Physician Cents

Hosted by Chad Chubb & Tyler Olson

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Jun 2026

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Welcome to the Physician Cents Podcast! A podcast designed specifically for physicians, offering a breakdown of complex financial topics to help you develop your financial IQ, further your financial journey, and improve your well-being. Whether you're a medical student, resident, fellow, or attending physician, you're sure to learn something new that will benefit your journey.

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June 15, 2026Episode 5518 min

Summer Survival: How Physicians Can Vacation, Enjoy Life, and Still Hit Their Financial Goals, Ep #55

On this episode, we're talking summer survival and exploring how physicians can enjoy vacations, family time, and relaxation without sacrificing their financial goals. We break down practical strategies for budgeting summer trips, managing the costs of family and kids' camps, and staying on track with long-term savings plans. Also on the show are tips for balancing lifestyle choices and intentional spending, making the most of your hard-earned days off, and enjoying guilt-free travel. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [00:00] Planning for your annual vacation expenses [04:20] Monthly contributions and cash flow planning for summer expenses [08:04] The philosophy of vacation spending and personal values [13:03] How vacation spending is incorporated into long-term plans [16:01] Monitoring and adjusting budgets for seasonal spending spikes [16:22] Cash flow analysis helps account for ups and downs in spending Building Vacations Into Your Financial Plan Instead of treating summer as a one-off expense or scrambling to cover costs on the fly, we recommend making travel a dedicated part of your annual or biannual spending plan. Our clients often split vacations into domestic and international line items in their financial planning, sometimes choosing major trips every few years and annual regional getaways in between. A big summer expense is also summer camps for kids—a not-insignificant line item that often gets grouped with travel for practical planning. The key is consistency and visibility. Link a savings account to your "vacation bucket" which is automatically funded monthly, which ensures funds are ready for family trips and children's camps. Over time, this system builds a guilt-free, stress-free process for planning—and paying for—summer fun. The Psychology of Guilt-Free Spending A recurring theme is the importance of "money mindset." Guilt can often creep in—should you really spend $15,000 on a vacation when there are other priorities? Embrace what matters most to you, whether that's a once-in-a-lifetime trip or simple downtime with loved ones. Guilt-free vacations, planned in advance, let you be fully present and savor every moment. Staycations or local hotel getaways can offer restoration at a fraction of the price. The key is intentionality: align your spending with your values while ensuring that big-picture goals remain on course. Staying On Track With Financial Goals When savvier systems are in place, most physicians can enjoy well-earned time off without derailing retirement, college savings, or investments. We advocate for robust cash flow tracking—from waterfall charts to custom spreadsheets—so clients can see that their regular savings for 403(b), Roth IRA, and 529 accounts continue uninterrupted alongside vacation spending. One-time splurges rarely move the long-term needle if the planning foundation is strong. Watch Out for Lifestyle Creep With schools out and days longer, extra spending can sneak in—whether on home projects, eating out, or impromptu outings. We recommend adjusting budgets to reflect seasonal upticks and reviewing cash flows over multiple months to set a realistic (and sustainable) average. Ultimately, the secret to summer satisfaction is balance. With proactive savings, clear value alignment, and honest self-reflection, physicians can vacation without compromising their financial trajectory. Be present, enjoy your well-earned break, and know you've planned to make every moment (and dollar) count. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned Mousehacking.com Holistiplan Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

June 1, 2026Episode 5434 min

One Portfolio, Many Accounts: Mastering Fund Selection, Rebalancing & Cross-Account Diversification Ep #54

