Needing an advisor isn’t a financial literacy failure. But knowing exactly what you’re buying, and who that person answers to, can be a multimillion-dollar decision over a CRNA career. Below is the full transcript of Episode 9 of The Financial Cocktail Podcast, lightly edited for readability.
Fewer Than 2% of Advisors Are Fee-Only Fiduciaries
There are roughly 321,000 financial advisors in the United States. Fewer than 4,600 of them are registered as fee-only fiduciary planners through NAPFA, the National Association of Personal Financial Advisors — the group that requires members to be paid only by clients, with zero commissions, zero product kickbacks, and zero third-party money changing hands. That’s not even 2% of the personal financial advisor industry.
So when I say “find a fiduciary,” I’m not being dramatic. I’m telling you that you’re intentionally searching for something rare, because the other 98% may have a very different definition of what’s “suitable” for you than what’s actually best for you.
Welcome back to The Financial Cocktail Podcast. I’m your host, Leland Murren. Today isn’t about whether CRNAs are smart enough to do this alone. It’s about knowing exactly what you’re buying when you’re considering a financial advisor.
Needing an advisor isn’t a financial literacy failure. CRNAs are high-income earners in a profession that gives them almost zero training in personal finance. We have a business course in school, but it looks at billing rates at the hospital level, the anesthesia group level, the W-2 versus 1099 level. It doesn’t tell you what to do with your paycheck when it hits your bank account. This gap is structural, not personal.
So the question isn’t “advisor or no advisor.” It’s this: whose interest is this person who claims to be my financial advisor legally required to serve?
The national average CRNA income is well over a quarter million dollars per year, which makes the CRNA community an attractive target for commission-based sales: high income, generational wealth-building potential, and clinicians who are often too time-strapped to really vet who they’re talking to, what services they’re getting, and what returns they’re seeing at the end of the year once all fees and taxes are considered.
In this episode we’ll answer a few questions. Do you need a financial advisor? If so, when is it a good time to add a professional to your team? And how exactly do you find a good one who won’t burn you — because “recommended by a friend” or “seems like a nice guy” is not the due diligence we’re looking for.
Fiduciary vs. Suitability: A Vast Distinction
There is a big difference between a fiduciary financial advisor and someone who recommends based on suitability.
Under the suitability standard, advice only has to be reasonably appropriate, not optimal — the general direction. Commissions and product sales are legal and very common under this standard, and these advisors generally push proprietary mutual funds. More on that later.
Under the fiduciary standard, those 4,600 advisors are legally required to act in the client’s best interest at all times — not just during a single transaction, and not just to set a heading.
The Whole Life Insurance Game
Here’s a concrete example of misaligned incentives for 99% of you listening, if not all of you. An agent selling a permanent life insurance policy earns a commission equal to about 50 to 100% of the client’s first-year premium. It takes about three years just to break even, and beyond that, the fees are extremely high.
That’s not a hypothetical conflict of interest. It’s a math problem built into the product. Whole life is suboptimal almost all of the time, so the people selling it to you are not suggesting what’s in your best interest. “It’s great life insurance.” There’s other life insurance that matches your needs better. “It’s got a cash value.” There are other ways to get your money out — it’s called a brokerage account. Lots of ways to do the same thing with far fewer costs, fees, hassles, and contracts.
High-income clinicians like CRNAs are a known target for commission-driven insurance and annuity sales precisely because of their income and their time scarcity. We spent decades in school, working in the hospital, training in anesthesia school. Even now, I spend a fair bit of time on call and working during the day. Mix in family time and the other things I like to do, and I don’t always have a lot of time to research. Physicians, CRNAs, and other high-income professionals have a long-standing reputation for spending so much time on their craft that they’re simply undereducated in personal finance.
So if your advisor has never once told you no to an idea or something you wanted to buy, you need to ask yourself who was actually driving that relationship.
Do You Even Need a Financial Advisor?
DIY is genuinely viable for a lot of CRNAs through most, if not all, of their financial lives. This show exists partly to make that possible — that’s what The Financial Cocktail is all about. The same strategies that work at a $10,000 net worth often work at $100,000, $1 million, or $10 million. You just add a zero to everything you’re doing. That’s a vastly oversimplified statement, but you can still do very well regardless of net worth with essentially the same strategy.
