In 2025, I celebrated a monumental milestone: I saw a patient within 20 miles of my home. While this may be a daily occurrence for most physicians, it was something I could not do for 18 months due to a non-compete clause from my previous job.

When I left my position as an academic cardiologist, I was bound by a non-compete clause that prevented me from practicing cardiology within 20 miles of my former practice for 18 months. In states where they are enforceable, these clauses are incredibly effective—dissatisfied physicians who would otherwise leave often decide against it because the cost of uprooting their families is too great. My family and I just finished riding out that non-compete period without moving or disrupting my wife and children’s well-being. Here’s how to do it.

Step 1: Build a worst-case scenario fund

As soon as I seriously considered leaving my job, my wife and I started building a side fund to cover a scenario in which I couldn’t practice medicine for 18 months. We already had an emergency fund in a high-yield savings account that would cover six months of living expenses; over the next few months, we expanded it to cover 12 months. Given our household situation and the favorable job market for cardiologists at the time, that amount felt conservative yet sufficient. Pick an amount that will allow you to sleep at night.

This often-neglected step is critical because it sets the stage for all future conversations with employers or clients. Negotiating from a position of strength gives you the power to advocate for necessary changes to your position, walk away from an unsalvageable job, or secure favorable terms for a new role. You never want to be in a situation where you must bluff or plead during a negotiation.

Step 2: Be clear about the future you want to build

My purpose in leaving was to create a more sustainable, part-time career where I could prioritize my health, marriage, and family. I wrote guiding principles about the future I wanted to build and got feedback from my wife to ensure we were aligned. Here are a few:

• Leaving this job will be the best thing that ever happened to our marriage.
• The net effect of my job change will be more flexibility and agency for my wife’s interests and career, not less.
• I must make at least half of what I made in my old position within a year.
• If I cannot accomplish these goals, I will return to a full-time job, possibly even the one I was leaving.

No matter what principles guide you, sticking with them will be difficult. Physicians spend years following a regimented and predictable career path, making change feel isolating and disorienting. You will face immense pressure to stay on the traditional path. If you leave a toxic job without a clear mission, it is too easy to lose yourself—or even return to your old position out of familiarity. I was tempted many times. Having a clear vision of the future I was building got me through.

Step 3: Explore and choose new sources of income that fit your vision

Practicing medicine outside the non-compete radius, engaging in medicine-adjacent roles, or pursuing non-clinical work are all viable options during a non-compete. For me, I chose to do locum tenens work about one week per month, be the best house-husband possible for the rest of the time, and undergo training to pass the Certified Financial Planner exam and build my own financial planning firm for physicians.

It is critical to complete Step 2 first, or you may be tempted to grasp whatever opportunity comes first, even if it leads you away from your ideal future. For example, if you choose to do expert witness work, be clear about its role in your career and how it will impact your personal life. Is this just temporary work to get you through the non-compete? Or will you continue after the non-compete ends because it aligns with your long-term vision?

Step 4: Make a Plan B and C

Once you decide on an alternative income source, create a Plan B and C in case your primary plan fails. Whatever your Plan A is, assume that it will become unsustainable, terminated, or unsuccessful in ways you cannot predict. Prepare for this inevitability in advance.

This happened to me—many locum tenens jobs allow either party to cancel with 30 days’ notice, and I had multiple gigs canceled, leaving me with employment gaps as long as three months. My worst-case scenario fund from Step 1 gave me the financial runway to execute my Plans B and C, allowing my family and me to weather those setbacks.

Step 5: Give notice and help your colleagues with the transition

Only after completing Steps 1 through 4 should you give notice. Start with your leadership team, then inform your colleagues and patients. Be gracious and fully dedicated through your last day—your colleagues and patients will be affected by your departure, and you should take every opportunity to ease the transition.

Even if you have no desire to do so, maintaining goodwill is crucial. You will need referrals from former colleagues when credentialing at another practice or health system. Since you are not leaving the area, keeping bridges unburnt is critical. Ensure you have a clear paper trail specifying when the non-compete clock starts to prevent ambiguity in the future.

With the right mindset and planning, you can reclaim control from a non-compete clause and chart your own career path.

Stanley Liu is a cardiologist.