Managing multiple investment accounts doesn't have to be complicated. This week, we're discussing the value of a simple, low-cost, diversified approach and why you should resist the urge for complexity. Asset allocation and asset location both play important roles. We cover how to view all your accounts as part of one portfolio and why tax considerations matter when deciding where different investments should live. The episode dives into strategies like using brokerage accounts as a secondary emergency fund, treating the HSA as a long-term retirement asset, and maintaining aggressive growth in retirement-focused accounts if your situation allows. Complexity doesn't always add value—the real benefit often comes from sound, comprehensive planning and tax optimization. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... 00:00] Prioritizing Simplicity in Investments [06:51] Creating custom client portfolios [08:06] Using third-party asset managers [13:24] Discussing wealth and business mindset [18:19] Planning investment allocations [21:51] Long-term HSA investment strategy [26:31] Building diversified investment portfolios [31:11] Rebalancing investment accounts regularly The Case for Simplicity in Portfolio Management Over time, we've found that complexity rarely adds commensurate value for most investors—especially for portfolios under $5 million. A portfolio made up of extremely simple, low-cost, diversified, indexed ETFs is often the best approach. This keeps things manageable while effectively balancing risk and growth. Excessively complex portfolios—with options trading, commodities, or too many actively managed funds—require constant attention and can often lead to stress and oversight. Instead, leaning towards index ETFs and well-diversified, low-cost funds allows investors to focus on the bigger picture, like their careers and personal lives, trusting their investments will quietly accumulate over time. Asset Allocation and Location One of the biggest questions when managing a portfolio across several accounts (such as an HSA, Roth IRA, 403(b), and taxable brokerage) is how to allocate investments thoughtfully and tax-efficiently. First, determine your broad mix between stocks, bonds, and cash. For example, if you're comfortable with 90% stocks and 10% bonds, divide that total allocation across all accounts combined. This is your asset allocation. Next comes asset location and deciding where to hold different types of investments, which can dramatically impact your after-tax returns. Taxable accounts are often best reserved for tax-efficient investments or municipal bonds, while long-term, qualified money like IRAs and 403(b)s can house more volatile, growth-oriented assets since taxes are deferred. For HSAs, often referred to as "extra retirement accounts", taking a long-term approach also pays off. Unless you need the money in the short term, investing the funds for growth allows you to leverage the triple tax advantage of HSAs for future high healthcare costs. The Art of Rebalancing Left unattended, portfolios can drift out of balance due to market movements. The process of rebalancing—resetting allocations back to targets—is crucial for risk control. Quarterly rebalancing (if automated) or annual rebalancing (if manual) is sufficient for most. In tax-advantaged accounts, rebalancing is straightforward. For taxable accounts, caution is warranted to avoid triggering unnecessary capital gains taxes. Whenever possible, new contributions or planned withdrawals provide natural opportunities to rebalance efficiently. Simplicity, discipline, and a clear plan are the pillars of successful long-term investing for physicians or anyone managing multiple accounts. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned Modern Portfolio Theory VTI-Vanguard Total Stock Market ETF Schwab US Broad Market Fidelity Total Market Index Fidelity Zero Funds Altruist Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

May 15, 2026Episode 5311 min

Should You Invest During Residency/Fellowship? (The Real Answer for Trainees), Ep #53

Navigating finances as a medical trainee can be overwhelming. The pressure to save for retirement while managing intense workloads, student debt, and low salaries creates a confusing landscape. In this episode of the Physician Cents Podcast, we dig into whether trainees should focus on investing early or whether building an emergency fund is more valuable. Drawing on real-life questions from physician trainees, we take a practical look at the benefits of prioritizing liquidity and mental health over early investment, explain the impact of matching contributions, explore the nuances between Roth IRAs and Roth 403(b)s, and debunk the pressure to start investing before you're financially ready. If you're feeling behind on savings or unsure where to put your next dollar, this episode offers clarity, actionable advice, and the reassurance that time is on your side. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [00:00] The pressure to start investing early [04:57] Prioritizing wellbeing over early investing [05:57] When should you start investing? [08:13] Roth IRAs as backup emergency funds [10:25] Learning about your investment options The Pressure to Start Investing Early It's easy to feel left behind. Trainees—including those with years left in their residencies—often express anxiety about not having started retirement savings or investments. Social media and financial gurus echo the mantra: "Start investing as soon as possible. Time in the market beats timing the market." But trainees, especially future high-income specialists, will have ample opportunity to build wealth once they become attending physicians. The "wealth-building shovel" grows drastically larger after training, meaning the ability to contribute significant sums to retirement accounts is just around the corner. Even with the burden of student loans, there are often loan forgiveness programs, especially for those training in nonprofit settings. Don't let anxiety about being "behind" force hasty financial decisions during training. The future earning potential of physicians allows for ample catch-up. Foundation Before Growth Prioritize cash savings over investments because liquidity equals confidence and security. Emergencies don't wait for a bull market. Whether it's a car repair, a sudden move, or a family need, cash on hand allows for flexibility and peace of mind. While investing can technically begin with small sums, the psychological benefits of having an emergency fund are "massively more important than investing" during training. The relief of knowing you can weather a minor storm without going into debt or prematurely withdrawing investment funds outweighs the benefits of early compounding in most cases. With the drastic increase in income at the attending level, building up retirement accounts can be achieved quickly—sometimes in just a month —whereas it would take years to save as a trainee. When Should You Start Investing? It's important to learn about investing and, if possible, get into the habit with manageable amounts—especially when employer matching is available. A matching contribution, even a small one, is "free money," so if your training program offers a 403(b) or similar match, it's worth considering, provided you have some emergency cash on hand. Aim to have at least $1,000 in a high-yield savings account as a buffer, then consider investing any surplus, especially if it unlocks a match opportunity. The process should never overshadow your mental health or well-being: don't let investing become a point of stress or self-judgment. Roth IRAs, 403(b)s, and Hybrid Accounts Roth IRA contributions can be withdrawn if needed—but relying on retirement accounts as emergency cash can create behavioral pitfalls and complicate objective financial planning. Here's a potential structure for most trainees: Build $1,000+ in an accessible high-yield savings account Take advantage of a 403(b) match if available Consider a Roth 403(b) through payroll for simplicity, automatic contribution, and low friction Learning how each retirement vehicle operates, even without actively contributing, sets the stage for future financial decision-making For medical trainees, focus first on building a solid emergency fund—$1,000 or more in accessible cash. Learn about your investment options and take manageable, low-stress steps into retirement accounts, especially when a match is offered. Remember that your earning power is about to skyrocket, and your well-being matters more than squeezing a few extra dollars into a volatile market. Taking care of your present self lays the foundation for a far more prosperous and fulfilling future. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned Suze Orman Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

