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White Coat Investor Podcast
MtoM #275: How a Small-Town Doctor Built a Million-Dollar Portfolio
00:32:33
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- [00:00]
A
This is the White Coat Investor Podcast, Milestones to Millionaire. Celebrating stories of success along the journey to financial freedom.
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B
This is Milestones to Millionaire podcast number 275. This episode is brought to you by KeyBank. For six years, White Coat member benefit partner Laura Road has been part of KeyBank. As of March, that partnership be became even stronger as Lower Road is now officially under the KeyBank brand. With the transition to KeyBank, the same tools and services you rely on now come with enhanced resources and support and the same great experience you trust. WCI members can contribute to enjoy the benefits and financial resources they always have with even more support from KeyBank. To learn more for terms and conditions, please visit www.whitecoatinvestor.com KeyBank all right, it is now may by the time you're hearing this, it's time to apply to be a speaker at WCICON27. You do that at WCIEvents.com the conference is going to be February 24th through 27th, 2027 at the Rosen Shingle Creek in Orlando. By being a speaker, not only do you get to speak, which is fun, but but you get to experience all of WC icon. You get a full registration, we fly you out, put you up, it's a good time, give you a little bit of a stipend and you get to have the whole three day experience. Four day if you count the opening reception beforehand. But the beautiful thing about our speaking panel, people that come and the faculty for the conference is they tend to stick around and meet people and talk with people and the interaction with the attendees is something that the attendees love and the speakers love just as much. Now obviously it's a little bit of a competitive process to be chosen as a speaker, but you can't win if you don't even get in the game. And so we encourage you to not only apply, but if you think you'd be able to give good presentations on multiple subjects, apply for multiple talks. Again, you do that@wcievents.com this is a great way to pay it forward to make a difference in the lives of thousands of physicians and their families and to come to wcicon. Absolutely for free. All right, we've got a great interview today, so I hope you're looking forward to that. We've got a millionaire we're bringing on the show. Our guest today on the Milestones to Millionaire podcast is Adam. Adam, welcome to the podcast.
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A
Thanks. Great to be here.
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B
Adam, you've been a white coat investor for a long time. You were telling me before we Started recording that you were reading in 2012 or 2013. You were actually there at our first conference. So thank you so much for being with us for so long.
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A
Yeah, no problem. I can't take all the credit. My wife is the one who kind of found you first and said, hey, we're going to head in this direction. So I had to say, yes, dear.
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B
Okay, well, everybody else doesn't know you, though, so let's have you introduce yourself a little bit to the audience. Tell people how far you are out of training, what part of the country you're in, what you do for a living.
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A
Yeah. So my name's Adam Wrench. I'm a family medicine physician. I am here in rural Nebraska, pretty much right smack dab in the middle somewhere. And I'm just about eight years out of residency trading.
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B
And you've accomplished something recently that's. That's impressive. Tell us what you became.
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A
Yeah, so we became millionaires. And when you're. I guess if you're talking about net worth, that happened a little bit ago. But my milestone that I was really looking forward to was a million dollars in investments. That's what I was going for. And so we hit that towards the. Just right at the end of last year.
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B
So very nice. And of course, it takes us a few months to get you on the podcast, and I think this doesn't even drop until about May 18, so hopefully you'll be a little bit wealthier by then. If you're on the track you've been on, I suspect you will be. So tell us a little bit about your net worth. The last time you added up, whether that's today or a few months ago. How much in home equity? How much in retirement accounts? Tell us what you have.
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A
So, yeah, I kind of follow it monthly. March wasn't a great month, so it kind of went down a little bit. But total net worth right now is about 1.4 million. Vast majority of that is in all our investments. I have mostly tax deferred accounts. I have a small taxable, but about 1.2, 1.25 million in the investments now since the end of last year. I had a couple good months. We have our primary residence, which is our only residence that we have, you know, about $180,000 in equity to equal that 1 point for almost 1.5.
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B
Now you're in small town Nebraska. Some people listening to this right now are in D.C. or Manhattan or San Diego. Tell us what your house costs. What's it worth today? I should ask what's your house worth today?
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A
Our house taxes just went up. We got one of those lovely little pink postcards last year. So the worth went up to about 360 to 380 I think this year when we first moved here. This house is a five bedroom house on a 0.67 acre lot built in 2013. And when we moved here, we bought it for 297.
