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Doctors at Work Podcast.

Episode #60

What are the benefits of a portfolio career?

Mat Daniel

07/02/2024

Whereas traditional medical careers have involved staying in the same place until retirement, more and more doctors are embracing careers based on variety and mobility. In this episode, Daniel tells me about his own portfolio career that involves clinical work in different settings, as well as non-clinical work. He outlines that this gives him flexibility, variety, and learning opportunities, and each clinical career contributes to him being a better doctor in the other careers. The different careers meet different things that he desires in his work. He also outlines a mindset interested in growth and development, and the importance of taking up opportunities as they arise. Finally, we also discuss money. This may be a dirty topic for medics, but in our discussions we discover that actually financial (as well as physical and psychological) health is important if we are to give the best we can to our patients.

Listen at https://matdaniel.net or watch on www.youtube.com/@dr-coach/videos

Daniel Lamp is an Australian doctor, who has a portfolio career spanning General Practice, Emergency, and telehealth medicine. Outside of medicine, he runs a podcast promoting the concept of financial health, as too often doctors are not taught personal finances and often don’t know where to start when it comes to investing. Connect with Daniel on LinkedIn, and check out his podcast ‘Passive Income Doctor’ at passiveincomedoctor.buzzsprout.com

Podcast Transcript

Welcome to Doctors at Work. My name is Mat Daniel and this podcast is about doctors careers. Today, we’re talking about portfolio career. Now, traditional medical careers have involved staying in the same place until retirement, but more and more doctors are embracing careers based on variety and mobility.

In this episode, Daniel Lamb tells me that his own portfolio career involves clinical work in different settings, as well as non clinical work. He outlines that this gives him flexibility, variety, and learning opportunities, and each clinical career contributes to him being a better doctor in the other careers.

The different careers meet different things that he desires in his work. He also outlines a mindset that is interested in growth and development, and the importance of taking up opportunities as they arise. Finally, we also discuss money. Now this may be a dirty topic for medics, but in our discussions we discovered that actually financial, as well as physical and psychological health is important, if we are to give the best to our patients.

Welcome Daniel, tell me a little bit about  yourself.

Yeah. My name is Daniel Lamp. I’m an Australian doctor working in general practice. I am based in Sydney. I love the flexibility of general practice. Um, I guess what you would call a portfolio GP. I work part time in kind of traditional GP clinic. But also at the moment doing some telehealth hospital in the homework and also doing some hospital kind of ward cover work just to maintain some of that as well.

And I guess outside of clinical medicine, um, I have an interest in finances and have my own podcasts promoting the idea that doctors need to look after their financial health.  And they invited you to talk about portfolio careers. What is a portfolio career?

So basically. I think the traditional thinking is you just, you know, do one thing, one path and you do that, you know, I guess until retirement, but I think more and more, um, younger doctors and medical students are seeing.

Um, there’s different avenues that you can do both clinical and nonclinical. Um, so for myself, um, I think I wouldn’t enjoy doing, you know, five, six days a week of seeing, you know, 40 patients a day in a traditional general practice setting. Um, you know, a lot of my colleagues, um,  talk about, you know, burnout from that.

So I guess, you know, You can have other interests in other areas of medicine, um, as I touched on, um, at the moment, doing some work in the telehealth space and also as well, um, doing some work for, um, the hospitals, um, you know, kind of state, state government work.

I’m interested in how you got started in that.

Did you wake up one morning and think that’s it, you know, I’m going to have a portfolio career or, you know, how, how did all of this happen?

Yeah.  It definitely wasn’t planned as such, um, I knew, um, in medical school and in junior medical years. You know, tossing up different specialties, um, you know, considering critical care medicine at one point, such as emergency medicine.

Um, but then I wanted kind of, you know, better  kind of more regular working hours and also kind of seeing the impact of chronic disease. So that’s why I jumped into general practice training.  And, um, yeah, general practice training was interesting, um, and, but even throughout my general practice registrar use, I did a little bit of, um, locum emergency department work, uh, partly to keep up my skills, but also  partly, uh, to, um, pay the bills as well.

