> In retrospect, I've concluded that the real problem they faced is they'd built a life dependent on a physician or surgeon's income. They were told they were building a castle, but instead they built a prison. The fact is, you just can't spend enough money to truly escape the stresses of your work, but you can certainly spend enough money to become shackled to it.
This. All of a sudden you go from 70k/year as a senior resident to 400k/year+ as a specialist with no financial education. Add on a decade worth of burnout (especially in training but ~60% in attending physicians) and living in relative poverty (70k/year - interest on $200k in debt doesn't leave much) and you end up with a group of mostly financially illiterate people making up for lost time and depression by overspending on luxuries with their new found income.
If you can believe it I worked with people who made > 1m and started having anxiety that they couldn't cover their mortgages when covid slow-downs resulted in a 25% pay cut.
Physicians are well paid, and I don't mean to suggest otherwise, but it's a really shitty path to earn that paycheck if money is all you want out of the career considering what you give up to get there (e.g. all of your 20s and spending 5 years working 24 hour shifts every 3-4 days and 2/4 weekends) and how stressful the job can be.
Obviously this is a generalization, and no one is forcing them to overspend, but I strongly suspect an element of this spending pattern is driven by unhappiness/regrets based on interactions with colleagues. Medical training is a lot of (very) delayed gratification until you get to the end and realize it is no where near as fulfilling/satisfying as promised.