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Financial Health AssessmentPediatric Critical CareEstablished

Archie and Aimee

Financial Health Assessment · Published October 22, 2026

Pediatric critical care Established attending Married, two children

Aimee, 40, is a pediatric critical care physician earning $220,000, and Archie, 41, is a stay at home dad. They have two children, ages seven and four, and a home they bought in 2014. The assessment scores them 32 out of 100, in the Needs a workup band.

32

FHA score out of 100 · Needs a workup

$220,000

Household gross income · one earner

Over $4,000/mo

Take home pay unaccounted for · hosts' calculation

$8,000

Credit card debt · beside a $24,000 taxable account

Start with what is funded. The accounts hold $318,800 across a brokerage account, two 401a accounts, a 403b, two 529s, and a whole life policy. Protection was bought: a $1,250,000 term policy, disability cover, an umbrella, and estate documents with a will and a power of attorney. The 403b takes 9 percent of salary, about $19,500 a year.

Then the hole in the middle of it. On the hosts' arithmetic, over $4,000 a month of take home pay, about a third of it, cannot be accounted for from the expenses and saving the household stated. Beside that leak sit $8,000 of credit card debt and a $5,500 car loan, in a house holding a $24,000 taxable account. The Transition framework, the one that grades the debt file, earns 0 of 10.

32

FHA score out of 100 · Needs a workup

$220,000

Household gross income · pediatric critical care

$460,700

Total stated debt · 2.09 times gross income

36

Score with the traced fix · Needs a workup band

Key takeaways

  • The score: 32 out of 100, in the Needs a workup band. The Decision Filter earns the full 4 of 4, while Transition earns 0 of 10 and the Tax Ladder 0 of 8.
  • Over $4,000 a month of take home pay, about a third of it, is unaccounted for on the hosts' calculation. That leak is the case.
  • About $8,000 of credit card debt and a $5,500 auto loan sit beside a $24,000 taxable brokerage account and a whole life policy with a $42,000 surrender value.
  • The traced fix uses money the household already holds to clear the card and car debt: 4 points, to a score of 36.
  • Protection was bought early: term life at $1,250,000, disability at $7,300 a month, an umbrella, and estate documents. The guardian for two minor children is not stated.

You cannot fund a goal with money you cannot find.

The Household

Aimee is a pediatric critical care physician, 40, grossing $220,000 with take home pay of about $160,000. Archie, 41, is a stay at home dad. They are married with two children, ages seven and four, in a home they purchased in 2014, with two dogs and two guinea pigs in the statement for the record. Their statement was read on air by a proxy reader, because the couple asked to stay anonymous.

The stated monthly flows run in several directions at once: 9 percent of salary into a 403b, about $19,500 a year; $500 a month into 529 accounts; $600 a month into a whole life policy; $500 a month into savings. The expenses are itemized across the intake, mortgage at $2,600 a month including tax and insurance, preschool, taekwondo, house cleaning, Amazon, home improvement, and about $800 a month of food.

The accounts are funded. The month is not accounted for.

The accounts are real. A Wells Fargo brokerage holds $24,000, an IRA holds $3,300, two 401a accounts hold $30,000 and $130,000, the 403b holds $43,000, the whole life policy shows a cash value of $53,500 with a surrender value of $42,000, and the two 529 accounts hold $22,000 and $13,000. Across the stated accounts, $318,800.

The debt file runs the other way. Student loans total $139,200: a Nelnet loan of $131,900 at 2.875 percent on a graduated repayment of $500 a month over 30 years, and a SoFi refinance of $7,300 at 4.25 percent over five years at $135 a month. The mortgage is $308,000 at 2.75 percent over 15 years. The auto loan is $5,500, being paid at $500 to $1,000 a month. And there is about $8,000 of credit card debt, with a stated plan to clear it by the end of June.

Protection is the strongest layer. Term life of $1,250,000 over 30 years costs $1,200 a year. Disability pays $7,300 a month for $2,400 a year, with the own occupation type not stated. A whole life policy of $750,000 costs $3,600 a year on top of the term. An umbrella is in place, its amount not stated. The will, power of attorney, and healthcare directives exist. A guardian for the two children is not stated, and the emergency fund amount is not stated anywhere.