So I kind of, you could say fell into that, or there was an opportunity.  And then later the hospital, you know, said, you know, there’s some other work. That is, um, ongoing. Would you like to do that? Um, and I was happy working there. Um, so that’s how I got into that one. And in regards to my telehealth job. I’m  trying to remember actually, I think I might’ve seen an ad or had a colleague talk about it.

And then I inquired, they were looking to hire at the time. Um, and yeah, I’ve stayed with them since.

How did the different careers interact? How does one role support the other role?

I think.  Staying in the hospital system, um, a little bit and having some of those more, uh, hands on skills and also talking face to face with some of the specialists, physicians, you know, cardiologists, geriatricians, I think does improve my general practice, um, setting as well.

You know, sometimes general practice, when it’s just you sitting in the room with the patient. It can be a little bit isolating, a little bit lonely. So, you know, one thing I missed from the hospital environment was having that more teamwork collegiality. So, you know, you could say, you know, kind of best of both worlds, um, obviously the hospital environments.

Perfect as well, you know, sometimes very under resourced, you know, pager going off left, right, and center, um, you know, running around dealing with lots of different things, um, you know, bureaucracy, et cetera, et cetera.  I think having a bit of  fit in both camps, I think has, um,  helped my own personal satisfaction, but I think also maybe a better doctor as well.

I’m interested in, in the phrase best of both words, because best of best of all worlds,  I guess you could sort of say it’s, it’s the worst of all worlds, but there’s a mindset there, isn’t it? So it’s, it’s, so what I’m hearing you saying is that, that different, different bits of your career that adds, it meets different needs and it adds stuff into your life.

It adds additional meaning and it adds additional satisfaction that, that one role. can’t meet. And, you know, and maybe the hospital roles, they, they, they don’t meet, you mentioned your interest in chronic disease, you know, in hospital, you won’t necessarily see that. But in general practice, you won’t necessarily have the kind of teamwork.

So different roles bring different aspects. Um,  um,  the other people that, you know, that have portfolio careers, you know, what are the reasons that other people do them? How do other people get into it?  Um,

yeah, that’s a good question. I think  someone  Um, my colleagues that I know do a little bit work outside traditional general practice.

Um,  I think also as well, the portfolio career has become more and more popular. Um, there’s a Facebook group for doctors in Australia. Uh, um, it’s called creative careers in medicine. Um, I think it’s quite a big group now. I think it could be like,  don’t quote me 30, 000 members or something. So basically there is a huge interest in kind of,  um,  careers kind of beyond.

Um, you know, traditional, you know, this specialty, that specialty and, and these roles are both clinical and non clinical. Um,  I know some people, you know, might do consulting for, um, private equity or pharmaceutical companies or digital health startups. So, um,  yeah, so basically there’s a lot of different roles and I think a lot of appetite for portfolio careers.

When I did my fellowship in Australia, which was in 2011 2012. I, I think that that’s where for me, the idea of portfolio career really appeared because what I saw was that, that, you know, people worked as doctors, but, but one day they would be in their private rooms, Tuesdays would be a public hospital clinic, Wednesday, private operating Thursday, public hospital operating, you know, or, or versions of that.

So, so people moved. between the different contexts and they saw, they saw different types of patients, they worked with different teams. Um, and the impression that I got was that, that the doctors were much more satisfied because what I saw is they came and they were doctors. Um, and then they left. They didn’t, they didn’t so much get involved in, in any of the, of the other things that come from being very much embedded in a hospital, whereas I think maybe the way that we work in UK, most of us probably sit just within one hospital or just within one practice or just within one setting.

Um, I mean, the advantage is that, you know, you are, you are completely embedded in that department, um, or that clinic and, you know, and that’s good. But the downside is that, that everything that happens then becomes very personal. ’cause it’s my department and it affects me. And if there are problems, they’re all, they’re all, they’re my problems and the things for me to solve, you know, we, we take ownership of everything that happens, even though a lot of the time it, it, it is sort of, it isn’t stuff that, that, that, that’s for us to fix.

