Podcast
Doctors Building Wealth
Hosted by Leti and Kenji · EN
Doctors Building Wealth is for physicians drowning in student debt and working endless hours, wondering if your medical career will ever bring true freedom. Despite your six-figure income, the path from successful doctor to financially independent professional feels impossibly complex.
We get it—balancing patient care and financial planning is overwhelming when no one taught you how to invest during medical school. Lucky for you, you don't have to figure it out alone.
Meet Drs. Letizia Alto and Kenji Asakura, physicians who've built a multi-million dollar real estate portfolio while maintaining their medical careers. They've helped hundreds of fellow doctors replace clinical income with passive cash flow—without sacrificing patient care.
Join Leti and Kenji each week as they interview physician investors who've escaped the burnout cycle, share step-by-step strategies to analyze deals, and provide actionable blueprints to build your real estate portfolio with your busy schedule. Learn how to leverage your high income, create tax advantages most doctors miss, and build the time freedom you deserve.
It's time to stop trading your time for money and start building generational wealth. Your patients need you at your best—not burned out and counting the years to retirement.
11episodes
Episodes
Newest firstAll episodes
How Doctors Use Bonus Depreciation to Legally Pay Almost No Taxes
5d ago00:26:46Tap to summarizeWhat If Your Tax Bill Isn't as Fixed as You Think?You did everything right to earn this income: the training, the years, the brutal hours. And every April, you watch a huge chunk of it simply disappear. You've heard that other doctors, people earning what you earn, somehow pay a fraction of what you pay. And part of you wonders if they're doing something shady, or if you're just missing something.Here's the truth: in most cases, they're not bending the rules at all. They're using the rules exactly as they were written.The tax code isn't a list of penalties. It's a list of incentives. The government wants more people building businesses and providing housing, so it rewards the people who do. Real estate sits right at the center of that, and the single most powerful reward it offers is depreciation.In this episode, we break down how bonus depreciation actually works, how we've used it to legally pay $0 in federal income taxes for multiple years, and the framework we use to turn properties into large, legal write-offs that can shelter even a physician's W-2 income. We also cover the catch most people don't see coming, how to plan around it from the very beginning, and why front-loading these savings is one of the moves that helped us reach financial freedom in three years instead of three decades.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:How we legally paid $0 in federal income taxes for multiple years, and why the tax code is designed to make it possibleThe difference between a passive loss and an active loss, and why only one can touch your W-2 incomeThe one status you have to earn before any of this works against your physician salaryHow scaling into a single larger property created an $850,000 loss in its very first yearTwo ways a single renovation can create write-offs, even on a property you've owned for yearsWhy the taxes you defer for decades may never have to be paid back at allThis isn't about being aggressive or cutting corners. It's about understanding one of the most powerful tools the tax code hands real estate investors, and using it on purpose instead of leaving it on the table. There's also a real window here: 100% bonus depreciation is back and permanent for now, but a future administration could change it, so the time to use it is while it's open.Investor Insights Newsletter: https://semiretiredmd.com/newsletter/READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →How to Maximize Returns on Properties You Already Own
3w ago00:30:15Tap to summarizeMost Owners Stop Optimizing. The Disciplined Ones Keep Finding Returns.You bought the property. You found the tenant. You set up the systems. Now it cash flows. It's stable. You don't really think about it anymore.That's the moment most owners quietly start losing money. Not in expenses, but in the returns they're not capturing because they stopped asking the question.We've been guilty of this ourselves, even with 185-plus doors in our portfolio. It's so easy to assume the property you already own is performing about as well as it ever will. But the truth is, the highest-return move you make this year might not be buying another property at all. It might already be on your rent roll.The discipline that separates owners who keep finding hidden value from owners who don't is a simple one: once a year, sit down with every property you own and run it through the same set of questions about income, expenses, and tenant experience. In this episode, we walk through the four highest-leverage answers we've found inside our own portfolio, including a tenant-type pivot that took one of our rentals from 10% to over 40% cash-on-cash, a tax deduction nearly every investor misses, and a category of expenses we've eliminated four or five different ways. None of it required a single new acquisition.