When you think about the student loan crisis, your mind conjures up images of twenty-somethings working at Starbucks. What you don’t see, however, are the hundreds of thousands of hard-working professionals who pull in comfortable salaries yet live in fear of their student loans.

Confused about how such a thing could possibly happen, and why those with deep pockets aren’t always on top of their student loan payments?

Consider this: most people do not graduate from school with high-paying jobs in place. Doctors in particular work many years before getting that fat paycheck. In fact, your friendly local physician likely spent a decade or better in a residency program, living like a college student.

Professionals of all stripes pay their dues for years, during which time they are just as unable to pay their student loans as any other college graduate. By the time their personal finance situation turns a corner, it’s too late to get back on the horse.

You see, federal student loans come with only so much in the way of forbearance. Once they’re gone, you can’t get another one.

So you fall behind on the student loan tab only to be told about consolidation for the federal loans (you can’t consolidate the private student loans unless you qualify based on your credit score). But once you consolidate, you can’t do it again – which leaves you saddled with a new loan that may have an interest rate too high to afford on your still-meager salary.

If you fall behind and go into default, you can catch up on your federal student loans by rehabilitating the payments (again, no such luck with the private student loans). But once again, you can rehabilitate your student loans only one time. Hit another bump in the road and you’ve got no recourse.

By the time your income rises enough to start paying the student loans, you’re faced with coughing up a huge chunk of change to cure a default or, in the case, of a federal student loan in default for a second time, the entire balance.

That can run tens of thousands of dollars for some, hundreds of thousands for others. Confronted with the lack of options, even the wealthiest of student loan borrowers can’t catch up on their payments as this story by WABC shows.

So next time you see a wealthy doctor, dentist or other professional don’t be shocked to find out you have something in common – a big student loan bill.