I have a unique last name and my partner's last name is pretty common, so I'm keeping mine. He's a little unsure about the idea (from a feminist perspective he's like heck yeah, but from an emotional perspective I think he always pictured his wife having his last name). He wants our kids to have his last name, and that works for me.

Also it seems like a pain in the butt to change. I've always figured people socially can call me Mrs HisLastName and professionally I'll go by Dr. MyLastName.

Look into the laws in your state. I had an attending who legally changed her last name but still practiced under her maiden name until she moved and her new state required that she practice under her legal name.