From a physician who understands how doctors really think about money
As a practicing physician who now helps financial advisors better serve doctor clients, I need to share something that might shock you: that specialist earning $850,000 annually with less than $400,000 in their portfolio after fifteen years of practice? That’s not the exception—it’s the rule.
The disconnect between doctor incomes and doctor wealth isn’t about intelligence or discipline—it’s about deeply ingrained habits that we develop during our medical training and career progression.
Let me give you the insider perspective on why your smartest, highest-earning clients often make the poorest financial decisions.
The Medical Mind: Why Smart Doctors Make Dumb Money Moves
Before diving into specific habits, you need to understand the physician mindset. We’re trained to make life-or-death decisions under pressure, to trust our expertise implicitly, and to believe that hard work directly correlates with success. These traits make us excellent doctors—and often terrible wealth builders.
We also carry unique psychological baggage: delayed gratification fatigue after 8+ years of training on minimal income, imposter syndrome despite our expertise, and the crushing weight of student debt that can exceed $300,000.
The Five Wealth-Destroying Habits I See in Every Doctor Client
Habit #1: We Operate Financially Blind
Here’s what financial advisors don’t realize: most doctors have never been taught to track personal finances. Medical school teaches us to monitor patient vitals obsessively, but we graduate financially illiterate.
I recently spoke with a cardiologist colleague who said, “I just want to make enough money so I never have to think about it.” This isn’t laziness—it’s avoidance born from overwhelm and lack of financial education.
We’ll spend hours analyzing a patient’s lab values but couldn’t tell you our monthly spending if our lives depended on it. The irony? We’d never manage a critically ill patient without knowing their vital signs, yet we manage our financial lives completely blind.
What This Means for Advisors: Don’t assume doctors understand basic financial metrics. We need education, not judgment. Create simple dashboards and use medical analogies. When you say “let’s check your financial vital signs,” we immediately understand the importance.
Habit #2: We Undervalue Our Own Worth
Most doctors are terrible negotiators when it comes to our own compensation. We’re trained to be healers, not businesspeople. We often accept the first contract offered and rarely optimize our revenue streams.
But here’s the deeper issue: we think about income linearly. See patient, get paid. Work more hours, earn more money. We rarely consider how our expertise could generate passive income or how business structures could optimize our tax situation.
I’ve watched brilliant surgeons leave hundreds of thousands on the table because they never learned to think entrepreneurially about their skills and knowledge.
What This Means for Advisors: Help us see beyond the exam room. Show us how our medical expertise can be packaged into multiple revenue streams. Partner with healthcare business consultants. Remember, we’re often more comfortable with the science of medicine than the business of medicine.
Habit #3: We Make Emotional Financial Decisions
In medicine, we use triage to sort patients by urgency and survival probability. It’s purely data-driven decision making. But when it comes to our own money, we triage emotionally.
The classic example? Medical school debt. I’ve watched countless colleagues aggressively pay down 3% student loans while their investment accounts sit empty. Mathematically, it makes no sense. Emotionally, it feels like freedom.
That debt feels like a “monkey on our back”—a constant reminder of our financial vulnerability during training. We want it gone, even when keeping it and investing the difference would build more wealth.
What This Means for Advisors: Acknowledge the emotional component while gently redirecting to mathematics. Use phrases like “I understand this feels overwhelming, but let’s look at what the numbers tell us.” Help us separate feelings from financial facts.
Habit #4: We Start Late and Fight Compound Interest
Most doctors don’t earn real money until our early thirties—a full decade behind our peers. Then we compound this mistake (pun intended) by accumulating consumer debt that works against us.
We understand compound interest intellectually—many of us have science backgrounds. But we don’t feel its power because we started so late. By the time we’re financially stable, we’re already behind.
Add in lifestyle inflation (we finally have money and feel we “deserve” nice things after years of sacrifice), and compound interest becomes our enemy rather than our ally.
What This Means for Advisors: Create catch-up strategies specifically for late starters. Show us compelling projections of what delayed investing costs. Most importantly, automate everything—we’re too busy and too tired to make optimal decisions consistently.
Habit #5: We Spend Unconsciously to Manage Stress
Here’s a personal story that illustrates this perfectly: I once placed a $300 plant order at 2 AM while writing post-op orders. I was exhausted, stressed, and that gardening catalog provided a momentary escape.
Shopping becomes stress relief for many doctors. The dopamine hit numbs the constant pressure of life-and-death decisions. We work incredibly hard and feel we deserve these small indulgences—except they’re not small when they happen regularly.
We also waste money through sheer inattention. I can’t count how many times I’ve thrown out food because I bought too much or forgot what I had. When you’re working 60+ hour weeks, conscious spending feels impossible.
What This Means for Advisors: Address the psychological aspects of money management. Help us create “speed bumps” that force conscious spending decisions. Implement automated systems that make good financial habits effortless.
How to Leverage These Insights in Your Practice
Understanding these habits gives you a massive competitive advantage in serving physician clients. Here’s how to use this knowledge:
Speak Our Language: Use medical analogies and terminology. “Financial health checkup,” “wealth-building prescription,” “investment vital signs”—these phrases resonate with us immediately.
Address the Emotional Component: Don’t just present numbers. Acknowledge the stress, overwhelm, and unique pressures we face. Show empathy for our journey.
Create Physician-Specific Solutions: Generic financial planning doesn’t work for doctors. We need specialized strategies that account for our late start, high debt loads, and unique tax situations.
Educate, Don’t Judge: Remember, we’re not financially illiterate by choice. Medical training simply doesn’t include financial education. Approach us as students, not problems to be solved.
Automate Everything: We’re too busy and too tired to make optimal financial decisions consistently. Build systems that work without our constant attention.
The Opportunity Ahead
Doctors represent one of the most underserved, high-value markets in financial services. We earn exceptional incomes but often lack the knowledge, time, or systems to build corresponding wealth.
By understanding how we think about money—our fears, motivations, and blind spots—you can position yourself as the financial advisor who truly “gets” physician clients.
The need is enormous. The opportunity is unprecedented. The question is: are you ready to become the go-to financial advisor for doctors in your market?
At Engaging Doctors, I help financial advisors develop these specialized skills and systems. Because when you understand how doctors think about money, you can finally help them build the wealth their incomes should generate.