation. She has rehabilitation experience working in brain injury, spinal cord injury, chronic pain, geriatrics, palliative care, orthopaedic rehabilitation, stroke, amputation and general rehabilitation. She has private clinics at The Wellness Place Blacksmiths. She also offers telehealth appointments and home visits. She has a special interest in acquired brain injury. She has an expert understanding of the behavioural, psychological and social challenges faced by people & the impact of environment, upbringing & social determinants of health.Dr Ward is passionate about holistic health and lifestyle, behavioural and psychological rehabilitation. She likes to incorporate evidence-based wellness tools like mindfulness, healthy eating, exercise and social/lifestyle prescription into her goal-directed and patient-centred care. She promotes the key message that living with illness or injury need not be a barrier to feeling well or living life to the full. Dr Ward's therapeutic emphasis is to support a client to self-compassionately accept themselves and acquire self-mastery skills to maximise their functional ability and quality of life. She aims to help empower clients to independently self-care and optimally manage their circumstance using wellness tools and adopting a healthy lifestyle.Dr Ward has always been an advocate of health professional wellbeing & promoting a more supportive & nurturing medical culture that facilitates wellbeing & sustainable careers. She founded Ataraxia Collective in 2018 as a creative adjunct to her clinical practice hosting retreats & workshops show casing powerful holistic tools like mindfulness & yoga. She currently runs doctor wellbeing & CPD retreats. She is the Chair of the Royal Australasian College of Physicians Member Health & Wellbeing Committee & director for the not for profit charity Mood Active. She enjoys professional writing on topics related to doctor wellbeing & is publishing her first self-care book Mastering Real Wellness this year.Website: AtaraxiaCollective.com.auBook: “Mastering Real Wellness” by Dr. Susannah Ward__Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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60 - Tax Benefits on Charitable Giving and In Kind Donations

Play Episode Listen Later Jan 30, 2025 34:12

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59 - Long-Term Investments and Tariffs with Diana Choi

Play Episode Listen Later Jan 15, 2025 37:41

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—In this episode, Dr. Wing Lim introduces a discussion with Diana Choi, team lead to a group of portfolio managers, about professional investment strategies. Diana Choi explains her investment philosophy; looking at the unpredictability of the future and the importance of focusing on quality businesses. She tells Wing that successful companies are ones that can perform well in various market conditions, thriving in good times and surviving in downturns. Through this approach, refined over 25 years, risk-adjusted returns can be delivered by identifying strong businesses that are resilient to market fluctuations.Dr. Lim and Diana Choi also explore the idea that investment decisions should not hinge on short-term events or political cycles, such as presidential elections. Quality companies transcend political changes and Diana points to the example of CCL Industries, a label-making firm with strong cash flow and growth potential. This strategy makes robust fundamentals a priority and not trends, fads, or short-term gains. The conversation highlights the disciplined effort that is needed to assess and maintain investments, with a focus on the value of patience, diligence, and durable business models.Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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58 - Revisiting Capital Gain Investments with Jason Pisesky

Play Episode Listen Later Dec 30, 2024 34:51

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—Dr. Kevin Mailo and Dr. Wing Lim welcome Masterclass faculty member Jason Pisesky back to the show to talk about the recent capital gains changes in Canadian tax policy. Jason is a tax expert with KPMG and he breaks down for Wing why the changes sparked widespread concern among professionals, small business owners, and investors. He and Wing examine the actual impacts, where they were felt most, and what the practical implications of the changes are.The conversation focuses on the government's decision to increase the capital gains inclusion rate from 50% to two-thirds for amounts exceeding $250,000 annually, meant only to affect the top 0.13% of Canadians. Jason explains that the policy affects those with significant investments, corporations, and trusts, while individuals have some exemptions. The nine-week notice period left people rushing for solutions, leading to a variety of overreactions, like liquidating assets too early, and responses such as corporate stripping. Jason advises caution against unnecessary asset liquidations that could trigger large, immediate tax bills. Despite the initial panic, Jason reassures listeners that the tax increases are manageable for most with proper planning, emphasizing the importance of consulting experts to avoid unnecessary financial losses.About Jason Pisesky:Jason is a tax lawyer with an international accounting firm, KPMG. His practice background is extensive and includes personal and corporate tax planning as well as litigation and dispute resolution. Whether you are scaling up your practice or winding it down, proper coordination between a tax lawyer and your accountant can ensure you're doing it right.__Jason Pisesky:Jason Pisesky at KPMGJason Pisesky on LinkedInPhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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57 - Medical Entrepreneurship Series with Dr. Adenike (Nike) Olowu and her husband, Daniel Ashaolu

Play Episode Listen Later Dec 15, 2024 45:43

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—Dr. Kevin Mailo introduces another episode in the Medical Entrepreneurship Series. Dr. Wing Lim interviews guests Dr. Adenike (Nike) Olowu and her husband, Daniel Ashaolu, masterclass members and entrepreneurs. Dr. Olowu is a full-time family physician and her husband Daniel manages their growing real estate portfolio. They tell Wing about their journey of coming to Canada, setting up practice, and how they are not just thriving but soaring. Dr. Adenike Olowu went to medical school in Nigeria, where she did her residency at University College Hospital before coming to Canada in 2017. She practiced for six years prior to immigrating and she describes the process of getting certified to practice in Canada. By January of 2020 she was practicing here. Daniels explains why they chose Canada and then Alberta, how the move worked for their children, and how they decided to start their real estate investing journey. Wing explores the fascinating process of how the pair dove into entrepreneurship and investing and what steps they took to ensure success.About Dr. Adenike (Nike) Olowu:Dr. Ashaolu Adenike Oluwatoyin Mulikat, also known as Dr. Ashaolu [Ash-a-loo], is a family medicine physician working out of the Elk Point Healthcare Centre and the Ayobami Oyebode Medical Clinic. She became the third family physician to practice in town. Dr. Ashaolu comes to Elk Point from Winnipeg. She arrived in Canada in September 2017 after completing her medical training and residency in Nigeria.With plans to specialize in geriatric medicine, Dr. Ashaolu enjoys cooking and hiking as well as spending time with her husband Daniel Ashaolu and their three children: Joshua, Jemimah and Joy.—Physician Empowerment: Join the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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56 - You As The Most Important Investment: Mindfulness

Play Episode Listen Later Nov 30, 2024 32:08

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—Dr. Kevin Mailo welcomes lifetime Masterclass member Dr. Iuliaa Povieriena as his guest in this episode to talk about mindfulness. This episode is part of a new podcast segment called “You As the Most Important Investment”. Iuliaa introduces mindfulness with the definition of “observing what's present in the moment without judgment or expectation”. She and Kevin discuss the importance of mindfulness to overall health and emotional wellness.Dr. Povieriena describes the “most important investment” that mindfulness is and how to approach mindfulness as being a more objective perspective. Instead of saying “I'm angry”, we could say “I'm experiencing anger”. Being mindful of the present moment not only aligns with personal wellness but also improves patient relations. Kevin and Iuliaa explore the practices of mindfulness such as meditation, body scans, and breathing exercises, how a even short mindfulness practice can be extremely helpful, and why investing in mindfulness supports our personal health and improves daily life.About Dr. Iuliia Povieriena:Dr. Povieriena is a Hospitalist at Georgetown Hospital and has been a physician since 2020. She is a primary care physician with a strong interest in inpatient care, and palliative and geriatric medicine. Iuliia finds her work very meaningful and enjoys spending time with patients. She also has experience in GP psychotherapy, which she says was one of the best jobs she ever had.Dr. Povieriena is a firm believer that everyone deserves an equal opportunity to pursue their passion in medicine and would like to express gratitude to all women who have paved the path for the female physicians of today.__Resources discussed in this episode:Mindfulness Meditation 3 Minute Breathing SpaceInsight Timer appTara Brach“The Mind Illuminated: A Complete Meditation Guide Integrating Buddhist Wisdom and Brain Science for Greater Mindfulness” by John Yates PhD, Matthew Immergut PhD, and Jeremy Graves“Attending: Medicine, Mindfulness, and Humanity” by Ronald Epstein, MD__Dr. Iuliia Povieriena:Iuliia Povieriena, MD on LinkedInCalming Chamomile on YouTubePhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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55 - Behind the Curtains: Common Threads amongst the Ultra-wealthy

Play Episode Listen Later Nov 15, 2024 42:45

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—Dr. Wing Lim introduces Physician Empowerment Masterclass faculty members Jason and Simon in a feature called “Behind the Curtain”. Jason Pisesky is a tax lawyer and Simon Wong is a wealth planner and they'll both be discussing what the ultra wealthy do, a topic which is also a focus in the upcoming Mexico Health and Wealth Summit. Simon and Jason talk with Wing about how the wealthy deal with their finances and what the current mindsets are. Some things they address are the shift from wealth accumulation to wealth preservation, mitigating risk, investment strategy and remaining level-headed, and how to select the right financial advisors for a team designed to manage assets for us. They detail who should be on the wealth building and planning team and why, and they discuss how to align wealth intentions to planning an end goal. This episode is full of sound advice and serves as an example of the in-depth topics covered in the Mexico summit. About Jason Pisesky:Jason is a tax lawyer with an international accounting firm, KPMG. His practice background is extensive and includes personal and corporate tax-planning as well as litigation and dispute resolution. Whether you are scaling up your practice or winding it down, proper coordination between a tax lawyer and your accountant can ensure you're doing it right.About Simon Wong: As an Integrated Wealth Planner, Simon's expertise lies in simplifying complex financial concepts into clear, actionable insights, forming the cornerstone of his Financial Plans. Simon specializes in navigating individuals and businesses through the intricate landscape of tax planning and investing, utilizing his extensive knowledge and experience to foster their financial success and stability.—Physician Empowerment: Join the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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54 - Medical Entrepreneurship Series with Drs. Renee Jacques and Sam Peters

Play Episode Listen Later Oct 30, 2024 35:28

PhE is headed to Cancun this February 23 to March 2 for our Health and Wealth Summit! We'd love to have you join: https://www.physempowerment.ca/cancun—Dr. Kevin Mailo introduces guests Dr. Sam Peters and Dr. Renee Jacques, a husband and wife team of doctors in Ontario who run a family clinic and an entrepreneurial medical site together. Dr. Wing Lim interviews Drs Peters and Jacques, both of whom are Physician Empowerment Lifetime Masterclass members, about how they met, what it's like to work together, and the drive they share for entrepreneurial endeavours.Dr. Sam Peters and Dr. Renee Jacques attended and graduated from the Northern Ontario School of Medicine in Sudbury together and had their first son at the end of their family medicine residency. They both enjoy the independence that family medicine offers in terms of freedom in practice and not being tied to a particular hospital. Sam and Renee talk with Wing about the hectic demands of balancing family and several entrepreneurial efforts. They elaborate on what they like about entrepreneurship, the new medical technologies they've been able to provide in their clinics, why being able to work with family inspires them, and the day-to-day office management platform they developed to help physician workloads. About Dr. Renee Jacques and Dr. Sam Peters:Sparrow Health was developed by a husband-and-wife team committed to serving the Northern Ontario region. As healthcare professionals themselves, Dr. Sam Peters and Dr. Renee Jacques know first-hand the post-pandemic burden the healthcare system faces, experienced by providers and patients alike.Sparrow Health was developed by a husband-and-wife team of family doctors who envisioned a way to help patients and physicians access quicker, easier care. We designed Sparrow Health specifically for helping physicians improve workflow, while ensuring that patients have simplified access to their doctor.__Dr. Renee Jacques / Dr. Sam Peters:Website: BorealMedicine.comWebsite: SparrowHealth.caPhysician Empowerment: Join the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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53 - The Burnout Crisis in Canada's ERs

Play Episode Listen Later Oct 15, 2024 25:34

Dr. Kevin Mailo welcomes Dr. Kerstin de Wit, a Professor of Emergency Medicine at Queen's University and a very active clinician and researcher practicing both emergency medicine and thrombosis medicine. Dr. Kerstin de Wit was interviewed for an article in the National Post that featured survey data from her latest research into high levels of burnout amongst emergency physicians. Her research was published in June's edition of the Annals of Emergency Medicine and it reveals the levels of emotional exhaustion and depersonalization aspects of burnout spiking in emergency medicine personnel. Dr. de Wit's study compared physician burnout levels during 2020, the first year of the pandemic, to levels reported in October 2022. The initial survey revealed that roughly 50% of physicians participating in the survey exhibited high levels of burnout already. In 2022 the levels had increased significantly. Emotional exhaustion, one of the two measured elements of burnout, had increased by an absolute 16% of the cohort, and depersonalization had increased by an absolute 12% of the cohort. Dr. Mailo and Dr. de Wit discuss how alarmingly high the revealed levels of burnout are, the realities and consequences of depersonalization, the quotes from the study that revealed how people feel about the broken state of healthcare in Canada today, and what can be done to lessen the burnout and mend the damaged healthcare and ER departments across Canada. This is a key episode about emergency medicine and the burnout crisis that will take serious intervention to turn around. About Dr. Kerstin de Wit, MD:Kerstin de Wit holds a Tier 1 Canada Research Chair in Emergency Venous Thromboembolism and is a Professor in the Department of Emergency Medicine at Queen's University. She works clinically as an emergency physician and thrombosis physician at Kingston Health Sciences.Dr de Wit was trained in internal medicine, emergency medicine, and research in the UK. She completed a Thrombosis Fellowship in Ottawa in 2013. Since then, she has worked in both emergency medicine and thrombosis. She leads a research program which focuses on the diagnosis of bleeding and clotting disorders in the emergency department and is funded by CIHR.Dr de Wit is the Queen's University Clinician Investigator Program Director and the Research Director for the Department of Emergency Medicine. __Resources discussed in this episode:“A Longitudinal Survey on Canadian Emergency Physician Burnout” Annals of Emergency Medicine, Volume 83, Issue 6, P576-584, June 2024, by Kerstin de Wit, MBChB, MD; Anna Tran, BSc; Natasha Clayton, CRA, RA; Caroline Gérin-Lajoie, MD; and Mathew Mercuri, PhD, PhD“‘I don't think I'll last': How Canada's emergency room crisis could be killing thousands” by Sharon Kirkey, National Post, July 19, 2024__Dr. Kerstin de Wit:Queen's University Emergency Medicine Faculty: Dr. Kerstin de Wit, MDKerstin de Wit on X/TwitterPhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

52 - Real Change in Our Healthcare System with Jayna Amadasun, MD, LLM

Play Episode Listen Later Sep 30, 2024 43:53

In this episode, Dr. Kevin Milo and Jayna Amadasun, an M.D. and ethical strategist, confront one of the most pressing issues in healthcare today: the burnout epidemic among our frontline professionals and why systemic change is no longer optional. They discuss the ethical and systemic issues that have led to a strained healthcare system, where overworked doctors and nurses struggle to provide optimal patient care. The episode highlights the importance of addressing the healthcare workers' environment to improve outcomes for both professionals and patients. Key topics include the lack of resources, the need for policy reform, and how burnout impacts the quality of care. This conversation is a must-listen for anyone concerned about the future of healthcare in Canada and beyond.Jayna also discusses how healthcare systems can become more sustainable by focusing on the well-being of frontline staff. By addressing burnout, healthcare providers can improve patient outcomes, foster a healthier work environment, and prevent the silent withdrawal of professionals who feel disengaged. Dr. Milo and Jayna provide practical insights into how healthcare leaders can begin making changes to support their teams.About Jayna AmadasunJayna Amadasun is a dynamic ethical strategist and consultant who coaches Black medical professionals. With an M.D. from the Dominican Republic, Jayna brings a wealth of experience, having worked as an R.N. in the Bahamas and trained in the U.S. healthcare system. She holds a Master's in Law and Medical Ethics from the University of Edinburgh and is committed to creating equitable healthcare environments. Her unique perspective, shaped by years in emergency and flight medicine, allows her to address the complex issues facing healthcare systems today.--Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.caJayna AmadasunWebsite: Ember Impact GlobalLinkedIn: Jayna AmadasunInstagram: EmberImpactCalendly: Jayna Amadasun

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51 - Insights on Boundaries, True Wellness, and Self-Forgiveness with Dr. Iuliia Povieriena

Play Episode Listen Later Sep 15, 2024 38:21

Dr. Kevin Mailo welcomes Dr. Iuliaa Povieriena as his guest in this episode to talk about boundaries and wellness. Dr. Povieriena is a hospitalist based out of Georgetown in Ontario and also a Lifetime Physician Empowerment Masterclass member. She discusses how she found balance for herself by re-applying her time outside of work to things that she loves like dance and yoga. She and Dr. Mailo talk about how to maintain non-negotiables for personal wellness.The pressure to sacrifice personal time to work is high, especially as a medical student or resident, and the things sacrificed contribute to stress and an inability to carve that time back out later in medical careers. Iuliia and Kevin talk about devoting time to things we love and not striving for perfection in them, necessarily, but simply maintaining the joy of those activities as a way to regulate stress. Setting boundaries around our time, not immediately saying yes to covering shifts, keeping an evening class commitment, and prioritizing family and non-negotiables are all aspects of true wellness touched on by Dr. Mailo and Dr. Povieriena that keep us healthy and engaged in our careers without burnout long-term. About Dr. Iuliia Povieriena:Dr. Povieriena is a Hospitalist at Georgetown Hospital and has been a physician since 2020. She is a primary care physician with a strong interest in inpatient care, and palliative and geriatric medicine. Iuliia finds her work very meaningful and enjoys spending time with patients. She also has experience in GP psychotherapy, which she says was one of the best jobs she ever had.Dr. Povieriena is a firm believer that everyone deserves an equal opportunity to pursue their passion in medicine and would like to express gratitude to all women who have paved the path for the female physicians of today.__Resources discussed in this episode:“Burnout: The Secret to Unlocking the Stress Cycle” by Emily Nagoski PhD and Amelia Nagoski DMA“F*ck No!: How to Stop Saying Yes When You Can't, You Shouldn't, or You Just Don't Want To” by Sarah Knight17 Questions That Changed My Life by Tim Ferriss__Dr. Iuliia Povieriena:Iuliia Povieriena, MD on LinkedInCalming Chamomile on YouTubePhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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50 - Key Wisdom in Building a Financially Vibrant Practice with Dr. Sajid Syed

Play Episode Listen Later Aug 30, 2024 40:25

Dr. Kevin Mailo welcomes dentist and implantology expert Dr. Sajid (Saj) Syed to the podcast to talk about practice building. Dr. Syed currently owns three dental practices in Ontario, all very successful, and he discusses his journey into dentistry and the business side of things with Dr. Mailo. As he says, “...the profession is 85% business and 15% actual dentistry” and emphasizes the importance of quality training to rely on and of not overthinking opportunities that arise.Dr. Syed did not start his medical career wanting to be a dentist. He began with a desire to do cardiology. But once he entered dentistry at the suggestion of a friend's father, he was hooked. Kevin prompts Saj to explain how he's moved beyond simple dentistry into being a highly skilled technician specializing in full mouth reconstruction and implant dentistry and then becoming a successful business owner. Saj and Kevin discuss the necessity of not over-analyzing goals, having a very skilled team around you, and prioritizing customer service when they talk about how to approach entrepreneurship. Dr. Syed draws on his multiple-practice ownership experiences to impart sound advice and financial tips for any medical professional looking to branch into business ownership.About Dr. Sajid (Saj) Syed:After graduating from the University of Saskatchewan in 2003, Dr. Syed began practicing dentistry in Estevan, Saskatchewan, where he worked for two years before moving to Ontario.In 2005, Dr. Syed purchased a practice in Dunnville, using his unique style and service improvements to maintain the quality care the Dunnville community has always enjoyed. Dr. Syed continued to expand his business, purchasing Pavillion Dentistry in 2009. He is dedicated to providing the residents of St. Catharines and surrounding communities with excellent dental care and personalized service.In 2021, Dr. Syed purchased Lakeside Dental in Stoney Creek. He and his family now live in Stoney Creek, where they love being part of a smaller community.Dr. Syed enjoys all aspects of dentistry, with a special interest in complex cases like dental implants, full mouth reconstruction, and orthodontics. He has a passion for performing life-changing treatments that increase a patient's quality of life by providing them with a fully functional smile.Recently, his dedication and hard work were recognized when he became a Diplomate of the American Board of Oral Implantology, the highest level of competency in implant dentistry. He is also an Associate Fellow and a Fellow of the American Academy of Implant Dentistry. Aside from being a big promoter of continuing education, Dr. Syed also mentors other general dentists wanting to enhance their clinical skills in implant dentistry.Outside of work, Dr. Syed loves spending quality time with his wife and two children. He also enjoys staying fit and playing tennis.__Dr. Sajid (Saj) Syed:Dentistry DunnvillePavilion DentistryLakeside DentalPhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

49 - Medical Entrepreneurship with Dr. Eileen Heo

Play Episode Listen Later Aug 15, 2024 26:58

Dr. Wing Lim hosts Dr. Eileen Heo in the first episode of a new series about medical entrepreneurship. Eileen graduated from the University of Toronto Medical School and then did a family medicine residency at UBC, across the country. Upon completing residency, she moved back to Toronto where she is in her first five years of real practice. Wing talks with her about why she chose not to open a clinic and instead went into being a hospitalist.Dr. Eileen Heo and Dr. Wing Lim discuss what it is about working in a hospital that Eileen finds so compelling and they also address the family medicine crisis in Ontario, which is also more or less nationwide. Eileen honestly shares that fee increases are not keeping pace with inflation and the related difficulties of wealth building as a medical practitioner. This led her to her non-medical entrepreneurship in educating herself about financial well-being through studying investing, stock options, e-commerce, and managing personal finances. Wing and Eileen shed a lot of light on why understanding finance is such an important investment for any physician. __Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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48 - Mythbusters in the Financial Marketplace with Nick Giovannetti

Play Episode Listen Later Jul 30, 2024 45:26

Dr. Wing Lim hosts Physician Empowerment Masterclass Faculty Member and Certified Financial Planner Nick Giovannetti in a myth-busting conversation on the financial marketplace. Win and Nick discuss the good and bad aspects of the industry, what to look for, how to verify information, and why research is important before entrusting your wealth to an advisor or team. Nick Giovannetti explains that the relative ease with which licensing can be attained in the financial industry leads to some advisors not being proficient in areas where they may claim proficiency. He advises anyone looking to work with a financial advisor to perform due diligence - to search how long somebody has been insurance licensed or, if they are less experienced, do they have a good team around them. It's alright to ask questions about somebody's abilities. Wing and Nick talk about why everyone should background check where information is coming from, perform peer review, encourage the financial team members to work together, and why we should not be afraid to explore other financial planning options if we've outgrown our current team. This episode myth-busts common misconceptions, addresses concerns, and offers sound advice on everything in the financial marketplace.–About Nick Giovannetti:Nick is a Certified Financial Planner® with a fully Integrated Wealth Planning Team. His approach to financial planning centers around a deep understanding of clients' goals and objectives, fostering long-term relationships built on trust and transparency.Nick is one of the professional Masterclass Faculty members of Physician Empowerment.__Contact Nick Giovannetti:LinkedInPhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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47 - Implementing AI in the Medical Practice

Play Episode Listen Later Jul 15, 2024 25:45

Dr. Kevin Mailo is joined by physician and entrepreneur Dr. Amjed (AJ) Kadhim-Saleh. AJ has a remarkable story to share because he is not only a family physician in Toronto who built his own clinic in his second year of residency, but an AI entrepreneur as well. He and his wife are the founders of Pippen, an AI technology specifically designed to ease the administrative notes burden of physicians. He tells Kevin all about how it works and why it will revolutionize physician lives.Dr. Kadhim-Saleh describes how building and managing his own clinic from the ground up was a big challenge that added an extra administrative burden to his days. He says that one of the largest unpaid administrative burdens is one that faces all physicians: taking patient notes. The extra time drain from that pushed him towards burnout. So he and his wife created an AI that works in the background of patient conversations, transcribes, and takes notes. It frees physicians from being stuck to a screen taking notes instead of facing patients and conversing and eases the burden. AJ describes the potential of AI for physicians to Kevin, explaining all the ways in which it is already making their lives easier and the ways it will be incorporated into practices and clinics in the future. –About Dr. AJ (Amjed) Kadhim-Saleh:AJ is a community family physician and clinic owner in Toronto. AJ has a deep understanding of the joys and pains of practicing family medicine, building an efficient practice, and creating workflows that work for family physicians. AJ developed Pippen [AI] so that family physicians could claim back their time, feel supported, and have a great day at work. AJ also wants to help physicians discover the wonder of AI, which is poised to revolutionize how physicians deliver care.__Dr. AJ (Amjed) Kadhim-Saleh:LinkedInWebsite: Pippen.aiPhysician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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46 - Journey to Financial Freedom

Play Episode Listen Later Jun 30, 2024 39:14

Physician Empowerment Masterclass Faculty Member Simon Wong joins Dr. Wing Lim for a conversation about financial freedom. Simon dissects how the interchangeable terms of financial freedom, financial independence, and financial security actually hold rather different meanings and how there are philosophical mindset factors that affect where people see themselves as finally achieving freedom or security. What are the quality of living goals, retirement goals, and wealth ambitions? Simon walks Wing through how all of these affect financial freedom. Dr. Wing Lim asks the question “When are we free?” which leads Simon to explain that financial freedom is almost impossible to 100% achieve because life will always contain risk. Even a passive income real estate portfolio carries the innate risk of rising interest rates or damage to a property due to fire. But Simon also points out that feeling 100% secure in whatever the projected “freedom” rate is for each individual isn't necessary because one can experience a sense of financial freedom at 70% certainty or 90% certainty. Simon and Wing discuss all the factors that affect financial freedom, how to think about it, what to set up to make it a future reality, and why a financial planner can assist in setting the right goalposts for hitting that freedom.–About Simon Wong:As an Integrated Wealth Planner, Simon's expertise lies in simplifying complex financial concepts into clear, actionable insights, forming the cornerstone of his Financial Plans. He specializes in navigating individuals and businesses through the intricate landscape of finance, utilizing his extensive knowledge and experience to foster their financial success and stability.Simon's academic and professional credentials, including an MBA in Accounting and a prestigious trio of designations - Certified Financial Planner, Chartered Investment Manager, and Chartered Life Underwriter - empower him to provide holistic and strategic financial advice. His career spans beyond traditional wealth planning, enriched by collaborations with elite asset management firms and a notable tenure at a leading accounting firm. __Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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45 - Connecting Through Our Vulnerability Transforming Our Personal and Financial Lives

Play Episode Listen Later Jun 15, 2024 21:57

Dr. Kevin Mailo and Dr. Wing Lim, co-hosts of Physician Empowerment, join together for this episode to talk about the recent Physician Empowerment Live Conference. They recount the success of the conference and attribute much of it to the vulnerability of the panellists and the willing feedback from the attendees. Addressing some of the topics broached, Kevin and Wing highlight lessons learned and stories shared that contributed to the atmosphere of positive connection. One of the things Wing revealed was that the conference was designed with the intent of the first day covering more ‘brainy' subjects and the second day reaching more into the heart of physicians. Attendees were pleasantly surprised by that revelation and equally enjoyed another highlight of the second day which featured a non-medical spousal panel. Topics like burnout, experiences being the spouse of a physician, wealth creation, leadership, and technology were all addressed at the conference by Masterclass leaders and students alike. Acknowledging the real heart-felt success of the conference, Wing and Kevin then moved on to announce the upcoming more relaxed destination conference weekend in Canmore. Physician Empowerment continues to grow through the inclusion and involvement of all members and through the success of events like these where attendees allow themselves to learn and share.__Physician Empowerment: Attend an upcoming Empowerment RetreatJoin the Physician Empowerment Masterclass nowWebsite: PhysEmpowerment.ca

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44 - Work Life Balance with Dr. Yatin Chadha

Play Episode Listen Later May 30, 2024 29:11

Dr. Kevin Mailo is joined by friend and ‘beyond MD' podcast host Dr. Yatin Chadha in a conversation about why the balance of personal fulfillment and wellness is so important to keep in alignment with both work and finance. Dr. Chadha continuously explores personal and professional growth in his own life and it's this experience that he draws on to illustrate how his mindset ensures the key relationships and goals in his life thrive alongside work. One of the first things Dr. Chadha addresses is the need to continue to find meaning in the work we do. He explains that he is continually asking himself what he can do to make his week better and answers that question by rotating focuses within his practice, pursuing additional education, honing a variety of skill sets, and finding the rewarding aspects of his daily tasks. Kevin and Yatin discuss the difficulty of focusing amidst today's constant bombardment of distractions, the difference between time spent and the quality of time in terms of productivity, and how to assess what your mind needs to be challenged in the future. Dr. Chadha will join the conference later in May to share even more of his inspiring insights and knowledge.–About Dr. Yatin Chadha:Dr. Yatin Chadha is a practising radiologist in Toronto. He's passionate about promoting financial literacy in the healthcare community as he believes exposure is lacking during training, leaving many unprepared as they transition to practice. This led him to create the beyond MD podcast. Outside of work and podcasting, Yatin is an avid golfer and proud father of 2 boys.__Resources discussed in this episode:beyond MD with Dr. Yatin Chadha podcast“Balance: How to Invest and Spend for Happiness, Health, and Wealth” by Andrew Hallam__Physician Empowerment: Join the Physician Empowerment Masterclass now

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43 - Key Skills as We Grow in Our Practice Lives with Dr. Dimitre Ranev

Play Episode Listen Later May 15, 2024 27:15

Dr. Kevin Mailo welcomes close friend Dr. Dimitre Ranev back to the podcast to share some practice lessons learned in the past months. Dimitre addresses the value of delegation to medical practice and for mental health. Physician Empowerment has touched on the topic of delegation before but Kevin believes hearing about a subject that is key to growth from different perspectives is a major factor in determining happiness. Delegation can be a challenge but both Dr. Mailo and Dr. Ranev believe it is incredibly valuable. Delegation, as defined, is the transferring of the responsibility of a task from oneself to somebody else. In studies of health professionals, doctors, and professionals in general, Dimitre found evidence of the advantages of delegating. What Dimitre and Kevin explore is how to delegate, which tasks to consider moving to somebody else, and vitally, who to delegate to. Building a trusted team is the path to being able to delegate with confidence. Having others contribute to getting tasks done increases available time and, by extension, revenue. But it also relieves stress, improves wellness, and allows a focus on the most valuable aspects of the work.–About Dr. Dimitre Ranev:Dr. Ranev is a duly qualified medical practitioner in the province of Ontario and Quebec. His primary practice is in Gatineau, Quebec. He currently specializes in sexual health, LGBTQ+ health, and fertility health. He also provides private consulting for Telus Health in preventative care. He has past experience with home and palliative care as well as Geriatric rehabilitation medicine at Gatineau Hospital. In Ontario, Dr. Ranev has past experience with home care, nursing home care, and student health. He has a special interest in Medical Education being the co-host for the Primary Medicine Podcast and holding a position of Faculty Lecturer at McGill University.__Interested in going further in your financial journey? Join our national conference and meet the PhE team live in Toronto this May 25 and 26th: https://www.physempowerment.ca/live __Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024Join the Physician Empowerment Masterclass now

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Bonus Episode - 2024 Federal Tax Budget & Changes - what you must know with Cherry Chan, CPA

Play Episode Listen Later May 14, 2024 35:27

Dr. Kevin Mailo introduces Cherry Chan, a renowned author and expert in real estate taxation, who discusses the implications of the 2024 federal budget alongside Dr. Wing Lim. They delve into how the budget targets the wealthy but inadvertently affects the middle class, particularly through the increase in capital gains inclusion rates. Their discussion explores how the changes penalize not just the ultra-rich but also ordinary Canadians who have invested in properties or stocks for long-term financial security.Cherry Chan and Dr. Wing Lim dissect the budget's effects on both unincorporated individuals and incorporated professionals. They explain how the changes disproportionately affect those who have incorporated their businesses to benefit from lower tax rates, as now, even the first dollar of capital gain within a corporation is subject to the elevated inclusion rate. This shift undermines the previous tax advantages of incorporation, significantly impacting investment strategies and financial planning for professionals like themselves. Cherry's insights help unpack the changes being instituted and how to approach them.–About Cherry Chan, CPA:As a real estate tax expert, Cherry provides specialized advice to a wide spectrum of clients in the real estate sector, from investors to agents, ensuring tailored solutions for their unique needs. Concurrently, at OTUS Group, she contributes to revolutionizing financial management for non-profits and associations, offering strategic oversight akin to a CFO's role. Cherry's dual involvement reflects a deep commitment to delivering expert financial guidance across diverse sectors.Cherry Chan on LinkedIn__Interested in going further in your financial journey? Join our national conference and meet the PhE team live in Toronto this May 25 and 26th: https://www.physempowerment.ca/live __Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024Join the Physician Empowerment Masterclass now

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42 - T4 vs T5: Battle of the Taxes

Play Episode Listen Later Apr 30, 2024 41:28

Physician Empowerment Masterclass Faculty Members Nick Giovannetti and Simon Wong, both Certified Financial Planners, join Dr. Wing Lim as he referees a battle royale between T4s (represented by Nick) and T5s (represented by Simon). What's best for incorporated professionals to pay themselves and why? What are the features of T4s and T5s? What do two financial planners advise? This episode will answer all these questions and prepare for more in-depth explorations in a future Masterclass. Accountants historically didn't offer choices between T4s and T5s but the wind is changing, and now there are different champions for each camp. Nick Giovannetti explains Canada Pension Plan benefits that come with a T4 while Simon explores the potential to do better investing on their own, as made possible by a T5. Nick and Simon debate the benefits, challenges, expenses, and lower personal tax rates between the T4 and T5, showcasing both pros and cons from a financial and accounting perspective. This episode seeks to break down in simple terms who would be best served by a T4 versus who would do better with a T5 and why there is such a split between accountants. The information here is expansive, solid, and based on extensive mutual experience. Don't miss this episode or the Masterclasses each Faculty Member contributes to in the future.–About Nick Giovannetti:Nick is a Certified Financial Planner® with a fully Integrated Wealth Planning Team. His approach to financial planning centers around a deep understanding of clients' goals and objectives, fostering long-term relationships built on trust and transparency.About Simon Wong:As an Integrated Wealth Planner, Simon's expertise lies in simplifying complex financial concepts into clear, actionable insights, forming the cornerstone of his Financial Plans. He specializes in navigating individuals and businesses through the intricate landscape of finance, utilizing his extensive knowledge and experience to foster their financial success and stability.Simon's academic and professional credentials, including an MBA in Accounting and a prestigious trio of designations - Certified Financial Planner, Chartered Investment Manager, and Chartered Life Underwriter - empower him to provide holistic and strategic financial advice. His career spans beyond traditional wealth planning, enriched by collaborations with elite asset management firms and a notable tenure at a leading accounting firm. __Interested in going further in your financial journey? Join our national conference and meet the PhE team live in Toronto this May 25 and 26th: https://www.physempowerment.ca/live __Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024Join the Physician Empowerment Masterclass now

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41 - Staying inspired through community and shared experience

Play Episode Listen Later Apr 15, 2024 26:59

Physician Empowerment co-founders Dr. Kevin Mailo and Dr. Wing Lim address why the events and masterclasses they hold are key to the foundations of Physician Empowerment overall. The promotion of wellness, health, and transformation in all areas of a physician's life - mental, financial, leadership, practice - is the impetus behind everything they do. This translates into how they approach events and the focus of masterclasses. As Wing Lim reminds listeners in this episode, Physician Empowerment was created to form a community and network for peer-to-peer empowerment. He reiterates the four foundational pillars of its existence: 1. Physician wellness, 2. Financial health, 3. Leadership development, and 4. Practice transformation. Those pillars factor into how they present learning in a conversational and community-friendly way. Kevin Mailo stresses that it isn't just about being better in the future but having that better life now. Wing and Kevin address what they've learned from mentors, what they hope to impart to the community, how the masterclasses are designed not just to impart facts but shape a different way of thinking, and their hopes that everyone can share their journeys together.__Interested in going further in your financial journey? Join our national conference and meet the PhE team live in Toronto this May 25 and 26th: https://www.physempowerment.ca/live __Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024Join the Physician Empowerment Masterclass now

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40 - Capital Gains in Real Estate Investments with Jason Pisesky

Play Episode Listen Later Mar 30, 2024 44:17

Physician Empowerment Masterclass Faculty Member and tax lawyer Jason Pisesky returns to the show to talk with Dr. Wing Lim about capital gains in real estate investments. Jason and Wing explore everything to do with real estate from tax to property depreciation and personal versus corporate real estate purchases.Jason addresses how the Income Tax Act applies to real estate and the nuances involved with the PRE or Personal Residence Exemption. He explains some of the insights that apply to buying and flipping houses, up markets and down markets, and depreciable capital property. Personal versus corporate purchases, income versus capital gain, and active versus passive axis are discussed in broad terms, enough to give a clearer understanding of what Jason will be addressing in greater detail in future episodes and at the Physician Empowerment Live Conference in Toronto in May. The knowledge Jason shares is foundational and directly applicable to anyone with an investment mindset.–About Jason Pisesky:Jason is a tax lawyer with an international accounting firm, KPMG. His practice background is extensive and includes personal and corporate tax planning as well as litigation and dispute resolution. Whether you are scaling up your practice or winding it down, proper coordination between a tax lawyer and your accountant can ensure you're doing it right.Jason is one of Physician Empowerment's professional Masterclass Faculty members.__ Interested in going further in your financial journey? Join our national conference and meet the PhE team live in Toronto this May 25 and 26th: https://www.physempowerment.ca/live __Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024Join the Physician Empowerment Masterclass now

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39 - You as the Most Important Investment with Dr. Michelle Jackman

Play Episode Listen Later Mar 15, 2024 30:53

Dr. Kevin Mailo welcomes physician coach, Physician Empowerment masterclass student, and 2024 Physician Empowerment conference speaker Dr. Michelle Jackman to the show today. Physician Empowerment not only focuses on financial health but on the mental and emotional health of physicians as well. Dr. Jackman's coaching aims at that need for emotional well-being and improves the mental health of physicians throughout their careers.Dr. Michelle Jackman came to physician coaching during Covid, by asking questions about her own career path and satisfaction. She worked with Dr. April Elliott, an executive coach, and Dr. Nadeem Lalani, a physician coach, and the self-awareness she gained guided her into leaving the career path that wasn't satisfying her and into coaching instead. She describes coaching as allowing us to prioritize ourselves and allowing us to make a commitment to ourselves and not just to our jobs and demands.Dr. Mailo and Dr. Jackman discuss all aspects of physician coaching from acknowledging strengths and learning from accomplishments to evidence-based neuroscience and how our brains can be rewired to change our thought patterns. Michelle offers small group and one-on-one coaching and she describes the benefits of both to Kevin. She affirms that asking for help is not a sign of weakness but of strength and encourages physicians to seek out coaching if they need support.Dr. Michelle Jackman will be at the Physician Empowerment Live conference in Toronto on May 25 and 26. –About Dr. Michelle Jackman | physician coach, PhE masterclass student, 2024 PhE conference speaker:Dr. Michelle Jackman is a practicing pediatrician, born and raised in Ontario. She grew up in the City of Kawartha Lakes and is a University of Toronto Alumni OT1. She completed three years of surgical residency at Queen's University in Kingston and earned her FRCPC in pediatrics in 2008. Dr. Jackman has been clinical lead at the Pediatric Centre for Wellness & Health at Alberta Children's Hospital since it was established in 2012. Her clinical passion focuses on supporting children and youth at risk for obesity through this multi-disciplinary program. Her clinical expertise is in supporting children and youth with mental health and metabolic and mechanical co-morbidities of obesity to achieve their best health. She recently completed her executive coaching certification and coaching mastery program through Erickson International and is passionate about bringing coaching into the medical field to help her colleagues navigate challenges, excel in their professions and increase their fulfillment in all aspects of their lives.Michelle lives in Calgary with her husband and daughter. She enjoys making her daughter laugh and being out in nature and mountains on bikes, skis and horses.__Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024*Early Bird pricing ends March 15*Join the Physician Empowerment Masterclass now

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38 - The Transformative Power of Coaching with Dr. Angie Hong

Play Episode Listen Later Feb 28, 2024 28:50

Dr. Kevin Mailo welcomes Toronto-based family physician and obesity medicine practitioner Dr. Angie Hong to the podcast. Dr. Hong has been involved in coaching for a few years now and joins Dr. Mailo to talk about the differences between coaching, mentoring and therapy and the specific value of coaching. Dr. Angie Hong stumbled into coaching when she accidentally joined the wrong course at the University of Toronto and found herself in Solution Focused Coaching instead of Solution Focused Therapy. She stayed in the course and “fell in love with coaching”. Angie describes the enjoyment she gets out of helping a client reach a goal that sometimes isn't even their original goal but something born out of self-discovery. Dr. Mailo and Dr. Hong discuss how physicians specifically find Angie and the challenges that drive them to seek guidance. Angie describes the feelings of emotional burnout and exhaustion that coaching can be effective in assisting and preventing. The journey of a physician drives towards burnout in many cases and Angie believes that engaging with coaching earlier, in medical school even, can help combat the issues that compound later. Dr. Angie Hong will be at the Physician Empowerment Live conference in Toronto on May 25 and 26. –About Dr. Angie Hong:Dr. Hong has been a family doctor for over 20 years and has focused on metabolic health and disease for almost a decade. She is a fellow of the CCFP and a diplomate of the American Board of Obesity Medicine, one of the first family doctors in Ontario to earn this credential.Dr. Hong is also an International Coaching Federation Coach, a body recognized globally as the gold standard of professional coaching. In addition, she is a graduate of the University of Toronto Brief Coaching program and was mentored by world-renowned researcher and coach Dr. Haesun Moon.For the past seven years, Dr. Hong has had the privilege of teaching coaches and healthcare providers throughout North America at various schools and organizations, including Obesity Canada, CBT Canada, the University of Alberta, and the University of Toronto, among others.Dr. Hong lives in Toronto with her husband, three teenage daughters, and her dog Hugo. Her downtime is spent with family and friends and laughing at dog memes. However, she can usually be found taking another course to increase her skills and knowledge.Dr. Hong's passion for lifelong learning is driven by her commitment to providing the highest level of care and service to her patients and clients.Learn more about Dr. Hong's services and contact her via her website at AngieHongMD.com__Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024*Early Bird pricing ends March 15*Join the Physician Empowerment Masterclass now

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37 - Tax Benefits of Family Trusts, with Masterclass Faculty Member Jason Pisesky

Play Episode Listen Later Feb 15, 2024 36:33

Dr. Wing Lim welcomes Physician Empowerment Masterclass Faculty Member and tax lawyer Jason Pisesky back to the show. Jason talks all about trusts from a tax perspective. He explains not only the history of how trusts came to be but also how they are defined today and how they work, offering knowledgeable insights into the complex topic.Jason explores the tax and non-tax benefits of family trusts, detailing the tax advantage of the multiplication of the capital gains deduction. He also explains the lifespan of a trust, the beneficiaries, how income splitting factors into a trust, and how family trusts are useful in facilitating the movement of assets from one company to another in a tax-deferred way. The topic of family trusts is a dense and layered one but the information Jason provides here works as a good base of knowledge. This information can then be further explored in a Masterclass.–About Jason Pisesky:Jason is a tax lawyer with an international accounting firm, KPMG. His practice background is extensive and includes personal and corporate tax planning as well as litigation and dispute resolution. Whether you are scaling up your practice or winding it down, proper coordination between a tax lawyer and your accountant can ensure you're doing it right.Jason is one of Physician Empowerment's professional Masterclass Faculty members.__Physician Empowerment: Register for the Physician Empowerment Live Conference in Toronto on May 25 - 26, 2024*Early Bird pricing ends March 15*Join the Physician Empowerment Masterclass now

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36 - Individual Pension Plans with Nick Giovannetti

Play Episode Listen Later Jan 30, 2024 42:18

Dr. Wing Lim hosts Physician Empowerment Masterclass Faculty Member and Certified Financial Planner Nick Giovannetti on the show today. Wing and Nick talk about Individual Pension Plans, or IPPs, breaking down how they work, who qualifies, and what sorts of benefits they provide for physicians. Nick has a wealth of knowledge about CPPs, RRSPs, and IPPs that he shares in this episode.Nick Giovannetti explains that IPPs are not a new financial tool, they've been around for over thirty years in Canada. But RRSPs have been around longer and are less complicated than IPPs to administer. There are more complex forms and filings to fill out for the CRA where IPPs are concerned and Nick says the lack of awareness about IPPs and the fear associated with the complexity prevents some accountants and planners from informing their clients about the IPP benefits. So Wing and Nick dive into exactly what an IPP is and how you can best benefit from it. They cover everything from contribution limits and family member beneficiaries to buyback and defined contribution versus defined benefit pension plans. This episode gives an overview of why Individual Pension Plans are worth exploring.–About Nick Giovannetti:Nick is a Certified Financial Planner® with a fully Integrated Wealth Planning Team. His approach to financial planning centers around a deep understanding of clients' goals and objectives, fostering long-term relationships built on trust and transparency.Nick is one of Physician Empowerment's professional Masterclass Faculty members.__Resources mentioned in this episode: “Kentucky Fried Pensions” by Christopher B Tobe and Kenneth C Tobe--Physician Empowerment: Physician Empowerment MasterclassLive Conference 2024--TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Doctor Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know! We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programing both in person and online so look us up. But regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:35] Hi everyone, so glad to have you out tonight for another webinar featuring the topic of IPPs, Individualized Pension Plans, which were in fact established by the federal government back in the 90s. They were not very well known until last 5 or 10 years when they've started to take off. But there are a lot of ins and outs to using these properly, and they have certain advantages over RRSPs that incorporated professionals really need to be taking a close look at. So to go on this deep dive, well, I shouldn't say it's that deep a dive, the deep dive is going to come with the masterclass. So if anybody's interested in that, do reach out to me and we'd be happy to talk further about having you join the masterclass, because this topic is dense. So Wing is going to take us through it tonight, and he's going to do it with one of our masterclass faculty, Nick Giovannetti. And Nick is an Integrated Wealth Planning Specialist, holds a lot of designations, and he and our other masterclass faculty member, Simon Wong, have done a ton of outstanding teaching on topics like this. Because you want to know what it is you're you're using when it comes to wealth creation and advanced tax planning. That's where these topics are so, so powerful to cover, like we're going to do. So again, if you have questions, you're interested, reach out to us. But let me take it from there, Wing, and hand it off to you. If you want to go ahead and introduce Nick to everybody. Dr. Wing Lim: [00:02:08] Sure. So good to see everybody and hear everybody's voices later. And yeah, this is very exciting episode in December this year. And we thought we'll wrap up the year by something that is really important. And that's about the RRSP, IPP, and the pension world. And like we said in the intro on social media, we're going to unpack this mystery box. So our guest today for our fireside chat is Nick. And Nick has a lot of designations. And he's actually also a multi-talented Renaissance man, I guess, he was previously an international recording artist. You might want to explore that on the different dimension of him. And we just talked about one of his designation is about cash flow personalities. Right? And we'll probably do an episode on that, definitely will be a lot of fun. But today we're going to talk about this project, sorry, this platform. There's RRSP that everybody probably heard about and some people do RRSP, some people don't believe in RRSP. Right. But then there's IPP pension world. So Nick, maybe you should walk us through, when we talk about this, you said you got to bring in CPP too, so may as well bring in CPP, RRSP, IPP. So walk us through a little bit of a history lesson and how it's pertaining to incorporated professionals. Nick Giovannetti: [00:03:33] For sure, yeah, thanks for having me, everyone. Like Kevin had mentioned, you know, the Individual Pension Plan, it's not a new financial tool. It's actually been around for over 30 years here in Canada. And as we know, the RRSP or the Registered Retirement Savings Plan has has been around even longer than that. It's been around since the 50s, and it was actually something introduced by the Canadian Medical Association because physicians even back then, yeah, physicians even back then were saying-- Dr. Wing Lim: [00:04:02] -- one for us-- Nick Giovannetti: [00:04:04] -- hey, we need a retirement vehicle. We need something tax sheltered. They'd done a lot of research back then, and to them it made sense to say, hey, where can I put money now, get some tax relief today, invest and grow that pot of money in a tax sheltered environment? And then I can strategically, you know, pull it out in the future and give myself predictable and secure income, something that I can count on in the future. So that's really what happened in the early 90s, was that small/medium business owners, they wanted pension plans. You know, a lot of people look at especially medical professionals around the hospital, how many of your coworkers and colleagues in the hospital have pension plans? And that's something that I think a lot of physicians look at and say, what if I could have that? What if I could even just contact the Healthcare of Ontario or OMERS or Teachers Pension and say, hey, can I just contribute to this? Can I become a plan member? And then I can also have a defined benefit pension in the future. Nick Giovannetti: [00:05:07] So physicians are not alone. Business owners have been wanting that, self-employed people have been wanting that. So in the early 90s, the first ever one of one, so one person to one company pension plan was allowed by the Income Tax Act. And it's called an Individual Pension Plan. So you could be one business owner, have one pension plan, and you're the only plan member, but you can take advantage of all of the rules that all the other pension plans in Canada follow. So everything that everyone is very fond of, federal government workers, teachers, firefighters, police, you can benefit from those same retirement savings rules. So from contribution limits to tax deductions to predictable guaranteed income in the future, you can create your own. And it's been around a long time. So if you're a physician that is incorporated, you should really look at this as part of your overall planning. Dr. Wing Lim: [00:06:05] So how does it compare to RRSP that everybody knows? Nick Giovannetti: [00:06:09] So there's a few key takeaways or few key differences and one would be that the RRSP happens on a personal level, and the Individual Pension Plan happens on a corporate level. So what I mean by that is if you want to participate in an RRSP, you're going to have to pull money out of your corporation, pay some tax, and then you're going to have to then contribute to an RRSP with your after tax personal income, and then hopefully get a tax refund on the personal side. Now the RRSP is also limited to a certain amount of contribution room, so I'll touch on that in a second. The Individual Pension Plan side, it works a little bit differently. So you can actually earn money to your corporation and if you have a pension plan, the corporation can right away save that money into a pension before any tax has ever happened on those dollars. Okay, so that's one of the big key advantages. So then the second one I touched on was contribution room. So Registered Retirement Savings Plans are capped to 18% of your salary that you pay yourself or bonus, so it's got to be salary or bonus, on the personal level, defined benefit pension plans can get as high as 30% of salary, which is a big difference. We get into, you know, a difference of 30 grand a year to 50 grand a year when it comes to maximum savings room. And on the pension side, because the government really treats pension plans favorably, you have a lot of additional ways you can put money in a pension plan. So I'll touch on a few of those. Nick Giovannetti: [00:07:46] First one is, the government cares about what the rate of return in an Individual Pension Plan is, and what they want to see is a minimum 7.5% rate of return and a maximum ceiling of it's about 9.375. They want to see pension plans grow in that window, averaging every three years. And if your pension is not growing at that rate, you're actually allowed to put in more money. When we look at the RRSP, nobody cares if your RRSP grows at 7.5%. You care, but the Government of Canada is not going to let you put more money in if your investments are not performing well enough. So you got a fail safe there. And you can also do strategies like dry powder hedging, where you purposely underperform your investments so that you can put in more money. So there's some unique strategies there. I would say another one is, defined benefit pension plans your income is based on a formula. So you know, very predictably, what are you going to have as an income stream in retirement, whereas your RRSP, it's totally up to you how you want to pull the money out. Some people pull out a lot quickly, some people don't pull out enough, some people just do the minimum that the government wants to see you pull out. So there's a lot of room for error on the RRSP side, where the Individual Pension Plan can be more predictable and easier to plan around because it's been created for you by a formula. Now there's a few different, Wing, that we could dive into. But I'll punt it back to you and we'll see where we go. Dr. Wing Lim: [00:09:28] So I guess it's a good time to talk about these formulas. Who writes these formulas? Who dictates these formulas? Nick Giovannetti: [00:09:36] It's a great question. So it's a legal framework that goes back to when the first Income Tax Act was created. Your pension plan could be structured in a way so that you're going to have, you know, a flat benefit. So it might be I paid myself this much salary, I worked for my company this many years, I'm this certain age, so I get a flat benefit based on a formula of a couple factors like that. There's also another factor which could be career average earnings. So it doesn't matter if you paid yourself lower salary in the beginning and then you upped it later on, you know your pension could be calculated on an average. You could also do it so that it's a final or best average earnings. Or a percentage of contributions. So these formulas, when you set up and register your Individual Pension Plan, the CRA actually has a registration form. And on the form you're going to check off these boxes of how do you want that formula to be identified. And it's in the Income Tax Act as to how that calculation will be made. Dr. Wing Lim: [00:10:41] Right. So this is way more complicated than RRSP. Right? So maybe we could just maybe help, maybe I will use a layman's way to bring everybody on the same page. So basically if you work for a big firm you have a nice pension plan. Right? And the employer and the employee are different people. But now with this IPP platform, they allow professionals or business owners to actually be the same person, that the employer/employee is the same entity, well same person, right, different entities. But to ensure that the benefactor of the pension plan gets so much dollar sometimes guaranteed and so that's why they have these elaborate formula. Right? But then who is funding it, well in our case it's the PC. So if you come to our masterclass, the whole series is called Fat PC Skinny, right? So you want to have a fat PC but you want a skinny me, but not a starving me, right? So you definitely want the money to come out, especially in the golden years, right? That you've done your hard work. And so you want the pension to come. And now is a way to efficiently fund this piggy bank called IPP. Right? And so that's why there's a lot more calculation than RRSP. So let's look at, yeah there's some difference. What about some similarity? At age, what, 71 both plans have to kind of be put an end to it. Can you elaborate on that, Nick? Nick Giovannetti: [00:12:11] For sure, yeah. So the similarity there is that the government of Canada, so the Income Tax Act wants you to have to start pulling money out of either an RRSP or your pension plan by age 71. You can, in an RRSP, decide to pull it out earlier, and you can do so with a pension plan as well. Some pensioners I've seen start an IPP and actually turn on their pension income as early as their mid 40s. So you have a lot of flexibility there as to when you want to start drawing the money out of these accounts. But traditional retirement age in Canada is 65, and you can delay that to 71 if you want to push it off as far as possible. Dr. Wing Lim: [00:12:55] So with IPP, you still have to do the like the RIFF and all that, right? Like there's to pull the money out there's no difference whether you have RRSP, IPP. Is there a difference the way that you pull the money out past 71? Nick Giovannetti: [00:13:07] Yeah, that's a great question. So with an RRSP it gets converted to, you mentioned it, it's called a RIFF. It turns into a Registered Retirement Income Fund. And the government will have a calculation as to how much you have to pull out each year as you age. And you're going to be doing that through wherever it is, your money managers, your trading, what have you. You have to pull out that minimum, but you could ultimately pull out whatever you want. With an Individual Pension Plan, you actually have three different options to how you want to pull the money out. So the first option is whoever's managing your Individual Pension Plan, you're going to just instruct them and sign the form that I'm retiring from my corporation and they will ask you, how do you want to pull out the money? Do you want monthly installments based on your defined benefit formula, or do you want a one year, once a year, lump sum, boom here's my payment? So that's the first way you could. So the money manager continues managing your money. Same with a RIFF and you're just getting your distributions. Okay? The second way, if you don't want any market risk, you can actually take your defined benefit pension that you save for yourself and you could go to a life insurance company and you could actually buy something called a copycat annuity. Nick Giovannetti: [00:14:24] So these are available even now for teachers, firefighters, police officers, doesn't matter. If you have a defined benefit pension, you can go to an insurance company and buy something called a copycat annuity. Now the word copycat means whatever your income you are guaranteed to have, so the distribution let's just say it was 200 grand a year of pension income, the annuity will guarantee you that paycheck every year for a certain chunk of whatever your investments were in that defined benefit plan. And then depending on interest rates and annuity rates, you might actually have a little extra so you'll get paid a bit of cash and you'll have this guaranteed income the rest of your life. Now, the third way is you could shut your Individual Pension Plan down entirely and go right back to RRSPs. So we call that a wind up. So you could shut it all down back to RRSPs or into a RIFF, and you're going to have a certain amount of your pension that's allowed to transfer. So it's a tax free transfer back to the old way. But generally speaking, you will have a chunk of money that is extra that can't transfer back to an RRSP. So you'd have to take that as an income the year you decided to do a wind up. But you actually have three different ways that you could collect. Dr. Wing Lim: [00:15:47] Right. Okay. So you got more choices, more diversity, right? More versatility. That's great. Let's talk about defined benefit versus defined contribution: DB versus DC. Because as physicians we haven't heard a lot about it, we just know that most people nowadays have a defined contribution plan meaning that the company would match you. Right.? Some of you may, listeners, may be working for a big hospital. You might be in a pension plan already. So defined contribution meaning that they define how much you contribute. They did not define how much you get, which is the benefit. And way back, there's every plan is a DB plan and now who's left with these juicy DB plans indexed with inflation? Well, our Premier, our Prime Minister, a lot of politicians do, but most corporate owners they only define a contribution not define benefit. So let's talk about DB and DC in the IPP world. Nick Giovannetti: [00:16:46] For sure, yeah. So a defined contribution pension, I think you already touched on it, Wing, the only thing defined is the amount you can contribute. And it's actually the same contribution amount to that of an RRSP which is 18% of your salary up to the maximum allowable each year. So you can put in 18% of your salary. And then when you retire, it generally just turns into a RIFF. So same as RRSPs, right? So you're going to have the choice of taking out the minimum that RIFF allows or as much as you want, but whatever you pull out of that is going to be taxable income when you pull it out. So there's nothing really more predictable about a defined contribution pension than that of an RRSP. It's just that defined contribution pensions you can contribute through your corporation, whereas an RRSP you contribute personally. Now defined benefit pension, what's defined is your benefit, the predictable guaranteed income that you're going to receive for the rest of your life. And Wing touched on it, it could be indexed to inflation, meaning that if the cost of living goes up 3%, then your pension distributions next year will go up 3%, right? That just happened with Canada Pension Plan. Everybody got a 6.5% bump to their income because inflation changed in Canada. It was a big bump to the cost of living. So everybody collecting those defined benefit Canada pension plan cheques got a nice bump. So defined benefits are formula based on what you're going to receive in the future. Defined contributions are really a corporate version of an RRSP. Dr. Wing Lim: [00:18:30] I guess some people have a fear that if they're stuck in a DB thing, that they, if they don't have a good year, they can't contribute. Right? But you say that it's just like the RRSP, right? And if there's a year, let's say you fallen sick or you had a bad year, you took a sabbatical, and you cannot contribute that much into the IPP, would it collapse? Nick Giovannetti: [00:18:52] That's a really great question. So it was, I believe it was the end of 2020 where if you're a connected person to your IPP, meaning I own 10% or more of the shares of the company that is sponsoring the IPP, so in most cases for a physician, it'll be your MPC sponsoring the company, you own all the shares, or hopefully you own at least more than 10%. You're what's called a connected person. You don't actually have to contribute to your IPP at all because you're a connected person to that pension. You own majority share of the company sponsoring it, or at least 10% of it. Your family members are also connected. So if you added a spouse or children, you don't have to contribute for them either. So a lot of the fear, Wing, of having to contribute to an IPP to top it up or boost it up, if you go on sabbatical you're behind, maybe you don't have the cash flow that year, a lot of those fears are now gone. If you were to have an IPP set up and you didn't own the company and somebody set that up for you, they would be liable to fund it the same way that if you worked for the hospital, teacher, firefighter, whatever, they have to top it up, right, General Motors, big union companies, they have to top up their pensions. So you have some flexibility as the owner. Dr. Wing Lim: [00:20:08] Right. And for the years that you didn't contribute full amount, then there is buyback or catch up. Right? There's this feature? Nick Giovannetti: [00:20:16] There is, yeah. So even if you've been incorporated let's say for 15 years and you've never had an IPP and you decide to open an IPP right now, they can do a calculation and they look at pension adjustments, your RRSP room, your your current RRSP balance, how much you paid yourself in the past and they can go back in time and say, okay, Doctor Lim, you have a catch up of 300,000 just for setting up a pension and never paying yourself salary again, but you just have, you still currently have 300 grand of room. And then you could pay yourself a salary that year, have a percentage of salary and carry forward. So you do have the ability to buy back, but it will be offset if you took care of some, if you were contributing to RRSPs. because they're going to do a pension adjustment to offset what did you put in RRSPs? What were your unused room? How well did the RRSP perform? And then that will work into the calculation of the buyback. Dr. Wing Lim: [00:21:17] So if you have had an RRSP and you're contemplating starting IPP, so what happens to the RRSP once you start the IPP? Nick Giovannetti: [00:21:25] So if you want to participate in the buyback, then they're going to use your RRSP balance as part of the calculation. And what will happen is, high level example, when you have 500 grand to buy back but based on the pension adjustment calculation, you have to take 250 grand from your RRSP, and it's called a qualifying transfer, it's tax free, you have to move 250 grand from your RRSP over to your pension, and then it would allow you 250 grand room to contribute. The rest of your RRSP, whatever's over and above that minimum transfer, you could leave it external, leave it as an RRSP, or you could bring it into your pension under a secondary account known as an additional voluntary contribution account. Dr. Wing Lim: [00:22:15] Right. So there's a lot of flexibility. And then there are certain age related benefits, right? With the room, contribution room versus RRSP. So when does the gap start to widen big enough to be meaningful? Nick Giovannetti: [00:22:30] Yeah. So, defined benefit pension plans, the formula of the matching of the salary is about 12.5% of your salary when you're 18 years old for a defined benefit plan. And RRSPs are 18%, and defined contribution plans are 18%. But by the time you're 38, the defined benefit matching curve has caught up to the 18% already. It's a little over 18% by the time you're 38. And then from the age of 38 all the way to 71, it gets as high as almost 30% of salary. So really, you'll see a lot of people heavily look at Individual Pension Plans if they're going to do the defined benefit schedule. A lot of people will heavily look at it when they reach 40. Dr. Wing Lim: [00:23:18] Right? So 40 is kind of the turning point. Nick Giovannetti: [00:23:21] The turning point for most, unless they have one of the combination registrations, so their pension has both types. You can have it where you have both types, a defined contribution and defined benefit. So if you registered it that way, a lot of those professionals will just start whenever they start, because you don't lose contribution room and you can just convert it over whenever it makes sense. Dr. Wing Lim: [00:23:43] Right. So you talk about a lot of these calculations that have to be done right. And if it is not, I heard that there's very stiff penalty from CRA. Right? And so who does all this, all these calculations? Nick Giovannetti: [00:23:59] Yeah. So when you have a pension plan it's really important to have a good team. So as part of that team you need actuaries. There's got to be an actuary or a team of actuaries that's calculating all the math behind these complex pension calculations. And there's a lot of them out there, lots of different companies doing that. So it's important that's kind of step one. You could go a step further and make sure on that team you have pension lawyers. And it's good to have pension lawyers because they can also help with a lot more of the compliance factor of your pension plan, because you will be registering it with CRA as Doctor Wing Lim pension plan, registered pension plan. So it's important to have a team that is familiar with pensions, they're able to help you manage the non-investment related factors, and then you'll have an investment team that takes care of the money. And hopefully you have an accountant and a planner that help you with the distribution and the planning side. Dr. Wing Lim: [00:24:56] So the beneficiary of these plans, so it could be me, the doctor, the spouse. What about kids? Nick Giovannetti: [00:25:02] Yeah. So you you can, you can absolutely name your children as beneficiaries, and you can even add children to an Individual Pension Plan if they work at all or have any level of employment with your corporation. Dr. Wing Lim: [00:25:17] So if they're employed, not a dividend, not T5, but they have to be T4 as well, right? Nick Giovannetti: [00:25:23] That's right, yeah. Dr. Wing Lim: [00:25:24] Right. Then they could be part of the IPP itself. But for the beneficiary let's say after you turn 71, right, you want to take money out. So kids probably well grown up by then, so they don't, do they have to be employed by to get the benefit, they don't have to be, right? Nick Giovannetti: [00:25:40] So if they, if you wanted to make them a beneficiary so if you passed away where would all these assets go, no, they don't have to work for your company to be a beneficiary. But if they wanted to be a plan member because you're looking for some different intergenerational wealth benefits, then at some point they would have to have an employee relationship with your company. I've seen the employment income as low as $3,500. I've seen some people hire their kids to do admin and social media work. Maybe they pay them 10, 15 grand for that. Whatever you do, they just have to be paid at least minimum wage for whatever job it is that they're doing. And they could be added with just one year of service. Dr. Wing Lim: [00:26:23] One year of service. And this applies not just to kids, but to the spouse as well. Right? Nick Giovannetti: [00:26:28] 100%. Yeah. So a lot of professionals and business owners will find work for their spouse to do, and then they can add their spouse to their pension plan, and the company can contribute to that spouse's pension plan. Right? Because most likely a pension plan contribution room will be quite a bit higher than that of an RRSP. Dr. Wing Lim: [00:26:49] Right. Yeah. And so this, we talked about TOSI in other episodes. Right? Test on, Tax On Split Income. So it's pretty harsh, but IPP is just one really smart, astute and legal way that you can do the income splitting, especially in the latter days, when you're drawing money out. Nick Giovannetti: [00:27:06] Exactly. Yeah. It's a very black and white way to get money into your spouse's hands by paying them legitimate T4 income, so salary or bonus, and saving for their retirement. And in the future you mentioned pension plans you can do income splitting on the income that comes out of it. So these are very CRA-approved registered pension plans that there's a lot of peace of mind knowing that that part of your strategy is ironclad. Dr. Wing Lim: [00:27:37] Right. And so who are not eligible for IPPs? Nick Giovannetti: [00:27:41] So those that wouldn't be eligible are those that are paying themselves out of their corporation dividends or capital gains. So if you're doing pipelining, capital gains stripping, and that's your only source of income out of the company, or non-eligible dividend, then those would not qualify for pension contributions. Dr. Wing Lim: [00:28:02] So if you have done T5 all along, right, and then you have never given yourself T4, then there is no room. Is that true? Nick Giovannetti: [00:28:10] So that means you won't have any buyback room. That's correct. Now you could change today. So you could say, because pensions are based on current year, RRSP contributions are based on previous year income, so you could decide in the year I'm going to pay myself salary this year and open a pension that year and participate in the pension that year. Dr. Wing Lim: [00:28:31] What about if you're not incorporated? If you don't have a PC, you're sole proprietor. Can you do IPP? Nick Giovannetti: [00:28:37] No. So you do need to have a corporation. Now another corporation could do an IPP for you. So if you worked for another clinic and they were employing you, they could register one for you, but you would now be a non-connected person. So they would have to fund that pension plan. And a lot of employers wouldn't do that because of the risk. Dr. Wing Lim: [00:28:58] Right. Yeah. I want to point this out because there are always exceptions to the rule. Right? And so that's what because some of our listeners, they, the first five years of practice, they haven't even incorporated yet, or they say the accountants told them there's really no reason if you spend it all, then you don't need a PC. And I have a colleague, 30 years after they started the practice, the accountant still says no need for PCs, and all these benefits, these powerful strategies, don't apply to them. Right? Or my personal story, my accountant way back said, no, don't believe in T4, only give yourself T5. So the first 20 years of my practice I only got T5, zero T4. So by the time I knew about IPP, my buyback is really small amount, right? And I wish I knew, right, I wish I knew earlier. And so that's why for people who are in the early or mid part of your career, this is something to plan. Nick Giovannetti: [00:29:52] Yeah. And I've heard all kinds of stories. And you bring up a good point because your accountant didn't only talk you out of being able to participate in your own IPP, but your accountant also doing what they did for you there, they talked you out of participating in Canada Pension Plan, because when you make the decision not to pay T4 income to open an IPP or an RRSP, you're also shutting yourself down from getting any Canada Pension Plan. Dr. Wing Lim: [00:30:20] Now this is really interesting because a lot of accounting accountants of my vintage, right, 30 years ago, but even newer ones I'm shocked to hear as they now you invest better than CPP. Do you want to make a comment on CPP? Nick Giovannetti: [00:30:36] Yeah, I mean, I've heard all kinds of very competent investors think that they can outperform Canada Pension Plan. Um, Canada Pension Plan is probably one of the best run pension plans in the entire world. And in order for you to compete with that, we could dive into that maybe in the masterclass or in another session, but if we wanted to calculate what you would have to earn, consistently guaranteed every year from now all the way till you pass away, to be able to recreate what Canada Pension Plan created for 6 to 7 grand a year worth of savings, it would be a very, very difficult thing for anybody to do, even an astute investor. Dr. Wing Lim: [00:31:19] Right. So CPP is a good thing. Right? And so when you offer RRSP and IPP, you also offer CPP right? Nick Giovannetti: [00:31:26] You do by default, you get two pensions. Dr. Wing Lim: [00:31:28] Yeah. Now, so then let's go back further about this accountant thing. And I'm not trying to belittle or badmouth any accountants. But a lot of accountants and advisors are so against IPP or so ignorant about IPP. Why is that? Nick Giovannetti: [00:31:46] That's such a great question. And from what I've come across, a lot of it is lack of awareness and fear. Or they're looking for something easy because it's easier for an accountant to pay a dividend. Right? There's a little more work involved if you pay T4 and you got to remit tax at source, they got to make sure they account for Canada Pension Plan, they got to do your pension adjustments, like there's reasons why it simplifies their life. And I've actually heard an accountant one time say to a physician, I was on this joint call, I don't mind paying you salary but I'm going to have to download all that work to you, Mr. and Mrs. Physician. It was the most unbelievable comment I'd ever heard. And sure enough, they asked me after the call, can you help introduce me to an accountant that would do this work for me? So it's not that big of a deal. A lot of it is very simplified. They do it for a lot of other business owners, because a lot of other business owners do have IPPs, so they have to do the salary. Dr. Wing Lim: [00:32:48] I'm just saying that this is a few years ago, 2020 before Covid, right? I read some stats that of all the eligible people in Canada for IPP, which is like millions, only 2% were implemented, right? The market penetration is like 2%. That's abhorring right? Nick Giovannetti: [00:33:08] Yeah. And again, a lot of that is it's lack of awareness and fear. So I've seen, I've seen what kind of benefit an accountant that is forward thinking and stays on the top of their game with pension plans, how well their clients have done and they stand out from the rest. And that's probably some of the 2%, because why would a business owner know to ask for an Individual Pension Plan if it didn't come from their accountant or their planner? And a lot of financial planners know very little to nothing about Individual Pension Plans. And where I say the fear comes from is because there is filings with CRA that need to be done. It's either done by your administration team or your planner or your accountant. And if they screw up, I've seen people wait years to get their pensions off the ground, and there's all this compliance problems and they're just not doing it properly. So again, if you're working with a team that's familiar, this stuff is like cakewalk, right? They do these things in their sleep and you get a lot of benefit. Why so many are afraid is because it is complex. It's more advanced planning. And just not everybody's prepared for that. Dr. Wing Lim: [00:34:17] So don't just find somebody that would just wing it, just by my name. This is not a place for somebody to wing it. This is complicated stuff. It has to be done properly. Nick Giovannetti: [00:34:28] Yeah. I've seen the big banks steer away from things that are complicated because they can't scale. So why do they push RRSPs even? It's because it's easy. You just sit with them, you meet for five minutes, you sign a form, boom. You got an RRSP, right? That's scalable. That's easy for them to administer. So even the big banks have participated in why only 2% of the eligible population are doing it because a lot of people deal with the bank. Dr. Wing Lim: [00:34:59] Exactly. Now. So this is awesome, Nick. Final question topic is messy one. Pension world. So if we can now do our own pension plan, what about different badging together like MEPs of the world? Even our medical associations are tapping into this thing. Can you just give us a quick overview of what that is about? It's a very mysterious world. Nick Giovannetti: [00:35:23] Yeah. I mean, there's a lot of different pension types out there. There's Individual Pension Plans, there's Multi-Employer Pension Plans, there's Joint Employer Sponsored Pension Plans, there's Specified Multi-Employer Pension Plans. So pension plans are a complex world. They're actually an entirely different section of the Income Tax Act than that of the RRSP. It's got its own section because there's so much complexity of how you can put these together. And I'm sure you'll see if you dig into this world, there's so many different ones out there. And the biggest thing that I find is that a lot of pension plans have been rolled out, and they may claim to be something that sounds great and polished, but until you know the underlying way it was registered and all those little details of how much do I contribute, does my company sponsor it or do you sponsor it? Who has control? What if I don't like how you're managing it? Can I take it and go somewhere else? Can I add my kids to this plan? So there's so many things there. What about indexing, right? What happens if there's a market correction? So there's so many things out there that you do need to make sure you're aware of. And one thing I find that most business owners and professionals want is flexibility and control. And the IPP generally checks off both those boxes. Dr. Wing Lim: [00:36:52] Right. Because there are talks, right, because we're busy professionals just nose down, bum up, working to our bones. And so we don't have time to think about, oh, if some big brothers sisters come and create this plan, even our own association or a fragment of our administration, right, we thought then they must do a better job just because there's bigger group of people, more asset under management that the sexy term AUM. But like you say it may not be managed well. Right? So I listen to podcasts and there is a book called The Kentucky Fried Pension. And this is a guy who is a whistleblower, which is actually a paid job in the US, and he was investigating the Kentucky State Pension and how screwed up, this is like you say, the firefighters, nurses, policemen, that how not just mismanaged, but there is just hankie panky mismanaged, like funds got stolen, siphoned to Wall Street, some favorite pals, you know, who worked there and get whatever kickback. It's just, bigger doesn't mean better. Nick Giovannetti: [00:37:59] That's so true. And you know what I, the most interesting thing I've heard recently, Wing, was there's a pension plan out there that is saying that they're going to give you a defined benefit income stream. So predictable guaranteed income stream. But when you look under the hood and the mechanics of how it's built, it's built like a defined contribution pension. Dr. Wing Lim: [00:38:22] Mhm. Nick Giovannetti: [00:38:23] Well defined contribution pension plans don't have any of the defined benefit fail safes. If the pension underperforms you can't put more money in. Dr. Wing Lim: [00:38:34] Mhm. Nick Giovannetti: [00:38:35] Right? Based on my age I can't put more money in. If there's massive market problems, can't put more money in. If I retire early, right? All these fail safes that define benefit pensions have to give people security in retirement, because anything could happen. Retirement could be 30, 40 years. Right? Look at Sears. Those pension plans were mismanaged and people lost their pension. So it matters. What are the fail safes? And if you claim a defined benefit income for the rest of someone's life, but you don't have any of the fail safes, and your contribution schedule is that of a lesser contribution room, how could you promise that? Dr. Wing Lim: [00:39:19] Right. I just want to address one more misconception, and then we'll move on to the next one, which is Q&A, and that is, there's different brands of the IPP. And you may have heard even in the physician world. And they package them, call themselves something else, but in front of CRA, there's only one thing. It's called IPP, right? You can say mine is curry chicken, mine is kung pao chicken, mine is coconut Thai chicken, curry chicken, but at the end of the day, there's only chicken. CRA only recognizes chicken, right? Not the fancy brand. And sometimes they mislead people. I don't know if it's consciously or subconsciously but that's what we want to educate on our listeners what is an IPP. And that's just it, right? There may be different ways they twist it, but at the end of the day, IPP is an IPP is an IPP. Nick Giovannetti: [00:40:14] Well, and I can give you a good example. Everybody here I would assume is familiar with the term Group RRSP. Group RRSP is not defined in the Income Tax Act. It's a made up term for RRSPs that are pooled benefits through a group. But if you look up Group RRSP in the Income Tax Act you won't find it because the underlying what CRA recognizes as the investment is just RRSP. You could call it fancy banana, but it's an RRSP. So again IPPs will follow the IPP rules and registration. They could be registered as defined benefit only or as a combination. So that might be one kind of flexibility piece. But just be aware of how it's registered. Dr. Wing Lim: [00:41:03] Right on, okay. So I want to thank Nick for so much wisdom, so much knowledge, so much information and the perspectives. Right? So we actually blown by quite like instead of half hour, way over. So we'll stop here the official one. Dr. Kevin Mailo: Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