On the hosts' arithmetic, the stated expenses and stated saving leave over $4,000 a month of the $160,000 take home pay unexplained, about a third of it.

Household factWhere it stands
CareersPediatric critical care physician and stay at home dad
Ages40 and 41
Household income$220,000 gross; take home about $160,000
Where they liveHome purchased in 2014
FamilyMarried, two children ages seven and four
Student loans$139,200: Nelnet $131,900 at 2.875 percent, and a SoFi refinance of $7,300 at 4.25 percent
Mortgage$308,000 at 2.75 percent, 15 year, $2,600 a month including tax and insurance
Other debtAuto loan $5,500; credit card debt about $8,000
Emergency fundAmount and months not stated
Saving9 percent of salary to the 403b, $500 a month to 529s, $600 to whole life, $500 to savings; about 14.5 percent of gross in stated flows
Account balances$318,800 across the stated accounts, including two 401a accounts at $160,000 and 529s at $35,000
DisabilityPresent, $7,300 a month of benefit for $2,400 a year; own occupation type not stated
Life insuranceTerm $1,250,000 in force, plus whole life $750,000 with a $42,000 surrender value
UmbrellaPresent; amount not stated
Estate documentsWill, power of attorney, and healthcare directives present; guardian not stated
GoalsBuild retirement and emergency savings, pay off student loans and mortgage, save for college, buy a vacation beach house

The Score: 32 out of 100

The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Archie and Aimee score 32, in the Needs a workup band. This household is scored on the attending rubric path.

20

Measures graded

7

Frameworks

32

Archie and Aimee's score

The 3-Bucket Framework earns 3 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 0, because its amount and its months are not stated. Named lanes earn 0, because the hosts' calculation leaves over $4,000 a month unaccounted. Goals funded earns 3, with dollars flowing to the 529, savings, and retirement goals without fully funding them.

The Physician Wealth Equation earns 7 of 14. The Debt Anchor earns 5: total stated debt of $460,700 against $220,000 of gross income is 2.09 times income. Stretch saving earns 2 on stated flows of about 14.5 percent.

The Protection Stack earns 10 of 22: life at the full 4 on the $1,250,000 term policy, disability at 2 with the own occupation type not stated, umbrella at 2 with its amount not stated, and estate documents at 2 with a guardian for two minor children not stated. Health coverage and malpractice type and tail are not stated.

The Transition framework earns 0 of 10. The student loans are not paid off and no forgiveness plan is stated, and the cards and other debt box earns 0 with about $8,000 of credit card debt and a $5,500 auto loan both open. The Tax Ladder earns 0 of 8: no Roth against pre tax reason is stated, and no bracket or deliberate move is stated.

The Decision Filter earns the full 4 of 4 on four stated goals. The Lifestyle Guardrails earn 8 of 22: the Savings Floor at 6 on the stated rate, the leak at 0 on the unaccounted third of take home pay, and wealth first automation at 2, because the payroll 403b runs while the wider split is neither automated nor accounted.

FrameworkWhat it coversPoints
02 3-Bucket FrameworkMilestones 0, emergency fund 0 (amount not stated), named lanes 0, goals funded 33 of 20
03 Physician Wealth EquationDebt Anchor 5 at 2.09 times income, stretch saving 2 at about 14.5 percent7 of 14
04 Protection StackHealth 0, disability 2, life 4, umbrella 2, malpractice 0, estate documents 210 of 22
05 TransitionLoan strategy 0, loans open with no forgiveness plan stated; cards and other debt 00 of 10
06 Tax LadderRoth against pre tax 0, bracket plus moves 0, neither stated0 of 8
07 Decision FilterGoals written 4, four goals stated including college and a beach house4 of 4
08 Lifestyle GuardrailsSavings floor 6 at about 14.5 percent, the leak 0, wealth first automation 28 of 22
TotalNeeds a workup band32 out of 100

Read the shape, not just the total. The balances and the policies say a household that started early and bought protection. The zeros say the monthly system underneath was never reconciled: a third of take home pay unaccounted, and consumer debt carried beside cash that could clear it.

