speaker-0: Monday comes early. This chapter closes. A new door opens. This is the second shift. I I can't imagine anything worse than not having any kind of support systems. My support system is family. ⁓ if there's one message I wanna get out to to your listeners is if you have any ⁓ problems, family related problems, if for some reason you've drifted apart or especially if you haven't gotten along with each other, please think about mending it. ⁓ old age is lonely. A and family are that the ones that know your history and you can share stories and I can't it would be so empty if I didn't have all of them in my life and be close to them. and that's definitely helped keep me going.
speaker-1: On today's episode of the Second Shift Podcast, we welcome Dr. Fred Dennis, a now retired emergency medicine physician who has done a bit of everything in his long medical career, from 37 years in clinical medicine to numerous non-clinical administrative roles. He recently faced the biggest shift of all. After his wife suffered some significant health problems just as they were about to enter those golden years that they had prepared so diligently for for decades. He is full of hard-earned and sage advice for the rest of us. I know you're going to enjoy this episode. Let's get started. Welcome, everyone, to another episode of the Second Shift Podcast. I'm your host, Brian Jepsen. I recently retired from medicine and worked full time as a financial planner. ⁓ we're gonna have to excuse my co-host today, Aaron Millage. He is ⁓ working for the military, ⁓ serving our country this weekend. So, so we excuse him. But I'm very excited to introduce our guest today. ⁓ it's Dr. Fred Dennis. ⁓ he is ⁓ MD MBA and ⁓ fellow of the American Academy. of ⁓ emergency physicians. American College of Emergency Physicians, I should know that, right? I'm part of that too. So Fred, thank you for joining us. I want to I want to talk a little bit about your bio first, and then we'll we'll get into some questions and get into your story. I think you have very interesting and impactful ⁓ story that I'm sure a lot of our listeners are going to learn a lot from. So Fred, ⁓ the the most current thing ⁓ I I think is that you are the anticipated chair of the exploring retirement section of the Amer American College of Emergency Physicians. Now we had Dr. Steven Anderson as a guest ⁓ recently also who is the acting or the current president. When do you take over, Fred?
speaker-0: ⁓ i i in October and and I anticipate I will be the chair. It's just that we had to postpone the elections. we've had sort of ⁓ hands up elections in the past and so officially according to ACEP, I I am not the chair until the meeting that we're gonna be having in Chicago. ⁓ that's when we passed the baton.
speaker-1: Well, ⁓ I I do want to talk a little bit about that at the end if we have time, ⁓ just because I think it's such a valuable section within our college. You know, that I I don't know how many other specialty colleges have something like that. ⁓ but but I think it's valuable because so many people within medicine are exploring retirement and trying to figure out what that looks like for them. and This is getting those people together and those who have gone through it and and helping, I think, ease the journey for the rest of us. So so I think it's a it's a wonderful section to be in. So you've got a very, a very long and storied career with all kinds of different things. Let me let me hit a few highlights. So you did your medical school training in in Canada, in Toronto, and then set up a general practice after it sounds it looks like some general practice training. ⁓ and and so you start out your career in general practice in a small town in in British Columbia, and then you found your calling. Is that right? So so you know, at that point you were doing all things that general practitioners do, ⁓ including working in the emergency department, and discovered that the emergency department was was where you felt at home. And so that led you to a emergency medicine ⁓ program ⁓ at McGill University, which is in Montreal. But at the time there was no emergency medicine specialty in Canada. So you moved to California and took your your ABM boards and became Board Certified in Emergency Medicine. Since then, lots of variety of things. You're president of the California ASAP, chair of emergency medical services in in LA County. Ultimately got an MBA in healthcare from UC Irvine, which which I want to learn more about. You've worked in hospital staffing companies, you've worked as an ER in ER consulting companies, you've worked in billing companies, you've worked in health plan companies, you've worked for independent physician association companies, you've done prior authorizations. ⁓ so pretty much everything within medicine that I can think of. I'm sure that there are plenty more. But so so tell us a little bit about all those different careers in inside medicine. When you look back. Which version of yourself felt the most fulfilled? Let me ask it that way.
speaker-0: Well well ⁓ I kind of followed my instincts in a lot of these and so I n backtrack to when I first went away to university where ⁓ at one point in time ⁓ people were going out partying ⁓ when I first arrived, I was reluctant to join them and ⁓ And they all left. And then I'm sitting there on a Saturday night in the empty dorm thinking, Why am I doing this? So I immediately changed my strategy to saying yes. And my career was essentially a series of saying yes. An opportunity presented itself and I said, Let's say yes. And what you learn in business is that it's you know, business is mainly sales. ⁓ You're always trying to convince somebody that you can help them with their particular problem. And when they say, okay, here you go, you may not have a clue how you're actually going to solve this. You've got some potential ideas, but you say yes. And so I followed various opportunities that arose. And I really have to say that in emergency medicine, my career was defined by the people that I met in Cal ASAP and ASAP. ⁓ I I joke and say the first job I got in Los Angeles was answering an ad in the back of a journal. And after that it was, you know, calling friends and saying, Hey, you know, I'm getting ⁓ getting the idea I'd like to move on and try something different. Do you know anybody who's hiring? And ⁓ more often than not they said, Well, you know, I I'd like to get a chance to work with you. Well Well make a position for you. ⁓ and careers were and jobs were created sort of out of thin air, so to speak, often. ⁓ and and and it was everything to do with friendship and camaraderie and ⁓ what we used to call as old guys the Rolodex, right? Yeah. Is the people staying in touch with the people that you meet and I and I keep on saying again to the younger generation. Keep your connections up, especially within your professional society, because you may be working in LA, but you'd like to work in Philadelphia. Well, you may have met somebody at a at an ASEP conference who who runs a a contract in Philadelphia. That'll get you a job much faster than just going online.
speaker-1: Yeah, absolutely. I I think that's those are two great points. One is that ⁓ how important relationships are, you know, to to not only your future career possibility, but just to the enjoyment of your career in general. Right. ⁓ you know, it's the I so I retired formally from the emergency department this past February. I don't miss the the client the patient work that much. I do miss the relationships that I have with colleagues and and you know team members and things like that. That's that's definitely more ⁓ I think impactful over time. You know, you the patients will always be there. ⁓ the but it's the relationships that you make with your colleagues that are irreplaceable. And and you're right also about the same. Yes. In fact, one of my questions was going to be, ⁓ were all these transitions between all these various ⁓ aspects of non-clinical work, intentional or opportunistic. And I think you had answered that question. I think I think it really is, you know, you probably didn't have it all planned out ahead of time. You just said, okay, well, you know, that sounds interesting at the time. Let's let's add that skill to my toolbox. And which really makes for an interesting career, but also ⁓ lots of transition opportunities.
speaker-0: Right. Well, one of the most fantastic opportunities I had was I had worked for a ⁓ for a a ⁓ not a billing company, but it was basically a a company that ⁓ provided office and and c ⁓ administrative services for various groups and hospitals and the rest of it, and become very friendly with one of the vice presidents. And I got a call out of the blue and he said, You know, I've got a ⁓ a doctor who owns fifteen hospitals in forty five states who's looking for someone to run his health plan and I think you'd be ideal for it. And I thought, sure, I've never run a health plan before. What you know what can go wrong kind of idea. Yeah. ⁓ but he he had pre he had already vetted me and he had already just met with the president of the company, the owner of the company, and and put my name in there. So when I arrived, ⁓ I already had somebody who was who they had trusted who was my backer and and ⁓ it was one of the easiest hiring processes ever because I I met with him and his executive vice presidents two of them and ⁓ after three quarters of hour or so ⁓ he said okay you got the job. and and as as with most jobs too, it it what you're looking for when you're looking for a business partner or somebody to work for you, I believe ⁓ and whether it's an emergency or not, you're looking for somebody who wants to be there, who's gonna do their best, and not just when things are going well, but somebody who you can count on when they don't, because that's the big unknown, you know. ⁓ you can't always plan if you're ⁓ if if you're running a group or you're ⁓ running a contract or if you're in any business situation on all the eventualities. You know that the wheels are gonna fall off at some point. But you want somebody else who will be there by your side at two o'clock in the morning, ⁓ and who's gonna be doing some of the heavy lifting alongside you. And ⁓ and so again, that's one of the other things that I tell people in ⁓ is that you know, enthusiasm counts for a lot. If you really do want the job, tell them you want the job. Ask for it. Make it obvious.
speaker-1: No, and I and I think it's so important, especially, you know, we in fact we had chatted a little bit about this before we pushed record, but how important it is for physicians to have side gigs, you know, and y because I think it th it there it does several things. It one is that it creates relationships, which can lead to other things, even if even if your the the side gig that you said yes to may not be your ultimate dream goal. I mean, it's creating skills that that you can adapt to other things. And then as you develop those relationships with people, your reputation gets out that you are somebody that can think outside the box or work well as it with the team or, you know, ha just has have some other ⁓ perspective that the run of the mill physician may not have. So so tell me what you think are or how you advise younger doctors to create that kind of purposeful movement, I guess.
speaker-0: Well well I think again i it requires some self analysis so to speak to find out where your skill sets are. And and sometimes we limit ourselves by thinking our skill sets are you know, I'm good at inserting central lines or I'm good at teaching the paramedics. And and they miss the fact that that something like ⁓ teaching paramedics, for instance, involves organizational skills. You have to pull together a group of people, you have to try to understand the different needs of everyone, you have to try to speak to them on their own language. What else what other kind of jobs might have that ⁓ opportunity? Would it be in something in the public health or or related to the EMS commission, for instance, is w where I where I got ⁓ such a lot of opportunity to meet some really incredible people who are providing pre hospital care. ⁓ so again don't don't limit yourself. Th the second is ⁓ the one of the one of the ⁓ opportunities that I had was ⁓ to ⁓ encounter the first iteration of managed care and it became obvious that it was a failure. ⁓ The idea of paying doctors to not refer patients, ⁓ so that you could keep the money that the referral would c be costing. ⁓ and all of a sudden every ⁓ PCP became an endocrinologist and a cardiologist, and the patients knew the difference. And but on the other hand, there was a c there was an element of of truth there. So I went back to get an MBA to understand it and realize that ⁓ ⁓ what I ⁓ didn't know was that we spoke a different language in medicine than in business. Business is about a a bunch of different parameters. They're very easy to figure out if somebody will explain them to you, break them down. But ⁓ for the rest of my career I often joked and said ⁓ I'm often doing a translating function here. I'm taking the business case, what the what the business people want to achieve. And I'm turning it into language that the physicians and techs and ancillary personnel can understand. And then I'm taking their comments, which sometimes are no, we can't do this, it's dangerous, and taking them back to the business people and say you're gonna fail because you're attacking them on a core level. I mean, they got into this because they wanted to make a difference with patients, and you're asking them to somehow subjugate that. to a profit margin. They they don't get it. It's it's it's not in their DNA to to wanna do that. And so translating back and forth and ⁓ being a bridge between business and medicine was a lot of fun. And ⁓ and e every job after I got my MBA had some element of that.
