Watching a young YouTube millionaire talk about money as I decompress after another 12-hour workday with a debt burden of 6 figures is frustrating. Like many of my co-fellows, I've been in training for almost a decade, and I'm still nowhere close to having my debts paid. We are often told that our financial health will improve once we are attendings, but I'm skeptical that more money will solve the real problem.

The Problem – The Business of Medicine

Medicine changes quickly. Health care costs are getting out of control. Insurance companies implement more hurdles. Administrative tasks increase every year. We work longer hours. As physicians, we spend 51% of our time on computers instead of our patients1,2. If you feel like we are not making any progress, you are not alone. Burnout is real and we all are at a high risk of burnout with limited solutions in sight.

Roughly 50% of physicians are burntout3. This likely means that at least 50% of physicians were contemplating quitting medicine at some point. It is also likely that the numbers are worse for trainees. It's not difficult to imagine why:

• An average of $200,000 student debt4
• Long work hours
• Medical record systems that make tasks more burdensome
• Lack of control (autonomy)
• Increased administrative tasks

This leaves us with limited time to do what we came into medicine for: to care for patients. Here's the rub: we work in a profession we love and a business we tend to hate.

However, more money won't solve our financial problems. We need to learn from some of the most highly paid workers in the U.S. – professional athletes. Sports Illustrated reported 60% of NBA players and 78% NFL players, who were millionaires, go bankrupt within five years of retirement5,6. I have also heard of many physicians who earn six-figure salaries but still live paycheck to paycheck. We must learn from their mistakes.

If we become financially savvy and independent, we'd likely be happier and less stressed in our personal and professional lives.

The Answer – Financial Education

Very few of us are taught how to handle finances. I strongly believe that financial education is the first step towards being financially strong. Once you build up a beachhead of strategies and resources, you become free to work on your own terms, negotiate aggressively on your contracts, and gain freedom to work when you want to, not because you have to.

Financial education has never been easier to find. The internet is full of books, videos and podcasts on how to manage your money. The time to learn about how money works is NOW because life only gets busier. I'd encourage you to find a resource you enjoy and read or listen for a few minutes each day. (Read my article, "The FIT Financial Foundation," that includes a list of books.)

Let's start with a short playbook or checklist:

1. Budget and reduce expenses as much as possible (be realistic)
1. Use free online tools like mint.com and Personal Capital.
2. Set goals
1. For example, securing retirement, buying a house and/or saving for a car
3. Build emergency funds
1. Save expenses for 3-6 months. I tend to lean towards 6 months to be conservative.
2. Store your emergency fund in savings or checking accounts. Do not use this money to invest in the stock market. Only gamble with money you can afford to lose.
4. Max out your employer-sponsored retirement funds like 401(k) or 403(b). Put in the maximum amount of money that your employer will match.
1. If your employer matches up to 3% of your contribution, then put in 3%.
2. Select low-fee, non-actively managed index funds as your investment option. "Actively managed" funds mean that brokers get to make investments with your money. Whether they make money for you or lose your money, they still take their hefty paychecks from money you put into their hands. It's a win-win for them, it's lose-lose for you.
3. Retirement portfolios like these can be particularly important when it comes time to think about retiring.
5. Pay your high-interest debts
1. Credit card debt has very high interest rates.
2. Pay these off as soon as possible to improve your financial situation and your credit score
3. Student loans are different (Read my article, "Foolproof FIT Finance," for my approach).

We didn't join the profession to focus on money, but it is important. Maybe we should learn from the young YouTube millionaires. Without focusing on money, we may continue to be trapped in a profession we love but a business we tend to hate.

References:

1. Arndt BG, Beasley JW, Watkinson MD, et al. Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations. Ann Fam Med. 2017;15(5):419-426.
2. Hecht J. The Future of Electronic Health Records 2019; https://www.nature.com/articles/d41586-019-02876-y. Accessed Oct. 3, 2021.
3. Peckham C. Medscape Physician Burnout & Depression Report 2018. 2018; https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235.
4. Budd K. 7 Ways to Reduce Medical School Debt. 2020; https://www.aamc.org/news-insights/7-ways-reduce-medical-school-debt. Accessed Oct. 3, 2021.
5. Torre P. How (and Why) Athelets Go Broke. 2009; https://vault.si.com/vault/2009/03/23/how-and-why-athletes-go-broke. Accessed Oct. 3, 2021.
6. Dudley C. Money Lessons Learned from Pro Athletes' Financial Fouls. 2018; https://www.cnbc.com/2018/05/14/money-lessons-learned-from-pro-athletes-financial-fouls.html. Accessed Oct. 3, 2021.

This article was authored by Vybhav Jetty, MD, a cardiology fellow in training at Saint Elizabeth's Medical Center in Boston, MA. Twitter: @jettymd.

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