Physicians spend a decade or more training for a career they believe will bring fulfillment and stability. But what happens when the reality doesn’t match the dream?
Dr. Brad Bennett followed the traditional path—prestigious training, a promising teleradiology role, and the security of a physician-owned practice—only to find himself exhausted, disconnected from his family, and questioning the future he had worked so hard to build.
Instead of staying stuck, Brad made the bold decision to step away and design a career and lifestyle that truly aligned with his values.
Listen in as we explore the financial realities, personal risks, and emotional challenges of leaving stability behind to create freedom and balance.
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Full Episode Transcript:
Dr. Brad Bennett: One thing I was—we had to talk to my wife is we lost maybe a large portion of income at this time, and we’ve gotta make sure that we have the cash to fund our hard life as we’re transitioning here. So there’s some situations you can find yourself in that are a little bit scary. But those are the risks, essentially.
Welcome to Finance for Physicians, the show where we help physicians like you use money as a tool to live a great life. I’m your host, Daniel Wrenne, and I’ve spent the last decade advising physicians on their personal finances with the mission to help them understand that taking control of their finances now means creating a future where they can practice medicine where, when, and how long they want to.
Daniel Wrenne: Brad, how’s it going, buddy?
Dr. Brad Bennett: Hi. Nice to meet you, Daniel.
Daniel Wrenne: Yeah, good to meet you too. I’m excited for our conversation. We’ve started catching up before we hit record, but Brad’s got a little bit of a—we’ll just call it like a non-traditional career track in radiology, correct? Is that your specialty?
Dr. Brad Bennett: That’s correct.
Daniel Wrenne: So I’m looking forward to understanding more about how you went about it. How many years outta training are you?
Dr. Brad Bennett: This point, two.
Daniel Wrenne: So not many years outta training, which is even more impressive and…
Dr. Brad Bennett: Yeah. Uncommon Yeah. To have broken away at this point.
Daniel Wrenne: Yeah. So we’re gonna talk through that.
We’re gonna go through kind of his progression from training and then starting in a little bit more of a traditional role and then transitioning into the current setup that he’s in now. So I think it’ll be valuable for you guys, especially, radiology, but really in any, especially I think non-traditional path is potentially a solution to a lot of the problems that exist in medicine today.
We’ll go through all that today. So first of all, thanks for joining me, Brad. I appreciate you coming on.
Dr. Brad Bennett: Yeah, pleasure. Thank you so much for having me, and I’m happy to share any bits of wisdom I can provide. Hopefully, it can be useful for your listeners.
Daniel Wrenne: Yeah, definitely. So maybe we could start with just like a brief background of—I’ve already thrown out some of the tidbits, but just give us a little bit of a brief background how you gotten to where you are today.
Dr. Brad Bennett: Sure. I actually have a bit of a non-traditional path before medicine, so I was an engineer initially and then spent some time in finance.
And then to top it all off, I didn’t really have any direction. And eventually I was like, medicine seems like a great place to be, okay, so I matriculated to med school in I think 2013, 2014. I went to Jefferson Medical College in Philadelphia. I met my wife there. We matched at Johns Hopkins, where I did my radiology residency and then went to University of Pennsylvania for a one-year neuro fellowship.
Neuroradiology subspecialty trained. All of that the tail end of my training was occurring through the pandemic. So I think I was an R2 at the time. So PGY-3, when 2020 hit, the world changed dramatically overnight. Ironically not very much for me in radiology. We’re kind of sitting in the basement of the hospital institution doing all of our work. But one thing that dramatically changed was the ability to be a teleradiologist was always seen as an alternative thing that was maybe looked down upon in the career was interestingly accessible for about 20 years prior to that, it was possible to be a teleradiologist, but it wasn’t really a standard pathway. But when 2020 hit, it didn’t take me long to figure out, I prefer the diagnostic end of radiology. I’m not really keen on doing procedures.
Moving forward with a full work-from-home environment was one of my goals. And my wife was able to support that as well. So when finishing up my training I looked for a primary teleradiology role, mostly neuro, probably 80% neuro, to keep some of the general skills in my skillset.
And with the goal of my family and I would probably move to the further up to the Northeast. And we live in New Hampshire in the mountains now. But at the time, I had signed with a practice in Texas. So upon finishing my training in 2023, I started with a practice in Texas and worked fully remote for them for the upcoming year.
Daniel Wrenne: So you’ve had a, I guess you could say above average number of career paths for standard positions. So is this it? What makes this it? Is this the right direction so far? And I’m just curious like what about medicine has been the thing that’s really turned you on that stuck?
Dr. Brad Bennett: Yeah. I actually loved engineering, but I guess the reasons that I flipped careers so early on was maybe just a lack of direction and poor decision-making. I wanted to follow some of my friends out into investment banking ’cause they were making so much money right out of college compared to the engineering job I was likely to get.
Couldn’t really see past that. I also graduated in undergrad at 2008, and I think I secured a financial job two months later, Bear Stearns and Lehman Brothers failed. So that was the start of my financial career, which I spent about three years in and did two levels of a CFA and…
So I spent some time there working hard.
Daniel Wrenne: Did you finish number two?
