Managing Money in a Physician's Marriage

Financial Unity Is a Key to a Successful Marriage

Over the years, I have spoken with many patients whose marriages were experiencing duress. By far the most common root cause of marital discord has been finances. Managing money successfully is an essential element for making marriages lasting and rewarding.

There can be some built-in advantages in physician marriages. Physicians tend to get married later in life, which has been one of the few reproducible correlations for reduced risk for divorce. It is also true that money cannot buy happiness, but it can rent it, at least for a while.

The overall higher median level of physician compensation, however, is no guarantee of either the financial success or the ultimate success of a marriage. Although it is true that overall rates of divorce are falling in the United States,^[1] and that physicians as a profession tend to have lower rates of divorce than other professionals,^[2] many physician marriages fall short of enjoying unity and success because of differences in attitudes on finances.

It is uncommon that two participants in any marriage enter the union with identical philosophies regarding many things, particularly spending and saving. Typically, one spouse will be more of a planner and more detail oriented, and one spouse will be more of a spender and more impulsive. All too often, this results in one spouse assuming greater (or even sole) responsibility for bill paying and budgeting.

This can result in a couple's stressing over their finances. In my experience, serving as the physician for thousands of couples over my career, I have often seen how failing to craft a union in financial matters fosters a divide in the relationship.

Get on the Same Financial Page with Your Spouse

The principle key to successful financial management is communication. Communication can keep those who are most naturally aligned as savers happy with each other's planning, nourishing a common bond. It can, with patience and persistence, get those with differing levels of attentiveness and motivation to come to a greater degree of understanding, even if this understanding falls short of full agreement.

It is important to work on this communication early in a marriage. Medical students and residents who are entering into their first (and perhaps only) marriage will naturally view the future as full of possibilities and opportunities. Much is made of the financial stresses felt by married medical students and early-career physicians. There is no minimizing the reality of these burdens, especially with student loan debt now commonly more than $200,000.

Unfortunately, no one gets a "mulligan" in life. Financial missteps early in one's career cannot be completely forgiven, and an absolute do-over cannot be arranged. As a result of mounting real estate costs, children's college expenses, the ups and downs of the investing world, and the unpredictability of incomes and employment in today's transitioning healthcare delivery system, many midcareer physicians find themselves facing uncertain financial futures.

Physicians often set their perception of how their incomes and lives will be as doctors early in life. Those early visions of sugar plums dancing in their heads can be very difficult to disavow when reality sets in.

Given the changes in the potential upside of physician income as an employed status, recent declines in certain specialty income and emerging trends such as pediatric income, as tracked by the Medscape physician income survey,^[3] the extent to which young physicians can trust their expectations of how their lives will turn out must be accompanied by a strong dose of caution.

If a physician is in a marriage that has emphasized good financial communication and shared decision making, then the prospects for weathering difficulties are enhanced. For those who have not acknowledged or not properly communicated the role of money in the marriage, the prognosis may be dimmed. Conversely, the prospects for an expensive divorce may loom even larger.

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