Happiness After Training

Transcription

1 Happiness After Training Stephen Ryu, MD FACS Department of Neurosurgery Palo Alto Medical Foundation Deputy Chief of Neurosurgery Stanford University Hospital Consulting Professor Department of Electrical Engineering Stanford University IEP Fellow Course 22 November 2015 San Diego, CA

2 disclosures consultant nuvasive stryker ldr

3 how to be happy be honest with yourself be prepared to avoid unhappiness learn to communicate choose to be happy

4 becoming a doctor be honest with yourself how important is money? do you care about your family? do you want to do research/teach? do you like cities? do you want to run a business or be employed? if you are an unethical bastard; fine, just be honest about it

5 the perfect job there is no perfect job but there are lots of good jobs don t trust everything anyone says

6 contracts and happiness contract stuff read it really you re a smart person get it in writing or it never happened the need for a lawyer is directly proportional to the number of pages of your employment contract specific things you must know: termination non-compete accounts receivable tail insurance coverage

7 contracts and happiness if you don t do due diligence, then you have no excuse later be prepared they are just as scared of you as you are of them don t jerk them around be professional it s never as bad as you think

8 doctoring and happiness choose to put your patients first, always don t go crazy you are not as good as you think you are trust your partners make sure you have partners you can trust no matter how good you are, you can t make up for experience

9 doctoring and happiness professional development start board certification ASAP courses are for your patient s benefit research / industry involvement companies will say whatever to get your business invest your time carefully and give it time

10 doctoring and happiness learn to code get a CPT guide read coding newsletters don t trust everyone who knows how to code lots of deliberate and inadvertent fraud

11 doctoring and happiness the 3 A s of success able affable available the 3 A s of failure awful arrogant awol

12 staying a doctor 50% of spine surgeons leave their first job within 2 years be honest with yourself maybe your family is unhappy? maybe you suck? maybe you are too greedy? maybe your partners are evil/unethical? maybe a better job came up? all jobs have tradeoffs write the pros and cons down and think

13 staying a doctor medicine and the man FDA on-label indications physician payment sunshine act of 2010 $10/$100 reporting threshold stark laws p.o.d.s ancillaries trust your spider sense

14 staying a doctor outcomes tracking future of medicine patient satisfaction outcomes pay per performance health utilization value

15 staying a doctor you will get sued multiple times? being sued usually has nothing to do with how good a doctor you are if you keep getting sued, though, you probably need help good communication with patients prevents lawsuits

16 money and happiness manage your money you will be amazed how you never seem to have enough money at the end of the day don t trust others entirely to manage your affairs, especially in the office only the paranoid survive andy grove

17 money and happiness $450,000 income $200,000 taxes $60,000 mortgage/housing (1 mil) $40,000 retirement savings $15,000 debt service $12,000 insurance $14,000 2 cars (1.3x for bmw; 2x for porsche) $18,000 daycare/preschool $30k+ for private school per child this is how I roll it seems $5,000 per month to live on and save and have fun!

18 money and happiness debt is NOT good repeat repeat repeat avoid the 3 F s of financial ruin any happiness gained from an experience is offset by the stress of paying for it do not turn your patients into a cost center

19 money and happiness the lottery solution! odds of winning the mega millions 1 in 176 million

20 money and happiness the lottery solution! odds of winning the mega millions 1 in 176 million things more likely to happen than that crushed to death by vending machine airline-related terrorist attack having identical quadruplets becoming president death by flesh-eating bacteria

21 money and happiness compound interest is a miracle jack saves $5,000/year from age jill saves $5,000/year from age who has more at retirement?

22 money and happiness compound interest is a miracle jack saves $5,000/year from age jill saves $5,000/year from age who has more at retirement?» jack has $600,000» jill has $540,000

23 money and happiness compound interest is a miracle jack saves $5,000/year from age jill saves $5,000/year from age bob saves $5,000/year from age who has more at retirement?» jack has $600,000» jill has $540,000

24 money and happiness compound interest is a miracle jack saves $5,000/year from age jill saves $5,000/year from age bob saves $5,000/year from age who has more at retirement?» jack has $600,000» jill has $540,000» bob has $1,142,000

25 money and happiness compound interest is a miracle

26 money and happiness

27 money and happiness the sooner and the more you save the more you play in later days the millionaire next door by thomas stanley

28 money and happiness must-know-absolute-basic financial rules* save minimum 10% of your income have minimum 3 months expenses in cash term life insurance ~6x your income get as much disability insurance as possible mortgage <2x your income vehicles should cost <20% of income stock allocation = 100 age 20 times income is retirement goal set up a revocable trust when you have a family

29 money and happiness where to start save 3 months of emergency funds max out your 401/403 always max out your non-elective contribution contribute to an IRA roth IRA contribute for your spouse contribute to a 529 if you have kids consider HSA then, start investing in other stuff

30 money and happiness where to invest 101 the majority of funds underperform the indices vanguard target age funds diversification invest in individual stocks carefully you should have a long-term plan really you re a smart person

31 what makes people happy you will be amazed that you really aren t that much happier than you were as a resident at the end of the day

32 what makes people happy life events are unpredictable maintain your health invest in good relationships maintain your relationships learn to communicate

33 what makes people happy happiness is the seventy-five years and twenty million dollars expended on the grant study points to a straightforward five-word conclusion: happiness is love. full stop.

34 what makes people happy a man who doesn t spend time with his family can never be a real man

35 what makes people happy living a life without regrets i wish i hadn t worked so hard i wish i had stayed in touch with my friends i wish i d had the courage to express my feelings i wish i d had the courage to live a life true to myself, not the life expected of me i wish i had let myself be happier

36 how to be happy as a doctor be honest with yourself be prepared to avoid unhappiness professionally and financially learn to communicate spouse, friends, family, and patients choose to be happy truly

37 the happy life happiness is a journey, not a destination; happiness is to be found along the way and not at the end of the road, for then the journey is over and it s too late you re dead

38 good luck!