CPA Spencer Carroll joins the show to unpack tax strategy for physicians: why your income type matters more than your income, and where the real savings hide. Whether you're a W-2 employee, a 1099 locums doc, or a K-1 partner, the levers you can pull are wildly different.

What you'll learn:

• Which of W-2, 1099, and K-1 is the best—and worst—way to get paid as a physician
• When an S corp actually makes sense, and how "reasonable salary" really works
• The truth about real estate professional status and the short-term rental loophole, from a CPA who owns rentals himself
• The one red flag that means you're probably overpaying: barely talking to your CPA all year

Resources:

• Head to moneymeetsmedicine.com/cpa to book a complimentary call with Gelt and get 10% off your first year. Subscribe to Money Meets Medicine wherever you get your podcasts, and leave a rating—it helps other physicians find the show.

Disclaimer: This episode is a part of a paid partnership between Physician Philosopher LLC with Better Technologies Inc. (DBA Gelt), a tech-enhanced tax-strategy company.

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Dr. Jimmy Turner cut back to part-time at 35—and ended up on antidepressants. FIRE wasn't the escape hatch he expected.

FIRE—financial independence, retire early—promises an exit from burnout. But what happens when you finally get there and realize you don't know who you are without medicine? Jimmy and Justin make the case for FIWO (financial independence, work optional) instead.

Resources:

Disability Insurance: Every physician needs to get individual disability insurance while in training. Get a quote from Money Meets Medicine Disability Insurance, a company you can actually trust. Built by doctors, for doctors.

Does your CPA only reach out in March each year and show you a giant tax bill? You need tax strategy, not just tax filing. Click here to get a 10% discount code to work with Gelt, the same tax strategy team that Jimmy personally uses.

Every physician needs basic financial literacy. Get a free copy of Dr. Turner's best-selling book, The Physician Philosopher's Guide to Personal Finance.

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What if your first three years as an attending decide whether you work three days a week in your 40s—or six days into your 60s?

Dr. Jimmy Turner burned out early in his career—antidepressants, 1.3 FTE, the works—before discovering the fix: working less. He and Justin Harvey, CFP, break down Coast FIRE, your Wealth Accumulation Rate, and why the savings decisions you make right out of training set a trajectory you'll feel for decades.

What you'll learn:

• Why a ~30% Wealth Accumulation Rate early on can buy you a 3-day clinical week later
• How Coast FIRE lets you save less down the road and still reach financial independence on time
• The two kinds of autonomy—personal and professional—that really drive physician burnout
• A smarter take on "live like a resident" so you can enjoy your income without losing the plot
  

Resources:

Are you a 1099, locums doc, or private practice partner or business owner? You need a tax strategy team. Get 10% off working with the team I use here (Gelt): https://moneymeetsmedicine.com/CPA

Every doctor needs own-occupation disability insurance. Get it from a source you can trust: https://moneymeetsmedicine.com/disability

Want a free copy of The Physician Philosopher’s Guide to Personal Finance? Snag your copy here: https://moneymeetsmedicine.com/freebook

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Physicians earning $400K are living paycheck to paycheck—and an 18th-century psychology trap is why.

Roughly 30% of doctors over 60 don't have $1M in net worth, even counting their home. Justin Harvey and Dr. Jimmy Turner unpack the behavioral-finance forces—the Diderot Effect, lifestyle creep, and leverage—that quietly erode physician wealth, and the simple framework that lets you spend guilt-free while still building real options.

Resources:

• Disability Insurance: Every physician needs Disability Insurance from MMM Disability Insurance. Click here to get a Quote from Money Meets Medicine Disability Insurance
• Looking for a new CPA? Use the one that Dr. Jimmy Turner personally uses and recommends (Gelt). Click here to get a 10% discount code on services when working with Gelt.

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There are two ways to get your student loans forgiven — and the one nobody talks about could leave you with a six-figure tax bill.

Most physicians know PSLF. Far fewer understand taxable forgiveness — the IDR path that hands you a massive tax bill 20 years down the road. Jimmy and Justin break down a real listener question (anesthesiologist + dentist, $400K in loans at 7%) to show why "married filing separately" math isn't as clean as it looks, and why your repayment plan now hinges on a looming July 2026 deadline.

Resources mentioned:

• Looking for a CPA that does more than just file taxes each year? Check out Gelt, the proactive tax strategy partner that Jimmy personally uses, and receive 10% off the first year through the MMM link.
• Get $100 off a Student Loan Consult with Student Loan Planner: moneymeetsmedicine.com/loans
• Looking to refinance your private student loans? Click here to learn how to find the lowest interest rates out there.
• Every physician must get disability insurance before leaving training! Get a disability insurance quote from Money Meets Medicine Disability.

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One student loan decision in the next few weeks could cost — or save — a physician six figures.

On May 1, 2026, the Department of Education finalized the 134-page rule rewriting federal student loan repayment. Dr. Jimmy Turner goes solo to break down what changed and the moves that protect six figures.

