👋 Hey, it’s Carlos.
Today’s issue is about the cash-flow system you need in order to stop reacting to your money and start building real wealth.
You’ll learn:
The one number that explains why $260K doesn’t feel like relief
The difference between reacting to money and actually directing it
And the income system I use to make cash-flow predictable again
Let’s dive in.
CASE FILE
“The Lifestyle Reactor”
Age: 33
Specialty: Hospitalist
Income: $260,000 (W2)
Household: Married, no kids
Living Situation: Renting 2BR for $2,450/mo.
Cash on hand: $6,900
Student debt: $210,000 (SAVE, payment jumped after income recert)
Investments: $12,400
Retirement Access: 403(b) with 4% match, contributing 2%
Burn Rate: $7,800/mo.
MY TAKE
The first thing I notice here is the gap between income and cash on hand. At $260,000/year, I’d expect more than $6,900 sitting in reserve.
Not because this physician is spending recklessly, but because their financial life expanded faster than the system underneath it.
They’ve got a solid income, student loans that just reset, and a burn rate close to $8,000/month. On top of that, only 2% is going into retirement, even with a 4% match available.
That tells me decisions are most likely being made on the fly:
- A higher paycheck comes in, lifestyle adjusts.
- Loan payments jump after recertification, savings get reshuffled.
- Benefits and deductions change, and the cash never quite settles.
This is what I mean by a Lifestyle Reactor.
It’s not carelessness. It’s what happens when you’re earning real money for the first time -- and reacting instead of directing.
Taxes, benefits, and loan deductions also take a bigger chunk of gross pay than expected, and the money doesn’t feel the way it looked on paper.
This is a common place for new attendings to start.
MAKE YOUR INCOME BORING AGAIN
If you and I were sitting across from each other and you told me your first attending paycheck didn’t feel the way you thought it would, I’d probably nod before you even finished the sentence.
There’s an expectation that once the larger income arrives, your shoulders will drop a little. That money will finally feel like a source of ease instead of pressure.
When that feeling doesn’t arrive, it can be unsettling. But this isn’t a money skill problem. It’s simply that your financial life scaled overnight, but your systems didn’t.
Many attendings try to hold everything in their head: bills, goals, surprises, lifestyle changes. That mental load alone is enough to make your income feel less meaningful than it should.
What helps is predictable flow. Money that moves the same way every month. Once that flow exists, relief shows up in daily life. Not just on payday.
Here’s a simple structure that creates that feeling—in five steps.
Step 1: Find your true monthly income floor
This is the number everything rests on.
To find it, look back at the last six months of take-home pay and identify the lowest month, then remove anything that was clearly one-time or temporary.
That number is your floor.
Example:
$14.2K, $13.9K, $14.8K, $12.7K, $15.1K, $14.0K
Your floor is $12.7K.
That’s your “normal” paycheck -- even if you earn more.
Step 2: Route all income into one holding account
Stop letting money flow straight into spending.
Open a new account and route everything to it.
All income goes here FIRST:
employer pay, call pay, bonuses, side income.
Nothing auto-drafts from this account.
Its only job is to absorb the noise so the rest of your system doesn’t have to.
Step 3: Pay yourself a fixed salary on the 1st and 15th
Set two automatic transfers to your main checking account:
50% of your income floor on the 1st
50% on the 15th
Three things will happen fast:
Your checking balance becomes predictable.
Your cash flow stops surprising you.
Saving gets easier.
Step 4: Everything above the floor is opportunity income
Any money left in the holding account above your floor is no longer part of your lifestyle. It’s optional, intentional, and flexible.
This is where I’ll usually guide physicians to:
Fund Backdoor Roths
Add to brokerage accounts
Build 529s
Execute targeted student loan strategies
Set aside PSLF buffers
Increase 401(k) or 457 contributions
Build a home purchase fund
Strengthen cash reserves
Plan giving or travel intentionally
This is exactly how you start building wealth beyond medicine.
Step 5: Use the holding account as a monthly diagnostic
Once a month, take a quick look.
If the balance is rising, wealth is building faster than planned. If it’s falling, something needs attention.
That’s it.
No spreadsheets.
No guilt.
Just clarity.