May 1, 2026Episode 5214 min

Two Big Pitfalls New Attendings Face (And How to Dodge Them), Ep #052

Transitioning from training to practice is an exhilarating milestone for physicians—one marked by a dramatic increase in income and, often, new financial responsibilities. With a big jump in income, it can be tempting to make big purchases right away or skip over the foundational "boring stuff" like insurance and budgeting. We break down how the "I deserve it now" mentality and avoiding critical financial groundwork can lead to lifestyle creep and long-term financial headaches, and provide actionable advice for early-career physicians aiming to build a secure financial future. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [00:00] Pitfalls during the transition to attending physician [05:48] Navigating lifestyle creep challenges [06:42] Benefits of delaying big financial decisions [07:53] Avoid neglecting foundational financial tasks such as cash flow management [11:58] Why to plan regular budgeting check-ins [13:29] Avoiding common business pitfalls The Temptation of "I Deserve It Now!" Decision-Making One of the most common traps physicians fall into occurs the moment those larger paychecks start rolling in. We call this the "'I deserve it now' decision making": after years of rigorous training and modest income, the urge to splurge is both understandable and dangerous. And the real hazard isn't any single extravagant purchase, but the compounding effect of multiple big decisions. Lifestyle creep factors such as: Moving into a large, expensive home before you're settled or confident in your new job or city. Leasing or buying luxury cars. Enrolling children in private schools due to perceived status or convenience, even before the need becomes clear. Taking costly vacations and elevating everyday lifestyle expenses. This stacking effect can quickly consume your newfound income and trap you in a cycle where your lifestyle must always match (or outpace) your earnings. Just because you technically qualify for a large mortgage, it doesn't mean you should commit to it immediately. Resist the urge to purchase a forever home or luxury vehicle during your first year as an attending. Allow time to ensure your new role and location are the right fit—renting or buying modestly can prevent costly missteps if circumstances change. Don't Skip the Financial Basics The second pitfall is perhaps even more insidious: skipping over the unglamorous but essential aspects of personal finance. Tasks like cash flow tracking, buying insurance, and organizing estate documents are seen as the "boring stuff," but these are the foundations of financial security. Financial Building Blocks 1. Cash Flow Awareness Many physicians don't thoroughly track their spending or understand where their money goes each month. This lack of clarity makes it impossible to assess how much you can truly afford for fixed obligations like a mortgage, or how much you could invest for the future. 2. Insurance Coverage Disability and life insurance may not feel urgent, but they protect your income and family from unforeseen tragedies. These protections should be in place before committing to new, ongoing expenses. 3. Estate Planning Estate documents may feel like a one-time hassle, but they are necessary to ensure your wishes are carried out and your loved ones are protected. Make a habit of reviewing your cash flow monthly or quarterly—even a simple check-in can uncover surprises and prevent overspending. Invest time in securing appropriate insurance and ensuring your estate documents are up to date. These "boring" tasks lay the groundwork for financial agility and resilience, giving you freedom as your career evolves. Putting It All Together By dressing the "I deserve it now" mentality and making the "boring stuff" a priority, early-career physicians can avoid common pitfalls and build a sustainable lifestyle. Once the financial foundation is set, you'll find even greater satisfaction in investing and enjoying your money with a sense of security, not anxiety. Laying the groundwork takes patience, but it unlocks decades of growth, opportunity, and peace of mind. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned Monarch Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

