dosing medication


Avoid 5 Financial Mistakes Physicians Make

Would you like to build wealth? The prescription is simple: spend less than you earn, invest wisely and partner with the right people.

Here are ways to avoid the physicians’ five common financial mistakes that stand in the way:

Mistake #1: Imbalance between spending and savings.

At every moment you are faced with a choice: Will I spend today, or save for a better tomorrow?

For an investor time works like gravity. An early start on savings is like riding your bike downhill; you benefit from the magic of compound interest. Conversely, a late start means you pedal uphill.

We physicians already get a late start on saving because of our prolonged training period and the burden of medical school debt. After all the years of deprivation, many physicians feel it’s time to live it up once training is over. It’s easy to grow into and spend any level of income.

The evolving field of neuro-economics suggests that biology may play a role in an individual’s propensity to save or spend. Some people are born “spenders” and others are born “savers.” While biology is not destiny, it takes self discipline for spenders to save—and for savers to spend. Discipline is a limited resource.

Here are some ways to save more:

  • Automate savings. If you don’t see the money, you will not miss it as much!
  • As you anticipate a financial windfall—whether it’s an inheritance, the transition from training to your practice or a higher salary in a new position—plan to save a high percentage of the increase.
  • Get a clear picture of your future you’re working towards. When you say no to something today, you know that you will enjoy more rewards tomorrow.

Mistake #2: Getting financial advice from the wrong people.

You have the intelligence to learn everything you need to know about building wealth, just like you could potentially manage any patient with any medical condition.

However, you also know that patients get better medical outcomes in the hands of physicians who see large volumes of similar patients.

Surveys show that physicians working with professional financial advisors are most secure about their retirement plan. Only half of physicians do so.

Many physicians turn to their colleagues for financial advice. I think of all the investment opportunities I heard about in the surgeon’s lounge between cases. Most physicians who jumped on the bandwagon lost their money. One financial advisor I know says that one of her major jobs is protecting her doctor clients from DDD’s—dumb doctor deals.

Here are steps you can take:

  • Ask yourself, “Do I really trust this person to give me sound financial advice?” Then listen to your intuition.
  • Ask physician colleagues, “Who helps you plan for retirement? What do you like about working with this person?”
  • Ask yourself, “How will I objectively assess investing opportunites?”

Mistake #3: Failing to manage taxes wisely.

Your ability to proactively manage your taxes correlates with your ability to build wealth.

Your CPA works hard to assure that you minimize your tax burden in any given year. However, it’s important look at the bigger picture.

When you place money in a tax-deferred retirement account, you don’t pay taxes on that money NOW; however you will pay taxes on this money when you take it out.

Experts predict that taxes are going up.

Here is a step you can take:
Work with a team of consultants who see the big tax picture for both today and for tomorrow.

Mistake #4: Failing to protect assets.

You carry insurance on your home and your car. You have a medical malpractice policy. You may even insure your smart phone.

Still, many physicians do not insure their most valuable asset: their ability to generate income.

Further, the activities of your partners impact your ability to build wealth. Do you and your life partner have an agreement about how to manage money that works for both of you? Do you trust the judgment and ethics of the colleagues in your practice?

Here are steps you can take:

  • Make sure you’re prepared for the “what if’s” in life. In addition to life and disability insurance, look into an umbrella policy for your home. Check with your medical malpractice carrier and see if you are protected for claims arising from social media activity.
  • Talk with your financial advisor about incorporating—even if you are employed.
  • Have a conversation with your life partner and your children about money. Assure that you and your life partner agree on a vision for your financial destiny. Teach your children wealth-building strategies.

Mistake #5: Ignoring the human condition.

Nobel laureate Daniel Kahneman studied how people respond to changing markets including the 2002 dot-com bust and real estate boom. He concludes that investors make irrational choices.

We make predictable investing errors. It’s part of the human condition.

If you have ever looked at optical illusions, you know how easy it is to fool the brain. Yet, even after someone proves that we have been tricked, our false perceptions persist.

Here are some of the predictable errors that get in the way of building wealth.

