Healthcare Retirement Advice Gap Persists Despite Broad Access to Employer Meetings

Healthcare employers have made retirement guidance easier to access, but personalized advice remains uncommon. That gap matters for physicians and healthcare executives, whose debt, late-arriving peak earnings and layered workplace benefits can make a standard retirement conversation a poor fit.

In a survey of 100 healthcare organizations, 90% offered virtual one-on-one retirement and financial wellness meetings, while 66% offered in-person sessions. Only 27% provided education tailored to specific employee groups, according to Transamerica. The findings echo Transamerica’s broader research on workers under severe financial strain. For advisors, the figures describe an audience that can have high income and complicated choices, but little time to sort through them.

Debt and delayed earnings shape the starting point

Many physicians reach their highest earning years later than other high-income professionals. Years of training can delay saving while student loan payments compete for cash. Evan Potash, an executive wealth management advisor at TIAA Wealth Management, cited a 2023 TIAA Institute survey of healthcare workers: 45% of retirement savers in the sector said debt payments led them to save less than they otherwise would.

That can leave clinicians facing two needs at once: addressing immediate obligations and building savings as income rises. Potash said career changes within the competitive healthcare industry can add uncertainty to long-term projections. His advice is to establish a plan that accounts for near-term priorities and longer-term goals, save consistently, and revisit the plan as circumstances change.

Iván Watanabe, managing partner at Opus Private Client, sees another influence in doctors’ professional training. Admissions, Match Day, residency and the first attending contract can involve years of limited control over major decisions. In his view, some physicians carry that pattern into their finances and rely heavily on colleagues for guidance. Advisors have also observed that physicians can enter the workforce behind on retirement saving.

Watanabe said advisors need to earn trust while helping clients question assumptions and see the choices they can make about their financial futures. That calls for advice that takes a physician’s experience seriously while making the available decisions easier to understand.

Workplace plans need to be considered together

The benefits on offer can add another layer. Among the organizations in Transamerica’s survey, 70% offered a 403(b), 52% a 401(k), and 28% a nonqualified deferred compensation 457(b) plan. Senior clinicians and executives may have access to multiple accounts, each with its own tax treatment, access rules and risks.

Laura Gaynor, Transamerica’s head of new business architecture and defined contribution practice leader, said advisors should explain how each benefit fits the client’s broader plan. The task is to help clients prioritize their choices and coordinate them with retirement goals, rather than assess each account on its own.

Watanabe said differences among 403(b), 401(a), and governmental and nongovernmental 457(b) plans can affect access to money, distribution flexibility and employer credit risk. The guidance on nongovernmental 457(b) deferred compensation plans describes distinctions from governmental versions, including that nongovernmental plans cannot offer age-50 catch-up contributions. Deferrals in these plans generally remain subject to the employer’s creditors, creating a risk employees should understand. Watanabe said protecting a physician’s ability to earn through adequate disability coverage belongs at the start of the discussion.

There’s also a trade-off between tax deferral and access to funds. Watanabe cautioned that maximizing tax-deferred savings can leave too little outside those accounts. Balancing tax efficiency with liquidity and flexibility can matter to people considering a career change or a different lifestyle.

Potash said the focus on lowering taxes today shouldn’t eclipse how income may be taxed later. Planning can include weighing pretax and Roth contributions, timing deferred compensation distributions and considering the tax treatment of different retirement income sources. Those questions can become especially relevant where top hat plans form part of executive compensation.

Advice has to change with the client

Healthcare expenses remain a leading concern: 86% of surveyed employers identified healthcare costs as a pressing financial wellness need, and 70% cited understanding the cost of retirement and healthcare in retirement. Gaynor said useful guidance turns these competing priorities into a clear, personalized course of action.

Flexible meeting times, including early mornings and evenings, can help busy professionals make room for advice. But Potash and Gaynor said availability alone isn’t enough. Advisors also need to anticipate questions and surface decisions before clients raise them. That can help turn complicated benefits and financial choices into manageable next steps.

Mark B. Murphy, chief executive of Northeast Private Client Group, said a large salary doesn’t automatically create wealth. He describes wealth building as a pyramid: clients first need to protect what they have, establish confidence in their cash position and set a sound strategy. Growth, income beyond a paycheck and multigenerational goals come later in that sequence.

The plan also needs to develop with the client. A new physician, an established doctor and an executive nearing retirement have different priorities, Murphy said. A financial roadmap created once can’t be expected to suit someone unchanged for decades.

Watanabe said advisors should keep asking clients how much control they want over their time and how long they expect to remain in their current work setting. If practice ownership, entrepreneurship or early retirement is a possibility, where assets are held and how easily clients can access them may matter as much as how those assets are invested. For healthcare professionals, the value of advice lies in connecting financial decisions to the choices they want their careers and lives to support.