Dr. Brad Bennett: I did.
Daniel Wrenne: I think that’s the hardest one, right?
Dr. Brad Bennett: And then I was like, “I can’t do this anymore.” So that’s when I started looking elsewhere. I was like, “You know what? This is not for me. It was hard. It was, yeah, been another six months living in a hole, right?
Yeah I went back to basics and thought, what do I love? I always love the science and aspect of engineering, and I was looking for more of a calling at that time. This is probably 2010 at this time. And a number of my friends had gone into medicine and had been very happy despite actually some of them were residents.
So I had a lofty a lofty view of what it would like to be a physician. And after working with a life coach and thinking for the better part of a year, I made the jump and committed to it. And I think it’s been a fantastic decision. I love my career. I feel deeply rooted and connected to medicine and radiology in particular.
I’m a tech person. I grew up gaming and radiology is sort of like that in real life. So it, it has a lot of natural qualities that I gravitate to, including the people too. You meet a lot of people who have similar interests and stuff in the field. So I think in terms of my education will largely be, I am a physician at core now and a radiologist, and I don’t think I’m going to be making any dramatic career changes other than maybe another entrepreneurial pursuit here or there. Okay.
Daniel Wrenne: Yeah. Yeah. That’s interesting that you had said you worked with a life coach.
I’m curious, was there some good purpose, values-focused conversations that were had with that person? How did that play into it?
Dr. Brad Bennett: Yeah, at the time, thinking back, this is probably 2010, very unhappy in my career and in finance, and I’m like, “This is not the setting for me. I think I need to make a major change.”
And we did our best to strip all that away. What was I chasing for the last few years and what actually matters to me? And those things had diverged quite a bit. Yeah, it was interesting. This is a side note, but the financial industry has a pool too.
My bosses above me at the time were saying, if you stay here, you’ll be a millionaire in a couple years. But you’ll be a physician and you’ll be indebted, which is true. But I am very happy, very happy with what I do. So in all accounts, I think that was the right decision.
Daniel Wrenne: Yeah, I think a lot of the average people in the culture think physicians get into it for money, which that’s not been my experience. We working with a lot of physicians and most of them that I know didn’t really do it for the money. It was more of a calling and there is a big long track and then debt and all the things on the front end that people, average person doesn’t actually realize.
That part too. They’re like, “Oh, I didn’t realize you have to go through training and all this education and delay, and you don’t actually get paid very well until all that stuff.” And then there’s the debt.
Dr. Brad Bennett: Yeah. It’s a decade or more. And if you’re taking out student loans, which I did, they grow during residency when you cannot pay them down.
There’s some really significant financial impact here that might take 10, 20, or 30 years to really come to fruition and pay off. Yeah. And a lot of people that I’ve met and been very impressed with really do care about other people, and they care about the career and doing what’s right.
And very rarely have I seen people come into medicine for financial reasons purely. And it’s pretty good. It’s pretty well known. I think it’s probably not the best field for that.
There are others where you could make more money.
Daniel Wrenne: Yeah. So you were mentioning the—this is something I talk about all the time.
The thing about like your, I think you described it as chasing something versus what was actually most important. And I would say like your action. Or chasing something versus your values. And when those deviate, like what you’re doing isn’t aligned with what you consider most important.
It’s like guaranteed disaster zone. You’re gonna be unhappy. And so it sounds like you were—I know a lot of people aren’t even aware when that’s happening exactly. And you’re in like the grind, especially when you’re in the grind, right?
You’re like just cranking it out and you’re like doing the things and making the money and doing all the things people say you should be doing. And you’re like, “But why am I so unhappy?” A lot of times it goes back to this, and you were able to gain awareness of it, and so that’s super awesome.
I’m curious though, going back to like your more recent career transition, did you use a similar framework when you transitioned from like the traditional practice you were just starting to describe into your now current new, more entrepreneurial setup?
Dr. Brad Bennett: Yeah. Actually I had a—I’ll answer that question in one moment.
I had a thought with what you were saying, which is people don’t often notice that the divergence of what they would like to be doing and what they’re actually doing when it’s happening. And I think there’s a fundamental problem in medical training, which is each level, each next level is opaque at the time that you’re in the level below.
So it’s like you’re in undergrad looking to go to med school, and you really have no idea what med school is like, and the requirements and the commitment that it takes to get there. And in med school, you might have six months to a year to decide on your specialty that impacts the rest of your life.
And oftentimes it’s hard to get a sense for what is it actually like to be a surgeon, an OBGYN, radiologist or a pathologist? Sometimes is colored very differently depending on just maybe the person you’ve worked with in that space. It’s like you’ve had someone who’s a resident who’s been really wonderful or really poor to you, and that changes your opinion.
In that regard, yeah I think it’s a challenging thing to, to choose the path that’s right for you. There are two things you can always, you can really, always change, and we see a lot of this in radiology. People come in from other fields. And then there’s one presentation we had in med school that I always love, which was an entrepreneur.
