THe MoneyRx for CRNAs and NPS Podcast

Most retirement plans are built for two. When one spouse dies, the survivor inherits a smaller income, narrower tax brackets, a smaller deduction, and in many cases, a Medicare surcharge she never paid before. Financial planner Brett Fellows breaks down how this happens, what it costs, and the window married nurses have to fix it before it’s too late.

Rental real estate builds wealth. But for CRNAs earning $200,000 or more, the math works differently than it does for buyers at lower income levels. Three problems show up consistently for high earners who invest in rental property, and most nurses never know they’re walking into them. Brett Fellows breaks down the real numbers on cash flow, depreciation, and exit costs, and explains a framework called the Capital Priority Ladder for figuring out where your capital should go first.

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.