2024-06-28_Friday

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00:00:30.320 | Today on Radical Personal Finance, it's live Q&A.

00:00:33.120 | Welcome to Radical Personal Finance, a show dedicated to providing you with the knowledge,

00:00:52.080 | skills, insights, and encouragement you need to live a rich and meaningful life now,

00:00:55.920 | while building a plan for financial freedom in 10 years or less.

00:00:58.400 | My name is Joshua Sheets. Today is Friday, June 28, 2024.

00:01:02.720 | And on this Friday, as we do on every Friday, in which I can arrange the appropriate recording

00:01:07.040 | gear and gadgets and setup, we do live Q&A. That means you direct the entire content of the show.

00:01:13.440 | I want to welcome many new listeners here to Radical Personal Finance.

00:01:24.080 | As I said, each and every Friday here, it basically works like Open Line Friday.

00:01:27.120 | You call up, you get to ask any question that you want,

00:01:29.520 | talk about any topic that you want, raise any concerns, disagree with me.

00:01:33.280 | I love it when you do that. Raise, sharpen some points, ask any personal questions.

00:01:38.160 | We can talk about your personal planning, personal finances,

00:01:40.480 | anything that you would like to talk about current events.

00:01:42.720 | It's all fair game here on a Friday Q&A show.

00:01:45.760 | If you would like to join one of these shows,

00:01:47.120 | you can do that by becoming a patron of the show.

00:01:48.720 | You go to patreon.com/radicalpersonalfinance,

00:01:51.280 | patreon.com/radicalpersonalfinance, sign up to support the show there on Patreon,

00:01:55.520 | and that will gain access for you to one of these Friday Q&A shows.

00:01:59.360 | We begin today with Samuel in Colorado. Samuel, welcome to the show. How can I serve you today?

00:02:04.240 | Thank you so much, Joshua. It's a privilege to be here. This is the first time I've been

00:02:10.720 | able to talk to you with that listening to your show since the beginning.

00:02:13.840 | Welcome.

00:02:15.520 | Yeah. I love the radical topics. Arrest proofing yourself is one that really interested me.

00:02:21.920 | Wonderful.

00:02:22.420 | My topic today is career and income planning.

00:02:26.800 | For a long time, I've had a goal of retiring at 35 and a little background about me,

00:02:35.360 | which makes that really hard. I'm currently 31 and been working in public accounting,

00:02:41.120 | financial statement auditing at a big four firm for the last 10 years.

00:02:46.640 | I'm a senior manager there now, making a reasonable salary for that job.

00:02:53.280 | The main challenge is I want to live out also your part about living a meaningful life now as well.

00:03:01.440 | My two biggest hobbies are rock climbing and skiing, and I'm not willing to give up even

00:03:06.480 | one weekend, even one day of one weekend for that, especially in the season, because there

00:03:11.520 | could be a powder day. The problem with the industry I'm in is if a client need comes up,

00:03:18.400 | you're just on it. It could be weekend and you might have to give up a 20-inch powder day,

00:03:25.120 | which you might only get once a year or less. I've been able to work with the firm to

00:03:30.480 | make adjustments in terms of not working weekends, but it's never a perfect solution

00:03:36.240 | because you're still often giving up your evenings. It's not a great balance,

00:03:39.840 | but there is some other flexibility that comes with working with public accounting,

00:03:44.320 | a lot of working from home and things like that. I'm open to the career side.

00:03:49.760 | Some of the things I've thought about are consulting. There's firms that will hire

00:03:57.920 | your time out, but I've also heard people say it's better to start your own business with that,

00:04:01.920 | which is more challenging. We're also just going into industry. We're also entrepreneurship,

00:04:07.200 | but I know you'd probably have to give up even more of your time for that and with career.

00:04:11.440 | I've thought about real estate. I don't really have the right temperament because if things

00:04:16.320 | break down, you're on the hook or you're paying someone for it. Just looking for radical ideas in

00:04:21.440 | any direction to free up my time and retire at 35. Tell me more about what your post-retirement

00:04:27.760 | lifestyle would look like, why retirement is important to you.

00:04:30.400 | Good question. I think like you've mentioned in some shows, I would likely still do some

00:04:37.440 | level of work, probably part-time, but I would like the option to not have to. It really would be

00:04:46.000 | both the skiing and rock climbing that I'm doing right now, but certain things in my personal life

00:04:53.440 | have fallen to the wayside. I'm a believer going to church, so if you have to work five days a week

00:05:00.720 | and evenings, I've gotten in the habit of skiing and rock climbing Saturday and Sunday,

00:05:06.720 | building relationships outside of work. It would be nice to be able to do it all,

00:05:13.200 | skiing and rock climbing, take trips further around the US and abroad. That stuff just

00:05:21.440 | doesn't make sense when you only have weekends. Really selfish, but also building relationships

00:05:27.360 | and spiritual. What's your current income and your current net worth?

00:05:31.520 | $130,000 per year and approximately $350,000. Current level of expenses,

00:05:41.040 | how much do you spend normally? A very low level of expenses,

00:05:45.600 | probably $1,000 per month. Are you married? Do you have children?

00:05:51.760 | I'm single, no children. Do you ever hope to marry or have children?

00:05:55.520 | It's a long shot. It would be nice, but I don't meet your qualification on your show about

00:06:03.600 | the right character and the right temperament to find an excellent wife. It's unlikely.

00:06:08.560 | The first thing I would say is – actually, one more question before I give you my comments.

00:06:18.960 | Why specifically did you choose the age of 35 as your target year of retirement?

00:06:24.400 | I think it was because somewhere along – it's fairly arbitrary, but I think it was mainly

00:06:30.640 | listening to your show pretty close to the beginning. 10 years or less, it's probably

00:06:36.320 | around 25, so I set that goal. One more piece of context. I haven't come up with any feasible way

00:06:46.240 | to do it other than I got roped in certain points of time to network marketing with Amway. I never

00:06:52.640 | got very far into it with Worldwide Group. I know you've spoke very briefly on stuff like that.

00:06:57.760 | They claim they can offer it, but I think the likelihood of achieving it with that is very low.

00:07:04.720 | I thought I did a show. I've spoken about network marketing, and I can put my comments.

00:07:11.840 | Yeah, you did very long ago.

00:07:13.520 | All right. I probably need to do a new show because it's important that people understand

00:07:16.800 | the benefits of network marketing and the tradeoffs of network marketing. If I encapsulate

00:07:22.000 | it into probably about 60 seconds, basically, network marketing is a business just like any

00:07:28.240 | other business. It's a business with a very low success rate because most people are not suited

00:07:34.480 | to a sales business. There are legitimate network marketing businesses and illegitimate network

00:07:39.440 | marketing businesses that are just scams. You can identify a legitimate network marketing business

00:07:44.480 | based upon the percentage of time spent selling product as compared to the time spent recruiting

00:07:50.000 | people into your downline. A legitimate business will always guide people towards doing direct

00:07:54.960 | sales selling product. The problem is that generally the products that you sell in a direct

00:08:00.080 | sales business are generally low commission products. There's not a lot of money into them,

00:08:08.000 | which is what pushes most people over to recruiting a downline.

00:08:14.480 | If you're comparing network marketing to other direct sales opportunities,

00:08:20.560 | if you find out that I like selling stuff and I'm good at selling stuff,

00:08:24.320 | then you would almost always be better off just going and getting a real sales job.

00:08:29.520 | Go and sell airplanes, or go and sell cars, or go and sell insurance, or go and sell something

00:08:34.480 | directly that has a much bigger price tag and a much bigger model or much bigger ticket price

00:08:39.760 | than selling in direct sales and network marketing. Similarly, if you flip over to

00:08:43.760 | recruiting in the downline, that's where the big money in network marketing is. You build a big

00:08:47.520 | downline and you become a trainer. Once again, if you're good at these skills, then these are skills

00:08:52.880 | that can be applied in all kinds of traditional businesses. You can build out a great sales

00:08:58.240 | business. You can start an insurance agency. You can do all kinds of things and you have a much

00:09:02.880 | higher earning potential in those businesses than you have in network marketing. If I'm actually

00:09:08.400 | coaching somebody, then very rarely do I point to network marketing as the best expression of it,

00:09:15.120 | where network marketing has usually gotten its legs has just been from people who either can't

00:09:20.160 | access the traditional marketplace. Somebody might have a felony or have children and providing

00:09:26.240 | childcare or time with mom and dad, or they can't go away to a traditional job, or they can't get

00:09:31.680 | hired in a traditional job, or they just simply don't have the ambitions desired for that and

00:09:37.600 | they just want to do a little bit here and there and make a few hundred dollars. That's fine.

00:09:41.040 | So as long as you're dealing with something where you're actually selling product and not opportunity,

00:09:45.120 | then it's legitimate, but it's just not the best. It's not the best option when someone has those

00:09:50.560 | skills and then it is not in any way per passive income. So I try to restrict exclusively the

00:09:58.240 | concept of passive income exclusively to expressions of basically living on dividends from

00:10:06.560 | public companies rather than earning money that's recurring revenue. It's fine to have

00:10:13.040 | recurring revenue. It's wonderful, but it's not passive income. So that was 120 seconds,

00:10:17.920 | but it's important to say that with regard to network marketing. So I would like to point...

00:10:22.400 | Go ahead. Oh, I was just going to say thanks for that context. Yeah. And I can expand that

00:10:26.880 | into a... I've meant to do a show on that for a while and expand the points with more evidence,

00:10:31.360 | but that's the outline of it. To the age of 35, I would say, first of all, it's important

00:10:37.120 | that you recognize that this is an arbitrary number. Arbitrary numbers are extremely useful

00:10:42.160 | as mental exercises. They're not so useful in real life planning. And so it's good to say,

00:10:49.040 | "Hey, how could I become financially independent in four years?" And that's why you're calling me

00:10:53.200 | and what we're talking about. But in terms of your actual life planning, it sounds to me like

00:10:57.760 | if you could be financially independent today at 31, then you'd take that because it would give

00:11:02.880 | you more powder time, more rock face time. On the other hand, if you reach it at 37,

00:11:08.000 | okay, big deal. It's not that... There's nothing materially different about your life between 35

00:11:12.400 | and 37. So step one, I would say, if you continue on your current trajectory, what do you project

00:11:19.760 | would be your financial independence date? Using a 4% rule, what would be your current

00:11:24.800 | projection at your current job, current trajectory? That's the thing. Unless I make a change,

00:11:31.680 | because I just got promoted to senior manager and at best people will get promoted to managing

00:11:37.760 | director six to eight years. But I'm a white male, so I don't check any of the DEI boxes for this big

00:11:44.640 | four. Just check the boxes. Just check the boxes. There's no point ever in identifying

00:11:50.640 | as a white male. So just check the boxes. It doesn't matter. Anyway, go on.

00:11:53.360 | But yeah, I was going to say, and I don't think I even want to be a managing director from what

00:12:00.160 | I've seen for those I work with. The higher you go in my organization, the less freedom you have

00:12:06.720 | now. You just have to give up the weekends. You just have to give up everything and you have to

00:12:12.560 | give up all the other hobbies. Like you said with selling, selling the business has to matter. It

00:12:18.160 | has to be your life. So it's kind of like a point of stagnation. I think I can probably get five to

00:12:25.440 | 10% raises every year, which are pretty good, better than probably average. But that being said,

00:12:32.560 | I think a million might be reasonable for me with the 4% rule, just because I can keep my expenses

00:12:37.360 | so low. So maybe I could do it in five to 10 years, probably more like 20, because I still enjoy

00:12:45.840 | traveling with gas, driving eight hours on a weekend to ski at Salt Lake City,

00:12:51.280 | or based in Denver. So I would say, yeah, maybe 15 years.

00:12:54.640 | - Okay. So it's important that you have an idea of what your current baseline is.

00:12:59.520 | And if you're not willing to give up your weekends today, then you're not a good candidate for an

00:13:04.560 | aggressive plan. And the first thing to focus on is the fact that, hey, listen, I can just,

00:13:11.840 | as I say every show, I can build a life I don't want to retire from. Working a job is not

00:13:18.640 | particularly burdensome. It's really not. And so your first step, what I always coach people in,

00:13:25.920 | is first, try to build a job that you don't necessarily want to retire from. Now, maybe

00:13:30.720 | public accounting has too much variability in your schedule, and that's not for you. Well,

00:13:36.080 | go and get a job working as a flight attendant, right? You'll take a big pay cut, but now you're

00:13:41.520 | going to have a standard schedule, and you can, okay, you can't ski all the good powder days

00:13:46.560 | because you're going to be working, but go and just take a job. Just have some kind of job where

00:13:50.800 | you go and work and are done with work when you're done with it. Or go and get a job in a mountain

00:13:57.200 | town. Move from wherever you are to a little mountain town, get a job at a ski shop as a

00:14:01.440 | front desk manager or something like that, and now you can put a sign on the door that says

00:14:08.240 | closed for powder when there's good powder, and you can be off on the weekends every time.

00:14:13.120 | Now, it sounds like I'm being flippant. I'm not being flippant. I'm trying to say

00:14:18.400 | that if you abandon the idea of first and foremost trying to build a plan for financial

00:14:24.720 | independence in the short term, and you start building your plans around building a life you

00:14:30.240 | don't want to retire from first, then you'll be able to accomplish your goals of having your

00:14:34.720 | weekends available, having your evenings available, things like that. I lead every

00:14:39.280 | show with building a plan for financial freedom in 10 years or less. It's been a while since I've

00:14:44.000 | addressed that tagline. I intentionally chose the term freedom rather than financial independence

00:14:51.440 | because I mean freedom, not financial independence. As far as I'm concerned,

00:14:56.320 | you're financially free today, and how I would define that to say that you can go and do just

00:15:03.200 | about anything that you want to do. There is no lifestyle change that is today outside of your

00:15:08.560 | grasp. There is no career change that is today outside of your grasp. There's no geographic move

00:15:14.160 | that is today outside of your grasp. There's no business that today, if you wanted to start it,

00:15:18.960 | is outside of your grasp. You have achieved financial freedom in, let's say, six years.

00:15:23.760 | If you started listening to me when you were 25, you've achieved financial freedom in six years.

00:15:28.400 | But using the definition that you have all choices available to you, any choices available to you,

00:15:35.360 | you can even stop working by my calculations with a $350,000 net worth. I wish I could get

00:15:41.280 | my calculator fixed because I always freeze up when doing math verbally aloud over the radio.

00:15:46.000 | Right now, you have a total net worth of 29 years of freedom. If you have $350,000 net worth and

00:15:54.640 | you have $12,000 of annual expenses, you have 29 years of freedom. That's what you've bought

00:15:59.520 | yourself right now. You haven't bought yourself a lifetime of freedom, but you've bought yourself

00:16:03.920 | 29 years of freedom based upon your savings. I'm ignoring investment growth, anything like that,

00:16:08.160 | just simply dividing $350,000 by $12,000. That's a huge, huge amount of financial freedom. If you

00:16:14.480 | want to take a year off, take five years off. All of these things are available to you.

00:16:18.240 | The only choice you don't currently have available to you, based upon what you're describing,

00:16:22.800 | is the choice to never work again the rest of your life. Now, could you get there in the next

00:16:27.600 | four years? You absolutely could, but I don't think you're willing to and I don't think you

00:16:33.280 | should. Could you do it? Yes, if you worked like a maniac and you took the highest paying job

00:16:39.040 | possible and you continued to live on $1,000 a month, which would be very unusual and you were

00:16:44.080 | completely committed to working all the time and making as much money as possible. You have your

00:16:49.520 | day job, you're working extra at your day job, all kinds of overtime, and you pick up something

00:16:53.440 | else on the side. Maybe you attend bar at nights and on weekends or have some other kind of high

00:16:58.160 | paying gig job that you do. Then you could increase your income and you could get yourself on track to

00:17:03.440 | be financially independent at 35. But you haven't articulated the goal to me that would make that

00:17:10.160 | make any sense. A goal would be like, "Okay, I'm going to buy a sailboat and spend the next 10

00:17:14.720 | years sailing the world." So I would say that instead of 35, why don't you stretch it out in

00:17:20.640 | your mind to 45 or 50 and say, "All right, I'm on track for early retirement at 45 or 50." When I

00:17:28.960 | do this work in private consulting, you could do your numbers yourself. But usually the first thing

00:17:32.640 | I do is say, "Let's assume that you stopped saving money and take your current expenses and calculate

00:17:39.200 | the year at which you would be able to live exclusively from the growth of your portfolio

00:17:46.400 | based upon a normal expected growth and calculate the year at which if you stopped

00:17:50.800 | contributing today, you would be able to live on your desired lifestyle." I'm not going to do the

00:17:58.240 | math right now, but take that number and grow it. Then usually what I'll say is the next question or

00:18:04.320 | next thing is, "How can you design a life that would be appropriate for you between today and

00:18:09.680 | that day in the future?" So let's say at 31 years old with a net worth of $350,000, let's say you

00:18:14.880 | calculate it and you say, "All right, if I don't save another dime, but I keep my full $350,000

00:18:21.120 | invested for the next 17 years, at that point in time, my portfolio, assuming 7% growth rate,

00:18:28.720 | my portfolio would grow to be enough to cover my lifestyle. Then I'll be fine, right? Because

00:18:33.440 | that's the benefit of saving super aggressively is that the numbers are going to get very huge

00:18:37.840 | in 15 or 20 years. So now then let's bring it back to a different problem and let's solve a

00:18:43.680 | much easier problem, which is, "How can I build a life or lifestyle over the next 17 years that

00:18:49.440 | I'm really comfortable with?" What I'll usually challenge somebody with is simply to say,

00:18:53.520 | "Here are the rules. Rule number one is you cannot spend any money from your investments.

