Life After Financial Independence: How Doctors Should Approach Work and Decisions
- Nisha Mehta, MD
- May 28
- 8 min read
While we’ve written a lot about financial independence and how to determine your financial independence or retirement number, we haven’t written a lot about how to approach financial independence once you get there. Similarly, most discussions in our physician community revolve around a person’s journey towards financial independence, and how to use side gigs and alternative income streams to get there. Although achieving financial independence is no doubt a good ‘problem’ to have, many doctors that reach this stage have a lot of interesting decisions to make, particularly in an era where the healthcare environment has become so much more challenging. While a lot of this is personal, we cover below a framework for which to approach these decisions, including how much or little to work (if at all), how to reset your goals to optimize happiness, and some perspective.
Disclosure/Disclaimer: Our content is for generalized educational purposes. While we try to ensure it is accurate and updated, we cannot guarantee it. Rules/laws can change frequently. We are not formal financial, legal, or tax professionals and do not provide individualized advice specific to your situation. You should consult these as appropriate and/or do your own due diligence before making decisions based on this page. To learn more, visit our disclaimers and disclosures.
Article Navigation
What is financial independence?
Financial independence can be defined in many different ways, but when we refer to it, we mean that you have reached the point where work is optional because you could support yourself and your desired lifestyle without having to earn more money through an active job. Note that most traditional financial independence calculations are done on the assumption that you will still be earning money on the money you have already accumulated and invested.
Learn more about Coast FIRE, the point at which you no longer need to be saving for retirement but just need to earn enough to cover your expenses.
Is financial independence (FI) the same as FIRE?
No. Financial independence (FI) is what we defined above. FIRE stands for financial independence, retire early, which is very different.
Many physicians hit FI in their mid careers, or even earlier depending on their income level and alternative revenue streams. Not all of these physicians retire - in fact, we’d bet most of them don’t, although given the frustrations with today’s healthcare landscape, there’s certainly more discussion of it, and more physicians making the decision to leave clinical medicine.
Should I continue to practice clinical medicine after I’ve hit financial independence?
As you’d probably guess, this is not a one size fits all answer. Fundamentally, when you hit financial independence, you should ask yourself a few questions.
Do you still enjoy practicing medicine?
If the answer is yes (which we hope it is), we hope that you continue to practice, albeit on your terms. The field needs good physicians who care, and honestly, once the financial pressure of working to earn money is relieved, many doctors find they enjoy the practice of medicine even more.
If you don’t enjoy medicine, the decision to leave is likely more straightforward. The joy in hitting FI is that you no longer have to do things for the money, so make the decision that’s right for you.
Would you be happier if you practiced medicine differently?
Once money is no longer the consideration, it’s time to think about what things about your practice are actively detracting from your career longevity or make you think about quitting. Is there a way to do less of what you don’t like, and more of what you do like?
Start with your hours. Would you prefer a different schedule? Options include:
Part time
Compressed schedules (same hours grouped into less days)
Locums
Per diem work with your same group or moonlighting with another group
Less call or eliminating call
Taking more vacation
Ending your days earlier or starting them later
Asking for or seeking roles with more flexibility
Move on to your responsibilities. Would you like to cut out anything or do less of it? Options include:
Cutting out procedures or types of visits that you don’t enjoy
Less call (already mentioned but also in this category)
Eliminating certain locations you practice at if you don’t like the travel or something else about it
Eliminating teaching or supervision responsibilities if you don’t enjoy them
There are obviously more variations, but hopefully this gives you a place to start.
What would you do with your time if you quit?
It’s important to understand where you’ll get your purpose or enjoyment if you leave medicine. If you’d be perfectly happy traveling or reading all day or if you don’t get joy out of clinical medicine, it’s more straightforward, but our experience is that most physicians still enjoy the heart of what they do and having something to do everyday.
Some options that we’ve seen physicians in our communities explore include:
Switching to a less lucrative but less intense job or a job that brings them more fulfillment in some way
Shifting careers to a more flexible model such as locums work
Switching to nonclinical roles or consulting or health tech roles
Making their side gig their main gig, or focusing on their hobbies
Doing more volunteer work or charity missions
Teaching at a medical school
Getting another degree such as an MBA or JD, to diversify their career options
Spending more time with family and friends, travel, or any other number of fun ways to spend their time
Will you be comfortable with the loss of income if you leave your current position, and do you really believe you have enough money?