35 - Be the Dumbest Person in the Room

Play Episode Listen Later Jan 15, 2024 25:17

Doctors Kevin Mailo and Wing Lim join forces to talk about the “d word” that isn't talked about enough: delegation. They lead a discussion explaining why we need to move away from assuming we know everything there is to know and instead embrace the expertise of others to achieve the best results. And how delegation is the key. Dr. Mailo and Dr. Lim break down what can and can't be delegated out. There are crucial tasks that only we can do and must continue doing, but there are plenty of other tasks we don't need to be spending our personal resources on tending to. They talk about the difference between delegation and abdication because very different results emerge from adhering to the wrong one. Dr. Wing Lim shares a checklist on how to do delegation the best way, with clear instructions and expectations keeping everyone informed on their part of the equation. This is an episode that's key to freeing up our time by ensuring that we do only those tasks which require us and that we responsibly delegate the tasks that don't need our direct involvement. –About Dr. Kevin Mailo:Kevin is an emergency physician based out of Edmonton, Alberta. He is known for his highly engaging teaching style that breaks down complex topics into memorable experiences. Kevin cares deeply about the long-term wellness of the medical profession and wants to see physicians and their families succeed personally and financially.About Dr. Wing Lim:Apart from his clinical & teaching roles, Wing has extensive experience in Practice Management and Business Development. He is passionate about sharing his extensive knowledge & experience (both clinical & business) with others in various settings, from his clinic mentoring younger colleagues, to churches, senior groups, ethnic functions, radio broadcasts, retreats, seminars, and national conferences.–Physician Empowerment: website | facebook | linkedin--TranscriptDr. Kevin Mailo: Hi, I'm Doctor Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know! We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programing both in person and online so look us up. But regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: Hi. Uh, it's Kevin again on the Physician Empowerment podcast. And, of course, we've got Wing here joining us. And today's topic is very near and dear to my heart because it has taken me a long time. To develop this skill because I was very much in the micromanaging, do it yourself space. And it's been not only, I think for myself, you know, in terms of life being less stressful, but it's also been really a lot of fun because as you expand your network, you begin to broaden your horizons, see things through other people's eyes, and grow as a person. And what I'm getting at here, and I didn't use the D word yet, is delegation. And that's what's so powerful in improving our lives. So in an earlier episode on the podcast, we talked about time management. And one of the keys to time management is being able to either automate a task and streamline its process, or hand off to somebody that you trust, who maybe you've even invested some time in training up, let's say if it's a medical office assistant. So today, Wing is going to be exploring the power of delegation in our lives. Because again, you know, Wing, you've achieved so much in the space of real estate practice building while maintaining a robust and happy family life. And I would venture to guess a big part of that success has been through delegation. Dr. Wing Lim: Yeah. Delegation doesn't come easy. So let's go deeper. And this one is not going to be a talk, Kevin and I, we're just going to chat on this. The delegation, I think we all talk about the D word, right, but deep down we don't want to. We really don't want to because we trust ourselves. Right? And this is a recurring theme at Physician Empowerment. The biggest enemy of freedom may be the guy in the mirror. Because we have so many years of education and processes and because lives are at stake. Mistakes are costly to other people and to yourself. So we tend to just do it, right, and they say, if you want to do it right, do it yourself. And so years after years, post-graduate training, residency, one fellowship and all that, teaching you that you are it, you're the expert. And so you have to do it right. And because of that, we have this intrinsic trust in ourselves. And some of us become very egotistical, giant ego, and even the God-like syndrome. Right? And we don't trust anyone. So as a result, it's very difficult for medical professionals to actually delegate. I'll give you an example. There are people who would rather take the, I have colleagues that would take the blood pressure themselves, like on a patient, rather than trusting a medical staff to do it. Why do you have to do that? Right? Because even blood pressure, you know, there's a good way and bad way to do it. Okay, I understand there's some procedures you cannot delegate out, but more and more we're team based. So I think the first thing to fight is this intrinsic bend towards just trusting yourself and not trusting others because I'm smart, therefore everybody else is dumb. So therefore I don't want to water down my quality. So I don't want to delegate to you. Dr. Kevin Mailo: And let me just interrupt there and say like, this is not about delegating the crucial tasks, right? You know, like if you're a surgeon, you know, and you're elbow deep in somebody's abdomen, you really want to make sure that it's done right. That's where you want to focus your energy is on those crucial, crucial tasks, right? I mean, I do the same thing in the ER in the trauma bay, right? Like sitting at the airway, making sure it's done properly. Because that's the crucial task. But realize that delegation, and I'm just going to go on a little bit of a rant here, delegation is a resource saving measure for us, right? Because we only have so much concentration and intensity and focus. So do you want to dissipate that by like measuring every single one of your patients blood pressure, because you don't trust that somebody will put the automatic blood pressure cuff on properly on the arm? Dr. Wing Lim: Exactly. Dr. Kevin Mailo: Right? Like there has to be some limits here because if you're so focused on that, are you really hearing the history? Do you know what I mean? Or if you are doing your own taxes because you don't want to pay an accountant, or you're doing your own bookkeeping, are you missing the big picture on high level tax planning that could mean hundreds of thousands of dollars to you. Right? So there is a limit to how much attention and focus we can bring in, right? Like I can't sit there and, you know, make sure every IV that, you know, my nursing staff in the department are doing it, doing it perfectly right. Like, no, I have to sit there and be able to focus on the things that no one else can do but me and then, and be comfortable delegating and trusting my team. So that's a personal growth thing, but don't feel bad about the parts that you need to micromanage in your life. By all means do it. You can't outsource personal relationships and friendships, but you want to be present for those. Dr. Wing Lim: Exactly. So you hit it right on the nose there, Kevin. So the paradigm here is this: only do what only you can do. That's the whole thing about delegation. Only do what only you can do. You're the only one that could be your significant other's significant other, spouse, or whatever you want to call it. You're the only dad or mom your kids have, right? You cannot delegate that out, right? When you have the chief surgeon, you have to do stuff that you have to do. But then everything else you should not do, right? It's like a flashlight versus a laser pen. Right? We all understand that, right? The point of focus is to just put everything out and just do only what you can, only you can do. And then, you know what? If you're a team lead in the department and your practice and your division, you know, what's the most scarce resource is a thing called thinking. Thinking--. Dr. Kevin Mailo: -- but it's true-- Dr. Wing Lim: -- is a hard thing. Otherwise everybody will be doing it. Dr. Kevin Mailo: It's very easy to do. And I think this segues nicely backwards to our earlier talk about time. I think it's very easy. Our minds like to get into that rut of, well, I want to focus on this one detail or task because it requires less mental energy. Dr. Wing Lim: Mhm. Dr. Kevin Mailo: When really, thinking, as Henry Ford said it, is the hardest job of all. And that requires some mental space. And to get that mental space, we need to delegate. Dr. Wing Lim: Exactly. So you cannot rely on your allied professional that you delegate down to do that for you. Right? Otherwise they should be sitting in your chair. Then you need to be delegated the task and they need to do the thinking. So if you're a clinic owner, you need to absolutely do the thinking. If a department head, the list goes on and on, right? And so, yeah, so do only what you can do. And if we can chew on that and then just plan your life accordingly, your life would absolutely change and everybody around you would absolutely change. But for that to happen, to only do what you want to do, only you can do, that means you have to have the intrinsic trust in other people. And I tell people that I love to work with people smarter than me. I love to be the dumbest person in the room. I love to because then I gain a lot, right? So I have no background in architecture construction. When we built this 156 unit senior home, state of the art building that won an award, second in the world, I didn't even know that until we got the award. And who won the award? What we did collectively. But the designers did, and I found myself and my partners, this was my dream, right? And I sat in a room downtown Edmonton, top architect, or biggest architect firm in the nation, in the Edmonton branch and in there is like 15 engineers. And I look around. These guys are all very, very smart. I didn't even know there could be 15 engineers, different disciplines. They kept looking at me and my partners. What do you want? Right? So if the why is big enough, the how comes. And so once you delegate the people who are smart and I said I'm the dumbest person in this room. And time and time again and once you do the delegation, things get done despite of you. I love that, not because of me, but things got done in spite of me, right? And then big things could happen. So that's delegation. Okay. Let's talk about what delegation is not. Delegation is not abdication. Okay, let me repeat. Delegation is not abdication. And why would you say that? Because that's the common mistake we have. And the top, top, top example is in finance. Okay, I just had a chat with one of our Physician Empowerment Masterclass attendees and this professional, we're talking about this application that we give our money to these transaction based, commission based people that set their financial advisors. And meanwhile, he's selling us products, right? Sorry. They are selling us products and they're going to help you be financially free. Maybe, maybe, maybe maybe not. Dr. Kevin Mailo: I don't know, I don't know. Dr. Wing Lim: What's assured is their commission, not your future. Right? And so this abdication just because oh, because you said you're good. I just give it to you. Give my whole life hard earned money to you. That's your abdication, right? Dr. Kevin Mailo: I mean, but I mean, you can also go the other way. I mean, you can blindly buy the market on a broad spread ETF and not pay attention to what, not that you want to time the market, but you want to time your life around the market like, you know, and ask yourself, am I ready to fall off the cliff 12 months before retirement if the market crashes, you know? And again, you can't just blindly trust a person or a process and say, well, that's good enough. You do have to, you have to manage your managers. I think that's what we teach at the course. Dr. Wing Lim: Another example. There's lots of horror story examples. We're just looking at a building in our city that was owned by a physician that went into receivership. Right.? And this dude trust to somebody else who is the expert who's going to run the whole thing. And I drove by that plaza, that plaza is full. It's hard to find parking. How does somebody run it down to the ground? Right? And now it's in judicial sale. And this, unfortunately, this guy's in deep trouble now. And so if you think, oh, real estate is going to, or whatever, you know, you pick a asset class, it's going to make me rich. No it doesn't. And unless you have a good management team, if you just blindly trust somebody, just abdicated your future, they're going to bite you back in the butt. Right? So that's a sobering example. Dr. Kevin Mailo: And I think the other reflection here is like a lot of the time when we've done something ourselves for many years, we unconsciously know all the ins and outs of it. We unconsciously know all the ins and outs of it, and so there has to be some patience when we're working with somebody and teaching them and some humility. Right? And put yourself in their shoes and remember when you were learning that process and that thing. And so just pause, put the time in and and make sure that they understand and make sure you understand their position as somebody new to this task. And so check your assumptions before you begin to sit down and have that instructions conversation with the person that you're about to delegate to. Dr. Wing Lim: Right. And then they don't perform well and you give them heck. You know what? You should give yourself heck, right? I'm just training a new staff, a highly reliable staff just left for a higher-paid position in the hospital. Right. We do that, lose staff all the time, right? We start with new and there's a lot of assumptions. So I got angry that why is this not done? Because they're new. I didn't teach them. Right? Next thing is you need to give a clear time frame. The song I love you tomorrow, you're just a day away. It keeps postponing tomorrow. If there's no clear time frame, don't expect to get it done. And relationships get tarnished, work relationships, even personal relationships get tarnished because you always say that I'm going to do it when. Right? So if you don't have a time frame, don't expect it to be done in a hurried manner. And then there has to be measurable outcomes. If there are no measurable outcomes, it's just a bunch of warm fuzzies. Sorry. It has to be measured. If you cannot measure it, it cannot be done. There has to be accountability. So you give the task to somebody. Is that accountable? Okay, let's jump from clinical practice to finance again. I have a colleague that was told by his wealth manager, doctor in the last 20 years, in the stock portfolio, you earn 20% a year for the last ten years. Is that even possible? Right. And the only reason, if you take that up... Dr. Kevin Mailo: Of course, I know where this is going. Dr. Wing Lim: It's the annual contribution. Then you had this was making money every year. Right? Dr. Kevin Mailo: Yeah. Dr. Wing Lim: Right. And there's no accountability because you just believe them, right? Whatever they say. And same, we delegate a task to the accountant. Like I do, I trust my accountant, but I don't run business decisions with my accountant. My accountant is not the guy who makes that business decision. He makes accounting decision. Right? So the accountability structure has to be well defined, and they have to be accountable to you or somebody else on something that is measurable. That's true. Dr. Kevin Mailo: Absolutely. Absolutely. Dr. Wing Lim: Final thing is consequence. If you let people do something where whether they do or not, there's no consequence, you have endorsed the non-performance. So somebody says if you, if your staff or whoever you trust in your team, they can get away with XYZ. And they keep getting, they will continue to get away, because you blessed it. You condone it. There has to be consequences. Yay or nay, right? Good or bad. So these are some of the guardrails that is supposed to be intrinsic. But you know what, I don't think it's really common knowledge. And while talking about it, I reminded myself 3 or 4 things that, oh shoot, I didn't follow what I preached. Right? This is just reminder for all of us that to be effective, you need team. And to have effective team, you need to have this delegation process. Dr. Kevin Mailo: I love it. I love it. Dr. Wing Lim: Right. And then to have a systematic thing. If you do this together as a systematic process that's at different level, right. Delegation was just talking about this act of delegating. But then you still, somebody still need to create the architecture, the whole conveyor belt, the whole, what do you call that, assembly line. Right? And A on B fold on C glue on D and you achieve E. Like so this has to be processed, and that's called systemization which is a different talk altogether. But this is really important for us to understand that to achieve more than what you can achieve by yourself, you got to let go of this ego thing, trust somebody. But with criteria. Dr. Kevin Mailo: And again this is people skills. This is absolutely people skills and I think that's so important. Right? Not only the words you choose, the time frames you give the person you're delegating to, how you provide feedback, how you discuss consequences or outcomes, all of this is people skills, right. And again this is the barrier to delegating because you go oh I'm not looking forward to this conversation. Maybe I'll just do it myself. But again, that's not how we grow as individuals. When we grow as individuals personally, professionally, financially, it's because we're able to have those tough conversations, but just have it with yourself in the mirror before you go in there. And again, emphasize to yourself that this is a people skill. This isn't about the given task or your process or anything more than, it is a people skill. Dr. Wing Lim: Right. And it's to empower your team up to their capacity. So we have, I've joined a practice management course a long time ago and that's a different talk as well. But basically what we learned is a doctor should never do a nurse's job, RN should not do LPNs job, LPNs should not do MAs job, MAs should not do a receptionist job, receptionist shouldn't do a janitorial job. But you can see all this in every clinic, every department, right? It's all screwed up. I was a patient once a few years ago, and I found a Sunday morning there's a RN changing bed sheets. I thought, why do you need to do that? Right? That's an absolute waste of public resource. And so if we understand that process we would be a lot more effective. Dr. Kevin Mailo: I'll just chime in with a few high level practical points about delegation. And this applies, because delegation can be done in our personal life and professional life. You know, do you change the oil on your vehicle or you take it into the shop to get it done? Do you mow your own lawn or do you hire it out? And so the first sort of matrix that I get people to look through, the first lens actually, is probably a better description, the first lens I get when I teach this topic at our conference or in the Masterclasses, is the first thing you want to look through is your hourly rate. Know how much per hour you make gross. And then net after overhead. And remember, when you're calculating your hourly rate, it is not just time in front of patients. It is administrative work, CME, emails, charting, whatever have you. It could even include your commute. Right? So understand what your hourly rate is. And I think unfortunately when you add up all of the unpaid things you do as a doctor, your hourly rate plummets and it's pretty depressing. Nonetheless, go through the exercise. I encourage everybody to do it. I know my hourly rate. And so number one is know your hourly rate because it allows you to make decisions on how much you're going to pay somebody to do something, right? And remember there are tax consequences. So if it's a corporate expense then it's a corporate expense. And you're more tolerant of, you know, that higher hourly rate to bring in a great professional, for instance, a great accountant or a great bookkeeper. Dr. Wing Lim: Exactly. Dr. Kevin Mailo: These people that help you build wealth. And then in your personal life, remember, it's after tax dollars, so you probably don't want to hold, you don't want to delegate to Skip the Dishes every night. Put it that way. You really don't. And or, you know, Uber Eats or whoever else is out there, right? Like you actually have to be very mindful of the after tax cost to yourself before you delegate. The other lens that I get people to look through, you know, we talk about this in an earlier episode, is what is crucial and cannot be delegated. That list is actually very short in our personal and professional lives. But don't delegate away the things that are actually going to matter in your life, whether it's driving your kids to soccer, spending time with your spouse or partner, even if it means taking him or her to the airport, right? Yeah, could you delegate a cab? But what about that moment that you could have shared together? Be mindful in delegation. This is, I hate the word efficiency in our lives, especially in our personal lives. I remember coming across, I remember I met an ophthalmologist once who was outstanding, said be efficient with things, not with people. Dr. Wing Lim: Mhm. Wow. Dr. Kevin Mailo: Like ideally if you have done time management and delegation properly, you should have lots of like free moments where you don't have to be anywhere else but enjoying that moment, right? Whether it's reading a book, spending time with family or friends, going for a walk, whatever, like or even just be free to like have like a day that just goes all over the place. But you didn't have to do anything else in your life because it was all properly delegated and you created that space. That's a gift to you. That is so powerful. And so that again is the next criteria that I ask people to use as a lens is, is this making my life happier? Like for instance I changed the oil on my truck with my kids because I like that time with my son and at times it's been three generations of us doing it just to teach and bond. I would never delegate that out. Right? That's just an example from my personal life. So try to be mindful and reflective of where you are delegating and delegate the things but don't delegate people. Don't be efficient with the people that matter in your life. And don't even be efficient with yourself. Like, you know, create downtime for yourself. Dr. Wing Lim: Mhm. Dr. Kevin Mailo: So that you can invest in yourself. So those are, those are again my reflections, you know having maybe learned the hard way about either under delegating or over delegating, frankly. There is a balance. Dr. Wing Lim: Exactly. Dr. Kevin Mailo: Okay. Maybe we'll wrap it up. Again that was another great one. I love, I love these topics because these are the things again that we all struggle with but don't even have a framework to talk about it or think about it. But if you can effectively delegate in your personal and professional life, you can go anywhere and build anything you want. That's a key. Dr. Wing Lim: And to earn back the freedom. Dr. Kevin Mailo: Oh goodness. The freedom's everything, honestly. Dr. Wing Lim: Mhm. Yeah. Dr. Kevin Mailo: Honestly I look at my, I look at my own teenagers living that free life and I'm deeply envious of their time richness. Dr. Wing Lim: Exactly. Dr. Kevin Mailo: You know? Dr. Wing Lim: No kidding. Dr. Kevin Mailo: Not all the drama of being a teenager. Not all the drama of being a teenager, but certainly envious of that, the wealth of time that they have compared to the rest of us who are so busy and overscheduled. Dr. Wing Lim: Mhm. Yeah. Dr. Kevin Mailo: All right. All right. Let's wrap this one up. Thank you. Dr. Wing Lim: Yeah okay. Thank you everyone. Dr. Kevin Mailo: Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

34 - What Time Management Actually Is

Play Episode Listen Later Dec 30, 2023 22:12

In this insightful episode, Dr. Kevin Mailo and Dr. Wing Lim engage in a profound conversation about self-control in time management. The discussion unfolds with a reflection on the evolution of time management concepts from one-dimensional to multi-dimensional approaches.Dr. Wing Lim introduces the audience to the Franklin Covey time management matrix, emphasizing the importance of not just handling urgent tasks but also allocating time to nonurgent yet crucial activities. He delves into the concept of significance, urging listeners to consider the long-term impact and purpose behind their actions.The episode further explores the notion of creating more time tomorrow by investing time today. Dr. Wing Lim introduces the concept of a "permission funnel," comprising permissions to eliminate, automate, delegate, procrastinate strategically, and concentrate on essential tasks. The episode concludes with a powerful reminder of the preciousness of time and a preview of future discussions, including an upcoming episode on delegation—a key component of effective time management. Overall, the conversation serves as a guiding light for physicians looking to regain control of their time and live a more purposeful and fulfilling life.About Dr. Wing LimIn 1993, Dr. Wing Lim embarked on his journey as a family physician, facing immense challenges in his first year. Despite putting in 100-hour workweeks, financial struggles, a receptionist issue, and the threat of eviction were formidable obstacles. Rather than retreating, Dr. Lim embraced these challenges, teaching himself Practice Management and transforming his approach.This resilience and newfound expertise turned his practice from that of a struggling "lone wolf" to the founder of one of Alberta's largest medical clinics. Dr. Wing Lim's story is a testament to overcoming adversity, highlighting the transformative power of learning and adaptation in the dynamic landscape of healthcare.Resources discussed in this episode:Stephen Covey: StephenRCovey7 Habits of Highly Effective People: franklincovey.comDragon Dictate: dragondictations.orgRory Vaden--Physician Empowerment: website | facebook | linkedinDr. Wing Lim/Synergy Wellness Centre: website | linkedin | Synergy Wellness Centre--Transcript:Dr. Kevin Mailo 00:01Hi, I'm Dr. Kevin Mailo, one of the CO hosts of the Physician Empowerment Podcast. At Physician Empowerment, we're dedicated to improving the lives of Canadian physicians, personally, professionally, and financially. If you're loving what you're listening to, let us know, we always want to hear your feedback, connect with us. If you want to go further, we've got outstanding programming, both in-person and online. So, look us up, but regardless, we hope you really enjoyed this episode. Dr. Kevin Mailo 00:35Hi, I'm Dr. Kevin Mailo, one of the CO hosts of the Physician Empowerment Podcast, and you guys probably already know that, because that's how I introduce myself every single time I'm on the show. And today, I've got my fellow co-host, Dr. Wing Lim, and again, I think most of you know who Wing is and what he does. And he's the one that leads our master class and does a phenomenal job teaching the ins and outs of high-level tax planning, wealth creation strategies, real estate investing. But there's a lot here with Wing. And that's why I look to you Wing like a mentor because I've learned so much from you, in so many facets of my personal and professional life. And one of the things in my personal life that I learned from you is the notion of time management. And so that's what we're going to cover today. And I'm very interested to hear your thoughts on how it is you've achieved so much in real estate development, full-time practice, a family, travel, you've done so much. And a lot of this comes down to not only goal setting but time management. So, why don't you talk and share some of your thoughts on this? Because I'm very interested to hear about it. Dr. Wing Lim 01:49Yeah, thank you, Kevin, for a very kind introduction. And I say when people talk up on you, you wish you would live up to it. And so I love doing this because every time we share with our colleagues, we're more alike than different whatever your specialty, and now listenership is not just in with MDS, right, they're out of medical professionals that they're dialling in. So, we all dealt with this problem that we're time broke, right? And at first time I heard this term, this is like 25 years ago, maybe, what does time property mean? Well, because there are people who trade time for money, and that's us, right? We trade time for money. You don't have trade time, you have no money, right? So, you keep trading time for money. And then the problem is, then very soon, you run out of time, right? So, you and I went through gruesome training, we all did, right? 120 hours way back residency, when we did one in two calls, one in three calls, 36 hours straight. Right? And even when I started my practice, 100 hours a week, so you pretty soon run out of time. So, then we take these time management courses, we pay for it way back? And then what do you get? Right? So, I think all of us understand that we need to manage time. So, I think all of us would at least have a to-do list. You know, we have this to-do list every day you put down, right? And then I learned as I go and then I learned that that doesn't work. How many of you and I will look at the to-do list and we actually get better? In fact, what you're doing on a to-do list is just bumping, right? You're just doing it based on urgency. So then, some 10 years later, decades later, the thinking and time management's like medical journal, right, like medical thinking, it's changed. So, that's called a one-dimensional time management. And you've just bump things, in fact, nobody could control time, time is a commodity that you cannot control. Time goes on whether you do it or not. And the truth is, most of us can do the urgency, but time management or event control, let's call it better event control. It's a very emotional base thing. Right? You and I have said, Okay, I gotta get these charts done. I gotta do that stupid medical legal report or WCB report. And you were so stressed out, that you ended up clicking on a mini-series six episodes later of the Netflix. Right? Ya know. Dr. Kevin Mailo 04:12No, It's true. And a lot of it is we feel overwhelmed by how much we have on our plates. And so then it becomes very easy to procrastinate or distract ourselves. And it can even be distracting ourselves, not just with like idle leisure, but even distracting ourselves in work. Right, that rather than doing the hard stuff, you know, maybe we go do some errands around the house or, you know, get some shopping that's not urgently needed to be done. Even just going to work and doing more paperwork. Dr. Wing Lim 04:44Yep. And then we just keep being busy, right? But keeping busy doesn't mean keeping being productive. Right, so I'm the perfect Master of this. I have 15 things on my to-do list today and I only got four done, right and every day you just keep bumping it right? So, that's called the first dimension. There's actually different dimensions, polly dimensional. So, dimension one is the to-do list, and it's based on urgency. Okay, which one do you bump? And we know that that's not adequate. Now then comes the 80s and 90s. And then there's a guy, Franklin Covey. I don't know how many of you heard of Franklin Covey. I used to have a big binder, called Franklin Covey binder, but that's how you organize the life, and Covey “The Seven Habits of Highly Effective People”, right, he's the guy. Dr. Kevin Mailo 05:31Oh, Stephen Covey. Dr. Wing Lim 05:34Stephen Covey? Yes. Dr. Kevin Mailo 05:35No, I got you. No worries. Dr. Wing Lim 05:37Yeah, yeah. So, there are two companies that join, right? So, Frank. Anyways, the two companies and so that's called Franklin. I used to have these big Franklin folders. And they go into the urgency and importance, right? This is called a time management matrix, where some of you have heard it from The Seven Habits of Highly Effective People, right? So, you have the urgent, nonurgent, important, not important, then you got four possibilities, right? And most of us still deal with urgent/important things. This is actually people who, like you'd practice within ER, you're dealing with urgent, important things, right? But nonurgent, and not important things get ignored. Right? And that's why they say, why do people not read more? And the Maestro says because books don't ring? Right? You will always answer to the phone, to the urgent things, but they're important things that we don't deal with. So us physicians and medical practitioners, are no tourists dealing with more urgent stuff, and we push the important things away. And then it fights back, I have literally met colleagues that forgot to file taxes for seven years. And the CRA came to the door and garnish their wage. How do you do that? Right? Because you keep doing the urgent one, right? And you forgot about it? So, this Time Matrix thing helps people to do okay, I need to apportion the time, right? Dr. Kevin Mailo 07:00Well, I was just gonna say even if you don't internalize it, so rigidly and for anybody that has not read Stephen Covey's The Seven Habits of Highly Effective People, I strongly recommend reading it, but even just to be able to have that mental pause, when something comes in front of you, whether you hear about it, or you read about it, or somebody you know, you're reminded of it in your head, say, is this truly urgent? Is it distracting me from what's important that I have to get done to move ahead on this project with this goal? Sorry, please continue. Dr. Wing Lim 07:34So, it's absolutely important exercise. So, for those of us who are still stuck with this linear thing called the to-do list, you need a second now y-axis to create the importance. And so you and I need to apportion our days, that the toughest one, or the nonurgent, but important things. Buying tax return, doing your tax planning, right, you know, those things are super important. If you don't invest in these relationships then relationships blow out, right down the row. And so definitely, that is important. But then at the end of the day, you are still juggling different things. And the biggest thing and the motive here, the MO is to do more things, right? But there's still not enough time of the day, right? You still don't create time. So, then I attended a leadership conference, I think during COVID or pre-COVID. And the guy said there's a third dimension, oh, what is the third dimension? The third Dimension is called significance. Right? You don't just deal with what is there, you deal with what is the long-term significance. The longer significance is not just what is important, is way beyond that. I went to a leadership conference way back a big 20,000-people thing in the States and they talked about legacy, what you're left with, and after that, that conference, that's how I gave birth to, dug up my dream and gave birth to Synergy Wellness Center. But these things are life-changing. What is significant to you, what is the endgame? And so when you throw in the X, Y, and Z axis, it changes what you're going to do. It may change your priority and change what you do. You've been doing things for so many years for decades. Isn't why you're still doing it. Right? You need to ask why? Why am I doing this? You're running on a treadmill now for 10, 20, 30 years, trading time for money, right? We're talking a lot of colleagues and say, I'm like 40 some year old practitioner. I got X number of dollars in debt. I can't afford to retire. Why am I doing this? Right, and a lot of people have that midlife thing awoken and say this is getting nowhere and that's why there's so much attrition people walking out of the profession. Right, so until we find out why we don't know what we're doing. And then there's this guy call. I forgot his name. Now, Rory, somebody, Rory Haun there we go. Rory Haun, give him the credit for doing this. And he says there's this funnel that you can help create time. Right? You really you can create time? You mean like other than the Avenger Timestone? You can create time? And the question is what can you do today, to create more time tomorrow? Wow, that's absolutely amazing. How do you create more time tomorrow? Well, are there things that you can do today? So, that you don't have to do it tomorrow? Okay, give you an example. Right. And you and I do charts, do things every day, right? We have chart work to do. If you have a way to let's say, create a macro in electronic medical record system EMR, it does the template for you, or those of you dictate, Dragon Dictate. Kevin you've tried that, right? Things that could save you time, right, then you get this ROTI, return on time invested. So, what can you do today that invest a little bit more time so that you reap the benefit? And the equation that I got was 30 times 30. So, whatever tasks you want to give up to make it disappear, you invest 30 times the time you spent. So, for example, a five-minute task, you invest 150 minutes, okay, simple math. What is the five-minute task, something that your staff could do? And so the problem that we have is we are our top enemy. We're the worst enemy because we want to do it. If you do want to do right, do it yourself. The more years we spend in tertiary care settings, the more we don't trust people, right, we just trust ourselves. I have, especially colleagues, if you refer them, they redo all the investigations all over because they don't trust anyone. So, this mistrust becomes difficult for us to delegate. And that's a different session we're going to talk about it's just delegation. But to delegate, you need a process, but the time we're talking about time management here, event control is a five-minute event you want it disappear in your daily life. It could be doing a chart, doing something that your clinic work. Invest 30 times 150 minutes to teach, delegate one of your staff to do the job for you. And then poof, you're earn five minutes per day. What if is an hour, 30 times, invest 30 hours. And that could be learning EMR. By learning EMR, what shortcuts can I do, so that I make these stupid things disappear? Right, prescription refills, you name it, and you invest 30 hours. I have colleagues who would not have 30 hours to get for anything. But you know what, if you invest the 30 hours, you earn one hour a day. And why don't we do it? Dr. Kevin Mailo 13:02It pays for itself in a month, and you still have your career to run. Dr. Wing Lim 13:06You want to make more money and you might keep a relationship that you cherish or sports or some hobby that you don't have to kill. Dr. Kevin Mailo 13:14You know, I mean, even just reflect like in, you know, in our personal lives, the parallel is children. I mean, you can sit there and you can clean up after your children. But at some point, you just need to teach them how to scrub floors, and tidy up the house and do their laundry, even if it's like you said, 30 times that it takes you to just do this task yourself. But you realize that ultimately you're creating more time for yourself and less stress, Right? And so this dovetails with every aspect of our lives. It is just willingness to put in a little bit of front-end investment in time to make our lives easier and simpler. Moving forward. Dr. Wing Lim 13:58Right, exactly. So, let's just end this episode with a funnel, okay, this funnel is called the permission funnel. We need to give ourselves emotional permission, okay? I can give myself emotional permission but once you give yourself emotional permission, then you can move forth. So, the first question, the first permission you give yourself is to eliminate. Elimination that's one. Can I do without this? Okay, can I do with all these things? Say no. Say no, no, no no for people like me who was a yes man, mostly, it's a very difficult thing. But if we want to get on top of this time management thing or more control, event control thing. We have to say no, can I do without it? So, the first permission is the permission to say no and exit out. I don't want to do it. Permission number two is can we all automate. Right? We're in an automation world. AI is gonna run the world. AI can read CT scans, better than we could, right? So can we automate? If you can automate, you're done. But the automation is not just AI, just technology. Automation means systemization. Can you have a system in your workplace, in your practice, in your finances, in your home life? Is that something that can be systemized? Right? And, of course, that's a different topic altogether. Can you systemize it? Or can you use technology to do it? Once you can automate, you're done. The third permission is permission to delegate. Okay, and we're going to have a whole talk about delegation. Can we delegate that away? And the fourth permission is, can I procrastinate? So, you thought procrastination is a bad thing. Yes, it is. Procrastination is the assassination of motivation, as somebody once said that, but there are things that we should procrastinate because we have a finite amount of time, right now. So, things that don't fit that grid, X, Y, & Z grid. You need permission to procrastinate, to go back to the funnel, okay? So, you either procrastinate, or you number five, concentrate. And whatever goes into the concentrate is like the filtration. You put all your time, energy, effort, you and your team into the concentrate, and get it done. And that's how people move and shake the world. Right? Dr. Kevin Mailo 16:33It's very powerful. Dr. Wing Lim 16:33And it's never been to me, I've lost so many people right in this space. But this actually did it for me, this crystallizes everything. Dr. Kevin Mailo 16:48Very powerful, very powerful. You know, I'm reflecting on when we were in Mexico in 2021, teaching with Physician Empowerment. And I remember coming across some wisdom that you shared as well, Wing because I think I actually had to deliver that talk. But I know that it was your wisdom and your knowledge in this space of time control. But one of the key elements here is that it's not actually time control. Because like you said, time is passing us by. It's truly self-control. It is self-control. It's knowing your priorities, setting them, and then sticking with them, even if that means saying no. And it's not just no to external requests on your time, your staff, your colleagues, your family, friends, whomever is asking for your time, but it's even that internal voice telling you, oh, but go do this, it's easier, right? Or this is important now. When it truly isn't, if you're honest with yourself, and that's about, again, self-control, not time control. And I think that's very powerful. Because when you look at people who have achieved enormous things, you know, heights in, you know, reached enormous heights, in business, politics, athletics, whatever. Fundamentally, they have the same number of hours in a day, as we do. Chosen, like you said Wing, to concentrate and focus. And it is fundamentally self-control, whether you're an athlete, a performer, you know, a business or political leader, or you know, even just a great dynamic physician, it comes down to self-control. And I think that is so, so powerful. And so key. That's certainly what I've taken away from listening and reflecting in this space. Dr. Wing Lim 18:40Mm-hmm, exactly. So, if we could apply these simple principles in every facet of our life, then we can have some freedom. But at the end of the day, we yeah, we only live one life, right? And we're getting older one day at a time, right? So, the sooner we get this in our brain, the sooner we reorganize our life and control our life. Then you get your life back and have more freedom. Dr. Kevin Mailo 19:10The only other reflection I really had was just how precious time is. And I did not appreciate this 20 years ago when I was a teenager. But I blink and a decade has gone by, I blink and another decade has gone by. And so the challenge is to ask yourself, what am I doing right now, with the time that I have, especially realizing that we don't know how much of it we actually have here. And I think that allows us to focus down and say, Okay, this actually isn't a priority. And I'm not going to worry about it. I'm not going to that meeting. Or I'm not doing that, you know, answering that email, because, frankly, it's not going to be something I'm going to remember a year from now, let alone a decade from now in my life, right? And so, again, just recognizing how precious these years in our lives are and that these years are comprised of a million small moments and countless hours that do drift by if we don't exercise that self-control. Dr. Wing Lim 20:13Mm-hmm, exactly. Exactly. Dr. Kevin Mailo 20:16Yeah. No, it's It's a wonderful topic. I think we could go on and on about it. But we are going to do a future episode where we cover delegation, right, which I think is the key to effective time management. Is being able to hand tasks off, or as you said Wing, we automate a process. Yup. So, we'll cover that in a later episode. And I'm really looking forward to it. Because again, these are the things I think speak to all of us regardless of specialty, regardless of stage of career, I think we all feel too busy. And we want a way out, we want things to be better, and they can be unconfident in it. Dr. Wing Lim 20:58Exactly. So, imagine you could go home at five o'clock, six o'clock, whatever, and be done with work, wouldn't that be a dream? Dr. Kevin Mailo 21:06True. Totally done. Yeah. Awesome. Thanks so much. Dr. Wing Lim 21:12Thank you, everyone.Dr. Kevin Mailo 21:15Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

