The 5 Smartest Moves I’ve Seen Doctors Make That Built Serious Wealth

Over the years, I’ve advised a great many doctors—from fresh medical school graduates who were my fraternity brothers at UCSD to those nearing retirement—and I’ve noticed that while many are understandably focused on practicing medicine, a few take bold, strategic steps that build not just comfort but real wealth.

With war and tariffs dampening investment in many sectors—and the dollar losing ground—more doctors are coming to me looking for a vehicle that offers strong downside protection and enough upside to beat inflation. The best solution I’ve found is a defined benefit pension plan.

It took a mountain of reading to fully master, but now I lead the investment committee at Del Mar Medical Devices, a medical trade association, and have been meeting nonstop with physicians eager to tap into this powerful strategy. They see the value in leveraging the Pension Benefit Guaranty Corporation to back their retirement payouts, with annual actuarial calculations filed to the Department of Labor through Form 5500.

I’ve seen all of these strategies executed outside of a pension, but they’re far more powerful when done within one. These aren’t high-risk, high-reward bets—most doctors I know aren’t wired that way.

Here are the five strategies that have consistently delivered strong results.

1. Bought Dirt, Brought Their Network, and Sold at a 5% CAP

Some of the wealthiest doctors I’ve worked with didn’t just rent an office—they bought raw land or a rundown building in a growing area and called their med or dental school buddies to co-locate practices there. By converting the space into a medical plaza and leasing to reliable, recession-proof tenants (read: themselves and colleagues), they created a yield-producing real estate asset. When institutions came looking for low-risk medical office space, they sold it at a 5% capitalization rate and walked away with 20x+ their initial investment—on top of the income it generated in the meantime.

2. Integrated Angel Investing Into a Defined Benefit Plan

Defined benefit (DB) plans are powerful tools, offering guaranteed retirement income and allowing for sizable, tax-deductible annual contributions. But the doctors who blew me away didn’t stop there. They used ERISA-compliant portfolios to include exposure to private equity and real estate, and in some cases, wove in their own angel investments.

Thanks to PBGC insurance backing the promised payouts, they retained downside protection while the upside from the private investments flowed through the pension. It’s like getting the best of both worlds: safety and asymmetric return. A few even structured their retirement distributions to mimic a venture fund waterfall.

3. Bought a Practice Cheap, Then Gave Equity to the Protégé

Buying a practice at 1–2x revenue is smart. But turning it into a wealth-building machine is even smarter. I’ve watched doctors acquire practices, then bring in younger professionals, mentor them, and eventually offer equity. These junior partners brought fresh energy and more capacity—while the senior doctor saw their ownership stake appreciate and their patient load lighten. When they were ready to exit, the business had scale, a succession plan, and a built-in buyer.

4. Joined a Venture or PE Fund as a Medical Venture Partner

Rather than writing checks into every exciting pitch deck, a few doctors I know joined venture or private equity firms as medical venture partners. This gave them early access to deal flow, upside through carried interest, and a chance to contribute their expertise—without betting everything on a single start-up that might flame out.

The relationship was symbiotic: the fund gained credibility through its physician partners, attracting more capital, while the doctors benefited from diversified exposure across a professionally managed portfolio. With the right fund structures in place, their returns weren’t tied to the fate of just one company—they were part of a broader, institutionally backed strategy.

5. Turned Their Office Into a Launchpad for Startups They Backed

The most strategic doctor-entrepreneurs treat their practices as platforms for innovation and investment. One ENT featured an otoscope developed by a medtech startup he funded, transforming a standard tool into a live product demo.

A dentist displayed products from a company he backed right in his waiting room—offering both early capital and recurring revenue that helped the startup build traction for future fundraising. These subtle, authentic touches not only build patient trust but also elevate the visibility and credibility of the ventures they support.

Doctors don’t need to be financial experts to build meaningful wealth. What they do need is a plan that leverages what they already possess: a strong network, professional credibility, and steady income. When those assets are paired with a few smart, strategic moves like the ones above, the impact can be profound. It’s not just about funding retirement—it’s about building a lasting legacy.

If you're a doctor, dentist, or medical professional, join Del Mar Medical Devices (DelMar.org) to receive exclusive invites to in-person and virtual events in San Diego. You'll connect with peers, hear from inspiring MD/MBAs doing groundbreaking work, and explore the opportunity to participate in a defined benefit pension plan.