00:19:01.040 | You cannot take any money from what you have saved or invested."

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00:19:37.440 | Rule number two, you can no longer save any money. So if you're content living on $1,000 a month,

00:19:45.040 | all you got to earn is $1,000 a month. And you can earn that in any number of jobs

00:19:50.320 | that are perfectly compatible with the lifestyle that you envision for yourself.

00:19:55.120 | So go and find a job that pays you enough to live on. And the rule is you can't spend any money from

00:20:02.720 | savings, but you can't save any money. So now you can kind of think about building a different

00:20:07.760 | lifestyle. Now the biggest X factor in your situation is going to be whether or not you

00:20:15.520 | ever marry and whether or not you ever have children. So I think you're probably self-aware

00:20:19.920 | to know that it is exceedingly unusual for someone to live on $1,000 a month. I think that you can do

00:20:27.040 | it. You can live comfortably on $1,000 a month if you're devoted to some kind of alternative

00:20:32.080 | lifestyle. And being some dirtbag out sleeping in your car by the cliffs is a perfectly reasonable

00:20:38.320 | lifestyle as being a ski bum sleeping in your car for fresh powder. You're in good company

00:20:43.840 | with the ability to live inexpensively there. But the big unknown is going to be if you ever

00:20:49.200 | changed your family situation and were responsible for supporting other people.

00:20:53.280 | So just be aware that you should keep flexibility in your plans. Until or unless you decide, "No,

00:20:57.920 | I'm never going to marry no matter what," then you should have a couple of plans. You should have

00:21:02.640 | plan A, which would be your single plan, and plan B, which would be your married plan. And ideally

00:21:08.160 | you would have a version of those that you're comfortable with. And by the way, to be clear,

00:21:12.640 | you don't need to marry somebody who's high maintenance. There's lots of people out there

00:21:18.080 | that you can find that are comfortable living really inexpensively. One of my favorite Twitter

00:21:23.280 | followers these days, I don't know his name, he goes on Twitter by something like Shagman Burke.

00:21:26.880 | I think you could find him with that. Super interesting writer. He just got married,

00:21:32.000 | but all during his 20s, he was a hitchhiker, just basically a homeless bum, hitchhiking

00:21:37.680 | left, right, and center across the United States. Fascinating guy, enormous interest,

00:21:44.080 | very interesting guy. But he found a girl who was totally acceptable with his very non-mainstream

00:21:53.040 | lifestyle, and they seemed happy couple ever, hoping to have a baby soon, and they just got

00:21:58.000 | married and seemed super happy and super content. So that can just be one of the things is that you

00:22:02.800 | want to marry some dirtbag rock climber, and perfect, she's a great fit for you, and that's

00:22:09.120 | just part of how you live together. There's lots of women out there who would accept that,

00:22:13.120 | but most people find that the hyper hardcore extreme savings doesn't work for the long term.

00:22:19.440 | So coming back to the point, number one, recognize that your number is arbitrary.

00:22:23.920 | Number two, you're probably not going to be willing to do what's necessary to hit the

00:22:28.320 | arbitrary number. You said it to me already, you said, "I don't want to work weekends." Okay, fine.

00:22:33.360 | Well, you're not going to get rich fast and be truly financially independent in a very short

00:22:37.200 | period of time without really going crazy. And I don't see any reason why you really need to go

00:22:42.640 | crazy. So what I would say is calculate the age at which, based upon your current savings, you can

00:22:49.120 | consider yourself fully financially independent based on portfolio growth. And then go back and

00:22:55.520 | say, "What could be a lifestyle that would allow me to live the kind of lifestyle that I really

00:23:01.680 | like living that's just sufficient?" I've known plenty of accountants over the years that just

00:23:07.040 | did seasonal work. They just did tax preparation. They just did seasonal work with a small handful

00:23:12.640 | of clients that they had themselves. They weren't making as much as you're earning. They weren't

00:23:16.880 | making top figures. They weren't trying to make partner. They just wanted to make enough money

00:23:21.040 | to support themselves. And they made $60,000, $70,000, $80,000 a year with part-time remote

00:23:26.240 | work, very seasonal, and that gave them the flexibility that they had. So that would harm

00:23:31.040 | your ability to be financially independent at 35, but it would fulfill your goal of having every

00:23:35.600 | weekend free between now and then and beyond. So that's where I would spend a lot of time

00:23:42.720 | thinking through the options to consider if there's just an alternate vision. It is a lot easier for

00:23:49.520 | you to get a different job with different features that are more attractive to you than it is for you

00:23:56.400 | to retire from working at all. And that's the thing that changed me off of the financial independence

00:24:02.720 | retire early plan. What I now see is that when I was obsessed with firing at a young age,

00:24:10.640 | I was obsessed with it because I didn't like my job. And I have found that it's a lot easier for

00:24:15.920 | me to get a job that I like more than to go and become financially independent, especially with

00:24:20.960 | all of the uncertainties of long-term financial projections and things like that. So keep on

00:24:26.560 | saving money, but spend some serious time finding and thinking of a job that you would like more

00:24:33.040 | that would provide you with the attributes of life that you're looking for before you go crazy

00:24:37.600 | just focusing on being financially independent at age 35. Thank you so much. That's a lot to

00:24:45.760 | think of and I'll call back in the future and refine in some other topics. I would love it

00:24:50.560 | if you did. That would be wonderful. Tyler in Missouri, welcome to the show. How can I serve

00:24:54.480 | you today? Tyler, that's you. You're already unmuted. Go ahead, Tyler. Going once. I'll come

00:25:08.160 | back to you, Tyler. It looks like you're having some trouble with your mute. I'll come back to

00:25:10.800 | you in a minute. Marcus in Pennsylvania, welcome to the show. How can I serve you today, Marcus?

00:25:14.320 | Hey, Mr. Sheets. How are you? Very well, sir. Welcome.

00:25:18.960 | Well, thank you. So I'm in a bit of a bind and my career has been kind of offset by a year.

00:25:25.920 | I'm wondering if, after what I'm going to tell you, if there's any other recommendations that

00:25:31.840 | you would recommend or anything that I'm overlooking. So I'm a recently graduated

00:25:37.200 | physician from medical school a month ago and I didn't match into residency this year. There's a

00:25:44.960 | bunch of stuff going on all throughout 2024. And I'm kind of wondering, is there any way to

00:25:52.400 | make up for, you know, the lost potential future income and the opportunity cost of not being a

00:25:59.600 | physician for a year? And how can I kind of make the most of this year, both financially? Am I

00:26:07.920 | able to do some of the things that I wanted to do later in my career, such as take a year off and

00:26:12.160 | travel, get an MBA, et cetera? And how can I best accomplish that without losing out too much?

00:26:21.280 | Why do you think you didn't match? I don't need all the details, but broadly speaking.

00:26:24.560 | So emergency medicine was especially competitive this year compared to the past two years.

00:26:30.000 | And because of my board scores, I don't think I made it past a few filters.

00:26:38.160 | I passed, but I just, I very lowly passed on my step to the boards.

00:26:42.240 | And then when I went back over my application, you know, I was going through a breakup at the time

00:26:47.920 | and my application was not refined. It was kind of unfocused. I had just torn my pectoralis major

00:26:54.480 | and I had surgery. There was just a lot going on. I'm driving on the Uber on the weekend so

00:27:00.720 | that I can make ends meet to cover what student loans won't cover. So it was just, I think,

00:27:07.760 | multifactorial. Okay. And pardon my ignorance. I know a lot about physician finances and very,

00:27:13.360 | not very little about how to actually be a physician. Is matching for a residency program,

00:27:19.360 | is that something that will only happen once a year, or is there a possibility that something

00:27:23.680 | can open up in the middle of the year? It's very uncommon that something opens up

00:27:29.040 | in the middle of the year. And there's the match process through NLMP, the National Residency Match

00:27:36.160 | Program. And that takes place, applications, I think, open up in September through this program

00:27:42.800 | called ERAS. And then you start the interview trail, like, what is it, like November, December,

00:27:49.760 | into like January and February. And then match day is early in March. So that's kind of where

00:27:56.880 | you find out. And then there's the supplemental process called the SOAP, where if you didn't

00:28:03.760 | match somewhere on Monday, they send you a list of all the open unfilled slots. So I had 10 interviews

00:28:11.600 | in two days. And then you find on Thursday, if you're getting any offers throughout four different

00:28:16.880 | rounds of extending offers, and that didn't happen this year. Is there an opportunity to retake your

00:28:21.760 | exams and score more highly? So that's what I've been looking into. If I can take step three of the

00:28:28.000 | USMLE without having, step three would be the next step. If I can do that without having

00:28:36.800 | an intern year completed, intern year would be the first year of residency.

00:28:41.680 | So I'm not the right person to ask about the specifics of the application process. So what

00:28:48.320 | I want to articulate that could be useful is simply a frame of mind. You still want to be a physician,

00:28:55.280 | right? Correct. Okay. Yes. So if you want to be a physician and you know, I want to be an emergency

00:29:00.800 | room physician, and you've done all this work to get to this point, then you really shouldn't be

00:29:06.080 | worrying or thinking or paying any attention to plan B. You should be completely focused on plan

00:29:12.400 | A. Because the guy who's completely focused on plan A, he knows what he wants and he's going to

00:29:17.280 | do what's necessary to get there. That's the guy who a year from now is going to be placed back on

00:29:23.200 | track with all of the normal stuff. Getting knocked off track is no big deal. That's normal.

00:29:28.160 | You had a bunch of stuff that happened. Okay, great. What's necessary is that you have to learn

00:29:32.720 | from it and you have to be an overcomer. And so in the American culture, especially, we don't look

00:29:40.000 | down on people ever who get knocked off track. We love hero stories, but we only look up to them

00:29:49.040 | when they have fixed their problems. So we don't have any cultural sense of

00:29:54.800 | failure being permanence. That's why our culture is so built around somebody goes through bankruptcy

00:29:59.520 | a couple of times, no big deal. We will still honor that person as the greatest businessman

00:30:03.440 | in the world once he's rebuilt things. But we only accept people who are successful.

00:30:08.640 | So if you still are down and you're just continuing to fail out and you're sitting

00:30:13.120 | at home and moping about how you're depressed, we don't want to hear about it. So what I would say

00:30:17.360 | is you need to be, from an attitudinal perspective, you need to be laser focused on saying, "That

00:30:22.640 | sucked. Last year sucked. I screwed it all up. I didn't score well. I didn't interview well. I

00:30:28.800 | didn't write good essays, and this has to change." So then by this time next year, if you can change

00:30:34.960 | that stuff and you'll be a victor and it'll come into your essays, and 20 years from now when

00:30:40.640 | you're accepting some fancy award for some prestigious breakthrough or service or whatever,

00:30:46.480 | then you'll say, "You know, the biggest challenge of my life was when I didn't get matched to

00:30:50.800 | residency and how humiliating that was because I screwed it all up and I had a breakup and blah,

00:30:55.680 | blah, blah, whatever it was." And then you'll inspire the next league of our culture who will

00:31:00.080 | go on and continue what we do of praising the underdog story. So my point is just recognize

00:31:06.160 | where you are in the story. "Well, that sucked. I've got kicked in the teeth. I didn't get what

00:31:09.280 | I wanted." But recognize now you have to do the hard work to fix the things that were wrong.

00:31:13.920 | And so if you know you want to be a physician and you know, "I want to be an emergency room

00:31:17.200 | physician," then you have to pull apart every single reason why you didn't get matched,

00:31:22.800 | and then you have to work like a maniac to fix those things. And the good thing is they're all

00:31:27.440 | fixable with specific coaching, with specific practice, with specific dedication and effort.

00:31:34.400 | So if you didn't score well on an exam, then you have to go back and you have to say,

00:31:38.640 | "Why didn't I score well?" And so you need to learn about learning, take a look at your scores,

00:31:43.280 | figure out what didn't work well, what was broken in my test preparation process. Now,

00:31:48.160 | I'm not interested in the details here. It could be that you just were so distraught over your

00:31:53.120 | emotional life and you were up late arguing and blah, blah, blah, and you just needed more sleep.

00:31:58.000 | All right, we'll fix it. But it could be that you really need to be focused on going through the

00:32:02.240 | knowledge and really mastering it. And the thing about academics is by the third or fourth time

00:32:08.000 | you go through the class, it should be pretty easy for you. You've passed all of the intellectual

00:32:13.360 | screens necessary to be confident of your basic ability. You're not stupid. You're not incapable

00:32:19.200 | of learning. So obviously you're capable of passing this exam. It just might be that you

00:32:25.280 | need to be the guy who goes through the material four times when all your classmates went through

00:32:29.360 | it twice and that was no big deal. So again, this can be reworked into part of your story.

00:32:35.520 | And you can take every failure and every setback and recast it as a success. And I failed that

00:32:42.400 | exam. That didn't work out well. So I dedicated the next six months to studying like crazy,

00:32:47.840 | and I passed the exam. And by the way, even if there's not an official metric for this,

00:32:52.560 | and I don't know anything about the step in the USMLE process, but even if there's not an official

00:32:58.320 | metric for this, what I would do is I would say, "I didn't do well on the boards," or whatever,

00:33:03.760 | "on the exam." So if I can't retake the exam officially, then I'll retake the exam unofficially.

00:33:10.880 | I'll find somebody to proctor an official version of the exam, and I'll get a good score,

00:33:15.360 | and I'll have that notarized, and I'll take that to my interviews, and they'll say,

00:33:19.040 | "Why did you do so badly on the exam?" And I'll say, "Well, I did really badly on the exam

00:33:23.200 | because I was going through this, and I didn't know this, and I didn't know the other thing,

00:33:26.240 | but I fixed it. And by the way, here's my form. Here's my notarized affidavit by so-and-so who

00:33:31.920 | proctored my exam and said that I scored brilliantly after really focusing on it."

00:33:36.000 | And you may be able to do that with going ahead and doing well on step three.

00:33:40.080 | So you need to pull apart all of the academic process, figure out and identify and diagnose,

00:33:44.400 | "Why did I not do well? And now I have to figure out how to do well. So if I don't know how to

00:33:48.960 | study, then let me go and get more coaching on studying. Let me go and improve the issues."

00:33:53.920 | Similarly, "Why didn't I interview well?" Because if you had interviewed better,

00:33:57.360 | then probably there would have been a better spot. So you may need to do some really focused

00:34:01.920 | planning and practice related to your interview skills and figure out, "How do I improve my

00:34:08.160 | interview skills? Maybe I need to do more practice interviews, more coaching."

00:34:12.880 | And it might be something that some individual can mentor you with. It might be something that

00:34:17.360 | you're just talking to chat GPT all the time, and you're having chat throw at you tons and tons of

00:34:22.400 | interview questions until you're really, really calm. And anything else that could have impacted

00:34:27.040 | essay questions, you might need coaching on your writing. And so you need to hire a coach and work

00:34:32.400 | on it and read some books on how to write better essays and really think about the package that

00:34:36.400 | you're presenting because all of these are influential and anything else that you can

00:34:40.640 | identify that would improve the process. So my point is that if you know the direction

00:34:45.440 | you want to go, then express the determination to not be denied. And there's a good chance that

00:34:50.880 | you were right on the edge. Your scores were just a little bit lower than they should have been.

00:34:56.000 | The field had this year a larger number of qualified candidates. Maybe there weren't quite

00:35:01.200 | as many vacancies in the industry as expected, but next year it could be totally different,

00:35:06.240 | or two years from now it could be totally different. So that would be my primary focus

00:35:11.440 | rather than moving on to anything else would just be to say, "How do I stay put on plan A?"

00:35:17.280 | And in the fullness of time, in the fullness of your life, being a year behind getting into your

00:35:22.400 | career or three years behind or whatever it is, whatever it winds up being, it's not going to be

00:35:27.280 | that big of a deal. So let me pause there. Do you think that's a decent start psychologically for

00:35:34.000 | you to work from? Yeah, absolutely. Especially as far as the academics and the exams and the

00:35:42.320 | application process is concerned. Supporting myself financially over the next year is my next

00:35:52.320 | thing to solve. I've been applying to jobs left and rights. My undergrad is in mechanical

00:35:58.240 | engineering. I'm struggling to find jobs in engineering. I'm driving Uber right now

00:36:05.040 | while applying to jobs as a server at high-end restaurants. And I'm wondering if I'm looking,

00:36:13.200 | overlooking anything that will be minimally time intensive to give me that time to study and

00:36:18.880 | prepare and do more research over the next year and volunteer and keep my clinical skills sharp

00:36:26.240 | while I'm supporting myself and my dog. Yeah. Well, I was just going to ask, it sounded like

00:36:34.160 | there might've been a baby there with you. Are you supporting a family or are you a single man?

00:36:37.920 | I'm a single man. Okay. So the good thing is that other... So are your student loans in deferral?

00:36:46.000 | They are. 300,000. Okay. And can you keep them in deferral for at least the next year or two?