That said, here are some signals that complexity has outgrown your DIY bandwidth:
• Ownership or equity in a group, depending on how it’s structured
• Multi-state 1099 income with tax complexity and big business expenses — the planes, trains, and automobiles
• Blended household finances after marriage
• Real estate investing beyond your primary residence, including syndications
• Genuinely complex or labor-intensive investing strategies, like active trading or direct indexing — not just buying some shares of Nvidia or Google
And the simplest answer of all: “I know I’m not doing this optimally, and I don’t want to learn it myself.” That’s your ticket out. It’s like a case that’s emergent — life, limb, or vision — we’re going now, and we’re getting it done.
Why DIY Works
The data supports index investing: broad-based, low-cost, passively managed index funds, with a few minutes of attention each week or month and maybe an annual review. Can you do it yourself? You can. The question is whether you want to spend a little time outside your shifts doing it.
And can you stay the course? Are you level-headed enough to do absolutely nothing during turbulent times? We all remember COVID. Some of you remember the 2008 crisis, maybe even the dot-com bubble. Doubling down during market corrections is usually a pretty good idea.
If you know yourself and you tend to panic — well, first of all, anesthesia might not be for you — but in all seriousness, that’s a legitimate, non-shameful reason to hire a financial advisor. At the end of the day, inaction carries a major cost too. Weigh the fee of a good advisor against the cost of a bad advisor, or years of not investing at all.
What a Financial Advisor Actually Costs
Assets Under Management (AUM)
A reasonable range to expect for a standard financial advisor is $2,000 to $10,000 a year, roughly 0.5% to 1% of assets under management annually. That’s what these fee-based advisors charge on the assets you give them to manage — you don’t have to give them everything. Often your 401(k) is managed elsewhere. If you have half a million in a 401(k) and half a million in a brokerage account, they’ll manage the $500,000 brokerage account and probably charge you 1% to do it.
The Episodic, Fee-Only Model
There’s also an episodic model, and it’s optimal for a lot of people. You don’t have to hire an advisor for an ongoing relationship year after year. Fee-only fiduciary planners usually bill hourly. It’s a hefty rate — much like hiring a CRNA — anywhere from $150 to $500 or more per hour, depending on their expertise and client load, for a single engagement.
That single session sounds expensive in isolation. But stacked against a career of AUM fees, it’s a rounding error.
When do you want one of these one-time engagements rather than an AUM relationship?
• Windfall income — you have more money than you’ve ever seen: a new-grad CRNA salary, a big signing bonus, a jump from $250,000 to $750,000 a year with locums, or a large inheritance
• The sale of a practice or business interest
• Approaching retirement
• An estate situation
The $500 you spend will be well worth it. A single engagement lets you build or stress-test a plan around one of these events so the money is spent and invested wisely. That’s the fundamental difference between AUM advisors and fee-only, one-time advisors.
How to Prepare for Your First Meeting
Being prepared saves everybody a ton of time and questions. If you’ve followed The Financial Cocktail methods, all of this is essentially done for you — just wrangle it up. Make their job easy and don’t waste valuable time at the visit.
1. Assemble your financial framework. Assets and liabilities, every account, and how much is in each. Bring your prior year’s tax return — one year is fine for a steady W-2 paycheck; bring one or two years if you have variable 1099 or locums income. Add an expected future income projection, whether it’s going up or down.
2. Explain your safety net. Give an overview of your insurance policies — life, disability, and so on — and bring your estate documents, wills, and trusts. If you’re missing some of these, they may tell you that you need them.
3. Explain your desires. This is basically your SMART goal, which should already be done if you’ve followed The Financial Cocktail steps.
4. Share your vulnerabilities. Understand your risk tolerance, which is very commonly misunderstood — not just for investing, but for legacy, too. If you’re concerned about leaving a certain amount to certain people, say so. “I have more than I thought I would, and I’m not sure what to do.” Or, “I have less than I want. Help me figure out where to go.”
Calling a financial advisor is not a financial failure. Paying an advisor to keep you accountable is a legitimate expense, and it’s a legitimate profession — as long as you know exactly what you’re paying for and who they answer to. Whether you’re buying a single checkup or a lifetime subscription makes a massive difference in the outcome and, ultimately, your satisfaction.
The Real Cost of a “Small” 1% Fee
One percent doesn’t sound like a lot. $2,000 to $10,000 a year? That’s nothing for a CRNA. Okay — let me rewind.
We’ll use very round numbers; it helps my Norwegian brain. Say you invest $10,000 annually at a 10% average annual return, which is roughly what the S&P 500 has done over long periods. We’ll run it with a 1% fee and a 1.5% fee.