speaker-1: Yeah. Well, and super important too, you know. I mean, I I think that it if we had more physicians getting MBAs, getting on the business side of medicine, and bringing our perspective as providers ⁓ to the business guys that look at patients in a different way than we look at patients. They're, you know, they're very numbers oriented and and you know, margins and bottom line. and sometimes when you're trying to take care of patients in the right way, you have to do some things that may maybe aren't exactly the best thing from a business sense, ⁓ because you're taking care of humans. So, so I I I applaud you for getting an MBA. I applaud you for going back and and being that translator to the business people because ⁓ I we just need more doctors doing that. And and the other thing that you mentioned, I think is how you can take your skills that you learn. ⁓ and maybe they're not maybe they're they're the soft skills, you know, about communication, breaking down complex ⁓ concepts into bite-sized chunks, ⁓ you know, that we we we learn that multitasking. We learn those skills as physicians that can then be applied to whatever else you decide to do, whether it's becoming a financial advisor or, you know, working in a ⁓ ⁓ health administration or or working in a veterinary clinic which or startup which is another part of what you have going on. But you know, the I I think that that's an important part of that side gig school if you if
speaker-0: you will.
speaker-1: So tell me ⁓ about When w ha ha ha did you continue working clinically through all this stu ⁓ all these shifts within your career or did you leave the clinical work behind as you kinda started doing a lot more of this business and administrative stuff?
speaker-0: Yeah. ⁓ I I had a problem working clinical shifts and as I started to get more involved administratively. ⁓ typically meetings are held in the business world Monday to Friday, nine to five kind of idea or in whatever time zone you're in. and ⁓ and so ⁓ I ha had to typically work my shifts on the weekends. ⁓ my clinical shifts on the weekends, w which which was okay. ⁓ but I found ⁓ For me the magic number was six. If I didn't do six clinical shifts a month, I was losing my timing. I was losing that intuitive approach that we take. I I I describe it as, you know, you look into the crystal ball and it's all kind of cloudy and then little points of light appear. And when you can connect dots to make a pattern, you move on to the next patient. And yeah. And people sort of say, I I somehow thought it was sort of more linear and more planning and the rest of it. But ⁓ what I see it as we're we're using a right and left side of our brain. We're using the knowledge we've accumulated and our impressions of the patients and those good diagnoses we make are often a combination of those where something just doesn't fit here. There's a piece of the puzzle that that it doesn't
speaker-1: A voice inside your head that says, think again. Yeah. About what you're doing. Yeah.
speaker-0: Yeah. Well, so anyway, I didn't want to lose my timing. I didn't want to be the boxer who shouldn't have fought the last fight. And so when my number got down low and then one weekend I ⁓ I was working a shift or scheduled to work a night shift on a Saturday night and I got a call Saturday morning from the CEO of one of our hospitals who said, ⁓ your director is not working out, he's gotta be gone. And and I said, ⁓ okay. How long do I have to replace him? She said, I'm I want you here on Monday morning ⁓ to to to give him the bad news. okay, I gotta find a director. This was a mid Midwestern Rural Hospital. and ⁓ and and she had very high goals and aspirations for her director. So she wanted a board certified emergency physician. And ⁓
speaker-1: Thank you.
speaker-0: And and so I said, ⁓ anything else I should know? She said, Yeah, I want him to keep working here clinically. ⁓ because we need him. He's a really good clinician. And I thought, Okay. Not too much to ask. But so I had to line up a co you know, coverage for my shift. I had to get on a plane all spent all day Sunday getting out there and prepping for the meeting on Monday and the rest of it. And I realized this was going to be increasingly a problem. which was working and administrative. So so at that point I I willingly gave up the the clinical part. I missed it a lot. I missed the fact that even though in emergency medicine we say, you know, you need to have a an arm that's long enough to pat yourself on the back because your patients are not going to do that. ⁓ in business
speaker-1: Or your hospital administrators mostly.
speaker-0: And it well in business it happens much less frequently. No surprise. The number of compliments you get is almost it's like the expectation is you're gonna do an excellent job. Don't screw it up, kid. and so I I really did miss that positive feedback from patients because I think that that kept me going for so many years through a lot of trials and tribulations when I was practicing clinically, which is the idea I I am helping people. They do appreciate it. They are thankful. A and ⁓ but when I got when I when I that started to happen then I realized I had to do full time administrative
speaker-1: And how far into your career were you at that point?
speaker-0: Well, so ⁓ let's see, twenty seven thirty seven years. So I had I had been like I said, cutting down on the number of shifts as I was doing more administrative work, but but I I had had a long career. Now again, the beginning of my career started in a rural general practice, which is you know, catching babies and assisting in the operating room and managing fresh MIs in the ICU. All that sort of stuff.
speaker-1: So when you made that that full transition to administrative, ⁓ did you did it affect did you have an identity crisis or or you know, since you were still within still working within medicine, did it ease that little bit?
speaker-0: Well I I have to admit that for a while I said, you know, how do I replace something as meaningful as this day-to-day affirmation that I'm helping people with something as kind of obscure as, you know, am I making a difference in administration? And and I realized that ⁓ if I was say I was regional director over five hospitals, ⁓ That if I could impact through some something that was beneficial, if I could negotiate if it was say ⁓ a hospital group that was working for a multi hospital company like a tenant or an HCA or something like that, if I could impact something with the a with HCA that would impact four or five different hospitals, then I would be impacting all the doctors who work. And in turn impacting the patients. So if I could make the doctors' lives better by being the interpreter and being the champion and the ombudsman and the rest of it, then ⁓ then I could continue to make a difference. It was more nebulous and I wouldn't see it on a day to day basis, but I knew that I would be making a difference and so so I kind of started to to think I wanna have a bit of a champion role here. And I may not always be popular with the with the the ⁓ company that I'm working for or the or whatever, ⁓ because I may not be telling them what they wanna hear. But on the other hand, ⁓ I had never t had trouble finding a job, so you know what's the worst they can do? Fire me, right?
speaker-1: Exactly. Yeah. Sometimes you sometimes you hope that that happens.
speaker-0: And that and that and and getting back to the you know the the ⁓ well we sort of little touched on burnout. If you don't if you burnout tends to happen when you're trapped, right? You have no ac exit ⁓ exit. There's no exit strategy in mind. You always need an exit strategy i if forever possible, whether it's just living off of your savings. You know this better than I do. I can't preach to a financial advisor about this. But y you know, you need to have a cushion financially, but you also need to keep your connections going so that if ⁓ the milk goes sour here, you know, you can you can ⁓ start to develop a connection for another potential opportunity. And that gives you often the confidence to to live through a a tough situation ⁓ without feeling trapped.
speaker-1: Yeah. I mean, I think that that's such that's the power of financial independence, right? Is the is the ability to say no to stuff. Cause and walk away. So yeah, so now you're no longer trapped. Doesn't mean that you have to stop working. I mean, you can you it just means that now your world is opened up because you ha you can take opportun you can take risk in opportunities that otherwise you may not feel comfortable taking that risk in because you feel like financially ⁓ you're not I mean you're tied to you to that particular role. So so yeah, absolutely. Financial preparation helps create that career freedom that then you can align that to your to your values. So so you can think of money as a tool to get you there. Yeah.
speaker-0: I may and sometimes, you know, when I sorry to interrupt you here. not infrequently when I went from one job to another, ⁓ I took a pay cut. ⁓ because the job looked good and and I I thought y you know, I had learned to live not like a resident, but I'd learn to live within my means and ⁓ and not take expensive vacations unless I had a windfall of money to be able to do that, but not using debt to finance the fun stuff. And and so I s and lo and behold, you know, a year or two later, gosh, ⁓ you know, with bonuses and the rest of it, I was doing a better financially than I had in the old one. And that that's often the case is that if you demonstrate value, you you then will be able to to get ahead. But if if you're ⁓ I remember ⁓ in my business school they Said you you know, ⁓ don't be a commodity. Right. ⁓ and emergency physicians are considered by CEOs to be all uniform. Everybody who higher who works at my hospital is good. And if I bring in another group, they're all gonna be good too. So you're not differentiating yourself. So you're like gasoline. Okay, what's the cheapest per gallon price I'm gonna fill up there? And after five or ten years and ⁓ working clinically and you you say, ⁓ you know, I need a raise and the person who's the one who's hiring firing says, Well, you know, I can hire a new resident for less than I'm paying you. ⁓ so why should I pay you more?
speaker-1: Yeah. And we're seeing that all over. I mean, it's that that corporatization of emergency medicine and independent groups are being replaced because of that very reason. Is, you know, they they haven't created that re irreplaceability. Yes, you know, uniqueness. Right. The uniqueness that that make that keeps their job. And so in and that's on a group level, on an individual level. ⁓ yeah, I I I think we underestimate the power that we have or the power that we can create. by creating that uniqueness. And and and that's that's looking outside the box. You know, it's looking for other opportunities. It's it's developing relationships that are just outside of your group. ⁓ you have to do that.
speaker-0: ⁓ so kind of open the kimono here a little bit and say that, you know, I was involved in ⁓ mo not a lot, but a few takeovers where the group I was with took over a contract and we would meet with the CEO before the contract changes hands and say, Okay, who do you want to keep, who do you want to go immediately, and who are you okay with, but we should replace them over the next year or two. And I think docs are shocked. by that c thought that that that they may be considered like ⁓ you know which shoes do I want to wear today kind of idea. But ⁓ but the the ⁓ the attractiveness of physicians often has to do with their relationships with the staff. Do you get along well with the nurses? Do you get along well with the attending physicians? Those are the things the CEO's listening to because those are the people that run his business or her business. And and so I so you wanna be one of those people who ⁓ they immediately say, ⁓ yeah, you know, keep Brian. He he's a he's a great guy, you know, I like him. You know, I've met him. I mean he yeah he saw my kid when he came in when the child came in with a you know broken toe or whatever. and ⁓ Yeah but we're not
speaker-1: Definitely the the the capa the capacity as a physician or the skills as a physician is a given, right? I mean that that's that's not what separates you. That's that's considered a given if you are if you're credentialed and especially if you're board certified, you should know how to take care of patients. It's the rela it's how you deal and communicate with the team that differ or or other skills that you bring to the table that differentiate you. Yeah, for sure. Okay, let I I w I want to shift gears just a little bit and say, ⁓ you know, you've you've had a long career, you've had a long life within medicine. ⁓ looking at you as your, I don't know, let's say mid career 40 year old self, 40, 45 year old self, envisioning what your retirement was going to look like, or what you thought it was gonna look like, how did things change? How how is it different in reality than what you thought it was gonna be when you were 40?
