The 2025 Tax Landscape: Insights on Changes and Planning Strategies, with CPAs Carole Foos & Greg Heimkreiter
Wealth Planning for the Modern Physician
Release Date: 02/05/2025
From Academia to Innovation: Redefining Pain Medicine with Dr. Peter Staats (Part 1)
Wealth Planning for the Modern Physician
In Part one of this two‑part conversation, Dr. Peter Staats shares the formative experiences that shaped his path into anesthesiology and pain medicine, beginning with his upbringing in Hawaii and the profound intellectual influence of his father, a pioneering academic psychologist. This early exposure to integrative thinking laid the groundwork for Dr. Staats’ approach to medicine, one that challenged traditional silos and emphasized the interconnectedness of behavior, psychology, and physiology. His medical training, initially aimed toward orthopedic surgery, ultimately shifted...
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Peer Review, Workplace Violence, and Protecting Your Career with Dr. David Koronkiewicz
Wealth Planning for the Modern Physician
Dr. David Koronkiewicz, a retired orthopedic surgeon and current leader in healthcare quality, safety, and risk management, joins the podcast to discuss two major issues affecting physicians today: the peer review system and workplace violence in healthcare. Drawing from more than 30 years in clinical practice and extensive experience in administrative leadership, he offers a rare, multidimensional perspective on how internal hospital processes can deeply impact a physician’s career, finances, and long‑term wellbeing. Koronkiewicz explains how peer review—originally intended to...
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Asset Protection Essentials for Physicians with Attorney Bo Loeffler
Wealth Planning for the Modern Physician
Attorney Bo Loeffler returns to the podcast to revisit with David the foundational principles of asset protection—what it is, why physicians need it, and how proper timing and structure make all the difference. The conversation begins with an overview of risk for physicians, from malpractice and employee claims to real estate liability and auto accidents and stresses the importance of addressing these risks before they arise. Bo and David emphasize the crucial concept that asset protection is only effective when implemented ahead of any foreseeable claim. The discussion then shifts to the...
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Ethical Entrepreneurship in Medicine: Building Smarter Practices with Dr. Paul Lynch
Wealth Planning for the Modern Physician
In this episode, host David Mandell welcomes Dr. Paul Lynch, a double board-certified anesthesiologist and pain management specialist, entrepreneur, and business leader. Dr. Lynch shares his remarkable journey from aspiring psychiatrist to pain medicine innovator—a shift inspired by his mother-in-law’s battle with cancer and the discovery of interventional pain treatments that could transform patients’ lives. His early experiences at the Mayo Clinic shaped his belief in comprehensive, integrated care—a philosophy that became the foundation for his first practice, Arizona Pain, which...
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Thriving in a Changing Healthcare Landscape with Jerry Kelsheimer
Wealth Planning for the Modern Physician
In this episode of the Wealth Planning for the Modern Physician Podcast, David Mandell welcomes back Jerry Kelsheimer, President of Medic Management Group. With decades of experience in healthcare business management, Jerry discusses how the healthcare landscape has changed dramatically over the past five years, affecting physicians' financial performance and operational efficiency. He outlines the evolving challenges medical practices face—including reduced reimbursements, higher labor costs, and increasing patient demands and stresses the importance of disciplined, intentional business...
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The Journey from Pediatrics to Scrub Sisters with Dr. Jacqueline Winkelmann
Wealth Planning for the Modern Physician
In this episode of the Wealth Planning for the Modern Physician Podcast, host David Mandell welcomes Dr. Jacqueline Winkelmann, a pediatric hospitalist and founder of Scrub Sisters. Dr. Winkelmann shares her journey from growing up in Puerto Rico, being inspired by her uncle's compassion and dedication to medicine and eventually pursuing pediatrics as her calling. She discusses how financial foresight and a unique tuition waiver allowed her to graduate debt-free, enabling her to maintain a balanced career and family life as a part-time physician at the Children's Hospital of Orange County. Dr....
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Innovation, Industry, and Ancillaries: Lessons from Dr. Jack Bert (Part 2)
Wealth Planning for the Modern Physician
In this second part of a two-part episode, host David Mandell continues his discussion with Dr. Jack Bert, a board-certified orthopedic surgeon and former president of the Arthroscopy Association of North America. In this conversation, Jack emphasizes the importance of ancillaries in building a financially successful medical practice. He explains how orthopedists and other specialists can significantly increase revenue streams through owning or participating in ambulatory surgery centers (ASCs), imaging services, physical therapy, and durable medical equipment. Dr. Bert stresses that...
