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The Unspoken Risks of NOT Retiring Early


Yes, there are risks when retiring early, and people are quick to point them out when a person makes that choice. What about the risks of not retiring early? Those don’t get as much play.

I suppose ordinary people are not like surgeons at grand rounds. That is, they don’t particularly enjoy talking about morbidity and mortality.

However, there is a very real risk of illness, injury, and death and the closer we get to a typical retirement age, the higher those risks are. We can protect against the financial implications of them with products like term life and disability insurance, but how do we protect against those things destroying our retirement plans?

The best way to maximize the odds of enjoying the long, healthy retirement you’ve got in mind is to retire as soon as you possibly can. That’s just the math.  The longer you put it off, the more likely you are to miss out on the ideal post-career life you’ve envisioned for so long.




The Risks of Retiring Early


I should start by pointing out some of the obvious risks you accept when you do retire early.

There’s a chance you could run out of money. Working as little as one more year can dramatically decrease your chance of failure.

Your Social Security checks will be smaller. Plan accordingly and forecast your future benefit so you know what you’ll be giving up by retiring early.

You might get bored. OK. Go back to work, then.

If you are unprepared for an abundance of free time to hit you all at once, any number of issues can arise. Relationships can be strained. Your social life may suffer if work provided most of it for you. You might take up dangerous hobbies that you never had time for before.

It is best to go into retirement with a plan for your time, money, and relationships. You know, retire to something (or on something).


How Soon Do You Plan to Die?


You will definitely die. So will I. We just don’t know when. While the question posed sounds morbid, it’s just another way of asking how long you expect to live.

There’s plenty of data out there to show how likely a person your age is to live another year, decade, or 50 years. There’s a tiny, but non-zero chance that I may not survive the two days between writing and publishing this article. Conversely, I might live to see my 116th birthday, but that outcome is similarly very unlikely.

Flowing Data uses the Social Security Administration’s data set to show a range of possibilities with individual outcomes randomly generated based on probabilities.

Here’s what I got from a few minutes of running the simulation on Fast mode at age 45. I encourage you to run a simulation of your own with your gender and age, watching the gray balls fall where they may.




Based on my results, it appears that the mere contemplation of one’s own mortality may contribute to increasing odds dying within the next year, but I’ll chalk up that “fat tail” on the left to randomness.

There’s a 4% chance I won’t see my 55th birthday. Those are 1 in 25 odds that I’ll die in the next decade.

The odds of dying in the decade after that are more than double, and I have a combined 13% chance of dying in the next 20 years before celebrating my 65th birthday.

The odds of living to 85 are stacked against me at a 61% chance of death to a 39% chance of still being alive. The statistics tell me that I’ve got only an 8% chance to live to 95 or older.

Now, it’s important to realize that these numbers are based on me being average, and my mother has assured me for 45 years that I am certainly above average.

Kidding aside, if you’re a non-smoker with a normal BMI and a family history of longevity (all of which are true for above-average me), you’ve got a decent chance of beating the odds by maybe 5 to 10 years.

When it comes to your own personal mortality, though, the percentages aren’t all that helpful. You’re not going to be 39% alive at age 85. You’ll either be dead or alive. A 96% chance of making it to 55 doesn’t matter if you fall from a mountain peak at age 52.

The later you retire, the more you increase the odds of having a short or non-existent retirement.



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Declining Health


While it’s true that your presence among the living is binary — you’re alive and kicking or you’re not — quality of life will vary along a wide spectrum.  A major factor in your quality of life will be your ability to do the things you want to do in retirement, and your physical condition is a key contributor.

I didn’t start running for exercise until I was in my early thirties, and I’ve never been terribly consistent with it. In the first 10 years or so, the main things that kept me from running regularly were a busy work schedule, two young kids, and a lot of competition for my time. Also, laziness.

In the last two years, however, despite having plenty of time to jog, I’ve had to stop running for weeks at a time on at least 3 occasions.

There was the stress fracture in my foot that made itself abundantly clear at the conclusion of a half-marathon in Barcelona. When I healed from that, some medial knee pain (possibly pes anserine bursitis / tendinopathy) sidelined me for a few weeks. Currently, I’m dealing with pain in the ball of my foot where my 2nd metatarsal meets the toe.

And I’m in my mid-forties.




