The first half of the year is already written. For surgeons who own their practice, that makes midyear the most underused planning window on the calendar. In one Saturday, you can run a simple “halftime report” on five numbers—income, tax liability pacing, retirement contribution progress, practice overhead, and personal spending rate—and make small adjustments while they’re still cheap. This framework helps surgeon‑owners avoid fourth‑quarter scrambles, smooth cash flow, and turn more of a surgeon‑level income into lasting wealth.