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Retiring Early in Healthcare Without a Physician’s Income

Chimborazo Ecuador peak

I hope you caught my guest post over on Can I Retire Yet last week. If you haven’t yet, be sure to check out Leaving a Prestigious High-Paying Career in Your Early 40’s. When you’re done, please come back — I’ve got another great guest post for you to read.

Today, Chris Mamula, one member of the tandem that also includes Darrow Kirkpatrick from Can I Retire Yet, is returning the favor.

I met Chris briefly at Fincon last fall as he was in the midst of this career transition. He’s a a stand-up guy, and we clearly have much in common as you’ll note in the post that follows.

Chris is on the other side of his physical therapy career and has answered the “can I retire yet” question for himself. Yes, he can and did retire from a career in healthcare. Read on to how, why, and what an early retirement means for him.

Retiring Early in Healthcare Without a Physician’s Income


Physician on FIRE, thank you for the invitation to share my story of achieving FIRE as a physical therapist (PT).

Neither my wife nor I ever managed to earn $100,000 for even a single year on our journey to financial independence. However, my story contains many parallel lessons that are applicable to physicians and other high-income earners likely to read this blog.

You may be thinking that I am one of those ultra-frugal people that is going to tell you not to spend your money. I assure you, I am not that guy.

Maybe you’re thinking that I am some kind of investment guru who has done everything right financially from day one. I assure you, I am not that guy either.

I found my way to this blog as a long time reader of the White Coat Investor. Unfortunately, I related all too well to his story of having been taken advantage of by the financial industry. I didn’t start finding blogs like WCI and PoF until I made massive mistakes by following conventional financial advice for the first decade of my career. Only in the last couple of years did I get a grasp on DIY investing and tax planning.

So I didn’t earn a massive salary, am not particularly frugal, and struggled with the technical aspects of personal finance for over half of my adult life. Then how in the world did I retire as a physical therapist at the ripe old age of 41, after a career of only 16 and a half years? Let me share six key lessons that you can start applying today on your own FIRE journey.

1. Determine What You Value


My wife and I love to travel. We’ve been on five of the seven continents (and we’re coming for you Asia and Antarctica, OK probably not Antarctica). Even our 5-year old daughter has been in 22 states in her short life.

We love to be outdoors. We’ve skied all over the west and northeast. We’ve hiked the Grand Canyon, climbed the Grand Teton, and backpacked Denali. We got into high altitude mountaineering and climbed Kilimanjaro and the volcanoes of Mexico and Ecuador. We’ve dove the Caribbean and the Great Barrier Reef. Last summer, we bought our retirement home in Utah so we could live and play in the mountains as much as we want.

We value experiences. We’ve attended two Super Bowls (XL and XLIII, Go Steelers!) and countless concerts and festivals. This spring, we went on a Disney Cruise with our daughter and my parents.


Super Bowl Steelers
go stillers! that towel is terrible, btw


On one hand, our story is not one of frugality. On the other hand, we have always managed to live far below our means. How we have done this is best summarized by Paula Pant who coined the saying “you can afford anything, but not everything.”

We’ve been able to live a life full of amazing experiences by spending our money in alignment with our values. Being a high earning professional will give most readers of this blog the opportunity to live an amazing lifestyle while still being financially responsible. However, we can’t afford everything, so we need to get intentional with how we spend our dollars.

2. Get The Big Things Right


The reason we were able to afford our lifestyle while saving approximately 50% of our incomes was that we kept our structural costs very low. We very purposefully limited or eliminated spending on those things that did not add value to our lives. What exactly does that look like?

From the beginning, we knew paying interest to a bank had no place in our lives. We paid off our college debt rapidly. We chose a house we could comfortably afford with a fifteen year mortgage and paid it off in seven. Our cars never made anyone envious, but they were always paid for with cash.

In the later years of our careers, we realized the importance of tax planning and limiting investment costs. We also looked closely at minimizing recurring costs. We cut out cable TV that detracted more than it added to our lives and switched to very low cost MVNO cell phone coverage.

