Attending Physicians: Stop Sucking At Your Job

A recent post by the White Coat Investor got me pretty fired up.  Dr. Dahle spoke about three of the main financial enemies that face physicians. The third one that he mentioned had something to do with medical culture.  The gist of it was that talking money in academic medical centers is considered taboo.  While I think WCI is right, it really made me angry.  As an academic attending physician, it made me feel like we are utterly failing our students and residents.

Why and how can we make the change?

Let’s dig in.

Why should you care?

If you are in academics, my presumption is that you care about educating future physicians on how to take care of patients.  How well do you think those future doctors will care for their patients if they feel the noose tightening around their neck as they suffocate in debt?

What if, as they age, they realize that retirement is just a figment of their imagination?  It’s not possible because no one ever cared enough to teach them how to budget, save, and invest their money.  They are at the point where the numbers just don’t add up.  How well do you think they will take care of patients then?

I am sure it is tough to imagine a world where a disconnected administrator tells the doctors you trained how to do their job (even if the administrator can’t do it themselves).  What if your future doctor had the knowledge to achieve financial independence so that they could stand their ground when people encroach on their craft unnecessarily?

All of these reasons, and many more, should encourage you to stop sucking at your job.  Teach your students and residents about money. Answer their questions. Don’t let it be taboo. If you don’t know the answer, go and find someone who does – and is non-conflicted.

The time is past where we ill-equip our future doctors to know how to take care of themselves so that they can take care of others.  Just do your job.  That’s all I am asking.

How can I teach them?

Teaching students about personal finance requires a certain amount of transparency.  Be open and honest.  Put the time in to learn the Pareto Principle (the 20% of the work that accomplishes 80% of the results).

If you can’t do it, then encourage someone else in your program with the requisite knowledge to create a curriculum for the trainees.  Give them the support that they need to fix the problem that you and I both know exists.

You should also try and be an example of someone who places an emphasis on being intentional about your debt and the financial goals you hope to achieve.  When do you want to become financially independent?  How are you going to do it? How did you deal with your loans?

These are not trade secrets.  They are secrets that are rarely traded.  Our trainees deserve better.

Resources and Take Home

Read the resident physician finance page and the attending physician finance page.  That would be a good starting point.

Consider listening to podcasts like ChooseFI, White Coat Investor, or the Mad Fientist. Then, Read a few books.  Take a few minutes per week to read a few recommended blogs.

The point is that the resources now exist and that it is your responsibility, as an academic attending physician, to teach our trainees about personal finance.  If you can’t do it, then support someone who will.

Our residents deserve better. It really is that simple.

Do you have a resident or student financial curriculum where you work or study?  What are the components involved in your program?  If you are a resident, what topics do you wish were covered during your training?  Leave a comment below.



14 thoughts on “Attending Physicians: Stop Sucking At Your Job

  1. This is actually what got me to start the blog. I offered to participate in my residencies conference to talk about financial planning / investing. It was amazing to see how most had no clue what steps to take but were eager to learn. Simple discussion about compound interest and investing in index funds got them staying after conference to ask questions when normally they leave at the first sign of noon.

    Another place I think Academics needs to make some adjustments is advice on career types. I see too often that the unviversity employed ED attending doesn’t really know how to advise residents on contract negotiations or even understand some of the reimbursement models. If you don’t know then bring in outside people because advising residents requires multiple view points

    • I had the exact same experience. Many times my intraoperative teaching consists of pertinent details related to the case and then is succintly followed by financial topics. The residents know I love talking about it and they like to soak it up. I usually have to leave the room before they run out of questions.

      Glad we are on the same team! Gotta fix the problem.

      P.s. agree on your second point. I am a failure there. I know very little about contract negotiation.

  2. Spot on commentary. It really is time that medical students and residents get proper financial training in the curriculum.

    You are absolutely right about how can a doctor give adequate patient care if in his or her mind financial discord is preoccupying them? Being in heavy debt will likely force them to practice medicine in a non-ideal way. Trying to cram way too many patients in too little time just to chase the dollar.

    I do think there is a culture change but I may be biased because the people that come to physician blogs have this mindset but likely represent a very small subset of the actual #s practicing.

  3. Your residents are lucky to have you as a mentor. You aren’t fully preparing residents and students for their career if finance isn’t part of the conversation.

    I spend time with our new hires that are straight out of residency to make sure they understand the group’s 401k, HSA, Cash Balance plan, etc. I’ve even convinced a few to start doing backdoor Roths.

    It is a huge gap in medical education. Luckily there has been an explosion of physician finance blogs to help fill the gaps.

    • Your new recruits are lucky to have you, too!

      As I learned from POF: a rising tide raises all boats. The more physician finance blogs the better, in my opinion. We all have a bit of a different slant.

      Keep up the good work, SHS!

  4. I love love love the perspective in this post. I had never really connected that there are a good number of academic physicians out there are who are soaking up the financial wisdom of the numerous physician bloggers.

    I often consider the problem of how to educate the thousands of students and residents about finance before they finish training. It seems like an insurmountable problem.

    But it makes so much sense to call these academic readers on the front lines to take action. I bet there are many would-be teachers who just need a little structured information and encouragement to help them get started.

    Maybe that is the solution. It would be nice to see a blog or just a series devoted to helping nudge academics to do more mentoring.

    • Thanks, Johanna. I agree that the problem seems insurmountable!

      The issue with nudging academics to do more mentoring is, unfortunately, that many of them don’t know this stuff either. So they never make it to these sites.

      I am slowly, but surely, trying to spread that word through this website and through my non-anonymous work at my main employer.

      Hopefully the spark will lite a fire at some point!

  5. Part way into my first year as an attending, I became interested in physician finance and planning how to dig myself out of my financial hole. Now I am somewhat obsessed with it. I plan on giving an informal talk to the residents in my program in the next 3-6 months about the various aspects of budgeting, managing debt, and retirement among other topics. I am by no means an expert (other than budgeting…I rock that), but I figure I can at least introduce some basics, get them thinking about it, and introduce them to my favorite physician financial blogs so they can keep on learning and hopefully help others down the road.

  6. I gave a marathon 2 part lecture last year. This year a colleague, who is also interested in personal finance, and I are developing a year long lecture series and going to hit all the major personal finance and FI topics.

    We are pretty stoked and if it is well received we might branch out to other departments! 🙂

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