Episode 34: How a Yale-Trained Physician Takes Things to the Next Level

Good afternoon, everyone. My name is Lynn S. Evans, and I am the host of Power of the Purse podcast. There was a time in my life not long ago when I believed three things about money. Number one, women are not supposed to talk about or be included in any conversations about money. Number two, women don’t have the natural ability to understand anything about money, and number three, men know best how to manage money, and those truths I made up about money guided me for years until I realized money was not a foreign language or some other obscure academic exercise, and it was something I could not only understand but teach to other women.

Too many times I have heard stories from women who ought to know better but didn’t until they were forced to because of divorce, widowhood, job loss, or the approach of retirement. This podcast will add another chapter to a rich history of successful women who, when faced with some personal challenges, found the ability to step beyond them. We’ll examine some of the truths they made up about money from their life experiences and how that shaped the paths they chose.

My mission is to help women have a healthy positive relationship with money. With that in mind, my guest today is Dr. Yen Tay. Dr. Tay is a first-generation immigrant to a Malaysian-Chinese father who had his PhD in medicinal chemistry from the University of Michigan and was a research scientist for over 15 years at Bristol-Myers Squibb, and a Filipino mother who has her master’s in social work and specializes in Alzheimer’s and dementia care for the elderly. She was born in Michigan, but grew up in the suburbs outside of Syracuse, New York. She graduated magna cum laude from Princeton University with a bachelor’s degree in molecular biology. She also swam for the women’s varsity swim team all four years. She took a year off after college and worked in Singapore and traveled through southeast Asia before returning to Yale University School of Medicine where she completed her medical training.

She completed a pediatrics residency at the Children’s Hospital of Philadelphia and a pediatric emergency medicine fellowship at the Children’s Hospital Boston. She returned to Philadelphia in 2012 to join the faculty at the Perelman School of Medicine as an assistant professor of clinical pediatrics, and an attending physician in the emergency department of the Children’s Hospital of Philadelphia. Her job combines teaching, mentoring and supervising medical students, residents and fellows at the patient’s bedside with taking direct care of children who come to the Children’s Hospital of Philadelphia seeking emergency care. Welcome Dr. Tay.

Thank you very much. Thank you for having me.

I can say just by reading your bio you’ve been a real slouch for the last couple years.

Thank you.

That’s an absolutely incredible pedigree. I cannot believe all of the things you’ve done, and what I haven’t said, which I want to bring up, is some of the things that you do for what we call fun because I think it’s just amazing that you said you love clearing your mind through exercise, so you do yoga, run, swim, and bike on a regular basis. This fall you’ll be attempting to complete a half iron man, which is 1.2 miles of swimming, 50 miles of cycling, and 13.1 miles of running, so my question is do you ever just sit on the couch?

Yes. Usually after I do all of those things.

Okay. Well, thank you then. I think you’re a normal human being. I feel more comfortable.

No, there’s always rest days that are built into the training.

Oh, I hope so. I hope so. On a more serious note, I would love to know how you… I realize that your parents had a very strong influence on your concerns and motivation to be involved with medicine and with getting a medical degree, but when did you realize as a child that this is really what you wanted to do?

I think I realized fairly young, but it may not have been a very kind of well thought out desire, but I think I wanted to be a doctor and help other people from a fairly young age. My parents would take us back home to the Philippines and Malaysia, and my mom recounts a time when I was probably like seven or eight when we saw a lot of people around us in poverty and sickness with disease that we probably would never see here in America, and me just kind of wanting to help, and what could I do, and at that very young age she kind of knew that I would probably end up doing something in the realm of medicine or health care, but it was probably a lot later that I kind of truly formalized those thoughts into a coherent desire to be a doctor.

Yeah. Well, when you decided that were you one of several in your family that went into the medical field?

