Financial Health Assessment
Arthur: Hematology Household Scores 27 Out of 100
By Ryan Inman
Published · Updated
HematologyNew attending · In his first yearCouple, one daughter, second child on the way
Financial Health Assessment score
27 out of 100
Needs a workup
- 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. Arthur lands at 27, in the Needs a workup band, score 0 to 39.
Arthur is a hematologist in his first attending job, an academic post in the New York City area started in July, on a base salary of $230,000, with survey income of $10,000 to $15,000 and an expected bonus of $30,000 to $50,000. His wife is a behavior analyst and part owner of her company, earning $125,000 as a 1099. The household earns about $395,000 at the stated low ends, with a daughter of three and a second child on the way. The assessment scores the household 27 out of 100, in the Needs a workup band.
The house runs the budget. Fixed expenses total about $12,600 a month, led by a housing payment of $8,160 including HOA fees, homeowners insurance and escrowed taxes, and variable spending adds about $3,000. Cash stands at about $50,000 across three bank accounts, about 3.2 months of the stated spending. A Fidelity brokerage account of $65,000, all in stocks, is described as a sort of emergency fund.
The bright lines are one executed decision and one earner's cover. Arthur is seven years into PSLF on $290,000 of loans, with the paperwork filed, and he holds about $2,000,000 of term life and an individual disability policy. Against that: the mortgage balance is not stated, so total debt cannot be computed. His wife's disability and life cover are not stated. The umbrella amount is not stated, and the estate documents are not itemized. The traced path runs from 27 to a target of 30, on one habit, and the prescription section shows it.
$8,160
Housing payment per month · about 42 percent of take home
$50,000
Cash on hand · about 3.2 months of stated spending
$290,000
His student debt · seven years into PSLF
About $395,000
Household income · at the stated low ends
$2,000 to $3,000
Stated saving per month · after retirement contributions
About $50,000
Cash · across three bank accounts
The short version
- The score: 27 out of 100, in the Needs a workup band. The Transition framework earns 6 of 10 and the Protection Stack 6 of 22, while the Physician Wealth Equation earns 0 of 14.
- The housing payment is $8,160 a month, about 41 to 42 percent of take home pay on the hosts' math. On the hosts' math, affording that payment comfortably wants about two and a half times the salary in income.
- The emergency fund goal is $200,000 to $300,000 against about $50,000 of cash. At $3,000 a month the goal takes about 100 months to build. The hosts priced three months of take home at about $60,000.
- His cover is real: about $2,000,000 of individual term life across two policies plus $140,000 through work, and an individual disability policy paying $7,500 a month. Her disability and life cover are not stated, and the umbrella amount is not stated.
- The traced path to 30 is one habit: track the spending with a budget tool for six to twelve months, the hosts' named fix, until the unaccounted money is identified (+3).
A $200,000 emergency fund, built $3,000 at a time.
What They Did Right
A first attending year with the loan decision already executed. This is the machinery already running.
- PSLF, executed and documented Seven years into income based repayment on $290,000, paperwork filed, payments resuming at $350 a month. The loan call grades at the full 6.
- Individual cover on the physician About $2,000,000 of term life across two individual policies, and an individual disability policy with a future insurability option.
- Cash in place while new About $50,000 across three accounts in the first attending months, about 3.2 months of stated spending, with a second child on the way.
- No credit card debt A lease and two student loans stand in the file, and the card line states no carried debt at all.
- Five goals, stated A fund target, a college path, a home for the monthly saving, a $55,000 improvement fund and a vacation home. The Decision Filter grades the list at full marks. The fight is funding order.
The Score: 27 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Arthur scores 27, in the Needs a workup band. This household is scored on the attending rubric, on the new attending fork of the Transition framework.
20
Measures graded
7
Frameworks
27
Arthur's score
The 3 Bucket Framework earns 7 of 20. Milestones earn 0, because the milestone net cannot be determined from what the intake states. The emergency fund earns 2: about $50,000 of cash against stated spending of about $15,600 a month is about 3.2 months. Named lanes earn 2, on three bank accounts and a brokerage account that sort the money, with no full lane system stated. Goals funded earns 3, with dollars aimed at every goal area while the stated emergency fund goal of $200,000 to $300,000 sits far past the stated saving flow, so goals are not fully funded.
The Physician Wealth Equation earns 0 of 14. The Debt Anchor earns 0: the mortgage balance is not stated, so total debt cannot be computed and the anchor cannot be graded. Stretch saving earns 0: stated saving of about 6 to 9 percent of income sits below the 12 percent partial line on the stated flow alone.
