How a California Oncologist Making $850k Spends Money

Welcome to the MedPage Today “Med Money Journals,” providing readers a look into the finances of doctors, nurses, medical students, PAs, NPs, and others practicing medicine. Each post offers information about one person’s financial background, wages, and spending over a 7-day period. Anonymously share your own Med Money Journal.

Job: Oncologist (MD, MS)

Age: 43

Location: Southern California

Salary: $850,000/year

Net worth: $2 million

Debt: $2.9 million (two home loans)

Amount per paycheck: $52,500/month (before taxes)

Other income: $6,400/month (from rental property), $5,000/month (consultations including honoraria from speaking and lectures), $2,000/month (stock dividends and bank interest)

Monthly expenses:

• Rental property mortgage: $4,300
• Primary residence mortgage: $7,300
• HOA fee: $71 (total for both)
• Gas/electricity bundle: ~$300
• Water: ~$200
• Disability insurance: $750
• Home/car insurance: $251
• Life insurance: $156
• Internet: $79.99
• Cell phones: $150
• Netflix: $15.99
• Spotify: $15
• Groceries: $400
• Gas: $200
• Electric charging for electric car: $100
• Piano lessons: $160
• House cleaning: $260
• Gardener: $80
• Pest control: $30
• Network drive/home storage server: $20
• Amazon prime: $9.92

What was your first job and why did you start working?

Call center at age 17. I started working to earn pocket money in high school ($7/hour).

Do you worry about money in your current situation?

No, I collect income as a 1099 S-corp, so I can write expenses off and lower my payroll tax (I only pay myself $13,000/month). I also am able to save over $300,000 a year, have passive income from a rental property and other side gigs, and invest $200,000 a year, lowering my tax liability further.

What financial tracking or money management/budgeting tools (if any) do you use? Would you recommend them to others?

Excel and Quicken. Yes, I recommend some form of tracking even if it’s a simple spreadsheet, to better understand your expenses and opportunities to save. I also recommend dissecting your paycheck to see exactly where the deduction and taxes are going.

Are there any other financial details readers should be aware of?

Financial success requires understanding of the key limits and the potential of physicians. The fundamental limitation is the “late start” to the first physician career due to education/training and the debt accumulated during this phase. The fundamental potential is realizing that working for a paycheck alone does not gain wealth. The latter involves saving/accumulating capital (consider moonlighting early), investing in assets not liabilities, mitigating risks through insurance, embracing unapologetic growth by realizing your talent and worth, and lastly, focusing on what is priceless in life beyond just money.

Do you have any comments or thoughts on the current state of compensation for people in your position/profession?

Physicians are grossly underpaid from the time they enter training (essentially as indentured servants) up to their first job when they must earn their ranks in partnerships. It is becoming more common for there to be a lack of negotiation in physician salaries, with most employers being large health systems with little flexibility in recruitment of talent.

Many physicians also have not taken the step towards unionization, therefore giving them very little leverage. Physicians in this climate therefore must consider side gigs and passive income, while acquiring new marketable skills and finding jobs that reflect their worth and value. Sometimes this requires waiting for the right opportunity, or even commuting to and/or living in underserved areas or states with favorable tax laws.

7-Day Journal

Day 1 (Monday)

Total: $130.32

I woke up this morning knowing it would be a long week, as I have to cover for my colleague who is out at a medical conference. While I usually drink homemade coffee, something told me I deserved a “comfort” latte from Starbucks. I added some customizations and a breakfast sandwich to my order, bringing my total to about $15, which seemed a bit high. In any case, it was indeed a tasty start to the day, but I remember thinking later that morning that I should have drank a liter of water instead, along with my regular home brew, so that I was better hydrated.

As our family (me, my wife, and two kids) did not eat out this past weekend, we wanted to eat at this Thai place on the last day of summer (my kids’ school starts tomorrow). After a long day of work — where I didn’t finish all my notes or tasks — I rushed home so that we could enjoy this family outing. Though a bit pricey ($115.32), it was worth the fresh ingredients and the mild spice level so that all of us could enjoy the food.

Day 2 (Tuesday)

Total: $45.25

I rarely go 2 days in a row buying coffee out, but this was a special occasion to catch up with an engineer friend that I hadn’t seen in 6 months. Since we are both busy professionals with children who we had to drop off in the morning to school, it was worth the inflated cost of a cup of coffee ($6.25) to talk “shop” on neutral ground.

Around 1 p.m. it was time for lunch. I brought my lunch in today, but after hearing some of the staff talk about waffle fries and chicken sandwiches, it was very hard to resist the urge to put in an order for myself at Chick-fil-A ($15). It satisfied the craving in the short term, but I regretted it later as I felt more tired than usual. I did end up eating my lunch for dinner later.

