Many people worry they will pay more in tax by deferring taxes for decades in a retirement account. These worry is misguided for the vast majority of physician investors. The real question is not whether you will pay a larger dollar amount in tax now or later, but which approach will leave you with more money after-tax. Contributions to your retirement account are made at your marginal tax rate, so you may save 40% or more upfront. When you withdraw money from your retirement account, assuming no other taxable income in retirement, you get to “fill the brackets” from the bottom up. For a married couple taking the standard deduction, the first $20K out of your retirement account comes out at 0%. The next $18K comes out at 10%. The next $50K comes out at 15%. The next $75K comes out at 25%. So you may be saving 40% when you put money in, and only paying an average of 15% when you pull the money out. That's a winning combination.