A few weeks ago, I was taking over a shift in the ER when one of my friends was giving me sign-out. The department was already on fire (not literally… thankfully), and he started apologizing for how busy and rough the next 12 hours would be. I shrugged and said something like, “I’ll be fine. I can do anything for 12 hours.”
As he was walking out, he laughed and said, “Well… not everyone has the luxury of being a PRN Princess.” I laughed too. But the comment stuck with me. The more I thought about it, the more I realized he was right. I do feel incredibly fortunate. I genuinely enjoy emergency medicine, but I also don’t feel trapped by it. I can appreciate the good parts of the job without feeling completely burned out by the difficult ones. That conversation made me start asking myself why. Was it because I work fewer shifts? Was it because I’m PRN? Was it because I own a business outside of medicine? The more I thought about it, the more I realized being a “PRN Princess” has very little to do with my schedule. It has everything to do with having options. And I think that’s something every medical professional should be working toward.
I Never Dreamed of Being PRN
Let me preface all of this by saying that most months I still work 8-10 clinical shifts, sometimes more if the facilities I cover need help. I am the furthest thing from lazy. In fact, I probably feel busier now than I did when I was working 14-16 clinical shifts every month. I’m also not financially independent. If I quit working tomorrow, my investments alone would not support my family’s lifestyle. I still have to work in some capacity.
What I have created over the last year, however, is something I never really knew I wanted: a schedule and a lifestyle that fit me instead of feeling like I had to fit my life around my schedule. I never thought this would be me. When I was a new PA, all I wanted to do was work hard, help people, and become the best clinician I could be. I assumed I would spend my entire career in emergency medicine. Later, after leaving my first ER job, I thought my next chapter would be climbing the ladder in a private company or eventually owning a medical business.
Then life happened. Some experiences changed the way I looked at medicine, leadership, and business ownership. The glass shattered a little, and for a while I wanted to get as far away from anything medical management or medical business-related as possible. As I was figuring out what I wanted next, opportunities presented themselves that allowed me to continue practicing emergency medicine while giving me something I had never really experienced before: flexibility.
I could work in the ER because I wanted to, not because a schedule told me I had to. That was a completely foreign concept to me. I still love taking care of patients. I know I’m good at what I do, and I also know there are people who are better than I am. A younger version of me would have obsessed over becoming the very best. Today, I’m okay not climbing that ladder. That may be one of the biggest shifts in my adult life.
I’m not usually a coaster. Ninety percent of the time, I’m an “all in, let’s build something” type of person. Whether it’s business, investing, writing, or running, I naturally want to improve, optimize, and grow.
But medicine is different now. For the first time in my career, I’m content simply practicing good medicine, caring for my patients, and then going home to the rest of my life. So what changed? I don’t think it was my work ethic. I think it was my definition of success.
PRN Isn’t Just About Working Less
For a long time, I thought being successful meant buying nice things. A bigger house. A nicer car. Luxury vacations. I assumed that was what financial success looked like. The older I get, and the more I’ve learned about personal finance, the more I’ve realized that money’s greatest gift isn’t what it allows you to buy. It’s what it allows you to choose. It allows you to choose where you work, how often you work, who you work for, when you take a vacation, and whether you pick up an extra shift. It gives you the confidence to know that if life throws you a curveball, you have some breathing room. It’s even nice for me to know that I have built enough margin that I know we could sustain ourselves for several months without a paycheck if we had to.
That small taste of freedom changes the way you think. Having a PRN schedule isn’t really about working less. It’s about flexibility. I don’t want someone else deciding that I have to work 10, 12, or 14 shifts every month. Maybe I want to work eight shifts this month, four next month because we’re traveling, and twelve the month after because I feel like picking up extra work. I want to spend four weeks traveling with my kids without asking permission or hoping my vacation request gets approved. That’s what I love about PRN.
