The Ramsey Show - App - Should I Go Into Debt To Buy Into a Medical Practice? (Hour 3)
Episode Date: August 2, 2021Debt, Savings, Relationships, Career Sign Up for a FREE trial of Ramsey+ TODAY: https://bit.ly/3rZTUAx Tools to get you started: Debt Calculator: https://bit.ly/2Q64HME Insurance Coverage Ch...eckup: https://bit.ly/3sXwUn5 Complete Guide to Budgeting: https://bit.ly/3utmVXi Check out more Ramsey Network podcasts: https://bit.ly/3fHhbVE
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Welcome to the Headquarters of the Live from the headquarters of Ramsey Solutions,
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it's the Ramsey Show, where debt is dumped, cash is king,
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I'm Dave Ramsey, your host, Ken Coleman, Ramsey personality.
Number one best-selling author is my co-host today.
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Check it all out at RamseySolutions.com. The phone number here,
888-825-5225. Cody's in Providence, Rhode Island.
Hi, Cody. Welcome to the Ramsey Show.
Thank you, Dave. Thanks for taking my call. I really appreciate it.
Sure. So I'm a resident physician.
My wife and I have been on the Ramsey plan for about a year, year and a half.
Been able to debt snowball about $40,000 worth of our small debts.
I've still got about $300,000 in student loans.
And my question is, there's a lot of companies willing to hire residents where you sign a contract,
you know, say three years early, they do prepayment, they do student loan forgiveness,
and, you know, it's all rolled into the thing, but then you're kind of signing yourselves over
to them under contract for, say, a certain number of years. And I guess what I'm wondering is,
is it wise to get that money now and early from a future employer, but locking yourself into one of these jobs,
or should I wait until I finish residency and just start fresh then?
Probably get the same kind of deals then, can't you?
Yeah, you can get similar ones.
I guess there's some, it just depends on the plan you get.
Some of them, though,, match your residency salary.
So instead, like, right now I'm making $67,000 a year.
So they'll, like, match that.
So you kind of double that early so then you can get paid off and, you know,
hopefully pay less interest overall would be there.
So they'll throw $67,000 a year while you're in residency or one time at the student loans?
Roughly, I mean, they advertise like $67,000.
Usually it turns out being about 40 or so.
I'm sorry, they
advertise 67, but they lied?
Well, they don't lie.
They say we career match, but then, you know,
read the fine print, the career match is up to
an X number of dollars. Well, then it's
a matter of negotiation.
Right?
It's a matter for you to negotiate your new job.
So how many years would you have to commit, three?
Yeah, usually it's about three or four.
And your benefit to doing that would be this one-time signing bonus of $40,000 to $70,000, right?
Is there another benefit?
For a year so i mean i guess not another benefit
that i would get right now um but you know other benefits like student loan payments but i think
you can negotiate it so whether well they will give you the student loan payment now so that
helps you to not build interest over the next few years until you, you know, really start getting that. So $40,000 to $60,000 now, or $70,000 now, and you sign, and for that you're trading
out, you're promising to work for them for three years.
But during the time you go to work for them, then in addition they would pay down student
loans?
Is that what you're saying?
Right.
Usually they'll pay like a certain number per year.
And again, it all depends on which program you end up in, but sometimes it'll be like $30,000 a year to a maximum of $100,000 worth of
your student loans or something like that.
Yeah, so if you can get, you know, like $70,000 now and another $150,000
over that three years towards this and get a competitive salary,
a competitive pay rate, then, yeah, I would look at doing those deals.
But there's nothing to say that you have to sign up.
I wouldn't sign up for $40,000 a day if that's all you're getting out of this, and you give
up three years of flexibility because you might make more than $40,000 a year extra
working for somebody else.
Yeah, I completely agree.
The way you set it up at first is like they may give a total loan
forgiveness. It's not that. It's not the whole enchilada. So I think you have to weigh what you
can make on your own in that three-year period versus the 40. And I'm with Dave. So if you come
out without one of these contracts, what's going to be your pay rate, do you think?
So depending on where you're willing to work, it's usually between about $200,000 and $300,000.
Or if you work at somewhere that's more like critical access, I've seen as high as $400,000 to $450,000.
So I'd go that route to knock out all my loans.
I'd do a short-term in that critical, do something, and bust it coming right out of residency.