00:36:51.920 | I believe that I can. Worst case scenario, I do income-based loan repayment. Okay. So first goal

00:37:04.320 | is keep your loans in deferral if at all possible. Then the second way to handle your money is you

00:37:13.200 | need to go as absolutely cheaply as possible with your living expenses. Are you living alone? Are

00:37:17.520 | you living with family or friends? What's your living situation right now? I'm living alone,

00:37:22.960 | but my last rent payment is August and then I'm going to move back in with my parents 20 minutes

00:37:30.000 | away. Perfect. Perfect. So that's exactly what you need to do. Move in with your parents.

00:37:33.600 | The easiest way that your family can support you at this stage is to give you a place to

00:37:40.000 | live rent-free and that'll be wonderful. Remember that the only reason that you wouldn't want to do

00:37:48.080 | that is simply if you're just basically a loser bum. That's the only problem. But you're not a

00:37:56.000 | loser bum and you're not going to be a loser bum. And so if you can move in with your parents and

00:38:01.200 | live there rent-free or with just a very token amount, then that should eliminate the financial

00:38:06.720 | pressure from living expenses. And then everything else is pretty simple. You should easily be able

00:38:13.840 | to live on some hundreds of dollars a month, especially if you have low rent, and that you

00:38:18.880 | can absolutely cover with any kind of gig that's just enough to cover your expenses. You have to

00:38:24.160 | stay focused on the big goal, which is getting placed as a physician. Because once you get

00:38:29.360 | through residency and once you get out of residency, the financial problems will be fixed.

00:38:35.120 | So this is just a short-term thing. It doesn't require some huge transition. And the most

00:38:41.440 | reasonable way to do this as a single man is to be hardcore about your expenses and be really

00:38:47.840 | dedicating yourself to study and to all the stuff that I've said. Now, is there a job that would

00:38:54.080 | enhance your hireability as a physician? For example, something related to an emergency room

00:39:00.480 | nurse or something related to EMS or anything like that, would any of that stuff improve your hiring

00:39:05.680 | attractiveness? I believe so. You just brought up EMS. I haven't even looked in the process of what

00:39:16.240 | getting that EMT certification looks like, but that would definitely keep me clinical and push

00:39:22.640 | me closer to matching next year. That would be what I would love to do. So I think we could solve,

00:39:29.440 | based upon just a broad thing. Other than your student loans, do you have a lot of other debt,

00:39:33.920 | personal debt, credit card debt, anything like that? I have $3,500 of credit card debt

00:39:39.440 | from my surgery that I just kind of put the last month of the semester on credit cards.

00:39:46.640 | Okay. So goal number one is keep your student loans in deferral. Goal number two is cut your

00:39:52.320 | living expenses to basically zero. Tell mom and dad the situation. Make sure they understand.

00:39:57.360 | Make sure they understand what you're doing. Your parents want to help you and they want to support

00:40:02.800 | you. Their only concern will be, are you actually working on a plan, working towards a goal,

00:40:08.880 | or are you living like a bum? If they see that you're working on a plan and you recognize this

00:40:14.480 | didn't work out last year the way that it was supposed to, but a year from now I'm going to be

00:40:18.160 | employed as a physician or a resident, then your mom and dad will be happy to give you a room to

00:40:24.560 | live in. They'll be happy to feed you. They'll be thrilled to do that. It'll be a great time for you

00:40:29.360 | to be at the table and they can feed you. They'll be happy to put you on their cell phone plan.

00:40:33.760 | They'll be happy to cover your expenses. Now, you have to make certain that you're bearing your own

00:40:43.520 | weight. So if your mom and dad are paying for all of your expenses as an adult man, then you need to

00:40:49.200 | be making certain that you're doing a lot at the house to help. But I wouldn't be scared to accept

00:40:54.480 | charity from your parents because they want you to succeed. And so if what's necessary for you to

00:40:59.920 | succeed is for them to cover all your living expenses while you study 14 hours a day and you

00:41:05.600 | network and you do everything that you can, they're going to be happy to do that. I would do it for my

00:41:10.560 | adult son. If you're a father someday, you will do it for your child because you see that in the long

00:41:15.920 | run, this is the best pathway. So if you have a job and you go and get a job and you're waiting

00:41:21.360 | tables or you're driving for Uber and you're making some money, of course that's fine. But

00:41:25.520 | you can only do that with time that's not going to invade your primary plan. You can only do that

00:41:32.480 | when you can still study effectively. You can't be out late, you know, tending bar somewhere and then

00:41:39.200 | not be able to study the next day. Your focus needs to be getting the academic stuff solved,

00:41:44.560 | the essay stuff solved, really hardcore, so that this time next year you are a resident and

00:41:51.040 | everything else should be in subjection to that. I wouldn't try to go for anything more creative

00:42:00.160 | than that because if you go off and you start hiking the Appalachian Trail because you think

00:42:04.400 | that would be fun, that's just going to destroy your studying, you're going to get rusty, you're

00:42:08.400 | going to do terrible on your exams. All of that stuff is going to be an impediment to the advancement

00:42:13.840 | of your career and you need to make certain that you recoup the investment of years of your life

00:42:18.320 | and $300,000 at this point in time. If the job in, say, working as an EMT or some kind of orderly in

00:42:26.880 | a hospital, if that job is going to get you closer to the goal, then you should do it. Not primarily

00:42:33.680 | for money. You don't just need money. Again, sounds like your parents can support you for a year,

00:42:38.560 | but you should do it because it'll help you get closer to the job. It'll keep you current,

00:42:42.720 | it'll allow you to exercise your knowledge, it'll help you to build relationships.

00:42:45.920 | Those relationships may pay off in a match in the future. They may create better endorsements

00:42:51.200 | by people who are going to write letters of recommendation for you. If there's an EMT job

00:42:56.320 | or an orderly job or something that you could get hired for around the medical business that would

00:43:00.560 | get you closer to the goal, then that's what I would do. Make certain that you're not neglecting

00:43:05.120 | the academics. >> Right on. Thank you so much.

00:43:09.440 | >> My pleasure. Anything else? >> No, that's it. Thank you.

00:43:12.480 | >> All right. Keep in touch and let us know how things go in the coming year. I'd love to hear

00:43:15.280 | back from you. Tyler in Missouri, back to you. >> Can you hear me now, Josh?

00:43:18.960 | >> Sounds good. Go ahead, sir. >> Great. Thanks. I have a question for you,

00:43:23.200 | life insurance-based. I'm actually asking on behalf of a relative of mine. He ended up getting

00:43:28.800 | a $500,000, 65-plus full life policy, and he's basically looking to get out of it. I just thought

00:43:35.920 | I would ask you what your recommendation was before he pulls that trigger, because I've heard

00:43:40.080 | on previous episodes you've advised certain things. I have a little bit of information from him. Let

00:43:46.160 | me know what you need. >> When did he get the policy?

00:43:48.000 | >> About three years ago. >> All right. If it's three years ago,

00:43:53.600 | then there's no—the reason I ask, let me just explain for anyone else who needs to learn.

00:43:58.080 | First of all, anytime you buy a life insurance policy, there are always a variety of options

00:44:03.760 | available with it. During the time that you're in underwriting, you can cancel the policy.

00:44:08.720 | Anytime that you buy a life insurance policy, once the policy is delivered in every state in

00:44:14.240 | the United States, you have some form of free-look period. It used to be two weeks in some states.

00:44:20.160 | Now it's 30 days. Basically, anywhere from a couple weeks to a month, depending on the state,

00:44:24.640 | you have a free-look period. We're not in any of those options, but that's why I ask.

00:44:31.040 | With a three-year-old policy, we're going to be focusing on the non-forfeiture

00:44:35.200 | benefits. The face amount of the policy is $500,000. What's his premium,

00:44:42.000 | and what's the current cash value? >> The premium is $625,000 a month.

00:44:47.520 | The surrender value is $4,900. I'm not sure if that's probably a lower amount than the

00:44:52.000 | cash value would be, my guess. >> Yeah. Why does he want to get rid of it?

00:44:58.160 | It's just an albatross. He got talked into it. At the time when he opened it,

00:45:01.840 | he was making roughly a little under $100,000. He wants to put it in something that's a higher

00:45:08.320 | yield return. I think he got talked into it for retirement purposes. He really has,

00:45:12.160 | from my understanding, no need for life insurance. He's a single guy, no kids, not married.

00:45:16.240 | >> Instead of putting money in a Roth IRA, instead of putting money in 401(k),

00:45:21.120 | he opened a whole life policy. >> Right.

00:45:23.680 | >> Okay. It's a little bit tricky at this stage of the policy life where he needs to think about it.

00:45:31.280 | First of all, the big problem with whole life insurance is simply that the short-term cash

00:45:37.120 | returns are pretty bad. If he cancels the policy now, he will lose the majority of his money

00:45:43.840 | because all of the expenses of a life insurance policy are all front-loaded. In the first year,

00:45:49.200 | you really accumulate almost no cash value in a whole life policy. In the second year,

00:45:53.120 | you're a little bit better. Third year, okay, we're back on track now,

00:45:56.800 | but it takes a number of years before the policy breaks even.

00:46:01.280 | First thing we want to do is understand the numbers. We want to understand the total amount

00:46:05.440 | of money that he's put in in terms of premium cost. We want to understand the current cash

00:46:10.080 | surrender value. You've stated those numbers. We can calculate 36 months at whatever it was,

00:46:14.000 | the monthly payment, and we can figure out where he is. The next thing we want to do is we want to

00:46:18.800 | look at what would be the alternative use of the dollar and what would be the break-even point in

00:46:25.120 | the policy. The alternative use of the dollar is really important. What a lot of people will do

00:46:33.280 | is they'll do something like buy a life insurance policy. They'll have regrets. Say, "I want to

00:46:36.880 | cancel it." He'll cancel it, but if he doesn't go on and save any money and he doesn't start putting

00:46:42.080 | the money into a better investment, then it's going to wind up being a bad decision for him.

00:46:46.560 | We don't compound a previous bad decision with a new bad decision. I've seen this happen lots

00:46:51.280 | of times. A guy will have a life insurance policy. He says, "Well, you know, I should have bought

00:46:54.800 | term and invest the difference. My life insurance agent ripped me off because he sold me this whole

00:46:58.000 | life policy that was inappropriate for me, blah, blah, blah, blah, blah." Cancels the policy three

00:47:01.680 | years later, has no money because he's not saving anything. We want to make sure that doesn't

00:47:06.000 | happen. We want to get clear on what is the alternative use of the dollar. The second thing

00:47:10.400 | we want to look at is, is there a way that he can continue doing it? You said the premium was how

00:47:14.480 | much? $560,000 a month? $625,000. $625,000 a month. If he's got $100,000 income at $625,000...

00:47:24.000 | His income has increased since then, but just at the time. He's at about $150,000 range right now.

00:47:29.840 | Okay. $7,500 a year of premium, that would be... You said he's at $150,000 now?

00:47:35.600 | Yes. That would be about 5% of his income going into this policy, something like that. Is that

00:47:41.200 | right? Correct. Okay. It probably was inappropriate when he bought it. He had a lot of motivation to

00:47:48.080 | buy lots and get really rich, but he probably could make that payment if he wanted to. I

00:47:54.000 | understand he doesn't want to, but he could make the payment today if he wanted to, right?

00:47:57.040 | Correct. Okay. If he's a single guy and he's good with his finances, he could do all of the above.

00:48:02.960 | If he's making $150,000, he could max out his 401(k), he could put money into a backdoor Roth

00:48:08.080 | IRA, and he could make this life insurance payment and still be okay. Agreed? Agreed.

00:48:13.440 | Okay. Let's not just dump it willy-nilly. Let's make an accurate assessment.

00:48:18.960 | Just because something... That's why I'm calling you.

00:48:21.440 | Perfect. Yeah. I'm pointing this out for people because it's like this. Somebody says, "I married

00:48:26.560 | the wrong woman." Okay. "I married the wrong woman." We can acknowledge the fact that you

00:48:31.040 | married the wrong woman, but does that mean necessarily that you should immediately divorce

00:48:35.200 | her? Well, that's a different question. The fact is you are married. There's a balance between

00:48:41.360 | engaging in fallacious thinking with a sunk cost fallacy versus making a fresh decision to say,

00:48:47.120 | "Here's where I'm at." There's lots of people who "married the wrong woman" who turn out to have a

00:48:54.160 | great life and have a great and rewarding marriage because they recognize, "If I had to do it over

00:48:59.440 | again, I would do things differently when I got started, but hey, here I am." When I approach a

00:49:04.080 | question like you're asking me, I do the same thing. Okay. Maybe there was inappropriate buying

00:49:09.360 | pressure. Maybe I was susceptible to it, but at the end of the day, let me not just say, "Well,

00:49:14.240 | I made a mistake then." Let me do a fresh analysis now and say, "Is this suitable for me now?"

00:49:20.480 | And from what you're describing, using purely the technical language of suitability,

00:49:24.880 | this policy would not necessarily be unsuitable for him today. He has the capacity to pay the

00:49:32.000 | premium. He has the capacity to fund those other things. The big question is, is there an

00:49:37.920 | alternative investment for him that is superior to the money that he's putting into this policy,

00:49:43.600 | especially given the fact that now all of the costs of the policy are paid? Once you get into,

00:49:51.520 | say, the third year of a policy, then now we can calculate, "Hey, this year I'm going to make a

00:49:55.600 | premium payment of $625 a month, but maybe now my rate of return on cash value is higher because

00:50:01.600 | I've already paid all the commissions and the expenses." So he should be doing a fresh analysis

00:50:06.320 | now. Now, if he weren't putting the $625 of premium payments today, what specifically would

00:50:12.880 | he do with the money? He'd probably just invest it in the stock market. I know that he's already

00:50:19.200 | maxing out his Roth 401(k) at work, and he's just been putting extra money in the stock market.

00:50:23.680 | Not necessarily mutual funds, but something similar. All right. So here's where our argument

00:50:30.640 | gets a little bit tricky. I think that in the fullness of time, if I have to put my money

00:50:37.360 | on which investment is going to turn out bigger, in the fullness of time, I would bet that if he

00:50:44.720 | put $625 a month into something like a stock market index fund, as compared to the life

00:50:51.120 | insurance policy, I'm of the conviction that the stock market index fund will probably do

00:50:56.640 | better in the long run with the $625 a month. So I think the stock market will outperform

00:51:04.480 | life insurance. The reason I think that is simply that the life insurance portfolio is all invested

00:51:11.360 | in fixed income investments and very stable, very safe investments. And in general, higher risk asset

00:51:18.160 | classes like stocks should outperform lower volatility asset classes like fixed income.

00:51:25.360 | Otherwise, what's the point of the whole stock market in the beginning? All of us would take

00:51:29.680 | an entire fixed income portfolio if it would return us higher than the volatility of the

00:51:35.280 | stock market. So we take the cost of volatility in exchange for the potential return of stocks.

00:51:40.880 | Now, so if you ask me, "Joshua, do you think that in the fullness of time, I will be better off and

00:51:47.600 | have more money in the long run if I just put $625 into the stock market versus $625 in the

00:51:53.360 | life insurance policy," I'm going to say stock market, okay? But that's not the situation that

00:51:58.480 | he's in. He's already putting aside, let's call it $30,000 or $35,000 a year in the stock market.

00:52:04.400 | So we have to look at it and say, "Is $30,000 or $35,000 a year in the stock market,

00:52:09.920 | is that enough money in the stock market where now we want to consider some alternative

00:52:16.000 | assets that have different features?" What do you think is the answer to that question?

00:52:22.480 | And that's probably a question for him directly. I'm not really sure.

00:52:25.600 | Right. But I've got you to talk to. What do you think about that question?

00:52:30.320 | If it was me, I would probably put less into life insurance and more into the stock market,

00:52:36.800 | but maybe not get rid of the policy completely.

00:52:39.120 | Right. And that's an option. We're going to go over the non-forfeiture options in just a minute.

00:52:42.240 | But my point is that this is where I think life insurance is very suitable and is very appropriate.

00:52:48.880 | So if I were a life insurance agent today, and I was selling life insurance,

00:52:52.640 | and I had to create a basic standard model, what would I do? How old was he when he bought the

00:52:58.800 | policy? About 31.

00:53:02.080 | Okay. So if I approach a 31-year-old guy, a single guy, what I would tell him, I would say, "Listen,

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00:53:36.880 | You should buy a whole bunch of term life insurance. If you want to buy some whole life

00:53:40.640 | insurance, here's how it works. So I would always do a full presentation of here's what 2 million

00:53:45.600 | of term life insurance is like, here's what 2 million dollars of whole life insurance would

00:53:48.720 | like. When you do that, 95% of the time, people are desperate to buy whole life insurance. When

00:53:53.600 | they actually understand how the product works, they're like, "Oh, absolutely, I should do it."

00:53:57.440 | And I would say, "No, I don't think you should do it at all." I would sell him, you know, 1.9

00:54:01.680 | million dollars of term life insurance and 50 or 100 thousand dollars of whole life insurance.

00:54:06.320 | The reason being that I think everybody will be glad to have a little bit of whole life insurance.

00:54:11.280 | Then what I would tell him is, but at 31, and whatever he was making at the time,

00:54:15.680 | you must first fund your Roth IRA and you must first max out your 401k. And I would tell him

00:54:21.920 | you must do that because every year that passes that you don't maximize these accounts, you lose

00:54:27.280 | because now you can't ever go back and get it back. Plus, that money works really well in the

00:54:31.440 | stock market where we have really great stock opportunities. And if we don't have that,

00:54:38.400 | and this money is asset protected, it's completely exempt from the claims of creditors depending on

00:54:42.800 | state laws on the Roth IRA. In addition, I would say this is the most flexible asset for the long

00:54:47.760 | term. So this is where most of your money should be focused. Now, for someone who's making 100

00:54:53.200 | thousand dollars or 70 thousand dollars, he doesn't have more money available to him than that.