speaker-0: Well w w first of all w when I was forty, one of the the fortuitous things that happened is ⁓ my wife ⁓ was talking to some of she's a she was cardiac rehab nurse, so she was talking to some of the business people who were ⁓ she was seeing and they said, Do you have a financial planner who's helping you? And she said, Well, we've got ⁓ somebody who sells us stocks and ⁓ No, he said a financial planner and so lined us up with somebody who who set me on a path for my retirement, who I wouldn't be able to retire. You know, automatic monthly withdrawals from my checking account into an investment account. ⁓ you know, and then we follow that strategy for our daughter when he when she wanted to go to when she was born. And that's that allowed her to graduate from vet school without any debt. ⁓ yeah so so setting those things in progress early on was was very important in terms of allowing
speaker-1: Not just assuming it's gonna happen by default.
speaker-0: Yeah, or or or necessarily assuming that I was a brilliant investor and I was gonna make all the you know, I was gonna listen to the pro to the stock tips when we had a physician's lounge we would go to, right?
speaker-1: That's the most dangerous place financially is the physician.
speaker-0: No, I guess nowadays even TikTok, right? Where you're or or or wherever you're gonna get your information from. ⁓ but with me, ⁓ retirement looked like it was going to be pretty calm. ⁓ I was winding down, I'd gone through covet, I'd been able to get a a job where I was working remotely. And then ⁓ one morning ⁓
speaker-1: Yeah, exactly.
speaker-0: I came back after driving my daughter and husband to the to the airport and I went in to check on my wife, she hadn't gotten up yet, and I found her incontinent ⁓ and unrousable, meaning she had had a seizure, no seizure history seizure disorder, a generalized seizure, and was essentially unrousable. So ⁓ i i it I immediately called nine one one. They were gonna div they were the h local hospitals were on diversion. I would they were gonna take her to this little tiny boutique hospital, which I said is not the place I want my wife to be. So I talked to the head paramedic and we kind of, you know, did the secret handshake and and he and I said, you know, I need to go to this ⁓ local hospital, which is the best hospital and he said ⁓ gee, I guess they just opened up. And so ⁓ so she got treated in the hall because of course there were not even any hall beds, ⁓ but in front of the nursing station they whisked her up for E G and a C T scan and a and a and the neurologist on call that day came down and said, This pattern resembles herpesimplex encephalitis that she's got. She's got specific problems with her parietal lobe on both the E G and the C T. We're gonna start our own a cyclovir Ivy right now in the hall. And that probably saved her life and certainly saved her from being in a vegetative state. ⁓
speaker-1: If you're it, your advocacy to get her to the right place also made up.
speaker-0: Yeah. Yeah. And ⁓ and so so immediately my world was turned upside down. ⁓ she was in a coma for a week. She was in and out of the hospital five times that first year for a total of ninety days. ⁓ she was getting breakthrough seizures. ⁓ it it took every bit of my medical knowledge and the rest of it to kind of maneuver her through the healthcare system, which which was an eye opener about how complex and difficult it is. and how much all of the experience I had came to bear here.
speaker-1: Yeah, imagine having to do that without the experience that
speaker-0: Yeah, you can't Exactly. It wouldn't have happened. I I mean y you know, she was having when she got out of the hospital, she was having these spells. We didn't know what it was, but she would go to bed and be fine at night and then wake up in the morning and be confused for about a day. And and ⁓ I finally took her to see a neurologist who was on call for her regular neurologist who was who had just finished his epilepsy training ⁓ as an epileptologist fellowship. And he ⁓ she needs to go to the epilepsy management unit for a week and see whether she and be wired up and see whether she's having silent seizures. I said I'd never heard of an epilepsy management unit. He said, Yeah, there's only two in Southern California, one where I trained and one at Cedars. And since I'd been a working at Cedars, I pulled some strings and got her in there and found out she was having breakthrough seizures. Well, I didn't even know that as a emergency physician who worked at a bunch of different hospitals. ⁓ the average person would have been no. She she would just continue to have them. But ⁓ you know, she was a different person when she finally got out of the hospital. ⁓ the the the disease process caused a necrosis of the brain. So she lost short term memory, some express has some expressive aphasia, executive functioning and ⁓ It it ⁓ it I miss her. I miss the the the wife I married.
speaker-1: Yeah. How many years ago was this?
speaker-0: So this was ⁓ twenty twenty four when it happened. So not very long ago. Tw no, twenty three. Twenty three was when she had her and three years. And so ⁓ so it's been it's been ⁓ a journey. ⁓ she she came home and ⁓ and and did not adapt well to being at home
speaker-1: Two years. Yeah.
speaker-0: She didn't have her driver's license, so she couldn't drive and and we're we're in a kind of a little bit of an isolated urban community here in Los Angeles and so there's no place to walk to and the neighbors had all aged along with us, so nobody was communicating and she was lonely. So I I finally ⁓ overcame the the the negative feelings that we often have as caregivers that I can provide the best care. Why would I let somebody else provide care when I can do a better job? And and ⁓ she's currently in a memory care unit which is fifteen minutes away and I see her every day. And and my and and that's when I completely retired was realizing why am I doing this? So I went to to my financial ⁓ planner and ⁓ and and ⁓ said ⁓ do I need to work? And they said, No you don't. He said, You've got enough of your savings and your lifestyle is ⁓ easy enough that you don't have to work. Don't buy a Porsche though.
speaker-1: Yeah. And
speaker-0: No and ⁓ and and then we were lucky too, early on we got long term care insurance when it was affordable, like again back in our forties or forty five or whatever. And so her care at this point is being financed out of long term care insurance, which is you know, you know, I mean, typically minimum of six to ten thousand dollars a month.
speaker-1: Yeah. Yeah. Yeah, especially in the memory care units. It's I I f resonate with your story. ⁓ you know, my my kids have ⁓ I t I have two adult special needs kids, so it's kind of the other side of the caregiving spectrum. But ⁓ just understanding where what you th thought th things were gonna be, turns out that that's not in the cards. And ⁓ you know, so we People when when your when your life is derailed, I think is a fair way of saying it, but when your life is derailed, how do you adapt? How do you adjust? And you know, and I think that there's a couple of ways that people do it. And some are turns they it turns negative and and they, you know, they lose their purpose in life and you know, ⁓ and others can turn it in a in a more positive way. And so my question is, how did you, you know, obviously this is not the retirement that you had envisioned, I'm sure, you know, in terms of whatever you had hoped to be able to do, you know, travel together, visit family, visit kids. ⁓ how have you been able to reinvent retirement so that you're still finding meaning and joy?
speaker-0: Well well one thing when it became obvious that she needed an institutional placement was I immediately had a family conference. I asked her she had a pre ⁓ two adult children with were blessed with grandchildren from them. ⁓ I asked them to come to town. ⁓ our daughter and her husband asked them to be here and we sat down and we talked about and I said, Look, I I'm gonna give you everything I know about her clinical history and what I've learned from all the specialists and I'm gonna tell you, explain to you the financial situation we're in right now. And I want to talk to you about where we're gonna go forward. And I want because I want your input and I want you to help me and to help her. And and ⁓ and it it worked out very well because they continue to be involved and ⁓ I see them as my advisory board so to speak. It as they and again, ⁓ just last night her son came up from the Caribbean with the son in law who's lives in Washington DC. They were in town and they came to visit Susan and they and they'd be doing that pretty much every day since they got here a couple of days ago. ⁓ because again, she is precious to all of us. And so ⁓ so I don't feel alone. ⁓ I I can't imagine anything worse than not having any kind of support systems. My support system is family. ⁓ and and I really I I I really i if if there's one message I wanna get out to to your listeners is if you have any ⁓ problems, family related problems, if for some reason you've drifted apart or especially if you haven't gotten along with each other, please think about mending it. ⁓ old age is lonely. And family are the the ones that know your history and you can share stories and it's just it it's I can't it would be so empty if I didn't have all of them in my life and be close to them. and that's helped me keep definitely helped Keep me going.
speaker-1: I think that's such an important message. You know, I mean, over and over again, in the financial world, ⁓ you learn that money is a tool. It's not a goal. And that's it doesn't that's not the source of happiness. And at at the end, you know, at the end of life, if you so the true source of happiness is the deep and meaningful relationships that you have with the people around you. Whether that's your family, whether it's friends, whether it's colleagues, that's what keeps people going and makes their life meaningful. And ⁓ you know, I I I love what you said about how important it is to create a team, especially if you are a caregiver. And and again, I I know that myself from my own personal experience, but that will become even more important as I age to the point where I can't my my wife and I can't be the ones to be the primary caregivers anymore. ⁓ to have to create that team of people, whether it's family or non family, but create that team of people that that you can transition that care to. So that ⁓ you know, because you can't do it forever and you can't do it by yourself. ⁓ and and and so it's such important message. And and and that's that also takes planning, you know so so your retirement, I I I think one of the great messages from you is that Yes, financial planning is important for retirement. But that's not the only type of planning that's important. It's it's it's life planning, it's transition planning, it's it's caregiving, it's it's all the other things, you know, it's bringing your family in and being sure that they're included in all that in in so yeah, thank you for sharing.
speaker-0: Yeah. A and and also too, you know, in my case it was going from ⁓ sixty to zero over in five minutes or thirty seconds when I realized my whole life was turned upside down. ⁓ and so so treasure each day. It's a cliche. And it and the cliche doesn't really come home until you've had someone who's close to you.
speaker-1: Yeah.
speaker-0: who all of a sudden is gone. ⁓ and unfortunately as we age we find that people who for whatever reason, ⁓ I think often just bad luck, are gone. And I just talked to them last week kind of idea. Well do they know that you cared about them? Do they know you know how important they were?
speaker-1: Yeah. Yeah, there are no givens, right? There are no givens in life. And and if if ⁓ you know what you envision your retirement to be may not be what it is because of health or loss of life or all kinds of things. So you can't keep putting off those things that are important that bring you meaning and joy for some time in the future that may not happen. So so I I I think a a great lesson to just remember You know, live each and every day to the fullest. Prepare for the future. You still have to prepare. but if you're you might be missing out on a lot if that's if you're only thinking about the future instead of maximizing your day. Awesome. ⁓ well again, thank you for sharing that. I I you know, normally at the end of our at of our ⁓ our conversations we have what we call the reckoning. I don't know if you watched any of our other podcasts.
speaker-0: Didn't because I didn't want to be biased. I didn't want to sort of say you know, ⁓ so so I thought, no, y you had mentioned you wanted to be as spontaneous as possible and I appreciate appreciated that. ⁓ you know.
speaker-1: Yeah. Good no, I I mean it's been a wonderful conversation so far. Norm now I'll I'll tell you that normally my colleague is the one who who does the reckoning. So basically what the reckoning is is just a few short answer questions. ⁓ that, you know, there's there's no hedging. It's just like what what comes first to your mind? And again, I'm gonna look through a list of things and see which ones would be some good ⁓ reckoning questions. Okay, actually here's one. So I I wrote a book called The Physician's Path to True Wealth. in your mind, after the life that you lived and the career that you have, how would you define true wealth? What does it mean to be wealthy?
