Money Talk For ER Docs™

Today, we’ll break down the latest updates on 401(k), IRA, and HSA limits for 2025, and forecast the tax landscape under the new administration. We’ll also look at the possible extension and expansion of the TCJA, the SALT cap, and tax credits—and even provide a few things you may want to do before year-end and things you may want to wait to do until after the new year kicks off.

We’re diving into a topic that many people overlook when it comes to their finances—the importance of working with a unified financial team. We recently received a question from an investment manager of a client we only handle tax services for, and it sparked an important discussion about the need for clear communication between financial professionals. Specifically, we’re looking at how IRA conversions can be impacted when tax planning and investment advice aren’t fully coordinated. We’ll also explore why splitting your financial advisors could actually lead to more confusion and missed opportunities. So, let’s break it all down and see why having one cohesive team in place is so crucial for making the best decisions for your financial future.

So today, we're diving into our post-election world, with a focus on student loans. Trump, plus a Republican majority in the Senate, means there's, at minimum, uncertainty on the horizon as it pertains to loan programs - income-driven, PSLF, SAVE, and anything in between. If you’ve got student loans or you’ve been planning your path to forgiveness, we'll try to unpack what you may want to do now before things change and it's too late.

In this episode, we explore the Roth vs. Traditional retirement account decision specifically for ER docs. With high income, fluctuating tax brackets, and the potential for major tax changes in the future, choosing the right account can significantly impact your long-term financial strategy. We break down the pros and cons of each account type, discuss how to leverage tax planning opportunities during your career and retirement, and help you navigate the complexities of saving for the future while balancing the unique financial challenges of being an ER doctor.

With the market performing well recently, many of you may find yourselves sitting on sizable gains in your portfolios. But how do you navigate these gains effectively to optimize your tax situation? On today's episode, we'll break down the mechanics of tax-gain harvesting—what it is, when to use it, and how it can potentially save you money—alongside the more familiar tax-loss harvesting strategies.

With so much perceived to be at stake and tensions running high, it's easy to get caught up in the political drama. However, as a finance-focused podcast, our aim is to shift the conversation toward how financial markets have historically reacted to election outcomes. We’ll explore the trends, debunk some myths about market behavior during elections, and offer our perspective on not only the market and economy, but personal finance as a whole whether we're led by a Republican or Democrat come November.

Disability can be one of the most significant financial threats to your career and income. 1 in 7 people will suffer from a disability that will last at least 5 years. That's fairly decent odds for a potentially severe financial outcome. On today's episode, we’ll explore why having the right amount of coverage is vital, how to calculate your needs, and which riders you should consider to tailor your policy. This is a must-listen episode if you are in residency or under-covered with your current DI policy.

Finance can be complex. It's very easy to focus on the bells and whistles instead of the tried and true. So today, we’re stepping back to explore the core financial principles that every emergency physician should know. Understanding what areas to focus on, and which to avoid, is just as important whether you're fresh out of residency or a seasoned pro.

Over the past 14 years, we’ve seen a major shift in interest rates that’s changed how we handle cash. Starting back in 2008 during the financial crisis, rates were so low that many people kept minimal cash because it just wasn’t earning anything. But after the pandemic, rates climbed, making it easier to earn decent returns on savings. Now, as we expect more rate cuts, it’s a good time to rethink how we manage our cash and consider smarter investment strategies.

How do you perceive your future self? How you answer that may matter when it comes to your finances. Research shows we may have a particular POV when it comes to looking forward at our lives, which can lead to challenges in saving for retirement. On today’s episode, we'll explore how this disconnect, along with concepts like temporal discounting and loss aversion, can impact your spending habits now and in retirement.

We’ll kick today’s episode off with a surprising New York Times article that challenges the validity of supercentenarians and those so-called Blue Zones we discussed before. From there, we’ll explore the current economic landscape, where conflicting predictions are the name of the game. With a heated presidential race and fluctuating markets, it’s time to unpack the chaos, debunk some myths, and find out what really matters for your financial future. Let’s get started!

