Open enrollment isn’t just a benefits paperwork exercise — it’s a tax planning opportunity. For orthopedic surgeons and other high-income physicians, the way you structure your health insurance, HSA, healthcare FSA, and dependent care FSA elections can materially impact your tax bill and long-term wealth. This article breaks down the 2026 limits, HDHP eligibility rules, and practical strategies to optimize your benefits before you lock in elections for the year.

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.

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.