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:The once-a-year property review discipline that surfaces returns most owners never bother to look forThe tenant type that took one of our long-term rentals from a 10% cash-on-cash return to over 40%, and the relationship you need in place to access itWhy the same property can quietly become worth a lot more once you change who's living in itThe two-part ROI framework that takes the emotion out of every rehab decision (and why most investors only think about half of it)The hidden tax deduction that 80 to 90% of investors leave on the table every time they renovate (and how to make sure you don't)Why one specific category of expenses can usually be eliminated at near-100% ROI, and the four or five different ways we've done it across our portfolioA surprisingly underused way to turn garages and storage space into real income that often beats straight rentWhether you own a duplex, a short-term rental, or a small commercial portfolio, the same questions apply. Your next big return might not be on the MLS. It might already be on your rent roll.Listen now and start unlocking what's already in your portfolio.Investor Insights Newsletter: https://semiretiredmd.com/newsletter/READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →How to Work with Your Spouse When Investing in Real Estate
May 1000:37:44Tap to summarizeShould You Really Invest in Real Estate With Your Spouse?You and your partner have been thinking about real estate. Maybe you've been dreaming about financial freedom for years. Maybe you've been watching other doctors build portfolios and wondering if it could work for you too.But one question keeps stopping you: do we do this together, or do I do it on my own?It's one of the most loaded decisions a physician couple can make. Most advice online skips right past the real complexity, treating "invest with your spouse" as an all-or-nothing choice. It isn't.We've been investing together since 2015, and over the last decade, we've seen the full range. Couples who thrive building portfolios side by side. Couples who divide and conquer with one passive and one active. Couples where one partner carries the whole thing on their own and still reaches financial freedom.In this episode, we walk through the honest upsides and downsides of investing with your spouse, the three structural models you can choose from, and the communication strategies that have helped us work through every disagreement we've hit along the way.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:The three distinct ways spouses can be involved in a real estate portfolio, and how to pick the one that fits your relationship right nowWhy decision paralysis is one of the hidden downsides of investing with a partner, and what to do about itWhy the disagreement you're most afraid of having with your partner might actually be the best thing for your portfolioA simple metaphor-based communication tool we pull out when a conversation starts to heat up (it's one of our favorites and we use it all the time)Why a real estate portfolio can actually deepen your marriage instead of straining it, and the structural move we made three years in that changed everythingThe honest truth about doing this on your own when your partner isn't interested, and why "my spouse isn't on board" isn't the reason you think it isWhether you're dreaming of building something together or planning to go after this on your own, this episode will help you figure out what structure actually works for your relationship and your goals.Listen now and find out how to invest with (or without) your spouse and still reach financial freedom.READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →What Does a Semi-Retired Life Look Like?
Apr 2600:49:24Tap to summarizeWhat If You Didn't Have to Wait Until 65 to Start Living?You're building wealth. You're making progress. But have you actually designed the life that wealth is for?Most physicians haven't. The default plan is to grind for 20 or 30 more years, retire, and then finally start doing the things you've been dreaming about. But what if that plan has a flaw you can't see until you get there?We found out the hard way. And what we discovered completely changed how we think about work, freedom, and what it means to be semi-retired.In this episode, we're pulling back the curtain on what the semi-retired life actually looks like, live from Japan, where we're spending three months with our four kids through a slow travel program. This isn't theory. This is the real thing: the daily schedule, the cultural moments, the logistics, the hard parts, and why we keep doing it.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:What happened five months into our year of full-time travel that changed how we think about retirement foreverThe day-to-day moments in Japan that no vacation could ever give you, and what our kids are learning from themWhy traveling with kids as part of a community is a completely different experience than doing it on your ownThe real logistics: packing for months, managing your home while you're away, negotiating with your kids' school, and handling time zone challengesHow we run our businesses and real estate portfolio remotely, and what our typical day looks like from the other side of the worldCreative ways full-time doctors in our community are finding ways to take month-long trips, even with clinical schedulesThe life you're building wealth for is available to you right now, in smaller doses, if you're willing to get creative and ask for what you want. Listen now and start making it happen.Boundless Life (use Leti & Kenji as referral for a discount): HEREREADY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →Why You Should Always 1031 Exchange (And How to Do It Right)
