Episode 35: Entrepreneurship As A Path To Physician Autonomy w. Dr. Bonnie Koo

In this week’s episode, Justin talks to his friend Dr. Bonnie Koo, to explore the topic of building autonomy into the life of a physician through business and entrepreneurship. The more we are able to build in mechanisms to have multiple external sources of income, the better off we are going to be.

Dr. Koo: 01:25
I’m doing great. I’m so excited to be with you today.

Justin: 01:28
Yeah I’m really pleased to have you and I’ve got to say to start off I don’t usually venture outside the specialty here for anesthesia and pain but your story was so compelling and it addresses quite directly one of the major issues that I see today with physicians that of physician autonomy and how it is dissolving everywhere we look and how you’ve really been able to intentionally build this into your life. And I’m looking forward to hearing your story and having our listeners learn from your experience awesome alive and more honored now. Yeah cool. So to start us off just tell us a little bit about your background and how you came to your your current vocational situation.

Dr. Koo: 02:04
Okay well I’ll try to keep it short but you know for those of you who don’t know me I am a dermatologist and I’ve been on a trading now for while it’s been I guess just over four years now.

Dr. Koo: 02:15
But to back up a bit more you know I didn’t go to medical school until I was 27 but I was always premed so I was a biochemistry major in college I went to college in New York City at Barnard College and I was on track to apply to medical school and start right after graduation but like life in general sometimes things happen. So nothing bad happened but basically I actually got a really great job opportunity at Morgan Stanley. Now most people think I worked in finance there but I didn’t. I was an I.T. person. But the reason why this job was amazing is you know I was what 21 22 and I was a senior in college and you know I had sort of lower middle class upbringing and so I never really traveled much.

Dr. Koo: 02:55
I never went on a plane. And so this job basically was like Well the first four months are in London England. Wow. So I basically was like sign me up now.

Dr. Koo: 03:07
And the reason why this opportunity even came my way is because my job I had a part time job in college. To actually one was babysitting. But the other sort of official one was working in the computer lab at Columbia University. And so when you work in the computer lab there a lot of my friends were computer science majors and then there were people like me who are not computer science majors but kind of knew more than the average person. And that’s how we got the job and all these computer science majors all ended up working at Morgan Stanley.

Dr. Koo: 03:35
And so I just got a call one day saying Hey we’re still looking are you interested. And I was like interested in going to London yes. So that’s kind of how it happened.

Dr. Koo: 03:44
Now I thought I’d worked there for a year and kind of then reapplied to medical school or apply rather it ended up being four years ago. So that’s sort of why I went to med school at 27 but ok I guess the good news is I still want to go to medical school despite making six figures at Morgan Stanley.

Justin: 04:01
Okay yeah.

Dr. Koo: 04:01
And that was probably just enough time to forget all your undergrad bio classes so I’m guessing there’s some time to brush up on the cat in their Yeah so I had to take the cats I never took it in college I actually was in a Kaplan em cat review course and my mom was quite upset cos she paid for that course and I don’t remember the cost but these things aren’t cheap right. Sure. So she was not happy about that.

Justin: 04:24
Got it. But then you made it into med school everything worked out and you mashed into derm. So what was that. What was that journey like for you.

Dr. Koo: 04:32
Oh so that was another journey. So as many of you know you know becoming a dermatologist getting into DERM residency is not easy.

Dr. Koo: 04:40
And so I did not get in the first time I applied so I didn’t get in until the third time I applied. So I guess there’s a little store there.

Dr. Koo: 04:47
So clearly I kept applying until he cut me I guess is the lungs the short story of it. Like many people trying to get to term residency I ended up doing a year of research actually two years of research one at UCSF and that one at UC Irvine and that’s where I ended up matching. Okay awesome.

Justin: 05:06
And then how did you find residency to be I.

Dr. Koo: 05:11
You mean like was it easy or hard.

Justin: 05:12
I mean coming from a background of being an I.T. which is like totally different and then doing med school you’re seeing a lot of different sort of swaths of life I guess and as you’re stepping into a clinical environment now and being a practicing physician how did how did that open up new possibilities or new challenges for you.

Dr. Koo: 05:30
Yeah. That’s a great question I don’t get that question a lot.

Dr. Koo: 05:32
You know I think because I had a job before medical school and obviously you know I don’t know any other way. But I didn’t find it that difficult in terms of interacting with people. So you know I think if I think of a traditional student who just goes straight from college to med school to residency to practicing that’s kind of all they knew versus you know I had a job where I had to interact with people in a professional environment for many I guess four years in a professional environment. I work with very intelligent people these were people who are sort of known for their specialty within I.T. and so Morgan Stanley tended to attract some of the I.T. star so to speak. And you know I’m proud to say that I’m still friends the lot of them and they’ve all moved onto some amazing careers. You know one is has a very high position and I think it’s Google. So they’ve all sort of moved on to really great things. But yeah I think having that experience interacting with other people really served me well.