33 - Critical Mineral Investment with Graham Koehler

Play Episode Listen Later Dec 15, 2023 33:04

Dr. Wing Lim invites Graham Koehler, an expert in flow-through shares and VP of Business Development focused on flow-through since 2010, to the show to explain what flow-through is. Not only does Graham define flow-through shares, but he also explains their amazing tax benefits, potential risks, and who they work best for.The flow-through program was developed by the Canadian government to help resource companies raise capital to explore for minerals to mine. The original program was developed with a main credit called the Canadian Exploration Expenses credit (CEE). Graham goes into detail about how the CEE differs from an RSP or TFSA and then explains the additional tax credits available to investors on top of the original CEE. He shares a partial list of the critical minerals that qualify, how flow-through shares work, potential tax deduction numbers, and the inherent risks worth considering. This is a fireside chat introduction to the opportunities of flow-through shares so we can all ask informed questions of our tax accountants and advisors.--Physician Empowerment: website | facebook | linkedin--TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment, we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know! We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programing both in person and online. So look us up. But regardless, we hope you really enjoy this episode. Dr. Wing Lim: [00:00:35] Okay, so welcome everyone to another exciting episode of Physician Empowerment, a live webinar series, and we talk about highly relevant topics. We interview interesting people on interesting topics that will help our physicians and medical colleagues live better lives. So we're not just physicians, we're physicians and other health professionals like dentists. And so we're really excited to have you join us tonight. And this, of course, becomes an evergreen podcast. So you can go back on. So let me introduce tonight our guest. Our guest is Graham. And Graham has been in the space of flow-through shares since 2010. So he's a Canadian living in Kelowna. But he's now talking to us from Huatulco, Mexico. And so we want to cover this topic, I've done three shares actually since 2012, and full disclosure, I actually bought it from from this company. And I really trusted them to have really, really good track record. So Graham's role is the VP of Business Development of the excellent capital in one of their flagship flow-through shares. So tonight it's a fireside chat to warm everybody up. What is flow-through, right, the history. What is about and how does it impact us as medical professionals? So without further ado, Graham, thank you for joining us from Huatulco in the midst of your holiday. Graham: [00:02:07] No problem. I'm really happy. I mean, quite frankly, Wing, I would always come on board when you ask. And I'm always thrilled to talk about this program because I've seen how it can help people save significantly on taxes in Canada, especially professionals. So I'm always happy to participate. Dr. Wing Lim: [00:02:27] Right now. So why don't you first walk us through? Because a lot of people have heard of it or haven't heard of it, but the knowledge base is almost zero. So walk us through what is flow-through share and why does the government creates such huge incentive like 100% plus tax write off? Graham: [00:02:45] I know, and, yeah, absolutely. When people get exposed to the flow-through, the government flow-through program in Canada for the first time, it's almost too good to be true scenario. But it is a, first off, it is a federal government program that's been around for a long, decades, quite frankly. And we'll talk about that and maybe why people haven't heard of it. But essentially the program was developed back in the 70s in its current form. So decades ago, because Canada, as we all know, is a resource rich country. We do rely heavily on our natural resources and always have in Canada. But the idea of companies going out to explore, what I call poke holes in the ground, to go out and poke holes looking for, you know, whether it's oil or gas or minerals of any kind, precious metals, gold, whatever the case may be, is risky business. These explorers, these Canadian wonderful explorers, go out there, typically on their own dime, looking for these resources and and hope they find them. Well, the truth is they sometimes don't and they're not successful. So it's risky. Exploration is risky business. So what the government, the federal government did back in the day was created a program to help these resource companies go out and explore, to raise capital, to raise money to do their business. So to help them raise capital from investors, which is typically where capital comes from for most things, they offered significant tax benefits for the investors to put their money up so that significantly reduces the risk involved, obviously, when you get tax benefits or tax refunds. So the original program was developed and still continues today with a main, a main credit, if you will, called the Canadian Exploration Expenses credit. CEE. So it's just simply, that credit is simply a 100% deduction from income for every dollar invested in the flow-through program. So for every dollar that you give to these companies that are out exploring and needing capital, you get 100% reduction of income. That part would be similar to an RRSP. Dr. Wing Lim: [00:05:13] Right. So then okay. Very good. So thanks for the intro. It's like gold rush. Right? So the government is incentivizing people to do gold rush equivalent. And then so there's, like RSP, there's some advantage. So can you tell us it's like RSP but it's not like RSP. In the sense it's better than RSP. Graham: [00:05:33] It is. It actually gives quite frankly far more deductions now than RSP does. A typical RSP platform, as we all know an RSP is simply an account, things have to go in it. The flow-through is an actual program. So really in Canada there's some different programs out there, but as far as federal government programs spanning the country, there's really three on the tax side. There's RSPs, which we pretty much all know about. There's the somewhat newer TFSA program, which doesn't save you taxes up front, but it builds tax free within the program. So it is a tax program. So we have RSPs, TFSAs, and flow-through. The main difference between RSPs and flow-through are that, well, number one RSPs can only be purchased by an individual, not a corporation. Correct. Whereas flow-through can be purchased by an individual, a corporation or a trust. There's also a maximum contribution limit every year on an RSP. Whereas with flow-through there is no upper limit. The only the would be on the investor's, you know, suitability for the program and their risk tolerance. But there is no mandated upper limit on the program. And then really the main significant differentiator is, as I mentioned a few minutes ago, the first credit with the flow-through program is 100% reduction of your income by the amount you invest. Graham: [00:07:15] That's exactly the way RSPs work. But in the flow-through case, there's two more federal tax credits involved on top of that. And these are for everybody that invests in flow-through individually. And they are what's called the mineral exploration tax credit. And that's a 15% additional ITC or investment tax credit on top of the 100% you get with the exploration expenses. And as of last year, 2022, there's now a third tax credit involved with flow-through. The federal government announced in 2022 that they were adding in a 30% tax credit, ITC, investment tax credit, on the flow-through program for any part of a fund that is invested in critical minerals. So it's called the Critical Minerals Investment Tax Credit. So you have the original 100% reduction of income for every dollar invested, which is somewhat similar to an RSP. You have the additional federal 15% mineral tax credit. And now the potential for a 30% tax credit on anything in a fund, in a flow-through fund, that's considered critical minerals. And the government gave a list of critical minerals. Dr. Wing Lim: [00:08:40] Can you give us, I just know the list is big. Give us some common ones. A common one, is it lithium or is it... What is it? Graham: [00:08:46] Yeah. There's a number of them, and some of them will make a lot of sense. Mainly they're minerals that are critical to the electrification of the world, to elect batteries, electric vehicles etcetera. So that's really what the government is promoting right now because we have a lot of those minerals, or most of them in Canada, and we can explore for them and bring them out of the ground. Examples, lithium of course, magnesium, cobalt, copper, the rare earth elements, none of which I can pronounce the names of, those elements as well. And interestingly, uranium, as of last year, the government has considered or has actually called now, classified, uranium as green. Dr. Wing Lim: [00:09:35] Wow. Graham: [00:09:36] Yeah. Yeah. Very interesting. Dr. Wing Lim: [00:09:37] When you think about it, it is very green. Graham: [00:09:40] Yeah. It is. And, you know, obviously this isn't the place or time to get into the pros and cons and things like that. But yeah, what happened a year ago was in this decades-old program, the federal government actually pulled oil and gas out of the flow-through program. So we can't buy oil and gas flow-through shares or, you know, shares of oil and gas companies now. They took that out. But they added in this critical minerals 30% tax credit. In other words, they're really trying to build, to help explorers and developers in Canada, Canadian companies, to go out and find more critical minerals. So that's the difference between RFP and flow-through right now. Dr. Wing Lim: [00:10:27] Now, can you educate us, Graham, that I've heard about tax credit and tax deduction. What's the difference? Graham: [00:10:35] Yeah yeah just... Dr. Wing Lim: [00:10:37] Briefly. Graham: [00:10:38] Yeah I will, I'll try and be brief there. And I'm glad you picked up on that, because I did use the two different terminologies here. I've mentioned the three different credits available. And the first one that I said has been around forever, for decades is the CEE, and that stands for Canadian Exploration Expenses. That is the main, that part is again, it's federal, everybody gets it. It's a 100% reduction in income. So for every dollar you invest, you get your tax slip from a flow-through company, you know, in the spring for the year, for the past year. And it'll show that CEE, your accountant simply reduces your income by that amount. So you save taxes, you know, to be simple, to simplify, if you're in a 50% marginal tax rate, a high income earner, and you invest in a flow-through, 50% of the money you invest is going to come back to you immediately in a tax refund. That's the CEE. In addition then, that second and third credit are called investment tax credits. They operate slightly differently than that first one. They don't reduce income by the amount, they actually, you multiply the first case 15%. It's called the mineral tax credit exploration, it's 15 - one five - percent. So you multiply your investment times 15%. That number comes directly off remaining taxes that you owe. So it's very powerful. And then the third credit is an investment tax credit as well of 30%. So you multiply, or you know, effectively, the auditors do this. You don't do any of this. We just in the industry give you a tax slip. But the critical minerals at 30%, any part of a fund that's critical, gets multiplied by 30%. And that number comes directly again off taxes you still owe. So very powerful. So there's a little difference in how the two... Dr. Wing Lim: [00:12:44] So can I just, just give some numbers? So and you can tell me if I'm right or wrong. Right? So if let's say doctor XYZ makes 100,000 this year, taxable income, and invest $10,000 in there. So just based on the first, the CEE, then the income taxable income becomes 90,000. Graham: [00:13:04] Right off the top. Dr. Wing Lim: [00:13:05] Yeah. So and if doctor XYZ owes the government $50,000 in tax right then hey 15% of that, whatever they invest in, comes right off the tax. So potentially 40, so if they do $10,000 investment, so what 45% of that? Which is 40... Graham: [00:13:26] But the only thing to keep in mind is the 100% everybody gets, the 15%, you get either the 15% on part of a fund or the 30. They don't stack on top of each other. Dr. Wing Lim: [00:13:40] Got it. Potentially, let's say we buy the critical mineral. Then 30% of 10,000, that's 3000. Graham: [00:13:47] That's right. Dr. Wing Lim: [00:13:47] 3000 comes off your 50,000. And you owe that year for tax. Graham: [00:13:51] Yeah, the way it works out for most funds, the way it works out, and again there's multiple, there's many many, you know, there's a number of flow-through funds in Canada. I would say on average an investor is going to get somewhere between 120 to 125% in deductions for every dollar they invest. So if they invest $10,000, they're going to get the equivalent of about $12,500 in deductions. Dr. Wing Lim: [00:14:23] That's absolutely amazing. Graham: [00:14:25] It is. And what it's done, especially with this added, when the government in 2022 added in this extra critical minerals tax credit, what it means again, and this is for an average fund, it depends how much a fund has in critical minerals or not critical or things like that, so it's hard to give exact numbers here, and every individual it will be different as well with their tax rates, but again, on average it'll be 120, 125% in tax benefits for every dollar invested. And what that does is it reduces, when you calculate it out, it reduces the at risk money, that $10,000 that you've invested, it typically reduces that down to $3 or 4000 out of the $10,000. That's the money you actually now have at risk because you've received all the rest back in tax refunds. Dr. Wing Lim: [00:15:13] So there's so much refund that you're only about 30% of this is really at risk capital. Graham: [00:15:18] And that's directly why the government's doing it. Is to, and by the way, there's no exact number on the benefit to the government. But I've heard in the industry many times over the years that the federal government, the CRA, basically, recoups, recovers anywhere from 3 to $4 in basically income generated for the government for every dollar they give back in tax credits to investors. And the reason for that is because these companies that explore, many of them are very successful and eventually pay a lot of tax. So it's been a very beneficial program for decades for both investors and the government, quite frankly. Dr. Wing Lim: [00:16:04] Right on. So I think we touched on this is such a good program. And the next question is, well, how comes my accountant didn't just jump at my throat on that? Graham: [00:16:15] It's you know, I've mentioned it's been around for a long time. The actual original, the very, very origination of the program in an older form was mid 1950s. This program's been around since before the RSP program. It came into its current life in the early 70s. Why isn't it more well known? One of the main reasons it's not is, and I think this is from the accounting side of it perhaps, is there is risk, of course. And a lot of times, quite frankly, I think accountants don't want to, you know, be responsible for talking about a product that has risk. You know, it's very, very difficult sometimes, even though it's been de-risked so much. The other reason, and I think this is far more, will answer the question I think far better, is the big institutions in Canada, the big banks, the big financial institutions, the big investment sellers, they're not really interested in the flow-through program. And the reason that they're not is it's just for them, not big enough, quite frankly. On average, over the years, the Canadian Federal flow-through program has raised, on average, about a half a billion a year in capital. So about 500 million a year gets raised every year in flow-through. And I'm sure that's, you know, in a niche market that's a pretty good number. But to the Royal Bank of Canada, it's just not look. They look at that and go, no, we're not interested in that kind of niche small market. They're far more interested in doing mutual funds and RSPs, which are, you know, continuous. That's really why it's been mostly, up until about ten years ago, it's been mostly the purview of certain accountants and certain tax lawyers that paid attention to it. Now there's more and more funds. So it's getting a lot more attention. There's more people like yourself looking at it. Dr. Wing Lim: [00:18:11] Yeah. So if you had 50% tax bracket, right, if you added 25% tax bracket, it doesn't make as much impact as 50 plus percent. Graham: [00:18:19] Yeah. And we get, you know, people ask me oftentimes like what would, who should buy this? Who should invest? Who should invest in flow-through? And there's two answers. One, anybody that's got a tax problem. If people have a tax problem, they should look at flow-through. If their tax problem is five grand in a year, maybe not. They're, really in my mind to get the biggest bang for your buck out of this, you really should be in the, I'd say the 35 to 50% marginal tax rate, right? Dr. Wing Lim: [00:18:58] The bigger the tax problem, the bigger the solution, right? Graham: [00:19:01] That's exactly it. Dr. Wing Lim: [00:19:03] Yeah. Right. So maybe tell us, okay, so this is the good side. Tell us the worst. What's the worst scenario that could happen? Graham: [00:19:11] People can lose money. And and I'm not being flippant. It just, it can happen. This is, there is risk involved with this program. And you know, that's why it's imperative too that the individuals look at, know a few good questions to ask a flow-through fund. And we can talk about that if we have time. But yeah, the ups and downs of it. This is, for the most part, junior, what they would call junior resource companies in Canada, which are smaller companies, their share prices are smaller, their, I guess they would be what's termed as penny stocks out there, even though some of them have been around doing this for decades. They've been around a long time. There are still smaller companies. They go explore, they find something, they move on. Or quite frankly, they get bought out and they start it again. They get, when they find something, they get bought out by a bigger developer and they start exploring again. So they're back to being small. So that's where the real risk is, is when a fund is put together, quite frankly, if the fund manager, the research team involved, aren't that great at picking the stocks, these funds can go down dramatically. I've seen funds, they don't go to zero these funds because they have many different companies in them, many different shares, but have seen a, from certain companies out there, I've seen a $10,000 investment get paid back at $1,000, let's say. A few, you know, 18 months or 24 months later. Well, you need to get back about $4, quite frankly, 3 to $4 to break even. Unattend, I'm talking $10 purchase prices. You know, so you would need to get back 3 or $4. I've seen returns of a dollar, $1.50. So those are actual real losses. Dr. Wing Lim: [00:21:07] And those is not right away. Right? It's over time. Right? Graham: [00:21:11] Yeah. Most flow-through funds in Canada operate on anywhere from a 8 to a 24 month kind of window. There are a select few out there that have done a great job by being a little bit longer term for their investors, maybe 3 to 5 years. I've found that those companies have done a little bit better, quite frankly, because what they've done is they've given the resource companies more time. So hopefully make a profit. So there are a few companies like that out there. Dr. Wing Lim: [00:21:47] But it's also dependent on cycles. Graham: [00:21:50] It is. And when I mentioned that these are junior resource companies, a lot of them are, most of them, in fact, of this variety, are traded on the TSX Venture Exchange, out of Calgary, not the general TSX, but they're traded on the TSX Venture. And so you've got to look at that exchange to see how it's gone up and down over the years. And it doesn't track the same as the TSX. Okay. It is a totally different market. Now the TSX Venture isn't just resource companies. There's tech companies and all kinds of small firms there, but it seems to have its own path. And yeah, it went through a long bare market, quite frankly, the TSX Venture went through a bare or a down market from 2010 to about 2017. So it's kind of on a downward rate, but it also goes up. And right now, by the way, the market in general for this in Canada is somewhat, is low, like it's been here. So there's, you know, who knows. But it may be an opportune time to get into natural resources in Canada because they are somewhat suppressed right now. Dr. Wing Lim: [00:23:07] Right. Tell us something about this super cycle. Graham: [00:23:10] Well, that's kind of where that, you know, we're in that, there are a lot of us believe that we're kind of in the first or second inning of a super cycle right now, and all that means is a bull market or a potential up market on steroids. Meaning that it's going to go high and it'll last, this bull market in commodities, if it truly is a super cycle - and there's been three super cycles in history before, this would be the fourth - it would last for maybe as long as 6, 8, 10 years. The super cycle. A lot of the very experienced portfolio managers, the commodity people out there in Canada, the, you know, commodity trading managers and the guys like Sprott and, you know, they've been calling this now for 2 or 3 years. And they all feel that we're in the beginning of that super cycle. And really it's because there was such a depression for those years I talked about. Nothing got done. And it takes, once things get rolling again - and precious metals, for example, like gold, and I think we're all pretty familiar that, you know, gold is on a, you know, should be and has been on a bit of a trend - people are looking for ways to buy precious metals right now, but it takes, and now critical minerals like lithium and stuff and uranium, by the way, uranium has started to go up dramatically now. Lithium went up dramatically 2 or 3 years ago. So that's, now just keep in mind that these super cycles, if that's what we're in, and a lot of us think we are, they don't go up in a straight line. Nothing goes up in a straight line. So it'll be a bit of a bumpy road right now, I think. Some years we'll be down a little bit, some will be up. But the general trend, I believe, for the next 8 to 10 years is going to be an upswing. So I look at the flow-through program, which was developed by the government to help this type of a cycle, really, as a significantly de-risked way for investors to get involved in commodities. Right? They don't have, yeah, they don't have to pick their own. They can get, you can get involved in gold and silver and lithium and a whole basket of these in the flow-through program now for your portfolio. Dr. Wing Lim: [00:25:36] Right. So I listen to a lot of podcasts. That's how I do my pastime. And we're truly in a global village situation. A war in Ukraine. Boom. It affects Canada. It affects the African food supply because the wheat basket, but also minerals and resources. Right? When Russia and Ukraine have big war and now we have Middle East war, and so it impacts and of course, like you say, we're electrifying everything. Right? Electric vehicles. A patient of mine just, he's in a developing business of different kind of battery that is going to make the regular battery that we see now obsolete. There's so much advanced, technological advance, but the limiting factor is still the resources. Man, you got to find those nickel, cadmium, lithiums of the world. Right? Graham: [00:26:27] And you do. And not only do you need to find them, once they're found, once once a resource is found, it doesn't relate to a producing mine next week. These take, these can take a few years to develop once that mineral is found. You know, there's obviously a lot of hoops and mountains to jump over literally with regulation before this gets off the ground and that mine gets running to produce what it needs to produce. That's why when I talk about the potential, if we're in a super cycle, I mean, we're in a bull market, but, you know, potentially a super cycle, that's why these can go for years because it takes time to ramp up reproduction. Dr. Wing Lim: [00:27:12] And then is it true that the world is now coming to us because we are the Canadian Shield, right? Other places they have, but there's political instability. They don't have infrastructure. Right? They're coming to us. Graham: [00:27:27] Yeah. The world does come to us. I mean, you know, we hear sometimes reasons why certain places don't come to us or they wish we were doing things differently here and there, regulation-wise in Canada. But the fact of the matter is, you know, for years, and I think it's true, I've been, to me, I like to keep things really simple, kind of dumbed down for myself. The world needs these minerals more than ever. We have them. So they're going to come and we're a stable country to deal with. And quite frankly, our environmental record is pretty good too, compared to a lot of other countries. Dr. Wing Lim: [00:28:06] Right. So because it's uncertain and we possibly could be going into a super cycle, so is it wise to do dollar averaging thing, buy some every year? Graham: [00:28:16] Well, yeah. Dr. Wing Lim: [00:28:16] Or just buy a big lump sum? Graham: [00:28:19] No, I would actually recommend that people don't buy a big lump sum necessarily, whatever big means to an individual. Um, I would say no, you're far better off once you understand the program and the merits of it, to cycle this, to buy some every year. Because there is going, even with the best fund in Canada out there, there's going to be the odd down year. One of the things to look at with any fund, quite frankly, is what I call an asymmetric return. How many, if a company has had 20 funds or 30 funds over the years, how many have been positive? How many have been negative? And if there's significantly more that have been positive than negative, that's a great asymmetric return for clients. Dr. Wing Lim: [00:29:08] Got it. Graham: [00:29:09] Right? It means that company kind of knows what they're doing. Dr. Wing Lim: [00:29:12] Good. Graham: [00:29:15] I recommend cycling. Dr. Wing Lim: [00:29:18] Good. So you're walking into the last question I'm going to ask is, the funds are not created the same, equal, right? So our program is not to flag a fund, but to empower our listeners to ask smarter questions to their advisors. So what are a few questions, maybe three questions, they should ask these funds? Like what are the key separating, what differentiating questions? One of which is probably the asymmetric return, right? They need to have good track record that. Graham: [00:29:47] That would be one, that wouldn't be the first question, or place to look, but that's absolutely one. How is the company done? You know, asymmetric? Have they had good asymmetric returns? To me, number one with anything in life, especially in the investment world, is management. Absolutely look at management. Look at their experience, their background, their credentials, how long they've been doing flow-through funds in Canada, what their relationships are with the mining groups, with the big investors in the mining community. I would also ask what that company's thesis is, what their investment thesis is. Because that can be critical, especially in flow-through. When you look at something like real estate, for example, buying a building, well, the thesis is pretty standard. Buy it and rent it and make money and hopefully it goes up. The thesis can be a little more, slightly more complicated in flow-through, but I would ask what the portfolio managers' thesis is. And they should be able to send you a 2 or 3 or 4 page only report on how they put, what their thoughts are, and how they put together the fund. And the reason you want that is, in my experience, I've seen a lot of flow-through funds out there that have focused on one thing only. Tax refunds for investors. That's great. But if you lose money, why bother? You really want to look for a fund whose investment thesis is to number one, try and put together a resource fund that's going to make people a profit and it comes, and just happens to come with flow-through shares. But in companies, their thesis is just to get you, is number one, to try and make a profit for their investors and give the significant benefits that down period in Canada were suppressed for about, they were poorly managed and just disappeared during the bare market. So I would look for companies that have just been consistent for many years, coming out with a product every year and doing their job. Dr. Wing Lim: [00:31:50] Okay, good. Graham: [00:31:51] Those are a few of the things that that you should look at. Dr. Wing Lim: [00:31:54] Right. Right on. Okay. So that's really good. So I want to thank Graham for his pile of wisdom. Pearls of wisdom. He's been in there the good days and bad days. Seen a few cycles. Dr. Kevin Mailo: [00:32:07] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

32 - Setting Boundaries and dealing with internalized shame with Dr. Megan Melo

Play Episode Listen Later Nov 30, 2023 29:17

Dr. Kevin Mailo welcomes board-certified family physician and obesity medicine specialist Dr. Megan Melo to the show. Megan has a coaching business, Healthier For Good, focused on transforming the lives of physicians through one-on-one or group coaching. Megan and Kevin talk about burnout, shame, and how physicians can learn to set boundaries and overcome perfectionism. Dr. Melo explains how perfectionism sounds benign and hardworking but is actually often shame avoidance. If we are perfect enough, we can avoid being shamed or called out. She talks about how that plays out in affecting the day-to-day lives of physicians. Megan and Dr. Mailo share stories from their own experiences and discuss what steps physicians can take to start pulling out of perfectionism and shame cycles. They address setting boundaries for self-care and why taking care of ourselves is such a vital aspect of being a physician. Megan offers coaching for physicians to help them achieve these goals, and this episode highlights some of the insights she has that can change lives for the better. About Dr. Megan MeloMegan Melo is a physician, board-certified in Family Medicine and Obesity Medicine, as well as a Certified Life Coach for physicians. She helps physicians struggling with burnout and overwhelm to feel better, including those who have been labelled "toxic" or "difficult" by their employers.Megan is on a mission to help physicians and other healthcare professionals heal from burnout and change their lives for the better. She does this through one-on-one and group coaching, as well as podcasting, blogging, and speaking to groups.Resources discussed in this episode:Ending Physician Overwhelm podcast--Physician Empowerment: website | facebook | linkedinDr. Megan Melo: website: HealthierForGood.com | linkedin | instagram--TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know! We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in-person and online. So look us up, but regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:34] Hi, everybody. I'm Dr. Kevin Mailo with Physician Empowerment, and I am very, very pleased to introduce you to Dr. Megan Melo. Megan is a board-certified family physician and obesity medicine specialist based out of Seattle, Washington, and she has an incredible coaching business focused on group as well as individual sessions called Healthier For Good. And the goal here is to transform the lives of physician clients who are coming through. And I think you've kind of got a focus, if I can describe it as that, Megan, on perfectionism. So why don't you tell us a little bit about your career journey to start with and how you got to this place, and then we'll get into today's topic? Dr. Megan Melo: [00:01:20] Yeah. So I grew up in a household of two nurses, and from a very young age I was like, I'm going to go be a doctor, right? And when you grow up that way, you get a lot of positive reinforcement. Oh, a doctor is a great thing to be. And oh, you sort of learn a lot of sort of people pleasing things along the way. And of course, socialized as a woman, we can throw that in there as well. Went straight from college to medical school and then into family medicine residency and did well, but was always kind of looking for gosh, like I wonder when things are going to feel better. And I remember my residency advisor would always be like, oh, second year is easier than first year, and third year is easier than second. And I was like, that doesn't seem to be true. I'm not sure why you keep telling me that over and over, because it seems like things are getting harder, more responsibilities, more people asking me to do things. But regardless, I graduated and went into practice doing pretty broad scope of family medicine for the United States. So I was delivering babies, doing clinical practice, occasional hospital medicine as part of teaching residents, and started a family at that point as well, pretty early in my career, and again, just had this experience of constantly looking for, When am I going to feel better? When is it going to get easier? When have I done enough that people will sort of start to ease off on all the things they're asking me to do? Along the way I picked up teaching in our family medicine residency, joined the faculty there, two kids by that point and life just kept feeling harder and harder, and I didn't know why and I thought it was me. I thought there was something wrong with me, that I don't feel happy. I feel like I'm constantly working harder and harder. And it never feels like enough. Dr. Kevin Mailo: [00:03:22] Wow. I think we can all relate to that. I'll share my own reflections. I mean, it's, you know, you sort of touched on this. This starts long before we even enter medical school. I mean, medical schools select for conscientiousness and a sense of duty and obligation, which is not a bad thing. I mean, that's how you want your doctors, but it is a perfect recipe for this perfectionism burnout cycle. And we're all surrounded by each other on top of it. Dr. Megan Melo: [00:03:56] Right? And we're all hiding how we feel from each other. Dr. Kevin Mailo: [00:03:59] We're hiding how we feel. Right? Dr. Megan Melo: [00:04:03] Absolutely. Dr. Kevin Mailo: [00:04:04] But you just, you don't want to raise your hand and say, I'm not happy, right? Or I don't feel like doing it. Dr. Megan Melo: [00:04:10] Like this isn't enough for me. Dr. Kevin Mailo: [00:04:12] This isn't enough for me. So then talk about, talk about perfectionism. Talk about how this impacts us in a very real sense. I'd love to dig down on this and hear more. Dr. Megan Melo: [00:04:28] Yeah. So you probably grew up with this same idea that perfectionism sounds great, right? It sounds like, oh, I'm just a perfectionist, right? It sounds like this very benign, hardworking sort of process. But a lot of the way that it's defined, especially by Brené Brown, who I follow closely, is that perfectionism is really shame avoidance. Right? So if I act perfect enough, if I know enough, if I, you know, look right and sort of perform excellently, then no one can shame me, right? No one can cast me out. No one, you know, I'll have to be a part of the group. And no one will see any flaws in me. And there is a huge difference between that perfectionism, right, that desire that I have to do everything just right, and excellence, right? Wanting to do a good job, wanting to learn more. If you've got a knowledge gap, you know, wanting to do the right thing. Those two things are not the same. But often, you know, again, our medical training has really reinforced this notion that I need to avoid shame at all costs. I mean, that's literally, you know, when we're on rounds, right? And we're being pimped by our attendings, you know, they're trying to find out all the things we don't know. And we are humiliated. Dr. Kevin Mailo: [00:05:53] Yeah, it's a shame-based learning system. Dr. Megan Melo: [00:05:56] So we're all steeped in that. Right? And it often, for many of us, just keeps going. But the stakes get harder. You know the responsibilities get more. We throw families and other, you know, kind of outside responsibilities in there. And then we're trying to keep up on those planes too. Have that perfect Christmas card or whatever the keeping up with the Joneses is. It's an unwinnable game and it's so toxic inside. Dr. Kevin Mailo: [00:06:24] And you know, I'll share my own reflection. I mean, you know, we talk about those external voices, right? Whether it's, you know, family or friends that have expectations of us, our broader community, of how we should behave or look, what colleagues say, superiors say. But the hardest one, the hardest voice, is that voice inside saying I'm not good enough. Or not worthy to be here or shouldn't be here. Dr. Megan Melo: [00:06:51] Yeah. And often that person that you may see, you know, and may be working alongside who is someone who seems really harsh, really judgmental, really, you know, kind of always unhappy with other, your performance, other people's performance. If we could listen inside of them, we would often find that that negativity, that judgment, that shame is even more intensely turned towards themselves because we can't shame and blame others without having a high degree of it within ourselves. Dr. Kevin Mailo: [00:07:26] Wow, wow. So. How does this play out in terms of our day-to-day practice as physicians who have now, you know, settled into our careers? Talk about how it impacts our scheduling, our patient interactions. Our, you know, vacations. Talk about how this, you know, bleeds boundaries, if you will. Dr. Megan Melo: [00:07:56] Yeah. And I often talk about this, you know, looking at perfectionism and people-pleasing and lack of boundaries together. Because there's a lot of overlap between them. But, you know, it shows up as us being unwilling and afraid to say no. Unwilling and afraid to set boundaries on our schedule, or whether we can throw in an extra patient or, you know, whether we'll set an agenda with the patient and say, I'm sorry, we don't have time to continue today. I know that you'd like to discuss these other things, but we're out of time for today. Right? So much of the time, too, we're operating in very broken healthcare systems, which are strapped and under-resourced. You know, there can be things like, you know, lack of beds, as we've discussed earlier or, you know, we don't have nursing staff or things like that. So everybody's responsibilities seem to have gone up, right, while our bandwidth has gone down. But if I'm internalizing that I'm not doing enough for my patients, and I'm bearing the weight of all of the shortages and the brokenness of health care, then that is a recipe for disaster, because I will not take the time to take care of myself. Make sure that I'm eating, sleeping, peeing, you know, feeling connected with my family, having some fun, God forbid. Right? Dr. Kevin Mailo: [00:09:18] And let me interrupt there and just say that this notion of shame in our careers and perfectionism bleeds into our inability to be present during family and personal time, because you feel this nagging inadequacy eating away at you in the back of your mind that you should be doing more, or that you could have done more. Maybe I should have. Dr. Megan Melo: [00:09:39] Or maybe I didn't do that right. Or maybe... Dr. Kevin Mailo: [00:09:42] Maybe I should have squeezed this other patient in. Dr. Megan Melo: [00:09:44] Absolutely, absolutely. And we often interpret, if we're used to sort of people pleasing and lack of boundaries, we often interpret other people's disappointment as proof that we're wrong or, you know, proof that we can't do that. Right? If I'm uncomfortable with saying no to you and you get upset with me, right? If my default is just to roll over and do it anyway, right? Like, oh, okay. You know, I guess so, I guess I'll do that. I guess I'll join that committee. I'll do these extra things for you today. Then I'm interpreting my own discomfort with their disappointment as proof that I shouldn't be trying to set boundaries, right? And that's where we often really hit a struggle because we can talk about boundaries, but we need to talk about us not controlling other people's expectations as well. Dr. Kevin Mailo: [00:10:34] That's theirs. Dr. Megan Melo: [00:10:35] That's theirs. Dr. Kevin Mailo: [00:10:36] You don't have to own that. You don't have to internalize that. That's an iss-them, not an iss-you. Dr. Megan Melo: [00:10:43] Right? I love that: iss-you. Yeah. Because, you know, I don't control, you know, how sick my patients are when they show up. I don't control that they've got a list of 17 items. What I'm working in, though, is, you know, a health care system that has, you know, time constraints and constraints on what is available to me to solve that day. Similarly, you know, sometimes in primary care or in the emergency room, right, we might get pushed to do things that, you know, are really, you know, at a specialist level. We want to help. We want to do more and provide the care that the patient needs. But that's not always the best solution. And the difficulty with finding, you know, finding specialists, if we continue to sort of suck it up and take on more than is reasonable for us to take on, then we're enabling the health care system to not make any changes. And as long as we do that, there's no pressure on the system to hire the appropriate amount of staff or resources, you know, get the appropriate amount of resources because they'll just continue to push us. Well, you care about people. Just take one extra person. Just do more. Dr. Kevin Mailo: [00:12:01] One year at our conference, we had an incredible speaker come who cares for physicians primarily in her practice as a psychiatrist. And she stood up and told the whole room, don't tell us to be more resilient. Don't give us another online module to do telling us to be more resilient. Dr. Megan Melo: [00:12:22] Yoga at lunch. Dr. Kevin Mailo: [00:12:23] Yeah, yoga at lunch. Dr. Megan Melo: [00:12:25] Or yoga before work. Dr. Kevin Mailo: [00:12:27] Yeah, like goodness, it is not about doing more and adding more to our to-do list. It's actually about doing less and doing it happily. But yeah, don't tell the profession to be more resilient. We are already highly selected for this resiliency. And we are trained in it and we practice in it. It's what is the limits of human capacity? Dr. Megan Melo: [00:12:51] Yeah, we need to learn how to turn it off. Dr. Kevin Mailo: [00:12:53] And most physicians who are burnt out are working beyond what is a reasonable limit for human capacity. Dr. Megan Melo: [00:13:00] Yes, yes, we need to learn how to turn it off. To say yep, even though I see it's very busy here and technically speaking, I could stay longer and do more, but it's ultimately better for me and every other person that I go home and rest, that I go home and take care of myself so that I show up again tomorrow. Dr. Kevin Mailo: [00:13:23] Yeah, yeah. Dr. Megan Melo: [00:13:25] But that's not something that often comes to us from the outside. People don't sit us down, our managers and clinical leadership and hospital... Dr. Kevin Mailo: [00:13:33] Nobody is going to sit you down say you know what -- Dr. Megan Melo: [00:13:36] -- they do not share that with you -- Dr. Kevin Mailo: [00:13:37] -- don't worry. Things are rough right now, but it's important you get home. But we actually need to start having those conversations in the workplace. Saying like, listen, you know, I know it's really busy today, but none of us is going to fix this. Let's just go home and, you know, we'll have to just hit it again tomorrow, right? So then okay, so talk to us about like some concrete steps to make this better. I mean love on your website it says I am a recovering perfectionist. Right? And in recovery, always in recovery. Dr. Megan Melo: [00:14:13] Right. Always in recovery. Dr. Kevin Mailo: [00:14:15] Because we always have those tendencies. I know for myself I've made a lot of progress in this space, but I always feel this backslide to take another sip of perfectionism. You know what I mean? And so talk to us about like, what we can do in a concrete sense. Because if I can be honest, I think a lot of this goes back to even early developmental stages in our childhood. Dr. Megan Melo: [00:14:37] Absolutely. Dr. Kevin Mailo: [00:14:37] Right. So how do you begin to rewire? What does that look like, Megan? Dr. Megan Melo: [00:14:45] Yeah, I mean, I think, you know, one really important step, right, is really tuning into our emotions. We've been taught to ignore our emotions often, the same way we've been taught to ignore our bladders, right. Or our stomachs. And this can be hard to do at first. Because if we're tuning into our emotions more, we'll often notice more negative emotions. We'll notice that we're feeling frustrated or resentful or overwhelmed or angry. But if we can start to understand what the thoughts are that are creating that, and often that's really where we see that perfectionism or that people pleasing, because the thoughts that are connected to those things are, I can't believe someone is asking me to do one more thing. Or don't they see how hard I'm working? Or how on earth could I possibly do more? Or I have to do this all right. You know, when we can start to really understand those negative emotions and those negative thoughts, we can start to unravel them and start to say, you know, it doesn't actually serve me to think that I'm the one who has to do all of this, that I can't ask for help. It doesn't serve me to continue to use other people's disappointment as a reason why I can't set boundaries for myself. Dr. Kevin Mailo: [00:15:57] Wow, that's a wrong fuel. Dr. Megan Melo: [00:16:02] So really sort of tuning in to understanding that dynamic. And it's hard work at first. Right? Because the well-worn ruts that are, you know, kind of that we're used to are saying yes, doing more, you know, not disappointing other people. And when we're doing this work, when we're tuning into who we are and what we need, we have to get out of those ruts. Right? And that's uncomfortable. One of my group members was saying, yeah, not only is it uncomfortable to, like, bump ourselves out of those ruts, but we're exposed. It's cold. You know, we're up at the elements. And I'm like, yeah, that's a perfect way to think about it because it's different. Right? Change is something that we have to put more energy into than following the well-worn ruts. But we also have to. You know, tune into ourselves and realize that I don't actually control other people's experience, right? I don't control whether my patients are happy, I don't control what their expectations are. But if I want to take care of myself and continue to serve patients in this model, in this place that I work, or however I take care of patients, then I'm going to have to set some limits on what I do for me. Because ultimately taking care of me is my job. No one's going to do that for me. And I think for such a long time, I wrestled with wanting and expecting that the healthcare system would somehow take care of me, right? That they would somehow, you know, tap me on the shoulder and say, hey, you need a break. Like, you know, here's a week's vacation. Or they would lighten my load somehow or pay me more or something. Dr. Kevin Mailo: [00:17:35] Or even just the reward and joy of practice. Dr. Megan Melo: [00:17:39] Right? Right. Dr. Kevin Mailo: [00:17:40] It doesn't... Dr. Megan Melo: [00:17:42] It's not enough. Dr. Kevin Mailo: [00:17:43] That's not, that shouldn't be the fuel. And it certainly isn't the antidote to burnout and perfectionism. Right? You have to be able to go in and love your job even when it's hard, right? And even when you struggle or, you know, you have complex patients or whatever it is, you have to be able to love your job, right? But that can't be the, that can't be the crux of, you know, oh, I'm really exhausted at work at 70 hours this week, but had some great cases. Yeah, that's not sustainable. That's not healthy. That's not the right reference point or goalpost that we should be using. Dr. Megan Melo: [00:18:22] Well in so much of, you know, kind of what we, what we think of, you know, in health care, so much of it seems tied to the physician. Patients do this, hospitals do that, like so much of a patient's outcome seems to be tied to the quality of the physician care. Right? That's what metrics are driven by. And we believe it too. So we are often carrying around this burden: I've got all these sick people, it's my job to make them better. Meanwhile, we're ignoring the fact that most of a person's health outcomes are related to their socioeconomic status, their genetics, how they've been living their life for the last 70 years, whether they got a vaccine, you know, and all of these other components that have much more of an impact than me taking care of them right now and trying to reverse things that are going on that are already pretty deep in the process. But again, when we go back to our training, right, treatment failures, bad outcomes are so often blamed on us, right? I must not have the knowledge, skills or experience to have properly taken care of this. Ignoring the fact that this patient came in septic with chronic kidney disease, poorly controlled type two diabetes, right? A really sick body. And I'm meeting it very late in the process. My ability to actually make impact is quite small, right? Something like 20% of our healthcare outcomes is related to the care provided by the physician and the healthcare team. The majority of it, generally speaking, is so many other factors that are outside of us. Dr. Kevin Mailo: [00:20:04] Much of the story is told before we ever arrive in the plot. Dr. Megan Melo: [00:20:09] Right. But if I'm carrying around this idea that most of the responsibility is mine, yeah, there's this little lifestyle and, you know, yeah, they inherited bad genetics, but most of the burden is mine, right? I'm going to keep in that perfectionism model. Because I'm going to feel like I'm never going to be able to do enough for that patient. We have to let go of that responsibility. Not to say that we're going to provide poor care, but let's be realistic about what is possible and what's not. Dr. Kevin Mailo: [00:20:39] Even just accepting the complications, misses inevitably happen. Dr. Megan Melo: [00:20:47] They do. Dr. Kevin Mailo: [00:20:47] I mean you're setting yourself up for failure if you become a surgeon and you say, I'm never going to have surgical complications. Well, that's, you know, that's just completely unrealistic. And yet when those complications occur, we feel horrible about ourselves. Well, I could have done this differently or that differently, or I missed this, or I missed that. And we, you know, we can tear ourselves to pieces, but without accepting the fact that every surgeon has complications. Dr. Megan Melo: [00:21:15] Right. And every body is a little different. Dr. Kevin Mailo: [00:21:17] And everybody's a little different. Dr. Megan Melo: [00:21:18] We learn where most of the organs are supposed to be, right, and how they're supposed to operate, but they don't always follow those instructions. Dr. Kevin Mailo: [00:21:24] So it's this notion of struggle is inevitable in a career like this. Right? I mean, you know, you're a professional athlete and you're going to have bad games. And so it's okay, well, how do I overcome that? And how do I keep going and not just limp along. But truly thrive. Say, okay, something happened. I'm, I've learned, I'm wiser. I put it into context and I can continue to confidently move forward in my career. That takes a lot of work, but it can be done and it should be done because like we said, like we discussed on your podcast, Megan, is if not now, when? If I'm not happy and thriving in my day-to-day clinical practice now, when am I going to? Because it isn't going to be sometime in the future, like you said. Dr. Megan Melo: [00:22:21] Right. We won't get to retirement and magically be a different person. Right? We won't have the capacity, honestly, to feel joy and gratitude because it's been, if we haven't been practicing it, we won't spontaneously experience it. Dr. Kevin Mailo: [00:22:37] And it's a skill. You have to work at it, but it does get better. So speak, you know, I don't want to keep going on and on and on, although I could. Trust me, we should just get you back on the show and dive deeper into these topics. But talk to me about, like, how coaching in this space can be so helpful for physicians. Dr. Megan Melo: [00:22:58] Yeah, I think a lot of the work that I end up doing with physicians is really about dialing down that messaging that I have to do perfect, I have to do everything perfectly. I have to say yes to everybody. I have to hold all of this. Because so often the messaging and the pressure on that physician is that they should just say yes with a smile. They should, you know, see more patients, make it to all the meetings, they should bring cookies. That's that's often, you know, for us, socialized as women. Right? Like we should contribute to the potluck and be just fine with, you know, being called that lady doctor or being mistaken for the nurse. Right? Dr. Kevin Mailo: [00:23:43] Yeah. I've got daughters myself, and it boils me over, and I'm working so darn hard to raise them without that, you know, socializing, as you call it. Because it is, it's horrifying. Dr. Megan Melo: [00:23:56] And it's quite pervasive. And it's, you know, we'd like to think, oh, we should be done with that, you know, in medicine. But no, of course, it's still just like racism persists, right? Like we're working on it, but we're not done with any of that. But really sort of trying to figure out like, what is that internal dialog that is going on for that physician about what they owe to others? You know, what's getting in the way of them taking care of themselves? Where are they struggling? A lot of times people come to me and they're really struggling with charting, or they're thinking they want to leave that job, you know? And we really sort of use that as a jumping-off point to really untangle this internal dialogue and figure out, okay, you're not broken, and you do have agency and choice, and you can start to say no. And here's how we, you know, start working on this. And through that process, really learn to, you know, be with our emotions, to see that connection between our thoughts and our emotions, and see that we are not responsible for fixing the broken health care system. But if we're going to continue to work in it, or if we're going to choose to leave, right, we need to learn how to take care of ourselves. Dr. Kevin Mailo: [00:25:07] Mhm. Dr. Megan Melo: [00:25:07] Because so many of my clients, you know, have been working 80-hour weeks and always putting others first and they, don't know how to do self care and they don't know how to answer the question what is it that I want. Like that question just stops them. Dr. Kevin Mailo: [00:25:23] Yeah. A lot of us don't actually know what we want. We maybe have a sense of what we don't want. Dr. Megan Melo: [00:25:31] I wanted to be a doctor. Okay, well, I am, but now what? What else? Dr. Kevin Mailo: [00:25:38] Yeah, yeah. Dr. Megan Melo: [00:25:40] Yeah, yeah. Dr. Kevin Mailo: [00:25:41] So powerful. Dr. Megan Melo: [00:25:42] It really does a lot to kind of offload the mind. Right? The mind that is telling them you're the only one who's like this. You should be happy just with the joy of taking care of patients and serving others, you know, and the guilt and the resentment and frustration that are kind of all tied into that. So really sort of understanding that internal dialogue and where that came from, and how do we start to undo it so that no matter what you decide to do, you will feel better, you will have better boundaries. You will see that you are not responsible for fixing the broken healthcare system, and you're not responsible for other people's emotions. Dr. Kevin Mailo: [00:26:21] I love that. Love that. So how do we reach you, Megan? For anyone that's listening. Dr. Megan Melo: [00:26:29] Yeah. So I've got a podcast called Ending Physician Overwhelm, and that's available on all the major podcast players. And then you can also find me at my website which is www.HealthierForGood.com. And I have a blog there. You can link to my podcast from there and you can find out about working with me either one-on-one or in my group coaching program. Dr. Kevin Mailo: [00:26:49] Wonderful. I love it. Thank you again so much for your time today and your insights, because I think this is the the unspoken... Dr. Megan Melo: [00:26:58] It's what we needed to learn. Dr. Kevin Mailo: [00:26:59] ... issue that we have pervasive within the medical culture. Right? And even when you just talked about like how others may be externalizing their internal shame was just eye opening for me. So again, I really want to thank you for, you know, highlighting such a big issue. And it's difficult to, I think I'll just share my own reflections before we wrap up, but it's difficult to, you know, except on the outside, you could say, well, this has been since my childhood. This is the way the profession is. But the truth is, it's highly empowering because it just, it's a matter of turning the cameras inward and doing the self-work. And we are highly resilient. We are highly intelligent and we're hard workers. So if we direct those energies towards self-improvement, it can get better. And it's independent of what hospital you work in, who your colleagues are, you know, what happened to you years ago in your life. The truth is, you can make it better now with that self-work. So I think that's so, so powerful. And again, it was wonderful having you on the podcast, Megan. Dr. Megan Melo: [00:28:11] Yeah, thank you so much for having me. It's been a real pleasure. Dr. Kevin Mailo: [00:28:14] Thank you for all your work supporting the profession. Dr. Megan Melo: [00:28:17] And for you. Dr. Kevin Mailo: [00:28:20] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

31 - Financial Education Awareness in Medical School with Christian Wigmore

Play Episode Listen Later Nov 15, 2023 32:07

In this episode of the Physician Empowerment Podcast, Dr. Kevin Mailo engages in an insightful conversation with Christian Wigmore, a medical student at UBC and the mastermind behind Budget Your MD. Together, they illuminate the critical role of financial literacy within the realm of medical education and practice. The discussion spans pivotal topics such as navigating student debt, management of lines of credit, and the influence of interest rates.Christian introduces his business, Budget Your MD, a debt projection tool and visual aid that empowers medical students to foresee their financial trajectory across various scenarios. The discourse places a strong emphasis on cultivating balanced financial habits that harmonize with professional ambitions, family life and personal dreams. Christian envisions a future where financial education seamlessly integrates into medical curricula, fostering a supportive community for open financial discourse within the medical community. Such an initiative, he believes, will play a pivotal role in alleviating burnout issues among physicians, ensuring a brighter, more empowered future for the medical profession as a whole. By melding financial wisdom with medical expertise, Christian and Dr. Kevin Mailo discuss how physicians can work toward a more prosperous and balanced lifestyle in the world of healthcare.About Christian Wigmore During Christian's first year at UBC Medical School, he noticed the lack of financial education integrated into the curriculum. Recently completing his double degree in Business and Biology, the importance of financial literacy heading into medical school was top of mind. He thought… we will be running small businesses and managing our personal finances in 6 years. Understanding the basics of finance is crucial to ensure we don't A) get taken advantage of by financial institutions and B) don't end up losing all the money we make in the process. All this, and much more, led Christian to start Budget Your MD. He tends to think of it as a passion project that he is slowly building as he progresses through medical school. Noticing the topics and problems his colleagues are interested in at each stage in the game. Christian hopes to one day play an integral role in changing how finance is discussed in the medical field. To not avoid these conversations, but rather dig deep to help one another live our best financial lives as physicians (because if we're being honest, our finances play a role in our health and wellness).--Physician Empowerment: website | facebook | linkedinChristian Wigmore/Budget Your MD: website | instagram | email |--Transcript: Dr. Kevin Mailo 00:01Hi, I'm Dr. Kevin Mailo, one of the CO hosts of the Physician Empowerment Podcast. At physician empowerment, we're dedicated to improving the lives of Canadian physicians, personally, professionally, and financially. If you're loving what you're listening to, let us know we always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming, both in-person and online. So, look us up. But regardless, we hope you really enjoyed this episode. Dr. Kevin Mailo 00:34Hi, I'm Dr. Kevin Mailo, one of the CO hosts of the Physician Empowerment Podcast. And I have today with me, our guest on the pod, Christian Wigmore. And I'm not introducing him yet as Dr. Christian Wigmore, because Christian is a medical student at UBC. And he founded a very interesting venture called Budget Your MD, and I wanted to share it because Christian connected with me over social media, we got talking, we had one of those great phone calls that I think was supposed to be probably five or 10 minutes. And it wound up being like an hour or two talking life, talking dreams, talking finance, talking career. And then of course, Christian joined us at our conference in 2023, and it was amazing to meet him in person. And we've stayed in touch ever since. So, I'm very glad to have you here, Christian. I love your passion. I love what you're trying to do for your fellow learners but I think there's a lot of wisdom here for us going through our careers, like I'm a mid-career physician, and I love your message. So, tell us a little bit about like your background. Tell us a little bit about what you were doing before medical school. And what you did you know, once you entered medical school? Christian Wigmore 01:41Okay, well, first off, super glad to be here. I can think back to when I messaged you first on, I think it was LinkedIn. And I think I might have messaged like six or seven other people, no answers, but you answered me right away, and then we get on that phone call. And then off we go to the conference in May. It's been cool to get to know you. It's so yeah, super glad to be here. So yeah, my name is Christian. I'm a fourth-year medical student at UBC. My journey has been pretty centred around medicine to start. I knew kind of in high school, I wanted to do medicine, you go to university, you do the sciences. But funny enough, like if you are UBC grad or you know how UBC medical school works, you get to drop your worst year. And I met my wife in second year and got like the worst grades.Dr. Kevin Mailo 02:27Was it worth it?Christian Wigmore 02:31Oh, well, I'm still married to her, right? So, I got the worst grades that year and I knew I needed to have a little bit extra time before that bad year can be dropped before getting into medical school. So I was like, What am I going to do? I grad with a science degree, that's going to leave me doing what? I know I don't really have an interest in something outside of medicine with a science degree. So, why not start taking some business courses, right? So I started doing business courses, and I realized, wow, I kind of liked this stuff. And you know, that wheel starts turning and I realized, okay, maybe if I start doing summer courses and push a little harder, I can grad with a science and a business degree. And so that ended up taking me five years. And after that, I found a small little internship in the midst of COVID with a financial advisor and kind of was able to be his associate and just watch the way he ran his business. And it wasn't only finance, but it was kind of more of like the operation side and entrepreneurship that really started to make me realize that there's that world out there. Like they don't teach any of that in science, you don't really learn any of it in high school. And so that got me excited. But that year I got into medical school, right? And that's the golden ticket everyone's waiting for is they think about medicine. And so after medical school, I went, but I guess over that time, the business mind was still kind of ticking at times. Dr. Kevin Mailo 03:46So, when calls that the white coat, black suit mentality, right? Do you wear the white coat when you're in your clinical work and the black business suit when you're managing your finances or your practice? So yeah, keep going, keep going. Christian Wigmore 04:01Totally. So like, I think originally, I was always believing that I would kind of wear that black coat, I guess like in my own personal finances, thinking about the ways that I'll eventually run a corporation through my medical practice or something like that. But what I started to notice is just the lack of any financial topics, discussion, or education at medical school. And then I realized I have friends around me that didn't necessarily have that same mind. And I said, Well, why don't we start talking about this stuff more? What? Why is this something that's never spoken of? The preceptors we work with don't really talk about it. And sure it maybe doesn't apply to us immediately as a first-year medical student, but eventually it will. So, when will this part of our education come into play? And I speak to people higher up than me, doesn't really seem like it's ever happening. And then I said well, you know, between studying and doing other things I kind of like finance and I probably know enough that I can make a few Instagram posts, so I start Budget Your MD is the name that I call it, right? And start to make little infographic posts and see how it goes. And at that time, it's still slow growing, and students are slowly finding out about it. But what I find is, as I go through each year of medical school, I'm able to see the questions, and topics and interests that students would have at that time. Like, I'll give an example in first year, it's the line of credit, like, what does that mean? I all of a sudden have been given sorry, $350,000 from a bank. What does that look like for me as a medical student? What is interest? How does interest even work? And you know, which bank offers the best package? And so that's kind of what I've used as an area to at least keep people interested on things that they're currently going through. And as now I go into fourth year, I realized disability insurance questions like that. Things that come up that are these decisions that require a little bit of financial savviness to understand, are being put on people's plates, right?Dr. Kevin Mailo 05:58I love that and so, you know, what are some of the big issues that and let's go a little bit beyond medical students to, you know, residents to fellows, people in early year practice. What are some of the struggles that people face in these early years? Because I think the big one for medical students is blowing through that line of credit, right? I remember, when I went through, it was low, ultra-low interest rates following the financial crisis, right? And so it was like how wasn't that bad, but interest rates have gone up massively, right? And so we have learners that are struggling with the thought of this interest piling up. But we also have a lot of physicians who have personal lines of credit used for consumer purchases, and it went from being tolerable to being very painful. If you think of it this way, and there's just little thing, and then we'll get back to the interview. But if you have a personal line of credit that you used for whatever home renovations or consumer purchases, whatever it is, and that line of credit is $1,000 a month of service, it's like $2,000, having earned because you have to pay personal tax on the money that you're going to use to service your line of credit. So, that's a really big hit. That's like working, you know, a whole long, busy clinic day, at a minimum, just to service that line of credit without even paying down the balance, right? So people are starting to feel the pinch of interest rates. But let's go back a little ways. And just talk me about what it is some of the issues that you see in you know, people that are now going through residency, although there's a little bit of income coming in, but there's a little bit of tax planning that has to start to begin. And also like in those early years of practice? Christian Wigmore 07:40Yeah. It actually reminds me of, I spoke with, I think it was the residence of doctors of BC when I think one of their whether it's the president or not, he showed me a presentation, at one point about the debt levels that residents have, when they start residency, this might just be BC specific, and when they end. And my thought had always been well, it would go down, right, like they finally started. Like you should be able to kind of work it down a little bit. 50% of it goes up, but of the students, 50% of residents will have more debt when they finish residency. And so things that mean, you have always talked about, but like, let's think it's got to be something rather than actually needing the fancy car or needing something. It's a mindset, potentially that's causing people to do this. Now, we always have to, like put in disclaimers, there's family circumstances, things that are out of–Dr. Kevin Mailo 08:33Yeah, I mean, when you're like in my household, when we were both going through medical school, we paid the nanny more than I made. Because we were both working like 80 hours a week and we had young kids and she was hitting overtime by Wednesday afternoons. So, yeah, you're right there, family circumstances, totally. And personal circumstances. Christian Wigmore 08:51There's potentially a mindset, right? And I have this funny little line that I heard from a physician at one point, and it goes, “If you spend like as a doctor, when you're a student, you'll live like a student when you're a doctor.” And that one hit me right away, right? Because it's that thought that if you blow up the line of credit through medical school, and you finally get into practice, and you think that pearly white income that you'll eventually earn will pay it all off, you start to realize that all that spending you did as a student, basically wrecks any of the beauty of having a higher income, I guess, as a doctor, eventually. Dr. Kevin Mailo 09:26And there's a huge tax penalty now, right? Like, that's the other reflection I have, you know, in your generation compared to mine, like, I mean, and it was even better years ago. But, you know, I graduated like 15 some years ago, it have been 10 years in practice. So, what am I, totally getting my numbers wrong. It'd been 10 years in practice, but like I was, you know, at a place where like, we could pay down the line of credit relatively easy with income splitting through the PC, and dividends to spouse. Personal Tax rates were lower and now it's different. And the cost of living has gone up, right? So, your base cost for food, clothing, shelter, transportation has gone up. So, there's less and less margin to pay off personal debt, right? Between taxes and the cost of living. And you're right, it's so critical to get this right in the early years of practice. Christian Wigmore 10:20Yeah, and I feel like what we're talking about here is just it's like, it's personal financial management. Like we're, there's kind of like, there's personal finance, and there's like your corporation management, all that fun, financial things that like we could all learn as doctors, but it's the personal side, the personal financial management that's so important. That could begin right as they get into medical school as they go through medical school, into residency, and then into practice. That is honestly the saving grace that appears like these days to save you from some of the hardships of feeling like you have to go to clinic every single day, or work that extra call shifts to pay for all the luxuries that have kind of built up over time, right? And so that's what I think of as like the end game in a sense when I see myself and I see the students around me of thinking about what do the decisions that we make right now as students and kind of the habits in a sense too that we make right now as students and the expectations that we make about what it'll be like when we start to make money. How that will actually impact our career, and how we can still be as healthy as possible as doctors in not only our lives as physicians serving our patients, but also in our financial lives, right? Dr. Kevin Mailo 11:35I couldn't agree more and it's so important to get that alignment right. Between what are your career goals and your personal goals, right? Because if you say, you know, I want to be healthy, I don't want to work in excessive number of hours, I want to minimize the number of call or night shifts I'm doing or whatever, or clinic days I'm doing in a month. Well, you have to have financial goals that align with that. Because if you don't, well, you know, I mean, your mortgage company doesn't care. You know, what, how many hours you want to work in a week that mortgage comes due every month, right, or the grocery bill or whatever else you're facing. And so it's again, it's being holistic in our lives, and looking across and seeing Okay, well, what do I really want? And then what financial decisions am I making that align with it? Especially the big ones, right, like mortgage and those kinds of things, like the big permanent purchases. Christian Wigmore 12:30Yep. Yeah. It's interesting and I think it like it ties in to, you know, we are offered this $350,000, when we've never had money before, there's like that aspect of like, quickly, your life-changing in the financial world. But then I assume, you know, I'm still like, early in the game, but I assume the moment I start making an income that is substantial enough, the bank's gonna come to me and say, Hey, here's this fancy mortgage, you can have it and but this million dollar house, and they make you feel like you can afford it. Because, in a sense, if you're willing to sell your life, you can, right? And it's those trip falls are like the traps that I think are just so important to be educated on as we're going through, to be aware and know the implications, right? Dr. Kevin Mailo 13:13And this is also another thing that we teach us at the conference. And I alluded to this, you know, when you were there as well Christian, is the notion of an hourly rate. Every one of us has an hourly rate, what we're worth per hour what we can bill. Remember that there's a tax penalty associated with that, right? So, if you're, you know, if you're billing $300 an hour, your after-tax income on that is actually going to be substantially less. So, when you say, how many 1000s of dollars do I have to pay on a mortgage every month and property taxes, and utilities, and maintenance, and repairs, and vehicle payments? Well, now you can actually calculate and, you know, I'm happy to show anyone that's interested, how many hours in a month you're gonna have to work just to maintain those big expenditures, right? And then how many hours are left for fun? And the bigger one is, how many hours are left to save for retirement? Which again, the sooner we start, the sooner we are better off. But if we if you know, we're struggling for 5 or 10 years to pay off a line of credit, then we've already really short in the compound growth curve, which is so vitally important not to do. Christian Wigmore 14:25Yeah, and something that like, is underrated and not maybe spoken about as much is student loans nowadays, like the government has announced that they're not charging interest on those. So, we already have it easier than the previous like, the generations before us, right? Like my student loans right now, if things don't change, I don't pay interest on it ever. Like I just have to make the minimum payment and it doesn't go up over time. Like that is a huge advantage. Dr. Kevin Mailo 14:50That's a good deal. Christian Wigmore 14:51I know, yeah, pretty sweet. Yeah, almost say thanks to the guys over the line that did it first and then Canada felt like they had to follow suit, but like, yeah, the only interest-bearing debt that we're going to have coming out of is the line of credit. And you have to jump into that a little bit to pay tuition, the student loans never cover it fully. But it is still a variable cost in my mind of kind of your lifestyle and things like that, that really push that number up. Dr. Kevin Mailo 15:18It totally. And I mean, I'm sympathetic to it as well. I mean, you know, when you consider, you know, broader, you know, sort of North American or Canadian society, there are very few people that are forced to delay gratification the way doctors are. Like, some of us go a decade or longer in school. In fact, it's actually much longer some of us regularly go like 15 years from undergrad to practice. Like that is a very long road, right? And it's natural to want the nice things in life. Right? You actually do deserve them, right? The message here isn't, you know, that you've got to live this extremely austere existence, that it's craft dinner and ramen noodles every night. No, it's, there's just got to be some balance, right? Because there's a very real cost to that lifestyle creep and remembering that if we're 10 years behind the average adult in entering, practicing and earning in our prime, it's also 10 years that we've lost on the compound growth curve. Again, it's another big impact. Christian Wigmore 16:25Yeah, I've used the example sometimes with students, as we kind of talked about our debt of what would it look like if you just became a red seal electrician right off the bat, and you saved 15% of your income over time? The amount of time it would take us as physicians, who are thought to have made/make so much more money than a red seal electrician to catch up to that person is incredible. I don't know the math in my mind, I'm not that much of a whiz. But like, it would take so long to catch up to that person for the compounding that they would achieve over those years that we're studying. Yeah. It blows my mind sometimes. But that just only solidifies the point of just good, sound, basic financial knowledge, just for basic, like, you know, your own finances, things like that. Dr. Kevin Mailo 17:10And the other reflection is, you know, again, another observation about younger generations coming through, they don't want to work the 70-80 hour workweeks that older generations of physicians have worked. And I actually think that's a wonderful thing. I think that's an example to the entire profession, that we should all be working fewer hours. The job is stressful, we deal in people's lives, and more should be spread, more duty should be spread across a larger group of physicians. Absolutely, right? It shouldn't be two rural physicians holding up a town, you know, in a remote part of Canada. It should be four, do you know what I mean? And this applies everywhere across our healthcare system. But again, if we're going to cut back those hours, our finances have to align with that broader goal. And so it's about like being mindful and intentional. And reflecting on what do we really want our ideal work week to look like? Because yours was actually very interesting. I really liked yours. You don't have to share it. But it was great. It was really balanced. Christian Wigmore 18:14Yeah, I'm happy to share like my dream in the future. Like, I think, first and foremost, for myself, like this is getting a little bit more personal into how I feel. I'm like a family man first. I've always been that way. Like, my dream is to be able to go to my daughter's soccer–Dr. Kevin Mailo 18:27I love it. Trust me, do it all. Christian Wigmore 18:29–basketball game. Like that's–Dr. Kevin Mailo 18:27That's wonderful. Don't miss any of those moments. Sorry, I'm going on and on. Christian Wigmore 18:34–I want to be able to drive my son and his buddies to the basketball game and hear them get hyped up to some Eminem or something on the way to the game. Like I want to be there for those moments, right? And so I think like, if I could work clinic two-three days a week, and then have two or three days a week that are more flexible, that they could be, you know, those moments with my kids, or be moments where I'm getting to pursue Budget Your MD and kind of push those things forward.Dr. Kevin Mailo 18:58A passion.Christian Wigmore 19:00Yeah, exactly. That gives me the balance, right? That allows me to really be the doctor, I want to be on those two to three days. And then be the dad I want to be hopefully, be the husband I want to be, and then still kind of use that other part of my brain that sometimes has to be shut off at times. Right? Dr. Kevin Mailo 19:15I absolutely love it. What an inspiring message. So okay, let's tell us a little bit more about Budget MD. We touched on and then we went on on all these tangents. Tell me a little bit more like what what do you do right now with it?Christian Wigmore 19:31So, the thing that I would say we provide or I provide the most value on is something I call the debt projection tool and I know of honestly centers around everything we talked about today. And I made it originally for myself, I was just interested, okay, if I have this much debt currently, and say I want to go into family practice, which is what I want to go into, or what if I want to do internal med or ER. What would those differing incomes look like in terms of eventually being able to pay off my line of credits, my student loans? Like how long would it take me to get to financial independence and if I want to save a little bit along the way? And so I took some Excel courses through my business degree and know three or four formulas. So, it's not the cleanest Excel spreadsheet in the world, but it works. And what I allow myself to do is to plug in, okay, this is my age, this is the specialty I might think of doing. And I even have like the house I may want to buy it some age, the interest rate that approximately it could be at at that time, and the downpayment, I could approximately have, and I even have in there, how many kids I would want to have. I just do an average, I think it's like just under $14,000 a year for a kid from the age of like, zero to 18. I've never been a parent before, so, I have no idea. That's what I found on the internet, right? So, maybe it skews a little bit more expensive into the later years as you're paying for universities and stuff if that's something you want to do versus the beginning. But you can correct me if I'm wrong there. But basically, the goal of this tool is to help what I find to be two groups of students. And this is what I get passionate about, there's students that are, A. super worried about their finances, like I've met a few that like, I have so much debt, I'm never gonna be able to pay it off. Dr. Kevin Mailo 21:09That was me. Christian Wigmore 21:10It's hurting their ability to learn. And I'm like, you're gonna be fine. Like, you actually need to be told that, like you're doing a great job, and like be able to move on with just learning and know that things are going to be okay, that's one group. And then the other group is the, oh, I'm going to be a doctor one day, it's completely fine. Yeah, I do DoorDash every single night because like, you know, we'll make a good income at some point and pay it off. And so it's those two groups that fill up this debt projection that I have, and kind of give their example scenarios. And I can show them well, okay, person A, that's worried about their life, you're going to be okay. You're like this is kind of your projection, approximately, like none of this is exact, but it gives them an idea that the debt will eventually get paid off and kind of eases some of their worries. Group two sees on their projection that with their current debt and spending, the curve only just continues to go up, it's almost like, you're not going to be able to pay all this off. And coincidentally, they're the people that say they want to buy a $3 million house, and then that mortgage payment really causes the curve to continue up as well. But it, my goal with that is to just start the conversation, right, is to get that part of there, get the light switch moment to go and realize that, okay, the current habits and mindset I have, are maybe a little bit off from what I need to currently be doing to make sure I'm setting myself up to succeed, not only as a physician, but in my own independent financial life. Dr. Kevin Mailo 22:39I love it. Christian Wigmore 22:40So, that's my big like, that's the one I really have fun with because I kind of like Excel, and they send over the projection, I do it completely for free, and I send it to them. And then I offer them 30 minutes to chat about it too if they want to. And so, that's been super fun. It's kind of an extra thing I'll do in the mornings or the evenings, I'll fill those out for people. It's not AI-generated at all, at this point. So, I'm still collecting some things together on my own computer, but I'm one of those rare breeds that likes to see an Excel spreadsheet. So Dr. Kevin Mailo 23:10Yeah, I love it. So, where do you want to go with it? Right? Because obviously, we're gonna hear more about it. You're in the early stages. Where do you want to go with it? Like, what's your dream, in terms of the profession? Christian Wigmore 23:22Yeah. So, my dream, in terms of the profession would be to like, almost not solve but help in the world of, you're gonna get my mind going too fast here, Kevin, when you ask me what my dreams for this thing like, it's so like–Dr. Kevin Mailo 23:41No, no. Like, I just did a podcast episode on dreams. It'll come out before this one. I'm a very big believer in being open about our dreams. So, talk about your scope. Christian Wigmore 23:55So, like a broad dream would be to change the way that financial education is brought into the medical programs across Canada. Like let's start Canada first, we don't need to go worldwide. I don't need to dream that big. Like if we could somehow incorporate financial education into the undergraduate medical degree, and whether that just be evenings or a lunchtime money talk or something to not only help students become aware of the pitfalls as they transition into residency and practice. But also just to be aware of kind of the habits that we've been speaking to a lot over the past, I don't know how long we've been–Dr. Kevin Mailo 24:37I love it. Yeah.Christian Wigmore 24:40So I mean, that's the number one goal, right? And then after that, like, I hope that that could evolve into like a better community in medicine that is willing and I think Physician Empowerments already absolutely spearheading this, but a community where doctors feel more safe to talk about this stuff, right? Like, it's rare, like as a student, have I ever had a preceptor bring up, you know, billing or how they're like clinic rents and stuff like that? No, I haven't. And if there could be a community where students can ask about this stuff, where people further down the line can give advice about these are the some of the mistakes I made as a student. And that doesn't have to be like physician to student that can be, you know, 20 years experience position to first five years practicing physician, just the space like that would be awesome. Just to provide that advice and care almost for the future generation of physicians. And I think in general, the dream, like, macro of all of that, is that that could then some, in some way help aid like the issues that we see in medicine as a whole right now, like the burnout issues, like that's the big word. Dr. Kevin Mailo 25:48Oh, without question. Christian Wigmore 25:50And I think me and you align on this that, like if personal finance, can be focused on more and physicians understand how that binds them, I think we can, hopefully, turn the dial a little down on the burnout rates. And that's the goal, right? Like, that's the hot word these days. And in medicine, practicing physicians is burnout, right? Dr. Kevin Mailo 26:10Yeah, I'll just go on, I'll go climb on my, you know, pedestal on this one and go. I teach wellness, right, that's one of the things we teach at Physician Empowerment, and I've done CME events for it. And I'm going to be blunt. I mean, you can do all of the mandated wellness modules online, that the system tells you to do. You can do yoga, you can journal, you can meditate, I do all of those things, you can do all of that. But if you are unhealthy, working 70 hours a week, no amount of extra stuff you do is going to make that better. If you're healthy number of hours a week is 40, then you just have to come down, the only way to come down is to be financially secure. Financial Security underpins all wellness, in our profession, in my opinion. The other big one, and we sort of touched on this before we started recording, was leadership. When we want to transform the system and make it better for our patients, better for us, better for our allied health colleagues, we need to be involved. We need to be able to sit on those committees, we need to advocate, we need to be a voice, we need to be present, truly present. That will only happen when we're cutting down on 70-hour work weeks, and we have a little bit more balance to get involved. Again, truly believe that and again, that is underpinned by financial security. Christian Wigmore 27:37Yeah, and, you know, it almost feels odd as a student right now talking to a physician who's current practicing to like speak about this financial stuff, because it almost feels weird, to be honest. Like we're doctors. And I think at the conference, Wing spoke about this, about where there's this altruistic mindset that's kind of ingrained in us that we're supposed to just work like crazy and not think about the finances, because we're serving, and I 100%, like, have that heart to serve. But I think it's gotten to a point these days where like, you have to start to think about that weird financial pit in your stomach because it has all these implications we've been speaking to, right? Dr. Kevin Mailo 28:16You will do your best care when you are not burnt out, when you are not exhausted, and when you're not overbooked and worrying about the overhead. That is what your patients deserve. A rested physician who is in control of her/his schedule, that's what's so powerful. And that's what will lead to better patient care. So, to serve, it means to serve ourselves first or to be to be our healthiest first is in my opinion. Christian Wigmore 28:42Yeah. And like, honestly, Kevin, I appreciate you saying all that. Because I think that some of the mindsets I've come to I would never be able to come to just as a fourth-year medical student, you know, learning–Dr. Kevin Mailo 28:54It's hard to talk. Christian Wigmore 28:55Yeah, it is. And like, No, there's no medical student out there that's thinking about these things. We only hear of it from people like you and Wing and all these other physicians that are starting to talk about this stuff that we can begin to create some of these ideas of important topics and frameworks that it will matter later down the road. But what's so awesome about this conversation is that hearing them then allows you to have the advantage of applying them early. I think that's the key that I get excited about. Because talking about them, you know 10 years into practice is awesome and super important, has a role but there's such an advantage to thinking about it or like–Dr. Kevin Mailo 29:32I couldn't agree more. I couldn't agree more. Christian Wigmore 29:35Because you're making lifetime decisions. Even the specialty you go into like that's bigger than the house you end up buying, the house you end up buying it's high up there too, but the specialty end up choosing, like think about this stuff like it. That's your life like you're signing, we're all in medicine to–Dr. Kevin Mailo 29:50It's very hard to retrain.Christian Wigmore 29:51Think about your life to go do that, like be ready. You know what I mean? Dr. Kevin Mailo 29:52Very hard to retrain. I'm envious of our nursing colleagues who are able to cycle through different aspects of nursing over the course of their career in health care. Because we really struggle with that in medicine, it's very hard to retrain, and understandably so I mean that there has to be a lot of technical proficiency. So, I thought this is absolutely amazing. I would encourage listeners to check out Budget Your MD. I know more is coming from you, Christian. That's why we want to bring you on the show because this is going to be a lot more than just medical students and residents, right? I think all of us should be going through this exercise. So, get building those spreadsheets, no I'm just bugging you. No, we look forward to the other offerings that are coming. And you do so much education as well. I know over Instagram and other other places. So, I again, encourage people to check it out because it's the what you teach is so true. And it's been great connecting, and great having you on the show. So, we'll we'll definitely have you on again. Christian Wigmore 30:49I appreciate your mentorship. Thanks for having me on. It's been so good to chat about some of these things. Dr. Kevin Mailo 30:54Wonderful. Dr. Kevin Mailo 30:56Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

