How to Get Rich Without Getting Lucky

I recently shared a viral 2018 post by tech-billionaire Naval Ravikant called How to get rich with a physician friend getting into tech consulting. It’s one of my favorite posts for shifting a doctor’s mindset. Naval is as known for his philosophies on wealth creation as he is for the tech products that made him wealthy. His post simplifies modern wealth creation into clear, concise principles.

You can read the original 3 minute thread here or listen to Naval’s 3 hour 30 min deep dive on it. Here are my quick thoughts on why it matters for physicians.

Naval begins by saying, “Seek wealth, not money or status. Wealth is having assets that earn while you sleep.” As doctors, we’re often stuck in a cycle of trading time for money. We see patients; we get paid. But to truly build wealth, we need to own, build, or invest in assets that generate income when we’re sleeping.

While real estate, the stock market, and private practices are the investments most doctors think of, there’s so much more out there. For physicians, this can mean owning equity in a startup, creating a digital health platform, or developing a product that uses your medical expertise.

Dr. Patrick Soon-Shiong, once a pancreatic transplant surgeon, made the leap from trading lucrative surgery hours to biotech investments, ultimately building a $19 billion fortune. He transformed his medical expertise into scalable biotech innovations that have impacted millions. His journey is a reminder that physicians can leverage their knowledge to create scalable products that provide value far beyond a clinic.

Naval also emphasizes, “You will get rich by giving society what it wants but does not yet know how to get—at scale.” This couldn’t be more relevant to physicians. We’re uniquely positioned to see the gaps in healthcare that others can’t. Whether it’s more efficient patient care or better diagnostics, we already know what’s missing. The key is to turn this specific knowledge into something scalable.

This brings us to another principle: leverage. Naval talks about three types of leverage in business—money, labor, and products with marginal cost of replication, like code and media. In medicine, our leverage has traditionally been clinical skills and the labor of support staff. Naval says labor leverage will impress your parents, but it’s not the type to waste your life chasing. Code and media, however, work for you while you sleep.

We know software is great because you build it once and sell it forever. But the same is true of media. You can create online courses, write books, produce content, or even start a podcast. Dr. Atul Gawande’s work as a surgeon is prestigious, but it’s his books and writing that have had a far broader influence, shaping healthcare conversations globally.

Writing, in particular, is something physicians can start easily. You don’t need permission, a big team, or even much capital. Whether it’s blogging, publishing articles, or building a personal brand on social media, writing offers an immediate way to scale your knowledge. Take Dr. Bonnie Koo, who combined her expertise in dermatology and finance to create Wealthy Mom MD, a financial platform that earns while she sleeps.

Naval also stresses accountability and trust as essential to making it far. In medicine, we’re trained to avoid risk, follow protocols, and protect ourselves from liability. But in business, accountability is a superpower. When you put your name on something—a tech product, a new treatment protocol, or a health platform—you unlock opportunities that would otherwise remain out of reach.

“Play iterated games. All the returns in life—whether in wealth, relationships, or knowledge—come from compound interest.” This is especially true in tech, where every project you build compounds into the next, whether in terms of your expertise or the relationships you forge.

Finally, Naval advises, “Learn to sell. Learn to build. If you can do both, you will be unstoppable.” Selling doesn’t just mean pitching products—it’s about communicating value, whether to patients, investors, or colleagues. Writing is a form of selling. It’s how we share ideas, educate others, and build influence. This newsletter is free, but in a way, I’m selling you the idea that involvement in tech is one of the most valuable skills a physician can have today.

As physicians, we already have the specific knowledge to know what needs to be built. Now we need to learn to build scalable products and effectively communicate their value. Mastering both of these skills is crucial for long-term success.

Naval’s principles give physicians a roadmap for breaking free from the limits of trading time for money. By owning equity, leveraging our unique knowledge, and embracing accountability, we can scale our impact—and our wealth—far beyond the walls of our practice.

The path is clear: apply your expertise to build something that matters, and let it grow beyond what you can do alone.

Co-Founder Opportunities:
I received two requests this week from friends in tech looking for a physician to start a company with. Send me a reply if your interested in being connected with either of them.

1. A bioinformatician is looking for a physician co-founder to explore ideas in the neuropsych space:
I'm interested in therapeutics for neuropsychiatric disorders (schizophrenia, MDD, alzheimer's). Excited about brain organoid models for translation, RNA, and in-silico modeling

2. An instagram engineer is looking for a physician co-founder to work on an AI solution to insurance claims.

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