speaker-0: ⁓ to ⁓ to to to me it's not about money. It it's about the people I met and the people I stay in touch with. And and again, it's ⁓ the the my what I consider the true wealth is the friendships and and the family. Ye part of the th the reason emergency medicine was a so attractive to me is I got a chance to talk to people about things that weren't you know, a little bit tangential, you know. ⁓ you know, you work for rocketine. What's it like to be a rocket scientist kind of idea? ⁓ and and I I just enjoy people and finding out about people and to be true wealth is is to be able to have those sort of experiences. It's it's not about y The he who dies with most toys wins.
speaker-1: Yeah. And and I I actually find that really interesting because the more people that I ask that question or or basically talk to about finances, the older you get, the less money means. You know, the ⁓ the less stuff matters. ⁓ and and the more relationship and experiences and things like that are are what really make a difference in in life. And so, you know, obviously you want to have the the money that will help. help sustain you and and give you the optionality that you want to create to be able to create that those opportunities but but that's that's why it's a tool and not the not the goal. Yeah. So so thank you. Okay, here's here's the next question. What advice would you give physicians approaching retirement who are anxious about losing identity or relevance?
speaker-0: Make sure that ⁓ you do some serious thinking on this topic bec and I think it's a it's an excellent one, ⁓ excellent question, is if you haven't planned to do more than just golf, you're gonna die sooner. ⁓ the the research is absolutely strong on this. It w if you lose your sense of personal identity, ⁓ I I I have lots of identities as you could tell from from the various jobs that I've had and the rest of it. So so I was lucky I kind of learned how to put on different hats kind of idea. ⁓ but again if you stick with your w all of us should actually have like a mission statement and a vision statement about you know, what what we wanna do and Yeah, I'm just looking here. I have a little thing posted on the on the wall here. ⁓ embrace life, gentle withal, never ever regrets. And and then ⁓ my my mission statement is to make people successful. So in my retirement, I find meaning in trying to help people, even if it's not anything to do with medicine, even even if it's just You know, go to the dry cleaners and say there's a better way you could be hanging those clothes. Well, you know, lots of times I think they think, What the hell is he talking about? You know? I didn't ask for that information. But yeah, but again, you you find meaning sometimes in the in the funniest places and you find often as we did during our careers, that you can make a difference in people's lives when you didn't even notice that what you said, that one comment. change their life or change their path. So think about how you can continue to do what we went into this ⁓ calling to do, which is to to help people. How can you continue to help people on some sort of level so you continue to do this? Because we obviously are hardwired to to do this to a degree that is beyond the normal population. Physicians sacrifice a lot to be ⁓ physicians. And and ⁓ s so I I think make sure there's some meaning in your life that way.
speaker-1: I think that's great advice. We're we're healers by nature, right? That's we we became doctors because we're healers and we want to help people. And and even if you're you don't have the white coat on anymore, there's so many ways you can heal people. And sometimes it's just with a smile and and you know, just making their day a little bit better. So so I I think that ⁓ being purposeful about that I think is is how you don't lose your identity as a healer because you don't need to when you when after you retired. So Great advice. Okay, here's the third question. ⁓ what do you wish your thirty-five-year-old self understood about career and life?
speaker-0: That ⁓ that a door would open before the previous door closed, that that I didn't need to be worried about taking chances, that I ⁓ that I could ⁓ be bolder, that I could do more, that I could risk failure more than I did. ⁓ I was very risk adverse at the beginning of my career because here was a Canadian in Los Angeles who knows nobody. How am I gonna, you know, be able to create an identity here? So I was very cautious in the beginning and and I I realized the more that I took chances, the more successful I was. Well, I wasn't always successful, because you don't succeed, you know, nobody's got a batting average of of, you know, a a thousand kind of idea. But but on the other hand, the ⁓ the more you try, the more you succeed. And so I I would say so be bolder.
speaker-1: Yeah, even failure is a learning experience that can leverage you for your next your next opportunity, right? And so I I think I think that's also great advice. And and and I found that looking back on on the chances that I took also, you know, they didn't always work out a hundred percent, but they always worked out. Yeah. You know, it it always worked out in in my benefit in one way or the other. And ⁓ and I think that so many of us ⁓ are afraid to take chances because of that, especially those who are high achievers enough to become doctors. I think in some ways we're afraid of failing more because, you know, we're used to not failing. And so failure is ⁓ scary. And ⁓ but yeah, I I think that that's wonderful.
speaker-0: Well when you're working in the ER, I mean you can see you can see twenty people a day who have failed, you know? I mean they there's just a a constant litany of people who tried something and did it wrong.
speaker-1: Yeah, you can't. That's right. Well, and and plus in the e you know, as as physicians, we are ⁓ conditioned not to fail, you know, because failure as a physician means somebody could get injured or lose their life even. And so there's a very high risk of failure as a physician. And so clinically. And so taking, you know, being able to Put that aside and and try something outside of your comfort zone can be a challenge, I think, for a lot of doctors. Okay, Fred, it's been an awesome conversation. I hate to end it. but eventually people will stop listening. So so ⁓ thank thank you again for joining us ⁓ today. ⁓ normally what we do afterwards is that if Aaron were here, he and I would kind of break down the conversation, pick out some highlights and and ⁓ you know, end the podcast that way. ⁓ I'll either have him do that with me ⁓ when he's available or I'll I'll just do it myself. But ⁓ Anyway, it's been it's been wonderful. I think you've given us many, many pearls of wisdom. ⁓ good luck with your family. Best wishes for your wife. ⁓ best wishes in your for formal retirement now. And and I hope that ⁓ you know, you can continue to find the meaning and joy as you help others. So thanks again. Thank you, Matt. All right, everybody, this is the time where we ⁓ recap ⁓ our conversation with Dr. Fred Dennis. I thought it was a really good conversation. He had a lot to say, a lot of of great pearls. ⁓ he's obviously lived a long career and a long life, ⁓ full of ups and downs, but lots of challenges and or lots of opportunities that he took advantage of. ⁓ I think one of the important things that he taught us is is ⁓ the importance of saying yes when opportunities arise. So he he mentioned that not all of his ⁓ career path was necessarily planned. ⁓ But it happened by saying yes when opportunities came up. ⁓ and that led him to new things that he may not have ever anticipated, ⁓ especially as an early emergency medicine physician. but ⁓ I think so many of us just forget, you know, to step out of our comfort zone and ⁓ to say yes to things as the as they come up. And and it's hard, you know, we have We're busy as is. ⁓ feels like ⁓ saying yes to other things is just adding to that and and maybe contributing to burnout. But in reality, I think creating those other streams of income or at least streams of attention can often prolong our careers because ⁓ it it gives us exit ramps for one, ⁓ but also ⁓ just adds variety to our work life and ⁓ you know ultimately it helps us be able to choose the things that we like to do and ⁓ you know, maybe pay somebody else to do the things that we don't like to do. ⁓ the other important thing I think he taught us is that a lot of times it's who you know. You know, developing those relationships is critical in terms of finding new jobs and new opportunities. And and I certainly see that a lot with with young ⁓ people in the workforce or trying to get into the workforce and and are having difficulty in spite of education and in spite of ⁓ you know, talent. ⁓ Lots of times they don't even get their foot in the door because they don't have ⁓ the people that ⁓ they haven't made those relationships yet. ⁓ and so cultivate those as you're going through your ⁓ your work, your work life, because those are what's those relationships are are what you can leverage ⁓ so that later on you can find the opportunities when you need one. ⁓ he was a great example of how ⁓ if he started getting bored in his career, it sounds like he just called somebody up and said, Hey, what kind of opportunities do do you know about? Or ⁓ and lots of times those were just created for him because those people wanted to work with him. ⁓ that kind of leads me to my next point about ⁓ and I don't know if this is a word, but I'm gonna I'm gonna say it anyway, decommoditize, you know, ⁓ lots of times. And more and more it seems that ⁓ physicians are becoming commodities and certainly are commodities to the ⁓ the business folks that are ⁓ making decisions about your career and the hospital that you work in. sometimes there's nothing that you can do about those those ⁓ transfers, but ⁓ when it happens and and if you're bought out and ⁓ you know and they're those that new company is asking who they should keep and who they should let go. you know, set yourself apart by adding broader skills than what is expected by any physician that would fill your role, but also by forging good working relationships. I found that for sure is that, you know, if if you ask nurses or techs or some of the other members of the team who they like to work with, They don't shy away from answering that question. And they know who the doctors are that are That the patients like, that communicate well and that work well as a team. And and that I think that goes with any career, you know, whatever whoever your team members are. ⁓ you set yourself apart by being a good team member and a team leader. And so that will help you keep a job and will help you find new ones if if you don't just become a commodity ⁓ to those people who are making decisions above you. All right. I think the most important ⁓ thing that he talked to us about is that there are no guarantees in life. ⁓ you know, what a challenging experience that he's had with his wife. ⁓ how difficult that must be, especially as you're just n s approaching your retirement years almost there. and suddenly your vision for r what retirement was going to look like is ⁓ drastic drastically changed. ⁓ He taught that how you get through that is is with your family. It's ⁓ it's the relationships around you. It's cherishing cherishing and nourishing those relationships. ⁓ you know, I I I thought it was very powerful when he talks about the loneliness of of ⁓ being elderly. And I think that happens a lot. I think that's ⁓ there's a high depression rate in elderly folks. ⁓ and mostly I think that be is because they're lonely and they they've lost skills, they've lost opportunities. There's a lot of loss in in retirement and in elder in old age. So the last thing that you want to lose is the relationships that add meaning and joy to your life. ⁓ that's your most important asset. You can have all the money in the world. ⁓ if you don't have those relationships, you're not going to have the same quality of life. ⁓ that you would otherwise have had. So I think his story amplifies that and something that we sh all should remember. All right. So again, thank you to Dr. Fred Dennis. ⁓ I appreciate the time and his his openness about his story. ⁓ I hope you enjoyed this episode of the Second Shift Podcast. Please tell your friends about us. Suscr subscribe and like to the channel. I think that does help. Get the word out there, ⁓ help sustain us. ⁓ so if you are finding this information useful, ⁓ please do that. Also, if you are interested in learning about your own ⁓ or learning more about your own second shift, ⁓ we do have the second shift blue the second shift blueprint that is available on our website at second shift. That's the number two nd podcast dot com. Please download that. ⁓ five important conversation questions that you need to ask with your significant other before you take on a next your next second shift. ⁓ and feel free to reach out to us. ⁓ we'd love to hear from you. Take care.
speaker-0: The work you did mattered. And you're not done. Welcome to What's Next. Thank you for listening to the Second Shift. If this conversation landed with you, please download our free guide called the Second Shift Blueprint. 5 questions you and your partner should discuss before any major transition. Get it at secondshiftpodcast.com. That's number 2ndshiftpodcast.com. And if you're approaching a transition and want to talk through the financial strategy, we offer a complimentary 30-minute second shift audit. Details are at secondshiftpodcast.com/slash audit. Join us next week for another great episode. And remember, your life and identity doesn't end with retirement. It's just entering its second shift. The content shared in this podcast is intended for educational and entertainment purposes only and should not be considered personal financial advice. You should always consult with a financial professional to determine what is appropriate for your individual circumstances.
