By Dr. David Edward Marcinko MBA MEd

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For generations, the prevailing belief in healthcare has been that physicians [MD, DO and DPM], with their high salaries and prestige, inevitably retire wealthier than nurses. Yet this assumption overlooks the financial realities of different nursing specialties and the long‑term impact of debt, lifestyle, and retirement planning. In fact, some Registered Nurses (RNs)—particularly Certified Registered Nurse Anesthetists (CRNAs), visiting nurses, and those who participate in structured pay programs like the Baylor plan—can retire richer than physicians. The reasons lie in the interplay of education costs, career flexibility, income potential, and disciplined financial planning.

Education Costs and Debt Burden

One of the most decisive factors shaping retirement wealth is the cost of education. Physicians often spend over a decade in training, including undergraduate studies, medical school, and residency. This path not only delays their earning years but also saddles them with substantial student debt. The median medical school debt in the United States exceeds $200,000, and many physicians spend years paying it down.

By contrast, RNs typically complete their training in two to four years, with advanced practice nurses such as CRNAs requiring graduate‑level education. Even so, their debt burden is far lighter, often less than half of what physicians carry. This difference means nurses can begin earning earlier, save for retirement sooner, and avoid the crushing interest payments that erode physicians’ wealth. A CRNA who starts practicing in their late twenties may already be investing in retirement accounts while a physician is still in residency earning a modest stipend.

Income Potential of Specialized Nurses

While physicians generally earn more annually than nurses, the gap is narrower in certain specialties. CRNAs, for example, are among the highest‑paid nursing professionals, with average salaries often exceeding $200,000 per year. This places them in direct competition with some physician specialties, especially primary care doctors, who may earn similar or even lower salaries.

Visiting nurses also benefit from unique financial advantages. Many work on flexible schedules, contract arrangements, or per‑visit compensation models. This allows them to maximize income while minimizing burnout. By avoiding the overhead costs of private practice and the administrative burdens physicians face, visiting nurses can channel more of their earnings directly into savings and investments.

When combined with lower debt and earlier career starts, these income streams can compound into significant retirement wealth.

💰 Highest-Paying Nursing Careers (2025)

• Certified Registered Nurse Anesthetist (CRNA) – ~$212,000 annually
• Nurse Practitioner (NP) – $120,000–$140,000+ depending on specialty (Family, Acute Care, Psychiatric)
• Clinical Nurse Specialist (CNS) – $120,000–$135,000
• Nurse Midwife – ~$115,000
• Nurse Manager/Administrator – $110,000–$120,000
• Informatics Nurse Specialist – ~$115,000
• Neonatal ICU Nurse (NICU) – $110,000+
• ICU Nurse – $105,000+
• Pain Management Nurse – ~$104,000
• Oncology Nurse – ~$100,000

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The Baylor Pay Plan Advantage

The Baylor plan, a structured pay program used by some hospitals, allows nurses to work full‑time hours compressed into fewer days—often weekends—while still receiving full‑time pay and benefits. This arrangement provides several financial advantages. First, it enables nurses to earn competitive wages while freeing up weekdays for additional work, education, or entrepreneurial ventures. Second, it reduces commuting and childcare costs, allowing more income to be saved. Third, the plan often includes robust retirement benefits, such as employer‑matched contributions to 401(k) or pension programs.

Nurses who consistently participate in such structured pay plans can accumulate substantial nest eggs, often surpassing physicians who delay retirement savings due to debt repayment or lifestyle inflation. The Baylor plan highlights the importance of systematic investing: by automating contributions and focusing on long‑term growth, nurses can harness the power of compound interest. A nurse who invests steadily for 35 years may accumulate more wealth than a physician who begins saving late and inconsistently, despite earning a higher salary.

Lifestyle and Work‑Life Balance

Another overlooked factor is lifestyle. Physicians often face grueling schedules, high stress, and the temptation to maintain expensive lifestyles commensurate with their social status. Luxury homes, cars, and vacations can erode their financial base. Nurses, while not immune to lifestyle inflation, often maintain more modest spending habits.

Visiting nurses, in particular, enjoy flexibility that allows them to balance work with personal life. This reduces burnout and healthcare costs while enabling consistent employment into later years. By living within their means and prioritizing savings, nurses can accumulate wealth steadily without the financial pitfalls that sometimes accompany physician lifestyles.

Retirement Wealth Beyond Salary

Retirement wealth is not solely determined by annual income. It is shaped by debt management, savings discipline, investment strategies, and lifestyle choices. Nurses who leverage high‑paying specialties like anesthesia, flexible arrangements like visiting nursing, and structured programs like the Baylor plan can outperform physicians in these areas.

Consider two professionals: a physician earning $250,000 annually but burdened by $200,000 in debt and high living expenses, and a CRNA earning $200,000 with minimal debt and disciplined savings. Over decades, the CRNA may accumulate more net wealth, retire earlier, and enjoy greater financial security.

Conclusion

The assumption that physicians always retire richer than nurses is outdated. While physicians command higher salaries, their delayed earnings, heavy debt, and lifestyle pressures often undermine long‑term wealth. Nurses, particularly CRNAs, visiting nurses, and those who participate in structured pay programs like the Baylor plan, can retire wealthier by combining lower debt, earlier savings, competitive incomes, and disciplined financial planning.

Ultimately, retirement wealth is not about prestige but about strategy. Nurses who recognize this truth and act accordingly may find themselves enjoying more financial freedom than the very physicians they once assisted.

COMMENTS APPRECIATED

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit an RFP for speaking engagements: CONTACT: Ann Miller RN MHA at MarcinkoAdvisors@outlook.com -OR- http://www.MarcinkoAssociates.com

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