Paying for a multi-week international vacation or $4,000 for a pair of Super Bowl tickets looks ridiculously expensive for people living paycheck to paycheck. However, if you get the big things right and minimize your structural costs, you can easily save thousands of dollars EVERY month compared to other high-income professionals. Then, when opportunities arise to do things you truly want, the money is there for higher earners to live an amazing lifestyle while still saving substantial amounts for retirement.

3. Domestic Geoarbitrage


One strategy I used to build our high savings rate that is particularly effective for those of us in the medical community is domestic geoarbitrage. While many high paying careers require living in high cost of living metropolitan areas, medical professionals are needed everywhere.

You can, as I did, use this to your advantage to both command a higher salary and decrease your costs of living simultaneously.

I graduated from the University of Pittsburgh and loved the city. While Pittsburgh is not exactly San Francisco, NYC, or DC, living in any large city is generally not cheap.

Pittsburgh also has a unique situation in having three physical therapy schools in a five mile stretch and two others within 90 minutes of the city. This means that supply and demand did not work in my favor. My first full time PT job in the suburbs of Pittsburgh started at only $36,000 a year!

Within a year, I decided to start looking further outside of the city and was able to increase my annual salary by over $20,000. This was more in alignment with the national averages at the time. However, this meant driving an hour each way every day.

I quickly realized what this was costing me financially to commute. It also cost me personally as I had little to no free time. We decided to look further outside the city. We ended up moving back to our hometown about two hours from Pittsburgh.

Moving to my hometown enabled me to increase my income to closer to $80,000, more than doubling my starting salary in just under three years. I stayed in this job for the rest of my career, topping out at over $90,000 in my best years.

Moving away from the city allowed me to cut my commute time and cost drastically. Housing is also comparatively cheap in my hometown. Having family nearby was a twofold benefit when our daughter was born. We saved a lot on childcare costs while allowing her to form a close bond with her grandparents. These factors contributed greatly to decreasing the structural costs of our lives.

Utilizing geoarbitrage was a lucrative decision. Still, we needed to figure out what to do with the money we were saving.

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4. Become Competent With Investing and Taxes


As I stated in the introduction to this post, I was ignorant when it came to investing and tax planning for the first decade of my career. This is a mistake that can be masked by a high savings rate for a while if you are getting the other big things right.

However, we learned expensive lessons the hard way. You have to take the time to gain at least an elementary understanding of the tax code. This is even more important for higher wage earners. You must also understand the basics of investing as you start to accumulate wealth.

Not doing so means that you are trying to win the game of life without learning the rules. Good luck with that.

PoF already covers the topics of simplifying investing and reducing taxes very well, so I won’t go deeply into specifics. However, I do want to add one point to ponder.

Becoming a DIY investor saves me tens of thousands of dollars every year. I eliminated thousands of dollars in advisory fees that I was being charged for horrible financial advice. I save even more by taking a few simple steps to eliminate unnecessary taxation every year.

Educating myself took an initial investment in time. However, I now spend about 2 hours per year managing our investments.

Some readers think you can’t afford to spend the time to learn this stuff. I would argue that you can’t afford not to learn it.

Once you build your desired lifestyle, accumulate wealth and learn how to manage it, there are still challenges to retiring early.

5. Find Your Calling


The term retirement carries a lot of baggage. Career and identity become one and the same for a lot of high wage earners. Who you are is often defined by what you do. Retiring can mean losing a large piece of who you are.

The challenge of choosing to retire can be especially hard for medical professionals. We all started down this path with a desire to help others. We have invested an incredible amount of resources, time, and money into our training. We came out on the other side with financially lucrative careers. It can seem crazy to want to retire early and walk away from all of that.

I was really struggling with what I wanted to do with the rest of my life if I retired. I had to look far outside of typical retirement planning resources to overcome this challenge. The answer for me came from a most unexpected source.

My wife suggested that I reread a book that was influential early in each of our careers, Dan Miller’s “48 Days to the Work You Love”. One quote specifically stuck out to me.


“A job should not define who or what you are. You should be able to leave today and it not change the overall purpose or direction of your life. Your calling is a much larger concept than what you do daily to create income. Work opportunities can come and go—the direction of your life should remain constant.” — Dan Miller


This quote made me realize that my calling is, and always has been, to serve others and help them to live better lives. Being a physical therapist is only one way I could do that.