He was a physician and he threw up this menu to the class and was like, everyone’s telling you can be a physician and go into private practice or work in academia, but I’m here to tell you that there’s a hundred different things you can do. And you should open your mind to that possibility that if you want to take your experience and work in a totally different way, or if you wanna create something like that is open to you. But very few people talk about that, so hopefully that can be a good, useful piece of advice for your listeners.
Daniel Wrenne: Yeah. That whole locking down the 20, it’s like, what do I want to do when I grow up?
That’s not a very easy question. At every progression, like you’re saying I totally get that. And then you gotta commit to I imagine like the whole undergraduate to medical school tradition, which a lot of people just go straight through. That is a huge deal. ’cause you’re like, as soon as you get the first student loan check, you almost feel like you’re locked down.
Dr. Brad Bennett: Absolutely. To answer your question now so I start working in practice. I am working from home, but things are definitely different at this point. So now we’ve got two children. I think my eldest is three years old at the time. So we’ve got two under three, a baby on the way.
We’ve moved up to New England. But I’m actually, I have signed on to a teleradiology job, excuse me, which is what I wanted, but the schedule is actually quite brutal, and I didn’t realize it until I was actually in it, so I had, I forget the totals. I’m working 240 days a year by contract, and about 40% of that are in off-hour shifts.
And those are week-long shifts. So I’m like flipping to nights and then I’m flip flipping to like evenings to early morning. So full nights being midnight to 9:00 AM my time, and then evenings being like 6:00 PM or 5:00 PM I think to like one or two in the morning. So just about once a month, I’m flipping my sleep schedule completely and getting maybe like a day or two break and going back into work.
And oftentimes what I’m doing is I’m working like a five day stretch over, Monday to Friday. And then I immediately go onto the, to the evening or the night block, which is a seven day block. So I’m working 12 days straight. And those final seven days are exhausting ‘cause my sleep schedule’s flipped. We’ve got young kids. I’m not sleeping very well.
And so the calculus has changed quite a bit at this time because my wife, who’s also a physician, is now burdened with taking care of two children and a baby. And I’m missing every single dinner every night despite being home because a lot of cases, I’m doing our stroke cases.
So I’m tied to my computer despite actually, live working at home, my kids can’t really come in and interrupt me, et cetera. So just the quality of life impact started to really drain on me. And I’m thinking like, this was initially a really good state of affairs, but now I’m not really so sure ’cause there’s a lot of burden shifted onto my wife.
I’m missing a lot of family time. I’m just drained all the time. And that was the primary driver. It was like, I want to be a radiologist. I love what I do. I’m not necessarily anchored to doing 100% neuro.
Like some people love their subspecialty and they don’t want to touch anything general, and I understand that. I’m willing to be more flexible in that regard. I started thinking, how can I claw back some of that quality of life? Like there’s an idealized dream here where I’m working from home, but I’m missing out on all the core pieces. I’m like rushing my kids to daycare and rushing back home to get that first stroke case that’s coming, and it’s this doesn’t seem right. It’s not the vision we had planned. I would say about maybe eight months into that job, I started thinking, there’s probably a better way and I’m gonna start figuring out what that is and planning for it.
Daniel Wrenne: What did that look like?
Dr. Brad Bennett: Part of this was informed by people within the practice and my schedule. So I’d say the first thing was like I thought, these evening nights are gonna be probably the easiest. They’re actually a little bit shorter than the normal shift, but it turns out those were actually brutal.
’cause I was working from 5:00 PM to like one, two in the morning. We’ve got little kids waking me up and I’m like sleeping piecemeal for a week, and I was just exhausted. The daytime shift was fine, except I was working past dinner and actually what we learned is like the overnight shifts, if just shifted a little bit, would actually be ideal.
My practice at the time had an internal overnight crew, maybe 15 rads or something who were very productive. They read a lot of emergency medicine, which I really like and gravitate to. And they worked in a two week on, two week off schedule. So I’m like these people have significantly more downtime than I do, and coincidentally are getting, are making a lot more than I’m as well doing about the same amount of work.
Daniel Wrenne: So they’re like working as an independent contractor for the practice you had started at?
Dr. Brad Bennett: The contracts were different for overnight workers so I was in a static salaried position and I had some benefits where I could earn the people working overnight were full productivity.
One thing that’s important here is I’ve always been, like, I’ve always loved efficiency in my work, and I try to tailor everything I do so that I’m like minimizing busy work and automating what I can to make my life easier. So I generally am on the order of a high producer. I’m starting to do the calculations here where I’m like, okay, if I’m getting paid per work unit here, I would be making significantly more than what I am now.
And at the rate I’m working naturally, I’m devaluing myself by quite a bit. So some of the basic math was like, how much am I actually working for per hour? Here’s my contract salary, here’s the total number of days I work, this is the approximate hours.
And it was like nine and a half hours a day, 240 days a year. You divide that from the salary and it was like, that’s actually a lot less than I thought than I was hoping. So some of the basic math is pretty striking once you actually set it out in a spreadsheet and think about it.
Daniel Wrenne: That’s a good point. I think everybody should—maybe not should—but like it might be a good idea for those that aren’t aware of what their per hour rate is, even if you’re on salary. ’cause it’s so easy to like not pay attention to that. Yeah. But if you’re on salary, I still think it’s even more reason to pay attention to like it’s just doing the math.
