As the new year begins, many doctors are focused on patient care, practice growth, and personal goals — but it's also one of the most important times to reset and optimize your financial strategy.

When tax planning, investing, retirement, and practice finances live in separate silos, opportunities are often missed. We help our clients take a coordinated approach — one that maximizes after-tax wealth, not just pre-tax income. Below are 10 smart tax moves every doctor should revisit early in the year

1. Maximize Retirement Contributions, Strategically

Many doctors contribute to a 401(k), but fewer coordinate all available retirement vehicles effectively.

Depending on your income and practice structure, you may benefit from:

• Solo or group 401(k)s

• Cash Balance or Defined Benefit plans

• Employer profit-sharing contributions

The key isn’t just maximizing contributions — it’s aligning them with your tax bracket, cash flow, and long-term investment strategy so you’re not locking money into inefficient buckets.

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2. Coordinate Backdoor Roth Contributions or Roth Conversions

High earners often assume Roth strategies are off-limits — but that’s not always true.

A coordinated plan may include:

• Annual Backdoor Roth IRA contributions

• Strategic Roth conversions during lower-income years

• Careful management of pre-tax IRA balances to avoid pro-rata issues

Done correctly, Roth strategies can create decades of tax-free growth — but mistakes can trigger unexpected taxes.

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3. Build a Truly Tax-Efficient Investment Portfolio

Asset location matters just as much as asset allocation.

A tax-efficient portfolio considers:

• Which investments belong in taxable vs. retirement accounts

• Use of tax-efficient ETFs, SMAs, or custom indexing

• Avoiding unnecessary turnover and capital gains

For doctors with multiple account types, poor coordination can silently erode returns year after year.

4. Harvest Gains and Losses with Intention

Tax-loss harvesting isn’t just an end-of-year tactic.

When done proactively, it can:

• Offset capital gains

• Reduce current-year taxes

• Improve after-tax compounding

Similarly, harvesting gains strategically (rather than avoiding them entirely) can reset cost basis and reduce future tax exposure.

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5. Use Family Income Shifting (When Applicable)

If you’re self-employed or own a practice, certain family income-shifting strategies may be available.

Examples include:

• Employing family members for legitimate work

• Funding Roth IRAs or HSAs with earned income

• Shifting income into lower tax brackets where appropriate

These strategies require careful compliance — but when done correctly, they can materially reduce a household’s overall tax bill.

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6. Capture Practice-Related Tax Deductions

Practice owners often overlook valuable deductions tied to operations and growth.

These may include:

• Bonus depreciation on equipment

• Vehicle deductions

• Technology and infrastructure investments

• Timing of expenses and capital purchases

The goal is not just deduction maximization — it’s strategic timing to align with your broader tax plan.

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7. Optimize Charitable Giving for Tax Efficiency

Many doctors give generously — but fewer give tax-efficiently.

Advanced charitable strategies can include:

• Donor-Advised Funds (DAFs)

• Gifting appreciated securities

• Qualified Charitable Distributions (QCDs) from IRAs

When structured properly, charitable giving can reduce taxes without reducing generosity.

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8. Fully Fund Health and Education Tax-Advantaged Accounts

Accounts like HSAs, FSAs, and 529 plans are often underutilized — or used in isolation.

When coordinated properly, they can:

• Reduce current taxable income

• Fund future healthcare or education costs

• Serve as long-term planning tools

HSAs, in particular, can function as triple tax-advantaged investment accounts when used strategically.

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9. Reassess After Major Life or Career Changes

Life events can change everything, financially.

Examples include:

• Practice buy-ins or exits

• Marriage or divorce

• Relocation

• Changes in compensation or employment structure

These moments often open (or close) planning opportunities that require proactive adjustments.

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10. Ensure Every Piece of Your Financial Life Works Together

The most important question isn’t about a single tax strategy — it’s about coordination.

A strong plan integrates:

• Tax planning and preparation

• Investment management

• Retirement planning

• Insurance considerations

• Estate and legacy planning

• Cash flow and budgeting

Without integration, even “good” strategies can conflict with each other.

Why Doctors Are Turning to Earned

Earned was built specifically for doctors with the goal to help them maximize their after-tax wealth over the long term.

Through coordinated planning, Earned provides:

• Integrated tax planning and preparation

• Doctor-focused wealth management

• Advanced investment strategies like custom indexing, tax-efficient ETFs, and SMAs

• Retirement plan design for practices

• Practice-aware financial guidance that evolves with your career

Start the Year With Clarity

When your tax and wealth strategies actually work together, the results can be powerful. If you’re unsure whether your current strategy checks all ten boxes, now is the time to find out.

A coordinated approach doesn’t just reduce taxes — it creates confidence, clarity, and momentum for the year ahead.

You’ve earned it.