Most physicians spend years, even decades, in training with the promise of a stable, high-earning career waiting on the other side. You land that dream job, sign a promising contract, and think, “I’m set.”
But here is the reality. Your physician salary may feel safe, but it is not guaranteed.
I’m not here to sound alarms. My goal is to prepare you for a truth I learned the hard way and that I have seen countless physicians face throughout their careers.
Disclaimer: This article is for informational and educational purposes only and does not constitute financial, legal, or investment advice. Any investment involves risk, and you should consult your financial advisor, attorney, or CPA before making any investment decisions. Past performance is not indicative of future results. The author and associated entities disclaim any liability for loss incurred as a result of the use of this material or its content.
My Wake-Up Call
When I came out of fellowship, I landed what I thought was the perfect job. Partnership track, meaningful work, a great location… everything I had worked so hard for. I told myself, “I’m set.”
But just a couple of years in, everything changed. The promises made at the start shifted. My expected shifts disappeared, and my “guaranteed” income was not so guaranteed after all.
That experience taught me a critical lesson. In medicine, security is often an illusion.
Years later, my group faced a forced employment situation. Contracts were renegotiated, compensation changed, autonomy lost. Many colleagues left medicine altogether. I was fortunate to have built other income streams by then, and while it was still scary, I was prepared.
Why Your Income Might Be at Risk
Several forces are reshaping the financial landscape for physicians.
Reimbursement Cuts
These happen, sometimes overnight, with little warning. Whether through Medicare reductions or private insurance changes, many physicians find themselves earning less for the same work.
Hospital Consolidation
As more physicians become employees of large health systems, autonomy and negotiating power erode. Decisions are increasingly made by administrators focused on the bottom line, not by physicians.
AI and Automation
While AI can enhance patient care, it is also beginning to automate tasks that physicians used to perform and get paid for. Whether it is diagnostic algorithms, automated charting, or virtual consultations, the shift is happening faster than many expected.
Burnout
The pressures of modern healthcare, combined with administrative burdens and long hours, are pushing more physicians to reduce clinical hours or leave the field entirely. Even if you love your work, burnout is a real risk that can affect your income.
Market Forces
Economic downturns, changes in healthcare policy, and even pandemics can dramatically alter the demand for certain specialties or procedures. Nothing is immune to the forces of supply and demand.
If your financial stability depends on a single income source, you are balancing on a one-legged stool. That may work for now, but it is dangerously unstable over the long term.
The Problem with “I’ll Do It Later”
One of the most common things I hear from physicians is, “I’ll start investing or creating passive income once I pay off my loans,” or “I’ll wait until I make partner,” or “I’ll think about it when I have more time.”
The problem is that life happens. And when it does, you will wish you had started building that safety net sooner.
Waiting until your back is against the wall means you will be making decisions from a place of fear and urgency, rather than strategy and confidence.
The Solution. Build Your Backup Plan
I am not saying you need to leave medicine. In fact, having a solid backup plan might help you stay in it longer with more freedom and peace of mind.
Here is how to start.
- Audit Your Income Sources.
What percentage of your income relies on you showing up at work? If you could not work tomorrow due to burnout, family needs, or a shift in your practice, what would happen to your finances?
- Invest in Financial Education.
Learn about passive income, entrepreneurship, and investments. The more you understand about how money works, the more options you will have. Knowledge gives you leverage.
- Start Small, Start Now.
Whether it is a real estate investment, a side business, or a new skill, take your first step before you feel ready. You do not need to replace your salary overnight. The key is to build momentum.
- Join a Like-Minded Community.
Surround yourself with others on the same journey. That is what Passive Income MD is all about. It is easier and faster when you are connected with people who can share advice, opportunities, and encouragement.
- Have a Long-Term Vision.
Building multiple income streams is not about getting rich quick. It is about creating flexibility and control over your career and life. It is about having choices when circumstances change, because they will.
A Real-Life Example from Our Community
I have seen this play out time and time again within the Passive Income MD community. One physician started investing in real estate on the side, not because they planned to leave medicine, but because they wanted options.
A few years later, when their practice faced unexpected cutbacks, they were not forced into panic mode. Instead, they adjusted their schedule, leaned on their passive income, and took time to figure out their next move. That is the power of having a backup plan.
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Final Thoughts
Hope is not a strategy. If the last few years have taught us anything, it is that change is inevitable and often out of our control.
But preparation is one hundred percent up to you.
So ask yourself. If your physician income changed tomorrow, would you be ready?
If the answer is no, it is time to start building your backup plan.
It does not have to be complicated. It does not have to take over your life. But it does need to start today.
And if you want help, you are in the right place. Let us know how we can support you.
Your future self will thank you.
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Peter Kim, MD is the founder of Passive Income MD, the creator of Passive Real Estate Academy, and offers weekly education through his Monday podcast, the Passive Income MD Podcast. Join our community at the Passive Income Doc Facebook Group.
Further Reading