The Protection Stack earns 6 of 22. Health earns 0, because household cover is not stated. Disability earns 2: an individual policy stands on Arthur, its own occupation status is not stated, and his wife's disability cover is not stated. Life earns the full 4, on individual term in force on Arthur. Umbrella earns 0, because the policy amount is not stated. Malpractice earns 0, type and tail not stated. Estate documents earn 0: planning is under way, the set is not finalized, and the documents are not itemized.
The Transition framework, on the new attending fork, earns 6 of 10. The loan call earns the full 6: a deliberate PSLF decision, executed and kept current, seven years of income based repayment with the paperwork filed on $290,000 at 6.75 percent. Contract clarity earns 0, because a contract or compensation review is not stated.
The Tax Ladder earns 2 of 8: pre tax 403b saving with a Roth decision still pending earns 2, with no bracket reason stated, and bracket plus deliberate moves earns 0, with no deliberate move stated. The Decision Filter earns the full 4 of 4 on five stated goals.
The Lifestyle Guardrails earn 2 of 22. The Savings Floor earns 0, on a stated rate of about 6 to 9 percent. The leak earns 0: the unaccounted share of spending is not stated. Wealth first automation earns 2: the 403b deferrals run through payroll, and the record grades the automation partial.
| Framework | What it covers | Points |
|---|---|---|
| 02 3 Bucket Framework | Milestones 0, emergency fund 2 at about 3.2 months, named lanes 2, goals funded 3 | 7 of 20 |
| 03 Physician Wealth Equation | Debt anchor 0, mortgage balance not stated. Stretch saving 0 at about 6 to 9 percent | 0 of 14 |
| 04 Protection Stack | Health 0 (not stated), disability 2, life 4, umbrella 0, malpractice 0, estate documents 0 | 6 of 22 |
| 05 Transition | Loan call 6, PSLF path executed and documented. Contract clarity 0, review not stated | 6 of 10 |
| 06 Tax Ladder | Roth against pre tax 2, bracket plus moves 0 | 2 of 8 |
| 07 Decision Filter | Goals written 4, five goals stated | 4 of 4 |
| 08 Lifestyle Guardrails | Savings floor 0, the leak 0, wealth first automation 2 | 2 of 22 |
| Total | Needs a workup band | 27 out of 100 |
Read the shape, not just the total. The bottom of this file is arithmetic, not character: a housing payment at about 42 percent of take home pay sets the savings rate before any habit gets a vote, an anchor that cannot be computed because one balance went unstated, and a leak nobody has measured yet. The top of the file is one executed decision, the PSLF path, and cover bought on the physician. A new attending file is a starting line, and this one states its own first fix.
The Prescription
The traced fix first, then the open items the record carries without a gain.
- Track every dollar for six to twelve months. The hosts named the fix on the episode: a budget tool, run long enough for every dollar to have one job. When the unaccounted share of spending is identified, the leak box moves from 0 to its partial pattern. (+3 points when the unaccounted money is identified.)
- Reprice the emergency fund goal. Three months of take home pay is about $60,000 and six months about $120,000 on the hosts' math. A goal the flow can reach frees the college path and the improvement fund behind it. No points are claimed for this step. The fund box grades months of cash on hand, not the size of the goal.
- Put her retirement saving on rails. A solo 401k for the 1099 income comes before taxable saving in the hosts' order, after the maxed 403b and the IRA decision. No points are claimed for this step in the record's basis.
- Finish the estate documents and state the missing lines. The documents are expected shortly. A guardian for two minor children belongs in them. Her disability and life cover, the umbrella amount, the mortgage balance and the household health cover are all unstated today. No points are claimed for this step. The record traces the target through step 1 only.
The traced path runs 27 to 30 on one step: plus 3 when the spending is tracked and the unaccounted money is identified. The rest of this file's work, repricing the fund goal, routing her 1099 income into a solo 401k, and stating the missing lines, is real work with no traced gain in the record's basis, and it is listed as such rather than dressed up as points. The target is 30, stated with its arithmetic.
What This Case Teaches
A goal can be the problem. The first goal in this file is an emergency fund of $200,000 to $300,000, and priced against the household's own take home pay it is roughly ten months of take home pay, about 100 months of saving at the stated flow. A goal that size does not sit on the list. It sits far past the stated flow. Sizing a goal is part of the plan, and the hosts' three month and six month frames are the sizing tool.
A goal the flow cannot reach is a wish.
The second lesson is what an unstated balance does. One missing figure, the mortgage balance, zeroes the Debt Anchor without the debt being graded at all, and it leaves total household debt uncomputable. An assessment can only grade what is stated, which is why these pages carry not stated as a finding rather than filling the gap with an estimate.
