The Burden of Financial Stress | Life

Evidence based insights into physician compensation, RVUs, contracts, healthcare economics, and personal finances. For residents, fellows, and early-career attendings.

Life and Finances, in Medicine.

What Is This About?

We usually think about financial stress in terms of numbers: expenses, debt, income, savings, or investments. But financial stress has a cost that extends well beyond your budget. Why are we talking about stress on a productivity and financial platform? Because there is almost no dealing with finances without some degree of financial stress.

Why Should Medical Professionals Care?

We all deal with financial struggles at some point in our lives. The scale, our own circumstances and the effects may be different, but financial stress can have profound consequences not only in our personal lives, but also in our professional ones. According to the American Institute of Stress, stress costs employers in the United States more than $1.1 trillion. Other research found that employees spend an average of 3.3 hours per week dealing with personal financial issues while at work, and approximately one-third of workers report high levels of stress.

Stress can also contribute to turnover, which itself is expensive. Replacing an employee may cost an organization from 100% to 200% of that employee's salary, depending on the position. But that is looking at workers in general. What happens in medicine?

An interesting study published in JAMA looked at more than 16,000 internal medicine residents. Residents with more than $200,000 in student debt reported substantially more burnout than residents with no student debt. They also scored lower in their in-training examinations. That does not mean debt automatically causes burnout or lower examination scores. The study cannot prove that. But the association is difficult to ignore. Other physician research has reached similar conclusions, finding relationships between financial stress, burnout, lower well-being, dissatisfaction, and even major life and career decisions.

And there is another side to this story: productivity. Research by Kaur, Mullainathan, Oh, and Schilbach examined workers experiencing financial concerns. When those financial concerns decreased, productivity increased by approximately 7%, and workers made fewer costly mistakes.

A separate occupational health study found that financial stress was independently associated with greater presenteeism. Presenteeism simply means that you are physically at work, but you are functioning below your normal capacity. And when you think about it, this makes sense. Financial stress consumes attention and your capacity to concentrate and function, which increases the risk of mistakes. So it is not only the individual who pays the price of financial stress. The organization does as well.

The Cost Beyond Productivity

But there is a much more important cost. Financial stress can affect our relationships with our families, our patients, and our coworkers. If your head is not well placed over your shoulders, financial stress can make you lose track of what is truly important in your life. And that is a much higher price than the financial one. Some people may even respond by using coping mechanisms that may make the situation even more difficult to solve, creating a vicious cycle. Breaking that cycle requires commitment. Just like solving financial stress itself.

How to address Financial Stress

I believe that almost every problem has a solution, even when that solution is not instantaneous or immediately evident. Sometimes you cannot see the solution yourself. But you can put yourself in a position to find it. The old expression, “Help yourself so I can help you,” contains a basic truth. Finding a way out of financial stress usually requires organizing, understanding the problem, doing your own research, and surrounding yourself with people who may have a clearer and more objective view of the situation.

Basic Steps Toward a Solution

The first step is simply to face the problem and to talk to someone. That person does not necessarily need to solve the problem for you, but sharing what you are going through may help reduce the burden, which may sometimes imply looking for professional advice.

Then, take inventory of your finances. What do you owe versus what do you own? What are the interest rates you are dealing with? What comes in versus what goes out? What should you pay first? Ask one question and make one decision at a time and crate a budget. You must answer these questions, as difficult as they are, before setting a plan. And, once you have a plan, stick to it.

Now, here comes the hardest part for most people: At the same time, you must take care of yourself. I know these will sound like general recommendations but, exercise, even when you do not feel like exercising. Eat well. Practice relaxation techniques. Breathing exercises and meditation can help. Mindfulness is a wonderful tool. And protect your sleep as much as possible. Financial stress may make sleeping difficult, but lack of sleep makes everything else harder. You will fell a lot better, and you will then be in the capacity to make better financial decisions.

Now, this is my own rule that I have been following for many years. When something bad happens to me, I try to do something good for someone else. It may be something small. Help someone. Be extra nice at work. Make someone's day a little easier. Anything counts. That’s how I counteract what is negative and painful: by creating positivity. I help myself by helping others.

Last, and perhaps the most important thing is, be grateful for the good things that remain in your life. Because even during very difficult periods, there is usually something good somewhere. Sometimes it may feel like an infinitesimal part of everything that is happening. But be grateful for that part.

Remember Why You Are There

For physicians, there is one additional responsibility. Do not allow financial stress affect the way you care for your patients. This is something we learn in medical school, primum non nocere. It is almost impossible to go through years of training, long hours, family responsibilities, debt, and professional uncertainty without bringing some personal stress to work. Financial stress is part of that. But our patients still deserve our attention. That is another reason financial health matters.

Understanding your finances is not only about building wealth. It is about reducing one source of distraction and anxiety so that you can devote more attention to your family, your patients, your work, and specially to yourself.

Remember, sometimes the real return on getting your financial life under control is not measured in dollars at all.

The Bottom Line

Financial stress affects more than your bank account. It can affect your health, relationships, your job, and how you experience your life. Getting your finances under control is not only about money. It is about getting back stability, protecting those around you, taking care of yourself, and getting back your peace of mind.

Key Takeaways

✓ Research suggests that financial stress can affect productivity. Physician research shows that financial stress is common and associated with significant consequences in your practice.
✓ Our financial health, our personal well-being, and our professional lives are much more connected than we sometimes realize.
✓ Sometimes the real return on getting your financial life under control is not measured in dollars at all.

“The greatest weapon against stress is our ability to choose one thought over another”

Attributed to William James

MD&D Quote of the Day

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