Practical write-ups and the MD-Universe Podcast — on licensing, reimbursement, and the business of medicine. Free, no account needed.
PSLF's 120-month clock counts qualifying employment, and for most physicians it started in July of intern year. Buyback converts forbearance months into qualifying payments priced at the income you had then — and a 2023 rule opened the program to California and Texas physicians paid through medical groups.
The pass-through deduction rises to 23% in 2026 and the phase-out band widens by $50,000, which pulls a lot more physician owners inside it. Inside that band, every dollar your practice puts into a retirement plan destroys 23 cents of deduction — so the standard advice to max everything tax-deferred stops being automatically right.
Captive insurance is legal and legitimate versions exist. It is also one of the most reliable ways for a high-earning physician to end up in a multi-year IRS examination.
Training is the only stretch of a medical career with a low income and high-stakes financial decisions happening at once. Some of the standard advice survives scrutiny. Some of it does not.
Buying umbrella coverage is the easy part and almost every physician eventually does it. The problem is believing it covers more than it does, and finding the boundary only after a claim is filed.
Most physicians buy disability insurance once and never reopen it. The base policy is the easy half — the riders decide whether it pays in the situations that actually happen.
The mechanics are two steps and take ten minutes. Almost every expensive mistake happens somewhere other than those two steps — in old accounts, missed forms, and money left sitting still.
Sixteen strategies, from the buckets every physician should fill first to the six-figure real-estate plays — and the gimmicks to leave alone.
Put in $100,000, borrow $1.9 million, collect 13% in US dollars with no currency risk. The product is real and the math checks out — but for a US-taxed physician one number decides the whole thing, and no video mentions it. Window closes 30 September 2026.