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Innovation, Industry, and Ancillaries: Lessons from Dr. Jack Bert (Part 1)
Wealth Planning for the Modern Physician
In this first part of a two-part episode, host David Mandell welcomes Dr. Jack Bert, a board-certified orthopedic surgeon and former president of the Arthroscopy Association of North America. Dr. Bert shares his background, including his training at Northwestern, Temple, and the Mayo Clinic, as well as his career—building one of the first outpatient ambulatory surgery centers in Minnesota. He highlights how his practice expanded from a solo effort into a large multi-location group, providing insight into the evolution of orthopedic practice models. Dr. Bert reflects on the influences that...
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How Practices Can Build the Right Physician Comp Models Today and Beyond with Attorney Jason Greis
Wealth Planning for the Modern Physician
In this episode, host David Mandell welcomes back attorney Jason Greis for his third appearance. Jason, a healthcare business attorney with extensive experience advising physician practices, discusses one of the most pressing issues for independent groups today: physician compensation models and partnership structures. With generational shifts and economic realities reshaping the field, many practices are rethinking what it means to become a partner and how to fairly compensate both younger and senior physicians. Jason explains how compensation models have evolved from the 1980s and 1990s to...
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The Journey from Solo Practice to Industry Leader with Dr. Cynthia Matossian
Wealth Planning for the Modern Physician
In the Season 6 premiere of the Wealth Planning for the Modern Physician Podcast, host David Mandell welcomes Dr. Cynthia Matossian, an accomplished ophthalmologist, entrepreneur, and industry leader. Dr. Matossian shares her unique journey into medicine, starting from an initial interest in political science and international relations before ultimately discovering her passion for ophthalmology. She discusses the early challenges she faced in starting her own practice in 1987, particularly as a woman seeking financial backing in a male-dominated field, and the resilience and determination...
info_outlineListen in as host David Mandell sits down with Carole Foos, CPA from OJM Group and Greg Heimkreiter, JD, CPA from Howard, Nunn & Bloom, Inc.
David asks both Carole and Greg to give their key insights on the tax landscape as we enter 2025 with a new party in control of both the White House and Congress. Carole begins with a discussion of potential changes to individual tax rates and Greg mentions the SALT limitations and dives into estate tax issues as well.
David then chats with Carole about retirement plan changes due to the Secure Act, new planning opportunities coming online in 2025, and the continued importance of tax diversification.
Greg then shifts the discussion to corporate taxation, including the possibility that C corporations may come back into more utility for medical practices and other small businesses.
Carole and David then discuss Qualified Opportunity Zone investments and how the deferred tax is going to be coming up for payment soon and what that means for 2025 tax planning.
David concludes asking both Carole and Greg for their input on the changes in the accounting industry and why so many physicians and practices are having difficulty finding good firms who want to provide tax return preparation services.
KEY POINTS
Tax Uncertainty in 2025: With potential changes to tax laws due to a new administration, tax planning remains a "wait and see" process, especially for individuals and businesses.
Expiring Tax Cuts: Key provisions of the 2017 tax reforms, including lower individual income tax rates and increased standard deductions, are set to expire at the end of 2025 unless extended.
Estate Tax Exemptions: Current estate tax exemptions of $13 million+/- per individual ($27 million for married couples) could be halved if laws revert in 2026, raising planning concerns.
SALT Deduction Limit: The $10,000 cap on state and local tax (SALT) deductions is a significant pain point, particularly for taxpayers in high-tax states like California and New York.
Retirement Plan Changes: The Secure Act 2.0 introduces supersized catch-up contributions for ages 60-63 in 2025 and expands options for Roth contributions, encouraging tax diversification.
Opportunity Zones: Taxes deferred through qualified opportunity zone investments will become due in 2026, requiring proactive liquidity planning for investors.
Inherited IRA Rules: New rules require most beneficiaries to withdraw inherited IRA funds within 10 years, potentially accelerating tax liability.
Business Tax Considerations: Proposed reductions in C corporation tax rates from 21% to 15% and changes in bonus depreciation rules could shift entity structuring decisions.
Qualified Business Income (QBI): The QBI deduction benefits pass-through entities but is not available to most high-income professionals, particularly medical practices.
Industry Shifts in Tax Preparation: A shortage of accountants and outsourcing trends have made finding quality tax preparation services more challenging for individuals and small businesses.
Roth IRAs and RMDs: Funding Roth accounts now can reduce future required minimum distributions (RMDs), offering long-term tax benefits.
Accelerated Depreciation: Businesses, including medical practices, may benefit from restored 100% bonus depreciation for assets like equipment.
Tax Diversification for Retirement: Balancing assets in different tax treatment "buckets" (e.g., Roth, traditional accounts) enhances flexibility and minimizes tax burdens in retirement.
Future of C Corporations: Lower corporate tax rates could make C corporations more attractive, but double taxation remains a potential downside.
Challenges in Accounting Industry: Many firms are shifting away from individual tax returns, emphasizing the importance of finding specialized services that align with clients' needs.
Learn more, including additional show notes, links, and more, by visiting physicianswealthpodcast.com.
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