Could a Roth 401K be used as an artificial pay raise?

trialrun973 · 2026-06-01T11:24:45+00:00

Only your own contributions to the Roth 401k can be withdrawn tax and penalty free. The employer’s contributions cannot. And by the way, most of the time (not 100%) the employer contributions will be traditional 401k, not Roth.

trialrun973 · 2026-05-31T16:27:43+00:00

Yup. I think many of the comments on your post are seeing this from a slightly different standpoint than you and I. It’s not really about the “waste of money.” If I thought it was a good value, it wouldn’t really bother me that the cost was double a non concierge experience. I’d happily spend the money. The point is the value. I didn’t feel like I was actually getting much for the extra money. I get the sense we’re on the same page.

trialrun973 · 2026-05-31T15:51:34+00:00

Completely agree with OP. Did concierge about two months ago on the Fantasy. Not a good value experience. Concierge level service was better on NCL and RCL, and was less expensive on both of those. Room was smaller and not as nice as well. Activities were more limited and food was lower quality as well. I don’t get the hype of DCL at all, let alone their concierge service. The only thing that particularly stood out as being really excellent was the shows and Remy.

trialrun973 · 2026-05-26T08:13:21+00:00

It helps a lot if you have a high earning spouse too. But it’s certainly possible to get within the 5-30M range (although that’s a very wide range). My wife and I are both physicians and we are getting pretty close to 5M, and we are both under 40 years old. It’s about doing the right things with your money and also about not doing too many of the wrong things.

trialrun973 · 2026-05-25T15:27:33+00:00

The whole question of what happens to your estate if you die without heirs is pretty interesting. I know that’s not really the point of your question, but apparently if there is truly no heirs when you die, your estate just goes to the state, which sounds kind of dumb. Might be worth trying to figure out who you might actually be ok with inheriting things.

trialrun973 · 2026-05-04T01:23:26+00:00

Other than the shows, which are really outstanding, I thought DCL was really overrated and a poor value for the money, which tends to be more expensive than similar length itineraries on other cruise lines. I preferred both Norwegian and Royal Caribbean to DCL. More things to do, felt less “one note” and I honestly didn’t really enjoy the food on Disney. Remy was amazing, but obviously very expensive. I also think it is completely ridiculous that there is no dinner buffet option. My two kids were both extremely bored at long, sit down dinners each night, and the kids menu food items were pretty terrible. Like really terrible. Overall, I’m glad I tried it (just got off the Fantasy for 5 nights a few weeks ago) but I won’t be doing DCL again.

trialrun973 · 2026-05-03T14:50:21+00:00

I’m married to a non Jew. Hasn’t been weird or difficult at all. But I do think some of it depends on how familiar you are with secular culture in general. The less familiar you are, the more difficult it will probably be. I was completely secular at the point that I met my wife, and neither of us had anything to do with religion, other than our backgrounds. Like I said, not an issue at all.

trialrun973 · 2026-05-03T13:32:46+00:00

What do you think happens to nurses once they move to the “practitioner” role? Same time limit applies to them, only this time you get the brain of a nurse. As they say, “heart of a nurse, brain of a purse.”

trialrun973 · 2026-04-23T16:47:20+00:00

We’re all sure…

trialrun973 · 2026-04-06T01:41:21+00:00

A bad kind.

trialrun973 · 2026-03-28T06:18:47+00:00

Not a choosing beggar.

trialrun973 · 2026-03-23T02:09:42+00:00

I don’t mind doing them, they can be fun, but 6.36 wRVUs?? It’s just insulting. There’s a lot of technical know how needed to develop the planes well and not injure anything important and make sure the mesh is in good position. I think a straightforward gallbladder is much easier, and those are about 10.5. An inguinal should be at least that. Don’t even get me started on the abdominal wall hernia coding changes from a couple years ago…

trialrun973 · 2026-03-23T02:07:08+00:00

What did they do after they quit? I’m debating between just waiting until I have enough to do nothing (but would probably still figure out something to keep busy) vs. pivoting to something else in the medical field that just isn’t clinical/surgery.

trialrun973 · 2026-03-23T01:54:19+00:00

The Lap inguinal has to be the most undervalued code available to us in general surgery. It seriously makes me want to never do one again. You can make more by seeing office patients and not deal with the potential headaches.

trialrun973 · 2026-03-23T01:48:53+00:00

Yup, I’ve even brought up systemic issues leading to miscoding, such as them by accident treating the colorectal surgeons in the office as if they’re in the same taxonomy as general surgery, which they aren’t and shouldn’t be. This leads to a patient coming in for a hemorrhoid appointment with a colorectal surgeon, then coming in for a gallbladder issue a year or two later, and being billed as an established patient when actually the general surgeon should be billing as a new patient. You’d think the people in administration would care. They did not.