Why 1.5% when I was just talking about 0.5% to 1%? Remember those proprietary funds? Many advisors — I won’t name names, but a lot of the corner-store offices in your small town operate like this — charge you 1% to invest your money and then recommend their own mutual funds. Instead of a 0.04% expense ratio, those funds carry a 0.75% or 1% expense ratio, which is extremely expensive, and the data says to stay away from them like the plague. Total fees for working with these folks can easily land between 1% and 2% if you don’t have a lot invested with them. As your balance grows, they take a smaller percentage, but it can still be $10,000 or $20,000 a year to do what you can do yourself.
30-Year Horizon
• Self-managed at 10%: about $1.64 million. That’s our base case.
• 1% fee (9% net): about $1.36 million — a 17% cost.
• 1.5% fee (8.5% net): about $1.24 million — a 24% shave off the top of your investment account.
40-Year Horizon
Now stretch it to 40 years. You might retire at 50, 60, or 70, but that doesn’t mean your financial advisor is out. If anything, most people use an advisor even more as they get older, because their wealth and complexity grow. So the fees compound against you for an additional 10 years.
• Self-managed at 10%: about $4.43 million.
• 1% fee: about $3.38 million — a 24% buzz cut.
• 1.5% fee: about $2.95 million — a 33% buzz cut. You don’t even clear $3 million.
“Just a couple hundred thousand bucks over 30 years, maybe a million over 40. It’s not the end of the world — someone took a lot off my plate.” Remember, though: this example was only about $800 a month. CRNA fam, you’ve got to be doing a lot more than $800 a month.
What if you’re investing $10,000, $20,000, or $50,000 a month? For those of you who think those numbers aren’t possible for CRNAs — they are. Try me. Add a zero to those contributions and add a zero to your lost gains. Now we’re easily talking about a seven-figure, multimillion-dollar decision when you hire an AUM advisor for your career. That kind of hurts.
This isn’t a story about a bad advisor. This is the arithmetic of a fee that, with nothing going wrong at all, can quietly take a third of your lifetime portfolio. So ask yourself: do I actually need ongoing AUM management, or can I get away with a flat-fee or hourly relationship and meet a couple of times a decade?
Stacked Fees and the Active Management Myth
The hidden layer most people miss is stacked fees. A commission-oriented AUM advisor rarely charges just the AUM fee. They frequently steer you into the firm’s proprietary funds on top of it, and those funds commonly carry expense ratios up to and around 1%. That’s exactly what happened when I had my Edward Jones guy. I didn’t have very much invested with them, and my total fees were 1.85%. My annual drag was close to 2% — not just the 1%.
Rerun the math at 2% and the gap widens even further: well beyond $1.5 to $2 million lost against that $4.43 million baseline. And this is the single most underappreciated point in the whole episode: that 1 or 2% compounds against you year after year after year.
“But My Advisor Is a Stock-Picking Expert”
That doesn’t rescue the math. According to the S&P Dow Jones Indices year-end 2025 SPIVA U.S. Scorecard, roughly 90% of actively managed large-cap U.S. equity funds underperformed the S&P 500 over the trailing 10-year period. And underperformance rates get worse — not better — the longer the time horizon. Stretch it to 30 or 40 years and virtually nobody outperforms the S&P.
Paying an extra 1% for active management isn’t a bet with decent odds. Historically, it’s a bet that loses nine out of 10 times, and you never know who the one-in-10 magical stock picker is going to be. Those aren’t odds I’m looking to lean into.
Stop Watching It
The other thing you hear about managing your own investments is: just stop watching it. The peer-reviewed version of this point comes from Brad Barber and Terrance Odean, whose landmark research on individual investor behavior found that the most frequent traders significantly underperformed both the market and a simple buy-and-hold strategy, largely due to costs, taxes, and poorly timed trades.
At the end of the day, a disciplined, low-cost, passively managed, hands-off investing strategy beats all this tinkering. It’s also why men generally underperform women when it comes to investing: they tinker and think they’re smarter than the market. You’re not. I can attest. I’ve done it time and time again, and I’ve had a couple of bets pay off — but more often than not, they don’t.
My Plan: The $4 Million Fee
My plan was fairly simple, and I came up with it a few years ago. I ran the math on a personal aggressive-saver trajectory: invest $20,000 a month, $240,000 a year, after tax. Basically live off Mrs. TFC’s income and invest mine. Do that for a short time, then tone down the investing, spend a little more, and coast toward that FI number.
