By Dr. Jim Dahle, WCI Founder
The more I learn about doctors and their finances and the more I talk to other docs, the more I see several recurring themes that cause them to have difficulty reaching financial success. This post explores these themes.
#1 Poor Debt Management
This one begins early for most medical students as they get into the habit of living beyond their means. Student loans, car loans, credit card loans, vacation loans, and poorly designed mortgages. It isn't just that the doc lives beyond her means (although we'll get to that next), but she is simply paying too much interest causing a major drag on her finances.
#2 Inadequate Savings Rate
Living within your means is very important. But to be truly successful, you need to live sufficiently far below your means that you can carve out money to invest, pay down debt, and build net worth. Saving 10% is the general rule for most people (although even that might be a little low given our current low-expected-return investing environment), but most people also have 40 years to save for retirement. Doctors only get 30 years, so they really need to be saving 15% if they plan to retire at 65. If you want to retire early, better bump that up to 20-25%. Remember that isn't counting saving for your next car, that boat, a house downpayment, or your kid's college fund. That's JUST retirement. A 5% savings rate just isn't going to cut it. So on a $200K salary, that's $40K a year. Just putting $17K into your 401K each year isn't going to be enough.
What keeps doctors from saving more? Debt is a big factor, as is a sense of entitlement after years in training and many long hours at work. But a major factor is the expectation in your own mind (and the mind of family and neighbors) that you need to live like a doctor. In short, you spend too much. Quit it. Like quitting smoking, it's simple, but not easy.
#3 Inappropriate Tax Management
Doctors are well-known to make all kinds of stupid investments just to lower their tax bill. Yet far too many don't take advantage of the simple tax shelters available to them. Why some doctors have investments outside their 401Ks and IRAs when they're not maxing those out is beyond me.
I'm always surprised how few doctors have heard about Backdoor Roth IRAs or Stealth IRAs. For most doctors, every dollar they put into a retirement plan saves them ~40 cents in taxes. Some self-employed physicians don't even open the right kind of retirement plan, severely limiting their contribution amounts.
Those doctors investing outside retirement accounts don't realize the impact of using tax-efficient investments, minimizing churn (and the capital gains taxes it produces), tax-loss harvesting, and using investments with low tax basis for charitable gifts and inheritances.
Most doctors are smart enough to either learn about the tax code and do their taxes themselves or hire a good accountant to do the job. But finding a few bucks here and there at tax time is missing the forest for the trees. The big gains are found in changing your tax behavior throughout the year.
#4 Personal and Professional Divorce
Starting over is expensive. There is nothing a doctor can do that will impact his finances as much as a divorce. It isn't unusual for a doctor to lose his home, a large chunk of his savings, and his future income stream (to alimony and child support). It is hard to recover from that. The old adage, “One House, One Spouse” is still applicable.
You can protect yourself from this in several ways. You can avoid marriage altogether, you can have a prenup or postnup agreement (especially if on a second marriage or if marrying after acquiring significant assets or after becoming well-established in your career), and you can live your life to make your marriage relationship a priority. You can also marry a doctor. Physicians as a whole have a 24% divorce rate (higher among female physicians) but dual physician couples have only an 11% divorce rate.
Professional divorce is also expensive. Breaking up with your partners, closing a practice, moving to another town, etc are all expensive. You may have moving expenses, buy-out fees, employee costs, malpractice tails, and a temporarily lower income. Go into any business relationship with your eyes wide open, and have your contracts reviewed by an experienced health care contract attorney.
