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Working longer is a surefire way to boost one’s financial prospects in retirement, but it’s not always possible. Factors beyond an individual’s control were responsible for 76% of early retirements in 2025, according to the Employee Benefit Research Institute’s annual Retirement Confidence Survey. They included health problems and disabilities, as well as company changes such as downsizing, closure, or reorganization.
A combination of delayed starts, aggressive lifestyle expansion, tax exposure, and structural financial blind spots means many physicians arrive at their mid-fifties with an income that looks impressive on paper but with a financial position that doesn’t match.
Many dread retirement for all the wrong reasons. They work because it’s all they know. Their identity and social circle orbit the workplace and they’re terrified of severing the ties. Work becomes who they are not what they do. Despite being financially comfortable they can’t let go.
The pied-à-terre tax, as it’s called, would add an annual surcharge on NYC properties worth over $5 million when the owner lives somewhere else. It would affect roughly 13,000 of New York City’s most expensive homes, more than half of which are currently owned by people who don’t actually live here. The projected revenue is $500 million a year.
Read this case study I found useful: When you inherit an investment account, the IRS resets your cost basis to the fair market value of the assets on the date of death. Quick review of cost basis: It’s what you paid for the stock to use as a benchmark for how much gain you may have when you sell.
For many investors, a tax refund can feel like a gift from above. But in reality, it’s simply the return of your own overpaid taxes—an interest-free loan you made to the government. While this fact may take some of the excitement out of receiving a refund, it should sharpen your focus on how to use it wisely.
Knowing what you want out of life is worthless if you don’t do anything about it. Author Mark Manson has written that learning more is a smart person’s favorite form of procrastination. Doing the work is hard. So we hide behind research, planning, and preparation instead.
A recap of this past week: We’re ending the weekend with a Japanese intervention to stabilise the Yen as oil shocks rumble through the region, the future of oil prices as the Iran Crisis continues, and Elon Musk’s testimony against OpenAI.
Nearly 30% of the generation born between 1997 and 2012 started putting money into markets in early adulthood, before they even entered the workforce, compared to just 15% of millennials and 9% of gen X, according to a World Economic Forum (WEF) report.
Most FIRE content is written for single-income households or for couples where one partner earns substantially more than the other. Dual-physician households are different in almost every meaningful way. And those differences cut both ways.
About 55 million Americans are on a diet at any given moment. Half of the country says it’s trying to lose weight. Diet and weight loss books generate about $600 million in sales each year. Diet books have been around since the 1860s, yet obesity grew 3,900% since then. A Cornell researcher named Adrienne Bitar decided to figure out why. She analyzed 400+ diet books spanning that entire history.
Why the Standard Money Waterfall Doesn’t Work for Physicians
Most personal finance flowcharts start with a $2,000 emergency fund. You probably moved more than that to checking this morning.
The chart was built for households earning $80K. Drop a hospitalist clearing $325K with locums income on top onto that same chart and the entire sequence falls apart. Everything changes when your tax bracket starts with a 3 and your retirement accounts include strange and powerful tools the average earner has never heard of.
A few things shift dramatically once you re-plumb the waterfall for physicians:
Six months of cash, no negotiation. A malpractice suit, an unexpected hospital firing, or a burnout exit can erase a year of income. The cushion buys you negotiating room when it matters most.
The Roth IRA front door is locked at $252,000 MAGI in 2026. Use the back door. Contribute $7,500 to a traditional IRA each January for yourself and your spouse, then convert to Roth within days. Repeat for thirty years and the cumulative tax-free space adds up fast.
The HSA is the most underused account in the tax code. Triple tax break going in, growing, and coming out. Max the contribution every year and pay current medical bills from regular checking, letting the balance compound in actual investments for three decades.
Solo 401(k) for any 1099 income. Even $80K of locums work opens up roughly $14,000 of additional pre-tax employer contribution space on top of your W-2 401(k) max.
Skip the SEP-IRA. It quietly kills your backdoor Roth strategy via the pro-rata rule.
The full breakdown, including the OBBB bonus depreciation play and the mortgage payoff math, lives on the blog. Come read the long version at Physician on FIRE.
Thanks for stopping by!
Jorge Sanchez, MD