All sorts of maladies can and will arise that can not only limit your ability to run long distances, but also make it difficult or impossible to perform regular activities of daily living. The older you get, the more likely such impediments become.

It may not be one injury or diagnosis that slows you down, but the aggregation of small annoyances that add up to you becoming incapable of doing the things you wouldn’t have thought twice about doing when younger.

A 7-mile hike might sound like a good idea if it weren’t for your arthritic right hip, the extra 25 pounds you’ve accumulated, your sensitive GI tract combined with the street tacos you enjoyed for lunch, and the achy back you’ll probably get from the 2-hour drive to the trailhead. Not to mention the fact that the cell phone reception out there is lousy, and the likelihood of some sort of emergency seems to have increased right along with your waistline as you aged.

One of those factors alone may not dissuade you, but the combination leaves you at home, comfortably close to a toilet, television, and telephone.

The younger and healthier you are when you retire, the more things you’ll be able to check off your bucket list, rather than crossing them off because they’re no longer feasible.


The Specter of Cognitive Decline


While you can expect your body to decline physically over time, your mind may remain sharp for decades to come.

Or maybe it won’t.

Even worse, you’ll be the last to recognize it if cognitive decline does begin to impact your decision-making abilities. An ailing brain may not realize its own failings.

Sadly, the FBI reports that elder fraud, as in financial scams that target the elderly, lead to losses of $3 Billion and growing in the U.S. every year. Senior citizens are targeted because they are more likely to have accumulated assets, may be overly trusting, and perhaps most importantly, may not have the mental faculties that they once did.

Alzheimer’s and other forms of dementia are more likely to affect individuals beyond a normal retirement age, but early-onset dementia absolutely afflicts those in their 40s and 50s.

Retiring early does nothing to protect you from cognitive decline, and could possibly contribute to it if you become a firmly-planted couch potato, but if you keep your mind active, you should have more years with your wits about you to look forward to when retiring young.


No Time to Recover from Financial Stressors


When your retirement date is based upon a standared retirement age, and you’re saving and investing accordingly, you could be in rough shape if the economy doesn’t cooperate.

For example, if you expect to have the money you’ll need to retire by the time you’re 65, a layoff at age 55 becomes a financial emergency.

A bear market leading to a harsh sequence of returns in the final years you planned to work could force you to work several years longer than you’d like. If you’re in your 40s, you deal with it. If you’re in your 60s, losing a few years of your retirement could be a serious hardship. You don’t know how many good years you’ve got left!

Even if you’re not dead-set on an early retirement, becoming financially independent at a reasonably young age should be a life goal. Having the ability to leave work without major financial consequences can make so many potentially disastrous events much, much easier to navigate.


Your Job May Become Less Fulfilling


I don’t know whether to be envious or sad when I hear that someone loves their job. Sure, it’s great to get paid to do something you thoroughly enjoy doing, but on the other hand, it’s an unrequited love.



For the love affair to last, two conditions must remain true.

First, the job cannot change in a way that causes you to love it less. Any change in your work schedule, obligations, compensation, benefits, or work colleagues that negatively impacts you can leave you feeling less amorous.

Second, you and the things you value and prioritize must remain indefinitely steady. The odds of this being true over a career lasting even a decade or two are on par with the chances that I fail to survive long enough to see this article published.

Think about who you were 5, 10, or 20 years ago. What mattered most to you then? Who were the most important people in your life? How did you balance a career with family, hobbies, and other outside interests? How has that changed?

Being excited about or even content with the job you’ve got is a lot better than despising the work you do. Just realize that as time goes on, the odds of remaining in love with your job will likely diminish.

With a shred of luck and some proper planning, your relationship with your career not be of the “’til death do us part” variety.

It’s not supposed to be.



Lost Opportunity for Low-Tax Years


If you retire in  your 60s, you’ll be collecting Social Security within a decade and by age 72, you’ll be required to withdraw RMDs from tax-deferred retirement accounts.

That leaves little time to do Roth conversions in a low tax bracket. You may never reap the benefits of being in the 0% long-term capital gains bracket (which also applies to qualified dividends).

It may sound silly, but one aspect of full retirement that I most look forward to is the possibility of paying very low taxes or converting hundreds of thousands of tax-deferred dollars to a Roth IRA while remaining in the 24% federal income tax bracket.