Loss aversion. We will take greater risks to avoid loss than to experience gains. That means investors predictably take risks at the time they should be erring on the side of safety.

Over and under reactions. Investors tend to behave with optimism when the market goes up, and become much more pessimistic when the market goes down.

Over confidence. Investors tend to overestimate their ability to beat the market, and underestimate investing challenges.

Relativity. Investors see the world through the eyes of relative experience. Imagine how you would feel if someone gave you a gift card. Now imagine how you would respond if someone gave you two gift cards and took one back. You have the identical outcome is each case, but it feels much different.

Spending as a stress management tool. Spending creates a positive feeling state through the release of dopamine. The medial pre-frontal cortex modulates this response. This part of the brain also regulates stress response. Could the growing numbers of physicians on the edge of burnout be using spending as a stress management tool?

An estimated 5 to 10% of Americans suffer from a shopping or gambling addiction.

Here are steps you can take:

  • Observe your investing behaviors. Ask, “When do I fall into these traps, and how can I avoid them?”
  • Consider whether you are using spending as a stress management tool. Consider healthier alternatives.
  • If you have concerns about a shopping or gambling addition, seek help. You are not alone.

You can build wealth. You simply need to set the intention and assure your actions are aligned with your goals.


Permanent link to this article:


9 Ways to Generate More Revenue

dollar sugn

Doctor, are you concerned about falling fees and rising costs?  Here is a video with 9 ways to generate more revenue.

I have implemented each myself.


Permanent link to this article:


Lesson for Investors from the Shark Tank

shark-tankThe wildly popular TV show Shark Tank offers lessons that investments in the right companies can be highly profitable.

If you want to generate wealth by owning a share of a company, you may want to think like a Shark.

Here’s what the business-savvy Sharks know as they scrutinize investment opportunities:

  • Look for disruptive technology  Find game-changing innovation. Assure that the intellectual property upon which the company is built is patent-protected.
  • Look for a proven market  Make sure that the product or service solves a buyer’s pressing problem.  Further, gather evidence that the buyer has an incentive to make the purchase.
  • Look for the right team  The process of bringing a product from the white board to the marketplace requires a specialized skill set.  Make sure that the team principals know how to build businesses.

To illustrate these points, here are three companies that would almost certainly excite the Sharks.  All three companies leverage licensed intellectual property developed at universities.  The teams include industry experts and serial entrepreneurs who have built companies.

Predictive Aviation

The problem: Aircraft component failures cause flight delays, flight diversions and cancellations.  They also lead to accidents and death.

The cost of the problem: World-wide airline maintenance costs run about $40 billion a year.  Further, component failures cost millions of dollars in lost productivity, aircrafts and property.

The solution: Predictive Aviation offers a breakthrough artificial intelligence to accurately predict probable aircraft component failure. This significantly reduces the airline client’s maintenance costs and increases overall safety. Low direct operating costs are keys to airline profitability.

Plasma Stream

The problem: The trucking industry actively seeks ways to reduce fuel consumption. A large portion of the power consumed by class 8 trucks is used to overcome aerodynamic drag. The reduction of this drag force would increase fuel efficiency and decrease engine horsepower requirements.

The Solution:  Plasma Stream offers an innovative mechanic solution that decreases fuel use by 10 to 20%.  Just as geese fly in a V formation to lower the overall work of resisting drag, Plasma Steam offers proprietary mechanical ways to reduce drag and improve fuel efficiency.

Wipe-Rite Technologies 

The problem: Many costly cases of central-line associated bacteremia result from a systems problem: clinicians’ poor knowledge of and adherence to hub cleaning protocols.

The cost of the problem: Cases of central line-associated bacteremia cost hospitals $9 billion; further, they lead to death in 25% of cases.

The Solution Wipe-Rite offers a wipe with a clearly recognizable indicator of compliance with hub-cleaning protocol. When sufficient amounts of pressure have been exerted on the hub, the clinician sees a color change.

You could potentially invest in and own a piece of any of these companies or companies like these!

Before you make any investments, conduct your own due diligence.  Make sure that any investment is right for you.

