A Physician Perspective on Offering Financial Wellness


By David Ashley, MD, MBA

I was working full time as a family physician during the Recession of 2008-2009. I saw directly the effects of the economic challenges that so many of my patients were suddenly experiencing. Patients and their spouses or children were losing their jobs. Kids were not moving out when they became adults, and some were moving back home. Bills weren’t being paid, and bill collectors were increasingly pursuing many of my patients. I saw firsthand the effects that the stress of these events caused. I saw a spike in sleep problems, depression and anxiety, over-all stress levels, headaches, back pain, and weight gain. Furthermore, when people could not afford their medications or lost their health insurance when they lost a job, that caused even further stress and problems.

Health Impacts and Financial Stress
When someone can’t cover necessary expenses like rent or electricity and are at risk of losing a car or even a home, this will cause apparent physical and psychological stress. When people do not prepare for the future with a financial cushion, like a savings or even an emergency fund to cover an unexpected expense, this can directly negatively impact their health.

Studies show that the majority of Americans do not have money in the bank to cover unexpected expenses. A savings account is like a flu shot. We need to financially prepare when we are okay so that when we are “exposed,” lose a job or have an unexpected bill, we are somewhat “immunized.” The adverse effects of the flu, or a job loss, are minimized, even prevented, when we prepare.

Physical and psychological wellness is challenging to address and achieve if a person is facing challenges with the necessities of modern life. The movement in health care toward supporting social determinants and adding resources to help employees is addressing this major issue.

Questioning Total Wellbeing without Financial Education
If basic needs aren’t first addressed and treated, it is challenging to direct appropriate attention to other medical issues. How can you expect someone to take care of their weight, depression, or lack of sleep when they are struggling to pay the bills on time? When basic needs aren’t met, focusing on exercise and healthy habits are seen as unaffordable luxuries. It is unreasonable to expect results in improving lifestyle choices like smoking, drinking, or increasing exercise until the basics, like financial freedom, have been met.

My career in Family Medicine has been all about promoting prevention. Healthy lifestyles, appropriate screening tests, and immunizations help to improve good health in individuals and our communities. I feel strongly that financial wellness is essential to address, and can also be achieved with some education and promoting healthy money habits.

Building Resiliency
When a person has debt under control, and some money in the bank, this helps to achieve some resiliency. Like an immunization, it allows you to cover emergencies and some income when the unexpected happens. Preparedness like this is not easy to achieve, but it is possible.

Change is hard for everyone. Quitting smoking, increasing exercise, eating a healthier diet is challenging to accomplish on a good day. Changing habits takes a lot of work. Changing money habits, like quitting the daily trip to buy coffee or lunch, is also hard. It requires more planning. Taking small steps today compound over time, and when that unplanned financial challenge occurs, you will be prepared.

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