I can be retired and focus on my daughter, my marriage, family, and friends. I can be a writer and blogger and help people discover this life-changing message of financial independence.


Chimborazo Ecuador peak


I can still work as a part-time or travel physical therapist if I choose. I can share my love of the outdoors with others as a guide or instructor. I can combine physical therapy skills with my love of the outdoors, working with disabled athletes or Wounded Warriors. The possibilities are endless.

6. Redefine Retirement


The first thing I am turning my attention to in my early retirement is trying my hand at being a writer. I am working on a book and I write at the blog Can I Retire Yet?

It is somewhat ironic that I’m writing a retirement blog. My mission is to blow up conventional notions of how retirement is viewed.

I want to redefine retirement as the period in life after we have become financially independent. Traditional retirement, defined as the time we stop working, should not be the end goal.

Whether we completely stop working for money, explore a totally new career path, or simply keep doing what we always have with less intensity or a different mindset after achieving financial independence is up to each individual.

We don’t need to be defined by the label retired any more than our identity should be tied to the title physical therapist, doctor, or whatever profession you have chosen.

We all need to figure out what makes us get out of bed in the morning, and then go about building that life for ourselves.

Financial independence is the goal because it gives you the freedom to define your life and choose your own adventures.

Go for it.


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21 thoughts on “Retiring Early in Healthcare Without a Physician’s Income”

  1. Thanks for sharing. I work with a lot of PT and OT and I recently realized that they share the same struggles as MD and DO. PT income is generally lower (though not always if they own the clinic!) but they have lower debt loads. They should be able to achieve FI within 20 years but often do not. No one is talking about it. But you are changing that.

    • Unfortunately, many new grad PTs are coming out with pretty massive debt. We regularly had interns come through our clinic graduating with $100-200k student loan debts, which is pretty massive with average starting salaries around $66k. The education demands are increasing substantially. I worked with PT’s with 4 year bachelors, I had a MPT (6 years) which at the time was the standard, and since the profession has gone to DPT (6-7 years). Pay is not increasing at anywhere near the same rate as education costs unfortunately.

      I think FIRE principles need to be shared with these young professionals to before inflating lifestyle. Those principles of creating spread between income and expenses could be used to get out of debt quickly rather than used to develop a high savings rate.

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  3. Cool how you’ve managed to find that common thread in seemingly unrelated activities. That was a really powerful concept for me to figure out to get over some mental hurdles that were holding me back.

  4. Nice to see two friends linking up! Great collaboration.

    I love the idea of a calling and weaving it throughout your activities, roles, and even life story.

    For example, I have played high-level football, started businesses, invested in real estate, started a family, written a blog, and taught classes. The common thread for me is a love of learning and applying those lessons to real life. The specific “jobs” come and go. But they each contribute to a lot of fun and fulfillment.

  5. Great post Chris! I am totally on board with determining what you value and spending our money in alignment with these values. Living deliberately and intentionally is key. Especially being intentional with how we spend our dollars. Best of luck to you with your writing endeavors!!! 🙂

    • Thanks for the positive feedback. Agree that intentionality is the key. A career of a decade or two is short compared to a 30-40 year career some have, but it is still a heck of a long time if you feel your suffering and sacrificing the whole time. You have to find a way to enjoy the journey.

  6. Hey Chris, PoF…Great advice. You don’t have to be perfect to become financially independent. The key is to make a series of good enough decisions, learn a little, and stick to your guns. The path is simple (not necessarily easy). Congrats on all your success!

    • You need to be consistently committed to the goal, but also flexible to learn, adapt, and improve as you go. Thanks for the kind words!

  7. I like the point about post FI. It’s financial freedom when money isn’t the first consideration anymore. I think you’ll have a hard time redefining retirement, though. It’s ingrained in our culture now.
    I still haven’t found my calling yet. I’ll keep exploring and taking my time with it. It must be great to have a North Star to follow.
    Thanks for sharing.