No, so from my immediate family my dad is a research scientist, and my mom was a social worker, so I always through all my interviews throughout my medical school and residency and fellowship I always kind of touted how I always thought of myself as a combination of my parents between the science and the caring and the social work aspect. My sister is actually in… She’s in advertising, but actually does pharmaceutical advertising, so she’s kind of in the realm.

Okay. Yeah, still there.

Then on my dad’s side actually there are a fair number of physicians on my dad’s side. My dad’s sister and her husband, my dad’s eldest brother, and then several of my cousins are in the medical or dental field actually.

Wow.

It is there, but most immediately I felt like I was a combination of my parents.

Yeah, for sure, so when you were born, you were born I think you said in Michigan? Is that where it was?

Yes. Yes, I was born in Michigan.

You were first-generation American?

Mm-hmm.

How did your parents feel about your being an American versus being a citizen of the countries that they grew up in?

Yeah, it’s really interesting. I think I never realized it growing up, but more as I became an adult speaking with my parents I got to understand a little bit more. At that time in the 70s I guess and the early 80s it was so important for them to make me feel assimilated and that I was just like everybody else, so then I would do Girl Scouts because everybody else was doing Girl Scouts, and I would play piano and have all the same experiences that my peers were doing, but they did make sure in some ways that I still held on to certain cultural things that they held near and dear to their heart. Whether it was food or even just making sure that both my sister and I traveled back to the Philippines and Malaysia on a fairly regular basis to stay in touch with our family, but also just to kind of understand where they came from and the cultures that they came from.

Did you have any difficulty assimilating both of those worlds?

I think it was not so hard. First, the language piece was easy because my father didn’t speak my mother’s native language, and my mother didn’t speak my father’s native language.

No kidding.

We spoke English at home. Yeah, and they met in America, so we spoke English at home and that was easy.

Yeah.

I think when we… My sister and I both went to public school, and we just had to kind of jump into those classrooms, and we both grew up in suburbs outside of Syracuse which were fairly homogeneous, but at the same time there was enough diversity that you knew you were different, but at the same time people didn’t necessarily look at you. You didn’t self segregate into just the Asian group or just the Hispanic group or whatever it was. There were so few Asians that you had to just be part of everybody else.

I guess so.

I’ve always felt that way that I was… Even though it was a fairly homogeneous high school I felt very assimilated because you just have to. You can’t self segregate with other people because you’d be all by yourself.

Yeah, yeah. Well, did you find that there was more curiosity as to your ethnicity by the other kids, or was it more that they shunned you?

No, I think it was more curiosity or just… Well, you look different, and you look different, but there was a little bit more I think understanding and openness because on the other end, on my end or other kind of minorities, we had to be open to everybody else because that’s how you survive when you’re so much in the minority.

Yeah, yeah. Well, that’s interesting. I’m glad to hear you say that you actually assimilated yourself into the world rather than being isolated because that could have been a very ugly childhood.

Absolutely. Yeah.

Now, how did you get from that, from public school into some of the pursuits you have into Yale School of Medicine? I mean, that is one of the things that I think most average American kids look at that and say wow that’s the pinnacle of colleges, if you’re going to become a medical doctor, that’s the top of the heap. So did you intentionally set out to go to Yale and figured out what it was you need to do to get there, or did you have the grades and the desire, and you had several offers and you chose Yale?

I would say that I definitely didn’t know from the medical school standpoint that that’s definitely where I wanted to go. Medical school is very competitive around the country, and what I liked about Yale medical school was actually that they have a very kind of more liberal curriculum and a more, what they call the Yale system. Which is more along the lines of an adult learning type of style which I really like. A lot of the tests were … They were more self assessments. They always said that we didn’t have grades.  We did have grades, but you took a test anonymously so that you know what your grade was, but the administration knows only whether you pass or fail, and your grade only gets uncovered if you really fail, so it’s the kind of system where you have to be dedicated, and you have to be hard working, and you can’t allow yourself to fall through the cracks because it’s really easy to fall through the cracks, but if you have the mindset and the work ethic to learn at the right pace then you can do really well.

