[openknot]

It's probably lifestyle inflation (https://www.investopedia.com/terms/l/lifestyle-inflation.asp), where spending increased in proportion or in excess to rises in income. A surgeon in the US wrote about colleagues who exhibited this behaviour in a blog (source: https://www.kevinmd.com/2019/03/why-many-doctors-live-payche...).

[nmfisher]

My surgeon brother told me that many older surgeons can't "afford" to retire, often because they lost loads of money in investment schemes (and probably coupled with an unwillingness to accept a cutback in lifestyle).

You probably lose a lot of basic savvy when you're insulated from "the real world" for decade after decade (undergrad, medical training, residency, surgical training, high paid private consultancy, etc).