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Christopher H. Loo, MD-PhD: Today, we have a guest, Dr. Elisa Chiang, and she's going to talk to us a lot about coaching, she's going to talk a lot about financial independence. And we'll go from there. So Elisa, welcome.
Dr. Elisa Chiang, MD, PhD: Hi. Thanks for having me on.
Christopher H. Loo, MD-PhD: Yeah, it was so interesting, we were talking backstage, and I'm glad we were able to connect and you're able to come on to the podcast. I think the listeners would have a lot of value from your appearance. So tell us all about your background, your journey, how you started, and how you got into what you're doing now.
Dr. Elisa Chiang, MD, PhD: So I'm going to start my story with just when I started learning about personal finance and investing, and that actually was early on in my life, when I was actually a medical student, so I did an MD-PhD program, a medical science training program. And, on average, that's eight years and I lived in Cleveland, Ohio, which has a relatively low cost of living. So actually, a lot of us end up buying a primary residence since eight years is long enough to make it worthwhile to buy something. And I was also married, so that helped. My husband didn't have a job when I started, but obviously, started looking for a job. And he is now a high school teacher.
And I actually grew up in the suburbs of Cleveland, Ohio. So in the end, I ended up buying the home I grew up in from my parents, and we structured it basically where I got the largest mortgage I could qualify for. And back then it was actually very easy to qualify for mortgages. This is before the whole mortgage bust. And in that process, I really just started learning about personal finances and investing. I started reading and following like the Motley Fool. I eventually read Rich Dad, Poor Dad. And you know, and this is kind of as usual going on, my parents actually recommended I open a Roth IRA right after I graduated college, I actually took a year off between undergrad and medical school in order to actually apply for medical school.
And so I had the Roth IRA to invest in and so I started doing some individual stock investing, as well as just index fund investing. And after being Rich Dad, Poor Dad, I actually started getting into real estate investing. And by that time, I was actually in the graduate part of my MD PhD program. And in retrospect, that was probably the first time that I kind of experienced some burnout. I really felt a little lack of autonomy as a grad student, which I know you know, just my, my principal investigator, my PI, he was just very micromanage-y in his style and, and I'm very self directed. And so I just like little things where, like, he didn't want me to listen to music while I was doing experiments just didn't make sense to me.
And so I actually, and I actually finished my PhD portion kind of off cycle. So I could have gone back to med school, but lost a lot of elective time. And so instead, I just went ahead and graduated from my PhD and took, I think, eight months off in order to just start your medical school in July when everyone else starts. During that time, I actually flipped two houses. I flipped one house during that time, and then bought the second house and then finished flipping it during my third year of med school. And, I really went around and met other real estate investors, got involved in some other deals, acted like a property manager for like two investments where we had two houses that we’re renting to college students and so I properly managed that for a while and just really learned a lot about real estate investing during that time. And also just investing in my Roth IRA as well. So actually, I kind of really built a really good financial background very early, which I think was really helpful in the path to achieving financial independence.
Christopher H. Loo, MD-PhD: That's wonderful. I’m glad to hear about your journey because we are similar; I was MD PhD. And, I also started investing very early in real estate too, where I was in the Houston area. So the question for you, though, which is really interesting was when your motivation for investing was what was it? Was it just curiosity? Was it you know, you feel like you had to or just, I’m curious?
Dr. Elisa Chiang, MD, PhD: Yeah. So like I said, at some point in grad school, I was like, Man, I do not want to live a life of having to chase research grants. And, my friends were in medical school and some of them were starting residency. I'm like, Wow, they really work hard. And it's not that I was afraid of hard work. I actually went to Caltech for undergrad and studied crazy hours to do well there, it was actually a really tough school. But at some point, I realized, like, I want to build to live on my own terms. I don't want someone telling me what to do, like the lack of autonomy during grad school and having someone micromanage me, like, I want to be my own boss.
