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.
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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.
This article is discussed on The Podcast by KevinMD: Why physicians stay in jobs they could afford to leave.
Stanley Liu is the only prominent practicing cardiologist who also practices as a 100 percent fiduciary, fee-only financial planner in the United States. He is the founder and principal financial planner at DocEmpowered, LLC, a financial planning firm dedicated solely to physician financial wellness.
His career pivot into the financial side of physician wellness began with a choice between walking away from his career as a beloved academic cardiologist and telling his young son he could never walk him to the school bus stop in the morning. Liu chose to walk away, creating his own financial plan to ride out an 18-month, 20-mile noncompete with his family and emerging on the other side with autonomy he once only dreamed of. Today, he practices medicine sustainably and with purpose as a self-employed cardiologist. He eats breakfast and dinner with his kids every day, salsa dances with his wife, and is a dedicated volunteer, advocate, and philanthropist for his community.
Liu also became a licensed financial planner, earned a Certificate in Financial Planning from Emory University, and passed the CFP examination, one of the most highly respected accomplishments in the financial planning profession. As a financial planner, he has helped physician clients across the United States reclaim autonomy in their lives and careers while staying true to their highest values.
Liu is a highly sought-after speaker for his expertise in financial planning and his unique ability to apply it to the physician community as a trusted peer. His insights have been featured in Medscape and PracticeLink Magazine, and he has been an invited speaker for multiple medical societies, including the American College of Cardiology, the American College of Physicians, and the Society of Cardiovascular Computed Tomography. He brings his audiences a rare perspective on the underrated connection between physician wellness and financial planning.
His mission is simple: Give every physician the financial power to serve their patients, families, and communities on their own terms. He shares more on his DocEmpowered blog, LinkedIn, Facebook, and X.