When I ran the numbers, I was pretty intrigued. A combined advisor-plus-fund fee of about 1% separated my $13.9 million self-managed portfolio (assuming S&P returns — a bold assumption) from a $10 million portfolio with a financial advisor at age 65. That’s a 28% cost difference: roughly $3.9 million in real dollars lost to a fee that sounds small.
Ignore the 1%? No. Not small. Four million bucks.
That was enough for me to get interested in personal finance. I’m frugal enough that learning about investing was worth my time, and ever since, The Financial Cocktail was born. I’m here to share what I’ve learned — not to be a gatekeeper. Everybody can come on in; there are plenty of seats at the top.
Let me put it this way. If I spend two hours per week understanding investing and portfolio allocation and reading books about managing my personal finances — and I simply match market returns with low-cost index funds over 40 years, not even beat the market — those two hours per week are worth about $960 per hour. I’m getting my $4 million back two hours at a time. Even at four hours a week, going hard, that’s about $500 an hour. It pays to understand this stuff and to self-manage. And even if you hire a one-time, fee-only advisor, you’re still earning that kind of return on your time.
My online course is out there, and it’s great content. The presentation is what you’d expect from a CRNA writing it during locums assignments while working full time, but it’s great value nevertheless. It will give you a foundation in personal finance and everything you need to talk to a financial advisor if you don’t feel comfortable doing it yourself.
Everything in this episode and everything on TheFinancialCocktail.com costs you time — not a percentage of your portfolio for the next 30 years. This is my way of giving back to the profession. There are plenty of people who are great at anesthesia and give back that way. This is my shot at it.
Five Pillars to Vet a Financial Advisor
If you decide to go that way, the relationship could be someone who runs your portfolio indefinitely, a one-time engagement, or a check-in a couple of times a decade. It’s especially valuable during major life changes or the years leading up to retirement, to make sure all your buckets are in place to get the money you need, when you need it, how you need it.
The five pillars to vet your current or potential financial advisor are fiduciary status, fee structure, comprehensive services, communication, and reputation and trustworthiness.
Pillar 1: Fiduciary Status
Arguably the most important. Fiduciary advisors are legally obligated to act in your best interest. Suitability advisors only have to recommend things that are generally appropriate, so they can recommend mutual funds with higher fees. A fiduciary cannot. They’ll say, “There’s an index fund that does exactly the same thing for far lower fees. I can’t put you in that proprietary fund — it’s not in your best interest.”
Look for verifiable fiduciary signals: CFP (Certified Financial Planner), CFA (Chartered Financial Analyst), and AIF (Accredited Investment Fiduciary). If fiduciary status isn’t clearly and proactively advertised, assume it isn’t there.
Ask: “Are you a fiduciary at all times, on all accounts, with no exceptions? Will you confirm that in writing?” A “sometimes fiduciary” is a big red flag disguised as a yes.
Pillar 2: Fee Structure
This is where the math really comes through. That 0.5% to 1.5% — up to 2% when proprietary funds stack — is the real annual drag. To find out which products may get pushed, ask: “How are you compensated? Is any part of that commission, revenue sharing, or third-party payment?”
Fee-only means they are paid by you: $150 to $500 or more per hour, a flat-fee retainer, or a transparent percentage of assets, with zero product kickbacks anywhere.
Pillar 3: Comprehensive Services
A good fiduciary doesn’t need to be an expert in every adjacent field, but they need to know enough to be dangerous and to flag the right considerations for the rest of your team: your CPA, your estate attorney, your insurance folks, and so on.
Ask: “Have you worked with CRNAs or anesthesia providers before? Do you understand 1099 versus W-2 structuring, my locums income, my real estate, my specifics?” Excessive complexity on their end isn’t great, but neither is broad, generic, hyper-conservative advice. Make sure their recommendations on retirement accounts, traditional versus Roth contributions, account prioritization, and debt paydown line up with what your CPA is telling you. You don’t want conflicting teammates.
Also ask: “How do you tailor your recommendations as my life circumstances, goals, and risk tolerance evolve? Can you give me an example of adapting a client’s plan after a major life event or market shift?” Whether it’s an inheritance or a market drop: How did you handle the last drawdown? Were you calling clients? What did they do, and what was the outcome?
If you struggle with fortitude — holding your heading during turbulent times — an advisor could be worth every penny. Here’s the real question for you: are you an emotional investor? Emotional investors can greatly harm themselves in downturns.