But either one of those is a fantastic option.
You can pay this off.
Yeah, I don't think – you know, when you start talking about 300 or 200, 300, 400 in one sentence,
you don't sell that chance for 40.
The difference in 300 – or the difference in 200 and 400, you don't sell that chance for 40.
So you've got to do it.
That's the whole thing.
And, you know, no, I'm probably not signing up given this.
I'm with Ken.
I think you explore all your options and you maximize the pay for a short period of time as soon as you come out and you go bananas and knock this out. I mean, good Lord, if you could go make $450,000 somewhere and work there two years,
you could put so much money in the bank and be debt-free.
It would be unbelievable, and then go do whatever you want to do after that.
That's option A.
Absolutely well said.
I mean, I'd do that.
If he can transition back to where he really wants to be, it's a no-brainer.
Go bust it for two years.
Obviously in a specialty.
Yes, he is.
Not doing general practice. Right, yeah. If you're coming out a specialty. Yes, he is. He's not doing general practice.
Right, yeah.
If you're coming out of school straight into 450, you're doing something there.
So I didn't ask what that was, but you're obviously doing something pretty incredible, Cody.
So, yeah, I would lay back in the weeds and get a better deal.
Let's get a better deal.
Don't sell your soul for $40,000 here.
It's not worth it um now am i if we could reverse the trend and
say uh you could have signed up at the beginning of this for zero student loans and they pay it all
in return you promised to work for them for three years and you did that at the beginning of med
school yeah uh and you never took out a student loan day one i'd make that trade absolutely that's
what i thought it was leaning towards that's right i'd make that trade. Absolutely. That's what I thought it was leaning towards.
That's right.
I'd make that trade.
That's, in a sense, going in the military, and they pay for it, right?
I mean, that's the same thing.
So absolutely, I'm going to trade three years of promise to work for someone
for $100 or $200 in return for free med school.
This is interesting.
I want to give Cody some love, Dave, but there's an interesting psychology thing happening here.
He was considering this because he's like, I just want to start paying this down.
So his heart's in the right place.
But you don't want to take that trade off just to make some progress.
Instead of finishing the residency, the debt's still going to be there.
Don't trade 40 today for 200 a year from two years from now.
That's exactly right. from now that's exactly
right yeah that's the bottom line and that's what i thought i was hearing by the time we got to the
bottom of that all right open phones at 888-825-5225 there's all kinds of ways to go to college college debt-free. The most well-known in the medical world is the MD-PhD program, where you are going after
your PhD while working towards your MD.
A lot of work there involved.
Very few of those seats available, but if you can get one of those seats, you're basically
an employee of the university, so all your education is free because you're working a
fellowship while you're doing this. And you can get get in that program that's a way to get through you can go through
undergrad all the time debt-free you just have to choose a proper college that you can pay for
you have to work all the time and you don't work for minimum wage that's it's very doable check
out anthony o'neill's book at Ramsey Solutions called Debt-Free Degree.
Teach your teenagers how not to take out debt.
You've got a lot on your plate.
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While you're enjoying the present, you can't help but think about your future and your finances.
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Visit chministries.org slash budget to see if it's right for you.
That's chministries.org slash budget. Ken Coleman Ramsey personality is my co-host today. He is host of The Ken Coleman Show and the author of the number one bestseller, The Proximity Principle,
and a brand new book that we launched for sale today called From Paycheck to Purpose,
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Adam is with us in Cincinnati. Hi, Adam. How are you? Great, Dave. Ken, thanks for taking my call.
Sure. What's up? Yeah, I've got a Baby Step 5 question about saving for kids' college.
I've got a 3-year-old daughter and a 9-month-old son,
but I've been paralyzed in Baby Step 5 because I can't figure out a savings target to aim for.
Now, I know how to project a cost into the future based on inflation,
but there's two variables that I can't figure out how to factor into my savings target.
First, I teach at a private liberal arts university, which offers a 90% tuition remission benefit.
Now, I have no plans to leave in 15 years, but I don't know if I can bank on that either.
And second, my parents have had a 529 set up for my kids, and there's about $35,000
in that to get us going.
I have no reason to think the money won't be there, but I also don't know how to bank
on that.
So in 15 years, sarcastically, I think I'll need somewhere between $30,000 and $300,000 per kid.