Justin: 06:32
Yeah awesome. And then talk a little bit about you know during this time the the financial timeline for a physician in general is very unique because for most people who go straight through yeah maybe go into debt for undergrad. You try to avoid it if you can but then you almost certainly go into debt for med school unless you know you have some family money or something like that and then you come out and you’re in residency making hardly anything trying to scrape by and then you become an attending and everything changes. There’s a lot of complexity a lot of moving parts but for somebody like you you know taking a less conventional path and also working at a financial firm would you say that that sort of prepared you for some of the financial hurdles that you’re going to face or how is your journey in that regard.

Dr. Koo: 07:17
Well I think logically it would help me but it did it.

Dr. Koo: 07:22
I mean being able to you maybe you didn’t have a lot of exposure to the finance side of things. Oh I had no exposure and I and like you know looking back like I had no interest in it too. So I basically you know threw away four years of opportunities where I could have learned something but I did.

Dr. Koo: 07:36
And you know instead I was focused enjoying New York City as a in my 20s which I don’t regret by the way that you know then the day could have learned a lot about the stock market. But I did it. So yeah I kind of was I think just you know like other people and other physicians you know no one taught me I didn’t grow up in a family where we talked about money or they taught me about money except for maybe I think my mom was always into savings so she would say you should save.

Dr. Koo: 08:01
My dad was a spender so I kind of took after my dad. That’s just how it was done. I had a sizable 4 1 k at Morgan Stanley and the store I like to tell is that I actually cashed it out before medical school.

Justin: 08:13
Well OK. Did you did that to pay for medical school or just to finance living.

Dr. Koo: 08:18
Yep you got it OK. I know the finance living in medical school I got loans like most people. Okay got it.

Justin: 08:26
OK and so you know right now your obviously you have it. Well this isn’t obvious but one of the current pursuits that you have and we’re gonna get to how this came about is being a physician finance blogger and having a pretty important voice in the chorus of physicians who were doing that. So clearly things evolved as you became an attending and then kind of kept on walking through your professional career and you. Your views on finances matured somewhat it sounds like. Talk a little bit about that journey and how that unfolded.

Dr. Koo: 08:53
Yeah. So like I said before I was pretty ignorant and I was ignorant through most of my training. And you know I had I loved the people I did runs with they’re all amazing and just we just all most of us got along. And so there were two guys who were friends of mine and they would frequently talk about money and I didn’t I didn’t really pay attention but I knew enough that they talked they’re talking about their investments. And of course my first thought I remember was thinking like how do these people have money to invest. I remember thinking that I never said that and they would talk about that time time they would talk about their stuff and I just ignored X I understand it. And then one day and it was my last year of residency and it was in the fall and I remember was like twenty four.

Dr. Koo: 09:36
It wasn’t 2014. And I think I just said how do you guys know this stuff like what did you learn this. Like what. What’s the deal. And I don’t remember what prompted me to even ask that. Maybe I just was tired of listening and not understanding. And they just turned to me and they’re like and they started telling me. And they said and then they also told me to buy the white coat investor book his first book. Now he’s got two books. And for whatever reason I did what they told me to. I ordered it on Amazon. I’m pretty sure at Amazon Prime. Then I think it’s free for residents or students. And I got it like two days later and I actually read it in a day. That’s a pretty quick read. Yeah. And I’m a really fast reader and I read it and I think I. And I was like Whoa. It’s like this whole other world of knowledge I never knew. I mean like I I knew existed but like pretended not to know. It’s just interesting how we all know that money is important but very few of us are curious to learn about it.

Justin: 10:31
Yeah. And so there’s probably some people in this audience who have heard about white coat investment thought oh you know what. That’s something I should probably look into. But for people who aren’t familiar what do you explain a little bit about what that is.

Dr. Koo: 10:42
Yeah. So the white collar investor is in a brand and it was started by Dr. James Daley who’s an emergency medicine physician and he’s a physician who writes about personal finance. His blog started in twenty eleven. I don’t think he was the first but he was kind of the first to gain traction and he wrote a book. And so he’s now his mission really is to educate physicians on money so they don’t make stupid mistakes basically. Right. And so he kind of was a starting point. I mean his book really started sort of my trajectory. So I’m one of those people that once I get into something a topic like I just inhale everything around it. So I basically inhaled his whole blog. I think I actually read almost every blog post at the time so I haven’t really kept up since. And I just started digging around like what where else can I learn from I discovered the vocal heads. I mean I just you know Google we live in a world a world now where you can find everything on Google and yes that’s right. I just found all these resources soaked it all up there’s so much free information out there order books etc.. And I also participated on online forums not Facebook but like online forums like the Bogle has in the way confessor. He started a forum and so I would ask questions and so I just started learning.

Justin: 11:54
And during this time you’re transitioning from residency into attending good someplace. Yep you got it. And so talk a little bit about how you began to take this knowledge and even the questions are starting to ask and say like Wow how does this apply to my situation. Did did things change quickly or you know did it take a while for things to kind of trickle all the way down to your actual checking account or how did that evolve well.

