Lisa and Mark
Financial Health Assessment · OB/GYN case
Lisa, 41, is an OB/GYN eight years into attending practice. Mark, 43, is an attorney. Their household earns about $550,000 in a large Southeast metro, and the assessment scores them 57 out of 100, in the Corrections band.
Eight years in, the education debt is gone. An individual own occupation disability policy and a $2,000,000 term policy are in force, and the credit cards clear in full every month.
The savings engine has not started. Saving runs at about 12 percent with only the 401(k) automated, spending is not tracked, and three written goals carry no numbers, dates, or dollars. Five fixes take the score to a 73, into the Stable band.
Financial Health Assessment score
57 / 100
CorrectionsThe score grades the household on 20 measures across seven frameworks. Lisa and Mark land at 57, in the Corrections band, score 40 to 69.
Key takeaways
- The score: 57 out of 100, in the Corrections band, and the shape is the story. The Protection Stack earns 18 of 22, while the 3-Bucket Framework earns 3 of 20.
- The debt side is finished work. The student loans are paid off, and about $800,000 of mortgage debt against about $550,000 of income is a debt anchor of about 1.45 times, full marks on the established line.
- Protection is nearly complete. Lisa holds an individual own occupation disability policy, a $2,000,000 20 year term policy is in force, the whole household is covered on employer health plans, and malpractice is an occurrence policy.
- The savings engine idles. About 12 percent goes in, about $66,000 a year, and only the 401(k) contribution is automated. Past the 401(k), nothing else moves on its own.
- Five fixes move the score 16 points to a 73: automate 20 percent on payday, build the emergency fund to three months, track spending for ninety days, write the goals with numbers and dates, and fund them so money flows to each one every month.
Most of the 57 points come from debt and protection.
The Household
Lisa is 41 and an OB/GYN, eight years into attending practice, earning about $370,000. Mark is 43 and an attorney, earning about $180,000. They have been married twelve years, they have two kids, 8 and 5, and they live in a large metro area in the Southeast.
The student loans are paid off, and the credit cards clear in full every month. The only debt is the mortgage: about $800,000 on a home worth about $1,200,000, against about $550,000 of household income.
Eight years in, the loans are gone and the wealth still is not compounding.
Investable assets are about $400,000. The emergency fund is about $25,000, about one month of expenses. Saving runs at about 12 percent, about $66,000 a year, and only the 401(k) contribution is automated, out of the paycheck.
Past the 401(k), nothing else is automated, and spending is not tracked month to month. Three goals are written down, retire at 60, the kids' college, and pay off the house, with no numbers or dates on any of them, and no money flowing to them.
Protection is the strong side. Employer health plans cover all four of them, Lisa holds an individual own occupation disability policy, and a $2,000,000 20 year term policy is in force. The umbrella is $1,000,000, malpractice is an occurrence policy through her employer, and signed wills are in place, with no power of attorney and no healthcare directive.
| Careers | OB/GYN, 8 years attending, and attorney |
|---|---|
| Ages | 41 and 43 |
| Household income | About $550,000 a year, about $370,000 plus about $180,000 |
| Where they live | Large Southeast metro |
| Family | Married 12 years, two kids, ages 8 and 5 |
| Student loans | Paid off |
| Other debt | None; credit cards paid in full monthly |
| Mortgage | About $800,000 on a home worth about $1,200,000 |
| Emergency fund | About $25,000, about 1 month |
| Investable | About $400,000 |
| Saving | About 12 percent, about $66,000 a year; 401(k) automated |
| Spending | Not tracked |
| Taxes | One deliberate move, maxing the 401(k); pre tax by default at sign up |
| Disability | Individual own occupation policy in force, Lisa's only |
| Life insurance | $2,000,000 20 year term, in force |
| Umbrella | $1,000,000 against about $1,600,000 of total assets |
| Malpractice | Occurrence policy through her employer |
| Estate documents | Wills signed; no power of attorney, no healthcare directive |
| Goals | Three written, no numbers or dates, none funded |
The Score: 57 out of 100
The Financial Health Assessment grades a household across the same seven frameworks and lands the total in a band. Lisa and Mark score 57, in the Corrections band. This household is scored on the attending rubric, established fork.
