Money Talk For ER Docs™

Conventional wisdom would suggest that becoming more educated should result in earning more money. And when you combine that sentiment with ambitions of change either within or outside of emergency medicine, seeking an Executive MBA may be an appealing option, especially for an ER doc looking to reduce clinical hours. But when it comes to EM, more money and a better opportunity may not be as matte...

It's no surprise EM has experienced volatility over the past decade. Whether it's in the form of general healthcare structure, insurance, government programs, private equity, and, importantly, compensation, it's clear things may not be running as efficiently as they should be. This has led to talks of unionization growing in popularity as a means to make long-desired improvements. On today's episo...

The majority of ER docs will earn contractor pay at some point in their career, which opens the door to new types of retirement accounts. One highly praised type is the individual 401(k). With all the great potential it brings, it also comes with additional responsibilities that can easily be overlooked if not careful, especially when considering the sheer number of tax deadlines and responsibilit...

Maslow's Hierarchy of Needs is a psychology theory that details our motivations as humans. Within that model, things like food, water, and health are all vital. But so, too, are employment status and property – actually within the same tier as health and safety. That shouldn't be a surprise; our ability to fund our survival goes hand-in-hand with surviving itself. Yet, it's almost like our brains...

What does the termination of a deferred compensation plan actually mean for employees? In the case of Envision, it appears to mean receiving a windfall of money upfront that was likely earmarked for retirement purposes. And if that wasn't challenging enough, there's inevitably going to be a tax hit that may not be fully realized until over a year after the funds are received. That's a lot of respo...

There's been a recent uptick in longevity protocols, research, medicine. There's a lot of bio-hacking methods like fasting, ice baths, grounding, avoiding microplastics and other forever chemicals – basically it's a hot topic and it's exciting, enticing, and promising. However, what most people don't consider is the financial impact of living longer. We can extend our lives, but how do we fund our...

Social media is explosive and fast-paced. It's also a breeding ground for misinformation. If you're an ER doc who is maybe in a place where you're looking for any opportunity to pivot out of EM, or simply looking for an alternative source of income, you may find yourself intrigued by an influencer's unscrupulous financial advice. On today's episode, we'll go over some of the common TikTok-esque fi...

There's no question that most tax schemes blur the lines between fact and fiction. Every deduction can run afoul quickly, especially if abused. So much so that the IRS annually releases its own list to educate and inform the public about these schemes. On today's episode, we go over the "dirty dozen;" many of which target high-income earners, like ER docs, to ensure listeners are aware of the diff...

Back-taxes are accompanied by repetitive, concerning, and somewhat threatening letters from the IRS and third-party collectors. It can be intimidating. And it should be. The IRS is no joke. That's when tax resolution companies take advantage of your vulnerability and attempt to sell a miracle pill. The reality is: you only have so many options with the IRS and as an ER doc, it's very unlikely anyt...

Each and every year, the single largest expense an ER doc pays is their taxes. This means a large percentage of our professional careers is spent staying on top of current tax legislation and strategizing around ways to legally reduce taxes for our clients. We've all grown accustomed to the current tax code and laws, but things do change, and inevitably will change, by the end of the 2025.   On to...

We just discussed the three best financial decisions an ER doc can make, but what about the three worst? What's interesting is poor decisions have disproportionally worse outcomes than good decisions when it comes to finances. That's something really crucial to understand and highlights why we are so risk adverse when it comes to the best ways for ER docs to become successful. On today's episode,...

When you think about it, we all make millions of financial decisions over the course of our lives. Is it the culmination of all of those financial decisions that results in your success or not? Possibly. But there is undoubtedly a mindset that we see common in all of the most financially successful ER docs that provides the framework for each and every financial decision they make.  On today's epi...

One thing about being in the field of personal finance is nobody will know everything. And the same is true for the field of emergency medicine. Yet, we do our best to acquire as much information as possible and pass that knowledge along. On today's episode, we'll go over certain misnomers or confusions we often see when it comes to personal finance and leverage our 15+ years of knowledge to addre...

Taxes are cumbersome and oftentimes painful (for most people). There are no two ways about it. But through proper planning throughout the year, plus a simple working knowledge of how the deadlines work, that combination really makes this responsibility manageable. On today's episode, we'll reference IRS statistics on extensions for high-earning taxpayers and discuss how we feel every taxpayer shou...

ER docs tend to think of their income in shifts. We tend to think of it more from an after-tax perspective. In other words, we're interested in how much ER docs get to keep, after taxes. So strategizing around that bottom line instead of simply working shifts can make a big difference not only on the perception of working, but also for wealth building. On today's episode, we'll provide a simple br...

Mortgage rates are high relative to very recent history. Despite this, it's inevitable that we may have to participate in those higher rates if we move, upsize, downsize, or acquire a first-time home. In any of these cases, there's an unconventional and little know strategy for reducing your mortgage payment over the life of the mortgage term.  On today's episode, we'll discuss a cash flow improve...

Paying tax is a good thing because it means you've made money. But when it's unplanned or unaccounted for (or worse – already spent!) that's when major problems can arise. With the stock market roaring since October 2023, depending on what you're invested in, your assets have likely bloated. In the event you need to sell out of these positions for any reason – car, house, change investments – ther...

Just as electric vehicles are relatively new, so is the tax code that was designed for them. Like anything in its infancy, there will inevitably be confusion, loopholes, and many updates to come. On today's episode, we'll get into how ER docs in the market for an EV can still take advantage of free rebates even if tax policy has attempted to disqualify them based on income limitations.

The Internal Revenue Code is like an onion – there are so many layers to peel back. Within each of these layers are deductions and credits, each with their own set of rules. As a high-earning ER doc, you should be aware of areas where you can take advantage, and for completeness and simplicity, areas where you can't. On today's episode, we'll construct and discuss the longest list of deductions an...

Recency bias: a cognitive bias that favors recent events over historic ones; a memory bias. I mention this because a composition of the 500 largest companies in the US, also known as the S&P 500, has recently hit all-time highs. While of course that's a good thing, recency bias is running rampant, making it difficult to remember times when the S&P 500 has severely lagged behind other markets. And...

Taxes aren't as much of a "season" as we tend to think. The reality is, taxes are all around us; they're a daily occurrence. Thus, condensing an entire year down to a single week or month is a fool's errand. On today's episode, we'll talk about tax season from a different perspective. A perspective that hopefully creates a mental shift and ultimately improves the way you think about and prepare yo...

ER docs tend to lead financially complex lives. With different income sources, different income types, and possibly earnings in multiple states, this provides a major hurdle when it comes to optimization. But not all hope is lost; the added complexity can often lead to opportunity, like in the case of additional contribution limits with multiple non-related retirement accounts. On today's episode,...

How do you pay for things? And what's the thought process behind what card you pull out of your wallet? The effort you bring to this area of your spending is a precursor to living an overall better and more organized financial life. On today's episode, we'll discuss the balance that works for most ER docs in a world of credit card rewards, mailed offers, referral codes, high-interest accounts, and...

529 plans are typically thought of as college expense accounts. And of course, they are first and foremost, but over the years we have gradually seen the flexibility and use of 529s expand. Whether that's using them for K-12 private schools, opening an account early in the parent's name in anticipation of the possibility of a future child, or even strategic changes to the beneficiaries of the acco...

Oftentimes the benefits of a vacation are felt prior to even setting flight or hitting the road. It's something to look forward to – and that can carry you through even the toughest of workdays. We know ER docs have a unique job when considering the hours and responsibilities, but it doesn't stop there – PTO and flexibility are also vastly different from not only other job types in America, but ev...