Emergency medicine can generate incredible income — but income alone doesn't create wealth. In today's episode, we're looking at wealth planning through a more structured lens, breaking it into four distinct stages that every ER doctor moves through, whether they realize it or not.

If you've ever felt like you're working nonstop, earning well, but not quite building long-term security, this conversation will change how you think about money, career, and freedom.

If you're a 1099-earning ER physician, the Qualified Business Income deduction—or QBI—can be a meaningful tax opportunity, but it comes with some very specific rules you need to understand. One of the biggest factors is whether your income is considered a Specified Service Trade or Business, or SSTB, which directly impacts whether the deduction is available at higher income levels.

In this episode, we'll break down how QBI works, why ER physicians almost always fall into the SSTB category, and because of this, what the most effective planning strategies are to get around this obstacle. We'll also walk through real examples to show how these rules play out in practice.

There's been a lot of discussion lately around federal health care policy and potential budget cuts, especially related to Medicaid. Rather than speculate or react emotionally, we wanted to step back and look at this through a financial lens specific to emergency physicians.

More importantly, we want to talk about how these kinds of changes tend to show up slowly over time — and what that means for how you plan and position yourself.

For high-earning ER physicians, capital gains aren't just about investments—they're about control. The way gains stack on top of earned income can change tax outcomes, portfolio risk, and even career decisions in ways that aren't obvious at first glance.

Today, we're unpacking how capital gains actually work in the context of ER income, and why small strategic choices can make a disproportionate difference over time.

As we've entered a new year, we wanted to pause and reflect on what's actually resonated most with you over time. After five years of producing this podcast, the data tells an interesting story about which topics consistently draw attention — and which ones quietly don't.

This episode is less about specific advice and more about patterns, preferences, and how that shapes what we focus on moving forward. It's a look behind the scenes as we set the direction for the year ahead.

At some point, almost everyone faces a financial decision that looks simple on the surface but carries consequences that stretch decades into the future. These are the choices where intuition feels comforting, guarantees sound appealing, and the real tradeoffs aren't immediately obvious.

Today's episode uses a seemingly straightforward scenario to explore how those decisions actually work under the hood. And more importantly, why the framework you use to think about them matters far more than the specific outcome.

There's been a surge in interest around self-directed IRAs (SDIRAs), especially for real estate investments. With younger investors seeking alternatives to traditional markets, and social media amplifying the success stories, it can seem like a compelling option.

But while the idea of using an SDIRA to invest in real estate sounds attractive, the reality is more complex—and, for most people, it's far riskier than it appears. In this episode, we'll dive into why this strategy might be more trouble than it's worth, and how it introduces unnecessary risks and challenges for those looking to build long-term wealth.

The new year is coming up fast, and 2026 is bringing some major updates to retirement saving rules. These aren't small tweaks—many limits are jumping in ways we haven't seen in a long time.

That's great news if you're intentional about your planning because more room to save means more room to reduce taxes and grow wealth. Let's walk through the biggest changes and what they mean for you.

As we head into the final stretch of the year, this episode is about the conversation many ER docs end up having with us in April — when it's too late to change the outcome for the prior year. The goal today is to shift that conversation into the present, while you still have time to make meaningful adjustments.

There are several strategies that simply don't exist once the calendar flips, and we want to make sure you're not one of the physicians who finds out in February or March how much they could have saved. So before another year slips by, let's walk through what can still be done right now.

Here we are again — the final stretch of the year. Whether you're visiting family, traveling, or squeezing in some much-needed R&R, the end of the year naturally creates a pause — the kind that invites you to take inventory of your financial life, not just the numbers, but the behaviors behind them.

So in today's episode, we're going to talk about reflection — what to review, what to evaluate, and how to think about your financial life heading into a new year. And then we'll wrap up with the key year-end deadlines you need to know before the calendar flips.