Of course, having a lot of money & spending a lot of money are not the same thing; in some ways, they’re the exact opposite. Every dollar you spend is a dollar that someone else now has and you don’t.
Wealth is defined by net worth, & net worth is built first by saving some portion of your income, then by investing it in some reasonable manner. Income is what you’re paid; wealth is what you have left.
Your patients, your family, your friends, and probably even you have expectations of what your financial situation should look like. That is usually imagined in terms of what you spend.
Society has a bit of a taboo about talking about money. However, that general taboo is nothing compared to what medical students experience from the time they start filling out medical school applications all the way through their careers.