Owning a piece of a start-up company offers a way for you to make socially-responsible investing choices that can support your own passions— while making the world a better place.

© 2016. Vicki Rackner MD.  All rights reserved.  You may reproduce this post with the following by-line:

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients, and she helps physicians run more successful practices. Contact her at (425) 451-3777.

Permanent link to this article:


Tutorial: 9 Ways to Generate More Revenue

Doctor, Would You Like to Generate More Revenue?

dollar sugnWould you like to generate more revenue?  Whether you need to pay for your third child’s college tuition, accelerate your retirement saving or take a vacation, you can make it happen by working smarter and not harder.

You have many ways to leverage your skills, experience and expertise to put more money in your pocket.  Here are ten ideas that have worked for me.

  1. Collect what you earn.
  2. Minimize your tax burden.
  3. Protect yourself from fraud.
  4. Serve as an expert in medical litigation.
  5. Sell products and services.
  6. Leverage your resources.
  7. Educate, empower and entertain.
  8. Coach and consult.
  9. Invest wisely.
  10. Reinvent your medical practice.

You will find all ten points laid out in this 30-minute tutorial.

What do you think?


Click here to learn more about our Thriving Doctors Bootcamp.

The next session begins February 24th, 2016.

© 2015. Vicki Rackner MD.  All rights reserved.  You may reproduce this post with the following by-line:

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients, and she helps physicians run more successful practices. Contact her at (425) 451-3777.

Permanent link to this article:


Doctor, What Makes You Remarkable?

While we have never met, I know something about you with absolute certainty.  You are remarkable.

You have a unique way of improving patients’ condition based on your unique gifts and passions and life experiences.

Why is being remarkable important?

The quickest way to grow your practice is to get people talking about you.  People talk about remarkable things.

You may not agree with Donald Trump, but he is remarkable.  People talk about him.

No one talks about normal day-to-day activities like car maintenance and shopping.  However, I’ve told these stories:

  • I took my car to a new gas station to get an oil change. When I picked it up, they had vacuumed the car.  Remarkable.
  • My son needed new dress pants for an event the next day.  We arrived at Nordstrom 15 minutes before closing.  We walked out with hemmed pants. Remarkable.
  • I was flying back home from delivering a keynote on Alaska Airlines when a passenger went into cardiac arrest.  The flight attendants conducted themselves with the level of professionalism of an ER staff.  Remarkable.

When patients value the thing that puts you in a class of your own, they talk about you.

Why is remarkable a smarter choice than average? 

Logic suggests that the safest way to grow your practice is to treat any patient who finds you.

Once you say, “I work with women with heart disease” you exclude half the patient population.  It seems like a risky choice.

Paradoxically, this exclusivity accelerates practice growth. What percentage of cardiologist have a special interest in woman with heart disease? You set yourself apart and become remarkable in the eyes of your patients and referring physicians.

How do physicians become remarkable?

Medical organizations and individual physicians have found many ways to be remarkable.

  • If you are a patient at Group Health, your doctor does not hand you a prescription.  It’s entered into the computer, and you stop by the pharmacy on your way to your car and pick it up. Remarkable.
  • Virginia Mason Medical Center offers a surgical warranty for hip and knee replacements. Remarkable.
  • A dentist works with phobic patients.  Remarkable.

You can become remarkable with something as simple as smiling and greeting each person who crosses your path.

What puts you in a class of one?

There is something remarkable about you and the way you deliver medical care.  Chances are good it falls right in your sweet spot where passion, purpose and profit meet.

Do you have a unique way of treating a medical condition?  Do you deliver an over-the-top patient experience? Do you offer rock bottom prices?

Here are some questions to help you identify your unique offering.

Do you create extraordinary outcomes in a specific disease process?

Think about the last time you went to your favorite restaurant. Chances are good that they are known for a signature dish.

Would you go to a restaurant that offers an assortment of Italian and Mexican and Thai dishes?  You might think this restaurant has an identity crisis.

