The Ortho Money Show : Money, Business, and Life Strategies for Orthopedic Surgeons

capablewealth.com : Hosted by Jared Paul
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The Ortho Money Show is a podcast for orthopedic surgeons who want to take control of their finances, grow their wealth, and build a life of freedom beyond the operating room. Hosted by Jared Paul, CFP®, CIMA®, CEPA®, this show delivers clear, actionable strategies on tax planning, investing, retirement readiness, and practice growth—specifically tailored to high-income surgeons and private practice owners. Whether you're looking to reduce taxes, optimize your practice income, prepare for a future exit, or simply gain clarity around your financial life, each episode breaks down complex topics into practical insights you can apply immediately. If you're an orthopedic surgeon who values efficiency, expertise, and results, this show is designed for you.

  1. 2d ago

    Ep #138: What 2026 Taught Us - Four Forces and the One Lesson Underneath

    2026 was the year a lot of things happened to orthopedic surgeons, very few of which anyone got a vote on. Tax rules were rewritten. Medicare took another swing at procedural payments. Consolidation kept moving. The Fed raised rates for the first time in more than three years. In this reflective episode, Jared walks through the four biggest forces that shaped a surgeon's finances in 2026 (the tax law's permanent provisions and where the headline SALT cap actually lands at surgeon income, the steady pressure on procedural payments, the shifting consolidation landscape, and what rising rates mean for variable-rate practice debt), then ties them together with a comparison of two surgeons who lived through the identical year with very different results, a gap worth roughly $16,000 in federal tax for 2026 alone, built entirely from decisions rather than luck. He closes with a twenty-minute exercise: split a page in two, write down what happened to you financially in 2026 on one side, and what you decided about it on the other, then look at the ratio. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #138: What 2026 Taught Us - Four Forces and the One Lesson Underneath

  2. Nov 3

    Ep #137: December 31st Doesn't Own Every Deadline: Sorting Your Year-End List

    A typical year-end list piles everything onto December 31: your HSA, your fourth-quarter estimate, your cash balance contribution, your charitable gifts, your tax-loss harvesting, all of it. When everything's due at once, the things that genuinely expire get the same frantic attention as the things that could comfortably wait until spring. In this episode, Jared sorts the real year-end list into four buckets that actually end at midnight on December 31, payroll (401(k) deferrals, Roth catch-up rules for surgeons with prior-year wages over $150,000, withholding), portfolio (tax-loss harvesting and the wash sale trap, Roth conversion timing), giving (RMDs, qualified charitable distributions, the new charitable deduction floor and cap, annual exclusion gifts), and the practice (the pass-through entity tax election, bonus depreciation, cash balance plan design changes). Then he covers the three dates that crowd most year-end lists but actually land in 2027: the Q4 estimated tax payment (January 15), HSA contributions (April 15), and cash balance funding (with the return). He walks through several worked examples along the way, including an $8,500 401(k) deferral gap that's gone for good on December 31, an $80,000 tax loss that can vanish because of a wash sale, and a $26,000 difference in federal tax depending on which year a Roth conversion happens in. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #137: December 31st Doesn't Own Every Deadline: Sorting Your Year-End List

  3. Oct 31

    Ep #136: Reading Your Practice's Numbers Looking Forward: The Year-End Review Before 2027's Fee Schedule

    What would you do differently this December if you knew that, starting January 1, roughly $100,000 a year of your collections was simply going to stop showing up? Run through one reasonable set of assumptions, that's close to what the proposed 2027 Medicare fee schedule could mean for a surgeon collecting $1.5 million a year, and most year-end reviews are built to answer a completely different question than the one that actually matters right now. In this episode, Jared flips the year-end practice review around to face forward instead of backward, with five questions built around CMS's proposed CY 2027 Physician Fee Schedule: what the proposal actually does to your top ten billing codes, how much of your commercial revenue is priced off Medicare's current fee schedule (and what that means at contract renewal), where each procedure is actually most profitable by site, whether the cash sitting in your practice is doing a job before December 31 (payroll deferrals, the pass-through entity tax election, and bonus depreciation all have year-end deadlines), and whether next year's budget is quietly built on this year's rates. He walks through a worked example on the proposed cuts (roughly $110,000 a year in collections for a hypothetical $1.5 million-collections surgeon, split between Medicare and Medicare-pegged commercial contracts) and a separate one on the pass-through entity tax election (turning $36,000 of otherwise-nondeductible state tax into roughly $13,000 of federal tax value). Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #136: Reading Your Practice's Numbers Looking Forward: The Year-End Review Before 2027's Fee Schedule

  4. Oct 20

    EP #135: 3 Things Before December 31 (And the Habit That Costs You More Than Any of Them)

    Picture the last week of December. You're not thinking about your 401(k), you're thinking about call coverage, family, maybe a case that ran long. Somewhere in the back of your mind is a folder labeled "financial stuff, deal with it in January." By the time you open that folder, almost everything inside it is already decided, by the calendar. In this episode, Jared walks through three specific things that still have a live window right now, before December 31: confirming your 401(k) deferral is actually on pace to hit this year's ceiling (which climbs to $35,750 if you turn 60 through 63 at any point in 2026), making sure any charitable giving you intend to complete actually settles by year-end rather than just getting decided, and getting your full-year income projection right so you can use withholding, not a January estimated payment, to retroactively cure any underpayment against your safe harbor threshold. He also covers the one habit worth retiring completely: treating the year-end financial review as something you get to in January, once every one of those three windows has already closed. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    EP #135: 3 Things Before December 31 (And the Habit That Costs You More Than Any of Them)

