Physician Online Advocacy with KevinMD | White Coat Investor (2024)

Transcription – WCI – 271
Intro:
This is the White Coat Investor podcast, where we help those who wear the white coat get a fair shake on Wall Street. We've been helping doctors, and other high-income professionals stop doing dumb things with their money since 2011.

Dr. Jim Dahle:
This is White Coat Investor podcast number 271 – Physician online advocacy with KevinMD.

Dr. Jim Dahle:

If you are finding our podcasts informative and helpful we would encourage you to sign up for our monthly newsletter! It is totally free and includes useful, actionable information NOT AVAILABLE on the regular blog posts. It's almost like being in a secret club – the kind of club that can boost your knowledge and enhance your wealth at the same time – with no strings attached. Sign up today at whitecoatinvestor.com/newsletter.You can do this and The White Coat Investor can help.

Dr. Jim Dahle:
Welcome back to the podcast. It's wonderful having you here. I appreciate everything you're doing out there. Your work is important. The day-to-day droning work that just seems like a job, just seems like you're on a factory assembly line assembling widgets matters. It matters in people's lives. It matters in the lives of your patients. They might be waiting for months to get in to see you for 15 minutes. And even though you got only one of 20 that you'll see today, it's important to them, and it makes a big difference in their lives. So, thank you for doing what you do.

Dr. Jim Dahle:
As you know, as you've been listening to this podcast for any length of time, there are lots of things you can do in the world that will make more money than practicing medicine or practicing law or whatever it is you do as a high income professional. But somebody needs to do these important jobs, and I appreciate you dedicating your life to do it.

Dr. Jim Dahle:
Let's do our quote of the day today since we'll be having an interview later on. This one is from Helen Gurley Brown. She said, “Money, if it does not bring you happiness, will at least help you be miserable in comfort.” A lot of truth to that even said, tongue in cheek.

Dr. Jim Dahle:
We'll be talking a little bit today about a lot of different subjects, about advocacy online, about combating misinformation, about managing your online reputation. We'll also be talking a little bit about burnout, and I'll get more into this at the end of the podcast. But I want to make sure you're aware of a program we've created in conjunction with The Happy MD called Burnout Proof MD.

Dr. Jim Dahle:
And this is a treatment program for burnout, which lots of docs have, more than 50% of docs have. It's essentially a six-month support system with a number of different components, including content that you work through on your own, including one-on-one coaching, including group coaching meetings, including being in a community with other physicians also struggling with burnout. It will give you the tools and skills to give you the hope you need to get back to your best life.

Dr. Jim Dahle:
So, pay attention at the end, you'll be able to learn more about how to get access to that. If you can't wait that long, go ahead and look at whitecoatinvestor.com/physician-burnout-coaching. It's also under our recommended tab on the website.

Dr. Jim Dahle:
All right, let's get our guest on here. This is a guest I've been looking forward to having on, somebody that's done a ton for physicians, patients, and medicine in general online over the last 18 years. Let's get our guest on the line.

Dr. Jim Dahle:
All right. Our guest, today on the White Coat Investor podcast is Kevin Pho, who you probably know better as KevinMD. He is an internist by training, however, probably best known as the founder of KevinMD.com, social media's leading physician voice. Welcome to the White Coat Investor podcast, Kevin.

Dr. Kevin Pho:
Jim, it's great to be here. Thank you.

Dr. Jim Dahle:
Let's let people get to know you a little bit at the beginning of this podcast, just so they can relate to you a little more. Tell us about your upbringing and how it affected your views on money.

Dr. Kevin Pho:
Sure. I grew up in Canada in Toronto. Upper middle-class upbringing. My dad was an engineer. My mom was a medical technologist. And I guess I was raised not to have any debt, pay off your credit card in full, and all that. And then, as you know, higher education in Canada is significantly cheaper than it was in the United States. I think that if I stayed in Canada, undergraduate education was measured in the thousands. Whereas in the United States, it's measured in the tens of thousands. I think undergraduate education now it's something like $50,000 to $70,000 a year.

Dr. Kevin Pho:
And I applied to an American university, Boston University. One of those combined undergraduate MD programs that I got accepted to. And for me, my family was in shock. And that was really the first time I was exposed to the fact that I had to take significant educational debt. And the decision I made at that time when I was a teenager would have significant financial ramifications going forward.

Dr. Kevin Pho:
I think that was really the first time that I had to be in significant debt. The first time I had to take loans. And it was really the first time that I was really attuned to how finances were going to affect my life then and going forward.

Dr. Kevin Pho:
I have to be honest, being in debt, even though it was educational debt, even though it was debt for medical school and undergraduate studies, it was certainly needed. It wasn't a good feeling. So, I think that instilled at the very beginning that I never wanted to be in debt if I didn't have to. And that's been a guiding principle for me going forward.

Dr. Jim Dahle:
Tell us about your education and training. Sounds like you did a combined program and then, obviously, an internal medicine residency. Tell us about that.

Dr. Kevin Pho:
Like I said, I went to Boston University when I was 17 years old. Three years undergrad, four years at Boston University School of Medicine. I stayed there for residency, internal medicine, and I thought I wasn't quite sure what I wanted to do. I always said I'll practice as an attending doing primary care for a few years, and maybe I'll go back for a fellowship. And I'm sure, as you probably know, once you get a taste of the attending life and attending salary, you don't go back.

Dr. Kevin Pho:
I graduated back in 2002 and decided to do primary care. I am in Nashua, New Hampshire now, which is about 45 minutes north of Boston. And I've been here since. So, 22 plus years doing primary care after my training in Boston.

Dr. Jim Dahle:
And you do primary care clinic, and is that halftime? I mean, you're putting a fair amount of time into KevinMD as near as I can tell. What's your career looked like as you've blended those two?

Dr. Kevin Pho:
Currently, I do primary care halftime, 0.5 FTE. When I first started out, I was a full-time regular primary care doctor. At that time, there weren't many hospitalists. So, we had to see patients in the clinic. We had to round at the nursing homes. We had to round in the morning at the hospital to see inpatients. So, a traditional internal medicine practice.

Dr. Kevin Pho:
And as that's evolved, certainly as medicine has become more siloed with hospitalists, I transitioned to strict outpatient primary care. And then, as KevinMD grew, and we'll certainly talk about that later on, it's given me the opportunity to cut down my practice. So, I went from full-time, 1.0 FTE to 0.75 FTE, to 0.67 FTE, and gradually to where I am now at 0.5 FTE.