00:54:58.000 | So maxing out the Roth IRA and the 401k is what always makes sense. So if I were coaching this

00:55:04.320 | life insurance agent, I would say, you dumbo, why would you sell him this big of a policy when he's

00:55:08.960 | not first maxing out his Roth IRA and his 401k? But when you come back and you're making $150,000

00:55:14.960 | a year or $250,000 a year, suddenly putting 30 grand in the 401k is not nearly what you need,

00:55:20.480 | and you need a lot more. So there's lots of other options of things that we can do. We could just

00:55:24.800 | open up a brokerage account, buy mutual funds or stocks, and that works fine. We could trade

00:55:30.800 | crypto. We could go buy houses, all kinds of things we could do. But here's where life insurance is a

00:55:35.120 | super interesting asset, because now we have an asset that grows pretty well if it's with a good

00:55:41.200 | company. It's safe and it's stable. It grows tax deferred. It can come out tax free in various

00:55:47.120 | forms. It's not reported on the FAFSA. It's creditor protected in many states. And so having

00:55:52.800 | a small percentage of your money going into it doesn't harm other financial goals. So with this

00:55:57.680 | guy, if there's not another financial goal that's being harmed, I would love to see him keep the

00:56:03.360 | full policy, because he can fully fund the 401k. He can fully fund a Roth IRA. That's all the money

00:56:09.600 | he needs in the stock market. He could probably do other important things like buy a house,

00:56:13.840 | things like that, without the policy impeding those important decisions. If he wants to get

00:56:21.600 | married, he can get married. I don't want a life insurance payment to disrupt his other decisions,

00:56:26.320 | but I think it's a really great fit for him now. I wouldn't have sold it to him three years ago,

00:56:30.320 | but today, from what you're saying, he can probably have it. And if we fast forward,

00:56:34.400 | there's a good chance that he will be happier to keep the policy, and his current annoyance with

00:56:41.680 | it will probably 10 years from now be general happiness with it, for all of those advantages

00:56:46.080 | that I said. Now, he may disagree. And if he does disagree, here's what I'm going to be listening

00:56:50.400 | for. What I'm going to be listening for is some important life decision or financial decision

00:56:57.040 | that is being hindered by the life insurance policy. So if he says, "Well, I just can't afford

00:57:01.840 | to buy a house," and he proves to me that I can't afford to buy a house because of the life insurance

00:57:05.680 | policy, well, I'm probably going to say, "Buy the house. Let's lower down the life insurance policy."

00:57:10.320 | Or if he says, "I really want to start a business, and this is really what I'm focused on,

00:57:13.520 | but I got this stupid $625 a month life insurance payment." All right, well, let's defer the payment

00:57:18.400 | in some way. Cancel it, defer it. We'll do a couple of things, but let's eliminate the payment so that

00:57:24.800 | you can do these other decisions. But if he can do those other important things and still be forced

00:57:30.880 | to save the 625, he'll probably be happier with that course of action 10 or 15 years from now

00:57:36.720 | than he will be if he just cancels the policy. Does that logic make sense? Do you think it holds

00:57:40.800 | water? I think it does, and that brings to bear. I do know that he was speaking to me about wanting

00:57:46.800 | to buy a house in the future, and he does live in a high-cost living state where houses are pretty

00:57:50.480 | expensive. So I know that was one obstacle he was facing, but I'm willing to hear also how he might...

00:57:56.400 | Primarily, what I wanted to ask you was to see what was the best decision he could make given

00:58:02.560 | that he's already three years into it and for the reasons you stated, what are the options that he

00:58:06.320 | has for A, getting out of it, or B, being convinced to stick with it, as you mentioned?

00:58:11.280 | So we'll go now to the getting out of it. I think I've said my piece.

00:58:14.800 | What I'm trying to do is I'm trying to acknowledge that I don't know if this was the right decision

00:58:19.360 | or the wrong decision. I know that when I sold life insurance, I oversold it sometimes. I was

00:58:24.720 | good at getting people to buy it, and then a year later, they would be like, "Oh, this was too much."

00:58:28.960 | And so I learned to stop overselling and start underselling because that was better for

00:58:33.600 | longevity, and then I would just have people come back and buy more in the future. So it's

00:58:37.600 | a common thing. I've made that mistake. He's made that mistake. I think what I've described,

00:58:42.240 | I believe I could defend this philosophy. I'm doing it in public, but I feel good about

00:58:48.720 | defending this to any financial planner. I feel good about selling small whole life insurance

00:58:54.240 | policies to anybody who wants one because I think that most people will be happy with them.

00:58:59.440 | I feel good about filling up all of the tax-deferred accounts first and then coming

00:59:03.520 | back to life insurance. I feel good about acknowledging that this is a useful asset

00:59:07.680 | class in those constraints, and then you can consider what's right from there. But to me,

00:59:13.760 | I think this is a reasonable appreciation and a good practical approach. So let's go

00:59:19.520 | to his options now. So the first thing that he could do is—and by the way, he doesn't have to

00:59:26.480 | do all or nothing. So the first step he should make is call the life insurance agent. He should

00:59:32.080 | ask for an in-force illustration showing him what's happening with the policy now, now that

00:59:37.520 | he's three years into it, what's going to happen this year, next year, the next 10 years, given

00:59:41.840 | whatever the dividend rates are of the company or given whatever the provisions are. So the first

00:59:46.880 | thing that he can do without actually touching the policy is he may be able to adjust his premium

00:59:53.200 | by looking at any riders or add-ons that he has. So sometimes someone will have some kind of

00:59:59.360 | aggressive rider system of additional purchase benefits or things like that, and if we drop that

01:00:04.240 | off, they might drop off $100 a month on a premium. And so look at any riders or options that he has,

01:00:09.520 | consider the cost of those, and maybe he doesn't want to have them. Maybe he bought the waiver

01:00:14.720 | a premium but doesn't need it anymore, and so that might reduce the expense down a little bit.

01:00:18.960 | The second thing to acknowledge is that he doesn't have to do all or nothing.

01:00:22.960 | So the life insurance policy can be reduced, and it can be reduced proportionally. So let's say

01:00:28.240 | he no longer wants to have a $500,000 policy, but he wants to have a $300,000 policy. He can

01:00:33.840 | reduce the face amount of the policy and just adjust it partially. He doesn't just have to

01:00:38.560 | surrender it. When it comes to his non-forfeiture options, here are the basic options. The first

01:00:44.240 | thing he could do is surrender the policy and take the cash value. That's step one, and that's the

01:00:49.120 | most straightforward thing. It terminates the policy, and he'll receive the accumulated cash value.

01:00:54.240 | That's the first thing. The second thing that he could do is he could take the policy reduced paid

01:00:58.560 | up. So he can say, instead of giving me the, I mean, $4,000 or whatever it is of cash value,

01:01:06.160 | instead of giving me the $4,000 of cash value, what if I just took the policy reduced paid up?

01:01:11.360 | How much whole life insurance would the $4,000 buy me? And that's an option. It's not going to

01:01:18.400 | be an exciting option because he has so little cash value, but when people get to higher amounts,

01:01:22.640 | then that's a good option. The third thing that he can do is he can take extended term insurance.

01:01:27.280 | And so he said basically the way that works is you take the cash surrender value, you tell the

01:01:30.960 | insurance company, "Hey, I don't need this money back, but how long of a period of term insurance

01:01:36.480 | would this buy from me?" So maybe the $4,000 of cash surrender value would purchase for him,

01:01:41.760 | say, 11 years of term life insurance at $500,000 for him. And so now he could be insured for the

01:01:47.520 | next 11 years in exchange for the $4,000. The other option is, of course, he can always take

01:01:52.320 | a partial loan against the policy. And he can do that even while he's continuing to make the

01:01:56.960 | premium payments. So if he needed, at this point, he doesn't have a lot of cash value, but if he

01:02:01.280 | needed a small loan, he could take a small loan out, use the money for some other financial goal,

01:02:06.480 | and then he could put it back in and keep the policy intact. Those are the options. He could

01:02:10.240 | do any or all of those options, and he can do them on a proportional basis, or he can do it on a

01:02:14.800 | total basis, depending on the specific contractual provisions of the contract. But what I would say

01:02:21.520 | from listening to what you say, if I'm coaching him, unless he has a clear and compelling use

01:02:27.200 | for the $4,000, I'm going to say keep the policy, and keep the policy at least a few more years.

01:02:34.960 | And the reason I say that is, number one, I don't think the policy is unsuitable for him,

01:02:40.560 | based upon what you've described. I don't hear any pressing financial goal that's not being

01:02:49.440 | met. And I would guess that within say four to six years, the policy will cross the break-even

01:02:57.360 | point. Those kinds of policies, it's often around year 10, year 11, I don't remember,

01:03:02.080 | but you could check that with a life insurance agent. And the break-even point, just meaning

01:03:05.760 | that he'll get back the full amount in his cash surrender value, he'll get back the full amount

01:03:11.200 | of money that he's paid in premium payments. So then, instead of having a net loss, he would

01:03:15.920 | at least be neutral, and he would only have a lost opportunity cost. But I don't hear any lost

01:03:20.880 | opportunity cost from what's being described. So I would probably fight to keep this one going,

01:03:25.920 | because I don't think it's unsuitable. He can decide based upon those factors.

01:03:30.080 | Okay. And if you throw into that, that he wants a slightly earlier retirement,

01:03:36.240 | let's just say 55, does that change any of the calculus at all?

01:03:39.760 | Not really. Again, we need to see what his other projections are. So not really. The policy could,

01:03:47.280 | so first thing for that, I would love to see the policy quick pay. And so I would take the policy

01:03:51.840 | illustration, I would see when it would quick pay. Definition of quick pay just means the dividends

01:03:56.000 | are sufficient to cover the premium payments. By the way, that's another thing he could do.

01:03:58.640 | I neglected to say that, but he could just take dividends. Usually, with policies like this,

01:04:03.760 | dividends are, any dividends that are credited are being used to make paid up, to buy paid up

01:04:08.320 | additions to the contract. But he can just change what the dividends are, the annual dividends are

01:04:13.360 | credited for. And instead of using the dividends to buy paid up additions, he can just turn the

01:04:18.720 | dividends to reducing the premium. And so that'll reduce his premium while still keeping his policy

01:04:24.240 | intact. So he should call the insurance agent and go over all these with the insurance agent.

01:04:30.480 | He should not be scared of the insurance agent. What often happens is guys like this, we're like,

01:04:35.040 | well, this insurance agent sold me a bad policy and I don't believe I should keep it and I don't

01:04:38.480 | want to talk to him because I'm scared he's going to push me over again. That's dumb.

01:04:42.000 | Call the insurance agent and say, I think you sold me a bad policy, I'm thinking about cancelling it,

01:04:46.080 | but I want you to go over it, go over my options with me again. This is, it's not a big deal.

01:04:50.480 | That's, insurance agents know that. So the insurance agent, well, that's disappointing,

01:04:54.320 | but hey, let's go over it. And he, the insurance agent will be able to make all these projections

01:04:59.280 | for him, go over each of the options, and then he could take that and have actual numbers instead

01:05:03.600 | of me doing it with just words on a podcast. And so at 55, if the policy is quick paying by then,

01:05:12.880 | then it can be really valuable. And I don't, I'm not here to sell insurance, but recognize that

01:05:18.880 | when insurance agents talk about insurance policies, they're not lying about the benefits of

01:05:23.760 | it. So having the money, for example, I was just, I spent this last weekend, I've been pouring over

01:05:29.920 | the FAFSA, the free application for federal student aid thing, really trying to make sure I really

01:05:35.120 | understand on a deep level, college financing and things like that. I've got a 10 year old,

01:05:39.280 | so I'm starting to make sure I really brush up on this. And one of the things that's really

01:05:44.960 | interesting is that things like the FAFSA, retirement assets are not counted, home equity

01:05:52.400 | is not counted for when calculating college need, neither is money that's in a life insurance policy

01:05:58.480 | or in an annuity. And so in a normal financial planning, I understand he doesn't have children,

01:06:03.040 | but in a normal financial planning, if you ask me as a father of children, would I rather have

01:06:08.080 | three or $400,000 in a life insurance policy, or would I rather have three or $400,000 in a taxable

01:06:16.720 | brokerage account? Well, from the perspective of something like college aid planning and need-based

01:06:21.440 | aid, which every college is going to be based on as a father of five children, give me the $400,000

01:06:26.160 | in the life insurance policy. That's much more valuable than having the money in the mutual fund

01:06:30.000 | account. And so these are not simple things where, oh, it's just absolutely I'll make more money in

01:06:34.400 | the stock market. It should have a holistic approach and be considered. So if he wants to

01:06:39.840 | retire at 55, I wouldn't ordinarily recommend life insurance as a primary funding mechanism

01:06:46.400 | for early retirement, but it can be a component of the mix. And so I would have to dig into that

01:06:52.400 | more. I don't see that this is an unsuitable policy based upon his increased income now. I

01:06:58.080 | don't see that it's unsuitable. So he can do what he likes, but I would say keep the policy now.

01:07:05.280 | You can always, all of these options are available to you next year. So unless you have an important

01:07:10.880 | alternative use of the 625 a month where you really need to do it this year, then look at

01:07:15.600 | what the cost would be, look at where the breakeven points are of the contract, and then go from there.

01:07:21.760 | I appreciate your answer, Joshua. I'll have him listen to this and then I'll see what he does.

01:07:25.680 | Up till this point, I just told him, hey, just hang tight at least till I can get some better

01:07:29.040 | advice from a guy I know. So thank you. Hopefully that helps him. And I would

01:07:31.920 | bet you, I would bet you, I'd put a whole $5 on this, believe me. But when I used to sell

01:07:37.840 | these policies, I would bang my fist up and down on the table, proverbially speaking. And I would

01:07:43.360 | say to you, I would say to you, the buyer, I'd say, listen, the only way you lose in buying this

01:07:50.960 | contract is for you to buy it today and then cancel the policy in two years. That's the only

01:07:58.240 | way you lose. So either don't do that, like don't buy the contract, or make certain that what you're

01:08:05.840 | buying, you're in it for at least a decade. Because the whole life insurance contract can

01:08:12.640 | work out fine and be very valuable in a decade, but all your costs are front-loaded in the first

01:08:18.480 | year. So the only way you lose is buying the contract and then getting out two or three years.

01:08:23.120 | And so he needs to, I would bet his insurance agent said something like that, but he doesn't

01:08:27.120 | remember, because nobody ever remembers. And everything that he talked about three years ago

01:08:32.080 | is fuzzy. So if he cancels it today, he will have had a very expensive mistake. But I don't think

01:08:37.600 | it's a necessary expensive mistake. He should acknowledge, all right, if I had to do this over

01:08:41.840 | again, I wouldn't have done it. But now let me make a fresh set of decisions. So hopefully that

01:08:46.640 | helps. Cavanaugh in California, welcome to the show. How can I serve you today? Cavanaugh.

01:08:53.520 | Hi, Joshua.

01:08:56.080 | Welcome.

01:08:56.720 | I called last week to talk to you about kids traveling, and you had some interesting things

01:09:01.680 | to say about that.

01:09:02.400 | And you said you were going to call me back and talk about my podcast about women working,

01:09:05.920 | right?

01:09:06.420 | I did.

01:09:07.520 | Wonderful. The floor is yours. Tell me what your thoughts are.

01:09:12.080 | Okay. So I guess I should start out by saying, I do think we probably agree on a lot. I'm a stay

01:09:17.600 | at home mom. I homeschool my kids. My husband works. I think it works really well for us.

01:09:21.200 | I agree that women should absolutely engage in leadership in the home, like you mentioned in

01:09:27.840 | your podcast. And I meant to go back and listen to it again before I called, but I ran out of time.

01:09:32.000 | So I'm doing my best. I wrote down a couple notes of what you said the first time. So I was like,

01:09:37.200 | I think I need to, I'm going to push back on this a little bit.

01:09:40.960 | Sure.

01:09:42.420 | I agree that strong, capable men will want a strong, capable woman. You talked about that.

01:09:45.940 | You talked about like some of the red pill stuff and how some of the guys were just,

01:09:49.300 | didn't want a woman who was going to engage in the home. And that that was, that's kind of what

01:09:53.460 | they deserve being like that is that they wouldn't get a capable woman by doing something like that.

01:09:57.380 | But I will say that you, I appreciate a lot of the things you said, but I wanted to

01:10:03.860 | gently suggest that maybe you missed the reason that so many women were upset by his speech.

01:10:10.740 | I think you saw a lot of people, the people that appreciated it were saying things like, well,

01:10:14.660 | he's so pro-family. But when you say pro-family, I wonder if he's kind of saying pro,

01:10:22.740 | the type of family he's suggesting really only existed post-industrial revolution.