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B
So five bedrooms you said, three quarters of an acre.
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A
Yep.
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B
And how many square feet in the house?
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A
Yeah, probably around 4,600, I think.
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B
Okay, so 4,600 square feet, five bedrooms, three quarters of an acre. Are you guys in San Diego listening to this here? This is what geographic arbitrage is, right? You leave your condo in San Francisco or D.C. or whatever and essentially get a mansion on almost an acre in rural Nebraska. Now the downside, of course, is it's in rural Nebraska and you better be okay with that because it's a little bit different. So tell us a little bit about your practice. You're the classic country family doc, right? I mean, tell us what you do.
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A
Well, and so that's one of the reasons why I chose rural medicine is I grew up in the biggest town in Nebraska, born and raised there, but my parents are from smaller towns. And when I was going through medical school, I liked a little bit of all my rotations. So I liked a little bit of OB at the time, didn't like that later on. But I liked psychiatry, I liked hospital medicine, I liked er. So when you become a family medicine doctor, if you're in a big city, a lot of times you're just seeing a whole bunch of patients in the clinic and that's kind of all you do in and out. And I knew that that was going to eventually lead down a path of potential burnout. I like variety. So coming to a rural facility, you get to do all. So just, you know, this morning I went and saw my inpatient because I have a patient in the hospital. So I got to round on that. Got to do some hospital medicine. Most of my day is clinic, just regular bread and butter family medicine clinic. I have opportunities to do other things. I actually run a wound clinic because there's no one else around that can do a wound clinic. Usually that's a surgery thing, but we don't have a general surgeon in house. So I run a wound clinic one day a week. And then every once in a while we are backup call in the ER or if we want to take a primary shift, I get to cover the ER if I Want to. So you kind of can make it your own. There's five whole docs in my office, in my. In my practice. So we get to share the load, too. So it's not like calls every one in five days. We do weeks of backup at the time. The. Our. Our PAs take primary call in the emergency room. And if there's traumas or codes, then that's most of the time we have to come in or if they just need some help.
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B
Okay, so give us a sense of what your income has looked like for the last eight years since you got out of training practicing rural family medicine.
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A
Yeah. So graduating residency came out here. I think my first contract was like $230, which is pretty good for a starting family medicine doctor.
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B
230,000, I assume.
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A
Yeah. What did I say? Oh, 230. Yeah, 233,000. Okay. Yeah. There's opportunity for bonus and production that you get from that. One of the big reasons why, I guess another advantage of coming to a rural facility is they're very keen to help you out, to get you here. And that for me, included a lot of help with loans. Being in a small town and actually our most rural hospitals, and I don't know if this is true everywhere across the country, but most rural hospitals in Nebraska are actually county hospitals. And so it's a government and they really kind of want you to come and help out. So they have a lot of programs, both state and federal programs, to kind of get you into these places. And so another big draw was a lot of loan repayment.
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B
As a county facility. Would that job qualify for public service loan forgiveness?
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A
It would. And so that's one of the conversations that we had when we moved out here. My wife and I was how we wanted to do that. Yeah, three years of residency and then seven years out here, which means right about now or this past year, I would have been done paying for public service loan forgiveness. But with the federal program that I got when I came out here, it's a federal program, would pay for a portion of it as long as your hospital matched the funds. And they paid for a little over two thirds of my loans, which I graduated with about $240,000 in loans with them paying 2/3, we thought, you know what we. I'm not as debt averse as Dave Ramsey would like me to be, but I really did not want to carry those loans for another seven years. So we just decided we were going to pay as if we were paying our own loans and got them off in about 30 I think it was. I wanted to do it in three years and I did it in 37 months, so I kind of missed it. Mark. But I didn't feel like paying my loans for seven years when I already had two thirds of it done, so decided to just go through with it.
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B
So has your spouse been working at all?
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A
So when we moved out here, she didn't. We had. Our oldest was going to go to kindergarten, but our youngest was only one, so. And we're, I mean just a try not to find a job. As we moved out here, she stayed home, so we didn't have childcare expenses. After my daughter got old enough, she got a part time job. She works for a nonprofit, but she gets to work at home, so she's here too. So no, the vast majority of our income now is mine and hers is just kind of adding a little bit on the top.
