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By Dr. Margaret Curtis, WCI Columnist

I am a pediatrician married to a urologist. We are part of a fortunate, hard-working, and growing demographic: the dual-physician family. There are wonderful aspects to being married to another physician, and there are particular challenges.

When I was in medical school, an attending told me, “If you marry another doctor, you will always have enough money, but you won’t have enough time.” Turns out this is only half true. We never seem to have enough time, even now that we are both well out from residency, and there have been periods when (I’m embarrassed to admit) we actually felt hard up for cash. Anyone can live above their means, and we had to become good stewards of our finances. This is what we have learned along the way:

 

Managing Your Money in a Dual-Physician Income Household

Many aspects of your financial plan will be the same as any other high-income family: pay off your (double) student loans early, live within your means, keep your investments simple. Your financial needs will differ from those of other high-earners in a few ways:

  • Insurance: As a rule, physicians need own-occupation disability insurance, but you may not need it for both of you. We decided to carry extra disability insurance for my husband but not for me when we did the math and realized we could get by without my salary. Since I am not in a procedural specialty, my risk of being completely sidelined by minor injury or illness is relatively low.
  • Expectations: You may have outsized expectations for your lifestyle. Our single biggest financial mistake was sending our kids to private school (this is a topic for another day). Remember: “you can have just about anything you want, but you can’t have everything.” Although it seems impossible that two people can spend what looks on paper to be a ridiculous amount of money, it is easier than you might think.
  • Length of Career: You will work very, very hard for your money, and you can’t count on both of you wanting to continue full-time work until a typical retirement age of 65. Your financial planning needs to include “escape hatches” for both of you right from the start. Our goal is that my husband can shift to part-time paid clinical work in the next three years and full retirement in seven. This is about six-and-a-half years longer than he would like, to be honest, but we still have three educations to pay for (see above). That will put him close to a typical retirement age, at which point he would like to segue into volunteer medical work, gardening, and building backyard hockey rinks. I can see myself working well into my 60s (I’m 50 now), largely because my job is not physically demanding and my patients are adorable.
dual physician income homemade hockey rink

Sticks and pucks in the backyard of the Curtis household

 

Managing Your Time

If you want someone to tell you it is possible to have two booming medical careers, a thriving family life, and time enough for both, I am not that person. I left medicine for five years to be home when my husband had a new solo practice and we had three kids under 6. We both think I had the harder job. I gave up some professional aspirations to do this but I will always be thankful that I could.

I have worked part-time since residency, and when I work more (say, an added clinic day), it feels a little like the wheels are coming off the bus. We are not alone in this: one study showed that only half of all women in dual-physician households worked full-time, while 87% of their partners did. Of course there are full-time medical couples who make it work, and I salute them. There is a lot of high-level planning that goes into that life.

There is also some expense required to work around uncompromising schedules, especially during residency and your early career. You will need reliable transportation, and I would argue you should live as close as you can to both of your workplaces. Minutes spent together is the single biggest predictor of satisfaction in two-physician families, so don’t waste them commuting. We live where our kids can walk to school, which is a huge saver of both time and hassle.

If you have children, you will need completely dependable childcare until your children are old enough to stay home alone, around 11 or 12. You will need backup childcare and night or weekend childcare when you are both on call. This will likely need to be in your home, since childcare centers generally won’t take kids with illness and can close due to inclement weather, etc. You might try to live near family or get a willing relative to move in with or near you. If you don’t have a willing Mae-Mae (as grandmothers are called here in Maine), this could be a nanny or au pair. My friend Lauren is an orthopaedic surgeon married to a urologist. She and her husband kept a calendar of who could leave work in case a kid needed to be picked up early on any given day.

An aside: no matter how well you plan your schedules, you will miss some of your kids’ events. I thought I was doing well getting to my kid’s hockey games until a teammate asked him if his mother had died. Decide your priorities, divide and conquer when you can, and forgive yourself for what you couldn’t get to.

Call is one of the biggest stressors on the two-physician household. You have to decide if you want to take call or work shifts at the same time as your spouse (and maximize your call-free time together) or stagger your call obligations (so one of you can manage the home front). When our kids were little, we tried to avoid being on call at the same time. I have done hospitalist peds and outpatient peds that included labor and delivery, and both of those made our lives much more complicated. My job now is call from home only, so this is no longer an issue for us (and is a major factor in why I chose this job). These time pressures ease up as your kids get older. Now that our kids are teenagers and can drive themselves to soccer practice, we have much more leeway in our schedules. (They don’t really want us around anyway.)

This is not a relationship advice website, but it bears repeating that your relationship is your single greatest asset. Divorce is expensive. Finding yourself at the end of your career with a spouse you look forward to retiring with is, to borrow a phrase, priceless.

Entire books have been written about physician marriages, and I won’t try to address the research on gender roles, career trajectories, and what makes a marriage work. I will say that some of the traits that make a good physician (work ethic, maturity, generally being people-oriented) are helpful in a long-term relationship and some (perfectionism, stoicism, intensity) are not. And even if you are the most important person at your work, you are just one of the team at home. As I like to tell my husband: this is not the OR, and there is no one here whose job it is to do your bidding. (I have only had to remind him of this twice in 20 years of marriage. I don’t care what people say about urologists, he is a fast learner.) I think dual-physician families actually have the advantage here, as there is less potential for a power imbalance than in families with only one physician.

For us, the challenges have been worth it. There is comfort in being partnered with someone who understands the day-to-day life of a practicing physician. Try saying “that diaper had positive margins” to your accountant husband and see how he reacts. (Better yet, say it to your teenagers. They will remind you that this is why they don’t want you around.) Every couple makes their own roadmap, but the end goal is the same: two healthy careers, a happy marriage, and enough time to enjoy it all. If you are as fortunate as we have been, you will get to a point where you can quote my husband’s favorite song:

“Look how far we’ve come
When you and I were young
This is all we ever wanted
Look how far we’ve come”

Are you in a dual-physician marriage? How have you made it work? How have kids complicated the issue? Has two physician incomes been worth it? Comment below!