Consider a pediatrician and his wife, a cardiologist. Together they earn over $700,000 per year. They have $200,000 sitting in a savings account earning 4 percent. They own a $750,000 house and lease a luxury sedan. They pay a financial advisor 1 percent annually to manage their retirement accounts, mostly because a colleague recommended him. Neither has ever heard of an expense ratio. When a friend suggests they open a brokerage account and buy a total stock market index fund, they say they’ll look into it. Six months later, nothing has changed.

Every week, the pediatrician sees a mother who refuses to vaccinate her child. She has read about adverse events online. She does not trust pharmaceutical companies. She cannot evaluate the FDA’s review process. From her perspective, the pharmaceutical market is opaque: There are effective products and harmful ones, and she cannot tell them apart. So she opts out.

The pediatrician finds this maddening. The MMR vaccine is 97 percent effective. The regulatory infrastructure works. “The science is clear, just vaccinate your child,” he wants to say.

He is right about the mother. But he does not see that he and his wife are the mother, in a different market. The financial products market has a regulator (the SEC), decades of evidence that low-cost index funds outperform active management, and a transparent default option charging 0.03 percent per year. These protections exist, but nothing in 11 combined years of medical training taught either of them how to evaluate whether financial institutions are trustworthy. From their information set, Wall Street looks the way Big Pharma looks to the vaccine-hesitant parent: profitable, opaque, and not to be trusted.

Using federal survey data covering 1,803 professionals across seven occupations, I found that physicians earn the most of any group but hold only 9 percent of financial assets in actively chosen equity, compared with 14 percent for software developers earning almost half as much. The strongest predictor of whether a professional invests in equity is not education, not income, and not intelligence. It is how comfortable they are navigating digital platforms, what I call quantitative-digital fluency. A software developer who has never taken a finance course invests more than a physician with 20 years of post-secondary education. Years of formal education have no significant effect whatsoever.

When physicians do not participate in equity markets, the money goes to three places. They overconsume: the luxury car in the driveway is not irresponsibility but a rational response when the alternative is a financial product you cannot evaluate. They overinvest in real estate: the one large asset whose quality you can assess directly. And they delegate to expensive advisors recommended by colleagues who are equally unable to evaluate advisors, paying a 1 percent annual fee that, compounded over a career, destroys more wealth than the suboptimal allocation itself.

A physician couple earning $260,000 and saving at the observed rate accumulates $2.5 million over 30 years. A household that saves slightly more, allocates optimally, and self-manages via index funds accumulates $3.5 million, 29 percent more. But unlike the unvaccinated child, who may eventually contract measles, the couple never confronts the counterfactual. They retire comfortably. They never know how much more comfortably they could have retired, the financial equivalent of an asymptomatic chronic disease.

The standard response is to propose adding financial literacy courses to medical curricula. This is the equivalent of teaching the vaccine-hesitant parent molecular biology. It addresses a real knowledge gap but not the binding constraint.

The binding constraint is institutional awareness. The physician does not need to understand portfolio theory. He needs to know three things: Financial markets have a regulator that ensures transparency, fiduciary advisors are legally required to act in his interest, and a low-cost index fund exists that requires no expertise and charges less in a year than his advisor charges in a week.

The intervention is small: one hour during residency orientation. It does not require a new course, a new faculty line, or a curriculum committee. It requires a physician to hear, from a credible source, what he already tells his patients every day: The system has protections, they work, and the cost of opting out exceeds the cost of trusting them.

Every physician who has been frustrated by a mother refusing to vaccinate her child should recognize the irony. The mother who will not vaccinate because she “doesn’t trust Big Pharma” and the physician who will not invest because he “doesn’t trust Wall Street” are exhibiting the same behavior, for the same reason, with the same solution.

The difference is that the pediatrician already knows the prescription. He just hasn’t filled it for himself.

Hernan Moscoso Boedo is an associate professor in the Department of Economics at the Carl H. Lindner College of Business at the University of Cincinnati. His research focuses on macroeconomics, economic growth, and development, with a particular interest in how uncertainty, institutional frictions, and technological change shape economic outcomes across countries.

His work has examined firm volatility over the business cycle, the role of informality in developing economies, and the interaction between policy uncertainty and financial markets. More recently, his research explores the macroeconomic consequences of artificial intelligence adoption and the effects of digital technology on demographic trends.

Dr. Moscoso Boedo’s scholarship has been published in the American Economic Journal: Macroeconomics, the Journal of Monetary Economics, the Journal of Economic Growth, and the IMF Economic Review, and has been featured in Fortune, ABC News, the Associated Press, and Marginal Revolution. He holds a Ph.D. in economics from the University of Wisconsin-Madison and, as the spouse of a physician, brings a close perspective on the intersection of economics and medicine. More information is available on his website and LinkedIn.