You would have to track your time to some extent. But doing the math on what that translates to per hour. Obviously it’s substantially different if you’re working 120 hours a week versus 20 hours a week. Huge differences can come into play and that’s like one of the key KPIs or whatever—total compensation’s important, but like compensation per hour is even more important.
Dr. Brad Bennett: Yeah. When they diverge so dramatically, then the total compensation would include benefits of course, and those sorts of things that might actually not be that much. And that’s what I learned as well, if I am working for half the amount of value that I can generate, then I can easily pay for my benefits no problem and have quite a bit left over.
So yeah, I gave a talk to some residents a couple months back and I encourage them to do the same thing. When you get an offer, look, slice it up, use, do some basic math and see what are you making per hour?
And what are you expected to do in that hour? What sort of pressures will you be under? What’s the technology you’re working with? Like one hour of time at one practice might be much easier than another practice. This is very true in radiology, depending on the technology stack.
So in the radiology world, there’s this new thing called an auto impression generator. So if you don’t have that, versus when you do have that, you might be repeating yourself a lot more. So that’s a big factor is is it easier to produce the same amount of work that has to be taken into consideration?
Yeah, even if the numbers are estimated, at least it can provide you a baseline of what am I actually earning? And does it fit with what I think I’m worth? And then you can take that a step further and go out onto job boards and see what is the current market rate for my work?
Daniel Wrenne: Yeah. So you started. It sounds like it was a combination of factors. You were already aware of this whole, I guess the first thing would’ve been like the values action discrepancy in that you are working these shifts that seemed like they might be okay on the surface, but in reality they were causing major conflicts with values and interfering and it was just, doesn’t sound like the timing was good at all. Plus maybe total hours was considerably more than you expected. And then on top of that, you started to realize the kind of like the numerical KPI type stuff of like dollar per hour, not near as good as what you thought.
And that, I imagine, did that set you down the path of looking at all the different options out there and exploring? Maybe looking at this night shift thing in your own practice and doing the numbers on that. Yeah, absolutely.
Dr. Brad Bennett: Yeah, absolutely. That was the first thing. I think we realized the impact on the family is too great. Something’s gotta change.
Daniel Wrenne: You were gonna change—were you gonna change when you figured that part out either way?
Dr. Brad Bennett: I think so. Yeah.
Daniel Wrenne: That’s important because I think that is very—I think that’s in an admirable, or not even an admirable, that’s a good standard to use is when you realize that you’re not doing things that line up with your values.
You have to change as quickly as possible even if the numbers—it was easier for you ’cause the numbers also confirmed all that. But even if the numbers don’t confirm that, there’s a problem there.
Dr. Brad Bennett: Yeah. Yeah. We would’ve changed no matter what, I think.
Daniel Wrenne: Yeah,
Dr. Brad Bennett: Early on we were just like, this is not the family life that I had envisioned.
And one of the main components of that is the pressure it put on my wife, who’s also, a very accomplished, sophisticated physician and deserves to focus on her career if she wants, and not be burdened with three children all the time while I’m stuck in an office, so we were gonna make the change and had initiated discussions with the practice to say maybe we should consider about switching to one of these night gigs or evening work or something like that.
But it honestly didn’t take me long to look out into the marketplace and say actually if I think about how much I typically do produce and what the market rate is for that, and it’s probably just better to look elsewhere.
So yeah within a couple days of searching online and looking at job boards, it was like pretty clear that it would be a hard sell to keep me to stay and from a non-financial part as well, so all this is happening at the same time. Like I had my foot in each part of this practice.
There’s full day workers, there’s full evening workers, there’s full night workers, and I’m actually spanning all of them. So I get to talk to all the people who are there, like what is your life like when you’re just working full evenings every week? Like you’re missing, you’re working one week on, one week off.
Is it tiring? Do you get enough rest? Do you spend time with your family? Like what’s the burden on your significant other? And through those conversations I met somebody who was doing one week on and two weeks off overnight work, which is a pretty common, I think, in radiology. And he was like, “I’d started this outta residency. I’ve got four kids and I absolutely love it. I’m there for them all the time.”
And it’s always a challenge having to go back on, but the time off is just pure goal. So that also aligned a lot with our ideas of making a better family life and searching for a practice environment that suited me.
AD BREAK
Daniel Wrenne: Let’s take a quick break to talk about our firm, Wrenne Financial Planning.
The goal of our podcast is to empower you to make better financial decisions, but sometimes the best financial decision you can make is to work with someone who understands your financial goals and has the expertise to keep you on track to reach them. That’s where Wrenne Financial Planning comes in. We are a full-service financial planning firm that works with over 400 physicians and their families across the country.
We charge a transparent monthly flat fee for our services and offer virtual meetings you can take from anywhere. Best of all, you’ll get to work with a team that specializes in working with physician families. So whether you’re starting out and wondering how you’ll balance your student loan payments and saving for a home, or you are established physician trying to figure out how to pay for your kids’ college and how much you need to save to reach financial freedom, we can help.
