Most physicians have an estate plan. The problem isn’t that they skipped it. The problem is they did it once, filed it away, and never thought about it again.
If you drafted your documents more than five years ago, and your life has changed in any meaningful way since then, that plan is probably wrong. Not slightly off. Wrong in ways that could leave your family dealing with a legal and financial mess at exactly the moment they’re least equipped to handle it.
Here’s how to think about it, what to actually check, and where physicians specifically tend to get tripped up.
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Why Physicians Let Estate Plans Go Stale
I’ll be honest about my own situation. I pulled out my estate plan a few years ago after a colleague of mine passed away suddenly. We’d worked together in the OR for years. He was in his early 50s, healthy, active. He was mountain biking and just didn’t come home. His kids were in high school.
That kind of loss makes you think about your own mortality. But it also made me ask a more practical question: if something happened to me tomorrow, would my family actually be okay? Not emotionally. Legally. Financially. Would the documents I have say what I actually intend them to say?
So I found my estate plan. And what I found was that it had been written before my second child was born.
My real estate portfolio didn’t exist when that document was written. My business didn’t exist. A beneficiary listed on one of my accounts was someone I would not have chosen if I’d sat down that day and actually thought about it.
None of that was wrong because I was careless. It was wrong because life happened. A decade passed. The document stayed the same.
For physicians, this gap is usually wider than average. Think about what changes in a doctor’s financial life over ten years. Kids are born. Real estate is acquired. Businesses are started. A second income enters the household. Net worth grows substantially. Every one of those events is a legitimate trigger for a review. Most of us never do it.
What’s Actually in Your Estate Plan
Before you can know what to update, you need to understand what you’re working with. A lot of physicians aren’t entirely sure what they signed. Here’s a quick breakdown of the core documents.
The will. This is what most people think of first. It says where your assets go when you die. But a will goes through probate, which is a court process. It’s public, it takes time (sometimes over a year), and it costs money. Most physicians with any meaningful asset base should not be relying on a will alone.
The revocable living trust. This is what avoids probate. Assets transfer directly to your beneficiaries without going through a court. Faster, private, and more control over how and when distributions happen.
But here’s the issue I see constantly: physicians have a trust that was never funded. The trust exists on paper, but the assets were never actually transferred into it. The house is still titled in their personal name. The brokerage account is still personal. The rental property, same. So when they pass, everything goes through probate anyway. The trust is just a document sitting in a drawer.
The durable power of attorney. This names who can make financial decisions on your behalf if you’re incapacitated but still alive. Most physicians named someone years ago and haven’t revisited it. Is that still the right person? Is that relationship still the same?
The healthcare directive. Separate from the financial POA, this document names who makes medical decisions if you can’t make them yourself and outlines your wishes around end-of-life care. As physicians, we understand what that actually means. We’ve seen both sides of what happens when this document exists versus when it doesn’t.
The Document That Quietly Overrides Everything Else
Here’s the one most people underestimate: beneficiary designations.
Your retirement accounts, life insurance policies, and many bank and brokerage accounts do not follow your will. They do not follow your trust. They go directly to whoever is listed as the beneficiary, full stop, regardless of what any other document says.
I’ve heard versions of this story more times than I can count. A physician updates their trust, spends real money on a good attorney, gets everything structured properly. But the 401k still names an ex-spouse. Or a parent who passed away years ago. Or it lists the kids as primary beneficiaries with no age restriction, meaning an 18-year-old receives a million dollars with no structure around it.
This isn’t hypothetical. This happens.
The fix is straightforward, but you have to actually do it. Log into every retirement account, every life insurance policy, every account with a beneficiary field. Look at what it says. Ask whether it still reflects what you want. If the answer is no, change it.
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The Layer Most Generic Estate Attorneys Miss
If you own real estate, run a business, or have any significant complexity in your financial life, a general estate attorney who occasionally does wills is probably not the right fit. Your situation requires someone who understands how these pieces connect.
Real estate properties need to be titled correctly, not just for estate planning but for asset protection. Are they held in an LLC? Is that LLC referenced in your trust? Does the trust actually hold the LLC interest? These aren’t just formalities. They determine what your family inherits, how they inherit it, and what’s protected if a lawsuit enters the picture.
If you have a business, the same questions apply. Who inherits your interest? What happens to the business if you’re suddenly gone? Is there a buy-sell agreement in place? Does your partner know what the plan is?
And if you’re still practicing, malpractice exposure is a real factor in how your estate should be structured. Certain trust structures and asset titling strategies are specifically designed for high-liability professionals. This isn’t a one-size-fits-all conversation.
What to Actually Do
You don’t need to overhaul everything this week. But start with one thing.
Find your estate plan. Look at when it was written. Look at who’s named as executor, trustee, power of attorney, healthcare proxy. Look at your beneficiary designations on every financial account you own.
Then ask yourself one honest question: “Does this still reflect my life as it actually is today?“
If the answer is no, or even “I’m not sure,” that’s your signal.
Schedule a review with an estate attorney who has experience working with physicians or high-net-worth professionals with real estate and business interests. That conversation usually takes two or three meetings. It costs real money. And it’s worth every dollar.
The kindest thing you can do for the people you love is make sure that when the worst happens, the one thing they don’t have to deal with is a legal and financial mess you left behind. That’s what estate planning actually is. Not a morbid task to check off a list. A practical act of care for the people who matter most.
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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.
Disclaimer: I am not a CPA, attorney, or financial advisor. The information in this post is for educational purposes only and should not be construed as tax, legal, or financial advice. Please consult a qualified professional about your specific situation before making any decisions.
Further Reading
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