Dr. Koo: 12:15
So I think it’s so funny when I really think about what my life would be like now or even that first year of attending good if I didn’t know this stuff I could kind of shudder because it literally could have gone a different way but because I was armed with this knowledge and because I was so curious and interested in it you know it was really. So my first job was at a large hospital. And so as you know large hospitals tend to have know really robust retirement offerings for their employees. So I was able to evaluate the benefits package you know critically and it wasn’t the thing that was going to keep me from taking a job because I don’t personally think you should not take a job because they don’t offer a good retirement plan you take the job because it’s a good job.

Dr. Koo: 12:56
And if they offer great retirement it’s just the icing on the cake. But. So I was able to evaluate and I was able to take advantage of it. So as you know most attendings will be finished residency in July. A lot of us take the summers off I started the end of August was basically September 1st which means I have just over a quarter to kind of like fill up my buckets of account so to speak. And so I manage to virtually I think I was not quite there basically maxed out my four or three be in that short amount of time because I knew it was something I should do or I knew about it I guess is the best way to say it.

Justin: 13:29
Yeah. So when you say filling up the buckets just so everybody knows what that means is. So at that time there’s probably like an eighteen thousand dollar limit on a four or one K meaning for one K or for three B could’ve been in your case is the retirement plan at a nonprofit institution. So the threshold of eighteen thousand dollars is something that most people would take an entire year to do fifty nine dollars a month like clockwork automated out of your paycheck in order to get the full tax advantage of making those pre-tax contributions which in that year will reduce your taxable income which for physicians is awesome because you’re in a very high tax bracket because you make a ton of money. So what you’re saying you did was you took that very short time of. It sounds like three 4 months maybe of being an attending and were able to do I guess like four or five thousand dollars a month almost. That’s what happened.

Dr. Koo: 14:17
Yeah I don’t think I did the full amount. That was very close and you know I was living in New York City which as you know is a very high after state tax but city tax.

Dr. Koo: 14:26
And so it just like was a no brainer for me to do that. It’s like I’m either gonna pay the government I’m going to pay myself. Yeah that’s right. That’s kind of how I saw it. Yeah.

Justin: 14:35
And then you know from there it sounds like that’s a that was a significant shift for you from the way that you had handled your so you went from spending down your for own K to live it up in New York to quickly ratcheting up your savings as an attending. So that sounds like a real fundamental shift.

Dr. Koo: 14:49
Yeah. And you know I think what made it easy for me and doable for me is I’m one of those people like if it’s out of sight out of mind. And so that’s what I loved about the fact the employer plans as it just comes out of your paycheck. So I don’t even have a chance to spend it first because I I still consider myself I tend to spend money. Yeah. So this is like it was like an easy way for me to not spend it.

Justin: 15:14
Yeah absolutely and I think that’s a great point. And whenever you can automate and systematized savings so that it doesn’t take incremental emotional effort so that every month you I feel like log into your checking account and push it somewhere if it happens like clockwork behind the scenes that is an ideal situation. I always counsel anybody who will listen like automate it. And if you can get out of your paycheck before it even hits your checking account that’s an ideal situation. Yeah totally. So then you know you’re you’re building knowledge you’re starting to implement this stuff and you obviously continue to learn continue to network in this community with physicians who are like minded how did this continue to evolve for you from their yes.

Dr. Koo: 15:52
So I just started. You know I kept learning and you know my first job I said I was at large hospitals also a residency program and so I had residents. And so I actually you know gave them theirs. So while I was there for just over two years so I gave the residents sort of a one hour lecture on finances and so obviously I put together this lecture myself just to kind of cover the basics of the stuff that I think they needed to know before they graduated. And as you said like my knowledge just kept growing and like what I thought about money and even retirement accounts back in 2014 2015 is not how I think about them today.

Dr. Koo: 16:32
Mm hmm. And so that’s also changed and evolved sort of my idea of what retirement means you know the financial independence movement or community. And so it’s still evolving and so that’s kind of I like that it doesn’t bother me that it keeps changing.

Justin: 16:47
Yeah. I must’ve been an awesome moment of validation you know stepping up to the podium with these residents who were there to hear you talk about personal finance take me to that moment. What was it like for you.

Dr. Koo: 16:57
Oh to speak there. Yeah well it’s you know it’s it’s relatively casual so it gets my reasons not like I was at a at a conference but it I really you know I found that I really enjoyed talking about it and it was to me it was like low pressure.

Dr. Koo: 17:12
And I also gave away some books to them. I just feel like you know they they’re so busy trying to just you know learn medicine or you know learn how to be dermatologists in this case. And so whatever I could do to kind of ease that transition to help them make better choices for their first job you know things like that I just felt like I went I was trying to be the person that I wish sort of I had access to and I was a resident yeah awesome so you found that there was a pretty strong appetite for that kind of wisdom that you had to share then.

Dr. Koo: 17:40
Oh yeah. I mean you know this this lecture I you know I actually give freely to anyone who wants it because I think people are asking for this knowledge when I say people I mean like the residents are.