The Two Frameworks Behind the Score

The score grades 20 measures across seven frameworks. Two of them carry this case: the Lifestyle Guardrails, which score 8 of 22 with the leak at zero, and the Transition framework, which scores 0 of 10 because the debt file was never closed out.

Framework one

The Lifestyle Guardrails

The Guardrails grade whether today's lifestyle leaves room for the plan: the savings floor, the leak, and whether wealth is paid first. The leak is the whole story here.

The leak

Fixed and variable expenses plus stated saving leave over $4,000 a month of take home pay unaccounted for, about a third of it, on the hosts' calculation. The box earns 0 of 6.

Missing

The savings floor

Stated flows of about 14.5 percent of gross (the 403b, the 529s, and savings) earn 6 of 12. The rate is real. It is also smaller than the leak beside it.

Partial

Wealth first automation

The 403b runs off payroll at 9 percent of salary. The rest of the split is not automated and not accounted, so the box earns 2 of 4.

Partial

Framework two

The Transition Framework

Transition grades the debt file itself: the student loan strategy, and the state of cards and other debt. Both boxes sit at zero in a household with $318,800 in stated accounts.

Student loan strategy

The loans total $139,200 and are not paid off, with no forgiveness plan stated. The Nelnet loan runs $500 a month on a 30 year graduated schedule. The box earns 0 of 6.

Missing

Cards and other debt

About $8,000 of credit card debt and a $5,500 auto loan are both open. The box earns 0 of 4.

Missing

The cash beside the debt

A $24,000 taxable brokerage account and a $42,000 whole life surrender value sit in the same file. The traced fix in the prescription is built from those balances.

Partial

What They Did Right

A workup band on a $220,000 income with these accounts is a systems problem, not an effort problem. This is what was done right.

Protection bought, not postponed

Term life at $1,250,000, disability at $7,300 a month, an umbrella, and estate documents, all in place while the children are young. The life box earns the full 4.

Retirement accounts funded at scale

Two 401a accounts hold $160,000 between them and the 403b holds $43,000, with 9 percent of salary still flowing in, about $19,500 a year.

College saving started early

Two 529 accounts hold $22,000 and $13,000, with $500 a month still going in, for children ages seven and four.

A modest mortgage on a 15 year term

$308,000 at 2.75 percent over 15 years on a $220,000 income. The Debt Anchor earns 5 of 10 with the student loans counted in.

Goals written down as a household

Retirement and emergency savings, debt payoff, college, and a beach house, stated as four shared goals. The Decision Filter earns the full 4.

The Missing $4,000 a Month

The first deep dive is the arithmetic that does not close. Take home pay is about $160,000 a year, about $13,300 a month. The intake itemizes the outflows: a $2,600 mortgage, about $635 of student loan payments, the car loan, the insurance lines, preschool, taekwondo, cleaning, food at about $800, and the rest. It also states the saving: the 403b off payroll, $500 to the 529s, $600 to whole life, $500 to savings.

Add the stated list up the way the hosts did and over $4,000 a month is left over with no stated destination, about a third of take home pay.

Cash flow accounting comes first. Every other answer waits on it.

The number matters because every stated goal runs through it. Building emergency savings is goal one, and the emergency fund amount is not stated anywhere in the file. Paying off debt is goal two. College is goal three. A household cannot route $4,000 it cannot find, and until the routing exists, each goal is funded at whatever is left over.

Card Debt Beside a Taxable Account

The second deep dive is the debt the household could close this month. About $8,000 of credit card debt, with a stated plan to pay it off by the end of June, and a $5,500 auto loan being paid at $500 to $1,000 a month. In the same file: a $24,000 taxable brokerage account, and a whole life policy whose surrender value is $42,000.

The hosts' illustration put the card debt ahead of the taxable account. A taxable account held beside card debt is money working at market returns while a balance compounds against the household at card rates. The same dollars, routed through the debt first, close the emergency and then free the $500 to $1,000 a month the car loan was taking.

The emergency is not the balance. The emergency is carrying it beside the money that clears it.