Many early retirees qualify for an ACA subsidy to help pay for health insurance, a benefit that few standard retirees will ever get.

The sooner you retire, the more years you’ll have to make low-cost Roth IRA conversions, potentially pay no tax on your capital gains and qualified dividends, and smile because you’ve got something in common with Jeff Bezos and Elon Musk.



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Missing Out on Time With Loved Ones


If you retire at 65, will your parents still be alive? Based on the actuarial tables, it’s not all that likely.

If you’re working when they fall ill, how difficult will it be for you to be at their bedside on short notice? What if they need assistance for weeks or months? How will you make that happen?

Looking at the other side of life, if you have children, how does work affect your ability to  spend time with them and be there when you’re needed most?

Think about how you might travel differently if you didn’t have a job to get back to. Imagine how a year or two of worldschooling as a family would compare to the usual routine.

We also have loved ones beyond our blood relations. Friends get married. Friends get divorced. Friends invite you to join them for a coffee or a beer. For a boat ride or for an amazing vacation.

If you’ve got a full-time job, you will rightfully suffer from FOMO — the fear of missing out. The less you have to work, the more you’ll be able to join your friends and family when you’re invited or needed.


one fine day from a 2-month trip to Mexico


You Only Live Once


Hashtag YOLO. I get it. You only live once, so you should live life to the fullest!

I’m on board with the concept, but often disappointed with the implementation. YOLO is often used as an excuse for spending excessively while ignoring the future. That’s the wrong approach.

Since you only have this one precious life to live, you should absolutely enjoy it now while also putting yourself in a position to make the most of whatever number of remaining years you’re granted.

Imagine how much easier it would be to live life to the fullest if you had another 40 to 60 hours to do as you please every single week!

If your dream life consists of spending most of your days in a clinic, cubicle, or cath lab, perhaps your career has you living life to the fullest already.

If you’re like me, though, you’ll find it’s much easier to embrace a #YOLO mindset when your schedule is wide open.

You don’t know how many years you’ll get, you don’t know how well your body and mind will hold up, and time is a precious and non-renewable asset. Take a page from the FIRE movement and make the most of yours.


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57 thoughts on “The Unspoken Risks of NOT Retiring Early”

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  15. Somewhat thought-provoking reading here but not for reasons that you might think. I think this was written by someone 25-30 years younger than myself, and so I’m going to invoke experience little bit. First of all, some of us got into medicine for different reasons. Many of my colleagues who retired couldn’t wait for, are enjoying themselves, etc. They also didn’t enjoy the last few years of practicing. They were waiting for the finish line. I “retired” at the age of 50 when I left a busy hospital based internal medicine practice and started a direct pay, integrative/functional practice. Since 2001, I have work mornings only and now work three mornings per week. It’s a small office, quite enjoyable, we can take new patients, and it is utter intellectual freedom in pursuing solutions customized to individual needs. Of course, I am a former professor of pharmacology at a major university and taught botanical and nutraceutical medicine. I also was one of the first to embrace bioidentical hormone management. We have contracts with laboratories all over the world and test for things that even the Mayo Clinic doesn’t do. It is as intellectually vibrant as you can expect. I take plenty of time off, still play competitive handball and ride my bicycle 5000 miles a year, and enjoy my eight grandchildren a great deal. But, I fully expect to continue to work until I am almost 80 if I practice what I preach.

    The author writes about “decline”. This is the typical parabolic functional aging curve. We as physicians as well as subjects should be trying to compress morbidity into the very end of life. This means doing everything that we can to prevent cancer, avoid unnecessary trauma, live with joy, sleep well, optimize nutrition, etc., etc. Does the author know what PEMF or PBM are? If not, he has missed a great deal of what can be applied to the healthy life to compress morbidity.

    I wish everyone the freedom to choose the life that they want. The intellectual “purposeful” medical life has been irreplaceable and a joy. It’s not something that I am seeking to “retire from”.

  16. Great article! I do believe that the worst part is the gradual cognitive decline that you initially ignore. Learning new things and keeping up with the changes/evolution in medicine becomes more challenging. Start “breaking yourself of a piece(s)” now.