Dr. Koo: 17:50
And so I have friends of mine who are still at that hospital who use my lecture to just give that same lecture to their residents because people are hungry for this because no one’s teaching them this.

Justin: 18:01
Yeah absolutely. And so you went from at least for the most part. Yeah yeah. It’s that there’s definitely a huge gap there. And I think we’re both sort of fighting the same battle here to try to bring financial empowerment and education to as many people as possible. Yeah. So you went from knowing not a lot to starting to get savvy yourself to starting to teach residents to all of a sudden at some point you said I want a bigger platform I want to be able to scale sharing this knowledge and I want to do that through a blog and eventually a business. So talk a little bit about how this continued to evolve for you.

Dr. Koo: 18:34
Yeah.

Dr. Koo: 18:34
So that’s an interesting question because I did not wake up one day thinking I want to do business or I want to start a blog like that was like the farthest thing from my mind to me it was just this is interesting. I really enjoy it and I enjoy talking about it and teaching people and so on that said so you know Facebook as you know those facebook groups. And I was I think I was talking to a physician a woman physician friend of mine about money and she’s like oh you know a lot about money I should add you to this group and I don’t even know what she’s talking about. I was like OK. So she added me to this group and it was a group of just women physicians but it was a group to talk about money. Now this group wasn’t branded it was just kind of a community group where I’m not even sure if you started to be honest and it was just a group of women asking questions about money.

Dr. Koo: 19:23
And it’s a private group because I think women physicians we like to kind of be in our own little groups together. Yeah. So I just started answering people’s questions. I started commenting on posts and then you know it became apparent to me that I kind of knew more than the average person in the group. And I just to me it was fun. I was just answering people’s questions. I was just you know scrolling in between patients. I think also this was a time when my practice was building say a lot of free time which means I was scrolling on Facebook a lot. And so I was just answering questions and then soon people start attacking me in the posts. And this was just happening and I was just having fun with it. And then a girlfriend of my and my wife just start a blog.

Dr. Koo: 20:01
And I was like it really was my first reaction I was like Why would I start a blog. And I literally said to her you know there is a blog it’s called the Waco investor and I basically said he’s already written about everything. I don’t need to reinvent the wheel. It’s already there. And then she’s like Yeah but you know you’re a woman and I think it’d be cool if you did it. But I kind of was like whatever because like because like who has time for that right. Yeah yeah. And it’s not something I was interested in doing. But eventually I’m not even sure what made me change my mind. But I think it had something to do with you know the same types of questions that to come up in these groups and as you know the way Facebook groups are they just it’s just keeps new post keep happening all the time cause people don’t necessarily. It’s not a forum where you can kind of search things easily. And then I was like you know if I wrote a blog post to answer the common questions I could just link the blog post so don’t keep writing out the same sort of paragraph each time. So then I thought okay I could do that and you know mind you this was before I had a child.

Dr. Koo: 21:02
So meaning I had more free time.

Dr. Koo: 21:04
So I started a blog on a timeline standpoint just like 20 15 20 60 2016. Okay. I think I get it mixed up. Jack was born in 2017 so it probably was 2016. So I start the blog you know takes a few hundred bucks and I started and it was like I wish I had it. I’m sure I have a picture somewhere but it was like pretty awful looking and I don’t really care. I was just trying like just get the stuff on there. Yep that’s kind of how it started. And then you know it was it was to me it was just like a fun little hobby I wasn’t thinking this is gonna be a business. You know I in my mind I’m a dermatologist that’s what I do for money and this is just something I do for fun on the side and it kind of you know it was a way to meet people and I’ve always been someone who is pretty social. I was I often was the social planner whatever that position was at med school a social chair at med school stuff.

Justin: 21:57
Awesome. And then so you’re starting a blog. Things are starting to get traction. It sounds like especially with the female physicians. Your your message your voice your insights are really starting to resonate in a way that perhaps surprised you a little bit.

Dr. Koo: 22:14
Yeah it was.

Dr. Koo: 22:15
I mean it’s so funny like it’s like I said I don’t wake up thinking I’d start a business one day but that’s what started the blog I started meeting other people other I guess like minded people other physicians interested in money and I just saw that there is this huge need and that same friend who told me to start the blog who actually was the same person who said you should make this a real thing and I’m like again. I was like what because you know I am a dermatologist and I’m not a specialty that usually is lacking in money. And so in my mind like I didn’t really see the need to have an extra source of income but this is back then. Now I kind of agree that you should have multiple sources of income. Yeah. And so it took some time to get there though you know because like I said I really did treat my blog for a hobby only until recently did I not say recently only the past year.

Justin: 23:03
Yeah. So talk a little bit about how the blog mapped onto your clinical experience and how that was unfolding for you.

Dr. Koo: 23:11
Yeah.

Dr. Koo: 23:12
So you know a bunch of stuff happened and I’m one of those people that really feels like things happen for a reason when I see a reason like there’s some lesson to learn or it’s like giving you like a push to go in one direction. And so we ended up moving so Matt and I. So you know I met my Matt who’s my fiancee. And we had a son in late 2017 and then we moved also that same year to Philadelphia and that’s how you and I met. Yeah right. So we moved. And so I moved into a private practice job. He also had a new job obviously in Philadelphia. And I kind of was like This is it. You know we found these great jobs.