30 - Why Your Dreams Matter

Play Episode Listen Later Oct 31, 2023 27:39

Dr. Kevin Mailo is interviewed by Physician Empowerment co-founder and co-host, Dr. Wing Lim, on the topic of dreams. Kevin once gave a talk on this subject at an accredited CME event in Mexico; about what dreams really are and why it's so important to have them. And in this episode, he shares a bit of that talk. Wing asks Kevin to first define dreams and differentiate them from goals, which are not the same thing. Something Kevin says in giving his definition is that “dreams are what help us keep going forward in our lives despite the struggles”. That is part of why dreaming is such an intrinsically vital part of wellness and forward motion.In this episode, Dr. Wing Lim and Dr. Kevin Mailo explore dreams, dreaming, why we have dreams, why they matter, what dreams give to us, and what dreams offer the world at large. Dreams not only give meaning to our lives but give us the ability to enjoy the pursuit of them and to flourish in the journey toward them. This episode will shake you out of going through the motions, which is a source of burnout, and leave you inspired to dig deep to reconnect with your own dreams.—Contact Information:Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know! We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programing both in person and online. So look us up, but regardless, we hope you really enjoy this episode. Dr. Wing Lim: [00:00:34] Well, welcome everyone to our next episode of podcast in Physician Empowerment. So I'm Dr. Wing Lim, I'm one of the co-founders of Physician Empowerment, and today I'm really glad to interview my co-host and co-founder, Dr. Kevin Mailo, who is an emerging physician out of Sherwood Park. And we're going to talk about a topic that he delivered in an accredited CME event in Mexico a couple of years ago. And it's about dreams, why dreams matter in your life, and how it ties into your wellness. So welcome everyone and welcome, Kevin. So why do you pick a topic like that? Strange topic, dreamy weamy stuff. Dr. Kevin Mailo: [00:01:16] Yeah, so this one actually, this was actually an accredited talk that I delivered when we, when we got invited to Mexico. And at first I was actually overwhelmed with this one. And today on the episode, I'm not going to go into it in its complete depth. There's a lot, a lot there. But boy, at first it was, like I said, overwhelmed. And I'm like, where do I start? And then I started and I just kept going and it was incredible. And this topic specifically represents really, I would say, my falling in love with Physician Empowerment, because in many respects, Physician Empowerment represents a dream for me to help transform the lives of Canadian physicians. But what was so powerful is that in this journey of teaching, I was forced to learn the material myself. I was supposed to take it. I was forced to take a very hard look at my personal life, my professional life, my financial life and making a lot of incredible change, and I'm just so much happier for it. And so this topic of dreams became very powerful for me because it brought a lot of focus into my life. And so, yeah, again, I could go on and on about about this, but yes, this was an accredited talk. You could claim main Pro Plus credits for it. Really far from blood pressure management. Really far. Dr. Wing Lim: [00:02:41] Manage your own blood pressure. Dr. Kevin Mailo: [00:02:42] Manage your own blood pressure. Exactly. By being better. Dr. Wing Lim: [00:02:45] So tell us. Tell us, Kevin, how does, why do our dreams matter to our wellness? Dr. Kevin Mailo: [00:02:50] Yeah. So. So dreams matter in our lives. And I'm not talking about goals, okay? Goals I'll get to later, that's a much narrower thing. Dreams are those things that we truly want that are part of our self actualization. Okay? Dreams are. When I think about a dream, I think about our life as a landscape. So I look at my life like it's a landscape. It's got hills, it's got paths, it's got fields, it's got forests, it's got mountains. It's got whatever in front of it. And on the horizon is a destination. That is a dream to me. That's the visual imagery I use to describe dreams, and that you can have multiple dreams in your life's journey, that you can walk across the landscape of your life, and you can go to all these vistas, all these points. All these locations, and each one represents a dream, right? So it's not one thing on the horizon. It's many things on the horizon. So dreams are what help us keep going forward in our lives despite the struggles, despite the setbacks, despite the monotony, despite the burn out, dreams end up being the thing that we can focus on so that when we're walking life's path and it's muddy, it's rainy, there's quicksand, there's no clear path ahead. Somehow we make it when we follow our dreams. Dr. Wing Lim: [00:04:20] Right? So yeah. So you said the dreams and goals are not the same. And most people, they just lump them up, dreams and goals. Right? Dr. Kevin Mailo: [00:04:27] Exactly. Dr. Wing Lim: [00:04:27] So how do you distinguish between them two? Dr. Kevin Mailo: [00:04:29] So for me a dream is a representation of a better future for myself, for my loved ones, and for society as a whole. The other thing is that dreams can be very small. You might have a dream to run a half marathon. Okay? Or a dream can be huge. We actually had somebody come to the Physician Empowerment conference one year - do you remember, Wing? I think you do - He is very successful physician entrepreneur, and we talked about physician entrepreneurs before, but his goal was to build his business and create a $50 million endowment for children with autism and autism awareness. And that was his big dream, right? So dreams can be huge. Dr. Wing Lim: [00:05:15] Mhm. Dr. Kevin Mailo: [00:05:16] Dreams can also be private. So they can be, you know, things that are very personal that we don't share. It can be something, you know, like a special trip. You know, you want to go to a great location and just experience a certain festival let's say. But dreams can also be shared. Right? You know, that you share with your loved ones that you share with colleagues. Like let's say, you know, you talk about your dream, Wing, of Synergy Medical. That was a shared dream to bring comprehensive health care to a county of, well, probably getting close to 100,000 people now, that was underserved. So dreams are a lot more than goals, you know. A goal might be to say, I want to have X amount of dollars in the bank when I retire, but a dream is really I want to have this money to do this great thing for myself or my family, have a sense of purpose. And the truth is, and you know, I don't want to sound too romantic here, but the truth is, our world is built on dreams. Every invention, innovation or discovery was a product of dreams. And the people who make the headlines, they're not particularly intelligent, not even necessarily particularly hard working, but they're dreamers. And they kept going despite the failures and the setbacks. Dr. Wing Lim: [00:06:41] Mhm. Yeah, I once heard one definition of dreaming is an attack on status quo. Dr. Kevin Mailo: [00:06:48] Ooh I love that. Looking at the world and saying I'm not happy with what I see, or looking in our lives and saying, I'm not happy with what I see. How can I do better? Dr. Wing Lim: [00:06:59] Mhm. Dr. Kevin Mailo: [00:06:59] For me, and I would say, you know, some of the most important people in my life are immigrants, including you, ing. But immigrants inspire me because their lives are, are an embodiment of a dream of a better existence for them and their descendants. When you think about the immense sacrifices somebody makes, you know, to travel to another country, leave everything behind that they know, and start working at a lowly job and start working up the ladder, is incredible. Right? Again, not happy with the status quo. Dr. Wing Lim: [00:07:37] Mhm. Dr. Kevin Mailo: [00:07:38] And somewhere along the line as we become adults, and it's funny because one of my kids had a birthday and I told him like, don't ever grow up. And it's not that I don't want my children to become highly responsible, industrious, hardworking, self-reliant young people that will have careers and families of their own. But the message behind that was, don't grow up. Don't give up on your dreams and become some stuffy adult that is focused on day to day tasks and has no meaning in the broader arc of their life, that loses track of the landscape. Because when you think about dreams, probably your best way to connect with your own dreams is to look at the ones that you had when you were a kid. You know, when you were a teenager. And it's like, what would I do in my career? Where would I live? Who would I marry? What would my kids be like? Where would I travel? What would I experience in life? What would make me happy? Somehow, as adults, we have lost that. Somehow, as adults, through career, life struggles, institutional level sort of functioning, being put into a system, whether it's an education system or the health care system or a business system or whatever, our dreams get ground down. We're told it's unrealistic to think like that. And yet, as I said before, some of the most powerful innovations in our world, inventions, new systems of government, whatever, are the result of dreams. Dr. Wing Lim: [00:09:19] I read some stats. I don't know who put it up. I can't quote your source, but somebody says that in North America by age about 25, we stopped. We just stopped dreaming. And for us, that takes us through med school and residency. You know what? It was a dream that that put us in to where we are as clinicians. It was our dream. Dr. Kevin Mailo: [00:09:40] Yeah, I had a dream of being a doctor. Dr. Wing Lim: [00:09:42] Exactly. And then what happened? Right. We stopped dreaming. And they also heard somewhere else that dream is like a kid, right? When we grew up, my family was really broke so we have school uniforms - I grew up in the British system and we have school uniforms - and my parents would buy me 1 to 2 sizes bigger so I can grow into it. And they say, dream is just like that. It's 1 to 2 sizes bigger than you right now so that you can grow into it. And once you fit it, now you need a new set of clothes. You need a new dream to grow bigger. Dr. Kevin Mailo: [00:10:12] And the thing is, is that dreams give us meaning in our lives. When I think of one of the biggest tragedies in modern human existence, I think of the loss of people's dreams, and I see so many people within our profession or patients, people you meet on the street who are unhappy because their lives lack meaning. Did they just go through the motions, check the boxes? But they're not aspiring to anything bigger in their life anymore. And so watching somebody lose their dreams by about the age of 25 and never recover them is, in my opinion, one of the greatest tragedies in modern life. Dr. Wing Lim: [00:10:54] Right. And when I look at how, reflecting upon when we went through med school, we were they say people were so broke they eat dog food and cat food. I couldn't even afford it. It was too high of a price item for me and my spouse at that time. Right? And then how do we go through 100, 120 hours of work without burning out? How do we go through work and study at the same time and doing the lowest, lowest job, menial job? How do we survive? Because we had a dream, right? So somebody also said that if there's power, if there's hope in the future, there's power in the present. So the dream helps us to become more resilient because we know that the stuff that we work through is only temporary, right? There's a brighter future. There's a brighter tomorrow. Dr. Kevin Mailo: [00:11:41] Well, it's walking to that destination on the horizon that you deal with what you face in the landscape of life, even when it's hard, even when you feel lost, even when you feel stuck or you're going in circles. It's that notion that it's somewhere on the horizon where you're headed to. Dr. Wing Lim: [00:12:01] Mhm. Dr. Kevin Mailo: [00:12:01] And there are a lot of ways, and I did research on this in preparation for, you know teaching it, and I'm not going to go into all the reasons why dreams are destroyed, but there are a lot of external factors. People are, some of us are scared of being successful, we're overwhelmed with consumer spending. To the point that we don't have any margin to pursue dreams, which is very true. Dr. Wing Lim: [00:12:24] Oh, what a sore spot. Dr. Kevin Mailo: [00:12:26] You can count how many hours you have to work clinically to pay your mortgage every month, and those are hours that you are not able to pursue a dream, potentially. There are lots of societal factors. Some people are, you know, will be jealous of you or want to hold you back. You told me this one, Wing, is a lot of well-meaning people think that they're watching out for you by telling you not to dream. Dr. Wing Lim: [00:12:51] Exactly. Yeah. Dr. Kevin Mailo: [00:12:52] And I actually, I can recall many conversations from friends and family who would caution me on my dreaming. Dr. Wing Lim: [00:12:58] We just don't want you to be hurt, honey. Dr. Kevin Mailo: [00:13:00] Exactly. We don't want to see you fail. We don't want to see you struggle. And, Wing, I really want it, that's my first big thank you on this topic. That's my first big thank you to you on this topic because you told me about that. Dr. Wing Lim: [00:13:15] Oh you're welcome. Dr. Kevin Mailo: [00:13:16] But the second and more profound part to that is you said it wasn't about the external voices that were hard to ignore when it came to your dreams. It was that inner voice saying, I can't do it. It's too hard. Why try? And I remember that conversation. It's that inner voice saying, I don't deserve it or I can't do it, why bother? That's the hard voice we have to learn to shut down and ignore from within that holds us back from pursuing our dreams. Dr. Wing Lim: [00:13:53] So some people astutely put it as the imposter syndrome. Dr. Kevin Mailo: [00:13:57] Yes. Dr. Wing Lim: [00:13:57] Who do you think you are? Dr. Kevin Mailo: [00:13:59] Who do you think you are to dream? To think you can change the world or change your life? Dreams are important because that better vision of the future of ourselves, of our world, of our family, it creates optimism and optimism drives positive action. When you are optimistic, you feel like you can take chances. You feel like you can step out of your comfort zone. You feel like you can do things. Pessimism and a lack of dreaming is the opposite. It leads to fear and inaction. Would I ever attempt that airway if I thought I wasn't going to make it? Would you do surgery if you thought your patient was going to die? Right. Would you do counseling, Wing, and clinic and say, Oh, why am I bothering my patient's not going to follow through on it anyhow? No. No. We take, we have an optimistic view of our interventions in the world, in our practices, and it leads to action. Right? So dreams provide enormous meaning in our lives. And they help unify our lives as well. So at Physician Empowerment we teach that there are three different types of people within. Dr. Kevin Mailo: [00:15:16] There's our physician self, the MD, the professional self. There is the personal self which includes our inner child, the one who used to dream. And there's the financial self. When you're a dreamer and you know your dreams, you've written them down, you have a clear sense of who you are and where you want to go in life, it allows you to unify the three selves. And in doing that, you make life and career and financial decisions that reflect your dreams. Right? Because your three selves can't be walking in opposite directions across the landscape. You can't say, I've got a dream of setting, of traveling around the world, but you've got a consumer spending problem that keeps you working endlessly. And you're not able to train and get fit to do it. Right? And, you know, I wish I had more time to explore the example that I used in Mexico because it was really beautiful. But it is on the website and I encourage you to to watch the talk. The other part to dreams, and I don't know if you want to share on this, Wing, because I know you've taken some big leaps over the years, is dreams give us courage. Dr. Wing Lim: [00:16:26] Mhm. Yeah, actually, let me relate to this. The first time I got exposed to this dreaming stuff was at my CCFP confo. This is at Banff, right, for us in Western Canada I went to bang for my CCFP confo. And so 8:00 in the morning this big conference started at Banff Spring Hotel. And then this lady, she was a Mount Everest climber, she was one of the first female Mount Everest climbers. And she talked about her journey, and I thought, why are we woken up at 8:00 in the morning to listen to somebody climbing the mountain? And she almost died, some of her teammates died. And then at the end of that talk, she had a five minute standing ovation and she ended her talk, she said, That was my Mount Everest, what's yours? Right? And it was, wow. It just woke me up from the depth of my soul. Right? And what's your Mount Everest? What is that impossible dream? What is that thing you want to achieve that is bigger than you, bigger than all you can muster together, right? And when that things, when thoughts like this got turned on, I think it unleashes a lot of power. And they also say that when the student is ready, the mentors will show up, right, the magical mentors, the resources, people that you need to make connections with show up. And that's how things got turned around in the world. How big things got changed in the world. Dr. Kevin Mailo: [00:17:55] Absolutely. Absolutely. Dreams also, and you alluded to this earlier on today's episode, Wing, is that dreams make sacrifice meaningful in our lives, right? Like we, don't focus, when we talk about dreams don't focus on the destination. Focus on what it does to you over the journey. But as you're walking life's landscape, inevitably you are going to encounter struggle, setback, and failure. But when we actively pursue our dreams, they make those sacrifices and those hardships meaningful. You know, I always think about my dream of being a father. I'd wanted to have kids since I was a teenager, and it was such a joy to have them. And we had the twins first, and I remember countless sleepy nights that I'd be up feeding babies, thousands of diapers changed, countless days spent chasing around toddlers that didn't want to get dressed while we were going through medical school and residency, you know, exhausted. And yet when you look at it in the frame of I'm living my dream, those things aren't relevant. Those things aren't struggles. Those things are a joy. Right? You know the long hours that we spend on the wards of hospitals as med students and residents represents us living a dream. And it makes the sacrifice bearable. It makes the sleep deprivation and the hardship bearable. Right? Because we're living a dream. And so being explicit about it can be very powerful in our lives. When we say, no, this isn't a chor, this isn't, I'm not working towards a goal, I'm working towards a dream. Dr. Wing Lim: [00:19:34] Mhm. Yes. Now so we're almost out of time. So Kevin, maybe give us some takeaway, a couple takeaway points. Dr. Kevin Mailo: [00:19:46] Yeah, okay. There was a lot here, and I wish I had time. And maybe I should come back to it later, because, I write down my dreams. Dr. Wing Lim: [00:19:54] Yeah, another episode. Dr. Kevin Mailo: [00:19:54] Big, big dreamer. Okay, so let me let me wrap this up here with this wisdom that I came to when I was reflecting on my own life's journey. The destination is less important than we think. Whether we get to our dream or not is far less important than the fact that we actively pursued it, that we gave ourselves meaning along the way, that we grew as people, that we challenged ourselves and in the process, we connected with those in our lives more meaningfully. So here I'll leave you with with one example. And imagine a young woman that's training in a marathon, and she spends five years training to become a top tier marathoner, and she wants to win that race, she wants to come in first. Which means that she sacrificed every day. She trained, she ate right. And let's say a month before the marathon, she suffers an injury. Is she a failure, Wing? Absolutely not. Let's say that she's running the marathon and she's in first place after five years of training and 100m from the finish line, she trips, falls, wipes out, and doesn't even place. Is she a failure? Dr. Kevin Mailo: [00:21:25] Absolutely not. Let's say that after five years of training and working towards her dream, she runs that race and somebody just happens to be faster than her and beats her. Is she a failure? Absolutely not. It's the personal growth along the way that makes us, that makes it so meaningful when we pursue dreams. That is what helps us grow as individuals. That's what takes us from being static, going through the motions of life, checking the boxes, to being this dynamic individual who's growing, who's changing, who's optimistic about their future. And so for me, I constantly try to reconnect with my dreams and I constantly remind myself that success or failure is irrelevant. It's the fact that I get up every day and I feel like in some capacity, I'm living one of my dreams. Whether it's as a doctor, as a father, as an entrepreneur in Physician Empowerment, whatever it is, I feel like I'm living my dreams and that's what gives me an enormous sense of meaning. Not whether, not whether a certain thing happens. That's a goal. It's are you living your reality? Are you living your best version of you? Dreams are intrinsic to that. Dreams are intrinsic to that. So I'll leave you with, you know, sort of, practically speaking, is to take some time, like real time, like many, many hours, to just think back to your childhood. To that younger version of yourself. Be vulnerable with who you are and ask yourself what you really wanted when you were much younger, when you were a teenager or a child. And then look back on the times when you sort of slowly let those dreams fall to the wayside. And you so-called, grew up. Dr. Wing Lim: [00:23:36] Mm hmm. Dr. Kevin Mailo: [00:23:36] And then begin to write them down. You don't have to share them with anybody. But just write them down and be bold. That's the, that's the third big thank you I have for you, Wing, is I remember in one of our earliest meetings at that little breakfast restaurant - I think it's called Tutti Frutti, remember, it was super loud and super crowded - and I remember you telling me I'm not dreaming big enough, and I still hold on to that. So again, that's what I'd encourage listeners to do, is, is to just connect with yourself and begin to dream unapologetically and stop worrying about what anyone will think, and stop worrying about whether you actually reach your destination or not. The real gift of a dream is in living it now and pursuing it now. Not whether you get there or not. Dr. Wing Lim: [00:24:31] Exactly. So I got lots of patients, who are hunters, right, at the end of the day they said the hunt or they said the kill isn't the hunt, right? It's a journey, right? It's a journey that counts. So that, those those are lots of really good points, Kevin. So thanks for sharing with us. And we hope, at Physician Empowerment, we hope we'll rock your boat a little bit. I know you're busy. We're busy. We're going 100mph. But we hope we stop you down, smack you a little bit on the side and disrupt you a little bit so you can dig deep and go deep down, deep down. Dr. Kevin Mailo: [00:25:04] Just get out of the everyday. Get out of the everyday. Because so many physicians are just going through the motions. And it's an enormous source of burnout. Because you feel like that hamster wheel never stops turning over. But when you get out of that comfort zone and you just, you just ask yourself some hard questions and begin to take steps along that road, it can be so profound. And, that's you know, that's one of the things that we try to achieve on Physician Empowerment is like helping you connect with with your inner self and to transform your life, like, really transform your life. Dr. Wing Lim: [00:25:46] So I'll just end this episode with a comment. So this, from my mentor that unlocked my potential, Dr. George is his name. Most of you don't know him, he's 88 years old already, and he asked me way back 30 years ago, or not quite, 20 some years ago, What if time and money were no object? What if success is assured? What would you do? What would you see? What would you become? What would you not do? Right? So he was the guy that changed my whole entire life by that little question. So we pass you along with this question, and for those of you are already in the journey that you're chasing your dream, you're living your dream, maybe you can be the dream giver, right? That's the next step, right? And ask people around you, empower them so that they can embark on the journey of reliving their dreams. So we hope this episode is meaningful for you, and we look forward to seeing a lot of you. Dr. Kevin Mailo: [00:26:37] All right. Thank you so much. Dr. Wing Lim: [00:26:38] Okay. Thank you. Dr. Kevin Mailo: [00:26:41] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

mexico dreams british canadian focus north america strange md manage falling in love mount everest wing mm pessimism cme banff tutti frutti mhm proplus sherwood park

29 - Dr. Sarah Smith, founder of the Charting Coach

Play Episode Listen Later Oct 15, 2023 47:57

Dr. Kevin Mailo welcomes back Dr. Sarah Smith as his guest to discuss the topic of sustainable clinical practice, what it means, and how to achieve it. In this episode, they discuss the struggles physicians face to organize their day, combat burnout, and take time off. Dr. Smith shares tactics she learned through her struggles as a physician in Australia and Canada and how she overcame them. Dr. Smith shares her best practices for physicians to manage their days, shift their mindsets, and set goals at a sustainable and manageable pace. You'll hear the impact of small decisions, and little shifts can lead to big changes both in your personal and professional life. They also discuss ways physicians can feel more empowered and make proactive decisions to provide quality care and balance their own mental and physical health. About Dr. Sarah SmithDr. Sarah Smith is the Charting Coach for Physicians. She is a Rural Family Physician and Certified Life Coach through The Life Coach School. She helps physicians get their admin and paperwork done more efficiently to create time for the things they love. Dr. Smith has spent the last three years coaching hundreds of Physicians, over 1000 hours of coaching, in the specific area of “getting home with today's work done”.Resources discussed in this episode:Slim's Cabins - SaskatchewanChartingCoach.caDr. Sarah Smith on LinkedIn—Physician Empowerment: website | facebook | linkedin—Transcript:Kevin 00:01Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment Podcast. At Physician Empowerment. We're dedicated to improving the lives of Canadian physicians, personally, professionally, and financially. If you're loving what you're listening to let us know we always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming, both in person and online. So look us up. But regardless, we hope you really enjoy this episode. Kevin 00:36Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment Podcast. And I am very, very glad to have a returning guest, Dr. Sarah Smith joining us again. So for those of you that have been following the podcast, we had Sarah on in one of our earlier earlier episodes, talking about charting and boundary setting. And Dr. Smith is known as the founder of the Charting Coach. And, yeah, and it's an outstanding program where she helps Canadian Family Physicians truly manage their practice, and more importantly, get to a better place personally and professionally. So that we are not feeling overwhelmed, that we feel like we can manage our work and our lives and your episode, the last time was just so powerful. It really connected with a lot of people, I got a lot of positive feedback about it. And so I'm very, very glad to have you back again, Sarah, and why don't you tell us a little bit about what you do. And I'll just introduce the topic today, which is sustainable clinical practice. And I'll let you tell us what that means to you and what that should mean to the profession. Sarah 01:49Sounds good. Thank you so much for having me back. Yes, last time I was on, I did promise to come back and talk about sustainable clinical medicine. So I'm back. I am a family physician, rural in Alberta right now and originally from Australia. And you'll find out how I got to Canada if you have listened to the last episode. But this time, we're talking from a slightly different perspective. So I went and did the hard work to become a different doctor. So originally, I was in that pain of hours and hours after work evenings, weekends, charting, inbox paperwork as a busy family doctor, and this particular painful experience had followed me from an Australian practice to a Canadian practice. So it wasn't the country at fault. Kevin 02:41We're looking at a global phenomenon. Sarah 02:43It wasn't the EMR. And it wasn't the government. It was a me problem. Kevin 02:47You're kind of an interesting test case, in that sense, Sarah, right, because I think we always view our issues as hyperlocal. But I do I myself do look at some of this data in health care across the western world. And you can see it, it's actually a global phenomena. That's there are many factors driving it. And I don't want to get into all of them. But you are the interesting test case, I don't know that anyone else has moved across the world, only to discover the problems… Sarah 03:17Followed me. Know, no, this was impossible, right? I thought this was the way right, sign up for family medicine, sign up for inboxes, sign up for never having a life, sign up for giving away my weekends. Like this is just what I expected. I asked every mentor along the way. How do I do this? And their answer was come in on Sunday, like that was the unanimous answer to my question that I'd had since residency. So the answers were not out there. And it was simply the listening to a general life coach at the time about, I can do impossible things, I can have a different experience in medicine right now with nothing changing. And I just thought that was completely ridiculous. And she had no idea what I was facing as a family doctor. So off, I went into the world to find the coach who could help me figure out this impossible puzzle because I was done with giving away my life to medicine. And I didn't want to leave medicine because I had no other skill set. I literally had no other way to support my family as the single-income earner in our family. Right. So for me, the skill set was medicine. I had to figure this out. So I went out into the world. At that time, the only physicians who were coaching, were helping me leave medicine and I wasn't ready because I had no other thing to do to earn money. Now, It's a lot of things like what you do to help me figure out how else I could have kind of approached that at the time. But in this moment in time, I'm like I'm gonna have to figure this out where I am right now, with the staff that I have the EMR that I have the patient panel that I have the way I'm being paid. And now what? So went back to the original general life coach and said, Okay, I'm in, I'm ready to do impossible things, you said it's possible, let's go. And it took me a full 18 months of changing everything about how I showed up within exactly the same clinic, EMR patient load, and going home, with everything done. Bucket loads of time, right bucket loads of time, sit on the couch at the end of the day, feeling accomplished, but also guilt free. Like, done. I'm done. And that was such a incredible experience. So proud of myself, and I had all this time and I'm like, I have to share this. So I originally started with the family doctors, yeah. Kevin 05:55Without question. And, you know, I'll just share my own reflections. So this year, I retrained in family practice, like I had originally, you know, done family medicine residency, and then done emerged and worked, you know, nearly 10 years in the ER, as a community emergency physician, but I decided I wanted to expand my skill set, and just have more potentially more flexibility down the road. But I was overwhelmed by how much a family doctor has to manage. And, frankly, if I, if I can be blind, until I go through your program, Sir, I don't know that I'm gonna feel super confident, taking on a panel myself. Again, just being very, very honest. Because until you learn that workflow, until you learn those boundary setting strategies, it's, you know, it's quite, it's daunting, honestly, it's daunting, and there is so much in that, that we just didn't get, we got, of course, a rigorous academic training in medicine, you know, the disease, diagnosis and management, and, you know, all of those core clinical skills, but nothing in practice management, nothing really in charting. So, so talk to us about what sustainable clinical practice truly means. Tell us. Define it Sarah 07:15Yeah. So just before I step in there, one of my very early mentors said, don't take on a practice owner, position until you've done five years of the medicine just to get used to the medicine because the decision-making around patient care, looking after a panel of patients, takes you about five years of getting used to the whole, just medicine and fast decision making required before you even think about taking on the whole hire and fire half. Like when we think about the business of medicine, those hats, you're right. Nobody's taught us that unless you had a mentor showing you in that apprentice style, how to do the business of medicine. And I was lucky growing up in the Australian system, I was one resident in one practice. So, I had the whole cohort of mentors to show me and they were very transparent, they would show me the earnings, how much it costs to hire and fire, but they didn't expect me to do any of those pieces. And, in addition, I was asked to see patients on my own panel, and I would earn 55% of the fee for service for those patients. So that was in my favor to learn how to do medicine as if I was graduate already. Right. So it's given me that it had a baseline so I could always, you know, fall under the number of people who need to be seen and still have a certainty about what I would be earning. But yeah, what does sustainable clinical medicine mean? So, in the world, there are lots of carrots and sticks to make physicians stay because it's very expensive to replace a physician. So, if you look at some of the US big organizations that estimate about a million dollars to replace a physician, so for physician says: “I'm done, had enough, burned out, you've done it, I'm out.” It's about a million dollars to turn over a new physician. That's it. That's pretty incredible. So of course they want retention. But when the physicians turning up and saying, it's too much, you're asking too much, I can't. I can't even go on vacation. Because I could check my inbox or iPad or whatever. It had to come from the physician. So me the physician in my clinic, and I watched this little video from the primary care network. It was about Evolution 2.0 And they were going to bring us team players to help us. I'm like great, sounds amazing. And in this little promotional video, they had this tiny little sentence that said, physicians get today's work done today. And I'm like wow. I'm in! I looked at through all of their resources, zero backup for that statement, so annoyed at that whole thing. So I'm like, okay, back to me figuring out on my own, here we go. So, um, sustainable clinical medicine means you have, wherever you are right now, physician, no matter what sort of physician you are, you have some things about your practice that you cannot change. For instance, your EMR, your location, how many staff you have the role that those staff play potentially, your hours of work, the number of patients, you have to see whether that's you choosing that number of patients, or an RVU, with those US physicians who are required to do a certain number of productivity encounters per week. And there's bonuses potentially attached to that, or because of the fee structure and your other expenses in life. So there are concrete things about your day that you can't necessarily change or can't change easily, right? So hiring a new person could be an amazing idea. But your organization will say no, for whatever reason, maybe they're unionized, maybe, you know, that's just you're just a salaried physician who has zero control over who's hired and fired. So there's concrete parts of your day. But a sustainable practice means, now that we know your concrete parts of your day. Now, what? What are you able to do differently about what you're doing in your day that can create a clinical day that is confined to what you're given? So whether you're ER, hospitalist psychiatrist, family doctor, what is it that you are being asked to do? And then how can we start to do it in a way that you can contain it to what you're given? And we're not looking for an answer immediately and an immediate change for tomorrow? Don't burden yourself with that. We're looking at what do you want to create? What does successful, sustainable look like for you? And then what are the steps we take to get there? What are the things we need to change about your practice? To get you closer and closer until you either get there or get at least closer to the mark? Sustainable means? Kevin 12:20I'll just share one reflection, and like already, what's, you know, what I'm hearing is the power of reflection and goal setting, right? Because we all say, well, I just want to be less busy. I just want to be less burned out. I just want to be but what does that mean, in clear, concrete terms? And that's a unique question we're all going to be answering for ourselves. Sarah 12:42That's right. So if you look at my example, I wanted to be home at five o'clock. Right? reliably, I was getting a text almost every day from husband saying when are you home? I wanted to just be able to be home at five. Right? But that's easy. All you have to do is hop in the car at ten to five you might have to,, Kevin 13:01So you're not from Toronto Sarah 13:05I didn't actually mean that I would be done. Yeah. Wait a minute. Okay, so I want to be home at five with everything done is a completely different sentence and a completely different goal-set than I want to be home at five. Right? Kevin 13:24Exactly. Exactly. But that's powerful. Right. It's about having that clarity. You know, yeah, I mean, when we coach physicians in this, not quite the charting and practice management space, but we talked, we talked about the power of like, clear goal setting in terms of actually write it down. Like if you have an ideal practice of what you want, write it down. Okay, continue. Sarah 13:52Alright, so I wanted to be home a five, and what had everything done. So now we have to step back from the busyness of the day, this is the big step back. And we have to really think about what's inside the day. And I like to use the phrase “we're mathematicians, we're not magicians”, okay. So there's going to be X number of phone calls, X number of inbox / Portal messages, number of results that come in and we'll have ebbs and flows. So as I come back from an emergency, if there's going to be a lot more in my inbox, or I might be covering a colleague, but for the most part, what is in the day, like how many patients, how many charts, how many interruptions am I getting? What is the expectation, like what is the rest of today's work? So we have to consider that when we're thinking about what do I need to have get done? Because I'm not just going to magic 200 results in 10 minutes. Not going to happen? Yeah. So that's part of the consideration of now that I know what my goal is. And now I have to think about what's involved in my clinical day. And then I have to think about why would I want to make a change? Because the way I turn up and do something is so easy and familiar, I've been doing it for years this way. Any change is putting another burden on you. So you have to have a reason why you'd want to do that. Kevin 15:15So how do you go about beginning to implement some of this? Sarah 15:19Yeah. Even before we start making changes, and there's foundational steps, which we kind of covered last time, they're getting your chatting done as you go, and the finding that protected time to get the inbox done. So you're not doing work twice. But it's the noticing what you're saying to yourself about your day, makes a huge difference. So you can get tired before you even walk out the door in the morning. So when you wake up, and your brain says “Here we go again. I hate clinic. Nothing ever goes right? Oh, no, I have to see Mr. So and so today. Ugh, this is so hard. I'm so tired.” We are defeating ourselves. We're not the inner cheerleader. We don't have to be all lovey, lovey. But we can also be adding suffering. So you have 13 patients today, for instance, and if you say, that's such a lot, that is already hard to overcome, because if you can say 13 patients, this is my day, let's go. Gives us a different fierceness about ourselves. That helps us in the moment, it's that part of I'm choosing it because I'm staying. So if I choose to come into work tomorrow, and there's 13 patients. That's what we're gonna do. We're gonna do 13 patients, we can do 13 patients. And that, that little bit of reasoning to ourselves. Kevin 16:52Well, I think you know, another part to this is that notion of acceptance of the things that we cannot control, you alluded to this earlier, right, is one source of burnout. And we know this across different, you know, different professions and fields in occupations is the fact that people feel burnt out when they feel powerless, right? People who work in large organizations that don't care about their feedback, feel disconnected from them, they feel burnt out, they feel irrelevant, right? And there are those aspects to being in even private practice, like you said, the EMR is potentially fixed, right? Or your workspace, you know, where you practice is fixed until the lease is up or until you sell, right? I mean, all of these things are fixed. But the things that are not, we should be seeking to exercise control. But that also includes the patients that we have, right, and acceptance that inevitably there are going to be those difficult cases that we have to navigate through. And in knowing that everyone deals with this, this is part of the job. Yeah, but you know, only people that are professional, like Netflix watchers get to really choose what they do all day. But for the rest of us, there's this notion of, there's going to be a certain struggle. But accepting that can be a very powerful source of wellbeing for us. Because then we say, Okay, where does my energy go? It goes into these things that I can control. Sarah 18:21Yeah. Now, there's the difference between ideal and what we've got. So ideally, for instance, a new patient, you might like to spend two hours with them to get to know who they are, and deal with today's issues, right, ideally, and you've been given X number of minutes to see them. Kevin 18:40Yea, not counted in hours counted in minutes. Sarah 18:44And excellent is the best you can do with the resources you're given. So when we come up against this and say, I can't do a good job, because I don't have two hours with this patient that really adds that suffering, right? You really feel shitty about you being a doctor, when you're saying, I can't do good medicine in 30 minutes, and then saying, Okay, I have 30 minutes or an hour, whatever your new patient is, how can I best spend the time? What is the objective of today's visit that would give my patient what they are most requiring? That's a huge question, not at them question. Remember, you're the boss in the room. This is another part of the work we do is we save the physician is the executive decision maker in the room. So when you're in the room and you're hearing the questions or requests in the room, you're really navigating what is of most importance here, whether that be because the patient is requesting that because I'm noticing that this is very important for us to achieve today. And then the dissonance of and I've got 30 minutes and now I have to make some decisions and negotiation and have all this tied up in a little neat bow with my documentation done in the minutes given, right? This is not going to look like an ideal medical history taking that you were taught in medical school. It's not going to look like a comprehensive physical exam, like you were taught in medical school. And the documentation is not going to look like something a professor would write. Right? And all of that is the puzzle of medicine. This is the part where physicians start questioning themselves and saying, Is this okay? And only you can answer? Does this you, know, did it cover the most important things for the patient? Did they get enough information to give me pertinent important information about this encounter? Can I kind of back up my decision-making with pertinent positive negatives? And is it good enough in my documentation for the next person or myself to follow what was going on next time I look at this chart? What else do I need in here? Or insurance and billing? Done? So we don't get two hours. We don't get to squish two hours into 30 minutes. We're not magicians. It's this now what? About my entire day. I have 30 minutes, now what? Kevin 21:17Yes. Yes. So, keep going. Tell us about like workflow during the day. Talk to us about, you know, boundary setting, you know… Sarah 21:31So some physicians will get a knock on the door, every single patient encounter. Okay? So it's the noticing is just being curious about what happens in my day. So you're in a room doing your highest level work with a patient, you're listening to their story, your physical exam, your illness, script, medical reasoning, decision making is all happening in the room, you're focused on them. And hopefully, we've dumped everything else out because we've completed our work because we work behind us. Knock, knock, knock. You open the door. Mr. Jones is 10 minutes late, will you still see him? Now, your brain says, what's happening this afternoon? Is it my day for kid pick-up? What time does daycare close? How far behind am I running? What's Mr. Jones got going on for him? I don't have a choice anyway. Because my, you know, my employer says I must patients, like literally, I've the amusement of there was no question, I had to see them anyway, because of the rules of what I engage with in my workplace. So it was a yes or no, and we close the door. We turn around and we're like, Where was I? that is very expensive. Oh, goodness, it's contributing to your decision fatigue, it's contributing to interruption of your highest level work? This is a very sacred space, it could look like a pop up, a knock on the door, an alarm going off? Whatever, you may have calls you have to take. And even then I would say do you have somebody who can intersect to say this is one that has to be taken and I will take it to the door and knock on her door and interrupt her? Versus that's, you know, this call and that call that didn't really need to be taken. And the one I was actually waiting for that came through? Right? So just protecting ourselves. What was the rule this morning at eight o'clock? You knew if you could run late this afternoon? And who did you need to tell as you tell that person, hey, I have kid pick up today? It's a no for anyone late this afternoon. You have my blessing to go rebook them. That will stop X number of interruptions this afternoon, this is handled for you. Kevin 23:37Well, just treating things not like one-offs, because I think that tends to be how we look at it. I mean, you know, you're always putting out fires in clinic-based practice, but you realize that there can actually be a pattern to this. Right, where you can exercise a lot of control in those interruptions, because you have clinic staff and Wing's talked about this extensively, as well as the importance of delegation, right? Because if you have rules or guidance, well now, and now we don't need to worry, but it even improves the working conditions for your staff. Right? So if you have somebody that's late, and you cannot and you know, you can't accommodate somebody who is 30 minutes late, then it's easy for your clinic staff to say, I'm so sorry. No, they don't have to run down the hall. They don't have to send you a message. They don't have to jumble like it, actually, you think it's improving just for you, but it's also improving for your clinic staff. Right? It reduces their burnout because now we have some guidance, right. And that's just one small example. Sarah 24:43Yeah. Let's say you have to see late patients and you still have kid pick up right now how do we engage in that next visit with that person who was late, who used up their entire appointment getting here? How are we showing up to run that consultation differently? If you have choice, you don't have to spend that X number of minutes you were given in its entirety. You have autonomy, about what is the focus for today, we're going to be super fast. Okay, that language with patients just learning new language with patients so important, even opening sentences, How are you? Versus what are we doing today will cost you three to five less minutes in an encounter. Anything else? At the end? catch yourself doing that, versus It was great seeing you today. Kevin 25:39Wow. Wow. But you're right. Back to your earlier point about? We have these ingrained habits, right? And there's so much automatic wiring. Sarah 26:00Yeah. Kevin 26:01But if we're, if we're mindful of it, and we're intentional, we can slowly make change. Where the sign off is different. The opener is different. And it dramatically improves your workflow. I love that. Wow. Sarah 26:15I get them to write it on their hand for the first week you're practicing it. It was good to see you today. Kevin 26:22Exactly. Not tell me the next five things that are worrying you. Sarah 26:27That's right, yes. Knowing that bringing a list into the room is expected. We talked a little bit about that last time. Right and not going and thinking you have to handle the whole list. Right? You're still the boss in the room. You still get to say this one and this one. Oh, I've just got a quick question about my 20 years worth of headaches. You know, that's not a quick question. You know, that's at least a five-minute deep dive to make sure. So you get to do things that are safe for you, such as triage the problem, but then I would love to spend the time understanding and working on this puzzle of your headaches, let's rebook that. So we have a good space to do that. Kevin 27:11Exactly. Exactly. Sarah 27:15It is part of the learning, the nuancing of us as the executive decision-makers in the room. Kevin 27:23And even for myself, you know, just reflecting on my own, you know, training time in family practice, you realize that every complaint, or presenting issue generates X number of minutes or hours of paperwork to follow. Sarah 27:40Potentially, yeah. Kevin 27:41And so, you know, you think it's that 20-minute encounter, but it's an hour of paperwork, referrals, results to order, or tests to order the results to review, communications to be made and follow up. So you have to be mindful of this, like fanning or this you know ripple effect on your workflow, when you would just agreed to see multiple complaints. And, you know, to go back to your point, how good a medicine are you doing, when you're doing that? And this is a lot of this is unique to family practice, in the sense that, you know, as a specialist, you can, you're kind of there to focus on a narrow problem, although some, you know, a specialist to be fair, like do deal with a lot of the psychosocial or, you know, complex interacting issues. But I think certainly family medicine is defined by a lot of this holistic care. Sarah 28:31But even in our specialty areas, when a surgeon is seeing your patient, and the surgeon is in the room singer new patient that you sent with, you know, a good letter, and we're not going to say we're doing a donkey letter at the, within this process, I think it's important that we say, here's a question I want answered, is this patient suitable for surgery? And the patient arrives and the surgeon has no CT or ultrasound report, or no history of their previous surgeries. And that surgeon has that happen five times a day, and they go looking for the CT. That there is a system problem. That there is a oh, now what? I noticed that I have to go looking for CT scans with every new patient and I wonder why? And we go back down to the corridor, we say, hey, Mary, when we get new patient encounters, what do we tell patients to bring with them? What do we ask to be found for this encounter? Well nothing. Oh, I wonder why. Or now what? I wonder, could we think about before this patient arrives, this checklist, tick, tick, tick. And then I can do my job in a much more efficient way and have an answer for this patient within this first encounter. It's these stepping back and saying what is really happening in my day that's costing me frustrating me. I whine about it all the time. That can be a good way to find these things. Kevin 29:54It's listening to that inner voice. You know, it's done in psychotherapy. Where is it coming? From dig deep, right? It can be highly informing. When you go, gosh, that annoys me and annoys me every day. And every time that happens, we let me stop. And can I fix this? Sarah 30:13Can I just have a conversation with someone? And who would I have to have a conversation with? And then I'll watch and monitor how that conversation went? Did I get it right? Do I need to edit it a little bit to get the results that I was looking for? Like, we have this ability. These are tradable skills, as part of our leadership role. We are all leaders as the executive decision maker, you are already a leader, even if you don't have a hat that says that. Kevin 30:36I like that, that is so powerful, and so empowering, as well. Because we forget, we feel like we're just, you know, pulled a million different directions responding to somebody else's request, whether it's the consultant, the patient support, or admin staff, colleagues in the clinic, like we're feel like we're always pulled. Sarah 30:57Yes. Oh, always, I had that experience multiple times. But we just want you to record it, if they're a smoker or not. And I would just be devastated. I'm like, You don't understand what I have to do in my day, I have so much to do already. I don't want to do that, too. I just don't have the time, mindspace, my bandwidth to do anything else. Stop it. Stop asking me to do things. Kevin 31:16Well, and again, it is, you are the most important resource in your practice. We teach that over and over again at Physician Empowerment. You are the rate-limiting step. For Success. Everything else is peripheral. Everything else is peripheral. It goes back to your comment about what does what does an interruption at the door for five seconds really mean? It means that you have disrupted the most important part of that patient's care at that time. Right. And you know, you've interrupted your own workflow. Sarah 31:51Yeah. Even the way we talk to our patients matters. So when we talk to dermatologists who are trying to improve the flow, they want to see high volume, that is what they choose to do. But the patient's appointment is at 3:40. Right? So when a patient's appointment is at 3:40, but there was absolutely no way the physician was going to be entering the room at 3:40. Because the patient is registered, goes upstairs, hops in the waiting room, goes into a room sees the MA, who does this. And then the doctor comes in, and then the nurse comes in to do education. But we've not explained any of that to our patient. If we step back and say, Okay, well, how do we help the patient understand, this is a team process, the physician is the three-minute part in the middle. But at 3:40, you're going to be meeting Mary, who's an excellent MA, and she's going to be taking the story. And then the physician will come in and go this, this and this needs to be taken off. And the rest of them are this and so it's this particular thing, doing their highest level work. Nurse Jane comes behind. Here's your nurse, this is Jane, she helps explain this better than I do. And she spends the time helping them understand where to put this. How to take off that. How to manage this wound after we take it off. And that is their experience rather than it's my job as the doctor to be in that room at 3:40. Like no, the way you set your clinic up was amazing. You just didn't give that gift to your patients to help them understand. Kevin 33:25Delegate right? Sarah 33:26Yeah, using our team wisely. Kevin 33:27Use your team. I mean it we see it in surgery. I mean, the surgeon doesn't set up the O.R. Sarah 33:34You wouldn't want them to. Kevin 33:36You wouldn't want them to right. I mean, it's everybody does it. But you know, for us, I think it's family doctors we get we feel, but it is okay to step away. Right. And, and yeah, your office staff when they're trained well, and they're supported in the day. The work can be more rewarding for them as well. For sure. Sarah 34:00There we found Family Medicine in Canada, we know we have a crisis right now. So we have somewhat about 18% of new family grads, saying that they want to take a panel of patients. Right? We have a lot of Canadians without a family doctor. And the education of family practice residents often happens within family medicine context where the family doctors are saying there's too much I need a break. I can't. So when we, when we're looking at these systems, structures, patient medical homes, whatever they look like, it's the stepping back and looking at it broadly, to help understand how do we interact with it as family physicians. This is just one again, another example within medicine. So academic practice. The family doctors have their own panel, they'll see patients on a 15-minute schedule, they work these hours and they have this break in the middle than another set of hours or they're seeing patients with residence at the same time, or this overseeing a resident or two or three or four, who are working and then not taking on patients that day. And then we look at how are they paid? How many staff do they have? How many rooms do they use? And we're starting to help them understand what is possible within this day? How can you show up in a way that's going to help you be successful? When you're ticking off those charts with your residents? That's now a new work list for your week, or your day that you're creating. When will you do this work? Because I'm sure you don't want to be doing it Friday night or Saturday morning. Kevin 35:42Exactly. Sarah 35:43And this resident might not even get the feedback then because they're not getting that at all if that you might be editing their notes. So it's this really interesting piece of how would I do it if I was going to be stepping into that role? Like, if you weren't working in this situation, you're just having a look at it from the outside saying, Okay, if I went and signed up for that, even if you're already there, just if I was to go and sign up for that. But and I wanted my evenings and weekends. What do you think I'd start doing differently about my day, in order to survive that environment? What would I have to say to my residents? How would I do my teaching? How would I see my patients? What would I be able to physically achieve in a consultation with a patient? Yeah. Yeah, big step back. This big eagle eye of our clinical days. Kevin 36:41Yeah. How do doctors manage? Give us some insights? This is just a question because I think so many of us are not static, right? We think about maternity leave, we think about paternity leave, we think about maybe, oh, God, wouldn't it be wonderful if we could take sabbaticals like truly as community-based physicians take sabbaticals? Like a month, three month, not a month, that doesn't count three months, a year? Something truly incredible, right? Like there's this ebb and flow, right, like, many of us are forced to work at this very steady concrete pace, you know, in practice, but is there ways to sort of say, okay, well, you don't want there was something going on, you know, in my personal life, and I'd like to work less, right, or a loved one needs me, I need to work more, or, you know, what I'm loving what my kids are doing in their activities. I don't want to miss things. Right? You know, or I want to be there in volunteering, kindergarten, or whatever have you right, like, so how do we adjust to that? Because this is a major issue with younger generations who were like, no, no, I'm not signing up for a 60-hour workweek for 40 years, no interruptions two weeks of vacation a year not happening, right? Because this is one of the reasons why younger generations of doctors are not interested in it because there's this lack of flexibility. Sarah 38:09Yeah, well, they feel like they're trapped. I even hear constantly. I haven't had a true day off for 12 year, or well, 10 years. Kevin 38:13I hear that from physicians so often. Sarah 38:14You hear that from physicians, okay. This is possible, you guys it is possible. And it's it's really important to protect you because you will, like all the humans, need rest and water and a break and holiday to make you a nicer human. Good for your physiology. You have physiology even when you're a doctor. Okay? You still need rest and water and food. Okay downtime. Kevin 38:41Sad that we have to veg that, but we do. Sarah 38:44You do, you have physiology, your afternoon, your brain is tired, even when you're looking after your brain during the day and not allowing interruptions and those sneaky peeks at the worklist in between patients and all the things that you're doing to add decisions to your day, even when you tidy all of that up. You're still human afternoons, brain sluggish, normal. Okay. So now we need to know that about you and figure out how do we look after you in the afternoon, that type of thing really important. So let's talk about holidays. So in part of my career, I got modeled this very well. So my first general practice, and one of my colleagues went on a month holiday to go fishing. He would not be on internet and this was way before we had access to EMR. Outside of the clinic right, before internet. We had an electronic EMR, but there was paper charts, but it was before you could just you know be 24/7 accessible. He went away from it. I saw his people for him. What was fascinating, I actually learned something from that experience. His patients would come in and about eight minutes in they'd stand up to leave. I was a brand new resident, year one or two. And I'd be like sit down I'm not done. My decision-making is not anywhere near I haven't got enough information yet. And I realized patients are trainable. Ha! Who knew? Even if you've had the same patient panel for 10 years, you can still train them. Kevin 40:09Wow. Sarah 40:10Because I've done it multiple times. Don't tell them. So they'd come in, sit down about eight minutes later, they'd be starting to get up to leave. I feel like what's going on? So, but he was completely off, inboxes handled, patients handled, gone for the month. Came back much better human. We can tell when he needed a holiday. You need a holiday, you do. So I love to find a destination that has zero internet access. We have this amazing little place in northern Saskatchewan it's called Slim's Cabins. They have cabins on the river. We go fishing, big pike, very little internet access. Okay, I give away my patients and my inboxes to my colleague. Okay, they have full autonomy. But there's rules, we talk about it. And we all have different rules. I could say if I wanted to, I want to read the consultation letters when I get back anything about them that you think is important, but leave them for me to read when I get back. Or, hey, I have these appointments set apart. So if you're seeing something and you need them seen by me on my return, put them in there just tell reception, put them in her calendar, where she's assigned these time for these patients to be coming back to talk to her. So they're not necessarily burdened by taking on and trying to manage these things that aren't very urgent while I'm away. So I like to have a full month off. It's amazing. And it's possible. Kevin 41:48Wow. Sarah 41:49Even if you're in micro practice or a single practitioner. Find a buddy. You know a locum may or may not be available. Find a buddy who's also similar practice to you. Figure out how to get in the EMR confidentiality contracts. And away you go. Like, manage it. Kevin 42:07Help one another. Sarah 42:09I have a buddy. I have, we normally have buddies in our like one doctor who will go away and you're their buddy, and then you'll reciprocate for them. But it doesn't have to be. We've got quite a few physicians in our environment. And we'll pick kind of maybe like practice, or just who's not had a break or who has had a break recently who could take on this. Can we just make it an easy yes. Then there's you away on holidays with internet access. And you can still beacon network this because you don't want to have to bother your colleagues about your patients. So you do it for them. And you think you're doing a good thing. You're not. You need a break. You need an actual rest. You are replaceable. This was a lesson learned when I took a sabbatical. Remember that 18 month going around Australia. I said enough full-time family medicine, I want to go see the world I want to be a mum, I want to create some amazing memories with my kids. It's highly, highly satisfying. Kevin 43:14I love that. I love that. It's such a hopeful message, Sarah, when so many of us are just like you said, we're hoping for a day off, let alone a month or a year. Yeah, I think the other thing too is we don't acknowledge how stressful this job is. We deal in people's lives. We deal with serious things. We deal with a lot of sad stories, but on top of it is enormous stress in managing the practice. Right? I mean, think about think about your colleagues that, or your patients that will come to you talking about burnout, and you know, they're their workplaces when they have these rules of responsibility as executives or managers burnt out, but they don't necessarily deal with the level of stress that we have in dealing with patients lives. And so you're right, invest in yourself to be happier, healthier, and a better, better physician for it. I'm already thinking that we should get you back on and talk about, I know I gotta like a million ideas to get you back on which means when we get you back on not if we get you back on but I'm just exploring how to begin to have conversations colleague to colleague within the clinic about like, Okay, I'm making change, but how do we make change and not just fighting over the EMR? Or whether to hire another MA? But it's like, okay, what can we do to support one another? I would love to go in that direction. And hear your thoughts on it, and I know it's not just your own experience. It's you talking to hundreds of doctors. Sarah 44:50Yeah. Yeah. You'd asked me to explain my program it was Charting Champions is our physician program and Smarter Charting is the program I have for clinicians who are not physicians, and it's just the place like you said, you will have a season that's happening for you right now, maybe you coming back from that leave, maybe you have small children, maybe you have children who are graduating, maybe you're in the phase where you want to work like a workaholic. And then you kind of have this realization one day, I'm so exhausted, I don't want this version of me anymore. How do I get the other one, that's not a workaholic anymore? Like working hard and working? A lot is okay, you are the boss of you, if that's where you're at, and you want to work hard, do it! And when you're at that point of pivot, you can. You have pivoted, so many times already, you have already become a doctor, you weren't one before. Like you've done impossible things already, you are capable of change, and you're not trapped. And you can redesign this within the system you're working or even if you're choosing to move somewhere else. That whole pivoting learning, like through a pandemic, we added portals, we added emails, things that we never had with patients before. Yeah, we pivot all the time. We just tell ourselves, we don't know how well we can't or it's too hard. Just notice that. Kevin 46:13And take the time to invest in doing things differently. Sarah 46:19Yeah, if you want something different, go for it. Honestly, just figure out what's my lowest hanging fruit? What do I actually want? Where am I going? I don't know. It's just an obstacle course. Let's go. Kevin 46:29Write it on your hand. I love it. I love it. What a beautiful, beautiful and uplifting message about making things better. Right, controlling what we can control. So with that being said, we went of course we went over. But this was incredible. I loved it. Again, thank you so much for being with us today, Sarah, and we can't wait to get you back on the show again. Sarah 46:52Sounds good. Thank you. Kevin 46:55Thank you so much for listening to the Physician Empowerment Podcast. If you're ready to take those next steps in transforming your practice, finances, or personal wellbeing. Then come and join us at physempowerment.ca p-h-y-s empowerment.ca To learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story. We'd absolutely love that as well. Please send me an email at KMailo@physempowerment.ca. Thank you again for listening. Bye.