So, so I think that’s kind of what I took away from Australia was that idea that people come in, they do the medicine. And then they move on to somewhere else and they don’t necessarily get embedded  within one department or, or, or, you know, doing, doing everything, but I guess sort of, you know, for you as an Australian, do people miss that idea that, you know, you don’t belong anywhere, you know, there isn’t, there isn’t someone that’s yours.

Do people miss that? Do you think?

Um,  that’s an interesting question. Um, I think, uh, what you touched on about, yeah, some of the doctors kind of. Go to multiple hospitals, um, you know, see the patients and, um, get out, I think, um, correct me if I’m wrong, but I think that might be the VMO model. So, um, a lot of  surgeons, um, and physicians, uh, uh, visiting medical offices or VMOs.

Um, I think different States might call them slightly differently while I know some, uh, staff specialists and then staff specialists, I think often have a. Uh, a fixed salary, um, and also some, uh, nonclinical duties, you know, such as, uh, teaching juniors or, um, you know, maybe hospital accreditation or sitting in on meetings, um, and things like that.

So I think, um, and there’s pros and cons talking to some physicians, um, that I work with about, you know, Visiting maker officer versus, uh, staff specialist. Um, but, uh, yeah, I’m not sure if that’s exactly what you’re  getting.

That’s absolutely, it’s sort of, you know, in the, in the UK system, um, and I suspect probably also in us is, you know, everybody would be a staff specialist.

You belong to a department and you’re there more or less full time, um, versus the model that I.  Maybe experience on my fellowship was the visiting medical officers, people go from from hospital to hospital from clinic to clinic. So I’m interested. What, what, what are your colleagues? What are they when they’re trying to decide people that are, you know, newly qualified in the thinking, which routes do I go down?

What are people talking about?

So obviously from my limited experience, um, some of the physicians, um, have said that some hospitals are now pushing more for the, uh, staff specialists rather than, um, the VMO contracts, uh, maybe it’s to do with, um, uh, funding. Um, I know  staff specialists sometimes, um, when they get, uh,  you know, answering calls or seeing extra patients, you know, they still get.

The, you know, normal salary while obviously a visiting medical officer, you know, get paid per job or per operation or per, uh, patient they see. So I guess they’re kind of, uh, different models, but yeah, I mean, I don’t have personal experience myself. It’s just kind of talking to colleagues and yeah, I think the advantage may

be of the, of the staff specialists or which would be the, you know, the UK equivalent model would be that if you know, you’re going to be somewhere.

For 20 years,  the advantage is that, you know, you can make changes. Yeah. So,  you know, this is my department, I’m going to be here for 20 years. Um, and then that means that I, I invest in that department,  you know, sort of, I, I, I grow it, um, and, um, then, you know, I, I can contribute, I can make changes. So, you know, that, that’s really satisfying.

I think staff specialists also get, um, yeah, you know, annual leave, long service leave, professional development, um, allowances, things like that. Yeah.

Um, and I guess sort of in portfolio careers, I’m trying to think of the two, are the two models exclusive? I mean, I suppose they’re not because, you know, because you, you, you can be somewhere for, for two days a week and that’s two days a week job for 20 years.

And grow it, develop it. So, so yeah, so maybe, maybe the two models are not as exclusive.

Yeah. I know some star specialists, um, it might be 0. 2 full time equivalent. So which would be, you know, kind of like, uh, one day a week. So, um, yeah.

Okay. Um, you, you, you talked about flexibility, so tell me a little bit more about the flexibility that comes in a portfolio career.

Yeah. So yeah, one thing, um, about general practice, um, in Australia anyway, is. The ability to, you know, within reason, you know, choose your hours, choose your days. And then another one is, you know, if you’re trying to book in a holiday, um, to Japan or Europe, you know, you can just let the practice manager know you don’t need, you know, submit it a year in advance and ask for approval from, you know, head of department or, you know.

Uh, the medical officer, admin manager, you know, um,  and another thing about the flexibility is, um, you know, you can choose within reason, kind of the style of practice, you know, some people like the slower medicine, um, some people, you know, within general practice might have a niche or a special interest.

You know, it could be woman’s health, it could be mental health, it could be skin cancer.  You know, it’s quite flexible in that regards to, and you can advertise yourself,  um, and be seen in the community as a, you know, kind of, uh, special interest in that area. And then you can attract those patients and build up your own private practice that way.