Dr. Koo: 23:48
I was gonna make more prior practice. He had a job with great benefits and was paying well. And we also moved to a lower cost of living so in my mind like I had done it right. You know like I was following all the advice I was giving to other women.

Dr. Koo: 24:01
And now life was gonna be you know you know Quentin basically. So obviously this is right. So clearly that didn’t happen. So a number of things happen. So you know I wasn’t making as much as I thought I would Mac’s job was.

Dr. Koo: 24:17
I don’t I say toxic book for lack of a better word just like you know he was working many hours it just wasn’t working for us and it kind of things came to a head. He lost his job. My job was paying less than what I was making. Academics and I kind of was like Whoa whoa whoa this is not supposed to be happening. This was supposed to be a great decision and you know I took some time I’m like what what’s going on. Like should I be doing something else. And I actually felt really I was actually angry for a period of time about all this angry at like myself that because I thought I had made the wrong decision for the family by moving us all this other stuff.

Dr. Koo: 24:54
And so that’s actually where I decided well you know it’s up to me like you know I’m responsible for my life nobody else’s not my employer not Matt or even his job. And I kind of was at this crossroads I either had to start my own practice basically I was like I need to do something. So I was either going to start my own practice a dermatologist or I was going to start a business and I chose the business clearly and part and part of the reason was I like the fact that it didn’t have to be tied to a physical location because I think my past is let’s just say I’ve moved a lot. And so I think I’m allergic to make a commitment to a physical location. And so I thought you know starting a practice is not a good idea because if I want to move in a year I can’t. I mean you can but it’s like a lot harder when you own a practice right.

Justin: 25:43
Sure yeah. So let’s talk about that transition because I’m sure there’s physicians out there who think you know I did like premed undergrad and then I went to med school and I did a residency and now I’m like a second or third year attending and I’m working so hard and what Bonnie did sounds really intriguing starting a business in air quotes like whatever that means I really don’t even know the first thing about I would begin an enterprise on my own to talk about how did you get to a place where you knew enough and had the self-confidence to sort of spread your wings jump out of the nest and what did that idea look like for you.

Dr. Koo: 26:13
Yeah. So I attended fin con two years ago and yeah was two years ago and I almost didn’t go so I bought a ticket and then actually sold it and then Carrie run also you know a friend of mine and she’s got that great podcast that we got to go. I’m like OK so I bought a ticket and I went. But like I literally almost didn’t go and when I went to that conference that’s when I actually met a lot of decision finance bloggers in real life like I’d met some of them before at the first buy could investor a year. But this is the first time where I was with a bunch of them and we kind of all hung out together the whole week. And one of them was Dr. Peter Kemp who’s passive income Andy. And I remember he told me I was just telling him because I kind of wasn’t sure what to do.

Dr. Koo: 26:52
I go big or go home. And he said that and I was like I don’t know which way to go though. And I remember leaving the conference still kind of confused and around the same time actually a few months earlier I’d like slash business coach. And so I think between Peter Kim working with my coach I still work with she helped me sort of make that decision. So my coach doesn’t tell me what to do but she sort of just asked decision on my own and so I just was like Well why not yeah you know why not try this. Like if I’m going try it let’s like go all and let’s not just do this like you know half baked sort of thing. And so I just one day and I haven’t looked back although you know I don’t. When the going gets tough Believe me the time is like I could just go back to being a full time.

Justin: 27:36
Yeah. So I have also. And for people who don’t know Finn con we’ve talked about that a few times in this podcast. That’s the the the conference for financial content producers. So it’s like a big nerd fest of a bunch of like you know YouTube stars and bloggers and I go there to network with some people like you and other financial planners and there’s some there’s a cohort of physician financial experts like yourself that go there as well. It’s a really cool meeting of the minds. A really unique community. And I I also had the chance to meet Dr. Peter Kim shout out to the anesthesiology community who’s out there on the West Coast doing great things with real estate. I’m actually hoping to potentially have him on a show here in the future but I found that that conference and the people there and the energy there similarly has been really inspirational to me as I you know branch out into the podcast and do other things that are not a natural fit for me. So as you’re walking through this journey and it’s starting the business. Were there any other people that played a key role for you and giving you the confidence and the technical insights that you needed to be able to to launch your business and then talk a little bit about what is your business exactly.

Dr. Koo: 28:45
Yeah. So you know that was think of that yes two years ago.

Dr. Koo: 28:49
And so just for those who don’t know when Fen condos it’s usually September ish each year. So we’re talking you know fall that year. And so you know the year finished and so we’re talking. I just it sounds like you know if I’m going to do this business thing I don’t know anything about business.

Dr. Koo: 29:02
And I was not someone who ever thought I’d ever be an entrepreneur. In fact I thought that was like for the really smart people and creative people and I’m not I’m just someone who takes orders that that’s kind of how I saw myself growing up.

