Binge read all things wealth building, debt reduction, & lifestyle.

Roth or Traditional 401(k)? Here's What I Tell Every Medical Professional

Choosing between traditional and Roth contributions to your 401(k) or 403(b) isn’t just a random checkbox—it could mean tens of thousands of dollars saved or lost across your career.

Let’s break down what actually matters in 2025 and beyond.

💡 Start with the Basics: What’s the Difference?

• Traditional = Pre-tax contributions
   ✅ Lowers your taxable income today
   ⚠️ But you’ll pay taxes when you withdraw the money in retirement.
  
  
• Roth = After-tax contributions
   ✅ You’ve already paid taxes upfront
   ⚠️ Withdrawals in retirement are 100% tax-free
  

The key thing to remember: Your 401(k) or 403(b) is one account, but it can have both traditional and Roth “buckets” inside. In 2025, your total contribution cap is $23,500—whether you do Roth, traditional, or a mix of both.

And no—this has nothing to do with your Roth IRA. Entirely separate thing.

🔁 What You’re Really Doing I...

You’ve seen the headlines. You’ve heard the stats.
But let’s get real… will AI actually take your job as a PA or NP?

And more importantly: what can you do right now to protect your income, career, and long-term freedom?

Let’s break it all down without the fearmongering.

🚨 AI Disruption Is Real (But Not the Full Story)

AI is already shaking up industries, with projections estimating 85 million to 800 million jobs displaced by 2030.

In medicine, specialties like radiology and pathology are already seeing massive shifts.

But what about PAs and NPs?

Here’s the good news:

You probably won’t be replaced.
But your job will change—and those who adapt will thrive.

💡 Step 1: Understand Automatable Hours

AI disruption isn’t all-or-nothing. The most important question is:
How much of your job can be automated?

Examples of automatable roles:

• Radiology = high risk
• General medicine = moderate
• Psychiatry = low (empathy can’t be coded)
• Surgery/Pro...

You’ve probably heard it already:
“Trump wants to give your kid a thousand bucks.”
And if you’re a medical professional trying to build wealth for your family, you’re probably wondering:

Is this legit? Should I open one of these Trump Accounts?

Let’s break it down... money-first, politics-neutral.

What Is the Trump Account?

This account is part of the One Big Beautiful Bill that’s officially passed and signed into law.

The details are still murky, but here is what the  Trump Account for kids plans to  offer:

✅ $1,000 in seed money for kids born in a specific time window from the federal government
✅ Up to $5,000/year in parental contributions allowed
✅ Tax-deferred growth
✅ Tax breaks (specifically taxed at capital gains rates rather than ordinary income brackets) if the money is used for:

• Education
• Housing
• Starting a business
  

But if the money is used for anything else?
Ordinary income tax + a 10% penalty.

Also, all funds must be withdrawn by age 31.

Sounds Good… But How ...

If you're a medical professional and either have kids or want kids someday, you've probably wondered:

How can I give them a financial head start I never had?

Let me show you how we’re doing it.

I’ve set up a system where both of my kids will be millionaires by the time they’re 35—and it doesn’t require hundreds of thousands of dollars.

It just takes intention, a few monthly contributions, and the right accounts.

First—This Is Not All or Nothing

Let me be clear:
You don’t need to hit millionaire status for this to be worth it.

Even if you can only do a fraction of this plan, you're still setting your kid up with a financial launchpad that most of us never had.

Even $100/month over time = six figures by adulthood. That’s still a huge win.

But if you do want to go all in, here’s exactly how we’re making millionaire status happen by age 35:

Step 1: Open a UTMA Account

We start with a UTMA account (Uniform Transfers to Minors Account)—
✅ It’s flexible
✅ It’s taxable
✅ And the mone...

The fastest way to wreck your finances as a medical professional?
Buying the wrong house.

I’ve seen it too many times—PAs, NPs, and PharmDs rushing into homeownership, only to end up house-poor, underinvested, and stuck in golden handcuffs for decades.

So if you’re dreaming of buying a home in the next 1, 2, or even 5 years, let’s walk through what really matters when it comes to buying a house without sabotaging your future freedom.

Step 1: Don’t Start With the House

Don’t start by asking what kind of house you want.
Start with: “What can I safely afford each month?”

This is one of the biggest money moves you’ll ever make—especially if you’re not planning to become a real estate investor. You’ve got to get this right.

