#140 Managing Risk and Staying on Target: When Should Doctors Pay Capital Gains?

#140 Managing Risk and Staying on Target: When Should Doctors Pay Capital Gains?

Author: Nate Reineke November 5, 2025 Duration: 35:17

The market is always moving, and it can be tempting to try to rebalance when you’d have to pay the least capital gains taxes. Tax savings are great, but is this really the best way to decide when to rebalance? Nate Reineke and Kyle Hoelzle break down how the market may play into rebalancing and what doctors like you should consider when deciding to rebalance. We also discuss why it is worth paying some taxes in order to manage your risk. We also answer your colleagues' questions. A listener emailed in and said, “I’m a 58-year-old surgeon in Pennsylvania and have been practicing for about 25 years, always as an employed physician. Over that time, I’ve built up several retirement accounts — a 401(k) with TIAA, a 457(b) plan from my second job that was frozen when the hospital was acquired in 2011, and my current 401(k) that started in 2011. I also have a cash balance pension plan that appears to be invested in a money market fund. As I start thinking about retirement in the next five to seven years, would it make sense to consolidate these accounts in one place — and if so, when is the best time to do that?” An OBGYN from Maryland got an email offering to put an ACATS Block on their account. They’re curious what that is, and why they would need one? The spouse of an OBGYN in Texas asks, “What is the Pro Rata rule, and how does it affect having/ opening a backdoor Roth?” A family med doc in California owns 2 properties that they use as investments, and they want to get a third so they can leave each child a property. They are three years from retirement and have enough for a down payment, but not enough to buy outright. Is it a good idea to buy? Are you ready to turn worries about taxes and investing into all the money you need for college and retirement? It’s time to make a plan and get on track. To find out if we’re a match visit physicianfamily.com and click get started or, you can ask a question of your own by emailing podcast@physicianfamily.com. See marketing disclosures at physicianfamily.com/disclosures


Finding a clear path through financial planning feels uniquely challenging when your career is in medicine and your heart is at home with family. The Physician Family Finances Podcast exists in that specific, demanding space. Host Nate Reineke, alongside co-host Chelsea Jones, brings their experience as Certified Financial Planner™ professionals directly to conversations with physician parents. They understand the dual pressures of managing a practice, caring for kids, and making smart long-term decisions with your earnings. Each episode moves beyond generic advice to tackle the real questions you face, from navigating student loan strategies and investment options tailored to a physician's timeline to planning for retirement without sacrificing your family's present. This isn't about quick tips; it's about building a sustainable framework that aligns with your values and goals. Tune in for a candid, practical discussion that makes complex topics like tax laws and wealth building accessible, so you can gain confidence and clarity with your finances. The entire podcast is built on the principle that securing your future should feel like an achievable part of your life's work, not an overwhelming distraction from it.
Author: Language: English Episodes: 100

Physician Family Finances Podcast
Podcast Episodes
#164 Extra, Extra: Hear All About Where Docs Can Keep Extra Savings [not-audio_url] [/not-audio_url]

Duration: 27:25
Building on the momentum of your high-earning years can sometimes feel like a puzzle with missing pieces. When it comes to finding a home for your extra savings, it can seem like there are a million account types, and it…
#160 Taxes are a drag. How can physicians cut the weight? [not-audio_url] [/not-audio_url]

Duration: 34:33
If you have a tax-inefficient portfolio, it can be like swimming with a giant t-shirt on. You can do it, but there is a lot of unnecessary drag. Nate Reineke and Kyle Hoelzle break down what tax drag in a portfolio means…
#159 How Do Doctors Know When To Break Their ARM? [not-audio_url] [/not-audio_url]

Duration: 22:26
Mortgage rates are on the move once again, and if you have an ARM that is coming up on a variable rate period, it may be time to consider changing your mortgage type. The answer to knowing if you should is easier than yo…
#158 What Should Doctors Upgrade Right Before Moving [not-audio_url] [/not-audio_url]

Duration: 26:17
The housing market seems to be heating up again as mortgage rates start to come down. If you’re planning a move, it can be hard to determine what upgrades to do on a house that will actually have a good return on investm…
#156 What is a Mega Backdoor Roth, And When Should Doctors Use One? [not-audio_url] [/not-audio_url]

Duration: 27:16
If you plan to hit your 401K contribution limit for the year, but see that you can still add money through “after-tax contributions,” you may be wondering if that is a Mega Backdoor Roth and, more importantly, if you sho…