April 15, 2026Episode 5112 min

Meet Your New AI Financial Advisor, Ep #051

Artificial intelligence has seeped into almost every aspect of our lives, from the smartphones we carry to the way businesses make decisions. It was only a matter of time before the concept of an "AI financial advisor" became a reality. It might be tempting: tireless, fast, available 24/7, and—maybe best of all—not prone to human judgments about our spending habits or life goals. But is replacing your trusted human advisor with AI really the smartest move for your financial future? Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... 00:00 AI replacing financial advisors 02:00 Why people might be tempted by an AI financial advisor 03:38 Importance of emotion, relationship, and people skills 06:29 The danger of relying on AI if you don't have a lot of financial knowledge 09:46 There's no accountability if AI gives faulty advice 11:03 AI is appropriate for quick queries, but not for comprehensive planning What AI Gets Right—and Where It Misses the Mark There are a lot of good use cases for AI. AI tools can help crunch numbers, surface data quickly, and even generate content like podcasts and blog posts. But there is a flip side, if you know a little bit about personal finance, and then you try to use AI to augment that or to help you to make decisions, then be sure to check the output because AI isn't always accurate. Without expertise, it's easy to fall into the trap of overconfidence, accepting what AI provides without realizing what you might be missing or misunderstanding. The Accountability Factor When you work with a human financial advisor, that person is accountable to you, to regulators, and to their own professional standards. If something goes wrong, you can talk to your advisor, ask questions, and yes, even hold them responsible. If you follow their advice and it goes sideways. AI tools all carry disclaimers, they're not licensed, not responsible for the outcome, and don't know your situation intimately. The Value of Human Advisors: Expertise, Empathy, and Accountability Perhaps the biggest limitation of AI isn't technical, but human: the inability to listen, intuit, and offer nuanced guidance tailored to your unique goals and fears. Good planners get to know their clients and have the insight and bravery to give timely advice, which you're definitely not going to get from AI. Financial planning is about more than just numbers. It includes the subtleties of your family life, your values, your fears, and the context that doesn't show up on a spreadsheet. Human advisors can hold you accountable in a compassionate way and help you make more confident decisions. AI is a fantastic tool for advisors and well-informed individuals to supplement their expertise, but it isn't ready to fully replace the empathy, insight, and accountability that a real advisor brings. If you value judgment, context, and a trusted relationship, your best move is still to keep a human on your financial team—and let AI play a supporting role. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