01:10:27.060 | When you talk about women at home with kids and men working like that, just wasn't a reality

01:10:32.180 | until basically post-industrial revolution given, and you mentioned that a little bit,

01:10:37.380 | talking about like the history of farming families and wondering school houses. I mean,

01:10:42.660 | you got into the history of literacy and kind of that, but when prior to the industrial revolution,

01:10:48.740 | I think you saw a lot of more of an even split raising children. And I, so in Harrison's speech,

01:10:58.900 | he spends a lot of time like praising his wife and saying, oh, she's, she does so much for our

01:11:03.940 | family. It's so important. And I'm really glad that they have the ability to raise their children.

01:11:06.900 | She can gather so well and that she does such a wonderful job being at home. But what I think is

01:11:11.860 | concerning is that he sets up a dichotomy between the women being full-time at home and raising kids

01:11:19.300 | versus women in the workplace. I've been told plenty of times by people, cause we have five

01:11:26.100 | kids and people are always like, oh, it's the hardest job in the world. I could never be a

01:11:29.380 | stay-at-home mom. It's the hardest job in the world. And generally the type of people that

01:11:32.100 | tell me that are saying it really condescendingly because they have no desire to do something like

01:11:36.340 | that. And it's sort of a, and it's not the hardest job in the world. It's a job. It's a good job. I

01:11:40.420 | like it. I'm fond of it. I like raising my kids. I like being involved, but it doesn't mean,

01:11:45.140 | and when I say that it's not the hardest job in the world, it doesn't mean it's not important,

01:11:48.980 | but it's one of a lot of things to do. And I find that when people are telling me, oh,

01:11:54.980 | it's the hardest job in the world, it's usually people saying, giving the verbiage to, oh, sure,

01:11:59.140 | we respect this. But at the same time, like I would never do it myself. I'm just going to say

01:12:02.500 | it's the hardest job in the world. It means that you should do it. So, and it's a lot of mostly

01:12:06.580 | guys saying it to me. It usually means like, I would never do it, but you should do it. So I

01:12:10.340 | can go do something really important is generally how the conversation, they don't say it flat out,

01:12:14.340 | obviously like that, but that's kind of how it ends. So when he talks about being pro-family,

01:12:18.980 | I guess I would push back on saying that if he was really pro-family,

01:12:23.620 | it would involve both parents working together to prioritize family life over career and figuring

01:12:29.380 | out what that would best look like for their family. I think a lot of times it is going to end

01:12:32.420 | up with the wife working at home just because it's like biological realities. And there's a lot of

01:12:37.060 | reasons it might work better that way. But to say that this is his wife's life truly began. I've

01:12:43.620 | seen that quote everywhere. His wife's life truly began when she became a wife and mother. I think

01:12:48.500 | that's shortchanging his contribution because he talks about that there's a war on masculinity.

01:12:53.780 | And I think that a true masculine man who wants to be like Christ, which is what he talks about

01:12:59.540 | in his speech, would also be prioritizing his family over career, not to the lack of a career,

01:13:06.020 | but both husband and wife should be prioritizing their family. Does that make sense?

01:13:10.260 | Yeah, it does. Absolutely.

01:13:12.340 | Okay. So, and I realized that's kind of like a, it seems like a small

01:13:16.820 | contradiction, but at the same time, I kind of just kept seeing it over and over.

01:13:21.860 | Right.

01:13:22.360 | There was one more point I was going to just bring up, because you talked about

01:13:25.620 | there's a toxic culture towards men. Oh, let me see here. I'm sitting at home. I'm not

01:13:29.860 | as scared of interrupting. You can go ahead and answer that for a second, and then I'll keep going.

01:13:34.420 | Yeah, I'll start to respond, and then I'll go ahead and come back in a field

01:13:38.660 | feeder and interrupting when your child is taken care of. What I want to say, I think

01:13:48.420 | among fair-minded people, I really didn't want to release that podcast, because I'm very conscious

01:13:59.700 | of how hard it is to communicate effectively on these topics. I sat on it for a week and a half.

01:14:15.300 | That's fair. When you say fair-minded, I get the feeling that you, like my husband and myself,

01:14:21.140 | have a very fair marriage. My husband, and just based on things you said about your wife's

01:14:28.820 | postpartum periods and stuff like that too, that you're involved in child rearing. You're not just

01:14:33.940 | throwing it all on her to do by herself as she's raising the kids by herself, and you're off making

01:14:39.860 | the money, and you're involved in the family. That's how my husband is too. He encourages,

01:14:45.700 | he's able to take the kids and help take care of everything. You're not just putting all of the

01:14:51.780 | effort on her instead of taking care of it yourself. However, I think especially the more

01:15:00.260 | you encourage men to go out and work and women to stay at home, and you're not allowing for any more

01:15:04.100 | variance in between, it doesn't always work out like that. I'm again in the reformed Christian

01:15:09.140 | circles where you run into a lot of guys who then take that as license to like, "Well, I just

01:15:14.660 | get to run everything." I'm not saying that's right or that's what's encouraged by that,

01:15:20.260 | but I think it's a natural side effect of saying, "Okay, it's going to be better if women stay home,

01:15:24.740 | and it's going to be better if men go out and work." I think you just have to watch out for

01:15:28.020 | that as a natural side effect of encouraging that. Right. That's a very fair concern,

01:15:34.580 | I think, is a proper concern. Go ahead. I think you had another point that you wanted to raise.

01:15:42.500 | Go ahead if you have more. Otherwise, I can respond. Oh, I was just going to bring up Viet.

01:15:48.500 | He talks about the war on masculinity, and then he says to fix it that women need to be back in

01:15:54.260 | the home. I think that he's kind of creating a straw man. Not that there's not a toxic culture

01:16:03.060 | towards men, but when you say when that's the only thing you're referring to, and then saying

01:16:06.820 | women back in the home will fix it, you're ignoring that there's equally toxic people

01:16:10.660 | against women. Maybe that's not something he's aware of as aware of as a man. Maybe that's not

01:16:14.820 | something you're as aware of, but as a woman, I can absolutely say that it exists. I have one more

01:16:23.460 | thing to push back on when you're talking about women in the workplace. You mentioned that men

01:16:27.220 | are more likely to engage in performative acts for women as opposed to focusing and working

01:16:33.060 | on what needs to be done or whatever decisions need to be made. That I was also going to push

01:16:38.260 | back on because, one, I think it's a pretty low view of men that if women are out of the workplace,

01:16:42.180 | then they're going to perform better. I think that rather than saying, "Well, women, you should be

01:16:45.300 | in the workplace so men can work better," men should be held to a higher standard and say,

01:16:49.780 | "Well, then rather than just appeal to their base or instincts, then let's say we'll then

01:16:55.700 | work harder so that you are supporting women where they need to be." Second, that's not even

01:17:03.060 | statistically true. I was curious, so I Googled it. I wasn't actually sure. In all of the Fortune

01:17:07.860 | 500 companies, the ones that have more women in the leadership actually perform better in everything

01:17:16.900 | from sales metrics to – I forget all the metrics that they use. You can look it up.

01:17:22.580 | Yeah. It's a fair – I'm familiar with some of that stuff. I haven't taken the time to look into

01:17:30.260 | the data behind those articles and things like that. I'm happy to accept it at face value,

01:17:34.580 | although in today's world, I don't think we should ever accept statistics at face value,

01:17:40.340 | especially whenever those statistics align neatly with a convenient line of thinking.

01:17:47.460 | There's so many ways to manipulate data, things like that. I think – I don't remember exactly

01:17:53.220 | that point, but let's start there. Do you think your husband – do you think he likes

01:18:01.940 | working with women or do you think he would rather work exclusively with men?

01:18:09.380 | He has worked with women. He works in a job where he has lots of contractors and definitely some of

01:18:14.740 | them are women. He doesn't work at the moment closely with other women. He's pretty neutral on

01:18:21.700 | it. I ran all this past him and he laughed at me. He's like, "All right, fine. Go call and go on a

01:18:27.700 | podcast," and he just doesn't care to get involved in stuff like this. He's like, "I'll have fun.

01:18:30.980 | That sounds good." The reality is in today's world,

01:18:35.620 | there's not really any environment in which most of us have much of a choice. We're pretty much

01:18:42.180 | stuck in our current reality. Unless you work alone or do something like that, then we just

01:18:51.060 | all deal with the world the way it is. None of us – we're not going to go back to 1872, whatever

01:18:56.020 | that was like. It's hard to know what 1872 was actually like, but none of us are going to go

01:19:00.500 | back there, so we all have to deal with it appropriately. The reason I ask that is just

01:19:04.660 | that most of my life, I've worked with women. I've had female bosses all over across the board. It's

01:19:09.940 | kind of just the standard thing. I don't know of anybody today, any man today, who would exclusively

01:19:18.180 | work with men. If you get into some really physically demanding jobs like, I don't know,

01:19:23.220 | maybe being one of those guys you see on the internet who's literally working on…

01:19:28.340 | Underwater welding.

01:19:29.220 | Yeah, underwater welding or the guys in the oil fields covered in black goop while they're

01:19:33.940 | spinning chains around drill bits. Maybe they are in exclusively a masculine environment,

01:19:40.180 | but even all of the traditional male-dominated societies, it's all mixed gender now.

01:19:45.700 | I'm not here to complain, and I don't like to be kind of the negative guy about anything.

01:19:51.860 | What I've just discovered from personal experience, though, is that it's hard.

01:19:56.180 | It's difficult to interact with women when you're a man. It's difficult to do that knowing that you

01:20:03.700 | always have to take your basic normal instincts and then filter it for who is listening to you,

01:20:11.140 | instead of focusing just on the core of the message. If I'm together with a group of men,

01:20:16.580 | I don't worry too much about how I say things, because things like taking offense, things like

01:20:22.820 | tone of voice, things like that, it's pretty immaterial generally in most male relationships.

01:20:27.620 | When I'm interacting with women, I'm always much more careful about how I say something to be

01:20:32.260 | sensitive and to be thoughtful about how I express myself. I don't think that means that you can't

01:20:38.420 | have a productive team. Obviously not. That doesn't in any way mean that you can't have toxic

01:20:43.620 | men. Maybe a collaborative style of leadership does outperform. Maybe female-led companies do

01:20:52.020 | outperform. I've seen lots of that stuff. I'm skeptical of the data because I think a lot of

01:20:57.300 | the actual experience of it is tilted. If you look at a thing like contracting—and I think I said

01:21:03.860 | this in the show, and this is not a super important point, but I think it's something that's worth

01:21:07.300 | mentioning in a conversation about this—is that what I think bothers men is if women get special

01:21:14.180 | treatment. I've noticed that any time a woman can hold her own on the same level that men are

01:21:21.540 | judged by, that generally men will happily accept her. I know some female contractors,

01:21:26.980 | and I don't think that they have anything but total respect by men around. I've worked with

01:21:31.780 | female business owners, and they have complete respect by men around because they're being

01:21:37.300 | judged by the same standard. The challenge is that in our current society, in many areas of society,

01:21:44.020 | we don't judge people by the same standard. We judge men and women differently,

01:21:48.980 | but we don't acknowledge that we judge men and women differently. This is one of the things that

01:21:53.780 | is really turning a lot of men off to relationships with women, and it's really frustrating.

01:21:58.660 | If you look at some of the male conversation around this topic,

01:22:02.980 | then the men themselves are very frustrated because they're like, "My entire life,

01:22:08.180 | all of the resources, all of the focus, all of the effort goes to women, and they're the ones

01:22:13.940 | who get pushed and promoted, and they're the ones who get trumpeted everywhere, and now I'm still

01:22:18.340 | expected to be superior, and yet I had never had any of that support." I don't care much for

01:22:25.380 | complainy-pants stuff. Some of my heroes are Booker T. Washington and Dr. Drew and some of

01:22:32.100 | these guys, and so I don't ever, ever indulge any of the whiny-pants stuff that men today are doing,

01:22:38.500 | but it is important to look at. This is kind of a minor point.

01:22:43.060 | Back to families, though. I think it's hard to know how to articulate any topic,

01:22:49.700 | and what annoys me is that I wish we could always shoot straight up the middle,

01:22:53.380 | and we could say what we think, and we could mean what we say, and we could just say clearly,

01:22:57.380 | "Here's what I'm saying," but it seems as though society doesn't work that way. It seems as though

01:23:01.700 | there's always a pendulum swing, and that people get exceedingly on this direction,

01:23:07.780 | and then all of a sudden there's a correction, and it comes in the other direction, and everyone's

01:23:11.140 | always going too far instead of stopping the pendulum right in the middle.

01:23:15.780 | I think we probably do that similarly in terms of these topics as well.

01:23:25.940 | There's an element where it's absolutely true that men should be helpers. One of the ones that

01:23:34.580 | annoys me and annoys a lot of women, and a lot of men too as well, but when you say things like

01:23:39.060 | a father babysitting his kids, I don't say that, because I'm not babysitting my kids. I'm being a

01:23:44.420 | father. In terms of roles in the household and things like that, I think most of the stuff about

01:23:51.780 | who cleans the toilets and who cooks is silly. I've never seen a successful marriage relationship

01:24:00.500 | in which the guy was some kind of alpha male who says, "I never cook. You make me coffee," and

01:24:05.700 | all of that stuff. That's not how my family works. I do plenty of household work, and I don't feel

01:24:12.420 | like I'm somehow emasculated when I do that. That's my job, is I'm a father, and so I need to

01:24:17.300 | help and serve my family. That's my basic function. What I observe, however, is that we don't get to

01:24:26.340 | look at the extreme cases. We have to look at the normal cases. What I've observed is that,

01:24:34.500 | to the extent that we know or have any concept of what "traditional gender roles" are,

01:24:39.220 | there's a really simple compatibility that is often stamped out in today's world.

01:24:46.180 | I've stumbled across this video, I think yesterday, of this beautiful young lady who was

01:24:56.340 | cooking dinner. It was some TikTok video that was shared. The guy had come home from a 14-hour shift,

01:25:02.500 | and here's his beautiful young Latino girlfriend who's making him an amazing taco dinner at 11

01:25:08.260 | o'clock at night when he gets home from a 14-hour shift. There were thousands of comments, and every

01:25:13.380 | single comment was, "Wife her up. Wife her up. Wife her up. Don't lose her. Don't lose her."

01:25:18.740 | What I find astonishing is that young women often don't recognize how relatively simple it is to

01:25:26.660 | attract a great man who's going to appreciate you. Literally, just make him tacos at 11 o'clock at

01:25:32.100 | night. You don't need to earn $100,000 a year. Just make him tacos at 11 o'clock at night,

01:25:36.580 | and he probably will turn out to be an incredibly devoted husband to you.

01:25:40.100 | That doesn't make a rule about anything. What gets lost in our current environment

01:25:47.460 | is the appreciation that men and women are different, and there are natural compatibilities

01:25:54.100 | that really work well, and that these can work well for most people. I struggle to know,

01:26:01.380 | should I communicate about what works well for most people, or should I communicate about what

01:26:06.820 | works well for everybody? This is a real challenge of communication. I don't believe that all

01:26:14.980 | marriages have to work the same. I think it's perfect. There are many marriages and families

01:26:19.460 | that work great with husbands and wives that both have jobs, and husbands that stay at home,

01:26:24.500 | and wives have big jobs or big businesses. I think those can work. I know of a significant number

01:26:30.660 | of examples of those relationships where they're working beautifully, and I would never come in

01:26:36.980 | and say, "Well, you have to change these things." There are lots of things that can work.

01:26:41.300 | The challenge is, is that the norm? Is that the norm? Today, I would say the data pretty well

01:26:48.180 | indicates that, for whatever reason, what we're doing right now is not sustainable.

01:26:57.540 | Relationships are not being formed. The relationships that are being formed are not

01:27:02.980 | being continued. Families are not growing. Children are not being born at the rates that

01:27:08.100 | are necessary for the continuance of our civilization. So what the answer to that is,

01:27:12.580 | I'm not certain, and I think that it's an open question. Just at lunch today, I was talking with

01:27:18.180 | my wife about this question. I read this really fascinating Washington Post op-ed that a listener

01:27:22.900 | sent me. It was just published two days ago, and it was by Monica Hess. The title of her essay was,

01:27:30.900 | "Don't pin the birthrate problem on the birth givers. A lot of women don't want 2.1 kids. We

01:27:35.700 | need an economic model in which that's okay." She wrote this very interesting essay, but the most

01:27:40.740 | important thing that she said was where she talked about population decline. Here's one paragraph

01:27:46.900 | from it, where she said, "Plenty of researchers studying population decline have attempted to

01:27:52.100 | figure out what is happening to begin with. But unfortunately, it turns out the answer is that

01:27:57.140 | we really don't know. What we do know is that almost without exception, when women live in

01:28:03.220 | places that allow them access to birth control, access to education, and access to jobs, they

01:28:09.220 | overwhelmingly have fewer children. Even if, as in Taiwan, Russia, Italy, and Greece, the government

01:28:14.900 | literally gives women cash money for reproduction. Even if, as in South Korea, the government has

01:28:20.100 | been addressing the issue from every possible angle, including building a high-speed rail system

01:28:24.740 | designed to shorten commutes and make more time for family life. The only parts of the world where

01:28:29.300 | the birthrate seems to be steady, or increasing right now, are in places in which birth control

01:28:34.260 | is hard to come by, and where women's roles are relegated to domestic labor. It's almost as if,

01:28:39.860 | when women are given the chance to control their own reproduction, and when they have the education

01:28:43.940 | to have the option of working outside of the home, and when their society welcomes their

01:28:47.940 | contributions in fields beyond motherhood, and when they're paid for their work, it's almost as

01:28:52.820 | if leveling the playing field between women and men has allowed women to truly choose how many

01:28:57.460 | children they really want to have. That answer, for a lot of women, seems to be fewer. She goes on,

01:29:03.780 | but I thought that was such an insightful question that she raised, is that we need to be talking

01:29:10.420 | about these things broadly and consistently, and in good faith, going back and forth to understand.

