Modern Aesthetics | Doctors Betrayed by Traditional Financial Strategies, Part 1
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Doctors Betrayed by Traditional Financial Strategies, Part 1

Part one of this two-part series explores why financial advice for the “average” consumer isn’t always the best advice for aesthetic physicians.
By: David B. Mandell, JD, MBA and Michael Lewellen, CFP


As authors of books and articles, we regularly interact with publishers, editors, and talk show hosts. Radio and television stations, book and magazine publishers, and internet content editors are looking for material for their “average” reader. In general, they fear that providing content generated for a few high-income readers will “alienate” their average readers and the advertisers who pay good money to reach a specific audience. Who is their “average reader”? Typically, they are defined in the parameters below:

1. The average American family, whose annual income tax liability is less than 12 percent.

2. The 98 percent of American families who will never owe any estate taxes.

3. An employee, not an employer, who will likely never be sued and who has no control over the choice of legal entity or type of retirement vehicles the employer will utilize.

Practically, what this means for aesthetic physicians is that much of the financial advice you get from print and online media and from large national firms is often not appropriate.

Physicians who follow advice that is generated for the masses and don’t take into consideration their unique challenges should see themselves as the patient who focuses on the results of his/her own 10-minute internet search over the specialist’s educated diagnosis based on decades of experience and the results of a personal exam and test results.

Because physicians face a large set of unique challenges, it is imperative that doctors look for advisors who spend the majority of their time working with physicians. To take it a step further, if you are a high liability or high income specialist, you will want to work with a team of advisors who are acutely aware of these additional challenges. For example, an obstetrician has a much greater need for asset protection than a pediatrician and a surgery center owner has much greater tax challenges than a primary care doctor.

Above, we pointed out what characteristics are common for US taxpayers. Solutions that are widely accepted in the media and by advisors are generally tools that work for these people. One hurdle that advisors who specialize in helping high-income physicians face is the fact that the solutions we (as a group) espouse are appropriate for less than one percent of the families in the country. For that reason, doctors who insist on implementing only strategies they have heard over and over again in the media and from their colleagues will miss out on valuable opportunities. Once you embrace the fact that you are different and require “different” planning than your neighbors, you will have taken one very important step to significantly improving your financial situation.

In the rest of this article, and in Part 2 of this article (which can be requested via email at Mandell@ojmgroup.com), we will share a few examples of common mistakes physicians make when listening to bad, but common, advice.

Mistake #1: “You Don’t Need a Corporation for Your Medical Practice.”

Despite what some CPAs may say, in most cases the cost and aggravation of creating and maintaining a corporation (or often two corporations) are insignificant relative to the asset protection and tax benefits corporations offer physicians. With recent tax law changes and with many new proposals over the next year, the benefits will be compounded. Though these corporate solutions can reduce taxes by $5,000 to $50,000 per year for the doctor, these particular strategies are outside the scope of this two-part article.

Mistake #2: Owning Assets in Your Name, Spouse’s Name, or Jointly

We acknowledge that owning assets in your own name or jointly with a spouse are the most common ownership structures for real estate and bank accounts. This is okay for 95 percent of Americans. Hopefully, by now, you realize that you are not in that group. You have potential lawsuit risk, probate fee liability, and estate tax risks. That’s why, in most states, owning assets jointly can be a mistake. Something as simple as a living trust or limited liability company can often solve these problems.

Mistake #3: Making a Bet on Qualified Retirement Plans … Without Hedging it

This is perhaps the single most important area of planning for aesthetic physicians to address once they understand that they are different. Typical retirement plans are great for rank-and-file employees because they force employees to put away funds for retirement. Employers may match some percentage of employee contributions (which is free money for the employee). The investment grows tax-free until funds are accessed in retirement when the employee is living on modest Social Security and these retirement plan funds.

As “the employer,” there is no “free money” for you as all the money that ends up in your plan account was yours to begin with. In fact, you are responsible for those matching contributions so the retirement plan does have some “friction” for you if you want to make any reasonable contribution on your own behalf. On top of that, you will not be living on $25,000 to $50,000 a year in retirement like your employees will. You will have taxable investments, much larger retirement plan contributions and greater Social Security income (maybe). In any case, you will be paying significant tax on your retirement plan withdrawals. Do you think that tax rates will be lower than they are now when you retire?

With rising costs for employees and a possibility that you may actually withdraw funds from your retirement plans at a HIGHER tax rate than the one you received for the original deduction, the real benefit of retirement plans comes into question. When you add the potential costs and aggravation of complying with ERISA, Department of Labor and tax laws surrounding retirement plans, AND the fact that any unused retirement plan balances will be taxed at rates up to 80 percent, you may find that retirement plans are not all they are cracked up to be. A growing trend among successful doctors is to implement non-qualified plan that hedges the future tax risk of qualified plans.

Non-traditional planning can offer higher income physicians opportunities to contribute significantly larger annual contributions. Whether you are using non-qualified plans or even a tool primarily designed for risk management benefits, like a captive insurance company, you could potentially enjoy tax benefits up to $100,000 to $1,000,000 or more annually. Most of these tools allow you access to the funds before 59½, will not force you to take withdrawals at age 70½ if you don’t need the money, and will not be taxed at rates up to 70 or 80 percent when you pass away. For these reasons, savvy physicians utilize nontraditional plans more than traditional retirement plans.

Note: Non-qualified plans vary significantly in their design, scope and applicability. Some plans work great for smaller practices with one or two partners. Others work best in practices with three to 20 partners. Still others may work best for larger practices. To determine which one is right for you, contact the authors for a free no-cost consultation offered to readers.

This is the first of a two-part article. More tips on tax reduction and other elements of financial planning that are specific to physicians and unnecessary for Average Americans will come in the subsequent part of this continuing article. The authors welcome your questions. You can contact them at 877-656-4362 or through their website www.ojmgroup.com.

David B. Mandell, JD, MBA, is an attorney, author of ten books for doctors, including Wealth Protection Planning for Dermatologists, and principal of the financial planning firm OJM Group www.ojmgroup.com, where Michael Lewellen, CFP® serves as Director of Financial Planning. They can be reached at 877-656-4362 or mandell@ojmgroup.com.

SPECIAL OFFER: To receive a free hardcopy of Wealth Protection Planning for Dermatologists, call 877-656-4362. Visit www.ojmbookstore.com and enter promotional code AESMAG12 for a free ebook download of Wealth Protection Planning.

Disclosure: OJM Group, LLC. (“OJM”) is an SEC registered investment adviser with its principal place of business in the State of Ohio. 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 pertaining to the registration status of OJM, please contact OJM or refer to the Investment Adviser Public Disclosure web site www.adviserinfo.sec.gov.

For additional information about OJM, including fees and services, send for our disclosure brochure as set forth on Form ADV using the contact information herein. Please read the disclosure statement carefully before you invest or send money.

This article contains general information that is not suitable for everyone. The information contained herein should not be construed as personalized legal or tax advice. There is no guarantee that the views and opinions expressed in this article will be appropriate for your particular circumstances. Tax law changes frequently, accordingly information presented herein is subject to change without notice. You should seek professional tax and legal advice before implementing any strategy discussed herein.

Chief Editors

  • Steven H. Dayan, MD, FACS
  • Heidi Waldorf, MD, FAAD

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  • Modern Aesthetics is the source for expert advice on patient care and practice development for cosmetic surgeons. With content by and for clinicians, each edition offers unique perspective and insight regarding the latest developments in aesthetics–from skin care to advanced procedures–and strategies for clinicians to successfully incorporate them into practice.