So I guess that’s one aspect of the flexibility.  Yeah.

Okay. Um, and I think also before coming on air, we were talking about the cow, how career decisions might link into burnout. So can you tell me a little bit more about, you know, how, how burnout affects our career decision making?  Uh, yes. You know, burnout very, um, you know, topical.

You know, in the media every now and then, but I think doctors. Yeah. And I think there’s some studies that doctors in particular, you know, kind of a high pressure job and rightly so, you know, high stakes, uh, often can have symptoms of, uh, a burnout. Um, so for myself, you know, when I was working, uh, you know, five.

Days or five, five and a half days of, um, traditional general practice, um, in, for example, in what’s called a bulk billing clinic, you know, where it works on, you know,  just from the business model, high turnover, you know, saying, you know, 40, even 50 patients a day, um, you know, it can be quite, uh, draining. At times,  and, um, you know, for those who, um, just to give a brief explanation about, uh, bulk billing.

So in Australia, um, specialists and, and also, um, GP specialists can choose to just accept the Medicare rebate as the full payment. From the patient, unfortunately, though, Medicare payments have not been, um, you know, indexed to inflation for like the last 10 years. So effectively if you were, um, just accepting that it’s a, you know, real pay cut  and in the background of, you know.

Inflation, you know, rising  practice costs, electricity, staffing costs, medical indemnity insurance, you know, it hasn’t become, uh, sustainable. Um, so I found myself, you know, with some symptoms of burnout, um, you know, working many hours and also,  I guess, you know, and not just the pay, I think it’s also, um, the idea of.

Um, being seen as, uh, valuable and, and valued.  So now, um, so once I obtained my fellowship, you know, re evaluated my options, I decided to just do part time general practice and also choose a clinic that, um, is kind of mixed or private billing, you know, where patients, you know, pay a private fee and then they claim back, um, that.

Uh, you know, Medicare rebate from the government, um, you know, it’s really a patient rebate rather than the government paying the doctor directly. So I think that has helped and also as well pursuing, um. Other interests, hobbies, but then, as I said, also as well, you know, doing some, uh, telehealth and also some hospital work.

Um, I think just  having that, um, kind of, yeah, well, well rounded career, I would say.

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Thank you. Now on with the show.  Let’s talk a little bit more about money and finances then. So what’s the, what’s the relationship between portfolio careers and money?

Um,  so  I wouldn’t say necessarily, um, portfolio  created by default, you can earn more, but I think,  um, but, uh, I can, you know, for example, you can do some, uh, local work, you know, some short term work, uh, often, um, you know, obviously Australia is a geographically, um, very huge country and yeah, in a lot of the rural areas, you know, some of the longstanding doctors,  uh, retiring or cutting down their work.

Um, or if they go on holiday and often, you know, they’re without a doctor. And, you know, kind of these short term locum doctors fill in, um, the gap and sometimes these roles can, um, uh, pay quite a lot of  money. Um, and that is, uh, one aspect as well. I mean, there are some other benefits as well, not just monetary, but also, you know, you get to experience a new health system, a new way of thinking.

Um, you know, possibly different, uh, disease pathology as well. You know, for example, if you work up, um, you know, in the, in the tropics, you know, far North Queensland, Northern territory, you know, it’s, um, quite interesting and you know, different medicine to say, you know, metropolitan Sydney.  Um,  and  yeah, I, I am interested in finances myself and I created a podcast called passive income doctor, where basically I saw a lot of my colleagues kind of making, um, you know, poor financial decisions, often not of their own fault, just, you know, we’re not taught in medical school, um, and often.

You know, sometimes accountant or, um, uh, so called financial advisor might recommend a particular aspect. And if you just kind of outsource all understanding and just say here, manage my money, you know, often you hear some horror stories. So that’s why, um,  uh, a passion project of mine is creating this podcast and kind of raising awareness.

And I think, yeah, tying it back to the question, you know, portfolio career.  Allows me to pursue, you know, interest, even outside of medicine.