Justin: 29:14
I don’t good says I can’t do that.

Dr. Koo: 29:15
It’s for the smart people because I’m someone who’s really good at taking you know let’s say following instructions.

Dr. Koo: 29:24
Yeah okay. That’s why I like going to like orange theory or having a personal trainer because I just do it or they tell me do an exercise but left to my own devices I can’t do it.

Dr. Koo: 29:32
So anyway so I was like you know who am I going to learn from and I don’t even know how I found out by discovered Amy Porterfield.

Dr. Koo: 29:38
And for those who are not familiar she’s an online marketer and she teaches entrepreneurs you know how to create digital courses and how to build their email lists and get a lot of mindset inspiration as well.

Dr. Koo: 29:50
So I started learning from her I bought her courses and I basically you know I called 20 19 the year of my entrepreneurship residency so to speak. I kind of drove into all these courses and conferences on how to be an entrepreneur the mindset piece that and then obviously the strategy as well.

Dr. Koo: 30:10
That’s why I did this year.

Justin: 30:12
Okay awesome. And so mindset mindset is so critical especially in business this is something that personally I’ve been I’ve been going down the rabbit hole of like understanding mindset and understanding what it means to like strengthen your own sense of self-confidence by understanding the things that you’re really good at and pressing into those things and allowing your strengths to define the activities which you pursue to talk a little bit about what does it mean for you to pursue maturing your mindset as a physician who’s really good at you know clinically but maybe doesn’t know anything about business and having to stretch yourself and a lot of that happening up here between your ears.

Dr. Koo: 30:51
Yeah. So that’s another thing we don’t learn so many and no one teaches us how to manage our mind. And you know one thing I’m learning is you know our brain is our biggest asset. And so like I say I did it on a residency entrepreneurship at I guess the residency also and learning how to really harness my brain because that’s really so basic I invest a lot in myself. So working with my coach her name is Sunny that has been crucial to really sort of learning how to manage my mind when I when I say match my mind.

Dr. Koo: 31:21
I mean just sort of like learning how to be a third party observer of what I’m thinking and sort of questioning you know questioning the thinking that I’ve been having so it’s so easy to say Oh business is hard and you know it’s never going to work.

Dr. Koo: 31:34
And it’s so easy for me especially as a dermatologist say well why bother like why even do this like Don’t do this it’s just just go back to being a doctor and there’s obviously being a doctor is a great profession so nothing against that but you know I think I also just want to push myself and see what I was capable of. And you know the more I learn about myself the more I see that it’s not. And so going back to sort of what I do is you know I feel like my job besides you know treating patients in terms of skin conditions you know my job is to really teach other women physicians that I focus on women that you know it’s optimal to men as well teach women physicians how to use money as a tool versus you know money using them. So I think a lot of feel like we don’t have a choice around money like you know. If only we had more money than we could do the things that we want. And so really teaching them that money is a tool that they can actually have under their control versus the other way around. Yeah.

Justin: 32:35
And so so tell me a little bit about your business model because you know people are listening is. OK. She had a blog and now we’re talking about a business and apparently she’s making money from it. How did when did that transition happen and how do I think about potentially either replicating that or doing my own type of thing like that.

Dr. Koo: 32:51
Yes. So one thing I’ve learned in is that money comes from value.

Justin: 32:57
And so I don’t think you and I’ve ever talked about that just and how we I don’t know but it sounds like a topic near and dear to my heart.

Dr. Koo: 33:03
Yeah. So one thing I learned with all this stuff I’ve been learning and I cannot remember like where or that phrase came from but one thing I learned is money comes from value.

Dr. Koo: 33:11
And so I think when I think about how my business has evolved even when I didn’t think it was a business. Remember I told you that I was just you know having fun you know answering people’s questions like I was giving value at the time. And so what I learned was money comes from value and whether I want to you know actually like you know harness that or not. And so what I realized was you know I feel like my job is to educate. And then in terms of like what actually makes me money so there’s multiple ways that I make money. So one is through sponsors. One is through affiliates. So for those who don’t know what that means that means I partner with certain companies and certain individuals and I promote their stuff. And if someone buys it through me then I get a little commission from it.

Dr. Koo: 33:54
I also have my own products now so this is the first year I offered my own products and so that the flagship product is an online course. Right now it’s called money for physicians but I think I’ll be changing the name soon and that’s it at an online course that’s give it that’s given life so actual classes are alive it’s pre-recorded but there live components and the courses only offered a few times a year. So it’s not something you can buy now if you wanted to at least at the time of this recording you can’t buy it now. So I created that course this year and then I sold it and then I’m also getting certified as a life coach because I was so inspired by my personal coach and I also saw how critical the mindset piece was to everything. And obviously since I’m a money person especially with money. So I just thought you know what. I will become a better educator I’ll become a better teacher if I learn how to be a coach as well. And so I’m currently getting certified awesome.

