“Money talks. Mine just says goodbye.” A physician client of mine once grumbled to me. He is in good company.

Physicians by and large, are horrible wealth accumulators. Thomas Stanley, author of The Millionaire Next Door, found that among all high income groups, physicians have the lowest tendency to accumulate substantial wealth.

This finding is not at all surprising to me. My wealth management practice focuses on physicians, so I’ve seen this happen firsthand.

Here are the top five reasons I think physicians don’t accumulate substantial wealth:

1. They start making good money later in life. Medical school takes years and a lot of borrowed money; after that, there is residency. By the time they can practice on their own, they are in their late 30s, usually with a family to take care of and debt up to their necks. Their C+ classmates who went into sales (or law or politics,) have already been making money for 10 years.
2. They have to live a lifestyle that befits a doctor, which usually means big houses, expensive vacations, and luxury cars.
3. They are very busy. After work and family, they have no time left to take care of finances.
4. They think they can do it all by themselves.
5. Unlike successful entrepreneurs, they can’t sell their practices for good money.

Numbers 1 and 5 are impossible to overcome; they are the nature of the beast. However, 2 through 4 are within a doctor’s control.

If you can make the following adjustments, money will not say goodbye to you again.

1. Live a lifestyle within your means.
2. Focus on what you do best and delegate the rest. John Bowen, (my practice coach,) likes to say: “Focus on bringing home the big check.” Doubling yourself as a nurse practitioner, or a claim filer, will certainly not bring home the big check.
3. Dedicate at least one hour per month to family finances. Stanley has found that people who do that are far more likely to be successful wealth accumulator.

Not every doctor has the inclination to do personal finance. If you don’t, you should delegate that to a highly educated, trustworthy financial advisor.

If you do, you nevertheless need some basic education. A little knowledge goes a long way. I recommend the books written by none other than a neurologist turned expert investor William Bernstein, particularly his latest, The Investor’s Manifesto.

Investing is not be all and end all of wealth management. There are other areas (asset protection, tax mitigation) physicians should pay attention to.

Michael Zhuang is founder of MZ Capital, an independent wealth management practice specializing in helping physicians achieve financial freedom.

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