What’s about, um, long term job security in portfolio careers?

Yeah. So  I guess with, um, security, for example, if you’re in a salary position with the government, such as a staff specialist or a salary position with say Aboriginal medical service.

Um, yeah, I guess you could argue might be higher, uh, job security. Um, although I’m pretty sure even those ones are often, you know, one year or two year contracts from my understanding. And I think as doctors overall, you know, would recognize, you know, overall privilege position to be in, you know, with, um, relatively high job security as compared to say, um, you know, other people working in, uh, you know, finance or,  um, you know, banks where, you know, If the business goes under, you know, you lose your job, I think with doctors, um,  especially at the moment anyway, in Australia, there’s a shortage of doctors generally, and you know, with an aging population, older population, still a  quite a high demand for doctors.

So I think  doctors that are considering a portfolio career shouldn’t  fear kind of job um, security and often as well, you know, all these roles, um, You know, when I started medical school, which not, not too long ago, um, you know, I would have never thought, you know, conducting, you know, just medicine purely through telehealth, you know, and I guess we, you know, times are changing, technologies change.

And I guess if we kind of embrace opportunities, um, with open arms, I think, you know, we don’t need to fear, uh, job insecurity. We can kind of, yeah, like choose your own adventure, you know, choose your own. Um, roles and jobs, um, you know, build  a private practice or improve a hospital system and you know, you can take action.

Yeah.  So this to me sounds

like a type of mindset. Yes. Cause you know, cause the mindset isn’t, I, I must have this income. I must have this security. The mindset that you have climbing is. This is interesting. This is interesting. I can learn here. I can grow there. There’s going to be something new and I’m going to jump and take advantage of it.

And I won’t struggle because there’s always going to be a need for doctors. I’ll, I’ll do whatever it needs to be. You know, I might not get my first choice of job and that’s fine. I’ll do something, but it doesn’t matter if it’s not my first choice of job because I’ll do it for two, three years and then something better is going to come along.

So, so that, that, that to me sounds like a very. a very specific mindset based on personal growth and personal development and taking opportunities one, one, one, one at a time, you know, rather than a mindset that says it’s all too difficult. I can’t do that. I must have a hundred percent job security. Yeah.

Does that sound a fair summary of the kind of mindset you’re outlining?

Yeah, definitely. I think Um, obviously, um, you know, doctors, you know, typically very, you know, high achieving and kind of, uh, very risk adverse. Um, but I think, yeah, in, in, in, in, in life and, um, you know, even our career, you know, we have to be still be open.

Uh, to change and, you know, um, you know, we might set off, yeah, on one particular path or very set on, you know, one particular specialty or one particular role. And then, but if you’re not successful, I think you can always, um, pivot and you never know, you know, something else, um, that you end up doing, you might really like, and you know, if you don’t try, you won’t know.

I think related to that, if I think with with my own, um, kind of career development, coaching type work that I do in my portfolio, a lot of that for me initially didn’t attract any particular money. I did it because I enjoyed it. You know, I loved it. And that’s the reason. Um, but actually sort of over time, it’s something that does generate money.

So, you know, if you go into a very clear medical role, then, you know, yes, there is income attached straight away. Um, but equally, I think if somebody is interested, um, so like, again, you know, another thing for me would be, you know, maybe working in, in, in the med tech sector. And again, often for me, that hasn’t initially created any income, but then in the long term, it does create income.

So it’s, so it’s taking a step and saying, okay, I’m really enjoying that. And I’m going to do it and I love doing it. I do it because I enjoy it. And yes, I’m not getting paid for it. Um, but often those kind of roles, even then they still do end up generating income, um, in the long term. So, but, but the income is delayed rather than immediate.

Yeah.  Um, okay. So, um, let’s just go back to kind of, you talked about the, the, um, financial health. Are we as doctors, are we good with money?

Um, so I think, you know, talking to different accountants and financial planners, you know, invariably the short answer is no. And I mean, it’s, it’s interesting, you know, like where does this stereotype or, um, you know, come from?