#5 The Wrong Insurance
Not only do most people (doctors included) not have enough of the types of insurance they really need (primarily life, disability, and liability -professional and personal), they have too much of the types they don't need. A quick reminder:
Insurance you probably need (circumstances do vary):
- $1-$3 Million of 20-30 year level term life insurance
- $7500-15000/month of good quality, personal, own-occupation disability insurance
- $1-3 Million of umbrella insurance (with accompanying high liability limits on your property insurance)
- $1-3 Million of Malpractice Insurance
Insurance you probably don't need:
- Cash Value life insurance (whole life, universal life, variable life, variable universal life, etc)
- Group disability insurance
- Consumer insurance (home warranties, appliance warranties, electronics warranties, etc)
- Low deductibles on your auto and homeowner's insurance
- Fantasy football insurance
- Marijuana grower's insurance
#6 Expensive Investments
In investing, you get what you don't pay for. Many doctors pay 1-2% a year or more for investing advice, mutual fund fees or loads, commissions, or other costs. The difference 2% a year can make in an investor's final net worth is astounding. Consider two physicians, both of whom invest $50,000 a year in similar investments. The first, however, minimizes her investment costs while the second accrues an additional 2% a year in costs. If they both make 5% after-inflation, but before costs, how much more does the first doctor have after 30 years? Nearly $1 million more ($3.32 Million to $2.38 Million). For a million bucks I think you can spend a little time learning about investing, hiring an advisor who offers good advice at a reasonable price, and analyzing the true costs of your investments. If you add on another 30 years in retirement, the numbers get even worse.
#7 Loaning Money
I'm not talking about buying treasuries or getting involved in Peer-2-Peer Lending. I'm talking about family and friends. If you've read through the Stupid Doctor Tricks post, you can see dozens of examples of people who loaned tens of thousands of dollars to parents, siblings, kids, and friends. You're “the rich doctor” so they come to you.
Well, I've got news for you. You're not rich. You can afford to help others out, but in general, make the money you hand to friends and family a gift, with no strings attached. This will do two things for you. First, it will preserve the relationship. A lender-debtor relationship is different than a family relationship, especially when the debtor goes into default. Second, it will preserve your money. Most of us are willing to lend much more money than we're willing to give. It's far better to give away $10K than to lose $100K in loans.
What do you think? What mistakes do you see your peers making? Have you made any of these? What happened to you? Comment below!
I think if one becomes married as an attending, you 100% need a prenup, otherwise you will have nothing to retire on.
For the Backdoor IRA – can you do that conversion every year. Example, I put in 5K into a standard non-deductible IRA for 2011 and another 5K for 2012, so I can convert the full amount 10K to a Roth IRA. Now, next year, when I put in another 5K into a non-deductible IRA, can I convert it again and just keep repeating that until congress changes the rules?
Kathy asked:
Now, next year, when I put in another 5K into a non-deductible IRA, can I convert it again and just keep repeating that until congress changes the rules?
Yes, Kathy, you are correct. That is what I do. If you are 50 years old or older then you can contribute $6000.
Be careful if you have other IRA’s that you have deducted. The IRS considers a conversion to be proportionally from all IRA’s.
Horrible advice, the devil whole life policy that WCI spews hatred towards is, as the IRS sees it, a giant Roth IRA with no contribution limits (or higher than any of you can possibly save) or income limits and the best tax shelter high income earners can possibly own. Fact. It also has self completion riders in the event of a disability(you’re glorious 401k have that? didn’t think so)and long term care coverage that doesn’t cost $20k a year for the policy and the issuing company will be in business when you need it. Cough Genworth.
[Off topic comment deleted- the blog is about finance, not medicine. Feel free to start your own blog about the problems in medicine if you like.-ed]
For the record, I have zero hatred for whole life policies. What I dislike is when it is sold inappropriately to physicians. In my estimation, that is about 90% of the time.
Whole life insurance is not a Roth IRA, not even close. However, that is one method that is frequently used to sell it inappropriately to physicians.
https://www.whitecoatinvestor.com/8-reasons-whole-life-insurance-is-not-like-a-roth-ira/
Love how we don’t need fantasy football insurance coverage. Nice
So excited to have found this website. Just bought the book and hopefully my husband and I can catch up quickly. It is overwhelming when after so much work half of your salary goes out the door in taxes because of poor planning.
The good news is you probably won’t lose half The bad news is it is relatively easy to lose a third.
Any advice for a 34-year old first year medical student with a meager $4K in retirement savings? A little worried about the future, but so glad I found this site and your book! Do you have a section about non-traditional docs/older docs staring on the website? I don’t want to retire early, but I assume I will need to double down on savings once I finish training (25%+ ). Any savings “catch up” opportunities available? Any advice is welcome 🙂
Retiring early or retiring at the usual time with a late start is really all the same. You’re absolutely right that you’ll need a higher savings rate. The other issue I see non-trad docs running into is that they tend to take out a larger student loan burden since they are more often married with kids in med school. You do have “catch-up” opportunities once you’re 50, including higher 401(k) contributions, higher Roth IRA contributions, and higher HSA contributions. Defined benefit plans also allow larger contributions when you’re older. You also won’t have the issue of figuring out what to do without Medicare and Social Security until you hit 65-67, since you’ll likely be working until then.