Justin: 34:48
So I really miss a few things on one package I think is interesting. So you said you know money for women physicians I’m curious how have you approached you know finances for female physicians in a way that you think might be like what somebody might say. How is it different if you’re a woman versus if you’re a man. What types of things have you found as you’ve developed this content and had all these conversations where your voice your approach your techniques whatever has been a little bit different than maybe what we might see on some of those other physician finance blogs that are owned by men.

Dr. Koo: 35:22
So my material isn’t like unique to women physicians. It’s unique to I guess higher earning women who may or may not be in partnerships or have children so you don’t have to be a mom to take my course. The reason why it’s only for one physicians is because like I said my course is sort of given an A Life format. Part of that life thing is a private community. And so at this time the product committee is only open to women physicians. And the reason why I chose that and that might it possibly can change in the future is you know women physicians feel they’re able to be sort of more authentic and vulnerable when they’re only around other women physicians. You know it’s not an elitist thing it’s just a privacy thing. We also I think physicians also just feel like we get each other. So that’s the reason why it’s specific to an incision. But the material itself isn’t like super specific. I think I talk about topics that some of the other bloggers don’t address. You know for example like the prenuptial agreements are in the Asset Protection Section. Yeah yeah. For example and I talk about it and I you know really obviously I think it’s a requirement for all people to get. But so I talk about topics that maybe some other you know bloggers aren’t talking about as much.

Justin: 36:36
Yeah totally. So to go back to one of the reasons were that I’m so excited to be having this conversation with you Bonnie is physician autonomy is as I mentioned before kind of under attack. And I think in all the different specialties there’s unique flavors of what that looks like and in anesthesiology it looks like consolidation and big groups buying out little groups and either big private or like public companies snapping up groups of physicians that have very intentionally created a business and a lifestyle for themselves and for the hospitals or other sites of service when they serve they’ve cultivated that they’ve worked hard at it for a long time. And then when there’s a regime change in an acquisition or in a merger whenever there there’s cultural issues that are manifest i.e. you you don’t have the kind of power and control in that seat at the table with the hospital whom you’re serving now you’re kind of answering back to corporate.

Justin: 37:30
And those dynamics can change. And there’s this loss of autonomy or in the context of no pain positions some of those similar dynamics exist with consolidation. If you only work for one practice you have one income stream. You’re sort of beholden to your employer and if your job evolves over time in ways that you don’t like you’re going to lose that power of self-determination if you don’t have other income streams. If you’re financially independent or if you have multiple income streams then you can say you know what. I don’t want to do this. So take a hike or I’m going to go do my own thing. So talk a little bit about for you how your expanding into business and expanding into these other ventures of starting a course. And I know we’ve talked about you talking to Dr. Kim so maybe real estate could be a part of this. How has this changed the way that you see your vocation and how has it changed the way that you think about your life and think about freedom and think about your ability to travel and other things like that.

Dr. Koo: 38:25
That’s an awesome question. Well first I will say dermatology is experiencing all those things you mentioned that for anesthesia for sure like we’re you know lots of practices are being bought up by large private equity groups and so that definitely is I think a problem. And so it’s you know it’s more challenging for the solo practitioner who wants to sort of hang their shingle and just you know they want to do a good job seeing patients and so on. Definitely one of the reasons why I decide to you know go towards like starting this business versus starting a practice just medicine is changing as so many things are not under my control for sure. Yes. And I just thought with this business I would have more control. And that’s just kind of how I see just like you said like I wanted freedom and there there’s financial freedom obviously which you know I’m not traditionally financially independent.

Dr. Koo: 39:15
You know by the current standards I just wanted autonomy and freedom over my time. And that’s really what it came down to. And when you’re on your own boss like everything you’re it’s everything’s up to you which can be good or bad. So for the right person it’s good for the you know there are people who rather be an employee. And so for that type of person this would maybe not be the right move but to me I saw it as an opportunity to control my schedule and I’m learning I’m still learning like how to best do that.

Justin: 39:42
So yeah. And so I know something that you’ve talked about that we’ve talked about together actually is locums. So I think for anesthesiologists in particular a little bit less so for pain but anesthesiologists have a great opportunity for locums to travel around to places where anesthesiologists are needed. And by the way they’re desperately needed almost everywhere and you can take this very specific skill set that you have which you can earn a lot of money on an hourly basis and go and sort of parachute in somewhere as you know for like a short or intermediate term engagement and use that to make a lot of money while you’re traveling around living somewhere different and just sort of shaking up the mundane rhythms of life. So talk a little bit about how locums has played into your grand plan and how you envision it maybe playing out into the years to come yeah.

Speaker 11 (40:28):
So you know that those jobs I mentioned to Philadelphia.

Dr. Koo: 40:32
So when we decided to sort of pivot when I say pivot I mean we left Philadelphia now we live just outside New York City. I wasn’t thinking of switching to locums but I kind of think about that Morgan Stanley job it just opportunity just came up and like I said I’m someone who feels like when you’re when you’re just like open to things things just appear like I firmly believe that. And I think just I was just open to something changing and I don’t even know where this came from. I must have been an email and it’s so funny because this wasn’t that long and six months ago.