Apr 1200:19:53Tap to summarizeWhat If Selling Your Rental the "Normal" Way Is Costing You a Fortune?You bought a rental property years ago. It's appreciated, you've paid down the loan, and now you're thinking it might be time to sell. Maybe you want to upgrade to something bigger. Maybe the property isn't performing the way it used to. Either way, the plan feels simple: list it, sell it, pay the taxes, move on.We get it. That's the path most people take, and it feels responsible.But here's what we've learned after years of building our portfolio: every time you sell a property and pay taxes, you're not just losing money today. You're losing decades of compounding. And the gap between selling the "normal" way and using a 1031 exchange isn't small. It's life-changing.In this episode, we break down everything you need to know about 1031 exchanges, including the rules, the timelines, the mistakes most investors make, and the exact strategies we use in our own portfolio to make sure every exchange goes smoothly. We also share why we're almost always 1031 exchanging and why we think you should be too.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:The shocking difference in long-term wealth between selling with a 1031 and selling without one (this number alone is worth the listen)Why anyone can use this strategy, no special tax status requiredHow 1031 exchanges can become one of the most powerful ways to pass wealth to your children, completely tax-freeThe difference between a "lazy 1031" and the real thing, and why we never settle for the lazy versionThe two deadlines you absolutely cannot miss, even by hoursWhy most investors make the same critical mistake when they sell first and shop second, and the simple fix that protects you from itCreative ways we've extended our timelines, including a lease-back trick that bought us months of breathing roomWhat to look for in a 1031 exchange intermediary so your money is safe and your deadlines are protectedHow some investors in our community are using tenants in common structures to scale into much bigger deals togetherThis isn't about being overly aggressive with your taxes. It's about understanding one of the most powerful tools the tax code gives real estate investors and learning how to use it the right way. Once you see what's possible, you'll never look at selling a property the same way again.Listen now and start planning your next move with the full picture in mind.RESOURCES WE MENTIONED IN THIS EPISODEOur 1031 Exchange Company Partners: [HERE]1031 Exchange Blog Article: [HERE]READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →Ep 175: Can Mid-Term Rentals Really Get You 20% Cash-on-Cash Returns?
Mar 2900:21:39Tap to summarizeWhat If You Could Get Short-Term Rental Cash Flow Without All the Work?Mid-term rentals have quietly become one of the most popular strategies in our community, and it's easy to see why. You take a property that would work as a regular long-term rental, furnish it, and rent it to tenants staying 30 to 90 days. The result? Significantly higher cash flow with a fraction of the turnover and management that comes with short-term rentals.In this episode, we break down everything you need to know to get started with mid-term rentals, from running your first cash-on-cash calculation to finding the right tenants, navigating taxes, and managing the property.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:Why mid-term rentals can generate 20%+ cash-on-cash returns on properties that would otherwise be standard long-term rentalsHow to use the long-term rental cash-on-cash calculator for mid-term rentals (and the additional expenses you can't afford to miss)Which property types and locations work best, and why proximity to hospitals, corporate offices, and good school districts matters so muchThe most common tenant types (traveling nurses, corporate workers, medical students, and insurance displacement renters) and how building relationships keeps your units fullHow mid-term rentals are taxed as long-term rentals (meaning you need Real Estate Professional Status to offset W-2 income with losses)What to watch for with city restrictions and how most regulations define short-term vs. mid-term staysHow to fill vacancy gaps between mid-term stays by listing on Airbnb or VRBO as a short-term rentalThe flexibility to move between long-term, mid-term, and short-term rental strategies as your goals and market conditions changeMid-term rentals offer a compelling middle ground: higher returns than long-term rentals, less intensity than short-term rentals, and the safety net of knowing your property works as a traditional rental if you ever want to switch back. The key is starting with properties that make sense as long-term rentals, building the right relationships, and developing the skills to flex across strategies.Listen now and see if mid-term rentals belong in your portfolio.RESOURCES WE MENTIONED IN THIS EPISODEBoost Your Cash Flow Course (Mid-Term Rentals): HEREAccelerating Wealth Course (Short-Term Rentals): HERELong-Term Rental Cash-on-Cash Calculator: HEREShort-Term Rental Cash-on-Cash Calculator: HEREREADY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →The Hidden Risks of Short-Term Rentals (And Why Most Investors Ignore Them)
