A Life Well Lived: A Physicians Guide to Wealth

From Burnout to Breakout: How One Psychiatrist Built $800K of Independent Income Before 30 | Episode 63

57 min · 12. maj 2026
episode From Burnout to Breakout: How One Psychiatrist Built $800K of Independent Income Before 30 | Episode 63 cover

Description

Most physicians don't have an income problem. They have an optionality problem. In this episode, James Nutter is joined by Donovan Miske — CEO and founder of Kona Medical Consulting and advisor to over 12,000 physicians across four countries — for a candid, story-driven conversation on what it actually takes to build freedom outside the hospital walls. Donovan walks through the three core pathways physicians use to stack independent income — medical directorships, locums work, and simple clinics — plus a few obscure ones most doctors have never considered (event medicine at major festivals, hotel-associated physicians for high-profile guests, personal physicians with a tiny private roster). He shares the hard-earned lessons too: the doctor who quit his hospital job before a credentialing board could meet and spent three months in financial freefall, and the now-infamous "dry cleaning" doctor who optimized his way toward bankruptcy by treating an income problem like an expense problem. Then James and Donovan dig into the playbook that changed one young psychiatrist's life — how thoughtful stacking during residency, prioritizing low risk over high comp, and forming a separate professional entity early built a runway most attendings never get. If you've ever felt like you're floating down a river with no paddle, this episode is the paddle. About the Guest Donovan Miske is the CEO and founder of Kona Medical Consulting — named, fittingly, after his dog. Before launching Kona, Donovan ran a hospitality MSO, and his pivot into medicine started with a single favor: looking into a failing clinic on the brink of bankruptcy. He uncovered embezzlement, built a recovery game plan rooted in hospitality operations, and discovered an entire industry hungry for that kind of forensic, systems-level thinking. That first engagement evolved into Kona's Business Wellness Exam — now run more than a thousand times. Kona's MSO clients consistently operate in the top decile of MGMA DataDrive performance, with average clinic overhead around 41%. 📍 Learn more or book a free consult: https://www.konamedicalconsulting.com [https://www.konamedicalconsulting.com] (mention the podcast for extended consult time) Top 5 Takeaways * Form your own entity first. Even if you're W-2 at a hospital, set up the company that will hold the stacked income. This is step zero, not step five. * Stack for low risk, not high comp. A handful of $500–$3,000/month medical directorships with strong indemnification almost always beats one high-paying directorship with exposure. Boring is the goal. * Residency is the cheat code window. The 28-year-old psychiatrist in this episode stacked six non-clinical roles (board seats, VC medical councils) during training — two days of focus apiece — before he ever needed a credentialing form. * Expense-cutting can't fix an income problem. The "dry cleaning doctor" blocked two hours every Tuesday to save money on errands and missed the thousand dollars he could have earned instead. Build the cushion; don't shrink your way to safety. * Budget time before you budget money. Most physicians call an MSO when they're already ready to quit. Donovan's #1 piece of advice: pump the brakes, give it a few months of real consideration, then move. RESOURCES & NEXT STEPS: * Download the PSLF Hacks Checklist [https://info.imwealth.com/pslf] * Join the waitlist for a  free financial wellness session [https://www.imwealth.com/takecontrol]with James * Get access to exclusive physician financial tools at www.imwealth.com [http://www.imwealth.com] * 1% of IM Wealth’s revenue is dedicated to providing scholarship funds to medical students. Learn more about the Meaningful Journeys Scholarship and how you can join the fight here [https://www.imwealth.com/meaningful-journeys-scholarship]. * Learn more about the impact IM Wealth is making in the lives of physicians here [https://www.imwealth.com/im-stories]. * Gain FREE immediate access to all of IM Wealth’s exclusive physician financial wellness resources here [https://www.imwealth.com/im-nest-signup]. ABOUT THE SHOW: This isn’t just another finance podcast—it’s a movement. We’re challenging the status quo, cutting through the noise, and giving physicians real strategies to take control of their money and their future.  Because true wealth isn’t just about numbers—it’s about freedom. Find and follow the show on YouTube [https://www.youtube.com/@imwealth1].  ABOUT JAMES NUTTER: James Nutter is on a mission to help physicians reclaim their financial power. With a deep understanding of the unique challenges doctors face, he provides real-world strategies that cut through the noise and lead to lasting financial freedom. Follow James on Instagram [https://www.instagram.com/jamesnutter_imwealth/] A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