Thank you for all the advice!
Im a graduating psych resident and will be an attending in California next July. I just learned about Roth IRA last year and invested 5500 on april 18th 2013. Currently, my residency only does an ING 403b though and I want to see if I can get any more tax shelter in 2013? Thank you!!!
If you’ve already done a personal (and spousal) IRA for 2013, you’re probably maxed out on tax shelters for 2013. You may have something available at your new job in the Fall.
Nailed us hard on #1 and #2.
Question about #3: I don’t understand the third and fourth items listed in this sentence: Those doctors investing outside retirement accounts don’t realize the impact of using tax-efficient investments, minimizing churn (and the capital gains taxes it produces), tax-loss harvesting, and using investments with low tax basis for charitable gifts and inheritances.
Is tax-loss harvesting and charitable giving explained more in another blog entry? I can’t find anything on the search engine.
Thanks as always.
Tax loss harvesting means selling an investment with a loss while buying something that is “substantially different” in IRS terms but highly correlated with the original investment. For example, consider buying $50K worth of TSM. It falls in value to $47K. You sell it, buying 500 Index Fund the same day. The value goes back up to $50K. You haven’t lost any money, but you get to deduct $3K off your taxes that year. Of course, in 30 years when you sell that fund, your basis is now $47K instead of $50K, but you may be in a lower tax bracket (or if you die first your heirs will get the step-up in basis.) If nothing else, you got to use the $1000 you saved in taxes for 30 years, which is worth something.
Appreciated shares given to charity are awesome. The charity doesn’t pay the taxes on the gains and neither do you. Meanwhile, you get a deduction for the full amount of the donation. If you give to charity each year, and have appreciated shares, best to donate shares rather than cash.
A couple more specific questions:
1. Can you donate shares to your church charity? How do you do this? Do you have to contact Church headquarters?
2. New problem for me that arose today: we were putting a low 4% in to our 401k so that we could get the company match for the full year (before over-contributing)… but just found out that there is a maximum earnings limit too of $260k? What?! We have gone over that and are now stuck. So we are not able to either: max out our $17500, get a company match or save any more money tax deferred for the rest of the year?! Isn’t that crazy? Are we doing something wrong or is this accurate? We have already maxed the HSA for the year along with both IRAs. What is the next step? Solo 401k? Thanks!!
1) Yes. Here’s a link to the information you seek for the LDS church. Other large churches may have similar websites: https://tech.lds.org/wiki/index.php/Donations_in_kind
2) You can’t do a Solo 401(k) unless you’re self-employed. I’m not sure what you mean by maximum earnings limit. You should be able to max out a 401(k) ($52K a year) on $260K of income. Are they limiting your contribution because you are a highly-compensated employee? I have seen 401(k)s that don’t give you the full match unless you spread your contributions out over the whole year (no “true-up”) but not sure exactly what you’re dealing with.
Thank you so much for the LDS link, Brother!
2. The 401k department for the huge hospital corporation (google says 40,000 employees) I work for told me that the IRS does not allow any contributions after $260000 gross earnings after January 1. The company match is 4% of each individual paycheck. I was told that there is no way that they pay more than $10400 to an employee in a year and if your contribution rate is set below 6.73% then you won’t get the match before over-earning. It doesn’t seem right to me… and it no doubt affects hundreds and hundreds of doctors. The person told me that no other physician had ever complained. Doesn’t something seem wrong? I did find this chart: http://benefitsattorney.com/charts/maximums/
After $260K, the thing should be maxed out at $52K. You need to ask them how much you can contribute each month to 1) Get the maximal match and 2) get the maximum possible into the plan each year. Then do that. Big corporations often have this “true-up” deal, where if you make your contributions early, they “true it up” at the end as if you made your contributions throughout the year. But all corporations don’t do that. Why are you surprised that no doc ever complained? Most docs can’t tell you the difference between an IRA and a 401(k). Financial illiteracy is rampant in our profession, and those who choose to become employees are often the least financially sophisticated.
