How Much Should Doctors Give to Charity?

This question we are going to address today is a loaded and very personal one. The question is: How much should we give to charity? Everyone must determine the answer to this for themselves. However, one could argue that as high-income earners, doctors have a greater obligation.

My wife Selenid and I talk about this not infrequently. However, the impetus for this post is a book I read recently called “Infectious Generosity” by Chris Anderson, the head of TED Talks.

The overall message of the book is that, in today’s society, we can harness our connectivity to spread generosity in an infectious, viral manner. The book is very good, if not a bit overly saccharine and optimistic. But I still recommend it.

One of the final chapters addresses the question of how much people should give to charity, or give away in general.

Guiding Principles for Giving

The idea of the book is that everyone should give. For the sake of this discussion, we are going to focus on financial giving, even though there are many non-financial ways to give, including giving your time. This is something that doctors do to an exceptional level throughout our careers.

Anderson lays out four main principles to guide all world citizens in giving to charity:

• It should be a norm for everyone. This not only encourages everyone to do it but eliminates that guilt felt by some for not “doing more.”
• The giving should be enough to reasonably address main societal problems.
• The giving should not be so demanding that the average person in the world could not do it.
• It should be “accepted as fair,” meaning that those who can give more should give more to charity.

Most of these principles are very reasonable to me, although some may scoff at the idea that those with more should give more. This take comes especially hot from doctors who took on incredible debt in time and money for their increased compensation later in life. I get that viewpoint too.

In history, there have really been two very good examples of universal systems of giving that adhere to the principles above.

• Tithing: This one is more commonly known. Rooted in Judaism and Christianity, tithing is the practice of giving 10% of your income to the church or synagogue. In the secular world, this 10% may be given directly to charities or causes. And, in general, this practice is for anyone who has the means to do so and is not “poor.”
• Zakat: Zakat is an Islamic tradition that I was not aware of previously. It is similar to tithing in that it recommends universal giving based off your means to give. Except in this case, the standard determining the amount given is not income but net worth. Zakat asks that everyone above a certain wealth level give 1/40th or 2.5% of their net worth annually to charity.

Which Is Better?

Neither is better. If you are following the principles of tithing or zakat, you are being very generous. And neither is easy to do.

A better question might be: Which tradition gives more to charity?

It depends on your income/net worth ratio. If your income/net worth ratio is high, then giving 10% of your income via tithing is likely the greater donation. Meanwhile, if your income/net worth ratio is low, practicing zakat will result in you giving more to charity.

Now back to our original question…

How Much Should Doctors Give to Charity?

Anderson asks his readers to make a pledge — a pledge to make it a life goal to annually give whichever is higher: 10% of your income or 2.5% of your net worth.

This is a huge ask. But the results could be equally huge. In his book, Anderson dives into the math showing that if one-third of everyone in the world committed to this pledge, it would generate $3.5 trillion in charitable giving and could solve the majority of the world’s biggest issues, including world hunger.

Astounding. But difficult. I can’t pretend like it’s not a big ask. (More on this later.)

In terms of doctors, giving via a pledge like this would likely divide us into two broad groups:

• Earlier-career physicians whose income is greater than their net worth who would practice tithing.
• Later-career physicians whose net worth is greater than their income and would practice zakat.

And I would argue that only attending physicians should be asked to take this pledge.

Is this reasonable to ask of physicians? I think it is. But I have to admit something…

Selenid and I do not practice tithing or zakat. In fact, you can look at our written financial plan and see that giving to charity is on it, but it’s low on the priority list.

Why is this? It is tough not to sound like I’m making excuses, but after reflecting, there are really three reasons why we have not given more at this point:

1. I feel like we need to take care of ourselves first to get a stable footing to be able to give more from a comfortable foundation (kind of like how I encourage everyone to save for themselves before their kids, and speaking of kids…).
2. It feels like we are giving a lot at this point, but we are giving it to our three kids.
3. I feel like we will be able to give more generally once we establish our own financial freedom (I don’t have the math to support this).

To me, these are valid points. But there are holes in my arguments for sure. The first and foremost being that some money now for those in need is often better than more money later.

Looking Ahead

We do give to charity now. But it is haphazard and usually one-offs. We see a cause and donate to it. We don’t think of it within the context of a giving plan. It is unintentional giving, an ugly cousin of unintentional spending.

What we need to do is to give to charity intentionally. We need to create a giving plan — and now is a good time to start. It’s something just about all physicians can reasonably do. In terms of whether we should practice tithing or zakat, tithing wins for us. We would donate about 50% more using our income as a standard compared to our net worth.

But to be honest, this won’t happen in one swoop. Just like when we started creating our savings rate, we will likely start making it a goal to give 2% first, and then build up. This makes the whole process more durable, creating a habit rather than more one-off giving.

Infectious generosity is possible. And we can play a big part in it. To me, that is exciting!

Jordan Frey, MD, is a plastic surgeon at Erie County Medical Center in Buffalo, New York, and founder of The Prudent Plastic Surgeon.

Looking to improve your financial well-being? Check out Frey’s online course, Graduating to Success, a comprehensive and interactive 12-module course that helps doctors achieve personal, professional, and financial success during and after their transition from trainee to attending, or read his 2023 book, “Money Matters in Medicine.”

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