April 1, 2026Episode 5034 min

18 Common Tax Mistakes Physicians Make (Part 3): The Quiet Errors That Create Massive Tax Bills Ep #50

Welcome to a milestone episode of the Physician Sense Podcast! In this 50th edition, we cap off our three-part miniseries on tax planning with actionable, nuanced strategies tailored specifically for physicians. Whether you're a medical student, attending, or anywhere in between, you'll find value in our tips on navigating real estate tax advantages and maximizing the power of Health Savings Accounts HSAs. We're also helping you understand the intricacies of W-4 updates, evaluate Roth contributions versus pre-tax options, and recognize the importance of year-round tax coordination and impeccable documentation. Blending real-world stories with our expert insight, this episode is packed with the kind of practical advice that will help you minimize headaches, avoid unexpected tax bills, and keep your financial journey on track. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [06:20] Real estate tax benefits explained [10:08] Understanding HSA plans and trade-offs [11:08] High deductible plans and HSAs [16:49] Managing taxes with life changes [21:04] Retirement tax planning options [23:33] Comparing pre-tax and Roth options [31:05] Organizing tax documents [33:25] Balancing tax planning efforts Real Estate Professional Status is Not as Simple as it Seems Investing in real estate is often touted as a path to financial freedom and tax deductions, but achieving Real Estate Professional (REP) status is rarely straightforward. Most physicians can't deduct passive losses unless they or their spouse qualify for REP. This requires meticulous documentation and significant time spent actively managing properties. Record-keeping is paramount, and physicians should understand the rigorous standards—casual efforts, like buying an air filter, don't count. For married couples, there's some flexibility if one partner can take on the real estate workload, but many physicians jump in without researching the bones of the rules—sometimes after costly educational programs that yield little benefit. Learning the requirements before investing money and time is crucial. Triple Tax Benefits with a Caveat Health Savings Accounts (HSAs) are the only "triple tax-free account", yet many doctors use them like checking accounts, missing out on compounding growth for future healthcare costs. Before committing to an HSA, it's important to first assess your family's healthcare needs. High-deductible health plans are not right for everyone—especially those with ongoing medical expenses. For those who can manage high deductibles, investing HSA funds and keeping receipts for big medical expenses can yield powerful tax-free withdrawals later. There's little urgency to reimburse minor expenses—think of HSAs as a possible long-term care fund rather than an emergency account. Roth vs. Pre-Tax: Tax Bracket Matters Roth accounts get a lot of love, but the decision isn't always clear-cut. For doctors in the highest tax brackets, pre-tax contributions may be more beneficial. State taxes also play a role. Maximizing pre-tax tools is key for high-earning physicians; Roth is often best when pre-tax options are "maxed out." Tax diversification is more important than Roth obsession. Future tax rates are unpredictable, so having a mix of pre-tax and Roth accounts provides flexibility for future strategies, such as Roth conversions during lower-income years. Don't blindly follow internet advice—consult a professional for tailored guidance. Tax Planning vs. Tax Filing Tax filing is reactive; tax planning is proactive. Most CPAs focus on filing, not planning, unless you pay for that service. For complicated situations—business ownership, side work, etc.—planning ahead can save thousands. Proactive strategies—W-4 changes, retirement contributions, entity selection—are best addressed earlier, ideally with the help of a planner who understands physician finances. The IRS isn't interested in your busy schedule—they want proof. Saving lives won't excuse missing receipts. Audit defense requires organized documentation: physical or digital folders for each year and category. Even rare audits are stressful; good records bring peace of mind. Always err towards simplicity—understand the basics, seek guidance, and choose strategies that fit your life. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

March 15, 2026Episode 4938 min

18 Common Tax Mistakes Physicians Make (Part 2): The Quiet Errors That Create Massive Tax Bills Ep. #49

This week, we dive into the second part of our three-part series on the most common tax mistakes doctors make. Today, we pick up where we left off last week, tackling mistakes 6 through 12—ranging from Roth IRA contribution blunders and retirement account coordination errors to the complexities of state taxes for locums and practice owners. You'll hear practical tips on avoiding the pitfalls of direct Roth IRA contributions when you're ineligible, understanding how to juggle multiple retirement plans without overcontributing, and the essential—but often overlooked—benefits of cash balance plans for high earners. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... 04:05 Backdoor Roth IRA contributions tips 08:44 401(k) vs. 403(b) Limits 15:08 Pensions for academics vs. private practice physicians 19:55 Income consistency and sustainability 25:35 Tax efficiency in bond investing 28:58 Married filing status & student loans 31:23 1099 tax strategies for doctors 34:31 Cross-border tax challenges Don't Trip on Income Limits for Direct Roth IRA Contributions Many doctors—especially those transitioning from training to attending roles—get caught by contributing directly to a Roth IRA even when their income makes them ineligible. Moving from trainee income to an attending salary can put you over the Roth IRA limits without realizing it. This triggers a 6% annual penalty, which can add up quickly if not caught. If you're close to the income threshold or anticipate a big jump in pay, default to the Backdoor Roth IRA process. Yes, this introduces an extra 5-year hold period for accessing converted funds, but it's a safer bet than risking penalties. And if you file as married, filing separately, something sometimes used for student loan optimization, you need to pay extra attention. If you're unclear, run the numbers with an advisor or accountant. Retirement Plan Coordination Physicians often juggle work at multiple employers, leading to multiple retirement accounts. For 2026, the combined employee contribution limit is $24,500, regardless of how many plans you have (excluding 457(b)s, which operate independently). Missing the nuances can lead to over-contributions or missed opportunities. Know the types of plans you have and their coordination rules. For side-gig/1099 income, solo 401(k)s are powerful—but you can't "double-dip" on the employee limit if you're also contributing to a work plan. Cash Balance & Defined Benefit Plans Cash balance plans (a type of defined benefit plan) can help high-earning doctors shelter over $100,000 per year. Most docs have never heard of these vehicles—or, if they have, write them off as too complex or niche. But they're a goldmine for established physicians, practices, or those with significant 1099 income—so long as you expect consistent high earnings for several years. Setup and administration involve actuaries, costs, and (often) "boring" bond-heavy investment choices. But saving $200k+ from high state and federal taxes can be a game-changer, especially in places like California. Evaluate this with your advisor; if you're close to the $200,000+ threshold and plan to keep earnings high, it may be time to explore. Tax-Efficient Investing: The Importance of Asset Location You might be maxing your retirement plans, but as your taxable brokerage account grows, tax-aware investment choices pay off big. Tyler recommends housing bonds inside tax-sheltered accounts and using municipal bonds in taxable accounts to blunt tax drag. High-turnover mutual funds in taxable accounts are a relic. Prefer tax-efficient index ETFs, and periodically review your investment "location" as your situation evolves. Remember, after a few decades of saving, this optimization can mean tens of thousands in net after-tax wealth. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned The White Coat Investor Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

