Prescribing financial wellness: How Dr. Stephanie Zhou is combatting physician burnout with smart money habits

Medical school taught Dr. Stephanie Zhou to strive to be the best doctor, but not too long after she graduated and started practising, she concluded that working crazy hours and risking burnout was no way to sustain a career in medicine.“When I graduated out of residency, it was around the start of the pandemic, so I started working immediately because I couldn’t travel or take a break and a lot of young doctors were needed to do vaccinations. I ended up working 9 a.m. to 9 p.m. seven days a week for my first year of family practice,” she told fellow doctors on a May 25 OntarioMD vendor spotlight webinar sponsored by Dr.Bill.The family physician whose roster she took over had just stopped working all of a sudden. There was no warning and she just assumed her predecessor had burned out, only to learn from her clinic manager that the doctor had taken his or her own life.“That was super shocking to me because I felt I was going down that same path,” she confessed. Being curious, she checked the doctor’s RateMD reviews and saw that they were very positive. Her predecessor had also worked long hours and had a huge roster, having taken on patients who would otherwise be orphaned when other doctors at the clinic retired.“I was questioning my career and asking myself if this was something I wanted to do. Would I end up quitting medicine? Was something going to happen to me mental health wise?” she asked.Money was piling up in her bank account because she worked so much and didn’t have time to spend it, but she wasn’t meeting her basic needs. “I wasn’t eating lunch because I was so late seeing patients and wasn’t spending time with friends because I worked on weekends,” she said.This is when Dr. Zhou began thinking about financial wellness as a means of reducing the number of hours she worked. In the May 25 OntarioMD webinar, Building a Financial Routine: Yearly, Monthly and Daily Habits that Optimize Financial Wellness, Dr. Zhou advised doctors to begin every New Year with the financial equivalent of an annual physical.January, she advises, is the time to think about investing in the alphabet soup of government savings plans—TFSAs, RESPs, FHSAs and RRSPs. It’s also the best time to think about any big expenses planned for the year—a maternity leave or a home purchase, for example. Dr. Zhou offered her own example of planning for a mat leave, pointing out that she was hoping to take a full year—significantly longer than the four-to-six-month leave favoured by most doctors.Taking off one year would be manageable, she figured, if she had $300,000 of annual capital gains, roughly equivalent to what she would forego as employment income. Similarly, $685 in monthly dividends would compensate for the income she would sacrifice by occasionally taking off a half day to exercise or cook a healthy meal.January is also a good time to think about checking one’s credit score, signing up for fraud alerts and shopping around for a better price for Internet and other subscriptions. She recommends checking out RedFlagDeals.com and the by-invitation-only Canadian Physicians Discounts, Deals & Rewards Facebook group.Dr. Zhou cautions doctors to be aware of investment management fees, which can range from 0.05% to 2.0% or more. A commission of 2.0% for a mutual fund may not seem all that high, she warns, but can add up to hundreds of thousands of dollars for an investment that’s held for 25 years. She also favours a buy-and-hold investment strategy rather than the risker option of buying and selling stocks based on market fluctuations.Before hiring an accountant to prepare a tax return, Dr. Zhou advises doctors to first prepare a spreadsheet identifying all of their tax-deductible expenses and credits because accountants charge by the hour and would otherwise spend an inordinate amount of time chasing after a blizzard of receipts. She suggests spending one or two hours a month going through credit card statements to build a spreadsheet identifying one’s tax-deductible expenses.Instead of waiting until the end of the day to do all their billing, Dr. Zhou urges doctors to bill immediately after seeing every patient. Billing when everything is fresh in your mind, she says, will result in fewer errors and reduced cognitive load. She also advises use of Dr.Bill’s resource for fixing billing code rejections.Many doctors, she says, have questions about incorporation, which she describes as a tax deferral strategy because money earned and left in a corporation is taxed at a lower percentage. In Ontario, for example, it’s a combined federal and provincial rate of 12.2% for eligible small businesses. The more that’s left in a corporation and the less that’s withdrawn as remuneration, the more money can be saved. However, “if your lifestyle expenses (and withdrawals from the corporation) are going to be high, I don’t recommend incorporating,” she advised, noting the expense of additional legal and accounting fees for corporations. Additionally, the CPSO, she said, charges a $400 fee for registering a corporation as well as an annual renewal fee of $175.Finally, to protect oneself against one of the costliest life experiences—divorce—Dr. Zhou strongly recommends seeing a lawyer about a prenup. A contested divorce can cost tens of thousands of dollars, she said, while a prenup will set you back $2,000 to $3,000. Lawyers also charge by the hour, she warns, so instead of relying on a lawyer to educate you about prenups, check out her video on Getting a Prenup: an Overview on Marriage Contracts and Cohabitation Agreements, one of dozens of videos offering financial advice for doctors and medical students on her BreakingBadDebt YouTube channel. Instead of the crazy hours she worked at the start of her career, Dr. Zhou has crafted for herself a diverse and rewarding career. She practices addiction medicine at Sunnybrook Health Sciences Centre, works three half days a week at the Don Mills Family Health Team in Toronto and has established a reputation as a financial wellness advocate, having developed a financial literacy curriculum for medical students at the University of Toronto and other Canadian universities. For five years running, she has also organized a Canadian Physicians Financial Wellness Conference in the fall.

Prescribing financial wellness: How Dr. Stephanie Zhou is combatting physician burnout with smart money habits

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