Most orthopedic surgeons look at tax returns and assume that number is what their practice is worth. In reality, buyers use normalized EBITDA—adjusted for owner pay, personal expenses, and one-time costs—to decide what they’ll actually pay. This article shows how to estimate normalized EBITDA and use it to negotiate from a position of strength.

When you sell your orthopedic practice, the IRS cares how much of the price is the business—and how much is you. This article explains personal vs. enterprise goodwill, why early documentation matters, and how thoughtful planning can translate into six‑figure tax savings at exit.

Private equity offers orthopedic surgeons big multiples and polished pitch decks—but the real story lives in the fine print. This article walks through how rollover equity, compensation resets, EBITDA ‘engineering,’ and PE hold periods actually work in many orthopedic deals. It then shows, with a simple $4M practice sale example, how planning around personal goodwill and deal structure can change a surgeon’s federal tax bill by hundreds of thousands of dollars. If you’re an orthopedic surgeon being courted by private equity, this is the pre‑dinner framework to read before you say yes—or no.

Most surgeons wait until 12–18 months before retirement to think about selling their practice—by then, leverage and tax options are already limited. This article lays out a five‑year, physician‑specific exit protocol that helps you separate personal goodwill, diversify revenue, recruit an associate, and structure a sale that supports both your valuation and after‑tax proceeds.

Most surgeons get second opinions in the OR, not in their financial lives. This article shows how a coordinated review of entity structure, retirement plan design, tax strategy, and investments can uncover six‑figure opportunities hiding between your CPA, advisor, and attorney.

Most surgeons move on after filing taxes, but the months between April 15 and year-end can be the most important planning window of the year. This article explains four high-impact moves—S-Corp salary review, cash balance plan setup, entity structure evaluation, and Roth conversion analysis—and why acting earlier creates more options

For years, “just do the backdoor Roth” was default advice for high‑earning surgeons. But after 2025’s OBBBA changes, that rule of thumb can quietly cost you money. This article walks through a simple three‑branch framework to decide when Roth still wins, when traditional and cash balance contributions create more value, and how your state‑to‑state tax trajectory can flip the answer. Before you fund another backdoor Roth on autopilot, model both paths and let the math—not the calendar—drive the decision.

Most surgeons never read their tax return the way they read an MRI. This article shows you four diagnostic markers—effective tax rate, QBI, retirement funding, and state tax—that reveal whether your financial structure is working or leaking.

Most surgeons track collections, not what they actually keep per clinical hour. In this article, I walk through a real‑world style example of a 2.4M orthopedic practice and show how overhead, tax structure, retirement plan design, and debt service combine to create a much lower effective hourly rate than most surgeons expect—and how targeted structural changes can raise that rate without adding a single additional case.

Medicare’s 2.5% efficiency adjustment feels like a small cut with big consequences for orthopedic surgeons. This article walks through why “doing more cases” is often the least efficient response, and how tightening overhead, rethinking income flows, and coordinating tax and entity structure can help protect your practice’s profitability without adding more OR time.

Many S-Corp owners are told to “keep your salary as low as possible” to save on payroll taxes—but at higher income levels, that advice can quietly cost you six figures in lost retirement wealth. This article shows Orthopedic Surgeons how to align salary, QBI, and 401(k)/cash balance contributions so their tax strategy actually builds wealth.

High-earning orthopedic surgeons aren’t overtaxed—they’re understructured. Learn how S-Corp salary tuning, cash balance plans, and cost segregation can plug $80K–$130K+ in annual tax leaks and build long-term wealth.

Budgeting, expense tracking, financial planning - all of these things can be beneficial for creating a strong financial foundation and help to increase the quality of your life. But being able to document your life by tracking where your money goes was something entirely new to me when I first heard about it.

Not many will argue with the merits of donating to charity. But some would say that if you allow your wealth to build over a longer timeframe, you could end up having a much greater impact on society.

I've heard many debate this topic, with valid points on either side. But there is one clear winner when you run the numbers. Just make sure you are assessing all of the numbers, and not missing out on some crucial information.

For so many kids, graduating from High School means immediately heading off to college. But this shouldn't be the path for everyone. Many should take some time off to truly figure out their next steps. And for some, they shouldn't go to college at all.

Financial freedom might be your goal, but what about the time from now until you reach that goal? If you want to live a great life characterized by having control, you need to be willing to make smart money decisions.

It can be hard to know what the best decisions for your finances are. There is a battle between living your best life, now, and saving for the future. The more you focus on one, the more the other suffers. So, which is it? Each person is different, but there are two lifestyles everyone should avoid!

Buying a home is a big step in most people's lives. But it doesn't come without a lot of decisions to make, and potential pitfalls to avoid. One question is around if you should have at least 20% of the purchase price when buying real estate. In this article, we discuss the pros and cons, and when it makes sense.

Lifestyle design is all the rage these days, and it seems like everywhere you go people are "living their best life." The problem is, most people have skipped the foundational parts of designing their lifestyles and jumped straight to enjoying it - which is leading to big issues!