Managing Money in a Physician's Marriage

Gregory A. Hood, MD


April 23, 2019

In This Article

Balancing the Spender and Dreamer Money Mentalities

To the detail-oriented planner, the answer appears simple, or at least simplistic, although it can seem to go too far: Don't spend money. Don't spend it early in one's career. Don't spend it later. Live to the height of frugality. Save every dollar, so that you may have the savings needed to weather life's storms.

Actually, frugality is often misunderstood. Frugality does not mean that money is never spent. It means that when money is spent, it is spent on the constructive accumulation of assets. This is an important distinction to consider and discuss with one's spouse, whether one is married to more of a frugal "hoarder" or a spending "dreamer." For the aspirational dreamer, there is a reward in living life, particularly once the deferred gratification of a substantial income begins to be realized. The tension that can be induced between a saver spouse and a dreamer spouse can become massive.

Bridging the gulf between a spouse who "understands the value of a dollar" and one who does not want to think of money as having limits takes consistent commitment and effort. Scheduling regular meetings with each other quarterly, if not monthly, to discuss the current financial situation, account balances, and upcoming expenses and to plan for both unexpected expenses and long-term dreams, can be very effective.

Financial planning might not sound romantic, but there is peace of mind that comes from implicitly sharing and communicating the same goals. Financial planning may sound as unromantic as scheduling dates or scheduling intimacy, but it is not nearly as unromantic as allowing one spouse to languish in the midst of feeling stressed and even scared, isolated, and unsupported.

When it comes to medical marriages, these types of imbalances can often be more exacting on female physicians, and may be part of the reason that, among physicians, divorce is more likely for female doctors than male doctors.

"Females traditionally bear more of the household and child-rearing responsibilities on average, and female physicians, if they have to do both that and maintain a job as a physician, that could lead to a lot of stress and lead to higher rates of divorce. For women physicians, they appear to be essentially getting a raw deal because there is a trade-off they have to make, that unfortunately the male doctors don't have to be making," says Anupam Jena, MD, PhD, from Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.[2]

Creating a Financial Partnership

How can couples prevent, or at least stop, the fights? How can couples grow richer while growing together?

The issue of "control" is sometimes a major factor. One spouse may insist that they are only comfortable if they are in charge of the finances. It is important to help that person understand how much more comfortable both partners can be if they are on an equal footing of understanding, regardless of who actually performs the bill payments.

[I]n a true and equal marriage, there is no assertion of power over another, only of partnership together.

Often this is seen as an issue of who "has the power" in the marriage, but this is a massive marital red flag because in a true and equal marriage, there is no assertion of power over another, only of partnership together.

Speaking of partnership, it is important for some couples to increase the role of women in marital financial decisions. It is a perspective shift that is still evolving, as the results of a survey in Money magazine revealed[4]: "These new dynamics, however, are also creating new tensions, as women feel heightened financial stress, men come to grips (or not) with shared decision-making, and both spouses struggle to figure out a fair division of labor (financial and otherwise) at home. Meanwhile, no matter how much the husband or wife earns, the survey found that money remains the top source of friction for couples overall, with spending a particularly contentious issue. And although spouses overwhelmingly think they're in sync about their finances, the survey results also make clear that when it comes to money, they are typically anything but: Husbands and wives often don't agree on the roles they play and the financial skills they have, or understand what really matters to their partner."

The issues of time and interest are important. Even in dual-physician couples, the demands of one specialty can be greater or more hectic than for another. Certainly, at some point, the finances must be managed by someone who has sufficient time to do so appropriately. There is also the issue of knowledge and interest: Who has the knack for understanding the finances, cash flow, and organization of an effective money management household system? It is okay, even as a physician, to recognize that someone else may be better at managing finances, and may even enjoy doing it more.


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