  5. Oct 13

    Ep #134: The RMD Checklist: What Surgeons Over 73 Need to Do Before December 31

    Two numbers are going to decide what happens to a chunk of your bank account this December: 73 and December 31st. There's a third lever sitting underneath both of them that most surgeons never learn about until the year they need it. In this episode, Jared runs through a four-item checklist for surgeons approaching or already past their required minimum distribution age, built for October rather than December, because by December most of the useful moves are already off the table. He covers how the RMD is actually calculated (a shrinking life-expectancy factor, not a flat percentage, so the required amount climbs every year), why the April 1 first-year delay is usually the wrong move for a surgeon still earning practice income, and the sharpest point in the episode: a Qualified Charitable Distribution now sidesteps both of this year's new OBBBA charitable-deduction restrictions (the AGI floor and the top-bracket value cap) entirely, making it the cleanest way to give for IRA holders past seventy and a half. He also covers Roth conversion sequencing (the real leverage window closes once RMDs start, not after), and how to coordinate RMD timing with practice income and compensation decisions before December locks those options in. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #134: The RMD Checklist: What Surgeons Over 73 Need to Do Before December 31

  6. Oct 6

    Ep #133: The Two Provisions That Just Made Your Checkbook Less Efficient

    Half a percent. That's the new floor under every itemized charitable deduction this year, and it isn't even the provision on this list that costs you the most. In this episode, Jared walks through two provisions inside the One Big Beautiful Bill Act that took effect this tax year and quietly changed what it costs a surgeon in the top bracket to give to charity: a new 0.5% of AGI floor on itemized charitable deductions, and a cap on the value of those deductions at 35% instead of the old 37% rate for top-bracket taxpayers. He rebuilds a worked example using this year's actual numbers, a $100,000 gift of appreciated stock to a donor-advised fund that lands at $34,300 in income tax value plus a separate $20,000 in avoided capital gains tax, not the roughly $37,000 figure that's been floating around from before the rules changed. He also covers why the 60% AGI cap on cash-gift deductibility didn't move (it's now permanent, not a temporary rule due to revert), and why bunching several years of giving into one donor-advised fund contribution clears both new frictions once instead of paying them every single year. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.**

    Ep #133: The Two Provisions That Just Made Your Checkbook Less Efficient

  7. Sep 30

    Ep #132: Closing the Contribution Gap: The Payroll Math, the Super Catch-Up, and the Cash Balance Lever

    What percentage of your paycheck is actually going into your 401(k) right now, this pay period, not what you elected back in January? If you'd have to go check, you're not alone. In this episode, Jared breaks down a new wrinkle in this year's contribution limits: surgeons turning 60 through 63 get a super catch-up of $11,250 that replaces, rather than stacks with, the standard $8,000 catch-up, bringing the total to $35,750. He walks through the payroll math on a stale January election (a flat per-paycheck number that has to triple or more once only a handful of checks remain before December 31), and why waiting until November to change it is often already too late once payroll processing lag is factored in. Then he covers the bigger lever most of this conversation misses entirely: the cash balance plan, which runs on the actuary's funding schedule rather than a payroll election, and can dwarf the 401(k) catch-up figures for a surgeon in her late 50s or 60s. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #132: Closing the Contribution Gap: The Payroll Math, the Super Catch-Up, and the Cash Balance Lever

  8. Sep 23

    Ep #131: The ILIT Strategy Most Surgeons Overlook Until It's Too Late

    Here's a number worth sitting with. A surgeon can have a $9 million estate, comfortably under the federal exemption, owe nothing in federal estate tax, and still have less than $300,000 of it sitting in cash. That's not a stress test. That's the ordinary math of a practice-heavy balance sheet. In this episode, Jared picks up where the show's estate-exemption episode left off, on the tool that closes that gap: the Irrevocable Life Insurance Trust, or ILIT. He walks through the actual mechanism (the trust owns the policy, not you, which is what keeps the death benefit out of your taxable estate), how to fund it correctly using Crummey withdrawal rights without touching your lifetime exemption, and the three-year lookback rule that matters if you're moving an existing policy into a new trust. Jared also covers what nobody sells you on: the real cost isn't the legal fees, it's control. Once the policy belongs to the trust, it belongs to the trust. He closes with a second worked example, a blended family where an ILIT solves an inheritance-fairness problem without forcing a sale of the practice itself. Copyright ©Capable Wealth, LLC. All Rights Reserved. The Ortho Money Show is produced by Capable Wealth, LLC, an investment adviser registered with the State of New York. This podcast is for educational purposes only, is not personalized investment, tax, or legal advice, and does not create an advisory relationship. Full disclosures and Form ADV available upon request.

    Ep #131: The ILIT Strategy Most Surgeons Overlook Until It's Too Late
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The Ortho Money Show is a podcast for orthopedic surgeons who want to take control of their finances, grow their wealth, and build a life of freedom beyond the operating room. Hosted by Jared Paul, CFP®, CIMA®, CEPA®, this show delivers clear, actionable strategies on tax planning, investing, retirement readiness, and practice growth—specifically tailored to high-income surgeons and private practice owners. Whether you're looking to reduce taxes, optimize your practice income, prepare for a future exit, or simply gain clarity around your financial life, each episode breaks down complex topics into practical insights you can apply immediately. If you're an orthopedic surgeon who values efficiency, expertise, and results, this show is designed for you.

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