speaker-1: On today's episode of the Second Shift Podcast, we welcome Dr. Fred Dennis, a now retired emergency medicine physician who has done a bit of everything in his long medical career, from 37 years in clinical medicine to numerous non-clinical administrative roles. He recently faced the biggest shift of all. After his wife suffered some significant health problems just as they were about to enter those golden years that they had prepared so diligently for for decades. He is full of hard-earned and sage advice for the rest of us. I know you're going to enjoy this episode. Let's get started. Welcome, everyone, to another episode of the Second Shift Podcast. I'm your host, Brian Jepsen. I recently retired from medicine and worked full time as a financial planner. ⁓ we're gonna have to excuse my co-host today, Aaron Millage. He is ⁓ working for the military, ⁓ serving our country this weekend. So, so we excuse him. But I'm very excited to introduce our guest today. ⁓ it's Dr. Fred Dennis. ⁓ he is ⁓ MD MBA and ⁓ fellow of the American Academy. of ⁓ emergency physicians. American College of Emergency Physicians, I should know that, right? I'm part of that too. So Fred, thank you for joining us. I want to I want to talk a little bit about your bio first, and then we'll we'll get into some questions and get into your story. I think you have very interesting and impactful ⁓ story that I'm sure a lot of our listeners are going to learn a lot from. So Fred, ⁓ the the most current thing ⁓ I I think is that you are the anticipated chair of the exploring retirement section of the Amer American College of Emergency Physicians. Now we had Dr. Steven Anderson as a guest ⁓ recently also who is the acting or the current president. When do you take over, Fred?
speaker-0: ⁓ i i in October and and I anticipate I will be the chair. It's just that we had to postpone the elections. we've had sort of ⁓ hands up elections in the past and so officially according to ACEP, I I am not the chair until the meeting that we're gonna be having in Chicago. ⁓ that's when we passed the baton.
speaker-1: Well, ⁓ I I do want to talk a little bit about that at the end if we have time, ⁓ just because I think it's such a valuable section within our college. You know, that I I don't know how many other specialty colleges have something like that. ⁓ but but I think it's valuable because so many people within medicine are exploring retirement and trying to figure out what that looks like for them. and This is getting those people together and those who have gone through it and and helping, I think, ease the journey for the rest of us. So so I think it's a it's a wonderful section to be in. So you've got a very, a very long and storied career with all kinds of different things. Let me let me hit a few highlights. So you did your medical school training in in Canada, in Toronto, and then set up a general practice after it sounds it looks like some general practice training. ⁓ and and so you start out your career in general practice in a small town in in British Columbia, and then you found your calling. Is that right? So so you know, at that point you were doing all things that general practitioners do, ⁓ including working in the emergency department, and discovered that the emergency department was was where you felt at home. And so that led you to a emergency medicine ⁓ program ⁓ at McGill University, which is in Montreal. But at the time there was no emergency medicine specialty in Canada. So you moved to California and took your your ABM boards and became Board Certified in Emergency Medicine. Since then, lots of variety of things. You're president of the California ASAP, chair of emergency medical services in in LA County. Ultimately got an MBA in healthcare from UC Irvine, which which I want to learn more about. You've worked in hospital staffing companies, you've worked as an ER in ER consulting companies, you've worked in billing companies, you've worked in health plan companies, you've worked for independent physician association companies, you've done prior authorizations. ⁓ so pretty much everything within medicine that I can think of. I'm sure that there are plenty more. But so so tell us a little bit about all those different careers in inside medicine. When you look back. Which version of yourself felt the most fulfilled? Let me ask it that way.
speaker-0: Well well ⁓ I kind of followed my instincts in a lot of these and so I n backtrack to when I first went away to university where ⁓ at one point in time ⁓ people were going out partying ⁓ when I first arrived, I was reluctant to join them and ⁓ And they all left. And then I'm sitting there on a Saturday night in the empty dorm thinking, Why am I doing this? So I immediately changed my strategy to saying yes. And my career was essentially a series of saying yes. An opportunity presented itself and I said, Let's say yes. And what you learn in business is that it's you know, business is mainly sales. ⁓ You're always trying to convince somebody that you can help them with their particular problem. And when they say, okay, here you go, you may not have a clue how you're actually going to solve this. You've got some potential ideas, but you say yes. And so I followed various opportunities that arose. And I really have to say that in emergency medicine, my career was defined by the people that I met in Cal ASAP and ASAP. ⁓ I I joke and say the first job I got in Los Angeles was answering an ad in the back of a journal. And after that it was, you know, calling friends and saying, Hey, you know, I'm getting ⁓ getting the idea I'd like to move on and try something different. Do you know anybody who's hiring? And ⁓ more often than not they said, Well, you know, I I'd like to get a chance to work with you. Well Well make a position for you. ⁓ and careers were and jobs were created sort of out of thin air, so to speak, often. ⁓ and and and it was everything to do with friendship and camaraderie and ⁓ what we used to call as old guys the Rolodex, right? Yeah. Is the people staying in touch with the people that you meet and I and I keep on saying again to the younger generation. Keep your connections up, especially within your professional society, because you may be working in LA, but you'd like to work in Philadelphia. Well, you may have met somebody at a at an ASEP conference who who runs a a contract in Philadelphia. That'll get you a job much faster than just going online.
speaker-1: Yeah, absolutely. I I think that's those are two great points. One is that ⁓ how important relationships are, you know, to to not only your future career possibility, but just to the enjoyment of your career in general. Right. ⁓ you know, it's the I so I retired formally from the emergency department this past February. I don't miss the the client the patient work that much. I do miss the relationships that I have with colleagues and and you know team members and things like that. That's that's definitely more ⁓ I think impactful over time. You know, you the patients will always be there. ⁓ the but it's the relationships that you make with your colleagues that are irreplaceable. And and you're right also about the same. Yes. In fact, one of my questions was going to be, ⁓ were all these transitions between all these various ⁓ aspects of non-clinical work, intentional or opportunistic. And I think you had answered that question. I think I think it really is, you know, you probably didn't have it all planned out ahead of time. You just said, okay, well, you know, that sounds interesting at the time. Let's let's add that skill to my toolbox. And which really makes for an interesting career, but also ⁓ lots of transition opportunities.
speaker-0: Right. Well, one of the most fantastic opportunities I had was I had worked for a ⁓ for a a ⁓ not a billing company, but it was basically a a company that ⁓ provided office and and c ⁓ administrative services for various groups and hospitals and the rest of it, and become very friendly with one of the vice presidents. And I got a call out of the blue and he said, You know, I've got a ⁓ a doctor who owns fifteen hospitals in forty five states who's looking for someone to run his health plan and I think you'd be ideal for it. And I thought, sure, I've never run a health plan before. What you know what can go wrong kind of idea. Yeah. ⁓ but he he had pre he had already vetted me and he had already just met with the president of the company, the owner of the company, and and put my name in there. So when I arrived, ⁓ I already had somebody who was who they had trusted who was my backer and and ⁓ it was one of the easiest hiring processes ever because I I met with him and his executive vice presidents two of them and ⁓ after three quarters of hour or so ⁓ he said okay you got the job. and and as as with most jobs too, it it what you're looking for when you're looking for a business partner or somebody to work for you, I believe ⁓ and whether it's an emergency or not, you're looking for somebody who wants to be there, who's gonna do their best, and not just when things are going well, but somebody who you can count on when they don't, because that's the big unknown, you know. ⁓ you can't always plan if you're ⁓ if if you're running a group or you're ⁓ running a contract or if you're in any business situation on all the eventualities. You know that the wheels are gonna fall off at some point. But you want somebody else who will be there by your side at two o'clock in the morning, ⁓ and who's gonna be doing some of the heavy lifting alongside you. And ⁓ and so again, that's one of the other things that I tell people in ⁓ is that you know, enthusiasm counts for a lot. If you really do want the job, tell them you want the job. Ask for it. Make it obvious.
speaker-1: No, and I and I think it's so important, especially, you know, we in fact we had chatted a little bit about this before we pushed record, but how important it is for physicians to have side gigs, you know, and y because I think it th it there it does several things. It one is that it creates relationships, which can lead to other things, even if even if your the the side gig that you said yes to may not be your ultimate dream goal. I mean, it's creating skills that that you can adapt to other things. And then as you develop those relationships with people, your reputation gets out that you are somebody that can think outside the box or work well as it with the team or, you know, ha just has have some other ⁓ perspective that the run of the mill physician may not have. So so tell me what you think are or how you advise younger doctors to create that kind of purposeful movement, I guess.
speaker-0: Well well I think again i it requires some self analysis so to speak to find out where your skill sets are. And and sometimes we limit ourselves by thinking our skill sets are you know, I'm good at inserting central lines or I'm good at teaching the paramedics. And and they miss the fact that that something like ⁓ teaching paramedics, for instance, involves organizational skills. You have to pull together a group of people, you have to try to understand the different needs of everyone, you have to try to speak to them on their own language. What else what other kind of jobs might have that ⁓ opportunity? Would it be in something in the public health or or related to the EMS commission, for instance, is w where I where I got ⁓ such a lot of opportunity to meet some really incredible people who are providing pre hospital care. ⁓ so again don't don't limit yourself. Th the second is ⁓ the one of the one of the ⁓ opportunities that I had was ⁓ to ⁓ encounter the first iteration of managed care and it became obvious that it was a failure. ⁓ The idea of paying doctors to not refer patients, ⁓ so that you could keep the money that the referral would c be costing. ⁓ and all of a sudden every ⁓ PCP became an endocrinologist and a cardiologist, and the patients knew the difference. And but on the other hand, there was a c there was an element of of truth there. So I went back to get an MBA to understand it and realize that ⁓ ⁓ what I ⁓ didn't know was that we spoke a different language in medicine than in business. Business is about a a bunch of different parameters. They're very easy to figure out if somebody will explain them to you, break them down. But ⁓ for the rest of my career I often joked and said ⁓ I'm often doing a translating function here. I'm taking the business case, what the what the business people want to achieve. And I'm turning it into language that the physicians and techs and ancillary personnel can understand. And then I'm taking their comments, which sometimes are no, we can't do this, it's dangerous, and taking them back to the business people and say you're gonna fail because you're attacking them on a core level. I mean, they got into this because they wanted to make a difference with patients, and you're asking them to somehow subjugate that. to a profit margin. They they don't get it. It's it's it's not in their DNA to to wanna do that. And so translating back and forth and ⁓ being a bridge between business and medicine was a lot of fun. And ⁓ and e every job after I got my MBA had some element of that.