Dr. Kevin Pho:
I see patients Monday, Tuesday, and half-day Wednesdays. And the rest of the time, I do a podcast like you are here and work on KevinMD, do some speaking, coaching. It's been a fantastic blend of doing medicine in the exam room and just exploring interests outside the exam room as well.

Dr. Jim Dahle:
Yeah, let's talk about that. I mean, you're famous. KevinMD.com gets two times the page views of White Coat Investor. You have a popular podcast, you do coaching, you do public speaking. Clearly, you could make enough money to make practicing medicine optional. Tell us why you're still practicing.

Dr. Kevin Pho:
I love being a doctor. That's really the simplest answer to that. I went into medicine, the cliche answer is to help people, make a difference in patients' lives. But as a primary care internal medicine physician, you're really needed. There are a lot of people who are looking for primary care physicians.

Dr. Kevin Pho:
I feel bad sometimes when I see a patient for like 15 minutes, and they've been waiting on this appointment for six months to see me. I guide them through our dysfunctional healthcare system. They come in with lab tests. They go off to an emergency department, no one's getting back to them. And in primary care, you're definitely needed. So, I do love being a doctor. I love taking care of patients. I love having those long-term relationships with patients in primary care. So, everything that is positive for primary care I love.

Dr. Kevin Pho:
But as a lot of doctors probably would say, you don't like a lot of the other stuff that goes along with it. The bureaucracy, and all the other issues that face primary care today. So, ironically, by cutting down doing primary care, by working only 0.5 FTE it's probably lengthened my career. It's probably kept me longer going to where I am. I love being a doctor. I love seeing patients.

Dr. Kevin Pho:
And then, of course, with my activities outside of the exam room, talking about social media to other doctors, being a practicing physician also gives you that credibility. Because as a lot of your listeners know, physicians tend to listen to other physicians, and they can tell if you're a physician in name only, and you're not seeing patients regularly. Whenever I talk about social media and I talk about my experience as a practicing physician, there's that certain credibility and relatability. So, my message, I think, resonates more with other physicians because I am a practicing physician.

Dr. Jim Dahle:
So, how long do you expect to practice? When you eventually hang that up, what do you expect retirement to look like?

Dr. Kevin Pho:
I don't know. I thought about that question. I have a daughter who's a junior in high school, so she's going to be going to college soon. I have another daughter who is in seventh grade. So, it's going to be a few more years before she goes to college. I'll be probably practicing until then, not knowing exactly how the cost of higher education is going to continue to skyrocket, who knows how much undergraduate education is going to cost 5, 10 years from now. It's probably going to break six figures.

Dr. Kevin Pho:
And I think that what I have now is a great blend. It's one of the things that I like to talk about is that we are more than our MDs, and we have a lot of control in terms of how we shape our professional careers. We're no longer confined to seeing 30 to 40 patients in the exam room from 9:00 to 6:00 PM.

Dr. Kevin Pho:
And I think that what I have now in terms of doing part-time clinical medicine and doing part-time KevinMD and exploring entrepreneurial interests and kind of filling that cup outside the exam room, I'm pretty happy where I am. So, I don't plan on retiring anytime soon. I certainly don't have a set date.

Dr. Kevin Pho:
But when it comes down to a point where whenever I feel like I work because I have to, that's probably a good sign that that's a good time to stop. You only want to work because you want to do it because you want to go in, and you certainly don't mind going in. And whenever it comes to a point where work feels like work, then that's probably a good sign that it's a good time to retire or cut back.

Dr. Jim Dahle:
Let's talk a little bit about something you said. You've mentioned a couple of times the cost of higher education, and I've always been surprised how regional this can be. You live in the Northeast. Education is really expensive at a lot of these colleges in the Northeast. You go into Boston, everything's $50,000, $60,000 a year.

Dr. Jim Dahle:
This is shocking to me because I live in Utah. My daughter's going to a college next year where the tuition is $6,000 a year. The state schools here are $7,000 to $9,000 a year. What do you make of that difference in different areas of the country, between different schools? And what should people think about that as they plan to send their kids to college?

Dr. Kevin Pho:
I think that going to college is not an issue. I think that there are so many undergraduate options in the United States that just going to a college is certainly not a problem. I think the issue is that everyone tends to apply to the same 30 to 40 colleges in the United States. And those colleges, especially now with them being test-optional, they are getting inundated with applications, and they can pretty much charge whatever they want.

Dr. Kevin Pho:
I think that, yeah, if everyone wants to apply to those same 30 to 40 colleges, and especially here in the Northeast, we're looking at an Ivy League education without any financial help to be at least $75,000. And that's pretty much how much it costs to go to medical school when I was going to medical school. And I think it's just simply unsustainable.

Dr. Kevin Pho:
I think it's a matter of expectations. I think that you could have a wonderful education at any undergraduate institution in the United States. If you want to go into medicine, of course, that's something that I'm familiar with. I think that really any undergraduate institution can prepare you for medical school. And it's certainly not needed, but it's just a matter of expectations. Who knows? Maybe it's family pressure, maybe it is peer pressure, maybe people want the prestige. But I think that the cost of education is driven by the fact that everyone's really applying to the same few dozen colleges that everyone wants to get into.

Dr. Jim Dahle:
I think our listeners would be really interested in hearing about the founding of KevinMD. This started in 2004. That was seven years before the White Coat Investor. It was the same year Facebook was started. It was a year before Reddit, two years before Twitter, six years before Instagram, seven years before Snapchat. You subtitled it Social Media's leading physician voice. As near as I can tell, when you started, it was just about the only voice. Tell us about that founding.

Dr. Kevin Pho:
Well, I like to say that I had a business back in 2004, and everything went according to that plan, but that's simply not the case. So, at that time, there were probably only a few dozen physicians who had blogs. That was when blogs were really just in its infancy. People just kept asking “What the heck is a blog?” And I really didn't know what to expect.

Dr. Kevin Pho:
I think that it was a format where people can share their thoughts, obviously on a blog. And there weren't very many physicians who shared their thoughts outside the exam room. And at that time, people would read news articles. There would be studies published in a newspaper, and they would ask me in the exam room, “Dr. Pho, what do you think about this study? What do you think about this new medication? What do you think about this recall?”

