MD Preferred Blog

Young physicians have some of the highest mortgage underwriting decline rates of any professional seeking real estate financing.  This should not come as a surprise as most residents have a negative net worth (typically loans far exceed assets) and many coming straight out of medical school have not filed taxes in years.  

How does one qualify for a mortgage with a negative net worth and little if any documentation of income?  

To solve these challenges, the physician home loan or doctor mortgage as it is also called, was created to overcome the challenges physicians in training and newly attending face when trying to qualify for home loans.  

What is a physician home loan?   

According to HousingWire, Amazon is preparing to move into the mortgage space by seeking out a new head for that division. From HW:

Earlier this week, we reported to the LendingLife community that online shopping giant Amazon may be looking to get into the mortgage lending business, or at least that's the rumor among mortgage lending professionals.

While limited in scope, Amazon's plans are to start with offering checking programs first, then maybe move into the debt product space after.

Well, after reporting that, we’ve received information that Amazon is currently looking to hire someone to lead their newly-formed mortgage lending division.

Due to non-disclosure agreements, we probably shouldn’t reveal their identities. After all, with Amazon planning a move into mortgage lending, it’s best we work with them and not against them. Am I right?

We can say that if you look at the top 10 HMDA lenders and pick out the nonbanks, that’s where Amazon is recruiting their talent.

I, for one, welcome our Amazon overlords.  

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I’m not a big fan of buzz words, but when I ran across this one—intrapreneur—I was intrigued. As organizations have grown larger, intrapreneurs—persons within a company who promote innovation within the organization—have become the new movers and shakers, and company executives are on the hunt for this new type of employee, for people who can lead on important internal issues and, where possible, effect internal change that’s positive and, in many cases, ground-breaking.

In my work with new docs, especially those coming right out of residency or fellowship, I tend to see three distinct types. There’s the new physician that just wants to practice medicine, and not be bothered by operational issues. There’s the new doc that is only interested in those operational matters that have a direct impact on his or her bottom line. Finally, and more rarely, there’s the intrapreueur, the one that looks at a bigger picture of healthcare and is looking analytically at their practice, the group’s practice, and the immediate healthcare environment, finding ways to make very productive changes that benefit their practice, group, patients, and hospital. 

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You need to protect yourself from the financially devastating epidemic in our nation- outrageous student loan debts!! You need to obtain student loan protection in the event of a disability. This protection will be a safeguard so you will be able to meet your student loan payments!

Disability Insurance offers you the financial protection from many things that could hinder your ability to earn a living. Most people think that disability does not happen to younger people and that most disabilities are due to work-related accidents. Actually, the odds of having a long-term disability (one that lasts 90 days or longer) before age 65 are as significant.  

A few months back I promised to discuss this topic a bit more, discussing the ways affiliations can be built, maintained and expanded in functional medicine practices. Let’s start with a few of the basics.

The primary combination of a good nutritionist and an FM doc is an absolutely “must have” for any functional medicine practice. Nutritionists don’t have to have an FM certification but need to be working in that direction; same with a doc if they don’t have an FM certification.

These two must get comfortable with each other to form an affiliation: More than just sharing referrals, the combination must be part of a clinical practice that is dedicated to expanding the patient experience and overall patient wellness. In my opinion, this is one of the most critical question to ask, and the answer has to be YES.

With this accomplished, the affiliates (I don’t want to use the word “partner” because it has an array of legal meaning) need to talk about their vision for creating this relationship, and discuss in detail their vision for the practice and its patients. Look down the road--Where would you like to be in 12 months? 18? 24??  

Here is a great article put together by National Mortgage News (NMN) highlighting the 10 US cities on the verge of a housing bubble. The data was provided by Attom Data Home Affordability Index. I encourage you to jump over to NMN to get the breakdown on all the data and to learn more about how the rankings were put together. But for now, here is the list.

10.  Nashville Metro, TN
9.  St. George, UT
8.  New York, NY / Newark, NJ
7.  Medford, OR
6.  San Francisco Metro, CA
5.  Seattle Metro, WA
4.  Sacramento, CA
3.  Portland Metro, OR
2.  Seattle Metro, WA
1.  San Antonio, TX 

When most people talk about “social purpose strategy” they usually mention some of the companies that have been most successful to making it part of their branding and marketing.  Patagonia is one of the first to come to mind—their constant commitment to environmental matters and to a manufacturing process that pays fair wages to workers shows concern for working environments and addresses sustainability and global concerns.

Their angle is to emphasize the social benefits their mission (i.e. social purpose strategy) brings to consumers and the world at large.  Patagonia has built this message into every aspect of their product line and image.  It’s a key element of developing a strong customer relationship, to develop and maintain a strong brand loyalty.

Recently I was speaking with a physician friend who regaled me with a wonderful story about volunteer work he did annualy deep in the Central American jungle.  These trips were part of the only annual visit to this remote region made by doctors in his specialty, and there would be long lines awaiting the opening of their mobile clinic every morning they were there.  Treating dozens of patients every day, of all ages, was clearly one of the things he looked forward to every single year. 

Two years ago I fielded a call from a surgeon I knew of but had not met.  Raised locally, she had left the state for undergraduate school, returning to Texas for med school and North Texas for her fellowship.  Heavily recruited, she wanted to stay close to home and her family, and accepted a position with a group of surgeons practicing at one of the area’s stellar hospitals.

But she wasn’t happy, two years into a three year employment agreement.  In fact, she was angry, frustrated, worried, and greatly concerned about her future.  

What had started out as a warm and fuzzy relationship with her group had gone decidedly in the wrong direction.  

The genesis of her story is almost a cliché in the physician recruitment environment.  In the last year of her fellowship, she suddenly started receiving inquiries from established practices or hospital employed groups, pitching a great future, good salary, moving expenses, and even a signing bonus.   Two visits to her soon-to-be employer focused on where to live, meetings with all of the group members, a hospital administrator or two (representing her surgical sites), and a real estate agent to look at homes.  Everybody seemed nice and she liked what she was shown.  Money was discussed, and a contract arrived shortly after the second visit.  She asked for a recommendation on a lawyer to handle the latter.