I’ll put a link in the show notes to schedule a no-obligation meeting with one of our certified financial planners. Wrenne Financial Planning, LLC is a registered investment advisor. For more information about our firm, please visit wrennefinancial.com. That’s W-R-E-N-N-E financial.com.
AD BREAK END
Daniel Wrenne: Was there a lot of value benefits associated with this whole like employed status that you, I think not just benefits, like on financial side, but I’m talking about support staff or like protection or insurance or those kinds of things?
Dr. Brad Bennett: Yeah, absolutely. That’s a great question. So the practice I signed on with is a large private practice. It’s also physician-owned. And that was very important to me ’cause it like many fields of medicine, there is an insinuation of private equity, so I didn’t quite vibe with that and wanted to be in a physician-owned practice. The role I initially took on was a partnership track, so my goal was to be a partner, and that does come with, of course, financial and non-financial rights.
So you get the quarterly and then end of your partner bonus, and then you also have voting rights and other things. The practice itself was quite large and so that allowed me to specialize more, which was also desirable right out of fellowship. And then they’re also like, they have a very big footprint and are well known to be a strong practice.
So there’s stability there, which is also key. In practice, what I realized is that I do have a slightly elevated risk tolerance and the stability itself was not necessarily that important to me when I’m taking essentially, a financial hit based on my capabilities.
So again, like looking at the numbers can really drive a decision, like how much—I’m working for this much an hour, how much do the partners earn? Okay, so they’re getting a nice lofty bonus, but what’s the tax, what are the tax implications of all those things and what do you have afterwards?
And so there are a lot of factors to dig into, but once you start looking at them and parsing it out, I think the decision can reveal itself at that time, and at least it did for me. Yeah, it is just an interesting study in what I thought I wanted and then pivoting very quickly when I realized the reality of what I thought I wanted was actually quite different, especially when it lifted with family life.
Daniel Wrenne: I think one of the gaps or issues I’ve seen sometimes in medical practices is that there’s not as high of a focus on like the team’s values, I guess you could say, like the people involved in their values. And so I think there’s some good opportunity for like small prac—or any size practice, but seems like something small, like adjusting how shifts work or like getting feedback from your people regularly or having really good communication and being tight with your people where they drive the culture, like that stuff doesn’t seem to happen very often, and I think that’s another potential solution to help move the needle on, especially physician-owned practices.
Now, private equity’s a different beast. Because you start to get different influencing factors. I wish there were more practices that really, like. If I was involved in that practice as a partner that you were working for, and I knew you were working there, I would want to know what challenges you were having and try to make adjustments to cater to the career path you wanted.
‘Cause we value you as a solid resource. That’s just a way of viewing it, but at the end of the day, you have to do what’s best for your family. And if it’s not a fit. And on top of that, it’s more lucrative to leave. That’s a home run.
Dr. Brad Bennett: Yeah. You hit the nail on the head. It was truly hard to justify staying once I realized what was out there, if I was willing to take a little bit of risk.
Daniel Wrenne: What was the risk like? Besides, so leaving the stuff you just described. That’s one. The risk that nobody pays you any money. What? What are the risks?
Dr. Brad Bennett: Yeah, so the risks are of course, like leaving stability. You could have variable income. That’s one factor. There’s timing-related risks where it may take six months or more to get—
Daniel Wrenne: Who’s paying you? The hospitals? Or who are you contracted with?
Dr. Brad Bennett: So I can go into that, but there’s timing related. There’s a lot of like little factors that could add up. There’s always like insurance related things like—
Daniel Wrenne: Practice.
Dr. Brad Bennett: Yep. Then there’s business insurance, cyber insurance. If you strike on your own—
Daniel Wrenne: Technology? You have to get your own technology.
Dr. Brad Bennett: Yeah, what I decided to do was basically form an entity for myself to operate under and then contract to practices in this kind of window of time. So I landed on working overnights from 10:00 PM to 7:00 PM or 7:00 AM Eastern time and like searching for gigs that would support that.
So only 1099. I’m looking for basically what is your technology stack? How, what is it like reading for you? What sort of case mix are we talking about? Mostly it was general, at this rate, now I’m planning and realizing, Just from a dollar per work unit, I might be making double what I was doing the same work, reading the same, neuro study with CTA head and neck for stroke and or like a body CT, the case.
The dollar per case might be literally double what I was looking at. So there was a bit of a need, which I think I tapped into, and there’s a bit of like savvy that I think I was lucky to have where I could realize that, these practices need.
The slot filled. There’s a premium pay for overnight, and there’s quite a bit of need. So I had a lot to choose from at that rate.
Daniel Wrenne: So there was definitely risk. I think anytime you’re making a big change, there’s risk of I guess even if it’s obvious, just not working out as you expected. Things go as planned.
Dr. Brad Bennett: Yeah. Just for timing risk, I have a pretty large credentialing packet, right? So I’ve worked in teleradiology for only three years, but now I have multiple state license. I’ve got tons of hospitals I’m credentialed at. From initiation of my business to, and the contracts with the practice to actually getting credentialed at all their sites. Like it took longer than expected and I lost out on a couple shifts and lost a fair amount of money actually at that time. And so one thing I was, we had to talk to my wife is we lost maybe, a large portion of income at this time, and we’ve gotta make sure that we have the cash to fund our hard life as we’re transitioning here. So there are some situations you can find yourself in that are a little bit scary, but those are the risks essentially.
