THe MoneyRx for CRNAs and NPS Podcast

She did it as a PA. Not a surgeon. Not an attending physician. A PA who refused to believe that wealth building was someone else’s story. In this episode of MoneyRx, she and Brett Fellows, CFP®, dig into the mindset traps, student loan mistakes, and tax strategies that determine whether high-earning healthcare professionals can build the financial freedom they’ve worked for. Read on for the biggest takeaways.

Amanda Kay left W2 life over a year ago. She lost a hospital contract, had some tight months, and almost went back. Her husband told her not to. Brett Fellows sat down with Amanda to hear what a year of full independence taught her.

Most CRNAs and nurse practitioners who ask this question are really asking the wrong one. The mortgage rate is not the variable that decides this, and for a household with most of its net worth locked inside a pre-tax 403(b), that distinction is worth about $190,000.

Most CRNAs approaching retirement are told they have to choose between an ACA subsidy and a Roth conversion. That framing can cost an average nurse’s household hundreds of thousands of dollars. Brett Fellows breaks down why the choice is false, what the shadow tax is doing to your marginal rate without showing up on your return, and how The Conversion Calendar puts both levers to work across the right years of your retirement runway.

Most nurses retire with a solid balance and a tax problem they never saw coming. This episode lays out the three reasons the default savings path costs high-earning CRNAs and NPs six figures in retirement, and the three moves to fix it before the window closes.

People who build a line-item retirement budget typically estimate what they think they can live on, not what they spend. That gap, 20 to 30% above estimates on average, can be the difference between a plan that holds and one that doesn’t. This post walks through the Subtract-and-Replace Budget: a two-part framework that starts with your paycheck instead of guessing at future expenses, and surfaces the four cost categories that decide whether a retirement plan survives.