Step 2: Calculate Your Max Monthly Housing Expense

Here’s the formula I use:

1️⃣ Take your gross annual household income (pre-tax)
2️⃣ Divide by 12 to get monthly income
3️⃣ Multiply by 0.2 (that’s 20%)

That number = your max monthly housing cost
✅ If you’re buying:...

I recently asked a room full of medical professionals, “Who here wants to work full-time until they’re 65?” Crickets.

No one dreams of spending four decades buried in EMRs and shift work. Most of us want options—whether that’s retiring early, reducing hours, or just being able to walk away if burnout hits hard. I find very few medical professionals don’t have a desire to never do medicine again - they just want control.

But here’s the truth no one tells you:
To have that freedom, you’re going to need a lot more money than you think.

Let’s break down what financial independence really takes—and how to actually hit that number.

What Financial Independence Actually Means

Financial independence means your assets pay for your life—forever. You’re not relying on your job, you’re not dependent on anyone else, and you get to decide how you spend your time.

You can build that a few different ways:

• Real estate portfolios that cash flow
  
  
• Ownership in operating businesses that send you pas...

Spring 2025 came in hot with tariff wars, rising inflation, student loan chaos, and stock market volatility that has a lot of medical professionals wondering...

“Is it even possible to build wealth in a season like this?”

Short answer: yes.
But you need a strategy—and some serious emotional discipline.

Why Personal Economics > Macroeconomics

The truth? You could come out of this economic mess ahead—if you have your personal financial systems dialed in.

✅ No high-interest debt
✅ 3–6 months of cash reserves
✅ Multiple income streams
✅ A student loan plan
✅ A long-term investing system

If you don’t have these in place, this season can wreck you.
If you do? You can use it to build wealth while everyone else panics.

What Investing in a “Down Market” Actually Feels Like

Whether you’re:

• A new investor putting in your first $1,000
  
• Or a seasoned one watching $70K disappear from your account in a day
  

It still stings.

But this is where people either panic and pull out...
Or keep go...

If you're a PA, NP, or PharmD and you're looking for real tax savings—not just a couple of bucks from writing off scrubs or CME—this blog is for you.

Because in 2025, there are two powerful strategies that are helping medical professionals save $10K… $30K… even $50K+ on taxes. And they don’t involve changing your job, lowering your income, or sacrificing your lifestyle. They DO require investing in real estate, which means you need to be financially ready to do so. In my mind, this means:

1. Free of all high interest debt (debt above 10% interest rate)
2. 3-month emergency fund in place (separate from property down payment)

When you’re ready, these are real wealth-building tools that I use myself. Let’s break them down.

Why Most Real Estate “Losses” Don’t Help High-Income Earners

Here’s the kicker: when you own an investment property, the IRS lets you deduct things like depreciation and expenses. This often creates a paper loss on your tax return—even if your rental made money.

B...

Many PAs & NPs, especially those with significant student loan debt, follow the common financial advice to pay off all student loan debt as quickly as possible post-graduation. Some medical professionals feel shame surrounding their debt burdens, and desire to clear this balance as quickly as possible. Others are interested in the increased monthly cashflow they would have available without a student loan payment. Despite these benefits, there is significant cost associated this approach. In this article I will walk you through the math of following this common advice as a PA-C or NP, and why it might not be the best choice for you.  

So... Debt Strategy: What Works and What Doesn’t

There are two commonly discussed methods utilized to clearing debt of any type. The first is the “debt snowball” strategy, which entails paying off all debt in order of current balance starting with the smallest balance. The benefit of this strategy is the psychological boost generated as you clear each...

You graduate. You pass your boards. You land the job.
That six-figure paycheck hits—and then... reality sets in.

If you’re a brand new PA, you know exactly what I’m talking about.
It’s not quite the dream you imagined. Expenses feel overwhelming. Loans are looming. And you’re wondering, “Wait… where did my paycheck go?”

Let’s walk through exactly what you should be doing in your first year of practice to get your money right.

Why Generic Budget Rules Don’t Work for PAs

You’ve probably heard of those 50/30/20 budgeting rules:

• 50% to needs
  
• 30% to wants
  
• 20% to savings/investing
  

I hate those.

They’re made for the masses—not for people like us.
If I followed that rule? I wouldn’t be a millionaire by 31. I needed a lot more than 20% going toward debt and wealth-building.

What you really need is a cash flow system that helps you grow your net worth—not just track your spending.

Inside the Millionaires in Medicine Club, I break down exactly how to do this with a free tracker you c...