But I don't really know how to set a savings target.
Even the SmartVestor Pro that we consulted with was a little bit stumped.
So I was hoping you could help me out.
Okay.
I would make two assumptions, and this will help narrow your variables down.
I would make the assumption that the 529 is going to be in your control,
and I would ask for it to be done, for it to be turned over,
for you to be the custodian of it,
because I have to be able to control it to put it in our planning, Mom and Dad,
and I think they'll probably do that unless they don't trust you with the money.
No, I don't think that's it.
They're Dave Ramsey followers, too, so I have no reason not to trust them,
but, yeah, that's a good plan.
Then the second variable is I would not count on you being there.
You might be, and if you are, that's gravy on the biscuit.
But I would run my assumptions with control of the 529
and not count on the free tuition or the 90% tuition.
And then from there I would back up and say, okay,
let's pretend I'm not working at this
private liberal arts university aren't where my kids going to go to school and you need to go
ahead and have that as your target and so in our case we said state school in-state tuition and
dorms and dorm food and you can run the numbers on that.
And you can find out what that costs today in Ohio.
And you'll find it to be about $10,000 a year roughly, maybe $10,000 to $12,000.
Most of them are somewhere right in that range for in-state tuition plus room and board.
And probably another $10,000.
So today it's about $80,000 to go through somewhere in that range um give or take okay
uh and you can go look at it you can do that do the actual research um and then you can add some
inflation to that and you'll be right on track and so you know if you say i got a brand new baby
we're gonna at least double it so we're probably looking at 200 and you got you now I got a brand new baby, we're going to at least double it. So we're probably looking at 200. And now you got your target, you know.
Or if you got one going in two years, your 80 is probably going to be pretty close.
But somewhere in that 60 to 80 range, I'll put a kid through right now,
plus or minus community college, plus or minus in-state tuition,
plus or minus staying at home and not having dorm and dorm food.
So you just got to look at, you can start to make some assumptions to dial it in.
But you can't say, I'm going to have no limits on where they go to school.
They can spend $300,000 a year.
You can't plan for that.
You don't have enough money.
God doesn't have that much money.
I'm kidding.
But he does.
Please don't do that.
It's not worth it.
No, I wouldn't spend it.
Oh, my gosh.
This is the Ramsey Personality, is my co-host today in the lobby of Ramsey Solutions on the debt-free stage.
Matthew and Brittany are with us. Hey guys, how are ya?
What's going on?
Hi Dave.
Welcome, welcome. Where do y'all live? Portsmouth, Virginia. All right, cool. And all the way
to Nashville to do a debt-free scream. How much have you paid off? $166,325. Wow, how long did
that take? Four years and five months. Wow, good for you. And your range of income during that time? 97 to 130.
Good. What do you all do for a living?
I am a metrology technician.
I work in victim witness at a local state attorney's office.
Wow. Neither one of you have uncomplicated things with your life. Oh my gosh, wow.
What kind of debt's the $166,000?
The majority of it was student loans on my end.
Oh.
Oh, yeah.
Oh, yeah.
We had the van, the medical bills, a little small credit card, but the majority of it was student loans.
How long have you guys been married?
Coming on 11 years.
Okay.
So halfway through the marriage, ding, ding, you wake up and you go, something
needs to change. Tell me the story. What happened? So it actually started in 2013. So it took us a
few years to totally get on board with this process. We were pregnant with our twins who
are here today. And my grandfather Pope gifted us FPU. So we took the class and we just didn't really believe we could do it at that point.
We were kind of doing it ish, as you say.
We were following a budget, but we weren't completely on board.
We weren't ready to completely dive in and just dedicate everything to it and be that gazelle intense that you talk about.
And I'll never forget the twins were two.
And our youngest was probably like six months.
And we got a bill in the mail.
And we found out we had a student loan that we didn't know about.
And that was probably the scariest moment.
Wow.
And that's when we knew we were ready.
That was it.
That was rock bottom for us.
That's your oh crap moment, yeah.
Yep.
How much was the loan?
A little over, I think it was right at $20,000.
So an extra $20,000 just shows up in the mailbox one day.
Yep.
Oh man, that will take your breath away.
Yeah, it did.
But it's what we needed to realize that we just had to go all in,
and we were ready at that point.
