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Certified financial planner Brian Case discusses the article, “Personal financial planning shouldn’t be a taboo subject.” They explore the often-overlooked link between financial stress and the crisis of physician burnout, turnover, and the alarming rate of physician suicide. Brian, Jerry, Jonathan, and Anders explain that despite high earning potential, many physicians struggle with poor financial literacy and significant student debt, which negatively impacts their professional satisfaction and mental health. The conversation also addresses the high level of mistrust physicians have for traditional financial services due to conflicts of interest. The authors argue that breaking the stigma around personal finance and providing access to transparent, unbiased resources is a vital, preventative component of physician well-being. Listeners will learn why integrating financial education throughout a medical career can empower physicians, giving them greater autonomy and enhancing the quality of patient care.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Brian Case. He’s a certified financial planner. He’s the co-author of the KevinMD article, “Personal financial planning shouldn’t be a taboo subject.” Brian, welcome to the show.

Brian Case: Thanks, Kevin. I appreciate you having me on. I really appreciate the work that you do with the community, too. I mentioned to you before that I listen to your podcast on bike rides, and I look forward to talking to you today.

Kevin Pho: All right. Well, thank you so much for listening. Just tell us a little about your story, then jump right into the article and share why you decided to write it.

Brian Case: Well, I grew up in a family of physicians, and I’m married to an OB-GYN doc. We’ve got three boys and raised our family in Connecticut, but we live in Utah now. I got to writing the article after spending about 25 years in traditional wealth management, sold that business a few years ago, and started focusing on physician well-being, which is kind of what I did.

I think of it as arm-wrestling style back in my wealth management days. But now I get to do it without the conflicts of interest that everybody struggles with in personal finance. Eliminating those conflicts of interest really let me start working with large groups of physicians, and we’re actually endorsed now by the Mayo Clinic’s Well-being Index and the Champions of Wellness. So I’m starting to work with them on bigger projects, hoping to have a big impact.

Kevin Pho: All right, so we talk about physician wellness and physician burnout a lot on KevinMD and on this podcast, but there is a clear intersection between that and a physician’s financial issues as well, and you talk about that in your KevinMD article. So share your article for those who didn’t get a chance to read it.

Brian Case: The basis of the article was just knowing from working individually with physician families for all those years that if I can take the financial stress level down, everything else gets a little bit easier. What I explored in the article with my partners were a lot of the issues that make personal finance a taboo subject. So I think at the end of the day, that’s what we’re dealing with: it’s a hard topic to talk about.

The joke in our house, being married to an OB-GYN, is that all we talk about is sex and money because I’m a CFP and she’s an OB-GYN. But in most households, those two topics cause a lot of stress and are hard to talk about. It really all does come down to language. What happens in the physician world, as you know, is you put your heads down pretty early on usually and start ignoring everything other than how to take care of other people. One of the things you tend to ignore are subjects like personal finance.

Unfortunately, in the future, when you get out of residency or training, you’re so busy it is really hard to get into personal finance unless you are really interested in it. So, I spent a little bit of time trying to help by calling it a financial literacy problem and finally learned that physicians don’t like to be called illiterate. So we started calling it a taboo subject, and I think that’s when I really started to understand what the problem was, what we could do about it, and started building a team and a process to address it.

Kevin Pho: In 2025, that intersection between what we call financial literacy or personal finance in the physician world—there has been so much written about that. We have popular websites talking about various investments and personal finance. Have we made enough progress in terms of making personal finance not a taboo subject in the physician world? How much progress have we made in the last few years?

Brian Case: I think on one hand, I’ve seen it get better because there is more discussion and there’s more transparency. But on the other hand, I think what we’re still dealing with is that most of what happens in personal finance feels like sales. Physicians especially get their radar up pretty quickly when they feel like they’re being sold something.

At the same time, as soon as you feel like you’re being sold, your guard tends to go up and your trust comes down. Then it’s a long road for everybody, even if you have willing parties on both sides and everybody’s trying to help each other. As soon as that trust comes down a little bit, it really does become a long road. I think that’s what I’ve been working on the most: making sure that people understand the conflicts of interest and learn how to navigate them. Again, that comes back to language.

If you understand the language of finance, especially as a physician, you are all very quick learners. You are used to new topics and navigating new things, but if you don’t have the language, it’s very easy for somebody like me or in my industry to talk over you, just like I’ve heard a lot of your podcasts actually talk about how easy it is, in my words, to talk over patients if you’re not careful.

Kevin Pho: You make that connection between personal finance and physician burnout. Give us some examples or tell us why financial stressors are such a trigger for burnout.