Daniel Wrenne: Was it scary at any point?
Dr. Brad Bennett: I think I had a good vision for how it would work, but there was a bit of time where I’m like, I’m not getting credentialed or it’s taking longer—
Daniel Wrenne: And like the last stretch in the home stretch?
Dr. Brad Bennett: Yeah, like before things are starting up and I’m starting to get a little nervous and then, of course, things are paid in arrears, so you’ve got, might have a month or two month and a half delay from when you actually did the work.
And so before I know it, I’m like, oh my gosh, am I gonna be able to fund my salary? Our life? And luckily that did come to fruition. But yeah, there’s some, we’ve gotta be able to manage that sort of thing. Maybe have a little bit of money in the bank in case and plan for it financially, because I think one of the adjective was like every plan for things to—cost double and take triple the amount of time so that you can adjust when needed.
Daniel Wrenne: And then you get pleasantly surprised instead of disappointed.
The perfectionist mentality ruined will mess you up in entrepreneurship. The perfectionist will say, let’s get the perfect timeline and the perfect budget. And then they go do it, and they’re like, overtime and over budget by 20% or something and they’re super frustrated even though it’s probably pretty efficient.
Whereas it’s probably better to be like, ah, double, triple, triple the budget, double, triple the time. And then you can be under and be like, wow, okay.
Dr. Brad Bennett: Yeah. But to answer your question, if it was scary, I mean, leaving a big practice to strike out on your own is a pretty big jump.
And I went from like having an IT department to help me work through, set up all my equipment and everything to like putting it up on my own and making sure I have the power to even run the stuff where I need to run it and connecting in and actually like reading the studies, which is like, when you have a team of IT professionals, they can just get you through it.
But it is a little scary, like when you’re doing it all yourself and you run into little snags here and there, and so yeah, that transition was a little bit scary, but we made it through and it’s been fruitful.
Daniel Wrenne: It’s a little bit overwhelming wearing all the hats and there’s nobody to—it all comes to you.
They’re like, if there’s a problem, I guess it’s my problem I gotta solve and it’s a little different than a working for a practice with multiple people and that sort of thing. You can, in some ways, I’ve heard a lot of people say they’re stressed out in their practices and when I understand what they’re stressed out about, a lot of times it’s these things that they.
I think the problem is it’s these things that they can’t change. It’s like these forced either red tape or mechanisms or practice standards or whatever that are causing the stress. So I look at it like two different flavors of stress. There’s stress you have no control over, which is 10 times more detrimental.
And then there’s the stress you have control over and you can solve the problems to make it go down or go away. And I think entrepreneurship is more in that camp. Because you can be like, oh I guess I can change things and I don’t have to go through all the red tape and.
Dr. Brad Bennett: Yeah. Absolutely. Absolutely. I mean that, that’s the trade off that you make too, is like you have a lot more control and if a contract isn’t working out for you, you can go and search for another one, but that’s also up to you. So you have to be in the driver’s seat there, and each transition you make might have its own benefits and risks that have to be assessed and.
So there’s, yeah it’s a transition from going to work sitting at your desk if you’re a radiologist, or seeing your patients to then thinking like more on the administrative side of how am I gonna get paid? Have I talked to my CPA recently and, do I need an attorney, and how do I stand up this entity and make sure that it has all the protections it needs, and can satisfy its responsibilities to the state and to the IRS and whomever else.
So it is an empowering scenario. It’s right for you, of course. But it has its risks that come along with it.
Daniel Wrenne: Yeah. And you’re not solely on your own either. Like you have, you’re like the quarterback I guess, but you have a team of people.
You already mentioned like an accountant. I don’t know if you still work with a life coach, you got a spouse, you got, I know you work with a financial planner like those kinds of people and consultants and you can hire those kinds of things. They’re very valuable, especially when you start talking about entrepreneurship ’cause there’s just so many things.
Dr. Brad Bennett: Yeah. So good tip for anyone who’s listening and thinking about this, early on I learned about the, just the small business development centers, which are usually in each state, federally funded and provide you with free resources.
So when I was initially thinking, I’m probably gonna do this, I reached out to them right away and got connected with an advisor, and he was instrumental in getting me through the first month or so of what am I actually doing? I’ve gotta register a business entity.
What type of business entity and what is an S corporation or an LLC, Electing S corporation status federally and all these things I had no idea about? They connected me to a CPA initially who was just free of charge. And she gave me some incredible advice and helped me get everything up and running.
So they’ve been key. I got attorneys that I use who have been great, and now I have an accounting firm that does my work. And you know that team has come together and they’re not on my payroll, but they certainly help round out all the things that I don’t understand or know about and can make it work.
But you can utilize that free resource. It’s there for anybody. It’s extremely powerful. If you’re going to go this route, expect it to take six months to get through it, especially if you’re working your full-time job right now and making the change. You might be just doing some paperwork off hours and that’s just what it takes, and it’s scary at first, but once you get through that, you just build a new knowledge base and then it becomes second nature, now I think about, tax implications of what I’m doing all the time where last year around this time, I had no idea what a lot of that meant for me at the time.
