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Welcome to the latest episode of the Physician Cents Podcast, where we explore complex financial topics tailored specifically for physicians. Whether you're a medical student, resident, fellow, or attending physician, you're going to find valuable insights that can help you increase your financial IQ, further your financial journey, and improve your overall well-being. Hosted by Chad Chubb and Tyler Olson, let’s dive in!
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Ready to debunk some financial myths, see what’s actually worth stressing over, and maybe get your money to do a few more sit-ups? Whether you’re a med student, a fresh resident, or already cruising the halls as an attending, let’s put all the big questions on the table. Think of this as your money advice happy hour, minus the cheap wine and small talk. We’ll get straight to what actually matters.
Let’s pull some questions from the mailbag and get down to the dollars. Real-life case studies, messy numbers, and “Wait, what am I supposed to do next?” moments—buckle up.
Alright, let’s talk about that mystical beast everyone chases: investment growth. You’ve probably seen those charts with arrows forever pointing up, or you’ve read about some lucky cousin who “just put it all in the market and let it ride.” Nice, but what are you actually supposed to use when running your own numbers?
“Future growth” in investments is just a fancy way of asking: How quickly can you turn your hard-earned cash into more cash, over time? Think 5, 10, even 30 years down the road.
Most people investing for retirement—or socking money into a 403b, 457b, Backdoor Roth, or that everyday taxable account—are really asking, “How much can I count on, on average?” Over the last many decades, the stock market usually spits out an average return of about 9% per year. Yes, that’s the number lots of textbooks use. But is that number your new lucky charm for all future math? Hold your horses.
Here’s where it gets spicy. If you remember one thing from today, let it be this:
What you actually get to keep after inflation is what matters.
That’s the real return. Why isn’t that perfectly crisp 9% good enough? Because every year, stuff gets more expensive. (Cue every dad’s favorite line: “I paid more for my latest car than I did for my first house!”) Inflation is the slow, black hole in your wallet. Planners like to use 3% for inflation. Sometimes it’s more, sometimes a smidge less, but for long-term guesses, 3% is a steady bet.
So if you’re banking on a 7% investment return, and life costs get 3% pricier each year, you’re actually growing your purchasing power by only 4%. That’s the magic number most of us should use.
Key takeaway:
Focus on real return, not just the big number in your account. Money that isn’t keeping up with inflation is just shrinking in disguise.
If history says 9% is normal, why do most money nerds run with 7% in their plans? Because nobody thanks you for guessing high and winding up short. Financial advisors (the responsible, boring ones) prefer conservative numbers. If your plan works at 7%, it’ll definitely work if returns are better. But if you plan for 9% and come up short? That’s when ramen becomes your new dinner buddy in retirement.
Now here’s a scene from the “Don’t Do This, Doc” files. Ever seen someone with $200,000 or more just piling up in a brick-and-mortar bank account, earning 0.01%? Ouch. With inflation running 3%, you lose value every year your money naps in that account.
Here’s how the math slaps you:
The antidote? High-yield online savings accounts that pay close to 3.5% or even higher. Names to know:
Look, every time someone moves their “lazy cash” to a savings account that pays real interest, a money angel gets its wings. And maybe you can finally buy those eggs without feelings of regret.
Planning to live off your savings? Welcome to the world of safe withdrawal rates. Let’s make this less intimidating than it sounds.
The “safe withdrawal rate” means what percent of your savings you can take out each year (and not run out before your grandkids need college funds). The famous answer? 4%. That’s the number research gave us back when bonds paid a lot more and people worried less about living to 100.
If you have $1 million saved, the “rule” says you get $40,000 yearly, adjusting a bit each year for inflation. Easy math, easy headlines.
But let’s not get too cozy. Money isn’t as bulletproof as it used to be. Bond yields are down. People live longer. Markets have moods. So, what’s a smart withdrawal today?
Most pros now suggest being a little more cautious:
If you’d rather not roll the dice, tread closer to 3%. Less chance of running out of money and more room to breathe.
Ever heard people say, “You need a million bucks to retire?” It’s not magic—it’s math. The 4% rule flips backward to the 25x Rule. Need $100,000 a year to live? Multiply by 25. If you really want to push the safety pedal, use 30 instead.
Six million dollar nest eggs aren’t just for TV doctors. If you want $250k a year for life, you’ll need to blue-sky it with real numbers.
Locking in a withdrawal rate for life? That’s like setting your treadmill speed for the next 35 years. Not happening. Smart planners use “guide rails”—think wiggle room to tweak your numbers up or down depending on what’s happening in the market.
Plus, how you pull money matters. Don’t just drain taxable accounts and leave pre-tax growing. Mixing draws from different account types means you can keep taxes in check and avoid those pesky Required Minimum Distributions sneaking up bigger than you planned.
For those who like puzzles, mixing in strategic Roth conversions—when your tax bracket is low—can save you a pile later on. Early retirees especially have a golden period to play with these moves before Social Security or big pensions kick in.
Let’s break down a classic scenario. You, a new anesthesiology resident (shout out to those who love paperwork and pressure), married to a high earner ($215,000/year). You’re staring down $130,000 in med school loans at a 6.7% interest rate. Filing taxes jointly pegs your loan payments at $2,000/month, set to finish by 2030. Filing separately cuts the payment, but the clock ticks much longer—and there’s a bigger tax bomb.
