#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
Is tax-loss harvesting a bad idea for physician investors? [not-audio_url] [/not-audio_url]

Duration: 14:27
Influenza. It’s a word that sounds ominous when you don’t know what it means. To a physician like you, influenza is nothing more than the average flu, but to a patient, it may sound scary. Does tax-loss harvesting sound…
Market goes bananas: What should physicians do? [not-audio_url] [/not-audio_url]

Duration: 14:27
Bananas are cheap but not as cheap as they used to be and the price of almost everything else is going up faster than a monkey up a tree. Everything else but stock prices that is. We’ve gotten several questions from phys…
Right before retirement, what should physicians buy? [not-audio_url] [/not-audio_url]

Duration: 23:05
Spring has sprung just like the freshly assembled Adirondack chairs in Ben’s back yard. Fumbling around while constructing Costco lawn furniture is normal, Ben proves that, but, you don’t want to stumble around with your…
Physicians ask: Does PSLF still work? [not-audio_url] [/not-audio_url]

Duration: 18:55
Things in the government are changing but, you already knew that, right? What you may not know is that public student loan forgiveness is still alive and well! Nate Reineke and Ben Utley discuss one pediatrician’s five y…
Investing with a Deadline: What's a Doctor's Best Move? [not-audio_url] [/not-audio_url]

Duration: 33:19
Introduction: In this new episode, hosts Nate Reineke and Chelsea Jones tackle the crucial topic of investment strategies for physicians with deadlines, particularly when facing urgent financial goals such as buying a ho…
Physicians still confused about backdoor Roth basics [not-audio_url] [/not-audio_url]

Duration: 22:19
Introduction: In Episode, hosts Nate Reineke and Ben Utley delve into the complexities of the backdoor Roth IRA, a popular strategy for high-income earners. They address common misunderstandings and provide clarity on ho…
How much DO physicians spend ? And save ? [not-audio_url] [/not-audio_url]

Duration: 24:55
Introduction: In this episode, hosts Nate Reineke and Ben Utley dive into the often-asked question: How much do physicians actually spend and save? They explore spending patterns among doctors, discuss financial strategi…
Becoming a Physician Mom Again in your 40's! Now what? [not-audio_url] [/not-audio_url]

Duration: 36:03
Introduction: Welcome to Physician Family Financial Advisors Podcast. In this episode, hosts Nate Reineke and Ben Utley address the joys and financial complexities of becoming a physician mom in your 40's, and what that…
Physician forever home mortgage, why not pay points? [not-audio_url] [/not-audio_url]

Duration: 32:28
Episode Summary: In this episode Nate Reineke and Ben Utley discuss the nuances of mortgage options for physicians, specifically focusing on the decision to pay points. The hosts explore the implications of mortgage rate…