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Is Decision Fatigue Responsible for the Bad Financial Habits of Doctors?

Everyone experiences decision fatigue. However, I think it’s fair to say that doctors experience decision fatigue more than most. This plays out on a daily basis. But there is a price to pay. And could that price be responsible for some of the bad financial habits that plague doctors?

I think it’s worthwhile to examine.

What is decision fatigue?

Decision fatigue is the idea that the more tough decisions that you have to make, the more difficult it becomes to make a future tough decision “correctly.” Of course, “correctly” in this sense is totally subjective. But we will let that slide for now and try to stay out of any grey areas.

decision fatigue doctors

For instance, let’s say that you just had to make the difficult decision to quit your job. When you come upon the choice later on to either eat a cheeseburger or a salad while you are trying to lose weight, you are more likely to choose the cheeseburger. That’s decision fatigue.

The taxing nature of your first decision left you more prone to a “less good” decision later on. Rather than staying strong and following your diet – a taxing decision that I can relate to, you are more susceptible to the tempting choice.

How does decision fatigue relate to doctors?

Well, not to take anything away from any other professions, but doctors are making taxing decisions at a rate that doesn’t even register.

It doesn’t even register for us while we are doing it. For us, it just seems like we are “doing our job.”

But think back to a typical day for you in your work as a doctor, how many difficult, impactful, and significant decisions did you make? When I do this exercise, I start to recognize all of these types of decisions I encounter in just one surgery. It’s mind boggling.

I’m sure you will have the same experience with this thought experiment!

How does this inevitable nature of our job impact us as doctors?

We would love to think that it doesn’t. Or better yet I’ll just speak for myself – I’d love to think that it doesn’t.

And if you had asked me in the past, I would probably have told you as much.

But the truth is that it does. The more and more that I got to thinking about this after reading on the topic, it just has to. I see it in my life. And I’m sure self-reflection will lead you to a similar conclusion.

After a particularly challenging OR case or clinical day in general, I am much more likely to:

  • Choose an unhealthy meal
  • Snack
  • Take the elevator in the parking ramp rather than the stairs
  • Put the TV on for my kids when I get home
  • Pass up on exercising
  • And the list goes on…

I’m not proud of these things. But that is what I recognize is happening…

Doctors make bad decisions

This is a huge generalization, so forgive me.

But aren’t you always amazed at how many doctors smoke? Eat poorly? Or substance abuse problems? Or have any other number of bad personal habits of varying impact?

We are a population that spends our days telling and teaching our patients to be healthy. But we turn around and then don’t follow our own advice.


There’s no simple answer. But decision fatigue is certainly part of the picture for doctors especially.

How does decision fatigue factor into personal finance for doctors?

Now the one area of personal habits that I have not used as an example yet is personal finance. But any reader of this blog knows that doctors significantly underperform in terms of financial milestones compared to their high income.

Again the reasons are multifactorial. But you cannot overlook the impact of decision fatigue.

And I want to quickly point out that this is totally separate from delayed gratification. Delayed gratification is the phenomenon of spending unintentionally after a sudden increase in income after a long period of lower income. Delayed gratification exponentiates decision fatigue. But it is not decision fatigue.

Similarly, this is different from analysis paralysis which is discussed in depth here.

I do fully believe that decision fatigue is directly correlated with bad financial habits for physicians

Based on personal and outside experience.

When we are very clinically busy, other aspects of our lives get thrown out of balance. And we seek the path of least resistance to “get through them.” The path of least resistance is often not the most prudent one (I’m sorry I couldn’t resist!).

When we make a ton of taxing decisions during the day, we feel more ready to “treat ourselves” with a purchase after it ends, even if it isn’t an intentional purchase. Again this is a different phenomenon than delayed gratification in this case. Instead, we are more susceptible to seeking out that transient dopamine hit from the purchase.

Related Post:
An Updated Formula to Practice Intentional Spending for Doctors

Luckily, however, there is a solution…

How to combat decision fatigue to make better financial decisions

Really this goes for any type of decision, not just financial ones…

Solution #1

The first solution here is to recognize what is going on. We need to acknowledge that decision fatigue is real and also begin to identify when it is setting in.

Before we recognize decision fatigue, we are facing a decision using System 1 of our brain (to borrow the parlance of Daniel Kahnemann). System 1 is the intuitive portion of our brain that we don’t even recognize is at work. We activate System 1 in these situations because our lazy System 2 – the active thinking portion of our brain – is tired out from being used so much in our earlier decision-making.

System 2 is fatigued now. The more we use it, the more tired it gets. An the more susceptible to System 1 we become.

So, instead of System 2 telling us that this $1,000 is better saved and invested, System 1 is already at work leasing the car (to use an example from my life).

Recognizing that System 2 is tired and we are falling back inappropriately on System 1 allows us to consciously call our System 2 thinking back into play to start using it.

The downside of this approach however is that it requires active vigilance and reconnection each and every time decision fatigue shows up. And when decision fatigue shows up, that’s when our vigilance is at its lowest. So that can be challenging…

Which brings us to…

Solution #2

What we need to effectively combat decision fatigue, especially as doctors particularly impacted by it, is a way to fight fire with fire.

We need to hijack our System 1 thinking to do the work for us, making the “right” decision even in the face of decision fatigue.

But how can we do that? Well, the answer more in front of our nose than we initially think.


Habits occur when we transform System 2 thinking into System 1 intuition and mindless implementation. They are automatic action responses that we develop and train. Habits hijack our native intuitive response into the response that we desire.

And unlike in Solution #1, habits don’t require active effort, recognition, and vigilance every single time we face some stimulus or decision. They are built in. Ingrained. Automatic. And that makes them a much more sustainable solution to the issue of decision fatigue.

Building healthy financial habits to combat decision fatigue

Well, the first step to building healthy habits is that you need to do the same thing over and over again. And then over and over again. In fact, it takes roughly 66 days to make a new habit.

So, for 66 days, you will need to be vigilant and active System 2 despite your decision fatigue. But after that, your System 1 can kick in and your healthy habits start to go on autopilot.

And the more healthy habits that you can stack, the quicker and quicker that you will improve your financial well-being and advance on the path to financial freedom.

That is really the theme of my financial comeback story…taking unhealthy financial habits and turning them into healthy ones…

Here are specific financial habits that I encourage you to build on your path to financial freedom:

What do you think? Have you experienced decision fatigue? How did it affect you? Did it impact your financial decisions? Let us know in the comments below!

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    Jordan Frey MD, a plastic surgeon in Buffalo, NY, is one of the fastest-growing physician finance bloggers in the world. See how he went from financially clueless to increasing his net worth by $1M in 1 year and how you can do the same! Feel free to send Jordan a message at [email protected].

    3 thoughts on “Is Decision Fatigue Responsible for the Bad Financial Habits of Doctors?”

    1. Our medical institution provides Split-Dollar compensation packages. What thoughts or comments do you have about this type of compensation strategy?


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