  17. Perhaps I’m in the minority, but I actually truly love my work as a radiologist. I began to proclaim (to anyone who would listen) when I was a teenager that I was going to become a doctor. I finished residency in 1983 and have not lost any desire or passion for what I do. I love the mental stimulation, challenge and excitement I feel when making a diagnosis, clinically conversing with colleagues, explaining diagnoses and prognoses to patients because their physicians either cannot or will not take the time to do so, or any number of other reasons that reward me for what I do. Last time I checked, litigation aside, medical doctors were still considered to be the most respected career professionals in the workforce. I consider it an honor to serve mankind in this role and couldn’t imagine doing anything else. Nonetheless, I appreciate the thought provocation your article generates. From my perspective, I say “burn out, shmurn out”. If you’re burnt out, quit or change your vocation. I simply enjoy what I do too much to ever stop doing it until I can no longer provide the kind of service that I have found so rewarding for so many people for so many years. I just can’t ever imagine giving that up as long as I am productive.

    • That’s fantastic, Ken.

      We need good doctors, and if you’re happier in the reading room than you would be without it, you’re obviously doing things right and are in a very enviable postion.


  18. “The best way to maximize the odds of enjoying the long, healthy retirement you’ve got in mind is to retire as soon as you possibly can. That’s just the math.”

    I couldn’t agree more with this sentiment. While I agree there are risks of retiring early, I firsthand saw the chances of not quitting until people were disabled or, unfortunately, had passed. The latter was especially hard for those still alive to process, as their loved ones had worked so hard for a dream that they never were able to realize.

    As a former advisor, I talked to many spouses and kids whose loved ones seemed okay until they weren’t, and COVID only accelerated this trend. If you love your job, this may not apply to you. If you have ups and downs with it, then reflect on how the grass is always greener on the other side and have the regret of not working while enjoying the time with your family and friends.

  19. I find this entire article an antithesis to my practice in medicine. In our difficult years of training, we could hardly wait to go into practice. I am hopeful most of us have found the practice of medicine incredibly rewarding, and our continued experiences with our patients most satisfying. I am one of the lucky ones to have practiced a specialty that allows continued contributions after retirement I did retire early, 67, only because at the time the requirement for electronic records was estimated to be 96 thousand dollars. Fortunately, as a plastic surgeon, I have been most fortunate to continue working on international cleft surgical missions–48 so far. I love my patients, love my work, and cannot imagine not being able to continue in humanitarian missions. I am almost 77, and look forward to a number of years of continued surgical missions. Also, I am a lousy golfer, and always say I picked the right profession.

  20. Better than retirement is find another less stressful work in the medical field. After retiring from 30 years of private practice, I transitioned to the corporate healthcare world. I am able to use my medical knowledge and experience in a completely different way. Also, the new career makes me feel that I’m just getting started rather than winding down. I will stay in my present position as long as they’ll have me, or until my mind and/ or body can’t go on.

  21. I think that having enough savings to retire sets you free. Once you reach that point, you can refuse to do whatever seems wrong for you, knowing you won’t starve.

    You, your family and society invested a lot in making you a doctor, so you owe it to yourself and them to maximize the return on that investment by keeping on doing what you’re trained to do. Working longer should also allow you to leave more to your heirs, which can set them free to do what they love.

    If being a doc is not fulfilling to you, then you should have chosen something else. I could have retired at least 10 years ago, and had thought I would do so until I realized how much I had come to love practicing medicine. Cutting back on my work has made it possible to continue on. I’m 38 years into it and am not burned out.

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  23. It is good to see this discussion going on among younger physicians than I. In the past, although physicians are generally goal oriented, it was rare that they chose a time and financial goal for retirement. Perhaps their goal was so focused on becoming a physician that they then worked until failing health precluded them from working; perhaps they neglected to become well rounded people , so that work was their entire life’s purpose.

    I thought I had planned carefully to retire as a “young” 70 year old. I was in excellent health, was financially secure, had a stable marriage, had worked 3/4 time for several years, and I had lots of plans for the future. A few months shy, I was diagnosed with a major cancer, incidental to a CT done for trauma. Surgery, radiation, and a miracle response to immunotherapy followed.

