#156 What is a Mega Backdoor Roth, And When Should Doctors Use One?

#156 What is a Mega Backdoor Roth, And When Should Doctors Use One?

Author: Nate Reineke February 25, 2026 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 should do it. Nate Reineke and Kyle Hoelzle break down what exactly a Mega Backdoor Roth is and some cases where physicians should use it. We also discuss how you can still contribute post-tax dollars, plus some alternatives that may save you taxes in the long run. We also answer your colleagues' questions. A Dermatologist in New Jersey asks, “Is VOO enough exposure to the US market right now?” A Double doctor family in Oregon says, “Should we invest in a condo for our daughter who is going to undergrad and medical school at the same college next year?” A Radiologist in Texas wonders, “I just received a $300k inheritance. When is the right time to invest it, and what should I invest in?” 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…
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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…
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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…

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