speaker-1: Yeah. Well, and super important too, you know. I mean, I I think that it if we had more physicians getting MBAs, getting on the business side of medicine, and bringing our perspective as providers ⁓ to the business guys that look at patients in a different way than we look at patients. They're, you know, they're very numbers oriented and and you know, margins and bottom line. and sometimes when you're trying to take care of patients in the right way, you have to do some things that may maybe aren't exactly the best thing from a business sense, ⁓ because you're taking care of humans. So, so I I I applaud you for getting an MBA. I applaud you for going back and and being that translator to the business people because ⁓ I we just need more doctors doing that. And and the other thing that you mentioned, I think is how you can take your skills that you learn. ⁓ and maybe they're not maybe they're they're the soft skills, you know, about communication, breaking down complex ⁓ concepts into bite-sized chunks, ⁓ you know, that we we we learn that multitasking. We learn those skills as physicians that can then be applied to whatever else you decide to do, whether it's becoming a financial advisor or, you know, working in a ⁓ ⁓ health administration or or working in a veterinary clinic which or startup which is another part of what you have going on. But you know, the I I think that that's an important part of that side gig school if you if
speaker-0: you will.
speaker-1: So tell me ⁓ about When w ha ha ha did you continue working clinically through all this stu ⁓ all these shifts within your career or did you leave the clinical work behind as you kinda started doing a lot more of this business and administrative stuff?
speaker-0: Yeah. ⁓ I I had a problem working clinical shifts and as I started to get more involved administratively. ⁓ typically meetings are held in the business world Monday to Friday, nine to five kind of idea or in whatever time zone you're in. and ⁓ and so ⁓ I ha had to typically work my shifts on the weekends. ⁓ my clinical shifts on the weekends, w which which was okay. ⁓ but I found ⁓ For me the magic number was six. If I didn't do six clinical shifts a month, I was losing my timing. I was losing that intuitive approach that we take. I I I describe it as, you know, you look into the crystal ball and it's all kind of cloudy and then little points of light appear. And when you can connect dots to make a pattern, you move on to the next patient. And yeah. And people sort of say, I I somehow thought it was sort of more linear and more planning and the rest of it. But ⁓ what I see it as we're we're using a right and left side of our brain. We're using the knowledge we've accumulated and our impressions of the patients and those good diagnoses we make are often a combination of those where something just doesn't fit here. There's a piece of the puzzle that that it doesn't
speaker-1: A voice inside your head that says, think again. Yeah. About what you're doing. Yeah.
speaker-0: Yeah. Well, so anyway, I didn't want to lose my timing. I didn't want to be the boxer who shouldn't have fought the last fight. And so when my number got down low and then one weekend I ⁓ I was working a shift or scheduled to work a night shift on a Saturday night and I got a call Saturday morning from the CEO of one of our hospitals who said, ⁓ your director is not working out, he's gotta be gone. And and I said, ⁓ okay. How long do I have to replace him? She said, I'm I want you here on Monday morning ⁓ to to to give him the bad news. okay, I gotta find a director. This was a mid Midwestern Rural Hospital. and ⁓ and and she had very high goals and aspirations for her director. So she wanted a board certified emergency physician. And ⁓
speaker-1: Thank you.
speaker-0: And and so I said, ⁓ anything else I should know? She said, Yeah, I want him to keep working here clinically. ⁓ because we need him. He's a really good clinician. And I thought, Okay. Not too much to ask. But so I had to line up a co you know, coverage for my shift. I had to get on a plane all spent all day Sunday getting out there and prepping for the meeting on Monday and the rest of it. And I realized this was going to be increasingly a problem. which was working and administrative. So so at that point I I willingly gave up the the clinical part. I missed it a lot. I missed the fact that even though in emergency medicine we say, you know, you need to have a an arm that's long enough to pat yourself on the back because your patients are not going to do that. ⁓ in business
speaker-1: Or your hospital administrators mostly.
speaker-0: And it well in business it happens much less frequently. No surprise. The number of compliments you get is almost it's like the expectation is you're gonna do an excellent job. Don't screw it up, kid. and so I I really did miss that positive feedback from patients because I think that that kept me going for so many years through a lot of trials and tribulations when I was practicing clinically, which is the idea I I am helping people. They do appreciate it. They are thankful. A and ⁓ but when I got when I when I that started to happen then I realized I had to do full time administrative
speaker-1: And how far into your career were you at that point?
speaker-0: Well, so ⁓ let's see, twenty seven thirty seven years. So I had I had been like I said, cutting down on the number of shifts as I was doing more administrative work, but but I I had had a long career. Now again, the beginning of my career started in a rural general practice, which is you know, catching babies and assisting in the operating room and managing fresh MIs in the ICU. All that sort of stuff.
speaker-1: So when you made that that full transition to administrative, ⁓ did you did it affect did you have an identity crisis or or you know, since you were still within still working within medicine, did it ease that little bit?
speaker-0: Well I I have to admit that for a while I said, you know, how do I replace something as meaningful as this day-to-day affirmation that I'm helping people with something as kind of obscure as, you know, am I making a difference in administration? And and I realized that ⁓ if I was say I was regional director over five hospitals, ⁓ That if I could impact through some something that was beneficial, if I could negotiate if it was say ⁓ a hospital group that was working for a multi hospital company like a tenant or an HCA or something like that, if I could impact something with the a with HCA that would impact four or five different hospitals, then I would be impacting all the doctors who work. And in turn impacting the patients. So if I could make the doctors' lives better by being the interpreter and being the champion and the ombudsman and the rest of it, then ⁓ then I could continue to make a difference. It was more nebulous and I wouldn't see it on a day to day basis, but I knew that I would be making a difference and so so I kind of started to to think I wanna have a bit of a champion role here. And I may not always be popular with the with the the ⁓ company that I'm working for or the or whatever, ⁓ because I may not be telling them what they wanna hear. But on the other hand, ⁓ I had never t had trouble finding a job, so you know what's the worst they can do? Fire me, right?
speaker-1: Exactly. Yeah. Sometimes you sometimes you hope that that happens.
speaker-0: And that and that and and getting back to the you know the the ⁓ well we sort of little touched on burnout. If you don't if you burnout tends to happen when you're trapped, right? You have no ac exit ⁓ exit. There's no exit strategy in mind. You always need an exit strategy i if forever possible, whether it's just living off of your savings. You know this better than I do. I can't preach to a financial advisor about this. But y you know, you need to have a cushion financially, but you also need to keep your connections going so that if ⁓ the milk goes sour here, you know, you can you can ⁓ start to develop a connection for another potential opportunity. And that gives you often the confidence to to live through a a tough situation ⁓ without feeling trapped.
speaker-1: Yeah. I mean, I think that that's such that's the power of financial independence, right? Is the is the ability to say no to stuff. Cause and walk away. So yeah, so now you're no longer trapped. Doesn't mean that you have to stop working. I mean, you can you it just means that now your world is opened up because you ha you can take opportun you can take risk in opportunities that otherwise you may not feel comfortable taking that risk in because you feel like financially ⁓ you're not I mean you're tied to you to that particular role. So so yeah, absolutely. Financial preparation helps create that career freedom that then you can align that to your to your values. So so you can think of money as a tool to get you there. Yeah.
speaker-0: I may and sometimes, you know, when I sorry to interrupt you here. not infrequently when I went from one job to another, ⁓ I took a pay cut. ⁓ because the job looked good and and I I thought y you know, I had learned to live not like a resident, but I'd learn to live within my means and ⁓ and not take expensive vacations unless I had a windfall of money to be able to do that, but not using debt to finance the fun stuff. And and so I s and lo and behold, you know, a year or two later, gosh, ⁓ you know, with bonuses and the rest of it, I was doing a better financially than I had in the old one. And that that's often the case is that if you demonstrate value, you you then will be able to to get ahead. But if if you're ⁓ I remember ⁓ in my business school they Said you you know, ⁓ don't be a commodity. Right. ⁓ and emergency physicians are considered by CEOs to be all uniform. Everybody who higher who works at my hospital is good. And if I bring in another group, they're all gonna be good too. So you're not differentiating yourself. So you're like gasoline. Okay, what's the cheapest per gallon price I'm gonna fill up there? And after five or ten years and ⁓ working clinically and you you say, ⁓ you know, I need a raise and the person who's the one who's hiring firing says, Well, you know, I can hire a new resident for less than I'm paying you. ⁓ so why should I pay you more?
speaker-1: Yeah. And we're seeing that all over. I mean, it's that that corporatization of emergency medicine and independent groups are being replaced because of that very reason. Is, you know, they they haven't created that re irreplaceability. Yes, you know, uniqueness. Right. The uniqueness that that make that keeps their job. And so in and that's on a group level, on an individual level. ⁓ yeah, I I I think we underestimate the power that we have or the power that we can create. by creating that uniqueness. And and and that's that's looking outside the box. You know, it's looking for other opportunities. It's it's developing relationships that are just outside of your group. ⁓ you have to do that.
speaker-0: ⁓ so kind of open the kimono here a little bit and say that, you know, I was involved in ⁓ mo not a lot, but a few takeovers where the group I was with took over a contract and we would meet with the CEO before the contract changes hands and say, Okay, who do you want to keep, who do you want to go immediately, and who are you okay with, but we should replace them over the next year or two. And I think docs are shocked. by that c thought that that that they may be considered like ⁓ you know which shoes do I want to wear today kind of idea. But ⁓ but the the ⁓ the attractiveness of physicians often has to do with their relationships with the staff. Do you get along well with the nurses? Do you get along well with the attending physicians? Those are the things the CEO's listening to because those are the people that run his business or her business. And and so I so you wanna be one of those people who ⁓ they immediately say, ⁓ yeah, you know, keep Brian. He he's a he's a great guy, you know, I like him. You know, I've met him. I mean he yeah he saw my kid when he came in when the child came in with a you know broken toe or whatever. and ⁓ Yeah but we're not
speaker-1: Definitely the the the capa the capacity as a physician or the skills as a physician is a given, right? I mean that that's that's not what separates you. That's that's considered a given if you are if you're credentialed and especially if you're board certified, you should know how to take care of patients. It's the rela it's how you deal and communicate with the team that differ or or other skills that you bring to the table that differentiate you. Yeah, for sure. Okay, let I I w I want to shift gears just a little bit and say, ⁓ you know, you've you've had a long career, you've had a long life within medicine. ⁓ looking at you as your, I don't know, let's say mid career 40 year old self, 40, 45 year old self, envisioning what your retirement was going to look like, or what you thought it was gonna look like, how did things change? How how is it different in reality than what you thought it was gonna be when you were 40?
speaker-0: Well w w first of all w when I was forty, one of the the fortuitous things that happened is ⁓ my wife ⁓ was talking to some of she's a she was cardiac rehab nurse, so she was talking to some of the business people who were ⁓ she was seeing and they said, Do you have a financial planner who's helping you? And she said, Well, we've got ⁓ somebody who sells us stocks and ⁓ No, he said a financial planner and so lined us up with somebody who who set me on a path for my retirement, who I wouldn't be able to retire. You know, automatic monthly withdrawals from my checking account into an investment account. ⁓ you know, and then we follow that strategy for our daughter when he when she wanted to go to when she was born. And that's that allowed her to graduate from vet school without any debt. ⁓ yeah so so setting those things in progress early on was was very important in terms of allowing
speaker-1: Not just assuming it's gonna happen by default.