The Protection Stack earns 18 of 22: health, disability, life, and malpractice at full marks, with umbrella and estate documents at 2 each. The Transition framework earns the full 10 of 10, on education debt finished and no lingering consumer or vehicle debt.
The Physician Wealth Equation earns 12 of 14. The Debt Anchor earns the full 10 at about 1.45 times income, under the established line of 2.0 times. Stretch saving earns 2: at about 12 percent with under $1,000,000 invested, the partial line is where this household sits.
The 3-Bucket Framework earns 3 of 20, all of it from milestones at a net of 4. The Tax Ladder earns 4 of 8, the Decision Filter 2 of 4 on three written goals, and the Lifestyle Guardrails 8 of 22, where the untracked leak earns 0.
| Framework | What earned what | Score |
|---|---|---|
| 02 · 3-Bucket Framework | Milestones 3, emergency fund 0, named lanes 0, goals funded 0 | 3 of 20 |
| 03 · Physician Wealth Equation | Debt Anchor 10 at about 1.45 times income, stretch saving 2 at about 12 percent | 12 of 14 |
| 04 · Protection Stack | Health 4, disability 4, life 4, umbrella 2, malpractice 2, estate documents 2 | 18 of 22 |
| 05 · Transition | Education debt finished 6, no lingering consumer or vehicle debt 4 | 10 of 10 |
| 06 · Tax Ladder | Roth against pre tax 2, bracket plus moves 2 | 4 of 8 |
| 07 · Decision Filter | Goals written 2, three goals on paper, no numbers or dates | 2 of 4 |
| 08 · Lifestyle Guardrails | Savings floor 6, the leak 0, wealth first automation 2 | 8 of 22 |
| Total | Corrections band | 57 out of 100 |
The points this household earned sit in finished work: the loans gone, the stack built, the anchor light. The five fixes go after the savings rate, the reserve, and goals with no dollars behind them.
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 earns 12 of 14 while a slow savings pace wastes a light anchor, and the 3-Bucket Framework, which earns 3 of 20 because the buckets exist in name only.
Framework one
The Physician Wealth Equation
Five forces act on every physician household: a late start, a debt anchor, a high income, a compressed window, and complexity that multiplies the leaks. This household's anchor is light and its income is high, and the framework earns 12 of 14 at a savings pace of about 12 percent.
The Debt Anchor, full marks
Total debt of about $800,000, the mortgage, against about $550,000 of income is about 1.45 times. Under the established line of 2.0 times, the box earns the full 10 of 10.
Stretch saving, a slow pace
At about 12 percent the household saves about $66,000 a year. At 20 percent it would save about $110,000, a gap of about $44,000 a year across the nineteen years left before Lisa turns 60. The box earns 2 of 4.
The window and the start
The first attending paycheck arrived in Lisa's early thirties, and nothing buys that decade back. A dollar invested at 41 has nineteen years to compound before 60. The same dollar at 50 has ten.
Framework two
The 3-Bucket Framework
Every dollar gets a job, in three buckets: the Safety Net, the Wealth Engine, and the Accelerator. Asked to sort their dollars into buckets, Lisa could do some of it, and the framework earns 3 of 20.
The Safety Net
The emergency fund is about $25,000, about one month of expenses. At 0 to 2 months the box earns 0 of 4. Three months, the starting target, is about $75,000.
Named lanes
Some dollars sort into buckets and the rest do not, which sits below the rubric's most line. With the lanes unnamed, the box earns 0 of 4.
Goals funded
Three goals are written down, and none of them has money flowing to it. Goals on paper with nothing behind them earn 0 of 6.
What They Did Right
A 57 eight years in has finished work under it. This is what is already built.
The student loans are gone
Education debt finished earns the full 6 on the established Transition box, and no consumer or vehicle debt lingers behind it. The whole Transition framework lands at a full 10 of 10.