I think, you know, many things, you know, one might be the mindset of, Oh, Hey, you know, during my medical school years or junior doctor’s years. You know, I don’t really need to care about, um, investing or, you know, saving money, you know, because once I become fully qualified specialist, I’m going to be making my big money and then I can, you  know, care about debts and investing then, you know, and, but, you know, in investing, you know, the time is so important, you know, um, Warren Buffett talks about the importance of compound growth.

And so if you start investing in your twenties, you know, versus. Say in your, you know, 10 years later, 15 years later, that can make a whole lot of difference later on. So that’s probably one aspect. And another, you know, is that, um, you know, you know, you can’t really blame doctors, you know, not really taught this in medical school, university.

Um, you know, it’s often a taboo subject, you know, like, you know,  it’s kind of,  um, not just within doctors, I guess, in lots of societies, not seen as a, uh,  Easy topic of conversation to, to talk about, you know, how much you’re earning and what are you investing and, you know, things like that. And if you don’t talk about it, then how can you improve or, you know, how can you generate ideas?

Um, and another aspect is, uh, yeah, you know, everyone’s got the perception that. Um, doctors, um, inherently, uh, uh, super wealthy,  but you know, um, you know, the starting salary, um, when I started as a intern doctor was base salary of 60 K, you know, and I think in the UK, um, from my understanding is, um, even lower.

Um, and,  um,  so,  uh, and this is after, you know, going through, you know, possibly undergraduate. Uh, university and then also, uh, postgraduate medical school, for example. So you’re earning this at, you know, say 25, 26, and by the time you’re fully qualified, depending on what specialty you might be in your early to mid thirties, um, or even, um, later.

So  I think, um, the perception that, you know, all doctors inherently earning lots of money is, is false. And so therefore we should.  Um,  and understanding of where our finances sit, we should, uh, educate ourselves  and it’s very hard, you know, often, you know, you might be, uh, busy studying for exams, um, or working over time  and.

Yeah, it’s very hard to, you know, set aside time to, uh, for example, set a budget or set or learn how to invest, um, or try and find a good accountant, um, um, you know, et cetera, et cetera. But I think, you know, often we’re so busy looking after our patients, um, that, you know, often. We neglect to look after our own, uh, you know, mental health, physical health, financial health.

Now I remember, you know, running around as a junior doctor and, you know, skipping lunch breaks just so you could facilitate, um, uh, early, uh, discharge of patients and, you know, make, make the nurse unit manager happy. Um. Or in a general practice, squeezing an extra patient. So then you don’t have a lunch break or toilet break, you know, which  is, I think it’s important to put your own physical health, um, as a priority as well.

Um, and then similarly, um, you know, financial health, you know, if. We’re working so hard and, you know, having a valuable role in society, but then if we make poor financial decisions that set us back, you know, over the longterm, hundreds of thousands or millions of dollars,  you know, then that’s, um, not a very good outcome.

So  in my podcast, briefly, I talk about, you know, turning our active income towards passive income so that making your money work harder for you. Um, not just you, you know, working 80, a hundred hour weeks, um, just to get by

and there’s something interesting there, you know, in terms of looking after ourselves and both, you know, physically, psychologically.

As well as financially that, that, that for me,  that, that, that supports good patient care. Yeah, and kind of I think like, well, how does, how does you go to support good patient care? But it’s one of the things that, you know, maybe I’ve experienced in my past career, probably similar to you is that you run around all the time and all the time you’re, you’re giving to others, you’re looking after others.

And, you know, that’s admirable and that’s very good. The problem with that is it’s not sustainable.

Definitely.

If all the time you’re, you’re, you’re giving and you’re looking after other people, then you, you, you’re not going to manage to sustain that kind of career in the long term. Yeah. You can do it for you for one year, two year, five years,  but you know, sort of 10 years down the line where you’ve skipped every lunch break and et cetera, and you’re unhealthy and you’re overweight.

I mean, I was heavily overweight at once. not, not, not now. Um, but you, you, you reached a stage where you’re not healthy and then because you’re not physically and psychologically healthy, you cannot. deliver for your patients, what you might want to, or worse, you find yourself being resentful because you say, well, you know, all the time I’m doing this, you know, who’s, who’s looking out for me.

