The "Rich": A Whole Different World

August 7, 2010
Jeff Brown, MD

The median family practitioner retires with a net worth of $2.5 million and the average cardiologist has $5.2 million. Although these numbers may qualify doctors as being "rich" among some people's perceptions, most physicians would say they sure don't feel or act rich.

This is always a popular subject, so once in a while when some new thoughts or information come my way, I'm happy to pass it on. To summarize in advance, one of my daughter's friends, who grew up among the upper crust in Manhattan, said to me recently: "Jeff, it's a whole different world."

Why should we care? For one example, the median family practitioner retires with a net worth of $2.5 million and the average cardiologist has $5.2 million. That differential has and will continue to be the source of columns here, to say nothing of the national healthcare debate. And of course the surgical subspecialties sometimes rise far above those numbers. Keep in mind that median means that half have less and half have more -- often much more. (MBAs average $1.75 million, physician’s assistants earn 850,000 and college graduates, in general, $340,000.).

Although these numbers may qualify doctors as being “rich” among some people’s perceptions, most physicians would say they sure don’t feel or act rich. We feel pressured, disciplined and hard working to financially get through life, unlike our perception of uninhibited spending and hedonism that we imagine the truly wealthy pursue. (And O.K., we all have a touch of voyeurism in us, too, let alone aspiration.)

We humans are hard-wired to want more until we fatigue physically, emotionally, and perhaps even existentially. After all, wanting is a thrill, perpetual having is a bore. Studies show that the dopamine flood occurs before, not after the purchase or experience.

One characteristic of the truly rich is that they speak as if anything but money importantly describes them. But ultimately, many use extravagant spending as an enabling centerpiece. For example, the wealthy are always air (or sea) borne. A self-imposed "labor," if you will. Even wealth has its limitations on how much you can wear or eat, but the area where big money can really make a difference is travel.

True story: A former chief executive of my acquaintance once had to fly first class commercially because his "G-4" -- Gulfstream IV, a large, high-status private jet -- was either in the shop or chartered. His response to riding commercial first class for the first time: "How can people stand to fly like that?" (Call it the modern equivalent of, "Let them eat cake.")

Part of the reason for traveling constantly -- aside from because they can -- is to use the multiple homes. My wealthy friend has five; he sees them as a convenience for the locales he habitually visits. Here I reveal my middle-class orientation by only seeing extra homes as more trouble, cost, responsibility, or just plain "work." Also, let's face it, fun vacation, business reasons or otherwise, travel can be exhausting. As one wag put it, "If you're so rich, why don't they come to you?"

Being superrich can be hazardous to your health in other ways. Always eating the best, drinking the best, partying the best, flying around to get there, and not getting enough sleep takes its toll. Then add to that health risk worry, drugs, and pliant society doctors -- remember Elvis Presley and Michael Jackson?

What, worry, you say? Rich doctors have nothing to worry about! Well, how about the mortgage, kids' education, retirement, declining reimbursements, increasing paperwork, etc.? We know that worry not only shortens, but poisons, the quality of life. What do the very rich have to worry about? You might be surprised that they do worry and worry a good bit. Worry, in fact, is the rich man's shadow. Being truly rich, it seems, does not end the war in your head.

The rich worry about many of the same things that we worry about; things that we cannot control, that comprise a perceived threat. Think about it: All of the little things in our lives, and all those writ large as well. They live with the paradox that the luck and/or skill and/or hard work that brought them success in the first place compels them to repeat and perpetuate it compulsively.

I know, many will say, "O.K., it's a hard job but somebody's got to do it. Where do I apply?" So not wanting the loyal reader to be left hanging without some means of advancing your situation, I will leave you with this piece of advice: Save on a steady basis, put the money in a tax-deferred account and diversify your investments. It's safe, prudent and minimizes risk. If you do it on a regular basis over your entire working life, you'll pay your bills on time, and live and retire comfortably.

For those of you who want a shot at becoming superich, listen to this "advice" from a successful, self-made bazillionaire: "You only need four or five good ideas in your life to get really rich. If you avoid mistakes, that is. And the way to avoid mistakes is to stick to what you know well. That's what gives you the edge over Wall Street." Huh? Gee, thanks, that made it easier.

Maybe I'll just stick to "buy low and sell high" or "only buy stocks that go up." Maybe my daughter’s friend was right -- being superrich is a "...whole other world."