There’s also, unfortunately, both of the schools I went to for college and for medical school had a thesis requirement, but at the same point the trade off for having to do a thesis is that the system kind of afforded you time and the opportunities to explore and do research and really kind of cultivate your interests. Instead of force feeding you certain facts and knowledge that you had to have before May 1st, June 1st, July 1st.

Mm-hmm. Did you get your first choice when you had the match day?

I did get my first choice at match day. I wanted to go to CHOP, or the Children’s Hospital of Philadelphia.

Yeah.

That was exciting for me because I knew I wanted to come down to Philadelphia because I knew I wanted to do pediatric emergency medicine, and the CHOP pediatric ER is excellent, it’s big, there’s a good volume, you see a lot of stuff, and it was great teaching, so I knew… I was very happy about that.

When did you decide that pediatric emergency medicine was what you were going to do? I mean, you could have been a rheumatologist.

Yeah.

Why did you pick this?

I really think my entire path in life has really been set out by the mentors that I’ve either chosen or come around and people that have become my mentors out of circumstance. Like I was saying, everyone at Yale has to do a thesis, and a lot of people actually take an extra fifth year to do research, and the university is great at finding a year of funding for you to do that.

Oh, that’s nice.

You have to find something that you’re interested in, and really kind of take that to the next level. In college I was a molecular biology major, so I had done a lot of bench research that I had found that I didn’t really love. I didn’t find it as fulfilling, and so when I had to pick my thesis project or decide what I wanted to do I wanted to try some clinical research, and the place in the hospital that does the host clinical research is the emergency department, so I went to the pediatric emergency department at Yale and found some people that were doing some interesting research projects, and I joined one of these research projects, and I was able to get the Doris Duke clinical research fellowship for it.

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Wow.

I spent my entire kind of what we call a fifth year. It’s a year in between your third year and your fourth year of medical school.

Yeah.

Just doing this research project, but I got to spend hours in the day in the pediatric emergency room, and so these people that worked, these attendings and these faculty, they really took me under their wing because I was there every single day enrolling patients in my study, but also asking questions and learning things from them, and also just becoming, I guess, friendly with them. I realized through that year that these were the types of people that I really enjoyed working with. I knew I would love having them as colleagues, and I also then started to understand that I enjoyed being in the emergency department. I enjoyed interacting with patients and families and seeing them in that setting, so it was kind of a combination of that, but it was definitely after that year that I knew I wanted to be in the ER, and I’d always known basically since I had started medical school that I wanted to do pediatrics.

Well, what would you say was the most bizarre, I don’t know what you would call it, event that occurred in the emergency room that you’ve dealt with?

Bizarre?

Yeah. Like something that you think to yourself… You think of emergency rooms as places where kids come in because they have high temperatures or they’ve broken something or other, but then every once in awhile there’s one of these really weird things that come through the door, and you just kind of shake your head and say, “Wow. How do I even start with this?” Was there anything like that? Anything at all that came up that you think to yourself, “I don’t even know how to start with this, but it was successful and it worked.”

I mean, we get bizarre complaints all the time, but I guess I’m trying to think of something. Well, I don’t know how good of an example this is, but sometimes the chief complaints are basically like the parents or the patients say is wrong with them, and I remember a year or so ago this kid came in and the chief complaint … All you see on the computer is this “chief complaint” and the chief complaint was chicken skin all over his body.

Chicken skin?

Chicken skin all over his body, and I turned to one of my colleagues, and I was like I have no idea what this is going to be. What am I going to walk into, and I walked in, got a history from the mom and the patient, and it turns out that he had had fever and a sore throat, and that that morning he had kind of broken out into this rash that basically to mom looked like it was chicken skin.

Oh, okay.

Basically what he had was scarlet fever or a rash from group A strep, which is very treatable, but it was one of the most bizarre chief complaints that I had ever had.

