PRN: Why You Aren't Rich

Physician's Money Digest, May 15 2004, Volume 11, Issue 9

If you happen to be rich already, you canskip this column. If you want to fretabout the exact definition of rich interms of net worth or annual cash flow,this column is not for you, either.

Obstructions to Wealth

Has becoming rich ever been yourstated goal? Contrary to popular belief,for all but a small percentage of docs,making money is a happy byproduct ofour careers, not the focus. The fact thatwe can even think about making andaccumulating more than "enough" is arelatively recent development. It is largelyan unintended result of the insuranceindustry's growth and the completelyunexpected acceleration of medical technology.So, it's a nice luxury to be able totalk about luxury. Below we're going tofocus on attitudes and behaviors that getin the way of wealth accumulation.

• Surveys show that a lengthy educationcorrelates negatively—that's rightnegatively—with amassing wealth. Howso? You lose a head start during those noandlow-income years of study, insteadacquiring a hefty debt, and you are notaccumulating early when it counts most.Postponing earning and saving isn't profitable,and it turns out that wealth isblind to degrees, among other things.

• Doctors are granted an elevatedstatus by society, and maintaining statusis expensive in money, time, andenergy. This means spending instead ofsaving, taking the time to spendinstead of earning or financial planning,and diverting attention awayfrom being productive. We rationalizeour expensive lifestyles in myriad ways."I've earned it," "Life is short," and "Iwant to provide a better life for myfamily," come to mind in my case. Alltrue enough, but not on point to gettingrich, if that's your goal.

• Docs by inclination and trainingtend not to be selfish, which is a frequentcharacteristic of the rich. Furthermore,we give proportionately more togood causes than others of similarincome. And because medicine hasbeen a traditional way for bright, ambitiouschildren to be uplifted beyondtheir parents' station in life, there isalso correspondingly less for most docsto inherit than the mean.

• Working hard and long in this professionoften means a high cash flow,which leads to a feeling that money is aneasily renewed resource. So docs oftendon't have a budget, just an income limit,or sometimes a debt limit. Needless tosay, our business-savvy friends wouldn'tdream of conducting their affairs withouta concrete plan and high regard for aworthy return on their spending.

• Even if you are in private practice,the business you build does not translateinto a high sales price. It's a characteristicof most professions, actually. Conversely,how many small businesspeople haveyou known who have cashed out big?Not all, but enough to make you thinkthat at least the potential is there.

Factors of Wealth

It is human nature that people tend toassociate with others who share a similaroutlook. So if you hang out with overconsumers,it will be mighty tough todecide to change and live in a differentway. Spending time with the Jonesesusually requires keeping up with them.

Time and energy are finite for all ofus. The choices we make, consciously andunconsciously, set us on a course todevelop in certain ways, factoring inchance. So if you care enough to askyourself from time to time, "Why aren't Irich?" think about these factors. Andthen be thankful for how well you aredoing despite them.

Jeff Brown, MD, CPE, a partneron the Stanford UniversityGraduate School of BusinessAlumni Consulting Team, is apracticing primary care physician.He welcomes questions andcomments at