Retirement account strategy, tax optimization, and long-term wealth building.
14 articles in retirement & taxes
Nothing is withheld from 1099 income, and the IRS charges for paying late even if you pay in full. Here are the safe-harbor rules, the deadlines, and the math.
Academic and government-employed physicians often have a 457(b) alongside the 403(b) — a separate $24,500 deferral limit. The governmental vs non-governmental distinction determines whether that money is protected and portable, or exposed to your employer's creditors.
The HSA is the only account with a triple tax advantage. At a 35% marginal rate, the 2026 family limit of $8,750 saves over $3,000 in federal tax this year — and the long game is better.
The 2026 federal brackets, the marginal vs effective rate distinction, and a $300,000 single attending worked line by line. Plus the arithmetic that kills the myth that a raise can shrink your take-home pay.
A cash balance defined benefit plan is the largest deduction available to a physician-owner — and a costly mistake for the wrong practice. The fit comes down to age, income stability, and headcount.
Both accounts shelter 1099 income, but at moonlighting-level earnings the solo 401k allows far larger contributions and never breaks your backdoor Roth. A worked example at $40,000 of 1099 income shows the gap.
Every attending is over the 2026 Roth IRA income limit, and the backdoor Roth is the lawful workaround. The steps take 20 minutes. The pro-rata rule is where physicians get burned — here is how to get it right.
The mega backdoor Roth can move $30,000+ per year into Roth accounts — but only if your plan allows after-tax contributions and in-service conversions. Most hospital 403(b) plans allow neither. Here is how to check yours.
Tax loss harvesting offsets gains and up to $3,000 of ordinary income per year, but most of the benefit is deferral, not elimination. Here is the actual math and the cases where it is not worth the effort.
Standard retirement benchmarks fail physicians, who start earning at 32 with negative net worth. Here are benchmarks by years since training, built from an explicit worked model, plus the catch-up math that makes attending income close the gap.
The right answer depends on return complexity, not income. W-2-only attendings in one state usually do fine with software; 1099 income, multi-state work, and practice ownership change the math fast.
Physicians are the favorite target of aggressive tax-scheme salesmen. Here is the real list — retirement accounts, HSA, backdoor Roth, charitable bunching, 1099 deductions, state awareness — each quantified with 2026 numbers for a $400,000 household.
You can finish residency without anyone telling you what an ETF is — then a 403(b) form lands with thirty fund names on it. Here is the whole vocabulary, and the fee math that quietly costs physicians six figures.
A $350,000 attending with the right employer plans can shelter more than $115,000 in tax-advantaged accounts in 2026. Here is every account, every limit, and the order to fill them.