Kristin Burton graduated from PA school in 2016 with over $160,000 in student loan debt and almost no personal finance education aimed at someone in her position. What existed for physicians did not translate. The income looked different. The loan burden looked different. The career timeline looked different. So she figured it out herself, paid off every dollar in 16 months, and became a self-made millionaire by age 31.
Today, she runs Millionaires in Medicine, a platform serving PAs, NPs, pharmacists, and other non-physician healthcare professionals. She also just published her first book, The PA Millionaire Path. On a recent episode of MoneyRx for CRNAs and Nurse Practitioners, Brett Fellows, CFP®, sat down with Kristin to walk through the ideas behind the book and what consistently gets in the way of healthcare professionals building real wealth. The conversation covered five areas worth paying attention to.
1. The Income Identity Problem
Most PAs, NPs, and pharmacists do not think of themselves as high earners. That is the surprising truth Kristin encountered as she started working with healthcare professionals at scale. Against a backdrop of national median household income, these professionals clearly qualify as high earners. But that rarely matches how they feel.
Two things drive that disconnect. First, they spend their days surrounded by physicians earning three or four times what they make. Second, student loan debt creates a monthly cash flow drain that makes it feel like there is nothing left over. Together, these two realities shape a money identity that says wealth building is not for people like me.
If you are a CRNA, PA, NP, or pharmacist reading this, that belief is worth examining. You are comparing yourself to the wrong peer group. The income is there. The question is whether the plan is.
2. Your Student Loans Are Not the Plan
Student loan debt is a huge emotional burden for healthcare professionals. It comes with shame, urgency, and a specific kind of tunnel vision. Many CRNAs, NPs, and PAs lock onto a payoff goal and treat it as their entire financial strategy. Kristin’s view is direct: the student loan debt is only one part of a much larger picture.
The right approach starts with a different question. What is your financial independence timeline? Do you want to work full-time until 67? Scale back at 55? Retire at 47? The answer to that question should drive your student loan strategy, not the other way around.
If you want to be financially independent at 47, spending five years making only student loan payments while investing nothing is not an option. You need to be building assets at the same time. The plan has to hold both things at once. Because investing feels foreign compared to paying down a known balance, it tends to get deferred. That deferral has a real cost.
3. The Investing Strategy That Worked
Kristin’s personal investing approach is, by her own description, boring. Automated purchases. Dollar cost averaging. Annual allocation check. One intentional move per year in the cash flow investing space, just to keep herself engaged. Everything else runs in the background.
The strategy that built her net worth was not active management or market timing. It was consistency. During COVID, while working demanding ICU shifts with nowhere to spend money, she kept investing. When she looked up later, the growth was there.
The most common obstacle for medical professionals looking to invest outside employer accounts is not overcomplication. It is not knowing where to start. That uncertainty creates a freeze, and the accounts never get opened. Simple, automated systems solve for that. You do not need a sophisticated strategy. You need one that you’re going to use.
4. The Three Tax Buckets
One of the most important concepts in both the book and this episode is tax diversification. Most people default to tax-deferred contributions because they are easy to set up and reduce taxes right now. The problem surfaces in retirement when every withdrawal triggers income taxes and required minimum distributions pile up faster than expected.
The three buckets to understand are tax-deferred accounts like traditional 401(k) and 403(b) plans, tax-free accounts like Roth 401(k), Roth IRA, and properly used HSAs, and taxable brokerage accounts where capital gains apply. When you have assets spread across all three, you gain something that money alone cannot buy: control.
You can control which accounts you pull from in any given year. You can manage your taxable income. You can time Roth conversions in low-income years. You can plan around Medicare surcharges. None of that flexibility exists if everything sits in a traditional 401(k). Brett makes this point consistently with Oak Capital clients: the IRS becomes your largest retirement partner by default if you do not plan around it intentionally.
5. How to Make Working Optional
Kristin’s framework for work-optional living follows three steps: define your baseline, future-proof it, then build a withdrawal strategy. The baseline is the annual income you need to sustain your lifestyle. Future-proofing means adjusting that number for inflation over the years between now and your retirement. The withdrawal strategy determines how you draw from your assets to preserve the portfolio over time.
The math almost always lands on a target in the multiple millions. For CRNAs, NPs, and PAs, that number is achievable. But it requires starting with a real number, not a vague aspiration. As Kristin put it, the name Millionaires in Medicine sounds aspirational, but it is closer to the baseline for retirement requirements in this profession.
You can listen to the full conversation between Brett and Kristin on the MoneyRx for CRNAs and Nurse Practitioners podcast. The episode covers all of this, plus the financial mistakes Kristin would do differently, the one investing hill she would die on, and her answer to where she wants to be in three years.
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