Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

It’s time for physicians to stop thinking like dogs

Cory Fawcett, MD
Physician Finance
July 3, 2019
Share
Tweet
Share

When I sat on the management committee of our surgery center, I was wondering why owners didn’t bring all their cases to the facility. They would clearly benefit financially if they increased their caseload. So why didn’t they? I realized, it was because we all think like dogs.

Dogs will do tricks if you give them a treat immediately after their successful performance. Dogs will not do tricks if you promise to give them four treats next month. Dogs don’t think long term, they think only about the present.

So if surgeons are thinking like a dog, then we need to incentivize them like a dog. We can’t promise they will get a bigger profit share check at the end of the year; we have to give them something this month. Profits need to be paid immediately if we want it to be a good incentive.

I also realized this applies to the rest of our lives as well. Here are two tests to see if you are thinking like a dog: Do you have a car payment? Do you have a 30-year mortgage? If the answer is yes to either question, then you are thinking like a dog, and it is costing you a fortune.

So exactly what is the problem? Dogs only see the present, not the future. Financially that means we only look at the monthly payment and not the total cost. Or we are more concerned with our monthly income than our total wealth. If we want to get ahead financially, we need to be looking at the long term outcome of our decisions.

When we shop for a new car, do we shop with the amount of monthly payment in mind or are we thinking about the total cost of the car in determining what we can afford? There is a big difference. Just because we can afford the monthly payment, doesn’t mean we can afford to buy the car. I like to remind people that the car we can afford, is the car we can write a check for. We cannot afford something if we have to borrow the money to get it.

If one goes shopping for a new Tesla and there is not $80,000 in their checking account, then a lower priced car should be sought. Never go shopping with a maximum monthly payment in mind. That’s how a dog would shop for a car. A financially responsible adult would go into the dealership with cash and spend the least amount of money that will get the job done to their satisfaction.

For some people, their satisfaction will be met with a Tesla. That is fine, as long as it is done with cash. We all have different tastes.

Here is the problem: If we cannot afford the $80,000 for the new car and we borrow the money to purchase it, how will we be able to afford the $92,000 we will have to pay for that same car using credit? How can we justify paying an extra $12,000 for something we couldn’t afford in the first place? Since we have a choice, why would anyone choose to pay $92,000 for something they could get for $80,000? The answer is because we are thinking like a dog. The monthly payment is more important to us than the total cost.

The same holds true for a house payment. The most expensive way to buy a house is with a 30-year mortgage that keeps getting refinanced every few years for another 30 years. This is done because we are looking not at the total cost of the house, but at the monthly payment. The present overrides the future.

A $500,000 mortgage at 5% interest for 30 years will cost $966,278 and even more if it keeps getting refinanced. That same mortgage will only cost $711,714 with a 15-year loan. That is a savings of $254,564.

What could you do with an extra quarter million dollars? That could buy a nice second home in a snowbird state. It could provide an extra $10,000 a year in retirement for the rest of your life if you follow the 4% rule. It could buy a new Tesla for each of your three kids. It could give you a lot of Mondays off.

So why don’t we save all that money? Because we think like a dog. The monthy payment for the 15-year mortgage is greater than the monthly payment for the 30-year mortgage. We want more money to spend right now, not later. Just like the dog, we want our treat now, or we won’t do the trick. That thinking is costing us a fortune.

ADVERTISEMENT

I see this type of thinking all over the place. What’s in it for me now? There are several articles popping up about people being disappointed about receiving a lower tax refund than they expected. They think the amount of their tax refund is a reflection of how much tax they paid. I don’t understand this, as it is a reflection on how much tax they (over) paid. They think if taxes are cut then their refund will be more than last year. Trump put out a tax reform that was to cut most people’s taxes. So somehow that has translated into “I will get a bigger tax refund.”

Not everyone got a tax break though. My taxes were expected to increase under the new tax plan as I showed in my article, “Calculating the New Tax Plan Results.”

Whether taxes are increased or cut have nothing to do with the amount of your refund. The tax refund only reflects how much you overpaid your taxes during the year. Getting a big tax refund does not mean you paid less taxes, it means you made a mistake. It means you mistakenly gave too much money to the government in the form of an interest-free loan.

If I asked you “Would you like to give the government an interest-free loan this year?” What would you say? Almost everyone I know would say “No way.” But if you got a tax refund, you gave the government an interest-free loan.

I read today about a woman who was upset that her tax refund was lower this year than last year. What upset her was that she uses her refund to pay her property taxes each year and the refund wasn’t enough to cover the taxes. She thought the tax reform would give her a bigger tax refund. She did note that she got a bigger check every month since the new tax reform took effect. But she didn’t put any of that money away to cover her property tax bill. She spent it each month as fast as she got it. She was thinking like a dog.

It’s time for us to start thinking in terms of the long term implications of our financial decisions and stop thinking like dogs. The effect today is not nearly as important as the effect overall. Stop doing things that will maximize interest payments. Stop making decisions that are all about the monthly effect and look at the long term effect. Stop thinking we are rich because we have a big paycheck; instead, look at our net worth to determine if we are indeed rich. A big paycheck and a negative net worth is not the picture of a wealthy person.

The next time they bring the dessert tray after dinner, I think I will look at my waistline to make the decision and not make the decision based on what is on the dessert tray. I have to stop thinking like a dog.

Cory Fawcett is a general surgeon and can be reached at his self-titled site, Dr. Cory S. Fawcett.  He is the author of The Doctors Guide to Starting Your Practice Right, The Doctors Guide to Eliminating Debt, and The Doctors Guide to Smart Career Alternatives and Retirement.

Image credit: Shutterstock.com

Prev

In the age of EHRs, why are we still asking patients to fill out paper forms?

July 3, 2019 Kevin 4
…
Next

The problem of physicians and nurses connecting patients with hospital fundraisers

July 3, 2019 Kevin 2
…

Tagged as: Practice Management, Surgery

< Previous Post
In the age of EHRs, why are we still asking patients to fill out paper forms?
Next Post >
The problem of physicians and nurses connecting patients with hospital fundraisers

 

ADVERTISEMENT

More by Cory Fawcett, MD

  • Should physicians own timeshares?

    Cory Fawcett, MD
  • 4 money mistakes everyone makes

    Cory Fawcett, MD
  • Here’s the secret to establishing a great physician reputation

    Cory Fawcett, MD

Related Posts

  • It’s time for physicians to be less “productive”

    Anonymous
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • The risk physicians take when going on social media

    Anonymous
  • When it comes to pay cuts, it’s time to look beyond physicians

    J. DeWayne Tooson, MD
  • Beware of pseudoscience: The desperate need for physicians on social media

    Valerie A. Jones, MD
  • When physicians are cyberbullied: an interview with ZDoggMD

    Monique Tello, MD

More in Physician Finance

  • Paid for twice

    Physicians paid for G2211 twice. Most never bill it.

    Michael Duben, MD
  • Why physician financial freedom matters more than salary

    Arthur Lazarus, MD, MBA
  • Charitable giving for physicians: 7 strategies for 2026

    Logan Foltz, MD
  • The sweet spot before physician financial independence

    Stanley Liu, MD
  • Negotiating physician compensation works better in groups

    Contract Diagnostics
  • How doctors lose money investing: 6 failure modes

    Harsha Moole, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

It’s time for physicians to stop thinking like dogs
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...