Advising physicians to build wealth, manage taxes, and make great life decisions. Host of A Good Problem to Have

Hartford, CT
Joined September 2011
This is a safe place to learn about finance. Every question is valid! #MedTwitter #MedStudentTwitter #financialplanning
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This might sound nuts. But I'm beginning to think that physicians in many (maybe not all) specialties MUST learn how to skillfully use AI if they want to have a successful career. It's an efficiency arms race.
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Practicing/Attending Physicians: What are the chances of your notes getting audited?
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Hard to believe how much has changed with the student loan landscape over the past 7 years. If you were here in 2020 and we talked about student loans at that time, say hello would ya?
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A key benefit to working with a great financial planner: Getting stuff DONE
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You’ve already delayed retirement saving for years Don’t keep delaying it as an attending You've got plenty of opportunities - 401(k) or 403(b) - 457(b) - Backdoor Roth - HSA Max out what you reasonably can Today’s new episode out now Listen on Apple or Spotify
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Outside of the box thinking:
Hi, I'm Dr. Nancy Yen Shipley, an orthopaedic surgeon in Portland. I help people keep their joints healthy for the long haul, without rushing to surgery. Joint preservation, regenerative medicine, and care that treats the whole person, not just the painful joint. You don't need to be a pro athlete to get pro-level care. Getting back to work, lifting your grandkid, your Saturday hike: whatever you want to do with your day is your pro sport. I started in orthopaedics when only 6% of us were women. I've been doing it my way ever since.
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Docs - What's holding you back from owning your own practice?
Own your practice and you don't have a job. You have a hobby that pays you. 2 years in. Still feels that way.
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Some great news. Financial independence, recreational employment (FIRE) secured for one of our GI doc clients. She's 53 and intends to keep on working. It's amazing to be able to work simply because one wants to. Guess whose admin has zero quality bonus leverage now?
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The public cannot (and likely will never) understand the unique financial and career problems physicians face.
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Docs - Chad is one of the tax-only advisors I'm talking about.
One of the biggest values I provide to medical professionals isn’t necessarily tax savings. It’s accountability. Physicians, dentists, and other medical professionals are busy taking care of patients and running their practices. Tax planning isn’t always top of mind. That’s where I come in. I remind them to make estimated payments, follow up on retirement contributions, revisit projections when income changes, and make sure planning recommendations actually get implemented. Sometimes the strategy isn’t complicated. The challenge is execution. A good tax advisor doesn’t just tell you what to do. They help make sure it gets done. That’s an underrated part of proactive tax planning.
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Doctors need a tax advisor 1000% more than they need an investment advisor. Sometimes you can get both in one person/firm. But an investment advisor that "can't give tax advice" does not merit your energy or money.
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And I don't mean your CFP needs to be an EA or CPA. I'm talking about the advisory firms that make their advisors shy away from all things taxes. They cannot function as an effective advisor under that expectation.
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Doctors - Do you need to hire a financial planner? If so, let me know and I can refer you to a few that do great work. (I am not taking on any new clients the remainder of this or next year who aren't already in our queue)
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Physicians looking for limited-situation tax advice: Message me if you want a referral for a great tax-only advisor. You may very well be better off working with a proactive planning-forward tax accountant.
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Some physicians' net cash per month (net income minus expenses) is so high that they can decide to just take the tax hit on the chin now. Maxing out Roth in their 401(k) instead of pre-tax Maxing out their personal backdoor Roth Then plow the rest into their taxable account
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Every doctor can choose to be smart with money.
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It's very possible for a physician to walk into his/her 60s with less than $1mil in net worth. All you gotta do is transition all of your stress-relieving wants into essential living expenses. Yes, spend intentionally. But yes, save intentionally. So you can spend later.
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Even some docs who move back "home" have realized they shouldn't have bought a house so quickly after training. So many factors can change unexpectedly during those first 24 months.
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You may give up millions in future wealth by pursuing a fellowship. But it doesn't matter if you're pursuing what you love. (and for you adult surgical subspecialists and heart-related specialists, maybe you'll actually increase your future wealth)
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When prospective clients reach out, they usually mention what they'd like to learn about me/my services. 100% of the time that they start out with asking what my fees are, it's a bad fit. In their minds, they're letting the cart lead the horse, and they don't even realize it.
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