When physicians accept a job offer from a hospital, they are often enticed with a signing bonus in the form of a forgivable loan.
Given the complexities of looking for a job and negotiating an employment contract, it’s easy to see the words “signing bonus” and overlook the term “forgivable loan.”
However, while this may seem like an attractive deal, it carries significant tax implications that …
In 2025, I celebrated a monumental milestone: I saw a patient within 20 miles of my home. While this may be a daily occurrence for most physicians, it was something I could not do for 18 months due to a non-compete clause from my previous job.
When I left my position as an academic cardiologist, I was bound by a non-compete clause that prevented me from practicing cardiology within …
If you have been offered the opportunity to buy into a medical practice, congratulations! For most physicians, this will be a tremendous opportunity. Being offered an ownership interest indicates that the current owners recognize your worth and are inviting you to “join the club.” It is hard to imagine a greater validation from your peers.
At the same time, physicians do need to protect themselves from a bad deal. In my …
When it comes to retirement savings, 401(k) and 457(b) plans are both popular options, but they have some key differences. While private employers typically offer 401(k) plans, 457(b) plans are available to employees of state and local governments and tax-exempt organizations under IRS Section 501, excluding churches and church-controlled organizations.
What is a 457 plan?
While a 401(k) is considered a defined contribution retirement account, a …
Most provider groups are not optimized to manage patient billing, and it’s breaking the bank. The problem often starts with the EHR systems that they have adopted, which are designed with insurance reimbursement as the priority, not the patient experience in mind.
For decades, providers operated in a world where the vast majority of their revenue came from insurance reimbursements. For most provider groups, patient billing was an afterthought. …
We, as physicians, dedicate years to rigorous education and training to excel in our chosen specialties. We endure periods of sleepless nights, poor nutrition, personal sacrifices, time constraints, and modest pay. For many, this journey is further compounded by the significant burden of student loan debt. We do this with the expectation that we will be able to make up for lost time later. Yet, too often, when financial stability …
No one knows for sure what’s coming in health care in the months ahead, but one thing is clear: The landscape in 2025 will undoubtedly be changing—and challenging. For physicians and others working in such fields, this is not new but an acceleration of recent trends. External factors, like the COVID-19 pandemic, and internal, more systemic ones have increasingly taken power away from doctors—impacting everything from patient care to physician …
Nothing is more of an insult than suggesting that the 1.2 million very intelligent practicing physicians in our nation, whom we trust to keep us healthy, have never come up with a revolutionary cure for what has now become health care and physician crises. Who knows better about the actual practice of medicine and the multiple problems and challenges they face daily than physicians themselves?
The mental function of due diligence …
Physicians face immense challenges, from demanding work schedules and administrative burdens to the emotional toll of patient care. Burnout, turnover, and even suicide are distressingly prevalent in the profession. While systemic changes to health care environments are essential, financial well-being is an often overlooked factor in mitigating these challenges. Personal financial education and planning resources should not be considered taboo but a vital component of physician well-being. When openly addressed, …
Bitcoin has recently surged past $100,000, marking a pivotal moment in the adoption of cryptocurrency worldwide. Coupled with a regulatory environment under the Trump administration that promises to be more favorable to digital assets, now is the time for medical practices to consider integrating cryptocurrency payments into their operations. This combination of market momentum and policy support offers practices a unique opportunity to attract a broader clientele and improve financial …
Dr. Peter Onorato, an accomplished anesthesiologist, found himself at a crossroads. With a lucrative career and a substantial income, he was eager to grow his wealth. Like many high-income earners, Peter believed he could outsmart the market. Despite his wife’s concerns, he decided to invest over $300,000 in a tech startup after several days of online “research” and hearing from several colleagues in the doctor’s lounge about the expected 25-30 …
Noticing the local physicians who practiced in your area, stayed for two years or so, and then moved to a “different place to practice” (cover story—meaning they never made enough income to stay in practice in your area) involves thousands of physicians across our nation annually, which has led to the physician attrition crisis today. Not enough money or income is most often the cause.
You may not know that you …
As physicians, we spend years mastering our craft—learning how to diagnose, treat, and care for patients. But there’s another area that demands mastery if we want to secure our futures: wealth building. The truth is, despite the high earning potential that comes with a medical career, far too many doctors retire with less than they imagined. Why? Because earning is one thing, but building sustainable wealth that lasts is an …
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“I’m in my final year of orthopedic surgery residency and will do a one-year fellowship (I finish July 2026). I’m in the early phases of talking to potential employers, many of which say they could offer a stipend as I finish my training. Do you have any advice on how a stipend should be optimally structured?”
Stipend secrets: Navigating your final year of residency
As you approach the final stretch of your …
It took me forever to retire—three years or so. It took so long that my nurses got tired of bringing me purple cakes decorated with whipped cream stethoscopes, but I did it. Now, a few years later, I can tell you that the things I worried about were not the ones that gave me trouble.
I had mostly agonized about money—had we saved enough to last us the rest of our …
When a physician signs on at a new hospital, a signing bonus is often included in the compensation package. This bonus can range from a small perk to a significant percentage of income, and its structure can be either straightforward or confusing. The signing bonus is one of the items in a physician’s compensation contract that can be negotiated, although some give-and-take is often involved. For example, in some situations, …
When planning for retirement, most of us focus on building a nest egg that will support us in our golden years. We diligently contribute to our 401(k)s, IRAs, and other retirement accounts, hoping to maximize our savings and minimize our tax burden. However, the passage of the SECURE Act and SECURE Act 2.0 have introduced new rules that could significantly affect how your retirement savings are passed on to your …
In today’s financial landscape, it is imperative for women in medicine to take charge of investing their own money. Physicians face a myriad of disadvantages when it comes to wealth building. The average medical student will be saddled with an average of $200,000 in student loan debt. The nature of prolonged medical training puts physicians at another disadvantage, with a high debt-to-income ratio until their mid-to-late 30s, causing them to …
A new, concerning trend in society has emerged online and across social media: money dysmorphia. It’s the latest version of the comparison trap and aims to describe a distorted view of one’s financial situation and how one is doing financially.
What is money dysmorphia?
Money dysmorphia is a psychological condition where individuals have distorted perceptions of their financial status, often leading to unhealthy behaviors and attitudes toward money. Similar to body dysmorphia, …
Having an ambitious understanding that small private medical practice businesses are the “belt and suspenders” that enable your medical career to approach your elite expectations for your medical career success is only part of your drive toward an illustrious medical career.
Your medical training, knowledge, and skills are how you grow, expand, maintain, and earn income. Physicians have struggled for decades to weave these two pillars into a highly functional, well-oiled, …
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