Before I was a financial planner, I was an ICU nurse.
I spent years at the bedside in a medical intensive care unit, a place where decisions happen in minutes, where incomplete information can have irreversible consequences, and where every patient is a complete human being whose circumstances, history, and condition are entirely unique. You don’t treat a diagnosis in the ICU. You treat a person… the WHOLE person and their family at what is often the most vulnerable period of time.
That experience has shaped everything about how I approach financial planning. We lead with compassion. A great financial planner is at their best when a client is at their worst. And the more I’ve reflected on it over the years, the more convinced I’ve become that the financial services industry would be dramatically better if it borrowed one of medicine’s most important concepts: the standard of care.
“In the ICU, you don’t treat a diagnosis. You treat a person…the WHOLE person. Financial planning should work the same way.”
What Is a Standard of Care, and Why Does It Matter?
In medicine, a standard of care refers to the diagnostic and treatment protocols that a reasonably competent clinician would follow given a specific set of circumstances. It isn’t a rigid script. It’s a framework, evidence-based, consistently applied, and anchored in the individual patient’s complete clinical picture.
A standard of care means that when you walk into a hospital with chest pain, the team doesn’t skip your EKG because they’re short on time. They don’t assume your symptoms are minor because you look healthy. They gather the relevant data, assess the full picture, and treat you as the unique individual you are, not as a statistical average.
Now ask yourself: when was the last time your financial advisor did the equivalent of a complete workup? Are they treating your arms and legs when you need your whole body assessed?
The Diagnosis Problem in Financial Services
For too long, the financial services industry has operated more like a walk-in clinic handing out prescriptions than a medical practice, delivering comprehensive care. A client walks in, mentions they’re worried about retirement, and walks out with a recommended allocation to a target date fund. Transaction complete.
The problem isn’t the product. The problem is the sequence. In medicine, we call it putting the treatment before the diagnosis, and it’s considered negligent.
A genuine financial standard of care begins with the equivalent of a patient’s history and a physical. It asks: What are your income sources, and what are your cash flow needs? What does your tax picture look like today, and what might it look like in ten years? What does your family depend on, and what risks haven’t been transferred through appropriate insurance? What’s your capacity, not just your tolerance, for absorbing a market downturn without permanently altering your plans? When it comes to your family, for example, are there family dynamics that could affect how much you might need to support one child over another? How do you think they’ll work together when it comes to settling the estate?
Only after gathering and integrating that information does a thoughtful advisor make a financial plan and deliver recommendations. And even then, the work isn’t finished.
Monitoring: The Discipline the Industry Often Skips
One of the most important lessons I carried from nursing into financial planning is this: Diagnosis is only the beginning. The real discipline is ongoing monitoring.
In the ICU, we continuously charted vital signs. We adjusted medications in response to real-time data. We ran labs and interpreted trends. A patient’s condition from Tuesday morning didn’t automatically describe their condition on Thursday afternoon.
Financial plans are no different. Life changes. Tax laws change. Markets change. Income changes. The birth of a child, a job transition, a health diagnosis, an aging parent who needs care, every one of these events has financial implications that a static plan simply cannot account for.
At Key Financial, we update account values nightly and make that information available to clients through a secure personal portal. We review plans on an ongoing basis, not once a year, and certainly not only when the market gets uncomfortable. Think of it the way most people think about an annual physical: the sooner you identify a problem, the easier it is to address. The same principle applies here.
“A financial plan built once and never revisited is like a chart from last year’s hospitalization. It tells you where the patient was. Not where they are.”
The Fiduciary Standard: Medicine’s Hippocratic Oath, Applied to Finance
Medicine has a foundational ethical commitment that has existed for centuries: first, do no harm. Financial planning has an equivalent concept: the fiduciary standard, which requires an advisor to act in the client’s best interest, not their own or their firm’s.
This distinction matters far more than most people realize. Not all financial advisors are held to a fiduciary standard. Some operate under a suitability standard, which simply requires that a recommendation be appropriate for a client, a meaningfully lower bar.
The difference is a bit like the difference between a doctor who prescribes the medication that’s best for you, versus one who prescribes a medication from a company that gives better perks. Both may technically be acceptable. Only one reflects a true standard of care.
What Does This Mean for You?
If you walked into your doctor’s office and she handed you a prescription without asking a single question about your symptoms, your history, or your current medications, you would be alarmed, and rightfully so.
You should apply the same standard of care to your financial health. Ask your advisor how they gather and integrate the full picture of your financial life. Ask how frequently they monitor and update your plan. Ask whether they are a fiduciary and confirm it in writing.
You wouldn’t accept anything less from your physician. You deserve the same from the person helping you build the financial life you’ve worked so hard to create.
Isn’t it a relief when you walk out of the doctor’s office with a clean bill of health? A well-monitored financial plan should give you that same sense of confidence, not once, but consistently, year after year.