What’s your signature dish? Can you focus on treating a specific medical condition which then leads to better medical outcomes?  Here are a few examples:

  • The Shouldice Clinic performs one procedure: a hernia repair.  They get such extraordinary results that patients fly in from around the world to be treated there.  Remarkable.
  • Dr. Atul Gawande points out that 117 centers in the US treat cystic fibrosis.  The mean lifespan for all centers is 33 years; however, a clinic in Minnesota boasts a 47 year survival.  Remarkable.
  • An ob/gyn helps women make a gracious transition through menopause. Remarkable.

Sometimes a practice focus evolves organically.  When I set up my general surgical practice, I performed all of the “bread and butter” surgical case.  Very quickly my calendar filled with women with breast concerns.

In the pre-Google era we quipped, “The whole world is pre-op.”  This is now quite literally the case. Last year an estimated 750,000 Americans went abroad to get their healthcare.  Could you become a destination for patients from around the world seeking your remarkable results?

Do you offer a unique experience?

You know exactly what kind of experience you will get at McDonald’s.  Every time.

What is your patients’ experience at your practice?  Is it uniform and consistent?  Is it remarkable?

I once referred a patient to an outstanding neurologist.  My patient game back and told me that she would never return.  The front office staff was downright rude to a patient in the waiting room.

The medical care you deliver is like a plane ride transporting your patients from point A to point B.  You have metrics to measure how safely and effectively you get patients to their health destination.

What level of comfort, convenience and kindness do they experience along the way?  Does your medical practice duplicate the level of service of a private jet, business class on a commercial airline or a no-frills, low-cost option.  There’s a place for all of them.

How can you make your experience remarkable? Do you leverage technology in new and innovative ways? Can you anticipate and fill an unmet need?  Can you bring your passion into your office?

  • I spent a month joining a surgical team in Thailand. Before the induction of anesthesia, the patient, physicians and staff all held hands, and the surgeon would offer a prayer, “God please guide my hands.”  Would you like to integrate prayer or complimentary interventions into your treatment protocol?
  • Could you create educational videos for your referring physicians to facilitate the transfer of care from your facility to the patient’s home?
  • If you offer nail care for diabetic patients, you know that they cannot get a pampered pedicure.  Could you invest in luxurious massage chairs and offer a spa-like pedicure experience at your office?  You can call it your “medic-cure” service.

Listen carefully when patients say, “I wish someone would fix this problem!” That someone could be you!

Do you understand your patients’ personal goals?

You work diligently to achieve medical outcomes.

How well do you understand why patients want the desired medical outcomes?  Behind each medical goal is a personal goal that inspires patients to take action.  This is what drives compliance.

A patient may not give up smoking to prevent lung cancer; however, they may be highly motivated to model healthy behaviors for their children. Being a good parent trumps cancer prevention.

Your ability to understand why patients make the choices they do contributes to remarkable outcomes.

Do you offer an extraordinary relationship?

The doctor-patient relationship forms the foundation of the health care system.  How would you characterize the relationship you create with your patients?

I have asked thousands of patients, “What do you want in a doctor?” Here’s what they tell me:

  • “I want a doctor who cares about me as a person.”
  • “I want a doctor who listens.”
  • “I want a doctor who treats me respectfully.”
  • “I want a doctor who cares what I think.”
  • “I want a doctor who works with lots of patients just like me.”
  • “I want a doctor who will tell me the truth—kindly.”
  • “I want a doctor who will be there for me.”
  • “I want a doctor who does not judge me.”
  • “I want a doctor who understand that I am watching my pennies.”

Patients want physicians who are authentic and present. Dr. Ed Hallowell, a child psychiatrist who treats kids with ADD, openly talks about his struggles and triumphs living with an ADD-wired brain.  In so doing, he becomes real and credible in a new way.

Offering an extraordinary relationship is one of the most effective ways of being remarkable.  Characterize that ideal relationship. Create this as the standard for every relationship in your practice, whether it’s between staff members or between staff and patients.

What makes YOU remarkable?

Most successful businesses—whether restaurants or stores or hotels—do not try to be all things to all customers; they focus and do something very, very well.

Think about the difference between Nordstrom and Target.  Or Costco and Whole Foods.  Or the Ritz Carton and Motel 6.