March 1, 2026Episode 4841 min

18 Common Tax Mistakes Physicians Make (Part 1): The Quiet Errors That Create Massive Tax Bills, Ep #048

Physicians are some of the highest earners in the country—and often some of the biggest overpayers in taxes. Not because they lack intelligence or discipline, but because the tax code punishes complexity. Multiple income streams, inconsistent withholding, overlooked deductions, and misunderstood retirement strategies quietly create five-figure mistakes that compound over time. This episode kicks off a three-part series based on Tyler Olson's widely shared thread outlining 18 of the most common tax mistakes physicians make each year. Part 1 tackles five of the most frequent and costly errors—many of which stem from coordination problems rather than aggressive tax planning. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [05:00] Not planning for multiple income types (W2 + 1099 + bonuses) [12:45] When an S-Corp election makes sense—and when it doesn't [19:30] Missing easy 1099 deductions like CME, licenses, and travel [27:10] Quarterly payments and how underpayment penalties really work [36:20] The Pro Rata rule and why it ruins so many Backdoor Roth IRAs Multi-Income Physicians: Where Withholding Breaks Down One of the most common physician tax mistakes is assuming payroll withholding is "handling it." Each income source calculates withholding independently. A university paycheck does not account for income from a physician group. Neither accounts for 1099 consulting. And 1099 income itself has no withholding at all. Bonuses create an additional trap. Productivity bonuses are often withheld at a flat 22%, which may be significantly lower than a physician's actual marginal rate. The result is a surprise balance due—even when it feels like plenty has already been paid throughout the year. The solution is coordination: projecting income early, reviewing pay stubs, and adjusting W4 elections or adding additional withholding before year-end. Without proactive adjustments, physicians can face large balances due along with unnecessary penalties. S-Corps: A Strategy That Requires Math, Not Hype The S-Corp conversation has become increasingly popular online, often framed as a guaranteed tax win once 1099 income reaches a certain threshold. The reality is more nuanced. Yes, S-Corps can reduce self-employment taxes under the right circumstances. But those savings must exceed the added costs of payroll services, separate business tax filings, and ongoing administrative work. In some states, additional business taxes materially reduce the benefit. This is not a default move—it is a numbers-driven decision. Physicians should evaluate projected tax savings against professional fees and state-level implications before electing S-Corp status. Without that analysis, complexity can increase without meaningful benefit. Quarterly Taxes and the Backdoor Roth Trap Physicians earning locums or moonlighting income frequently miss quarterly estimated payments. The IRS expects taxes to be paid throughout the year, not in a single lump sum at filing. Even if the full balance is eventually paid, penalties can apply if payments were not made on time. Quarterly estimated payments—due in April, June, September, and January—help prevent underpayment penalties. In some cases, increasing W2 withholding can simplify the process and reduce the need to manage separate payments. The final major mistake covered in Part 1 involves the Backdoor Roth IRA. High-income physicians often attempt this strategy while holding pre-tax balances in traditional IRAs, rollover IRAs, SEP IRAs, or SIMPLE IRAs. When those balances exist, the Pro Rata rule applies, causing part of the Roth conversion to become taxable. Before executing a Backdoor Roth, pre-tax IRA balances should typically be moved into a 401(k), 403(b), or Solo 401(k) if eligible. Skipping that step can create unnecessary taxes and undermine the intended benefit of the strategy. These five mistakes share a common theme: the fundamentals matter. When income streams are coordinated, elections are evaluated carefully, and compliance is respected, physicians retain more of what they earn. Resources Mentioned IRS Direct Pay – https://www.irs.gov/payments/direct-pay Connect with Tyler and Chad WealthKeel LLCOlson Consulting LLCTyler Olson on XChad Chubb X Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