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74 episodes

episode Your Health Is Your Wealth: Why This Doctor Rejected Traditional Medicine | Episode 73 artwork

Your Health Is Your Wealth: Why This Doctor Rejected Traditional Medicine | Episode 73

What's the point of building wealth if you don't have the health to enjoy it? Too many successful professionals spend decades optimizing their careers while neglecting the one asset that makes everything else possible—their health. In this episode of Your Health Is Your Wealth, James Nutter sits down with Dr. Andrea Stoecker, DO, a board-certified family physician specializing in Direct Primary Care and Functional Medicine, to explore why she chose to reject the traditional insurance-based healthcare model before ever entering it. Instead of practicing assembly-line medicine, Dr. Stoecker built a practice around something increasingly rare in healthcare: time. Time to listen. Time to ask better questions. Time to uncover the root cause—not just prescribe another medication. Together, James and Dr. Stoecker discuss physician burnout, the limitations of today's healthcare system, the rise of Direct Primary Care, and why prevention, relationships, and personalized care may be some of the best investments you can make in your future. Because at IM Wealth, we believe true wealth isn't measured by your portfolio alone. It's measured by your ability to enjoy the life you've worked so hard to build. After all, don't be the richest person in the graveyard. IN THIS EPISODE * Why Dr. Andrea Stoecker, DO, chose Direct Primary Care over the traditional healthcare model * The hidden cause of physician burnout and moral injury * Why 10-minute appointments often fail both patients and physicians * How Direct Primary Care creates stronger physician-patient relationships * The difference between treating symptoms and finding the root cause of disease * Why nutrition, sleep, stress, gut health, and lifestyle are foundational to long-term health * How having more access to your physician can improve both confidence and health outcomes * Why investing in prevention today can create a healthier, more meaningful tomorrow ABOUT DR. ANDREA STOECKER, DO Dr. Andrea Stoecker, DO, is a board-certified family physician specializing in Direct Primary Care and Functional Medicine. Her practice is built around a simple belief: healthcare should be personal, proactive, and focused on helping people thrive—not simply treating disease after it appears. By combining longer appointments, root-cause medicine, personalized care plans, and ongoing physician access, Dr. Stoecker helps patients optimize their health so they can live fuller, healthier lives. CONNECT WITH DR. ANDREA STOECKER, DO To learn more about Dr. Stoecker's Direct Primary Care and Functional Medicine practice, visit: Table Health 🌐 https://tablehealth.com/ [https://tablehealth.com/] ABOUT THE YOUR HEALTH IS YOUR WEALTH SERIES At IM Wealth, we believe your greatest asset isn't your investment portfolio—it's your health. This series explores the habits, decisions, and conversations that help you protect the one thing money can't buy back: your time. Because financial freedom means very little if you aren't healthy enough to enjoy it. Don't be the richest person in the graveyard. Learn more at www.IMWealth.com [http://www.imwealth.com]. A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

21. juli 20261 h 3 min
episode Marriage, Money & Maintenance: How to Build a Life That Lasts (Replay) | Episode 72 artwork

Marriage, Money & Maintenance: How to Build a Life That Lasts (Replay) | Episode 72

