The cobbler’s children have no shoes
Mental health providers spend their careers helping other people look ahead. We ask clients what they want their lives to look like in five years. We help them weigh tradeoffs, tolerate uncertainty, and make decisions based on evidence rather than fear.
Then we go home and avoid opening our own retirement statements.
I say that with affection, because I have been there. Many of us chose this field because we care about people, not portfolios. Money talk can feel uncomfortable, even a little at odds with the work. But the same skills we teach every day apply here: name the avoidance, gather real data, and make a plan you can actually follow.
Why our situation is harder than it looks
Retirement planning for a clinician in private practice is not the same as planning for a salaried employee with a pension. A few features of our work make it more complicated:
- Mixed income streams. Many of us combine W-2 work, 1099 contract work, evaluations, supervision, and sometimes rental or other side income. Each stream grows, shrinks, and ends on its own schedule.
- No built-in safety net. Solo and small-group practitioners often have no employer pension and no one automatically saving on their behalf. If we don’t build it, it doesn’t exist.
- A practice to wind down. Office rent, licensing fees, malpractice coverage, software, and payroll don’t stop on their own. They taper and end on a timeline we have to plan.
- The gap before Medicare. Leaving practice before 65 means paying for health insurance on our own, often at a real cost.
- Medicare surprises after 65. Medicare premiums rise with income through IRMAA surcharges, which look back at income from two years earlier. A strong final year of practice, or a property sale, can raise premiums later.
- Two people, two timelines. For couples, each person has a different age, Social Security claiming date, and Medicare start date.
None of these is unmanageable. But together, they make a back-of-the-envelope estimate unreliable.
Rules of thumb are not a plan
Most of us have heard the shortcuts: save a fixed percentage, plan to spend a fixed fraction of your savings each year, retire at 65. These are reasonable starting points, but they assume a typical career. Ours rarely is.
As psychologists, we already know the value of measurement. We would never make a diagnosis from a single impression when we could gather structured data. Retirement deserves the same rigor. A good planning tool lets you:
- Enter your actual accounts, income sources, and expenses instead of national averages
- Update the numbers over time and see how reality compares with your projections
- Test “what if” questions before you commit to an irreversible decision
- See results in a chart, which is far easier to reason about than a column of figures
There is also a psychological benefit. Uncertainty feeds avoidance. A clear picture, even an imperfect one, tends to reduce anxiety and make the next step obvious.
Why I built Retirement Planner
When I looked for a tool that fit a practicing clinician’s situation, I kept running into the same problem. Consumer calculators were too simple. Professional software was built for advisors, full of jargon, and rarely handled practice expenses or Medicare well. So I built my own: Retirement Planner, a web-based dashboard designed around the realities of a professional practice.
It pulls everything into one place:
- People. Each household member, with date of birth and an assumed life expectancy, so projections run through the later of the two.
- Accounts. Retirement accounts, brokerage, savings, HSA, and cash, each with a log of actual balances over time and its own projected rate of return.
- Income. W-2 wages, multiple 1099 streams such as contract or rental income, and Social Security for each person, with a chosen claiming age and a cost-of-living adjustment.
- One-time events. An inheritance, a property sale, or the sale of a practice, with an expected date.
- Other assets. Your home or other property, with the option to include or exclude each from the “how long will my money last” calculation.
- Expenses. Standard household categories plus a separate set for practice costs, such as office supplies, phone, travel, equipment, licensing, malpractice coverage, software, continuing education, and payroll. Each line can have its own start date, end date, and inflation rate.
The guiding design principle was plain language. The dashboard says “money left over each year” rather than “net cash flow,” and “how long your savings last” rather than “portfolio depletion.” If a chart needs a finance glossary to read, it isn’t doing its job.
How it works in practice
Under the hood, Retirement Planner runs a year-by-year projection. For each year it adds up all income, subtracts all expenses, and draws the difference from (or adds it to) your accounts, applying each account’s expected return. The result is a running picture of your savings from today through the end of the plan.
Real markets don’t deliver the same return every year, so Retirement Planner also runs a Monte Carlo study. It simulates a large number of possible futures, each with its own mix of good and bad years in a different order, and counts how many of them leave you with money through the end of the plan. The result is a confidence level: a plain estimate of how likely you are to make it through retirement on your current projections.
Three features matter most for clinicians.
Side-by-side scenarios. You can build several versions of the future and compare them on one chart: a baseline, retiring two years later, cutting discretionary spending, or claiming Social Security early versus late. Each scenario appears as its own line, with a clear marker if and when savings are projected to run out. Seeing two or three options together turns an abstract worry into a concrete choice.
Practice wind-down. Because practice expenses are tracked separately, you can set them to end at a planned closing date and immediately see the effect. This is often where the most useful insights appear, because practice overhead disappears at the same time practice income does.
Health insurance and Medicare. Health coverage is modeled as its own module rather than a single expense line. Before 65, you enter your expected private or marketplace premium. After 65, the tool estimates Medicare premiums and checks your projected income against an editable table of IRMAA brackets, using the two-year lookback. That makes it possible to see, for example, whether a large final year of practice or a property sale might push premiums higher later, and to adjust timing accordingly.
Supporting charts show income versus expenses by year, a breakdown of spending categories, and projected Medicare costs over time.
Where to start
Whether you use Retirement Planner or another tool, the process is the same:
- Gather the facts. Current account balances, your Social Security estimates, and a realistic picture of household and practice expenses.
- Build a baseline. Enter what you know today, using conservative assumptions where you are unsure.
- Ask your “what ifs.” Retire earlier or later, scale back gradually, sell the practice, change your claiming age. Compare the results side by side.
- Revisit regularly. Update balances once or twice a year and watch how reality tracks against the plan.
- Bring in a professional. A tool clarifies the questions; a fee-only financial planner, CPA, or attorney can help you act on them, especially around taxes and estate planning.
Want to try Retirement Planner? If you’d like access to the tool for your own planning, email me at [email protected] and I’ll set you up.
We ask our clients to face hard questions with honesty and good data. We owe ourselves the same courtesy. A retirement plan is not just a financial document. It is a commitment to the person you will be after the last session ends.
This post is for general education and is not financial, tax, or legal advice. Please consult a qualified professional about your own situation.
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