What the Canadian Rockies Taught Me About the Right Reason to Keep Practicing Medicine

The Entrepreneur's Life

What the Canadian Rockies Taught Me About the Right Reason to Keep Practicing Medicine

Ten days ago I stepped off a train in Calgary having just crossed the Canadian Rockies aboard the Rocky Mountaineer — one of the most celebrated rail journeys on earth. I was there to speak for PEA on practice management and AI in medicine. I came home with something I did not expect: a clear and quietly powerful picture of what a physician's professional life can look like when it is built correctly from the beginning.

Let me tell you about the journey first, because the setting matters. It is part of why what happened on that train felt significant rather than coincidental.

Vancouver to Calgary — Ten Days Through Some of the Most Extraordinary Landscape on Earth

The Rocky Mountaineer departs from Vancouver's waterfront and climbs eastward through terrain that changes so dramatically, so continuously, that you stop trying to absorb each individual moment and simply surrender to the accumulated effect of all of it together.

The first day out of Vancouver the train winds through the Fraser Canyon — sheer rock walls rising above the Thompson River, the water running glacier blue far below, the rail line carved into cliff faces that look like they should not support anything heavier than a footpath. You sit in a glass-domed car watching the geography unfold and the word that keeps coming back is immense. Not beautiful in a comfortable way. Immense in a way that makes your professional concerns feel briefly and usefully small.

Kamloops. The Spiral Tunnels at Kicking Horse Pass, where the train curls back through the mountain twice in a configuration that seems geometrically impossible until you are sitting inside it watching the engine emerge from a tunnel above the cars that are still entering it below. The Bow Valley, where the mountains rise on both sides and the river runs straight and cold between them, the kind of landscape that reminds you there are places on this earth that were here long before medicine, and that will be here long after all of us are gone.

Lake Louise at first light. The water a color that does not have a clean English name — something between turquoise and jade — framed by mountains that still carry snow at the peaks in summer. Ellen documented everything, as she always does, for Scrapping In My Sleep. Some places deserve a record.

Banff was the final stop before Calgary — a mountain town that manages to feel both civilized and genuinely wild, where elk graze on the edge of the golf course and the main street sits beneath a skyline of peaks that look like they were designed to make architecture feel humble.

It was in this setting, over the course of ten days aboard a train moving at the pace that actually allows you to see a landscape rather than merely travel through it, that I had the conversations I want to tell you about.

The Physicians on That Train

Medical conferences aboard luxury rail journeys attract a particular cohort. The physicians on this trip were, by and large, older — many in their 70s, several in their 80s. They came from across the country and across specialties. Some were internists. Some were specialists. There were family physicians and a psychiatrist who had transitioned primarily to telehealth.

I was there to speak on practice management and AI in medicine — the ways that AI-powered tools are changing clinical workflows, what physicians need to understand about them, and how physician entrepreneurs in particular can use these tools to work smarter rather than simply harder. The content landed well. But the conversations that happened after the presentations — in the dining car, on the observation deck, over cocktails while the Rockies scrolled past the windows — those were the education that I serendipitously signed up for.

Almost every physician I spoke with at length was still practicing. Part-time, most of them. A few days a week, some less. The forms it took were varied: academic work, clinical teaching, telehealth, cash-based specialty practices, consulting arrangements with health systems, expert witness work. One internist in his late 70s told me he did two days of telemedicine per week and had never felt more professionally satisfied in his life. A specialist in his early 70s had transitioned to teaching at a medical school and described his schedule as the first one he had ever had that actually fit around his life rather than the other way around.

I asked each of them some version of the same question: do you have to work?

Almost universally, the answer was no.

Related resources

Blog: Coast FIRE: A Strategic Path for Self-Employed Doctors to Reduce Burnout and Enhance Autonomy

Blog: Reclaim Your Time: Prioritizing Experiences Over Wealth

Blog: The Pentamillionaire Doctor: Your 10-Step SimpliMD Roadmap

Free guide: Dare to Dream: Goal-Setting Guide for Physician Entrepreneurs

What They Chose to Do — and Why

They kept working because they wanted to. Not because they were bored. Not because they needed the income. Because they had built professional lives structured around the parts of medicine they genuinely loved — the patient contact, the teaching, the intellectual challenge of a complex case, the sense that what they knew and what they had seen was still useful to someone — and had methodically shed the parts they did not: the administrative burden, the productivity treadmill, the institutional politics, the documentation systems designed for billing rather than care.

None of them were running full-time employed practices. Every one of them had some form of independent or flexible arrangement — a direct-contract relationship, a part-time academic appointment, a telehealth arrangement with a platform that let them set their own hours. The clinical work had been distilled down to the part that originally drew them to medicine, and that distillate was worth showing up for even in their 70’s-80s.

They also had something else in common. They used their work to fund their adventures. The Rocky Mountaineer journey qualified as CME — practice management content, AI in clinical settings, professional development presentations aboard a certified medical education program. Their professional lives and their personal adventures had become, intentionally and structurally, the same thing. A journey like this one is not inexpensive. For these physicians, their part-time clinical income covered it comfortably while their retirement portfolios grew untouched. That is not an accident. That is decades of structural decision-making paying its dividend.

Related resources

Free eBook: Design Your Career Around Your Life: The Physician's Guide to Professional Freedom (subscriber free)

Free eBook: Balancing Life and Practice: The Micro-Corporation Advantage (subscriber free)

Free eBook: Job Stacking For Doctors: Modern Medical Lifestyles (PEA Explorer)

Blog: Find Freedom by Downshifting Your W-2 Job

The Lesson I Kept Coming Back To

I spend a lot of time in this community talking about financial independence — the Pentamillionaire target, Coast FIRE, the retirement contribution math, the structural advantages of the micro-corporation. All of that remains true and important. But the physicians on that train gave me a different frame for why all of it matters.