Daniel Wrenne: Yeah. Yeah, it’s a good and then healthy exercise to go through. I think entrepreneurship is very healthy. It’s a little bit, it’s more holistic. It’s like you, it forces you to get into more areas than just like the grind. You kinda have to look at the holistic aspect.
Dr. Brad Bennett: Yeah. Yeah. And if there’s a lot of different ways to go about your career, but I know some people will maybe drop down to 0.75 or even 0.5 FTE and then utilize that free time to go into a hobby and maybe build a small business related to that.
And that can be very successful and fulfilling in its own right. So it’s really no different from what I’m doing from a practice standpoint. You just would still use the same resources and hopefully it would be an enjoyable experience, but I do agree.
I think it’s been incredibly empowering to have gone through this process and to still be alive at this time.
Daniel Wrenne: Yeah. you’re probably healthier than ever. Definitely sounds like getting more sleep and more family time.
Dr. Brad Bennett: Yeah.
Daniel Wrenne: And financially beneficial. Those are all good things. So I’m thinking about the state of medicine and there’s a lot of burnout or career frustration. Or maybe if I’m listening and I’m not even in practice and I’m like in training and I’m like a little bit overwhelmed by the prospects of that, ’cause you hear about that and you see it and you get taste of it and yeah, you’re like, oh my goodness, how am I gonna avoid that?
But you’ve done a good job navigating that really well, or at least from my observation, I’d like to hear your take on this too, but from my perspective, it looks like you’ve been able to navigate life hurdles, dissatisfaction, burnout, whatever you want to call it very well, and allow the profession to compliment your life instead of interfere with your life.
Seems like you’ve done a really good job with that, which I think is super important. But the part that I really like especially is I know a lot of people that have done pretty good with that, but in order to do that, they had to leave medicine completely.
Which I get frustrated when I see that for several reasons, not, I can’t really blame ’em, but like it’s especially encouraging when I talk to people that have figured out a way to navigate that while also still staying in the group. So I’m curious, so your take, am I on, is that an accurate assessment?
Do you feel good about that on your end and then maybe advice you would have for others that are struggling with that?
Dr. Brad Bennett: Yeah I feel like if I had to summarize what I understand about that problem, it’s that the people who leave medicine don’t do it because of medicine. They love the job, they love being physicians.
If you’re a surgeon, you love to be a surgeon. It’s all the other stuff that gets in the way of that—the charting burden, things like that. I know administrative burden, if you’re calling insurances, and dealing with insurance and payers and certain aspects of the career that are not well suited to clinical practice and are there to—they’re there for a reason, but they’re not efficient and they drag you down and they’re sometimes even downright painful to go through.
Yeah. My heart goes out to those people and I do think maybe there are some solutions coming down the pipeline, for example, like the AI note taking technology that’s coming can dramatically change the experience for—my wife’s a psychiatrist and she uses that now almost exclusively, and says, “I have a conversation with a person now. I’m not typing the entire time. And then when I finalize the patient encounter, I look at the notes and I just edit what I need to and move on.”
So that note taking burden has dropped significantly. That’s not the only thing. I know there is multifactorial, but in radiology in particular, I do see some older physicians who have never really learned the technology that we work with.
There are sometimes ways to make your life easier, but there’s really nobody to teach you. It’s like you get an introduction to the technology you use like the first day of your training and then never again. And I would encourage those people who are maybe really frustrated with the systems that they have to try to spend some time and dig deeper, ask questions like, “Can I automate this process? Is this a task that I could delegate if that’s possible?”
Or any of these little burdens that you might come up against I’ve gotta click the chart like five times to do this thing. There are scripting languages you can do to automate mouse movements and keystrokes and stuff like that.
That might just be like a fun technical thing for people inclined to that to try to dig into. Yeah. And now in particular is a really good time ’cause you can just fire up ChatGPT or Claude and say, “This is my work and I am really frustrated by these 10 things. Like create me a plan to try to address some of them and reduce the burden.”
Daniel Wrenne: It’s surprisingly good. It’s surprises me regularly. I’m like, that’s pretty good. Something answers that it comes up with and something about problem solving, like really, I don’t know, maybe it’s because I’m a problem solver, but I think everybody is to some extent and something about solving the problem that’s slowing you down or causing stress or frustration in your life. That’s really, even if it’s like an incremental solve, like that’s a really rewarding thing and it can be incredibly stressful in an environment where you’re unable to solve the problem.
Dr. Brad Bennett: Yeah, I that’s the beauty of the language models is that you can utilize that to unblock or challenge some of the thinking that you have and do it in a way that only takes a little bit of time. It doesn’t cost anything. You don’t have to act upon it in any way. So you can say these are the assumptions I work under, challenge them. And if we were to address one of them, what’s the highest impact?
