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Financial Grand Rounds
with Bryan Jepson, MD, CFP®
All Posts


Real Estate Depreciation for Physicians: Separating Tax Strategy from Sale Pitch
Of all the alternative investment options marketed to physicians, real estate probably gets the most traction. And I understand why. Doctors tend to have more discretionary income, even after maxing out their 401(k), and the smart ones are looking for ways to leverage that income for their futures, rather than just spending it on a fancier lifestyle. Because of that draw, a whole industry has emerged—physician real estate investing. And with any industry that involves mon
bryanjepson
2 days ago9 min read


The Best Retirement Plan for Physician Practice Owners: 401(k), SEP-IRA, or Cash Balance?
One of the most common questions I get from physician clients who own their own practice is simple? How can I reduce my tax bill? When your income climbs into the high six figures, taxes are no longer just a nuisance—they’re one of your largest expenses. And unlike W-2 physicians, small-business owners have significantly more control over how much they pay. One of the most powerful ways to reduce taxes, while simultaneously building long-term wealth, is through a well-designe
bryanjepson
Apr 84 min read


Are you ready for your second shift? Reflections on the physician retirement transition—identity, purpose, and what comes next
I recently wrote an article on Doximity.com about what I felt after the death of one of my medical school classmates. He died of metastatic pancreatic cancer at the age of 58. It forced me to pause and reflect on what is truly matters, starting with meaningful relationships, especially with those closest to us. It was a stark reminder that despite our best planning, life does not always unfold that way we expect . When that happens, we have the choice: succumb to our cir
bryanjepson
Mar 204 min read


Is Long-Term Care Insurance Worth It?The answer could be worth $5 million.
One of my clients asked me to review a proposal for long-term care insurance for him this past week, and the result was instructive. I thought it would make a good post. First let me start with a few points: Although I am not a fan, in general, of commission-based financial advising as a compensation model—I think the conflicts of interest are too strong to be truly fiduciary—, I have nothing against the people who work for insurance companies. I think that most of them fe
bryanjepson
Mar 97 min read


The Last Shift: Gratitude, Anxiety, and the First Year Beyond Medicine
In my last blog post, I mentioned that I was on the precipice of retirement from medicine. Well, a couple of weeks ago, I officially worked my last shift. My personal perspective on the transition is still fresh, perhaps still too fresh, but that may be precisely what makes it worth examining. So, let’s dive a little bit deeper into some thoughts as I look forward to the first post-medicine year. Maybe I will revisit it a year later with the perspective of looking back. It
bryanjepson
Feb 215 min read


Sequence Risk Isn’t Just About Retirement — It’s About Career Transitions
Why leaving clinical medicine can amplify volatility — even if your math works. Sequence risk is typically framed as a retirement math problem. But it’s often a life-timing problem. The real danger isn’t just poor early returns — it’s when volatility collides with income reduction and identity shifts. Anyone familiar with me from my website, blog articles or podcast appearances knows that I am a second shifter. "The Second Shift" is the name of a new podcast that I am co-ho
bryanjepson
Feb 78 min read


Donor Advised Funds Explained: A Practical Guide to Tax-Efficient Charitable Giving
Donor Advised Funds: A smart tax strategy In my last post , I spoke about a great tax strategy for charitable giving called a Qualified Charitable Distribution , or QCD. QCDs allow you to lower your Adjusted Gross Income (AGI) dollar for dollar and still take advantage of the standard deduction (or itemize if it makes sense) for further reduction of your tax bill. The main problem with the QCD strategy is that it is available to a relatively small demographic: charitably
bryanjepson
Jan 307 min read


Qualified Charitable Distributions: One of the Most Overlooked Tax Strategies in Retirement
This week is Christmas, which feels like the perfect time to write a post about charitable giving. I recently worked with a retired client couple who were excellent candidates for a Qualified Charitable Distribution (QCD): are charitably minded, still have relatively high income (pension/social security/part-time employment), are required to take RMDs, and hold a meaningful balance in a traditional IRA. I introduced the concept to them and was able to save them thousands of d
bryanjepson
Dec 27, 20255 min read


Asset Location After You Retire: What Changes and Why It Matters
When most of us think about saving for retirement, we often start with a net worth goal—a number generated perhaps by a formula like the 4% rule or financial planning software. Once we hit that number, we figure, the work will be done. So, we put our heads down and earn, save, and invest diligently to achieve our retirement goal. These working years can also be called life’s accumulation phase. Well, the reality is that life doesn’t stop at retirement, and neither do th
bryanjepson
Dec 17, 20257 min read


What is one of the most overlooked investment strategies? Asset location
When most people think about “investment strategy,” they immediately jump to asset allocation —the mix of stocks, bonds, and alternative investments that matches their risk tolerance and time horizon. But there’s a second, equally important concept that rarely gets discussed outside of professional planning circles: Asset location. If asset allocation is what you invest in, asset location is where you place those investments. And getting this right can add tens of thousand
bryanjepson
Nov 26, 20257 min read