One thing most physicians struggle with at this stage is deciding how much is really enough. There is a phenomenon referred to as 'one more year syndrome' which can go on for years. It's one thing to see that you're financially independent by numbers, it's another to actually believe it enough to resist the urge to work one more year to really feel sure it's sufficient to support you and the lifestyle you want forever.
Whether you’re quitting entirely or just cutting back, if you are used to getting a substantial paycheck every month, it may be unsettling to rely on your savings or income generated from your investments to live off of. Most people are okay with paying for a vacation out of their savings account, but it’s a different feeling when you’re pulling money out from investments to pay an extra $300 a night for the room upgrade.
You’ll want to be really honest with yourself about what sorts of lifestyle changes you’ll make once you don’t have the regular paycheck. It’s important to get any loved ones you support financially on board with these changes as well.
If you aren’t okay withdrawing from your savings yet, you may be a better fit for Coast FIRE, where you stop having to save money in your retirement and investment accounts, but continue to generate enough money to cover your expenses in one of the ways covered above.
If you need more help evaluating your financial situation to see if you’re really ready to retire, speak to a financial advisor familiar with physicians.
How do you want the value you get from work, legacy, and impact to be defined?
Now that money isn’t the primary goal of your working, you may want to think about the bigger picture. This is where people start thinking a lot about legacy and impact. Take a while to jot down what goals you have for the professional time you commit. This could include things like:
Trying to get more involved in charitable roles or board seats for nonprofit organizations
Trying to become an advisory board member for startups or companies in the space
Incorporating more charity care into your practice, or a larger percentage of your professional time being dedicated to seeing underserved populations / Medicaid
Having more students rotate with you or getting more involved with teaching
Exploring areas for innovation within your field as a founder or developing a medical device
How do you want to define success going forward as you shape the next chapter?
For better or worse, many people define professional success at least in part on how much money they make. Now that you don’t have to worry about that, put some thought into what will make you feel successful. It could be:
More time with your kids or spouse
Freedom and autonomy to practice medicine in the way that you want
The ability to take more time off and travel more
The creation of impact and legacy
How happy you feel most days (there will always be days that annoy you, but how do you feel at baseline?)
How much sleep you get
New skills learned or acquired (most doctors are lifelong learners)
New income streams developed through side gigs
What are some things I need to consider if I decide to FIRE?
There are other practical things to make sure you think about, such as:
Are you comfortable with your sense of identity going forward?
For many doctors, being a physician is a huge part of their identity. Although you’ll always have your degree and experience, if feeling like a doctor is important to you, take that into consideration and see if there are ways to retain ties to medicine, whether it be via side gigs, thought leadership, occasional locums, or paired down versions of what you do. We always thought things like being a cruise ship physician or an events physician could be fun yet stimulating! Of course there's also things like occasional locums work.
Learn about side gigs for retired physicians.
Do you want to retain the ability to practice medicine and maintain your license?
If you are at all unsure about your decision, you’re going to want a backup plan should you change your mind. For many physicians, this means:
Keeping your medical license active
Participating in continuing medical education (CME)
Maintaining your board certification and MOC requirements
Keeping a DEA number if needed
You should also consider doing occasional clinical work as a locums or per diem if you don’t want to have to explain large gaps in your work history on future licensing and credentialing. Read more about the challenges of re-entering clinical practice after a long break.
What will you do about health insurance or other benefits you get through your job?
The reason many people want to stay employed is to have access to good health insurance, and with insurance costs being what they are, it’s easy to understand this. Understand your options for buying health insurance outside of an employer and put together a plan.
Be prepared to deal with some criticism or judgement (or even guilt yourself) about leaving medicine
This is something that several members of our community have experienced or expressed. While we don’t think that this should be the case (it’s your life), many people have guilt about leaving the field or their patients, and even more have others say something about ‘wasting’ their education. Especially given all the physician shortages, you may get pushback from colleagues about the choice as well, or feel guilty about burdening partners with more work. Remember that you also have the right to do what’s best for you (and your loved ones, if applicable), and that there are lots of ways to make an impact. Being a physician will always be a part of who you are, whether you’re practicing or not.
Conclusion
Life after financial independence opens up a whole host of opportunities, including the ability to create a life in medicine on your own terms. It is a gift, and you should treat it as such. Whether that future involves practicing medicine or not, it’s important to be intentional about what your goals are and how you approach decisions in a way to maximize the happiness you’ve worked so hard to achieve.