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

Choosing the form and structure of one's medical practice is an important decision. Most advisors to medical practices believe that the avoidance of potential double taxation makes the S Corporation the logical choice. This "conventional wisdom" overlooks the potential benefits a C Corporation can offer. If you want to explore ways to reduce unnecessary taxes without subjecting yourself to double taxation AND would like to see how you can do this without having to change any of your insurance provider or Medicare provider numbers, this article is ideal for you.

By Christopher R. Jarvis, MBA, David B. Mandell, JD, MBA, Jason O'Dell

They say your home is your castle. Did you ever think there might be barbarians at your gate? With half of all medical malpractice lawsuit judgments over $1 million dollars, there is a real chance that a lawsuit judgment against you or your partners could actually threaten your personal assets. If you aren't lucky enough to live in one of the few states with excellent "homestead" protection, you are likely to be at risk of losing your home in the event of an outrageous judgment (and even homestead is now threatened as well).

By Andrew Schwartz, CPA

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. That translates to an income tax liability of less than 12%. 98% of American families will NEVER be worth more than $2,000,000 and owe an estate tax. Lastly, the average American is an employee, not an employer, and doesn’t have the government determine how much income they receive for their work. As a result, most people will never be sued because of work-related activities and don’t have to worry about their income dropping substantially each year. Therefore, there is no need for most people to address protection from lawsuits or to take advantage of every possible tax benefit when times are good. Does the situation above sound like your life? Of course it doesn’t.

By Scott Einiger

The recent amendment of Subsection 48 to New York Education Law, Section 6530 and Section 230-d to the Public Health Law will likely have far ranging implications to physicians who perform office-based surgery. The new law requires accreditation on or before July 18, 2009 for the physician seeking to perform office-based surgery (OBS) in his or her office. Additionally, practitioners must consider prior opinions from the Department of Health (DOH) governing corporate structure and the New York State self-referral laws ("mini-Stark") to avoid potential violations of the corporate practice of medicine doctrine, illegal fee sharing and licensure requirements that could have repercussions to the physicians' license and his or her livelihood. Finally there will be an enormous economic impact as the market shifts to embrace this new facility construct as cost containment is a central feature of the evolving health care delivery system.

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

As frequent speakers to physicians on asset protection and advanced planning, we are often asked about captive insurance companies (CICs). Certainly, CICs can be ideal tools if they are created for the right type of practice and are established and maintained properly. In this article, we will examine the benefits and costs of CICs and then demonstrate a case study of two doctors who use CICs to significantly enhance many areas of his comprehensive financial planning.

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

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.

Even in medical practices that are larger, and have a significant number of younger physicians, most doctors maintain the same complaint. While they may typically have a right to a few of months of payments from accounts receivable (AR) after they retire, this is a pittance compared to the value they have brought to the practice over the years. We would agree with them in this assessment -- a few months of AR certainly does not compensate a physician for 20+ years of building a practice and its reputation.

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

Over the past few years, we have written many articles on potential strategies that a doctor can use to reduce income taxes, increase benefits, or build retirement savings. In that time, we have also consulted with hundreds of medical groups on how to implement such strategies for their practice. Unfortunately, these consultations too often turn out to be less than fruitful because of office politics.

Typically, while the younger members of the group are very motivated to reduce their income taxes, the older doctors are often uninterested. Either they are already so close to retirement that don't need extra retirement planning or they are simply set in their ways and don't want to change anything - the old "if it ain't broke, don't fix it" mindset. The result: planning gridlock.

By Scott Einiger

The advent of the internet has led to enticing advertising and communication prospects. Through this forum the medical community has access to an unlimited patient market that reaches out across the globe. Persons with professional licenses, however, need to be wary of the potential liability faced when marketing a medical practice across state lines. While utilizing this medium has a huge potential upside, the myriad of laws, both state and federal, create liability exposure that can implicate civil, licensure and even criminal laws.

By C. L. Huddleston, J.D.

Physicians think that because of their medical training and/or their resources, they should know how to deal with aging ... theirs or their parents., but even physicians do not understand the enormous challenges of aging until they have experienced it. Help is available, and it is unfair to yourselves and your loved ones to ignore the basics of planning for aging and declining capacity.