In Season 1 of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, sat down with Dr. Desmond “Desi” McGuire, a respected ophthalmologist and founder of Retina Associates of Orange County. Their conversation traced Dr. McGuire’s path from childhood influences and early career choices to building a thriving practice and navigating the financial ups and downs of medical entrepreneurship. For physicians seeking guidance on balancing clinical excellence with sound financial and business decisions, Dr. McGuire’s story offers practical lessons and a dose of hard-earned wisdom.
Finding a calling in ophthalmology
Dr. McGuire’s interest in medicine was sparked at a young age. Growing up in Rockland County, New York, he spent much of his childhood in hospitals as his younger brother battled serious health conditions. Witnessing the impact of physicians on his family left a lasting impression. Later, while driving his grandmother to regular ophthalmology appointments, he became fascinated with the specialty, particularly its technology and precision. A job as a medical scribe and the chance to observe surgery firsthand confirmed his passion: Ophthalmology would be his career. After completing medical school in Israel and training in New York and California, Dr. McGuire launched into practice. His career trajectory quickly became a blend of clinical work and entrepreneurial ventures, shaped by both success and challenges.
Building a practice from the ground up
Dr. McGuire’s first job out of fellowship was with a unique shared-location practice run by three physicians. Recognizing the need for full commitment, McGuire stepped in, energized the practice, and eventually purchased it. Not long after, a senior physician approached him about merging practices. With the help of a trusted consultant, McGuire structured the deal and brought on a close friend and colleague, Dr. Charlie Eifrig. Together they launched Retina Associates of Orange County, which has since grown into a successful multi-physician group. One of the keys to long-term growth, McGuire emphasized, has been careful hiring. Rather than relying solely on stellar résumés, the group prioritized personal recommendations and cultural fit. “Anyone can look great on paper,” McGuire noted, “but building the right team requires trust, respect, and shared values.” For physicians in private practice, avoiding turnover and nurturing collaborative partnerships can make the difference between stagnation and sustained success.
Hard lessons from business ventures
Beyond his core practice, Dr. McGuire, like many entrepreneurial physicians, pursued additional business opportunities. Some proved costly. He candidly described failed ventures, including an HMO startup and another project that required physicians to sign personal guarantees. Both collapsed, resulting in significant financial losses. His advice to other physicians is direct: never be a completely passive investor in business deals, and never sign a personal guarantee for ventures you don’t fully control. He acknowledged that doctors often feel pressured to join such projects because respected colleagues are involved, but cautioned that medical expertise does not automatically translate to business acumen. “Just because someone is a great physician,” he observed, “doesn’t mean they know how to build a hotel or run a health plan.” For McGuire, those setbacks were invaluable teachers. They reinforced the importance of active oversight, skepticism of “can’t-miss” opportunities, and reliance on professional advisors with relevant expertise.
Financial planning and the power of starting early
On the personal finance side, McGuire credited his parents, who came from modest backgrounds, for instilling the importance of saving early. As soon as he began his internship, he signed up for retirement plans and has consistently invested in pre-tax, post-tax, and insurance “buckets” ever since. Both he and his wife, also an ophthalmologist, kept their lifestyle in check while building financial security. Looking back, he reflected that they may have been overly conservative, particularly in aggressively paying down real estate debt instead of leveraging low mortgage rates for investment growth. Still, starting early and living below their means laid the foundation for long-term success.
Advice for young physicians
When asked what he would tell younger physicians, or his 30-year-old self, McGuire stressed the importance of building a strong advisory team across finance, law, accounting, and investing. Few physicians can be experts in all of these areas, and the right counsel can prevent costly mistakes. Equally critical is a willingness to revisit decisions periodically. As new physicians join a practice or as laws change, fresh perspectives can highlight overlooked risks or opportunities.
Conclusion
Dr. Desmond McGuire’s story blends inspiration with pragmatism. His journey into ophthalmology was rooted in personal family experiences, but his success as a practice owner came from deliberate choices: investing early, hiring wisely, learning from failed ventures, and leaning on trusted advisors. For physicians charting their own professional and financial paths, his advice is clear: Start early, stay engaged, and surround yourself with the right people. As McGuire demonstrates, the road to success in medicine is rarely linear, but with foresight and humility, it can be deeply rewarding.
Click here to listen to the entire conversation with Dr. Desmond McGuire, or access the full library of Wealth Planning for the Modern Physician episodes and subscribe on your favorite podcast platform.
David B. Mandell is an attorney, wealth manager, author, and partner in the wealth management firm OJM Group, LLC, where he and his team provide comprehensive and multidisciplinary financial planning services tailored specifically for physicians across the United States.
David hosts the Wealth Planning for the Modern Physician Podcast, now in its fifth season with over 95 episodes and 50,000+ downloads. The show focuses on the unique wealth planning concerns faced by today’s doctors and features interviews with physicians across specialties and stages of their careers, as well as insights from financial and industry experts. Listeners gain practical tips on building wealth, protecting assets, reducing taxes, and achieving long-term financial goals. Click here to listen and subscribe.
He is also the co-author of more than 15 books, including the newest release, Wealth Strategies for Today’s Physician: A Multi-Media Playbook. This innovative guide includes over 250 pages of actionable content and more than 90 embedded links to videos and podcast episodes. Organized into seven key strategies, the Playbook helps physicians reduce taxes, invest wisely, choose the right insurance, protect their assets, and plan for retirement. Click here to get your free print copy or eBook download, available exclusively to members of the KevinMD community.
David has spoken at major national medical meetings, including those hosted by the American Academy of Ophthalmology, the American Association of Orthopaedic Executives, and the International College of Surgeons. He earned his bachelor’s degree from Harvard University, his law degree from UCLA School of Law, and his MBA from UCLA Anderson.
Connect with David and OJM Group on their website, LinkedIn, Facebook, Instagram, YouTube, and X @OJMGroup.
Disclosure:
OJM Group, LLC. (“OJM”) is an SEC-registered investment adviser with its principal place of business in the State of Ohio. SEC registration does not constitute an endorsement of OJM by the SEC nor does it indicate that OJM has attained a particular level of skill or ability. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered or qualifies for an exemption or exclusion from registration requirements. For information about OJM, please visit http://adviserinfo.sec.gov/ or contact us at (877) 656-4362.
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