28 - The Physician Entreprenuer

Play Episode Listen Later Sep 30, 2023 28:17

Dr. Kevin Mailo interviews fellow Physician Empowerment co-founder and co-host, Dr. Wing Lim about entrepreneurship. Wing is an accomplished businessman, entrepreneur, and real estate investor in addition to being an excellent doctor, and he talks with Kevin about what it took to make his journey from Med School to where he is now. Wing recalls how risk averse he was when he initially graduated from Med School thirty years ago. He looks back and see how dramatically he has grown and changed and a lot of it had to do with mindset and learning how to develop the entrepreneurial side of being a physician. What physicians aren't taught is how to manage the clinical side, the business, the “dark suit” side of their careers outside of patient treatment, often to the detriment of personal fulfillment and smooth-running clinics.In this episode, Dr. Kevin Mailo and Dr. Wing Lim address how physicians can encourage their entrepreneurial sides to grow. They talk about not being the know-it-all and becoming comfortable with being “the dumbest guy in the room” in new situations because it offers a chance to learn. Failure is part of growth as much as embracing dormant dreams and learning to feed other aspects of smarts besides simply intelligence. Kevin and Wing share their ambition to help all physicians realize their entrepreneurial sides through mentorship and Masterclass advice of the sort Wing offers in this episode. Resources Discussed in this Episode:Physician Empowerment Masterclass—Contact Information:Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally and financially. If you're loving what you're listening to, let us know. We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in person and online so look us up. But regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:34] Hi, I'm Dr. Kevin Mailo, one of the co-founders and co-hosts of the Physician Empowerment podcast. And on today's episode, I'm going to be interviewing my fellow co-founder and host Dr. Wing Lim. Wing is, as many of us know, is a very, very busy, ambitious dreamer within our profession. And it's truly admirable what you've done, Wing, over the years. And I thought that today we should explore a little bit about your journey, because when we look at you as, you know, an entrepreneur and a real estate developer and a highly successful clinician, there is a lot there. But I have the feeling that it hasn't always been the case, that you were something else when you started 30 some years ago. So with that being said, Wing, why don't you tell us about how you journeyed from being, you know, a physician to becoming a physician entrepreneur because we see that a lot in our Masterclass attendees. So a lot of our attendees in the Masterclass with Physician Empowerment are entrepreneurial. They're trying to build something, whether it's something they're building in real estate, building in their practice, we even have some that are kind of working more in a tech space. So it's really, really interesting to see how physicians come to this point of moving from being strictly a professional to being a professional who's also an entrepreneur. So tell us a little bit about your journey, Wing. Dr. Wing Lim: [00:02:02] Yeah, sure. So yeah, so I go to a local med school, went to U of A like 30 some years ago. And I just finished my 30th year of practice in family practice. So the journey is torturous. There are ups and downs and if you have a time machine and just bring me back to the me 30 years ago and just the present Wing and the Wing that is just out of practice, I think if you say this is going to be you in 30 years, I say that it's a lie. I couldn't even believe that, the metamorphosis is like unbelievable. Right? I was at a larval stage. Dr. Kevin Mailo: [00:02:41] You were just a little grub. Dr. Wing Lim: [00:02:44] I was just crawling on the space. Right? It's like the primordial soup. So where I was was I was risk adverse. I was diligent, hardworking, medical graduate, just like anybody else. But then life, life has its twists and turns. Right? Yeah. So to recap one of the stories is my preceptor had a really good faith in me more than I had faith in myself. He actually spent the money. He wanted to build a clinic. He spent all the money to put me in a clinic to start one, and I was just finishing my R2, right? And so he says, okay, Wing, I'll set you up. And then I told my wife, my newlywed, said, No, this is too, too scary, too risky. Starting a clinic from scratch, what if there is nobody coming in? Then we don't even have money to pay rent. And my very astute and pragmatic wife, some of you know her, Kitty, said that look your boss gave you - oh, there's a Chinese dish, famous Chinese dish called the soy sauce chicken - she said your boss gave you the chicken and asked you to cough up some soy sauce, and you said that's too risky. So that was how risky, how risk adverse, and I actually said no, believe it or not, I said no. And then went and find a locum instead. So that's where I was. Right? And then so fast forward 30 years, yeah some of you heard my story, right? We developed one of the largest clinics in Alberta and we developed a wellness center that processes 2000 patients a day, more than half a million visits a year. And we just launched a senior home that is six storey high, 156 units, and it's 90% full. So there's a lot of other stuff that I do and I look at, Wow, how did we end up here? So is this nature? Is it nurture? And I would say somewhere there are some pivotal people. We call them mentors. They disrupted my world. How dare they, right? Dr. Kevin Mailo: [00:04:48] So yeah, the first thing I'll just highlight here that's resonating with me is the notion of mentors, right? Those people that come into our lives and carry enormous meaning and kind of push us to the next level, help us grow. I mean, you know, you're one of my mentors and I can certainly recall a lot of those kinds of moments. So continue, continue on with your story. Dr. Wing Lim: [00:05:10] And the mentors are not didactic. Like we went to med school eight hours per day for four years, right? Or three years. And then 100 hours of rotations. But mentors are the ones that open doors for you and they open doors by disrupting your status quo, by asking you some pivotal questions or give you like a light bulb. And one of my mentors, we just spent an evening with him, Dr. George we call him. He's in his late 80s and he asked me a question. He says, Wing, what if time and money were no object? What if success is assured? What would you like to do? And that's when we started this dreaming session, writing it down, and we called it The Power Page. You write down first 20 items and you think, Oh, I want to have this car, this boat, you know, this trip, you know, all these bucket lists. But then very soon you run out of steam. And then and then they say, don't stop. Keep going. Don't question it. Don't, don't disqualify. Keep writing. And if you last 20 minutes later, there's some more notable stuff that are coming out if you don't stop your pen, some of these bigger, more noble dreams come out. Right? And some of that would be your life calling, your life's destiny. First time emerging and calling your name. Dr. Kevin Mailo: [00:06:25] Wow. Dr. Wing Lim: [00:06:26] And all of those you need to break out of your shell. And that is where entrepreneurialism comes. Dr. Kevin Mailo: [00:06:33] Yeah. And and it is about that personal growth. And we see that so commonly in the physician community where, you know, it's this brilliant mind of a physician. And, you know, I'm not going to try to toot our horn too much, but truly, the selection pressure within the profession is so high. You know, we have this collection of brilliant minds who are incredibly hard working and industrious, but at the same time, the profession can be somewhat constrictive in that it's not necessarily a creative space or a space for our dreams. Dr. Wing Lim: [00:07:05] It's not. In fact, it's the opposite of creativity. It's called conformity. We are bred in extremely purebred, incestual kind of purebred environment that we don't question whatever has been agreed upon, right? The clinical practice guideline or whatever the college says, right? Whatever your profession says. And then you're locked into there and you're supposed to be better and better and better. So there's a concept called white coat versus dark suit. So I came across this a number of years ago. We went to school to become white coat. But then as soon as we got our billing number, our practice license, we started work in the department, got the first paycheck, first billing, depending on fee for service or your stipend, wuddenly your first year's income is bigger than your last many years. No, sorry. Your tax bill this year is better than your income last year and then you start to become dark suit, right? Suddenly you have to adopt the business side, especially those of us who are in private practice. Or you are noncommissioned too, you have a research grant or you have the whole department funding. You suddenly have to manage it like the dark suit. And of course, we didn't go to business school, right? So this is where we fumble. We struggle. Dr. Wing Lim: [00:08:15] For me, my journey, I bought my practice right off the bat after I said no to the preceptor. And then we borrow money that we haven't got. We got evicted by the landlord within two years. Our son was just one year old, barely in the car seat. Right? And there are a lot of hard lessons to learn. And so a lot of this dark suit side, we never went to school, right now I went to school a long time ago, but I heard my recent colleagues that there is hardly any business education, any entrepreneurial side of the business, about the medical practice, the practice side of the medicine, right? The nitty gritty detail of it. We don't, how do you run a clinic, right? I have some great clinician, some of my own doctors. I love them, but every time it's a solid two hours wait at the office and just looking at their workflow, it just aches my heart. And hospitals be waiting for 12 hours, 14, 26 hours, right? There's so much wrong in the practice of medicine because we are clinicians, we're white coats, we're not black coats, black suits. And so it is a journey and a half to evolve. Dr. Kevin Mailo: [00:09:27] And I would say that that journey can be deeply meaningful in our lives. I mean, we talk about dreams quite a lot at Physician Empowerment because they bring focus to what we're doing. And a lot of physicians, you know, that we've encountered over the years find it so meaningful to have that entrepreneurial outlet, that place where you can pour your energy and your passion and your creativity with the dream of making things better, whether it's within your practice or within education or other areas strictly outside of that face to face encounter with the patient. I think that's so important. Dr. Wing Lim: [00:10:06] Yeah. So this is nature versus nurture, right? Are these medical entrepreneurs, are they born with it? Is this a nature or is it nurture? Are they, did they go to school and become a business person? I'm going to say it's more a concept like epigenetics, right? You know, the genes and you get the environment can turn on and turn off the genes like uncle genes and other genes. So I'm going to say that we yes, of course, we deal with the brightest of minds, the highest GPAs, the high achievers. Those become our colleagues. Right? But we only breed them in their scholastic intelligence. Right? When people nowadays look at intelligence, they're like nine kinds of intelligence. IQ is only one of them. There's Adversity Quotient, there is a Relation Quotient. There's Emotional Quotient. Right? And if you have high IQ and low three of those, you become one of those department's delight. Everybody is scared of you, right? In my days, some grumpy surgeon would throw scalpels at the nurses. That's before the days of AIDS. Yeah. And so there's just these people with personality of doorknobs that run the department. Dr. Wing Lim: [00:11:10] But now things have changed. Everybody is more civil. But then I'm going to say that these brightest of minds, they got turned on one gene. The gene is the scholastic education. But now that they're thrown in a different environment, now the brain is saying, what else? Right now, with the money, with the influence, what am I going to do? What can I do? And we're fumbling because we haven't turned on those genes. Right? As we move on, as we allow people to talk about these things, their genes will be turned on. And so that's why when we do these Physician Empowerment encounters masterminds, we're like magnets. We're attracting people that either come out and say, Hey, I've got that gene, or people say, Hey, I think I might have that gene turned on. So when, let's say for you and I, Kevin, right, when we met, we thought we were X-Men. We're the Mutants, right? And now we find that there are more and more X-Men, X-Women out there. Dr. Kevin Mailo: [00:12:04] Yeah, there are just so, so many of us that are, yeah, are interested in doing something, you know, along the lines of an entrepreneurial pursuit. And it's really wonderful because although the thrust of the activity where specific projects someone is working on may be radically different, there's a lot to be said for sort of the cross-pollination that occurs when you get people together where they share their experiences, they share their perspectives, they share their advice with each other. And that's that's a very, very powerful part of the community experience that I've noticed over the course of doing our master classes. Dr. Wing Lim: [00:12:44] So this thing about entrepreneurship, so one time I was invited to speak at a religious context, right? These are congregants and we're talking about entrepreneurship. So compare what the the religious world would see as, let's say, a clergyman or somebody who is really good at running, let's say a charity or NGO. The list of attributes and skills versus a successful multi-billion dollar international enterprise, the skill set or the build - borrowing from people who are gamers - this character's build, it's identical. Whether you are a money driven, money hungry entrepreneur or you're an altruistic NGO builder, right? The skills are identical. So if you have a dream to run your department different, to run a new idea, new medical idea that could change the world, it all takes the same skill set, right? Same resources. So we just came back from Iceland at a CME trip and we met this dermatologist who discovered that he grew up in Iceland and it's a fishery country and they throw away the fish skin since he was a kid, and he discovered fish skin is the best for human skin regrowth. And so he created a product, right, that is selling everywhere and haven't got in Canada. And fish skin has the least amount of rejection compared to, you know, any other animals. Dr. Kevin Mailo: [00:14:09] Wow. Dr. Wing Lim: [00:14:09] This thing is going gangbusters. And you know what? I look at them, this is now, this thing is going public, they have like 20 plus million dollars of investors money. Right? And now this becomes, his dream became true because somebody kicked in with that entrepreneurial side. Right? Get together with him and make this dream come true. And now it's benefitting people all over the world. Dr. Kevin Mailo: [00:14:32] I love that. Dr. Wing Lim: [00:14:33] That's a good story, right? Dr. Kevin Mailo: [00:14:35] Yeah. And you know, again, one of the things that that's so important as well is this notion of margin, right? That there has to be some balance in our personal and professional lives to create space to come up with these ideas and to develop them and then to actively work towards them. Right? Like, you know, if you're working 80 hours a week and you've got a big dream, it's going to be frankly, hard to achieve. I don't know. What are your thoughts on that, Wing? Dr. Wing Lim: [00:15:02] Yeah, exactly. So people say, where do you find time? But I think we always find time to think, do things we want, because time management is never rational. It's emotional based. Dr. Kevin Mailo: [00:15:12] Ooh, I like that. Dr. Wing Lim: [00:15:14] Were we supposed to do this, and supposed to do dictation, do charts, and you ended up watching six hours of Netflix, right? Because you're so, so dry, so burnt out that you got to pacify yourself with something, right? So I think what is more costly than time is headspace, right? So I tell people that I'm a serial entrepreneur. I build multi-million dollar corporate entities, so I'm a profit driven, some are for profit, some are not for profit. But it all takes time and effort. So persistent quality, part time effort, right? We could carve out from our calendar say, I want to, let's say you name a number, two hours, three hours, five hours, ten hours, whatever. Right? We just met a new person that we met through our Physician Encounter Endeavor. This guy now cuts out 15% of his week to do something entrepreneurial. Right? So as long as you can do that, well, it's no different than if you need to take a master's degree like MBA, MPH or whatever through your residency or through your clinical hours, you carve out the time to do it, right? So if you do that and nurture the entrepreneurial side and with the bright mind that you already got - you won't be a successful physician if you're not being bright - we just need to give ourselves permission that, okay, I'm learning a new thing, I'm starting from zero, right? From being like a pre-med student stage, right? And we just own that up and say, Hey, I'm an idiot outside of my own field. I'm going to start in the field and the time. Dr. Kevin Mailo: [00:16:44] I love that that, that powerful humility, that vulnerability. Dr. Wing Lim: [00:16:49] And the permission for us to say, okay, I'm learning a new thing, like learning a new language, go to yoga class, and knowing nothing like me learning dance, right? When could not even dance like Pinocchio, like my kid said, right? Start something new. You learn something new and that's about personal growth. Dr. Kevin Mailo: [00:17:05] And I was just going to add, you know, before when we started our journey together, and we've been at this for well over the better part of a decade now, but I remember being the type that used to be terrified of being the dumbest one in the room. And now I feel honored to be the dumbest one in the room because I feel like I'm learning. But that was a mindset shift for me, to realize that I'm being immersed in a field or a topic or an area of expertise that I have no background in, that someone else is going to know a lot more than me and this is my time to to quietly learn or not so quietly learn and ask my questions. But that takes a lot of personal work and personal growth that's very far from that medical student or resident on the wards who's getting ready to get thrown a doozy of a question by the senior resident or the staff or the fellow, and you're expected to know it. And God forbid you're not the smartest one or one of the smarter ones in the circle at the patient's bedside. So it's a big mindset shift. Dr. Wing Lim: [00:18:10] Yes, because contrary to our paradigm, the know-it-all does not own the world, right? And here's a paradigm that I've learned, that I embrace now, if you get the why big enough, the why, then the whats would come to you. The whats and the hows would come to you. Just like Mr. Ford, when he started this motor vehicle revolution. And he actually started with a dream. His dream is not to be the number one seller of cars, his dream was when he grew up he saw the countryside, he lived in the countryside, his dream was to have every American have a chance to have an affordable way to travel to see the countryside. And because of that dream, right, and he's not an engineer, he's not a technical person, and one time at a press conference, they say, Mr. Ford, how do you become so smart? Do you actually know how to fix this part of the engine? And then he picked up the phone and they said, wait a minute, what are you doing? He says, I'm going to call my engineer. They said, That's cheating. He says, No, that's not cheating. In real life, if the why is picking up, the hows would come to you. Right? So I think that is important, right? People ask me, how do you learn so much about so many things? You have your hands in so many different things. I said because I hang out with people smarter than me. Right? Always look to be the dumbest. And one day when we were building this senior home, I found myself downtown in one of the top architect firms. So there are a few of us surrounded by 3 architects and 15 engineers from different disciplines. Dr. Kevin Mailo: [00:19:38] Oh, wow. Dr. Wing Lim: [00:19:39] These are top notch engineers. And they were grilling us and saying, What do you want? What do you want us to build? Right? And I'm just not qualified. I'm just the dumbest person in the room. But I had a dream. But I had a dream. Dr. Kevin Mailo: [00:19:54] Exactly. Exactly. So I think we could go on and on in this area. But tell us, like, what practically have you done in terms of personal development to get where you are as an entrepreneur? Going from that very narrow technician to being this expansive entrepreneur who dabbles in so many fields. Tell us. Dr. Wing Lim: [00:20:23] Sure. So I think we already talked about some ABCs, maybe we just put them down more formally. A is to give yourself permission, right? That I don't know anything. I'm learning a new discipline. The second part is to carve out your head space, right? You got to dedicate some head space together as time and also quietness. The mindfulness that I'm going to learn this and then you got to feed it. You got to feed that part of the brain. You got to turn the genes on. You got to keep feeding it. And that's why listen to podcasts. And well, 30 years ago there were no podcasts, right? You can read books, you can listen to tapes. I grew up with tapes, right? And so for now, you can listen to our podcast. And actually, Kevin, you and I were just talking about we're going to start a new series, right, called the Medical Entrepreneurship. And let this be our kickoff, right? This kickoff session. We're going to interview a lot of our colleagues who have that mutation, that mutant gene of entrepreneurialism. And when you interview our colleagues, how do they do it? What started it? We're going to interview people's journey. And somewhere there is like a tuning fork where you go binnnngg and the guitar box, the rest of this box is going to resonate, right? So we put different tuning forks and then we're going to turn people on. We're going to turn on your gene, right? And those of you who have that gene, it's going to echo. And those of you who don't think you have one, maybe you would echo too. Dr. Kevin Mailo: [00:21:45] Take time to explore it. You know, and the other thing I'll reflect on is the goal is less important than you think. The journey is far more meaningful. Dr. Wing Lim: [00:21:56] That's right. Yeah. Dr. Kevin Mailo: [00:21:57] You know, because for me, just reflecting on my own journey as an entrepreneur, there's just been so much growth and it's been so much fun and so exciting and I think that's a real source of personal renewal is like doing more than just the 9 to 5 grind. And we know it's not the 9 to 5 grind, it's the 8 to 8 grind for doctors. Dr. Wing Lim: [00:22:20] Yeah, exactly. Dr. Kevin Mailo: [00:22:22] It has to be more than that. Dr. Wing Lim: [00:22:23] It's very hard for us. It comes with a price tag, right? It comes with a price tag. So it's an investment. It's an investment in your future and for unknown number of people's lives. Right? Because when I go to the wellness center that we built, there are patients who say, Wow, we're so thankful that somebody built this. They from two hours away, rural, they could come to Sherwood Park and downtown Edmonton. And I'm glad that when I want to go to this center, I'm not known. People don't know me. I have a very healthy ego. I don't need to be thanked. But it scares me sometimes to think about what if I did not activate on my dream? That reality today that everybody took for granted would not be there. We would be struggling. Our medical delivery would be a mess in our county. Right. So exposure. Exposure, right? And then learn the lingo, learn the mentality, talk to people. Allow yourself to dream. Allow yourself to take more risks. It's a metamorphosis. Dr. Kevin Mailo: [00:23:22] And allow yourself to fail. Dr. Wing Lim: [00:23:25] Exactly. Dr. Kevin Mailo: [00:23:26] This is a lot less stress than you think it is. If you can get past the ego component where you're worried about what people think or what you'll see in the mirror when you look. You know, when it comes to, you know, especially like, you know, sort of business and real estate and things like that, you know, there's money at stake, right? But it's not the same pressure as medical errors. And so, like, be comfortable failing, be comfortable having setbacks and frustrations and be comfortable learning from those. That was the other thing that I took from that is that it sounds so cliche to say that, you know, failure is the path to success, but it is. Every single highly successful entrepreneur, highly successful, not just entrepreneur, you know, whether it's a political leader, an athlete, a musical performer, an actor, an actress, that person has had innumerable failures on their path to success. And we don't know them, right? Dr. Wing Lim: [00:24:24] We only meet them when they're successful. Right? So I have kids who are musicians, right? So I understand that mentality. And then in our in our profession, there is zero margin of error. Right? So therefore, it's very one of the toughest thing is not A) every time you're successful, the first time you try, you got to fail. B) I'm not the know-it-all. Right? I need to be the dumb guy, right? And don't DIY, don't do it yourself, do it your way. If there's one way to do it, do it yourself. So I find it very difficult for us to delegate. If you want to be huge in this entrepreneurial world, you gotta learn to let go of yourself. Dr. Kevin Mailo: [00:25:02] Oh, yeah. Oh, yeah. Dr. Wing Lim: [00:25:04] And we teach this concept of leverage. I have a talk on that in Mexico that we did about leverage. Right? It's leverage is the way to to build success. The time, money and talents, the three essential T's for success. All of those lessons are learned and you learn from your own mistakes or other people's mistakes. So it's better to learn from other people's mistakes. Right? And that's why it's good to join us. Join us on our podcast, webinar, Masterclass, fun conferences and our destiny trips. That's where we share our ups and downs. Dr. Kevin Mailo: [00:25:38] Yeah, and there are a lot of downs. Dr. Wing Lim: [00:25:42] Lots of downs. It was shameless. We share our failure stories, right? Dr. Kevin Mailo: [00:25:46] It was no fun having a business built around live events during the pandemic. Yeah, that was a real struggle. Nobody seemed to want to come to our conferences while a pandemic was ravaging the globe. Dr. Wing Lim: [00:26:00] Or at a Mexico conference. The spouse showed up, but the doctor could not because of pandemic, the hospital would not let him go. Dr. Kevin Mailo: [00:26:08] Yeah. So lots of ups and downs, but still so wonderful. And so with that being said, why don't we wrap it up? Because we'll be coming back to this topic over and over again. Dr. Wing Lim: [00:26:21] Yeah, so Kevin, so we're going to interview people. So we already have a list of people. And for people who are our audience, if you have a good story to share about your journey of medical entrepreneurship, let us know. We would love to hear your story. Dr. Kevin Mailo: [00:26:36] Oh yeah, yeah. I was just going to say please and I forgot to plug this many episodes ago and I got to start remembering to do it now. If you are hearing this and you want to share something on a topic of wellness, practice transformation, leadership, finance, entrepreneurship, talk to us because we want more guests on the podcast. We want this to be a community of physicians who are sharing their story, sharing their journey. We don't want it to be the Wing and Kevin Show. So if you have something great, let us know and we'd love to have you on the show. Okay. That's it. That's it. Thank you. Dr. Wing Lim: [00:27:13] Okay. Thanks, everyone. Dr. Kevin Mailo: [00:27:16] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

26 - Corporate Structuring Strategies with KPMG Tax Lawyer Jason Pisesky (masterclass faculty)

Play Episode Listen Later Aug 30, 2023 36:07

Dr. Kevin Mailo hosts Dr. Wing Lim interviewing KPMG tax lawyer Jason Pisesky, a Masterclass faculty member, about corporate structuring strategies and corporate tax planning. Jason pulls from a wealth of practical knowledge and experience to shed light on what to do and what to avoid with a PC. Dr. Wing Lim asks Jason to first explain the SBD, small business deduction, of $500,000 and strategies Jason advises around that amount. There are things to consider in how you structure your PC that will affect the SBD in the future, and Jason explains what those considerations are. Wing and Jason break down their discussion in ways that offer insight to physicians regardless of which career stage you're currently in.In this episode, you'll learn from KPMG tax lawyer Jason Pisesky how to set up PCs between spouses in similar career fields, or with partners, that offer the structure for corporate taxes. He breaks down why it may not be the best advice to invest everything into your PC, things to consider for future sale options, and when to start a trust if you want one. Above all, Jason shares that investing and structuring with intention is the best way to plan ahead and advises talking to a professional if you haven't started tax planning yet. About Jason Pisesky (masterclass faculty):Jason's practice covers a broad spectrum of taxation law matters including corporate, personal, farm and estate tax planning as well as representation in dispute resolution and litigation mattersJason joined KPMG in January 2021. Prior to starting at KPMG, he spent over six years working at a leading western Canadian boutique tax law firm. Jason has experience in both the tax dispute and tax planning for both personal and corporate taxpayers.Jason has worked with small and medium-sized owner-managed operations to reorganize structures in a tax-efficient manner, acting as counsel for vendors and purchasers in arm's length deals as well as families in the midst of related party estate and succession planning. He has argued on behalf of taxpayers in many contexts and obtained favourable results for taxpayers from auditors, appeals officers and lawyers at the Department of Justice. Jason has appeared before the Alberta Court of Queen's Bench.Resources Discussed in this Episode:Physician Empowerment Masterclass—Contact Information:Physician Empowerment: website | facebook | linkedinJason Pisesky: website | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment, we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know. We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in-person and online. So look us up. But regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:34] All right. It looks like we've got everyone here. I am so sorry. Three years into everybody using Zoom, I still struggle with it, but we are slowly, slowly getting there. So at any rate, I want to thank everybody for joining us for the webinar tonight. I'm Kevin Mailo, one of the co-founders of the Physician Empowerment podcast. And our programming, as you know, we cover a wide spectrum of topics and today we are very, very glad to have Jason Pisesky returning back on the webinar, back on the show, to talk about tax hacks for busy physicians, busy medical professionals. And what we're going to be covering today is corporate structuring, one of the most powerful wealth creation vehicles that physicians enjoy in this country is the ability to be incorporated, to set up holding corporations. But it has to be done properly. And that's why we're bringing in an expert. So Jason is a tax attorney who works with KPMG. He is a KPMG tax attorney. And so he has an incredible, not only knowledge base, but a whole well of experience to draw on. So I'm going to be stepping back and Wing's going to be interviewing Jason. And if you like what you're hearing, you want to know more, come and join us for the Masterclass because this is what we teach. And Jason, of course, is one of our faculty members. So again, thank you, everyone, for being here tonight. And why don't I let you take it away, Wing? Dr. Wing Lim: [00:02:02] Okay. Thank you, Kevin. Yeah. So welcome, everyone, to tonight's exciting episode. I'm Dr. Wing Lim. As most of you know me, some of you don't. I'm one of the co-hosts and co-founders of Physician Empowerment. So Jason and I went back quite a while. For those of us that haven't met Jason yet or haven't listened to a previous podcast, Jason and I went back, we were classmates on the dance floor and he was a really nice dude. He was openly admitted to be the teacher's pet. The teacher, the dance teacher, said that. He's a super nice guy with he doesn't have an ego problem. And a number of years later I went into some corporate tax planning pickle and then I dialed up his phone number and said, Hey, Jason, I think you're a lawyer, right? I think you can help me. So that's how we started to talk about a lot of these fancy corporate structuring that that he's doing on a daily basis. So welcome to the show, everyone, and welcome to the show, Jason. So Jason, so you and I were talking the other day about some good and bad stories in corporate tax planning. So you have two different cases you have in your file, in your portfolio of clients. Can you tell us the difference? And we can go from there. Jason Pisesky: [00:03:15] Absolutely. Happy to be here. Thank you very much. And Kevin as well for the very nice intro. Thank you. So, yeah, we were chatting yesterday and just about all the different aspects, facets there are to corporate tax planning and wealth building, just some of the things I've seen. And we got talking about the issue of corporate association. So there's many different types of relationships in the Income Tax Act. There's related association, there's affiliation, there's connected, foreign affiliates, all these different terms for how different taxpayers can be linked to one another and what that means. For your small business corporation, one of the big ones is association. If you're associated, that means you have to share certain benefits. But there can be certain benefits on top of that too, to actually being. So it's not all consequences. What we were talking about was the approach to corporate investing. If you are associated corporations, you have to share the small business deduction. We talked about that a little bit in our last show. Small business deduction gets you the low rate of tax on generally the first $500,000 of income earned corporately on active business income. Jason Pisesky: [00:04:20] So if you're associated, you have to share that amount, that 500,000. By the same token, if you're associated, I'm sorry to back up, when you earn investment income, that might start to reduce your small business deduction. Even if you're just one company and you're not sharing with anyone. And so we got talking about kind of some ways to structure around those two problems, not wanting to share, not wanting to reduce the small business deduction either. So we're talking about a client I've worked with in the past. It was two medical professionals. I've seen many ways done, many times done this way. The idea is you just have two different doctors, doctor/dentist, doctor/lawyer, and they each just have their own PC and they don't have any cross-shareholdings in each other's PC. So they just wholly owned their own. And that's the way to avoid association. Association arises once you start to own some shares of the other one, it can start to cause a problem. Not automatically, but once you cross certain percentage thresholds. Dr. Wing Lim: [00:05:20] So can we just stop there? Because I think we need to clarify this thing because not everybody may be on the same page. Right? So this is, you're talking about husband and wife. They're both professionals, let's say, pick this first case that they have both medical professionals. They both own a PC, and there are certain tax advisors, accountants would advise them, hey, you know, you can share a PC together. Right? And then so you're talking about the nuances about is this a good or a bad thing to do? Is that what we're diving into? Right. Jason Pisesky: [00:05:49] Yeah. Or even, hey, just, you know, both of you be 50/50 shareholders in each other's PC. Just, you know, if one doctor has an up year, one has a down year, then you can maybe pay some dividends or shift or share in the growth across both of them. Yeah. So kind of a couple of different avenues to why you may get there, but the likely ideal structure is to have both of them having one PC, both of them doing their own thing, and both of them getting that full 500,000 shelter on the income until the investment base grows big enough. And then you have different problems. And what I've seen in other files is, for example, I had one where, again, it was it was two professionals. One of them had ceased kind of working and was just going to be the stay-at-home spouse. But they had kind of some cross-shareholdings. The one who had stopped working had been very successful and had built up a multi-million dollar portfolio in the PC. And then they were finding, though, that the investment income in that, call it the inactive PC, was starting to reduce the small business deduction in the active PC and starting to reduce the ability to kind of grow this tax-deferred base. Yet there's some easy steps you can go through to sever that association, to get rid of those shareholdings, change them into different shareholdings, transfer them over, repurchase them, lots of different avenues to kind of fix the problem as to for when they came to us. But yeah, and it's one of those things that happens organically, happens over time. And if you don't have that good advice at the outset, then, again, it wasn't a problem for the first, you know, three, four, five years. But after many, many years of working and building up this wealth, you start to have these relationships that maybe you didn't expect or you definitely probably don't want. So. Dr. Wing Lim: [00:07:32] Right. So I can totally relate. That's exactly us, right, some of you know, my wife and Jason definitely knows us both, and that's when I went to Jason because we had, over the years, right, we didn't have these nice seminars and webinars to go to. We didn't have the good mentors and advisors. We just bumble along the way. And before long, so I have a bunch of corporations, she has a bunch of corporations and everything collided, right? We share some of them, not all of them, and become a big spider web. And by the time we want to think about, oh, do we, can we take a SBD, small business deduction, it becomes like separating a Siamese twin, pair of twins. Right? Becomes very difficult. So what are the consequences? You talk about this erosion of the small business deduction. Can you bring everybody up to speed. This 2017, 18 new tax rule that came and stayed? How that would have impacted like this couple, this doctor / dentist couple with this erosion, what would that mean in tax load? Jason Pisesky: [00:08:34] Absolutely. So corporations generally have a favorable tax rate, kind of no matter what your situation is. You know, at the height, again, we have this across cross-Canada audience. So the starting place, once you work through all the math, is, you know, in the low to mid 20s for the corporate tax rate, 23, 24, 25%, on active business income. We're going to talk about active business income right now, which everyone here would be earning from their medical practice. So that's your starting place. However, for small businesses, for small business corporations, there's a benefit, the small business deduction, that gives you a lower rate of tax for the first $500,000 of income. Slight variances across different provinces. Sometimes there's a provincial rate versus the federal, a different 500,000 amount. So it's not always 500,000 depending on the province you're in. But yeah, and that will drop it down to the low teens, low to mid-teens. So again, 11 to 12, 13% depending on the province you're in, and that's where the advantage comes. So you earn $100 of active business income and you don't need to take it out to spend it. Buy bonus or dividend. Then you just keep it in. And so instead of if you had maybe earned that personally, you would have paid up to 50, up to or even above 50% tax, depending on some provinces and tax rates. And then you'd only have, you know, $48 left to invest, leave it in the company and you all of a sudden might have 88, $89 to invest. So that's the advantage of having the small business deduction and why you don't want it reduced. And then but you also have to be mindful of how you are, you know, you have that $88, call it, you invest that and then it's going to start generating investment income or capital gains. Jason Pisesky: [00:10:21] So you have to be mindful of tracking that as well, because once you have too much investment income, that can also start to reduce your small business deduction. And then there's also, the third one is there's also rules around once you reach a certain size, once you have, it's a very large amount, kind of I think it's right now 15 million and then it gets phased out slowly. So that's a far down the road concern for most. But yeah, those are the concerns of why you want it and how you start to lose it. And then planning around it is do we move those, we move those investments out of the PC, and if you're you're married and have a spouse, then you can try to put those into your spouse's hands. And like I was saying with that first example of the couples who have one corporation for one doctor, one corporation for the other, you can do the same thing if you have a spouse who doesn't have the advantage of being able to use a PC, their stay at home spouse, or they are just in a profession or a career where they don't have access to them. Which is most, then yeah, you can maybe make an investment corporation in that person's name and just figure out how to shovel all the assets into that other person's hands to go there. And then the income earned on that won't affect the small business deduction in the prime active business generating PC. Dr. Wing Lim: [00:11:39] Right, now so can I make a couple of points and observation? Number one, this husband and wife, the two spouses having separate corporations, even for yeah, medical versus non-medical corporations, right? Like for me we're not a double medical income, right? I'm a medical income. My wife has a bunch of corporations that are non-medical. But, and so this separation is not just good for tax planning for those of us, and a lot of the listeners are real estate investors, right? And when you want to apply for mortgages, you need your lending power. You know what? Everybody has a ceiling, right? Some banks, three, four, five high is probably 11 doors that they will lend you. Right? And again, we didn't know better, so we cosigned the loan for all of the properties that we had and then found that, oh-oh, when the time comes, we have capital to grow, now they say no, because you already exceeded that, right? So again, it makes sense to have husband and wife separate the corporations, right? Especially if you're going into investments, then you won't, you again have to, like double the amount of small business deduction, now you have double the amount of credit rooms to grow in the real estate empire. So that's one observation. That's not exactly tax planning. Secondly is, yeah, I have colleagues that have such a good year. They're up in the years and the stock portfolio did very well and their, I think their passive income that year I think exceeded - I forgot how much - I think first 50,000 they give you free, right? By the time you're 150,000, the small business deduction has gone. And then so this poor chap ended up losing the whole small business deduction. And so that was a very, very painful year. I would have thrown up if the accountant just said, cut the check. Right? I would have thrown up. Jason Pisesky: [00:13:30] Yeah, you got the numbers right there. Yeah. So the first 50,000 of income, investment income to shelter doesn't affect your small business deduction. And the policy behind that being like, hey, corporations have to keep some money on hand to pay their current expenses, working capital, so and yeah, you shouldn't just have to keep that in burlap bags tucked under the bed. You can put that in a savings account and earn some interest. That's the reasoning behind it. But yeah, once you go above 50,000 of investment income, which includes capital gains, the taxable portion, it starts reducing the small business deduction that 500,000 on a 5 to 1 basis. So every dollar, so $50,001, you lose $5 of your small business deduction. So by, once you have 100,000 above 50,000, i.e. the 150 you talk about, your small business deduction is completely ground away. And you may have, you may find yourself having, you know, an extra 10 to 15% tax on that 500,000, which is, let's see if can do quick math in my head. You know, an extra $75,000 of tax. Now I'm self-conscious and want to double check that, but... Dr. Wing Lim: [00:14:35] Well, it is very painful. How about that? Jason Pisesky: [00:14:39] Yeah. 75. There we go. All right, good. All right. If it's a 15% spread between the two, it's kind of in and around there. It'll be 10 to 15%. So. Dr. Wing Lim: [00:14:48] Right. So suddenly you cough up with that because you had a good year. And when you think about, Wow, this guy is very successful. But when you think about it, by the time we retire, 150k, you hope there's 150k. 150k doesn't go very far by the time we retire, most of us, right? And so that's important. And the problem is this guy was not old enough to retire. They were just winding down. Still have an active PC. Right? And so this is very, very painful. The other observation is a lot of my colleagues, and they talk to their everyday accountant, they're advised to invest everything inside their PC. Right? And so, Jason, would you advise that or would you advise against that? Jason Pisesky: [00:15:29] I would generally not for the one reason we talked about. The three big reasons come to my mind immediately. One, we talked about, hey, you're going to have to start to juggle this small business deduction as the portfolio grows and you'll probably start to get very annoyed at playing that game and having to time everything, to the non-tax reason, creditor protection. You generally want your assets not sitting right next to the business where if the business gets sued they're exposed. And so, yet professionals have a bit of extra layer to deal with there. We talked about this a little bit on the tax ID, we'll talk about it in two weeks time on the Masterclass. But professional corporations, you generally don't have that same type of corporate shield that someone who's just doing real estate or, you know, running a general store or whatever in a corporation would where there's a liability that arises because of the profession, the professional and the PC are usually equally on the hook. And there's insurance and things, of course. But for that reason it's also advantageous to kind of move things out of the PC to the extent you can into, again, ideally a spouse's hands if that's tenable to someone. And then the third reason is if you have a business that may be salable in the future, capital gains deduction, which shelters currently $971,000 of capital gains, it becomes harder to access as you have a big build-up of what we would call inactive passive investment assets in the corporation. So again, not all PCs are salable, but if it is or, you know, if there's a clinic or something else, usually having the investments not with the shares that may be sold is advantageous. So most generally advise to not just keep it all in the PC, even though that's simple and maybe hey, the first couple of years you do that, but long term you want a better, more nimble structure. Dr. Wing Lim: [00:17:23] Right. So while most accountants told us that medical practice were nothing, but practices are sold, right? Not very frequent, but they are. I'll give you an example. 30 years ago I bought a practice, right, that's when nobody wanted to buy a practice, I did. I borrowed money I hadn't got, bought my dream practice at the time. We just talked to friends who sold their practices at our clinic. We are in a joint clinic, new doctors come and buy out the old doctors, right? So these things do happen, right? And so I think that what you talk about is not totally out of date or irrelevant. It is irrelevant for some people who are planning to retire. Right? If they're lucky enough to be bought out, they want to be sure because this purification, that's what you're talking about, with the purification rule. There's the time of the sale and T-24 months. Right? Two years prior, you better plan your purification. Right? Jason Pisesky: [00:18:18] Yeah. And I think even like ten years ago, I would have probably said, like you probably know, like based on your medical field if your PC is salable, but, and I don't know what the kind of what you're hearing from, you know, all the back channels, but what I'm starting to see is much more consolidation and there actually is a push, I know like it's happening with optometry, with dentistry, where they are having big conglomerates come in and try to snap up practices and build a big portfolio. And, you know, I don't know the exact inner workings, but it looks like kind of like, you know, make a public company model where you just, you know, own hundreds of practices across the country. And so I would say if, definitely you're on the younger side, you never know. So I think you kind of proceed on that basis of, Hey, I may be able to sell this. And so if it just, you know, is a little more kind of work expense and complexity, but I kind of set myself up for that potential down the line that would think it's it's worth it just based on how much the field is changing right now for medical professionals and kind of... Dr. Wing Lim: [00:19:20] Yeah, so now in Alberta, we're not, we're still mostly fee-for-service, right? So we did our physician and empowerment talks. We were in Mexico, Kevin and I, teaching in Mexico and there's this very senior guy, he was high up in CMA and all that, and he retired and he sold his practice for a very high price. He had a very nice panel. So in Ontario it's capitation model, right? So you have the whole panel and each panel carry, every patient has a price tag, multiply I think 200 bucks times our number of patients, right? And so basically he sold it, the whole panel. And he was very happy. Right? So these things are actually more relevant than what we like to think, right? So I just want everybody to just maybe tuck it, file it somewhere in your brain and say, don't just dismiss this. Right? It might apply to you. And that's a lot of money. Right? So right now is, what, $915 thousand dollars, almost? Jason Pisesky: [00:20:16] 971. So if it's not, and it's indexed to inflation, so if it's not a million next year, it will be by 2025, especially with inflation the way it's currently going. So even a million bucks of shelter. Dr. Wing Lim: [00:20:30] So yeah, exactly. And if you're not even, so if you're practicing just over a million at least whatever you sold it for, then it's tax-free, right? And then for those that are advantageous to have a spouse in there, whoever else to share the PC, I think each one have that capital exemption, then it could potentially be a big thing. And some people, they have a practice, not just a medical practice, they have a business side, let's say an esthetic practice, right? I know of one of our consultants, Mark Friesen, he's one of our consultants that work with some of our clients, and he worked with a Calgarian physician who had a cosmetic practice. And Mark is an accountant. He's kind of a CFO for hire. And helped to shape the practice in two years time, so they sold it for a very good price to a conglomerate, right? And only because they did all the right accounting, right tax planning, right structural corporate planning. Jason Pisesky: [00:21:26] Mhm. Happens a lot in dentistry. You'll have the dental business and then the hygiene. The hygienist business. Dr. Wing Lim: [00:21:32] Right, Right. Jason Pisesky: [00:21:33] So yeah, absolutely. Again you'll have hey, maybe you start a clinic and you have a building in there too. Or maybe you want to sell the building. There's opportunities there. So. Yeah. Where are you, where are you keeping things. I would say the rule of thumb is not just to keep it all in the PC. I'd say, yeah, you kind of need that advice and that, the long view range of where I may be in 20-30 years, what my exit plan looks like. And sometimes an admission of I have no idea what my exit plan might look like. I just need to, you know, set the chess pieces in the right place. So whatever comes, I'm in a good spot. Dr. Wing Lim: [00:22:04] Right. Now we're on the topic of small business deduction, I want to just dive into other things because a lot of physicians later on, they join venture with other people, other physicians or other businesses they encounter, or investment or real estate, they're going to different joint ventures, partnerships. But I think last time you talked about a lot of the tax ID, and I heard that if you're not careful, you end up everybody and their spouses, everybody shared one small business deduction of 500,000. So can you walk us through some of the bad or good and bad scenarios of how that could happen? Jason Pisesky: [00:22:40] Absolutely. So I mean the most popular model, tax aside, for professionals to work together is a partnership. You know, the LLP, that's what 98% of all legal arrangements are for lawyers, sorry, accountants are just LLPs, partnerships, limited liability partnerships. So the starting rule with nothing else is that you kind of share one small business deduction between all the partners when you have a partnership. There were some old rules where you could kind of have two PCs and you have a PC providing services to the actual partner PC and then everybody got their own small business deduction. That was shut down maybe 2018, 2019, I don't think earlier. Yeah. So. But now, you kind of go back to the default rule, Okay, everybody shares the small business deduction if you're a partner. But there are other, so there are other arrangements out there that may give access to allow people to work in some way together or collaboratively in a way that isn't a partnership and everybody gets their small business deduction still. There are joint ventures, there's cost-sharing arrangements. Those are the big ones. You just have to be very careful with the wording of the arrangements to make sure you're not a partnership at law because a judge will look through it and say, fine, you slap the label on it of this, but when I actually look at it, it is a partnership. So there are ways for professionals to work in tandem, to some extent at least, and be able to still protect their small business deduction and not have to share it with the other professionals. Dr. Wing Lim: [00:24:19] Right. So let's say if some doctors, they got together and say, Hey, we want to buy this piece of land or just buy, start a new corporation, buy a strip mall medical building. So if they structure it incorrectly, then maybe it would collide with everybody's whole codes or PCs? Jason Pisesky: [00:24:38] Yeah. And so that kind of circles us back to the association problem where we said we're like, Oh, you have two spouses, you should both just have your own PC. Because what can happen is, say you have two unrelated professionals who both have a PC, they're the only shareholders of it, and they say, Yeah, let's buy this piece of farmland and they buy it in a corporation that they both own 50/50, then you're probably all going to end up associated and you're going to be sharing the small business deduction with this unrelated doctor who you're not even carrying on a medical practice, he is just a buddy of yours who you're not carrying on medical practice with at all, in partnership or otherwise. And because of an investment you've made, you end up sharing the small business deduction. Dr. Wing Lim: [00:25:19] Right. Yeah. So I seem like I'm belaboring this, but I've seen a ton of this, right? I've been to some real estate clubs for 12 years, investment clubs, and I certainly know people who were avid real estate investors, right? They just keep forming partnerships and JVs and corporations and some, they begin to go into limited partnerships. Right? So but yeah, so basically, I tell my friends, you're just jeopardizing everybody's SBD if you have a good year, if you sold that building, that multifamily or whatever, you're going to have a tax problem. Right? So then for people who already have the spider web, or even with a spouse or non-spouse, other business partners, what would be your advice, Jason, to them? Jason Pisesky: [00:26:04] I think talk to someone. I know, I like the term spider web, I see it all the time of you know oh I'm doing a new thing, pop up a new company, I'm doing a new thing, pop up a company, and it kind of sounds like maybe people could take two minutes like, Oh, Jason is saying, you want lots of companies, you want companies for everything and to protect all your stuff, that may or may not be the case. It's, you know, everyone's situation is completely unique. We have lots of clients who come in and they have the spider web and we end up kind of collapsing in on itself because, hey, you have too many, too many things going on. And your life is just kind of overly complex without giving you the benefits maybe you thought you were getting from it. So again, we have a handful of files right now, I always have a handful of files on the go, where we are, yeah, we have ones where we're adding complexity because they come to us and hey, you could really benefit from having some more entities and moving some things around. And we have some where they come to us and we have, hey, you have too many for what you have going on. Let's amalgamate them. You know, combine some companies together, let's dissolve them, and then simplify a bit and then rethink about what kind of complexity you want and what's going to benefit you. So that's the blessing and the curse of being a small business owner is it's highly customizable. Everybody goes through it entirely different, like what kind of investments you want to make first, if you want to get into real estate, if you want to build an investment portfolio, then jump into real estate down the line, completely changes and shapes how your structure grows out. But just being intentional about it, I think, and speaking to professionals. Dr. Wing Lim: [00:27:34] Intention, yeah. Intentionality I think is a big one. But most of us don't. We just kind of wing it, right, all the way through until we got caught in a spider web. So yeah, there's so much we can cover. Now, just one last question. Right? And then we'll open this file and then we'll be done. So at what point in our career, typical professional career, would you say that it's worthwhile to consider a family trust of sorts? Jason Pisesky: [00:27:59] Um, for a professional, it's probably once you have kids, if kids are in your future, again, no real rule of thumb. I think it makes sense to chat with your accountant and your lawyer about it and find the right time, but I don't think you really need one immediately. So traditionally we would keep trusts around for 21 years. If people have heard the 21 year rule. Like trust can extend for decades and decades and decades. But there's a taxable event at the 21 year rule where, 21 year mark, where the trust is, basically it's deemed to, for tax purposes, to die. It, all of its property is deemed to be disposed of, reacquired, there's a taxable event if there's an accrual of value in there. So again, that sounds scary. There's ways to deal with that. You can transfer property out of the trust, you can roll it out, and then things continue on. The big, one of the big benefits of the trust is around sale planning and structuring. And so, you know, if you put a trust in too early, then you might miss the sale date. So I would say you don't want one fresh out of med school unless you kind of are going to be someone who kind of slowly grows and builds practices and then sells them and builds a practice and then sells it, maybe that makes sense. But I would say, yeah, graduate med school, build your practice, grow a little bit of wealth, start a family. And that's kind of when you want the family in family trust, right? Dr. Wing Lim: [00:29:20] So what you're saying is there's a because there's a 21 year lifespan, you don't want to start too early. But then when you have kids and then you build some wealth, maybe some wealth outside of your PCs, right, and then it gets, when the spider web is starting to emerge, right, maybe it's time to consider a family trust, right? Jason Pisesky: [00:29:39] Yeah. And I would say a good, to send people away, a good indicator of when you may be ready is when you start having another corporation. Hey, I want to start a real estate investment corporation. Because again, there's restrictions in most provinces on who can actually be in a family trust that owns shares of a PC. So in Alberta, for example, it can only be the professional, their spouse, and children under the age of 18. So that's restrictive. Otherwise you could have anyone under the sun in your family trust if you have a real estate company. And so yeah, but then it's great because you can have these things right under the family trust. And so, yeah, having that family trust at that point, that's kind of a good indicator of definitely when hey, I should talk to someone and see if now's a good time because I'm going to start a bunch of real estate things on the side. Should I do it under a family trust? And get that creditor protection, get the benefit to the family. And again, those may be more easily sold entities, too, whether they get the capital gains deduction or not, the ability to share proceeds amongst beneficiaries. Dr. Wing Lim: [00:30:42] Right on. Well, so good. So thank you, Jason, again for a wealth of information. I don't want to make this going on and on, I think there's a lot here to be digested and I want to thank you for bringing your wealth of knowledge and experience every day, a very live example that pertain to us. And of course, the different people here have different backgrounds, different scenarios, and different stages of life. And I think we're going to systematically look into these at future sessions in our masterclass and future podcasts. So thank you again, Jason. And so I guess, is it fair to summarize that this word that you bring up, this intentionality, right? We cannot just go in blindly and just go and wing it, right? I think we start a PC with, okay, what do we need, a PC, that was one step, that one thing we need to cross. Make that decision. Okay, I need a PC and then somebody says you need a whole code. Should I do it? Should I not? The spouse, both of the careers, and then there's a bunch of others. Right? So I guess what you're telling us today, the take-home message, is so that we have this intention to deal with this and when things get a little complicated, don't just be complacent with just what you think you know. It's time to maybe ask some professionals. Jason Pisesky: [00:32:00] Yeah. I think that's well said. Yeah. The intention is important and, again, once you start to have some material accrual of wealth in the PC, that's when it's time to start thinking about do I need to add some complexity? And once you're starting to make different kinds of investments, again, the second opinion, it's talking to other people and just seeing what's going on and what's available. You don't want to go, you know, as with doctors and their patients, you don't kind of want to go 25 years never talking to a doctor and then show up riddled with issues. You know, you don't kind of want to go 25 years without talking to a tax planner or somewhere if you're building some complexity into your life. Dr. Kevin Mailo: [00:32:40] That was kind of what I was doing, Jason So you're saying I shouldn't. Jason Pisesky: [00:32:43] Are we talking about the medical part or the plotting part? If you've not seen a doctor in a while... Dr. Kevin Mailo: [00:32:49] No, no, no, the doctor thing I'm doing. But yeah, certainly the tax planning, I really got to sit down with you at some point and begin to sort this out, because you're absolutely right, both of you, about being intentional behind this. And also one other point that you made, Jason, is being that everybody's situation is unique and that's why there is no cookie-cutter solution here. You need to sit down in front of a professional, a great accountant, a great tax lawyer like yourself, and really sort through what you need to be doing for you, not what a colleague did or someone else that you share clinic space has done, it's about what you as an individual need to do and it needs to align with your broader life goals in terms of retirement and wealth creation. Jason Pisesky: [00:33:32] Yeah. And I think I may have said the benefit or the curse or the benefit of the cost, like, you know, you're not someone who's just working at a bank. You have a great pension or, with the government, even more. And they have, you know, a great guaranteed pension that's going to look after you. You're most likely out-earning those people. But that does put the onus on everyone on this call, you have to think about it. And if you, and it can be, you know, orders of magnitude between the people who put the thought into it and are intentional and get those extra percentage points every year compounded. There's tons of calculators that say, you know, adding 1% every year to your growth magnifies it. And here we're talking about not 1%, you know, tax savings is often your biggest expense in any business. And so again yeah, just over the life of your career, it's a huge opportunity. Again, everyone will probably be fine if you do no tax planning, but the opportunity is there to just really blow things out of the water. So. Dr. Kevin Mailo: [00:34:30] I love that. I love that. All right. I think we should wrap it up. We always say we're going to keep this like, short, like 20 minutes, 30 minutes. But we always go over and I love it because what you have to share is just so outstanding, Jason And it's real value to the physician community where we're all busy, we're all working. So again, thank you so much for joining us today and we look forward to having you back again. Jason Pisesky: [00:34:54] A pleasure, as always. Thanks for having me and thanks for riding shotgun with me, Wing. Pleasure, as always. Dr. Wing Lim: [00:35:00] Well, yeah. Thank you. Thank you again, Jason, for your valuable time. And we look forward to more episodes together. Dr. Kevin Mailo: [00:35:08] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

25 - You Are More Than an Empty Vessel with Dr. Kevin Mailo

Play Episode Listen Later Aug 15, 2023 27:28

Dr. Wing Lim interviews Physician Empowerment co-founder and frequent co-host Dr. Kevin Mailo on the subject of burnout. Kevin addresses how the language we use for recovering from burnout makes us sound like a drained battery and reminds us we are not simply vessels that are either full or empty. He discusses building daily wellness and resiliency. Dr. Mailo resists the language that makes us sound like fuel tanks and instead shares his vision of each of us being a great oak tree that can withstand storms, drought, and pesticides without breaking. That is the image he uses when he teaches wellness: the notion of us as growing living beings, needing daily nourishment, not just a refuel when we are empty.In this episode, Dr. Wing Lim and Dr. Kevin Mailo talk about the very real stresses of physician's careers and how frequent burnout truly is. They address the need to be honest about our needs, about needing time off, or cutting back on hours. Kevin reveals the three selves that need to be nourished in balance: the personal, professional, and financial selves. He has some ideas on how to both do more to achieve constant growth and self-care, and also how to do less in order to rest. This episode is vital for understanding the importance of cultivating resiliency and healthy boundaries.About Dr. Kevin Mailo:Kevin is an emergency physician based out of Edmonton, Alberta. He is known for his highly engaging teaching style that breaks down complex topics into memorable experiences. Kevin cares deeply about the long-term wellness of the medical profession and wants to see physicians and their families succeed personally and financially.Resources Discussed in this Episode:“YOU as the most important investment” mini-course by Dr. Kevin Mailo—Contact Information:Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment, we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know. We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in-person and online. So look us up. But regardless, we hope you really enjoy this episode. Dr. Wing Lim: [00:00:34] Okay. Welcome everyone, to our episode of Physician Empowerment. I am Dr. Wing Lim. I'm a family physician, one of the co-founders of Physician Empowerment, and we're really glad to interview my partner and co-founder, Dr. Kevin Mailo, emerged out of Sherwood Park as well. And today we're going to talk about a topic that he presented in Mexico. This is back in 2021, 22. We brought in the New Year at that time, Kevin, right? So we had a lot of fun. And this topic that you presented was very well received and there was a lot of echoing from the depth of people's souls. So we'd like to bring this up. And the topic is you're more than an empty vessel. So Kevin, tell us why you had that name as a topic. Dr. Kevin Mailo: [00:01:19] So if you want to get down to sort of what we're going to be covering in brief today, this is not by any means the comprehensive discussion that I had during our time in Mexico. Thankfully, we're not going to spend that much time. But it's the notion of burnout. Right? And one of the first things that I came to realize in the current model of physician wellness, and occupational wellness in general, is this idea of burnout being that you are some kind of empty vessel, right? Like how many times do we hear that imagery kicked around in wellness circles of you are some kind of fuel tank that runs out of fuel or you are a battery that runs out of power. And somehow in the current model, when we get close to empty, we're supposed to do something dramatic or not so dramatic to refuel the tank to get better. Dr. Wing Lim: [00:02:18] Of course, that was not just our phone, even our car. It's got to be plugged in overnight. A zoom, two, three, four, five, six hours later, you're good as new. Dr. Kevin Mailo: [00:02:25] Exactly, right? But like, we're people. We're not electric cars. I'm not a Tesla. Okay? And frankly, that model is exhausted because when we think about the length of our careers, it has to be better than a pendulum or a yo-yo where you oscillate between being okay, you know, relatively full and empty. So that's why I titled the talk 'You are more than an empty vessel'. And so this is a Physician Empowerment concept in the notion of personal growth and resiliency. And in my opinion, it's a far more optimistic model of looking at physician wellness because burnout is only half the discussion. Yes. Is it a very real fact of life? You bet it is. We work extremely stressful jobs. We have one of the most stressful jobs in society. We deal with people's lives. And more than that, we make decisions that are, frankly, life and death. And it doesn't matter what kind of specialty you're in. As a psychiatrist, you're constantly assessing your patients for risk of self-harm or suicidality. As a pathologist, how good are the margins on that sample you looked at? As a radiologist, is it a benign nodule or is it cancer that needs to be followed up aggressively with a repeat CT. Right? So we're constantly faced with this and we're very highly trained. So we don't necessarily consciously have an awareness of this. But the burnout is a very, very real fact. Dr. Kevin Mailo: [00:03:50] And the other thing that I came across is the CMA data. And if you have not looked at this data, I would strongly encourage you to look at this data. It was published in 2017, 2018, somewhere around there. And I know the post-pandemic data is even worse. But to summarize in very broad strokes, I'm not going to get into the numbers or the figures, is that at any given point, six out of ten physicians are experiencing some kind of burnout. And at any given point, three out of ten of us are screening positive for depression. So, and that doesn't mean that we're not performing well in our jobs. It doesn't mean that we aren't great doctors, but it means that we're barely treading water. For many of us, we are just surviving in our careers and our personal lives. And frankly, life has to be better than that. We need to be thriving. And that's really my mission. One of the reasons why I started Physician Empowerment is to see physicians truly thriving, truly happy in their lives, happy in their careers, healthy, doing the things we should be doing to be our best selves. Dr. Wing Lim: [00:04:57] So let's yes, let me just have a point of reflection. Right? So I think we know, I've been around 30 years, so we went from hush-hush with ten feet tall, bulletproof. Nobody's stupid. Nobody's weak. Everybody's Superman. Right? There's no Kryptonite, right? Everybody's strong. To a point that now we realize that, oh, gosh, people are burning out, but we still hiding. Right? But then suddenly I've heard some colleagues, the department now have these forcible sessions of wellness. Dr. Kevin Mailo: [00:05:25] Oh, forced wellness modules. Dr. Wing Lim: [00:05:27] Yeah. Forced modules. Suddenly you're supposed to be well, now. Okay. Dr. Kevin Mailo: [00:05:31] You're supposed to be well, you did a module, Wing, and the organization got to check the box. Dr. Wing Lim: [00:05:37] So how do you manufacture wellness? Dr. Kevin Mailo: [00:05:41] Yeah. So let's agree that, you know, you're probably not a battery. I'm not a battery. I'm not a fuel tank. You're not a fuel tank. Um, the image that I have, and this is actually the image that I teach with, so I had one slide in Mexico when I taught this. There was only one slide. And that was a picture of a big, beautiful tree standing on a hilltop with the sun. And that, you know, when you think about a plant, it's a living thing like us. And you don't wait until the plant withers and begins to shrivel before you water it, sun it or weed it. But at the same time, the plant itself has an intrinsic resilience, an intrinsic drive to grow and to become stronger. To reach greater heights. And that's the way I look at it when we talk about ourselves and our lives personally, professionally and financially. So when it comes to wellness, I have this vision of a tree, a great big oak or something along the lines of that, a tree that withstands droughts, hail, attempts to cut it down, pesticides, storms, lightning and the tree lives for hundreds of years and encounters those things. And it does not break. It continues to grow. And that's the vision that I try to have for myself as I go through the ups and downs of life and career. Where despite whatever struggles I face, I continually invest in myself, continually grow. And that's really how I've been teaching it for a few years now. This notion that we are growing living beings, very three dimensional, that we need to nourish ourselves every day, physically, emotionally, and spiritually. The other thing that I would challenge you on, and again, I brought this forward to our attendees in Mexico, challenge you on if you were your own patient, what would you say to yourself? You'd probably say work less, sleep more, strengthen your personal relationships, strengthen your relationship with yourself. Set boundaries. You would do all of those things, or at least you would tell your patient to do all of those things. Dr. Wing Lim: [00:08:00] Isn't that ironic? It is ironic, right? We tell people this and there's a very high degree of hypocrisy about ourselves. Dr. Kevin Mailo: [00:08:08] Yeah. Dr. Wing Lim: [00:08:09] Right? Do we exercise enough when you go to these pharmaceutically sponsored meals, people just gorge themselves, but then, you know, they prescribe it. Do they actually exercise and eat well? Right? Dr. Kevin Mailo: [00:08:21] And it's not about being a model of perfection because that itself can actually be a source of burnout. Right? I am not saying, you know, we all have to be, you know, exemplary. I'm hardly that when you watch me hit the McDonald's drive-through. If I'm having a busy day with the kids or whatever and work, right? There has to be lots of room for self-forgiveness. There has to be lots of room for, you know, being the humans that we are, not robots but imperfect beings. But we should be striving not to be someone else, but to be the best version of ourselves, right? And so again, it comes back to that challenge of if you were your own patient, what would you be telling you to do? And we rarely take time to reflect on that. So I want to, you know, share two sides of the coin here. Number one is the notion that there's burnout and that's the negative aspect of high-stress jobs like health care. And then there's resiliency, which is the beauty, you know, within. Right? It's our ability to overcome. It's our ability to grow despite challenges and setbacks. And so let's explore burnout first, very briefly. And again, this isn't going to be a definitive exploration. This, actually we do have this full talk on the website, so we'll show you how to, how to link to it, or if you have questions, just reach out to me because I think it's worth, I really think it's worth watching. Honestly. It's one of my best. It's one of the things I'm most proud of in this journey. Dr. Kevin Mailo: [00:09:57] But number one is burnout. These so-called lows, they can be prevented. They're not all preventable. But over the course of a 30-year career, maybe you have fewer of them. And maybe the lows aren't so low, right? So maybe the lows don't have to be as low as they get. Again, when you consider this kind of yo-yo back and forth between, you know, struggle and success is one of the first things they want to highlight. Okay. And I've got a few strategies that I'll go over, but only very briefly, because again, we don't have a lot of time for that. Okay. Dr. Wing Lim: [00:10:35] Okay. Sure. Dr. Kevin Mailo: [00:10:36] So again, it starts with self-care and the notion that suffering in our professional and personal and financial lives is inevitable. You know, it's like saying I'm going to be a diagnostician, so I'm going to be a physician, you know, who works on the front lines and primary care, internal medicine, emerge, whatever, you're going to have a certain miss rate. Or being a surgeon and saying, well, I'm never going to have surgical complications. Of course you are going to have surgical complications. This is an inevitability, right? So accepting some of those inevitabilities in our practice lives can be very powerful because when they arise, we can put them in context. And rather than flogging ourselves, we can look at them as a point of deep reflection and improvement in our practices. And I'm not just talking about technical improvement, but saying what is the context? How much was I working? How much call was I doing that week? Whatever it is-- Dr. Wing Lim: [00:11:31] Can we just stop right there, please? Because I think this is huge, right? So we don't even allow ourselves to park there because a) is there's a lot of shame. Dr. Kevin Mailo: [00:11:41] Yes. Dr. Wing Lim: [00:11:42] And b) there is a lot of consequence. Right? So there will be a lot of cover-up and denial. And actually people ended up with malpractice complaints and lawsuits are the ones that either a) denied or b) over embracing and apologize when it's not their fault. Right? Because we are our own worst enemies, right? Dr. Kevin Mailo: [00:11:59] Oh, without question. Without question, Wing. And that can become a kind of a, you know, a negative, self-feeding cycle where we get down on ourselves and it begins to rock our confidence. And so it's really important that we address that. And there's lots of formal supports and informal supports. There's lots of reading that can be done around it. But even spending time with, you know, in counselling or some other formal support like that can be extremely, extremely powerful. But just recognizing the inevitability of complications and setbacks in our career can be a very powerful source of resiliency for us because we're not alone. We're not the first and we're not the worst, to borrow the words of one of my mentors, when we go through our struggles. The other thing that I try to highlight is that there are three selves, and this is another Physician Empowerment concept. And one day I'll go on a big deep exploration on the podcast or something like that. But there's a personal self, a professional self - so the MD - and there's a financial self, and those all have to be in harmony. Right? And they all affect one another differently. So if you are struggling in your personal life immensely, it will inevitably at some point bubble up in your professional life. Likewise, if you have financial struggles, they will at some point impact you professionally or personally. Right? So these things are all tied to one another. But resiliency. Resiliency is about having margin. So resiliency is when the system is putting pressure on us and the work environment becomes too stressful, having the ability to set boundaries and step back and work fewer hours when we need to, is a huge source of personal professional renewal. Right? And the way we do that is by having that constant awareness of self in our professional lives going, Wow, you know what? Call has been really busy on the wards these days, and I think I'm getting a little tapped out. Maybe I should be working less. Dr. Wing Lim: [00:14:07] Yeah, that's a really good patch there, Kevin. So let's dwell a little bit on it. Number one in response to that, a) we're taught and we bred and we're still expected to be so professional that we don't let anything come through, right? And when we do, we fail, right? But, you're right, the personal and financial side does affect the professional side. So. And then when you say, okay, let's just cut back some calls. Well, I think you and I lived through it, the shame, the guilt, the hate that we get from our colleagues, you know? Dr. Kevin Mailo: [00:14:43] But in my opinion, that's not a marker of weakness. That's a marker of strength. Strength says I'm aware of my limitations. Strength says I'm powerful enough to be vulnerable with my colleagues and say I need to work less. And financial strength says I can afford to do it. Right? But again, we struggle with that culture in medicine of like being the quiet warrior and you just go in, no matter how much it negatively impacts your personal health or your relationships, and just work more and more. But resiliency in our personal lives also affects our professional life, right? So when we have lots of, you know, margin in terms of sleep, exercise, diet, you know, healthy relationships with people that build us up and support us, healthy time for self where we're not consumed with work, those things, again, can be an enormous strength of resiliency and an enormous strength of happiness in our lives that let us keep going and go back to that stressful ward where we're struggling with high volumes and patients laying in stretchers in the hallway, which, let's be honest, we're increasingly facing. Dr. Kevin Mailo: [00:16:01] The other thing that I want to talk about, and this underpins wellness both personally and professionally, is money. Financial resiliency. A lot of people, you know, will ask, you know, why at Physician Empowerment do you guys talk about money or teach financial literacy like you do? I'm not here as an educator in finance to help, if I can be blunt, to help doctors buy nicer cars, homes, boats, vacation properties or whatever. That's not my goal. That's not my dream at all. And I'll be very blunt about it. The power of financial security and why I teach it is that it allows us to step back from the stresses of the profession when we need to. Right? That we're not worried about paying the bills. That we have a, that we work in an efficient practice where if we need to take a week off for a personal or family matter or a health issue, that we can do it. And we're not worried. We're not dragging ourselves in. So we're doing better medicine when we are financially secure. Dr. Wing Lim: [00:17:08] Or, may I add too, the guts to stand up and speak against authorities that could affect your livelihood. Dr. Kevin Mailo: [00:17:14] Exactly. So one of my mentors who spoke up very boldly at a lot of meetings, one time I sort of walked up to him and said, like, how do you do that? And he goes, I have money. I don't care. They can fire me. And I thought that was very powerful. Like, if you want to change the system, you need to be able to do it from a place of personal, but also financial strength. So you're not worried about any retributive behavior. The other other side to this is, you know, when we talk about financial resiliency is, you know, being able to do those wellness things that matter. Right? Like so when your wellness module is online, take you to you should do more yoga and meditate and exercise and go on a nice vacation. Well, all of that costs money, whether it's a direct expenditure, or whether you're giving up clinic time to do it. So again, when I teach this to residents - and I do a lot of teaching to residents about money, not through Physician Empowerment, but as, you know, an academic doctor that I am - I say that money is not the cake, but it's one of the ingredients. And so, you know, again, financial resiliency is so key. It's about financial security. It's about peace of mind. It's about when things are getting rough in the hospital or you start having physical ailments or there's a loved one that needs you, you can cut back on your clinical hours without worrying about money, because in those situations, that's the last thing you should be worrying about. Dr. Wing Lim: [00:18:44] Well, let's face it, wellness has a price tag, right? A colleague of mine just had a minor surgery, and they said that, well, I can't afford not to come back within two weeks. Right? So just saying. It's so real. It's so real. Dr. Kevin Mailo: [00:18:58] It is so real. We all face it. And it's not necessarily that it's going to go away, but we can do a lot to make it better. And so let me talk about resiliency more practically. And then we're going to wrap up here because I know this is already going on and I can keep going on and on. So resiliency, when I think about it, this constant investment, growing the tree of our lives, is a daily activity. That it's something we set out daily to do. It should be consciously and mindfully undertaken and shared with those closest with us, like so our colleagues, our spouse or our partner, even our children. Setting a positive example. Resiliency should go across the three selves - personal, professional, and financial - and it should occur regardless of our mood. So the people that are, you know, training, let's say for a marathon, that person gets out there and runs, whether it's a good day or a bad day, whether they feel like it or not, good weather or bad weather, they're out there training. Okay. And resiliency can be big things like saying, okay, you know what, I've got a very powerful goal to be retired within ten years and I'm going to take the steps to get there. Or it can be something small, which is like, I'm going to go for a walk every single day. Right? And, you know, resiliency needs to be built into our dreams, our aspirations, and our goals, and not just our own personal individual dreams, but the shared ones with our spouse, family, or even our colleagues. Dr. Kevin Mailo: [00:20:28] Okay. So let me just go with a brief overview of what we call quick wins and what we call long-term strategies. So when it comes to like quick, easy things you can do to feel better and to be more resilient rather than running out of the tank, try just some of these sorts of things. So the first category I have on quick wins is doing less. Actually let me go with doing more. I like doing more better to start with because doing less is funnier. So doing more. Spend a day laying in bed and sleeping. Watch a favorite movie. Go and exercise. Walk or go for a drive. Have a wonderful meal, like cook one, you know, go buy the ingredients, go real slow, take your time. Have some comfort food. Phone a mentor or a friend that you can confide in. Hug your spouse or partner, tell them how much you love them. Hug your kids or your pets, tell them how much you love them. Spend time with the people who aren't medical. Like get out of the health care space, you know, and hang out with non-medical friends or family, people in your, you know, religious or cultural community if you're affiliated with one. And again, those are just examples. I don't want to be prescriptive here. That's the whole point of this is not to give you a bunch of modules or a checklist, right? But to do, you know, but to share just some ideas of what you can do to invest in yourself on a day-to-day basis. Dr. Kevin Mailo: [00:22:04] So when it comes to quick wins, though, there's actually a lot in the doing less space. And this is where I kind of have a little more fun with these. So draw up a clinic day. We already alluded to that. If you are feeling burnt out, then start cutting back, right? It's not only better for you, it is better for your patients, it is better for the system in the long term. Our patients deserve to have happy, healthy, resilient doctors who are taking their own advice. Here's another good one. Turn off the notifications on your phone. Or better yet, put it away for the day and just unplug. Don't check your email or your EMR. Stop. Set some boundaries. Don't go and spend more money that you don't have. Buying more consumer items that you know deep down are not going to make you happy. Right? Like, truthfully, and again, that's not why we started Physician Empowerment when we started talking about financial education. And then here's my favorite, skip another useless meeting. Honestly, do that for yourself. Do that for yourself. Another big one that I rely on is practicing gratitude, really trying to sit down and be thankful for what I have in my life and not just focusing on the problems. Dr. Kevin Mailo: [00:23:25] Obviously, we can't be avoidant towards problems or try to distract ourselves. You know, we have to face our problems because that's the only way that life gets better. But at the same time that we face them, keep looking ahead at the beautiful things in our lives and remind ourselves of what's really important. And then in the long run, it's about like having very clear, personal, professional, and financial goals that you are working towards every day because those things keep you on your path. They help you set your priorities. More importantly, they help you set boundaries. They help you say no when you need to say no. Because there are system-level issues that are never going away. Health care is inherently stressful and it will only get more stressful and more complex. So you as one person in this giant, giant machine, need to care for yourself. Okay. And so I regularly check-in. I regularly write my dreams down. I regularly write down my goals. And I'll talk in another episode about the difference between dreams and goals. I think maybe last Zoom meeting we had, Wing, I was accidentally screen-sharing my dream panel. I had them written down. Maybe you didn't see it all, which is probably just fine. Um, but I've got a, it's probably my biggest note on my computer. Dr. Wing Lim: [00:24:50] There's a name for that. It's called the power page. Dr. Kevin Mailo: [00:24:52] Yeah. Ooh, I like that. Ooh, I like that a lot. Dr. Wing Lim: [00:24:55] Yeah. The power page. Dr. Kevin Mailo: [00:24:56] Okay. So again, at a future point, I'm going to talk about dreams. And I really want you to hold on to that concept because that's something that's very near and dear to me. And I really, really love talking about it because it's so important. So with that being said, I think we're going to wrap up and, again, check us out on the website. And if this resonated with you and you want to talk further, hear some of the things that I've done over the years to become more resilient. I'd love to connect. I am so, so passionate about this, so just reach out to us over email or you can text me. Thanks so much. Dr. Wing Lim: [00:25:31] Yeah, thanks Kevin, for sharing. And yes, to recap, everybody knows about burnout. Everybody talks about it. Everybody knows seven out of ten of us and maybe us was just denying it. And we look around, nobody is owning it up and saying, I'm the one that burned out. Right? So this is a very toxic environment. And as you know, in Alberta and any other places, the working environment is getting so stressful post-pandemic. Well, we're not even post-pandemic yet. And then we cannot just manufacture wellness just based on a few wellness modules. And it's not something to plug a USB in the brain and then you download a wellness app and you're better, right? This is a lot of hands-on stuff and I hope we just creating an awareness and we're ready to walk through with our colleagues, east to west coast, right? Dr. Kevin Mailo: [00:26:19] Absolutely. Absolutely. Dr. Wing Lim: [00:26:20] Wonderful. Good. Well, so thank you, everyone, for joining us today, and we'll look forward to seeing you at the next event. Check our website. All right. Dr. Kevin Mailo: [00:26:29] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend. And head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions, or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