Dr. Kevin Pho:
And I think there was one medicine that was recalled, and someone was seeing a patient the next day after the announcement of that recall. And she said “I read your blog posts on your website, and now I'm comforted by what you had to say. And I realized that I have other options for this medicine I was taking.”

Dr. Kevin Pho:
I think that's when it really shocked me that really, we can have a voice, not just one-on-one in the exam with a patient, but with a blog. And now, with so many social media options, we have a platform where we can influence patients and other people who may be listening to us outside the exam room. Instead of one-to-one, we now can influence one to many.

Dr. Kevin Pho:
And it's evolved obviously since then with the platforms and online media and social media, they evolve every year. The landscape now is certainly much different than it was back in 2004. We have so many different platforms that suit everyone's strengths. On video, you have, of course, YouTube, Twitter, LinkedIn, Facebook, and the website itself, used to have email newsletters. We just have so many platforms where people consume information. And I think KevinMD has evolved to meet those different ways information can be consumed.

Dr. Kevin Pho:
Now, as a primary platform where I built it up to a point where I can share other clinician voices, they're mostly physicians, but I also share voices of patients as well, as well as advanced practice providers, where they can share their story and perspective.

Dr. Kevin Pho:
And it's important to have something that's physician-run because I can certainly set the agenda. I can choose the articles that are published. I can choose the articles that I want amplified. I can choose the narrative. And I think that's important because if you look at newspapers or other mainstream media platforms, their agenda isn't necessarily consistent with what's in the best interest of physicians. And as a physician myself, I want a platform where I can drive that narrative.

Dr. Kevin Pho:
I've just been very grateful that people trust my platform. People come to my platform if they want to be seen, if they want to be heard, if they want their stories to be shared. And it's just been a fantastic experience, not only sharing those stories but also learning from them as well, because there are thousands and thousands of KevinMD authors that I've just learned from by reading their story and talking to them on the podcast.

Dr. Kevin Pho:
Being what it is today, it continues to be a work in progress. It's been a fantastically interesting evolution. And like I said, there was no business plan. It's just kind of taking it as it goes over the years.

Dr. Jim Dahle:
Now, you mentioned all these places you've been, and we've kind of had the same evolution of White Coat Investor from blog to newsletter, to podcast, to videocast, and all these social media platforms. Do you have a favorite social media platform? If you could only be in one place online, where would it be?

Dr. Kevin Pho:
I want to reframe that rather than favorite. I would say the most powerful platform. I think the most powerful platform has to be Facebook. And all the reasons why I think it is the most powerful also has a flip side, in fact, it's also dangerous as well. I think for every good that Facebook gives you, I think there's a detriment that it gives you as well.

Dr. Kevin Pho:
I learned so much by connecting with like-minded individuals, not only on your boards, White Coat Investor group chats, I have Nisha Mehta's Physician Side Gigs and physician community. I have the KevinMD community, and just talking to other physicians and hearing their stories about what they're going through, how they solve problems to me is a fantastic learning experience.

Dr. Kevin Pho:
I do a lot of listening on social media. I don't necessarily contribute my own stories, but I just do a lot of listening, and just listening to what other physicians are going through, I think is tremendously valuable.

Dr. Kevin Pho:
But I think there's a flip side to that as well. I think what makes it powerful also makes it dangerous as well, because you have a lot of dangers that Facebook has given. I think there's a lot of harm that Facebook has in terms of connecting people who are like-minded in negative ways. It perpetuates misinformation. It closes people's worldviews. People only are siloed into a specific worldview.

Dr. Kevin Pho:
So, I think that whatever good Facebook gives, however much I learn from Facebook, there's also a flip side to that, and I'm very cognizant of that as well. So, when you ask what's my favorite one, I would say the most powerful one that I learned the most in terms of being where you're at, it has to be Facebook.

Dr. Jim Dahle:
Let's talk about your role at KevinMD. What is your role now and how has that changed over the years?

Dr. Kevin Pho:
I still own and run KevinMD on a daily basis. I think one of the challenges I've had is scaling because it's something that I've struggled with letting go. It's something that, like my own child, is something that I've grown since 2004 that I've overseen the day-to-day operations. Currently I still own and run it. I choose the articles that I want published. I edit my own articles. I do my own podcast. I produce my own podcast. I publish everything myself.

Dr. Kevin Pho:
I do have partners. I have advertising partners with MedPage Today, and then I have other people who use the KevinMD platform if they want to share their message with my audience. But in terms of who runs, who makes the editorial decisions, the technical decisions, it's still me. And it's been like that since 2004.

Dr. Jim Dahle:
Now, as a business, how's it changed over the years? I mean, obviously, you have some display ads there when you go there. How does KevinMD make money? How's that changed over the years?

Dr. Kevin Pho:
I think to run the platform, it's into six figures to run the platform. If someone were to make money, this is probably not the best way to do so. Content production is very, very difficult. It was difficult back then, even more difficult now. It's very difficult to stand out because there's just so many people competing for your eyeballs online.

Dr. Kevin Pho:
And in terms of how we make money, it's at least advertising space. Like I said, I have a partnership with MedPage Today where they use KevinMD to display banner ads. And then, I have also other places like my podcast newsletters, where I'm able to share sponsored content from other people who are interested in reaching the physician audience.

Dr. Jim Dahle:
Having done this now for not quite two decades, but a long time, would you recommend online entrepreneurship to other physicians? Why or why not? Do you think it's still possible to do something like you or I did more than a decade ago, or has this ship sailed?

Dr. Kevin Pho:
I think you have to be passionate. You can't go into it because you want to make money. It has to be a passion for you. And talking to other physicians out there, if your passion is seeing patients, if your passion is going to the hospital and operating or doing procedures or working in the emergency department, that's what you should do. You shouldn't go into online entrepreneurship or create a company online or create content online if that's not something that you're passionate in.

Dr. Kevin Pho:
Because it's very difficult to do what you do with White Coat Investor. It's very difficult to do what I do with KevinMD. It takes a lot of hours. I've published however many tens of thousands of articles and running a podcast. And if I didn't have the passion for it, or if I did consider it work, I wouldn't do it because on top of raising a family and doing primary care and seeing patients, doing KevinMD takes up a lot of my hours. It's pretty much a 24-hour day, seven-day a-week job.