So, you know, you burn out, you become resentful. And even if you avoid burning out and being resentful, you are, you are not physically. fit in well enough. And paradoxically, the very thing that you sort of say, I want to look after our others, you know, that’s the starting point for us as doctors. But paradoxically, if we don’t look after ourselves, we cannot deliver the very thing that we want to deliver, at least not, um, in the long term.

I quite like, um, the, the, um,  the, the idea of dialing up and down different bits. So to one of my previous podcast guests talk about that, that, okay, I’ve got exam It’s all about exam. I’m not going to pay attention to my family and my health because I’ve got to spend six months revising and then after exam, you say, okay, well, that’s fine.

I now need to look after myself, look after my family. And, you know, and I’m just going to work 95 and it’s going to have to do so. So it’s not that all the time you’re looking after yourself or all the time you’re looking after others. It’s like, you know, for these six months, I’m doing that. Or, you know, Monday, Tuesday, I’m doing this.

Wednesday, Thursday, I’m doing something else. So all the time you’re dialing up and down how you’re doing different things. So, so there’s something there about balance, you know, rather than not, not being me, me, me, or not being you, you, you, but it’s recognizing it needs to go you, me, you, me, you, me, you, me, you, me.

And, you know, that’s the only sustainable thing in the long run.  And certainly, you know, the research data. Um, when it comes to burnout backs that up that that we know that that if people if the the more the more patient focused altruistic somebody is the more likely they are to burn out yeah which is just you know paradoxical isn’t it yeah but if I kind of come back to to money um it it’s interesting that that if I think for looking around UK and you know you in UK we’ve got sort of strikes at the moment that that are Um, um, about a number of things, you know, pay being one of them, um, and, um, the, the, I’m seeing that the, the, the people’s basic financial needs are not met.

Um, that means that, that it’s not, it’s not a question that people have a decent lifestyle. Um, and, um, that enables you to work, but actually sort of people’s basic financial needs are not met, which means that they are not able to deliver the best thing that they can for the patient. So kind of again, you know, going back to your point, how, how all of that.

Um, matters because somebody might say, well, you know, I want to look after my patients. I’m not interested in money and I can say, well, actually, but you know, if you, if you yourself are not in a financially good position, you’re not going to be positioned where you’re going to be able to give.

Yeah. So yeah.

Yeah. And touching on that as well, I think, um, so general practice, um, overwhelmingly in Australia is, um, private practice, you know, and. I guess, you know,  which is a business and, you know, if your business is losing money, then it’s not sustainable. So then, you know, there have been instances where general practice clinics have been unfortunately forced to shut.

So then, you know, how does the patient win in that scenario? Now they don’t have access to, um, a GP service. So I guess, um, yes, you know, it is providing health care and putting the patient, but it has to be a viable business model. So hence, um, it has happened over the last probably one to two years, more and more GP clinics are moving away from that kind of bulk billing where the patient pays zero gap towards the, you know, um, uh, private billing, you know, they might still no gap.

Fee for, you know, certain, um, you know, uh, young kids or, or on a case by case net basis. But then, you know, I guess similar to, you know, um, if you have a certain, you say your lawyer or see your accountant, you know,  usually you have to pay a fee. So similarly, you know, kind of, um,  Medical practitioners, um, you know, kind of, um, there’s more understanding, I think in the community that, um, you know, general practitioners work very hard to get to there and they provide a valuable job in helping chronic disease and preventing patients from, um, you know, ending up in the hospital or, or needing, you know, bypass surgery and things like that, uh, which, um, I think unfortunately is often overlooked.

Um, by the government, but I think it is, um, slowly changing. So yeah, I think it’s a good point where, you know,  Uh, yeah, you know, often don’t want to talk about money, but in a general practice setting, at least, you know, kind of setting the appropriate fees to ensure the practice is viable  and that doctors, um, as well, you know, have, um, enough to support themselves and their family.

Um, you know, uh, on my podcast, I interviewed, um, a doctor who’s come from the UK  to Australia, who’s a proponent of, um, you know, private billing and, you know, patients.  Seeing value and, and, and, um, you know, paying for that. And yeah, it’s interesting, um, what’s happening over in the UK as well.  So there’s a kind of short

term long term paradox that, that we might all say, you know, we, we, we want to, you know, of course we put patients first and, you know, we want to be efficient, um, with our money, um, and, and, you know, and also personal finances.