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B
So I mean, I'm doing the math in my head here. Over the last eight years you've made something like $2 million and you've got 1.4 million of it left.
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A
Yeah.
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B
Right?
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A
Yeah.
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B
I mean this is really good. I mean you got some appreciation of the house and you know, of course the stock market's done well the last few years. The bottom line is you saved a whole bunch of your income too.
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A
Yeah.
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What do you think your savings rate's been on average over those last eight years?
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A
I calculated last year our savings percentage kind of fell around 32%. It's been nice for a number of reasons. Another, I guess another advantage of me working in this county hospital is there's a few different strategies that I could use that I probably wouldn't do in a. In your own, I guess maybe not private office, but at least a urban location. My facility, we have a 403B because we're a non profit, but we also have the 457 that's offered, which is a governmental 457 because I'm a government employee. So I had to email. I think the HR department was not very happy with me because I emailed them three times. Just saying. Are you sure it says governmental? Because I'm just a little leery about that. I read too much. But then also being a governmental employee, I have access to a 414 account which is for governmental employees and for highly compensated employees. That's how my facility does the match. It's a mandatory 3.5 percentage of my income that I have to contribute and It's a mandatory 3.5% income for the hospital that Employs me. So it caps out. I think the income limit is like 360,000. So I think this year it'll be a max of another 25,000 I can contribute. And so doing the 403B plus the 457, plus the 414, along with our Roth IRAs that we do every year and then whatever, we kind of want to throw in taxable. I think last year we saved about 130,000.
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B
Okay, so this is pretty awesome. Right before that last paragraph, I'd never heard of a 414. So I'm sitting here googling, I'm like, 414, what's that? But indeed, this pickup plan, they're often called, is another tax advantaged retirement account specifically for government employees. It sounds like it works an awful lot like a 401A. I don't know if you're familiar with those plans. Pretty similar sounds like another similar plan to that. So that's great that you've learned about what's available to you and taking advantage of them. At what point do you think you'd start thinking about doing Roth conversions or maybe doing some Roth contributions of some of this money now that you've got seven figures in tax deferred money?
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A
That's an interesting question. It's one that I've kind of put off and thinking about just because I wanted to focus on putting some money away. But now it's a good problem to have considering that, I mean, we've both, my wife and I, we both contribute to our Roth IRAs every year. And I think each one of them has 140 or 150 in it each. So that's going the right direction as well. So I haven't really thought about that. But now you're giving me another research topic.
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B
No worries. Okay, let's talk about some advice for people that want to do what you're doing right. They're like, well, rural medicine sounds good, but I hear the pay is a little bit lower. I know the cost of living is lower and I don't know anybody that's done it. What advice do you have for somebody that would consider practicing, you know, not just in the Midwest, but in a small town in the Midwest. What, what advice would you give to them?
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A
I think it has been overall an amazing choice.
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B
Yeah, the.
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A
You always worry with family medicine, just lower paid specialty. But again, geographic arbitrage. Not only is your cost of living cheaper, I mean, I live two blocks from the hospital. My wife makes fun of me because I drive most days and I probably really shouldn't. She probably walk. So. But even then, gas is cheap. Not anymore. But when you're only driving two blocks, yeah, it's, it's nice because you get to know the other docs in your practice really well. You get to know the administration. So yes, I'm an employed physician. I work for a county hospital. But really being one of the five docs, you have a lot of say in what goes on in that hospital. Yes, the CEO probably makes the financial decision, but if he pulls all five of us doctors in your room and says, hey, I'm thinking about this, and all five of them say, that's not a good idea, we're not going to like that, then he tends to go a different direction. You do end up getting paid more. 233 was my initial salary, but I, I don't quite make double that. But it's getting pretty close to that after bonuses as your practice gets busier. So as a rural family medicine physician, I didn't think I was be making around 400,000. And that's kind of where we're at right now. So it's got a lot of advantages. We get to know your neighbors, you get to know your patients really well. You get to have time. I don't feel like I'm in and out of the office on a rat race. And you kind of get to make it what you want. And so if you are worried about seeing 35 patients every single day in a clinic environment, in and out, working on all those notes without doing anything different, then really check out your smaller towns because you can kind of make it whatever you want.
