[Editor's Note: Today's guest post was submitted by  Steven Podnos, MD, MBA, CFP®, the principal of Wealth Care LLC which provides fee-only financial planning and asset management nationwide. He was also a speaker at WCICON20. Although this is not a sponsored post, Steven is a paid advertiser on the site. In this post, he provides his observations from his medical and advisory careers.]

When I was practicing as a Pulmonary/Critical Care physician, there was always some “latest and greatest” study purporting that I should be using some new form of therapy.  As a resident physician, we’d hear on rounds about the newest theories and latest drugs to use.

Invariably, with time, other studies would emerge that would invalidate the early ones.  We’d find that the “latest and greatest” was a mistake and could actually be doing harm to patients.  Part of the wisdom of being a good physician was having the skepticism and discipline to discern which therapies were really the best for the patient.  Luckily, there has been an increasing prominence to Evidence-Based Medicine, in which multiple studies are subjected to careful review before recommendations are made.

Now, as a financial planner, I find the same is true.  There exist some great dogmas that are vastly misinterpreted as well as a constant flow of academic studies and opinions suggesting different investing behaviors all the time. Markets move in long cycles and much of market movement is related to investor psychology, a variable that makes empiric truths hard to prove.

So, I increasingly rely on “evidence-based investing”, putting some beliefs based on history and observation together.  Some of this is backed by some good academic research and some is just my opinion from being a Fiduciary planner for two decades. 


My Financial Recommendations


Stocks Will Outperform Bonds in Long Term

Stocks are likely to have higher long term returns than fixed income or cash (especially starting with the low-interest rates of today). We see better bond returns only in the periods in which interest rates have dropped steadily and significantly (as during the last two decades.  With very low-interest rates today, it is very unlikely that bonds will perform well.

The following charts are visual evidence of superior returns by stocks over fixed income in different time periods.


stocks vs bonds

Investors Need to Stay the Course

We must all fight strong behavioral tendencies to panic and sell just when we should be buying, and vice versa.  CNN has even developed a “fear and greed index” to help with controlling emotional-based investment movesStephen Wendel found that panic could reduce investment returns by double digits over a ten year period.

Asset Protection Needs to Be a Priority

Asset protection should be done prospectively, or it will often be too late.  It is easy to brush off the risk of lawsuits for a variety of reasons, but being sued will immediately focus the mind, and for a long time. Every family is different (especially two physician families), and every state has different laws.

Doctors Need a Comprehensive Estate Plan

Estate planners often start with boilerplate documents that are lightly modified.  Physicians often have specific differences from the general population in how their estate planning documents should read. 

Two examples: 

  1. Physician’s children are likely to inherit large sums of money and much care should be given to how that money is both controlled and protected over their lifetimes. 
  2. Most practicing physicians should be wary of inheriting assets that might be exposed immediately to creditors.

Don't Rely on Your Accountant to Reduce Your Taxes

Accountants have slowly become loathe to make suggestions on reducing taxes.  Either regular reading to keep up with changes in tax law or having a good non-accountant advisor can save a great deal of money on taxes.

Know What is Important in Your Employment Contract

Not knowing what is important in an employment contract can be very destructive to making good choices.  There is a common issue I find happening with many of our physician clients having their contracts reviewed by an attorney. The attorney will relate dozens of issues that the physician must consider in a contract and explain everything that can possibly go wrong to “cover” any blame after the fact.  However, they frequently fail to address the most important issues that really matter for a physician such as — restrictive covenants, partnership options and path, and what happens in the event of a practice sale. 

Know What Type of College Education You'll Pay for Your Children

Mentally preparing yourself and your children for what type of college you are willing to pay for far in advance is a major investment concern.  The difference in cost between a state university education and a private college can easily be an extra $200,000 per child.  This means that you have to earn as much as a third of a million dollars per child to choose a private school over a public one.  You and your spouse should make this decision carefully and prepare your children for your choices.  I told my three children that if they chose a state school, then they would have no debt on graduation.  They chose wisely.

Steven Podnos financial advisor

Steven Podnos, MD, MBA, CFP®

Get Rid of Debt

You should have no debt in retirement.  For most retired physicians, income in retirement is dependent on withdrawals from savings — which can be very stressful in the face of debt that requires regular payment.   Not having debt gives a family more flexibility to adjust a budget as needed in retirement.

Always Take Reasonable Tax Deductions

Tax audits should not prevent you from taking reasonable deductions.   You can always argue about these.  Not reporting income, however, is very dangerous.

Beware of Expensive Employer Retirement Plans

Employer retirement plans that are not transparent and run by non Fiduciaries are wealth killers.  Many plans are “free” to the employer but kill participants with expensive, poorly performing fund choices.

Have a High Savings Rate and Begin Investing Early in Your Career

If you don’t save enough and early enough, market returns can’t begin to save you.

Beware of Risky Investments

Believing that any “investment” in a small business you don’t directly control will work out well is quite risky.

Be Very Careful Investing in Real Estate

I am commonly asked about investing in real estate — rental houses, vacation houses, commercial space, land, and more.  I think there are rare times that this is a good investment.  I’ve dealt with many families that have “dabbled” in both commercial and residential real estate for shorter periods of time and have had poor results in terms of aggravation, lost time, and poor investment results. Further, one’s home is a quality of life issue, not an investment in most cases.  Even very desirable home property appreciates at best around the rate of inflation nationally. 

You should recognize that real estate is illiquid — it can be hard to sell and also take a long time to dispose of.  If the property has, or develops, environmental or structural problems, this compounds the illiquidity.  External events can act against the property — think of prices in 2007-11 in most locales.  Think about owning rental real estate in one of our major US cities at this time in a pandemic.

Real estate buildings carry multiple ongoing costs, regardless of the price you can sell them for.  There is insurance, property tax, scheduled repairs,  expected large capitalized expenses (roof, A/C), and unexpected damage and repairs (termites, hurricane damage, etc.).  

When long term investing in global stocks can reasonably be expected to return 6-8% a year over the long term, real estate investments, with all its risk and illiquidity, should be expected to return at a minimum — a double-digit return.  We see many proposed investments that do not even come close.

[Investing in real estate certainly isn't for everyone and isn't required for a doctor to achieve their financial goals.  However, it has provided many investors with incredible wealth and diversification and should at least be considered in your portfolio. What is the best way for YOU to invest in real estate? I'd start by reading this post: How Should You Invest in Real Estate. — ed]

Find Trusted Advisors

Finding competent and trusted advisors in the many aspects of your financial life is worth doing, but not easy. The same goes for me — finding skilled accountants, insurance agents, and attorneys with high levels of integrity for myself and clients is a large task.


WCI Recommended:

Financial Advisors

Tax Strategists

Contract Negotiation & Review Partners

Insurance Agents


Beware of Salespeople Masquerading as “Advisors”

Relying on “advisors” that are really salespeople is a recipe for financial disaster.  Their “advice” will always put their needs ahead of yours.  This includes every insurance agent pushing annuities and whole life insurance and every commission-based broker I’ve ever encountered.

Every physician I know has the ability to achieve wealth.  Physicians make enough money to achieve this goal by saving enough in a long term, disciplined manner.  It is a great tragedy when I encounter older physicians that “have to work.”

Building financial security takes a lifetime; trying to accomplish it quickly leads to mistakes.

Financial planning is so much more than investing.  Understanding the complexity of asset protection, estate planning, tax planning, retirement planning, educational planning, business planning and more is not simple.  Actually, investing is relatively simple if you have emotional discipline.

I hope that these thoughts help you be successful!

What do you think? Agree or disagree with these recommendations? Comment below!