For high-earning ER physicians, capital gains aren't just about investments—they're about control. The way gains stack on top of earned income can change tax outcomes, portfolio risk, and even career decisions in ways that aren't obvious at first glance.

Today, we're unpacking how capital gains actually work in the context of ER income, and why small strategic choices can make a disproportionate difference over time.

As we've entered a new year, we wanted to pause and reflect on what's actually resonated most with you over time. After five years of producing this podcast, the data tells an interesting story about which topics consistently draw attention — and which ones quietly don't.

This episode is less about specific advice and more about patterns, preferences, and how that shapes what we focus on moving forward. It's a look behind the scenes as we set the direction for the year ahead.

At some point, almost everyone faces a financial decision that looks simple on the surface but carries consequences that stretch decades into the future. These are the choices where intuition feels comforting, guarantees sound appealing, and the real tradeoffs aren't immediately obvious.

Today's episode uses a seemingly straightforward scenario to explore how those decisions actually work under the hood. And more importantly, why the framework you use to think about them matters far more than the specific outcome.