It was interesting because that night we just prayed about it,
like, how can we do this?
We have to do this.
And within a couple weeks, I randomly got this job offer out of the blue
that was significant more than what I was making at the time.
And we just took that as a sign, and we just ran with it.
Cool.
So you get the old FPU kit out and blow the dust off, or what?
Or you go back to a class?
Yeah, we went back to a class.
Okay, good.
Then we started coordinating it.
Oh!
And that actually kind of kicks you into gear there.
And we didn't want to be the hypocrites you know yeah so uh we got gazelle we started grinding and grinding uh and
did it for that long uh it was uh that's a long track shoo yes yes sir so first of all i gotta
tell you i'm from the 757 so I'm a Hampton Roads boy.
Yes, I wanted to shout out some local folks there.
So the 97 to 130, what happened there?
Give me the details there.
What jumped it up?
So OT over time on my end.
How many hours were you pulling?
I can't even think.
It was a blur. It was that many. I was just, any time I could? Oh, I can't even think. It was a blur.
It was that many.
I was just, anytime I could get it, I got it.
Yeah.
Is it worth it?
Absolutely.
You were bone tired, but it was worth it.
Oh, man.
Absolutely.
So how much of the 166 was paid off in the last year of the four years?
About 53.
Okay.
Wow.
So you paid off the most in that? Yeah yes sir. So once you got
the momentum it just plowed it rolled right downhill. Yes and I think that was like a huge
motivator too and doing it like how you talk about it is it just it shows that it works and it shows
that after you pay each debt off you can just keep paying more and more towards the next one.
You know every every year we would sit down and get a goal for the full year,
and then we would separate it for the month.
And having those small goals is what,
those little celebrations of moving somewhere.
You know you're on track.
Yes, sir.
You have to measure it.
We probably two years prior said we're going to do this in March of 2021.
So that was our goal long before we made it.
And that's when we paid it off.
I believe it was March 15th.
Wow.
Look at you.
And COVID didn't stop it.
Nope.
Help it or hurt it?
Neutral.
It hurt it a little bit.
He didn't get overtime at that point.
Yeah, but at that point, think we were we were so close yeah so you're pushing it on through way to go you guys i'm so
proud of you what do you tell people now that you're coordinators and you actually paid off
166 000 in debt what do you tell people the key is to get out of that never give up never give up especially those who know it's
going to take a while yeah you know you just got to keep going and you know the the the marathon
right the you got to get to that finish line one step at a time so that's what i would say
we were definitely the the tortoise in the race, but like you say, slow and steady wins,
and that's what we did.
I think another key for us is after each debt we paid off,
we would do something to kind of celebrate that debt,
like, all right, we paid this off,
we're going to go to a nice dinner,
and then just buckle down and put our heads down
until we get to the next one.
There you go.
And it was just little things like that
along the way that made a huge difference.
I'll tell you, there's three reasons right over there where it'll get you going.
Yes, sir.
It'll get you back up, waking up, you know, really early for me and just grinding all
those hours.
There's three little boys over there will get you going.
Now you got the rest of your life.
That's right.
Now that you're free, how's it feel?
It feels great.
Amazing. Can't believe it's here. Now that you're free, how does it feel? It feels great. Amazing.
Can't believe it's here.
Was it worth it?
Absolutely.
Will you go back in debt?
No, sir.
Not for anything?
Not for anything.
Ever?
Ever.
No.
I have you on video now.
This is your video testimony.
Go ahead.
I love that.
Well done, guys.
So proud of y'all.
All right. Bring the boys over. Let's introduce them. So proud of y'all.
All right, bring the boys over.
Let's introduce them.
What are their names and ages?
This is Jude.
He's five.
And these are our twins, Finn and Hudson.
They're seven.
Also known as when the student loan payment came.
Yeah. I love it.
The extra piling on of the student loan.
All right.
That's it.
Very cool.
Well, you guys look like you're worth it.
I think you're worth it.
I think you're worth your family tree changing.
You got your mom and dad are heroes.
They're absolutely incredible.
Very, very well done.
We got a copy of the Legacy Journey for you.
That's the next chapter in your story for sure.
An extra copy of the Total Money Makeover giveaway and pay it forward.
Thank you for leading the class.
You've been paying it forward already, showing other people the way.
I'm so proud of y'all.