The IRA point rides with it. The stated IRA balance is $3,300, in a household where both spouses could be funding IRAs every year. Tax advantaged room expires every year. The taxable account does not.

The whole life policy is the slower conversation, and the hosts kept it in that order. The policy costs $3,600 a year for $750,000 on top of the term cover, and shows $53,500 of cash value against a $42,000 surrender value. Their rule: replacement coverage in place first, and only then a decision about the policy and where its surrender value goes. The traced prescription uses those balances on paper. Nothing in it requires selling anything before the coverage question is answered.

Milestones: Scored on What Is Stated

Inside the 3-Bucket Framework, the milestone checklist tracks the markers an established household has already hit. This checklist earns 0 for Archie and Aimee, 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 because its amount is not stated, named lanes earn 0 because a third of take home pay sorts into no lane at all, and goals funded earns 3 of 6. The framework earns 3 of 20, and it is the bucket framework failing on accounting rather than on effort.

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The Prescription

One traced fix, and the open items behind it.

1

Clear the credit card debt and the auto loan with money already in the file.

This is the Transition framework, and it gains 4 points, moving cards and other debt from 0 to 4. The hosts illustrated it with the household's own balances: the taxable account or the $42,000 whole life surrender value clears the $8,000 card balance and the $5,500 auto loan, leaving no consumer or vehicle debt outside the mortgage.

2

Account for the missing $4,000 a month.

No point gain is traced for this item in the target basis, and the hosts put it first anyway: until the third of take home pay with no stated destination is routed, no other goal in the file can be funded on purpose.

3

Fund both IRAs every year.

The stated IRA balance is $3,300. An IRA for each spouse, every year, is low cost room that expires annually. No point gain is traced for this item.

4

Review the whole life policy after replacement coverage is in place.

The order matters: replacement cover in force first, then the decision about the $750,000 policy and its $42,000 surrender value. No point gain is traced for this item.

Run the traced fix and the arithmetic is 32 plus 4, a score of 36. A score of 36 out of 100 keeps the household in the Needs a workup band. The fix closes the debt box. The leak is what moves this score next, and it carries no traced points because the record cannot price money it cannot find.

What This Case Teaches

Funded accounts are not a funded plan. This household holds $318,800 across its stated accounts, bought its protection early, and wrote its goals down. The score still lands at 32, because a third of take home pay moves every month with no stated destination, and consumer debt rides beside the cash that could clear it. The plan layer, routing, is the layer that was never built.

Households often already hold the fix. It is sitting in the wrong account.

The second lesson is the ordering. The traced fix does not ask for new money. It asks for the money already in the file to change jobs: out of a taxable account and a surrender value, against a card balance and a car loan. Households often already hold the fix. It is sitting in the wrong account.

Questions this case answers

What score did Archie and Aimee receive on the Financial Health Assessment?

Archie and Aimee scored 32 out of 100, in the Needs a workup band. The Decision Filter earns the full 4 of 4, while the Transition framework earns 0 of 10 and the Tax Ladder 0 of 8.

Where does the unaccounted $4,000 a month go?

The record does not say, and that is the finding. The stated expenses and stated saving leave over $4,000 a month of take home pay with no stated destination, about a third of it, on the hosts' calculation.

Why is the credit card debt treated as the emergency?

About $8,000 of card debt and a $5,500 auto loan sit beside a $24,000 taxable brokerage account and a whole life surrender value of $42,000. The hosts' order was debt first: the same dollars clear the emergency, then free the car payment for other goals.

What do the fixes do to Archie and Aimee's score?

The traced fix is worth 4 points: clear the card and auto debt and the arithmetic is 32 plus 4, a score of 36. A score of 36 out of 100 keeps the household in the Needs a workup band. The accounting fix behind it carries no traced points.

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 household's statement was read on air by a proxy reader, because the couple asked to stay anonymous.

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: the student loan strategy, and the state of cards and other debt.

Written by Ryan Inman, MBA, MAFM. Last updated October 2026.

About

Ryan Inman is a retired financial planner who worked with about 500 physician families. He created the Financial Residency podcast (about 3 million downloads) and is no longer affiliated with it. Financial Fellowship is his sole focus. This guide is educational. Last updated October 2026.

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