Physician Retirement Planning: 5 Pitfalls Doctors Over 50 Still Miss

You’ve spent decades taking care of others—how confident are you that your retirement plan is taking care of you?

If you’re a late-career physician or hospital executive thinking about the next chapter, you’re not alone. Many physicians in their 50s and 60s are finally lifting their heads from the intensity of clinical practice to ask, “What’s next—and am I truly ready for it?”

I’ve been fortunate to work closely with physicians across the country—especially those navigating this critical pre-retirement stage. And while no two journeys are identical, there are common—and surprisingly persistent—mistakes I continue to see, even among highly accomplished, financially successful doctors.

So whether you're three years or ten years from retirement, here are five retirement pitfalls that physicians over 50 still miss—and how you can avoid them.

1. Underestimating the Tax Consequences of Retirement Withdrawals

A successful medical career often means substantial retirement savings in tax-deferred accounts—401(k)s, 403(b)s, 457(b)s and traditional IRAs. But those savings come with a future tax bill that many overlook.

The pitfall? Not planning for the tax impact of distributions—especially when combined with Social Security, pension income, or post-retirement consulting work.

For example, a physician retiring at 62 with a $2.5 million portfolio may assume their tax bracket will shrink—but Required Minimum Distributions (RMDs) starting at age 73 can inflate their taxable income, potentially pushing them back into a high bracket.

What to do: Incorporate tax diversification now. Roth conversions during low-income years (say, between full-time work and taking Social Security), strategic drawdown planning, and charitable giving strategies like Donor Advised Funds can help you manage your lifetime tax liability.

2. Delaying the Discussion Around Lifestyle and Spending

A successful retirement isn’t just about assets—it’s about lifestyle alignment. Yet many physicians enter retirement without a clear understanding of their true annual spending needs, or how that might change in the years ahead.

It’s common to overestimate how much you’ll scale back or underestimate how inflation, health care, travel, or supporting adult children may impact your budget.

I often see this play out with clients in their first year of retirement. After years of deferring gratification, it’s natural to want to enjoy the fruits of your labor—whether that’s international travel, home renovations, or helping grandchildren with college expenses. Those expenses aren’t inherently “bad”—but when they haven’t been planned for, they can throw off even the best-laid strategies.

What to do: Start with an honest lifestyle audit. Create tiers of spending—essentials, discretionary, and legacy—and stress test your retirement income plan under various scenarios. Retirement is rarely linear, and neither are the expenses.

3. Overreliance on Hospital or Governmental Pensions or Buyouts

Many physicians nearing retirement work in health systems that offer pensions, retirement lump sums, or phased retirement packages. These benefits can be valuable—but they can also be overestimated or misused.

Some assume the pension will “cover everything,” only to realize the income isn’t inflation-adjusted or doesn’t support both spouses’ needs. Others take lump sum offers without comparing long-term outcomes, or fail to coordinate benefits with other retirement income sources.

What to do: Evaluate the total value of your employer retirement benefits in the context of your overall plan. Consider factors like longevity risk, cost-of-living adjustments (COLAs), spousal survivorship options, and tax treatment. Don’t make a one-time, irreversible decision without a second opinion from a fiduciary advisor who understands physician compensation.

4. Not Having a Strategy for What Comes After Retirement

Here’s something we don’t talk about enough: Physicians often struggle with retirement identity loss.

After years of being “Dr. So-and-so,” the transition into post-career life can feel disorienting. Some jump into consulting or locums immediately—not because they need the money, but because they’re unsure what else to do. Others withdraw without a plan and experience boredom, restlessness, or even depression.

Retirement is more than a financial finish line—it’s a reinvention. But without a vision, even a well-funded retirement can feel unfulfilling.

What to do: Start crafting your post-retirement identity now. Ask yourself:

• What would a meaningful week look like without clinical responsibilities?

• Where do I want to contribute next—mentorship, teaching, volunteering?

• What gives me energy that has nothing to do with medicine?