speaker-0: Yeah, or or or necessarily assuming that I was a brilliant investor and I was gonna make all the you know, I was gonna listen to the pro to the stock tips when we had a physician's lounge we would go to, right?
speaker-1: That's the most dangerous place financially is the physician.
speaker-0: No, I guess nowadays even TikTok, right? Where you're or or or wherever you're gonna get your information from. ⁓ but with me, ⁓ retirement looked like it was going to be pretty calm. ⁓ I was winding down, I'd gone through covet, I'd been able to get a a job where I was working remotely. And then ⁓ one morning ⁓
speaker-1: Yeah, exactly.
speaker-0: I came back after driving my daughter and husband to the to the airport and I went in to check on my wife, she hadn't gotten up yet, and I found her incontinent ⁓ and unrousable, meaning she had had a seizure, no seizure history seizure disorder, a generalized seizure, and was essentially unrousable. So ⁓ i i it I immediately called nine one one. They were gonna div they were the h local hospitals were on diversion. I would they were gonna take her to this little tiny boutique hospital, which I said is not the place I want my wife to be. So I talked to the head paramedic and we kind of, you know, did the secret handshake and and he and I said, you know, I need to go to this ⁓ local hospital, which is the best hospital and he said ⁓ gee, I guess they just opened up. And so ⁓ so she got treated in the hall because of course there were not even any hall beds, ⁓ but in front of the nursing station they whisked her up for E G and a C T scan and a and a and the neurologist on call that day came down and said, This pattern resembles herpesimplex encephalitis that she's got. She's got specific problems with her parietal lobe on both the E G and the C T. We're gonna start our own a cyclovir Ivy right now in the hall. And that probably saved her life and certainly saved her from being in a vegetative state. ⁓
speaker-1: If you're it, your advocacy to get her to the right place also made up.
speaker-0: Yeah. Yeah. And ⁓ and so so immediately my world was turned upside down. ⁓ she was in a coma for a week. She was in and out of the hospital five times that first year for a total of ninety days. ⁓ she was getting breakthrough seizures. ⁓ it it took every bit of my medical knowledge and the rest of it to kind of maneuver her through the healthcare system, which which was an eye opener about how complex and difficult it is. and how much all of the experience I had came to bear here.
speaker-1: Yeah, imagine having to do that without the experience that
speaker-0: Yeah, you can't Exactly. It wouldn't have happened. I I mean y you know, she was having when she got out of the hospital, she was having these spells. We didn't know what it was, but she would go to bed and be fine at night and then wake up in the morning and be confused for about a day. And and ⁓ I finally took her to see a neurologist who was on call for her regular neurologist who was who had just finished his epilepsy training ⁓ as an epileptologist fellowship. And he ⁓ she needs to go to the epilepsy management unit for a week and see whether she and be wired up and see whether she's having silent seizures. I said I'd never heard of an epilepsy management unit. He said, Yeah, there's only two in Southern California, one where I trained and one at Cedars. And since I'd been a working at Cedars, I pulled some strings and got her in there and found out she was having breakthrough seizures. Well, I didn't even know that as a emergency physician who worked at a bunch of different hospitals. ⁓ the average person would have been no. She she would just continue to have them. But ⁓ you know, she was a different person when she finally got out of the hospital. ⁓ the the the disease process caused a necrosis of the brain. So she lost short term memory, some express has some expressive aphasia, executive functioning and ⁓ It it ⁓ it I miss her. I miss the the the wife I married.
speaker-1: Yeah. How many years ago was this?
speaker-0: So this was ⁓ twenty twenty four when it happened. So not very long ago. Tw no, twenty three. Twenty three was when she had her and three years. And so ⁓ so it's been it's been ⁓ a journey. ⁓ she she came home and ⁓ and and did not adapt well to being at home
speaker-1: Two years. Yeah.
speaker-0: She didn't have her driver's license, so she couldn't drive and and we're we're in a kind of a little bit of an isolated urban community here in Los Angeles and so there's no place to walk to and the neighbors had all aged along with us, so nobody was communicating and she was lonely. So I I finally ⁓ overcame the the the negative feelings that we often have as caregivers that I can provide the best care. Why would I let somebody else provide care when I can do a better job? And and ⁓ she's currently in a memory care unit which is fifteen minutes away and I see her every day. And and my and and that's when I completely retired was realizing why am I doing this? So I went to to my financial ⁓ planner and ⁓ and and ⁓ said ⁓ do I need to work? And they said, No you don't. He said, You've got enough of your savings and your lifestyle is ⁓ easy enough that you don't have to work. Don't buy a Porsche though.
speaker-1: Yeah. And
speaker-0: No and ⁓ and and then we were lucky too, early on we got long term care insurance when it was affordable, like again back in our forties or forty five or whatever. And so her care at this point is being financed out of long term care insurance, which is you know, you know, I mean, typically minimum of six to ten thousand dollars a month.
speaker-1: Yeah. Yeah. Yeah, especially in the memory care units. It's I I f resonate with your story. ⁓ you know, my my kids have ⁓ I t I have two adult special needs kids, so it's kind of the other side of the caregiving spectrum. But ⁓ just understanding where what you th thought th things were gonna be, turns out that that's not in the cards. And ⁓ you know, so we People when when your when your life is derailed, I think is a fair way of saying it, but when your life is derailed, how do you adapt? How do you adjust? And you know, and I think that there's a couple of ways that people do it. And some are turns they it turns negative and and they, you know, they lose their purpose in life and you know, ⁓ and others can turn it in a in a more positive way. And so my question is, how did you, you know, obviously this is not the retirement that you had envisioned, I'm sure, you know, in terms of whatever you had hoped to be able to do, you know, travel together, visit family, visit kids. ⁓ how have you been able to reinvent retirement so that you're still finding meaning and joy?
speaker-0: Well well one thing when it became obvious that she needed an institutional placement was I immediately had a family conference. I asked her she had a pre ⁓ two adult children with were blessed with grandchildren from them. ⁓ I asked them to come to town. ⁓ our daughter and her husband asked them to be here and we sat down and we talked about and I said, Look, I I'm gonna give you everything I know about her clinical history and what I've learned from all the specialists and I'm gonna tell you, explain to you the financial situation we're in right now. And I want to talk to you about where we're gonna go forward. And I want because I want your input and I want you to help me and to help her. And and ⁓ and it it worked out very well because they continue to be involved and ⁓ I see them as my advisory board so to speak. It as they and again, ⁓ just last night her son came up from the Caribbean with the son in law who's lives in Washington DC. They were in town and they came to visit Susan and they and they'd be doing that pretty much every day since they got here a couple of days ago. ⁓ because again, she is precious to all of us. And so ⁓ so I don't feel alone. ⁓ I I can't imagine anything worse than not having any kind of support systems. My support system is family. ⁓ and and I really I I I really i if if there's one message I wanna get out to to your listeners is if you have any ⁓ problems, family related problems, if for some reason you've drifted apart or especially if you haven't gotten along with each other, please think about mending it. ⁓ old age is lonely. And family are the the ones that know your history and you can share stories and it's just it it's I can't it would be so empty if I didn't have all of them in my life and be close to them. and that's helped me keep definitely helped Keep me going.
speaker-1: I think that's such an important message. You know, I mean, over and over again, in the financial world, ⁓ you learn that money is a tool. It's not a goal. And that's it doesn't that's not the source of happiness. And at at the end, you know, at the end of life, if you so the true source of happiness is the deep and meaningful relationships that you have with the people around you. Whether that's your family, whether it's friends, whether it's colleagues, that's what keeps people going and makes their life meaningful. And ⁓ you know, I I I love what you said about how important it is to create a team, especially if you are a caregiver. And and again, I I know that myself from my own personal experience, but that will become even more important as I age to the point where I can't my my wife and I can't be the ones to be the primary caregivers anymore. ⁓ to have to create that team of people, whether it's family or non family, but create that team of people that that you can transition that care to. So that ⁓ you know, because you can't do it forever and you can't do it by yourself. ⁓ and and and so it's such important message. And and and that's that also takes planning, you know so so your retirement, I I I think one of the great messages from you is that Yes, financial planning is important for retirement. But that's not the only type of planning that's important. It's it's it's life planning, it's transition planning, it's it's caregiving, it's it's all the other things, you know, it's bringing your family in and being sure that they're included in all that in in so yeah, thank you for sharing.
speaker-0: Yeah. A and and also too, you know, in my case it was going from ⁓ sixty to zero over in five minutes or thirty seconds when I realized my whole life was turned upside down. ⁓ and so so treasure each day. It's a cliche. And it and the cliche doesn't really come home until you've had someone who's close to you.
speaker-1: Yeah.
speaker-0: who all of a sudden is gone. ⁓ and unfortunately as we age we find that people who for whatever reason, ⁓ I think often just bad luck, are gone. And I just talked to them last week kind of idea. Well do they know that you cared about them? Do they know you know how important they were?
speaker-1: Yeah. Yeah, there are no givens, right? There are no givens in life. And and if if ⁓ you know what you envision your retirement to be may not be what it is because of health or loss of life or all kinds of things. So you can't keep putting off those things that are important that bring you meaning and joy for some time in the future that may not happen. So so I I I think a a great lesson to just remember You know, live each and every day to the fullest. Prepare for the future. You still have to prepare. but if you're you might be missing out on a lot if that's if you're only thinking about the future instead of maximizing your day. Awesome. ⁓ well again, thank you for sharing that. I I you know, normally at the end of our at of our ⁓ our conversations we have what we call the reckoning. I don't know if you watched any of our other podcasts.
speaker-0: Didn't because I didn't want to be biased. I didn't want to sort of say you know, ⁓ so so I thought, no, y you had mentioned you wanted to be as spontaneous as possible and I appreciate appreciated that. ⁓ you know.
speaker-1: Yeah. Good no, I I mean it's been a wonderful conversation so far. Norm now I'll I'll tell you that normally my colleague is the one who who does the reckoning. So basically what the reckoning is is just a few short answer questions. ⁓ that, you know, there's there's no hedging. It's just like what what comes first to your mind? And again, I'm gonna look through a list of things and see which ones would be some good ⁓ reckoning questions. Okay, actually here's one. So I I wrote a book called The Physician's Path to True Wealth. in your mind, after the life that you lived and the career that you have, how would you define true wealth? What does it mean to be wealthy?
speaker-0: ⁓ to ⁓ to to to me it's not about money. It it's about the people I met and the people I stay in touch with. And and again, it's ⁓ the the my what I consider the true wealth is the friendships and and the family. Ye part of the th the reason emergency medicine was a so attractive to me is I got a chance to talk to people about things that weren't you know, a little bit tangential, you know. ⁓ you know, you work for rocketine. What's it like to be a rocket scientist kind of idea? ⁓ and and I I just enjoy people and finding out about people and to be true wealth is is to be able to have those sort of experiences. It's it's not about y The he who dies with most toys wins.
