There are basically two things in my life I’ve been good at: practicing medicine and talking about personal finance. Interestingly enough, I’ve found that the exact same philosophy governs both.
It comes down to the 80/20 rule. Or, as I like to frame it: Simplicity always trumps the last 20%.
The Medical Optimization Trap
For the first two decades of my career as a general internist, and now in hospice and palliative care, I’ve watched the health and wellness space become paralyzingly complex.
If you listen to modern medical influencers, you’d think surviving the week requires a two-hour morning routine. We are bombarded with endless podcast debates about intermittent fasting windows, the exact minute to get morning sunlight, maximizing VO2 max, and micro-managing gut microbiomes.
But the truth is, 80% of your health comes from the painfully simple stuff:
Wearing your seatbelt.
Limiting your alcohol intake.
Eating reasonably healthy foods.
Getting standard, age-appropriate health screenings.
Moving your body regularly.
Connecting with others to lower your stress.
Chasing that last 20% of peak medical optimization takes a massive amount of energy. Even worse, it can actually cause harm. Over-training leads to bone and joint damage. Extreme dietary restrictions cause unexpected micronutrient deficiencies. The sheer anxiety of tracking every single biometric marker drives up your stress levels.
The Personal Finance Parallel
Personal finance is the exact same beast. You get 80% of the benefit just by following a few boring, foundational rules:
Earn more than you spend.
Invest the difference in low-cost index funds.
Keep your money in the market for the long haul.
Use a basic, diversified asset allocation.
Utilize standard tax-advantaged accounts.
Yet, just like in medicine, we obsess over the last 20%. We fall down the rabbit hole of complex Roth conversions, obscure tax loopholes, and alternative investments we don’t fully understand.
The Hidden Cost of “Perfect”
Trying to squeeze out that final 20% of financial optimization often backfires. Overcomplicating your tax strategy can lead to IRS penalties or losing out on healthcare subsidies. Constantly tweaking your portfolio usually results in lower returns than if you just left it alone.
In both health and wealth, the pursuit of perfection demands an enormous tax on your time and mental bandwidth. You end up running on a treadmill, burning precious energy for minimal, if any, real-world gains.
Stick to the simple 80%. It is the most reliable path to being healthy, wealthy, and wise.
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I’m on solid ground on the financial front, but just ending (I hope) a two-year stretch of over-optimizing on my health. But that attempt to optimize taught me a lot and I’m not sure I’d have wanted to do without it. There’s something to be said for exploring the contours of optimization in order to rest more securely in the basics, don’t you think?
This is especially true early on when time is limited and more valuably spent on increasing your career trajectory or investing in relationships.