And in medicine, I think that's still a possibility, right? I mean, you can have your own private practice and still be your own boss, but that is being an entrepreneur and reading Rich Dad, Poor Dad was kind of like, well, but is that just really being self employed versus actually being a business owner? And so it was really looking at, how can I find ways of having my money work for me, so I don't have to work for money?
Christopher H. Loo, MD-PhD: It's good that you learned early on, just because most people don't start till they're after residency and they’re attending. And you know, at that point, if they haven't had good financial education, they make a lot of mistakes, so they have a lot more at stake. So, yeah, it's curious, because mine was, I started investing because I knew I would be four years behind all my classmates and would be four years ahead. So I wanted to at least be on equal footing when I finished. So I made myself learn how money worked, and how to make money work for me. So our paths and our journeys are so interesting.
So yeah, tell us, you so now you have a Roth IRA, real estate, and property management. So and you're currently practicing, or I know you're doing a lot of coaching. So tell us more about what you're doing now.
Dr. Elisa Chiang, MD, PhD: Yeah so, I went back to med school, and it's funny. During third year, I kind of went through each rotation and I was like, not this, not this. And I was really kind of getting worried. I'm like, Oh, my goodness, am I not going to practice medicine after all this time? And at least I wouldn't have the loans having done the NSDP Program. But I actually did fall in love with ophthalmology and surgery. And so I ended up doing ophthalmology residency at Northwestern, I love residency, I did an Oculoplastics Fellowship. And actually, I really loved fellowship. And during that time, I wasn't really investing in real estate, like I said, I flipped the properties and made good money on the flipping of those properties. Though in retrospect, I would have made better money holding on because they were I mean, they would have been great birds to refinance, get the money out and just rent those.
I don't know, there was something in me that just said, that once I become an attending physician, I’ll really have a lot of capital and be able to invest in real estate actively. And I was starting to learn about syndications at that time, as well. So when I took my first job in Virginia, that was like a completely different market. I was in the Virginia Beach, Norfolk, Suffolk, Chesapeake area, which is a high military area, so there was actually a ton of rental property. I ended up renting a house for 1800 a month. That was like a four bedroom, two and a half bath, like hardwood floors, granite countertops, like, yeah, like this beautiful house for $1,800. I was like, this makes no financial sense. Like whoever's renting me this is not making money. And the thing is, that wasn't like the only house like that there were other houses, just like that was the market.
And so that really made me pause in buying any rentals in Virginia and so I started looking for syndications. But of course, to be an accredited investor, I had to actually wait two years and make the intended income. And over that time, I basically realized that the practice I had joined I had hoped to become a partner and you know, be an owner and and be on you know, more on that kind of business management side. But when I realized that wasn't going to happen, then I decided, well, I should go back home to Cleveland where I really know the real estate market. I can start doing my investing again, like I have contacts there. And I also had a lot of friends there from the time I was doing my MD PhD, I made a lot of friends who were even outside medicine. And so they're just all established in Cleveland, as well as in some of my medical school friends, they stayed and did residency, and are attending in Cleveland. So I went ahead and made the move to Cleveland. And that was in 2019. So I started looking actually for a house to buy, and I was thinking, well, we'll buy a house that, we’ll essentially kind of do a house hack where, we'll buy it, we'll live in it for, one or two years, and then we'll rent it out, and then maybe we'll sell it like, two and a half years after we've rented it, so that we can, have all the capital gains without having to pay any taxes on that and repeat that process.
I was having all these thoughts on what to do, but the market had become so hot, that houses were flying off, like, the houses that we want to look at, that we chose out a week before we were visiting Cleveland, we're already off the market, already under contract by the time we actually came a week later. So it's like, gosh, I can't buy this kind of speed. So we're just like, Okay, we’ll rent, and then once we get here, then I'll find stuff. But yeah, like in the market really has. It's like a completely different environment from when I was investing before. Before, when I found those two houses. They were both foreclosures and there were tons of foreclosures. And no, in a way, there were tons of deals, I should have done more. And so I was just in total sticker shock. I eventually decided to take another real estate course. I took Leti and Kenji’s Zero to Freedom course. And I did end up buying some multifamily property in Cleveland proper, and then bought a short term rental in the Hocking Hills area.