Brian Case: I think what I saw back in my wealth management days is my typical new client would be a physician family, around their fifties, maybe 55 or so, when, the way I thought about it, the rubber kind of started to meet the road. Maybe practice is going well, they’re finally saving for retirement, and it’s time to pay for college. They tend to feel stuck when they get to that point because it’s really not what they necessarily signed up for. To still be paying off student debt in your fifties—that’s not what you thought back in your twenties would happen. To have to worry, even worry about paying for college, really shouldn’t have been a problem.

So that mixed expectation of what you thought you were signing up for financially and where you end up, that all comes to roost. A big part of that is the deferred life plan that physicians and physician families end up on. You go to school and training for 10 or 15 years longer than most of society, and at the same time, society’s kind of calling you a rich doctor. When all that comes to roost, it ended up being my favorite part of the job because as a financial planner, it was not all that complicated to get people unstuck because we’re not close to it.

I was just listening to your guest Kara Pepper, and it really drove that home because with all the coaching she does, at the end of your episode, she talked a lot about the financial aspects of it and feeling stuck. Frankly, that’s what financial planning does for people: it allows you to understand where you are and the path you’re on. At the end of the day, financial planning is looking at those two things and saying, “Hey, is there anything I would do differently today?”

What I find myself wishing for everybody is the path that my wife is on, which she doesn’t feel stuck. She knows the path we’re on because of my background, and she is practicing medicine on her terms.

Kevin Pho: So is it really the overwhelming amount of educational debt a lot of physicians carry? Would you pinpoint that as the major financial stressor?

Brian Case: I think for the young people getting out of school now, it’s certainly ramped up. If I think about 25 years ago, it wasn’t as big of a deal. The numbers weren’t as big relative to income. But I think the numbers have gotten bigger, the cost of the education has gotten bigger, and the incomes have not grown along with that, especially in primary care type fields.

But I think the biggest thing is the difference in expectations. Again, I always go back to the “rich doctor” as a one-word statement. As a physician family, I know most physicians have good incomes, but that doesn’t make them rich. Again, going back to that kind of playing catch-up or a deferred life plan, there’s a lot to do in that compressed period of time, especially when physicians are so busy just keeping up.

Kevin Pho: One of the things you mentioned earlier that really resonated with me was that your wife was able to practice medicine on her terms. To me, I think that really encapsulates the goal or ideal a lot of physicians should have. They should practice medicine on their terms because if they don’t, I think that is going to lead to a lot of the burnout that we see today. Give us some specific financial steps that physicians need to take in general, from what you’ve seen, so they can practice medicine on their terms.

Brian Case: I think the first step is to decide whether you’re already there or not. Sometimes it’s just incremental changes. I can’t tell you how many physicians I’ve talked to that just needed a little bit of encouragement to go to four days a week or to change their schedule and be more protective of their time. Sometimes they just need to know that that’s OK. From my perspective, I got to have the conversation with two hats on. One was as a financial planner. I can encourage people that it’s OK, financially it’s OK from an objective point of view.

Kevin Pho: And what do those conversations look like when you talk to these physicians about maybe working less than 1.0 FTE, going down a little bit? Do you get a lot of resistance? What are those conversations like?

Brian Case: There are two sides to it. One is purely financial. There’s a lot of playing catch-up, there’s a lot of keeping up with the Joneses, and there’s an awful lot of momentum in personal finance, especially when you start having kids and all those things. So breaking that momentum sometimes is the hardest part. But what I found most of the time is people, physicians especially, don’t know where they are today. So they don’t know if they have the ability to do that. They haven’t taken the time to understand the path they’re on.

Kevin Pho: One of the things that you mentioned in your book is Roy Reed’s book on trust. Tell us why that’s the first step we can take when we’re talking about a culture of financial transparency. Talk about how that concept plays in.

Brian Case: I think it comes down to the language of finance. You know, what I noticed, or I guess maybe a better way to put it is, I can’t tell you how many conversations I have with people outside of medicine that think physicians are arrogant. Some of them are; I mean, some people across the board are arrogant. But what I’ve learned, and I find myself correcting a lot of people on, is that it’s not arrogance; it’s that they don’t know the language.

Kevin Pho: And what do you mean by the language? What kind of language are we talking about? What kind of terms are we talking about?

Brian Case: Literally the words, because if you don’t understand what the words mean, you can’t understand the concepts. What I know about physicians is if I give you the words and the definitions of terms that I’m using and I’m careful not to talk over you, the concepts come quickly because it’s not that complicated. It’s complex, you know, there’s a lot of stuff, but it really is a literacy problem that’s hard to backfill because there’s so much noise out in personal finance.

Most of the time, if you pick your head up and you start Googling anything you want to learn about personal finance, the top three pages are going to be selling you something, and it’s really hard to navigate. Going back to the trust issue, as soon as you feel like you’re being sold, it becomes a long road for both sides of the equation.

Kevin Pho: So short of working with a certified financial planner like yourself, what are some ways that physicians can filter out all that noise? How can they discern what they’re reading online is trustworthy or not?

