Practical guides on tax planning, bookkeeping, and financial strategy — written for independent health practices.
Make sure you're getting the basics right. This checklist covers the foundational tax strategies every medical practice owner should have in place — entity structure, retirement plans, deductions, and more.
Quick-reference PDF
Tax strategy, practice finances, and real-world advice for independent practice owners.
Why filing on time isn't the same as saving money. The difference between reactive compliance and proactive strategy.
How S-Corp election works, when it makes sense, and how to set reasonable compensation the right way.
Side-by-side comparison of retirement plan options for practice owners. Contribution limits, flexibility, and tax impact.
Common patterns that cost practice owners thousands. What to watch for and how to fix them before filing.
The IRS is watching your S-Corp salary. Here's how to determine what "reasonable" actually means for your practice.
Don't let the tax tail wag the dog. How to evaluate equipment purchases with real ROI analysis, not just deduction math.
The quarterly rhythm that eliminates tax surprises. How to project, estimate, and stay ahead all year.
The 15 things you should review before December 31. A structured approach to year-end optimization.
How solo and small practice owners can put away $60k+ per year tax-advantaged. Plan structure, contribution strategy, and common mistakes.
What triggers a tax audit — and why good documentation is your best defense. Avoid these common red flags that put practices on the IRS radar.
Your bookkeeping should do more than keep you compliant. Here's how clean books translate directly into real tax savings.
The retirement plan most practice owners don't know about. How cash balance plans let high-income doctors shelter significantly more than a 401(k) alone.
Quarterly estimated taxes don't have to be a guessing game. A structured approach to paying what you owe — and not a dollar more.
A legitimate tax strategy — if you follow the rules. How to hire family members in your practice and document it properly.
Many practice owners miss the home office deduction because they think it doesn't apply. Here's when it does — and how to claim it correctly.
Most practice owners underutilize their CPA. Here's how to turn a compliance relationship into a strategic advantage.
If you're paying for health insurance as a practice owner, you may be eligible for an above-the-line deduction. Here's how it works.
Two methods, very different outcomes. How to choose the right vehicle deduction method for your practice and document it properly.
Not every practice needs a tax planner on day one. Here are the signals that it's time to go beyond basic tax prep.
Timing matters. The decision to elect S-Corp isn't just about tax savings — it's about when the numbers make sense for your specific practice.
A packed schedule doesn't mean a healthy bank account. Here's the cash flow system that changes everything.
The 7 KPIs that tell you exactly how your practice is performing. No MBA required.
The bank account system that answers the hardest question in practice ownership — "Can I take a draw this month?"
Tax preparation is filing your returns accurately and on time — it's backward-looking compliance. Tax planning is proactive: identifying strategies throughout the year to reduce your tax liability before the return is even filed. Good tax planning includes quarterly projections, entity structure optimization, retirement plan analysis, and year-end strategy implementation. Most practice owners only do preparation but benefit significantly from planning.
Generally, S-Corp election makes sense when your net practice income consistently exceeds the reasonable compensation you'd pay yourself as a W-2 salary. The savings come from avoiding self-employment tax on the distribution amount. For most solo medical practices, this tipping point is around $80,000-$100,000+ in net income. However, the right answer depends on your specific situation, state taxes, and retirement plan strategy. An improper S-Corp election can actually cost more than it saves.
The 10 numbers that matter most for independent practices: total collections (month-to-date), payroll as a percentage of revenue, overhead ratio, owner compensation, cash on hand, accounts receivable aging, patient visit volume, revenue per visit, operating margin, and tax reserve balance. These give you a clear picture of practice health without drowning in data. Our free KPI checklist breaks down each metric and what to look for.
The IRS requires "reasonable compensation" — a W-2 salary that reflects what you'd pay someone to do your job. For medical practice owners, this depends on your specialty, location, hours worked, and practice revenue. Setting it too low risks IRS penalties; setting it too high means unnecessary payroll taxes. The right number should be documented and defensible, typically based on comparable salary surveys for your specialty and market.
It depends on your goals and income level. A Solo 401(k) works well for solo practices and allows up to $72,000+ in annual contributions (2026). A Safe Harbor 401(k) is ideal if you have employees and want to maximize your own contributions without discrimination testing. Cash Balance Plans can layer an additional $100,000+ per year for high-income practice owners. SEP IRAs are simpler but may not maximize savings. The best approach often combines multiple strategies.
If something you read raised a question about your own practice, let's talk. The discovery call is free and there's no pressure.
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