Um, and in the short term, you can do that for a period of time, but in the long term.  If things are not financially sustainable, then the very thing that we want to do, which is put the patient first, that disappears, you know, like with your example of a private practice, the very thing, you know,  presumably those practices have said, we want to keep the costs down because we want to do the very best for the patients, you know, admirable sort of great idea in the short term, but then in the long term, um, The very thing we put in our patients first, that’s the very thing that has disappeared because of poor financial decisions.

Yeah, and maybe like, you know, on a personal level, sort of, if I think, you know, with me, if I have money to invest in myself, and I have money to, to, to pay for, you know, whether that’s holiday or whether that’s therapy or whether that’s coaching, you know, or, or, or whether it’s time out, whatever it might be, you know, if I, if I can afford to pay that, that makes me a better doctor because it means, you know, when I do go into my work environment, whether, you know, I’m rested, I’m happy, I’m psychologically well.

Um, I’m well trained. I can afford to do CPD. I can afford to do, you know, additional qualifications, master’s degrees, you know, if I want to. But the fact is that all of that, that’s, that’s, I have the money and time and often the two are related. So to invest in myself, but by investing in myself. That actually then makes me a better doctor.

Um, so, so the way thing is, you might say, well, you know, like I’m not, not interested in talking about money, but, but the very, the presence of money means I can invest in myself and making sure that I am, you know, in, in a good. Um, thing that, you know, when I turn up to work, you know, as, as the instrument of healthcare that, that, that I am fine tuned, polished, you know, rested in the optimal position condition means that that, that is the best way that I can deliver the best thing for

my patients.

Yeah. I think definitely. And, you know, I guess it’s, it’s, we’re not, you know, um, you know, the reason I invest is not just, uh, to pursue, you know, material things, you know, I think a lot of doctors would like to, um, have a bit better work life balance, you know, work a bit less, uh, spend more time with the family or, uh, be able to afford, um, to spend time doing pro bono work or doing, um, charity work or, you know, pursuing.

Interest that, you know, don’t, don’t pay very well. So I guess it’s kind of, you know, pursuing that kind of financial independence, um, the reason, you know, what is the reason, you know,  as I said, if, if it is to spend more time with family or to give back to the community, I think that is a good end goal. So therefore, you know, in trying to, um, earn a sufficient wage.

And also investors, well, you know, should not be a taboo or controversial subject.  Let’s,

um, bring us to a close, Daniel, what would be your top tips for doctors at work?

Yeah. So I would say looking back on my career, I think it’s Okay. Um, not to know exactly what specialty you want to do straight out from medical school or, you know, um, first postgraduate year.

It’s okay to take some time, try out different specialties, talk to, um, a doctor slightly ahead of you, or even further ahead of you. Um, to try and gauge what different specialties are like, you know, it’s, it’s not a race is probably my first tip.  Um, my second tip would be, is to consider working in different areas and different roles.

You know, I’ve talked about, um, how portfolio career I have found very beneficial and rewarding. Um, there’s so many different niches and. Roles out there, I think there’s a,  there’s a place for, um, for everyone really in medicine.  And my final point, third point would be, um, uh, to take your financial health seriously, you know, invest, you know, it might be very hard to start, but you can start by, you know, reading, um, a book or listen to podcasts, you know, some,  uh, well known investors such as, uh, Warren Buffett.

Um, you know, try to talk to some of the colleague and see if they’re open minded about it. Um. You know, you can also check out my podcast as well, passive income doctor, where I talk about, you know, mindset, um, and,  um, you know, how to choose the correct advisors. And also for those, um, in Australia, um, you know, one area that I’m very interested in is residential, um, real estate, but definitely I would say to summarize number one.

It’s okay not to know straight away, what specialty you want to do. Number two is to try different roles and be open to opportunities to present. And number three would be to invest.  Thank you very much, Daniel.  Thank you. Thank you for having me.

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