Dr. Alex Schloe graduated from medical school debt-free thanks to the Air Force Health Professions Scholarship Program. He completed his family medicine residency near the beautiful beaches of Destin, Florida, then served at Schriever Space Force Base in Colorado Springs.
But on June 29th of this year, something remarkable happened—he separated from the Air Force not to transition to another demanding clinical position, but to practice medicine on his own terms: just two days per week at a direct primary care clinic he loves, while spending the rest of his time with family and building his real estate businesses.
This is the power of strategic real estate investing for physicians. Dr. Alex’s journey into residential assisted living demonstrates how healthcare professionals can create meaningful wealth while serving an increasingly critical community need—quality care for our aging population.
The Foundation: Why Family Medicine and Why Freedom
Dr. Alex always knew he wanted to be a family medicine physician. Growing up, he watched his town’s family medicine doctor attend baseball games, care for his sick mother, and maintain deep relationships throughout the community.
“I really wanted to have that relationship with the community and be a jack of all trades, master of none, and take care of everyone in our town,” he explains. “It was really cool to see that personal relationship you can have in family medicine.”
After medical school at VCU School of Medicine in Richmond, Virginia, and residency at Eglin Air Force Base, Dr. Alex began his military service. But even as he fulfilled his commitment, he was building something else—a path to practicing medicine exactly how he wanted.
The key realization? Traditional medicine alone wouldn’t give him the freedom to prioritize family and practice on his own terms. He needed to create additional income streams through strategic investing.
The Time Management Reality: Building While Working Full-Time
One of the most common questions physicians ask when considering real estate investing for physicians is: “How do I find the time while working full-time?”
Dr. Alex’s approach was both disciplined and intentional. He made a non-negotiable commitment: family came first.
“I would get home, I’d put my phone away, play with the kids, hang out with my wife,” he shares. “And then it was after the kids went to bed, after I was able to connect with my wife, then it was time to work on the business.”
This meant limited time—late nights after everyone was asleep, early mornings before work, weekends carved into productive blocks. But Dr. Alex viewed this sacrifice through a crucial lens: short-term intensity for long-term freedom.
The Time Optimization Strategy
Dr. Alex discovered several principles that maximized his limited available hours:
Conduct a Time Audit
“You may be surprised to see that although we’re really busy as physicians and as parents and spouses, you have more time than you think if you really buckle down and prioritize,” he notes.
He watched maybe two or three non-Disney movies the entire previous year. Television time? Essentially eliminated except for watching Bluey with his four-year-old. Instagram scrolling? Minimized. Every recovered minute was redirected toward building his future.
Prioritize Self-Education
Dr. Alex invested heavily in learning from resources like Doctors Building Wealth, White Coat Investor, and Bigger Pockets. “I didn’t get any education in medical school about real estate or entrepreneurship,” he explains. “I had to educate myself to see there’s another way to do this.”
Delegate and Build a Team
Recognizing his limitations, Dr. Alex hired a virtual assistant to handle podcast production and administrative tasks. He also partnered with two business partners, Charlie and Luke, allowing them to divide responsibilities and multiply their impact.
“You have to get help,” he emphasizes. “There’s a lot of ways to buy back your time if you figure out you have a little bit more time than you think you do.”
Discovering the Residential Assisted Living Opportunity
Dr. Alex’s real estate journey began like many physicians—with a single-family rental property purchased while still in residency. But as he educated himself and explored different investment strategies, he discovered an opportunity that perfectly aligned with his healthcare background and values: residential assisted living (RAL).
What Makes Assisted Living Different?
Unlike traditional nursing homes or institutional care facilities, residential assisted living homes provide care in a homelike environment—typically 8-16 residents in a large single-family home with 24/7 caregiving staff.
The compelling advantages include:
Growing Demographic Demand
“There’s going to be so many baby boomers who are going to need these homes,” Dr. Alex notes. The aging population creates consistent, increasing demand for decades to come.
Superior Cash Flow
Residential assisted living can generate 2-3 times the revenue of traditional long-term rentals. While a standard rental might bring in $2,000-$3,000 monthly, an assisted living home with 10 residents at $5,000 per resident generates $50,000 in monthly revenue.
