Three Ways “First, Do No Harm” Applies to Personal Finance

By Jimmy Turner, MD
The Physician Philosopher

We are taught it early and often in medical training: First, do no harm.  The premise is that medical diagnostics and treatment can and do cause harm.  So, your first job in medicine is to not cause further harm to patients.  Interestingly, this is no different in personal finance (or physician finance).  The first job is to avoid causing yourself harm.  Today, we will discuss three causes of harm in medicine and their corollary in personal finance.

So, how can you “First, do no harm?” I’ll tell you three ways.

Let’s dig in.

1)The Incindentaloma in Medicine

I often hear people say, “man, if I could just get a full-body CT scan to make sure everything is fine…”  The problem is that this may not be helpful at all.  Random findings on CT scans can and do cause harm.

They even have a name (“incindentalomas”).  In other words, they are incidental findings that would not have been found if a test was not ordered.   They may or may not have significance to your health.

For example, let’s say we order a chest x-ray for a person’s cough and find a “spot” on the plain film.

This doesn’t sound like a big deal until the person has a random enlargement in their lung, they get a biopsy, and then get a pneumothorax and chest tube… all to find out that the growth was benign.  In this case, the incindentaloma caused harm and no harm would have occurred without our interference.

The Incidentaloma in Personal Finance

When you run across someone who has new information in personal finance, just be weary.  If you don’t understand it, then you probably should not be investing in it.

For example, someone recently told me about aglorithim based investing.  It sounds like a great idea, but I just don’t understand it.  If my current investing plan, which involves low-cost index funds, is going to get me to my goals, why take the risk on something I don’t understand to get me there faster?

The same goes for whole-life insurance (a.k.a. cash-value life insurance, annuities, etc).  It’s complicated stuff and, honestly, you likely shouldn’t be dabbling in it for you or your family.

The same can be said for cryptocurrency or any other kind of speculation.  Just because someone incidentally told you about this new “great” idea doesn’t mean you should make a change.

Just stick to the easy, low-cost, “set it and forget it” plan that you started with.  You can thank me later.

2) Prevent Badness: Make a Contingency Plan

An apple a day keeps the doctor away!

This idea has been here for ages.  Preventative medicine is usually the best kind of medicine.  It goes something like this: Eat well, exercise, and take care of yourself (sleep hygiene, don’t smoke, moderate alcohol consumption, etc).  This can prevent a lot of bad health.

The basic premise here is that an ounce of prevention is more than a pound of cure.  Doing all of the above after you sustain a massive stroke is going to be too little, too late.  Prevent the badness and have a plan for it before it happens.

That’s how you can “first, do no harm” to yourself.

The Personal Finance Contingency Plan

It turns out the same advice is applicable to personal finance, too.  You need to make sure you protect yourself and prevent badness.

Make sure you know what you’ll do before a bear market happens.  Have a plan, and stick to it.  If you don’t have a financial plan, then make one. Or get someone to help you make one (fee-only flat hourly rate advisors are best here; I can recommend some, if you need).

Get asset protection. If you have a spouse or children, get life insurance.  If you are a resident or attending physician, get disability insurance and umbrella insurance.  Have a plan before the badness happens.

If you need advice on where to seek disability insurance, just shoot me an email and I can make a couple of recommendations to you.  The important part is for them to be independent disability insurance agents.

3) Advocate for yourself

The best person to look out for yourself interest is you.  Smart patients realize they need to advocate for themselves.  Insurance companies and big hospitals rarely perform this function.

When I was a fourth year med student (a bad year in some ways as you’ll find out below) I took a charge in the championship intramural game.  I got knocked down and my elbow hit the ground causing a large laceration that would require a couple of stitches.

Doing the responsible thing, I figured I’d save the hospital system and my insurance the emergency department bill.  Instead, I put a dressing on it and lined up an appointment at my family practice doctor the next day.

A couple of stitches later it was fixed.  $20 co-pay. Sweet.  Well, that’s what I thought.  A couple of months later I received a $450 bill for surgery. For stitches.   Naturally, I called the insurance company and pointed out to them that stitches aren’t surgery.

“Well, sir, when anything that is sharp goes under your skin is sharp that is considered surgery.”

