By Michael Sacopulos, Esq, Jeff Segal

People don't like uncertainty. Sociologists teach us that structural ambiguity motivates individuals to seek security and certainty. Well, it's difficult to imagine an industry with a more uncertain future than healthcare. Congress passes laws and regulations by the ream. Third party payers behave more and more like slot machines in the Las Vegas Airport. Patients misinterpret the complexity of medical care by Google searches. What a mess... Who won't want to hit the Staples "Easy Button?"

By David B. Mandell, JD, MBA, Kimberly Renners, MBA

Captive insurance companies (CICs) have become more common in recent years for small closely-held businesses, including professional practices, such as consulting firms, law firms and medical practices. In fact, our firm – whose principals have worked with CICs since the late 1990s – has seen an increase steadily over the decade – especially during the medical malpractice insurance crisis earlier this decade. While CICs can offer a medical practice, large group or even hospital system significant asset protection, risk management, and tax benefits, we have seen a significant lack of proper investment advice in many common CIC arrangements. This is unfortunate, as a sub-optimal investment approach within the CIC can erode many of the financial benefits for which the CIC was created in the first place.

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

As authors of 4 books for physicians, including our latest, For Doctors Only: A Guide to Working Less & Building More, we have consulted with thousands of doctors of all specialties during the last decade. From this experience, we have become intimately familiar with the mistakes physicians make when working with their CPAs, attorneys, and other financial advisors. Whether it is in the area of tax, asset protection, retirement planning, or other areas, the result is almost always the same. We leave the meetings or conference calls asking ourselves, "How could this doctor get such [poor, uncreative, or just plain wrong] advice?" It would be laughable if it weren't so troubling.

By Carole C. Foos, CPA, Christopher R. Jarvis, MBA

The government bailouts caused significant stresses on the tax system. How might they impact you?

By Brian S. Kern, JD

Following the crash of the traditional medical malpractice insurance market at the turn of the last century, the alternative risk market - in particular a model referred to as a risk retention group (“RRG”) - has enjoyed unprecedented popularity. Now that the traditional market has rebounded, the value of many RRGs has been called into question. Promises ranging from ownership or control convince some physicians and administrators to entertain RRGs, but since so few have strong financial backing, they should first understand the full scope of potential risk factors before signing on.

By Christopher R. Jarvis, MBA, David B. Mandell, JD, MBA, R. Paul Wilson, CRPC®

In Part 1 of this article, you learned why the strategies and techniques used by most attorneys, accountants and financial advisors betray physician families that pay high marginal taxes, are subject to heightened government control, and have greater liability risk and retirement challenges than average American families. Part 1 offered three common mistakes doctor families' make:
1. Not using a corporation (or using the wrong type of corporation).
2. Owning ANYTHING in your name, spouses's name, or jointly with spouse.
3. Wasting time and money on traditional qualified retirement plans.

By Christopher R. Jarvis, MBA, David B. Mandell, JD, MBA

According to the US Census Bureau, the average American family earns less than $49,000. To become a large national firm in the fields of law, accounting, investments and insurance, you MUST deliver services, products and strategies that can be replicated millions and millions of times. Before you can understand why MOST strategies and services are bad for doctors, you must understand the dynamic of the “Average American,” for whom these products and services are designed.

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

As consultants to hundreds of physicians, we encounter many misconceptions about asset protection planning everyday. In this article, we will address the most important of all misconceptions regarding asset protection: that this area of planning is not important. The thinking of many physicians around the country, and unfortunately their advisors as well, is that there is little to any risk of a physician losing their personal assets in a malpractice claim, especially if there is $1-3 million malpractice insurance coverage.

By Jeff Segal

Most of you know Angie's List as a consumer rating site. They launched as a web portal, rating assorted service providers such as roofers and plumbers. Believing that the practice of medicine is little different than roofing and plumbing, they dipped a toe into rating doctors.

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.