Or help me understand which would be the highest impact and how I could go about it. And so you can explore these dark caverns in ways that wouldn’t really be possible before, under normal circumstances. At least that’s how I feel like it’s like splunking with a headlamp instead of like doing it in the dark and like feeling my way through in a way that like I’m unblocked quite frequently by some, by problems that I would take me much longer to solve.
There might be things that are really challenging, like I know insistence by certain organizations that like primary care physicians see shorter and shorter patient encounters to have more and more patients on the schedule. That’s really tough. ChatGPT cannot solve that problem, but there might be a creative solution.
And early in my career, I spoke to, this is back in medical school. I spoke to a primary care doctor who elected to do some concierge medicine. It was interesting in the fact that it was not what I had anticipated it would be like, it was still a pretty high patient load. It wasn’t just like working for one family, or two very wealthy families.
So they actually had numerous patients and had made that work where they found work-life balance, right? In a way that wasn’t really possible.
Daniel Wrenne: I think ChatGPT could, like ChatGPT is an example of an AI technology. You go in there and you ask it, you’re like “I’m really stressed out about my primary care job. The problem is that I have to see so many patients that I don’t enough time and the burdens with the insurance.”
And ChatGPT might just say, why don’t you just leave it and charge patients per month at a rate that translates to the number of patients you wanna have? And that’s essentially what concierge medicine is.
It’s just like, how many patients do I want to have? In other words, how concierge do I want it to be? Yeah. And then let’s back into how much we charge per month to make the finances work. And then you’re off to the races. Old school, it’s really more—it’s not even concierge. It’s really like how it used to be way back in the day.
Dr. Brad Bennett: Yeah. Like cash fee for service and yeah. Then there is a problem with that. The fundamental problem is, of course, that there, we live in a society where some many people cannot pay. And so you leave people out and diminish access to care.
Daniel Wrenne: There’s always problems. So you have to like, make sure you’re not getting, letting the problems paralyze you. And instead moving forward with solving the problems you can solve. That’s one thing I’ve noticed, especially in primary care. It’s like there’s all these 25 problems and there’s no point.
Like I’m just gonna throw in the towel and bury my head. And that’s the worst thing you can do. You gotta be like, okay, which of these 25 problems can I solve? Let’s focus on that one.
Dr. Brad Bennett: oAnd those are big systems problems. No single physician can change the state of economics and and aging in our society.
And yeah you do have to do what’s best for you. Of course, there are a lot of wonderful people out there who care very deeply about serving the poor or the frail, and I think that’s a beautiful thing. But yeah, you cannot solve those problems by yourself. And if it’s driving you to the brink, then it’s certainly worth exploring a change.
And then of course, there’s lots of ways to advocate around that as well. But yeah, I certainly feel for my primary care colleagues who are I feel like squeezed very often and under this continuous type of cycle where they’re being forced to just do more and more with less.
So yeah, that’s a tough situation.
Daniel Wrenne: Yeah. No and I think the biggest thing I would encourage for everyone, which Brad’s got a really good handle on, is just always making sure you’re clear on what’s most important. At the very beginning, you’re talking about chasing the things.
When you’re not clear on what’s most important in your life, you always gravitate towards chasing the things that the culture tells you to chase, which always lead to unhappiness. And so you have to like be intentional with taking the time to iron out or remind yourself of what’s most important in your world and then hang on to that.
‘Cause there’s so much pressure to go the other way. It’s like everywhere. You were talking about with the finance industry, I can verify all that. It’s like this, it’s like money, more money, money. That’s just one of the big influences. It’s like you can be a billionaire, you can be a whatever and solve all your problems.
Dr. Brad Bennett: Yeah, A lot of my colleagues went into medicine because they wanted to do something that’s really valuable and your skills are incredibly valuable and I think that actually is very important at the dawn of AI, when I use it all the time and still realize that last final judgment piece is very much lacking.
So the human component is incredible, and I hope it is not replaced. And I think that there’s still a role for all sorts of the physician specialties out there. And hopefully, the technology can come and make our lives easier in a way that it can bring the joy back into medical care.
So that’s my hope for the future. And if that’s not something that you’re experiencing and you’re really unhappy in your current role, I would just encourage you to look out elsewhere and see what else is available. ‘Cause there may be, I don’t wanna say the grass is always greener, of course, but we live in a unique time, there may be opportunities that suit your life better.
And if you’re unhappy, that just really doesn’t help anybody. It doesn’t matter how many people you may be saving or how much money you’re making if you are really unhappy in your life.
I do think it’s important to explore a change, and for us it was family time. And, I don’t want to be. I don’t wanna miss dinner every night with my children. That’s non-negotiable.
Daniel Wrenne: Yeah. I completely agree, Brad. This has been fun. I’ve enjoyed talking. I would love to keep going. I feel like we could go on for a few hours. I can sense a little entrepreneurial spirit in you, which I love. We didn’t get to talk too much about it, but I could definitely get into the weeds with that, but I really appreciate you coming on and talking through your experience.
Dr. Brad Bennett: Yeah. Thank you so much. We can do this again another time. Yeah, it was my pleasure.
Daniel Wrenne: Definitely.
No guests or clients appearing on the podcast received any form of compensation for their appearance and obtained no other benefit from us. It should not be assumed that every client has had the same experience.