Dr. Kevin Pho:
So, should physicians do it? I think only if they're passionate. And if they are passionate, income will come. I think that if you have put enough hours behind your project, whatever your online business is, and you spend a requisite amount of time on it, nurturing it, watching it grow, I think the money will come. So, to answer your question, should physicians do it? I will say, yes, but only if they're passionate and if their passion is not 100% into these online ventures, then they shouldn't do it.

Dr. Jim Dahle:
Now, let's turn the page a little bit. You're an expert in social media. What do you see as the biggest problems with social media and its intersection with medicine?

Dr. Kevin Pho:
I would say two. The biggest problem, number one, is misinformation. I think that it's so easy to perpetuate misinformation. And we've seen that during the pandemic. I think we're elevating people who have legitimate scientific credentials and putting them on the same platform with your neighbor who maybe just heard something from someone else and giving them that same platform. And I think that's confusing the audience in terms of what's reputable information or not.

Dr. Kevin Pho:
So, talking to patients specifically in the exam room, there's so much misinformation that they've heard on Facebook that I have to spend time clearing up. So, that's the number one biggest problem, is the perpetuation of misinformation.

Dr. Kevin Pho:
Number two is that I think that silos people, and what we talked about earlier about siloing people with similar worldviews, that's good and bad. And I think that if you look at the negative aspects of that, you only talk to people who share your political viewpoints and just share your worldview, and you don't really get exposed to ideas or perspectives that differ from yours.

Dr. Kevin Pho:
And if you look at how Facebook runs the algorithm, you only like stuff, or you click on stuff that you agree with. And in a sense that self-perpetuates, because that only feeds more information that you agree with. So, I think that's been a real detriment of social media in that it really adds to the divisiveness of our society by enforcing the world views that we already have.

Dr. Jim Dahle:
Let's talk about that first one, because it grows out of one of the things that's wonderful about social media, that's wonderful about the internet and that's that you can get your voice out there. Even if you're not a big, huge media company, even if you're not famous, even if you don't have political power, you can get your voice out there. And if people like it, it spreads quickly, and it can go viral, etc.

Dr. Jim Dahle:
That's a great thing, but it also puts a random blogger that started last week on par with CNN or on par with USA Today or whoever, some big media company. How do you balance free speech with the need to reign in disinformation?

Dr. Kevin Pho:
Yeah. And I think that's the question that a lot of social media companies are still grappling with. I think it's really a tenuous balance. I don't have a good answer to that. I think that when it comes to public health, should there be more moderation from the social media companies? Maybe when it comes to deliberate misinformation that harms public health. And I know that a lot of companies like YouTube and Twitter, they post warnings if they know that there is misinformation specific to the pandemic.

Dr. Kevin Pho:
But I think that you bring up a wonderful point. I think the power of social media in terms of elevating everyone, that, like I said earlier, is indeed a double-edged sword. But I want to talk about what our responsibility is as physicians. I think that one of the themes that I always try to talk about whenever I give talks on social media to other physicians, is that we do have a responsibility to combat misinformation.

Dr. Kevin Pho:
One of the ways that we can do it is that more of us need to go online and either create content or share reputable content, because this is really a content game. And whoever has that biggest influence is going to change minds out there. So, I always encourage physicians to get online and really create a counter-narrative of reputable health information to combat all the misinformation that's out there.

Dr. Kevin Pho:
Because I always talk about how people who perpetuate misinformation, they've had a head start on us. I talk to doctors, and they say “Why do I need to go on social media?” And while I'm convincing doctors to get on social media, people who perpetuate, for instance, anti-vaccine stances. They've had a five to 10-year head start and a five to 10-year head start online, you know that's an eternity. So, we are already playing catch up.

Dr. Kevin Pho:
That is one of the pleas that I have for physicians is to really go online, and you don't have to create content like you or I do, but simply share reputable pieces of content. And by creating again, a counter narrative of reputable health information, you're doing your part in hoping that reputable health information reaches patients online. Because we already know they're exposed to a lot of disinformation misinformation. So, as physicians, we need to also perpetuate a reputable source of information, so they can reach our patients.

Dr. Jim Dahle:
Let's talk about the second issue with social media that you brought up, the siloing. And we all know somebody, a family member or a friend that is just deep in a silo on the internet or on Facebook. But how do we combat this for ourselves to make sure we're not just in a silo, but also how do you pull somebody else you care about out of one of these online silos?

Dr. Kevin Pho:
Again, a great question. I think that's also been a challenge. I think you would understand where they're coming from. I think that you cannot talk down to them. You cannot say that they're wrong, but I think you just have to listen and understand. And it's very similar to when I talk to patients in the exam room and they have views on, for instance, the COVID vaccine, and they've read something online about how it's dangerous, or if they want to take Ivermectin or something like that.

Dr. Kevin Pho:
And you have to see where they're coming from. You have to listen to their concerns. You have to listen to their story, and you have to take the time to understand, because a lot of people who believe in misinformation, obviously, they're not bad people. They're people who sincerely believe in that, and they're doing what's best for themselves and their families.

Dr. Kevin Pho:
So, it's important that we understand that, and we have to understand where they're coming from and really have that conversation about what their motivations are. You talk about what you would do or what I would do for my family and my kids, and realize that we have that commonality, that we want to do what's best for our families, and we may have different ways of doing so.

Dr. Kevin Pho:
And you just have to find that common ground. And once you have that common ground, I'm not saying that you're going to convince everybody, but I've convinced more than a few where they come in with some type of strongly believed misinformation, and we have a conversation about what's their motivation behind them. And they have second thoughts, and even some of them have changed their minds and gotten, for instance, the COVID vaccine.

Dr. Kevin Pho:
So, I think it is important to not talk to them in “us versus them” matter and realize that, hey, we do have the same motivations, and we just have different ways of getting there. And it's important that we just hear each other out.

Dr. Jim Dahle:
How about in ourselves? Is it just a matter of making sure we get our information from both CNN and FOX? I mean, how do we make sure we're not ourselves getting into an online or political silo?

Dr. Kevin Pho:
Yeah, I think it's important to get information from different sources of political worldview. So, when I read editorials on a specific issue, I make sure that I read them from The New York Times, The Washington Post, and The Wall Street Journal. So, it's important to get a diverse spectrum of perspective.