Tuesdays are discount nights at our local movie theatre. I remember the days when matinee/discount movies were only $3 a ticket! Nevertheless, it was worth spending an evening with my wife at the movies ($24) while the kids were asleep with their grandparents visiting.

Day 3 (Wednesday)

Total: $7.54

After a long day rounding in the hospital and a full clinic, something lured me to eat a burger with fries from Wendy’s ($7.54), which must be my weakness and comfort food.

Was it worth it? You bet it was!

Day 4 (Thursday)

Total: $107.34

Most weeks, I do intermittent fasting for periods of 18 to 24 hours. It helps me feel healthy, and some data suggest this behavior can be a “reset” button for the body, leading to autophagy and improved gut health. In any case, keeping hydrated is a major part of getting through the day when I am fasting and I’ve found that nothing quenches my thirst better than 1-L glass bottles of Gerolsteiner mineral water with electrolytes, which I get from the local Trader Joe’s. I bought enough bottles today to last me a month ($48.75).

I like listening to talk radio and sports radio on my 40-minute commute to work (each way), and my Sirius free trial was expiring, so I gave in to a marketing email and agreed to a 12-month subscription for a little over $5/month ($5.43). But I immediately put in a calendar reminder 1 year from now to cancel, because I know that they will auto-bill and increase the rates at that time.

Though we ate out earlier this week, being a back-to-school week with a lot of activities and after-school pickups, my wife and I decided it was easier to order in for dinner tonight. The sandwiches from a local shop that we frequented on summer afternoons gave us a satisfying, last taste of summer break ($53.16).

Day 5 (Friday)

Total: $505

This was my splurge for the month, on a new hobby that I’ve always wanted to pick up: sailing. I have done basic sailing in the bay, but I wanted to get formal training to have the skills and safety necessary to be able to take passengers along the coast. The 2-day weekend course will take place in October, but buying the course now ($425) allows me to also start gradually reading the syllabus and course materials so that I can pass the test without any stress from the usual burdens of clinic on any given week.

Every Friday, to end the week, I try to buy something for the office staff, whether it means coffee with breakfast or a healthy lunch. Today, one of my medical assistants found a place that makes fresh fruit and acai bowls, which were incredibly filling and healthy ($80).

Day 6 (Saturday)

Total: $494.06

In a small town near our home, there is an outdoor French-themed coffee shop with not only fresh pastries and croissants, but also animals. Each Saturday there is a dog adoption across the street, which allows my children to play with the puppies, most of which are abandoned street dogs (so I’m told). On the premises, the shop owner also rescues bunnies and brings in some of them for kids to play with in caged enclosures. It is a very relaxing way to spend a weekend morning. This morning, I spent $45 on coffee and breakfast.

In the afternoon, my teenage daughter took me into Sephora to get my opinion on various scents and lotion products. Though I wasn’t planning on buying anything, it was hard not to get her a small gift ($25), given that it was her first week back to school and that we were spending time together.

We usually go for a dog walk in the mornings and evenings, but on the weekend we sometimes take our pup with us on the afternoon excursions. On today’s trip to the mall, we ended the day by walking him into a boutique pet store to replenish his supply of treats ($12.06).

A theme is emerging that I like to eat out a few times a week. This particular dinner was to celebrate my and my wife’s birthdays a few weeks early while my parents were in town. Though we enjoyed the ambiance and ocean sunset at this new Italian restaurant on the coast, I felt that the food was overpriced, salty, and not fresh. The service was also slow, but it wasn’t the waitress’ fault. Even though we shared plates, after the final 20% tip, this meal ended up costing more ($412) than we typically spend on a month’s worth of groceries! Even for a birthday meal, I felt that this was an overrated experience. For my next birthday, I want to cook a feast in our kitchen and enjoy more meaningful time together.

Day 7 (Sunday)

Total: $157.36

If you haven’t noticed by now, my daughters love animals. We found a new bird sanctuary and rescue at the end of the summer. For $60, I added on a family membership for the year, which allows us to have unlimited admissions to this sanctuary to pet, feed, and learn about the incredible parrots, cockatoos, and lorikeets here.

In the afternoon, I did some online shopping. As I am starting to do more Zoom calls and podcasts from my home office, I purchased an entry-level softbox lighting kit ($44.98) from Amazon. I was pleased with this purchase as it provides a more professional look while preventing glare.

We learned from our disappointing dinner experience the night before and decided to go grocery shopping at the end of the day. For $52.38, we were able to buy fresh vegetables, ingredients for salad, a sourdough bread loaf, and a couple of T-bone steaks. We grilled and prepared the food at home, and ate it together. Everyone remarked that it tasted better than the food last night and was a perfect culmination of the weekend.

Week total: $1,446.87

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