We are our own worst enemies and harshest critics. I find this true frequently of my over-achieving USMLE step students who clearly master the content of medical school curriculum but suffer perpetual test anxiety and disproportionately low performance on standardized tests.

90% of the battle to getting awesome numbers (be it high scores on USMLE or high net worth/wealth) is overcoming the only person that stands in the way of each individual physician’s success: himself or herself.

As a toast to our intelligence, diligence, and discipline dedicated to our profession, I hope these 5 principles will make doctors rich in spite of themselves.


1.       Pay yourself first by never seeing your money in the first place.

Auto deposit into your index funds with every paycheck. Set goals to max out your 401k to get the max company match and stash away the maximum you can. Above and beyond 401k, you can set up back door Roth IRA (by regularly contributing to traditional IRA with the intention to convert to Roth by paying taxes) or Roth IRA (if you are still PGY and have relatively low income compared to attending years.) There are plenty other tax-advantaged saving accounts such as 403B, 457B, , 529, HSA, Childcare related spending accounts. For self-employee doctors, you get to stow away even more into SEP-IRA, Profit-Sharing Plan, Keogh or solo 401k. Beyond the tax-advantaged accounts, there’s still taxable brokerage account where you may also automate paying yourself per check.

There’s no end to paying yourself. Set up a goal and pay yourself automatically, before the money even gets deposited into your bank account.


2.       Be the bank.
Collect interest from others. Invest in assets that will generate more money for you rather than just spend. Especially avoid spending money on liabilities, things that will take money out of your pocket. Before you lend your money away like a bank does, always ask, what is my rate of investment (ROI)?
The higher the ROI, the higher you should prioritize investing in this instrument be it index funds, real estate or other creative ventures you may discover.
And of course, risks you take should be proportional to ROI. Never take unwarranted risks, just like you won’t recommend a treatment where risks greatly outweighs the benefits to a patient, don’t do that to yourself and your loved ones.


3.       Avoid the bank, unless they are lending you negative to 0% interest rate money.
Tomorrow is uncertain. If you can pay down a debt with 6.8% interest rate today and make that guaranteed 6.8% tax free R.O.I., I’d say go for it. Since none of us know for sure we will land a PSLF-eligible job upon finishing training, paying down debt aggressively does feel pretty amazing.
I admire how much Dave Ramsey helped the poor, but I can’t agree with him on paying the smallest debt first. Numerically, always tackle the debt, regardless of size, with the highest interest first. In fact, convert debt with higher interest to lower interest anyway you can, including refinancing, home equity loans, or using credit card resourcefully.


4.       Use your assets to pay for luxuries.
Want that fast car or larger home? They are both liabilities, things that will take money out of your pocket rather than put money into it.
So first invest in assets, which make you money before going for these costly liabilities. Use the income generated from your assets to pay for your splurges.
For instance, instead of buying a 100k car, you bought some index funds. The 100k in index funds grew to 200k in 9 years, you then use the 100k from your 100k investment to buy the car. Sure you waited for 9 years, but you are much better off from the stand point of total wealth.
Not saying you have to delay your gratification. You can certainly find better investment opportunities and make your assets produce money faster for you to get the nice car.

Like my money hero Robert Kiyosaki said, “As a habit, I use my desire to consume to inspire and motivate my financial genius to invest.”


5.       Use other people to pay your liabilities.
You absolutely have to have to large home today? Then rent out 1-2 rooms to help you lower your mortgage liability.
Must have that fast car today, then do the “Air-B&B” for cars and share that fast car with other people who are willing to help pay your monthly car payment to lower the cost of your owning a liability.


Doctors are the worst patients because they are so used to giving orders rather than listening and taking orders. Patient compliance is nearly impossible if the patient himself or herself is a doctor.
Since our biggest weakness and enemy frequently may be ourselves, we need to set up our finances in a doctor-proof manner that we don’t stop ourselves from getting rich!


 If you like this article, you might enjoy other DWM articles on Personal Finance, Investing, Retirement, Practice Management, & Lifestyle.

All articles by DWM are for informational purposes only and not intended as a substitute for professional advice. Please consult a professional accountant, financial adviser or lawyer, before making financial decisions.
5 Doctor-Proof Rules to Wealth