Brett K. Fellows CFP Financial Planning for CRNAs and NPs

Brett K. Fellows CFP Financial Planning for CRNAs and NPs Helping CRNAs and NPs make work optional, pay less in taxes, and invest smarter.

Oak Capital Advisors is an independent, fee-only registered investment advisor located in Charleston, SC. We specialize in exit and retirement planning for CRNAs located in and around Charleston, SC.

09/02/2026

Your brain doesn't know the paycheck stopped.

Twenty-five years of savings teaches one lesson, that whenever you feel behind, you pick up a shift, work a little later, or take one more project, and pulling that lever always worked.

Retirement takes the lever away, but the reflex stays. The brain still reaches for it out of habit, the same way someone might reach for a light switch in a house they don't live in anymore.

On the latest episode of MoneyRx for CRNAs, I walk through why a mathematically safe withdrawal can still feel dangerous, and what to do about it.

08/28/2026

I sat down with a CRNA last week who was getting ready to sign one of the most permanent forms in retirement planning. It's called a pension election form. Once you choose how your checks get paid out, that choice sticks for good.

As I said in the new episode of MoneyRx for CRNAs and NPs, "Most money decisions in retirement you can frankly walk back if you get them wrong. This is not one of those decisions."

If you have a pension or a cash balance plan coming up, this episode walks through the three choices on that form and why the biggest check isn't the one that protects your family best.

08/26/2026

We watched this play out in real time last year.

Last spring the S&P 500 dropped almost 19% before turning around and finishing the year up close to 18%. Two of our retired clients felt that swing in very different ways.

One had to pull money out of stocks near the bottom just to cover normal spending, so those losses became permanent the moment the shares sold.

The other had already set aside a few years of spending in cash and short-term bonds, something we call the War Chest, and never had to touch her stock portfolio at all. She kept living her normal retirement while the market did its thing, and by the end of the year her portfolio had fully recovered.

Same crash, same recovery, and two completely different experiences, decided by a decision made well before the drop ever happened.

New episode of MoneyRx for CRNAs and NPs is live now.

08/19/2026

Ten years of picking the best fund in your 403(b) comes out to $30 a month.

Run the math on a decade of perfect fund picks in a 403(b), the single best performer every year instead of the safe, familiar option chosen in real life. On a $450,000 balance, the difference comes in under $9,000 total. Turned into retirement income at a 4% withdrawal rate, that's about $30 a month.

Redirect an extra $450 a month from an oversized cash cushion into a 403(b) and backdoor Roth IRA instead, and over eighteen years it grows to roughly $180,000. Twenty times the fund-picking number.

Full breakdown in Episode 102 of MoneyRx for CRNAs and NPs.

08/14/2026

Harold walked in with a plan for his retirement year that sounded completely reasonable. Roll the 401(k), set up marketplace insurance, and convert some savings to Roth to start clean.

But his final bonus, his PTO payout, and his deferred comp were already stacking up as income before he made a single one of those moves, putting him right at the edge of the ACA subsidy cliff. Then the Roth conversion landed on top of all of it and pushed him straight over the Medicare surcharge tier too.

The year you retire packs in more one-time income than almost any other year of your life, and the moves that would've been brilliant in a quiet year can turn into the most expensive mistakes you make when they collide with everything else hitting at once.

Harold's plan fell apart because of when he tried to run it, not because any single move was a bad call.

We walk through exactly how we untangled it in the full video. Link below.

08/12/2026

Most nurse practitioners and CRNAs think about Social Security as a personal number. Their check, their timeline, their trade-off.

If you're the higher earner in your household, it's bigger than that.

Claim at 62 instead of waiting until 67, and your benefit locks in at roughly 30% lower. That reduced number doesn't just follow you. If you pass away first, your spouse's survivor benefit steps up to whatever you were actually receiving, not your full unreduced amount. Your claiming age becomes their income floor for the rest of their life, potentially decades after the PRN shifts and the extra income you claimed early has faded from memory.

This is exactly why I tell couples to run the survivor number before they run anything else. It's the piece that gets decided in twenty minutes on a claiming form and then lived with for thirty years.

Watch the full breakdown in Episode 101 of MoneyRx for CRNAs and NPs.

08/07/2026

Most nurses get onboarded into a 403(b) on day one and never hear another word about their retirement accounts again. That's too bad, because there’s usually two better tools sitting right next to it that don’t get touched.

1. A 457(b) that doesn't share a contribution limit with your 403(b), and lets you tap it at any age without the early withdrawal penalty once you leave your job.

2. An HSA that most people drain every year on bills instead of letting it invest and grow tax-free for medical costs later.

You aren’t saving more; you’re just sending the same dollars to more places, so you have options to pull from instead of one account the IRS controls.

Watch the full video on YouTube to see how it works.

08/05/2026

I did not grow up wanting to be a financial planner.

What I grew up around, and what I still see every week in this work, is people who give an enormous amount of themselves to somebody else on a shift, and rarely stop to ask what they are building for themselves in return.

That is who CRNAs and NPs are, almost without exception, in my experience. You take care of people at the worst moments of their lives. On your feet, on call, missing holidays, sometimes missing your own kids' games. Somewhere in the middle of all of it, your own financial life ends up on autopilot, because there is no time left over for it.

Here is what keeps me showing up to make this show, a hundred episodes in. When a nurse who has spent twenty five years absorbing everyone else's stress finally sees a real plan that says she can drop that extra shift and still be fine, something shifts in how she carries herself, even outside of work.

That is the whole point of this show.

07/31/2026

A couple came in ready to sign a $9,000-a-year long-term care policy. I told them to put down the pen. Long-term care is a HUGE threat to a retirement plan. But writing a $9,000 check every year for two decades may not be the right call when you have a $1.6 million portfolio.

The primary danger of a care event is what happens to the surviving spouse. If you pull money from pre-tax accounts in the wrong order, it triggers tax bracket spikes and Medicare surcharges right when costs peak. When the care ends, the survivor is left living alone for another 10 to 15 years on a depleted portfolio and a slashed income stream.
Instead of spending $200,000+ on rising premiums, we built a $300,000 Care Reserve inside their portfolio to lock in the survivor's income first.

Check out the full video on YouTube to see how we structured the plan. Have questions? Happy to talk.

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