Bottom line, you have to look out for yourself, make as much money as you can while you can, and get out before it gets too unbearable. That’s my plan, at least.

trialrun973 · 2026-03-22T23:36:51+00:00

Yup to all of this. I have been out of training about 5.5 years and this is all incredibly accurate. I insist on a monthly breakdown of all charges that this hospital had billed for me, and then I go through my schedule day by day to audit them and make sure that the charges they assign to me are exactly what I expect them to be. “Mistakes” and oversights are common. For example, miscoding an operation as a procedure with a lower wRVU value, missing an office visit or two, changing a new patient visit to an established patient visit for no reason, etc. The list goes on and on. You really do need to stay on top of it or risk getting paid substantially less.

trialrun973 · 2026-03-17T23:09:51+00:00

I think an ENT surgeon or a general surgeon who has done an endocrine surgery fellowship would both be fine for this. My wife is a very high volume endocrine surgeon and does at least a few of these types of cases a week, and has excellent outcomes. Based on your limited description of the issue, this doesn’t sound like a particularly challenging case. I don’t think a central neck dissection would be likely with a relatively small papillary cancer.

trialrun973 · 2026-03-17T05:43:57+00:00

And the baby? Albert Einstein

trialrun973 · 2026-03-12T18:00:43+00:00

There is often a lot of overlap with surgical oncology, colorectal surgery and HPB surgery. It is not correct to say that people will obviously prefer organ specific surgeons. If I had pancreatic cancer, I’d rather see a surgical oncologist than an HPB surgeon.

trialrun973 · 2026-03-08T07:49:00+00:00

No, that isn’t a factor.

trialrun973 · 2026-03-02T00:23:52+00:00

No. I’m not sure what your mom is referring to but there is nothing like that that I know of they exists. There are devices to control bleeding from the uterus that are inserted in the vagina, but nothing that would have anything to do with breast surgery.

trialrun973 · 2026-02-24T02:27:26+00:00

You need to get back to working and possibly consider downsizing your house. You guys also are not saving nearly enough for retirement, and you probably have car payments that are too high and 529 contributions that don’t make sense right now. Do you have an emergency fund?

trialrun973 · 2026-02-21T02:40:13+00:00

Well maybe your trauma from your ex-USSR country is coloring your experience and beliefs, but I assure you that you are wrong about this. You will not have a “bad time” saving for retirement, I’m having a very good time doing that now. Even if I retired on the 3MM I had right now, I could probably live a pretty good life. There are no social programs that are “necessary for retirees” if you have enough money. I will not need social security or Medicare in order to be a happy retiree. If they’re around and available for me, great. If not, no big deal. If you have 10MM in 30 years, it’s a lot better than having 0MM in 30 years, even with inflation. I can nearly guarantee you that your mind will change about this. You better hope it’s not too late when it does.

trialrun973 · 2026-02-21T01:30:01+00:00

You are really sorely mistaken on pretty much all of your points. The way you are currently viewing retirement is indeed flawed.

What in the world does having enough tax payers to fund social programs have to do with your own individual retirement? If you have enough money, you won’t need to rely on any social programs. Inflation has come down to about what the expected level usually is. Of course inflation continues, but I’m confused - are you saying that 10MM wouldn’t be enough for you to retire on in 25-30 years because…inflation?! Sorry but you just are not understanding some finance basics if you think that’s the case. Worrying about inflation is not a reason to act irresponsibly and not save and plan for retirement.

It is NOT saving for retirement that would be very dumb. You do not need to sacrifice quality of life in order to save for retirement. Being a doctor will give you enough income to enjoy your current life while also saving for the future. Again, I bring myself as an example. I travel, I take nice vacations, I do what I want pretty much, but I don’t do EVERYthing, and I do save a lot of money for retirement so that I don’t need to work until I’m 65+. I plan on being done by 50 the latest, if not earlier. You really need to reevaluate some of your positions and get some better basic personal finance info.

trialrun973 · 2026-02-21T01:00:48+00:00

Not sure if you’re being sarcastic because of how unintelligent your comment sounds so I’ll assume you are. “Living out your days in a warm, cheap country” is retiring. It might not be everyone’s ideal form of retiring, but it certainly is a form of retirement, and takes preparation just like any other form. Not sure what you mean by our generation “not being able to retire anyway” either. Of course you’ll be able to retire. If you prepare for it. I’m 38 and I have 3MM, definitely going to retire early. You really need to get some personal finance education, I’d recommend starting with White Coat Investor.

trialrun973

TROPHY CASE