Even AUM fees during the 2008 recession or the COVID pullback would leave you better off than pulling your investments at the bottom. A 2% fee is nothing compared to the roughly 57% peak-to-trough decline in 2008 or the 30-some percent drop during COVID. It’s all relative.
Pillar 4: Communication
You want an advisor who spends real time understanding the big picture — after all, complexity is one of the reasons we look for an advisor in the first place. Net income, net worth, cost of living, retirement timeline, family dynamics. You don’t want someone who jumps straight into product recommendations in the very first meeting. Think of it a little more like a therapist: someone who listens, takes everything in, computes, and produces an answer for you.
Responsiveness matters, but so do expectations. A genuinely good, in-demand advisor might not be available for a week or two. That’s a sign of a healthy client base and a smaller practice, not a red flag. Book the meeting and use the wait time to prepare, because preparation is what makes the first session valuable. It’s not a meet-and-greet where you sip coffee and eat crumpets. At, say, $300 an hour, you want to get something out of it. You may need to meet again, but aim for a few meetings, not weekly meetings for two months.
Know what you’re looking for. Don’t just say, “I need help, and I don’t even know where to start.” You do know where to start. You’re a smart person who knows a lot about a lot. A little preparation will give you a far better experience.
Ask: “How often do you proactively review and update client financial plans? What’s your process for communicating with me when my goals or circumstances change, or when the market has a massive correction? Will you coordinate directly with my CPA and estate attorney if I need changes?”
Pillar 5: Reputation and Trustworthiness
Ask: “Are you a CFP, and are you a NAPFA member?” Those aren’t the only valid credentials, but they’re a fast, verifiable cheat sheet for an ongoing fiduciary commitment and continuing education.
There’s also Form ADV, a public disclosure filing with the SEC and state regulators that shows disciplinary history and exactly how the firm makes money. You may not get much from it, but if you really want to vet someone, it’s there. Think of it like looking up a CRNA’s NPI number: it doesn’t tell you a lot, but there could be a flag on it.
This next part is a little gray. Ask directly about their experience with clients in a similar position — high-income healthcare professionals with similar goals and net worth. But watch for a red flag: if they disclose too much, they’re sharing information they shouldn’t. You want specifics without anything that resembles HIPAA-type information.
Word of mouth carries some weight here. Ask your colleagues who they use and, most importantly, why. If it’s for the same reasons you would, great. Look at what vetting they did and what credentials their advisor has. Just because someone sends a popcorn tin around Christmas doesn’t mean they can do the job.
Red Flags to Watch For
• Pressure to buy insurance products early in the relationship
• Reluctance to put their fiduciary status in writing
• Proprietary, in-house funds
• Vague answers about how they’re compensated
• Gossip about other clients and their financial situations
Where to Look
• NAPFA’s Find an Advisor tool
• XY Planning Network (XYPN) — a network built around fee-only planners who work with younger, high-income professionals
• The CFP Board’s verification tool
The Bottom Line
The question was never whether CRNAs are capable of managing their own money. It’s who is legally required to put your interests first, and what the relationship actually costs over 30 to 40 years. Use these five pillars, and read everything before you sign.
Even if you hire a financial advisor, you should still understand every concept from The Financial Cocktail, because a good advisor welcomes an informed client, and a bad one is threatened by you — threatened by an educated person, by someone who asks questions, by someone who brings a counterargument.
This isn’t an anti–financial advisor episode. It is an anti–predatory fee episode. A fiduciary who genuinely earns their keep during a windfall, a business sale, or retirement is worth every dollar. An AUM advisor might offer good suggestions, make some good moves, and keep you out of trouble — just know that their fees can quietly shave 25 to 35% off your lifetime portfolio through lost compounding. Underperforming the index net of fees is not cheap advice.
Don’t hire confidence. Hire a fiduciary, in writing, who is paid exclusively by you. And if you already have an AUM advisor, their suggestions may be good and viable — just know what their percentage costs you over time.
Next time, we’re diving into contract negotiation. Subscribe wherever you get your podcasts so you catch the next episode, follow along on Facebook, and find the blog at TheFinancialCocktail.com.
Disclaimer: I’m obviously not a fee-only fiduciary financial planner — otherwise I would have been soliciting my services this entire time. I’m a gas man and a personal finance enthusiast, and I offer my opinions for free. This podcast and blog are for entertainment and educational purposes only and are not financial, tax, legal, or investment advice. Consult a qualified professional about your specific situation.
Take care. Leland out.