Mar 1500:26:23Tap to summarizeWhat If the Biggest Risk in Short-Term Rentals Is the One You're Not Thinking About?Short-term rentals are one of the most popular strategies in our community — and for good reason. The tax benefits through the short-term rental loophole are incredible, the cash-on-cash returns can be 15–20% or higher, and you get the added bonus of a vacation home your family can enjoy.But here's the thing: we've seen too many investors jump into short-term rentals without understanding the risks that can turn a great investment into a stressful liability. And most of these problems are completely avoidable — if you plan for them upfront.In this episode, we break down the three most common risks we see short-term rental investors face — low cash flow, changing STR regulations, and overwhelming workload — and give you the exact strategies we use to mitigate each one so your property stays profitable for years to come.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:How to use a cash-on-cash calculator properly (and the two conservative assumptions we always build in to protect our downsideWhy you should never "set it and forget it" with a short-term rental — and how actively managing revenue and expenses drives up your returns over timeThe counterintuitive reason you should buy in markets with well-established STR regulations (not markets with zero rules)How one couple in our community turned a $650K property into a $1.3M exit after a surprise STR ban — because they had a backup planWhy forcing appreciation is your ultimate safety net, whether or not regulations changeThe year-one vs. year-two management strategy that frees up your time while keeping the tax benefitsHow automation, delegation, and virtual assistants can dramatically reduce your workload without sacrificing performanceShort-term rentals can be life-changing investments. But only if you go in with your eyes open, a solid cash-on-cash calculation, and a plan to handle what comes your way. Don't learn these lessons the hard way — listen now and invest with confidence.If you're ready to go deeper, check out our course Accelerating Wealth at semiretiredmd.com/acceleratingwealth, where we teach you how to buy and operate truly profitable short-term rentals. And if you want to start running the numbers yourself, grab our free short-term rental cash-on-cash calculator at semiretiredmd.com.READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →Will Real Estate Investing Make My Life More Stressful?
Mar 100:19:48Tap to summarizeWhat If Real Estate Investing Actually Reduced Your Stress?You're already juggling a demanding career, a family, and a never-ending list of responsibilities. The last thing you want is to add more stress to your plate.So when someone suggests real estate investing, your first thought might be: "That sounds like a lot of extra work I don't have the bandwidth for."We get it. We felt the same way. But here's what we discovered after building a portfolio that replaced our clinical income: real estate didn't add stress to our lives. It removed it.The real source of stress for most physicians isn't being too busy. It's feeling trapped. Trapped in a toxic work environment you can't leave. Trapped with a single income source that everything depends on. Trapped with no flexibility and no options.In this episode, we break down why real estate investing can actually decrease your overall stress over time, both through practical strategies that make the work easier and mindset shifts that change your entire experience of the process.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:Why relying on a single W-2 income is actually one of the most stressful financial positions you can be in, and how a second income source changes everythingHow the bulk of the work in real estate happens upfront and gets dramatically easier with each property you buyThe systems, teams, and delegation strategies that can put your portfolio on near-autopilot over timeWhy "who not how" is one of the most powerful stress-reducing principles in real estate (and a real example of a physician who made multiple six figures on a deal she barely had to work for)The mindset shift that turns the discomfort of learning something new from a source of anxiety into a source of excitementHow to catch disempowering stories you're telling yourself and intentionally choose meanings that keep you moving forwardThe stress you're feeling right now isn't a reason to avoid real estate. It might actually be the best reason to start. Because on the other side of that initial learning curve is a life with more options, more flexibility, and a whole lot more freedom.Listen now and start rethinking what's really adding stress to your life.READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →
Should I Pay Off Student Loans Before Investing?