Christopher H. Loo, MD-PhD: Oh, wow. So you've had quite a very great real estate career. So I know a lot of listeners are physicians or dentists, and they're interested in real estate. I guess now that the market is very different from 2008. What are some of the differences that you see, and some of the pitfalls? I know there's talk about the housing bubble. Maybe comment on that?
Dr. Elisa Chiang, MD, PhD: Yeah, so we've been lucky in that interest rates have been kind of low for a long period of time, and now they're starting to rise. And I do think with the rising interest rates, it is a little harder, because the housing market is still kind of hot and priced - not low, that's for sure. So you've got to work a lot harder to find a deal. And then now with the increased interest rate, it's like you need even better deals so that you can get that cash flow, if you're aiming for like a 10% cash on cash return. I think it is easier to do that with a short term rental, but you've got to be really aware of the regulations of wherever you're buying that short term rental. And because you know, a new regulation could come up and that could totally kill your model if you can't continue to rent it as a short term rental.
Christopher H. Loo, MD-PhD: Yeah, exactly. And I also read somewhere that a lot of institutions, Blackrock, Blackstone, these funds are actually just buying up, real estate just buying, they have the funds. And so a lot of investors are getting priced out, because these institutions have so much money just buying up properties. So yeah, it's definitely a totally different landscape than pre 2008.
Dr. Elisa Chiang, MD, PhD: And now they're even like syndications that are looking at single family homes. Whereas before, I think syndications are more looking at big apartment complexes and self storage and commercial and hotels, but I know the Alpha Investing Group has a syndication that you can buy where they're actually buying single family houses in the Southern Ohio area.
Christopher H. Loo, MD-PhD: Yeah, yeah, exactly. What are some, what are some good resources for people to go and read about real estate? I know, there's all that there's a novice investor, there's people that never owned real estate, and there’s the seasoned. So what are some resources that helped you to get started or helped you to continue your education?
Dr. Elisa Chiang, MD, PhD: So I've taken a lot of real estate courses. So back when I was a med school grad student, I actually did the rich dad poor dad like real estate courses, which was like $18,000, right. And they really sell it to you like sitting there and they're talking to you like, I mean [inaudible] like you go to college, it's not guaranteed money after you graduate college. And, but you know, these courses are guaranteed to teach you how to make money. And, they start telling you to call your credit cards and up your credit limits. So, I had a fire under me to make money in order to actually pay back that 18,000. And I have to say, those courses were not that great, I would not actually recommend those courses. I think there are much better courses out there now. But so I started taking those courses. And then I wasn't really actually getting anywhere.
So then I took a course with Bob Campagna. And his course included coaching from him. So you went and actually did the course, a live course, where you learned all this information, but then there were weekly calls, and then you had a cell phone, and you could call and review deals. And that's really where I was able to do that first flip, and then do it again. And so I really think having a mentor, someone to guide you, someone to, to review things, as well as having a community to discuss deals to. If you have a win to share those wins, so that it keeps reinforcing your propensity to move forward. And also, when you hear about other people's failures, but then how they learn from it, then you can learn from other people's mistakes, and hopefully avoid making those mistakes yourself. So, I think what's really important is, mentorship community. And of course, educating yourself either through courses or books, or some combination of that.
Christopher H. Loo, MD-PhD: Yeah, I've found that when coaching clients, a coach, a mentor, somebody that can show you the ropes, they can tell you to avoid the pitfalls, so really a good community of just like minded people to share. So you've given a lot of good tips. And now, what are you doing currently? Are you doing real estate? Are you doing syndications?