Thank you, sir.
Very, very well done.
Impressive, impressive people.
All right, Matthew, Brittany, Finn, Hudson, and Jude from Norfolk.
$166,000 paid off.
Four years and five months of grind.
$97,000 to $130,000 was the income.
Count it down.
Let's hear a debt-free scream ready guys three two one
well done boys yeah boys bring it bring it i love it that is fun
you guys tune in and you listen to that real careful.
You can hear those little boys screaming up through their parents' microphone.
If you didn't know what the sound of a family tree changing sounds like, you just heard it.
That's the sound of a change, a permanent change.
I've opened up the mailbox and gotten out something that did that to me
it's a knife to the throat an extra 20 000 and she she remembered it years ago
tears came and it was years ago if you're watching that on youtube and you see britney's tears
and she only stopped crying to be able to gut scream we're debt free she was remembering it
but now she's on the other side of it that's beautiful that's freedom that's just unbelievable
what a great family you guys are rock stars very cool this is the ramsey show Thank you. Our scripture of the day isaiah 45 2 i will go before you and we'll level the mountains i will
break down gates of bronze and cut through bars of iron thomas edison said when you have exhausted
all possibilities remember this you haven't. Take that.
There's nothing else I can do.
Yes, there is.
I like that.
Dave's with us in Madison, Wisconsin.
Hi, Dave.
Welcome to the Ramsey Show.
Hi, Dave.
Listened to your show for a long time, and I wish I was calling for a different reason, but my mother-in-law is a ward of the state.
She has MS.
She's in a nursing home.
She's been there for quite a few years.
She had to go have a medical procedure at a local hospital because she had sepsis for
about the third or fourth time.
And we have been getting bills from that local hospital for months now.
And the nursing home has said, well, you know, she's on Medicare, I'm sorry, Medicaid, and obviously has no money.
And so, you know, they're supposed to take care of it.
But yet, once again, we keep getting these bills.
And now, you know, I just got one today one today saying you know my mother-in-law
is seriously delinquent and that they're gonna take further action and and uh you know send it
to collection and so i guess i'm wondering what are they gonna collect she has no money and she's
in a nursing home a ward of the state there's no she has nothing does she own anything no she can't you know they take her social security
check every month and obviously that doesn't cover the cost of the it's a county nursing home
yeah um so that that doesn't come near close enough to cover why are the bills coming to your house that's well so my my wife is the power of attorney
she's an only child okay and so she has to make all the decisions financially yeah and so when
um when my my mother-in-law's husband died my my wife's stepfather um you know, they didn't have an address anymore, and so it became our address.
And so my wife is very concerned that now stuff's coming to our address
and that we're going to get some knock at the door from some collection bozo
that's going to try to shake us down for money.
Well, you don't owe anybody, so he can shake all he wants.
He can shake, rattle, and roll right out to his car and leave.
There's nothing.
I mean, besides that, people don't do door-to-door collections hardly anymore,
except on really redneck stuff.
So they're not going to fool with you on this.
But what I would do is, as the power of attorney,
I would contact them by mail, certified mail return receipt requested,
and just say, I'm acting as her power of attorney.
She is penniless.
She is a ward of the state.
Your only hope of collecting this bill is through Medicare.
Here's the nursing home that takes care of all that.
Okay.
And sick them on the nursing home.
Because that's who should have taken care of this, by the way.
That's how Medicaid, Medicare, somebody should have picked that up,
and they're supposed to be running that over there.
So they should have filed these claims.
If there's a claim you can file on your mother-in-law's behalf, that's fine.
If your wife wants to do that, if there's some Medicaid, Medicare process, she can help the hospital collect their money from Medicaid or Medicare.
That would be wonderful.
But you in no case end up owing something because you're the power of attorney.
There's no such thing.
Okay, because, yeah, it turns into I try to be supportive and I just get mad
and then it doesn't go very well.
Well, there's nothing to get mad about.
This is just the government inefficiencies of life.
Medicare, Medicaid is the DMV of the medical world.
I mean, you're just in line trying to get your license.
I mean, it's just a pain in the butt.
Nothing about it is efficient.
Nothing about it runs properly.
But we all need socialized medicine, right, because it's just crap.
And so, you know, you're just dealing with a welfare state, dude.