Dr. Kevin Pho:
On KevinMD, this is something that I emphasize because I do include political perspectives, not only from the left, but also from the right as well. Because it's important to learn from people who may not necessarily agree with us. So, that is something that I certainly emphasize.

Dr. Kevin Pho:
I have my own viewpoints, but I would post things on KevinMD that I don't necessarily personally agree with, but I think that it is important to have that diversity of opinion that is out there. So, like you said, it is important to step outside our silo and listen to people that we don't necessarily agree with. And it is possible to have incongruent viewpoints of the same issue. And you just have to understand that and be accepting of people's perspectives that may not be your own.

Dr. Jim Dahle:
All right. Let's talk about online reputations. You've co-written a book about managing your online reputation. You called it, and it's a very descriptive title, “Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices.” Why is that a subject important enough for you to spend that sort of time and effort on?

Dr. Kevin Pho:
Yeah, that book was published a long time ago. It's almost an eternity. It's certainly overdue for another edition. But at that time, it was really my call to arms, so to speak, for physicians to go online because more so back then, physicians didn't really know why they should be online. They just said, “I just see patients in the exam room. I don't care what my online reputation is. It doesn't matter how I appear on Google. I don't need to be on Facebook, Twitter, and LinkedIn, YouTube. I just want to see patients in the exam room.”

Dr. Kevin Pho:
And I was trying to convince them. And we talked a little bit about this before that, we need to go online because that's where our patients are. Not only are they going online to research health information, they're going online literally to Google their doctors as well.

Dr. Kevin Pho:
And I think that I wanted to really share that if we don't take a proactive stance to manage our online reputation, someone else is going to do it for us. Because like you know, if you Google your name online and you don't have an online presence, what normally shows up, it's going to be something from Healthgrades, RateMDs, Vitals, Yelp, and whatnot.

Dr. Kevin Pho:
If you don't define yourself online, someone else is already going to do it for you. So, you might as well be a little bit more proactive and control how you're presented online. Not only for your own knowledge, but patients as well, because a lot of patients are just going to be Googling you online before they see you. And then now that rationale is certainly expanded.

Dr. Kevin Pho:
We talked about that misinformation piece, but there's also a third piece that I want to talk about is really advocacy. I think that there's a lot of changes to our profession. A lot of clinicians who are listening to this podcast, they're going to know that sometimes our profession is changing by the day. There's a lot of regulations that are coming up. There's a lot of just bureaucratic influences. There are a lot of things that are going to change how we practice as physicians. And if we don't speak up, people who don't have our best interests at heart are going to make decisions for us, and already we're not going to like the effects of that.

Dr. Kevin Pho:
I wanted to also give that third reason that, “Hey, we have these tools. They are powerful tools, whether it's a website or Facebook or YouTube, where we can advocate for our profession, where we could share our stories and try to gain some influence on these policy decision-makers that are going to affect our lives.” And really add that reason to the call of arms of why physicians should go online. Not only for the patients, not only for online reputations, but for the profession as a whole, to really try to take some of that control back and make a difference.

Dr. Jim Dahle:
You mentioned proactively getting out there to manage your online reputation. I mean, what do you mean? Should people buy the URL with their name and put something up there so that that's the first thing that hits when people Google you instead of Healthgrades or Yelp? Is that what you're talking about when you're talking about managing online reputation or is this just for plastic surgeons to have before and after photos on a website?

Dr. Kevin Pho:
I think it depends on how aggressive you want to be. I think at the very least you could do something like LinkedIn. LinkedIn is a fairly common website that gets ranked high. If you do a LinkedIn profile where you can control what shows up, that can compete with things like Healthgrades or Yelp or a patient review, at least.

Dr. Kevin Pho:
And the more you do, the more effective it's going to be. So, once you get comfortable being online with LinkedIn, yep, you could buy a URL with your name. You can adjust your Google business profile. The more of these online platforms that you control and be more proactive and customize, the more you control how your online footprint is going to be.

Dr. Kevin Pho:
Now, that's the first step. There are going to be some physicians who think that's enough. And I think that's great. I think that if people just grab a LinkedIn profile and just change my business thing, it takes a few hours and that already puts them ahead of the game.

Dr. Kevin Pho:
And of course, there's going to be some physicians who are going to utilize online platforms to talk about some of the things that I talked about earlier, whether it's telling stories, patient education, advocating for the profession, and yeah, they can create a URL for their name and have that online website. And the more visible they are online, the more they're going to control their own reputation.

Dr. Kevin Pho:
So yes, there are physicians who have their own blogs and really just share their stories and kind of do what I do where they use that website as that central repository of content. And then they can speak out to all the different online social media platforms where people can consume their information.

Dr. Kevin Pho:
So, I think it depends on the physician. It depends on what their goals are, it depends on how interested they are in terms of managing and creating online reputation. But I think that there is a spectrum based on what those goals are and how committed they are to it.

Dr. Jim Dahle:
Now, online reviews of physicians are notoriously terrible. Some of us really don't care. If you're a radiologist, if you're an emergency physician, if you're a hospitalist, frankly, you don't care what people have put about you on Healthgrades or Yelp or whatever. People don't Google the emergency docs for choosing an emergency department.

Dr. Jim Dahle:
But obviously that matters for lots of people, lots of practices. If you're trying to build a practice just about every patient is going to look at your reviews before they come see you. What should doctors do about negative reviews?

Dr. Kevin Pho:
The first thing I recommend is really just read them. And a lot of times, when people write a less than positive review, it's not necessarily the physician himself or herself, it's something to do with their office staff or something that they have no control over. It could be not enough parking. It could be that the support staff, they didn't get back to that patient in time. So, there are times where those reviews can point out problems in your practice that you may not even be aware of. That's the first thing, is just to read it and fix whatever you can to fix.

Dr. Kevin Pho:
The second thing I normally recommend is just asking in general, more patients to rate you online, and a lot of medical systems, I believe University of Utah, they already do this. They use their Press Ganey reviews and put that on their public website and use that to kind of saturate the public physician reviews.

Dr. Kevin Pho:
Because in general, patients like their doctors, if you look at Press Ganey scores and Press Ganey reviews, in general, they're pretty good for their physicians more so than say something on Yelp or so. I know a lot of medical systems are using these official Press Ganey reviews as part of your public-facing feedback for physicians.