The Protection Stack is nearly complete
Health, disability, life, and malpractice all earn full marks: employer coverage for all four of them, Lisa's individual own occupation policy, $2,000,000 of term in force, and occurrence malpractice.
The Debt Anchor is light
About $800,000 of debt, all of it the mortgage, on about $550,000 of income is about 1.45 times, well under the established line of 2.0 times. The anchor earns the full 10 of 10.
One deliberate tax move
Maxing the 401(k) is a tax move the household makes on purpose, and one deliberate move earns the partial on the Tax Ladder. The contributions run pre tax, the lane picked at sign up and still held.
Milestones net positive
On the 12 item checklist, five positives against one negative net to 4, earning 3 of the 6 milestone points. The foundation habits are on the board. The systems around them are the prescription.
A Light Anchor, an Idle Engine
The first deep dive is the Physician Wealth Equation, and the finding is pace. Eight years of attending income, a household at about $550,000 a year, about $400,000 invested, and about 12 percent going in. The foundation is clean. The compounding still has not started in earnest.
Start with the anchor, because it is not the problem. The student loans are done, the mortgage sits at about 1.45 times income, and the Debt Anchor earns full marks. The late start is the second force: a decade of compounding is gone, and nothing buys it back.
Time is the only force that works for them, and it is worth the most right now.
The accelerator is the fuel: $550,000 a year of high income. At 12 percent, about $66,000 a year goes to work. At 20 percent it would be about $110,000, a difference of about $44,000 a year, and across nineteen years that gap is about $836,000 more going in before a dollar of growth.
The window is compressed. Lisa is 41, and the plan runs to 60, so a dollar invested today has nineteen years to compound. The same dollar invested at 50 has ten. Every year at 12 percent closes a year of that window for good.
Complexity is the fifth force: two careers, two kids, and a big house multiply the places money can leak untracked. The fix for the whole framework is one move: automate 20 percent on payday, and let the accelerator do the work.
Buckets in Name Only
The second deep dive is the 3-Bucket Framework, and the finding is where the money goes. About $550,000 comes in. One month of expenses sits in the emergency fund. Spending is not tracked. Three goals are written with no dollars behind them, and asked whether the dollars could be sorted, Lisa could do some of it.
The Safety Net is cash, there so a surprise, a job change, or a new roof does not turn into credit card debt or a forced sale at a bad time. This show wants three months of expenses to start, about $75,000 at roughly $25,000 a month of spending. This household holds about one month.
When all three buckets work, the money stops competing with the month.
The Wealth Engine is the long term money, left alone for decades. The 401(k) lives here. The Accelerator is money aimed at goals with a number and a date, like college or paying off the house. In this house, the Accelerator is empty.
The leak is unmeasured. Nobody tracks spending month to month, so nobody can say how much of the $550,000 goes somewhere the couple would choose on purpose. The look back comes first, because it sizes the Safety Net honestly.
The fix runs in order. Build the Safety Net to three months with an automatic transfer of about $4,200 a month, track spending for ninety days without cutting anything yet, then give the goals numbers, dates, and money flowing to them.
Milestones: A Net of Four
Inside the 3-Bucket Framework, the milestone checklist is where an established household shows its momentum. Lisa and Mark net 4 on the checklist, five positives against one negative. On the attending scale, a net of 3 to 4 earns 3 of the 6 milestone points, and a net of 5 or more would earn the full 6.
The rest of the bucket picture sits around that net. The emergency fund, about $25,000 at about one month, earns 0. Some dollars sort into lanes and the rest do not, so named lanes earn 0. Nothing flows to the written goals, so goals funded earns 0 as well.
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The Prescription
Five moves, in priority order.
Automate 20 percent on payday.
This is the Lifestyle Guardrails, and it gains 6 points, moving the Savings Floor from 6 to 12. Twenty percent of about $550,000 is about $110,000 a year, the household already saves about $66,000 a year, and the gap is about $44,000 a year, roughly $3,700 a month.
Set it up so the money moves the day the paycheck lands, before anyone sees it in checking. When a raise comes, the dollar amount rises with the rate.
