Roth Conversion or ACA Subsidy? You Don't Have to Choose.

Why High-Earning Nurses Never Feel Wealthy (with Kristin Burton, PA Millionaire)

Kristin Burton paid off over $160,000 in student loan debt in 16 months, became a self-made millionaire by 31, and built a platform called Millionaires in Medicine that now reaches PAs, NPs, pharmacists, and other non-physician healthcare professionals across the country. She also just published her first book, The PA Millionaire Path. In this episode, Brett Fellows, CFP®, sits down with Kristin to talk about what holds high-earning healthcare professionals back from building wealth. They cover the identity problem around income, why student loans should never be the whole money plan, the three tax buckets that create flexibility in retirement, and what it takes to make work optional. Kristin also shares the investing philosophy that built her net worth and the financial mistakes she would do differently. Key Timestamps: (0:18) Introduction of guest Kristin Burton and her personal wealth milestones (1:38) Origins and grassroots mission of Millionaires in Medicine (3:53) Failure of non-physician medical professionals to self-identify as high earners (5:13) Time management strategies for balancing clinical practice and entrepreneurship (6:18) Shift from short-form infographics to deep long-form conversations (10:23) Inspiration for publishing a tangible and enduring financial guidebook (12:05) Why behavioral choices and mindset outweigh pure financial intelligence (16:22) Reframing student loans as a career investment instead of an emotional burden (19:03) The three-pillar framework to track earnings, multiply investments, and build net worth (22:03) Long-term advantages of a boring and fully automated dollar-cost averaging approach (27:35) Spreading assets across three tax buckets to optimize retirement withdrawal strategies (30:04) Three-step process to establish and future-proof baseline lifestyle expenses  For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Amanda Kay on One Full Year of 1099: What She Got Wrong, What Changed Everything

A year ago, Amanda Kelly jumped into full 1099 independence with income goals, an S-corp, and many unknowns. Now she’s back. In this episode, Brett Fellows, CFP®, sits down with Amanda Kelly, CRNA, coach, and founder of The Mindful CRNA, to hear what happened once the theory met real life. They talk through the financial surprises that came with running an S-corp, why most CRNAs leave money on the table at tax time, how the independent market has shifted heading into 2026, and what Amanda learned from a 30-minute tax return walkthrough with Brett that changed how she thinks about her money entirely. They Cover: * The honest financial case for going 1099 in your 40s or 50s * Why salary vs. distributions inside an S-corp matters more than most CRNAs realize * What CRNAs consistently get wrong with deductions and bookkeeping * How the 1099 market has shifted since 2024 and what to expect going forward * Running a side coaching business, and when to spin up a second LLC * The tax return review that made her numbers finally make sense * Baby Roths, HSAs, and what a "money machine" looks like in practice * Three financial moves she would tell every new CRNA to make first #CRNAs #1099CRNA #TaxPlanning #FinancialPlanning #MoneyRx Key Timestamps: (0:18) Return of guest Amanda Kay to review her first year of independent contracting  (1:43) Simple bookkeeping and revenue tracking methods using basic apps  (2:56) Psychological adjustments when transitioning away from W-2 employment  (4:40) Spousal communication strategies for managing variable monthly income  (6:50) Common first-year errors with S corp compliance and deductions  (10:53) Tax efficiency benefits of prioritizing business distributions over salary  (13:40) Proactive recordkeeping habits to easily track business expenses  (15:56) Evaluating the financial case for switching to 1099 contracting  (18:40) Choosing the right entity structures when managing multiple income streams  (19:58) Projected overhead costs and platform fees for digital courses  (27:13) Navigating anesthesia market shifts and establishing cancellation policies  (30:04) Protecting income through continuous clinical skill diversification For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Should I Pay Off My Mortgage Before Retiring?

If you are within five years of retirement and thinking about paying off your mortgage, you are asking the right question, but… you’re probably asking it the wrong way. In this episode, Brett walks through a sample client household, Imani, a 60-year-old nurse practitioner retiring in December with $1.7 million in her 403(b) and a $228,000 mortgage. Her plan was simple: pull the money from her retirement account and walk into retirement debt-free.  Brett shows why that one decision would have cost her roughly $190,000 in taxes, lost growth, and destroyed planning runway, and the three moves that got her to the same outcome for about $9,000 instead. Brett covers: * Why the mortgage rate versus investment return comparison is the wrong framework for most CRNAs and NPs * The four separate tax bills hiding inside a single 403(b) withdrawal, and why almost nobody adds them up * Why January of your first retirement year is the worst possible time to make this decision * The three-move mortgage payoff runway that keeps retirement accounts untouched and the ACA planning window intact * How Imani went from a $190,000 mistake to a $9,000 solution without changing her goal at all #CRNAs #NursePractitioners #RetirementPlanning #TaxPlanning #MortgagePlanning Key Timestamps:  (0:18) Financial risks of pulling from pre-tax accounts for mortgage payoffs  (1:23) Case study introduction of a nurse practitioner aiming for debt-free retirement  (2:33) Breakdown of how the wrong asset source creates a major planning mistake  (4:33) Failure of standard rate versus return comparisons for pre-tax accounts  (6:38) Four separate financial liabilities triggered by a single lump sum withdrawal  (8:13) Delayed impact of retirement account liquidations on future Medicare surcharges  (10:28) Heightened compounding dangers of large early retirement lump sum distributions  (11:43) Preservation of the low tax window for strategic Roth conversions  (13:03) Alternative approach using accelerated principal payments from current cash flow  (14:53) Structural benefits of utilizing a five to seven-year payoff runway  (16:00) Mathematical guidelines for evaluating mortgage payoff choices based on interest rates  (18:03) Protecting retirement accounts from accelerated debt elimination plans For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Roth Conversion or ACA Subsidy? You Don't Have to Choose.

