You spent a decade learning medicine. Nobody taught you the tax code is written against you.
Published IRS data shows physicians pay 35-40% effective tax rates when structures exist to bring that to 28-32%. The gap isn't intelligence — it's architecture. Most practices are structured for compliance, not optimization.
Based on typical client scenarios. Individual results vary depending on your specific situation.
The problems hiding in plain sight.
These are the issues we see most often with healthcare & medical businesses. Most owners don't know they have them.
You're Auto-Renewing Malpractice and Overpaying Every Year
Most practices auto-renew malpractice without shopping it. Carriers count on this inertia. Published industry data from medical professional liability associations shows that re-quoting every 2-3 years typically saves 15-25% — with equal or better coverage. Your claims history, practice size, and specialty all change. Carrier appetites change too.
Your Practice and Your Building Are in the Same Entity
If your practice owns the building it operates in, a malpractice judgment can reach both. The American Bar Association and every asset protection attorney will tell you the same thing: the building should be in a separate entity. This protects the real estate from practice liability, creates rental income flexibility, and makes a cleaner exit path when you're ready to sell the practice but keep the property.
Your Benefits Package Is Losing You Staff — or Costing You Too Much
Healthcare staff turnover costs $5-15K per position in recruiting and training, according to the Medical Group Management Association. Right-sizing your benefits package — ICHRA instead of traditional group, HSA optimization, strategic retirement matching — is almost always cheaper than constant recruiting. Most practices are either overspending on benefits or underspending on the ones that matter.
You're Maxing Out a 401(k) When You Could Shelter $200K+
Physicians and practice owners over 45 can shelter $150-250K per year through cash balance and defined benefit plans — well beyond the $23K 401(k) limit. The IRS publishes these contribution limits. Most CPAs don't suggest this because it requires actuarial work they don't do. Every year you wait is a year of six-figure tax savings you can't recover.
Want to see what you're leaving on the table? A 30-minute Foundation Review built specifically for healthcare & medical.
Book Your Healthcare & Medical Review →What healthcare & medical owners get wrong.
And what to do instead.
Keeping practice ownership and real estate in the same entity +
Auto-renewing malpractice insurance without shopping it +
Under-utilizing health savings accounts and defined benefit plans +
No disability insurance on key revenue-producing providers +
Where the money actually is.
Opportunities we typically identify for healthcare & medical businesses — and coordinate with your tax and legal professionals to capture.
What a Foundation Review actually looks like.
An anonymized engagement from our work with healthcare & medical businesses.
Multi-Provider Medical Practice
$6.2M annual revenueA five-physician practice had been focused on clinical growth but had neglected the financial infrastructure underneath. The two founding physicians — who generated 60% of revenue — had no disability insurance. The group's retirement plan was an off-the-shelf 401(k) that wasn't optimized for high-earning owners. Malpractice was up for renewal.
- No disability insurance on the two highest-revenue providers — if either was injured or ill, the practice would lose 30% of revenue with no income replacement and no way to cover their overhead
- 401(k) plan was leaving $180K+ per year on the table: a cash balance plan layered on top would shelter significantly more for the senior physicians while still offering competitive benefits to staff
- Malpractice re-quoting across three carriers showed potential savings of $45K annually — consistent with published MGMA benchmarks for practices that haven't shopped coverage in 3+ years
- Also identified: entity restructuring opportunity (separating real estate from practice for asset protection) referred to their attorney
The Foundation Review placed own-occupation disability policies on both founding physicians (through Ash Brokerage), restructured the retirement plan to include a cash balance component, and re-quoted malpractice at renewal. The disability coverage alone closed a $2.4M income protection gap. Retirement plan optimization added $180K/year in tax-advantaged savings for the owners.
Details anonymized and modified. Individual results vary — your Foundation Review will be specific to your situation.
We've sat in your chair.
Not just advisors — operators.
Most financial advisors look at your business from the outside. Our team has actually been inside — as internal CFOs, management consultants, and business operators. We've built the financial models, managed the cash flow cycles, and navigated the entity structure decisions firsthand.
That means when we look at your situation, we're not guessing. We've seen the patterns from the operator's seat — and we know which moves actually move the needle.
Good Deals is an independent fiduciary. We don't work for an insurance company or a wirehouse. We work for you. No proprietary products, no sales quotas — just the best path forward for your specific situation.
- CFA charterholder — one of the most rigorous credentials in finance
- Internal CFO experience — we've managed P&Ls, cash flow, and entity structure from the inside
- Management consulting background — financial modeling, growth strategy, and M&A advisory for businesses from startup to $50M+
- Licensed insurance professionals — life, disability, and commercial coverage, not just referrals
- Independent and fiduciary — legally required to act in your best interest
- Austin, TX based — we know the local market, the tax landscape, and the business community
Ready to keep more of what you earn?
30-minute conversation built for healthcare & medical. No pressure. We'll look at your specific situation and identify the highest-leverage opportunities.
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