Dr. Kevin Pho:
But I really think the best way to manage something negative is to, again, be proactive because you want to, I don't want to say marginalized, but you want to make negative reviews less visible. And by creating your own content, whether it's a website and controlling how your footprint is online, what that sometimes can do is push down the visibility of negative reviews, maybe onto the second page of Google. So, the more online platforms that you can control and you can customize, that can hopefully make less than negative reviews that you don't control, make them less visible.

Dr. Jim Dahle:
Let's talk a little bit about what you're doing with the blog and the podcast. The first thing somebody notices when they go to KevinMD, or they look at podcast is that there's an absolute ton of content. There's a ton of stuff there. Where does it all come from?

Dr. Kevin Pho:
It comes from guest authors, they're primarily physicians, but anyone who intersects with healthcare. I think the mission I have is to share the stories of the many who intersect with our healthcare system that are rarely heard from.

Dr. Kevin Pho:
And it turns out there are thousands of people in our healthcare system who want to be heard, but don't have a platform to do so. I get dozens of guest articles daily. I publish three to four times per day, just over the last 20 years, almost 40,000 pieces of content, and more than I can get through.

Dr. Kevin Pho:
But I think that it just really speaks to a need where healthcare professionals or anyone intersect with the healthcare system, they just want their stories told, that there's just nowhere for them to do that.

Dr. Kevin Pho:
You can go to a place like The New York Times or whatever newspaper, and that's perfectly fine, but sometimes physicians may not be the best writers. You may not have a New York Times quality op-ed. And that doesn't mean that your story is any less important. It doesn't mean that your story is any less poignant if you're not a polish writer.

Dr. Kevin Pho:
So, I create that platform where people can get heard, not only just on the website itself and on social media, but I have a lot of television producers, newspaper editors who read my site, and people who've written on KevinMD. They've parlayed that into opportunities to write books, to appear on national local media and use KevinMD as a springboard where they can share their story on a larger platform.

Dr. Kevin Pho:
So, I've built a platform. It's not easy to start a platform. It takes time and effort. But now that I have that platform, I use that to really share stories from healthcare professionals who want to either tell their side of the story, or just want to share an experience. And I'm just really gratified that people trust me to do that.

Dr. Jim Dahle:
In essence, your content is provided to you free, it's donated to you essentially by people that want to get it out there.

Dr. Kevin Pho:
Yes. And I think that it's in exchange certainly the visibility and the fact that it certainly spreads on social media and giving them that opportunity. So, they can be heard otherwise, as you know, it's very difficult to be heard, it's very difficult to cut through all that information clutter that's out there. I do give that opportunity where they can cut through the noise. So, they can not only, at the very least they'll be heard, but sometimes they could even make connections, and again, parlay that into bigger media platforms.

Dr. Jim Dahle:
Do you worry that that model attracts people with an axe to grind or simply people looking to promote whatever they're doing rather than maybe the content that is most important to get out there?

Dr. Kevin Pho:
Yeah. I think absolutely. And I'm sure that you feel that as well. The White Coat Investor platform you have, a lot of people who do want to share their stories with the physician audience but that's where being an editor comes in. And by all means, I'm certainly not perfect. I think some things that I've published that I've had second thoughts about. But yeah, that's where the editorial discretion comes through.

Dr. Kevin Pho:
So, I think that everything I do read through, if there's things that are promotional and I don't think that would benefit my audience, I just simply would decline it, and I've declined many, many pieces. But yeah, I do think that is a concern. The bigger you are as a platform, the more people are going to utilize it, but not in the best interest of my audience.

Dr. Jim Dahle:
Now, you've embraced a variety of voices on your blog and podcast far beyond just physicians. You often feature advanced practice clinicians and even patients. Has there been any blow back from going beyond doctors? Tell us about that.

Dr. Kevin Pho:
Yeah. Sometimes. I sometimes get feedback from physicians, “Why are you including perspectives of nurse practitioners? It should be physicians only. Why are you including perspectives of patients?” So, yeah, I do sometimes get some pushback against that, but I think it goes to what we talked about before in terms of siloing our world and how we need to break out of that.

Dr. Kevin Pho:
Because as physicians, talking about why include patients, for instance. As physicians, a lot of us don't know what it's like to be in our healthcare system from a patient perspective. And I think it's important to know that. I've learned so much from patient written articles. I've learned so much by talking to them on my own podcast, and they share some of their stories and difficulties in our healthcare systems that I had no idea about as a physician.

Dr. Kevin Pho:
Knock on wood, I'm lucky. I rarely use our healthcare system as a patient, but hearing these stories, I think it has made me a better physician. It's made more empathetic in terms of what patients are going through. And I've learned a tremendous amount and the same goes for people who are not necessarily physicians and advanced practice providers, physician assistants and nurse practitioners, it’s interesting to hear what their journeys are in our healthcare system.

Dr. Kevin Pho:
Because our healthcare system, despite what a lot of physicians think, it's vast, it's huge. And I think that there's so many aspects of it outside of the physician world that we just simply don't know about.

Dr. Jim Dahle:
Now, KevinMD.com has never been one to shy away from controversial topics. What do you see as the top three to five most controversial topics in medicine right now?

Dr. Kevin Pho:
Yeah. I think that it all boils down to really one thing, the future of our profession. And that can manifest in different ways. I know that there's a lot of controversy when it comes to advanced practice providers and independent practice. That's certainly a topic that garners a lot of controversy whenever I post an article on that or whenever I share on Facebook. It just elevates into a huge shouting match in the comment. So, I think that's the one thing.

Dr. Kevin Pho:
And then I think there's so many aspects in terms of the role of government in our healthcare system, anything political that's going to generate a ton of controversy as well because there is no right answer and people are so entrenched on each side that no matter what people say, it's very difficult to convince people's minds.

Dr. Kevin Pho:
But I think it really just boils onto the future of our profession. What does it mean to be a doctor today, and what does it mean to be a doctor going forward? And I think that a lot of the controversy really stems from that question and exploring that question. It's changing as we speak.

Dr. Kevin Pho:
What it means to be a doctor today is different from what it was 10 to 20 years ago. You have a lot of doctors with these proverbial side gigs. You have doctors now who don't necessarily see patients only in the exam room or go to the hospital. You see a lot of physician coaches, you see a lot of physicians who are practicing, not in a traditional manner.