What’s the smartest move?
Enter the resident-specific refinance offers from Laurel Road. They let you pay as little as $25 to $100/month during training—less than what most folks spend on takeout or scrubs. The best part? Interest rates are lower than that 6.7% ball and chain, assuming you and your spouse keep your credit in solid shape.
But heads-up: If you refinance, you lose all federal loan perks. Goodbye, Public Service Loan Forgiveness (PSLF), deferment, forbearance safety nets, all of it. So only do this if you’re sure PSLF isn’t worth it for you (hang tight, we’ll get to that).
In our case study, PSLF’s looking kind of meh. With that much household income and just $130k in debt, the forgiveness number won’t be huge compared to paying off the loan outright. You’d probably get around ~$70,000 forgiven, but at the cost of a higher annual tax bill from filing separately, plus extra years in the game. Most attending anesthesiologists are earning anywhere from $350k to $425k, so they can knock this out the old-fashioned way.
Slogging through PSLF here would eat years of your peak earning potential and churn up more headaches at tax time.
Here’s a game plan:
If you want to throw more at the loan when you get attending income, all the better—becoming debt-free sooner is worth some fireworks.
No financial Q&A is complete without the big car debate: new or old, buy or lease, cash or finance? This one’s less about spreadsheets and more about how you live.
Let’s lay it out:
Buying a new car is like picking a long-term companion—you’re going to see a lot of each other. Leasing is like casual dating: shiny, low commitment, but you’ll never get the “paid-off” feeling.
Here’s a little inside baseball: Some dealerships give you a price break if you finance, even if you turn around and pay it off right away. That’s right—play their game, then slam-dunk the loan and walk away.
Tip: Always ask for the “if I finance with you, how much can I save?” angle. Get the discount, then pay off as soon as the paperwork allows.
Leases are perfect for those quick “just get me to the hospital” commutes, folks who aren’t racking up miles, and anyone not planning to settle in one city just yet. If you’re relocating soon, handing back the keys is way easier than selling a car across state lines.
Plus, with cars becoming rolling tech devices, the idea of trading up every couple years suddenly doesn’t sound so bad—no worries over that dying battery or software updates that cost half a paycheck.
If you go new, commit to driving that car into the ground (7 years or more). That’s the only way you’ll get your money’s worth after that initial drive-off-the-lot depreciation hit.
If you go used, think about adding a warranty (especially for tech-heavy vehicles). That extra few grand can bring peace of mind that’ll beat rolling the dice with surprise mechanic bills.
The pros practice what they preach. Lease the family hauler (kids destroy anything in under 3 years anyway). Buy a reliable, boring commuter car for yourself, maybe certified pre-owned so the warranty gods smile on you. If you get a loan with a low rate, take it—then stash those monthly payments for the next car once you’re done.
Honda, Subaru, Toyota—these cars are “point A to B with a side of don’t-make-me-wait-for-a-tow-truck.” And don’t sleep on extended warranties if your vehicle has more computers than a 90s Radio Shack.
It’s easy to get spun up in the details, but sometimes you just need a reality check. Here’s what works, no matter your specialty.
Physicians are swamped. Life comes at you fast, and suddenly it’s been five years since you peeked at your retirement projections. Get a financial checkup—even if it’s just a one-off with a pro at WealthKeel or Olson Consulting. A second set of eyes on your numbers gives you confidence or a gentle nudge to make smarter moves.
Whether you’re an attending in Manhattan or a resident in St. Louis, local costs change the savings game. It’s not “bad” to spend more for family, proximity, or lifestyle, but know what you’re trading. Own those decisions, and budget like you mean it.
Doctors face a different set of challenges than your average nine-to-fiver. Deadlines, debt, licensing, older when you hit your peak earning years—it all adds up. Use providers who know this landscape. Laurel Road is popular among residents for refinancing, and for broader financial planning, firms like WealthKeel and Olson Consulting have seen all your quirks before.
Get your own team or at least tag in for the occasional consult. Your patients trust you with their health—you should trust yourself with your money.
Ready to make your next financial move? Got a burning question that didn’t get covered? Drop it! This playbook is just starting to fill out its pages.
The info here is for general guidance. For moves on your own money, loop in a certified advisor, CPA, or attorney to make sure you’re firing on all cylinders. Your wallet, your career, your rules.
The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don’t expect!) about a sponsor, please let us know. We call it the “best of the best” for a reason, and we will maintain that standard for our listeners & viewers.
This information is for general purposes only. This information is not intended to be a substitute for specific professional financial, tax, or legal advice, as individual circumstances vary. Please see a financial professional, CPA, and/or an attorney in regards to your own individual situation.
Wealthkeel’s Advisory Services and Financial Planning offered through Vicus Capital, Inc., a Federally Registered Investment Advisor. WealthKeel LLC, 615 Channelside Drive, Suite 207, Tampa, FL 33602 -- 267.590.9533.
Olson Consulting LLC, Offering Advisory Services and Financial Planning, is a State-Registered Investment Advisor.
A podcast designed specifically for physicians, offering a breakdown of complex financial topics to help you develop your financial IQ, further your financial journey, and improve your well-being. Whether you're a medical student, resident, fellow, or attending physician, you're sure to learn something new that will benefit your journey.
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Conversations helping graduating medical students to attending physicians build a strong financial foundation
