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Good thoughts, all of them. Sailingdog, I understand your reluctance to equate "American trained" with quality care, and I agree with you, there are a lot of lousy docs out there, American or otherwise. It happens that I'm an ER doc, so by training I'm pretty good at the Urgent Care type of setting. Hopefully, doing good work would grow referrals and build the business, like any other venture. Being a board certified American trained ER doc might not be much of a selling point in a lot of places I've been since their medical systems are already well developed (ie Costa Rica, Thailand, BVI), but I imagine that isn't the case in a lot of choice destinations around the globe. Somewhere out there, there's likely a place where there are a lot of tourists who would be very relieved to know they didn't necessarily have to navigate a local ER in a foreign country if they got sick or injured.
Pbzeer and CruisingDad, you are right, I could be trading one land-based practice for another, which certainly doesn't get me cruising. I'd fully expect to be married to it 24/7 for a while (6 mos, a year?), but I've got a like-minded partner to share the burden, and the hope would be to grow it enough to employ others so that eventually, we could run it mostly from afar.
I think GySgt has it exactly right (thanks for the book suggestion, I'll definitely look for it), the ultimate object is to have an "automated and passive" income source, which is the whole idea. Don't need to be making piles of money, just enough to keep the place (and boat) afloat, ultimately without having to keep a strict schedule at the office...
Azeotrope, thanks for your info, I'm glad to hear that others have been doing this sort of thing already. I think doing a stint at an already existing clinic that caters to this sort of thing is an excellent idea. Would learn a lot about how feasable this really is. Let me know if you can recommend any good ones that you've seen...
Cruisingdad: you are right, I've seen ads for MDs in Austraila and New Zealand. It might be that you're also right about keeping it simple and just saving up to go without strings attached...trouble is, that's going to take me a long while (lots of debt from med school, residency, etc still hanging over me). Working shifts at various locales while cruising doesn't lead to the automated income goal, but it might get us living the dream sooner, and maybe with fewer complications.
Do appreciate your thoughts. This site is an excellent sounding board...