Dr. Kevin Pho:
And that is one of the things that I am interested in exploring. And it does get some pushback because you have a lot of traditionalists out there, and they don't necessarily see side gigs in a favorable light, for instance. They think that doctors who don't necessarily see patients 24/7 they're not considered proverbial real doctors. They think that what some of us are doing with entrepreneurial ventures, they're distracting from our true purpose as being a physician.

Dr. Kevin Pho:
So, I think there's evolution there. There's a lot of pushbacks from people who view medicine traditionally versus a newer generation of physicians who realize that medicine shouldn't be all-consuming. So, it's interesting being on the sidelines and seeing this and seeing the discussion that emerges from this. And really essentially, what we're dealing with is the evolution of what it means to be a doctor. So, I think that's garnered the most pushback.

Dr. Jim Dahle:
Let's talk about what people aren't talking about. What do you think is not getting enough attention in physician-focused social media?

Dr. Kevin Pho:
It's difficult because I think that talking to people like yourself and people in our world who blend clinical medicine with entrepreneurial ventures, we like to think that that's what it is everywhere. And it really isn't. I think that what we're doing in terms of you with White Coat Investor, what I do with KevinMD is actually not norm.

Dr. Kevin Pho:
And I think that even though we talk about this a lot on both of our platforms, I don't think it gets talked about enough in terms of we are more than our MDs. I think that if I talk to physicians who are not plugged in on Facebook and don't read KevinMD or the White Coat Investor, and they're just spending whatever, 80 hours seeing patients every day, they think that's all there is to medicine and they're burning out.

Dr. Kevin Pho:
I think that even though I talk about it a lot on KevinMD about burnout and what it means to be a physician, I don't think that we talk about it enough. I don't think it's normalized quite yet. And I think we do need to address that issue of clinician burnout. We both know what the numbers are. It's like more than 50% or something like that, physicians are burning out. And to let them know that there is hope out there. That there is a solution to this.

Dr. Kevin Pho:
And we talk about burnout a lot, but I think it needs to be normalized in terms of the solutions to burnout, whether it's either cutting back or doing things outside the exam room or doing things outside of clinical medicine. So, you're just not working because you have to. I think that's something that even though we talk about it a lot, I think it needs to be just normalized and make people realize that, “Hey, there are other ways to be a physician than what's traditionally thought of.”

Dr. Jim Dahle:
Let's turn the page to finances a little bit. A few years ago, KevinMD started incorporating financial content onto the site.

Dr. Kevin Pho:
Yeah.

Dr. Jim Dahle:
Why? And what have you learned about teaching finance to doctors by that experience?

Dr. Kevin Pho:
I think I was inspired by what you're doing in terms of, I think one of the things that I mentioned when I had you on my show a couple of weeks ago is that you created a whole new asset class of content, which is the healthcare personal finance space.

Dr. Kevin Pho:
And I think that there were a lot of KevinMD audience members who don't necessarily read the White Coat Investor. And I wanted to really just expose them to say, “Hey, this is important information, almost as important as what you know clinically.” Because if you, as a physician, aren't financially literate, you are going to struggle going forward. You are going to be burnt off from your job. You are going to feel like you have to work because you have to pay off debts or you bought that expensive doctor car or house, and that's only going to contribute to your burnout.

Dr. Kevin Pho:
So, I thought that it was important not only to share the traditional KevinMD stories about medicine whatnot, but really to kind of share a little bit of the financial aspect as well, because I think if you are financially literate, it is actually going to help with the burnout prices that's affecting the medical profession today. So, that's the main reason why I wanted to include some financial pieces on KevinMD.

Dr. Kevin Pho:
And now it's still a minority of the content, but I do have physicians who contribute financial stories, financial tips and advice. And I think that those stories are just as poignant and relevant as the clinical stories that I share on
KevinMD.

Dr. Jim Dahle:
Now you have interacted with lots and lots of docs, both online and in real life. What are your general thoughts on the financial situation of physicians?

Dr. Kevin Pho:
I think it's better than it was, but I read on your Facebook group some of the questions that people have. For instance, as we're speaking today, the S&P is down 20% and people still ask “Should I wait for the bottom? When should I time the market?” And I think there are a lot of basic financial questions that people are still asking that people need answers to. I think that it's better than it was. Certainly, thanks to what you do.

Dr. Kevin Pho:
But I think that there's certainly room to improve in terms of financial literacy of physicians. And that's certainly what I continue to try to do a little bit on KevinMD by sharing these articles. And I think that everything that your audience is familiar with in terms of the unique issues that physicians face, I think they're continuing but slowly but surely hopefully will narrow that gap.

Dr. Jim Dahle:
Let's get a little bit more personal. Do you feel like you've got your financial ducks in a row? And if so, how did you do that?

Dr. Kevin Pho:
I don't know if I have my financial ducks in a row. I think that certainly there are a lot of things that can do better, but I think overall, it's pretty good. What I mean by that is really, I don't have any debt. And I think that if you just follow that one rule and just really try to minimize or eliminate any unnecessary debt, I think that you already will be ahead of a lot of the other clinicians who are out there. That value that was instilled in me early on, that's really something that I've lived by. And if I didn't do anything else, just not having any debt, I think that I would be fine.

Dr. Kevin Pho:
And then in terms of what else did I do to get my financial ducks in a row is really reading White Coat Investor. And just following your tips and advice. Specifically, I think that one of the things that was very helpful was when I was just learning about investing, I would start by reading that book, “The Dummies Guide to Mutual Fund Investing.” That yellow one and black book.

Dr. Jim Dahle:
Eric Tyson. Yeah?

Dr. Kevin Pho:
Yes. Eric Tyson. Yes. I'm sure that's the first book that a lot of physicians would read. I would read that, but then it wasn't until I read information by John Bogle and White Coat Investor that investing doesn't have to be complicated. You just have a three-index fund portfolio, and that's really good enough.

Dr. Kevin Pho:
And I think that just reading from what White Coat Investor does from a physician perspective, as it relates to personal finance, I've learned a lot. Investing and managing money doesn't have to be complicated, even if there's a lot of exotic ways to invest, but it doesn't have to be complicated. If you stay out of debt and just do index funds, you'll come up way ahead.