24 - Tax Hacks for Busy Medical Professionals with KPMG Tax Lawyer Jason Pisesky (PHE Masterclass Faculty)

Play Episode Listen Later Jul 30, 2023 44:57

Drs. Kevin Mailo and Wing Lim host a webinar with guest Jason Pisesky, a tax lawyer with KPMG Law. Dr. Lim takes the lead in interviewing Jason on an overview of tax hacks and advice that will form the contents of deeper focus in future Masterclass events. Jason Pisesky starts the conversation by discussing the financial incentive of tax deferral in having a PC. He highlights when a PC is most useful in a professional's career journey along with when it is an advantage and when it may not be. But Jason's biggest piece of advice is to be surrounded by, and work with, trusted professionals who can guide decisions correctly. In this episode, Dr. Wing Lim and Jason Pisesky wade into the shallow end of tax hack topics that will be covered in depth in the upcoming Masterclass. They discuss the benefits of having a PC, what to put in a PC and what to keep out of it, when a hold co or sister corporation is beneficial to form, the change in TOSI rules, how salary can work where split income no longer does, and many other insights and advice from Jason's wealth of knowledge on all things tax-related. This is vital information to digest and will whet appetites for even deeper conversations in the Masterclass. About Jason Pisesky:Jason's practice covers a broad spectrum of taxation law matters including corporate, personal, farm and estate tax planning as well as representation in dispute resolution and litigation mattersJason joined KPMG in January 2021. Prior to starting at KPMG, he spent over six years working at a leading western Canadian boutique tax law firm. Jason has experience in both the tax dispute and tax planning for both personal and corporate taxpayers.Jason has worked with small and medium-sized owner managed operations to reorganize structures in a tax efficient manner, acting as counsel for vendors and purchasers in arm's length deals as well as families in the midst of related party estate and succession planning. He has argued on behalf of taxpayers in many contexts and obtained favourable results for taxpayers from auditors, appeals officers and lawyers at the Department of Justice. Jason has appeared before the Alberta Court of Queen's Bench.Resources Discussed in this Episode:TOSIPhysician Empowerment Masterclass—Contact Information:Physician Empowerment: website | facebook | linkedinJason Pisesky: website | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally, and financially. If you're loving what you're listening to, let us know. We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in-person and online so look us up. But regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:35] Hi, everyone. I'm Kevin Mailo, one of the co-founders of Physician Empowerment, and we're bringing another great webinar podcast episode to you. Today it's going to feature Wing interviewing outstanding tax lawyer Jason Pisesky, and Jason is an associate with KPMG, one of the world's preeminent accounting firms, one of the biggest in the country. And they're going to be talking about tax hacks for busy medical professionals. And this is just the start of how much there is to know. And we are following this up with our master class where we dive into these topics in a lot of depth. And I think it's important for Canadian physicians to be reminded of the fact that it is not just good enough to play offense, right? We're all out there, we're all learning and we're all working hard to, you know, make those returns in our investment portfolios. But a key part that's often neglected is long-term tax planning. And so this is our introduction to that because it can be worth hundreds of thousands of dollars over the course of your career, if not millions, depending on where you're at and how you invest. So with that being said, Wing, I'm going to hand it over to you and let you go at it. Dr. Wing Lim: [00:01:54] Sure. Thank you, Kevin. So Wing, I'm Wing Lim. I'm a family physician based out of Edmonton and I'm a co-founder of Physician Empowerment. And a lot of you know me. Some of you don't. And yeah, so so we're launching a new tax series at our Masterclass. And then today it's kind of like a content page, we'll run over a lot of concepts and it's meant to be an overview. So if there's something that kind of goes over your head, don't worry about it. It probably goes over other people's heads. But then instead of lecturing, we thought, it's better to do interview, right? And so Jason and I went back quite a bit and of all places, we met on a dance floor. And so my wife Katie and I and Jason and his wife, Amy, we were kind of dance classmates. And so it's been a number of years, right, that we knew each other as friends, I liked him right away. He was one of the dance teacher's pet, teacher's pet. The teacher actually said that. And then we became friends. And then a few years later I got stuck with a tax planning issue. I got like a dozen companies and the whole thing looked like a spider web. And it went to a tax accounting firm that was ready to skin me alive in fees. So I was unhappy. And I said, Jason, you're a tax lawyer, aren't you? And that's how we started, right? And he got me out in a pinch and we dove into a lot of really, really neat tax strategies. And then so we like to have a chit-chat, another fireside chat with Jason. So Jason is not just a nice guy on a dance floor. He is also a prominent tax lawyer. So he, I think he started at a prominent tax firm in Edmonton and he jumped into one of the largest tax firm in Canada and he's heading the tax division. He told me that, but Jason, you said you got 98% colleagues, accountants, and you're the 2% that are lawyers? Jason Pisesky: [00:03:46] Yeah. No, that's that's about right. Yeah. It's technically two firms. There's KPMG LLP, which is the accounting side and then KPMG Law, which is where I am. And we are the little brother. But we are becoming more and more important as we kind of stay in the firm longer. Dr. Wing Lim: [00:04:01] Right, so you deal with accountants all day long, right? They present you cases after cases after cases. And most of them are professionals, business owners and including medical doctors, right? Jason Pisesky: [00:04:13] Absolutely. Yeah. Yeah. And that's one of the reasons I'm at KPMG is for, as you said, one of the biggest shops in Canada, if not the biggest. And yeah, the variety, the depth, the, you know, working with people across the country is fascinating and gets you out of bed in the morning kind of thing. So. Dr. Wing Lim: [00:04:28] Right. So I may have to put some put the brake on if you go on a little bit fast on the professional track, I may need to slow down and have you hey, dumb it down, dumb it down to the MD level, right? Where I heard one thing that we are idiots outside of our own fields, right? So, you know, we're ignorant outside. So we're here to learn. We're here to learn and have some fun. So. Hey, so we're going to talk about some tax hacks, right? So busy professionals. Meaning that we're busy. We're busy. We're making money, right? We're on a treadmill or trading time for money or trading or trading life energy for money. And at the end of the day, we're in a progressive tax system, unlike where I came from, Hong Kong, which is regressive. And so I think we did the math the whole lifetime after overhead and tax, maybe we only take one-third if we're lucky. Right? So that's substantial, right? So let's have some tax hacks for busy medical professionals. And we're not going to be able to cover everything. But as I said, we had a quick chit-chat before today. So let's talk about some easy ones. I know a lot of people have PCs, a lot of people don't have PCs. Right? And so when does it make sense to have a PC? Jason Pisesky: [00:05:41] So the tipping point for medical professionals in particular, for everyone who's kind of entitled to a PC, that's lawyers, accountants, dentists, doctors, normally when you have a corporation, a lot of people do it for the liability shield, right? Limited liability. I can't be sued if the corporation gets in trouble. You know, generally speaking. Professionals don't get that kind of protection. And so for them, really, it is kind of a purely financial decision of when do I need a PC? And that determinant is when you're no longer spending all of your income. The financial incentive for having a PC is called tax deferral, where you get to keep the money in the company paying corporate tax at a lower rate and you take out less and spend it. But there's some left behind. If you are early in your stage in your career or maybe just in a in a field or a stage of your life where you're not earning excess amounts and you're just spending all your earning, then having a PC won't provide much of an advantage for the professional. Dr. Wing Lim: [00:06:40] Yeah, so I'm surprised to hear that one of my neighbors, who's a specialist, and some colleagues, husband and wife, both medical doctors and I'm ten years later, 40 years later, their accountants still said that you don't need a PC, right? That's shocking the money that you left on the table. Right? So then. Yeah. So then how do we do this? Like, should we, once we earn more than we spend, or we budget as such in such a way? What do you do? What's the advantage? What's the advantage of the tax deferral? Jason Pisesky: [00:07:14] So actually, I'm going to tag on to what you just said there first about talking to their other advisor. And you actually said in your opening comments, too, about, you know, we're all only experts in the things that we, of course, spend years studying. We can't know everything. And actually, one of the first tax acts I'd like to highlight is like, surround yourself with the right people, with people to take these tasks off your hands. I'm sure you can allude to it as well. I know tons of professionals of all those stripes, engineers, dentists, doctors, lawyers who, you know, every year come June, they're struggling through TurboTax, trying to figure out their own taxes, collecting receipts, pulling their hair out, just praying they don't get audited by the CRA. And same thing on the legal side of looking after their own minute books and trying to record things and keep everything up to date. And that's not a good use of your time, I would argue. You work hard. You've reached a high level of competency in a very specific set of skills. And what is money but the stored value of time and labor that you can spend to get yourself more time. Jason Pisesky: [00:08:17] And so, yeah, one of the easiest tax acts is hire people to kind of take some of that off your shoulders to do it correctly. Because as I always tell people, you kind of, you pay for it eventually one way or another, you either pay for it a little bit every year or you wait until you're audited by the CRA, or you start to do a transaction and someone's going to buy your PC and you know, they want to see good minute books and financial records and you have to go pay someone probably a lot more than what that would have been annually to catch you up and kind of do almost a forensic audit to figure out what have you been doing for the last 20 years? I have no idea. But they want to see good journal entries and general ledgers for all the money that's come and gone from the corporation. And so for many reasons, the simplest tax hack is kind of offload a good portion of the tax work onto someone else who does deal with it on a daily basis. Dr. Wing Lim: [00:09:04] Yeah, but with that, there's always this XYZ accounting that doesn't change the lesson plan. I liken it to Mrs. Jones, a fictitious Mrs. Jones, that taught Macbeth for 30 years and never changed her lesson plan. Right? You know, like a lot of have one that accountant that I fired because ten years later found that I could have done something ten years for the last past ten years, I could have saved a ton of money. He never mentioned it, right? Jason Pisesky: [00:09:29] Absolutely. And there's no right answer to how do I know if my professional is doing the right thing? And again, hopefully the audience appreciates there's, in medical field, there's differences of opinions of diagnoses and prescriptions and all these things. So I think the answer there is, you know, get someone who you do believe in and kind of comes with perhaps good referrals. But there's nothing wrong with getting second opinions, you know. Maybe every five years or ten years or when you reach a certain milestone, you get married or you have your first kid. I don't think a professional should be offended if you go out and speak to another one just to pick their brain and see what's out there, especially if - and a lot of people don't know or don't like to think about it - but accounting is very much like the medical field in that you have general practitioners, then you have expertise in certain areas. So not every accountant is a tax accountant. And so if you have a more of a general, call it a GP accountant, then there's nothing wrong with going out and speaking to a tax accountant or a tax lawyer to pick their brains. But yes, you had asked me about corporations and the benefits of them. Jason Pisesky: [00:10:33] So say, yeah, you've reached the point where you're earning a certain amount and you're not spending it all. So keeping it in the corporation leads to what I call tax deferral, where you pay a low level of corporate tax, lower than you would pay if you just earned it all personally. So for the first generally call it $500,000, it depends which province you're in, but generally, for the first $500,000, you'll pay a tax rate, again, province dependent, kind of in the range of 12 to 13% or 11, maybe 11 to 15% on that first $500,000 in the company that's left behind after you take salary and dividends. And then after that, it kind of goes up to about, you know, the 23 to 25% range. So, and it doesn't take very much as an individual taxpayer to kind of get up, definitely to get above 13% basically, once you're past your personal credit limit, you're kind of into the 25% range. And then, of course, even comparing to the 23%, it doesn't take much to get above that as an individual for every marginal dollar you earn. So that's the benefit there. You build up that pool of income, lower-taxed income. Of course, if you take it all out, you pay a tax rate that is meant to approximate had all of the money been earned by the individual. Jason Pisesky: [00:11:52] So don't be afraid of, well, what if I am going to yeah, I'm going to be banking an extra 1 or $200,000 in my PC. But what if I need it? Then I'm going to take it out and I'm going to pay personal tax and I'm going to be behind the eight ball? No, generally the system is set up, we call it integration in Canada, where the idea is on the flow through of money, you should end up at the same place as if you'd earned it personally. So all that is to say is when you take the dividends out to recoup the money left behind, you pay a lower rate of tax than you would have if you would just earned a salary on that amount. So the net amount, it's not always perfect, but generally you end up at the same spot if you just kind of flow the money out of the corporation. So you're not, certainly not penalized for having a corporation, but I do hear stories of professionals that have just take all the money out. And so really, you're just paying professional fees and accounting bills and these things to keep the corporation running, but you're not getting the benefit of it. Dr. Wing Lim: [00:12:46] Right. So I guess the conventional wisdom is stuff as much in the PC as possible and then pay you as yourself the least amount. And then just invest, invest, invest, right, within the corp and then you pay the tax when you take it out, when you retire, so to speak. Right? So but is there a reason not to just put all the money, all the investments inside the PC? That it may not be wise? Jason Pisesky: [00:13:13] Definitely. And so PCs are like any corporation. If the PC gets sued, its assets are subject to potential creditors of the PC. So definitely it depends, of course, what field you're in and what you feel your risk of, you know, getting sued, malpractice suit are. Obviously higher in some fields than others. And so in a perfect world, you'd kind of move those investments from the PC earning it into a sister corporation, one that's kind of beside it or a Holdco. It's above it, again, that's province dependent which structure will work best for you. The idea is, is you want to kind of strip those assets out to the side. You can do that in a way generally that you shouldn't be paying income tax on it. Then you set it up in a side corporation and then if the PC gets sued, what does it have? It has its medical license and maybe a couple pieces of equipment and a laptop. That's kind of all you really want exposed in the PC. That said, again, without the shield, the individual, the professional is usually the same thing as the PC. So that's why a lot of professionals, they will like to set up an investment company under their spouse's name, shuffle everything over there to the best you can, and have kind of the growth in the investments grow in the spouse's name who of course should not be sued if you as the professional are. Dr. Wing Lim: [00:14:30] Now so that itself when we cover this thing at the Toronto live conference, a lot of people said, really, I've never heard of it. So lots of people stock everything, real estate, stocks, everything portfolio, everything under the PC. And they never heard of a whole course of how they do that. Can you move money over there tax-free, like you know, it's so confusing for a lot of people. So at what stage should a physician or a professional, right, that say, hey, okay, I'm building up some assets, at what time is it wise to set up a Holdco system under the spouse's name? Jason Pisesky: [00:15:06] Yeah, I'd say once you kind of reach, maybe that - I mean there's no magic number, of course - but once you reach that kind of autopilot moment where, you know, you're married, you've got the house, the kids, are kind of looked after, you've got some college funds set up and you just know like, yeah, every year I've got a certain amount that's going to kind of go there. You know, there's no big renovation bills that we expect to come. We've got new cars. Um, you have to wait till all those things. But it's that point in time where you're just you're starting to every year accumulate a material amount of extra things in the PC, things being investments. Don't collect other things in the PC. Dr. Wing Lim: [00:15:41] For example, don't collect, what, cabins? Jason Pisesky: [00:15:44] Yeah. Cabins in the woods and, you know, a little hobby plane. And generally I would say don't collect those personal use items in the PC. It just kind of leads to a headache. And then if you're using it, you have to charge yourself for its use and without having shareholder benefits and it kind of becomes a mess. So that's definitely a tax hack. Don't have personal items in your corporation's, general advice, even like, Oh, but I'm saving the tax because don't have to take it out personally. But again you have to charge yourself, they're huge audit red flags, CRA loves to go after those things. You know, the company owns a plane and it's not running an airline. And so, you know, have you been charging yourself for the use of that plane every year and all of a sudden you find yourself with penalties and interest. So, generally there are more tax efficient ways to get money out of the corporation, buy the plane, do it outside than to keep it in there and maybe keep it simple. But setting yourself up for a headache down the line. Yeah. The idea is, you know, once you're kind of you're starting to accumulate, you know, into the six figures, maybe approaching seven figures - and again, it depends what field you're in. If you're in a field where maybe you feel, hey, one slip of the scalpel and I'm going to be sued for everything I own, then maybe it's more prudent to be more aggressive on stripping things out of the PC early on. If you feel you're in a relatively peaceful practice where the odds of something going horrifically wrong are lower, then again, maybe you can let it build up a little longer because then you don't have to, you know, incur the professional fees to set up the structure and peel things off to the side. Dr. Wing Lim: [00:17:12] Well, for most practicing professionals in Canada, we have this thing called CMPA, the Canadian Medical Protective Association. So I don't know the ceiling, but most of the malpractice suits are covered by them. But other liabilities, if you have a clinic, somebody slip outside that is not, your CMPA ain't going to cover that. Right? Especially for those who stuff all the real estate condos and all that inside the PC. They definitely can sue your PC, right? And that's when you say that it's better to strip those assets outside of your PC and into a sister court, right? Jason Pisesky: [00:17:48] Yeah. And without the risk of maybe getting into too much detail, it probably never hurts to really early on set up a side sister corporation to do the investment, again under a spouse's name, because you can always move some assets over without doing more complex steps. Because the professional will probably generally always be exposed to the initial earnings. You know, you earn an extra 100 grand. There's kind of a sort of gifting it to your spouse, which can lead to other problems, that hundred grand is always in your head. What you want to move is the growth. Over a 30 year career, that 100 grand is going to turn into, what, a multiple of 16 or 20? I don't know what, you know, your standard investment advisor will tell you that'll turn into over a career, but what you want to move over is that growth over to the spouse. So yeah, you can just have the PC loan it over to that sister corp. Sister corps invests it and the benefit goes to the spouse and then that initial $100,000 is at risk. And then again, there's a way to kind of clean that up down the line with some tax planning. Dr. Wing Lim: [00:18:46] Right now, let me just dovetail on that. So there are people who advise that, oh, for some provinces at least, the spouse can be inside a PC. So should the spouse be, if the spouse has a Holdco on the outside, should the spouse be still part of the PC? Jason Pisesky: [00:19:01] I would say generally, yes. If there's always a personal element to it, you never want the tax to, uh, to put the tax cart before the wagon for the horse. Sorry. But all else being equal, it definitely doesn't hurt to have the spouse in there. Yes, there are income splitting rules, which can mean maybe there's no immediate benefit to it, but if there's ever a sale of the company, then certainly there can be benefits to having that spouse be a shareholder. There may be ways, some tax planning available to, you know, get the spouse some income and some benefits without falling afoul of those income splitting rules. And kind of a third reason is, oh it's jumped out of my head. Sorry. Dr. Wing Lim: [00:19:46] Well while you are thinking... Jason Pisesky: [00:19:49] Future sale annual. Oh, and once - sorry - once you reach the retirement age, 64 or 65, then you can income split with that spouse out of the company. So, playing the long game and they kind of need to have to accrued value. You can't just add them as a shareholder when you're 64 or 65, you know, they have to build up value and you only do that by having them be a shareholder for a long period of time. Dr. Wing Lim: [00:20:11] Right. So while you're on that topic, I think we should spend a couple, maybe a minute on tax on split income, but as of 2017, CRA has a much stricter definition and a lot of people fall in traps to that. So can you highlight a few of those things for us so that we get a good reminder slap on the upside of the head? Jason Pisesky: [00:20:31] Yeah. And it's probably just, I'll give kind of a broad overview of the rules and that's maybe as far as we'll go because they're, yeah, I mean they could... I've given whole day, you know, eight-hour courses on TOSI before. Dr. Wing Lim: [00:20:42] No not that, not that. Jason Pisesky: [00:20:44] Yeah. They are a thing on their own. So the idea of TOSI is, is that again what was happening in the market was people were adding, you know, their spouses, kids, nieces, nephews to corporations and paying them dividends. And then over the age of majority, there used to be rules blocking it for minors, and then basically just expanded those rules. So the idea is, is that they don't want people who are related to the main business person driving the business in the company, to get kind of, to pull out money from the company as dividends if they aren't also involved in the business. That's kind of the most simple explanation of the TOSI rules. We call it tax on split income, with split income being the bad type of income that's being split. So yeah, what will happen is people will, well what was happening is you'd have your spouse and your university-age kids as shareholders of the PC and then, you know, you're paying out dividends to them, you know, to a spouse who was probably a little bit more maybe, you know, 2, 300 grand to use up all of their lower brackets. But, you know, I think that would save you about $40,000 in tax if that all went to the professional spouse earning income at the highest bracket, probably a little lower, maybe just tuition fees plus some living expenses for the university kid. Jason Pisesky: [00:21:56] But that's kind of all been cut off now. So you'd have to either have them be kind of getting capital gains or kind of wait for a sale to get the advantage, although that's kind of a good dovetail into sometimes you actually don't want your spouse to be a shareholder. If your spouse is a professional doing their own thing or they have their own company, you may not want them to be a shareholder because that may, if you both have your own corporation doing your own thing, you'll both get your own small business deduction. That first 500,000 that's taxable at that relatively low rate, low teens. But if you start to have each person being a shareholder in the other one's company, then you can, you'll have to share that 500,000 limit. And so again, very personal decision, not just are you comfortable with your spouse being a shareholder, the non-voting shareholder in your PC? Dr. Wing Lim: [00:22:51] So let me highlight this thing. The tax hacks is not just what to do, but what not to do. Right? So I think the takeaway is don't pay your spouse a dividend that is not commensurate with what they actually working, their actual contribution. Right? And my accountant says he has seen a lot of the clients, like you say, pay the spouse a few hundred thousand dollars without even showing up at the clinic at all. And those would be dinged. Right? It just pays tons of money to the kids under the age 25, and that's why it cuts off at 25, right below 25. You should not do the dividend to your kids, right? Jason Pisesky: [00:23:31] Yeah. And then, but again, hack tax, salary. You should be able to pay a reasonable salary to your spouse as long as there's some justification for it. If they're doing the bookkeeping, if they're helping doing some of the admin side of the practice, usually accountants will feel comfortable kind of 40, 60,000. And honestly, that soaks up most of the benefit for the income splitting. You don't, again going up to the I think it's like 340, 350,000 to get to the top bracket. Yeah, 80% of that benefit comes from paying someone you know under a hundred grand kind of thing is where all that income splitting benefit comes from, getting their personal tax credit and using the 25% tax bracket instead of the up into the high 40s or low 50s. So yeah, salary, it's just subject to a reasonableness test as opposed to the TOSI rules which are much more explicit and bright-line tests that are much easier for them to attack. You also have to, again, you have to kind of have really good records to feel, for your accountant to feel comfortable wading into the TOSI realm of dividends and are they justified, whereas salary, it's a reasonableness test. Your downside is just denial of the deduction in the company, whereas for TOSI your downside is kind of high rate income for the individual and you've already paid the tax in the company because dividends are paid by after-tax money. So you've already given up that. Dr. Wing Lim: [00:24:50] So to recap, so this hack is if you want an income split with your spouse and your kids, then pay them a salary instead of a dividend. But does it, is it...? Jason Pisesky: [00:25:01] Basically find a way to feel like you can fit into the salary rules which are generally more lenient and well-established. The problem is also TOSI is, you said 2017, there's no court cases on it. There's a million conflicting CRA opinions on it. Whereas you know, the reasonability of deductions for salary and things, tons of cases, really well-established rules. They've been around for decades and decades. So yeah, we kind of, we know how to guide you through those rules a lot better, right? You don't want to be the first person in Canada to go to court on the TOSI rules. Dr. Wing Lim: [00:25:33] Don't want to be the famous one. Jason Pisesky: [00:25:34] That's the tax act. Try to not be the first person in court on a specific issue. Dr. Wing Lim: [00:25:38] Right. Have your name on this, the state versus you. Okay. Jason Pisesky: [00:25:42] Yeah, be referenced as that case going forward forever. Yeah. It's great if it works, it's great if it works, then you're known as, you know, that case becomes your calling card. But. Dr. Wing Lim: [00:25:53] Right. Let's pivot a little bit to talk about, since we're on the topic of salary versus dividend, T4 versus T5. Right? So there are a lot of strategies, right? Some are conflicting. Some say, okay, do nothing but T5 to draw dividend. But then there's some strategies like RSP and IPPs, you need a T4 to build a route. So can you highlight T4 versus T5 salary versus dividends? What's the pros and cons? Jason Pisesky: [00:26:19] Yeah. And so this is a great one where, kind of circling back to that hack about, again, having someone to help explain this to you every year, because it will be an annual decision, especially if you're sending some T4 salary income to a spouse. Again, figuring out what the right mix is for your family. So as I said at one point, kind of that concept of integration in Canada where we, you know, the government wants you to be indifferent for earning that dollar through the corporation or personally. So if you earn $100,000 in the PC and you pay $100,000 salary, well, you get a deduction in the company for $100,000, and then the person pays the personal tax. Dividend, if you earn $100,000, the company pays corporate tax on it and then it uses the residual and pays a dividend and you kind of end up at the same spot. So the big one is, is for T4 income, you're going to be subject to CPP. There's a related party exception for EI, there's not for CPP, so you're going to have to pay the employer and personal half of the CPP. So that's just a kind of a little bit of leakage, tax leakage. Jason Pisesky: [00:27:25] At the same time, you do gain access to the RSP, the individual pension plan, IPP. I believe that's going to be talked about in a later webinar, Wing, so I won't dive into that. Plus, it's very, again, you get a whole day course on IPPs if you so wish and all the modelling and that goes into those. So it's a personal decision. It's an annual decision. There's no right answer to, you know, I can't tell you oh, you always take this. I think it depends on what you value. Some people really value RRSPs and IPPs and building up those kind of after-tax pools that they'll take out later in retirement. Some people will say, you know what, I want all my money tax paid. I want to know I can access it at any point in time. And that's what they value. And so, but there are definitely things to consider, and it's not just a well, just I'll just do this one because someone told me to do that one. It's, it warrants consideration every year. Yeah. Dr. Wing Lim: [00:28:21] Right on. Okay. So let's move over to a couple more topics or strategies. So what about this trust, family trust and whatnot? We're thinking of a retirement or upon death or the corporate assets would be deemed disposed. Right? So and it may not be free from liabilities. So what about trust, family trust? Is there still a place in it because the government was trying to castrate it? Up to 2017. Jason Pisesky: [00:28:50] Absolutely. Trusts were definitely one of the things targeted in those 2017 new anti-income splitting rules. That said, I still think there's a strong place for them in kind of a well-rounded, high-net-worth family plan. I am in the process of settling a handful of them and I do tens of them every year, I help people set them up because they absolutely do. As with a lot of things you don't always want, again, tax to drive the conversation. So trusts are great, they do offer again another layer of creditor protection. They allow you to introduce people to the ownership structure without actually giving them direct legal rights over shares, which may lead to oppression remedies in court and, you know, entitlement to financial statements and rights to vote on certain things, even if they're non-voting shares. You kind of cut all that out with the trust. And you also don't have to, they're kind of maybe shareholders when they're through the trust, right? Maybe they'll get a dividend, maybe they won't. Maybe you'll transfer shares out of the trust to them, maybe you won't. So that flexibility is what a lot of people are interested in the trust. The two big ones for tax are again, flowing dividends out, generally not going to lead to much tax advantage in a trust. The big ones are a potential sale. What might we be able to sell in the future? Then the capital gains deduction, that's the tax-sheltered, you know, almost $1 million right now. Jason Pisesky: [00:30:13] You might be able to access the beneficiaries of the trusts' capital gains deductions and shelter several millions of dollars using those. You may also be able to do some planning with the trust to flow out some type of income. Generally involves more steps, a lot of prep work involved, but there can be advantages to that. And then you also have the advantage to, in the future, transfer shares to the individuals. We talk about this a lot in some other industries. Farming is a big one where, okay, you now know who the farming kids are. You can transfer shares to them. Probably not as pertinent that one for medical professionals. But at the same time, a family trust can help you avoid some estate tax, depending on when the family trust is put in your life. Of course, when an individual dies, they're deemed to dispose of all their capital property, which can result in a capital gain. The family trust outlives the creator's death. And so that can be avoided depending on when the family trust is put into place. So there's lots of advantages, many of them non-tax, many of them tax. So, and again, it depends which province you're in too, and who is allowed to be a beneficiary of a trust. So very personalized decision. Dr. Wing Lim: [00:31:23] Right. So trusts are definitely a very valid tool. It has to be customized to your needs. But then I think most are only what, 21 years, the lifespan of a trust? Jason Pisesky: [00:31:35] So a trust can live, they can they can outlive 21 years. And so like, I think BC has a hard 80-year rule maximum. Many of the other provinces again it's 21 years past everyone who's kind of involved in the trust be them the creator, the trustee or the beneficiary. So that can be your longest-lived person, is one years old and they live to 90. You get another 111 years, kind of, it's how long a trust. For tax purposes, so I said that rule of, hey, when you die, you're deemed to dispose of all your property. Parliament wised up pretty quickly to the fact that trusts they could live for 100 years. We don't like that. And so they decided on 21 years, which is, you know, about the span of a generation, maybe not so much when families are getting created a little bit later in life now, but the idea that trusts live for 21 years and then they also go through a deemed death, dispose of all their property, and then they can continue on for another 21 years, do the same thing. So in tax conversations we generally say trusts, yes, they live for 21 years because at that point you're going to have to decide should we do a tax-deferred rollout of the property to the people? Should we eat the tax bill and keep it in there? Should we do some other planning to manage this event that happens in 21 years? So I'd say rule of thumb, I don't see many trusts outliving 21 years. So yeah, 21 years is kind of your starting point for looking at a trust. Dr. Wing Lim: [00:32:57] Right. And then at what point, like would a practicing professional contemplate, Wow, this is I've got a PC, I've got my sister Holdco, at what point should they contemplate on family trust? Jason Pisesky: [00:33:10] So the benefit of the family trust is accruing value into other people's hands. So I'd say for a medical professional, you don't want to start it too early, I guess is the thing. You don't want to, you know, get out of med school in your late 20s or early 30s and then settle it and then your 21 years happens kind of around 50 when maybe you're still practicing. And so probably maybe five, ten years into your career, maybe even 15. Once you're established, you know what field you're working in. You have your clinic or, you know, your kind of day-to-day routines and where your money's coming from. And that's when you, again, you'll have that growing investment pool and you can do more of the setting up the structure in the right spots. And just because yeah, the succession planning piece isn't as much, generally you're not going to have a kid take over your PC. Maybe it'll happen. Not impossible, but not the same way you have, you know, someone who's running the general store, you know, their kid may take over it, or a farm, where again, it's that succession planning piece and then maybe you where a sale is possible, you kind of want it in as early as possible. Jason Pisesky: [00:34:11] So if we have, you know, professionals here who are in a field where they think, hey, I may be able to sell this within 21 years, that's the other concern. So if you're just looking at building it up and trying to get into retirement with it, yeah, a little later in life. If you're in a field where you think I may be selling this corporation, earlier is better. Dentists in particular sell their practices quite a bit. We're seeing it more and more in other medical professions as they start to consolidate debt. People are buying medical PCs and dental PCs. And so if you feel that is a game plan for you, then earlier is better because you can then grow more value into the family trust. Which is the ultimate goal: to shift as much value out of your hands into the trust hands. Dr. Wing Lim: [00:34:59] Wow. Okay. So there's a lot there. So now I'm aware of the time. So one last thing I want to go back to a few times you mentioned this lifetime capital gains exemption, and I know a lot of my colleagues have never heard of this phrase. So can you expound on that a little bit? And how much, what close to a million, like, and how do we take advantage of it? Jason Pisesky: [00:35:17] Sure. So the lifetime capital gains exemption, the idea being parliament created this thing to incentivize people to start and grow businesses in Canada. If you do that, you can sell the shares and if certain conditions are met, you get shelter on the first portion of the capital gains. Currently, it's $971,000. It's indexed to inflation. So it kind of goes up call it 15, $20,000 a year. So it'll be over a million if not next year, the year after. And so that'll save you in the realm of $240,000 in tax for everybody who can claim it. So again, if you're the only shareholder of your company and you sell and there's a $5 million gain, you're going to have, you know, shelter on the first million, call it, and then 4 million subject to full rate capital gains tax of, you know, in the realm of 25%. Depending on your province. Whereas if you have a family, if you have a spouse who's a shareholder, that's great. You got two cracks at it. If you've got a family trust with some kids in it, maybe you've got 3, 4 or 5 cracks at the capital gains deduction. And so the conditions that need to be met for it, there's three. Again, without diving into too much detail, there's the you have to own the corporation for, no unrelated person can own the shares for a 2 year period 24 months before the sale. For the 24 months before the sale, more than 50% of the assets have to be used actively in the business carried on in Canada. And then at the time of sale, it has to be 90% pure. So 50% for the two years before, 90% at time of sale. Jason Pisesky: [00:36:55] And so that's another benefit of either having a side investment corp or a family trust. They can help you take money out of the PC to keep it pure is generally the word used in tax. Purification, removing these surplus extra assets, cash, investment portfolios. Again, if you don't listen to my advice, your cottage and your - what else did I say - your plane, putting them somewhere else so that when time of sale comes, you don't have to do a bunch of extra steps. You're already pure, you know you're good on that 50% test. I have seen people skating very close to the 50% test, and it kind of comes down to what was that investment worth on that date? Okay, we're good. We're good on the 50% test. You don't want that stress. So moving assets somewhere else helps you meet those tests. And then, yeah, you get that big benefit if you get the sale, which again, I think is becoming more and more common. So. Dr. Wing Lim: [00:37:46] Yeah. I think the take-home message is don't, you got to think of this ahead of time. Because I have friends who got caught or partners got caught, they want to retire this year, they have a sale. Somebody, be lucky enough somebody would buy them out, oh they didn't purify the 90/10 rule. Right? And they didn't do the 50/50 rule, T-24 months. Right? They didn't do it. So they kiss that money away, right? That tax exemption. Right? So yeah. Jason Pisesky: [00:38:12] Yeah. No. And again, circling back to that initial point that I said is one of the most key is, again surrounding yourself with people that you trust. And that's kind of the point of this whole group, right, is having that network of people who have your back so you can go do what you're good at to earn money. Because I've also had clients come to me and say, Hey, I've got a, you know, I've got a pharmacy, I've got someone's coming in and offering me, you know, 8 million bucks for my couple of pharmacies. And that's great. I've heard a lot about these family trusts. I've got young kids. Can I put a family trust in? It's like, well, no, it's too late, you have to put the family trust in earlier so value grows in the family trust. And so, like with many of these plans, the, you know, it's sowing seeds. The benefits come earlier sometimes, like the case with the trust there's quite literally nothing we can do. Passage of time, I can't go back in time and put it in place. Some of these, the purifications, there are steps that can be done. It's just more expensive and time-consuming if we're able to do it to kind of get you back on side to meet that 90% test. If you're floating around like 50%, then it's quite a bit of work to get you to 90. So if you're, if you've done a good job and you're at 85%, then boom, nice and easy to get you to 90, you know, one small dividend and you're on side and off you go and you sell and you get your big benefit. Dr. Wing Lim: [00:39:27] Right on. Okay. I think Kevin is bringing the big stick. We can go on for hours. But this... Dr. Kevin Mailo: [00:39:32] So a huge thanks to Jason for being here this evening. You know, every time we have you on, every time we, you know, have you speak to our group, there's just more and more information that shakes out. And we're learning very quickly that pretty much the only thing you cannot do, Jason, is travel back in time. But it seems like you're able to do a whole bunch else. So we're so glad to have you participating with Physician Empowerment because this is what Canadian physicians need. They need long-term tax planning that goes far more than just filling up your RSP. So there is one question, though, that I wanted to bring forward here while we, while we're still recording the episode, and then we'll open it up afterwards to the group because we got a big group tonight. The big one is, the question I've got is, what is the net worth level in which a family trust will make sense? Is there any kind of rule of thumb or general guidance? Jason Pisesky: [00:40:24] No, it is. It is, I think it depends. You've got your two streams of people. You've got your ones who think, hey, I'm going to be able to sell this business, I'm in one of the fields that's getting consolidated or think it's going to be ripe for consolidation or maybe, again, I'm running my own clinic and I've got buildings and these other things that, again, someone's going to want to buy. Then early, early is better as soon as you can kind of viably see like, yeah, I'm on a good trajectory here. Things are established. I've got my necessities looked after. That's when the family trust I think makes sense, when you're, as long as the sale is within 21 years is kind of what you're looking for. Beyond that, if you're looking for more of the kind of family management succession planning tool, again, the goal is to shift as much money into the trust as you can because you can always pull money out of the trust yourself too. Well, it depends which province you're in and yadda yadda. Some of them, the only beneficiary of the trust can be children. Jason Pisesky: [00:41:20] And so again, that needs to be something you're prepared for if you're in a province where the rule is only children, you have to make sure that you've left enough shares in your hand that you'll continue to be able to pull out dividends and accrue value. So unfortunately, no direct rule of thumb, it is how am I going to use this? Who are my beneficiaries? How many kids do I have? Do I have no kids? What are the rules in my province around who's allowed to be in this trust? Can I have companies be our beneficiaries? If you're in a, if you're in a province where corporations are allowed to be shareholders of a PC or of a trust, you're golden. That's awesome. Some of them are extremely restrictive. So I think would just draw a line for you. And if you think you're going to sell within 21 years, you're a great candidate almost no matter what your net worth is. Past that, it's quite a hodgepodge and you kind of have to sit down and really hash out what the next 21 years look like for you. Dr. Kevin Mailo: [00:42:13] Okay. So there's a lot there. There's a reason why you're working full time navigating the tax system and we're very grateful. Thank you for your time. For anybody that's struggling with this, because it felt like drinking from the fire hose for me tonight. By all means, reach out to us because this is what we're doing in the master class. We are breaking down all of these topics and we're starting our next hack series coming up next month. But everything's recorded and you have access to our faculty, you have access to Wing for sort of one on one discussions. So with that being said, I think we're going to wrap it up. Wing, do you have any closing comments? Dr. Wing Lim: [00:42:50] Well, I'm going to say that there's certainly things you should not do with DIY. If you do DIY, you do DYI - you do yourself in. So tax is just one of those. I have people take time off work and do their own books. Like how smart is that, right? You know, but then yeah, so, we're here to empower you, right? It's peer-to-peer empowerment. Empower you to ask smarter questions, to ask your advisors smarter questions, and get smarter advisors for some people. Right? If you have outgrown your advisors and like Jason says, it doesn't hurt to have a second opinion. Right? And so yeah, so little plug is in a couple of weeks time we start a masterclass series. For those of you enrolled, so we'll have faculty members teach this third year of Masterclass. So first year Kevin taught, second year I taught, third year I teach co-teach with the faculty member like Jason, all the other high-level professionals that came and worked with us. Yeah. So and I would love to see all of you at Masterclass if we can. Right? And then we'll break down in different topics and then we'll spend a few months doing that and then we'll do some case studies. Dr. Kevin Mailo: [00:43:55] Awesome. Thank you again. Dr. Kevin Mailo: [00:43:58] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

23 - Retirement Wisdom with Michael Byrne

Play Episode Listen Later Jul 15, 2023 43:13

Dr. Wing Lim steps in to interview guest Michael Byrne about retirement “fibs and tips”. Michael Byrne is a business coach with decades of experience in the finance industry. Michael talks with Wing about common myths surrounding retirement and how best to start planning for retirement now.Michael states the simple truth that a desired retirement is possible but that it requires us to be intentional. Some of the myths surrounding retirement that he has encountered include a belief that “some entity will take care of me”, “markets go up and down but really up over time”, “I'm too young to start planning” or the opposite “I'm too old to start planning”. Michael debunks some of the myths with facts from his years of experience. In this episode, Dr. Kevin Mailo and guest Michael Byrne address the potential that exists in preparing for retirement and liken the plan required to assembling an orchestra under a skilled conductor. Michael lays out all the various professionals and plans that can assist with retirement portfolios, what to look for, and what options exist for those starting late. He also roughly defines pension plans and explains what some rumored potential changes to pensions might mean. There is a lot of wisdom in this episode to whet an appetite to learn more and start planning a robust retirement portfolio.About Michael Byrne:Michael is a business coach with an extensive background in tax-planning and insurance solutions for high net worth clients. He strives to ensure clients are taking the long-view of the finances and are optimally tax efficient.Resources Discussed in this Episode:Canada Pension Plan—Physician Empowerment: website | facebook | linkedinMichael Byrne: linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. At Physician Empowerment we're dedicated to improving the lives of Canadian physicians personally, professionally and financially. If you're loving what you're listening to, let us know. We always want to hear your feedback. Connect with us. If you want to go further, we've got outstanding programming both in-person and online so look us up, but regardless, we hope you really enjoy this episode. Dr. Kevin Mailo: [00:00:36] Hi, everyone. I'm Dr. Kevin Mailo with Physician Empowerment, and I'm very pleased to introduce Dr. Wing Lim, my co-host of the podcast, along with Mr. Michael Byrne, who Wing is going to be interviewing. And, you know, Mike wears a lot of hats. And, you know, I'm just going to summarize in a very, you know, abbreviated fashion because there's so much there. There's such a depth of experience. But Michael is a friend, a mentor and a business coach with decades of experience in the finance industry. And today he's going to be talking to us about retirement planning, and Wing is going to be interviewing him. This is going to be a great, great episode and I'm really looking forward to it. So with that being said, Wing, why don't you go ahead and take it? Dr. Wing Lim: [00:01:19] All right, Right on. So welcome to Physician Empowerment webinar slash podcast. And yeah, so I'm really excited to do this episode and interview, Michael. So the topic is going into retirement, fibs and tips, right? So we're going to split it into this fib side and a tip side. But let me formally introduce Michael. I've known Michael for over 20 years and he's worn very many hats, very diverse background from being a tradesman, insurance agent, serial entrepreneur and taking some companies public, founding an IPP company, philanthropist, business coach, leadership coach. And he just assisted a Mutual Fund Trust launch with $100 million dollars management. And he's currently working on a retirement and wellness center in Saskatchewan. And this is all at a tender age of 76. So, Michael, you got a lot of spunk. So then Michael kind of linked up with Physician Empowerment back in 2017 and you have become the head coach at the office and you've joined the faculty of the master class. So welcome to the show, Michael. Michael Byrne: [00:02:35] Thank you, Wing. Dr. Wing Lim: [00:02:36] So tell us, how do you manage to have so many hats and how does your journey change like that? Michael Byrne: [00:02:42] It's called delegation. Dr. Wing Lim: [00:02:44] Delegation. Tell us about that. Michael Byrne: [00:02:46] It's called delegation and it's called building, putting a team together. And really what I do is I manage a team of leaders. And that's really how it works. I, I'm surrounded with a lot of people who are smarter than me. And I like to say sometimes that a lot of my best thinking is done by other people or by a collaboration of other people. Let's put it that way. And that's kind of how it works out. Dr. Wing Lim: [00:03:17] Okay. Right. So you in your vast decades of experience, so you have come across lots of entrepreneurs, business owners, right? One of your hats is you coach and help business development from a $10 million company to $15 million company. I've met you at that phase of your life. And so you come across a lot of professionals, including doctors. And everybody dream about this golden retirement. Just go in a sunset with a stylish retirement. Right? And so, but then not everybody arrived when I arrived there. So what would be some of the fibs, some of the misbelief, fallacies, and lies that they found themselves? What's your experience? Michael Byrne: [00:04:06] Well, your description of desired retirement is certainly possible. But to achieve it, you know, we really need to have to be intentional. And it doesn't just happen. You know, you asked about some myths or fibs. I guess that's false perceptions. Oh, you know, it's probably an endless list. But, you know, a few that come to my mind is when you retire, you'll spend less. Well, the reality is, if we look at our life today or pre-retirement, you know, we spend most of our money on Saturdays or on the weekends. Well, in retirement, our life is full of Saturdays and weekends, you know. So there's that one. Dr. Wing Lim: [00:04:52] I was told that it's Saturday 1, Saturday 2, there are 6 Saturdays and a Sunday. Michael Byrne: [00:04:56] Exactly. You know, another one is well, you know, I'm going to look at this simplistically. If I maximize my RSP, invest it in a mutual fund, it's going to work out okay. And maybe another one is, and I've heard these and seen these, and, you know, some entity will take care of me, you know. And, you know, you might think that that might only be a mentality in the employee environment, but I have seen it in the business and professional retirement as well. Dr. Wing Lim: [00:05:28] So can we slow it down a little bit? So wait a minute. So this maximize RSP and put them in mutual funds, what's wrong with that? Most people do that, don't they? And what's wrong with that? Why is that a fib? Michael Byrne: [00:05:45] Well, it's a component, but there's not an awful lot of predictability to it. And really what happens there, Wing, is that people maybe focus on rate of return and really, you know, the goals, the objectives, desires you know, really determines your rate of return. There's no point in getting a great rate of return if it's going to be eroded by taxation, for instance. You know, and if you retire in the wrong part of the market, you know, that could work against you as well. So, you know, you could have a whole discussion on that particular myth. Uh, another one, I suppose, it'll all work out. You know, it really only takes a few moments or a little bit of time to plan for retirement. And, you know, this is not a unique observation, but the reality is that many or maybe the majority of individuals spend more time planning their vacation or buying a car or improving their golf game than they do in their retirement plan. And what's interesting is in every one of those situations, they will go to, you know, some advisor or expert or a family member to get some advice on it. And if they want to improve their golf game, they're going to hire a golf pro, you know, at their club or some public club to help them improve their golf game. Another myth is that markets go up and down, but they really do go up over time. Well, yeah. Yes and no. But it's not something that, it's more complicated than that. Um, another one, I'm too young to start planning. And another one is, you know, I'm too old. You know, there isn't enough time left to, you know, to make it work. And the other one is planning for retirement really involves only investing. You know, or maybe insurance, but really, in some cases only a pension plan. But it's much more than that. Dr. Wing Lim: [00:07:59] So can we go back to too young and too old? So let's go to too young then go to too old because we come across decisions, we're just starting, or physicians who should have retired a decade ago. So what do you say to people? Are they, should enjoy life to pay off their debts? Like, should they do that versus worrying about retirement four years later? Michael Byrne: [00:08:23] Well, I don't believe it should be an either-or because, you know, the instruments that are available to save for retirement don't just magically appear like at a later age, like 30, 35, 25 or 40. You know the tax advantages, for instance, of RSPs or TFSAs, they work at a very young age. And so what happens is you maximize your opportunity to grow. So even if you're not maximizing, at least start something, you know. And what I have seen is in instances where, you know, they live, we live our life as in as soon as. As soon as I'm done this part, then I'll start saving. And as soon as, and all of a sudden, there's always another reason. And eventually it doesn't happen. And then you can't make up for lost time. You can't go back sometimes, you know, and recoup it. But more important, like I've seen individuals who are in their mid-30s, Wing, who are much further advanced than individuals that are in their 50s. And in many cases, those individuals, they don't have the same salary or income, but you know, they're on a great start. So. Dr. Wing Lim: [00:09:53] So you're implying that if you start sooner, you might have less income potential to contribute, but you might be further ahead because of the time thing. Michael Byrne: [00:10:01] That's right. Yeah,. Dr. Wing Lim: [00:10:02] That's a good point. So what about the flip side? People like some of the comments says, early on there's a physician coming to us in the 60s and he said, my accountant told me I cannot afford to retire and was in tears. So what do you say to our colleagues like who felt like that, felt too old? Michael Byrne: [00:10:19] Oh, well, you can't, you know what, we can't escape reality. But so you know, what can we do? There's no real solution. But basically what you do is you take stock of where you are. What are the opportunities? You know, once you identify, you know, where you are, where you want to be - and it may not be ideal - but, you know, you use every option available to you at that particular stage in time to do the best you can. Now, in the business world, I mean, yeah, some businesses just don't work out and sometimes they don't work out at the wrong time. You know, and wow, what do you do? But in the business world, and I suppose it could be the same in the medical world, you get at that age, you have a lot of knowledge. You have a lot of expertise. And perhaps there are ways where, uh, you know, there might be some, you create some auxiliary income and where you might do consulting or you put yourself in a position where other individuals are working and you get a benefit of what they do. Like sometimes you just basically have to depend on other individuals out there earning revenue, be it in a company or some sort of an organization, and you have a relationship where you can share some of the income. Those are examples. I'm working with one individual entity like that right now. So it certainly, I mean, the reality is, no, you don't have as many options. Dr. Wing Lim: [00:12:14] But maybe what you're saying and what I heard you said in other settings, that people actually have options. They just do not know they had it. We don't know what we don't know. Michael Byrne: [00:12:25] That's right. You don't know what you don't know. There are always options. But if you're living in a silo, you know, and you just don't know what options are. I'll tell you very quickly, a funny story. There's a farmer who has a chicken farm and his chicken farm is kind of in a wetland. You know, it's prone to flooding from time to time, and usually every spring. And typically, you know, more years than not, he finds out that he has to move his chickens to higher ground. And many times he's losing them, you know. And so this goes on over a period of time. And he's complaining to his wife and his wife, she finally says, look, I'm tired of hearing you complain, I don't want to hear about it anymore. And he says, well, great, maybe you've got some great ideas. Give me a good idea. And she says, Buy ducks. So there's always an option. But you have to, you know, you have to either, you know, not so much think out of the box. And sometimes we need help. We need to collaborate with other people, to connect with other individuals to help us find out what the options are. Dr. Wing Lim: [00:13:33] Right. So you know what? That is a good segway to pivot over from the fibs, the many, many fibs, to maybe some practical tips. Right? Because each fib that we bought into, of course, we pay handsomely for, there's always a tip to counter that. Right? And so what would you say? And again, we're busy professionals, we have high potential, infinite potential. We usually go through a lot of debts and we also got taxed out of our eyeballs. So what would be some practical strategies that you see would be applicable to incorporated and unincorporated positions? Business professionals' positions? Michael Byrne: [00:14:19] Well, I'll go back to what I said before that retirement planning, like business planning, it needs to be intentional. And the only way to really be intentional is to really identify clearly a destination. In retirement planning, it may sound strange, but really it starts with the will. Like, how do I really want this all to end out? And then you work backwards from there. It's like planning any kind of a project. You start at the end and work backwards. But, you know, so a big thing would be is to become aware of all the tools and the strategies that are available. So it's kind of like, you know, it's like an orchestra. There's a bunch of musicians out there, but you have to put them together, otherwise it's not going to work. And the way you do it is you have to have a conductor. You know, otherwise you got a bunch of people, a bunch of musicians, playing a different song. The thing is, it can be challenging, but you don't have to be alone. Like if you look at it this way is that in many times in retirement planning and in so many circumstances in life, we don't know what, we don't know that we don't know. You know, we're so busy in our career and our lifestyle and our family, whatever it is we're doing is that we just don't know that we don't know. It's a terrible place to be. And the next one is we don't know what we don't know. And once, if you can come to that realization, now you're set up for a breakthrough because the next step is we know that we don't know and we want to find out what we don't know. And then that's when we start looking out for help to help us identify, you know, it's like becoming educated, you know. Dr. Wing Lim: [00:16:20] I like that analogy. I think it's a new one for most of us, orchestra. So in my experience, personal and otherwise, if you come across a lot of physicians, it's always one financial advisor or two. It doesn't sound like an orchestra to us. It sounds like a solo, right? And so maybe you say somebody would take care of us, maybe that that's, my financial planner would take care of me. So how do we become a, how do you have an orchestra playing for you for retirement versus soloists? Michael Byrne: [00:16:58] Okay. Well, there's a lot of practical strategies. And really what it involves is the integration of financial instruments, strategies and professionals. Or advisors, if you would. And integration is a key word, because integration means more than simply cooperation. Integration you need to take, you know, we want to take it to the next level, which is really collaboration as opposed to cooperation. A good example of describing cooperation: cooperation is one plus one equals two. Collaboration is putting one and one side by side, and what do you have? 11. If you can visualize that, that is the kind of a way to illustrate what collaboration is. So when you look at I mentioned, you know, three categories like financial instruments, you know, you got RSPs, you have the individual pension plan, you've got retirement compensation arrangement, you've got the TFSA, there's the flow-through shares, there's mutual funds, there's segregated funds, there's corporate class mutual funds and other types of mutual funds. There's family trusts, there's inter vivos trusts, there's life insurance, there's disability insurance, there's general insurance. And that, and I could add to that list. So those are instruments. When you, what are the strategies? Well, some strategies would include the insured retirement plan, immediate financing arrangement, infinite banking, a pipeline or capital gains stripping, RSP and RIF meltdowns, for instance, lit dollar insurance, split dollar strategies. And maybe those are a few more, but those are many of the common ones, and various types of income splitting and really exploring what's available, you know, for us today. Michael Byrne: [00:19:03] And then of course, in the professional world, the list is probably a little bit shorter. You know, you've got accountants, lawyers, but even in the law area, you've got tax lawyers, you've got estate will planning lawyers, corporate lawyers, securities lawyers. And each one of those is an area of expertise. And then, of course, you've got, you know, investment specialists, you have portfolio managers. In the private equity world, you know, you have private equity specialists, you have exempt market specialists, and so on. And the thing is, is that many financial plans is going to incorporate maybe not all of these, but certainly a significant number of them. And it's how to work them all together. So what ends up happening is, most of the time, is you have each of these typical professionals or these strategies are implemented in silos. You know, and yeah, you're making possibly a great return on your investment. However, you're exposed to taxation, you know, maybe you're saving a significant amount of money. You're saving a lot of money in your PC, for instance, not realizing that, wow, I'm getting a great rate of return, but I'm potentially exposing myself to a lot of taxation. Dr. Wing Lim: [00:20:40] So let's slow down a little bit. Yeah, there's a lot of terms. So let me recap what I could understand. Right? So you talk about financial instruments. There are strategies and they're professionals. Michael Byrne: [00:20:51] That's right. Dr. Wing Lim: [00:20:52] Right. So there's a plethora of instruments. It's like back to your analogy of orchestra, right? There's like violin, there's woodwind, there's percussion, there's on and on. And the strategies, maybe some sort of a piece. And then professionals would be the musicians, right? And you tend to get them in silos and I can really echo that because as my financial knowledge, literacy increased over the last three decades, I started from here, and each time I go to a little seminar here and there and I met these professionals and I met a cellist, I met a specialist, insurance specialist. I meet this guy, that guy wanted to, they always want to sell me something, right? And as I did that, I learned a bit and kind of, wait a minute, years later, they really don't quite do this. All right. They achieved this, but not that. And then some of them are conflicting. Some would say T5, some would say T5. Well, how do you do either or you do both, right? So after a while you get very confused, right? And most of us don't even have a head space for that, let alone the intimidation. This is too much. We feel really, really intimidated and we shy away and we just throw it off. We, instead of delegating, abdicate. Right? Give all the money to advisors and they do it and so how do we break away from that to have a true symphonic experience. Michael Byrne: [00:22:22] A symphonic, I like that. I like that. Uh, basically knowing, you know, what to use, when to use it, how to use it, and who's going to do it. And the financial planning industry, and when I talk referring to the professionals and advisors, it's not immune from biases. We all have biases. And I might be biased to this solution and I might be biased to that solution. I might be biased to that product and what the result, unfortunately, what happens is the client gets fit to the product or the solution as opposed to the product and the solution being tailored for the client, you know, and it's like a difference of me buying a suit off the rack as opposed to, well, the extreme would be to go to a tailor and have it just fit exclusively for me. And that's what should happen. But the amount of effort to do that is certainly greater. And in some cases the cost is going to be greater. Dr. Wing Lim: [00:23:47] So where do we, so let's be pragmatic. So where do we, like we met these silo type professionals and a lot of them are actually charged by the hour versus commission based. So how do we evolve from that into having a conductor doing the whole thing? Like, what's your advice for us? Michael Byrne: [00:24:12] The advice is to enter the world of where the bias would is collaboration or an integrated formula where the bias is bringing in a group of professionals and looking at financial instruments. Like that's the strategy. And that leads to a more comprehensive plan and a more comprehensive solution. You know, so a bias towards collaboration, Wing, you know, I think that that's the key to the beginning of the solution. Dr. Wing Lim: [00:25:00] So each one have their biases. It's like each woodwind section, percussion, each have their thing. Right? But a conductor needs to put them together, right? You're saying that actually we need a coach slash conductor to collaborate everybody together, to integrate everybody together? Michael Byrne: [00:25:17] That's right. Well, that's the job of the conductor to make sure that the violinist doesn't play too loud or the drummer, you know, the percussionist doesn't come in when they shouldn't. Do you know, maybe I'm stretching myself here to find the analogy, but it's basically a team effort. You know, you can compare it to any sports team. You know, you got a great group of athletes, but you really need a coach to bring it all together, right? Dr. Wing Lim: [00:25:46] Like, I think we come into a very much a DIY world. You know, everything at the fingertip touch with a cell phone and computer. Everybody's kind of DIY. They come in, consume the media, consume a podcast, they want to learn everything themselves, right? So what you're saying is you can't just DIY it and do the sunset and the glorious sunset, right? You need somebody to put everything together, right, intentionally and to put everybody in place. Is that what you're saying? Michael Byrne: [00:26:17] Well, that's right. You know, and the do-it-yourself world, if you look at it, maybe one component is looking just looking really great. And maybe everything that you're doing or the way that you're measuring yourself is doing just great. You know, you're hitting it out of the park with this investment or that strategy or whatever. But I'm going to go back to the beginning of our discussion, is that if you're living in a world of, like I said, you don't know what you don't know, you're missing out. You don't know what's sitting around the corner that is going to compromise your plan. And that's, and the most simple description I could make is that, you know, you're getting a great return. But what you don't realize that when you want to realize the fruits of that return, you're going to be exposed in a very, very high or unnecessary level of taxation. Dr. Wing Lim: [00:27:20] Right. That, upon reflection, this is what we're trying to achieve, right? We're trying to help all of us. Like this is a peer-to-peer common platform. We try to educate people and ourselves on what we don't know, right? We're aware of what we don't know, and we kind of get to know what we really don't know. And then we can build a vocabulary and we empower everybody to ask smarter and better questions. Your advisors, right? To understand what their biases might be. And then in the journey to find that maestro to put everything together. Right? But each time that's why financial literacy and financial IQ, so to speak, increase my meeting with my accountant and my advisors. Every year is different, right? It's getting more and more complicated and more and more in control because I'm knowing where I want to go. But not just blindly, take me there, right? Michael Byrne: [00:28:12] Yeah. A good indicator of what we're describing here is in the world of the very, very wealthy families, and I mean families offices, like the family offices or basically our office, our families that have, you know, $1 billion of assets or at the very least, you know, 300, 400 million, and what they do is they basically have the resources to hire a team of professionals to manage the whole, you know, their whole portfolio, all their wealth, let's put it that way. And they don't have just an insurance agent. They don't just have an investment advisor. They have a full team. And if you don't meet that category, then we have what we call multiple family offices. So you might have a group of where maybe the entry level is maybe $100 million. Okay. And so they kind of collaborate. You might get a half a dozen of those together and then you basically hold the same risk, have the same resources. And the next step, what has happened over the last ten years, you have seen certain accounting firms, it's, I don't know what's going on in the rest of the country, but I know here in Alberta, there are a number of accounting firms who basically have an integrated planning process and they have all the resources like within their firm. They'll have tax lawyers, they'll have insurance specialists, they'll have will and estate people. As a matter of fact, many of them, for their corporate clients, they'll have marketing resources. They'll have IT resources. Dr. Wing Lim: [00:30:08] So they're trying to do everything for them. Now, so now I'm aware of time. So maybe we'll just spend a couple of minutes. There's rumbling, right? I mean, rumbling, we heard that there's some retirement fund or pension plans that would soon become available to us. Right? So what what's your view about pros and cons of these kind of pension plans? Michael Byrne: [00:30:33] Okay. Uh, pension plans are very, very complex subject. You probably could spend an hour on it, but here, I'll give you the headline version. Dr. Wing Lim: [00:30:40] We'll invite you back for that. Michael Byrne: [00:30:43] Okay. There's two... Dr. Wing Lim: [00:30:44] There's a broad brush. Michael Byrne: [00:30:46] Okay. There are really two types of pension plans defined benefit pension plans, and there's defined contribution. And the defined benefit is built around the benefit, the end result. Okay? The defined contribution, as it implies, defines, is built around the contribution. Okay. So just to quickly, for defined contribution is basically what you put in plus rate of return is what you're going to get out. The benefit of it is if it's a pension plan, you have a number of individuals, employees if you would, contributing to it. And so you have the benefits of large assets under management, which of course should lead to greater investment opportunities. A key, so with a defined benefit plan, it's basically based on a formula. 40 years ago, defined benefit plans were pretty much all that there was around there. So if you worked for typically 35 years and there was a factor of 2%, some of them were one and a half, some were two, but the best pension plan in the land had used a factor of 2%. So you would take that percentage, multiply it by the years of service, which is 70. And 70%, so you would receive in retirement guaranteed for the rest of your life 70% of your pre-retirement income. Dr. Wing Lim: [00:32:17] That sounds really good. What's the problem? Michael Byrne: [00:32:20] There's no problem with that at all. And certainly they were indexed. And there was absolutely no problem at all with those if you have a big corporation with deep pockets to make sure that you can ensure those benefits, or if you're the government, you know, we hear about the government pensions, our government employees, our MPs and so on. Dr. Wing Lim: [00:32:45] Our politicians, all that. Michael Byrne: [00:32:47] Right. So what they have is a certainty of income based on that formula. But the thing is, is that with those pension plans there's an employer who is a separate entity, and the employee which is another entity. So you mentioned the rumblings, and I've kind of done some research and I've seen that some of the things, some that are coming out is where the employer and the employee are the same entity. Dr. Wing Lim: [00:33:16] Meaning the doctor? Michael Byrne: [00:33:17] Yeah. You got, you have a PC which is the contributor and you have the doctor which is really under T4 is the employee. So you're, basically you're guaranteeing your own future revenue or income in retirement, which is kind of an impossibility. Now the pros of that is that you have a group, and you have a number of, in this case, physicians that would be contributing. But however, the benefits depend on the health of the plan. Dr. Wing Lim: [00:33:57] What do you mean by health of the plan? Michael Byrne: [00:33:58] The health of the plan is the assets under management and the performance of the plan. And so if the health of the plan doesn't have the resources to pay the benefits, let's say that you signed up for or that you should have had because of your contributions and your years of service, the plan may not be able to meet those obligations. So consequently you would have to take less. And that's what's in the description. That's the only variable. The only variable is the income that the pensioners would receive. The contribution limits are fixed because they're based on a formula, and the formula that would determine the benefit is sound except that it's dependent upon the assets and the performance of the plan. So, for instance, the government pension plans, yes, there's a fund. But if at any point in time, like, for instance, we've seen these down markets and so on, we've had lower interest rates. Pensioners in from government, they're not concerned about any of that because if there's a shortfall, our tax dollars make up the shortfall. But with the plan that we're talking about right now, those types of plans, they're kind of like multiple employer pension plans. You don't have the benefit of a major employer or a government to guarantee the benefits. So it's kind of a false sense of security. And the other thing that happens there is you're giving up your flexibility. You see, you can't get out. You know, you're kind of stuck when you're in there. Dr. Wing Lim: [00:35:58] So what you're saying is if we are sign up with these group basically, right, the employer. So we are the funding source of that plan. So if the plan, if the investment doesn't measure up, then you have to cough up your piece. You have to cough up more money, as the employer. Right? And then if you have an unhealthy year or a sucky year in your profession, then you're really stuck. Michael Byrne: [00:36:23] I guess it would be safe enough to say that, you know, we'd have to look at all of the details of the plans that are being offered. But the fact that it's marketed as a defined benefit plan, in my mind, and I've talked to some other analysts, is that it's kind of misleading. You know, maybe that's a little bit strong, but it perhaps a false sense of security. Dr. Wing Lim: [00:36:50] Right. So what about defined contribution plans? Like are they more flexible? Michael Byrne: [00:36:55] Defined contribution plans are more flexible. You know, when when it comes to, well, again, let's put it this way. Defined contribution plans are basically, again, are dependent upon the health of of the fund. And usually they're based on market performance. Today the majority of defined contribution plans, the assets are in the public market. Dr. Wing Lim: [00:37:23] Which hasn't been doing so hot lately. Michael Byrne: [00:37:26] No, no. A big shift took place in the early 80s in the pension world. Prior to 1980, every pension plan in the land was invested in the public market only. And you started to see a shift in the 80s where pension plans started to diverse their portfolios to the point where they were maybe 50% public market, 50% private equity. One of the best-performing pension plans in the world right now is the Canada Pension Plan. And up until around 1997, thereabouts, the Canada Pension Plan was invested 100% stocks and bonds. And right around that time, they made the change. They established the Canadian Pension Plan Investment Board and they shifted to, you know, their target was 50/50, 50 public market, 50 private equity. And the performance has been stellar and the majority of large pension plans and even some smaller ones are the same. So when you look at the investment market today or the investment world today, the majority of defined contribution plans, and sadly to say, the majority investors like RSP plans, RIF plans, even individual pension plans, the IPP, are invested in, the majority is all in the public market. So in other words, they're investing the way pension plans used to invest 40 years ago. Dr. Wing Lim: [00:39:08] Wow. So it's kind of past saving. Now we should wrap this up because, so I think there's a lot here. And so Michael if you, if you have a dream, you can imagine one, what would you like to see in our retirement? You're the Wizard of Oz. Michael Byrne: [00:39:29] I've been working on this for five years. If I had a dream, my dream five years ago was I did a lot of work on the Individual Pension Plan, and my dream was to be able to have an asset manager that would be able to manage my Individual Pension Plan clients like a pension plan, like the CPP. That's my dream. Dr. Wing Lim: [00:39:56] So? So like a CPP style, right? So it's not just the 80/20, 80% equity, 20% bonds, right? Like, it's like, like CPP, right? Like you run it with a thick private equity asset class right inside that and run by professionals. Michael Byrne: [00:40:14] That's right. And you know what the reality is, there are many of us who do that on our own or try to do that on our own by investing in real estate. In other words, we find ways to invest outside of the public market. You know, I could give a whole session on the private equity market and how it's evolved about 13 years ago. And I was part of a team that was instrumental in moving private equity products into individual pension plans. But we want to take it to a step higher than that, where it's... Dr. Wing Lim: [00:40:53] So what you're saying is for us, we don't have 30, 40 million. We might not even have 3, 4 million, like a lot of physicians. Right? But people who have far less in the RSP/IPP world, if there's a way to combine that and then they can gather as and now we get like take advantage of like these professionally run pension style portfolio, like a CPP. Right? That would be, what would be doing complete. Michael Byrne: [00:41:23] I'm not going to, I don't know exactly what the magic number would be, but it would be somewhere in the neighborhood of about 25 to $50 million of assets under management to really take advantage of good opportunities and use diversification. But what you just described, it's not that far away, Wing. If you have 100 Individual Pension Plans with an average asset of, the average today is between 750 and $1 million in the existing IPPs, if you have 100, that's $100 million. You've got a pension plan. Dr. Wing Lim: [00:41:55] Yeah. Now, so for those of us who still not quite know what IPP, we'll have a different session, so I'm going to wrap up the formal interview. So thank you, Michael. So at Physician Empowerment, again, we're here to empower people to learn more about these vocabularies and concepts, the instruments, the strategies and the professionals. Dr. Kevin Mailo: [00:42:15] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

