Financial Wellness Series Part 2
Beyond Billing: Financial Wellness Across Your Career
In Part 1, we focused on capturing the value of the work we already do. Equally important is how we manage that income to support long-term financial wellness. This is a deeply personal endeavor shaped by your priorities, lifestyle goals, and the people who depend on you. There are many financial resources aimed at physicians, and frankly, I sometimes find them overwhelming. Below are a few practical pearls compiled from various sources as well as high-level advice from financial advisors I polled.
Early career priorities
- Get organized: understand what you own, what you owe, and your cash flow. And, don’t forget that you’re going to be paying 1/3 of your income in taxes now
- Beware of the lifestyle creep – you don’t have to live like a trainee, but you will be in trouble if you start living outside your means
- Obtain specialty-specific disability insurance outside of your institution (ideally during training)
- Establish an emergency fund (start with ~1 month of expenses)
- Expand your emergency fund to 3–6 months of expenses, particularly as income guarantees end or during potential job transitions
- Maximize employer retirement matching through your institution’s retirement plan
- Pay off high-interest debt (>7%)
- Establish a Roth IRA and maximize contributions if eligible
- Create an estate plan, especially if you have a spouse or dependents
- Begin investing outside retirement accounts
- Gradually pay down lower-interest debt
Mid-career advice
- Maintain a long-term focus – avoid trying to time the stock market and allow compounding to work in your favor
- Aim for a diverse investment profile- low-cost mutual funds and ETFs can make it easy to diversify. Bonds can provide additional diversification
- Avoid unnecessary debt whenever possible
- If investing in a business, favor businesses you understand, with durable competitive advantages and strong leadership
- Beware of hard-to-understand financial products and ensure you understand the fees and risks involved
- Ultimately, financial wellness is an area that requires some ongoing time and attention throughout your career. Many physicians choose to work with financial advisors, which can be incredibly helpful, especially if financial management is not a personal area of interest. However, don’t be afraid to say “no” or get second opinions- some advisors are paid by commission on the financial products they sell.
I am certainly not a financial expert, but I hope these reflections encourage you to prioritize optimizing coding in your daily practice and to recognize financial health as an important component of overall physician wellness. Money may not buy happiness—but in modern healthcare systems it often buys time, staffing, and fewer administrative headaches, which might be the next best thing.1
Practical Takeaways
If you remember nothing else from these articles, remember these points:
1. Billing knowledge is professional leverage.
RVUs are the language health systems understand. Capturing the work you are already doing accurately gives you leverage when advocating for time, staffing, and resources.
2. Small documentation details add up.
Appropriate modifiers, time-based E&M coding, and accurate surgical coding can significantly change RVU capture over the course of a year.
3. Treat coding education like CME.
Take a coding course every 1–2 years. Billing rules evolve, and staying current protects both you and your department.
4. Build relationships with your billing team.
Your coders and billers are allies. Ask questions, review denials, and learn from them.
5. Protect your future self.
Financial wellness isn’t just about income today. Emergency funds, retirement contributions, insurance, and long-term investing create flexibility later in your career.
6. Don’t ignore finances just because they aren’t your passion.
Most of us did not go into medicine because we love spreadsheets. But ignoring the financial side of our work doesn’t make it go away; it simply means someone else is making those decisions for us.
Financial Wellness Resources
- SGO coding resources
- SGO Wellness curriculum financial module
- AAMC Financial Wellness Resources
- The White Coat Investor (blog/book/website)
- The Physician Philosopher (blog/book)
- Facebook communities such as Women Physicians Personal Finance, PSLF-Eligible Physicians, and Physicians on FIRE
Reference
- Whillans AV, Dunn EW, Smeets P, Bekkers R, Norton MI. Buying time promotes happiness. Proc Natl Acad Sci U S A. 2017 Aug 8;114(32):8523-8527. doi: 10.1073/pnas.1706541114. Epub 2017 Jul 24. PMID: 28739889; PMCID: PMC5559044.
Stephanie Sullivan, MD is a gynecologist oncologist at Gynecologic Oncology of Middle Tennessee practice in Nashville, TN. She is also a member of the SGO Wellness Committee.