Financial Health Assessment
Adrian and Cynthia: Radiology Household Scores 55 Out of 100
By Ryan Inman
Published · Updated
RadiologyNew attending · Two years post trainingCouple, two young children
Financial Health Assessment score
55 out of 100
Corrections
- Needs a workup 0 to 39
- Corrections 40 to 69
- Stable 70 to 84
- Healthy 85 to 100
The score grades the household on 20 measures across seven frameworks. Adrian and Cynthia lands at 55, in the Corrections band, score 40 to 69.
Adrian is a radiologist two years out of training, earning $364,000 a year and rising to about $500,000 at partnership in two years. Cynthia is a radiologist who recently finished fellowship and works part time, earning $250,000 to $300,000 a year. The hosts put the household at about $600,000 of income. They have two young children. The assessment scores the household 55 out of 100, in the Corrections band.
The wealth equation is finished work. Stated saving runs about $157,000 a year: two 401k accounts at $57,000 apiece including employer contributions, backdoor Roth IRAs at $6,000 apiece, an HSA at $7,000, and 529 accounts at $12,000 per child per year, a rate the hosts calculate at about 26 percent. The debt anchor grades the stock at about 2.8 times the hosts' $600,000 income figure, inside the new attending bar, and takes the full 10.
The open items are the cover on the incomes themselves. Adrian's stated disability benefit is $5,000 a month, its type and own occupation status unstated. Cynthia's disability cover is not stated at all, and the hosts call disability the household's biggest gap. There is no umbrella policy and there are no estate documents, with two young children and no guardian stated. The traced path runs from 55 to a target of 67, and the prescription section shows the three steps that trace.
$1,705,000
Total stated debt · mortgage and student loans
About $157,000
Saved a year · across five stated flows
$5,000
Disability benefit per month · stated on one spouse
About $600,000
Household income · the hosts' figure
$1.5 million
Mortgage principal remaining · 30 year loan
67
Score with the three traced fixes · Corrections band
The short version
- The score: 55 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 14 of 14 and the Lifestyle Guardrails 14 of 22, while the Protection Stack earns 8 of 22.
- Total stated debt is $1,705,000: a $1,500,000 mortgage and $205,000 of student loans refinanced at 2.9 percent fixed with a payoff planned by 2023 at the time of the intake. At about 2.8 times income, the Debt Anchor takes the full 10 on the new attending scale.
- Saving runs about $157,000 a year across two maxed 401k accounts, backdoor Roth IRAs, an HSA and two 529 accounts, about 26 percent by the hosts' calculation.
- Life cover is laddered on both spouses, $3,000,000 on him and $1,500,000 on her. Disability cover is the gap: a stated $5,000 a month benefit on one spouse, its type unstated, and none stated on the other.
- Three traced fixes are worth 12 points and take the score to 67: substantially more disability cover for both spouses (+4), an umbrella policy (+4), and an estate package with a guardian named (+4).
The equation is finished. The cover is not.
What They Did Right
Two radiology incomes with the saving system already at scale. This is the machinery already running.
- A full wealth equation Debt anchor and stretch saving at full marks together: 14 of 14, on about 26 percent saving and a 2.8 times anchor.
- About $157,000 saved a year Two 401k accounts at $57,000 apiece, backdoor Roth IRAs, a maxed HSA and 529 funding for both children.
- The loan call, deliberate $205,000 refinanced at 2.9 percent fixed for five years with a payoff planned by 2023 at the time of the intake. The loan call earns the full 6.
- Life cover laddered on both $3,000,000 on him in 20 and 10 year layers, $1,500,000 on her the same way, in force on both radiologists.
- No consumer debt Cards paid in full monthly and both cars paid off, beside a $1,500,000 mortgage and the student balance.
The Score: 55 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Adrian and Cynthia scores 55, in the Corrections band. This household is scored on the attending rubric, on the new attending fork of the Transition framework.
20
Measures graded
7
Frameworks
55
Adrian and Cynthia's score
The 3 Bucket Framework earns 5 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0: cash balances and months are not stated. Named lanes earn 2, on the main expenses and a lumped credit card total, with no detailed budgeting stated. Goals funded earns 3, with dollars flowing to the stated goals while the boat goal carries no stated flow.
The Physician Wealth Equation earns the full 14 of 14. The Debt Anchor takes the full 10: total stated debt of $1,705,000 against the hosts' income figure of about $600,000 is about 2.8 times, inside the new attending bar of 3.0. Stretch saving takes the full 4, on a savings rate of about 26 percent by the hosts' calculation.