What makes you one of a kind?  What is your signature dish?  What is the experience you offer?  What is the nature of your relationships with patients, colleagues and staff?

Your ability to communicate the ways in which you are remarkable contributes to your rate of practice growth.

© 2015. Vicki Rackner MD.  All rights reserved.  

This is an excerpt from Dr. Rackner’s upcoming book The New Medical Mindset: How Physicians Can Think Differently, Reinvent Themselves and Thrive in the Post-Google Era.

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients, and she helps physicians run more successful practices. Contact her at (425) 451-3777.

Permanent link to this article:


Worried about Retirement? What NOT to Do

Screen Shot 2015-08-10 at 6.34.31 PMPhysicians in their 50s and 60s worried about retirement know that time is not on their side.

I see smart doctors take desperate financial steps that make matters worse rather than better.

Here are three strategies to avoid:

• Denial. Yes, it’s difficult to face an unpleasant truth. However, ignoring financial problems works about as well as ignoring a progressive medical illness.

• High-Risk Speculation. Physicians interested in catching up with retirement planning may be tempted by high risk investments. Safety must come first.

• Asking the Wrong Person. Many physicians turn to physicians whom they trust for financial advice. Ask a cardiothoracic surgeon for advice about mitral valves, not retirement income.

I waited until late in life to start a family, and faced fertility issues. My wonderful son was conceived through IVF.

Few physicians know about “financial IVF” interventions that make retirement possible when time is not on your side. You may not know about proven investment strategies and financial products used every day by sophisticated investors like Warren Buffett. He invests in indexed universal life insurance (IUL). He understands the tax advantages.

Did you know that banks will issue physicians loans to invest in IUL policies, just like they issue mortgages? The loan is secured with the IUL.

Yes, I am aware of the controversies surrounding IUL. My own financial advisor dismissed it as an imprudent investment. I am not a financial advisor, and do wish to enter the IUL vs market debate.

I do know that IU is a viable option for physicians in their 50s and 60s who do not have time on their side. In their case, “leveraged IUL” is the best and safest path to retirement.

A mentor once said, “Where there’s life, there’s hope.” The same is true with financial health and retirement plans. Explore options with experts who use IUL every day.

© 2015. All rights reserved.  

You are welcome to reproduce this blog post; please include this by-line:

Vicki Rackner, MD, President of Medical Bridges, helps physicians get back to the dream that attracted them to a career in medicine.  This author, speaker and consultant leverages her experiences as a practicing surgeon, clinical instructor at the University of Washington School of Medicine and serial entrepreneur help physicians thrive. Contact her at (425) 451-3777 to learn more about how she helps physicians craft a career in which passion, purpose and profits meet.


Permanent link to this article:


Do Physicians Need Sales Skills?

hands1Can you imagine attending a medical meeting, and seeing that a choice for a break-out session is “sales and marketing for physicians”?

If you ever do, please attend!

Selling is a critical skill for any physician who wants to increase patient compliance, create a culture within the practice or inspire employees to be their best.

Click here to read my article in Physician’s Money Digest that explains why.

Permanent link to this article:


Practice-Building Lessons from the Blueberry Farm

PattsBlueberriesMy son and I pick blueberries each summer.  Sounds like a nice relaxing family activity, right?

It was in years past.  Now, however, my son is a highly competitive adolescent who wants to win. Even though I am no slouch, my son can pick two to three pounds of berries in the same amount of time I pick one.

On the way home I asked for his high-performance tips.  I share them because I believe the same tips can help you build your practice.

Begin with a plan.  My son points out that he used to arrive at the blueberry farm, and start picking at the first bush that attracted his attention.  Or he would stroll down the rows of blueberry bushes reaching for a handful from one bush then the next.

High-performance picking is driven by a plan—not a whim.  Even before we arrive at the blueberry farm, he has a picking plan.  He tweaks his plan.

Do you have a proven system to get in front of more patients?  Do you try new things to see if they can be even more successful?

Identify your favorites.  The blueberry farm has many different kinds of plants that grow blueberries of different sizes and tastes.  My son has his favorite: a plant that produces a large, sweet berry. He knows how to identify it.