I get to build my work around my life instead of building my life around my work. The funny thing is, I don’t think I work any less than I used to. I still work hard. I work hard as a PA. I work hard in our business. I work hard writing these articles. I work hard as a runner, an investor, a wife, and a mom. The difference isn’t the amount of effort I’m putting in. The difference is where that effort goes. Instead of pouring every ounce of energy into one career, I’ve intentionally spread it across the parts of my life that matter most to me: my health, my family, my business, my patients, and my own personal growth. Creating financial margin didn’t make me stop working. It simply gave me the freedom to decide what was worth working hard for.
You Don’t Have to Leave Medicine
Recently, I’ve had several conversations with people who are approaching retirement from medicine. Those discussions have been fascinating to me. How do you know when it’s time to walk away from something you’ve spent decades pursuing? How do you let go of a career that has shaped so much of your identity? I know I am not anywhere near this, but I love hearing their responses. For me, I still love practicing medicine. I enjoy taking care of patients. I enjoy the challenge of emergency medicine. I enjoy the relationships I’ve built with my coworkers.
What has changed isn’t my love for medicine. It’s my relationship with it. Medicine has become something I get to do instead of something I have to do. That subtle shift has changed almost everything. I don’t leave for work already counting down the hours until I’m off. I don’t feel trapped by my schedule. When I have a difficult shift, I know it’s just one shift, not my entire life. Even the little things seem to bother me less. The patient who comes to the ER for a runny nose. The inevitable changes insurance companies force. The hospital administrators are pushing another initiative. The lazy coworker.
None of those things disappeared. But they also don’t carry the same emotional weight they once did. Medicine is no longer the only thing carrying my identity, my purpose, or my financial future. It’s one important part of a life that also includes my family, my businesses, my writing, my running, and the freedom to spend time where I choose.
I’m not financially independent, and I’m not advocating that everyone quit medicine or retire early. That’s not the point. The goal isn’t FIRE at 35 for me. The goal isn’t retirement. The goal is creating enough financial margin that your decisions are guided more by what you want than by what your bank account demands. Even a small taste of that freedom can change your perspective.
For me, it gave me the psychological space to stop asking, “How much longer do I have to do this?” and start asking, “What do I want my career to look like from here?” Those are two very different questions. And I think asking the second one has helped me rediscover the joy in the first place.
Conclusion
If there’s one thing I hope you take away from this article, it’s this: take your personal finances seriously. Work hard early in your career while you’re hungry. Learn your craft. Become excellent at what you do. Become the most marketable clinician you can be. But be just as intentional with what you do with your paycheck as you are with your patients. Use your career to build the life you want.
Maybe your goal isn’t working PRN. Maybe it’s simply picking up fewer extra shifts. Maybe it’s saving six months of expenses so you can sleep better at night. Maybe it’s paying off debt. Maybe it’s starting a side business. Maybe it’s investing enough that one day you’ll have the confidence to say “no” to an opportunity that doesn’t fit the life you’re trying to build.
Whatever your version looks like, start building toward it today. Medicine is an incredible career, but it doesn’t have to become your entire identity. It also shouldn’t be your only retirement plan.
Maybe my friend was right. Maybe I am a PRN Princess. A few years ago, I probably would have been offended by that comment. Today, I take it as a compliment. Not because I don’t like working. Not because I’m lazy. Not because I’ve reached financial independence. I still work hard, probably as hard as I ever have. The difference is that today I’m working hard on the life my family and I have intentionally built instead of simply reacting to whatever opportunity comes next.
For years, we made hundreds of small, boring financial decisions. We lived below our means. We invested consistently. We built businesses. We tried to avoid lifestyle inflation whenever we could. None of those decisions felt glamorous at the time. But together, they quietly bought us something far more valuable than a bigger house or a nicer car. They bought us choices. They bought us time. Time with our kids. Time to travel. Time to build businesses we enjoy. Time to rediscover why I love practicing medicine. Maybe that’s why my relationship with medicine has changed so much. Medicine didn’t change. I changed. Somewhere along the way, “PRN Princess” stopped sounding like a joke and started sounding like the life I had been quietly building all along. If that’s what being a PRN Princess means… I’ll gladly wear the crown.