Recast, Refinance, or Stay Put? Smarter Plan for Physicians

Most physicians shop mortgages the same way they shop rates: quick glance, pick the lowest number, move on.

The better question isn’t, “What’s the lowest rate I can get today?”
It’s:

“How do we build a long-term plan around my career, my family, and my goals—and use the mortgage as a tool to get there?”

Once you start there, rate is just one variable. You also care about:

• When to recast or refinance
  
• How extra payments vs investing fit into your bigger picture
  
• How today’s loan sets you up for future real estate moves
  
• The true cost of a loan, not just the rate
  
• A simple decision framework so you’re not reacting to every headline

We cover recast vs refinance in detail in End-of-Year Recast, Refinance, or Stay Put? (link to your existing article). Here, we zoom out and focus on long-term strategy.

1. Have a Recast/Refinance Plan Before Rates Move

“I’ll refinance when rates drop” is not a plan.

You should know in advance:

• When a refi makes sense:
  • “If I can lower my rate by about X% with costs under $Y and break even in Z years, I’ll seriously consider it.”
• When a recast makes more sense:
  • “If I get at least $___ in bonus/stock/cash and plan to keep this home ___ years, I’ll ask about a recast.”

Refinance = new loan, new rate, new costs.
Recast = same loan, same rate, lower payment after a lump-sum principal payment.

Good strategy = knowing which lever you’ll pull before the market moves — especially once you understand what actually goes into qualifying for a physician mortgage beyond just the rate.

2. Be Intentional With Extra Payments vs Investing

Extra principal payments:

• Lower total interest
  
• Shorten your payoff timeline
  
• Build equity (that you can’t easily access without selling/refi)

That’s great—if you’re also:

• Funding retirement accounts
  
• Keeping a real emergency reserve
  
• Preparing for known future cash needs (practice buy-in, second home, big move)

Instead of guessing each month, decide:

• “We’ll send $___ extra to principal as long as we’re on track for retirement and keep at least ___ months of expenses in cash.”

If you value flexibility, lean more toward investing/saving.
If you value debt freedom, lean more toward extra principal.

Just make it a decision, not a mood — particularly when you understand how much of a house you can actually afford in relation to your broader financial picture.

3. Plan for Future Real Estate (Second Home, Rental, Clinic Space)

Your first attending home probably won’t be your last. Many physicians eventually want:

• A second home
  
• A rental property
  
• A clinic condo or small building

So ask now:

• Is this a 3–5 year house or a 10+ year house?
  
• Could this ever make sense as a rental?
  
• Do I want to own clinic space down the road?

If you want future properties, it often makes more sense to:

• Preserve cash and liquidity
  
• Choose a loan with a comfortable payment and flexibility
  
• Avoid over-concentrating all your wealth in one home

Your current mortgage shouldn’t block your next move.

4. Look Beyond Rate to Total Cost and Fit

A lower rate with high fees is not automatically better.

Always ask:

• What are total closing costs (including points)?
  
• Am I rolling costs into the loan and quietly increasing my balance?
  
• What’s the term and how long do I realistically plan to keep this loan?
  
• Does this product (physician vs conventional, fixed vs ARM) actually match my timeline?

Compare options by:

• Payment
  
• Total cost over the years you’re likely to keep the loan
  
• Flexibility (can I pivot if my career or location changes?)

Sometimes the “second-best” rate is the best financial move.

5. Put a Simple Decision Framework in Writing

Most bad mortgage decisions happen in reaction to:

• A Fed announcement
  
• A colleague bragging about their rate
  
• A scary or flashy headline

Create a one-page framework that includes:

• Time horizon for this home
  
• Payment comfort zone (not just max approval)
  
• Trigger points to act:
  • When you’d refi
    
  • When you’d recast
• Priority order (liquidity, wealth building, debt payoff)
  
• Your team (lender, planner, CPA)

Then, when the noise hits, you don’t ask “Should we panic?” You ask, “Does this meet the criteria we already set?”

The Shift: From Rate Shopper to Strategist

You’ll see rates rise and fall many times over your career. That’s noise.

The signal is this question:

“How do we build a long-term plan around my career, my family, and my goals—and use the mortgage as a tool to get there?”

Set your:

• Recast/refi plan
  
• Extra-payment vs investing plan
  
• Future real estate plan
  
• Total-cost lens
  
• Decision framework

Do that, and you’re not just chasing a number—you’re using your mortgage to support the life you’re actually working for.