A few years ago, I met a talented internist who had been practicing for 15 years. She owned a small clinic, worked long hours, and ran a thriving patient base, but when we reviewed her financials, I realized she’d been paying far more in taxes and taking far more risk than she needed to.
Her response was one I hear often: “Clint, I’m not a businessperson; I’m a doctor.”
It’s a mindset …
Physician asset protection: a guide to entity strategy
Most physicians practicing medicine today were trained to diagnose and treat patients, not to navigate one of the most complex industries in the world, an industry characterized by ever-changing payer contracts, evolving reimbursement structures, complex and sometimes mystifying coding, and challenging operational realities. Despite the lack of training, these same physicians and providers are leading multimillion-dollar businesses and are expected by their health systems to reduce costs, improve outcomes, and …
Why physician business literacy matters
A few months ago, I received a call from a frustrated surgeon.
It wasn’t about a malpractice claim; he was covered there. The problem was that his teenage son had totaled the family car. Nobody was seriously hurt, thankfully, but the other driver’s attorney was already sniffing around his assets. He told me, “Clint, this can’t touch my house or savings, right? I have medical malpractice insurance.”
That’s when I had to …
Why malpractice insurance isn’t enough
In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed two guests who have navigated a common trend in independent medicine today: private equity. Dr. Steve Hamilton, sports medicine physician and orthopedic surgeon at Beacon Orthopedics, and Andy Blankemeyer, CEO of Beacon and OrthoAlliance, shared their firsthand experiences with practice growth, private equity partnerships, and what physicians should consider when approached …
How to navigate private equity in medicine
Many physicians do not seem to grasp the risks inherent in physician employment agreements that impose a minimum threshold of wRVU production. However, there can be many pitfalls in these agreements.
What is the effect of the threshold?
The first pitfall is determining the effect of a threshold. Some agreements provide a salary “assuming a minimum threshold of” some number of wRVUs. I have reviewed many agreements with a provision like that …
wRVU threshold risks in physician contracts
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Certified financial planner Michelle Neiswender discusses her article, “Why physicians should not be their own financial planner.” Michelle explains why physicians, despite being brilliant, often make costly financial mistakes when managing their …
Why being your own financial planner is costing you millions [PODCAST]
Leadership is often discussed in broad strokes: some leaders are structured and precise, while others are flexible and improvisational. But behind those visible styles lie quiet personal and generational histories, the emotional terrain that shaped how we learned safety, trust, and control. I’ve come to see that these histories profoundly influence how we lead and how we’re perceived as leaders, especially in health care, where the stakes are high and …
How your past shapes the way you lead
In aviation, the right seat is typically reserved for the instructor. In medicine, it’s the role of the diagnostician, the mentor, the gatekeeper. I once piloted a T-37B “Tweet” trainer from the right seat, not as a student, but as someone trusted to guide. That experience shaped how I approach clinical decision-making, interdisciplinary fluency, and the choreography of care.
During a military training program, our squad faced a simulated obstacle: an …
Interdisciplinary medicine: lessons from the cockpit
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Certified financial planners Michael Lynch and Alisa Olsen discuss their article “Create your own financial vision for independence,” an excerpt from their book Taking Care of Your Future: Your Simple System for …
A financial vision to define your retirement [PODCAST]
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Certified financial planner Paul Morton discusses his article “Physician practice ownership: risks, rewards, and reality.” Paul breaks down the massive differences between an employed physician’s financial journey and that of an equity …
Is owning a medical practice worth the ultimate financial risk? [PODCAST]
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Health attorney Dennis Hursh discusses his article “First physician employment agreement mistakes.” Dennis shares his amazement after 30 years in health law at the timidity of new attending physicians during contract negotiations. …
An attorney’s guide to your first physician contract [PODCAST]
In a unique episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, sat down with a resident, although not your typical resident! Dr. Wendell Cole, an orthopedic surgery resident at the time, is also a fellow podcaster, author, and entrepreneur. Despite being in the early stages of his medical career, Dr. Cole had already built a track record of innovation and initiative. His story …
Physician entrepreneurship and financial freedom
Introduction
In a recent episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed Dr. Michael Ast, an orthopedic surgeon specializing in adult reconstruction and joint replacement surgery. Beyond being an accomplished clinician at the Hospital of Special Surgery in New York, Dr. Ast also lectures often on business and career issues, and is especially passionate about teaching younger physicians how to build their practices …
How new physicians can build their career
Doctors, I like to think, are fairly intelligent people. We worked hard in school, extremely hard in residency, and continue to refine our skills decades into practice. In addition to being intellectual, we are often experts in our fields. We enjoy more respect and higher salaries than most professions. Our work can be humbling and challenging, and it exposes us to the flawed nature of humans. Despite deeply understanding that …
Why doctors make bad financial decisions
I have been representing physicians for over 30 years, and I am still amazed by the attitude of most young physicians going into their first attending position. These are smart, accomplished, fully qualified physicians who have received some of the best clinical training in the world. And yet, many of these highly trained individuals in a field with massive shortages seem reluctant to acknowledge even the slightest modicum of self-worth.
Bear …
First physician employment agreement mistakes
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Veteran attorney Dennis Hursh discusses his article “Private practice employment agreements: What happens if private equity swoops in?” In this episode, Dennis explains how private equity acquisitions of medical practices complicate the …
Protecting physicians when private equity buys in [PODCAST]
As a physician, you are no stranger to complexity. From the first days of medical school to the years of long shifts in residency, you make high-stakes decisions every day. Yet many doctors tell us they feel too busy, or under-resourced, to give their money the same level of care.
That is where a Personal CFO helps. Just as a hospital relies on a chief financial officer to align budgets, risks, …
Why physicians need a personal CFO and how tax mitigation fits in
An excerpt from The Savvy Physician: A Financial Wellness Handbook for Physicians and Professionals.
As a physician, helping people in need is among the greatest honors and privileges in the world. In the complex world of medicine, physicians and health care professionals have the opportunity and privilege to enormously contribute to patient well-being at a time of significant personal and/or family health crisis.
In addition, many physicians and health care professionals …
The link between financial literacy and physician burnout
I’m going to say something controversial: the DPC community’s obsession with “purity” is missing the point. After two decades designing health care financial models, negotiating payer & vendor contracts, and building compliance frameworks, I’ve learned that most alternative payment models don’t fail because they’re impure. They fail because someone forgot to do the math.
When $1 million can’t save a bad idea
The University of Houston medical school launched a direct primary …
Why direct primary care (DPC) models fail
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 …
Building a practice and avoiding business pitfalls
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