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FINANCE + MEDICINE

How Much House
Can a Physician
Family Afford?

Six hours after making an offer on a home, we withdrew it. A year later, we understood just how much that decision had protected our family.

Chris Herring
Chris Herring
Entrepreneur • Husband • Father • Med Spouse
Co-Founder, Other Side Med
Finance + Medicine

Six hours after making an offer on a house, we withdrew it.

There was nothing wrong with the house; we absolutely loved it! Hannah was finishing residency, we were preparing to move, and we were both making great money.

Making the mortgage payment wasn’t the issue…

What became less clear was whether we could make that payment and still use our money the way we wanted to everywhere else.

We wanted to pay off med school loans as quickly as possible.

We wanted to max out our investment accounts.

We wanted to give generously.

We wanted to build a comfortable emergency fund.

With that house, we could do all of that, but only if both incomes stayed right where they were.

That was the part we couldn’t get comfortable with. We weren’t worried about making the first payment or the fiftieth payment. We were asking what the house would require from us in the event our lifestyle needed to change in some way.

So we pulled the offer.

Six months later, Oliver received a life-changing diagnosis. Six months after that, I left a career where I was making more than $200,000 a year to care for him full time.

We obviously didn’t know any of that when we pulled our offer on the house. We just knew we didn’t want a mortgage that depended on both of us continuing to earn at that level.

Looking back, that six-hour reversal was one of the most important financial decisions we have made in our marriage.

We probably could have kept the house.

Had we bought it, we likely would not have lost the house. As an OBGYN, Hannah earns a strong income. But we would have been forced to adjust other parts of our finances to make the payment.

It likely would’ve required Hannah to take on more call or add locums to weekends she was off. Maybe we would’ve slowed down debt repayment, invested less, stopped giving entirely, or done some combination of all three. I’m not sure, but something would have had to change.

And during a time when Oliver had appointments, therapies, specialists, medical equipment, and new diagnoses, the financial pressure at home would have pushed Hannah toward more work when she wanted to be home with the family.

There is nothing wrong with wanting the nicer house.

I want to be clear about this because conversations about physician spending can become self-righteous very quickly.

There is nothing wrong with a large house. There is nothing wrong with beautiful finishes, more privacy, extra bedrooms, land, a pool, or any of the other things people may want after spending years in training. Physician families do not need to live like residents forever to prove that they are responsible with money.

We still want nice things. We enjoy our home. The question is not whether it is wrong to buy something expensive. The question is whether this is the right time to buy it and whether the full cost fits alongside everything else you want your money to do.

That “full cost” matters because buyers tend to focus almost entirely on the mortgage.

A bigger home usually means higher electric and heating bills. A larger roof costs more when it eventually needs to be replaced. Heating and cooling more square footage may require larger or multiple HVAC systems, which also cost more to repair and replace. Taxes, homeowners insurance, landscaping, pest control, cleaning, and general maintenance tend to rise too.

Then you have to furnish it.

The furniture from your previous home may not fill the new rooms or fit the look of a much more expensive house. There are more windows that need treatments, more walls that need something on them, and more spaces that feel unfinished until you spend money on them.

You do not have to do all of that at once, of course, but most people do not buy a beautiful home with the intention of leaving half of it empty.

None of these expenses makes the house a bad purchase. They are simply part of the purchase, even though they are not included in the number a lender shows you.

The mortgage payment is only one part of what the house actually costs.

If a family looks only at the principal, interest, taxes, and insurance in the estimated payment, it can buy a house that fits the monthly budget. But they’ll likely be surprised by how expensive the house is to actually own.

Why this is easy for physician families to miss.

Speaking from experience, attending income can make almost anything look affordable by the month.

After years of putting off purchases, it is understandable that families want to upgrade quickly. And because lenders are often willing to approve physicians for very large loans, the amount offered can start to feel like evidence of what the family can afford.

It isn’t.

The approval answers the lender’s question: based on your finances today, are you likely to repay this loan?

It does not account for whether one spouse wants to leave work, whether the physician hopes to reduce clinical hours, or whether a child will eventually need much more care. It doesn’t know that taking on the maximum payment could make it harder to leave a terrible job or say no to extra call. And it is not measuring the other goals that matter to your family.

A bank may approve someone for a $1.2 or $1.5 million house. That does not automatically make either number irresponsible. It also does not make either number affordable.

The answer depends on what owning that house would require from you both now and later.

The questions we ask now.

We still ask whether we can make the payment. That is just no longer where the conversation ends.

Before a major purchase, we also ask:

What will this cost beyond the loan payment?

Could we continue carrying it if one income disappeared?

Can we buy it and still pay off debt, invest, and give the way we want to?

Does it help us reach our long-term goals, or will it compete with them?

What choices might become harder after we take on this payment?

Buying a less expensive house allowed us to go from two high incomes to one without reworking our entire life. We are still aggressively paying off debt, maxing our investment accounts, and giving generously.

Most importantly, I was able to leave my job and care for Oliver without first having to determine whether our mortgage would allow it.

That is what we were actually buying when we chose the less expensive house. We bought the ability to change plans.

Freedom = Flexibility.

There may be a time when a much larger or more expensive home fits our finances and everything else we want for our family. If that time comes, we can enjoy it without apologizing for it.

But I never want to confuse being approved for the payment with being able to afford everything that comes with it.

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