Physicians writing on KevinMD about their own money and the business of practice: student loans and forgiveness, disability and life insurance, index funds and retirement accounts, whether to hire an advisor, financial independence and retiring early, side income and real estate, contracts and negotiation, selling a practice to private equity, and leaving insurance for direct primary care. Three maintained records draw on this archive: Physician personal finance: what physicians say about their own money, in their own words, Private equity and corporate medicine: what physicians say, in their own words, and Direct primary care: what physicians say, in their own words.
Hospitals are facing unprecedented financial pressures, with staffing shortages and shrinking margins. Revenue cycle teams are stretched thin, and hospital leaders and health care professionals must continue to find ways to reduce costs and improve financial health.
One often overlooked opportunity to improve financial stability is denials management, which includes prevention strategies. Although hospital leaders and revenue cycle managers recognize denials as a significant issue, their lack of visibility to the …
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The hidden impact of denials on health care systems
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 …
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Signing bonuses and taxes: What physicians should know
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 …
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5 steps to ride out a non-compete without uprooting your family
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 …
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What every physician should know before buying into a medical practice
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 …
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Navigating your 457 plan: key steps for physicians changing jobs
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. …
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From caregivers to collectors: Navigating the new landscape of patient payments
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 …
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Advancing health care through physician leadership: 5 skills for changing health care
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 …
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What if the solution for physicians’ struggles was right in their faces, yet remains unrecognized?
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, …
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Personal financial planning shouldn’t be a taboo subject
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 …
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The case for cryptocurrency payments in health care
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 …
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Behavioral finance: your mood and your money
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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Leveraging your medical career for long-term wealth building
“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 …
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Navigating stipend offers: a resident’s question
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 …
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The surprising struggles of retirement no one warned you about
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, …
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The secrets of physician signing bonuses