What do thriving marriages and lasting wealth have in common? They both require intentional maintenance. In this replay episode of A Life Well Lived: A Physician's Guide to Wealth, James Nutter is joined by financial planner Jeff McPherson and longtime friend Todd Spencer for an honest conversation about what it really takes to build a strong marriage while navigating demanding careers, family life, and financial decisions. From physician schedules and shifting family roles to communication, conflict, and shared financial goals, this episode explores why successful relationships don't happen by accident—they're built through small, consistent investments over time. Whether you're newly married, decades into your relationship, or simply looking to strengthen your partnership, this conversation offers practical wisdom that applies far beyond your finances. IN THIS EPISODE YOU'LL LEARN * Why marriage and money require ongoing maintenance—not perfection * The biggest communication mistakes couples make around finances * How physician families can navigate demanding careers together * Why intentional check-ins strengthen both relationships and financial health * The importance of grace, flexibility, and shared expectations * How to align financial decisions with your family's long-term vision * Practical habits that help marriages thrive through every season of life KEY TAKEAWAYS * Strong marriages aren't built during the easy seasons—they're strengthened through consistent daily choices. * Financial stress often reveals communication issues more than money problems. * Regular conversations about goals, expectations, and priorities prevent resentment from building. * Small habits practiced consistently create extraordinary long-term results. * Lasting wealth means very little if you aren't building a life worth sharing. LISTENER CHALLENGE This week, schedule a 30-minute conversation with your spouse or partner. Discuss: * What is working well in your relationship? * Where do you each feel unsupported? * What financial goal are you both working toward? * What's one small habit you can begin this week to strengthen your marriage? Small conversations today prevent big problems tomorrow. ABOUT THE GUESTS Todd Spencer shares the unique perspective of supporting a physician spouse while raising a family, offering practical insights on communication, partnership, and navigating life's changing seasons together. Jeff McPherson, CFP® is a financial advisor specializing in helping physicians build intentional financial plans that support both wealth and a meaningful life. His approach emphasizes aligning financial decisions with family values and long-term goals. ABOUT A LIFE WELL LIVED A Life Well Lived: A Physician's Guide to Wealth helps physicians take control of their money so they can build lives filled with purpose, freedom, and intention. Hosted by James Nutter, each episode combines practical financial strategies with conversations about the habits, relationships, and mindset that create lasting wealth. CONNECT WITH IM WEALTH 🌐 IM Wealth: https://www.imwealth.com [https://www.imwealth.com] 📅 Schedule a complimentary Financial Wellness Session 📚 Access physician financial resources 🎓 Learn more about the Meaningful Journeys Scholarship IF YOU ENJOYED THIS EPISODE If this conversation encouraged you, please subscribe, leave a review, and share it with a colleague or someone who could benefit from building a stronger relationship with both their money and the people they love. A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

14. juli 20261 h 19 min
episode Built, Not Born: The Standards That Create an Unbreakable Life | Episode 71 artwork