The Protection Stack earns 8 of 22. Health earns the full 4, standing behind $7,000 a year of HSA contributions. Disability earns 0: Adrian's $5,000 a month benefit is stated with its type and own occupation status unstated, and Cynthia's cover is not stated. Life earns the full 4, on individual term in force on both spouses, laddered. Umbrella earns 0, stated absent. Malpractice earns 0, type and tail not stated. Estate documents earn 0, stated absent.
The Transition framework, on the new attending fork, earns 6 of 10. The loan call earns the full 6: the remaining $205,000 was deliberately refinanced at 2.9 percent fixed for five years, with a plan to pay it off by 2023 at the time of the intake. Contract clarity earns 0, because a contract or compensation review is not stated.
The Tax Ladder earns 4 of 8, at 2 and 2: the HSA is maxed and backdoor Roth conversions are deliberate moves, with the marginal bracket itself not stated. The Decision Filter earns the full 4 of 4 on five stated goals.
The Lifestyle Guardrails earn 14 of 22. The Savings Floor takes the full 12 on a rate of about 26 percent by the hosts' calculation. The leak earns 0: the unaccounted share of spending is not stated. Wealth first automation earns 2: the saving flows run at about $157,000 a year, and wealth first automation is not stated.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 0 (months not stated), named lanes 2, goals funded 3 | 5 of 20 |
| 03 Physician Wealth Equation | Debt anchor 10 at about 2.8 times income, stretch saving 4 at about 26 percent | 14 of 14 |
| 04 Protection Stack | Health 4, disability 0, life 4, umbrella 0, malpractice 0, estate documents 0 | 8 of 22 |
| 05 Transition | Loan call 6, deliberate refinance at 2.9 percent with a payoff plan. Contract clarity 0, review not stated | 6 of 10 |
| 06 Tax Ladder | Roth against pre tax 2, bracket plus moves 2 | 4 of 8 |
| 07 Decision Filter | Goals written 4, five goals stated | 4 of 4 |
| 08 Lifestyle Guardrails | Savings floor 12, the leak 0, wealth first automation 2 | 14 of 22 |
| Total | Corrections band | 55 out of 100 |
Read the shape, not just the total. One framework is finished outright: the wealth equation, anchor and stretch at full marks on about $600,000 of income and $1,705,000 of debt. The drag sits across one stack: disability cover priced at $5,000 a month on one of two radiology incomes, an umbrella that does not exist, and an estate box at zero with two young children in the house.
The Prescription
The traced fixes first, then the open items the record carries without a gain.
- Put substantially more disability cover on both spouses. Substantially more cover for both spouses, per the record, in place of one stated $5,000 a month figure with its type unstated and no cover stated on Cynthia's line. (+4 points when in force.)
- Buy the umbrella policy. $1,000,000 is good now on the hosts' sizing, against stated investable assets of about $172,000 plus unstated cash. (+4 points when in force.)
- Sign the estate package and name a guardian. A will, a power of attorney, a healthcare directive and a trust, with a guardian named in the will for the two young children. (+4 points when in force.)
- The hosts' remaining prescriptions, untraced. A refinance of the physician mortgage toward conventional pricing, a taxable account, and more term cover for Adrian stand in the record as host prescriptions. No points are claimed for these steps. The record's target does not trace them.
The traced path runs 55 to 67: plus 4 when disability cover stands on both spouses, plus 4 when the umbrella is in force, and plus 4 when the estate package is signed with a guardian named. Nothing else in this file traces a gain in the record's basis: the malpractice line and the leak sit unstated, and the emergency fund's months are not stated. The target is 67, stated with its arithmetic.
What This Case Teaches
A full equation is not a finished file. This household maxes the framework that grades debt and saving, anchor and stretch at full marks on about $600,000 of income. The same file holds a disability box at zero, an umbrella that does not exist, and no guardian named for two young children. The frameworks grade different halves of a household's safety, and a perfect half is still a half.
The equation grades the money. The stack grades the risk.
The second lesson is what high income does to small numbers. A $5,000 a month benefit reads as real money until it is set against $8,000 a month of mortgage payment and two professional incomes. Cover is sized against the life it protects, not against the premium, and this file's gap is the size and the terms of the cover.
Behind the score
The Household
Adrian is a radiologist who finished training two years ago, earning $364,000 a year and due to rise to about $500,000 at partnership in two years. Cynthia is a radiologist who recently finished her fellowship and works part time, earning $250,000 to $300,000 a year. Combined current income is about $614,000 to $664,000, and the hosts use about $600,000. The household has two young children.