Healthcare Professional Advantage
Physicians understand care standards, regulatory compliance, and quality metrics in ways that traditional real estate investors don’t. This knowledge provides a significant competitive advantage.
Meaningful Mission Alignment
“We’ve seen people stuck in the hospital for a year because they can’t find placement,” notes the podcast hosts. Providing quality assisted living options addresses a genuine crisis in elder care.
Recession Resilience
Unlike discretionary spending, elder care remains necessary regardless of economic conditions, providing stability across market cycles.
The Investment Model: How Physicians Can Participate
Dr. Alex identifies several pathways for healthcare professionals to enter residential assisted living, particularly for those still working full-time clinically:
The Lease-to-Operator Model
This approach allows physicians to invest in the real estate without providing the direct care operations.
How it works:
- Purchase and renovate a suitable property
- Lease it to an experienced assisted living operator
- The operator manages daily operations, staffing, and resident care
- You collect lease payments while building real estate equity
“The Lease-to-Operator model is a great way for full-time physicians,” Dr. Alex explains. “It is difficult to find the right operator, and that is the most important piece.”
The Partnership Model
For those wanting more operational oversight without full-time management, partnering with an experienced operator provides middle ground.
Key considerations:
- Align on values and care standards
- Define clear roles and responsibilities
- Establish regular communication and reporting
- Create partnership agreements that protect all parties
What Makes a Good RAL Property?
Not every property works for residential assisted living conversion. Dr. Alex provides specific criteria:
Essential Property Features:
- Large single-story home (multi-story creates accessibility challenges)
- Maximum number of bedrooms and bathrooms possible
- Sufficient square footage for common areas and staff space
- Appropriate zoning and neighborhood compatibility
Required Renovations Often Include:
- Fire suppression/sprinkler system ($10,000-$20,000+)
- Widened doorframes for wheelchair access
- Wheelchair ramps at entrances
- Grab bars in showers and bathrooms
- Durable LVP flooring rather than carpet (fall risk reduction)
- ADA-compliant modifications throughout
Strategic Approach: Look for previously licensed homes when possible to avoid lengthy permitting processes and reduce renovation costs. In some markets, permitting and compliance can take 18-24 months.
The BRRRR Strategy for Assisted Living
Dr. Alex sees significant opportunity in applying the BRRRR method (Buy, Renovate, Rent, Refinance, Repeat) to residential assisted living:
“I think there’s a great opportunity to do like a BRRRR. So you’re buying the home and you’re renovating it into an assisted living home,” he shares.
This strategy allows investors to:
- Purchase properties below market value
- Add value through assisted living conversion
- Refinance based on increased value and income
- Pull out invested capital to repeat the process
The higher income potential of assisted living accelerates the timeline for recovering initial investment compared to traditional rental properties.
The Wealth Mindset: Taking Imperfect Action
When asked to define what separates wealthy individuals from those who aren’t, Dr. Alex’s answer cut to the core of physician psychology:
“I think it’s the ability or willingness to take action. As physicians, we really want to have all the information. We want to have as much data as we possibly can before making a decision. And you have to realize in real estate and in entrepreneurship, you’re never going to have all that.”
This insight addresses a fundamental challenge in achieving financial freedom for doctors. Medical training emphasizes thoroughness, evidence-based decision-making, and minimizing risk. These are essential qualities in clinical practice but can become paralyzing when building wealth.
Breaking Through Analysis Paralysis
The solution isn’t reckless action—it’s educated action despite imperfect information. Dr. Alex’s approach included:
- Extensive self-education through books, podcasts, and courses
- Seeking mentorship from those already successful in the space
- Starting with manageable projects rather than massive undertakings
- Learning through experience while maintaining risk awareness
- Building systems and teams to reduce personal knowledge gaps
“You just have to have the willingness to take action and go from there,” he advises.
The Freedom Definition: Medicine on Your Terms
When asked to define wealth, Dr. Alex’s answer was elegantly simple: “Freedom. For physicians, it’s the freedom to practice medicine and live life how you want to.”