Built, Not Born: The Standards That Create an Unbreakable Life | Episode 71

In this episode of Life Well Lived, James Nutter welcomes Paul for a raw, energizing conversation about why standards—not goals—are what actually change lives. Paul’s life story is anything but polished: growing up feeling like an outsider, facing real consequences, rebuilding through discipline, combat sports, faith, and relentless consistency. What emerged wasn’t perfection—but resilience. Pauly explains why goals fail when they’re not rooted in identity, why discipline eventually becomes automatic when standards are aligned with who you want to become, and how pressure doesn’t break you—it reveals you. From jiu-jitsu mats to Ironman training to leadership in business and family life, Paul shares what it means to live by non-negotiable principles rather than fleeting motivation. The conversation moves beyond productivity and into something deeper: servant leadership, faith, responsibility, and the idea that if you can do something—you must. Whether it’s your health, your relationships, your work, or your calling, this episode challenges listeners to stop drifting, stop negotiating with their comfort, and start showing up fully. This isn’t about doing more. It’s about becoming more—on purpose.   WHAT YOU’LL LEARN * Why goals fail when they aren’t tied to identity * The difference between motivation and standards * How discipline turns into freedom over time * Why pressure doesn’t build character—it exposes it * The role faith plays in resilience and leadership * What “If you can, you must” really means * How to create non-negotiable daily habits that compound * Why servant leadership leads to lasting fulfillment * How to stop letting feelings derail your potential * Why the hardest seasons often become the greatest setups   FINAL TAKEAWAY A strong life isn’t built in moments of motivation—it’s built through standards you refuse to negotiate. If you want a life that doesn’t break under pressure, you have to become the kind of person who shows up even when it’s uncomfortable—especially then.   ADDITIONAL RESOURCES  * Download the PSLF Hacks Checklist [https://info.imwealth.com/pslf] * Book a free financial wellness session [https://calendly.com/yourmeaningfuljourney/financial-wellness-diagnostic] with James * Get access to exclusive physician financial tools at www.imwealth.com [http://www.imwealth.com] * 1% of IM Wealth’s revenue is dedicated to providing scholarship funds to medical students. Learn more about the Meaningful Journeys Scholarship and how you can join the fight here [https://www.imwealth.com/meaningful-journeys-scholarship]. * Learn more about the impact IM Wealth is making in the lives of physicians here [https://www.imwealth.com/im-stories]. * Gain FREE immediate access to all of IM Wealth’s exclusive physician financial wellness resources here [https://www.imwealth.com/im-nest-signup]. ABOUT THE SHOW: This isn’t just another finance podcast—it’s a movement. We’re challenging the status quo, cutting through the noise, and giving physicians real strategies to take control of their money and their future.  Because true wealth isn’t just about numbers—it’s about freedom. Find and follow the show on YouTube [https://www.youtube.com/@imwealth1].  ABOUT JAMES NUTTER: James Nutter is on a mission to help physicians reclaim their financial power. With a deep understanding of the unique challenges doctors face, he provides real-world strategies that cut through the noise and lead to lasting financial freedom. Follow James on Instagram [https://www.instagram.com/jamesnutter_imwealth/].  DISCLAIMER The opinions expressed in this podcast are for informational and educational purposes only and do not constitute financial, legal, or tax advice. Any financial decisions should be made in the context of your unique circumstances and in partnership with a trusted financial advisor who understands your personal plan. A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

7. juli 20261 h 21 min
episode Your Health is Your Wealth: Beating Burnout Without Losing Your Edge w. Dr. Mary Anderson, PHD | Episode 70 artwork

Your Health is Your Wealth: Beating Burnout Without Losing Your Edge w. Dr. Mary Anderson, PHD | Episode 70

In this engaging episode of "Life Well Lived: A Physician's Guide to Wealth," host James Nutter is joined by the dynamic Dr. Mary Anderson to delve into the complex issue of burnout, especially as it affects high-achieving professionals like physicians. Dr. Anderson shares her insights on how to balance drive and well-being, referencing her widely-acclaimed book, "The Happy High Achiever," now available in multiple languages. Their discussion offers practical strategies to manage and prevent burnout by incorporating science-based self-care practices and positive cognitive therapies.    Throughout the episode, James and Dr. Anderson explore the root causes of burnout, emphasizing that it is not a sign of weakness but rather a signal that something critical is being ignored. They discuss actionable solutions centered around the acronym SELF—Sleep, Exercise, Look Forward, and Fuel—which are essential elements for maintaining mental and physical health. As Dr. Anderson states, "Self-care is a necessity, not a luxury," reminding listeners of the importance of setting boundaries and engaging in regular self-reflection. Together, they encourage high achievers to seek sustainable success through methods that boost mood, enhance productivity, and reduce anxiety.    Key Takeaways: * Recognition of Burnout: Understand that burnout signals missing self-care practices and isn’t a sign of personal failure.  * Adopt the SELF Framework: Prioritize Sleep, Exercise, Look Forward to pleasant activities, and Fuel your body and mind as core components of self-care.  * Mindful Self-Talk: Challenge and redefine negative self-talk and cognitive distortions with more supportive and realistic alternatives.  * Boundary Setting: Learn to set and respect personal boundaries to protect energy without being burdened by the fear of letting others down.  * Invest in Personal Health: Recognize that physical and mental health is the foundation of sustainable success and fulfillment.    ABOUT THE GUEST  DR. MARYANDERSON IS A LICENSED PSYCHOLOGIST, AUTHOR, AND SPEAKER WHO’S HELPED COUNTLESS HIGH ACHIEVERS—PHYSICIANS INCLUDED—RECLAIM THEIR ENERGY, CLARITY, AND SENSE OF PURPOSE. WITH A PH.D. IN CLINICAL PSYCHOLOGY AND SPECIALIZED TRAINING IN HEALTH PSYCHOLOGY FROM HARVARD AND BOSTON UNIVERSITY-AFFILIATED INSTITUTIONS, DR. ANDERSON UNDERSTANDS THE UNIQUE STRESSORS OUR LISTENERS FACE.   Her new book, The Happy High Achiever, [https://www.amazon.com/Happy-High-Achiever-Essentials-Success_Without/dp/1538722747] is already making waves as a blueprint for managing anxiety, stress, and burnout—without giving up your drive.   CONNECT WITH JAMES NUTTER Website: https://www.imwealth.com/ [https://www.imwealth.com/] Instagram: https://www.instagram.com/jamesnutterfinancial/ [https://www.instagram.com/jamesnutterfinancial/] LinkedIn: https://www.linkedin.com/in/james-nutter-cfp/ [https://www.linkedin.com/in/james-nutter-cfp/] A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

