Jonny Hatch
Over the past 4 months, I’ve slowly gone blind. What started as headaches from staring at Step 1 practice questions, ended with 20/100 vision and an MRI of my brain. They found a 3.5 x 4 x 3.5 cm pituitary macroadenoma compressing the optic chiasm, frontal and temporal lobes, and extending into the cavernous sinus.
Many medical students suffer hardship. Many people suffer medical ailments every day. That’s why we become doctors: to help people heal, to rid bodies of cancer, to avoid complications of diabetes, and to help people who are blind.
Jonny Hatch
Some blindness can be cured. Some is permanent. Yet, blindness is almost never optional. Unless it comes to medical students and their financial literacy.
My undergraduate degree is in business. As such, my undergrad classmates lived and breathed both business and personal finance. Contrast that with a conversation I had with one of my medical school colleagues. “You’re a part of the Medical Business Association? Do you only care about money?” she asked. We were good friends, so we could joke about things like this, but her tone was still a little incredulous.
“Come on!” I said. “Everyone needs to know about the business side of medicine. You can’t give your patients the care they deserve unless you understand how the decisions you make impact them financially. Of course, their health is the center of all your decisions, but will the treatment you offer leave them in financial ruin?”
That conversation didn’t go very far. But months later, this same classmate and I attended a lunch lecture where a physician explained her rural cash pay practice. The physician was dynamic and intriguing. She explained how she could give discounts to patients who wore spurs and cowboy boots. She told stories of treating undocumented immigrants, a population that historically had difficulty obtaining care at clinics with traditional insurance models. She explained why she practiced the way she did and why she loved it so much: because she could balance effective treatments with affordable options. This gave her patients the best care possible for their unique medical and financial situation.
Later that afternoon, I saw my friend in anatomy lab. “I want a practice like Dr. Hobbs!” she said. “She was talking about stuff I’ve never heard of before . . . What is ‘overhead’?” I smiled to myself and gave another quick plug for the Medical Business Association.
On another occasion, a fellow classmate explained to me how he went to pick up his Albuterol prescription and it was 10x more expensive than usual. He realized he had been prescribed Levalbuterol. Instead of paying a premium for this sole isomer, he called his physician and had the prescription changed.
These are decisions that financially aware physicians can help their patients make. Do they need to pay a premium for Levalbuterol? Or, for certain patients, does the racemic mixture of traditional Albuterol work just fine? The difference could pay for a box of diapers or the next tank of gas.
Sure, not everyone will open a practice, but the more we know about finance, both for our medical practice and our personal finances, the better we can help our patients.
I’ll be honest, my classmates aren’t the only ones discouraging medical students to learn about finance. I once asked a question on a White Coat Investor forum. I got some great answers, but a few responses discouraged me from thinking about finances during school. “Focus on your coursework. You can figure out finances later.”
I agree that I need to focus on my coursework, but is it possible to focus on one thing too much? Have you ever driven without your peripheral vision? The classical visual presentation for someone with my kind of tumor is bitemporal hemianopsia. Essentially, I can’t see in either of my temporal visual fields. While driving, central vision is most important, but you need your peripherals to avoid getting blindsided by a merging car. In some ways, I wonder if institutions want us to “only focus on the patient.” In this way, they lead us like horses with blinders on. We are kept focused on the road ahead but ignorant to the landscapes on both sides that only the rider enjoys. We are tools rather than autonomous individuals.
In some ways, yes, studying and learning medicine are the most important things you can do during medical school. But, if you ignore finance, you are driving without your peripheral vision. Once you graduate, you will be blindsided by the amount of debt you’ve incurred. You will be clueless whether or not you should defer your loans, how to do it, and how to create a stable financial plan for your future.
In order to restore peripheral vision, you must first figure out what’s causing the vision loss. For medical students, financial blindness is usually due to a lack of financial literacy. In my case, it’s a prolactinoma. Fortunately, these tumors can usually be treated with the dopamine agonist Cabergoline. The medication will slowly shrink my tumor and allow my vision to return. Yet, my sight will not return overnight. It’ll take months to be back to normal. What’s the most interesting part? The dosing regimen: one small 0.5 mg pill, two times a week.
I believe that medical students will be better physicians if they are willing to learn all things finance. As students and doctors learn about their personal finances, the finances of their employer, and the finances of their businesses, they will be more stable physicians. They will enjoy treating patients more. They will be better equipped to address the financial impact of medical decisions on patient care. Financial literacy is essential for physicians to truly deliver holistic care.
So, if you’ve put on blinders to focus on your coursework or clinical responsibilities, lower them a little. Listen to a financial podcast once a week. Read a few personal finance articles a month. Take your 0.5 mg pill twice a week.