Why High-Achieving Physicians Rarely Retire Completely

It was about 4 and a half years ago that I made the decision to start exploring career options outside of medicine.  A lot has happened since then.  I earned a master’s degree in finance, became a CFP® professional, started practicing as a financial advisor, created this blog, started a podcast, and am currently completing my second book. 

I could have just retired.  I thought about it.  But I also realized something about myself even at the time that I was burned out in emergency medicine and knew I needed a change: I wouldn’t have been happy.  I understood that I needed something to keep me busy and productive.  I still enjoy adding value to the world and I still enjoy getting paid to do it. 

And I don’t intend to stop working any time soon.  I anticipate that as time goes on, a much higher percentage of my “work” will be unpaid.  Volunteerism is an important part of my history and will be an increasing part of my future.  For now, though, I am enjoying my second shift immensely. 

One of the great side benefits of hosting The Second Shift podcast is that I get to know my guests in a way that would be uncommon for me in a casual meeting.  By virtue of them accepting my offer to interview them, they give me permission to dig deeper into their stories.  I learn from them alongside my listeners.

I am storing those pearls of wisdom, and I expect many of my future blog posts to draw from that growing archive.  Today’s post is like that. 

The physician retirement paradox

One consistent theme among my guests has been that retirement rarely looks completely leisurely. I have interviewed many high achievers with long lists of accomplishment during their careers.  Very few of them have chosen retirement as a permanent withdrawal from meaningful work.

The traditional ideal of Financial Independence Retire Early (FIRE), where you save and invest as aggressively as possible for the opportunity to live a life of leisure as soon as possible, simply was not a fit for these folks. 

They have notably all emphasized the importance of financial discipline and how appropriate savings and investing gave them the  opportunity to explore in their later career.  Some tried early retirement and found themselves unhappy and unfulfilled, prompting them almost immediately to return to paid work or pursue meaningful volunteer opportunities.

Isn’t it interesting that some of the physicians who worked the hardest and managed their money most carefully may be the least likely to retire completely?  That is the retirement paradox. 

Being financially prepared to do so does not mean you have to retire.  On the contrary, it might actually open up your world to all kinds of possibilities for work that you had not previously even considered. 

A recent, not-yet-published podcast conversation with Jimmy Turner, MD, founder of Money Meets Medicine, brought this idea home. He uses a different acronym:  not FIRE, but FIWO (Financial Independence Work Optional).  I love that.  Just because you don’t have to work doesn’t mean you stop.  It means you now have the choice to work differently.

Some examples from the podcast:

1. Logan Foltz, MD: a psychiatrist who discovered early in his career that clinical medicine was not a good fit. He saved hard to achieve financial independence with visions of early retirement and a life of leisure.  When he achieved it in his early 40s, he quickly discovered that full retirement was not at all what he expected. He figured out that suddenly he was the only person in his circle of friends who had unlimited time for leisure, and doing it by himself was far less satisfying.  After only about six months, he began exploring a different path that ultimately led to a new career as a tax advisor to physicians.

   
   

2. Stephen Anderson, MD: an emergency physician who served in leadership roles within his group, his hospital, and the American College of Emergency Physicians. After retiring from clinical practice, he shifted toward volunteer leadership, chairing passion projects such as the Naloxone Project, the Emergency Medicine Foundation, and the Exploring Retirement section of ACEP.

   
   

3. John Shufeldt, MD: another emergency physician who repeatedly noticed systemic problems during his clinical career and began designing solutions for them. That led him to create multiple businesses, including one of the nation’s first urgent care companies, an early telemedicine company, and a national staffing company serving Native American tribes. His passion for building businesses eventually led him to start a venture capital firm that supports other physician entrepreneurs. He also helped establish a medical school bearing his name that combines traditional medical education with mechanical engineering, with the goal of developing a new generation of healthcare problem-solvers. 

   
   

4. Marvin Wayne, MD: a surgeon-turned-emergency physician who helped build a highly successful EMS system in Washington state. He continued working clinically well into his 70s and, now in his 80s, continues to lecture, mentor, and contribute to the medical literature.

   
   

Those are just a few of the examples.  I could go on.  Nearly everyone I have interviewed has developed a sense of passion and purpose outside traditional clinical practice.

When you see such consistency, it means something.  These physicians retired from jobs, schedules, and obligations. They did not retire from curiosity, contribution, or the need to remain useful. Financial independence allowed them to separate those things for the first time.