Dr. Elisa Chiang, MD, PhD: All of the above. And so, I do coaching as well. And so I got into coaching because of burnout. So when I moved back to Cleveland, I ended up taking a job at a big hospital system, which I never wanted, but I just wanted to come back home to Cleveland. And that was kind of my ticket to do it. But definitely lack of autonomy there. And I was taking a 24/7 call, which I had agreed to but the way that expectations of my division had in how I took the call was not, we were not on the same page on that. So. So coaching really helped me get through the burnout of being at that job. And, I was actually at that point where I was ready to quit my hospital job and start my own private practice, and again, be the entrepreneur, the owner. But as I thought about it, coaching has a lot of aspects of medicine that I love in terms of being really able to help people and connect with people. And it also doesn't have all the regulation of medicine.
And it also gives you other freedoms, like you talked about the four freedoms, location freedom, time freedom, financial freedom, and emotional freedom. Well, coaching actually kind of gives you that financial freedom because it allows you to build and manage your mind. And so I continue to have my own coaches to work with to continue managing my mind and have that emotional freedom. Having a coaching business also gives location freedom, because I coach over zoom calls, I can do that virtually from anywhere, whereas if I open a private practice, or plastics clinic, then I am very much tied to the location of where my clinic is and where I'm doing surgery.
And then you know, the time freedom with coaching, I can schedule calls, whenever my clients and I find it convenient. So, I mean, and that can be evenings and weekends, and leaving me days where I can go run other errands, when stores are open. It can be whatever works for me as opposed to kind of, the typical clinic model where you're working weekdays you know, eight to five or, or whatnot because that's when you know, ASCs are open, that's when people expect a mobile clinic. Though of course, nowadays people would love to have clinics open on weekends and evenings but then you also have to find staff that are willing to work those hours and so that can all become just more of a handful. So you know, so I decided to start a coaching business instead of starting my own private practice. And I went down to working part time as a physician in order to have that time to work on my coaching business.
Christopher H. Loo, MD-PhD: Nice nice. I actually like the way you think about things and how you weigh the pros and cons. And so I know a lot of physicians are interested in coaching. Can you tell us more about which certifications, if you did get any, or just in terms of how to get into coaching for the listeners out there.
Dr. Elisa Chiang, MD, PhD: So I was certified at The Life Coach School. And part of it is because my introduction to coaching was through Sunny Smith, and listening to The Life Coach School podcast. And, when I started listening to that podcast, I really binged it. I had read, like, some self help personal development books before and like, never finished them. It just didn't click with me. But when I heard Brooke Castillo talked about the model, and I really thought about it, and a lot of the things that she teaches, it really made sense to me. And when I incorporated the tools that she teaches, like, it really made changes in my life. And so, I was just kind of all in on the Life Coach School and did that certification.
And honestly, like, when I did that certification, I was still, I wasn't necessarily like, Yes, I'm going to be a life coach and make a business out of it. Part of it was, so I did during COVID. And so I had all kinds of a lot more time on my hands, because my social life had kind of come to a halt, and all my vacations were canceled. So, I thought, “Well, why not do this for more of my self development?” But I really found that I love doing the coaching during the certification. Of course, you do a lot of peer coaching in order to develop those skills, and I just really enjoy doing the coaching itself.
But, starting a business, it's not for everyone, it's something I definitely wanted to do, but there's no formula for it, there's probably more of a formula for starting a private practice than there is for starting a coaching business. You really got to learn how to market yourself, you really got to learn how to put yourself out there, you got to really learn how to go out and find clients. And, as physicians, we typically don't think about that. When we think about finding patients to come to us, it's more of talking to, other physicians who might be referrals, like so for me and ocular plastics or ophthalmology, talking to you know, optometrist or ophthalmologist, primary care doctors, and asking for patients to be referred, as opposed to kind of reaching out to patients directly. But as a coach, it's reaching out to your clients directly. And that has a much different mindset.