Build the emergency fund to three months.
This is the 3-Bucket Framework, the Safety Net, and it gains 2 points, moving the emergency fund from 0 to 2. Three months at about $25,000 a month of spending is about $75,000, and the household holds about $25,000, so the gap is about $50,000.
A separate automatic transfer of about $4,200 a month into a high yield savings account closes the gap in a year. Once the fund lands, that same transfer rolls into the goals.
Track spending for ninety days.
This is the Lifestyle Guardrails, and it gains 3 points, moving the leak from 0 to 3. Right now there is no way to know how much of the $550,000 goes somewhere the couple would choose on purpose.
Pull every account and every card and categorize three months. Cut nothing yet. The look back sizes the Safety Net honestly.
Write four or more goals with dollar amounts and dates.
This is the Decision Filter, and it gains 2 points, moving goals written from 2 to 4. The filter checks money decisions against stated goals, and it cannot do that when a goal has no number.
Retire at 60 needs a number. College needs one for each kid, and the house payoff needs a year. A fourth goal counts too: the Safety Net at $75,000 by next September is one.
Fund the goals.
This is the 3-Bucket Framework, and it gains 3 points, moving goals funded from 0 to 3. Once the goals carry numbers, each one divides by the months left, and that quotient is the monthly transfer.
College gets its own account with its own automatic contribution, and the house payoff gets a number and a date. Once the transfers are automatic, the goals stop competing with the month.
Run all five and the arithmetic is 57 plus 16, a score of 73. The gains are 6 for the payday rate, 2 for the emergency fund, 3 for tracking, 2 for goals written, and 3 for goals funded. A score of 73 out of 100 moves Lisa and Mark into the Stable band.
What This Case Teaches
The debt and protection carried this file. Lisa and Mark killed the student loans, built the protection stack, and kept the anchor light, and that finished work is most of the 57. The lesson of this case is that compounding starts with the rate, the reserve, and the goals, and none of the three has started yet.
The 401(k) runs itself. Everything else waits for the end of the month.
The second lesson is about payday. The 401(k) is automated, and everything past it waits for the end of the month, so the household's biggest decision, how much to save, gets made by whatever the month happened to cost. Payday automation moves that decision to the front of the month, where it belongs.
Questions this case answers
What score did Lisa and Mark receive on the Financial Health Assessment?
Lisa and Mark scored 57 out of 100, in the Corrections band. The Protection Stack earns 18 of 22 and the Attending Transition Blueprint a full 10 of 10, while the 3-Bucket Framework earns 3 of 20 and the Lifestyle Guardrails earn 8 of 22.
How can a household earning about $550,000 score 57?
Most of the 57 points come from debt and protection. The student loans are paid off, an individual own occupation disability policy and a $2 million term policy are in force, and the cards clear every month. But saving runs at about 12 percent with only the 401(k) automated, the emergency fund holds about one month of expenses, spending is not tracked, and three written goals carry no numbers, dates, or dollars.
What is the household's debt position?
The only debt is the mortgage, about $800,000 on a home worth about $1,200,000. Against household income of about $550,000 that is about 1.45 times income, well under the established attending line of 2.0 times. The Debt Anchor earns full points.
What is the first prescription move?
Automate 20 percent on payday. At about 12 percent the household saves about $66,000 a year. At 20 percent it would save about $110,000, a gap of about $44,000 a year across the nineteen years left before Lisa turns 60. The move earns 6 points on the Savings Floor by itself.
What would raise Lisa and Mark's score to 73?
Five moves add 16 points and reach the Stable band. Automate 20 percent on payday. Build the emergency fund to three months, about $75,000. Track spending for ninety days until the unaccounted share is under 3 percent. Write four or more goals with dollar amounts and dates. Fund the goals so money flows to each one every month.
Sources and Basis
This assessment is built from the household's record in the show's year end case bank: the build brief, the episode script, and the OB/GYN case file for Lisa and Mark. 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. Established attendings are scored on the Transition fork: education debt finished, and no lingering consumer or vehicle 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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