    Do I regret not retiring earlier? No. Coming to work with my flail chest led to concern among my co-worker physicians, which led to a CT to diagnose multiple rib fractures and incidentally, my liver cancer. As a practicing physician, I got the best referrals to the best treating physicians. Although going instantly from full time doctor to full time patient is a major adjustment, I treasure every sunrise, and I think I treasure my time with friends and family all the more. An earlier retirement would have given me more selfish “bucket list” experiences, but probably less satisfaction and maybe even an earlier death.

    • Treasure every day, Dr. Millar.

      Thank you for sharing your perspective, and I’m so glad to hear you responded well to treatment.


  24. Excellent article. I did not see who the author is. I am financially capable of retiring but can’t seem to pull the trigger. I enjoy my work immensely but do not know how to do it part time and pay full time expenses.

  25. Let’s face it – it all boils down to two factors:

    1) Do I have enough $$$ to retire?

    2) Can one endure the fact that the mass of knowledge/skill set one has accumulated over a career in medicine essentially vanishes when you retire….
    It doesn’t mean you can’t offer advice, or do something else, but….

    Let’s say you are a oncologic surgeon and remove tumors for a living – helping some people immensely- that skill set isn’t too useful once you retire

    I personally think coming to grips with #2 is as important as #1

    Thanks also for the insight about health insurance, tax implications, others

  26. I hear very little about how to pay for a good health insurance when you retire early, as that is certainly the biggest worry of mine. I would hate to pay the horrific premiums that the US healthcare system offers, and still have one of the worst (but expensive) life expectancy in the world (I know you all know this!). I still would love to retire early and try to invest in keeping a good health myself, but it is daunting the thought of having to pay health insurance on my own. How do people do it?

  27. I’m curious how the FIRE mindset aligns with famous people who age. Biden is 78, Buffet is 90, Clint Eastwood, Anthony Hopkins, Morgan Freeman are working into their 80s. These folks have amassed wealth multiple times over that of the average physician. Granted Biden “only” has a net worth of like 9million which is in the doctor range.

    Why do they keep working? Why not enjoy the fruits of their labor?

    • They work because they want. If they die tomorrow they will probably not regret having been president or having done one more movie.

      If you are not passionate about anything outside medicine/ or you true passion is medicine this post would be hard to wrap your mind around (i e Afan above)

    • I think they are enjoying the fruits of their labor. Everyone mentioned has something very few physicians have, and that’s fame. They also possess unique skills and talents that few others have acquired. There are about a million practicing physicians in this country. I can only name dozens of famous actors, household-name investors, and politicians.

      There are also plenty of physicians who work well past regular retirement age. They either possess something that I don’t (a true passion for practicing medicine above all else) or lack something that I have (the financial ability to not practice).


      • A 78 year old specialty physician who is still working and has invested prudently should easily have this amount of savings given the lucrative historical pay and the enormous run up in stocks, bonds, and real estate since 80s.

  28. The health risks of not retiring early are real. One of my best friends is in his 20’s as well…. and the last time I saw him he had white hairs. Not just one off hairs, but about to grow into huge bunches.

    That was a very scary sight. It may be genetic and not all work stress but I can’t imagine work stress not contributing to that either.

    • I got my first gray hair as a 26-year old. Just happened to coincide with my first year of residency.

      My wife got her first grays as a 22-year old. She also started dating me as a 22-year old.

      I don’t think either of those were coincidences.


  29. I find it sad that so many people are in such a hurry to end their careers. I don’t WANT a long retirement. I will retire when I can no longer work, either because of failing health or lack of demand for my services, neither of which would be good news.
    I get a sense of accomplishment from my work that I cannot access in any other way. Yes, I could volunteer doing something else, but why would I think I would be as good at that as I am at practicing medicine? Whatever I do as a volunteer, I will not have devoted decades to trying to be as good at it as I can.

    I am prepared if a long retirement were to be forced upon me, but it is something I hope to avoid by working a long time and then dying not too long after I quit.

    I don’t see NOT retiring early as any risk at all.

    • Have you considered (or done) volunteer work as a physician? There are plenty of opportunities and need.

      I’ll also reiterate what I stated in the post. How you feel about your career can very well change. Maybe you change. Maybe the job changes. Maybe both. Few start out disillusioned with their careers, but burnout can be very real.


    • I totally agree. If you love what you do, keep doing it. If not, do something else. This is not the dress rehearsal.

      • Dr. Glengary!