Behind the score
The Household
Arthur is 33 and his wife is 31, married almost seven years. He started the hematology job in July. She works as a behavior analyst and part owner of her company. They recently bought a home in a New York City suburb, a high cost of living area, and a part time nanny is planned at about $1,500 a month when the second child arrives.
The stated fixed expenses total about $12,600 a month and include the $8,160 housing payment, a car lease at $280 with about $10,000 left to run, car insurance at $212, cable, internet and phone at $190, electric at about $260, water at $75, an umbrella premium at $28, disability premiums at $150, about $80 for the term life, and subscriptions at $85. Variable spending adds about $3,000 a month, for stated spending of about $15,600 a month. Cash stands at about $50,000: about $30,000 in a TD checking account, about $10,000 in TD savings, and about $10,000 in a KeyBank checking account.
Retirement saving runs through his job and her old accounts. His 403b holds $61,000 and is being maxed, and a 457b becomes available later. Her 401k holds about $80,000 and her Roth IRA about $25,000, and she is not currently contributing to a retirement plan. An IRA or backdoor Roth decision is open, and the hosts pressed a solo 401k for her 1099 income. The household states saving of $2,000 to $3,000 a month after retirement contributions, about 6 to 9 percent of income.
His student debt is $290,000, consolidated at 6.75 percent on income based repayment for PSLF, seven years in with the paperwork filed, and payments resuming at $350 a month. Her student debt is $30,000 at 6.9 percent, with a refinance in progress toward about $350 a month over seven to ten years at 3.25 percent. The mortgage balance is not stated anywhere in the intake, so total household debt cannot be computed. A gas conversion of about $15,000 is priced and not yet started, with an option of $600 a month over 25 months at no interest. No credit card debt is stated.
His protection is bought. Hers is not stated. His term life is $1,500,000 for 20 years and $500,000 for 25 years, with $140,000 more through work. His disability is an individual MassMutual policy paying $7,500 a month with a future insurability option, plus employer coverage. Own occupation status is not stated. His wife's disability and life cover are not stated. An umbrella policy stands at $28 a month, and its amount is not stated. Household health cover is not stated, and malpractice type and tail are not stated. Estate planning is under way and expected to be finalized shortly, the documents are not itemized, and no guardian is stated for two minor children.
| Household fact | Where it stands |
|---|---|
| Careers | Hematologist, new attending in an academic post started in July. Behavior analyst and part owner of her company |
| Household income | About $395,000 at the stated low ends: base $230,000, survey income $10,000 to $15,000, expected bonus $30,000 to $50,000, plus $125,000 as a 1099 |
| Family | Couple, daughter age three, second child on the way |
| Housing | Payment $8,160 a month including HOA fees, insurance and escrowed taxes. Mortgage balance not stated |
| Student loans | His $290,000 at 6.75 percent, income based repayment for PSLF, seven years in, payments resuming at $350 a month. Hers $30,000 at 6.9 percent, refinance in progress |
| Other debt | Car lease $280 a month with about $10,000 left. Gas conversion about $15,000 priced and not started. No credit card debt stated |
| Emergency fund | About $50,000 of cash, about 3.2 months of stated spending of about $15,600 a month. Stated goal $200,000 to $300,000 |
| Saving | Stated $2,000 to $3,000 a month after retirement contributions, about 6 to 9 percent of income |
| Balances | 403b $61,000. Her 401k about $80,000. Her Roth IRA about $25,000. Fidelity brokerage $65,000, all in stocks |
| Disability | Arthur: individual MassMutual policy, $7,500 a month benefit with a future insurability option, plus employer cover. Own occupation status not stated. His wife: not stated |
| Life insurance | Arthur $1,500,000 for 20 years plus $500,000 for 25 years plus $140,000 through work. His wife: not stated |
| Umbrella | Policy in place at $28 a month. Amount not stated |
| Estate documents | Planning under way, expected to be finalized shortly. Documents not itemized. No guardian stated |
| 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 Protection Stack, which scores 6 of 22 on one earner's bought cover, and the 3 Bucket Framework, which scores 7 of 20 with every box partial or empty.
Framework one
The Protection Stack
The Protection Stack grades the coverage that keeps one bad month from ending the plan. One earner is covered like an attending. The other earner's lines are not stated at all.
- Life, in force on Arthur Built
- Individual term of $1,500,000 for 20 years and $500,000 for 25 years, plus $140,000 through work. The box earns the full 4.
- Disability, individual on Arthur only Partial
- A MassMutual policy paying $7,500 a month with a future insurability option, plus employer cover. Own occupation status is not stated, and his wife's disability cover is not stated. The box earns 2 of 4.