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B
Yeah, pretty awesome. You know, there we get requests a lot for people. They're like, oh, you only put people on the podcast that make a gazillion dollars. You know, why aren't there more moderate income, you know, physicians on there? And here we are, we have fam practitioner on here that demonstrated a few things. One, that there's a pretty good range of income in every specialty. Right. You might have started at 230 and now you're closer to 400. Well, 400 is more than lots of emergency docs are making. The average emergency doc's making like 375. So half of them are making less than that. You know, the average physician's right about that amount as well, something around 375. So here you are doing supposedly a lower paid specialty and getting paid more than the average physician and dramatically lower expenses thanks to the geographic arbitrage. So you Know, it really demonstrates just how possible it is to be successful. No matter what you choose to do or where you choose to do it, you can have success. So I appreciate you coming on to demonstrate that. All right. What would you tell somebody that just wants to be successful like you? They're not necessarily interested in rural medicine. They're not interested in family practice. What financial advice would you give to another doc if they ran into you at a conference and asked for your best tips?
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A
Probably the thing that worked out best for at least my family is educating yourself. We found you early. We read the books. We didn't have the money to save and do all those things. I didn't have enough. We didn't make enough money to save $130,000 a year right away. But learning and educating yourself so you know what to expect going forward, it doesn't matter how much you make. Right. It doesn't matter necessarily where you live. If you know what options are available to you, then you can save. And on the other side of it, I think that what we've started to do more, seeing how quickly our savings has grown, is we're trying to spend intentionally, figure out what makes us happy. And in rural Nebraska, like you said, the cost of living is low enough that while we're here, it doesn't, you know, cost us much to live. So one of the things we like to do is travel. We use that money to take a few big vacations, maybe a White Coat investor conference every once in a while and live it up while we're there and then come home and repeat.
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B
Pretty awesome. Well, congratulations on your success. Thank you for being so willing to come on the show and share it with others and hopefully inspire them to do the same.
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A
No problem. That was great. Thanks.
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B
All right. I hope that was helpful. The interesting thing about this sort of a situation, when somebody becomes financially literate before making the money, how much better they do. Right? I mean, his wife introduced him to WCI in like 2012, 2013ish. He came to WCI Con as a senior resident. So that was in, like, 2018. So by the time he heard about it, he was a young medical student and he was still years away from the big bucks. So by the time the big bucks started rolling in, he knew exactly what to do with it. And I think that's very helpful to get that financial education so early. That's why we do our champions program. Right. We're trying to distribute a copy of the White Coat Investors Guide for students to every first year medical Dental, et cetera, student in the country. This is one of the things we do each year because we know how powerful it is to get started right up front. Even if you're a relatively low paid physician, all of a sudden, now you negotiate a little bit better. You take a job that pays you a little bit better. You pay attention to the cost of living. You quiz HR about how your retirement accounts actually work, and you take advantage of them. You get your entire match. You make sure you have adequate insurance. You do the things right, right from the beginning. And so no surprise, the wealth comes, right? He's eight years out, already a millionaire. His goal was to be a millionaire by 40. He crushed that goal. And you know what? The first million is the hardest. The second one comes a whole lot faster and then they just start piling in. And before you know it, you have enough money that you can do whatever you want with your life. And I hope a lot of you will choose, even once that happens, to still practice medicine like I am, on your terms, the way you want to do it, as much or as little as you like. If it makes sense for you to continue to embrace that calling. So many of us feel to serve others and to do what we can do, what we spent a decade learning how to do. But to be able to live your life on your terms, intentionally, with the trips and the things you want to be able to do for your family and to support the causes you care about, it's a pretty awesome thing that becomes possible simply by becoming financially literate and financially disciplined and a little bit intentional with how you're living your life. And Adam's done that. I'm super proud of him and exciting to be able to discuss those successes he's had with him.
