Q&A with Dr. James Dahle, Emergency Medicine, Founder of White Coat Investor

By Gloria Onwuneme, Medical Student, University of Nottingham, UK

Dr. James Dahle is a practicing emergency physician and founder of White Coat Investor, a website in which he shares what he has learned about personal finance management and wealth building.
Dr. Dahle graduated in 1999 with a BS in molecular biology from Brigham Young University before obtaining his medical degree from the University of Utah School of Medicine in 2003. Following this, he trained at the University of Arizona Emergency Medicine Residency Program and then served four years with the Air Force and the Navy, which took him across military bases on four different continents.

After creating the White Coat Investor website in 2011, Dr. Dahle published the best-selling book The White Coat Investor, A Doctor’s Guide to Personal Finance and Investing in 2014. He is a columnist for ACEP NOW and has a blog, podcast, and videocast. He just finished an online course that went live in January 2018.

When did you first decide to become a doctor? Why?
I think the first time I considered it was middle school when we had some career event that forced you to think about what you wanted to do when you grew up. I’m sure half the class wanted to be a doctor and the other half lawyers. But I really made the decision as a junior in college, just before it was time to start studying for the MCAT. That was when I committed.
Why? Truthfully the same reason as everybody else: I loved science and wanted to help people. That’s still the reason I drag myself into the hospital to work shifts. I really do like helping people.

How/why did you choose the medical school you attended?
I chose to go to the University of Utah because it was a good school in a place I enjoyed living in, and it was close to where my fiancée was finishing her college. My other top choice was the University of Washington’s WAMI program, but I didn’t want to move every year from Anchorage to Seattle and back, especially without my wife. No regrets there. I made the right choice.

What surprised you the most about your medical studies?
I suppose the most surprising thing was that I couldn’t get away with just understanding the principles and pass the tests like I could as an undergrad. I actually had to memorize a bunch of facts.

What information/advice do you wish you had known when you were beginning your medical studies?
I wish I had known how the military match really worked before I signed up with the military. In the end, it worked out okay for me, but I had a lot of colleagues who had been unpleasantly surprised.

Why did you decide to specialize in emergency medicine?
I thought I’d go into family medicine until I went to a lunch-and-learn as an second year medical student where the speaker was an emergency doctor. I remember thinking, “That guy is just like me!” I later had his son over at my house for dinner when he went to medical school a few years later. I hope I returned the favor.

Has being an emergency physician met your expectations? Why?
No, it has exceeded them. I make more money, have a better lifestyle, have awesome colleagues, and still enjoy the practice and the crazy stories.

What do you like most about being an emergency physician? Explain.
I like being there to help people on some of the worst days of their lives. And foreign body removal. And nursemaid’s reductions. Those never get old. It pays well too.

What do you like least about being an emergency physician? Explain.
Night shifts. They were fine while I was at work (in fact I always liked the night shift nurses and the lack of administrators around the hospital), but I didn’t like what they did to the rest of my life. I don’t work them anymore; instead, I essentially pay my younger colleagues to work my share for me.

What’s your typical work week like?
Typical in emergency medicine? There is no typical. But I’m currently working 12 shifts a month. I work on The White Coat Investor pretty much every day, though, usually for a few hours. It’s kind of crazy really, because one thing that attracted me to EM was the fact that when I was off, I was off. No call. No pager. No work. And now I’ve picked up a job where there is always something to do.

Tell me more about how you started White Coat Investor.
I mostly just started typing random stuff into search boxes. Seriously though, learning about online entrepreneurship, while helping my colleagues stop doing dumb stuff with their money, was a really fun journey. I didn’t tell my partners about it for a year or two before they all found out. Now they use it to help recruit new doctors to the group!

How has White Coat Investor informed your clinical practice?
There is a great synergy between my two jobs. When I get burned out at the hospital, I can go home and work on something completely different. When I get sick of being in the business world, I can go to the hospital and relax and just talk to people and try to make them feel better.

What do you like most about running White Coat Investor?
I enjoy the interactions with the readers. I really like the basic questions because I already know the answer to those ones, and yet answering them really helps someone make a dramatic difference in their financial lives. I wish I was better at inspiring others to make the changes they know they need to make.

What do you like least about running White Coat Investor?
Coming home from a busy shift and finding 160 emails in my email box.

On average: How many hours a week do you work? How many weeks of vacation do you take?
A lot lately, but it’s mostly self-inflicted. I work 12pm-8pm shifts at the hospital, plus another day or so of meetings a month. Then I’ll spend perhaps another 30 hours a week on White Coat Investor stuff, on average. But bear in mind, that’s zero hours some weeks and 60 hours other weeks!

How do you balance work and life outside of work?
Isn’t that what we’re all trying to figure out? I’ve got a great wife and four wonderful children. I also have way too many hobbies. I also love to travel and adventure around the world. My approach lately has been to just plan the trip and then I have to go on it!

What types of outreach/volunteer work do you do, if any?
I work with a group of great young men on a regular basis to help them improve their lives, both indoors and out. I also belong to a group that takes Boy Scouts climbing, rappelling, and canyoneering.
I’ve been trying to figure out a way to volunteer at the local food bank, one of my favorite charities, but can’t seem to work it out with my schedule. I’ve always had an interest in international medical volunteering, but haven’t been able to do it since I did an elective as a resident. I’m sure we’ll figure that out after our children get a little older.

From your perspective, what is the biggest problem in health care today?
People can’t afford it. I had a patient the other day who mostly just needed a job. He simply couldn’t afford the health care he wanted and needed since he lost one of his two jobs. We’ve got to bring the cost of care down. I think there are three keys to doing that: increase transparency of pricing, increase transparency of effectiveness (which will dramatically reduce consumption), and make sure everyone has a reasonable amount of skin in the game.

Where do you see medicine at large in five years?
I suspect there will be very few changes. It really is a behemoth with incredible inertia, and many people are invested in the status quo. But we’ll continue to make slow progress like we have been for the last couple hundred years. We’ll look back 100 years from now and realize that we were practically Neanderthals with what we were calling medicine back in 2018.

Where do you see emergency medicine in five years?
I would like to see emergency physicians take the lead in healthcare reform. We’re uniquely positioned to do it. I hope small democratic groups will continue to exist so that emergency physicians coming out of training can have the opportunity to own their business like I have had. I’d love to see the large Contract Management Groups losing contracts to small groups of doctors left and right, but that’s probably a pipe dream.

What is your final piece of advice for students interested in pursuing a career in like yours?
Don’t be afraid to take a few risks and see where your career takes you. I never thought my family’s main source of income would be from a stupid website and that medicine would become a well-paid hobby for me. Find your niche. Everyone has one. It might take years and it might not even be in medicine. But there is something you can do better than anyone else in the world. Find that and do it. I’m excited to see what happens in the next decade of my career.

About the Author

Gloria Onwuneme is a Danish-born Nigerian who’s studying medicine at the University of Nottingham, UK. She has a strong interest in neurology and psychiatry, and a growing interest in healthcare innovation and medical entrepreneurship. In her spare time, she reads a lot, jogs sometimes, and she (thinks she can) write poems.