#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
Should you contribute to your company’s cash balance plan? [not-audio_url] [/not-audio_url]

Duration: 32:25
Episode Overview: Join Nate Reineke and Ben Utley as they unveil insights into optimizing retirement and investment strategies tailored for self-employed physicians. This episode explores why a solo 401(k) might be more…
Are we on track for retirement? [not-audio_url] [/not-audio_url]

Duration: 38:58
On today’s episode we answer more of your questions! Are we on track for retirement? My mom and dad need a little help with money - how much can I help? Is now the right time to upgrade in house? Another physician inheri…
How will you invest my money? [not-audio_url] [/not-audio_url]

Duration: 26:47
On today's episode we answer YOUR questions! Should I stop contributing to my taxable account and 529s if we are going to move in a year? How much can we contribute to our grandchildren's 529 accounts without going over…
Should I pay off my house with my inheritance? [not-audio_url] [/not-audio_url]

Duration: 23:19
How do I use my 529 to pay for college? Should I make regular 529 withdrawals or can I leave the 529 money in the account growing tax free as long as possible? I received a large inheritance, should I pay off my 2.5% mor…
Should I pay down debt or invest? [not-audio_url] [/not-audio_url]

Duration: 21:32
On today’s show… Is it finally time to pay off my student loans? I make $700,000 a year and I want my spouse to work..am I wrong? Should I put my college money in cash or 529s? Did my $2M home purchase derail my retireme…
How should I choose a tax preparer? [not-audio_url] [/not-audio_url]

Duration: 17:09
On today’s show… • How do I choose the right tax preparer? • Why didn’t my automatic payment come out for my mortgage? • Should we move closer to our parents? • Should I count on hitting my RVUs? • Should I buy into my s…
Are Financial Advisors Worth it for Physicians? [not-audio_url] [/not-audio_url]

Duration: 29:52
You’ve been waiting for it all this time. So here we are, on our 67th episode - here comes the shameless self promotion. Right? I mean what advisor doesnt think they are worth it. Well not only do we believe we are worth…
Physician College Planning: What your colleagues are saying now [not-audio_url] [/not-audio_url]

Duration: 22:12
Physician culture is a funny thing. Your colleagues may be thinking the same thing you’re thinking (about paying for college) but you would never know. Well, we do. As our in house college planning specialist, Nate Reine…
Demystifying Defined Benefit Plans with Courtenay Shipley [not-audio_url] [/not-audio_url]

Duration: 25:10
If something seems too good to be true, it probably is (not?) When physicians hear that they could save tens of thousands of dollars in taxes by utilizing a Defined Benefit Plan for retirement saving, it sounds like a pi…

«1...678910