01:29:18.340 | Maybe it is the case that women have been oppressed throughout history. Maybe it is the

01:29:25.460 | case that when women have education and are empowered and have birth control and whatnot,

01:29:33.220 | that they don't want to have babies. Maybe that is the case. Then why? Is there a sustainable

01:29:39.220 | alternative? Let me stop because I'm kind of rambling a little bit. I don't disagree with

01:29:44.740 | your comments. I think most of your comments sound to me just like the challenge of communication.

01:29:49.700 | Who are you communicating to and doing it one way versus two way? I do hope that we can continue

01:29:58.900 | in our own private circles and, when possible, in public to talk about them. I guess back to

01:30:04.020 | the point I was trying to drive is, should I talk to everybody or should I talk to the majority?

01:30:10.660 | Maybe at 60 percent or 80 percent of men and women would work really well in a situation in which

01:30:20.740 | the husband goes out and has a job and the wife is a stay-at-home wife and mother. Maybe it would

01:30:26.420 | be 60 percent where that would work well or 80 percent where that would work well. Maybe it's

01:30:30.340 | 20 to 40 percent where that wouldn't work well. I don't want to cut off that 20 to 40 percent,

01:30:34.660 | but what I observe talking to a lot of young people today is that they believe that they

01:30:39.460 | have to make everything up in life themselves. If you go and you talk to a 24-year-old fresh,

01:30:45.220 | new college graduate and you start asking him about his life, it kind of sounds like he's got

01:30:52.260 | to figure everything out. He doesn't really believe in religion and he's not so sure about

01:30:56.980 | religion, so he's got to come up with all of his own original religious ideas about what he thinks

01:31:02.740 | is right and what he thinks is wrong in the first place. He doesn't really believe in family,

01:31:06.580 | so he's got to think about does he believe in marriage, does he want to get married,

01:31:10.020 | and he doesn't really believe about gender roles. He's got to work it out individually. He doesn't

01:31:14.900 | believe about children. He's got to take each child and he can't have some preconceived idea

01:31:18.900 | about how to take care of a child, so he has to look to the child and have child-led parenting.

01:31:24.740 | He doesn't really know what to do with his work and it's just exhausting. It's an exhausting

01:31:28.580 | scenario. So could we figure out a really healthy way to say this is our culture, this is the wisdom

01:31:36.340 | of our cultures over the years that works. This doesn't work for everybody, but this works for

01:31:41.860 | most people and you should accept these things because it'll work for most people and help young

01:31:47.060 | people to kind of be on the fast track where they're willing to accept the wisdom of their

01:31:51.300 | elders and the society that birthed them and grew them rather than them having to make everything up.

01:31:57.460 | So that's what I wonder about is in our current scenario. Can we communicate that? Is that

01:32:03.380 | appropriate to communicate or is that wrong? So I'll let you say anything else you want to say.

01:32:07.380 | No, that's fair. I appreciate those thoughts. I thought it was funny when you were talking

01:32:11.540 | to the woman that wrote the letter and she was responding to whatever you'd said to young men,

01:32:16.420 | and I hadn't listened to that episode because I guess I'm not a young man, so I didn't care what

01:32:19.860 | you had to say to young men. But, and then to hear that then you were talking, as you're talking

01:32:27.860 | about choosing your audience and saying, well, I'm talking to young men, I'm talking to young

01:32:31.060 | women. Do I have to hedge what I say if I'm talking to young women? I guess I would encourage you not

01:32:38.660 | to have such a low view of young men that they can't listen to you talking to women because you

01:32:42.500 | said something in there about like, oh, well, I have to, if I address my podcast to women,

01:32:47.540 | men wouldn't listen. If I address my podcast to men, women will listen. And so that's a favoring

01:32:52.580 | point of women. And you're kind of like having a pretty low view of men thinking that they,

01:32:56.580 | whatever you have to say to women, isn't worth their time. So maybe just a point of consideration

01:33:04.020 | when you're talking about what's going to work for the majority of people, I think with the setup

01:33:10.260 | that you and I both have, works really well when you have a solid marriage. And I think you are

01:33:17.380 | pretty generous in assuming that the world has, that the vast majority of the world has a solid

01:33:22.260 | marriage that can stand one person not working. Cause that's a lot of, I mean, that's a lot of

01:33:29.300 | financial risk for that person to take, right? And I say that again, in the, I'm in a reformed

01:33:36.020 | Christian church. And for probably the last, I've been married for 15 years for 10 of those,

01:33:43.780 | the first 10, I probably felt exactly like you do. And I thought, you know, that there was,

01:33:50.820 | this is the best way to live. And that basically, if it works for me, it should work for the

01:33:54.740 | majority of people. It's only a small exception that it worked for. And then I would say over

01:33:58.340 | the past five years, I've encountered way too many situations of men who have been emboldened by the

01:34:05.620 | message that their job is more important than their wives, because, you know, lots of people

01:34:13.220 | can stay at home, but they need to go out and provide. And then, and I'm thinking of a situation

01:34:18.820 | where then as part of providing, he got addicted to uppers to keep him working and then ended up

01:34:25.860 | like leaving his entire family. And now she's been staying home for 10 years and has no way of

01:34:29.780 | supporting herself and her kids and doesn't have supportive family that can take over there. So

01:34:33.220 | she's stuck. And I, there's another very similar situation. And I've just like watched that happen

01:34:37.540 | too many times. And I'm starting to question, assuming that everybody is capable of having

01:34:42.020 | a loving marriage where two sides support. And I'm thinking that the unhealthy marriages are

01:34:47.220 | actually way more common in the world. This is a consideration when you're talking, when you're

01:34:50.820 | thinking about who you're talking to and hopefully you're not, that's not who your audience is made

01:34:54.420 | up of. And again, I, like I said, it's not nothing you've said makes me think that you're secretly

01:34:58.260 | a raging misogynist that is like that to your wife. And I assume you guys have a wonderful

01:35:01.380 | unmarried too and it's great and good for you. It's just a consideration about who you're talking

01:35:06.100 | to. Yeah. And to be, so I don't consider myself, I don't think of myself as an extremist on any of

01:35:12.180 | these things. So I think the reasons what you are exactly saying, I spent a lot of time thinking

01:35:17.140 | about should education, for example, should education be different for boys and girls?

01:35:22.660 | And on one element, I would say absolutely, or should be in terms of the way that boys learn,

01:35:27.540 | the way that girls learn, I would, I've taken an interest in boys' schools versus girls' schools.

01:35:34.500 | So anytime I can ask somebody who's gone to an all girls' school or an all boys' school,

01:35:37.860 | I always ask them about their experience. And it seems to me that it's probably not universal,

01:35:41.780 | but many people who are having trouble in school would often be better off if they were put into

01:35:46.820 | a boys-only school or a girls-only school. But it doesn't seem like that's a universal rule,

01:35:50.820 | but separately. But I've asked myself this question, do I think that education should

01:35:55.860 | be different for boys and girls? And my answer is no, I can't find anything that I think should

01:36:04.980 | be different about education for boys and girls, except perhaps for emphasis, not for actual

01:36:13.140 | details. And so the point you're saying is really important, right? I have a daughter,

01:36:17.700 | I have a wife, I'm responsible to protect these women that are under my care. And one of the

01:36:24.260 | things that's important is if my daughter gets hooked up with some deadbeat and she gets abandoned

01:36:31.940 | and she has three children or five children or something like that, I have to make certain that

01:36:36.820 | she is well-prepared. And so I simultaneously have to prepare her for a world of career excellence

01:36:44.900 | and employment and making money and a career of domesticity. And I have to prepare her for

01:36:52.020 | both of those things. And even with skills that are other things, I don't want my boys to be

01:36:57.940 | incompetent and not be able to cook and not be able to clean and not be able to take care of a

01:37:02.500 | baby. I look down on men who don't have these basic skills and abilities. I've been the man

01:37:08.740 | to receive all five of my children. So that tells you something about how much I care. I don't like

01:37:14.740 | the idea of, "Oh, I'm going to sit out here in the waiting room and let you... This is my family,

01:37:18.900 | these are my children." So I think we need to prepare for that. And there is certainly significant

01:37:25.700 | levels of abuse that happen. And in fundamentalist circles where people are hardcore, I think that

01:37:30.420 | that can many times lead to abuse. And that in many cases, women bear the brunt of that abuse.

01:37:36.100 | The question is this, can we properly protect women while also simultaneously properly protecting men

01:37:43.380 | and create a culture that is going to continue and expand? And anybody who can fix that

01:37:50.180 | is fundamentally going to be part of the future. But my fascination with birth rates and these

01:37:56.580 | issues from a birth perspective or from just a numerical perspective is simply that many of the

01:38:02.740 | cultures today that are the loudest will disappear because they're not able to reproduce. Whereas

01:38:09.140 | cultures that have a healthy balance will do that. So I consider the culture that I'm a part

01:38:14.980 | of pretty healthy. I don't personally know much dysfunction. I know some, but I don't know much

01:38:22.260 | dysfunction. In my family with my siblings, I don't know much dysfunction. Most people have

01:38:27.940 | healthy marriages and things tend to work pretty well. And so that's not to say that sin can't

01:38:33.940 | enter in and there's all kinds of sinful people and I'm never going to count against that. But

01:38:41.140 | I think that I'm from a pretty healthy culture, but it seems like to have a healthy culture,

01:38:46.660 | you probably need to have a strong emphasis, but not a mandatory rule. So my fight has always just

01:38:54.100 | been to say, let's appreciate mothers, let's appreciate women for what they do because I

01:39:01.860 | believe that it's worth it. And my wife's work, what she does, I don't think it's the hardest job

01:39:07.140 | in the world. I think that's dumb to say that it's not, but I do think it's important, an important

01:39:12.580 | job. And it's a job that to change the impact of her work would be pretty challenging to just

01:39:19.620 | replace it with money because not everything can be replaced with money. And I would simultaneously

01:39:24.180 | stand side by side with you and tell any father who's trying to build a career where he's just

01:39:30.020 | going to go off and make money. I hate, for example, I hate immigration for this reason

01:39:34.180 | because all around the world, all around the world, I wind up talking to men who left their

01:39:39.540 | wife and children in the Philippines and moved to Dubai to go and make money. And it's such a

01:39:45.540 | destruction of a father's responsibility and he is in no way fulfilling his responsibility towards

01:39:51.860 | his family just because he sends a paycheck home. So we should be fair-minded with that.

01:39:57.540 | But anyway, we could probably go back and forth all day. But at its core, it seems to me,

01:40:05.140 | back to just to finish, to respond to your comment about men and women

01:40:09.620 | and talking to men and women. I care about men. I care about women, but I care about men. And men

01:40:18.180 | are facing enormous issues right now. And you can see that in a way that we've never seen that

01:40:22.420 | before. And so we need people to speak to the issues that women face and help them to make

01:40:28.180 | good decisions. But we really need right now men to speak to men's issues and to do it in a not

01:40:35.060 | destructive, toxic way. And I hope that I can say a few words that help people in that. But

01:40:40.180 | I will undoubtedly do it imperfectly. So as I'm sure is the case with you and me, we have to

01:40:45.700 | listen to one another charitably, push back, clarify, and then try to figure out individual

01:40:50.340 | application, because all of us have different circumstances that we have to apply things to.

01:40:54.820 | So thank you for calling. And I welcome feedback at any point in time. And may you know great wisdom

01:41:02.580 | in pressing through your challenges. And may I know wisdom in the same.

01:41:07.140 | I appreciate that, Joshua. Thank you.

01:41:11.140 | Thank you very much. All right, Drew in Missouri, welcome to the show. How can I serve you today,

01:41:15.220 | Drew?

01:41:15.720 | Hey, good afternoon, Joshua. How are you doing?

01:41:19.380 | Very well, sir. How are you?

01:41:20.180 | Doing good. Been listening to your conversation. It's been interesting. So

01:41:27.540 | we are looking to the Mexico residency. We have an RV. I was on a consulting call with you about

01:41:34.260 | a month ago. And after listening, after that consulting call, then you had another episode

01:41:40.180 | with a close friend of yours that started to hear about that. Thank you for doing that commentary

01:41:45.300 | on that episode. That has led me down to the path of, if I go down to Mexico,

01:41:51.380 | have you ever looked into like, as a 40 year old man, that has been in the doctor in years,

01:41:58.180 | I'm on no medications at all, I feel great. But after listening to that episode, if there's like

01:42:02.900 | a full body scan MRI that I could do, just like maybe once every few years or something.

01:42:09.780 | And then I've tried to research this online, it's been a little hectic. It's hard to decipher which

01:42:15.460 | is a legitimate services to look into. We have six figures in our HSA account. So the cost isn't

01:42:23.300 | really a constraint. I'm just looking to utilize that as we move into our Mexico residency options,

01:42:30.020 | doing this as part of that, like a medical tourism.

01:42:35.860 | Understood. So I would say, first of all, I'm not a doctor. So I can only just give you general

01:42:41.060 | suggestions. But I would strongly refer you to those who would actually know what they're talking

01:42:45.220 | about, from a medical perspective, that's important. So from my layman's like, friend,

01:42:51.620 | friends talking over a cold drink perspective, I would say don't try to look into anything extreme

01:42:58.580 | until you do the basic stuff. And so the basic stuff would be to go and visit just a standard

01:43:04.900 | physician and get a basic checkup. And then I would say, ask the physician about what would be

01:43:13.620 | the important tests and things that would be good for a man of my age to start thinking about.

01:43:19.780 | Now, I have been asking this question for a good number of years, specifically about,

01:43:25.460 | you know, I'd love to have an evidence-based approach for knowing confidently,

01:43:33.540 | like what you should do at each age. I've looked for books. I've had a couple recommended to me,

01:43:39.860 | but I haven't found kind of an ideal one. I've looked at a few, but I'm sure they're good.

01:43:44.500 | But I would say you could start with just kind of standard, a few standard articles or

01:43:49.140 | chat GPT or something like that, and just say, you know, what should a guy of my age be doing?

01:43:54.340 | And so, you know, I would think, first of all, you would begin with a standard physician

01:43:58.580 | with just a regular checkup. You would talk to that physician about the status of what you have

01:44:06.740 | and what you know about your situation. I would think, certainly, you would consult a cardiologist

01:44:12.180 | because heart disease and heart attacks are a leading cause of death for people. That was what

01:44:18.660 | killed that client of mine, was a heart attack. And so, you would start with a cardiologist and

01:44:24.660 | just get an overview and do whatever the cardiologist recommends. And then, it's my

01:44:29.540 | understanding that the most important thing to be looking at is not just a one-time snapshot,

01:44:36.100 | but more importantly, the trends. And so, I've collected some data and suggestions on doing just

01:44:43.220 | things like regular blood panels. And so, I think one of the things that you should do is have a

01:44:49.060 | comprehensive blood panel. I don't know how frequently, maybe annually, at least annually,

01:44:53.220 | and recognize that if you're going from never having consulted with a physician to

01:44:58.500 | today, starting that process, everything you do is going to be an improvement. But at least an

01:45:03.940 | annual blood panel, a comprehensive blood panel, would be a good place to begin. There is a guy

01:45:10.980 | named Emigal, E-M-I-G-A-L, Emigal, who I've read his blog. And if you go to Emigal.com, you can

01:45:20.260 | find, for example, under his longevity guides section, where he has his comprehensive blood

01:45:26.580 | testing panel for longevity. And so, you can read through what the tests are that he wants you to

01:45:33.060 | give. And then, I would say the internet is a great resource for you to learn how to read

01:45:39.220 | those blood panels. And so, if I were in your shoes, I would take those blood panels, I would

01:45:44.020 | feed them into ChatGPT, then I would start going over them, and then I would start tracking them.

01:45:49.140 | So, the goal is not necessarily to see what they are specifically today, but to see what the trends

01:45:53.860 | are. So, start collecting the data, and start being aware of the trends of your own data,

01:45:58.420 | so that you can properly monitor the data from there. The other thing, then, we get into scans.

01:46:05.620 | I don't know, I'm not a doctor, I don't know the effectiveness of all the scans,

01:46:10.180 | things like that. I have read Emigal's contributions on it, and he is the guy who

01:46:18.020 | started the company that I learned about called Ezra. And that's his healthcare AI startup,

01:46:27.540 | where he's trying to detect cancer early using a full-body MRI, and then artificial intelligence

01:46:34.580 | to go over it. Is it good? Is it not good? I don't know. After I recorded those comments,

01:46:40.100 | a listener sent me an article or sent me some resources basically saying, "Hey, you got to be

01:46:46.580 | super careful of over-testing and over-diagnosis." I'm not competent to tell you. So, go your own

01:46:53.060 | pathway. But to me, it would seem like doing some kind of scan like that could potentially help you

01:46:59.620 | to get better early detection of cancer. But you should also do all of the stuff that your doctor

01:47:05.780 | recommends. So, you should probably do colonoscopies regularly and any other things that

01:47:10.740 | are recommended for you. And then you should have the data of just the consistent data for yourself.