Why leisure is often insufficient

We became doctors for a reason.  It is rarely a career chosen by chance.  It takes considerable effort to get there, and the process weeds out all but the most motivated. So, by nature, doctors are driven people.  But there are a lot of driven people in society.  Physicians are different though.  We chose to use our intelligence, drive, and ambition to help other people. 

Too often, however, the medical system suppresses that passion by eroding autonomy and commoditizing care.  In my opinion, this is one of the major contributors to physician burnout: losing touch with the passion that originally drew us into medicine. For some physicians, this creates something deeper than ordinary exhaustion. It creates moral distress and, when repeated over time, can contribute to moral injury: the lasting psychological, emotional, or spiritual harm that occurs when clinicians participate in, witness, or are unable to prevent care that violates their deeply held sense of what is right for the patient.

Leaving that environment may relieve the injury, but it does not eliminate the physician’s underlying need to serve, contribute, and remain useful.

I don’t think most of us have lost our sense of purpose or drive. Instead, our sources of purpose and motivation have simply changed over time. And that makes sense. We change.  But our traditional careers don’t always change with us. 

Simply escaping a now ill-fitting career is rarely a complete solution. Many of us still need the identity, structure, relevance, relationships, and purpose that we initially found in medicine. We are not well suited to a retirement built entirely around a life of leisure.  The most successful and happy “retirees” that I have met have found a way to maintain those things just mentioned in their second shift.

Financial independence changes the terms of work

The problem arises when you are psychologically ready to move beyond traditional medical practice, but your financial choices have left you without the freedom to do so.  We hear about the “golden handcuffs” of a high-income career.  Those handcuffs tighten when you fail to convert some of that high income into assets capable of eventually replacing it. Many physicians find themselves supporting a lifestyle they cannot maintain without a physician’s salary.  Without a significant lifestyle reset, exploring a second shift may feel impossible and, in some cases, may actually be.

That is not a good place to be.  Such stress can strain relationships, increase workplace dissatisfaction, compromise patient care, and contribute to general unhappiness. Still, you continue because you feel you have no other choice.

It doesn’t have to be that way.  The alternative just takes some planning.  A disciplined financial plan can solve the money piece.  Forging new professional relationships, broadening your skills, and saying yes to outside opportunities can create the options to pursue when you are ready for a change. I like to say: “Build it before you break.” 

You can start building from the moment you leave residency. And there is no reason to wait.  Some might argue that doing so demonstrates a lack of commitment to medicine.  I disagree. I believe that developing a broader range of skills, interests, and relationships can make you a better and happier physician. It may even extend your medical career, although that career may look different from those of previous generations.

Financial independence is a gift we give our future selves.  It allows us to choose work based on fit and meaning rather than income or obligation.

The question to ask before retiring

The question is not merely, “Do I have enough to stop working?” but “What do I want the freedom to keep doing?” 

I have previously written about Jordan Grumet’s book The Purpose Code, and its message is once again relevant here. You don’t have to save the world in your second shift.  But you do need a purpose that is meaningful to you.  It may be within or without medicine.  That is less of the point.  It should be something you are excited to get out of bed in the morning to pursue. It should provide structure to your days, allow your identity to evolve, and reconnect you with the desire to help others that originally drew you into medicine.

Physicians have much to offer, whether they are at the beginning of their careers or beyond the end of clinical practice. Those decades of experience have shaped you and taught you lessons of considerable value. Your skills and experience can continue to help others while giving you a renewed sense of purpose.  Finding that purpose as your enthusiasm for your original career begins to wane requires creativity, honest introspection, and a healthy dose of courage. That doesn’t represent a failure.  It represents evolution.

To listen to these conversations yourself, check out the Second Shift Podcast wherever you get our podcasts. 

And if you would like help with the financial considerations of your next move, reach out to me for a free discovery call,

You also might enjoy reading:

The Three Stages of Wealth: Why Financial Independence is About More Than Early Retirement

5 Signs You’re Ready for Your Second Shift (Even If You’re Not Ready to Call It Retirement)

The 5 Conversations to Have With Your Partner Before Retirement, Career Change, or Any Major Life Transition

Disclaimer: the material in this blog post is intended for general educational purposes only and should not be considered specific financial advice. You should always consult with your personal financial advisor to see how it might fit within your personalized financial plan.