You opened the practice to treat patients, not to read 200 pages of tax code. We design the retirement plan, run cost seg on the building, set reasonable S-Corp comp, and keep your locum 1099s defensible.
High-earning practice owners are the textbook case for a defined benefit / cash balance plan. Almost none of you have one because the conversation never came up. We have it.
A solo practitioner age 50+ can shelter $150K to $300K per year in a cash balance plan stacked on top of a Solo 401(k). The IRS lets you fund it with deductible contributions. Annual actuarial filing required. We coordinate with a TPA and keep the plan compliant.
IRC §401(a), §404(o), §415(b); ERISA §302Dental chairs, CBCT, autoclaves, surgical lasers, x-ray equipment. Up to $1,160,000 of §179 expensing for 2024 plus 60% bonus depreciation on what doesn't fit §179. We time purchases against year-end income so the deduction lands when you need it.
IRC §179; §168(k); Rev. Proc. 2023-34You own your practice building? A $1.2M building gets carved into 5, 7, and 15-year property buckets, generating $200K to $350K in first-year depreciation. Even better if you own through a separate LLC and lease to the practice (self-rental rules apply, we handle them).
IRC §168, §469(c)(7); Rev. Proc. 87-56; Treas. Reg. §1.469-2The IRS targets medical S-Corps for low-comp positions. Watson, Glass Blocks, Davis: all on point. We benchmark your specialty, region, and patient volume against industry comp surveys (MGMA, ADA) so your salary holds up while you take the rest as distribution.
IRC §1402(a); Rev. Rul. 59-221; Watson v. US; Glass Blocks v. Comm.Malpractice premiums are fully deductible business expenses. Disability insurance on the owner is generally NOT deductible (so benefits stay tax-free). Group DI for staff IS deductible. We structure the mix so you don't accidentally make future benefits taxable.
IRC §162(a); §104(a)(3); §106Worker classification audits hit medical practices hard. Locum coverage on your DEA, your equipment, your patient list looks like W-2 to the IRS. We document the indicia of independent contractor status (Form SS-8 factors) and structure the engagement so it survives a 1099-NEC challenge.
IRC §3121(d); Rev. Rul. 87-41; Form SS-8Solo dentist, age 52, S-Corp, $410K net practice income 2024. We designed a cash balance plan stacked on a Solo 401(k) and ran §179 on $185K of new equipment.
$142,000 shelteredTotal deductible contributions plus §179 in 2024. Roughly $52,000 in federal + FL tax saved at marginal rate, plus future tax-deferred growth.