• Women physicians have large student loans and face a potential $2 million gender wage gap during their career.
• A financial strategy that accounts for all resources can build wealth while fostering joy.

Brittne Halford, MD, MPH, paid off $138,000 in medical school debt in 2 years and 9 months without feeling (terribly) deprived of the good things in life.

“I am from a family that’s rich in culture and community and support, but not as far as passing down wealth. My parents could not afford to send me to college, but I was able to acquire enough scholarships to pay for undergrad and matriculate to medical school,” Halford, an internal medicine physician and financial coach, told Healio. “Like many individuals, I had a lot of graduate school debt, and I saw how it was impacting me personally. So, I committed to paying it all off aggressively, and while doing that I also realized that there’s a lot more that I could do with my finances if I educated myself.”

She began to share what she learned on social media and eventually founded More Joy More Wealth, a company that helps clinicians understand finances.

Ahead of her presentation, “Creating financial systems not just goals,” at the Women in Medicine Summit, Halford spoke to Healio about student loan debt, using nonfinancial resources to avoid “retail therapy” and the importance of financial literacy.

Healio: You’re speaking at the Women in Medicine Summit, is there advice you give specifically to women in medicine, as opposed to men or people in other professions?

Halford: There are some specific challenges women in medicine face that other people in medicine or in other professions do not. Women in medicine still face a gender pay gap that over the course of a career could be $2 million. That’s substantial not only in terms of the amount of money, but in what that money can afford, the opportunities it presents. Compared with men, women in medicine also have fewer investments and more student loan debt. They also tend to manage the household and carry the mental load of caring for kids. Other literature shows that women in medicine, women physicians, don’t have the same longevity benefit over men as women in many other types of professions.

All these things impact how a woman, and particularly a woman in medicine, experiences her career and her financial stewardship. If you’re dedicating time to your patients and to your family, there might be little time to engage in your finances and attain that financial literacy that makes you feel confident to navigate this portion of your life well. Women often defer to someone else to manage their money. There’s an assumption that a financial advisor is doing the right thing on their behalf, but there’s a lack of awareness and confirmation.

Healio: Your website is called More Joy More Wealth. How do you think about joy connecting to wealth?

Halford: There’s literature that shows when you focus on joy, you actually have more wealth. Wealth can be defined as the numbers in the bank account, but it also includes other forms of wealth: emotional, physical and social wealth. I want women to think about what wealth means from a holistic perspective and how they can get there.

When I was paying off my student loan debt, it felt like a cloud around me. But when I decided to pay it off aggressively — $138,000 in 2 years and 9 months — I also decided I would do it without completely depriving myself of everything else that brings me joy for this one goal. I can have joy and experience life while achieving this goal.

I want women to know that they have permission to experience joy while seeking wealth and to understand that if they do, they will actually have more wealth. There’s an opportunity cost there. If you focus on the things that matter for you, you won’t feel deprived and you won’t be unnecessarily spending on retail therapy. You can invest that money and pay down your debt or achieve other life goals.

Healio: What is the main takeaway of your presentation?

Halford: The main takeaway is to spend on systems. When we think about money, we think about what money can do and also about spending. Spending is the use of money, but also the use of other types of resources — time or mental energy or other types of resources. Instead of just spending on trying to get yourself to a specific goal, I want women to invest in the systems that will help to create sustainability for themselves, to prevent burnout and to sustain their abilities to achieve goals. We set new goals all the time, but we don’t want to have to recreate the financial system for every goal. You can invest in systems — whether that’s the people or resources around you, the schedule that allows you to monitor your resources, invest in yourself by spending time with a therapist so you can understand some of the fears and things you might be trying to put a bandage on by using your money.

That’s the big picture. I walk people through a feedback loop to look at their inputs, the process, the outputs and the feedback, and how they can apply a familiar framework to their finances.

Healio: Do you have an easy example of that?

Halford: One easy example: An input can be your income. Depending on the person, they may have income from various sources or one source, but then it goes through a process, what you do with your money when it comes in. Part of what I teach is to have a four-part bank account system that allows you to have an output where managing money feels good, you have the freedom to spend while also accomplishing your goals and you have enough for uncertainty that protects your peace.

You create four different accounts: one for your fixed needs, one for your variable wants, one for your emergency fund and one for those goals. You can do all four at the same time. They require different levels of monitoring, but the system ensures that you have all your financial needs met by having that structure in place.

Healio: What is the most common concern women in healthcare have about their finances?

Halford: For women in healthcare, the biggest concern is student loans. We have large loans and often that’s the first major expense we must pay regularly. It is also something we experience a lot of negative emotions about because it is such a large amount and can limit our lives. I have a colleague who did not get married — she had a fake wedding ceremony, but they legally were not married — because of their student loans. They had to think about all their assets and all their calculations for repayment. That is extreme, but it reflects a sentiment of putting your life on hold because of this financial burden. Yes, student loans are something I see women in healthcare often facing.

Healio: What is the biggest financial mistake you see women in healthcare committing?

Halford: The mistake I see is deferring financial literacy to someone else. Financial literacy has two components: understanding and use. Often women might read a book or listen to a podcast, but then from there, there’s no action, they don’t engage more meaningfully with their finances after acquiring that information, which then does not allow them to build their financial confidence. And so they defer to a financial advisor or to their tax professional or someone else with this assumption that everything is being done correctly. I know from personal experience that that is not always the case.

What I want women to do instead is to engage more meaningfully. Mastery comes from practice and from honing that skill so they can build financial confidence. If they choose to delegate the responsibility of investing to someone else and they understand the cost of that decision, that’s fine, but I don’t want you to defer because you feel disempowered.

Healio: Are there a few things that readers can act on right away?

Halford: The first thing is to believe. It sounds cliché, but everything we do starts with a thought. If we have this negative talk, “I’m not good with money,” “the financial advisors are better,” “money is just stressful,” we don’t engage. Whatever you hope to attain with your money, you have to believe that it is possible.

Belief then is often followed by curiosity. Then you start to act on it. So, the second piece is: Don’t wait. Often I hear people waiting for the best opportunity, the best time — “I’m going to start investing when I pay off my student loans, get married, finish residency.” Fill in the blank. I’m saying you are only going to get there by doing it. Women often make up excuses for why they are waiting. Just don’t wait, start engaging now.

Brittne Halford, MD, MPH, can be reached at morejoymorewealth@gmail.com.