Feb 1500:25:21Tap to summarizeWhat If Paying Off Your Student Loans First Is Actually Costing You?If you're a physician sitting on $200K+ in student loans, you've probably been told the same thing over and over: pay off the debt first, then start building wealth.It sounds responsible. It feels safe. And we get it, because we both did it ourselves.But looking back, we wish someone had challenged that advice. Because what we've learned after reaching financial freedom in just three years of real estate investing is that waiting five to ten years to start can cost you far more than the interest on your loans ever will.In this episode, we break down the real arguments for why you might consider investing in real estate before your student loans are fully paid off. This isn't about being reckless with debt. It's about being strategic with your time, your money, and the opportunity in front of you right now.BY THE TIME YOU FINISH LISTENING, YOU'LL DISCOVER:Why the five to ten years you spend paying off loans could be your most valuable investing years, and what that delay may actually cost youHow real estate returns can significantly outpace your student loan interest rate when you stack all six ways to earnWhy having only one source of income (your W-2) is actually the riskier position, and how cash-flowing properties change thatThe tax strategy that could put six figures back in your pocket each year, giving you the ability to invest and pay down debt simultaneouslyHow to rethink "good debt" vs. "bad debt" so fear doesn't keep you on the sidelinesThe real question you should be asking: not "should I pay off my loans first?" but "how do I start building assets while managing debt responsibly?"Whether you're a fellow, a new attending, or a physician years into practice still chipping away at your loans, this episode will give you a new way to think about what's really possible when you stop waiting for the "right time" and start building now.Don't let conventional wisdom cost you your best investing years. Listen now and start making a plan that works for your life.WANT TO LEARN OUR EXACT STRATEGIES FOR PAYING LESS TAXES? Register for our signature Zero to Freedom program here.READY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →Why Retirement Planning Isn't the Same as Planning for Financial Freedom - Interview with Austin Dean
Feb 100:27:51Tap to summarizeWhat if you could stop waiting until 65 to enjoy the freedom you're working so hard for?Most financial advisors hand you a retirement plan and tell you to max out your 401(k), invest in the market, and wait. Wait until you're older. Wait until you have "enough." Wait until you've traded decades of your life for a number on a statement.But here's the thing: a high net worth on paper doesn't buy you freedom. Cash flow does.In this episode, we're sitting down again with Austin Dean, founder and CEO of Waystone Advisors, who's been recognized by Forbes, Business Insider, and the American College of Financial Services for his unique approach to wealth building. Austin works with physicians who are tired of the traditional retirement playbook and ready to create financial independence on their own timeline.By the time you finish listening, you'll discover:Why having a high net worth statement can still leave you trapped in your job (and what actually creates freedom)The difference between a retirement mindset and a financial freedom mindset, and why the shift changes everythingHow to make your money work harder by creating a "flywheel" that generates cash flow while you sleepThe most common mistakes physicians make with traditional retirement planning (including the FIRE strategy trap)Alternative investments that can generate 13-18% returns with the right guidanceWhat to look for in a financial advisor who actually understands the path to financial freedomFinancial independence is closer than you think. It starts with asking better questions and surrounding yourself with people who've walked the path before you. If you're ready to stop waiting and start building cash flow that gives you options, this episode is your starting point.IS 2026 THE YEAR YOU GET FINANCIALLY FREE?Register for the Legally Lower Your Taxes Bootcamp HEREREADY FOR REAL ESTATE SUCCESS? Book your call HERE for your next move.RESOURCES + LINKSWork w/ SRMD: HEREJoin our FREE Facebook Groups: HEREFOLLOW + CONNECTConnect with SRMD: Website | Instagram | FacebookLiked this episode? Share it on social and tag me @semiretiredmdLove the show? Leave a 5-star review and let me know!
Transcribe →