My quick response pointed out the ridiculousness of that definition.  “Ma’am, if I get a vaccination with a needle would you consider that to be surgery?  I had two stitches and could have paid a $100 emergency department co-pay, but decided to save you and the system money and am getting screwed for it.”

Guess what happened?  Nothing.  I had to pay the $450.  The insurance company was not advocating for their customer.  I should not have been surprised.

The Need for Personal Finance Self-Advocate

Just like that insurance company above, the financial industry can often hurt you just as much as it can help.  We have all had our situations where people who we thought were there to help us or give advice did just the opposite.

My first rude awakening occurred when I was told to apply for personal disability insurance as a 4th year medical student.  I just had a baby girl, and all I wanted was life insurance.  I was trying to be a good dad.

We all know how that story ended. I can’t get personal disability insurance now.  The same can be found in the financial advising industry where there can certainly be massive conflicts of interest.

So, learn to do a little Do-It-Yourself personal finance.  It’s not that complicated.  Seriously.  If you still need help, then consult a fee-only hourly financial advisor who will not give you conflicted in their advice.

Above all else, advocate for yourself. Do some research. Ask the tough questions.  Take responsibility for your future.

Take Home

People are rarely going to be looking out for your self interest.

First, Do No Harm.  Make a plan and stick to it. Ignore the random pieces of financial information that people often want to drop on you that doesn’t line up with your plan.  Don’t speculate.  And advocate for yourself.

What are some of your examples where you got harmed?  How could you have prevented this?  Leave a comment below!  



  1. Crispy Doc


    So many equivalents of that elbow laceration come to mind…most notably, my PCP suggesting I get my routine labs drawn at my hospital because they provided an employee discount. Turns out it was not for docs (I should have verified), so a year and lots of back and forth negotiation later, I paid only three times what it would have cost at the local outpatient McLab around the corner from the hospital.

    Appreciate the wise and resonant words of caution,


    • ThePhysicianPhilosopher

      I was mad when I had to pay for those stitches. I bet you were on fire about the labs.

      It’s a sad reality of having to deal with our non-transparent healthcare system.


  2. Dr. McFrugal

    Great points here! A part of financial independence is being independent of the financial services industry. Agents and insurance salesmen are primarily looking out for their own self interests and you make a very good point about being your own best advocate. The only person you can truly have a fiduciary relationship is with yourself.

  3. Xrayvsn

    Hey Let’s Not Get Carried Away About Not Ordering Imaging Studies!!!! (I still need my primary gig as I may be only be able to eat out a few times a year on the money rolling in from my blog gig) LOL

    Great points as usual. No one cares about your money more than you so you need to educate yourself.

    Incredible about charging as a surgery for stitches. It’s no wonder healthcare costs are out of control

    • ThePhysicianPhilosopher

      Hahahaha I thought of you and MD when I wrote this post. I fully endorse and support indicated imaging!

  4. Doc G

    So true. It seems there are so many avenues to do harm if you don’t keep it simple.

    • ThePhysicianPhilosopher

      Definitely more ways to cause harm than to succeed. And very little help along the way for most of our students and residents.


  5. Doyle

    That is a really good tip particularly to those fresh
    to the blogosphere. Short but very precise info… Thanks for sharing this
    one. A must read post!

  6. Frogdancer Jones

    The more I hear about the US medical system, the gladder I am that my ancestors sensibly decided to migrate to Australia 200 years ago. Maybe they knew what was coming…!
    Enjoyed this post.

    • ThePhysicianPhilosopher

      I hear you. We are in a tough place right now, but hopefully we will decide to improve at some point.

      Thanks for stopping by!

  7. MattTheRNMentor

    You nailed this post from start to finish.

    In the FI space we’re smothered with a barrage of new and sexy ways to invest money. We often rely on experimenters to give their review and post about their experience. Just because it’s right for them, doesn’t mean it’s right for us.

    The problem with financial self help is that it’s SO easy to be lead astray. When I was 21 I decided to become financially literate and read every financial book I could get my hands on. Unfortunately, I didn’t choose the right books to read.

    In medicine, you have the ability to assess the quality of new research and decide whether it’s worth implementing it into practice.

    Unfortunately for the financial self-help market, there’s no such metric aside from relying on the “stars” that appear next to it. In that case, we shouldn’t exactly trust the general public to influence the content we consume and then implement into our lives.



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