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Talk with your spouse or partner about shared and individual expectations. A clear purpose doesn’t just make retirement richer—it can reduce the impulse to “go back” prematurely.

5. Treating Estate Planning as a One-Time Task—Or Skipping It Entirely

In my experience, many physicians don’t tackle estate planning until their 50s—if at all. And even when they do, the plan often reflects a moment in time when kids were younger or sometimes teenagers and the focus was more on guardianship than long-term wealth transfer.

The problem? Laws change, family dynamics shift, and the size of your estate grows. But the estate plan stays the same—untouched for years, sometimes decades.

This can lead to unintended outcomes: outdated or missing beneficiary designations, unnecessary tax exposure, or confusion for your spouse and heirs during an already emotional time.

What to do: Make estate planning a living process—not a one-time event. Review your documents every few years, especially as your wealth grows or laws evolve. Coordinate with both your estate attorney and financial advisor to ensure that your trusts, wills, and account titles work together—not at cross purposes. If you're charitably inclined, consider strategies like Donor Advised Funds or charitable trusts that can support your legacy goals while offering current tax benefits.

Why Physician Retirement Planning After 50 Requires a Specialized Approach

As physicians approach retirement, their financial challenges often diverge from those of the general population. High incomes, deferred compensation, tax-heavy retirement accounts, and the potential for consulting or locum work make physician retirement planning uniquely complex. A one-size-fits-all strategy simply won’t cut it. Tailoring a plan to your clinical timeline, tax exposure, and long-term goals is essential to protect your wealth and create a sustainable, purpose-driven retirement.

Final Thoughts: It’s Not Too Late—but It’s Time

If you’re a physician in your 50s or 60s, retirement may feel closer than ever—but that doesn’t make it simpler. In fact, it’s often the most nuanced and high-stakes financial phase of your life.

The good news? You don’t need to do this alone. With the right guidance, you can move from uncertainty to clarity—from reactive to intentional.

I work with physicians and healthcare professionals who are preparing for this next chapter. Whether it’s optimizing your retirement income, aligning your tax and estate strategies, or simply figuring out what you want your legacy to be—my role is to be your advocate.

You've spent a lifetime taking care of others. Now it's time to take care of your future—with the same skill, precision, and care you’ve given your patients.

About the Author

Daniel R. Harris, JD, is the founder and principal of D.R. Harris & Co., a national, fee-only fiduciary financial advisory firm dedicated to serving physicians across the United States. Based in La Jolla, California, Daniel provides personalized, physician-focused financial planning—specializing in retirement preparation, tax-efficient strategies, and comprehensive wealth management—for clients in both urban and underserved rural areas.

Daniel graduated Phi Beta Kappa from Stanford University, earning both a bachelor’s degree and a master’s degree before completing his Juris Doctor at UC Berkeley School of Law, where he focused on tax, estate, insurance, and real estate law. His strong academic foundation enhances his ability to navigate the complex financial and regulatory environment physicians face. While Daniel’s firm offers sophisticated

financial advice informed by his legal background, it does not provide legal advice to clients in exchange for compensation.

Before founding D.R. Harris & Co. in 2009, Daniel gained valuable legal experience working at the U.S. Attorney’s Office and at Pillsbury Winthrop, where his contributions supported client matters and prosecutorial work. He began his financial advisory career at Merrill Lynch, then the largest full-service wealth management firm in the country. These experiences have shaped his comprehensive approach to financial planning—grounded in legal insight and practical investment expertise.

Daniel works closely with physicians in their 50s and 60s to help them confidently navigate the transition into retirement, addressing unique challenges such as tax planning, estate considerations, and sustainable income strategies. Having grown up in a mid-sized medical market, Daniel understands the financial complexities physicians face, especially those practicing in underserved regions.

“My goal is to help physicians build retirement plans that are strategic, tax-aware, and tailored to their unique careers—all while maintaining the highest standard of fiduciary care.”

If you’re a late-career physician considering your next chapter, schedule a complimentary consultation today to discuss how a tailored, physician-focused retirement plan can help you retire with confidence. Visit the Contact Page to get started.