- Umbrella and estate, open Missing
- An umbrella policy stands at $28 a month with its amount not stated, and the estate documents are not finalized or itemized, with no guardian stated. Each box earns 0.
Framework two
The 3 Bucket Framework
The 3 Bucket Framework grades the cash system: milestones, the cash buffer, the lanes the money sorts into, and whether the goals are funded. In a first attending year, every box here is a start rather than a finish.
- The cash buffer Partial
- About $50,000 across three bank accounts, about 3.2 months of stated spending. The box earns 2 of 4.
- Named lanes Partial
- Three bank accounts and a brokerage account sort the money. No full lane system is stated. The box earns 2 of 4.
- Milestones and goals funded Partial
- The milestone net cannot be determined from the intake, so milestones earn 0. Dollars are aimed at every goal area, with the $200,000 to $300,000 fund goal far past the stated flow, so goals funded earns 3 of 6.
The House Payment Is the Budget
The first look is the payment. The housing line is $8,160 a month, including HOA fees, homeowners insurance and escrowed taxes. On the hosts' math, take home pay runs about $20,000 a month in a full month, which puts the payment at about 41 to 42 percent of it. On the hosts' math, affording that payment comfortably wants roughly two and a half times the salary in income.
The payment explains the rest of the file. Stated saving of $2,000 to $3,000 a month after retirement contributions is about 6 to 9 percent of income, which is why the Savings Floor and the stretch box both earn 0. The goals stated beside it, a $200,000 to $300,000 emergency fund, a college path, a $55,000 home improvement fund and a vacation home in five to ten years, all queue behind the same $8,160.
The house payment is $8,160. The goals line up behind it.
The mortgage balance itself is not stated anywhere in the intake, which is its own finding. Total household debt cannot be computed, so the Debt Anchor earns 0 without being graded at all: the box pays for a stated balance sheet, and this file does not state one.
None of this is hidden from the household. The intake states the payment, the percentages are arithmetic, and the hosts' advice was to give every dollar one job. The house is bought. The work now is sequencing everything else around a fixed $8,160 first claim.
A $200,000 Cushion, Priced Out
The second look is the first stated goal: an emergency fund of $200,000 to $300,000, against about $50,000 of cash today. The hosts priced the goal against the household's own numbers. Three months of take home pay is about $60,000, six months about $120,000, and both figures sit far under the stated target. At $3,000 a month of saving, the stated goal takes about 100 months to reach.
An oversized first goal starves the rest of the list. Separately, the wife's retirement saving is not running: she is not contributing to a plan today, on $125,000 of 1099 income the hosts wanted routed to a solo 401k before taxable saving.
Three months of this household is about $60,000. The goal says $200,000.
The brokerage account belongs in this picture. $65,000 at Fidelity, all in stocks, described as a sort of emergency fund. The hosts' point was about fit: a household that feels over leveraged holding an all stock account is telling on its own risk tolerance.
The traced fix in this file is not the fund size. It is the tracking. The record's prescription is the hosts' own: run a budget tool for six to twelve months until every dollar has one job and the unaccounted share is identified. That step, and only that step, traces points.
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 Arthur, 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 2 at about 3.2 stated months, named lanes earn 2 on accounts that sort the money without a stated lane system, and goals funded earns 3 of 6 on aims that reach every goal area below the stated target pace. The framework earns 7 of 20.
Questions this case answers
What score did Arthur receive on the Financial Health Assessment?
Arthur scored 27 out of 100, in the Needs a workup band. The Transition framework earns 6 of 10 and the Protection Stack 6 of 22, while the Physician Wealth Equation earns 0 of 14.
Why does the Physician Wealth Equation earn zero?
Both of its boxes earn 0. The Debt Anchor cannot be graded because the mortgage balance is not stated, so total debt cannot be computed. Stretch saving earns 0 because the stated saving of about 6 to 9 percent of income sits below the 12 percent partial line on the stated flow alone.
Is a $200,000 to $300,000 emergency fund the right goal?
On the hosts' math, three months of this household's take home pay is about $60,000 and six months is about $120,000. The fund holds about $50,000 today, about 3.2 months of stated spending. At $3,000 a month, the stated goal takes about 100 months to build, which is why the hosts pointed at the three month and six month frames.
What is missing for Arthur?
The mortgage balance is not stated, so total debt cannot be computed. Household health cover, malpractice type and tail, the umbrella amount, and his wife's disability and life cover are not stated. The estate documents are not itemized, and no guardian is stated for two minor children.
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.