The Plight of the Golden Handcuffs

Daniel Paull MD briefly explains why his colleagues should "forget the nice house, cars, and private school"..

A common mistake that many physicians make out of training, “Finally, I have the paycheck I deserve, time to upgrade my life”.

Don’t do it, it’s a trap. Maybe you want to replace your car that has 200K miles on it and breaks frequently with a more reliable one, but you shouldn’t immediately go for the Mercedes.

Physicians are masters of delayed gratification through all of their medical school and residency training. This creates a strong drive to keep up with everyone else once they get that initial starting salary. The problem is that with each large purchase, the rachet of the golden handcuffs tightens.

It’s not uncommon to find a doc a few years out of training struggling to make ends meet because they bought: too nice of a house, luxury cars, the nicest of everything, kids to expensive private school etc..

Before they know it they somehow went from existing on 55K a year to barely being able to get by on 300K. The problem becomes keeping that salary as reimbursements go down and overhead goes up. Hospital systems also know that they have a lot of leverage in getting a salary addicted doctor to sign a crappy contract with a non-compete.


Before they know it they somehow went from existing on 55K a year to barely being able to get by on 300K. The problem becomes keeping that salary as reimbursements go down and overhead goes up. Click To Tweet


Before you know it, the physician is impossibly stuck with a terrible job that they absolutely need to pay for their expensive lifestyle. Their autonomy and freedom are lost. The solution is to actively resist the urge to put the golden handcuffs on. Buy a reasonable car, buy a reasonable house, send your kids to public school like everyone else. Your future self will thank you.


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