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.

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.

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.