I think that qualifies. Yeah. A chicken skin. That’s an interesting one. Okay, I love that story. That’s a pretty good one. Let me go back to asking you something about when you were in medical school, and you had some opportunity to make some decisions. You mentioned something about it’s the mentors that you had.

Mm-hmm.

Was there any particular mentor that you would say was the most influential in your life?

From a medical standpoint?

Yeah, yeah.

Let me see. Definitely my research mentor David Spiro. He is somebody who just kind of took me under his wing. He saw that I was interested and motivated and had this idea of a research project concept that he hadn’t really gotten off the ground yet, and so he really empowered me to take a lot of ownership of the project. I was able to do a lot of … I enrolled most of the patients myself. I was involved in the IRB which is kind of like our institutional review board to make sure that all of the studies that are done are done ethically, and all the way through data collection and phone follow-up to the point where we started to write it up, and so I feel very, very, very lucky that he was so open to having a medical student be a part of it. As well as kind of have me involved all the way through, so this is a study that we were actually able to get published in JAMA, which is it’s the Journal of the American Medical Association. Which is maybe the second or third highest impact journal in medicine.

That was a really lucky thing because I think when that goes on your CV that’s like a wow factor, and I had never anticipated anything like that, but he always kept shooting for the stars. The first journal that we actually submitted to was the New England Journal of Medicine, or NEJM, which is the highest impact, and so we shot for the moon, and then we landed on a great star, and that kind of mentorship to always kind of push yourself to do more than you think that you can do I think was… Really help shaped a lot of the stuff that I do now.

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That’s a gem. You got somebody who does that for you. That’s gold. That’s really wonderful. All right. The only other question I had about your career that I was curious about, and I think I already know the answer, but I’m sure a lot of times when you see very sick children come in, and they’re not at an age where they can really verbalize too much about what’s going on with them, I’m sure it has some kind of a… It would probably tend to make you feel somewhat anxious and depressed when you know you can’t do anything because you can’t understand what’s wrong, so at the end of the day, literally, when you’re done, and you go through situations like this what do you do to relieve the stress?

You know the answer, right?

Yeah.

I go exercise.

Yeah.

I do. It’s like the best thing to clear my mind. There are days when I just do come home, and I have to sit on the couch for an hour and turn on the TV or maybe have a glass of wine, but I don’t necessarily get to clear my mind as well as when I put on my shoes and go for a run, or go and swim, or even go and take a yoga class, and just kind of sit and breathe for a little bit.

Yeah.

That for my mind and my body, my soul, is so rejuvenating, but I do definitely … Some of the hardest days I’ll just kind of veg out on my couch for a little bit before I can kind of muster up the wherewithal to get out and exercise.

Okay, well that’s a good thing because now I know you’re really human, you know? Okay, let me switch this around now, and I want to take about your experience in relationship with money because I think it’s important that our listeners get a sense of how do these, as I said before in the introduction, how do these decisions or myths I call them sometimes, but how do they shape who you become and how you make decisions about your career and your life, so let me see if I can do a little digging here.

Okay.

What’s your first memory around money?

I would say my first memory around money is probably when I first started getting an allowance, which I can’t remember exactly when that was.  I’m guessing it was probably around second grade or so, and in order to get an allowance my sister and I would have weekly chores, and they would rotate, but we’d have to perform those chores and do it to a certain quality in order to earn our wages basically.

Okay.

It was never an allowance that was… It was never owed, or it was never a given that I would get a certain amount of money no matter what. You had to empty the dishwasher, gather the garbage, set the table. They were helping out around the house tasks, but they were … It was important for my parents to make sure that we had that. That we did that.

Then what did you do with the money when you got it?

I put it in the bank.

Okay.

Yeah.

Then for what purpose would it come out of the bank?