    • Agree that the idea of retirement is pretty ingrained, but I think that individual perspectives can be changed by sharing stories that people relate to and allow them see different ways of approaching life. I still don’t necessarily know what I want to be when I grow up or where life will ultimately take me, but finding that calling or driving force guides me in the right direction.

  8. The first time I read about taking a different look at the job/calling debate was after reading Louis Profeta’s article (https://www.linkedin.com/pulse/those-four-words-may-offend-you-also-just-save-louis-m-profeta-md/). I started med school in 2007, so it took nearly 10 years to hear a different message.

    He basically argues that medicine is job and not a calling. A job that you would drop in an instant if something more important was happening in your life (if you could…financial independence!).

    Our identities are so wrapped around being physicians partially because of how much we sacrificed on the way here, how prestigious that identity is, and how much value we can derive from our work. I’m with Dr. Profeta in that my job is medicine and my passion/calling is what I go home to, being a new dad, husband, friend and part of a loving family. The biggest reason for me to pursue financial independence is to righten that balance. Now it is far too heavily skewed towards my job and not enough of what is really important.

    • Interesting read. I agree that has health care professionals what we do is important and demands our best when at work, but at the end of the day we need to learn to separate and define ourselves rather than being defined by career.

  9. Great post! I am about 4 years behind you and your words give me hope beyond my current situation. I can see the happiness in your faces and it is refreshing. Just coming back from a longer trip to Hawaii, I was surprised how miserable everyone at work looked. They look like prisoners not realizing they have key. You and your wife have shown that your income doesn’t matter as much as your conviction and planning. There is only one problem, what will happen to the healthcare industry when everyone leaves? Congrats

    • You are so right about “prisoners not realizing they have the key”. So many people get caught up in dumb arguments about whether someone else is “really retired” because they make money in retirement or whether someone is “really frugal” because they save a lot by having a high income. All of these things are choices that we have that enable us to escape the “prisons” that only exist because we build them for ourselves.

      I don’t think everyone is going to retire early and create a shortage of professionals, but I would love to see a world with more people choosing to think independently instead of having their life energy sucked from them working jobs b/c that’s their only option. Maybe freeing more of these people could lead to new solutions to old problems that never seem to get solved.

  10. Hey PoF,

    One typo. That is a Terrible Towel (proper nouns are capitalized). It flies like the flag in Steeler country, especially after we win Super Bowls. Don’t Vikings fans do that after they win……Oops, never mind. 😉


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  12. Love your story Chris! And I agree the last part about identity is very very important.

    And you should totally go to Antarctica, cruises there have come down in cost over the years, as cheap as some of the other trips that you’ve taken. Why not have all 7 continents!

    • Thanks for the kind words my friend. You never know where life will take you, though I kind of get my fill of Penguins watching Crosby, Malkin, and the boys going for another Stanley Cup.

  13. Man, that last bit is so spot on. Our identity too often gets tied up in what we do for a living. I’ve written on this before because I’ve seen the extreme side of this when it becomes disabling to those who lose their career.

    As I started branching out into this personal finance blogging community and having other interest outside of work, my identity in my job has become less and less. I love practicing anesthesiology, but its not who I am. It makes saying “no” to things much easier. If it doesn’t add value to my life or is not something that I am passionate about pursuing, I just say no. Helps me stay grounded.

    And leaving my job someday will not change the course of my life. (Though, because of how much I love it, I may stay in it for longer than I need to and focus on the aspects of the job I love).

    Your path is extremely encouraging! I love it when people make mistakes, put the hard work in to understand finances (and make a plan), and then just make it work. Sounds like you found a good life-work balance even before you retired.

    • Thanks for the kind words. I’ve gotten to know quite a few physicians and think this tying of identity to profession is particularly common in your profession. I witnessed multiple physicians whose time had come and gone, and it was sad to see them unable to leave their careers or deal with being forced out b/c they’d devoted so much of their life to it, they had no where else to go and nothing else to do.

      • The struggle is definitely real. After seeing people become depressed and even suicidal after getting kicked out of medical school, it is very real in my mind.

        I am trying to actively fight against it for others and myself. Getting the word out on the issue before it comes up is a big part of that.


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