This philosophy drives everything he’s built. Rather than leaving medicine entirely, Dr. Alex now practices two days per week at a direct primary care clinic—maintaining the patient relationships he loves while having time for family and business development.
His real estate portfolio generates sufficient passive income to support his lifestyle, removing the financial pressure that forces many physicians into unsustainable practice models or settings they don’t enjoy.
This is the ultimate goal of strategic real estate investing for physicians—not necessarily to stop practicing medicine, but to practice it on your own terms, in settings you love, with the schedule that serves your life priorities.
Key Lessons for Physicians Considering Assisted Living Investments
Dr. Alex’s journey offers actionable insights for any healthcare professional exploring this opportunity:
Start with Education
Invest time learning from credible resources, successful investors, and specialized communities before deploying capital.
Audit Your Time Ruthlessly
You likely have more available hours than you realize once you eliminate time-wasting activities and optimize your schedule.
Consider Your Unique Healthcare Advantage
Your medical background provides valuable insights into care quality, operations, and regulatory compliance that traditional investors lack.
Build the Right Team
Success requires surrounding yourself with experienced partners, operators, contractors, and advisors who’ve navigated this path successfully.
Choose Properties Strategically
Not all homes work for assisted living conversion. Focus on large, single-story properties that meet regulatory requirements with minimal modification.
Plan for Meaningful Capital Investment
Expect $10,000-$20,000+ for fire suppression systems plus additional costs for accessibility modifications, permitting, and licensing.
Focus on Finding Quality Operators
If using the lease-to-operator model, the operator selection is your most critical decision—it determines both your returns and the care quality provided.
Take Action Despite Imperfection
You’ll never have complete information. Educate yourself thoroughly, then move forward despite uncertainty.
The Bigger Picture: Solving a Healthcare Crisis
Perhaps the most compelling aspect of residential assisted living investment is the mission alignment. Dr. Alex and his partners aren’t just building wealth—they’re addressing a genuine crisis in elder care.
As hospitalists noted during the podcast, they’ve seen patients stuck in hospitals for an entire year simply because appropriate assisted living placement couldn’t be found. The shortage of quality, homelike care environments for aging adults represents both a humanitarian concern and an investment opportunity.
“I think personally [this is] the best opportunity in real estate for decades to come,” Dr. Alex states. “There’s a real contribution component behind it.”
For physicians who entered medicine to make a difference, residential assisted living offers the rare combination of strong financial returns and meaningful community impact—caring for a vulnerable population while building financial freedom for doctors and their families.
Your Path Forward: The Time Is Now
The baby boomer generation is aging rapidly, creating unprecedented demand for quality senior housing. The question isn’t whether this need exists—it’s whether healthcare professionals will step up to address it while building their own financial security.
Dr. Alex’s journey from active duty military physician to practicing two days per week didn’t happen overnight. It required sacrifice, discipline, strategic thinking, and willingness to act despite imperfect information. But the result—freedom to practice medicine on his terms while spending quality time with his four-year-old and wife—validates every late night and weekend invested in building the business.
What would freedom look like for you? Perhaps it’s reducing to part-time clinical work. Maybe it’s starting a direct primary care practice without financial pressure. Or possibly it’s maintaining your current practice while building wealth that provides security and options.
Whatever your vision, residential assisted living represents a strategic vehicle for achieving financial freedom for doctors while addressing one of healthcare’s most pressing challenges.
Related Episodes You’ll Love:
- Episode 159: Aline & Carlos: How to Build a Successful Real Estate Portfolio with Assisted Living Facilities
- Episode 158: Dream Bigger: From Limiting Beliefs to Six Short-Term Rentals with Dr. Lama Noureddine
Dr. Alex Schloe is a family medicine physician, entrepreneur, and residential assisted living investor. After serving in the Air Force and separating in 2024, he now practices medicine two days per week while building his real estate portfolio and helping other physicians enter the assisted living space through his mastermind community. Learn more at theralroom.com.