Financial independence is not the goal. It is the prerequisite for the goal. The goal is practicing medicine for the right reasons. Practicing because you choose it, not because the mortgage requires it. Practicing in the form that serves patients and serves you, not in the volume and format that serves an employer's revenue targets. Practicing for as long as it remains meaningful, and stopping — or changing form — when it no longer does.

The physicians on that train had reached the point where every clinical day was a choice rather than an obligation. That shift — from obligation to choice — is what I watched transform how they spoke about their work. There was no bitterness, no burnout, no exhaustion. There was something that looked like genuine engagement. A specialist in his early 70s described his two days of teaching per week with the same enthusiasm I hear from residents describing the specialty they just discovered. That enthusiasm is not a personality trait. It is a structural outcome. He had built his professional life in a way that preserved it.

This is what I am building toward. Not retirement. Not the absence of work. The freedom to choose the work — and, having chosen it freely, to do it well.

I wrote about what this choice looks like at different life stages in my posts Coast FIRE: A Strategic Path for Self-Employed Doctors to Reduce Burnout and Enhance Autonomy and What If the Point Was Never the Money? Both posts read differently after ten days with physicians who had already arrived at the destination I am describing.

A Note on the AI and Practice Management Content

My presentations on this trip covered the intersection of artificial intelligence and physician practice — what current AI tools actually do in clinical and administrative settings, how physician entrepreneurs can leverage them without surrendering clinical judgment, and the specific ways my innovative on-demand urgent care platform ChatRx uses AI-powered triage to deliver care at a price point that genuinely changes access for the patients who need it most.

The conversations after those presentations were some of the richest I have had with physician audiences. Older physicians are not, as a category, resistant to AI in medicine — they are thoughtful about it in ways that younger physicians sometimes are not, because they have watched decades of technology promises land somewhere between transformational and oversold. The questions were precise. The skepticism was healthy. The interest was genuine. I came home thinking the AI conversation in medicine needs more voices like the ones on that train — voices that have seen the long arc of healthcare technology and can place the current moment in perspective.

Related resources

Free eBook: 7 Ways a Professional Micro-Corporation Helps Physicians FIRE (PEA Explorer)

Free eBook: Retain More, Grow More: The Hidden Wealth of Micro-Businesses (PEA Builder)

Blog: Retained Income: The Lost Money Doctors Are Leaving Behind

ChatRx: Buy A Piece of ChatRx — $25 on-demand urgent care, physician-governed, AI-assisted

Is This Deductible?

CME Travel Aboard the Rocky Mountaineer — Airfare, Rail, Hotels, and Meals

Deductible — when CME content is the primary purpose

The scenario: You attend a ten-day CME conference aboard a luxury rail journey through the Canadian Rockies. The program includes formal presentations on practice management and AI in medicine with documented CE credits. Costs include international airfare, rail passage, hotel accommodations at stops along the route, and meals during the program. What is deductible?

The ruling: When CME is the primary purpose of a trip, the travel expenses directly associated with attending are deductible as ordinary and necessary business expenses. This includes airfare to and from the program location, rail passage when the rail journey is the CME venue itself, hotel accommodations for nights that are part of the program schedule, and a portion of meals. The IRS applies a primary-purpose test — if the main reason for the trip is the professional education program, the transportation and lodging are fully deductible. Meals are typically deductible at 50 percent under current tax law.

By the way, one of my favorite elements of using CME Away isn’t the incredible international destinations; it’s that spouses get to join for free. That’s a nice bonus!

The key documentation: Keep the CME program brochure or registration confirmation showing the dates, content, and continuing education credit hours. Keep all receipts. Note in your records that the primary purpose of travel was CME attendance. If personal sightseeing days extend the trip beyond the program schedule, only the program-related portion of accommodation costs is deductible — the personal extension days are not. Pay all deductible expenses from your S-Corp business account and have your bookkeeper categorize them under professional development or continuing education.

For questions about CME deductibility in your specific situation, consult your CPA. I refer physicians to Cerebral Tax Advisors and DocWealth for physician-specific tax guidance. And grab the free eBook Tax Deduction Guide for Micro-Business Owners (PEA Explorer) for the full landscape of business deductions available to your S-Corp.

Join the movement

The physicians on that train had something in common that went deeper than their specialty or their income level or their age. They had built professional lives structured around the parts of medicine they chose, not the parts assigned to them. Most of them had done it gradually, incrementally, over years — converting employment arrangements, reducing volume, adding flexible income channels, letting the retirement portfolio do its work while their clinical identity stayed intact.

That is exactly what this community is building toward. If you are earlier in that process — still figuring out how to restructure your arrangement, reduce your W-2 dependency, or build the financial foundation that makes the choice possible — I want to help you get there faster than those physicians did.

Book a $500 Business Strategy Session and we will map the specific moves — the entity, the income structure, the retirement strategy — that build toward the professional life you want to choose at 75, not the one you are stuck with.

Join the PEA community at $99/year for Explorer membership. The free Dare to Dream guide is where I would start — it helps you put the destination in writing before you map the route. And the free eBook Design Your Career Around Your Life shows you what the structural path from where you are to where those physicians arrived actually looks like.

The Rockies will still be there. Build toward the day you can see them on your own terms.