Out of all the patients in your community, have you identified your favorites?  Can you describe your ideal patient?

Identify the high-performance opportunities.  My son has a picture in his mind of his ideal picking opportunity: it’s a bush with big clusters of ripe blueberries. He knows what ripe berries look like.

He will pass up good bushes to pick at the great ones.

Once he finds a great bush, he picks the whole bush before going on to the next.

Do you know where you can find the bigger marketing opportunities that get you in front of groups of patients?

Pick the ripe ones. My son sits down in front of a great bush and “milks” the blueberries into his bucket.  Ripe berries will fall off the bush with just a gentle rub.  If he tries to do this too quickly, he’ll get stems and twigs and must spend time cleaning the berries.

Do you know the signs of patient ready to take action?

© 2015. All rights reserved.  

You are welcome to reproduce this blog post; please include this by-line:

Vicki Rackner, MD, President of Medical Bridges, helps physicians get back to the dream that attracted them to a career in medicine.  This author, speaker and consultant leverages her experiences as a practicing surgeon, clinical instructor at the University of Washington School of Medicine and serial entrepreneur help physicians thrive. Contact her at (425) 451-3777 to learn more about how she helps physicians craft a career in which passion, purpose and profits meet.

Permanent link to this article:


Celebrate the American Dream

Photo by JAL at

Photo by Jal Schrof at

It was a Fourth of July celebration I will never forget.

I was honored to be invited to a friend’s naturalization ceremony. He came to the US as an adult to live the American dream. I witnessed the long hours he invested learning what he needed to know to become an engaged American citizen.

On a warm July Fourth, I joined thousands of people who cheered as their loved ones and friends said the Pledge of Allegiance as US citizens for the first time.

Gary Locke congratulated the new Americans and told his story.  A hundred years earlier, his grandfather left China on a steamboat to work as a houseboy for an American family in Washington State.  His grandfather washed dishes, gardened and swept floors in exchange for English lessons.

And a hundred years later, this man’s grandson was sworn in as the Governor of the State of Washington. Governor Locke’s then home–the Governor’s mansion– is less than one mile from the house where his grandfather worked. He noted that it took his family one hundred years to travel one hundred yards.

That July 4th I celebrated the American Dream.  I understood viscerally that we are blessed to live in this land of opportunity.

Governor Locke went on to become the United States Secretary of Commerce to China, sworn in by President Obama.

A dream attracted you to a career in medicine.  I believe that dream is still alive and well.

Let’s celebrate the American Dream this Fourth of July!

© 2015. All rights reserved.  

You are welcome to reproduce this blog post; please include this by-line:

Vicki Rackner, MD, President of Medical Bridges, helps physicians get back to the dream that attracted them to a career in medicine.  This author, speaker and consultant leverages her experiences as a practicing surgeon, clinical instructor at the University of Washington School of Medicine and serial entrepreneur help physicians thrive. Contact her at (425) 451-3777 to learn more about how she helps physicians craft a career in which passion, purpose and profits meet.

Permanent link to this article:


Physician Compensation Report

work-station-straight-on-viewA 2015 Medscape Compensation Report sheds light on physicians’ earning potential.  Here are some key findings from a survey of 20,000 physicians in 26 specialties:

  • Orthopedists ($421,000) and cardiologists ($376,000) are still the top earners among physicians.
  • Physicians in private practice earn significantly more ($329,000 for specialists) than do employed physicians ($258,000 for specialists), despite the trend toward employment.
  • Male physicians earn more ($284,000) than their female counterparts ($215,000).
  • North Dakota and Alaska ($330,000) are the top-paying states for physicians, while Rhode Island ($217,000) and Maryland ($237,000) are the lowest-paying.
  • 9% of physicians have concierge or cash-only practices, the same percentage as last year, while ACO participation continues to grow.

However, it’s not what you make that’s important; it’s what you keep.  Click here to read a blog post about the Myth of the Rich Doctor that addresses the disconnect between income and wealth. 

What are your thoughts about physicians’ potential to enjoy financial independence? 

Permanent link to this article:

Older posts «