Why Build Wealth?

DECEMBER 08, 2016
Vicki Rackner, MD


Some physicians believe that a commitment to service and a desire to build wealth would pull them in different directions.  But, what if wealth gave you the ability to serve in a bigger way and make a bigger impact?

I think of wealth as the freedom to do what you want to do when you want to do it.  

What Is Your Mind-set about Money?
 
When you think about money, what thoughts and phrases pop into your head?
 
Mind-set #1: Money is good.  On one episode of Shark Tank, the Sharks talked about how much they loved everything about money – the feel and scent of it. It’s hard to imagine a physician saying those words out loud. 
 
Mind-set #2: Money is bad or dirty or evil. For most physicians there is something “dirty” about money. Discussing it feels less than professional.
 
When I began my practice, we were taught not to discuss money. When I asked a colleague how much he charged for a surgical procedure, he turned to me with a look of horror and said, “You can’t ask that question. If I answered, I would be in violation of antitrust statutes.”
 
I remember prescribing a new antibiotic for a nurse in the 1990s.  And, when I bumped into him in the OR, he said, “Vicki, do you know how much that antibiotic cost? $100! I paid for it out of my pocket.” It was ridiculous just how clueless I was about how much things cost. 

Mind-set #3: Money is neither bad nor good; it’s simply a tool.  Money serves a simple purpose: it facilitates the exchange of value. And value, like beauty, is in the eyes of the beholder.
 
In other words, money, like a hammer, is not inherently good or bad. It’s simply a tool. You decide whether you will use the right tool for the right job. It is the way that money can be used for good or for bad.
 
What is Wealth?

You are wealthy if you can comfortably and reliably meet your monthly expenses to support your desired lifestyle – even if your earned income ended today. You measure your level of wealth by the duration of time you could sustain your desired lifestyle without earned income. 
 
Are Physicians Wealthy?
 
Physicians’ high incomes do not reliably translate to high net worth and the freedom wealth buys. Roughly 40% of senior physicians are actively engaged in patient care. Some continue to practice medicine because of the ongoing professional rewards. 
 
Here’s the dirty little secret. Many physicians will be economic slaves to their practices well into their retirement years. They are not positioned to replace their earned income with investment income at age sixty-five or even seventy-five. 
 
According to a 2016 AMA report, “It is the opinion of the Council on Medical Education that physicians should be allowed to remain in practice as long as patient safety is not endangered and that, if needed, remediation should be a supportive, ongoing and proactive process.” They invested resources to explore the complex task of creating guidelines and standards to assess the clinical competency of aging physicians.
 
Why Is Building Wealth Important? 
 
Your financial security impacts every part of your personal and professional life. Here are some benefits that come with wealth.
 
Financial security opens doors to professional possibilities. Wealth gives you more choices as you consider how you position yourself for success in the era of the Affordable Care Act. You can afford to take professional risks, whether it's making an investment in a new therapeutic direction, buying new equipment or writing the book you always dreamed about sharing.
 
Financial security helps you avoid distracted doctoring. Money worries serve as a constant source of distraction. Just as you wouldn’t text and drive, similarly, you should avoid distractions about financial security. 
 
Financial security helps you put your family’s needs first. A colleague decided to cut back on her ER shifts when her children became adolescents. She knew she wanted to be there to guide her kids through this tricky stage of development. She also knew that she could afford it. 
 
Financial security immunizes you from burnout. Insufficient income is one of the top five risk factors for developing burnout. Further, insufficient savings and debt correlate with burnout. 
 
Financial security helps you treat burnout. You may decide to cut back on your hours, create a specialty focus in your practice, or launch an entrepreneurial venture like writing a blog or building a company around a medical invention you made. 
 
Financial security helps you put the patients’ needs first. You may remember the case of the Michigan oncologist who was found guilty of a $35-million Medicare fraud scheme. The doctor harmed, and in some cased killed, his patients by administering chemotherapy they did not need for his own financial gain. I remember the hushed whispers about the orthopedic surgeon performing surgical procedures only marginally indicated because he needed the income. 
 
Financial security helps you serve in a bigger way. The greater your wealth, the greater impact you can make in the world. 
 
Financial security helps you leave a legacy.

The Bottom Line about Wealth

The greater your wealth, the greater impact you can make for your family and for worthy causes you’re passionate about.  Wealth is a tool that can support your commitment to service.



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