With being a physician, if you take insurance, and you're really kind of separated almost for the payment, right? And then the patient comes in, they get their insurance, you build insurance, like, there's a copay for the patient, like, and as physicians are, a lot of times were, like, we'll order something and we have no idea how much that will cost the patient. Like, if you were ordered to a lab, you don't know what the patient copay is, or how much it's going to cost the patient's you just kind of, order and send it off. But when you're really running a business, you definitely do have to start learning some of those things. And so I think probably in private practice, people do start kind of knowing all the specifics, and I do think it's actually important, even if you are employed physicians to start learning, like, what are the collections? When you do a procedure, how much do you get paid for that? And how much is the patient paying for that? And you know, what the difference is, there's a lot of physicians now going to direct payment plans, where they're eliminating insurance. And I think that makes it a lot more transparent. But, yeah, there's just so much to learn, running a business.
Christopher H. Loo, MD-PhD: Yeah. It's so fascinating to hear, because it's like you have all this wisdom and experience. So you mentioned something about mindsets. What are some of the mindsets that helped you succeed, and some of the mindsets you find, physicians may limit them when trying to become business owners or entrepreneurs?
Dr. Elisa Chiang, MD, PhD: Yeah, so, most businesses are actually run by people with high school degrees. And very few businesses are run by people with doctorate, or really high levels of education, which is really interesting. You know, we as physicians tend to be kind of perfectionists, right? Depending on what we do, lives matter, like, if we make a mistake, it could really seriously like, harm or affect someone. And so we really want to avoid any kind of mistakes or any kind of failures, but in the business role, like you're gonna have failures all the time. And in fact, like, that's how you move forward, right?
It's all kind of experimentation. You don't know exactly what's going to work. So you've got to just put something out there, see if it works or doesn’t, tweak it, put it out again. And basically it's an endeavor and failing forward. And you gotta put yourself out there in a way that I think as physicians were generally not necessarily comfortable doing. And we're generally not comfortable with failure and, and learning to be like, okay, like that. That didn't work out the way I thought it was. But that's fine. I'm just going to tweak this. I'm going to try it again. And just having that mentality of, yeah, like, every time I try something, I'm learning something new and, and just keep moving forward.
Christopher H. Loo, MD-PhD: One of my mentors, he told me, if something doesn't work, and you're not sure, just try something and just get information and that information is feedback. And then what you talked about iterating forward and failing forward and just constant improvement.
So this has been a very fascinating discussion, and it's really interesting to see physicians, with the same walks of life, the same experiences. So, I know a lot of listeners are interested in finding out more about you, contacting you, and maybe even working with you. So how can they do that?
Dr. Elisa Chiang, MD, PhD: The easiest way to find me is to go to my website, growyourwealthymindset.com. There, you can actually see all my other social media links. I'm on Facebook, I'm on Instagram, I have a YouTube channel as well.
Christopher H. Loo, MD-PhD: Awesome, awesome. Any last parting words of advice before we call it a day?
Dr. Elisa Chiang, MD, PhD: Yeah. So I really believe that by having financial security and kind of working that path so that, when you're financially independent, that physicians can then be in a much better place to kind of negotiate at their job, and really practice medicine the way they want to. And so I really encourage all physicians to kind of learn about finances, learn about investing, so that they can really create that financial stability for themselves not feel like they're tied to their paycheck.
Christopher H. Loo, MD-PhD: Yeah, so well said. So for all the listeners on the show. This has been a fantastic discussion. All of the resources will be included in the show notes. And Elisa, thanks so much. It was a fantastic conversation.
Dr. Elisa Chiang, MD, PhD: Thanks for having me. I really enjoyed it.
Christopher H. Loo, MD-PhD: Many thanks again for being here. If you’re new, you can find me online at Christopher H. Loo, MD-PhD, where I have links to other episodes or links to online resources that will support you on your financial literacy journey. I’ll see you there in on next week’s show. While I bring you thoroughly vetted information on this show regarding a variety of financial topics, I cannot promise you a one size fits all solution. This is why I caution you to continue to learn. Educate yourself and seek professional advice unique to your situation. If you want to talk to me, I welcome it. Please reach out via my website or email at Chris@drchrisloomdphd.com. I read and personally respond to all of my emails. Talk soon!
Editor's note: This transcript has been edited for brevity and clarity.