What purpose? It would have to have been something that… Some kind of nice thing that we would want, or a thing. Usually it was some sort of thing that we would want. For our activities and those kind of things my parent were good about if I needed a new swimsuit or a cap they would pay for those kind of things, but it would be for a doll that I would want or something like that I can imagine.

You saved the money for something that you wanted, and then when you had enough money then you took the money out and bought it?

Absolutely.

Okay. All right. What lessons about money did you learn when you were growing up besides that one? What else did you see?

That was definitely one of my big lessons. My other lessons I definitely learned from my father. One was never to spend outside of your means. Not never, but as much as possible not to spend outside of your means, and I learned that definitely through high school as my allowance would get bigger because I would have more responsibilities, but so would my desires to go out with friends and those kind of things.

Yes. Work toys.

I would never… Not never, but if I didn’t have the money to do something then I couldn’t do it, but there were ways to earn more money or those kind of things, but in general it was the overarching principle in my family was to try to spend within your means.

Do you remember the way it was set up with your mother and father? Did your father give your mother a certain amount of money every week or every month, and she paid the bills, or did he do all that? How did that work?

I’m fairly certain that my dad paid all of the bills, but my parents… Well, my mom didn’t work until I was 13, but after I was old enough to baby-sit on my own and my sister and I could kind of be latchkey-type kids after school she went back to work, so I know they had a joint account, but she also had her own money, and she could spend on her things. What I learned from my mom which still “haunts” me to this day is that you should never buy something full price when you know you can get it on sale.

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All right.

That is something that I still do, and my friends will always laugh at me because if I’m wearing a shirt that they like I’ll tell them the price of it immediately because I’m so proud that I got it at 50% off of what one would expect to pay for that shirt.

That’s great. That’s good.

Yeah.

You learned to be…

They didn’t start out with a whole lot coming over. The best thing that my family had going for them is their education, and so just through time my parents were able to earn and save, but they definitely didn’t… You know, my mom will recount she learned how to sew and make clothes, so my sister and I wore homemade clothes for the first several years of our lives. She became a Discovery Toys representative, so she could… I don’t know if Discovery Toys still exist, but they’re these educational toys that kind of similar style to an Avon saleswoman.

Yeah, yeah.

She was a Discovery Toys salesperson, and would have trunk shows at our house and those kinds of things, so she said she became a Discovery Toys sales rep so that my sister and I could have those Discovery Toys around and we could play with.

That was good.

Yeah.

Yeah. That was very convenient actually. She wrapped the two together.

Yeah.

What are some of the best and the worst financial decisions you’ve ever made?

I think the best financial decision I’ve made recently is to buy the house that I own right now. Throughout most of my training I’ve been kind of moving around, so medical school is four years, and I was in no position at that point anyway to buy a house, but residency I was three years in Philadelphia, and then I did three years of fellowship in Boston, and just moving around made it hard to kind of settle down and gain equity somewhere, so I think when I came back to Philadelphia in 2012, and I decided to buy a home it was one of those decisions that put a big knot in my stomach. Made me really nervous because it was so much money. At least for me at that time, but I know it’s a good decision. I know the neighborhood that I live in is good. I know the value of my house will go up over time. There was tax abatement on it as well.

Good.

I think now that I’m “an adult” I think that’s probably the best financial decision that I’ve made in a long time.

Yeah. That’s a big one for most people.

Yeah.

Congratulations. Welcome to adulthood.

I know. Thanks.

What do you think was the worst financial decision you’ve made?

I think that there’s probably ways that I could maximize my money better, but I just either don’t know, don’t know how, or I’m fairly risk-averse, so I think that that probably is if one were to look at how much I make versus how much I’m putting away into high-interest or high-return kind of funds and those kind of things I think that would probably categorize as poor financial decision making.

Well, are you a participant in a 401K plan?

I am, yes, so it’s a 403B because CHOP is a nonprofit or the university’s nonprofit, but yes. I do do that, and I do matching, so the university matches up to a certain percentage of what I put away, so I do that because it’s… As I’ve been told it’s easy, it’s automatic, and it’s basically free money.