22 - Lessons in Personal Finance and Happiness with Nour Khatib

Play Episode Listen Later Jun 30, 2023 32:32

Dr. Kevin Mailo welcomes Dr. Nour Khatib back to the show to share her insight into personal finance and finding happiness. Dr. Khatib has an MBA and worked in the finance sector before returning to medicine as an emergency physician, which has given her educational and practical knowledge on physicians and finance.Nour Khatib talks to physicians about burnout and wellness because, she said, digging into those topics made an impact on her and she wants to share that learning with her colleagues. Part of happiness is finance and she has some key pieces of advice to share. Advice for those just getting started, because it's never too late to caretake your personal finances, but also advice for those already on their financial journey. In this episode, Dr. Kevin Mailo and guest Dr. Nour Khatib talk all about personal finance, from what incorporation means to compounding to diversification. Nour explains the time value of money, why everyone needs a team of experts to assist their financial aspirations, and how diversification can reach beyond the public markets into the public sector. The conversation is full of book recommendations, practical tips, and also real questions around what makes us happy and how finance is only one part of that equation.About Dr. Nour Khatib:Dr. Nour Khatib MD CM, MBA is an enthusiastic and dynamic emergency physician and financial professional with keen interest in Quality Improvement, Patient Education and Global Health. She completed her family medicine training at Sunnybrook Health Sciences Center and did further training in emergency medicine at the University of Ottawa (CCFP-EM). With extensive experience and a professional record as a financial and business analyst, Dr. Khatib has excelled in both international and local firms with determination, hard work, and resourcefulness. Utilizing a broad acumen in healthcare, finance and business practices, she aims to solve issues regarding the quality of healthcare and the patient experience.Resources Discussed in this Episode:Physician Empowerment “Episode 5: Med School Dropout with Dr. Nour Khatib”“Millionaire Teacher” by Andrew Hallam“The Wealthy Barber Returns” by David Chilton“Beat the Bank” by Larry Bates“The Value of Simple” John Robertson, PhD“The Millionaire Next Door” by Thomas J Stanley, PhD and William D Danko PhD“The Millionaire Mind” by Thomas J StanleyThe Happiness Lab with Dr. Laurie Santos podcast—Physician Empowerment: website | facebook | linkedinNour Khatib, MD CM, MBA: linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo and you're listening to the Physician Empowerment podcast. At Physician Empowerment, we're focused on transforming the lives of Canadian physicians through education in finance, practice transformation, wellness and leadership. After you've listened to today's episode, I encourage you to visit us at PhysEmpowerment.ca - that's P H Y S Empowerment dot ca - to learn more about the many resources we have to help you make that change in your own life, practice and personal finances. Now on to today's episode. Dr. Kevin Mailo: [00:00:35] Hi everyone. I'm Dr. Kevin Mailo, one of the co-hosts of the Physician Empowerment podcast. And today I am absolutely honored and excited to have Dr. Khatib, Dr. Nour Khatib, joining us again for another great episode. And today Nour is going to be talking a little bit more about her financial journey and some of the fundamental aspects of finance that every physician, regardless of their stage of practice, needs to understand. And for those of you that do not know Dr. Khatib, she wears a lot of different hats. But the big thing is that she is a physician like us. She's an emergency physician, but she had a career before medicine. She practices not only in the GTA, but also northern Ontario in remote, and she does do some international work as well. Dr. Khatib also has.... well, maybe you want to describe it for us, Nour? Why don't I just, why don't we just break there and I'll let you just talk and share what you do, where you're at. Dr. Nour Khatib: [00:01:35] Thanks so much, Kevin. I really appreciate the introduction. And thanks for having me tonight. Dr. Kevin Mailo: [00:01:39] I'm not very good at these. Not when they get this long. Dr. Nour Khatib: [00:01:43] No. No. I thought you did great. Dr. Kevin Mailo: [00:01:44] Such highly accomplished guests on the show, so I'm just going to have to let you do it yourself. Dr. Nour Khatib: [00:01:48] You're too kind. You're too kind. So over the last couple of years, I also started speaking to physicians like myself about burnout and wellness. And I know you're all rolling your eyes because I did, too. But I really feel that it's something that's affecting all of us. And I decided just a few years ago to stop rolling my eyes at things that are labelled wellness or labelled well-being and really start to dig deep and try to learn what that means. And it really made an impact on me and I wanted to share with my colleagues. So I've been invited to give talks about wellness and burnout in physicians. And so if you need to reach me to help out with your group, I'm happy to as well. Dr. Kevin Mailo: [00:02:28] Awesome. Okay, let's start. Tell us a little bit about your journey, Nour. How did you get from here? And for those of you that don't know the earlier episode, I think it's episode number five on the Physician Empowerment podcast, was a deeper introduction to Nour's background, but it's entitled Med School Dropout, so a really great story and by all means go back and listen to it. But for now, just tell us how you got to where you are. Dr. Nour Khatib: [00:02:54] Absolutely. It's entitled Med School Dropout for a reason, because actually, I was a med school dropout. So basically what happened is, I had gotten into med school at a very, very young age, wasn't sure that it was for me, and ended up two months in quitting and going into business. So I in fact, did a finance degree. I worked in finance for Pratt and Whitney Canada, which is an engine airplane engine manufacturer. And there, that's where did my MBA at the same time. All in all, at the same time, always thinking what if, what if, what if, what if I had continued? What if I had not left? What if I had a different path? And at that point I thought to myself, If I don't try now, I never will. And I'll always be second-guessing and I'll always be wondering. So decided to risk it and quit the business life that I was working in and ended up going into medicine and absolutely love the fact that I left the first time. And I'm very, very grateful for being able to come back the second time. And in that career, though, in that path, I learned quite a few things about finance that I actually was never taught in my finance degrees. So there's a lot of things that real life teaches you and not your degree, not your piece of paper, not the textbooks. Dr. Kevin Mailo: [00:04:11] Good. Love it. One theme that's already popping out is the notion of the lifelong learner. I mean, we talk about continuing medical education throughout our careers, but it sounds like, you know, this has been a, you know, a big personal journey for you. Dr. Nour Khatib: [00:04:27] Absolutely. And I would say the first ten years, I didn't not learn personal finance. But then once you start making money and wanting to know what do I do with it, that's when you start learning personal finance. And it's not really taught well in business school. It truly isn't. I believe it was an elective and one elective in the entire four years of the bachelors. So it wasn't even mandatory when truly it should be something mandatory for everyone in every field. Dr. Kevin Mailo: [00:04:56] Awesome. Awesome. Okay, continue. Share. Share your journey with us. Dr. Nour Khatib: [00:05:01] I remember graduating and thinking, okay, great. It's June 30th. I'm ready to take on the world. I, you know, no longer does anyone have to sign the bottom of those charts. And, you know, these patients are now mine and these decisions are now mine. And I felt great about it until I realized, Oh, damn, these patients are now mine. These decisions are now mine. And I have no, there's very little hand-holding, especially when it comes to outside of medicine in terms of what do we do next? Who do we talk to next? So July 1st really felt overwhelming, especially the month after July 1st when you start actually making some income and realizing, okay, when do I incorporate? How do I invest, who invests my money and how much do I save and how much do I even invest? And what do I even mean by investing? So I spent the first two years after graduating, doing a lot of learning on my own. And honestly, it taught me more about finance and personal finance than I ever learned in business school. Dr. Kevin Mailo: [00:05:59] Wow. Wow. Dr. Nour Khatib: [00:06:01] So exactly what you said, the lifelong learning thing. And I'm still learning. I still got a few books that I want to get through to learn more about it. And I'm telling you, a finance degree and an MBA did not teach me any of these personal finance pearls that you need, in fact, anytime. Dr. Kevin Mailo: [00:06:17] Let's stop there and I'll just share one reflection that I'm having is the fact that you don't have to have an MBA to be great at personal finance. You don't have to have a background in real estate to be a real estate investor. You don't need these things necessarily to be successful in this space. I'm not, I don't believe in do-it-yourself, not one bit, but you need to have at least the tools to be able to interact in the world of finance, and those can be acquired through self-learning. Dr. Nour Khatib: [00:06:49] Absolutely. The tools, the drive and the curiosity. And I would say curiosity is the big one. You have your best self-interest in mind. And so if you're, you know, if you're not putting pen to paper and trying to learn on your own, and I know we all lead busy lives, but we're leading them for a purpose, right? We're leading them not just to work the 12 hour days that some of us do. It's because we want a better life for our families, because we want to retire eventually, we want to have a better life or enjoy what we're doing or earning. Right? And who better to try to sort that out than yourself through learning about how to do that? And so the first things I asked myself after is, okay, so what about this debt that I have, and when do I incorporate, when do I not? The first thing is get your tribe in order. And who's your tribe? It's going to be your accountant, your lawyer, your financial planner or advisor, and get the right people in your circle to advise you appropriately. I'm not saying become an accountant. I'm saying you need people around you that know things, more than you do, not everything can be DIY. I completely agree, Kevin. There are some things that can and some things that can't. And accounting is definitely one of them. Dr. Kevin Mailo: [00:07:59] Wealth creation is a team sport. Wealth creation is a team sport, in my opinion. Dr. Nour Khatib: [00:08:04] Absolutely. Absolutely. And so when it came to debt and incorporating, I spoke to my accountant and we literally ran the numbers together. He was very, very patient with me and went through, okay, this is what happens if we incorporate now, this is what happens if we incorporate later. This is how much you need to save a month in order for it to make sense that you incorporate. So just keep listening to them, keep learning, keep looking that up, and just be curious about it. And whether you're two years in, six months in or 15 years in, don't think of the years that are lost. That's what we call in finance sunk cost. That's not going to help if you think that way because there's still the many, many years ahead that you can help renavigate yourself in the right direction. Dr. Kevin Mailo: [00:08:48] What an optimistic message, right? Because I think there's a lot of us out there who look back and go, woulda, coulda, shoulda. And I think that's all of us in some aspect of our financial lives. But the truth is, it's irrelevant to worry about past financial mistakes or I shouldn't have bought so much house or, you know, I missed out on this investment opportunity, or I wish I learned about real estate sooner in my career. You know, you can go endlessly with those kinds of questions, but I don't think it's helpful. I think what's helpful is looking at the here and now saying what's the best decision I can make for my life, for my family and for my future? Dr. Nour Khatib: [00:09:19] Absolutely. And I mentor a couple of students from U of T, and what I've told them is here is here's what I wish I knew. And one of them was learn about what it means to incorporate. Even if you're a few years in it's good to know, it's good to know what you can expense, what you can't expense and what it means to incorporate. We all think that it's just a way to save us some taxes. No, there's a lot more to it than that. And there's a lot of things that we can learn at any stage really about incorporation. Dr. Kevin Mailo: [00:10:12] Love it. Love it. Okay, keep going. Dr. Nour Khatib: [00:10:14] The next question I asked myself was, okay, so who invests my money? I mean, with a finance degree and an MBA, shouldn't I be investing my money? But I felt like I wasn't sure, wasn't capable, wasn't, wasn't sure if I wanted to, to do that on my own. So what happened is I ended up actually interviewing six financial advisors. It was a period of like three months where I met six different financial advisors, met with them, talked to them, and learned what they can offer me, what they can help me with. And in the end, what was right for me personally was I ended up doing the DIY investing route, but I hired a financial planner who helped me make some decisions that made sense for me. Okay, so I still, even though I had and I can tell you my job title at Pratt and Whitney Canada was financial planner. So, but I was a corporate financial planner. But regardless, I still needed that hand-holding, that guidance to help me decide what I need to do and look at like retirement planning and all that. So I still hired someone to help. So again, the degrees don't really help you with this stuff? It's you. It's your curiosity. And trust me, this information is not beyond our intelligence whatsoever. You as physicians, you're very intelligent people. You're very curious people. You will be able to understand these concepts with just a little bit of curiosity and a little bit of time, you'd be able to understand these concepts. Dr. Kevin Mailo: [00:11:44] My own reflection on this as well, when we're talking about wealth creation is a team sport, is make sure that as you build your team, the people you know, your accountants, lawyers, real estate professionals, financial advisors, portfolio managers, whoever it is you're working with, make sure they're accessible for you. Because in the end, you pay them and you should feel comfortable asking questions, including the so-called stupid questions, the really basic ones, where you're like, Actually, can we roll this back? I don't understand what you're saying, but I feel like it's important. Can you explain it to me? And I've learned over the years it took me a while to just go ahead and ask the questions that are popping into my head because these folks, they want to help. Right? And they can't help if they don't know what the issue is. So, again, you know, it sounds like you found somebody, Nour, that you can work with who meets you exactly where you're at. Dr. Nour Khatib: [00:12:39] Absolutely. And so how did I decide on this person? First off, for me, I was looking at someone who was accessible, someone who would answer my stupid questions, because I had some, and someone who, of course, their costs were low. And for me, the fee-based financial planner was perfect for me. I was comfortable doing some investments on my own, but I just needed help, guidance, help with guidance on retirement planning, budgeting and things that really I never really looked into before. So that was in the end what did it for me in terms of how I picked the person that I picked. So it was the financial planner, the accountant, the lawyer, and I made sure that all three of these were people who were accessible and responsive and would answer any question that I had, right? And for me, the accountant was ideal for me to make sure that I have someone that I trust and that I can and that other people have vouched for. So I found him through word of mouth because I actually spoke to other accountants who I felt were more interested in how much business they were making themselves. And you can get that if you meet them face to face or whether it's virtual, you can get that sense and, you know, really go with your gut when that happens and you realize it's not a long-term relationship, you can always change if anything, if anything happens or you don't feel comfortable with them again. Dr. Kevin Mailo: [00:14:03] Absolutely. Absolutely. So, you know, you have all this background in business, years and years of training and you worked in finance. Tell us the big lessons you learned about money and personal finance. Dr. Nour Khatib: [00:14:17] Sure thing. Absolutely. Here are some things that in seven years of business school, what I've learned mainly about personal finance and there are three concepts I think everybody should know in any field. Okay, so we'll start with the idea of compounding. So compounding, it's basically the process in which an asset's earnings are reinvested to generate additional earnings over time. So for example, if you are investing, if you are making, if you're investing $10 and then you make an extra dollar above that, the compounding is what that $1 will make in the future. It will be compounded for more and more. So it's really an exponential growth. Investments will generate earnings from both your principal, so your $10, and the accumulated earnings from the interest part, which is the $1. And so that, over time, is an incredible exponential growth. And the power of that idea of compounding is so significant that if I give you an example of like there's, here's an example of one investor who starts at the age of 25. She sets aside $5,000 a year for ten years. And that's it. At age 34, she stops. Then you've got a second investor who starts at 35, so starts ten years later than her, and he puts in $5,000 each year for 30 years and he stops age 65. Believe it or not, the first investor that only invested for ten years does better in the end at age 65 than the second investor, and that is because of the power of compounding. That's not because investor one was smarter than investor two or invested their money better, with someone better than investor two, it's literally about the amount of time. So when do you start? Now or yesterday. And don't feel bad that you haven't started yet or that you, um, or that you haven't looked into this yet. Just start is my biggest take, my biggest learning lesson. Dr. Kevin Mailo: [00:16:18] Wow. I love it. So. So what's this related concept of time value of money? Dr. Nour Khatib: [00:16:23] Yeah. So the other concept that they teach you and they hound you in business school is the time value of money. Basically saying that the value of a dollar today is worth more than the value of a dollar in the future, mainly because the money you have today, the money that you get today can be invested and therefore can make more money in the future. So I'd rather have $100 now than $100 a year from now because in that one year, I can invest it and make more money. So that's the time value of money. Money today can be invested and therefore has potential to grow. And so it's worth more. And it's used to make some strategic long-term financial decisions, such as whether you invest in a project with certain cash flow versus another cash flow. So, you know, like when they tell you, well, if you win the lottery, would you like the lump sum now or would you like it over a few years? So people use time value of money calculations to try to make that decision. And it really it's compounding and the time value of money together are very, very similar concepts. Dr. Kevin Mailo: [00:17:25] I love that. Absolutely love that. And I mean, this also even just is, you know, a reflection of our personal spending. Right? Like spending on consumer goods or what have you, I mean, it's out the door, right? And that, it's not just the value of that dollar that was spent now on consumer spending. It's what it could have bought you 10, 20, 30 years down the road when it's been compounded. And that's always the calculation that runs in my head when I consider like, do I really want this like widget? Dr. Nour Khatib: [00:17:55] Absolutely. And you have to think to yourself, like how much, when I start thinking like that, I go through a rabbit hole and then I don't want to pay for anything. But then you think to yourself what marginal benefit or marginal happiness is this going to get me? Dr. Kevin Mailo: [00:18:08] Yeah, right. Love it. Dr. Nour Khatib: [00:18:10] Is this widget going to bring me more joy in the future or is it going to give me immediate joy for the next ten minutes and then once I get used to it, the joy is gone? Dr. Kevin Mailo: [00:18:17] Yeah, totally, totally. Love it. Keep going. Tell us what else you learned. Dr. Nour Khatib: [00:18:22] So the third aspect that they teach you in business school is diversification. So diversification basically means it's a strategy where you're not going to put all your eggs in one basket. Okay? So what that means is you mix a variety of investments or a variety of different things in your basket so that if one does poorly, you're not at a huge loss because when one does poorly, sometimes one does better or one stays the same. And so it's a strategy that mixes a wide variety of investments within a portfolio in an attempt to reduce the portfolio's risk. So diversification is most often done by investing in different asset classes, like, for example, in stocks and bonds and real estate. And so when you mix that up, then the risk of that portfolio is actually reduced. So buying investments in different countries also is a type of diversification, industries, sizes of companies, and so that's also a concept that business school really hounds. And in fact, in a lot of classes in business school, they make us go through the calculation of trying to figure out how many stocks do you need in order to have a diversified portfolio. And if you look at some of these indices nowadays, there's like 12,000 stocks in them and whatnot. Right? But in fact, it's only a handful. It's about 30 stocks that you need in different industries and different companies and different types of companies that will help mitigate risk. And so you can mitigate that diversifiable risk. Dr. Kevin Mailo: [00:19:56] And what about diversifying outside of the public markets? Because I mean, we've seen we've seen a big market correction this year or last, beginning last year. And a lot of physicians, you know, come to us asking about private equity and whether that's startups or real estate projects, people are looking to diversify. It actually, if you look at the numbers, there's a lot more money being made outside of the public markets in the private markets than there is in the public, than there is, you know, on the stock market, if you want to call it that in its simplest term. So how do physicians diversify there? Right? Because there are pitfalls associated with it. Dr. Nour Khatib: [00:20:36] Absolutely. So there's many types of diversification. You can diversify within the stock market, whether it's bonds or stocks or, you can diversify within that. But then what you're saying is go externally and that's another level of diversification. So absolutely, if you have the luxury of being able to access markets that are outside of, you know, the public domain, then that is a different, that's a type of diversification. As long as you're not putting all of your eggs in that one thing. Dr. Kevin Mailo: [00:21:02] Exactly. Dr. Nour Khatib: [00:21:03] That's a type of diversification. Dr. Kevin Mailo: [00:21:05] Yeah. I mean, I often deal with physicians who are very keen to join in certain real estate projects, and I will often tell them to exercise some caution about like, don't put so much money into this, you know, if it's really going to hurt to lose it or if you're not, even if you're not going to lose it, but you're just not going to sleep well at night, you really haven't added to your well-being by making such a big gamble. And the other thing that, you know, I'll reflect on in the private markets is that physicians are very, very privileged because of our high incomes. We are almost all of us are accredited investors. And an accredited investor means, is a category that allows you to join in the private markets in a way that the general public cannot access because their income is not high enough. And those rules were set up to protect essentially middle and working-class folks from getting swindled in private equity deals. And so there is risk. But at the same time, there's a lot of upside because there's a lot more money that's made in the private equity sphere than the public markets potentially. But there has to be a lot of due diligence and caution exercised there as well. Dr. Kevin Mailo: [00:22:14] So again, it's just, it's that notion of diversity can be a lot bigger and a lot more three-dimensional than just picking a wide spread of stocks. The other reflection, and this is something that, you know, I kind of learned from Wing was, you can diversify within an asset class that you're comfortable with, right? So if you love real estate, you can own reits which are publicly traded. You can own reits that are privately traded. You can own your own doors and manage them yourself. You can invest in private equity deals and real estate projects where you are a limited partner and you're hands-off. You can even consider your personal residence to be a part of that diversification as well. Right? So again, it's kind of wrapping our heads around the idea of diversification being more than just, you know, a spread. And to allude to what Nour said earlier is like, you know, we sit there and you look at the staggering array of different stocks you can buy in the market, but there aren't necessarily a lot that are wildly different from one another when you're trying to diversify. Dr. Nour Khatib: [00:23:15] Absolutely. Agree with everything you've said. And then the fourth concept, though, is with increased risk, increased return rate. When you have got a lot of risk, you might have a lot of return. Low risk, low return. That's another concept to think about. But as long as you're diversifying, whether it's public, private or a mix of both, as long as you have that in mind and you're comfortable with it, and keep in mind, you have to be very honest with yourself. Are you more of a conservative investor, more of an aggressive investor? And there is a ton of surveys out there that will help you decide that because you might not know yourself, right? Dr. Kevin Mailo: [00:23:53] Oh, I love that, actually. That's great. Dr. Nour Khatib: [00:23:55] These will help you decide what kind of investor are you. There are certain questions and behavioral questions that they can take you through and they'll help you decide. Yeah. And whenever you sit with a financial planner or you sit with a financial advisor, they'll go through something like that with you. But if you don't have one right now, that's it's fine to try to understand what kind of risk are you? Dr. Kevin Mailo: [00:24:15] Developing our own notion. I love that. Developing our own notion of risk tolerance and what we can live with. Right. Because, and I've said this again, I kind of rant on it, is like no matter how much money you're making, you really want to be sleeping better at night. That's one of the whole purposes behind money is not just to buy you things, but to buy you a sense of security and peace of mind. So if you're not enjoying your process of investing, then maybe you should reconsider something that fits more along the lines of you as a conservative investor or you as a, you know, an investor with a higher risk tolerance. Right? Because there's upsides and downsides to both. The other aspect to diversification and appreciating risk is the notion that, you know, when we are diversified, that means that not everybody's a winner, right? Like if you look at your basket of investments, if you are truly, truly diversified, it's rare that they're all going up. And it's great when things are going down in certain categories because others will go up. But psychologically, you have to internalize the fact that, yeah, well, if I really spread myself geographically or across different asset classes, then it's, you know, there are going to be times when, you know, certain asset classes underperform relative to others and be willing to accept that as part of the discipline of diversifying. Dr. Nour Khatib: [00:25:33] And you're constantly learning, you're going to learn about yourself. You're going to learn what your risk, your, you know, when it comes to real life, it might be very different from the survey you took to see what your risk level is. But that's the beauty of it, is that you're going to constantly learn and constantly adjust and just stay the course, stay, adjust, but stay the course, if that makes any sense. So it just is, navigate slowly but surely, as long as you've started. And I think that's the biggest thing I learned over the years, is that I just need to keep learning about it. I just need to keep going, keep learning about new asset classes or things, ways for me to diversify, ways I'll be comfortable with. And the learning never stops. And I hope that this kind of instilled a sense of curiosity in you, because I, I do have a couple of books that I would love to recommend to you and might recommend to your listeners. And they're books you may have heard of. And I've always had thought of reading, but I highly would recommend books like The Millionaire Teacher, The Wealthy Barber Returns, Beat the Bank or the Value of Simple. So those are the four books that I'm looking at and it talks a lot about investing. Any books, Kevin, that you highly suggest to the listeners? Dr. Kevin Mailo: [00:26:47] You know, like the ones written by Stanley Thomas in the 90s were foundational for me. They were called The Millionaire Next Door and The Millionaire Mind. He kind of wrote this millionaire series and he was a researcher, a PhD, and he did a lot of like quantitative, but also a lot of qualitative research. But really, I found those books to be so powerfully centering because society's concept of wealth, like what's projected on the media, social media advertisements, is very different from what real wealth looks like and that most people that enjoy an extremely high net worth, let's say, you know, people that are in the eight-figure range and up, they live a lot further below what you would think they do. And it's because fundamentally they haven't changed as a person. Right? And he summarizes his books by saying a millionaire is a cheap date, which means a millionaire can have fun, can enjoy life doing basic things. And not that you can't travel, not that you can't have nice vehicles, nice homes, all those sorts of things. But it's a centering and this grounding exercise. And so those books were very beautiful for me. It's something I teach my children, but it's being happy with what is now rather than always I want, I want, I want. Because that force, when we're in that position, we're spending today's dollars. And as you said earlier, Nour, the time value of money is so precious. Right? So I'd rather that money was compounding than a very transient joy or little dopamine hit from whatever little experience or widget I purchased. So it's funny, those books are, they don't teach investing, they don't teach anything about like making money. They're not even that relevant for the 2020s now. But there's a lot of wisdom there and a lot of universal truths. So, so those are the ones that I really, I really center on. Dr. Nour Khatib: [00:28:45] That's a great add. That's a great one. Dr. Kevin Mailo: [00:28:47] And there are lots of others I recommend whenever I teach but those are the first ones that come to mind. Dr. Nour Khatib: [00:28:53] You made me think of one of my favorite podcasts, actually. It's called The Happiness Lab. So the Happiness Lab by Dr. Laurie Santos. She's a psychologist at Yale. Oh, you're going to love it. You're absolutely going to love it. So every episode she talks about the science of well-being, the science of what makes us happy, and all these evidence-based studies that talk about what makes people truly happy. And the biggest thing that she mentions is something called the hedonic treadmill, the hedonic adaptation, basically the tendency of us mere humans to quickly return to a relatively stable level of happiness despite a recent positive or negative event that has happened. So buying that boat, eventually you'll go back to your stable level of happiness that you had before buying that boat. So just things to consider and things that I learned on that podcast were phenomenal. And adding to my, I would call it wellness wealth, I would say, because it's really helped. It's really helped. Dr. Kevin Mailo: [00:29:56] Your happiness bank. Dr. Nour Khatib: [00:29:57] My happiness bank. Yeah. And it's something that definitely I would add to your financial literacy because it really does help in making us decide on what's important and what's not important. Dr. Kevin Mailo: [00:30:07] And even just the bigger question of the pursuit of money because I think it is important. Money matters. That's why I teach it. That's why I try to live by some of these principles. But in the end, it's like, how much do you need? How much? How much is enough for you? Not looking at what society thinks we should have, not looking at our neighbors, our colleagues, you know, but really, it's that bigger question of what do I need right now to be secure and enjoy peace of mind and have the most amount of happiness? And when I teach it, I've got this little cute slide saying that money isn't the cake, it's one of the ingredients. And that's all it is. That's all it is. And another million probably isn't going to have a meaningful impact in most people's happiness. Dr. Nour Khatib: [00:30:55] Completely agree. Completely agree. When I teach my wellness talks, I tell them wellness wealth, one of the prongs is your financial goals. Dr. Kevin Mailo: [00:31:05] Love it. Dr. Nour Khatib: [00:31:05] One of the prongs of the wellness wealth is your financial stuff. But otherwise it's many different things. Dr. Kevin Mailo: [00:31:11] Nour, this has been absolutely phenomenal. I know we've got more, but I think we've got to wrap up. So that means we just have to get you back on the show again at some point in the future. Dr. Nour Khatib: [00:31:22] It would be my pleasure. Thanks so much, Kevin. Dr. Kevin Mailo: [00:31:24] You know what? It was just amazing. Every time we talk, I always love it, I always feel like I'm learning and not just like concepts, but the wisdom that you share. And for those of you that don't know, look Nour up. She does this incredible work in the space of workplace wellness, which I feel our profession needs now more than ever, because obviously things aren't getting better post-pandemic. So again, I encourage you to reach out to Nour for your group or your event. And with that being said, I want to wrap up and sincerely thank you, Nour, for joining us. Dr. Nour Khatib: [00:31:58] Thanks for having me, Kevin. Have a wonderful evening, everyone, and thanks for joining us. Dr. Kevin Mailo: [00:32:03] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo @ PhysEmpowerment.ca. Thank you again for listening. Bye.

21 - Private Equity and Real Estate with Gaurav Sobti

Play Episode Listen Later Jun 15, 2023 33:53

Dr. Wing Lim hosts guest Gaurav Sobti, Vice President at Create Commerical Mortgage Services, in a discussion about private versus public equity and real estate investing. Gaurav holds designations as CPA, CA, and CFA, and has a wealth of knowledge to draw from in shedding light on equity and what the average investor needs to know. Gaurav Sobti is the husband of a physician - he likes to joke that his parents wanted him to be a doctor so he did the next best thing and married one. He understands investments both from the financial point of view, his career, and from a physician standpoint as well. Gaurav defines a lot of terminology for Dr. Lim and offers insight into the markets and asset classes. In this episode, Dr. Kevin Wing explores the world of private versus public equities with guest Gaurav Sobti. They talk about the differences between public and private, the pros and cons of each, the differences in leverage and liquidity, and who to buy such funds from. Gaurav shares some important advice on what to investigate and what questions to ask when approaching an EMD (Exempt Market Dealer) or fund manager. This episode is a solid groundwork guide into the world of private and public equity and real estate as an investment from a financial expert.About Gaurav Sobti, CPA, CA, CFA Gaurav Sobti has 10+ years of financial services experience across real estate, investments, finance and accounting.Gaurav's most recent formal role was with a national real estate finance firm where he was responsible for originating and underwriting commercial mortgage transactions with a specialty on CMHC insured (multi-family) financing. Prior to that, he spent 4+ years at a private investment fund which had a mortgage investment fund. Prior to that, Gaurav worked at Alberta Teacher's Retirement Fund Board on the private investments team focused on private equity transactions. Gaurav was part of a top performing team that managed a $3Bn institutional grade portfolio. Gaurav started his career at Deloitte, one of largest accounting/advisory firms in Canada and worldwide.By training, Gaurav is a designated CPA, CA and CFA Charter holder. Gaurav is a licensed mortgage associate.Resources Discussed in this Episode:Gaurav Sobti on LinkedInCreate Commercial Mortgage Services—Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo and you're listening to the Physician Empowerment podcast. At Physician Empowerment we're focused on transforming the lives of Canadian physicians through education in finance, practice transformation, wellness and leadership. After you've listened to today's episode, I encourage you to visit us at PhysEmpowerment.ca - that's P H Y S Empowerment dot ca - to learn more about the many resources we have to help you make that change in your own life, practice and personal finances. Now on to today's episode. Dr. Wing Lim: [00:00:34] Well, welcome, everyone, on a Monday night, and it's always good to see you guys. And yeah, so Kevin there, me and Gaurav. So I'm Wing Lim, Dr. Wing Lim and this is Dr. Kevin Mailo and there's Gaurav, our guest. So welcome, everyone. There are other people who might pop in later. Yeah, so we're super excited to be hosting this one, this webinar, live webinar and etiquette as we record the show and so that you guys know it's being recorded. So yeah, I'm one of the co-founders of Physician Empowerment and what we do with the live webinar and the podcast is we interview interesting people on interesting topics that might help physicians live better lives. So we're here to do all that. And so tonight I'm super pumped to have Gaurav to be our guest. And Gaurav is interesting for many, many reasons and we'll dive right into it. But Gaurav is a physician's husband, so this is one of the spouses, but he's got a very diverse background. So maybe tell me or tell us a little bit about your immediate family or extended family, how you link into the physician community. Gaurav Sobti: [00:01:45] Sure. So thanks, Wing So I like to joke that, you know, I come from an East Indian background, lots of medical doctors in that from that background. And so my parents wanted me to be a doctor. So I did the next best thing and married one. And so, yeah, my wife, she's a family physician. She's been a family physician, I think since probably 2015 when she finished her residency. She works as she works out of a clinic. We don't run the clinic. She just works out of a clinic. And yeah, her family has a few, there's a few doctors and her mom's a doctor and so is, I think her, her cousins as well. Dr. Wing Lim: [00:02:23] Right. And then you got some on your side, right? Gaurav Sobti: [00:02:26] Do I? I'd have to think actually, I don't, I'm not sure actually if I have too many on my side. Dr. Wing Lim: [00:02:31] Right, yeah. But it doesn't matter, right? We're all regular people anyways, right? It doesn't matter what profession we are. So now professionally, you have a very interesting background. You're a CA, CPA, CFA, that's quite a designation. You have institutional background and you're not, I guess you don't want to be stuck behind a desk doing people's tax returns. So you do a whole diverse a lot of things and you're into financing as well. So tell us more about what your journey is like. Gaurav Sobti: [00:03:01] Yeah, so I went to school in Waterloo. I actually studied biotechnology and chartered accountancy. So, you know, I was kind of hedging my bets, thinking maybe I'd go into medicine. Um, but yeah, so I, I worked for Deloitte, which is an international accounting firm there. It was good, I liked it, gave me a good investigative background, but kind of always knew I wanted to do finance. Decided to move out to Edmonton to join a sort of mid-size and growing pension fund, our teacher's retirement fund, and didn't really know much about finance really until I got into there and we were doing private investments. The program was, you know, I would say the book was, you know, it was a $3 billion book where that's what we were building. Dr. Wing Lim: [00:03:46] Wow, Wow. Gaurav Sobti: [00:03:47] Half was private equity, half was infrastructure. And I worked primarily on the private equity side. Yeah, we were investing in funds and co-investments. And it was fun. It was, I could have had a very cushy job, but decided that I wanted to kind of do more entrepreneurial things. So I, you know, long story short, I joined a private lender. That's where I kind of got my experience in real estate, I was there for about four years, kind of originating deals, mortgage deals. Right? Again, probably prior to that really didn't think of mortgages as investments. And then decided I wanted to get some CMHC experience, which is related to multifamily. So I joined a national real estate finance firm, learned multifamily financing, CMHC, and then now I've kind of become, you know, independent, you know, I am technically a mortgage broker, right? I like to think of myself as more of a sort of consultant, like I put together my own deals as well, equity deals for real estate as well because I think that's where my passion lies. Dr. Wing Lim: [00:04:52] Right? So that's a really interesting background. And so of course you're more qualified than anyone, but what you just said just caught my attention. You said you learned about private equity and real estate quite a few years after you became a CA, right? So that tells me that the CAs that we use, if they're the general practice kind of CA, they might not know a lot about this stuff, do they? Gaurav Sobti: [00:05:16] Yeah, no, you're totally right. Like I, when I was a CA and doing audits, right, you know, I would say my Excel skills were pretty limited as well. Right? Think now, you know, with new CAs that's improved. You know CAs, you know, they know numbers. Some of them, even within CAs, some of them know taxes, some of them don't. There were some CAs who were auditors who didn't even do their own personal tax returns. Right? So I think obviously, just like physicians, CAs come from different kind of backgrounds and experiences. Just as finance advisors do as well, right? Dr. Wing Lim: [00:05:55] It never ceases to amaze me how my colleagues and I made a lot of decisions, East, West Coast. They always run business ideas by the accountants. Gaurav Sobti: [00:06:02] Usually they'll tell, you know, then if it's your accountant because they're generally pretty risk-averse, right? Dr. Wing Lim: [00:06:08] They're very risk averse. They'll shoot down your idea even if it's a good one. Right? So anyways, that's just for what it's worth, right? Do not go to your accountant for business advice. Go there for your tax return advice. Right? So, yeah. Okay, so let's move on. So when we talk about private equity, let's talk about public markets, right? There's public, private and most people just give their money to their advisors. And most people, most physicians I know of have thrown their money into the public markets. And it's a mess out there. So do you want to make some comment about the reason that bank runs stocks, bond reversal, crypto upheaval can just give me, get a broad brush. What's the weather like? What's the temperature like out there in the public markets? Gaurav Sobti: [00:06:53] Yeah, no, I mean, so obviously there's a lot of volatility, right? You know, after Covid. Well, when Covid hit, you know, the markets took a big dive. And then there was a big run-up related to all the printing of money. Right? Now, they're kind of out of favor again. The markets have taken a hit with just interest rates rising. Right. Tech has definitely taken a huge hit. And, you know, now there's definitely recession fears coming. So, you know, the yield curve is kind of changing, you know, by the month. Right? And especially with these banking failures with ICB and now Credit Suisse like people are worried like is this another 2008? Dr. Wing Lim: [00:07:34] Very much so. Gaurav Sobti: [00:07:35] So there's definitely a lot of volatility. You're seeing that in the bond market for sure. Dr. Wing Lim: [00:07:39] Yes, exactly. So historically, people say, well, 80/20 rule, 60/40 rule 60% stocks 20/40% bonds. Oh, you're set. Well, gee, if both of them tank, what do we do if that's our retirement? Gaurav Sobti: [00:07:53] Yeah, me personally, like, I think capital should be, you know, flexible. I'm not saying, you know, public markets are bad, but sometimes, you know, there's sometimes a time to invest in them. And so there's sometimes there's better times and sometimes there's worse times. That being said, I think you look at the Canadian pension plan model, right? And Canadian pension plans are really pioneers globally when it comes to investing, right? They tend to put a lot of money into alternatives. And I would say the three big asset classes are private equity, infrastructure, and real estate. So definitely that has a place in someone's portfolio. And you know, there is a trend towards, you know, making this more widely accessible. But yeah, you definitely have to understand sort of what the risks are and, you know, private equity, again, very broad term. Right? Dr. Wing Lim: [00:08:42] So before you go further, because treat us like grade eight in finance language. Right? So what is private versus public? Why do they call it public versus private? What distinguishes them apart? Gaurav Sobti: [00:08:57] Yeah, so private, private and public, I mean, the simple difference is that, you know, public is on a, you know, it's openly traded on an exchange. There's generally more regulation there. Right? Like, you know, to go public, like there's a lot of securities documentation that have to be filled out. Whereas private can be, although there is securities regulation associated with private, it's not as regulated, right? And yeah, it's, you know, just it's privately owned. Dr. Wing Lim: [00:09:27] Right. So why do people consider, why people go into private equity versus public? What's the advantage there? Gaurav Sobti: [00:09:35] Well, I think there's a few things. So one is control, right? When you invest in a public security. Well, especially if you invest, let's say, through an EFT or a mutual fund manager, well, that manager does not have really any say or control over that over that company. Whereas, you know, if you invest in private securities, whether you're doing your own or you're investing with the manager, they're generally going to have more control, right? That's one reason. The second reason is, you know, there's diversification. There's the universe of public companies, like there's lots of public companies out there, but there's way more private companies out there. So, you know, if all you do is invest in public, then you're missing out on a segment of the market. And then I would say generally private investments they tend to, I mean they have outperformed. Right? That's another reason. There is potential for more alpha because of the fact that there is control and also because you might be investing in different, you know, smaller mid-sized companies or projects and that could eventually go public right through consolidation. Right? Dr. Wing Lim: [00:10:56] So let's go back a little bit because we are afraid of jargon. So when you say more alpha, do you mean that there's more profit? Gaurav Sobti: [00:11:02] There is potential for more profit. There is potential. Dr. Wing Lim: [00:11:04] And then that means that potentially there's more rate of return because people go to private, I know, at least I know people, myself included, go there because all the rate of return is more attractive. Gaurav Sobti: [00:11:14] There could be, yeah. Now, you know, I will caution that part of that return comes from leverage as well. Like the public markets hate leverage, right? So like if you look at like a public REIT, for example. They're definitely not going to put as much leverage on the asset. Now they'll say it's because of risk and, you know, there's probably some truth to that. But part of it is just if they put too much leverage on it, they're punished by the public markets. You don't have that issue in the private markets. Dr. Wing Lim: [00:11:45] Let's backtrack. By leverage you mean they actually borrow some money? Gaurav Sobti: [00:11:48] Yeah, they borrow. Yeah. Typically private investments, there's more leverage in loan. Right. Which, you know, leverage, you know, it can be in, you know, in the right instances, it can be a good thing for returns. Dr. Wing Lim: [00:11:58] Right. So so what other things should we consider like, say, the downside or the cons of private investment that we need to watch out for? Gaurav Sobti: [00:12:07] Yeah, I would say a con, one con is that it's not as liquid, right? So, you know, when you invest in a stock, if you need to sell, you can sell immediately. Now that can be a bad thing too, because sometimes you're your worst enemy, right? Dr. Wing Lim: [00:12:23] Chicken Little. Gaurav Sobti: [00:12:25] So yeah, like, you know, I would say if you're investing in private, you have to have a longer-term horizon, right? You shouldn't be investing funds that you're going to need anytime soon. Dr. Wing Lim: [00:12:35] So what kind of horizon, What months, years, decades? What are we talking about? Gaurav Sobti: [00:12:40] Well, definitely years for sure. Like, you know, obviously it depends on what you're investing in. But, you know, the thing is like public, you can literally buy something today, can sell it tomorrow, I might sell it for a loss, but I can sell it tomorrow. Right? Private securities, you don't necessarily have that liquidity. There are, there's I mean, we can probably for another conversation, there is a whole area called secondaries in the private markets, which does provide liquidity. But that's, again, that's probably too much for this conversation at this point in time. In general, private securities are less liquid. The other thing is transparency. Now, depending on the group you're investing in, right, like, you know, it's less regulated. So there's going to be, there can be less transparency around it. With public you have to file your statements quarterly. You're dealing with the regulator. Private overall is just less regulated and there can be less transparency. Like you could, you could just get into a deal with like, for example, a local developer. There could be, you know, very limited transparency around it. Dr. Wing Lim: [00:13:46] So in your experience, what's the split that, like most people, do they do like 80% of their money in public, 20% in private? What's your feel, like an average professional. Gaurav Sobti: [00:14:01] That's a tough question, but I would say it really depends on your own personal circumstances. And your need for liquidity. You know, that being said, I don't think you should be 100% in private, right? I think the public markets do, there is a role for them. Dr. Wing Lim: [00:14:20] Right. Gaurav Sobti: [00:14:22] And so it's, I would say, what I can tell you is that like, for example, the pension fund that I worked for, we had 35% in privates, right? So 10% was in private equity. 10% was in public equity, not public equity sorry, infrastructure, and 15% was in real estate. So I think if you look at a lot of the pension funds, you can pull up their reports, right, for Canada. Like I would say, they're anywhere between, you know, 30 to 50% in privates. Dr. Wing Lim: [00:14:55] Right. I think for most physicians, we don't, like we don't do day trading. We don't have time to do that. We're long-term. We're building up the nest egg for retirement for us and in intergenerational wealth. So for long-termers, you think it's a good idea, right, to... Because these are longer horizon, like you said. Gaurav Sobti: [00:15:16] Well, I think physicians, like the advantage they have is, you know, especially in Canada they're, generally if you're a physician, you're a physician for a very long time period. Right? You have very predictable earnings. And it's almost like a bond, right, in itself. Like that cash flow stream. So because of that, you can probably rely on that more than, let's say, other professions. Right? You know there definitely is a case to be made to invest more in private securities. Dr. Wing Lim: [00:15:49] Sure. So let's dive into it. So how can an average Joe get involved in private securities and where do they find them or what kinds are there? Gaurav Sobti: [00:15:59] So I mean, you know, some of the private wealth managers or investment managers, they may have a private offering. I will caution you that, you know, sometimes these guys are just trying to sell private securities for the sake of almost as - well I'm not sure what the right, I don't want to use the word gimmick - but they're just like, okay, we know private securities is hot. Let's get someone into, let's get these guys into private securities, but they don't necessarily know how to do actually, honestly, the proper due diligence is one. And frankly, they probably overly diversify. So when I was at the pension fund, for example, we actually ran a very concentrated private equity book where we invested inside fund managers. And then we also did direct deals alongside the fund managers. And the reason we were concentrated is because if you have like, let's say, 40 managers that you're investing in, well, they're going to have multiple funds that invest in, you know, 8 to 15 companies each, right? So that's just, like you're just overly diversified. You're probably going to end up, after all the fees are said and done, you're just going to end up getting like an ETF type return. Dr. Wing Lim: [00:17:21] Well that's exactly - I totally agree with that. And actually, it's not just me. So last time we interviewed Brandon Carlson. He's a portfolio manager and the podcast just got released. And so we asked him, I actually interviewed him in December and say, what's 2023 going, right? Where's the public markets going? And he's just saying exactly that because it's a zoo out there. So he says, if I were to predict where Fortune 500, half of this is going this way, half of that going that way. And if you just do a very broad-based diversification like index fund, you end up with the very mediocre thing, which is, you know, not much different, right? But then if you become more selective and you're not just picking average Joe, you actually need to understand what they do. And become more select, more focused. Then you probably win, right? So I guess that applies to private equities then? Gaurav Sobti: [00:18:17] No, definitely. Yeah. Like, so that's one thing to consider. You don't want to be overly diversified either because if you're trying to, you know, the whole one of the reasons to invest in private is to get that additional return. And if you just end up overly diversifying there, it kind of defeats the purpose. Right? And honestly, you have to just, depending on who you're investing with, like you might be able to find like a manager that you can invest directly who invests in companies. Right? Or you can invest through what is known as a fund of funds. So the fund, they create a fund like a feeder fund, which invests in a variety of managers. And honestly selecting the right manager to invest in, there is a skill to that. And there is a process. But if that manager is investing in, if your fund a fund is investing in too many managers and then they're laying on too many fees, then again, you're just going to end up with a ETF return, right? Dr. Wing Lim: [00:19:18] Right, exactly. Now let's pivot and move into that space, into more day-to-day. Who would end up buying these funds from. And there's a, one of the hot, hot, at least in my experience and in my space, but one of the hot, hot things is real estate, right? Real estate funds is part of this private equity. And they're a big chunk of real estate. And so I think you and I are both passionate in this space. And there's a lot of capital raised. There's a lot of good returns. So how would you describe the space right now, this real estate fund space. Is it expanding? Is it hot? Is it worth getting into it? Gaurav Sobti: [00:19:55] Definitely expanding. The whole alternatives is expanding and real estate is probably, you know, I haven't looked at the statistics, but it's probably one of the largest private asset classes. Right? And there are more private funds kind of showing up. Yeah, so you could find a manager to invest with. You could find a sponsor to invest in. You could go through an EMD as well, right? EMDs have different products on their shelves. But again... Dr. Wing Lim: [00:20:30] Let's talk about EMDs, that's a good catch phrase. Right? So what does EMD mean and what are they? What do they do? Gaurav Sobti: [00:20:40] Yeah. So Exempt Market Dealer - I was actually formally registered as an Exempt Market Dealer back in 2015 and I'll be honest, I didn't fully understand it at that point. I was maybe 25, 26. I just had the right credentials and someone got me registered. I got to learn about this space a lot later on, right? And think I have a better appreciation for it. So yeah, so an EMD is an exempt market dealer. From my understanding these are groups that are essentially allowed to raise capital in the exempt market space. Dr. Wing Lim: [00:21:12] So why, exempt from what? Gaurav Sobti: [00:21:14] From a prospectus. So when you're raising capital, there's, if you raise capital in the public markets, you have to prepare what is known as prospectus. Which is essentially a legal/marketing document to go public. When you raise money in the in the private markets, there's various exemptions that you can rely on to raise that capital. And, you know, one is, you know, friends and family, another is the accredited investor exemption. Right? And so if you're, I would say EMDS, one) from a from an issuer point of view, from like a sponsor point of view, if they're raising capital on a very frequent basis, then I believe they need to use an EMD right, to stay on with regulation. But EMDs also provide products to potential investors, right? So they have products on their shelves that they essentially sell. So you know, we've done our due diligence. We've approved them. And here you can invest in this product. That being said, I would say, I would caution you coming from a pension background and coming from learning from a mentor who really taught me how to do diligence and having an audit background, I personally would be skeptical of an EMD's, like how much diligence have they truly done? Right? There's probably some out there that are great, but there's some out there that are just pure salespeople who don't really understand the risk, haven't really done significant amount of diligence. Right? And frankly, they're probably not even investing their own capital in the opportunity. Dr. Wing Lim: [00:22:53] So basically, to recap, EMD in my mind, is more like a brokerage house that they have a product shelf and then the different products and these are all private equity products. Gaurav Sobti: [00:23:06] Yeah, that's a... Dr. Wing Lim: [00:23:07] So to speak. Gaurav Sobti: [00:23:08] That's a good way to sum that up. Dr. Wing Lim: [00:23:09] Good way to sum that up, right? So versus you go to mutual funds manager or advisor mutual funds. So that's all the public equities. Most average financial planners will sell you public equities, right? And the private equity salespeople are the... DRs. Right? So, and I don't know how everybody's exposure is, there more and more DRs because there are more and more projects. So other than EMDs, would there be some funds that people can buy directly or like, say, from this what you call sponsor, like the developer, the issuer they call them? Or what about a REIT? Can people just directly buy from these people? Gaurav Sobti: [00:23:48] Well, even if you invest in a private REIT, for example, most likely that private REIT is raising capital on a frequent basis. There will be an EMD involved. Like for example, I was just more curious, I won't name the shop, but, you know, I was just very curious about a certain apartment sort of issuer. Right? Private issuer. So I just, you know, I reached out to them. They immediately, you know, directed me to a third party EMD who I had a chat with about the suitability, first of all, about the opportunity. But whether it's suitable for me. Right. So chances are, if you're dealing with somebody who's raising capital on a very frequent basis, you will get in touch with an EMD. You can invest in projects directly without an EMD, right? But then the issuer has certain responsibilities. Dr. Wing Lim: [00:24:41] So you talk about accredited investors, right? So think a lot of EMDs, they look for doctors because we are mostly high net worth, right? So can you briefly just tell the audience what's the space about accredited versus non accreditors, the eligible to like, where do they make the cut-off? But do we fit? Gaurav Sobti: [00:25:01] So accredited investors, I mean... You know I think it's you have to have $1 million in net financial assets that can include your house or you have to make, you know, $200,000 individually or $300,000 with a spouse. And I believe it's like a two-year cut-off. And you have to believe that it's going to persist, right? So that's kind of the definition of accredited. So most doctors, you know, even if they don't meet the financial, the net financial asset test, they'll generally make it on the income test. Right? And then, you know, there's obviously a path forward to get to that net financial asset test as long as they, you know, continue to save money and invest properly. Dr. Wing Lim: [00:25:41] Right. And then for those of us who are a little bit more exposed, I don't know about the audience, but certainly I'm very familiar with this space. So they promise a lot of returns, double-digit, like 8, 9% prep and then back end. So we end up with 15, 20, 20+ percent. So do you think those are realistic? Are these real? Are they true or are they poo? Gaurav Sobti: [00:26:05] Yeah, I mean, I think I think they can be realistic, but, you know, definitely there can be a game to it as well, right? Like you can, you know, you can put together a model, right? And, you know, you can make whatever assumptions you want and you can create that 20% potential return. But I think you have to, like I think there's a few things you got to look at. What I look at, for example, is like definitely I want to have alignment of interest with whoever I'm investing with. I want to make sure that they have skin in the game, you know, whether it's through investing cash, hard cash in the deal, plus, you know, potentially putting up their guarantee. Right? They don't always have to have everything, but there's got to be some level of alignment of interest. And then you want to see what kind of, do they only talk about the potential gains, do they even mention any of the risk? What's their track record? Have they done it before? Right? And so those are kind of some of the critical pieces. Do they understand financing? I think that's pretty, especially in real estate that's very important. So I've met with Bob Dylan, for example, from Main Street, right, which is the company. He's very successful. Dr. Wing Lim: [00:27:22] Big guy Gaurav Sobti: [00:27:24] Big personality type. And you know, he said like, you know, in this business, you know, you make money on the buy - and again he's more value-add apartments - you make money on the buy, you make money on the financing. You'd be surprised how few sponsors, like how little finance knowledge they actually have and how little knowledge they have related to like even financing. Like I was, people send me opportunities to look at from time to time and, you know, I kind of give my input, right? Like I try to give my unbiased opinion. And someone showed me an opportunity in Winnipeg and it was $100 million project and they were using an interest rate that was like 2% below the current market, right? And so it's like, do you not understand? Like, you know what I mean? Like, you should have this basic understanding. And the other thing I would say is you have to see like, listen, you're going to pay fees, right? Whether you invest in the public markets, if you invest your manager or you invest in private, there are going to be fees. And sometimes the fees in privates are going to be higher. It is more work to put a deal together versus just investing in a stock. But is there an alignment of interest? Like is there a preferred return, for example? Right. I was just looking at another opportunity the other day for somebody and, you know, these guys were taking 40% sweat equity, no preferred return. And they didn't, it didn't seem like they were really putting any cash in the deal. So these are some of the things you should look for, right, when you're kind of evaluating somebody. Dr. Wing Lim: [00:29:01] Right. So to recap what you say, well, they give you very attractive return while some of those are actually true. But there's a lot of stuff hidden behind that is all by assumption. And we have to do some sort of a due diligence. Gaurav Sobti: [00:29:16] Or you have to get somebody who knows how to do it. Like, you know, like-- Dr. Wing Lim: [00:29:19] Because they-- Gaurav Sobti: [00:29:19] -- who can do it for you. Dr. Wing Lim: [00:29:21] Or you have to find somebody who could do the due diligence, short for DD, right, a proper DD. So of course with your background being an accountant, auditor and with your CFA, of course you would know how to crunch numbers. How would average Joe Doctor know whether the salesman across the table knows what they're talking about? Gaurav Sobti: [00:29:43] I mean, I would say you got to educate yourself, right? So if you want to take the path where you're going to do it on your own, then you definitely have to educate yourself. And it's not that it can't be taught, but you have to invest in that process. You know, despite being relatively educated, right, on the financial side, you know, I think anybody is capable of learning something. But they have to they have to have the time. And they have to commit to it. Dr. Wing Lim: [00:30:11] Right, exactly. Now, so we have actually gone over time, but I want to switch over and spend a little bit of time about institutional-grade real estate investment. So that's part of our topic. So what would you say is the institutional-grade real estate investment project? Well, you can. Gaurav Sobti: [00:30:29] Think of institutional grade as generally, I mean typically they are larger assets, but I mean I think you can do it on a small scale too. You just have to have some of the same structures, right? So when, let's say when you're valuing an opportunity, is there a preferred return built in? That's one, that's probably, you know, that's typically a sign of, that's like an institutional concept, right? If they don't have that, then it's definitely not meeting that test, right? Dr. Wing Lim: [00:31:00] So to me, institutional grade is what institutional funds would buy, right? So that or they would sell, right? And so if somebody builds a project and they would the institution would smell you and say, I want to buy you out, then, you know, you got institutional grade real estate, right? Because you're worth pursuing. But it's different, right? Because we, most doctors have one, two, three, 20 doors of condos or houses. And so these are moms and pops, right? And there's a different level, which is the bigger, more sophisticated real estate. Gaurav Sobti: [00:31:34] So yeah, generally larger assets for sure are considered more institutional grade for sure. Yeah. Dr. Wing Lim: [00:31:39] And the returns are different. The effort is different, right. And so that would be a discussion for a different day. Okay, so, one final question. So yeah, you already answered some of that for us, what's the next step if we're interested in this or - our audience is diverse, I know some of the audience already talked to you one on one - some already have a huge portfolio and they're actually walking into institutional-grade already. So what's next for people like that or for the average doctor if they want to expand? Gaurav Sobti: [00:32:14] Yeah, I mean you can consider investing in, like these GPLB structures, right? Just kind of keep kind of some of the things that I said in mind, right, when you're kind of evaluating these opportunities. And, you know, there are, you could talk to an EMD. But just again, if you're talking to an EMD I would say make sure that they're investing their own capital in those same opportunities. That's probably one of the first questions to ask them. And really understand their due diligence process and who's doing their due diligence. Dr. Wing Lim: [00:32:46] Yeah. Okay, good. Thank you, Gaurav. It's a lot of questions. It's a lot for people who haven't heard about this quite a bit. Dr. Kevin Mailo: [00:32:54] Thank you so much for listening to the Physician Empowerment podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