We’re excited to feature our first client on the Money Talk for ER Docs podcast! We’ve planned to do this for some time now and couldn’t be more thrilled to have Dr. Brian Laakaniemi as a guest as he discusses his path to EM as well as his finances. We love the idea of continuing to host existing clients on the podcast and we hope you, as a listener, not only enjoy hearing the perspective of a fellow emergency medicine practitioner, but also find value in their experience and insights. For legal purposes, we are required to disclose that Brian’s experience as a client may not be reflective of the experience of all clients and he did not receive any compensation for speaking with Scott. Hope you enjoy!

Identity theft is a real concern for ER docs due to high patient interaction volume. Consider the reality that accessing an EP’s signature can open up opportunities to obtain medications or allow for other financially-driven motives. Combine this with other variables, such as higher income and thus higher credit limits and a busy lifestyle that may prevent them from noticing identity theft schemes, it’s no mystery as to why ER docs as a subset of professionals are prime targets. On today’s episode, we’ll discuss a large data breach that impacted most Americans and lay out the things you can do today to prevent fraud happening tomorrow.

We are constantly inundated with clickbait-y headlines and concepts that are hard to ignore. A once-a-day pill to shed fat, increase alertness, get wealthy, grow your hair back – whatever it may be, even the biggest skeptics can begin questioning their skepticism when painted a convincing enough picture. But what about velocity banking? Is it another fad or an exception? Can you really use this as a method to not only shave years off your mortgage, but also save hundreds of thousands of dollars in interest over the life of your loan? On today’s episode, we’ll discuss the ins and outs of velocity banking and also revisit the math behind amortization schedules for refinancing.

From white water rafting to taking a trip to the grocery store, there’s always some level of practical analysis and mapping that can, and probably should, be performed. Doing so helps us make more informed decisions, capitalize on strengths, address weaknesses, seize opportunities, and mitigate threats to enhance overall well-being and productivity. On today’s episode, we perform a SWOT Analysis of the personal finances of emergency physicians to really evaluate all of the ways EPs can find success (and failures) within their working career.

We all have experienced a pretty rapid run-up in mortgage rates since 2020-2021. Of course, no one knows where the top (or bottom) will be moving forward. But at least over recent history, rates have dropped a good amount to the point where there are mortgage opportunities for many to explore. On today’s episode, we’ll discuss the decision-making process of refinancing and get into other forms of equity lines of credit that can be appealing even for those with low-interest rate primary mortgages.

The market and its behavior, though it may not feel like it, is predictable. It’s like a broken record: there will be ups and downs; some bigger than others. Despite this, in the moment, it can feel very serious or dire. But if we let history be our guide, there are plenty of lessons to draw from that show how to react and what to do to get through those stressful moments. On today’s episode, we’ll talk about the market’s recent movement and also discuss the surge in small cap value stocks that will leave those who jumped on the large cap stock trend feeling a bit left out.

Happiness can come in so many forms. When it comes to the relationship between work and happiness, whether we care to admit it or not, they tend to be pretty intertwined. But what if they weren’t? How would you structure your life if you were optimizing for happiness over money? On today’s episode, we’ll get a bit psychological and look at the science behind happiness and how much things like your job and spending money play a role.

Many ER docs may not be aware of cash balance pensions. These are a type of retirement plan that can really supercharge retirement savings and minimize tax liability. But buyer beware: these aren’t a DIY solution. That’s one of several reasons why they are underutilized despite being an extremely attractive option for saving large sums of money. On today’s episode, we’ll discuss these relatively complex plans and how they may be the best tool to help guide ER docs to their retirement goals.

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 matter of fact as it is with other careers. On today’s episode, we’ll discuss our experience with clients who have pursued and obtained their Executive MBA and what changes it led to personally, professionally, and of course, financially.