For the Physician Near Retirement

You have spent decades on call. Nights, weekends, holidays, and a lot of patients who will never know your name but are better because you showed up. Now the finish line of full-time practice is in view.

The next few years are a unique window for giving. Income is often at its peak right before it drops. Planning across that shift, rather than one year at a time, can help your generosity keep going long after the last shift ends.

This is not a financial plan. It is a map of the questions worth asking while there is still time to plan.

The Last High-Income Years

In your top-earning years, you are more likely to itemize, and a charitable deduction may be worth more. After retirement, income often falls, and many retirees take the standard deduction: $16,100 single or $32,200 married filing jointly in 2026.

That means the years before retirement may be the best time to do planned giving that you would otherwise spread across your seventies. It does not change why you give. It may change when.

It helps to look at what you own, not just what you earn. Many physicians hold stock or mutual funds that have grown for years. Shares held more than a year are generally deductible at fair market value, up to 30% of AGI, if you itemize, and you generally do not pay capital gains tax on the growth. Your CPA can help choose which shares.

Why Timing Matters Now

A donor-advised fund can help bridge the two seasons. You give into the fund in a high-income year, may get a deduction in that year if you itemize, and then recommend grants to eligible charities over many years into retirement.

The usual limits apply. Cash to a DAF is generally deductible up to 60% of AGI and appreciated long-term stock up to 30%, with a five-year carryforward. From 2026, itemized charitable deductions face a 0.5%-of-AGI floor, and the deduction value for the top bracket is capped at 35%. Your CPA can model how much giving makes sense in which year.

One honest reminder: giving always costs you more than it saves. A deduction lowers your tax by a fraction of the gift, never the whole gift. Give because you want the money to do good, and let the tax rules make that generosity go further.

If You Are Selling a Practice

Some physicians consider giving part of a practice interest before a sale. That is complex territory. A gift generally must come well before a sale is binding or nearly certain, and your attorney decides where that line is. Many sponsors are cautious with private business interests, and a qualified appraisal is generally required over $5,000 (over $10,000 for non-public stock).

Often the simpler path is giving cash from the sale proceeds in the year of the sale, when income is highest. Either way, talk with your CPA and attorney before the letter of intent, not after closing.

What Changes After Retirement

A few rules come into view as you move into retirement.

1. 1

   Income Drops

   With lower income, the standard deduction may win. Direct cash gifts may still count toward the new non-itemizer deduction.

2. 2

   Required Distributions Arrive

   Required minimum distributions from retirement accounts generally begin at 73 or 75, depending on your birth year.

3. 3

   QCDs Open at 70½

   Qualified charitable distributions from an IRA can go to many charities. They generally cannot go to a DAF.

A qualified charitable distribution moves money from an IRA straight to an eligible charity, up to an annual limit indexed for inflation, and can count toward your required distribution. It is not deducted, because it is not counted as income in the first place. That makes it useful even for people who take the standard deduction.

Retirement accounts you plan to leave to charity at death are another conversation for your attorney and CPA, since those accounts are often taxed differently in the hands of heirs than in the hands of a charity.

Number Our Days

Retirement is a good time to take stock of what the years were for, and what the next ones will be for.

Numbering your days is not gloomy. It is how you spend them on purpose.

For many physicians, retirement is the first season in decades when the calendar is truly their own. How you spend the first year often sets the pattern for the rest.

Give More Than Money

Your training does not retire when you do. Many physicians serve at church-based clinics, on short-term medical teams, or by mentoring younger doctors who want to practice with faith. Some teach health workers overseas.

Ask any ministry you serve with about licensing, liability coverage, and what kind of commitment actually helps. The best volunteer is the one who shows up steadily, not the one who does the most in a single week.

Consider, too, the quiet gift of your story. Younger doctors and nurses in your church may need someone who has walked long years in medicine and kept their faith. A cup of coffee with one of them could be among the most important things you give this year.