This episode is going to get technical — so if you’re not ready to get lost in the math and mechanics of debt, investments, and balance sheet risk, you’ve been warned. But for high earners like ER docs, these seemingly small decisions — like whether to pay down a mortgage early or redirect that cash flow into investments — can have six- or even seven-figure implications over time.

With today’s higher mortgage rates and more volatile markets, the old rules don’t necessarily apply, and what once was considered conservative might now be the riskiest choice of all. We’re going to break down how to analyze these trade-offs, with real numbers and real behavioral considerations that go way beyond “just do what feels right.”