Balances are stated in part. The 401k accounts hold about $70,000 apiece, the Roth IRAs $14,000 apiece, and the HSA $4,000, about $172,000 of stated investable assets. Cash stands at Wells Fargo and in a Goldman Sachs high yield account, amounts not stated, and the emergency fund's months are not stated.
His income rises at partnership. The stated cover is one number.
The stated saving runs about $157,000 a year: $57,000 into each 401k including employer contributions, $6,000 into each backdoor Roth IRA, $7,000 into the HSA, and $12,000 per child per year into 529 accounts. The hosts calculate the savings rate at about 26 percent. Spending runs through credit cards at $5,000 to $6,000 a month, paid in full monthly, with no detailed budgeting stated.
Debt is two large lines. The student debt stands at $205,000 remaining of about $350,000 combined at the start, refinanced shortly before the intake at 2.9 percent fixed for five years, with a plan to pay it off by 2023 at the time of the intake. The mortgage stands at $1,500,000 of principal remaining on a 30 year loan at $8,000 a month, bought with a physician mortgage at 15 percent down. Both cars are paid off. Total stated debt is $1,705,000, about 2.8 times the hosts' income figure.
Protection is uneven in the way the hosts name: disability is the biggest gap. Adrian's stated disability benefit is $5,000 a month. The policy's type and own occupation status are not stated. Cynthia's disability cover is not stated. Life cover is laddered on both: Adrian holds $1,500,000 for 20 years and $1,500,000 for 10 years, and Cynthia holds $750,000 for 20 years and $750,000 for 10 years. Health cover stands behind the HSA contributions. The household states it has no umbrella policy and no estate documents, and no guardian is stated for the two young children. Malpractice type and tail are not stated.
| Household fact | Where it stands |
|---|---|
| Careers | Radiologist, two years post training. Radiologist, fellowship recently completed, part time |
| Household income | $364,000 plus $250,000 to $300,000. Combined about $614,000 to $664,000. Hosts use about $600,000. His income rises to about $500,000 at partnership in two years |
| Family | Couple, two young children. No guardian stated |
| Student loans | $205,000 remaining of about $350,000 combined, refinanced at 2.9 percent fixed for five years, payoff planned by 2023 at the time of the intake |
| Mortgage | $1,500,000 principal remaining, 30 year, $8,000 a month. Physician mortgage at 15 percent down |
| Other debt | None stated. Both cars paid off. Credit cards paid in full monthly at $5,000 to $6,000 a month. Total stated debt $1,705,000 |
| Emergency fund | Cash balances and months not stated. Accounts at Wells Fargo and a Goldman Sachs high yield account |
| Saving | About $157,000 a year: 401k $57,000 each including employer contributions, backdoor Roth IRAs $6,000 each, HSA $7,000, 529 accounts $12,000 per child per year. About 26 percent by the hosts' calculation |
| Balances | 401k about $70,000 each. Roth IRAs $14,000 each. HSA $4,000. Stated investable assets about $172,000 |
| Disability | Adrian: $5,000 a month benefit stated, policy type and own occupation status not stated. Cynthia: not stated. Hosts name disability the household's biggest gap |
| Life insurance | Adrian $1,500,000 for 20 years plus $1,500,000 for 10 years. Cynthia $750,000 for 20 years plus $750,000 for 10 years |
| Umbrella | None. The household states it carries no umbrella policy |
| Estate documents | None. The household states it has no estate planning documents |
| Goals | Five stated goals |
The Two Frameworks Behind the Score
The score grades 20 measures across seven frameworks. Two of them carry this case: the Physician Wealth Equation, which scores the full 14 of 14, and the Protection Stack, which scores 8 of 22 with the disability layer graded at zero.
Framework one
The Physician Wealth Equation
The Wealth Equation grades the stock of debt against income and the rate at which income becomes wealth. Both boxes are full here: this is the finished framework in the file.
- The Debt Anchor Built
- Total stated debt of $1,705,000 is about 2.8 times the hosts' income figure of about $600,000, inside the new attending bar of 3.0. The box earns the full 10 of 10.
- Stretch saving Built
- About $157,000 a year of stated saving is about 26 percent by the hosts' calculation. The box earns the full 4 of 4.
- The savings floor, in the Guardrails Built
- The same rate takes the full 12 in the Lifestyle Guardrails. The flow is graded in both frameworks and is full in each.
Framework two
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. Health and life are bought. The disability layer, the umbrella and the documents are not: 8 of 22.
- Health and life, in force Built
- Health cover behind the HSA, and laddered individual term on both spouses, $3,000,000 on him and $1,500,000 on her. Each box earns the full 4.
- Disability, the named gap Missing
- His stated benefit is $5,000 a month with type and own occupation status unstated. Hers is not stated at all. The box earns 0 of 4, and the hosts name it the household's biggest gap.
