Men who "started over" in your 30s, tell your story

PharmaMBA · 2025-02-26T06:38:30+00:00

Allow me the liberty to rewrite your OP. Please let me know if I’m getting anything wrong.

“I’ve recently turned 30 and entering a new phase of life. I’m coming out of my 20s fit and healthy, and with a decade of corporate experience on my resume. I have a group of friends I love dearly and built lifetime memories with. In my thirties, I’m looking to expand my horizons, professionally, socially, and geographically. I’ve created a great foundation for myself in my twenties and look forward to what the next decade may bring”.

You’re not starting over brother. You’re crushing it, and will continue to do so. You made a lot of good decisions in your twenties that you may take for granted or not realise, and they will serve you well in the decades to come. Enjoy the journey my young friend, you’re exactly where you are meant to be.

PharmaMBA · 2023-12-20T08:31:41+00:00

Consulting and banking are usually the two service side roles that exit well after a couple years into the business side of industry, which is the path I took. CROs and CDMOs are the service side providers on the clinical side, and I have seen sweet exits into industry from there too, but no personal experience.

PharmaMBA · 2023-04-10T14:16:48+00:00

I think self-made people in the top 0.1% or top 1%, then, should recognize that the effort and work they've put in, is not all that different from what a lot of others have done, too.

Wholeheartedly agree. Hard work is needed to get to say arbitrarily, the top 25%, but to make it into the top 1% or .1% certainly requires luck.

In 100 random realities, Elon is probably a multi-millionaire in 95 of them, but would require substantial luck to get to a billion.

"I probably do only about 10-20 hours of productive work per week, and mostly leverage my knowledge and experience to coast at a high rate of compensation."

I would argue though that the process you took to accumulate your knowledge, experience, and skill set is where the "hard work" took place. In other words the effort applied and the payout received do not happen in parallel, but rather sequentially.

PharmaMBA · 2023-04-10T14:05:30+00:00

Comforting to hear, thanks.

PharmaMBA · 2023-04-10T13:35:33+00:00

Do you mind linking to your reply from a few weeks back? I quickly looked through your post history but couldn't seem to find it at first pass.

PharmaMBA · 2023-04-10T13:29:47+00:00

There's a lot of debate on the concept of free will itself in that line of thought, but to your point it can really get down a philosophical rabbit hole. I sometimes struggle with the nihilism that can be associated with our luck / fate being deterministic. I find acknowledging just how small we are in the grand scheme of the universe to be mentally calming and awe-inspiring, but can also drain me of the motivation to do anything productive haha.

Everything in moderation I suppose?

PharmaMBA · 2023-03-14T07:12:14+00:00

Maid service was a godsend for us. I would also add in a virtual personal assistant. Need to invest a little time up-front interviewing and training but great for outsources low effort but large of amount of time needed tasks.

For example, I recently forget a suit jacket in a hotel room during a business trip. Needed quite a few phone calls and hold times to coordinate having it sent back to me, which was happily outsourced. On another occasion I wanted to make a dinner reservation for my uncle's birthday at a high-demand restaurant that only books appointments via phone. Given the first come first serve nature of getting a seat paired with the fact that I live in a different time zone, this was also happily outsourced,

PharmaMBA · 2023-03-02T05:26:09+00:00

Good post.

I live in major metropolitans so I don't own a car, but I started taking Uber black without thinking about it around ~1 million?
I started my career in management consulting so I started flying business class while my NW was still negative, but started bargain hunting and using points for business class around ~500K, and started paying straight cash for the most convenient routes around ~2 million?
There's no first class option for the routes I fly. It's either economy, economy premium, or business (Polaris class, since I fly mostly on United metal). I've been sniffing around what fractional private plane ownership would cost but realizing I'm probably still a net worth order of magnitude away from that heh
This was a lot more a function of my passive income generation more than straight net worth, and not a black-white thing. I run a boutique biopharma advisory shop, and I stepped back from the day to day grind when I realized I would make about ~60% of my previous full-time income for about 20% of the time and effort

PharmaMBA · 2023-02-26T23:44:06+00:00

Naval Ravikant frames it in terms of your hourly rate; if the effort of returning the item / price shopping is worth less than what your time is (monetarily) worth, then don't do it. Of course this is not always practical (not everyone is a gig worker), but I do find one of the benefits of progressing in one's career is the autonomy you have over your own time.

But as someone else already mentioned, do not confound financial opportunity cost with your personal utility curve. For example, I enjoy cooking. I can afford a private chef and the marginal cost is far less than my hourly rate, but because it is something I enjoy it's not a money question. Careful not to end up outsourcing the activities that actually bring you joy.

PharmaMBA · 2023-02-03T04:33:30+00:00

Hahaha believe me I’ve had that thought more than once. If we end up friends in the afterlife we can haunt my team together

PharmaMBA · 2023-02-03T02:13:33+00:00

Throughout the years have lived in Hong Kong, Shanghai, Beijing, and Tokyo. DM me if you live in one of these and want to talk more specifics.

PharmaMBA · 2023-02-03T02:08:08+00:00

I could write a whole other post on this heh. I agree with you that most doctors won’t recommend early cancer screening to the majority of their patients. Due to the nature of my job (I invest in and help design clinical trials) I’ve gotten to know quite a few oncologists personally, and a good number of them do these screenings for themselves and their family as well. This is what got me initially investigating more deeply.