01:47:17.780 | At its core, most of it is going to be based upon living a healthy lifestyle. And so, if you're

01:47:23.540 | living a healthy lifestyle, you're doing a lot, then it's just a matter of detecting something

01:47:26.900 | early. And if you're detecting something early, it would seem to me that blood panels and regular

01:47:31.460 | scans are probably the key to most detection. Beyond that, I'm way out of my element in any

01:47:38.980 | further comments. >> Awesome. I appreciate your

01:47:43.700 | insight on that. Am I last on your call list today? >> I got two more behind you. So, go.

01:47:50.500 | >> Okay. I'll hop off here then. I appreciate it, Joshua. Thanks. >> My pleasure. And I would say

01:47:54.100 | the key thing, as a man, just be paying attention. Men are famously averse to going to the doctor.

01:47:58.660 | Men are famously averse to following what the doctor orders. Women are much better about going

01:48:02.820 | to the doctor and doing what the doctor says. So, one of the reasons why they live longer than us.

01:48:07.380 | So, we need to be following through. And when you recognize how important it is, do it. And also,

01:48:13.620 | to your comments on birth tourism, I think this is a really good reason to do medical tourism.

01:48:18.980 | If it's hard to do in the United States, there's such a weird medical system in the United States.

01:48:22.980 | But if it's hard to do in the United States, you can certainly do this stuff going abroad.

01:48:26.740 | So, you can get concierge service in Mexico, and you can do all the stuff there. My friend,

01:48:33.220 | Mikhail Thorup from Expat Money, he does this in Panama City. He's super into this biohacking stuff.

01:48:42.020 | And he goes in, spends a whole day at a fancy clinic, and they take you. You have a personal

01:48:46.500 | concierge who takes you from here to there to the next thing and does it all for you. And so,

01:48:50.820 | I think this is where doing medical tourism really does pay off. But you need to have

01:48:54.820 | a basic plan to begin with. And the nice thing is, many times outside the United States, you can just

01:48:58.980 | order all the stuff for yourself. You don't need referrals. You don't need any of that stuff. You

01:49:02.020 | just do it yourself. So, good for you for paying attention to it. Man, Teresa, I think you must

01:49:06.420 | be my fourth caller from Missouri today. So, I've hit the nerve in Missouri. Welcome, Teresa,

01:49:11.300 | to the show. >> Hi, Josh. This is Brandon. >> Okay, Brandon. Well, the screen said Teresa.

01:49:17.620 | So, anyway, you're still my fourth caller from Missouri. Go ahead. >> I'm still milking my

01:49:22.180 | parents' color ID plant. >> Good for you. How can I serve you today, sir? >> Got a quick question

01:49:28.660 | for you about your book recommendation, Deep Nutrition. The author, Dr. Kate Shanahan,

01:49:35.220 | makes the argument in the first third part of the book that it is ideal for a woman to wait

01:49:44.020 | preferably three if not four years in between pregnancies for optimal health for offspring.

01:49:52.660 | This makes sense just from a practical perspective. I should note that I haven't read the rest of the

01:50:01.220 | book. I'm only a third of the way through, but I intend on reading the rest of it. But, obviously,

01:50:06.820 | I would say the vast majority of couples in America who get married in their 20s or 30s at

01:50:14.500 | this point, they're looking to have multiple children. They don't have the luxury of that

01:50:19.780 | kind of time before the woman reaches a point of infertility. So, how should we think about

01:50:29.540 | the vitality of offspring versus the quantity? >> Interesting question. There are probably two,

01:50:39.860 | I'm sure there are many approaches to that, so let me not limit it to two. So, for example,

01:50:45.460 | most people would have the approach just to say that husbands and wives have sex,

01:50:50.340 | babies come when they come, why worry about it, take it as it comes. That would be one approach

01:50:56.580 | that some people engage in. That's pretty uncommon, at least among my circles and probably

01:51:01.860 | your circles as well. One of the features of our modern-day philosophy is that basically we assume

01:51:11.380 | that childbearing is up to us. I think that that assumption is only true in some circumstances,

01:51:20.340 | that in many cases it's not up to us. So, it can't be planned as perfectly as we think it can be.

01:51:26.340 | Usually, I think this comes more from the perspective of infertility. I'm making a minor

01:51:31.460 | cultural comment here that I've talked to all kinds of young couples who just said, "Well,

01:51:36.180 | I have to worry about this. Are we going to use birth control or are we not? How are we going to

01:51:41.540 | plan our family out?" They have all these ideas and then they decide to start having babies and

01:51:46.020 | five years later they still have no babies. Their attitude is totally changed when you realize,

01:51:51.060 | "Wait a second, this is not necessarily up to us." So, that would be one approach.

01:51:55.620 | Another approach, you could take the technologist approach and you could say, "What we should do is

01:52:00.580 | we should store our sperm and bank our eggs and have all of our babies with implanted embryos

01:52:09.380 | that have all been genetically tested for optimal outcomes." So, you could take the high

01:52:15.140 | technologist approach. You could take the approach of, like you said, of having a perfect plan.

01:52:22.740 | Where I first ran into this was with the Domen people and Glenn Domen, who I read a lot of his

01:52:30.260 | stuff on Teach Your Baby to Read and early child education. He was big on making sure that you

01:52:34.580 | really maximize those years. So, I used to read all the Domen mom blogs and some of them were like,

01:52:38.900 | "Well, I need to make sure I have three to four years between my babies so that my babies can be

01:52:43.380 | absolutely perfectly educated in reading and doing advanced calculus by the time they're

01:52:49.140 | four years old. Then, I can go ahead and take another baby. Otherwise, I'll be shorting

01:52:52.660 | my children and their long-term outcomes and benefits." Then, you could take, as you alluded

01:52:57.460 | to, Dr. Shanahan, who says, "For the optimal health of the baby, the mother's body needs

01:53:01.140 | time to come together," and all of this stuff. So, I'll give you my answer, which is obviously

01:53:06.900 | what you're asking, but I'm just pointing out some of the things that happened. First of all,

01:53:09.940 | do you have any children today? We have one on our way. Okay. Congratulations.

01:53:15.860 | Here's my philosophy. Take them one at a time. What I mean by that is just the only people that

01:53:24.340 | matter are you and your wife. Take them one at a time. When I got married, I didn't set out to

01:53:31.380 | have a goal of having 18 children. I just took them one at a time. My wife didn't have a goal

01:53:36.580 | of having 18 children. I took them one at a time. So, if you take it one at a time and you recognize

01:53:42.900 | that the most important duty that you have, your fundamental duty and obligation, is to your wife.

01:53:48.020 | So, back to the earlier conversation from the lady who called in in response to what I said,

01:53:54.740 | as a husband, I believe one of the most fundamental duties that you have is to move

01:53:59.620 | together with your wife and to work together with your wife. If you and she are not in agreement

01:54:06.500 | about your children or your lack of children or your use of birth control or not use of birth

01:54:12.260 | control or the timing of your children or the number of children or things like that,

01:54:17.220 | you have to work together. And that means that you have to be on the same page. And so you interact

01:54:24.100 | and you work with her and you understand her position and you share your position and you

01:54:28.740 | don't move forward until and unless you are in agreement and you talk about it between the two

01:54:35.540 | of you. And the issues related to children are much bigger than just, you know, waiting three

01:54:42.980 | years between pregnancies. It's everything as far as what our family can handle, what our family

01:54:48.340 | can't handle. And different couples are going to have different experiences. You and your wife

01:54:56.820 | may only be able to handle one child, which makes the entire thing a moot point. Your best friends

01:55:02.420 | across the street, they may be able to handle 11 and be fine. You and your wife may be able to have

01:55:08.900 | a baby every 18 months and she's just the picture of health. Your friend across the street, she

01:55:14.580 | might only be able to have a baby every five years and barely recover. Everything is subjected to

01:55:22.340 | this. And so everything from natural birth to C-sections, if a woman has multiple C-sections,

01:55:27.860 | it becomes very risky for her to have many children. And there's just so many more elements

01:55:33.860 | as far as the age of the children, how strong you are as parents versus how overwhelmed you are by

01:55:39.700 | your children. Are your children getting the attention, the care, the time, and everything

01:55:44.100 | that you receive? So the only answer I'm going to give is that you talk about it together with

01:55:50.420 | your wife and the two of you come to an agreement. And you should be able to have enough experience

01:56:01.060 | together in the fullness of time to understand what's necessary. But if I'm a husband and let's

01:56:06.980 | say that I observe that my wife is struggling physically. My wife had a bunch of dental

01:56:12.420 | problems after one of the babies and we think it was probably due to not sufficient nutrition and

01:56:17.540 | to the baby basically sucking vitamins out of her bones. And so we needed to improve some things.

01:56:24.020 | If I observe that my wife is physically not strong and that she's not physically completely

01:56:31.780 | rested and recovered from childbirth, I don't want to have any babies. I don't want her to

01:56:36.820 | be overwhelmed. And if she's not confident about it, then I don't want her to be in that situation.

01:56:42.660 | So my answer is simply to say that in the intimacy of your relationship together with your spouse,

01:56:49.620 | the two of you talk about these things and you come to an agreement. And it's nice to be informed

01:56:54.820 | by what people say, but most of my babies are two years apart, so I'm not following Dr. Shanahan's

01:57:01.860 | advice. But that's not the only thing, right? There's all kinds of things. So the other component

01:57:06.020 | I would just say is that for me, having babies has always been a matter of faith. And that faith is

01:57:12.820 | not—when I use the word "faith" in this context, I don't mean like kind of just screwing up and

01:57:18.100 | believing in something, as some people interpret the word. I mean coming to a place of confidence

01:57:24.020 | and my trust in God and my trust in the outcome that I'm willing to have a baby. My wife and I

01:57:30.820 | are not young anymore. And so as we get older, if we have children, there's an increased risk of

01:57:36.820 | handicapped children, various disabilities, things like that. And I have five beautiful,

01:57:42.660 | healthy children. And you think, "Man, you know, what's the risk about having a handicapped child?"

01:57:48.660 | And I don't really want a handicapped child. And so if I were to have a baby, I would have to come

01:57:53.300 | to a place of faith and confidence just to say, "I'm willing to do this." My wife has to come to

01:57:58.260 | that as well. So I would just—I would want to encourage you very strongly, take somebody who

01:58:04.020 | gives a philosophy. You know, I try to make an argument, an apologetic for, "Hey, let's have a

01:58:09.540 | lot of children. Let's have a lot of grandchildren, great-grandchildren." But I'm assuming and

01:58:14.020 | explicitly saying now that you should take whatever's inspiring to you about that,

01:58:20.500 | and you should go back to the relationship with your wife and your own confidence and your

01:58:25.060 | relationship with God, and you should make whatever decisions there that are appropriate to your

01:58:29.700 | family. Take external input, external encouragement, and then re-filter it within your own

01:58:34.980 | personal context. Take them one at a time. I don't see any other solution other than just take them

01:58:40.820 | one at a time based upon where we are, what we can handle, what we can't handle, how we're doing,

01:58:45.220 | and then go from there. And don't worry about kind of any of that long-term philosophy stuff.

01:58:49.220 | Appreciate it. I think that's what I needed here, Joshua. Also, I loved your podcast episode on

01:58:55.700 | employment at work. It was fantastic. Good. Thank you. I'm glad that it was helpful,

01:58:59.940 | and thank you very much. Peter in New York, you're going to round us out today. Welcome. Thank you

01:59:04.740 | for being patient. How can I serve you today, sir? Hey, Joshua. How are you? Very well. I have a

01:59:11.860 | quick question about consulting, but can I give a 30 seconds on the caller too before who asked

01:59:17.700 | about screening? Please do. Yes. I saw your name, and I should have brought you on live to that.

01:59:24.740 | Well, I don't know how helpful it would have been, but so I'm a urologist, so I am a doctor.

01:59:29.380 | We do do some screening mainly for prostate cancer, but just, you know, at a high level,

01:59:36.660 | when you're talking about what he's talking about is screening for illness that he doesn't have yet

01:59:40.660 | as opposed to treating a condition that he has. And so when you're talking about what we call

01:59:47.380 | the primary prevention of disease, preventing it before you get it, it is very complicated,

01:59:53.460 | and there are a lot of different things that you can try to primarily prevent.

01:59:57.860 | When it comes down to it, there are guidelines that are out there for, you know, the broad

02:00:04.340 | physician community and then within sort of specialties as well about what screenings are

02:00:08.820 | age appropriate for what people at various ages, and most of them relate to screening for cancers

02:00:13.860 | like breast cancer with mammograms, prostate cancer with PSA testing, lung cancer with chest

02:00:18.740 | CT scans, colon cancer with colonoscopy, et cetera, et cetera. But things like immunizations

02:00:24.100 | fall in there, smoking cessation, physical activity, good diet, et cetera, et cetera.

02:00:29.220 | So, you know, to the executive physical panel of blood tests, full-body CT, full-body MRI,

02:00:35.220 | I'm not an expert on this. I've had friends ask me about it, and I've looked at it with the data

02:00:39.700 | that's out there. You know, when it comes to those things, there's pros and cons, and it's difficult

02:00:44.660 | to say to the population whether that's appropriate or not. But there are things like cholesterol

02:00:50.740 | screening or sexually transmitted infection screening for certain populations, blood

02:00:55.300 | pressure screening, diabetes screening, visions, whatever, you name it, that are broadly applicable

02:00:59.780 | to the population, and most of that can be found online, actually. And a good resource is something

02:01:05.780 | called the U.S. Preventive Services Task Force, and they promulgate guidelines on everything for

02:01:12.260 | adults, kids, children, pregnant women, et cetera. And, you know, the documents are dense,

02:01:17.540 | but when it comes down to it, I think a lot of people bias the detection of disease over the

02:01:22.660 | harms of screening that exist. And I can really speak only in my field, you know, prostate cancer

02:01:28.980 | screening, about 10 or 15 years ago, this task force gave it, they give them letter grades,

02:01:34.260 | A, B, C, they gave PSA screening for prostate cancer a D, not because it has been helpful

02:01:40.100 | in reducing prostate cancer, that's what it has, but the further workup of abnormalities led to so

02:01:45.540 | many problems that the benefits were outweighed by the problems of further workup. And, you know,

02:01:50.260 | that has shifted over time, but one of the big negatives of full-body CT or MRI is the detection

02:01:55.860 | of incidental findings that are meaningless that create either stress or other tests that don't

02:02:00.500 | lead to an elongation of life or better health outcomes. And so I think patients often think

02:02:06.020 | every time you find something you're going to live longer, but we as doctors see the downside

02:02:10.260 | of detecting diseases that are meaningless or breed concern, or frankly, lead to complications

02:02:16.020 | in their further workup. So, you know, whether you get a full-body CT or MRI, that's not broadly

02:02:20.980 | suggested for the population right now, but things like, you know, that guy getting his

02:02:24.660 | cholesterol check probably makes sense. So. - So I pulled it up, it's the U.S.

02:02:28.900 | - There's my two cents. - Yeah, U.S. Preventive Services

02:02:32.020 | Task Force, and they have on their website, they have published recommendations,

02:02:36.500 | recommendations in progress. - They got it all.

02:02:38.180 | - Perfect. So this is a good place to look for info.

02:02:40.500 | - And these things change, you know, and they'll say, you know, we did this document last 10 years

02:02:44.820 | ago, and these are the updates to the document as our knowledge base changes. And they'll give

02:02:50.020 | a recommendation, A, B, C, D, letter grade as to whether people should do that type of screening.

02:02:54.580 | So that's probably in the United States, the single best resource that exists for people

02:03:00.020 | to find answers to what they should do at what age.

02:03:02.020 | - Thank you. One question related to that. So it sounds like what you're saying broadly

02:03:08.660 | agrees with what I said that, you know, having, tracking your blood pressure, tracking your

02:03:13.380 | cholesterol, things like that, I don't see any harm, any potential harm from that stuff.

02:03:17.460 | With regard to things like full-body MRIs or CT scans or whatever it winds up being,

02:03:24.420 | would the concern about harm mostly result from false diagnosis or mental stress due to an anomaly

02:03:33.380 | that doesn't actually turn into something? Or do you think that there's some reason to

02:03:37.300 | be concerned about the actual physical procedure itself causing harm?

02:03:42.020 | - So I think, so let's take something that would be easier to extrapolate. So let's go with full-body

02:03:49.540 | CAT scan because it exposes people to ionizing radiation. So theoretically, if you applied that,

02:03:56.580 | so screening by definition means you're taking people who have no symptoms of disease and you

02:04:02.180 | are trying to identify a disease before it would be symptomatic. And if you diagnose it and have

02:04:08.820 | an intervention, it will then lead to some improved health outcome, which usually we think of as

02:04:14.740 | living longer. So the classic is if you smoke, and I don't know the amount of time that they do it

02:04:21.060 | now, but if you were a smoker of some length of time, they recommend, I don't know the age 'cause

02:04:25.940 | I don't do this, let's just say it's 50, but there's a recommendation you get a screening CT

02:04:30.340 | scan of your chest at, let's say it's age 50 is the age, if you've smoked 20 pack years. And that

02:04:37.540 | leads to an increased rate of detection of early stage lung cancers, which has dropped the lung

02:04:43.620 | cancer fatality rate. So it used to be, there was no effective screening for this chest x-rays

02:04:49.220 | weren't sensitive enough. And now if you smoked X amount, your doctor will put you through this,

02:04:53.140 | you'll find a lesion and it leads to some improvements, but you also find some lesions

02:04:57.300 | that are nothing that then lead to more chest CTs or people are nervous. And we find these all the

02:05:02.180 | time on other tests, people who have no risk of lung cancer really, you find small lung lesions,

02:05:06.180 | they freak out, they need a chest CT and they're nervous. So let's go back to full-body CAT scan.