Brian Case: I know I sound like a broken record, but it’s taking the time to understand the language. My joke has been for years that we both have the same Google, right? So I can Google something about personal finance and I’ll recognize the sales terms in there as opposed to what I think of as the real financial terms, the real financial definition. So taking the time to get that education is really important.

The hard part with that, besides the fact that there’s so much sales that goes on in the industry, is that financial planning, especially financial planning education, is a process, not an event. So if I sat here and educated you on everything I can think of about Roth IRAs and you don’t use it tomorrow, you’re going to end up losing it if you don’t have an application for it.

I guess the maybe self-serving answer to your question is that’s what I’ve been working on for the last few years: a way to get into financial planning, get into that process without having to trust, without having to worry about being sold something. What I’ve put together is a company, or a few companies, that allow for that on-ramp to financial planning without the guard going up, without it feeling like sales.

What I’ve been most surprised about is how well received that’s been on both sides, both financial advisors and physicians, because there’s a lot of advisors out there that truly want to serve physicians, but they’re in such a conflicted environment that it’s hard for them to attract them. What we’re doing is creating confident, capable consumers for financial advisors. So that’s been the biggest surprise for me, how much traction we have on the well-being side because there’s a need, a desire for conflict-free financial planning. The pleasant surprise has been on the advisor side, how many people are encouraging me and, frankly, helping the physicians that we’re working with.

Kevin Pho: So when you say financial planning, talk to us about the components of financial planning that go into something that’s comprehensive. We talked earlier about that, but tell me about the other components that comprise comprehensive financial planning.

Brian Case: Again, to go back to where it gets confusing for people, a lot of people start financial planning by aggregating all their accounts with some tool. Those tools are generally fishing for money to be moved around or invested or some version of that. So what I encourage people to do is to start more at a hundred thousand feet and really organize every aspect of your financial life before you start drilling down into investments.

Everybody wants to talk about the shiny objects of investments, right? Nobody wants to talk about estate planning, death and dying, and disability. That’s really the order of events. So the best thing you can do, in my opinion, is to go through a very high-level fact-finding process. What we do is we treat it like a report card.

We have people go through about a six-minute survey that doesn’t require any personally identifiable information so that the guard doesn’t go up. Then we produce a report card that basically says, “OK, start here.” If you failed estate planning, it might be a good place to start. Most physicians already are getting a relatively high grade on income, probably a decent grade on savings rates, but they, again, tend to ignore the things that are easy to ignore, the things you don’t want to talk about. So that’s my advice: start at a hundred thousand feet and then drill down to the things that are important in that priority order.

Kevin Pho: So we started off this conversation making that connection between financial planning and physician burnout. Now, can you share some stories or examples where a physician client comes to you, you help them with their financial plan, and that directly led to an improvement in their burnout?

Brian Case: I think the person that first comes to mind was somebody who, again, at that age, he was probably 50-ish, and the introduction to me was, “Hey, how soon can I retire?” That’s typically the solution: “Get me off this treadmill as quickly as you can.” The cool thing for me is that I was able to take that person and kind of get them off of that cliff and say, “What’s your version of practicing medicine, and how can we get there?” For him, it was a pretty dramatic change because he had sucked it up for far too long in the situation he was in, let a lot of things go, and there wasn’t a way to navigate that situation.

So, what we were able to help that whole family do was reassess the whole situation, from where they want to live to what the next chapter looks like. The great thing is that this particular family got to stay in the general area that they were in. They got to change one of the things that was bothering them: they felt stuck in the house that they were in. So we were able to put that goal together with practicing on his terms, if you will, and put all those layers together and help them prioritize those things to then go, I would call it “shopping for a job”—go looking around for all the opportunities that fit all those different components. But most importantly, go there with a plan.

Going there intentionally, not “the grass is greener,” not “get me out of this thing that I finally let get to me.” We got to get ahead of that curve. And I think the cool thing is, Kevin, I just probably mixed three stories together as I went through that. I’ve been blessed; I’ve been able to help people navigate a bunch of those.

Kevin Pho: We’re talking to Brian Case. He’s a certified financial planner and co-author of the KevinMD article, “Personal financial planning shouldn’t be a taboo subject.” Brian, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Brian Case: I think that’s what I said before: financial planning is a process, not an event. So if you haven’t gotten started, get started. If you have gotten started but you’re not comfortable with the situation, go back and get some education on personal finance because the worst thing for both a financial advisor and a consumer is blind trust. There’s a lot of that going on right now. So, sometimes it’s just a little bit of a step back. Sometimes it’s a second opinion on your current plan. But I think that’s the long story short: don’t rely on blind trust when it comes to personal finance.

Kevin Pho: Brian, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

Brian Case: Thanks, Kevin. I appreciate it.