Suppose you were offered the following two work opportunities. Which would you choose?

Career A: an acceptable opportunity that pays slightly more than your current job; you’re guaranteed never to make less than you do today.

Career B: a dream opportunity that sings to your soul but comes with no guarantees. While you may make much more than you do today, you could also potentially take a six-figure pay cut.

In other words, do you maximize the upside? Or do you minimize the downside?

In medicine, we are trained to minimize the downside to our patients. First do no harm. The potential benefits of a treatment must outweigh the risks, and even then, we will only start it after shared decision making with the patient. And that is the way things should be.

We often extend the same logic into our career choices: First do no harm once more. Most physicians I know will choose Career A. We have mortgages to pay, loans to pay off, or families to feed. These are non-negotiables, and we cannot put our families in a worse bind in pursuit of a dream that is not guaranteed.

But what if we imagined a situation where the worst-case scenario was acceptable? Suppose your finances were set up such that you could absorb that six-figure pay cut without causing short-term or long-term harm to your family’s wellness. Would you still choose Career A?

There are many ways that a solid financial plan could help make Career B’s potential downside more acceptable:

• Proactive tax planning to ensure you preserve more of what you earn
• Creating a reserve fund to ride out any income gaps
• A long-term investment plan whose goals won’t be derailed by short-term drops in income
• A debt payoff or forgiveness plan that can survive a worst-case scenario
• Optimal contract negotiation to optimize revenue and minimize short-term financial risk

My current career (as a self-employed cardiologist and an independent financial planner) exists because I personally chose Career B after doing everything on that list. The uncertainty of Career B is not for everyone, and even many physicians with strong finances will still choose Career A. That’s totally fine.

But what I hope for every physician is that the choice is theirs and theirs alone. As a physician, you should be in a position where Career B is a reasonable bet regardless of what you ultimately decide. Imagine if every physician were in that position. How much more empowered would we be as a community?

So where do you fall? Are you the first-do-no-harm physician who wants the power to take smart risks when necessary? Or are you the physician already dreaming of something better and wanting to build the financial foundation to do so?

Wherever you are in your career, investing time in understanding and organizing your financial life is not simply about wealth accumulation. It is about creating the conditions for sustainable, self-directed career decisions.

And in a world where physician autonomy is under constant threat, that may be one of the most under-appreciated forms of security we can build.

Stanley Liu is a self-employed cardiologist and a flat-fee-only, 100 percent fiduciary financial planner who has passed the CFP examination. He is the founder of DocEmpowered, LLC, a financial planning firm dedicated to helping physicians gain the financial power to serve their patients, families, and communities on their own terms.

Dr. Liu combines his clinical and financial expertise to help fellow doctors pursue greater wellness, autonomy, and alignment in their personal and professional lives. Clinically, he practices in locum tenens and value-based care settings on his own terms. He also serves as advocacy chair of the Maryland chapter of the American College of Cardiology and is an award-winning medical educator.

Drawing on both personal experience as a physician and professional training in financial planning, Dr. Liu helps other physicians build careers and lives that prioritize health, marriage, family, patients, and community. He shares more at DocEmpowered, LinkedIn, Facebook, and X.e