Dr. Jim Dahle:
As you think back over your career, all the financial advice you've been given by docs, colleagues, etc, what do you think is the most helpful thing you've been told?

Dr. Kevin Pho:
I want to just, yeah, expand what I said. It doesn't have to be complicated, like I said. And sometimes I don't even follow that advice. So, you read about the latest cryptocurrency and I've invested in cryptocurrency and you read about real estate and I've invested in real estate. And I think back to myself, “If I just stuck with a three-fund index portfolio and not get into that, would I be better off than I am now?”

Dr. Kevin Pho:
And I think the biggest piece of advice is really just to keep it simple. You don't necessarily have to follow whatever the latest trend is or whatever your colleagues may be investing in. And if you just keep your investing principle simple and stay out of debt, you'll come out way ahead. And I think that probably is the most powerful piece of advice that I was given.

Dr. Jim Dahle:
Well, you now have the ear of 30,000 to 40,000 listeners, and our time is short. What have we not talked about yet that you want them to know?

Dr. Kevin Pho:
Yeah. I want to talk about clinician burnout. I know we mentioned that earlier and if you have your financial ducks in order, if you're financially literate, that's really going to be a solution to burnout. And it's not necessarily, if you can be financially independent, quit medicine altogether, but you can do similar to something I did. And it gives you the opportunity to cut down to half time and lengthen your career in clinical medicine.

Dr. Kevin Pho:
So, that to me, I think is the biggest message is that I think that we are more than our MDs. We don't necessarily have to be in the exam room seeing patients 24 hours a day. But if you can find a way to follow passions, if you have them outside of the exam room, that to me, is the strongest solution to the burnout crisis that's affecting a lot of physicians today.

Dr. Jim Dahle:
It's interesting you mentioned that. The first thing I tell somebody when they tell me they're burned out is “Why don't you cut back the full time?” Because so many docs are already working far beyond full time.

Dr. Jim Dahle:
But you're right. It's really hard to get burned out when you're working halftime or quarter time. It's hard to get burned out when that's how often you're going into work. And it takes financial know-how to get your life to that level. That's not necessarily the solution for everybody, but it certainly is a solution for many, many docs that are burned out, is simply to work a little bit less. And all of a sudden, they love their jobs again. So, good tip.

Dr. Jim Dahle:
All right. Well, what's the best place for people to learn more about you? Or if they want to hire you as a coach or as a speaker, where's the best place for them to go?

Dr. Kevin Pho:
Sure. KevinMD.com has everything that you need there as my content and information on speaking and coaching. And of course, you can search for my podcast. It's a daily podcast. We're going almost 800 consecutive daily episodes. And just go to your favorite podcast platform and search for the podcast by KevinMD.

Dr. Jim Dahle:
Awesome. Well, it has been great having you on here, Dr. Kevin Pho, MD, founder of KevinMD.com. Thanks for being on the White Coat Investor podcast.

Dr. Kevin Pho:
Thanks for having me.

Dr. Jim Dahle:
I hope you enjoyed that as much as I did. One of the best parts about having a podcast is you get to bring people on that you want to talk to. And I like talking to Kevin. He's got a lot of insight into medicine. He's been online for a long time, and you learn a lot when you're online interacting with a lot of people. Well-spoken and so knowledgeable. It's always great to hear from him.

Dr. Jim Dahle:
He's right about the burnout. Burnout is a huge problem. 50% plus of docs have some burnout. And if you look at the percentage of whom it's having a severe effect on their life, it's in the 10% to 20% range. If you multiply that by a million doctors in this country, that's hundreds of thousands of doctors whose burnout is severely affecting their life.

Dr. Jim Dahle:
We partnered with The Happy MD to create something called Burnout Proof MD that you should check out. If you go to whitecoatinvestor.com/physician-burnout-coaching, this is one of the things we offer. We have kind of a spectrum ranges from private coaching, all the way to online courses, but in the middle of that is this product that we think is really great.

Dr. Jim Dahle:
It's called Burnout Proof MD. You get a six-month support system of weekly, two-hour group coaching. You get three one-on-one personal coaching calls during the program. You join these other like-minded physicians in a private community. You get access to 29 plus hours of Burnout Proof training materials that you get CME for. So, you can use your CME funds to pay for this. Most importantly, though, you get the tools, you get the skills you need to live your best life to overcome burnout.

Dr. Jim Dahle:
You've got to optimize for longevity. You can insure against death. You can insure against disability. You can't insure against burnout. So, you need to prevent it. You need to treat it when you get it. And that really is one of the most important financial steps you can take in your career.

Dr. Jim Dahle:
All right. Thanks for those of you who have been leaving us a five-star review and telling your friends about the podcast. Our most recent one comes in from Easwar Sankar who says, “Fantastic. Jim Dahle is the perfect balance between Dave Ramsey and Robert Kiyosaki. If you know you know. Enough said.” Well, that's very kind of you. I appreciate that five-star review.

Dr. Jim Dahle:
If you are finding our podcasts informative and helpful we would encourage you to sign up for our monthly newsletter! It is totally free and includes useful, actionable information NOT AVAILABLE on the regular blog posts. It's almost like being in a secret club – the kind of club that can boost your knowledge and enhance your wealth at the same time – with no strings attached. Sign up today at whitecoatinvestor.com/newsletter.You can do this and The White Coat Investor can help.

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Dr. Jim Dahle:
Keep in mind that other people often have different opinions. Like our most recent podcast about Bitcoin a few weeks ago. Lots of people loved it. Lots of people hated it. It's a controversial topic, no doubt about it. But we appreciate getting the feedback, and we do use it to guide this podcast.

Dr. Jim Dahle:
We also put your questions on the podcast, as you know. If you want your questions answered, you can leave them at whitecoatinvestor.com/speakpipe, and we'll get you on the podcast. We'll answer your questions.

Dr. Jim Dahle:
Until then, keep your head up, shoulders back. You've got this, and we can help. We'll see you next time on the White Coat Investor podcast.

Disclaimer:
The hosts of the White Coat Investor podcast are not licensed accountants, attorneys, or financial advisors. This podcast is for your entertainment and information only. It should not be considered professional or personalized financial advice. You should consult the appropriate professional for specific advice relating to your situation.