From Medicine to Financial Independence: How Two Physicians Built a 100+ Unit Real Estate Portfolio

In 2015, Drs. Letizia Alto and Kenji Asakura set out to achieve a bold financial goal: replace both of their clinical incomes through real estate investing within seven years. Driven by a desire to escape the demanding schedules of hospital life and gain more time with their family, the physician couple began redirecting their savings into rental properties. Today, they own and manage a portfolio of over 100 units and are fully financially independent.

The foundation of their strategy is positive cash flow, the income left after all property-related expenses are paid. Alto and Asakura only pursue investments that meet strict cash-on-cash return criteria, utilizing a proprietary calculator and input from a vetted team of real estate professionals. If a property doesn’t meet their financial benchmarks, they walk away. Their approach ensures each acquisition contributes to their ultimate goal: sustained income and time freedom.

Another core wealth-building mechanism is debt pay down. As tenants pay rent, a portion of that income is used to pay off the mortgage, gradually increasing the couple’s equity in each property. Simultaneously, they actively pursue forced appreciation intentionally raising property value by increasing income or reducing expenses. Examples include converting garages into rentable workspaces, sub-metering utilities, or adding bedrooms to enhance rental potential.

They also benefit from immediate appreciation, often acquiring properties below market value and generating equity from day one. While market appreciation is unpredictable, the couple strategically invests in emerging neighborhoods to increase their exposure to long-term growth opportunities without relying on market trends alone.

Perhaps most strategically, Alto and Asakura maximize tax benefits available to real estate professionals. Through the IRS-designated Real Estate Professional Status (REPS), they’re able to offset active income with passive real estate losses, especially during years when property renovations generate substantial deductions. This approach has allowed them to reinvest tax savings back into their growing portfolio.

Now based in Puerto Rico, the couple spends their time managing their properties, educating others through their Semi-Retired MD platform, and enjoying life with their three children. Their story underscores how a disciplined, business-minded approach to real estate can create lasting financial independence and the freedom to live life on your own terms.