February 15, 2026Episode 471 hr 7 min

The Disability Insurance Crossfire: Planners vs. Brokers and the Must-Knows for Docs with Michael Relvas, Ep #047

As a physician, your most valuable asset isn't your car, your home, or even your impressive degree—it's your ability to earn an income through a unique skillset you've spent years (and sometimes decades) developing. We're discussing disability and term life insurance with special guest Michael Relvas, an expert who has spent nearly twenty years advising physicians on these crucial protections. We tackle complex decisions—like whether to include a COLA rider in a disability policy, how to prioritize insurance on a tight resident budget, and the pros and cons of graded versus level premiums. We also discuss scenarios for dual-physician households, review strategies for term life coverage as your family grows, and answer rapid-fire listener questions on applying for disability claims and updating older insurance policies. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... [05:45] The cost of peace of mind [11:13] Pros and cons of COLA riders [16:31] Managing tight budgets in training [23:14] Evaluating perceived vs. real roadblocks [27:53] Choosing graded vs. level premiums [35:38] Dual high-earner disability insurance debate [47:30] Life insurance strategy insights [52:06] Clarifying occupational duties in claims [01:05:36] Questions from listeners on disability insurance Disability Insurance is the Foundation of Physician Financial Security Disability insurance isn't just another checkbox for your financial plan—it's a necessity. Disability insurance protects both your present lifestyle and the future earnings you've worked so hard for. Even young physicians, barely out of training, have invested major time and resources into their careers, making the stakes for an income-disrupting event extremely high. The Cost of Living Adjustment (COLA) rider is a feature that increases your monthly benefit during a disability claim to help keep up with inflation. Most young docs recognize its value, but some question whether the additional premium is worth it given the low statistical likelihood of long-term disability. It's essential to protect against catastrophic scenarios, and COLA is not the premium cost that will break your budget. Skipping COLA to save a few bucks is short-sighted when the risk, however unlikely, is devastating. Budgeting for Disability Insurance as a Resident or Fellow What if your budget feels impossibly tight? It's a common dilemma, especially for residents and fellows who are saddled with student loans and low stipends. We recommend getting coverage even if you have to reduce your benefit amount or opt for graded (lower initial) premiums that ramp up later. The key is to lock in coverage while you're still healthy and keep the door open for future increases without re-underwriting. Program-specific guaranteed standard issue (GSI) offers can offer flexibility without medical underwriting. However, these programs aren't guaranteed to last, and only you can determine when an apparent financial roadblock is truly immovable or just a matter of making difficult choices about your spending priorities. Graded vs. Level Premiums: Playing the Long Game As insurance carriers shift away from unisex pricing, especially for women, graded premiums are becoming more attractive for some. They allow physicians to pay much less in their early years by "grading" the cost up annually, but total costs level out over time. Switching from graded to level premiums later can raise your ongoing cost. Still, if graded premiums are the only way to afford coverage in training, it's a tool to use—just lock in level premiums as soon as your cash flow allows for long-term savings. Predictability and simplicity are best: level premiums are preferable if your financial plan assumes a long career horizon. Two-Physician Households: Should You Maximize Coverage for Both? Unless you're already financially independent, maximize coverage. Losing one income—even a high one—changes everything, from current expenditures to retirement and children's future opportunities. Term life insurance is important during your family-building years, especially when debt is high and kids are young. We recommend coverage that lasts at least until your youngest child is 18, but ideally extends through the end of college. Laddering term policies (stacking policies with varying durations and amounts) adds flexibility as your savings grow. As net worth builds, coverage can decrease, but most people keep policies active until family responsibilities are fully covered. Whether you're considering COLA riders, struggling to fit premiums into your budget, or wondering how much coverage to purchase, the advice remains consistent: Take action early, prioritize coverage in your financial plan, and re-evaluate as your career and family progress. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Connect with Michael Relvas MR Insurance Consultants Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK

February 1, 2026Episode 4632 min

Taxes and Student Loans with Adam Markowitz, Ep #046

Physicians, medical trainees, and other healthcare professionals walk a uniquely challenging financial path. High educational debt, income variations throughout career stages, and complicated tax policies are just the start. We're joined by tax expert and Certified Student Loan Planner (CSLP) Adam Markowitz to tackle a complicated topic all physicians have to deal with: how taxes and student loans are intertwined. Adam brings a wealth of firsthand experience, and you'll want to listen to his strategies to help keep your payments low and avoid IRS headaches. Looking for help with Disability Insurance, Physician Banking, Student Loan Refinancing, Physician Mortgages, Contract Reviews, and more? Check out our "Best of the Best" sponsors page to find a list of the professionals Chad & Tyler team up with for their clients. You will want to hear this episode if you are interested in... 04:09 Managing student loans post-COVID. 10:24 Community property tax impact explained. 16:59 Tax strategies for maximizing your benefits. 19:19 Tax challenges amid the rising costs of living. 23:57 IRS complexity and processes. 28:03 The importance of taking expert tax advice. Why Taxes Matter in Student Loan Planning If you think your tax return is a standalone document, think again. Student loan repayment plans, especially income-driven plans like SAVE or IBR, use your latest tax filings to calculate monthly payments. As our guest, Adam Markowitz says, for medical residents and fellows earning lower salaries, it could be strategically advantageous to delay filing your next return if your income will soon increase. For instance, a trainee finishing residency in 2025 could benefit from an extension, resulting in their student loan payments for the coming year being calculated from their lower 2024 income. This maneuver buys them another 12 months of cheaper student loan payments, cushioning the financial leap into attending status. The Impact of Public Service Loan Forgiveness (PSLF) While PSLF aims to forgive student loan debt for those working at qualifying institutions, it can be tricky to get to grips with. Many residents, especially post-COVID, haven't made qualifying payments due to forbearances, so ensuring they're on the right repayment plan (rather than SAVE during a non-qualifying period) is so important. Even if you're not on PSLF, income-driven payments during lower income years can provide a fantastic financial runway with manageable bills, reduced stress, and preparation for larger payments as your income grows. Community Property States Marriage introduces another layer of complexity, especially in community property states. As Adam explains, that in the majority of situations, half of what you earn is technically money your spouse has earned, and half of the money that your spouse has earned is what you have earned. This can help or hinder student loan payment calculations, depending on who earns more within the couple. For example, a resident married to a high-earning spouse could see their payments jump since their incomes are pooled. We also touch on states with opt-in community property laws. While technically possible, opting in comes with wider legal ramifications, including asset division, so it's not a simple student loan hack. DIY Tax Filing Risks Missing Out on Big Benefits Many trainees opt for DIY tax apps, but this approach can be risky. Adam estimates that while about 60% of returns will come out fine, the other 40% can contain costly errors or missed opportunities, especially regarding student loan recertification, credits for retirement contributions, and unique deductions. There's also the peace of mind factor, receiving an IRS notice is universally stressful and having a professional to interpret these letters or catch tricky policy changes can be invaluable. The IRS is overstretched, and communication delays persist. From delayed EIN number confirmations to confusing notices, a simple mistake or missed 1099 can easily snowball. Now more than ever, having proactive, accessible financial and tax advice is essential for physicians and trainees. Seek Guidance, Save Stress Student loan repayment and tax filing go hand in hand, especially for physicians and medical trainees. From optimizing payments based on timing, navigating marriage and state laws, or simply surviving IRS quirks, consulting experienced professionals can mean the difference between financial ease and future headaches. The best of the best list is a paid sponsorship, but these are professionals/companies that Tyler and Chad collaborate with within their own practices or have been vetted to earn a spot on this list. By supporting our sponsors, it allows Chad & Tyler to dedicate more time to you and the Physician Cents community. If you ever have a question (or not a great experience, which we don't expect!) about a sponsor, please let us know. We call it the "best of the best" for a reason, and we will maintain that standard for our listeners & viewers. Resources & People Mentioned Luminary Tax Advisors Connect with Adam Markowitz Adam Markowitz on LinkedIn Connect With Physician Cents WealthKeel LLC Olson Consulting LLC Tyler Olson on Twitter Chad Chubb, CFP®, CSLP® on Twitter Subscribe to Physician Cents Apple Podcasts Audio Production and Show Notes by - PODCAST FAST TRACK