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C
The Thrift Savings Plan, or TSP, is the federal version of the 401 for federal employees and military members. And it changes from time to time like any 401 plan does, but in general has remained pretty similar across the years. Ever since I was in the military and was using it as my retirement savings plan. It currently offers both a tax deferred and a Roth option. So whether you want to make tax deferred contributions into it or Roth contributions into it, you have both of those options in Thrift Savings Plan. The Thrift Savings Plan has been known for low expenses over the years. Now the truth is the that over the years, Vanguard and Fidelity and Schwab have kind of caught up to them iShares as well. So you can get very low cost investments in other Places as well. Now, it used to be the TSP was the cheapest index funds you could ever find. That's not the case anymore. But they're still very, very cheap. And certainly to the point where you shouldn't be choosing between Vanguard, Fidelity, the tsp, et cetera, based on expense ratios. If they're cheapest index funds, they're all very, very cheap and practically free to invest in. So that's one big, huge advantage. Another big, huge advantage of the TSP was that they just kept things relatively simple, right? It has basically five funds that you can invest in. The first one is the C fund or the common stock fund. And that is basically an S&P 500 index fund. The next fund is an S fund or a small stock fund. And this is the equivalent of an extended market index fund that you might see at Vanguard or Fidelity. Put those two together, and it gives you a total stock market index fund, right? But 80% of your money into the C fund and 20% into the S fund. You basically got a total stock market fund. The third fund in the TSP is the I fund or international fund. And this is similar to a international total stock market index fund. A few years ago, that I fund changed from just developed markets to include also emerging markets. So it's most similar to a total international stock market index fund. Now it also has two bond funds. The first one is the F Fund for fixed income fund. And it's basically a total bond market index fund. The other bond fund is unique to the thrift savings plan. It's called the G Fund for government securities. And it basically offers you treasury bond yields with money market risk. So it gives you the average yield of Treasuries that are out there, which is usually, if the yield curve is not inverted, Is usually a little bit more than you can make in a money market fund. But the duration of this fund is essentially no more than four days. So it really functions as a money market. You don't lose principal in the G fund. You earn a little bit more than you would with other cash investments over the long run. And so it's a very simple, safe fund. Because of its uniqueness. A lot of people, even they leave the military or leave government service, keep their TSP just because they like to invest some of their money into that G fund. My entire TSP is invested in the G fund these days. But granted, that's a very small percentage of our overall assets. If you have access to the thrift savings Plan, just like any other retirement plan, you have Access to. You should probably use it. Hey, It's a good 401k. There are lots of terrible 401ks out there. This is not a terrible 401k. This is a good one. So if you have access to it, please, please, please use it. You're not going to regret it. You'll have a little bit more money for retirement, right? Because in retirement plans, money grows faster because it doesn't get taxed as it grows. It also gives you a little bit better asset protection. Right? In every state, this money is protected from your creditors. So heaven forbid you have an above policy limits judgment that isn't reduced on appeal and you have to declare bankruptcy. You get to keep your tsp. It's a great reason to max it out every year. It also facilitates estate planning. Right? That money doesn't have to go through probate. You can just list your beneficiaries and the money goes directly to them relatively quickly after your death. So very convenient retirement plan. Definitely use it if you have access to it. Now, in the olden days, military members didn't get any sort of a match in the tsp. I never received a TSP match during my military service. That changed a few years ago. And now both civilians that are government employees as well as military members can receive a match of up to 5% of base pay. Now, not receiving your match in a retirement plan is the equivalent to leaving part of your salary on the table. Don't do that. Make sure at a minimum, you put enough into the plan to get your entire match. Now, in addition to the five basic funds in the tsp, there are some other funds they call the L funds. L standing for life cycle. And these are similar to the target retirement funds you might find at Vanguard or Life Cycle funds you might find at other mutual fund companies. They are a mix of the other five funds. And you're supposed to choose your mix based on the date that you want to retire. So you can get one that's 2025 or 2030 or 2035 or 2050 or whatever. And you simply choose it based on when you think you're going to retire. Approximately. And then the TSP experts choose what percentage of your assets ought to be in each of the funds. And as you get closer and closer to retirement, it becomes more and more and more conservative. More money in the F fund, more money in the G fund, less money in the stock funds as you go along. But if this is your only retirement account, that's perfectly reasonable to use these L funds if you're like a lot of docs and you're mixing it with three or four other retirement accounts and a taxable account. You probably are going to have a little more complex portfolio and you're probably going to need to roll your own TSP asset allocation. But if it's your only