It is.

Yes. I do do that.

Well, that’s good.

Yeah. Yeah.

What are some of the events that have happened in your life that you would describe as defining moments?

Probably all of the moments where I kind of graduated or kind of completed a level and headed to the next level. Those I think were all fairly defining moments whether I was graduating from college or medical school. One thing that has happened that has been more recent is my father passed away in 2010, and that of course is an incredibly defining moment in my life because someone who I’ve already talked about so much in this podcast, and who’s given me a lot of advice and has taught me so many things now is like all right. Go ahead. I taught you everything. You’re going to go off on your own.

You’re free to move about the country. That’s a defining moment.

Yeah.

Yeah, and what do you think you learned from your father that has somewhat been clarified after he passed? Something that you said, “Boy, he always told me that, but I never paid attention to it, and now I see what he meant.” Is there anything like that?

Yeah, well, I was thinking about this when I was listening to the beginning of your podcast about women and finances, and when my father passed, my mom… I love her, but she relied on my dad for so much, and when he passed the fact became so much more evident, and she’s an incredibly strong woman, and she is totally fine now, but those first couple of years where she kind of struggled to get herself kind of mentally and emotionally back on her feet. Not just financially, but just even to wrap her mind around the finances.

Yeah.

Of her own finances now were a struggle, and I think because my father only had daughters, my sister and me, he really tried to instill a sense of financial independence in the two of us.

That’s great.

That I think thankfully we listened to most of it when we were growing up, but I think as we got older we really understood, and both my sister and I own the places that we live. We both save and contribute to our retirement, and we both have maybe not the best understanding of our overall finances, but definitely a lot, so that we can kind of be independent women and function, and not feel like we’re totally floundering or dependent on somebody else.

I guess you’d say that you probably have a leg up on your mother as far as your financial literacy?

Yes. Absolutely.

Yeah. Okay. That’s good.

Especially now that I’ve gone through that back end part with her as well. Just even understanding, and it still takes me a lot, but things like pensions and annuities and what happens when you turn 70 and a half, and what you have to… All those things.

Yeah.

Unfortunately.

Yeah, there’s a lot out there to know.

Yeah.

Where do you want yourself to be financially five years from now?

I mean, I hope to have a family in the next five years, so I would definitely… I feel fairly good about where I am financially independently, but when you bring a spouse and potentially children, that’s a whole new ballgame.

It sure is.

Hopefully where I’d like to see myself is still in a really safe and stable position, but just having to account for some more people.

That sounds good.

More goals and dreams and those kind of things, and making sure that college like it was for me and my sister, college was always a given.

Yeah.

I definitely want that or some sort of higher education to be a given for my children.

Well, maybe as you set higher goals the next one’s going to be not a half Iron man, it’s going to be a full Iron man. I can’t even wrap my arms around a half Iron man, but I think it’s fabulous that those are the kind of goals that you have for yourself. I just want to say thank you so much, Dr. Tay. It’s been a great experience just listening to the story of your life, and to all of you in my Power of the Purse community, I hope today’s podcast was helpful in enriching your understanding of money and how it can help you achieve your life goals.

If you’d like to spend 15 minutes on a call with me and ask me questions about your personal finances please go to my website powerofthepursepodcast.com, select the contact tab, and find the time that works for you. Thanks again, Dr. Tay, for sharing your time and knowledge, and tell us how can people get in touch with you if they really would love to ask you some questions?

Well, thank you again for having me, Lynn. If anyone would like to contact me they can email me, and my email at work is tayk@email.chop.edu.

Thank you. Okay. Thanks again for sharing your time and knowledge. Until the next time, thanks for listening, and remember money is not the enemy. Your ignorance of it is. Thank you, and goodbye.

How to contact Yen:

• Email: tayk@email.chop.edu

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