20 - Creating a Canadian Locum Network with Dr. Jordan Vollrath

Play Episode Listen Later May 30, 2023 24:29

Dr. Kevin Mailo returns as host and welcomes Dr. Jordan Vollrath, physician and co-founder of Cherry Health, to the show to talk about how he created an innovative physician network. It started with just locums but Dr. Vollrath describes how far Cherry Health has expanded and how it helps physicians. Jordan Vollrath had only worked in clinical medicine for a brief time after graduating from his residency when contacts and ideas fell together in serendipity to create Cherry Health. He enjoys his clinical work, which he currently does very part-time at the Alberta Obesity Clinic, but saw a real opportunity to create a job connection network for Canadian physicians where one was currently lacking.In this episode, Dr. Kevin Mailo and Dr. Jordan Vollrath talk about how Jordan's start in locum work led to the first iteration of Cherry Health as a locum network, how it quickly expanded to all manner of medical employment, Jordan's vision for the future information hub that Cherry Health will be, and why such a network will transform physician's lives for the better. This episode will pique your interest in Cherry Health and the connection opportunities available. About Dr. Jordan VollrathDr. Vollrath completed his medical school at the University of Alberta in Edmonton before going on to finish his Family Medicine residency at the University of Calgary.He has worked in a wide variety of both urban and rural clinical settings including ER and hospital based medicine. He is a co-founder of Cherry Health, a Canadian technologies company. In 2020, he was awarded the Joule Physician Innovation prize by the Canadian Medical Association. He has a passion for mental health and its relationship with weight outcomes.In his spare time, he enjoys being active and outdoors - skiing, camping, mountain biking and spending time with his French bulldog.Resources Discussed in this Episode:Jordan Vollrath, MD on LinkedInCherry HealthDoximity in the USAM3, Inc in JapanDoctors.net.uk in the UK—Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo and you're listening to the Physician Empowerment Podcast. At Physician Empowerment, we're focused on transforming the lives of Canadian physicians through education in finance, practice transformation, wellness, and leadership. After you've listened to today's episode, I encourage you to visit us at PhysEmpowerment.ca - that's P H Y S Empowerment dot ca - to learn more about the many resources we have to help you make that change in your own life, practice, and personal finances. Now on to today's episode. Dr. Kevin Mailo: [00:00:35] Hi, I'm Dr. Kevin Mailo, one of the co-founders of Physician Empowerment and one of our podcast hosts. And today I am very excited to introduce to you Dr. Jordan Vollrath. Jordan is a family physician based out of Calgary who has developed, if you haven't heard of it yet you will, Cherry Health, Which is an online platform, online app, that allows physicians to connect with different locum services. So, Jordan, why don't you tell us a little bit about yourself, where you are in your career, what you do right now clinically, and then share a little bit about your journey? Dr. Jordan Vollrath: [00:01:12] Yeah, for sure. So thanks for having me, Kevin. Glad to be here. It's an honor. But yeah, basically like right now I'm working at the Alberta Obesity Center, so I'm mental health specialist and really I'm only part-time there. So I'm doing about like one day a week on average of actual clinical practice. And then the rest of the week is working at Cherry Health. Dr. Kevin Mailo: [00:01:31] Awesome. Awesome. How many years have you been in practice? Dr. Jordan Vollrath: [00:01:34] I've been an adult since 2019, so we're coming up on like four here. Dr. Kevin Mailo: [00:01:38] You've been a grown-up for a few years now. Dr. Jordan Vollrath: [00:01:40] Yeah, yeah. We're getting older. Dr. Kevin Mailo: [00:01:41] You're like, you're like a pandemic baby. Dr. Jordan Vollrath: [00:01:44] Pretty much, yeah. Just before that I actually had like, a real job for about seven months, and that's when things started to shift. Dr. Kevin Mailo: [00:01:51] Yeah, there was a time when we didn't wear masks for every patient encounter. There was a time, Jordan. Dr. Jordan Vollrath: [00:01:57] I recall that briefly from residency. Yeah. Dr. Kevin Mailo: [00:02:00] Okay. Yeah, yeah, yeah. I suppose it would have been some residency in med school before then. Okay, so tell me a little bit about, okay, where did you come up with this idea and then what were the early steps that you took to build Cherry Health? Right? Because I mean, clearly I mean, you had an idea. How did you take those first steps? Dr. Jordan Vollrath: [00:02:18] So it evolved just out of solving selfishly, like a problem that I had for myself. So after graduating, I was working as a locum physician, so I was doing locums, you know, all around Calgary, Southern Alberta, rural/urban stuff. And then so I really liked just the flexibility of booking my shifts on short notice. So I would do short notice coverage. I'd do like short-term coverage for a day, a week, a month, you know, anything in that kind of ballpark. And it was really fun. It was a really rewarding way to actually practice, like covering for people when they got sick. If somebody needed like last-minute time off, it was very appreciated by like all the doctors in the clinic. So I'd actually be, because that was like a very sorely needed thing. They didn't really have very many people that were willing to practice like that, but it had its pitfalls practicing that way, right? So it was kind of if you want to cover short-notice things, you have to leave your schedule open until short notice. So that resulted in lots of downtime, lots of like days where I actually didn't have anything arranged. Not that I really hated having a day off here and there, but like in terms of efficiency of... Dr. Kevin Mailo: [00:03:17] Yeah, quit bragging, Jordan. Keep going, keep going. Dr. Jordan Vollrath: [00:03:23] You know what I mean? Dr. Kevin Mailo: [00:03:24] No, no. I know what you mean. Dr. Jordan Vollrath: [00:03:25] It got to the point where there'd be like down days, down weeks. I'd be picking up a shift at a time, at some walk-in clinics, things like that. But anyways, like then the pandemic kicked in. Like I had only been working for six, seven months because I had graduated the previous summer and then took a month off. And then March came around and suddenly, like nobody needed vacation coverage anymore, you know, nobody was going anywhere. Nothing was happening. People weren't actually even leaving their houses. So zero people were showing up to the walk in center. And so now suddenly it got like even more of a stress, an actual like issue to try and book things back to back on this short notice. And so the whole inspiration for Cherry Health kind of was a bit of a serendipity. Like I was actually just like hanging out with some friends at one at somebody's house one day. And then I met a guy who worked at a local, it's called a venture studio, so basically, like what they do, instead of investing in startup companies, they invest their time and then they get a return of like a stake in the company. And so this guy, Maximilian Kurz, yeah, so I met up with this guy, Max Kurz, and he's a genius. So this is like what he does for a living at this venture studio. And we were kind of just like talking. He was telling me what he does, and I was like, That's super cool. Like, just like the whole process of innovating and coming up with new things and like, you have an idea how do you actually get it off the ground. And it's basically like consulting, but for startups and implementing all these different strategies for growth and building like operations and things like that. Dr. Jordan Vollrath: [00:04:56] And so I was like, That sounds super cool. Like, you know, the creative outlet and the actual ability to, like, think outside the box. You know, I found that, like a lot of the times in medicine, thinking outside the box seemed like a good avenue to malpractice suits and losing your license. You're very much expected to think inside the box for a lot of things. So anyways, this just sounded very foreign to me, like this whole premise of like, how he operated. You show up to work one day on a Monday and you'd have really not necessarily an idea of what you'd actually do that week because you kind of got to figure it out as you go. So we're kind of just talking and I was like, Hey, if anything medical comes across your desk, drop me a line anytime. I'd love to weigh in or hear what you guys have planned. And then the next week he just called me up on the phone and he's like, Do you have anything in health care, like problems that you yourself have or anything else? Any ideas? We kind of just started spitballing ideas and it started out with, Hey, I do all these locums and it's a pain to organize sequential work and high-quality opportunities. And then next week he called me back again and he'd put together the most impressive, gigantic spreadsheet I'd ever seen. And he's like, I think we can do something with this. I think this is, I think this idea has got legs. That's really how it all started. Dr. Kevin Mailo: [00:06:08] Wow. Wow. Excellent, Excellent. Dr. Jordan Vollrath: [00:06:12] Serendipity, hey. Dr. Kevin Mailo: [00:06:13] Love that. Okay, so. Okay, so we kind of know what, you know, what it started as. But tell us what Cherry Health is right now for Canadian physicians. Dr. Jordan Vollrath: [00:06:23] Okay. So it started out with the locum perspective on it, right? So we initially launched it just to tailor it to like connecting these temporary jobs. It's since expanded. So now it's all across the country, it's no longer just family doctors, and it's no longer just locums. So now it's full-time long-term jobs, part-time jobs, telehealth jobs, contracting jobs, any physician specialty, really all the provinces in Canada. So it's kind of like the one-stop employment shop now. Dr. Kevin Mailo: [00:06:51] Love that. Love that. And then talk to us about where you're headed with Cherry Health. Like what's your dream or what do you want for Canadian physicians with Cherry Health? Dr. Jordan Vollrath: [00:07:04] So, okay, this is where the really interesting opportunity, I think, lies is we're building this network essentially, right? And so the backbone of this network currently is predicated on employment, on jobs. And so the goal is to like start strengthening those connections between people. So right now, they're looking for work opportunities. In the future, we want to start expanding it more into sharing research articles, into sharing medical news. Dr. Kevin Mailo: [00:07:29] Oh, wow. Dr. Jordan Vollrath: [00:07:30] Kind of becoming the one-stop, you know, kind of platform for digital physician networking in Canada. Like right now, there's not a whole lot of like infrastructure, like digital infrastructure for physicians in Canada. Like other countries, the US has Doximity, you know, the UK has physicians dot net, you know, Japan has M3. It's essentially like LinkedIn for doctors, all these companies I'm describing. So that really is kind of the goal, right? So you could, you take this network, kind of this core foundation that we're building that's, you know, founded around the employment thing, and then you start adding more tools, more widgets, more things on there to actually like help physicians make their lives easier, their jobs throughout the day. Right? So that really is the value of the whole thing is you've got this collection of people and you can start putting on new tools, new utilities, all kinds of different stuff, you know, resources, different articles like how to optimize your billing, how to optimize your clinic workflow, connecting you with all the other innovations, all the other exciting things that are popping up in Canada. Dr. Kevin Mailo: [00:08:34] So as you grow, how do you maintain the quality of what's on the platform? Because I think it's one thing, it's like, okay, I'm a clinic, I'm advertising a locum opportunity, I'm a locum physician, I'll sign up, you know, Airbnb it, I get it, right? But how do you maintain, you know, quality? Is there a chat platform? Like what do you do in terms of that? Because I think one of the issues that we face in medicine, and I'm guilty of being part of that, is that we just throw so much information out there that it can be a little bit overwhelming for physicians. Like I kind of don't know what to do with the latest podcast episode on all of the different podcasts that I'm subscribed to, right? And so, you know, so talk to us about that, right? Like intentionality and finding some balance. Dr. Jordan Vollrath: [00:09:24] So one of the things we did initially, we actually had ratings and reviews on there. So for the different clinics now that was a bit of a hot-button topic. Yeah, like there was a lot of physicians who were like, Wow, this is a sorely needed thing. Like, how many digital marketplaces do you interact with lately that don't have that on there? Right? Like Uber, Airbnb. Dr. Kevin Mailo: [00:09:44] Yeah. Well, and you know, you step into like that clinic and you're like, blow the dust off the paper charts and you look in and you see like, it's going to be a little bit of a long week for me. Dr. Jordan Vollrath: [00:09:55] So anyways, that feature did not get ported over to the new platform that we just updated. It released. It may come back at some point in this next little while, I don't know yet. But in terms of that quality otherwise, like that really is a big thing that I'm dealing with right now is like we've got this very sophisticated tool and how do you engage everybody to use it properly? Like so we've been doing some webinars for some of the local health associations recently just on like how to recruit. And this included a big focus on how to create a job posting that was actually appealing. Yeah. So that's a lot on us, right? Dr. Kevin Mailo: [00:10:33] Yeah, yeah. I'll be honest. Like when you flip the pages of most medical publications, it sounds a little dry, you know? Dr. Jordan Vollrath: [00:10:42] Okay, part of preparing for those webinars is actually one of the funnest things I saw was just looking through some of the job ads on the CMAJ and the CFP and like those things are very expensive. It's like, I can't remember, but you get so many. Dr. Kevin Mailo: [00:10:56] I've advertised on some of those. Yeah, not cheap. Dr. Jordan Vollrath: [00:10:59] Right? And so some of these job ads, like even though they paid all that money, they didn't even use up like the 80 words or whatever they were allowed to. It was like one sentence on like, Hey, we have a clinic and we use this EMR. Dr. Kevin Mailo: [00:11:12] Yeah, think I was skipping spaces between words just to, you know, get my money's worth. Dr. Jordan Vollrath: [00:11:19] So a lot of it is like, you know, it's on us to like really educate people and provide them resources on like how to actually successfully recruit. Recruitment is a very complex, difficult thing. That's why there's these professionals that actually do this for a living. And so physicians and most of us medical people, you know, never had exposure to that. And then you have a clinic and you need to like, how do you choose office staff? How do you hire more physicians? It's just very foreign to a lot of people. So in terms of ensuring that quality, that's definitely a big part of it is like teaching people actually like what needs to be done, and there is a messaging platform in there as well. To answer your other question, that's like coming out next week, I think. That will be updated finally. So we're super excited for that. Dr. Kevin Mailo: [00:12:00] Very cool. So okay, so going back to the core offering. So how does it work if you've got questions about the locum, do you just like is there a messaging way back and forth between you and the clinic or do you just pick up the phone and call the clinic manager or the physician you're seeking to replace and just, you know, sort out the finer details there? Dr. Jordan Vollrath: [00:12:21] So it would just show you right away the contact details. You got one outgoing message if you were interested, you got to put some text in there and then it would send a thing and show you the contact details. But again, as of like literally any day now, finally we will have the messaging system implemented in there. So they'll be like peer-to-peer chat now, if you have questions you can reach out. Very low pressure, low committal. You know, our generation of millennials and most of the people doing the locuming right now are a little, you know, afraid to pick up the phone and talk to a human. So text-based interface, it'll be nice. Dr. Kevin Mailo: [00:12:52] Yeah, I got. What is the fee model for the core offering? Dr. Jordan Vollrath: [00:12:58] So we got three things. Two of them haven't been released yet. The one that is on there so far, the partnerships model. So we actually have sponsorship deals with other companies that are doing really cool, innovative stuff in health care, clinical tools, things that will update your EMR workflow, things that will help you engage with your patients, all kinds of different like actual things. It's all these things that you've never heard of, right? Because advertising in medicine is incredibly expensive, right? Like there's tons of big conglomerates out there with large budgets that will send reps to your office. Dr. Kevin Mailo: [00:13:32] Well, we compete with Big Pharma. Big Pharma writes the biggest checks. Dr. Jordan Vollrath: [00:13:37] Yeah, exactly. And so there's so much cool stuff out there that's happening that you've never heard of because these companies can't afford to have you hear of them in a lot of cases. So forming partnerships with them like stuff that actually like adds value to the physician's lives. And so that's like one of the fee models. And then just like any other LinkedIn, indeed, you can upgrade your post. So that'll be coming very soon if you want it to be seen at the top of the pile, you can pay to play and get some more exposure, which, you know, kind of the whole premise of the platform is that we really want to democratize recruiting, right? That's the thing right now is that most clinics, most organizations, they cannot afford to pay to play. And so that's why we have this very sophisticated freemium model where there's like a ton of value and ability to, like, get your jobs in your locums out there based on meritocracy as opposed to just purely like the relative size of your budget. Dr. Kevin Mailo: [00:14:30] Wow, isn't that great? Dr. Jordan Vollrath: [00:14:32] And then number three is the recruiter seat. So actually, if you want to like take that advanced functionality and really start doing the outreach, the active outreach, to other people on the network, that's a paid feature. So those are kind of like the three things that fuel the network. Dr. Kevin Mailo: [00:14:46] So listen, I'm not going to sit there and poke and prod you too much longer about it. I would encourage everybody who's listening to this to download the app. I did, and I love looking at it. I mean, I got, I'm very much busy enough as it is in my existing position, but I can see how much better this is than trying to track, track it down through, through traditional publications, trying to track down a locum through traditional publications or word of mouth or whatever. Right? And I think my big reflection on Cherry Health is that this is a massive productivity boost to the profession, right? Because at the beginning of this, Jordan, what you shared with us is your downtime, right? You know, here you are as a, you know, a young physician wanting to be in practice, but, you know, wanting to take your time to find out what you really like and what you want to be doing rather than just jumping and joining a practice. And so this locum app, you know, really allows you, Cherry Health really allows you to, as a physician, find, you know, maybe the thing that fits the best for you. But as across the profession, you can see that this offers a ton of value. Right? And it's not just, and I hate using the word productivity like at Physician Empowerment, we're always ranting about like it is not about churning more output in a given day. It is about living better, practicing your best medicine. Dr. Jordan Vollrath: [00:16:11] But that work-life balance and like... Dr. Kevin Mailo: [00:16:12] Exactly, exactly, right? Like it is, it's huge. Dr. Jordan Vollrath: [00:16:16] So there's a couple problems in medicine right now, right? Like there's the absolute lack of physicians. Dr. Kevin Mailo: [00:16:23] Only growing. Dr. Jordan Vollrath: [00:16:23] Which is just a mess across everywhere. Yeah, only getting worse. And then there's the second thing, which is the actual like relative fraction of locums that are going around right now, right? So if you talk to anybody, there's just an absolute paucity of locums out there. Like it's a struggle to recruit anybody. So I think by making it easier actually, like making a big giant digital shiny pipeline of locum work, a lot of the new grads are going to be, you know, kind of drawn to actually practicing in that manner. And then we're going to have less burnt-out physicians, right? So once we start actually balancing and making that match a little better of the established physicians versus the temporary relief coverage like that's going to be huge to actually just cutting back all the doctors that are retiring early, cutting back their practice, moving away, taking time off, reducing their clinical hours, doing things that are non-medical. Right? So that's going to be one of the biggest benefits of like, obviously not today, but like as the months and years roll on. Yeah. Dr. Kevin Mailo: [00:17:20] Oh long-term, right? I mean, this is the next step, right, in the labour shortage that we have across this country. Right? Because, you know, we're not about to suddenly get more doctors to address the shortage, but having them deployed in a better, more efficient way really matters. And I think, you know, again, reflecting on the other end of the spectrum, physicians that are late career and contemplating retirement, well, maybe they'll push that back if they can reliably get locums, right? Because if you can't get a locum and you know, you're 60, I mean, you know, 70-year-old doctor, which they're out there, you know, I work with one and you want to start slowing down, you want to start taking those vacations and you realize like, well, if I can't get a locum, well, then I'm just going to shut down my practice and retire, you know? So again, like there's just so many advantages here and it's truly inspiring to see what you're doing because I think it's a lot more than just a service, right? It's the opportunity to transform the profession and create better work-life balance for everybody, which we all need. That is a crisis within the profession. Absolutely a crisis within the profession. Dr. Jordan Vollrath: [00:18:24] 100%. Dr. Kevin Mailo: [00:18:25] Okay. So, of course, like, what did I tell you? 20, 25 minutes and we keep going on and on. But tell me, Jordan, share some reflections about your journey thus far. Tell us a little bit about how you went from being a family medicine graduate to here you are as a physician entrepreneur because we constantly, at Physician Empowerment, we always have the, you know, physicians that are reaching out to us, that they're developing something on their own, whether it's clinic based or outside of medicine entirely, or health tech or whatever. But talk to us a little bit about your journey, some of your reflections, maybe a bit of wisdom along the way. Dr. Jordan Vollrath: [00:19:02] Well it's kind of funny looking back in the rearview mirror, right? Like when we got started, like the company is almost three years old now, getting pretty close, like, did I think I would be here today? You know, like almost not doing hardly any clinical medicine four years after graduating my residency. Like, was that my intention from the get-go? Like, no, absolutely not. Right? Like I really enjoy like, actually, my Monday is where I see my patients most of the time. It's one of my favourite days of the week. I actually really like health care. But it's just that it kind of evolved, right? And there was this window of opportunity to like really enact some significant systems change and it just kept getting bigger. So we've kept following it and I've kind of been just tapering back my clinical practice like as needed by the company. Right? It all started out like we won The Joule Physician Innovation Prize, in January 21 for physician or was it Physician Health and Wellness was the category, right, just for this creating a tool to actually cut back on burnout and that work-life balance. And so that really catapulted things, like that opened so many doors like as a for-profit company, right? Like as a registered incorporation, like a lot of the time in health care, it's very difficult to actually like get meetings and get things done because it's like, oh, it's one of those evil corporations, right? But like having that actual endorsement coming from the top down of the regulatory body opened so many doors. So that immediately, like obviously the money was a huge boost to just productivity and being able to like build more stuff and more technology. Dr. Jordan Vollrath: [00:20:36] But that opened so many doors, and so leveraging that, like talking to more people, getting in with some of the like health care organizations actually getting like more reach and more awareness of the system. Got that going. We turned that into then some funding. So actually like we closed some private investor funding last year. So that really like really, you know, things just kept kind of skyrocketing past that point. Then we had more staff, more team members. Everything just kept getting more sophisticated. Now we're up to, I think, like seven full-time people. We've got a few interns and apprentices. We've got a job description posted right now hiring for another marketing person. So we just continue to grow and kind of that window of opportunity to like really do some good for Canadian health care system just keeps getting bigger. And so we keep just following it. But it's been a fun journey. Dr. Jordan Vollrath: [00:21:25] It's definitely very different from like all the normal doctory things we're used to doing. But it's been a really enjoyable journey. The people you meet, like going to the, you know, networking events and business minglers, meeting other people that are in the health care space. There actually is a fairly well-developed like innovation space in health tech, right? And actually, as of yesterday, we just found out that we've been accepted to a health accelerator program. Like as the startup, I'm not allowed to name it or embargo on. I don't know when this is coming out, when this will actually be published, but so we're super excited that we'll be working with some of the biggest basically agencies in health care in Alberta for the next few months on some of these things. So you just meet tons of interesting people that are doing all sorts of really fascinating things. And it's very cool. Like I hadn't really seen any of that previously. Right? You're kind of just, you got your blinders on of clinical operations and patient care and, you know, whatever the thing du jour is. But now that you take a step back and actually look at what's going on around us in the innovation system, there's so many interesting things happening. Dr. Kevin Mailo: [00:22:33] Awesome. Absolutely awesome. Okay, we're going to wrap it up. Dr. Jordan Vollrath: [00:22:37] Yourself included, of course, like obviously like all your projects your company has on the go, all the stuff you guys are doing for physicians. Like that's how we match, right? It's just kind of like... Dr. Kevin Mailo: [00:22:47] Yeah, honestly, I mean, a year and a half ago, somewhere around there, a little less than a year and a half ago, we were in Mexico teaching, doing our course. And like, if you'd asked me five years ago that I'd be lecturing in Mexico, I, you know, at a beautiful resort, I wouldn't have believed it. And knock on wood, we're off to the Galapagos in early 2023 for a big tour. So we'll see how that goes. Dr. Jordan Vollrath: [00:23:10] That'll be a fun spot. Dr. Kevin Mailo: [00:23:11] You'll get an invitation. I'll come shake you down. Dr. Jordan Vollrath: [00:23:13] Oh, perfect. Awesome. Dr. Kevin Mailo: [00:23:15] All right, good stuff. Let's wrap it up. Thank you so much again, everyone, this was Doctor Jordan Vollrath, founder of Cherry Health. Thank you. Dr. Jordan Vollrath: [00:23:24] Awesome. Thank you so much, Kevin. Dr. Kevin Mailo: [00:23:26] Thank you so much for listening to the Physician Empowerment Podcast. If you're ready to take those next steps in transforming your practice, finances, or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you, I'd really appreciate it if you would share our podcast with a colleague or friend and head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

19 - Side Hustles and Passive Income for Physicians with Dr. Jordan Frey

Play Episode Listen Later May 15, 2023 35:50

Dr. Dimitre Ranev steps in to host Dr. Jordan Frey, plastic surgeon and writer of The Prudent Plastic Surgeon blog, on the show. Dr. Frey's blog addresses finances and passive income for physicians which is what he and Dr. Ranev discuss for listeners. What side gigs are available and how are they found? Jordan started his blog as a passion project and for the first six to nine months did not monetize it to ensure he could maintain quality content. He shares how the audience grew quickly and monetizing it became an easy choice. It now provides him with a solid side income that he appreciates not just financially but because he enjoys writing the blog so much.In this episode, Dimitre Ranev and Jordan Frey talk about why addressing finances for physicians is not a taboo subject and should be more openly examined. Jordan explains the different sources of side income available to physicians, from blogs and podcasts to medical knowledge surveys, medical chart and insurance claim reviews, and of course real estate. Jordan provides real life insight into what each income stream requires and how to find one to pursue.About Jordan Frey, MDJordan Frey is a plastic surgeon specializing in microsurgery and breast reconstruction. His hope is to spread the principles of personal and financial well-being to other physicians, trainees, and people of all walks of life by sharing his journey on this pathway of fulfillment, purpose, and happiness. Jordan runs and writes for The Prudent Plastic Surgeon blog and is also co-founder of BeautyTune.me.Jordan lives in Buffalo, NY with his wife Selenid, a college professor, and three boys, Samuel, Emery, and Camilo.Resources Discussed in this Episode:Save the Date for May 6-7, 2023 in TorontoJordan Frey, MD on LinkedInThe Prudent Plastic Surgeon blog“Physician Side Gigs to Make You Passive Income” by Jordan Frey, MD, posted on MedPage Today December 16, 2021—Physician Empowerment: website | facebook | linkedin __TranscriptDr. Kevin Mailo: [00:00:01] Hi, I'm Dr. Kevin Mailo and you're listening to the Physician Empowerment Podcast. At Physician Empowerment, we're focused on transforming the lives of Canadian physicians through education in finance, practice transformation, wellness and leadership. After you've listened to today's episode, I encourage you to visit us at PhysEmpowerment.ca - that's P H Y S Empowerment dot ca - to learn more about the many resources we have to help you make that change in your own life, practice and personal finances. Now on to today's episode. Dr. Dimitre Ranev: [00:00:35] Welcome back, everyone, to the Physician Empowerment podcast. We have a very special guest today. It's Dr. Jordan Frey. He's a plastic surgeon based in Buffalo, New York. And he also runs a blog called The Prudent Plastic Surgeon, where he shares his financial journey and helps full-time physicians like us achieve financial independence. Tell me a bit about, Jordan, about the blog. You it started how many years ago? Dr. Jordan Frey: [00:01:00] It's been about two and a half years ago now. Yeah, And it started really at the end of the end of my fellowship. And I always joke, it was just, I was in a bedroom in Brooklyn because I did my training in New York City. My wife and kids had already moved to Buffalo, where I am now, as an attending, and we basically stopped renting out our apartment and I was just staying with her aunt in Brooklyn. But basically at the end, to backtrack a little bit from that, you know, towards the end of my training, I realized that I was feeling burnt out, which was a surprise to me. And I'd been feeling these symptoms of burnout for a long time. I didn't know that they were burnout. And I finally sort of came to terms with that, and so then started looking at what was causing it and which was obviously multifactorial. But a huge part was my financial situation, which was really stressing me out. And I realized that my financial well-being was really nonexistent and that was hurting me a lot because I was, you know, I was nearing the end of my training and people were telling me, oh, it's going to be great. You're going to be a plastic surgeon. You're going to be making all this money. And I was just like in my head going, No, you don't understand. It's not great at all. I, you know, I have half $1 million of student debt. I have credit card debt. I have literally no savings, no investments. I have a family, like this is not good. And yes, my salary is going to increase, but I'm just being told like I have to buy a big house, I have to buy a fancy car, I have to buy fancy clothes, like all this stuff, because now I'm going to be a doctor, like an attending physician. And so I felt really stressed about that. And long story short, my wife and I, we made a conscious decision that we were going to learn about personal finance and start getting our finances under control. Over the course of months, we began to do that and then started managing our own finances and we created a financial plan. And the shocking part to me was just having that plan. My financial well-being really shot through the roof and I actually felt my symptoms of burnout improve, even though, you know, my actual money situation hadn't changed. I was still in training. We still lived in New York City. Dr. Jordan Frey: [00:03:16] We still had just as much debt and everything like that. But now I had a plan and I just said, okay, if I follow this plan, I can get out of debt, I can reach financial freedom, I can practice on my own terms. And that was just so powerful. And then, you know, there's this taboo in medicine that if we think about money, that's a bad thing, because we didn't become doctors for the money, which is true. But it's also true that it's okay to think about money. And I experienced that once I started thinking about money, I actually became a better doctor. I was more able to focus on what I loved about medicine. So that was really surprising to me. And then I started this blog basically for two-fold reasons: to try and break that taboo and also to show people that you can start in such a bad position like I was starting in and still make steps to improve and to create the ability to reach financial freedom, which I'm not at yet. I'm still very much in the process, but it's fun sharing that. So that was kind of a long-winded answer to your question, but that's where the blog was born out of. Dr. Dimitre Ranev: [00:04:24] So I actually, I went through your blog. It's a great blog. I really suggest our listeners take a look. And I did notice a bit of pushback, actually. Early on, you had some comments saying, oh, you know, you shouldn't worry about money. This, you're not in it for this. I can't paraphrase specifically, but I remember reading some of those comments. Dr. Jordan Frey: [00:04:42] Yeah. Dr. Dimitre Ranev: [00:04:43] I'm just wondering, how much pushback did you get? Because you got some on the website, but were you getting more from your colleagues or...? Dr. Jordan Frey: [00:04:51] There definitely was some. Yeah. It's, one of the very first comments that I had was a really negative one. Someone just saying like, this is totally... Just basically saying like, this is BS. Like why are you doing this? Why are you worrying about this? And I was actually like, Man, if I got this kind of an emotional response, I'm on to something. Dr. Dimitre Ranev: [00:05:13] Yeah, yeah. Dr. Jordan Frey: [00:05:14] And I think it's just that. It's because it's hardwired in and there is just, it's a taboo, it's something that I fell for where people just say, like, if you're thinking about money, you're not a good doctor. And it's not, I'm not thinking about money in the sense of like, oh, I'm trying to squeeze every penny I can out of my patients or something like that. Like it's the complete opposite. It's just like, Hey, we're blessed to be high-income earners, but doctors are really bad with money because we have a bad money mindset. We spend money poorly. We don't have any financial education. So there's a lot of pushback because people are just stuck in that traditional thinking. And my response is always like, look, patient care is still what's number one. It's just this, our financial well-being, it's an important part of our overall well-being. And if we neglect our overall well-being or any part of it, we're making ourselves worse doctors for our patients. And that's what I experienced firsthand, which is scary to say, because I did realize I was providing, you know, worse patient care because I wasn't totally focused and wasn't totally enjoying medicine. And when we enjoy medicine, that's when we're at our best. So I get that. And then the other form of pushback, I get a lot - kind of publicly and people just talking to me - is they're like, you know, Oh, you're always talking about financial freedom, which is this idea that you can, you don't have to work anymore. You're financially independent and you're only, you know, I'm in my third year of practice out of training. Like, why do you want to retire so early? And the truth is, I don't want to retire at all. I really love what I do. Like, I get really amped up and excited to go to work every day. But I do know that I am happier knowing that I can work because I want to, not because I have to. Which again is not a point, is not where I am currently, but that's where I aspire to be. So, you know, and I think my argument is always, Imagine if there was a world, you know, you're in Canada, I'm in the US, regardless of country or whatever, right, imagine if there was a world of doctors that were financially independent. That could work because we want to, not because we have to. And how we could change medicine for the better. Because right now there's so much bureaucracy and administrative restraints on what we're able to do. And a lot of doctors work at jobs they don't like because they need the paycheck and put up with things from insurance, you know, from whatever, because we kind of have to and if we could take back that control, I just can't even fathom how much of a positive impact that would have on just patient care. Dr. Dimitre Ranev: [00:08:06] Yeah, but it also, if you're financially secure, you can stand up for your patients better as well. Dr. Jordan Frey: [00:08:11] Exactly, yes. Dr. Dimitre Ranev: [00:08:12] I mean, people don't realize that. But you can put your foot down and say, fire me if you want to, I don't care. I'm going to do the right thing for the patient. Dr. Jordan Frey: [00:08:21] Exactly. Yeah. So that's so powerful. Dr. Dimitre Ranev: [00:08:23] And that's true across the board, whether it's in the US, Canada or anywhere in any other country. And I think what you mentioned, you know, what's the specificity, what's the patient, the skill of a doctor who's thinking about his finances - well, he's he or she's examining you - right? Like they're not paying attention to you because they're worried about making the mortgage payment. So it's so interesting, the pushback, because we got the same amount of pushback when we started Physician Empowerment. This 'you can't talk about money'. You can't. But it's so important. Dr. Jordan Frey: [00:08:56] So important. Dr. Dimitre Ranev: [00:08:58] So let's talk about money. And I want to talk about, there's this great article that you published and I'll share as well, hopefully in the podcast, where you talked about side gigs. And I guess, what would you define as a side gig for a physician, Jordan? What's your definition there? Dr. Jordan Frey: [00:09:15] I think, you know, it's pretty broad, sort of anything, anything outside of your main clinical gig or job, if you'd call it. You know, I'm a W-2 employee, which just means I'm an employed physician for a hospital. So sort of anything outside of that, I consider a side gig. Dr. Dimitre Ranev: [00:09:37] And you have some examples and I'll now go through them. I don't want, I want to start with maybe the one that you have the most knowledge with. Well, a lot of knowledge with, I wouldn't say the most, but blogging and just the website process and the podcasting process. So I'm assuming you enjoy that a lot. Like you blog. You enjoy the blog process. Dr. Jordan Frey: [00:09:57] For sure. Dr. Dimitre Ranev: [00:09:58] And have you, if you don't mind me asking, have you monetized that? Like, does it bring you any income in any way? Dr. Jordan Frey: [00:10:06] Yeah. No. I don't mind you asking at all. Yes, it does. And it started out, so like I said, it's about two and a half years. The first, like 6 to 9 months of it, I didn't monetize it at all. And I had some opportunities to. But I really kind of just said, you know, I want to take the first while - I initially said a year, but then it kind of took off quicker than I even anticipated or had hoped - but I wanted for the first 6 to 9 months to be purely just focusing on content, making sure that I could provide really good content and hone my skills in terms of writing and providing value and that sort of stuff. And then it started to get to the point of where I was doing that, and people were asking me for resources and advice that I couldn't sort of, I could provide in a general sense but not as specific. So things like, okay, I need to refinance my loans. Can you help me do that? And so I obviously am not a loan refinancer, but I could say here, this is who I used. These are companies that I trust that I've personally vetted, or things like that. Things like I need disability insurance, who should I use? And that I could say, well, this is who I used or this is who I know will get you what you need and be fair about it. So things like that. And it's obviously slow starting out. You know, I always tell people this is not something where, like if you're looking for this to be immediately a source of income, I think there's better ways to do it. And we'll talk about that because there are times people come to me and say, I want side gigs that are going to give me immediate money. This isn't really it, but if you stick with it, it will become a significant source, like so after that initial year, you know, the following calendar year, it made me, you know, somewhere like low five figures. You know, like 15,000, 20,000, something like that. But then in the second year now, it's making me in the six figures. So it's a significant source of income. Dr. Dimitre Ranev: [00:12:32] Right. Dr. Jordan Frey: [00:12:33] And it's fun because that ties in with, all of those sources of income from the blog tie in to my why with the blog which is just providing people avenues to reach financial independence. So whether it's things like the course I offer helping people to reach financial independence, whether it was, in the past I've done coaching, I don't do that now. So whether it's that or whether it's through other referrals or sponsors I have that I've used myself in my journey that I can help recommend to other people to accelerate their own journey. Dr. Dimitre Ranev: [00:13:08] So it took a lot of sweat equity, but it paid off. And obviously you do it because you enjoy it. That's the first thing you have to enjoy it. Dr. Jordan Frey: [00:13:17] If you break it down as like in a, you know, how many dollars per hour, I don't know how much it is, but it is a lot of work. But if you enjoy it, it's worth it. And that was the worst advice I got when I started doing this, was someone who's very well established in the field and probably was speaking from some point of self-preservation, but basically said like, you should not do this. It is a bad idea to start a blog on physician finance. And I try to tell people the opposite of that. Like, if you love it, if this is really something you're passionate about, you should do it. And I'm always, there's people that I've talked to and helped that have started their own sites or podcasts, you know, around this area. And there's no shortage of need for unique perspectives in this area like what you're doing. So if you are passionate about it, it is really a great thing to do and you can certainly monetize it and make it into a very viable side gig. It's just one that you plant the seeds and you have to water it and kind of let it grow. It's not an immediate one. Dr. Dimitre Ranev: [00:14:23] I'm curious, you have a course and how long did it take you to sort of, to get that done from the beginning, the idea, to the actual recording it, like how many hours do you think you spend or how many months did it take? Dr. Jordan Frey: [00:14:38] It took probably like a full year. And it's gone through a few iterations and improvements. So yeah, because you start out and you say like, I have this idea for a course and so my course is, it's really for anyone, but it's really geared for young physicians who are kind of starting and saying, I'm at the beginning of this process. I don't really know much about personal finance or how to develop the right habits or how to create a financial plan, how to set my course to financial freedom. So sort of starting from there. And so it takes, you know, going through and planning out what topics do I need to hit, what order, developing a script and then recording everything, doing video editing, which I didn't do myself. I outsourced that. Dr. Dimitre Ranev: [00:15:26] It's very time-consuming. Dr. Jordan Frey: [00:15:29] Yeah, very time-consuming. And then developing the, you know, different downloads and resources. And then once you actually have the course, guiding students through it, which is a process. I am fortunate in the sense that my wife has a PhD in education and so is really like... Dr. Dimitre Ranev: [00:15:50] She had pointers. Dr. Jordan Frey: [00:15:51] She's like okay, you need, yeah, you need to develop learning objectives for everything. And so could kind of help throughout that. But it's definitely a process. Dr. Dimitre Ranev: [00:15:59] And do you offer your course only through your website or do you offer it through other like teaching websites? Just curious. Dr. Jordan Frey: [00:16:06] I offer it only through my website mostly because that's the only way I know how to do it, I guess. Dr. Dimitre Ranev: [00:16:12] Right, Right. No, I am just so curious. Dr. Jordan Frey: [00:16:14] It's only through my website. It's evergreen. So like, at any point anyone can sign up for it whenever it's right for them and it's kind of self-guided but with access to me throughout. So, yeah. Dr. Dimitre Ranev: [00:16:28] Okay. So you're there. You're sort of there for Q&A, for first-hand guidance. Dr. Jordan Frey: [00:16:33] Yeah, exactly. So I offer like, anyone who is in the course gets personalized coaching with myself, gets access through email and phone calls, you know, as our schedules allow. So I didn't want it to be something where it's just like, you know, okay, you just have the recordings and you're on your own. Like, no, it's... I wanted it to be able to be personalized. Dr. Dimitre Ranev: [00:16:54] Yeah. And as a teacher for both, I think educators really, getting the contact, it's just you get energized from it, from talking to somebody and helping them. Dr. Jordan Frey: [00:17:03] Totally. Yeah, exactly. Dr. Dimitre Ranev: [00:17:04] So you need that. That's great. I didn't know you had the interactive component there, but that's amazing. And again, our listeners should check it out. I think it looks like a really interesting course as well. So that's sort of one side. That's more niche, I guess. You have to like writing, you have to like teaching. You have to like helping people. Dr. Jordan Frey: [00:17:21] Yeah. Yes. Dr. Dimitre Ranev: [00:17:22] Let's talk about some more, I guess, general ones you can use. Just leverage your medical knowledge. And you mentioned those in the article as well. One of them is medical surveys. I like your approach to that, that you say that you should only do them if - I guess you're saying if you have nothing better to do, maybe, maybe phrase it better than me. But yeah, don't do them if you're supposed to spend time with your family or do something else. But if you have the extra 30 minutes while you're watching your sitcom or Netflix, you can do one. How did you, did you sign up for them, or did they come looking for you? Because in my case, they came looking through LinkedIn, they found me. I use the analytics. But did you look for surveys or how did you enroll in that? Dr. Jordan Frey: [00:18:07] I initially did look for them, you know, and I was starting out, I was basically, you know, a new attending. And yeah, so I looked up, you know, medical survey companies and just signed up for them. And essentially what I would do is just yeah, wait for ones that I thought was a good fit. And they kind of come in a few different flavors, like some of them come and they say, you know, hey, this is a completely online survey and it's 15 minutes and we'll pay you 50 bucks. And that's what I mean, like you shouldn't, I wouldn't carve out other valuable time or other family time or something. These are ones that like, if I happen to be sitting there and just in a moment where I'm in the surgeon's lounge, like doing nothing, like scrolling through ESPN or something like that, and I have 15 minutes, I say, Oh, well, yeah, sure, I'll do this. And those are not ones that are going to, you know, get you to the point where you go, Oh, I'm making significant amount of income from doing these 15 minute surveys. But what it does is the more of those you do, those companies start to recognize and say, okay, this is someone who has a lot to offer, who's willing to contribute. And you start getting these ones that say, okay, this is actually a phone interview for 30 minutes. And we're going to pay you 300 bucks. And then it starts evolving to where those companies, and then you start getting on the radar of other companies where you can even set your own rate. And I set my rate at - which this is a totally arbitrary thing - I just said, I basically within my head and with my wife even, said, okay, how much would it take for me to say, Okay, I'm going to set aside an hour of my time? And we said $500. So I set a rate of $500 for an hour. And that's what I say. And companies can say, Well, that's too much. Or they can say, Oh, that's a fair amount for these opportunities. So they come along and these companies will approach you and say, I have someone who is looking to understand the breast reconstruction landscape or how you utilize breast implants and breast reconstruction, because that's something that I do. That's a focus of my clinical practice. And then I say, okay, yeah, I know a lot about that. I meet the criteria that the company is looking for, that's my rate, $500 an hour. And they say, okay, great, they want to talk to you and we schedule it and then you get that. And those opportunities start coming up more and more. So it starts off slowly and then it can build up and it can really be something significant. Not myself, but I know people who make tens of thousands of dollars each year doing that. So that's one way. And then the other way, of course, is if you, within your field of medicine, if there's certain products, whether it's pharmaceutical or actual devices that you use a lot and you believe in and aligns with your sort of clinical values, you can just approach those companies and be like, Hey, do you want me to do talks for you? Is there anything I can do to help you with your stuff? And a lot of times they'll approach you if you're a real user of their products. And honestly, that's not something that I have done to this point. But that's certainly something I know other physicians have done very successfully. Dr. Dimitre Ranev: [00:21:38] And another way to leverage your knowledge, but yeah I can attest for the surveys. I'm sort of in the same steps as you, now I'm getting to the interview part so it happens. For our listeners, I would say M3 Global seems to have a - I into it - seems to have also a Canadian area and the analytics is the Canadian one. So if you guys are interested, you could take a look and yeah, just like you're sitting in the lounge and you can do one in 15 minutes, it's worth your time. I would again agree with you. Anything more than half an hour, though? I don't know unless it's a phone call. Dr. Jordan Frey: [00:22:13] Yeah. Dr. Dimitre Ranev: [00:22:13] But 15 to 30 minutes is, it's the right spot for me. Dr. Jordan Frey: [00:22:17] Yeah, 30 to 60 I kind of reserve for phone calls because they tend to, you give more value to the survey company as well and you get compensated better. And I'll say, too, it then evolves into something where you can refer colleagues to these survey companies and you get compensated for those referrals, and sometimes really nicely because they run promotions. So there's a lot of ways that you can kind of leverage that that makes sense as a doctor. Dr. Dimitre Ranev: [00:22:49] 100%. So listeners, look into it if you like pressing buttons and doing surveys. Dr. Jordan Frey: [00:22:55] Yeah, exactly. Dr. Dimitre Ranev: [00:22:56] The other thing I want to ask you about, again with the idea of leveraging your knowledge, medical chart reviews, and perhaps insurance claim reviews as well. Have you done both of these or are you still doing any of these things? Dr. Jordan Frey: [00:23:09] I haven't personally done those just because of time commitment and obviously the blog and stuff, that takes a lot of my time and tends to be a focused side gig of mine. But I know a lot of colleagues who do this and it's really beneficial. And I know initially people get, or doctors get this really like kind of bad feeling when they're like insurance reviews, Oh, insurance is the bad guys or, you know, medical chart reviews are like, you know, they're the bad guys or expert witness work lawyers, they're the bad guys. But you have to think - and the more I've learned about this and got on the inside of it - because those were kind of my initial reactions... Dr. Dimitre Ranev: [00:23:51] Mine too. Dr. Jordan Frey: [00:23:51] ... You know, it's really kind of a disservice if you have that reaction because like it or not, again, depending on where you are in the world and stuff, but pretty much everywhere, you know, lawyers, malpractice cases or whatever, insurance claims chart review, these things are just realities of medicine currently. And yes, once we all become financially independent doctors, hopefully we can eliminate that. But there are current realities and there's a need for ethical, responsible, knowledgeable physicians to assist with this. And a lot of times - and this is making a sweeping generalization - but a lot of times the physicians who maybe are doing this aren't as knowledgeable or as plugged in as they could be. And I'll give an example of this. You know, even myself doing, again on the US side, we have private and public insurance, but it's largely private. And so, you know, I'll have these surgeries that I'll need to do. Like sometimes I'll get a surgery that's a combined case. So a patient that has breast cancer is getting a mastectomy. So it's getting their breast removed to remove the cancer, and then getting breast reconstruction, which is by law a protected and covered procedure for them, for psychosocial reasons and everything that's been shown to be beneficial. But anyway, sometimes these, which you would think is just like it comes across an insurance person's desk and it's like, okay, yes, that's obviously covered, sometimes these get denied and then I have to do peer to peer review and I'm doing a peer to peer review with like, you know, a psychiatrist or something, who, to be fair to them, doesn't quite understand. But then like continues to deny this claim, which is just a horrible thing. And if there was just someone on the other side who was a little bit better educated or familiar with the procedure, familiar with this area, it would go a lot smoother and be better for patient care. It'd be better, frankly, for the insurance company because ultimately they are going to have to accept this because it's literally a law in the US and now they're just wasting their own resources at this point. So it's beneficial on all sides. And same thing with the malpractice review. You know, people worry about, oh, I'm just screwing - I guess, pardon my language on that - but I'm just screwing other physicians because I'm like testifying against them or something. A) that's not really the case. A lot of times you're supporting physicians who are being sued by patients or other entities or something like that. But you want to protect good patient care, and that's what you're doing by offering your services. You know, you are a very qualified, knowledgeable person. You want to make sure that qualified and knowledgeable physicians are being supported or if there is actual malpractice happening, that patients are being protected. So in that sense, I do think it's really valuable. And, so yeah, it is. And you get compensated well for doing that for your time. And it's actually pretty, I don't want to say easy to get plugged in, but like the opportunities are there. Dr. Dimitre Ranev: [00:27:28] Yep. Dr. Jordan Frey: [00:27:28] Like there is, there is a need for your knowledge and expertise in these arenas and you just kind of need to know where to look for it. But once you get started, like it's certainly possible if you are looking to get out of clinical medicine for whatever reason, to completely replace your income by doing these sort of endeavours. And alternatively, as a side gig, it can make you a good amount of money as a side gig. So definitely things to look into. And again, I haven't at this point because my other side gig, my other passion, kind of takes up that time. But it's something I'm learning more and more about and I'm even, you know, taking a course to learn about expert witness work and kind of how to find it, and how to be the best at it, because it is something in the future that I think I will do. Dr. Dimitre Ranev: [00:28:26] So I did insurance check reviews and I agree with you. If anything, it also helps you as a doctor to your patients being able to, when they do have to deal with insurance companies, you know how the process works so you can actually advocate better for them. Dr. Jordan Frey: [00:28:40] Yeah, that makes sense. Dr. Dimitre Ranev: [00:28:41] Yeah. And I've done that before and it pays very well. It pays better than clinical work and you need good guys there. You're right. You need good guys because it helps everybody. Patients, insurance companies, the system. And there's a lot of demand in Canada, in the US obviously. So if a listener is interested, I can give, I mean, I know with the companies in Canada what they are, but obviously this is different, but I can give some references. So I know we're close to the end, even though I have like a thousand questions here, but I'll finish off because, you know, Physician Empowerment talks a lot about real estate. So real estate also could be a side gig, obviously. Dr. Jordan Frey: [00:29:21] Yes. Dr. Jordan Frey: [00:29:21] And just quickly, I know you have to go soon, but can you tell me a bit about that? Like how you got into real estate, how much time are you spending on it, and what specific things you invested in when it comes to real estate, if you don't mind. Dr. Jordan Frey: [00:29:33] Yeah, I really enjoy real estate and think it's an awesome side gig, particularly for physicians. And I say that now. The first time I heard other physicians talking about real estate investing, I had what I think is a typical response, which is, What are you crazy? Like, don't have the time for this. And I do probably what's considered the most time-intensive form of real estate investing, or active real estate investing. So what I do is - and I say I, it's my wife and I - but we buy small multifamily properties like duplexes or triplexes within the Buffalo, New York area, which is where we live. You certainly don't have to buy them where you live. You can do it from afar, but we enjoy investing in our community, so we buy them and we rent them out and we manage them myself, my wife and now my brother who we've hired on to kind of assist us with it as we've grown the number of properties that we have. But it's really, really a powerful thing for a number of reasons. Obviously, you get cash flow from the rent that comes in and you make money above the mortgage you're paying, etcetera. You also build equity as your tenants pay off the mortgage. There are significant tax advantages, especially if you achieve something called real estate professional tax status in the US, which allows you to use these paper losses that exist in real estate to offset your active doctor income. Dr. Dimitre Ranev: [00:31:07] Interesting. Interesting. Dr. Jordan Frey: [00:31:09] That's a really powerful thing. And we do that because my wife is a real estate professional from a tax standpoint, and that's just based on the number of hours you put into participating in your property. But the real beautiful thing about real estate is, you know, our clinical work as doctors, when you really break it down, we're in the service industry. Our income is tied to the work that we put in in a 1 to 1 fashion. Real estate, you know, doing active real estate like I do, buying properties, renting them out, managing them, there is active work that goes into it, a lot on the front end. But then that 1 to 1 ratio starts to get broken. All of a sudden it becomes that there's not a lot of work, especially as you start to automate your processes and get more experience, etcetera, to where you're not really working a lot. And that money keeps coming in, so it becomes more passive income and that's really powerful. You know, we started two years ago. We bought our first place, just a small duplex, and now we've built it up to where we own seven places, which is 16 units, and that brings in $10,000 a month in net income for us. And a lot of that is tax protected. So that's income after mortgages, after maintenance, after things like that. So that's really powerful. And now we just, the way we've been able to scale so quickly is we just take that income and we use it to invest in more real estate. But eventually what it'll do is just become extra income that we can use for, you know, fun stuff. For vacations, for our kids' education, and for our retirement. So that is really powerful and that's like a whole podcast episode in itself. Dr. Dimitre Ranev: [00:33:07] I'd love to. I'd love to, just thinking, I want to talk to you again. Dr. Jordan Frey: [00:33:11] We can definitely, definitely we can do that. And there's tons of resources on my site about it and I'm very open. You know, it's not all, it's not all biscuits and gravy. You know, there's hiccups and there's stuff along the way. It's ultimately very worth it. But I try to be even, I'm obviously very open about our successes, but I am equally open about our mistakes and about the tough parts because I think not enough people do that. But it's really, really a powerful thing and that's what has accelerated our wealth building or our path to financial freedom, kind of more than anything else. And I'll say there are much more passive ways to do it. You can, you can do what we do, but also use a property management company to manage the day-to-day workings for you. You can invest in things like syndications, which is basically you are, you're just a money person, you just contribute the money. Someone else does all the investment aspects for you and there's pros and cons to all of this, but there's lots of ways that doctors can be involved in real estate investing very successfully. Dr. Dimitre Ranev: [00:34:21] Yeah, I have to have you back. This is so fascinating, Jordan. Dr. Jordan Frey: [00:34:26] And I'm happy to do it. Dr. Dimitre Ranev: [00:34:28] Listen, thank you so much for your time. I suggest the listeners take a look at the website. It's really good. Take a look at the course. And Jordan, thank you again. We have to talk about real estate because you have so much knowledge, I have so many questions. But this is, it's about time to stop. So all the best, Jordan. Hopefully we speak in the future. Dr. Jordan Frey: [00:34:47] Absolutely. Thanks so much for having me again, Dimitre. Dr. Dimitre Ranev: [00:34:49] Take care. Bye. Dr. Kevin Mailo: [00:34:50] Thank you so much for listening to the Physician Empowerment Podcast. If you're ready to take those next steps in transforming your practice, finances or personal well-being, then come and join us at PhysEmpowerment.ca - P H Y S Empowerment dot ca - to learn more about how we can help. If today's episode resonated with you I'd really appreciate it if you would share our podcast with a colleague or friend. And head over to Apple Podcasts to give us a five-star rating and review. If you've got feedback, questions or suggestions for future episode topics, we'd love to hear from you. If you want to join us and be interviewed and share some of your story, we'd absolutely love that as well. Please send me an email at KMailo@PhysEmpowerment.ca. Thank you again for listening. Bye.

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