retirement account, the L funds are a great option. Okay, now what's wrong with the tsp? Is there anything wrong with it? Well, I mean, the expenses can be slightly higher now than some of the stuff you can buy at Vanguard and Fidelity, but it's close enough. You shouldn't worry about that. I'm not a huge fan of S&P 500 index funds. I think a total stock market index fund is slightly better. And the TSP uses an S&P 500 fund, the C fund, so that's a little bit of a downside. That's a pretty minor quibble. It also doesn't have any sort of true small stock fund, even the S fund. It's mostly a mid cap index fund. Right. It does have some small stocks in it, but it's not a true small stock fund. So if you wanted small stocks in your portfolio, heaven forbid small value stocks in your portfolio. You're not going to be able to get that really in the tsp. You're going to have to do that in your taxable account or another 401. You're eligible for your Roth IRA or whatever. Another criticism some people make is that it errs too far on the side of simplicity instead of diversification. Right. The TSP has traditionally been very slow to add any new asset classes. So one big criticism that people have had of it over the years, well, for a while they criticized that you couldn't buy emerging market stocks in it. Well, they've changed that. So now you can, but you can't get foreign bonds or real estate investment trusts or treasury inflation protected securities or small value funds, much less alternative kind of assets like gold or Bitcoin or something like that. So that might be a downside for some people. Now simplicity is usually a good thing. Lots of people have portfolios that are way too complex out there. But that could be a criticism of the tsp. Another downside to using the TSP in the past was that you could only have one partial withdrawal in your entire lifetime. So that was not really very helpful. So what people would end up doing is when they got to retirement and actually started withdrawing from their plan, they would roll it into an ira. Well, there's pluses and minuses of that one of the minuses was that you'd no longer have access to the G fund, for instance, or the super low cost index funds elsewhere available in the TSP. There's a few other upsides of having a 401 instead of an IRA. For example, you can start withdrawing from a 401 at age 50 without any penalty, whereas you have to wait until age 59 and a half for an IRA. So that was a downside, but that is a little bit better. Now they have both hardship based and age based in service withdrawal and just a lot more options after you leave federal service. So this has been a problem with the tsp. They've gotten a lot of criticism here over the years, but they slowly seem to be improving this aspect of it. The distribution options are still somewhat limited, of course. I mean, you can leave the money in the TSP and just take your required distributions. You can take all the money out at once or roll it over into an IRA or another 401. You can take out a certain amount each month until the money is gone. It has to be the same amount each month and it has to be at least $25. You can take out an amount each month that's calculated based on your life expectancy. It's not technically an annuity. I mean, there's no guarantee that payments won't go down over time and that amount gets recalculated every year. But it is an option. And then of course it lets you annuitize the account. Single annuity, joint annuity with either 100% or 50% to the survivor can be flat. Payments can be indexed to inflation, which is pretty unusual in annuities these days. So lots of combinations available when you want to withdraw from the account. I think most people are still doing what most people do with their 401s, which is roll it into an IRA. So all they got to manage in retirement is one traditional IRA and one Roth IRA. Another downside of the federal TSP is that over the years there has not been a mega backdoor Roth IRA option, meaning you can't do after tax contributions and in plan conversions, well, you could do after tax contributions at least while you're deployed as a military member, but you couldn't do in plan Roth conversions. Well, that's changing. Starting in 2026, you can do in Plan Roth conversions in the TSP. So that's basically going to give you a mega backdoor Roth IRA options for all of you who have tax exempt money in there from when you were deployed or something like that. So that's a real benefit and a good change for the TSP. Bottom line, TSP is a good 401. If you have access to it, you should use it. Especially check out the unique aspect of the G Fund. A lot of people like that in particular because it gives you higher bond like yields with only taking money like risk. And they've made lots of improvements to the plan over the years. It's even better than it was back when I was in the military. And take advantage of it if you have it.
- [31:38]
B
This episode is brought to you by KeyBank. KeyBank is one of the nation's largest full service banks offering banking, lending and financial solutions for healthcare professionals at every stage of their career. Key suite of services includes student loan guidance and financial education tools to help clients find financial peace of mind. To learn more and for terms and conditions, please visit whitecoatinvestor.com KeyBank all right, we've come to the end of another episode. If you'd like to be featured on the Milestones podcast, you can apply@whitecoatinvestor.com Milestones until next week. Keep your head up, shoulders back. We'll see you next time on the podcast.
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A
The White Coat Investor Podcast is for your entertainment and information only and should not be considered financial, legal, tax or investment advice. Investing involves risk, including the possible loss of principal. You should consult the appropriate professional for specific advice relating to your situation.