        It’s been nearly 15 years, but you helped orient me at one of my early locum gigs. I hope life has treated you well in the interim. Things went well for a few years there for me, but ended on a very sour note.

        I landed on my feet, though, obviously.

        Leif / PoF

  30. As a 44 yo surgeon who loves rock climbing more than anything, this post was sufficient ammunition to start the process of going part time — you don’t see that many 60’s year olds at the crag. I think that part time will give me the best of both worlds.

    • Good luck, Carlos!

      I was a part-timer for the better part of 2 years before hanging it up for good. Enjoy the rocks while you’re well and able. And be safe up there.


  31. Beautifully framed, PoF. There is a large downside risk of not making it to Act Two in the great production that is your life; not being available for life’s “Bingo!” moments (You must be present to win); accepting the default mode in your occupation as a substitute for struggling to determine how you will create meaning, value and service for others.

    Only point I take issue with: those street tacos were totally worth it.



    • I’ve learned to buy my street tacos after my long hikes, and I agree, totally worth it.


  32. I enjoyed reading this article. I think reading it from the point of view of the risk of not retiring is very helpful. I am 59 and part time clinical with my “days off” devoted to medical student teaching and some small side gigs that I learned from reading blogs like yours(eg compensated interviews). I stopped telling people I work part time because my off days are pretty full with non-compensated administrative work and teaching.

    This article has made me consider full retirement as early as next summer. The big question in my mind is health care. Could you offer any advice on the gap between having commercial insurance and medicare which will kick in at age 65? Would you recommend ACA exchanges or something else.

    • It sounds like you’re in a great position to ease into retirement, MM, while maybe keeping some of the more meaningful work and side gigs going strong if you’d like.

      We bought our health insurance from the exchange, and we also had a broker look for plans, but the plans they found were identical to those on the exchange. Health care sharing ministries could be an option. I wrote about them and why we ultimately chose the more expensive traditional health insurance here.


  33. Great brain food today, Doc. Wise to look at the risks of NOT retiring early, a serious risk that too many overlook. I, like you, love the reality of having many years of ROTH conversions ahead before those dreaded RMD’S kick in. Plus, we’re able to spend as much time as we like with our 2-year-old granddaughter, who lives 300 miles away. Value? Priceless, and something we’d have missed had I worked until “traditional” retirement age

  34. Reading this article has me kind of excited to enter my own numbers…even if it means contemplating my own mortality thereby increasing my odds of death based on the “fat tail.” Haha. Oh well. A better YOLO, how loving a job is unrequited, and remember “your presence among the living is binary.” Lots of gems and I really enjoyed this one 🙂

  35. Thought provoking post. I really resonated with two parts: the fallacy of “loving your job” and having time to attend the events of your family.

    It’s taken me years to realize that making time for family is important and your job (while providing some fulfillment) will not be loyal to you.


    Psy-FI MD

  36. Good article. One thing i have noticed – high stress jobs lead to health issues. You need to get out from that stress earlier than later. To put it another way, retire BEFORE that heart attack. Perhaps it won’t happen. OTOH my 58 y.o. procedure nurse died at age 58 of ALS. He had a fairly low stress job. Perhaps sometimes it is inevitable.

    • Excellent addition, Bill.

      I’ve come to realize that I internalize stress. I barely notice it mentally, but it manifests itself in the form of a sore back and neck or GI symptoms. I’ve had far fewer issues like that in the last 2 years since leaving my anesthesia career.


  37. Sort of funny coming from someone who gains status, money and relationships from an extremely successful blog that could be considered work. 🙂

    • You’re absolutely right…. but consider this. Everyone is always “working” if you are getting up and creating or providing value in the world and helping others. So the question becomes are you in control of how and when you decide to create that value or are you being instructed on how or when to provide that value? Which way causes less stress in your life? If you could “work” with less stress and more time… would you?

    • Oh, I’ve never pretended to be fully retired. I’m Retired Not Retired, as I like to say.

      The work that I do here still allows me to take advantage of so many things that my doctor job couldn’t. My schedule is entirely up to me, and I can work as little or as much as I want. I can do it from just about anywhere in the world.

      I’m very happy with the balance I’ve struck. I’ve mitigated most of the risks of not retiring early (just not the low-tax years one) while having a super-flexible vocation where I’m my own boss. I try to be very transparent about that.



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