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Money Shock Management for Physicians

Article

Physicians and other care providers are experiencing record levels of uncertainty in their lives. Here are recommendations for how physicians can prevent and manage money shock to their lives and their practices.

Physicians and other care providers are experiencing record levels of uncertainty in their lives. The end result for many is to feel shocked, stressed and even exhausted from having to cope with all of the change.

There are three stages of Money Shock:

• Financial triage

• Choice and change management

• Well-being management

In addition to explaining the three stages, this article will present specific recommendations to guide physicians in both preventing and managing Money Shock with finesse.

Imagine any of the following:

…Your sole contract with a hospital is cut at the end of the year.

…Your partner leaves the practice earlier than expected.

…Your volume is down due to cancellation of elective procedures.

…Your divorce puts you on the edge financially.

…Your house is “underwater” and that was your major investment in your portfolio.

…Your accountant informs you that reimbursement will be cut by nearly 25%.

All of these are examples of Money Shock for physicians. Given that we are human, your first reaction may be the “fight or flight” response. If this is the case, you will not think clearly, you will not make decisions armed with data and reason, and you will be more than likely to act impulsively or fail to act at all.

Your world may have turned upside down. Your goals have come to a screeching halt. You may feel a sense of injustice. Perhaps you even experience a loss, sadness or rage. The key when confronted with the challenge of such a shock to your financial life is to “get a grip.” The first phase of Money Shock helps you to do just that.

Financial triage

The goal here is to dampen and eventually eliminate the “fight or flight” response. This will take some time depending upon other stressors and your coping resources. After you have quieted down psychophysiologically, you will be ready to identify and make decisions that take into consideration both the short-term perspective and the long-term perspective.

Choices and change management

The goal here is to become aware of what choices and changes are under your control. You may not have control over the triggering even — such as changing reimbursement due to the Affordable Care Act — but you do have control over how you respond to that change after you have gone through the first phase: financial triage.

The key here is to be honest with yourself about what choices and changes are under your control and which are not. After categorizing these choices and changes, map out a plan as to which choices and changes must be made now, sometime soon or later down the road.

Well-being management

The goal here is not only to minimize any damage to your financial life but also to your physical, psychological, family and occupational life. Remember, when money changes, life changes, and when life changes, money changes. These two principles are true in the case of Money Shock.

Interestingly, an article in the Journal of Periodontology found that financial strain was associated with depression and periodontal disease. The impact of financial distress on marital satisfaction is well established.

To respond in a healthy and rational fashion to Money Shocks facing physicians today, it is highly recommended that you first seek to decrease the probability of experiencing one, while also recognizing that everything in life cannot be prevented, including Money Shocks. Then, it is strongly suggested that you implement a problem-focused coping approach to ride through the storms of Money Shock.

Prevention

Look back over the six Money Shock examples at the beginning of the article and ask yourself this question, “Could they have been anticipated in advance?”

For instance, having one contract with a hospital is a risk regardless of how long you have had the contract and how well you know the key players. A way to prevent this type of Money Shock would be to diversify your revenue streams so if the contract was terminated, then all of your revenue would not be at risk.

Some of these Money Shocks certainly could have been anticipated in advance, but although others — such as the onset of a sudden, debilitating illness, disease or disability, or a natural disaster such as a hurricane or tornado — cannot be prevented with careful planning, some damage may be minimized.

Problem-focused coping

Psychologists know that the most effective and efficient way to cope is to use problem-focused coping rather than just emotion-focused coping. Emotion-focused coping is all about feeling better typically for a short period of time while not even touching the problem. On the other hand, problem-focused coping is about solving the problem so that when the problem solved, there is less to cope with emotionally.

Conclusion

Money Shocks are part of what it means to practice medicine today. Do not waste time trying to fight things you cannot control. Instead, master things in life you can control and influence.

Marty Martin is on the faculty at DePaul University and is a financial psychologist at Chicago-based Aequus Wealth Management, a financial planning firm specializing in helping people bounce back and thrive during times of transition. For more than 10 years, he has conducted and applied research in the psychological aspects of money and how to help individuals, couples and entrepreneurs make better financial decisions. To reach Dr. Martin, email him at marty@aequuswealth.com.

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