Explore the World of Fiscal Imagination

September 16, 2008
Louis L. Constan, MD

Physician's Money Digest, January31 2003, Volume 10, Issue 2

It can't have escaped your attention, doctor,that financial advisors think differently thanwe do. They can go on and on, and we haveonly the foggiest notion of what they're talkingabout. They seem knowledgeable, but most of uswill admit that when they pull out their graphs andaccounting reports, our eyes gloss over.

So how will we ever learn to workwith people like this if we don't understandthem? The answer is simple really.Put a financial advisor's brain into aphysician's body. In this case, I'veplaced the brain of a financial advisorinto the body of Dr. Welby Bloomberg.After giving him a few weeks to get settled,I met with Dr. Bloomberg for anexam in his posh Manhattan office.

Dr. Bloomberg:

Dr. Lou, I wantyou to know that I'm a really wonderfulphysician. I've been successful in diagnosingand treating diseases in the past.Of course, you know that past performanceis no guarantee of future results.

Dr. Constan:

I can accept that.(Why didn't I think of using that linewith my patients before?)

Dr. Bloomberg:

Okay, now let's get started.We'll discuss my fees. I'm willing to manage yourcomplete health care needs from this day forward.My usual charge is 2% per year of your total assets.However, as a professional discount, I am willingto go down to 1.8% for you. If you bring me moreclients, I will, of course, cut that further.

Dr. Constan:

Sounds fair. (I must have beenseduced by the soft music playing, or I would haverealized that I was agreeing to pay him, every year,the equivalent of 4 coronary artery bypass graftprocedures.) Let's review my medical situation.

Dr.Bloomberg:

I will need you to fill out theseforms. I want to know your past health data, andthat of your family. We'll do some lab work andx-rays, and then plug all the data into my software.I can then tell you the state of yourhealth, and what you need to do to stayhealthy. See the front desk to arrangethe tests and a return appointment.

A month later

Dr. Constan:

What did you find?

Dr. Bloomberg:

Well, Lou, youneed to lose a few pounds and get thatcholesterol down. I recommend thatyou attend my seminar on how to controlweight and lower cholesterol. It'sthis evening at the country club. Don'teat beforehand; there'll be plenty of refreshments.Pizza, crab cakes, taco rolls,that sort of thing—plus an open bar.

Dr. Constan:

(Would a real doctorfeed his patient "financial seminar"food?) Well?anything else?

Dr. Bloomberg:

You've also gotgallstones; they'll have to come out.

Dr. Constan:

When can you arrange it?

Dr. Bloomberg:

Here is a list of surgeons whodo this sort of work, their fees, and their morbidityand mortality stats. Would you like to go withthe most expensive, or would you prefer a riskiersurgeon with better fees?

Dr. Constan:

How about Dr. Hatchett andAssociates? His fees are mid-range. His morbiditystats are fairly good as well. I don't think I canhandle more risk. I think I'll take him.

Dr. Bloomberg:

Now we get to the patienteducation portion of my services. I expect you tospend at least 1 to 2 hours a week going over yourhealth and lifestyle choices. You know that youcan't expect to be financially healthy unless you dothis. Your physical health is no different. Keep allthe information on this spreadsheet here. We'll goover it when I see you for your yearly review.

Dr. Constan:

Is that all?

Dr. Bloomberg:

No actually, the tests showyour blood pressure is borderline.

Dr. Constan:

What should we do?

Dr. Bloomberg:

You have 2 choices here. Youcan go for a short-term fix and I could give yousome medication. My analysis shows that this willbring your blood pressure down 6 points, whichshould be enough. Of course, this option opensyou up to certain other risks, such as side effects.Or you could go for a long-term fix, which willmean adding 2 hours of exercise each week. Thatshould lower your blood pressure an equivalentamount. It depends on your investment horizon.Are you a short-term patient who wants to makeyour health statement today, or are you one wholooks down the road 10 or 15 years?

Dr. Constan:

I've never been able to thinkmore than 1 or 2 years ahead. I'll take the short-termoption. (I've got a 1-year contract with him;I'm going to get all I can for the fee he's charging.)

Dr. Bloomberg:

Excellent. You've made agood choice. Here's your prescription. By the way,stop at the desk on the way out and ask Suz for acopy of my latest Health Care Planning book. Igive a discount to patients.

Dr. Constan:

Certainly, it's been a pleasuredoing "business"with you, Dr. Bloomberg.

Louis L. Constan , a

family practice physician

in Saginaw, Mich,

is the editor of the

Saginaw County Medical

Society Bulletin and

Michigan Family Practice.

He welcomes questions

or comments at 3350 Shattuck Road,

Saginaw, MI 48603;

517-792-1895; or louisconstan@hotmail.com.