- Umbrella and estate documents Missing
- No umbrella policy and no estate documents, both stated, with two young children and no guardian named. Both boxes earn 0, and both are traced fixes.
$5,000 a Month of Cover on Two Radiology Incomes
The first look is the disability number. Adrian's stated disability benefit is $5,000 a month. The household earns about $600,000 a year between two radiologists, carries a $1,500,000 mortgage at $8,000 a month, and holds two young children. The policy's type and own occupation status are not stated, and Cynthia's disability cover is not stated at all.
The box grades the stated cover at 0. Life cover in the same stack is laddered and full, $3,000,000 on him and $1,500,000 on her, which makes the disability line the stack's open layer rather than a general neglect of cover.
The life ladder is built. The income cover is a single stated number.
The hosts name disability the household's biggest gap. The record traces the full box, +4, to substantially more disability coverage for both spouses. No benefit amount is traced. The page carries the gap as the hosts stated it.
His income rises to about $500,000 at partnership in two years, which raises the stakes on the same line: the stated cover is one $5,000 a month figure against $364,000 of his income today. The score grades the cover that exists, and on the stated file what exists is one number, $5,000 a month, with its terms unstated.
Two Young Children and No Guardian Named
The second look is the estate box, graded at zero on an empty set. There are no estate documents: no will, no power of attorney, no healthcare directive and no trust, and no guardian is stated for the two young children. The household states the absence plainly.
The record traces the full estate pattern at +4: the package of will, power of attorney, healthcare directive and trust, with a guardian named in the will. The guardian line is the one this file leaves blank.
Two young children, two radiology incomes, and no names on the paper.
The umbrella stands beside it in the same state: none. The record traces +4 to umbrella cover, and carries the hosts' sizing with it: $1,000,000 is good now, against stated investable assets of about $172,000 plus cash the intake does not total. The traced step is to hold it.
Add the traced items together and the file's path is three purchases and signatures: disability cover for both spouses, an umbrella policy, and the estate package, 12 points. The hosts' other prescriptions for this household, a mortgage refinance toward conventional pricing, a taxable account and more term cover for Adrian, stand in the record untraced, and this page carries them the same way.
Milestones: Scored on What Is Stated
Inside the 3 Bucket Framework, the milestone checklist tracks the markers a household has already hit. This checklist earns 0 for Adrian and Cynthia, because the intake never states a milestone list the net can be computed from. The box pays only for stated milestones.
The rest of the bucket picture: the emergency fund earns 0 with cash balances and months unstated, named lanes earn 2 on main expenses and a lumped card total with no detailed budgeting stated, and goals funded earns 3 of 6 on flows that reach the stated goals while the boat goal carries no stated flow. The framework earns 5 of 20.
Questions this case answers
What score did Adrian and Cynthia receive on the Financial Health Assessment?
Adrian and Cynthia scored 55 out of 100, in the Corrections band. The Physician Wealth Equation earns the full 14 of 14 and the Lifestyle Guardrails 14 of 22, while the Protection Stack earns 8 of 22.
How does $1,705,000 of debt earn a full Debt Anchor?
The anchor divides the stock of debt by income. Total stated debt of $1,705,000 against the hosts' income figure of about $600,000 is about 2.8 times, inside the new attending bar of 3.0 times, so the box takes the full 10. The mortgage is $1,500,000 of the total and the refinanced student balance is $205,000.
What disability cover do two radiologists carry?
On the stated file, Adrian's benefit is $5,000 a month, with the policy's type and own occupation status not stated, and Cynthia's disability cover is not stated at all. The hosts name disability the household's biggest gap, and the record traces the full box to substantially more cover for both spouses.
What is missing for Adrian and Cynthia?
Substantially more disability cover for both spouses, an umbrella policy, and estate documents, all stated absent or unstated, with no guardian stated for two young children. Malpractice type and tail are not stated, the emergency fund's balance and months are not stated, and the unaccounted share of spending is not stated.
Sources and Basis
This assessment is built from the household's own intake for the Financial Health Assessment and the episode assessment of it. Every figure on this page comes from that record, and the score is traced box by box under the locked attending rubric.
The attending rubric weights the seven frameworks at 20, 14, 22, 10, 8, 4, and 22, for a total of 100. The bands are Needs a workup from 0 to 39, Corrections from 40 to 69, Stable from 70 to 84, and Healthy from 85 to 100. Attendings are scored on the Transition fork by years since training: the loan call, and the new attending contract.
Written by Ryan Inman, MBA, MAFM. Last updated October 2026.