Dr. Koo: 41:04
Some emails came up saying locums in Seattle for the summer and I’m like Oh that sounds cool. And then I just looked into it and then the next thing I knew I got the job. Yeah. And so yes we switched to locums which is a little different for da but you know same province you can travel make some money.

Dr. Koo: 41:22
I like that they’re short term assignments and I just like you said I just want to shake things up and see what else was out there. And this job was also cool that was two weeks on two weeks off over a three month period and the dates like perfectly lined up with still being able to attend Fen con this year for example. So I almost felt like I was meant to have this job. And so during the two weeks off that’s when I actually worked on and created by course this year. And so I have another locums job lined up which starts in about a month. The time we’re recording this and that’s actually in Hawaii. And that also just I just got an e-mail. Oh yeah. And it was an e-mail from a recruiter is actually e-mail from a former CO resident of mine who knew that I had changed to locums.

Dr. Koo: 42:06
Mm hmm. So you know when it’s just so anyway. And this job at this job is at Kaiser in Hawaii. And what’s even great about this job is I actually interviewed at Kaiser Hawaii two years prior if you knew that Justin. I didn’t. So I actually applied for a job and actually interviewed in Hawaii with Kaiser. I didn’t take the job obviously right. So but I already met the whole department. So long story short I think that facilitated me getting this locums position there.

Justin: 42:32
Yeah awesome. So it sounds like when you’re willing to be open to these types of opportunities instead of being stuck in New York City in December or January you can take some time go to Hawaii be working full time or maybe most of full time. What’s your schedule like in Hawaii.

Dr. Koo: 42:49
It is full time so it is Monday through Friday but because it’s over the winter holidays you know quite a few days off there.

Justin: 42:54
Yeah. And then have the flexible all the perks and flexibility that comes with being in a beautiful place for a really cool time.

Dr. Koo: 43:02
Yeah. And as you know locums is great because they may pay for your stay and you get paid to work. So yeah so basically I got paid to live in Seattle in the summers is the best time of the year to be there. You know I’m getting paid to live in Hawaii during the winter. Yes.

Justin: 43:15
It’s not too bad. This is a great commercial for for locums actually. So for anybody listening I want to mention this selling link to in the show notes some of the resources we’ve mentioned so Amy Porterfield resources and some of the we’ve talked about locums before and some other things that have come up so Amnesty’s success dot com slash 35. It’s gonna be this episode and you can find all the show notes all the things we’re talking about. If you’re interested in exploring more what locums might look like for you. Definitely want to want to check that out.

Justin: 43:43
So Bonnie really appreciate your time today and I want to sort of wrap things up here as you look back over all the things that you know all the things that have. Happened for you or that you have gone after. Do you see are there any developments where you’re like That was a catalytic moment for me this was something that when that happened that set me on a new trajectory because it sounds like you’re somebody who is always open to new opportunities new even there’s an intellectual curiosity that you have that I think in large part contributes to your willingness to learn new things outside of your primary domain of expertise. So how has that sort of played out. Were there any one or two maybe big moments for you over the over the last four years.

Dr. Koo: 44:21
You know that’s a great question. You know I’ve I’ve tried to remember these big moments and I don’t think it was one mom I think it was like lots of little moments that sort of like ended up adding up to a big moment. So I think exactly what you said I’ve always been curious and I think that’s just something a trait that I’ve always had and I’ve just sort of you know been open and open to having a coach for example. And so that’s something I think you know many people don’t even know that this type of thing even exists. And being open to that and then I first I wasn’t paying for services but now I do pay her. And just showing up to my coaching call now it sounds kind of stupid but like I actually you know know do the work so to speak. And I’m also willing to get uncomfortable. And when I say uncomfortable I mean there are definitely days or even periods of weeks where it was really uncomfortable where it would’ve been so easy to quit and just go back to doing something else that was quote unquote easier. Yeah. So I think well you know the willingness to be uncomfortable but also sort of knowing that something better is on the other side of that. And so that’s what’s kept me going.

Justin: 45:28
Yeah. Awesome. And so if there’s somebody listening out there who says I want to just have like one or maybe two to do items to begin to push in the direction of what Bonnie is building to be able to have maybe it’s the self-confidence to start getting out of that comfort zone to start pushing in a new direction to start building autonomy building multiple income streams building some flexibility into life. What might you recommend as far as four steps yet.

Dr. Koo: 45:55
Well you know the first thing that came to mind when you asked that question was actually to listen to the life coach school podcast. So it’s called a life coach school podcast but start from episode number one. There’s like over 200 not saying I listen to all them. We just start with no one listen to the first year then you can kind of skip around. That’s a podcast by Brooke Castillo and that’s the life coach school that I’m training with. And so you’ll learn how to manage your mind a little bit. And I think it starts with that. Awesome.

Justin: 46:24
Cool well we’ll wrap it up with that. Dr. Bonnie Q Thank you very much for joining us on the anesthesia success podcast.

Dr. Koo: 46:30
Thank you so much for having me.