This is a little different from most Friday Q&As.  This was a post on Sermo, with 437 responses in about a week.  I’m going to cite what I thought were 15 of the best ones.  This entire site consists of my answer to the question.

Q.

How can I become a millionaire as a physician?  Straightforward question. No BS please. I would love to retire in 10 years, but worked in Massachusetts as an employed doc and realize that my present situation – income minus lifestyle expenses is definitely not cutting it. And yes, I know I could drink only water and drive a used prius and live in a shack…My question is – how can I EARN more, a lot more? How have YOU done well?

A.

1. Income vs out go. Live below your means.  I still eat hamburgers off the grill instead of only fillet mignon steaks. I do have some toys. I’ve got the same Jag that I purchased 11 years ago. Amazing how cheap title and taxes are. Still purrs down the road. Still have the first wife, same house for 20+ years.  Put more than you think you need to away before you see your paycheck. Can’t spend what you don’t have. Don’t have kids.

2. For most docs the truth is that nothing will pay more per hour that what we earn in clinical medicine. Want to earn more as a doc? Straightforward way is to move to a more lucrative practice. There are a lot of docs who live in flyover country and Alaska who do really well. Also save well and learn about investing.

3. Live frugally, spend wisely, invest conservatively and keep working.  Read The Millionaire Next Door.


4. The days where you could be a good doc with a good practice and become a millionaire from that alone are all but gone, except for a few specialties. It also used to be that you could work harder/longer and make more money. That too has become harder to do, especially as a PCP. Now, to retire early and well, you almost have to have made some money from a outside source, investments, real estate, side business etc.  [Ed note- Almost being the key word.]

5. First of all, why do you want to be a millionaire?  Then the next question is? How many millions? Is 1 enough? or 2 , or 10?  You will never be satisfied, whatever you make.  Like many said above, live below your means, and try to find happiness in things you do well.  Be nice to your family. Have 1 or 2 good friends and spend time with them.  Live life to the fullest. Being a millionaire really doesn’t give you happiness, if that is what you are aiming at.  Being jealous of the neighbor who is an investment banker living in a million dollar home is only going to bring sadness in your life. Move away and live in a different community !!!

6. I once heard Bill Gates say that the only way to become really rich is to be in a position where you make money while you are sleeping. He said that many copies of Microsoft office were sold throughtout the world while he was asleep. I do not know many docs that make money while they are sleeping.

7. $150/hr x 12=$1800/shift x 12 shifts/month =$21600/month x 12 months/year =$259200/year. Live on <$100k/year. Save the rest. Bingo, done in 10 yrs.

8. I can tell you my story – I recently turned 40, and have a plump 7 figures in my brokerage account. I’ve done well with investments, in particular a well timed, long investment in the markets upon the election of Pres Obama.
I’ve worked in academic medicine, have 2 kids in private schools, but live in a modest home. My wife does work full time, but earns less than half my salary.  We take 2-3 decent vacations a year (places like Hawaii, Costa Rica, Europe, etc), but generally live well within our means. We don’t go out to dinner regularly, we don’t go out to movies regularly. We spend lots of time at the public library, etc.

9. THINK OUTSIDE MEDICINE. Most physicians are trapped in a SINGLE realm of thinking. Here is my advice to you: 1. NARROW your practice to the 3 to 4 areas you do best. 2. Transition your practice to become less dependent on 3rd party payors (if you are an independent practitioner) and which carry the least amount of risk. 3. Team up with your spouse to start ventures outside of medicine. Demanding careers as doctors often stifle the dreams and ambitions of our spouses. 4. Invent a product. 5. Become an effective speaker and presenter. Even a semi-professional speaker will not accept an engagement below $3,000. Physicians undercharge for their value and their time as speakers and presenters. 6. Pay off your debts and live slightly BELOW your means.

10. Move to a place – if you can tolerate the lifestyle – a bit out of the way. Income will be the same or even maybe more, but overhead – your house mainly – drops. It works. Lots of well to do docs in dem dere out of the way places. But the key thing; could you tolerate the lifestyle for 10 or so years? Like you, I wanted out, so added it up, made-do with the lifestyle, saved up the money, and it worked. But don’t expect that after a long hard day, you are going to be able to say, hey honey let’s go jump in the car, hang out downtown, and re-invigorate ourselves. The option doesn’t exist.


11. Follow the good old advise of buying what you need not what you want. I think if you cannot park your car in the garage because it is being used a storage, you are spending too much on stuff.  Save 30% of your income and invest in index funds.

12. I hit that mark before 40 as a part time FP and a husband who refused to work. I have always been thrifty, always maxed out retirement plans, and started saving with my first job. Having children who studied and earned scholarships to private schools helps a lot. When you start saving at a young age you have time to compound your money, too. I have always taken nice vacations, but have not been extravagant.

13. If you earn 250K annually and pay 50K annually in taxes (if you take advantage of tax advantaged investments this is feasible), put away 100K annually and that leaves 100K to live on. After ten years this would give you $1 million, assuming zero growth in the money you put away.

14. This allows you 100K annually to live on, post tax and post investments. If you can’t live on 100K annually, you are doing it wrong. This is a pipe dream for most Americans, many never earn anywhere close to this level much less have it to live on after investments and taxes.

15. I cannot fathom why, if you are 10 years from retiring, and assuming you are 50+, you are not a millionaire now. My daughter just finished residency, makes $125K working for a medical school teaching and in clinic and has begun saving at level that will have her in excess of $1 Million in 15 years assuming reasonably expectable gains.  Too many docs live the high life and don’t save. I have little sympathy for them. Anyone who makes a reasonable living and does not may out their 401k, SEP, Keogh, etc. is foolish. Spending too lavishly is often the reason folks find themselves where they are. I can trace a fair amount of my wealth to the fact that I have never driven anything more luxe than an Accord or Camry, and then I keep those for a long time. Those got me everywhere I needed to go. Ironically, at 66 I could easily afford a BMW or the like and may do it since my future is secure.

What do you think?  Comment below.