02:05:10.340 | So let's say you take a population of healthy people and you expose enough people to a full-body

02:05:14.340 | CT scan, you will induce some de novo malignancy that somebody would not have gotten absent the

02:05:20.500 | radiation exposure. Now, I don't know how many people you would have to expose and what malignancies

02:05:25.460 | would be and what would happen to them, but that would be an example of a harm that you would

02:05:29.460 | induce on a healthy population by the exposure to the test. I think MRI is probably generally

02:05:35.140 | perceived as safer and there's probably less of an obvious risk. Although if you did them

02:05:39.540 | on enough people, you'd probably find something. So I think that the risks of screening with that

02:05:45.140 | and the reason why it's not widely suggested, I mean, number one, it's impractical. You know,

02:05:49.860 | CTs and MRIs, there are only so many machines and they're used for people with problems for the most

02:05:54.260 | part right now. So, I mean, you could fix that, but if you tie up every MRI machine in the country

02:05:59.060 | with people getting whole body screening, you know, you don't have machines able to deal with

02:06:02.740 | someone who's coming in the ER with a stroke or who's getting a malignancy worked up. So that

02:06:07.540 | there is some impracticality, but the issues are in two directions. So number one, you can have

02:06:11.940 | false positives. So you find things that turn out to be nothing. And there's actually a name for

02:06:16.580 | imaging on imaging, what are known as incidental omas. Omas is a, you know, the suffix for tumor.

02:06:23.060 | So they actually call like incidental masses in the adrenal gland in the medical literature are

02:06:27.700 | called adrenal incidental omas and they're present in 1% of adults. And so there are other lesions

02:06:33.700 | that you find incidentally that are of no health consequence, but breed stress may lead to other

02:06:38.340 | imaging tests, may lead to biopsies, may lead to surgery and may not change anyone's health outcome.

02:06:43.540 | And, you know, you do enough of that on enough people, you get complications of those other

02:06:48.340 | things. And, you know, it doesn't happen to the average person very often, but if you're a doctor,

02:06:53.620 | you might see it. And certainly if you look at the population, you see that. So you can get false

02:06:57.060 | positives. You can also get false negatives. So you could have, let's say you do a full body MRI,

02:07:01.380 | you find nothing, you could be lulled into a false sense of security that you don't have a

02:07:05.380 | problem that when you, let's say you get a cough, it doesn't go away a year later, you don't get

02:07:08.580 | evaluated. So it goes by directionally. The other thing is there, there are each test that you

02:07:14.340 | subject people to there's false positives and false negatives. And those tests have a range

02:07:19.140 | of characteristics that they work within where they can either detect things when people are sick,

02:07:23.940 | or they don't detect things when you're healthy. And those are known as the sensitivity

02:07:27.860 | and specificity of an individual test. And so when you're doing screening, what you need are

02:07:32.900 | tests that are what are called highly sensitive, which means they never miss abnormalities,

02:07:38.020 | but what you end up getting then is a lot of false positives. So the classic example is,

02:07:44.020 | is the HIV test. If you have a low risk population that you just draw blood on a screen for HIV,

02:07:49.780 | most positive results are false positives as opposed to people actually having HIV.

02:07:54.500 | And there are other ways to prove that's not what they have. But this is one of these things in med

02:07:58.580 | school, like first year of med school, they teach you about test, testing dynamics and screening.

02:08:03.860 | And, you know, you go to the doctor, you think every test, well, this is the result. Well,

02:08:07.460 | every test has a range, it works within a sensitivity and a specificity. And there's

02:08:11.700 | something called the pre-test probability of a test being abnormal. So if you come in to see me,

02:08:16.580 | you know, I have my, my odds making in my head that you have a certain diagnosis. And then when

02:08:21.140 | I order a test, I, there's a probability that you have the disease I'm testing for. And all those

02:08:25.620 | things come out to, you know, spit out where you come to diagnosis and treatment. And it gets

02:08:30.420 | complicated statistically, but there's a thing called Bayes' theorem, which I'm sure you're

02:08:33.940 | familiar with, but it comes into play with the patient you're seeing, what's the probability

02:08:39.140 | they have an illness. And then you go run a test. What's the test sensitivity and specificity and

02:08:43.380 | how reliable is the test result? So it's sort of a long exposition.

02:08:50.900 | No, it's really, really fascinating. So I have one more clarifying question you can deal with

02:08:55.460 | shortly. So from what you're saying, the usefulness of comprehensive imaging would be

02:09:03.220 | debatable. Maybe so, maybe not. We don't know. Right. Possibly harmful, possibly helpful. We

02:09:09.300 | don't know. As I hear you, the usefulness of call it just standard, you know, checking your blood

02:09:15.700 | pressure, listening to your heart with a stethoscope, these basic things incontrovertibly

02:09:21.700 | important, no harm coming from them. Obviously this should be done. You should, you know,

02:09:26.260 | check your blood pressure consistently. So then the question regarding blood panels, I don't see

02:09:31.540 | any harm of having a history of comprehensive blood panels. I can only see help from that,

02:09:38.180 | not harm. Would you agree? Is that, is that fair or is there harm that I'm just not, I don't know

02:09:43.060 | about? So I can't speak authoritatively to everything, but I think that there are certain

02:09:50.820 | tests which are of benefit for screening purposes. Again, you're talking, you don't have a problem.

02:09:57.140 | Obviously, if you have a problem, running tests is designed to sort it out. You know, you come in

02:10:01.860 | with, in your jaundice, you know, running liver tests obviously is crucial. I can't tell you off

02:10:06.740 | the top of my head the utility of getting a screening, complete blood count or a basic

02:10:12.180 | metabolic panel, which tests your kidney function and electrolytes or, you know, doing liver tests

02:10:18.340 | in the average person. There is information about that out there. I think the reality is the

02:10:23.540 | benefits of those are probably pretty marginal to the average person who feels fine. And, you know,

02:10:30.340 | getting blood drawn is not high risk, but you know, you do it enough and you nail some, you know,

02:10:35.540 | someone's on our nerve and they get a numb hand and people get bruising and, you know, people get

02:10:40.340 | scared of needles and have a nice weekend and, you know, stuff like that happens. But, you know,

02:10:46.740 | I would say firmer ground would be screening for diabetes with either blood or urine testing at a

02:10:53.300 | certain age. I don't know off the top of my head the specifics for that, but there's better evidence

02:10:57.780 | for that. But, I mean, to be honest, if you draw, let's say you drop 20 blood tests, the chance of

02:11:07.620 | a lab error or some anomaly that's medically irrelevant by chance alone is pretty high

02:11:14.900 | on that panel of tests. So, like I said, I can't speak authoritatively to a lot of that, but

02:11:20.900 | cholesterol screening is one thing where there is evidence that it's beneficial

02:11:25.860 | and they do break it down by your age and your history. So, I mean, that's even something like

02:11:31.620 | in your 20s, getting your cholesterol checked, if you're even a low risk of heart disease,

02:11:35.940 | there is benefit to that. And they've got, you know, statements on that. But yeah, I think the

02:11:41.620 | reality is, is that I think a lot of patients overestimate the benefit of a lot of these things

02:11:48.980 | and their actual benefit is, I mean, even the annual physical, I think can be somewhat debated.

02:11:55.460 | You know, if you're talking about specific things like screening for cervical cancer with pap smear

02:12:00.820 | and, you know, HPV testing, if you're talking about getting a mammogram, if you're talking

02:12:04.900 | about a colonoscopy, you're talking about, you know, these other specifics, that's different.

02:12:10.020 | But just, you know, the benefit of these individual components of the once-over,

02:12:16.900 | I think a lot of it is frankly debated. - Yeah, that's good because I would be one

02:12:22.900 | who, as a non-educated layperson, I wouldn't think about the potential harms, which is why

02:12:30.980 | I appreciate the listener who brought the comments up and you yourself. So, that's good. Well, I'll

02:12:36.580 | continue to follow this and hopefully 10 years from now, we'll have more evidence and can make

02:12:40.260 | better recommendations. In the meantime, what we can all do is do what we know to do.

02:12:45.140 | We just did that. We'd probably get better outcomes. So, go ahead with your question

02:12:48.740 | or comment related to the reason for your call. - Sure, yeah. So, I think I know the answer. So,

02:12:54.420 | I do, in addition to my day job, I do a lot of sort of side consulting stuff through different

02:12:59.700 | groups. And when I started doing this, a lot of what I did was through groups that have a variety

02:13:10.660 | of different consultants in different industries and then they'll get usually either finance firms

02:13:14.260 | or consulting firms will come to them to get an expert in a specific area and then they will

02:13:19.220 | engage you in a one-time, one-hour call to talk about stuff and get compensated for it.

02:13:23.700 | As I have gotten older in my career, I am finding that I am getting inundated by all these groups

02:13:32.260 | with completely irrelevant stuff and my degree of engagement in those things is diminishing.

02:13:39.060 | However, every now and then stuff still sneaks through and I think the problem is the way they

02:13:43.860 | screen has gotten loose and they're just, you know, they don't match me up with stuff that's

02:13:49.140 | my expertise anymore and I don't think they're capable of tightening it up. So, the question

02:13:53.460 | I have is how harmful would it be to just unsubscribe from all these things and lose

02:14:01.700 | any ability to get that revenue stream at this point? - How significant is the current revenue

02:14:07.940 | stream? - I mean, from all of those things combined is maybe a couple grand a year.

02:14:15.060 | - That doesn't seem like a big harm to what I'm projecting to be your overall finances.

02:14:20.980 | If you weren't inundated, if you weren't getting those kinds of requests, could you make a few,

02:14:27.540 | take your time for it up and make just a couple few contacts, let's say, with somebody who would

02:14:34.500 | be really good for some expert witness work or some really targeted consulting work? Is it

02:14:39.860 | harming you to deal with these inappropriate questions in some way? - For the most part,

02:14:48.340 | no, because I usually just delete most of these things and if I ever get one that's decent,

02:14:51.540 | I just, I screen them and go through that, you know, I'll look at the questions and see what

02:14:55.620 | they want and, you know, the hit rate's pretty low. I've got other more lucrative consulting

02:15:00.020 | things that I do, so this is a small part of it, but it's, I guess the real question is how

02:15:06.020 | important is it to seek out every single opportunity to make a couple extra grand?

02:15:10.180 | I guess that's really the question. - I would see it as probably of limited importance if you know

02:15:15.300 | that it's not going somewhere. So the reason that, just kind of the basic philosophical reason you

02:15:21.140 | want to clear detritus out of your life is so that you're free to focus on the high priorities

02:15:27.620 | and the guy who goes after the high priorities with a laser focus is going to be ultimately the

02:15:34.340 | most successful. At the beginning of the call, I think you were not on yet, but I received a

02:15:37.940 | first or second call today, was a question from a young medical school graduate who had, was not

02:15:44.980 | matched during the residency process and he's talking about, you know, what do I do? And my

02:15:50.260 | answer to him was you need to be laser focused on making certain that when next year rolls around,

02:15:55.940 | you get your residency. And so you need to get rid of everything else except this most impactful

02:16:02.260 | thing. You don't want to go off hiking the Appalachian trail right now. You need to be

02:16:05.860 | focusing on fixing the problems with your board exam scores. You need to be focused on fixing the

02:16:11.220 | problems with your interview skills, with your essay writing, whatever it was, you got to fix

02:16:14.900 | that stuff. And so drawing from that for listeners who heard the earlier call, what I would say is

02:16:19.540 | philosophically, we want to be really focused on our top opportunity or our top couple of

02:16:24.580 | opportunities. And anything that's not that can be distracting to us and keep us from something

02:16:30.340 | that's superior. So it may be that the actual time involved with deleting emails consistently

02:16:37.060 | and just answering one a month, okay, the actual time may not be all that significant,

02:16:42.580 | but maybe that's draining like the mental reserves where you're thinking, oh, my backup plan is I

02:16:48.500 | could do this expert consulting work and I've got a really great system. But in reality,

02:16:52.820 | if you said no to that couple thousand dollars and you challenged yourself to say,

02:16:57.780 | what would be a much better option? Maybe there's another type of approach and it might be in

02:17:03.460 | medicine where now I could add $100,000 to my income. Maybe this is the year I can write the

02:17:08.420 | book on evidence-based prevention for urology. Or maybe this is the year that I can do cutting edge

02:17:15.380 | research in something and really advance forward or something totally outside of medicine.

02:17:21.460 | So the only framework that I would use to answer it would be getting rid of the little stuff so

02:17:27.300 | that you have bandwidth for the big stuff is usually the best pathway of success because it

02:17:35.060 | keeps you focused on the big opportunities that lead to the big wins. And those things often don't

02:17:41.220 | come when you have a busy cluttered mind. >> Got it. Well, I think I'm going to

02:17:46.580 | unsubscribe. I've got much higher value opportunities that I get hits on all the

02:17:51.060 | time. Don't clutter the inbox that I deal with. So this will be easy to just get rid of them.

02:17:55.780 | >> So the bigger application for you to take away from this call would be, all right,

02:17:59.140 | well, that's pretty easy to just unsubscribe from the emails. Maybe it's easy. Maybe it's

02:18:02.900 | not easy to get off their list. But going back to your main priorities, let's say you have

02:18:09.860 | category A, which is big money, category B, which is pretty big money, category C,

02:18:14.900 | which is pretty big money, and category D, which is a lot more than this, which is category G.

02:18:18.420 | But you might need to get rid of category D as well, where, okay, this is something that makes

02:18:24.020 | me $24,000 a year. But that might be distracting you from the thing that could make you $240,000

02:18:30.820 | per year. So I'm not imposing that on you. I'm just saying that the framework is, let me figure

02:18:36.500 | out what my best opportunities are. And I probably can't effectively handle more than a couple of

02:18:41.940 | good opportunities. But by being really focused on the handful of really high-value opportunities,

02:18:48.020 | that's where my biggest wins can come from. So I need to be pretty ruthless about clearing my

02:18:52.500 | schedule of the other stuff so that I have the ability to always focus on my biggest opportunities.

02:18:57.860 | >> Got it. It sounds like I should have tuned in earlier to help that kid who didn't match.

02:19:03.940 | It happens. It usually works out. That's what I can say. It usually does work out.

02:19:10.660 | >> It sounded like to me that if he could just... It sounded like he was on the edge. So if he could

02:19:14.740 | just improve a few things around the edge, then... And it may have been a fluke. He wanted to be an

02:19:18.340 | emergency medicine physician. He said there was a lot this year. So maybe next year there'll be a

02:19:22.660 | smaller class and he's in. But we got to work at it. So thank you very much for the call. And I

02:19:28.100 | appreciate the extra advice, even around those subjects. Thank you all for listening to today's

02:19:33.460 | Friday Q&A show. That ends today's show. In closing, I just want to encourage you. I really

02:19:38.580 | love the feedback and I really appreciate it. I don't keep comments open on the website.

02:19:44.180 | So this is actually a really great way. If you agree with something, disagree with something...

02:19:49.380 | Oops. Wrong music. I was going for music and I hit the wrong one.

02:19:53.620 | If you agree or disagree with something, I would really appreciate it. Just call in,

02:19:59.380 | talk about it. It makes for a really interesting conversation among the community here. And as

02:20:03.220 | always, I don't say this every day because I think it's dumb to say this every day. But

02:20:06.980 | here is a basic framework for any kind of advice and any kind of input that you ever hear.

02:20:12.980 | Take what's useful, discard what's not. So just take in any idea, any comment that's useful,

02:20:20.820 | and then get rid of it. When you disagree with something, as I frequently do with many people,

02:20:27.220 | disagree with something, but use it as a chance to say, "Wait a second. Why do I believe what I

02:20:32.020 | believe and can I make a good defense of that?" And then in so doing, in the fullness of time,

02:20:36.740 | we can find truth, we can find the reality that gives us the best long-term outcome.

02:20:42.180 | And so disagreement is fine. Healthy individuals should be able to disagree with things.

02:20:46.020 | And what I'm very glad, what I hope to continue to encourage, to cultivate is

02:20:51.140 | that you and I can be an example to the world where we can talk about important topics,

02:20:57.380 | we're going to discuss them imperfectly, we're going to ramble a little bit sometimes,

02:21:00.740 | we're going to get a little bit wordy, we're going to say the wrong thing, use the wrong expression.

02:21:04.740 | But in the fullness of time, it's in the relationships that you and I have together

02:21:09.140 | and with our other friends where we can approach a clearer understanding. In order for that to work,

02:21:16.500 | we have to build a safe space, a safe space to disagree, a safe space to have conversation

02:21:21.540 | and to speak with one another in respectful dialogue. It pains me enormously that our society

02:21:27.300 | has minimized many of the fora that we used to have for this kind of respectful dialogue.

02:21:33.780 | But we can rebuild it, and we can do it right here at Radical Personal Finance,

02:21:37.620 | and you can do it right at your dinner table and whatever other fora that you yourself create.

02:21:42.740 | So thank you for listening. Have a great weekend. I'll be back with you soon.

02:21:45.380 | [Music]

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2024-06-28_Friday_QA