speaker-1: Yeah. And and I I actually find that really interesting because the more people that I ask that question or or basically talk to about finances, the older you get, the less money means. You know, the ⁓ the less stuff matters. ⁓ and and the more relationship and experiences and things like that are are what really make a difference in in life. And so, you know, obviously you want to have the the money that will help. help sustain you and and give you the optionality that you want to create to be able to create that those opportunities but but that's that's why it's a tool and not the not the goal. Yeah. So so thank you. Okay, here's here's the next question. What advice would you give physicians approaching retirement who are anxious about losing identity or relevance?
speaker-0: Make sure that ⁓ you do some serious thinking on this topic bec and I think it's a it's an excellent one, ⁓ excellent question, is if you haven't planned to do more than just golf, you're gonna die sooner. ⁓ the the research is absolutely strong on this. It w if you lose your sense of personal identity, ⁓ I I I have lots of identities as you could tell from from the various jobs that I've had and the rest of it. So so I was lucky I kind of learned how to put on different hats kind of idea. ⁓ but again if you stick with your w all of us should actually have like a mission statement and a vision statement about you know, what what we wanna do and Yeah, I'm just looking here. I have a little thing posted on the on the wall here. ⁓ embrace life, gentle withal, never ever regrets. And and then ⁓ my my mission statement is to make people successful. So in my retirement, I find meaning in trying to help people, even if it's not anything to do with medicine, even even if it's just You know, go to the dry cleaners and say there's a better way you could be hanging those clothes. Well, you know, lots of times I think they think, What the hell is he talking about? You know? I didn't ask for that information. But yeah, but again, you you find meaning sometimes in the in the funniest places and you find often as we did during our careers, that you can make a difference in people's lives when you didn't even notice that what you said, that one comment. change their life or change their path. So think about how you can continue to do what we went into this ⁓ calling to do, which is to to help people. How can you continue to help people on some sort of level so you continue to do this? Because we obviously are hardwired to to do this to a degree that is beyond the normal population. Physicians sacrifice a lot to be ⁓ physicians. And and ⁓ s so I I think make sure there's some meaning in your life that way.
speaker-1: I think that's great advice. We're we're healers by nature, right? That's we we became doctors because we're healers and we want to help people. And and even if you're you don't have the white coat on anymore, there's so many ways you can heal people. And sometimes it's just with a smile and and you know, just making their day a little bit better. So so I I think that ⁓ being purposeful about that I think is is how you don't lose your identity as a healer because you don't need to when you when after you retired. So Great advice. Okay, here's the third question. ⁓ what do you wish your thirty-five-year-old self understood about career and life?
speaker-0: That ⁓ that a door would open before the previous door closed, that that I didn't need to be worried about taking chances, that I ⁓ that I could ⁓ be bolder, that I could do more, that I could risk failure more than I did. ⁓ I was very risk adverse at the beginning of my career because here was a Canadian in Los Angeles who knows nobody. How am I gonna, you know, be able to create an identity here? So I was very cautious in the beginning and and I I realized the more that I took chances, the more successful I was. Well, I wasn't always successful, because you don't succeed, you know, nobody's got a batting average of of, you know, a a thousand kind of idea. But but on the other hand, the ⁓ the more you try, the more you succeed. And so I I would say so be bolder.
speaker-1: Yeah, even failure is a learning experience that can leverage you for your next your next opportunity, right? And so I I think I think that's also great advice. And and and I found that looking back on on the chances that I took also, you know, they didn't always work out a hundred percent, but they always worked out. Yeah. You know, it it always worked out in in my benefit in one way or the other. And ⁓ and I think that so many of us ⁓ are afraid to take chances because of that, especially those who are high achievers enough to become doctors. I think in some ways we're afraid of failing more because, you know, we're used to not failing. And so failure is ⁓ scary. And ⁓ but yeah, I I think that that's wonderful.
speaker-0: Well when you're working in the ER, I mean you can see you can see twenty people a day who have failed, you know? I mean they there's just a a constant litany of people who tried something and did it wrong.
speaker-1: Yeah, you can't. That's right. Well, and and plus in the e you know, as as physicians, we are ⁓ conditioned not to fail, you know, because failure as a physician means somebody could get injured or lose their life even. And so there's a very high risk of failure as a physician. And so clinically. And so taking, you know, being able to Put that aside and and try something outside of your comfort zone can be a challenge, I think, for a lot of doctors. Okay, Fred, it's been an awesome conversation. I hate to end it. but eventually people will stop listening. So so ⁓ thank thank you again for joining us ⁓ today. ⁓ normally what we do afterwards is that if Aaron were here, he and I would kind of break down the conversation, pick out some highlights and and ⁓ you know, end the podcast that way. ⁓ I'll either have him do that with me ⁓ when he's available or I'll I'll just do it myself. But ⁓ Anyway, it's been it's been wonderful. I think you've given us many, many pearls of wisdom. ⁓ good luck with your family. Best wishes for your wife. ⁓ best wishes in your for formal retirement now. And and I hope that ⁓ you know, you can continue to find the meaning and joy as you help others. So thanks again. Thank you, Matt. All right, everybody, this is the time where we ⁓ recap ⁓ our conversation with Dr. Fred Dennis. I thought it was a really good conversation. He had a lot to say, a lot of of great pearls. ⁓ he's obviously lived a long career and a long life, ⁓ full of ups and downs, but lots of challenges and or lots of opportunities that he took advantage of. ⁓ I think one of the important things that he taught us is is ⁓ the importance of saying yes when opportunities arise. So he he mentioned that not all of his ⁓ career path was necessarily planned. ⁓ But it happened by saying yes when opportunities came up. ⁓ and that led him to new things that he may not have ever anticipated, ⁓ especially as an early emergency medicine physician. but ⁓ I think so many of us just forget, you know, to step out of our comfort zone and ⁓ to say yes to things as the as they come up. And and it's hard, you know, we have We're busy as is. ⁓ feels like ⁓ saying yes to other things is just adding to that and and maybe contributing to burnout. But in reality, I think creating those other streams of income or at least streams of attention can often prolong our careers because ⁓ it it gives us exit ramps for one, ⁓ but also ⁓ just adds variety to our work life and ⁓ you know ultimately it helps us be able to choose the things that we like to do and ⁓ you know, maybe pay somebody else to do the things that we don't like to do. ⁓ the other important thing I think he taught us is that a lot of times it's who you know. You know, developing those relationships is critical in terms of finding new jobs and new opportunities. And and I certainly see that a lot with with young ⁓ people in the workforce or trying to get into the workforce and and are having difficulty in spite of education and in spite of ⁓ you know, talent. ⁓ Lots of times they don't even get their foot in the door because they don't have ⁓ the people that ⁓ they haven't made those relationships yet. ⁓ and so cultivate those as you're going through your ⁓ your work, your work life, because those are what's those relationships are are what you can leverage ⁓ so that later on you can find the opportunities when you need one. ⁓ he was a great example of how ⁓ if he started getting bored in his career, it sounds like he just called somebody up and said, Hey, what kind of opportunities do do you know about? Or ⁓ and lots of times those were just created for him because those people wanted to work with him. ⁓ that kind of leads me to my next point about ⁓ and I don't know if this is a word, but I'm gonna I'm gonna say it anyway, decommoditize, you know, ⁓ lots of times. And more and more it seems that ⁓ physicians are becoming commodities and certainly are commodities to the ⁓ the business folks that are ⁓ making decisions about your career and the hospital that you work in. sometimes there's nothing that you can do about those those ⁓ transfers, but ⁓ when it happens and and if you're bought out and ⁓ you know and they're those that new company is asking who they should keep and who they should let go. you know, set yourself apart by adding broader skills than what is expected by any physician that would fill your role, but also by forging good working relationships. I found that for sure is that, you know, if if you ask nurses or techs or some of the other members of the team who they like to work with, They don't shy away from answering that question. And they know who the doctors are that are That the patients like, that communicate well and that work well as a team. And and that I think that goes with any career, you know, whatever whoever your team members are. ⁓ you set yourself apart by being a good team member and a team leader. And so that will help you keep a job and will help you find new ones if if you don't just become a commodity ⁓ to those people who are making decisions above you. All right. I think the most important ⁓ thing that he talked to us about is that there are no guarantees in life. ⁓ you know, what a challenging experience that he's had with his wife. ⁓ how difficult that must be, especially as you're just n s approaching your retirement years almost there. and suddenly your vision for r what retirement was going to look like is ⁓ drastic drastically changed. ⁓ He taught that how you get through that is is with your family. It's ⁓ it's the relationships around you. It's cherishing cherishing and nourishing those relationships. ⁓ you know, I I I thought it was very powerful when he talks about the loneliness of of ⁓ being elderly. And I think that happens a lot. I think that's ⁓ there's a high depression rate in elderly folks. ⁓ and mostly I think that be is because they're lonely and they they've lost skills, they've lost opportunities. There's a lot of loss in in retirement and in elder in old age. So the last thing that you want to lose is the relationships that add meaning and joy to your life. ⁓ that's your most important asset. You can have all the money in the world. ⁓ if you don't have those relationships, you're not going to have the same quality of life. ⁓ that you would otherwise have had. So I think his story amplifies that and something that we sh all should remember. All right. So again, thank you to Dr. Fred Dennis. ⁓ I appreciate the time and his his openness about his story. ⁓ I hope you enjoyed this episode of the Second Shift Podcast. Please tell your friends about us. Suscr subscribe and like to the channel. I think that does help. Get the word out there, ⁓ help sustain us. ⁓ so if you are finding this information useful, ⁓ please do that. Also, if you are interested in learning about your own ⁓ or learning more about your own second shift, ⁓ we do have the second shift blue the second shift blueprint that is available on our website at second shift. That's the number two nd podcast dot com. Please download that. ⁓ five important conversation questions that you need to ask with your significant other before you take on a next your next second shift. ⁓ and feel free to reach out to us. ⁓ we'd love to hear from you. Take care.
speaker-0: The work you did mattered. And you're not done. Welcome to What's Next. Thank you for listening to the Second Shift. If this conversation landed with you, please download our free guide called the Second Shift Blueprint. 5 questions you and your partner should discuss before any major transition. Get it at secondshiftpodcast.com. That's number 2ndshiftpodcast.com. And if you're approaching a transition and want to talk through the financial strategy, we offer a complimentary 30-minute second shift audit. Details are at secondshiftpodcast.com/slash audit. Join us next week for another great episode. And remember, your life and identity doesn't end with retirement. It's just entering its second shift. The content shared in this podcast is intended for educational and entertainment purposes only and should not be considered personal financial advice. You should always consult with a financial professional to determine what is appropriate for your individual circumstances.