On irs.gov it states that the 401k maximum contribution is $18k, why is it that you state it maxes out at $52k? What am I missing?
The employee contribution is $18K. The total of employee and employer contributions are $53K (used to be $52K).
I’m in a unique and very, very fortunate situation to begin with. I don’t have any student loans whatsoever, and I’m starting my first of a five year residency. What are some broad tips you have for someone in my shoes? What pages on your site do you recommend viewing? I’m new to the site, and looking forward to learning! Thank you!
Here’s the start here page: https://www.whitecoatinvestor.com/new-to-the-blog-start-here/
You can skip anything about student loans, but that’s about it. With no loans, your goal should be to get as much into Roth IRAs, Roth 401(k)s, and Roth 403(b)s as possible between now and the Christmas after graduation.
I have a 401k question for you. Recently my current practice was bought out by a larger company. With the new practice our docs are only able to contribute to our 401k with a 5k match after we max out at 18k. Previously I was able to max out my 401k and pension at the IRS 53k limit. I have talked with my financial advisor and new employer about the possibility of contributing to an after tax 401k account. I have spoken to several high ranking HR members of the company who say that this is not available because it wouldn’t pass discrimination testing since only the high earners would take advantage of the benefit. Any idea if this is legit or not? Would love to be able to contribute more pre-tax money or even post tax 401k.
Thanks
If the plan doesn’t allow it, you’re out of luck. Plans do have to pass discrimination testing.
I just graduated residency 2 years ago. I’m trying to set myself up for success in the future and have been getting up to speed on your website over the past several months (now that all boards are done!) I notice that in several of your posts you discuss a 15-25% savings. Is that amount based on pre or post tax income? Is that in addition to 401k and IRA contributions or in addition to that? Would you consider the money that you are putting into real estate investments as part of that savings? Thanks for all of the helpful info on your site!
My general recommendation/rule of thumb is 20% of gross for retirement. That includes 401(k) and IRA contributions and real estate investments.
Great post as always. I share your interest in lowering my tax burden, particularly on investing. I am currently employed in a small private practice that set up a 401K plan only last year. As an employee, I can contribute the $18,500. They will offer me the chance to go to 55K as a Highly Compensated Employee (HCE).
My problem with their plan is the high fees – easily 1.25-1.5% for funds in the plan (no index funds offered). Given the amount of erosion in my wealth that these fees can cause, as your example above shows, would you still recommend avoiding taxes now by using the higher HCE limit of 55K in the 401K? I go to the employee limit of 18,500 despite the fees, to get the match (5-6K), which is close to free money.
But I feel Vanguard, Fidelity or a similar online investment firm can give me much lower fees for the other 36.5K I would have put in the 401K as an HCE. Yes I pay taxes now, but later I would only have to pay long term capital gains taxes, whereas when withdrawing the 401K funds in retirement, the full taxes of my then current bracket would be due. Also, I would lose the match when I go above the 18.5K employee limit. Thanks for your input!
Yes. I’d still contribute. The plan may change. You may change jobs. At which point you can roll it elsewhere. It has to be a really terrible 401(k) to not use it. Of course, do lobby HR to change it. You might remind them that they are opening themselves up to a lawsuit for not discharging their fiduciary duty to you.
https://www.whitecoatinvestor.com/what-to-do-with-a-crummy-401k/
I’m working my way through the beginner’s recommended blog posts, and the boot-camp book, but have a few questions. I, like someone mentioned above, am very fortunate to be in my 2nd year of practice, and have essentially no debt (I have a mortgage, but that is being paid by my renters. No student loans, no car loans, no CCs). I have maxed out my TSP, and IRAs, and am working on getting disability insurance. Where do I go now?
I’d start with getting a written financial plan in place.
https://www.whitecoatinvestor.com/investing/you-need-an-investing-plan/
That will help you decide whether to save more for retirement in a taxable account, buy some more rental properties, pay off that mortgage, spend some money, save for college in some 529s etc.
Do you recall the website that allows physicians to share salaries to increase transparency? I can’t find the post/podcast you mentioned this.
Medscape does surveys. Doximity will be out in two days with their annual survey. I bet that’s the one you’re thinking of.