By David B. Mandell, JD, MBA, Jason O'Dell, CWM

Too many physicians over the last decade have sought cookie-cutter asset protection plans to give them some “piece of mind” that if they ever endure an outrageous malpractice case, they won’t lose everything. While we admire these doctors’ commitment to pro-actively managing their risk, we have to remind doctors we speak with that all “asset protection plans” are not created equal. In fact, many will not even “work” if they ever are relied on.

By Carole C. Foos, CPA, David B. Mandell, JD, MBA

With the legislation President Obama has signed into law this year, nearly all physicians will see their federal income, Medicare and capital gains taxes increase in the coming years. When you add to these federal tax increases, the various proposals in place to increase state and municipal taxes and fees, you could see your combined marginal tax rate increase by 10% (up to 45% to 58%, depending on your state). This could be an increase of up to 20% on the taxes paid on dollars earned over $250,000. This is no small set of changes and they should not be taken lightly.
Though many of your colleagues are complaining and some have been threatening to leave the country, we want to offer more practical advice in this article. The good news is that there are techniques most doctors can implement in 2010 to help reduce your taxes in 2011… and beyond. Many of these techniques are powerful enough to equalize or go beyond the proposed tax increases. Savvy doctors who take advantage of these strategies could expect to reduce their annual tax liabilities – even if all the proposed tax increases become law.

By Carole C. Foos, CPA, David B. Mandell, JD, MBA, Jason O'Dell, CWM

As a physician, do you realize that – between income, capital gains, Medicare, self-employment and other taxes, you spend 40 to 50% of your working hours laboring for the IRS and your state? That is a lot of time with patients for someone else’s benefit. Given the significance of this fact, shouldn’t your advisors be giving you creative ways to legally reduce your tax liabilities? How many tax-reducing ideas does your CPA regularly provide you? If you are like most physicians, you probably get very few tax planning ideas from your advisors.

By David B. Mandell, JD, MBA, Jason O'Dell, CWM

As an attorney and consultant to thousands of physicians across the country, we are constantly astounded by the attitudes of physicians regarding the sale of their medical practice. Most often today, we hear the complaint that doctors do not feel they can sell their practice for any significant value. They generally do not feel the practice is “worth anything,” especially if they do not have younger partners to buy them out.

By Andrew Schwartz, CPA

Taxes are going up. With many of the provisions of the 2001 Tax Act expiring at the end of this year, most tax brackets are set to increase by a few percentage points on New Year's Day. For high income taxpayers, the top bracket will increase by 4.6%, from the current rate of 35% up to 39.6%. Meanwhile, the tax credit for a child under the age of 17 is slated to be slashed in half to $500, and the dependent care credit will be cut by 20%. Plus, we'll see the return of the marriage penalty and the stealth tax.

Sounds rough, right? There is some good news for doctors in practice, however. Let's take a look at a few new tax breaks enacted earlier this year.

By Karen Zupko

Don’t pick the wrong people to fill business office positions – it is an expensive mistake.

Because staff salaries are the largest component of overhead in any practice, focus on hiring staff who have the skills and talent to do the job. No matter how hard you work inept, business office staff will cost tens of thousands of dollars. Use the following guidelines to help hire competent winners.

By Karen Zupko

Too often both doctor and staff forget the total cost of employment. The form accompanying this article shows you what to include when valuing staff benefit, bonuses and overtime.

By Carole C. Foos, CPA, Jason O'Dell, CWM

If you think medicine is a difficult business today, “you ain’t seen nothing yet.” You are about to face your largest financial challenge ever. There is an approaching confluence of events that could have a significant financial impact on most doctors – unless you do something to protect yourself.

Medicare reimbursement cutbacks will reduce the income of most doctors. Even if you don’t treat Medicare patients, you are not immune to this cut. If your private insurance contracts offer you some percentage (say 120%) of Medicare, a cut in Medicare reimbursements will lower your insurance reimbursements. In addition, the healthcare overhaul the President is promoting will further reduce physician income. On top of both of these “gross” income reducing events, there are is a significant “net” income reducing threat that shouldn’t be ignored.

By Catherine Kowalski, RN

This brief article outlines some of the key reasons an ambulatory surgery center (ASC) could face scheduling problems. By identifying and addressing scheduling conflicts and issues, ASCs can improve their system and increase cases at their facility.

By Jeff Moffatt, CPA, CVA

The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is set to replace the ICD-9 system of coding as of October 1, 2013. Although this change is still a few years off, the healthcare industry is already starting to get prepared for what this new system will entail. This article will describe the ICD coding system and some of the changes that we will see between ICD-9 and ICD-10.