L
etizia Alto and Kenji Asakura, a physician couple, created Semi-Retired MD to share their real estate investing journey. They set a goal in 2015 to replace their clinical incomes with real estate cash flow within seven years.

    The couple built a portfolio of over 100 units, focusing on strong cash-flowing properties. They use a cash-on-cash calculator to evaluate potential investments and run the numbers twice before making an offer. If the deal doesn't work, they won't buy the property.

    There are six main ways to make money in real estate:

    1. Cash flow: generating income from rental properties while covering expenses.

    2. Debt pay down: building equity through mortgage payments.

    3. Forced appreciation: increasing a property's value by boosting net operating income (NOI) or decreasing expenses.

    4. Immediate appreciation: buying a property that increases in value immediately, often due to renovations or off-market deals.

    5. Market appreciation: benefiting from market trends and neighborhood growth, although this is unpredictable.

    6. Tax benefits: leveraging tax incentives for real estate investors, such as sheltering income using "real estate professional status" (REPS).

    Alto and Asakura use business principles to manage their rental properties, focusing on increasing revenue and decreasing expenses. They also prioritize cash flow, aiming for a positive return on investment.

    The couple has scaled back on medicine and spends most of their time managing their portfolio, building their community, and traveling with their three kids.