30. juni 202658 min
episode PSLF, Payoff, or Balance? The 3 Student Loan Paths Every Physician Needs to Know | Episode 69 artwork

PSLF, Payoff, or Balance? The 3 Student Loan Paths Every Physician Needs to Know | Episode 69

Student loans remain one of the biggest financial stressors facing physicians today. Between demanding careers, family responsibilities, retirement planning, taxes, and investing, it's easy to delay making a clear plan for educational debt. The challenge is that physicians are often flooded with conflicting advice. Some experts recommend pursuing Public Service Loan Forgiveness (PSLF) at all costs. Others advocate paying off loans as quickly as possible. And many physicians find themselves stuck somewhere in the middle, unsure which strategy best supports their long-term goals. In this Physician Wealth Masterclass, James Nutter breaks down the three primary student loan paths available to physicians: PSLF, aggressive payoff, and a balanced wealth-building approach. He explains how to evaluate each option based on your career path, income, family goals, and overall financial picture so you can move forward with confidence instead of uncertainty. Whether you're a medical student, resident, fellow, new attending, or established physician still carrying student debt, this episode provides practical guidance for making informed decisions about one of the largest financial obligations many physicians will ever face. IN THIS EPISODE, WE DISCUSS: * Why so many physicians feel stuck when it comes to student loan decisions * The mindset shift that changes how you think about educational debt * Why your medical degree may be the highest-return investment you'll ever make * The three primary repayment paths available to physicians * How Public Service Loan Forgiveness (PSLF) works and who it may be best suited for * Common mistakes that can delay or jeopardize loan forgiveness * Recent repayment plan changes physicians need to understand * How to build a student loan strategy that creates confidence—not just optimization * Why clarity matters more than chasing the perfect answer RESOURCES & LINKS 🌐 IM Wealth https://www.imwealth.com/ [https://www.imwealth.com/] 🎙 A Life Well Lived Podcast https://www.imwealth.com/podcast [https://www.imwealth.com/podcast] 📋 Free PSLF Hacks Checklist https://info.imwealth.com/pslf [https://info.imwealth.com/pslf] CONNECT WITH JAMES NUTTER Website: https://www.imwealth.com/ [https://www.imwealth.com/] Instagram: https://www.instagram.com/jamesnutterfinancial/ [https://www.instagram.com/jamesnutterfinancial/] LinkedIn: https://www.linkedin.com/in/james-nutter-cfp/ [https://www.linkedin.com/in/james-nutter-cfp/] A Physician’s Guide to Wealth Podcast — Brought to you by IM Wealth: Helping physicians take control of their money so they can live a purposeful life. For more resources, visit IMWealth.com [https://www.imwealth.com]. Advisory services offered through Commonwealth Financial Network®, a Registered Investment Adviser.

23. juni 202638 min