If you work with physicians long enough, you will eventually hear it sometimes quietly,
sometimes with visible distress:
“I’m anxious about my debt.”
It may be medical school loans.
It may be a mortgage.
It may be leverage from real estate or a business investment.
What’s important to understand is this: **anxiety about debt is not a sign that something is wrong.
In many cases, it’s a predictable response to responsibility, uncertainty, and high stakes.
And how you respond to that anxiety matters far more than the numbers alone.
Anxiety About Debt Is Commonand Understandable
Physicians are trained to avoid catastrophic outcomes. Their professional identity is built around
responsibility, precision, and competence. When debt enters the picture, it can trigger a deep
fear:
*What if I can’t handle this?*
*What if I lose everything?*
Many early-career physicians describe medical school debt as “a monkey on my back.” One
physician likened borrowing to walking into a lake ankle-deep at first, then waist-deep, and
eventually feeling like the water is “up to my face.”
Emotionally, that makes complete sense.
But emotionally compelling does not always mean financially accurate.
The Anxiety Is Not About the Debt
A critical insight for advisors is this:
**Debt itself does not cause anxiety.**
Anxiety comes from the perceived *threat* of being unable to repay it.
To the nervous system, debt can feel like:
* Exposure
* Loss of control
* Existential risk
When a physician fears “losing everything,” their nervous system shifts into survival mode. At
that point, logic, time horizons, and probability calculations are difficult to access.
This is why simply “running the numbers” often fails to calm anxious clients at least initially.
Anxiety Is Not Intuition
Many physicians mistake anxiety for intuition.
They are not the same.
* **Anxiety** is loud, urgent, repetitive, and catastrophic.
* **Intuition** is calm, grounded, and spacious.
Feeling scared does not necessarily mean something is unsafe especially when the numbers
suggest otherwise.
For example, low-interest student loans paired with a long earning horizon often make early
investing mathematically sound. Yet anxiety may still insist, *“Pay everything off first so I can feel safe.”
Understanding this distinction helps advisors avoid reinforcing fear-based decisions.
—
How Anxiety Quietly Sabotages Wealth-Building
Unchecked anxiety often leads physicians to delay:
* Investing
* Practice improvements
* Entrepreneurial opportunities
* Education or coaching that could accelerate growth
Statements like:
* “I’ll invest once my loans are gone”
* “I need to have zero debt first”
are usually driven more by emotional safety than financial strategy.
Anxiety collapses time.
Wealth is built over decades.
Good Debt vs Bad Debt: A Tool, Not a Moral Failing
One of the most helpful reframes advisors can offer is separating **consumer debt** from
**strategic leverage**.
* **Bad debt**: high-interest consumer debt that drains future options
* **Strategic debt**: education, real estate, businesses used intentionally to build assets and cash flow
Debt is not a moral issue. It is a tool.
The relevant question is not *“Do I have debt?”*
It is *“Is this debt serving the life I’m trying to build?”*
Engage the Planning Brain Without Dismissing Anxiety
Anxiety is not always wrong. Sometimes it’s an early warning signal.
If assumptions are shaky, margins are thin, or reserves are inadequate, anxiety may be appropriately prompting caution.
This is where advisors add enormous value:
* Running the numbers
* Stress-testing scenarios
* Modeling best- and worst-case outcomes
* Adding perspective and time horizon
**Calming the nervous system does not mean ignoring risk.**
It means creating enough internal safety to evaluate risk accurately.
A useful frame for clients:
*We want anxiety in the room but not in the driver’s seat.*
Risk Is Realand Fear Can Coexist With Leadership
All investing involves risk. Money can be lost.
At a recent physician investor meeting, one doctor said:
“I’m millions of dollars in debt and my goal is to be tens of millions in debt. That means I’m building assets.”
That statement only makes sense when paired with:
* Rigorous planning
* Cash flow discipline
* Reserves
* Emotional tolerance for leverage
This is not bravado. It’s math plus self-leadership.
Advisors help physicians understand that **courage and fear often coexist** in meaningful financial decisions.
A Compassionate, Contrarian View of Anxiety
Many physicians want anxiety gone. They get frustrated with the part of themselves that wakes
them up at 3 a.m.
But anxiety is not the enemy. It is a protective part trying sometimes clumsily to keep them safe.
A helpful reframe for clients:
“Thank you for working so hard to protect me. I’ve got this.”
Medication may be helpful for some people, and that deserves respect. But medication alone
does not teach someone how to *relate* to anxiety or lead themselves through uncertainty.
Be Willing to Feel Anxiety It Will Pass
Anxiety rises, peaks, and falls if allowed.
Resisting it is like holding a beach ball under water it eventually pops up with more force.
One helpful metaphor:
* The initial fear is the trigger
* The struggle with the fear is what causes the most damage
Feeling anxiety is uncomfortable but not dangerous.
Fighting it is exhausting.
The Advisor’s Real Value: Nervous-System Leadership
Doctors don’t just need financial models.
They need a calm, grounded presence when stakes feel high.
Financial confidence is not the absence of anxiety.
It’s the ability to stay present, think clearly, and make values-aligned decisions *while anxiety is present*.
When advisors can hold space for both **emotion and math**, they become indispensable not
just as planners, but as trusted partners in a physician’s financial life.
If you’d like, I can:
* Adapt this post for **LinkedIn articles**
* Create a **short advisor-facing checklist** (“How to respond when a doctor is anxious”)
* Or write a **companion piece for physicians** that advisors can share with clients
This topic is a quiet differentiator and you’re leaning into it exactly the right way.