What you'll learn:

• Why the July 1, 2026 cutoff decide whether you keep IBR at all
• The consolidation trap that can permanently lock residents out of IBR
• The RAP interest subsidy that keeps a $300K balance from ballooning during residency
• The RAP-to-IBR playbook for PSLF: which payments count, and when to switch
• Married or in a community property state? How filing separately changes the math

Resources:

• Every doctor needs their own occupation disability insurance. Get it from a source you can trust: https://moneymeetsmedicine.com/disability
• Have private loans? You should refinance those to the interest rate you can find. To do that, check out Juno: https://moneymeetsmedicine.com/JUNO
• Looking for a new CPA? Use the one Jimmy uses (Gelt). Get a 10% discount when working with them here: https://moneymeetsmedicine.com/CPA
• Looking to save $100 on a student loan consult? Visit moneymeetsmedicine.com/loans

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Becoming an accidental landlord could cost you a six-figure tax bill — or be the smartest move you make. You're finishing training, moving cities, and that house you bought a few years ago — the one with the enviably low mortgage — is suddenly a decision: sell it and pocket the equity, or rent it out and start building "passive income"? It sounds simple. It isn't. Dr. Jimmy Turner and Justin Harvey, CFP®, break down the real math behind renting vs. selling your home as a physician — and the IRS clock most people don't realize is already running.

What you'll learn:

• How Section 121's $500K capital gains exclusion works — and the 2-out-of-5-year rule that quietly creates six-figure tax bills
• Why "I have a 3% mortgage" is golden handcuffs, not a strategy
• The honest cost of becoming an accidental landlord — property management, the 1% maintenance rule, the curveballs
• When renting during a fellowship is a smart, low-risk way to test landlording
• Why real estate tax breaks aren't free — what 1031s and "die-with-it" actually require

Resources

• 1099 Doc, locums, or private practice partner? Upgrade your CPA with Gelt (the tax strategy team Jimmy uses). Use this link to get a 10% discount when working with Gelt: https://moneymeetsmedicine.com/CPA
• Get Disability Insurance from Money Meets Medicine Disability Insurance — moneymeetsmedicine.com/disability
• Have a question you want discussed on the show? Email me at jimmy@moneymeetsmedicine.com

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40% of doctors have a side gig — and most are one contract clause away from handing it to their employer. Forty percent of physicians now run a side gig — chart reviews, expert witness work, SaaS tools, real estate, content, consulting. But here's what nobody covered in residency: most are leaving money on the table at tax time, mixing business and personal finances into an unfixable mess, or unknowingly signing away their intellectual property in an employment contract they barely skimmed. In this episode of Money Meets Medicine, Dr. Jimmy Turner and CFP Justin Harvey unpack what physicians actually need to know before they earn their first non-clinical dollar — and what to do once they're already five figures a month in. If you've ever wondered whether you should be an S Corp, whether your hospital can claim your nights-and-weekends project, or whether business ownership is even worth the headache, this one is for you.

Resources:

• Need a new CPA? Work with Gelt, the proactive tax strategy partner that Jimmy uses, and receive 10% off the first year through the MMM link — https://moneymeetsmedicine.com/CPA
• Disability Insurance — Where physicians (especially trainees) can request a GSI quote and learn whether one is available at their program — moneymeetsmedicine.com/disability
• Medscape 2025 Physician Side Gig Survey - https://www.medscape.com/slideshow/doctors-side-gigs-2025-6018502

Episode Summary

An orthopedic surgeon writes in: he's pulling $550K at an academic center and has quietly built an AI-powered prior authorization SaaS now generating five figures a month. What should he be thinking about? Jimmy and Justin use that question as a launchpad into the financial reality of physician non-clinical income — the ups, the downs, and the surprisingly counterintuitive parts.

Jimmy, recently transitioned from 15 years as a W-2 academic anesthesiologist to a 1099 private practice gig, shares why business ownership has been more stressful than running codes — and why he's still glad he did it. He explains why a $30,000 surprise tax bill finally pushed him to bring in a real tax strategy team (not the February-only compliance CPA most physicians settle for), and the difference between the two.

The conversation digs into the Medscape 2025 numbers: 40% of physicians have a side gig, 50% between ages 40 and 50, and 60% say they're doing it for extra income. Most physicians aren't actually trying to leave medicine — they're trying to build enough financial freedom to practice on their own terms. Sometimes a $60,000 side income buys back a day of the week.

Justin pushes on the harder questions: What's your goal? What's the actual ROI once you factor in CPA fees, self-employment tax, and the brain space business ownership demands? Why some physicians thrive in 1099-land and others should sprint back to W-2.

They also walk through the practical setup — the deceptively simple three-step LLC-EIN-bank-account process most physicians overcomplicate or skip entirely — and the contract landmine almost no academic physician thinks about: who actually owns the work you do on nights and weekends. Plus the tax-strategy doors most W-2 doctors don't realize are closed to them: S Corp elections, QBI, solo 401(k)s, cash balance plans, and pass-through entity tax.

If you're already running a side gig or seriously thinking about one, this is the cheat sheet you wish someone had handed you before you started.

What You'll Learn

• Why 40% of physicians now run a side gig — and the real reason most start one (it's not what you think)
• The three-step business setup most physicians overcomplicate: LLC, EIN, separate bank account
• How an employment contract clause can quietly hand your side gig over to your hospital — and how to negotiate it before you sign
• When a tax strategy team actually pays for itself versus when basic compliance is enough
• The ROI math on 1099 income: what your side gig really needs to clear after self-employment tax, professional fees, and added complexity
• Side gigs with lower ceilings but much higher odds of success — and why 90% of online businesses fail

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