Virtual financial planning for physicians

You are exceptional at medicine. You should not have to become a part-time financial planner on top of it.

You started ten years behind, and everyone knows it

A physician finishes training somewhere around thirty-two, carrying debt that would frighten most people, having earned almost nothing during the decade her college roommate spent compounding a 401(k).

Then, at the exact moment the income finally arrives, so does everyone selling something.

I have watched this play out for twenty years. The insurance agent who found your name in a residency directory is not there because he is worried about your disability coverage. The whole-life pitch, the private placement, the real estate deal from a colleague: these show up in a physician’s inbox at a volume other professionals do not experience, and they arrive precisely when you are too tired to evaluate them.

The catching-up trap

The most expensive years of a physician’s financial life are usually the first five good ones.

You spent a decade deferring, and the deferral was real. So the house is larger than it needs to be, the cars arrive early, the private school tuition begins, and the lifestyle sets in a bracket before the savings rate does.

None of that is a character flaw. It is a completely understandable response to ten years of postponement. It is also the thing that turns a very high income into a surprisingly ordinary net worth by fifty-five, and I have seen that ending more often than I would like.

Mid and late career gets harder, not easier

By your forties and fifties the questions change shape. College. Tax strategy that is now complicated in ways it never was. Retirement income planning. Practice or partnership decisions. Reimbursement pressure from hospital systems and insurers pushing income the wrong direction for the first time in your career. Burnout, which is a financial event as much as a personal one.

Most physicians discover this late. Accumulating the assets was the straightforward part. Converting them into reliable retirement income while managing tax and risk is the hard part, and it arrives right when you have the least appetite for another complicated project.

Your employer plan matters

I have worked extensively with employer benefit plans, including Atrium Health and Novant Health.

Employer plans have specific features, specific limitations, and specific interactions with the rest of a physician’s plan. I work from the plan document in front of us, not a generic checklist. Knowing which questions to ask saves a great deal of time and occasionally a great deal of money.

Concierge, in the direction you already recognize

Plenty of physicians have moved toward concierge medicine, for a straightforward reason: a smaller panel means the person knows you when it matters.

I run the financial version. One flat fee, and the advisor doing the work is the one you hired. When you call, you get me. You are not routed to an associate you met once at the onboarding meeting.

The fee is $10,000 a year regardless of what you have accumulated, which matters more for physicians than for almost anyone, because your asset curve is steep and late. Under a percentage-of-assets model, your fee climbs fastest during exactly the decade you are trying to catch up.

What we work on

• Student loan strategy in the context of everything else, not in isolation
• Cash flow and savings rate during the first high-income years
• Employer plan optimization, including Atrium and Novant
• Tax planning coordinated with your CPA, including deferred compensation
• Disability and life insurance review, with nothing to sell you
• Asset protection considerations, coordinated with your attorney
• Practice, partnership and buy-in decisions
• Retirement income planning and the transition out of clinical work
• Divorce financial planning where relevant, which physicians face at rates worth naming out loud

What happens next

Step 1 — A virtual conversation. 30 minutes, scheduled around your call schedule, not mine.

Step 2 — Your plan and your fee, in writing.

Step 3 — The work.