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  • Writer's picturePhysicians Financial Design

Debt Disorientation Syndrome

Updated: Feb 7

Obviously, one of the hottest discussion points among young physicians encompasses the often-significant amount of student loan debt that results from training. This article will simply examine the perspectives on debt that many young doctors or soon-to-be doctors have as they journey through their professional training.

First, let's examine how the financial environment during training years has a huge effect on long term financial status. What I’ve seen in many young physicians is similar to the disorientation sometimes experienced by pilots while flying, which is known as “Spatial D” or Spatial Disorientation. This is the phrase used to describe any kind of perceptual illusion that you might experience while flying. For a pilot, this can be deadly. According to the Federal Aviation Administration, the most common form of illusion is known as “The Leans” and is described as this: "The Leans…is caused by a sudden return to level flight following a gradual and prolonged turn that went unnoticed by the pilot." I liken this disorientation to the debt accumulation process. During the 12-15 years most physicians spend in post-secondary education and training before signing their attending contract, debt accumulation just becomes part of everyday life. At first, it might strike a sour note each time a new debt is added to your balance, but over the course of many years, the debt accumulation becomes undetectable. And before you know it, accumulating debt just becomes part of life – a disorientation caused by an illusion from an undetectably gradual change. By the time a physician makes the jump from a resident’s salary to that of an attending, their disorientation from financial reality has come into full force.

Failure to pay attention early on when the plane is slowly creeping off course can cause a major disillusionment of what the correct course should be. Even that extraordinary jump in salary experienced by a new attending physician that feels like a silver bullet can actually jolt them off course if not careful. In fact, I believe that this substantial income boost can even have a negative effect on a physician’s path to finding success in their personal finances. The reason is that many doctors and future doctors use this income explosion as justification for making poor financial decisions. And once they make one poor financial decision, they are much more likely to make another one given the opportunity. Just like your success in a weight loss program, you likely need to create positive momentum early on. The rationale that one can out-earn their economically unsound decisions often leads to a lifetime of poor financial management. It’s similar to the diabetes patient that doesn’t take their disease seriously. They continually ignore and mismanage their disease to the point where they’ve done irreversible damage. As frustrating as it probably is for their physician to watch that scenario unfold, so too is it heartbreaking for me to watch young doctors make poor decision after poor decision without regard for what it could be doing for their long-term financial health.

But fear not! Because simply by reading this far into a financial piece geared towards physicians has already shown that you are willing to put in some effort to make headway on whatever financial goals you might be aspiring to obtain. And just like any diagnosis wouldn’t be much good without a treatment plan, so too am I offering the hope of a plan to overcome any financial shortcomings that you might be feeling.

The Treatment

Unfortunately, the treatment for this syndrome takes a little work, but think of it as prescribed physical therapy. The more discipline you put into recovery, the quicker your financial health will rebound and get on the right track. Here are some guidelines that may help you gain momentum towards reaching the financial future that you’ve envisioned since you enrolled in your first pre-med course:

  • If you haven’t already, do some honest self-evaluating. Here at Physicians Financial Design, we like to structure it like an H&P with yourself as the patient. We start with your Chief Complaint (what you’d like to improve), your (financial) Health History, an honest Assessment (review of financial profile as well as financial tendencies), and then come up with an achievable Plan.

  • Don’t wait until you’ve gotten through residency before you start to focus on your finances. Even if you don’t yet have the salary to accomplish the lifestyle that you dream of, start working on your habits and start mentally preparing for the moment when your paycheck triples, quadruples, or more!

  • Don’t let your standard of living jump as fast as your income. Remember, momentum is measured by money in versus money out. If the money coming in jumps substantially, but so does the money going out, then you’ve just created a zero-sum game that results in no forward momentum. Be disciplined, stay the course, and use your new attending salary to boost your financial future instead of extenuating a problem by spending away your silver bullet.

  • Create a list of financial goals that you would like to accomplish. Whether it is a number in your investment account, a deadline to pay off those pesky student loans, or a new toy that you’ve always wanted – write it down and keep the list close by. Use this to help you make your financial decisions. Don’t just put down goals that sound nice on paper. Be honest with yourself and write down the things that you truly want to accomplish, because those things will keep you motivated and on track.

  • Don’t be afraid to ask for help. Just like many people rely on you for your expertise in medicine, it’s ok to rely on a professional to help you accomplish your goals. A fiduciary financial advisor can evaluate and advise on your specific needs. For example, he or she could help with:

    • Student loans: Managing debt and navigating loan forgiveness programs.

    • Investing: How and where to invest based on your tax situation and financial outlook.

    • Planning: Changing jobs, starting a family, saving for kids’ college, retirement, etc.

    • Insurance: Determine the best way to protect yourself, your family, and your assets.

    • And a great deal of other, equally important conversations.

Hopefully this information has helped you grasp a little more self-understanding, which is the first step towards being successful with your finances. If you stay intentional about your financial decisions and avoid the big mistakes, I am confident that you will find joy and success inside your personal economy!

If you have any questions or feedback about the above article, please email me at For a free, no obligation financial evaluation, please click on the button below to schedule directly to my calendar and you’ll soon find out why Physician’s Financial Design could be right for you!

Thanks for reading! For more articles geared toward young physicians and their money, click here or check out The Money Malpractice Podcast on any of the major platforms.



• RichMark Private Wealth Management. LLC is registered as an investment adviser with the State of Michigan, and only transacts business in states where it is properly registered, or is excluded or exempted from such requirements.

• Content should not be viewed at personalized investment advice. Market events and other factors may affect the reliability of the potential outcomes. Simulated growth is purely hypothetical and does not represent actual performance.

• Different types of investments involve varying degrees of risk, and there can be no assurance that any specific investment or strategy will be suitable or profitable for a client's portfolio.

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