Winning the distribution phase: How to efficiently access your money when you retire
You’ve worked hard your entire career and made the right financial decisions to build a solid nest egg and to be positioned to retire on your own terms. But the accumulation phase in life is only half of the story. Now you have to start distributing and living off your assets. First, are you ready for that shift in mindset? It turns out that it is harder than you think. Second, do you know how to access your money in a logical and tax-efficient manner? These are common qu
bryanjepson
Nov 19, 20258 min read


What are Roth conversions—and how can they save you millions
One of the most powerful tools in the financial planning toolbelt in terms of tax strategy is called a Roth conversion. It is simply moving money from your pre-tax retirement accounts to your tax-free (or Roth) retirement accounts after you have stopped working and when you are in a lower income tax bracket. Let’s review how it works. Nest-egg buckets As you save, invest, and grow your retirement nest egg, there are three possible destinations, or buckets, where those asset
bryanjepson
Oct 23, 20258 min read


DIY vs. Using a Financial Advisor: How to Decide What’s Right for You
I’ve been a DIY investor for nearly three decades, and a financial advisor for almost three years. I’ve always enjoyed learning about investing and managing my own finances and, honestly, never seriously considered hiring a financial advisor before I became one myself. So why the career pivot? After many years in emergency medicine, I wasn’t mentally ready to retire — but I was ready for something different. I decided to dig deeper into my passions and see where that led. For
bryanjepson
Oct 11, 20256 min read


Are you confused about how bonds are priced? You’re not alone. Here’s how it works
In my last article , I talked about the basic types and terminologies of bonds. We learned about terms like coupon rates, par values, and maturities. The thing that used to confuse me most about bonds is their pricing. I would hear on the news that interest rates were up, and bond prices were falling. That didn’t really make sense to me. Wouldn’t higher interest rates make bonds more attractive? Actually, it’s the opposite. Today, I’ll explain how it all works. The tw
bryanjepson
Oct 2, 20256 min read


You likely have bonds in your portfolio. But do you understand how they work?
I was aware of bonds early in my investing career but will admit that I didn’t really know that much about them or how they actually worked until I took a basic financial management course as part of my master’s program in finance. I just knew that they paid out interest, were less volatile, and had lower growth potential than stocks. I was comfortable with the risk of the stock market and wanted the growth, so I didn’t have much interest in bonds and had very few in my por
bryanjepson
Sep 26, 20258 min read


Evaluating the bonds in your portfolio: Are they doing what you think they’re doing?
We all know that we need to invest to achieve our long-term financial goals, right? But are we confident in knowing how to invest? My last several blog posts have been about making smart decisions with your portfolio that will help you maximize your return, minimize fees, and manage your risk. Today, I’m going to talk about bonds—not the nuts and bolts of how they work, but how to decide if your selections are meeting your goals. Stocks or bonds? When we think about portfol
bryanjepson
Sep 5, 20256 min read


Investment Alpha and Beta Explained: How to Measure Portfolio Risk and Performance
In my last article, I pulled back the curtain on expense ratios —those “silent fees” that can drag down your portfolio without you noticing. But keeping costs low is only the first step in smart portfolio management . The next question is: how do you actually measure whether your portfolio is performing well? That’s where alpha and beta come in. These two simple metrics can show you not just how much you earned, but how much risk you took to get there. Passive vs Active Inv
bryanjepson
Aug 18, 20255 min read


Are Fees Eating Your Returns? What Every Investor Should Know About Mutual Fund Costs
As a financial planner, I review a lot of investment portfolios and have learned a few things by doing so. There are some common mistakes eating into portfolio returns that investors are unaware of or have just overlooked. Over my next few posts, I am going to discuss some ways that we can all be a little more careful with our portfolio selections. Today’s post is about paying attention to hidden fees, namely mutual fund expense ratios and sales loads. First, why do I refe
bryanjepson
Aug 6, 20256 min read


Do you know your net worth? Projecting it out can keep your financial goals on track.
Every quarter, public companies are required to report their finances to shareholders ad potential investors. These reports can significantly alter stock prices and company value if anything defies expectations, even slightly. The core of the financial report is a balance sheet, an income statement, and a statement of cash flows and then there are a lot of pages of explanations and projections. With personal finance, also, it is a good idea for you to generate similar fina
bryanjepson
Jul 21, 20254 min read


Budgeting is not a dirty word! Knowing what is coming and going is the key to your financial success.
I grew up in a household where making ends meet was always a struggle. When I look back on it, I am amazed at how my parents did it with their low income and five children to feed and clothe. We didn’t have much extra compared to many of my peers, but I never felt significantly deprived. The only way that could have happened is that my parents were really good at budgeting. And they still are! Now in their mid-80’s, they still live below their means even though their only s
bryanjepson
Jul 12, 20255 min read
Disclaimer: The content in this blog is for educational purposes only and should not be considered financial advice. You should always consult with your own financial advisor to see how any of it would fit into your personal financial plan.
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