Most nurses retiring in their early sixties think they face one decision when it comes to ACA subsidies and Roth conversions: pick one or the other. But there’s another way. In this episode, Brett walks through the story of Renata, a 60-year-old CRNA retiring after 28 years with $1.78 million in her 403(b). She spent six months researching the ACA-versus-Roth question, talked to two CFPs, and was leaning toward skipping every conversion. What she discovered in a planning meeting changed everything. The cost of the question she had been asking, run across twelve years of her household's life, came to $280,000. In this episode, Brett walks through the three reasons this mistake keeps repeating, and introduces The Conversion Calendar: a 12 to 15-year framework that lets nurse households capture ACA subsidies and do Roth conversions at the same time, by placing each type of move on the right years of the retirement runway. Brett covers: - Why the ACA-versus-Roth binary is a false choice, and why 2026 makes it far more costly as enhanced credits expire - The shadow tax that adds 10 to 19 percent on top of your federal bracket without showing up on your tax return - How a household can go $3,000 over the cliff line and lose $14,000 in subsidies while saving only $300 in federal tax - The three-step Conversion Calendar built around Renata and Ben's 13-year runway - How this household saved $420,000 in lifetime federal taxes while capturing $45,000 in ACA subsidies #CRNAs #NursePractitioners #RothConversion #RetirementPlanning #ACASubsidy Key Timestamps: (0:18) Trade-off between ACA subsidies and Roth conversions (1:39) Case study of Renata and Ben’s early retirement transition (2:54) Risks of the false binary approach in tax planning (4:26) Reappearance of the hard 400% FPL cliff in 2026 (6:07) Hidden shadow tax impact on real marginal rates (7:29) Actual cost of conversions compared to federal tax brackets (8:58) Shifting the planning focus to the multi-year retirement runway (10:33) Benefits of using a conversion calendar for long-term sequencing (11:33) Visual mapping of retirement into distinct tax environments (12:53) Strategy for pairing ACA years with measured conversions (14:53) Impact of sequencing on future required minimum distributions (16:08) Lifetime tax savings achieved through strategic decision ordering For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].

Why High-Earning Nurses Leave Money on the Table in Retirement

You've worked for decades, maxed your 403(b) every year, and built a solid balance. But what if the structure of those savings is quietly setting you up for a six-figure tax problem in retirement? This episode follows Dana, a CRNA with 22 years at the same hospital and $1.4 million saved. She did everything the articles told her to do. What she found out in the first planning meeting was that doing everything right in a single account is still a problem. Brett walks through the three reasons high-earning nurses arrive at retirement with a tax structure they can't control, and the three concrete moves any nurse can make in the next 90 days to get back on track. Brett explores: * Why having 96% of savings in one pre-tax account creates a retirement tax rate the IRS sets for you * The hospital plan features most nurses never use, including a 457(b) that could have added $200,000 in contributions * The eight-year window between retirement and Social Security that is the cheapest tax opportunity of a high-earner's life * How to audit your hospital plan, redirect future dollars, and draw a conversion calendar * What the Tax Diversification Reset looked like for Dana and Marcus, and how it saved their household $190,000 in lifetime federal taxes If you have a growing balance in your plan and no real strategy for how it gets taxed in retirement, this episode is for you. Key Timestamps: (0:18) Risks of long-term concentration in a single pre-tax account  (1:23) Shift of financial control from the retiree to the IRS  (2:32) Distinction between missed contributions and missed financial flexibility  (3:38) Financial exposure of households with large pre-tax balances  (4:54) Institutional incentives that promote the default retirement structure  (6:03) Impact of Medicare IRMAA surcharges on retirement cash flow  (7:38) Unlocking overlooked features in complex hospital plan documents  (9:13) Identifying the low-tax planning window before required distributions hit  (10:58) Gaining control through tax-aware ordering and account types  (12:53) Three concrete steps to audit hospital plans for new options  (14:53) Mapping the conversion runway to minimize future tax brackets  (16:08) Lifetime tax savings achieved through strategic asset repositioning  For more information and resources related to this episode, please visit the show notes [https://oakcapitaladvisor.com/the-moneyrx-for-crnas-podcast/].