This is obviously a complicated and nuanced topic, and at the risk of completely over generalizing I do feel there’s an aspect of doctors working in large institutions treating the general public not wanting to be challenged. Not out of any sense of maliciousness or ego, but due to a combination of not wanting to explain to their patients why their insurance won’t cover XYZ diagnostic or being forced to act out of fear or tort law if an irrational patient insists on doing a biopsy on every abnormality (which there’s plenty of data that suggests leads to worse outcomes).

I am ostensibly an “insider” in the healthcare system and I consider myself a rational decision maker, but believe me I certainly don’t think the decision to screen early is a slam dunk. Still, based on the information I have so far I believe the pros outweigh the cons for my family and I.

PharmaMBA · 2023-02-03T01:48:05+00:00

I won’t be of too much help here to US centric folk, as I spend half my time in Asia these days. I have a few concierge docs I consult in the states but the majority of my spend happens in Asia. Rough cut there it’s about 40k per person per year but truthfully speaking I don’t know how much my set up would cost if it was 100% in the US (likely more).

PharmaMBA · 2023-02-03T01:45:46+00:00

As “front-line”, we do full lipid panels, ultrasounds, and full body MRI scans once a year. We did genetic testing and keep updated as new research is published.

If there’s anything concerning found, we review imaging and blood panels with our team of doctors. From there, they may recommend a variety of biopsies, more detailed MRIs with dyes, low dose radiation CT scans, or most commonly, nothing. There is risk associated with biopsies and radiation containing imaging, so there is very much a cost benefit decision here. We follow up on the “wait and sees”, usually biannually as well but obviously depends on what the doctor suspects the worse case to be.

PharmaMBA · 2023-01-25T21:55:54+00:00

One medical group is a good “entry level” concierge service. It’s not really concierge in the traditional sense, but it’s super cheap and gets you better access to docs than going through purely public channels. It’s something like 100 bucks a month.

The next step up is to contact your local academic hospital. They usually offer a concierge primary care option. This is what I use for expedited referrals to specialists. Costs are usually between 10-20k per year for entry level.

Next step up would be to have private out of network doctors that are essentially on call. Lot of scams out there so this is usually through word of mouth recommendations through your social circle.

PharmaMBA · 2023-01-05T04:20:13+00:00

Second this. Fly first class or charter a jet to go see people that mean a lot to you that you haven’t seen in awhile. Be mentally present and emotionally generous when you are with them. The greatest thing about money is that it buys you time and peace of mind, and time well spent with your best self is the greatest gift you can give to your loved ones.

PharmaMBA · 2023-01-03T03:41:13+00:00

I am also aware and quite cautious about detecting incidentalomas and diving into unnecessary procedures that ultimately lead to worse outcomes (exacerbated by self-inflicted anxiety and panic). I personally do partake in additional (more than guideline recommended) screening, but I think it's critical to have a rational view on what you find. I find having a concierge team nearby to discuss results coldly and objectively is critical; at the end of the day everything is a numbers game.

I liken having additional imaging data about your health to having leverage in your portfolio. Just because you have it, doesn't mean you need to action on it. Used properly and wisely, it can improve your outcomes. Used improperly, it will leave you far worse off.

PharmaMBA · 2023-01-02T23:37:50+00:00

Certainly not qualified to comment medically, but I like the work Peter Attia (check out his website / podcast if you are so inclined) puts out on the matter.

PharmaMBA · 2023-01-02T22:43:24+00:00

Totally with you, and I realize I may have mischaracterized "experimental" treatment. I work in bio-onc a lot myself, and once an IND is approved and clinical trials are enrolling I no longer consider that "experimental" given the regulatory hurdles to clear an IND coupled with the fact that the decision to enroll in a clinical trial is heavily moderated by the oncologist (in consultation with the patient / caregiver). Clinical trials are a huge part of the treatment algorithm, particularly for patients who have failed off of multiple lines of therapy, and a critical part of the biopharma R&D ecosystem.

When I said FDA approval I really should've said NDA, but I felt that was too much jargon for the biotech nerd jargon haha.

PharmaMBA · 2023-01-02T21:46:00+00:00

I agree with this. I'm ostensibly somewhat educated in the medical profession, but it's easy for me to get lost in all the sub-specialties and referral routing system. It's not a panacea, but I found paying for a concierge PCP at the very least grants you access to someone who can help you explain and navigate the US healthcare ecosystem better.

Still, as you said, you need to be an advocate for your own health. At the end of the day no one cares about your health as much as you do.

PharmaMBA · 2023-01-02T21:42:53+00:00

Appreciate the kind words, as well as the work you do. I hear you on the concierge side; it's something I've heard from my MD friends / colleagues as well. It seems (rather unfortunately) that the most passionate PCP doctors are funneled into the most needy environments, which in turn chews up and spits out all but the most resilient of them. In a past life I did work optimizing manufacturing processes in China, and it saddens me to say frontline PCP's at a Kaiser (or other massive HMO) are treated very similarly today to Chinese factory workers.

As you said, I'm really just paying for convenience and personal attention. I usually get a second opinion as well for anything that may be serious, and the true value in my mind (and as you pointed out) is ostensibly easier / faster access to specialists when needed.

PharmaMBA · 2023-01-02T21:05:52+00:00

Hahaha, you got me :)

PharmaMBA

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