And so, you know, your wife can put some effort into it and probably should on her mom's behalf
to try to make sure the claims get filed properly with Medicaid and Medicare as her mom's representative,
rather, as the power of attorney.
But you're under no financial obligation.
And so what I'd do is jump on the
phone with the nursing home jump on the phone with the hospital administrator and say hey look
this is a medicaid medicare claim how can i help you get that done because obviously she's not
going to pay it and we're not going to pay it she can't pay it and obviously we're not liable
so um yeah but i mean as her power of, I'm more than willing to sign whatever forms you got to help you guys get paid.
Okay.
Because she's tried to contact the hospital, and they just say, well, it's gone to collections, so we can't talk to you anymore.
Well, that's perfect.
Dumb butts.
And then the idiot collections that person who's been on the job four and a half days is going to call.
You know.
Tell him to pound sand. i would just give him the
number to the nursing yeah just give him the name of the nursing home and just say you can talk to
her she's got dementia y'all will get along well oh my gosh unfortunately unfortunately she does
she has she would have no idea what anybody would be talking about i'm sorry that's tacky but but i
mean that's the truth is is that you're dealing with you know this is a horrible horrible system and it's obviously inefficient so yeah when
they call just say you need to contact nursing home we can't help you uh if you guys want to
send the medicare stuff over here we can sign the power of attorney but i'm not having a bunch of
discussions with you idiots and because dude you got somebody literally that's been on the job four
and a half
days going to call you uh because collectors don't keep their jobs very long because they would
rather clean out septic tanks than do the job of collecting and so as soon as the septic tank job
comes open they leave right the turnover turnover is just incredible they have a sheet in front of
them i'm not operating i'm not kidding it's four and a half days that guy's been on the on the
phones before he calls you so So it's a mess.
So I'm sorry.
I'm sorry you're all going through this.
But the good news is, Dave, you guys aren't going to owe the money.
And so you can exert as much energy as you want to out of a sense of loyalty or honor to her mom as the power of attorney.
But you're going to find, you know know i called up and tried to help you
fill out the forms oh we can't help you we sent a collection that's my favorite there you go kiss
my butt that's it that's the end of this discussion you know oh my god unbelievable all right frank's
with us in philadelphia frank welcome to the ramsey show hey ken hey dave thanks for taking my call
sure what's up so um i have a question about going into debt for the purpose of buying into a medical practice as a physician.
There's a little bit of a different situation with this particular buy-in.
It's not buying into a traditional independently owned practice.
It's a practice that's getting acquired by a private
equity group. And I just want to get your thoughts on that type of situation. It's kind of a trend
in medicine. So how are you buying in if a private equity group's buying it? Well, so the private
equity group is acquiring the practice. So the current owners of the practice, which I'm not an owner right now, are obviously, you know, they're getting their buyout.
But then in order to keep people with skin in the game and to stay incentivized, all the physicians have to buy into this new platform.
So the platform is basically a group of several practices across a large region that's owned by the private equity group.
And they keep the physicians sort of, you know, vested and incentivized by having, you know, having a small piece of the game.
And slave.
Yeah.
Listen, my tolerance for debt is very low my tolerance for private equity is even lower um and uh across multiple platforms where you have absolutely no control you're going to
buy in you're what's known as a minority shareholder at best uh which means you have
absolutely no power and they're going to give to you what they want to give to you as a minority shareholder at best, which means you have absolutely no power,
and they're going to give to you what they want to give to you as a return.
Meaning they could choose to run this thing in the dirt and make your share worth nothing.
Not because they would do it on purpose, but because they were idiots.
Yeah.
I mean, this particular platform has been around for several years right now, and they have been very, it's been well run, and it's been profitable.
I mean, it's up to you, Doc.
If you want to do it, I wouldn't do it.
Run.
I don't do private equity deals.
I don't get involved with those characters, and I don't do minority share positions.
I don't care what the track record is on it, and I sure as crud don't go in debt to do all that.
So I personally wouldn't do it.
But you certainly got to make your decision.
Thank you for the call.
Ken Coleman, James Childs, Kelly Daniel.
Good show today.
I'm Dave Ramsey, your host.
We'll be back with you before you know it.
In the meantime, remember, there's ultimately only one way to financial peace,
and that's to walk daily with the Prince of Peace, Christ Jesus.
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