Healthcare employers have expanded access to retirement guidance, but a new survey suggests that personalization remains scarce—a gap that financial advisors are increasingly targeting. Transamerica's Retirement Plan Trends in Healthcare survey, based on responses from 100 healthcare organizations, found that 90% offer virtual one-on-one retirement and financial wellness meetings, and 66% provide in-person sessions. Yet only 27% deliver education tailored to specific employee groups, such as physicians or executives.
The findings underscore a persistent challenge: high-income healthcare professionals often face complex benefit structures and limited time, making generic advice insufficient. According to a 2023 TIAA Institute survey cited by Evan Potash, an executive wealth management advisor at TIAA Wealth Management, 45% of retirement savers in the healthcare sector are saving less than they would like due to debt payments. Potash notes that physicians typically enter peak earning years later than other professionals, after years of training and student debt, which delays retirement saving.
Iván Watanabe, managing partner at Opus Private Client, argues that medical training conditions doctors to surrender autonomy, from admissions through residency and first attending contracts. This mindset often leads them to rely on colleagues for financial advice, compounding the problem. "Advisors need to respect that trust while challenging conventional wisdom and helping physicians recognize they have far more control over their financial futures than they've been conditioned to believe," Watanabe said.
Coordinating multiple retirement plans
The survey reveals a mix of retirement vehicles: 70% of healthcare organizations offer a 403(b), 52% a 401(k), and 28% a nonqualified deferred compensation 457(b) plan. For senior clinicians, this can mean juggling accounts with different tax treatments, distribution rules, and employer credit risk. Laura Gaynor, head of new business architecture and DC practice leader at Transamerica, emphasizes that advisors should help clients see how these pieces fit together rather than evaluate them in isolation.
Watanabe highlights three critical differences among 403(b), 401(a), and governmental versus nongovernmental 457(b) plans: access, distribution flexibility, and employer credit risk. For instance, nongovernmental 457(b) plans cannot offer age-50 catch-up contributions, and deferrals remain subject to the employer's creditors. He also stresses that disability coverage should come first to protect earning power. "Too often, physicians maximize tax-deferred retirement savings without considering whether they're also building sufficient assets outside those plans," Watanabe said.
Potash adds that while reducing today's tax bill is a priority for high earners, it should not overshadow planning for future taxation. This includes balancing pretax and Roth contributions, timing deferred compensation distributions, and considering how different income sources will be taxed in retirement. Employers often use "top hat" plans to sweeten executive pay, adding another layer of complexity.
Proactive advice and client needs
Healthcare costs top the list of financial wellness concerns, with 86% of employers identifying them as pressing, and 70% citing the need to understand retirement and healthcare costs in retirement. Gaynor says good advice means "turning competing priorities into a clear, personalized course of action." Both Potash and Gaynor advocate for proactive engagement, such as anticipating client needs rather than waiting for questions. Flexible scheduling, like early-morning meetings, is just the starting point.
Mark B. Murphy, CEO of Northeast Private Client Group, warns that a large salary does not automatically build wealth. "You can't build a pyramid from the top down and expect it to stand," he said, emphasizing the importance of protecting assets and building a solid financial foundation. For advisors, this means helping healthcare clients balance tax efficiency with liquidity and flexibility, enabling them to make career and lifestyle decisions on their own terms.
As healthcare employers continue to offer more retirement resources, the opportunity for advisors lies in personalization. By addressing the unique needs of physicians and executives—who often have high incomes but complex benefits and little time—advisors can turn a collection of benefits into a coordinated retirement strategy. The data from Transamerica and TIAA suggest that tailored guidance is not just a luxury but a necessity for this segment.
