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EDITORIAL BOARD ROBERT M. GOLDMAN, MD, PhD, DO, FAASP World Chairman-International Medical Commission Co-Founder & Chairman of the Board-A4M Founder & Chairman-International Sports Hall of Fame Co-Founder & Chairman-World Academy of Anti-Aging Medicine President Emeritus-National Academy of Sports Medicine (NASM) DR. RONALD KLATZ, MD, DO, is the physician founder and President of the American Academy of Anti-Aging Medicine. In 1984, Dr. Klatz was a pioneer in the clinical specialty of preventative medicine: as a principal founder of the National Academy of Sports Medicine and researcher into elite human performance and physiology. Dr. Klatz is a best-selling author, and is columnist or Senior Medical Editor to several international medical journals. He is the inventor, developer, or administrator of 100-plus scientific patents, including those for technologies for brain resuscitation, trauma and emergency medicine, organ transplant and blood preservation. DAVID B. MANDELL, JD, MBA, is a former attorney and author of ten books for clients, including For Doctors Only: A Guide to Working Less & Building More, as well a number of state books. He is a principal of the financial consulting firm OJM Group He has co-authored the Category I CME Monograph Risk Management for the Practicing Physician which has gone through 5 editions since 1998 & is certified for 5-hour business of medicine CME MANON PILON, Speaker, International Educator, SPA & Medical SPA Specialist – Mrs. Manon Pilon’s background spans over twenty-seven years of professional experience in SPA and MEDICAL SPA operation and management, marketing strategies, Medical Spa concept and development, and motivation methods. She is holding senior management positions in companies such as Europe Cosmétiques, CurAge Med, CurAge Spa, and Europelab. Founder of a private Aesthetics Professional School in Montreal, Canada.
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Tax Returns
DAVID B. MANDELL, JD, MBA, is an attorney
DO YOU REALIZE THAT AFTER THE TAX INCREASES OF RECENT YEARS
PAIN RELIEF FOR NEXT TAX RETURN Four Tax-Saving Ideas You Can Do Now
and author of five national books for doctors, including For Doctors Only: A
By DAVID B. MANDELL, JD, MBA CAROLE FOOS, CPA
Guide to Working Less & Building More, as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com, where CAROLE C. FOOS, CPA is a principal and lead tax consultant.
They can be reached at 877-656-4362 or
As a physician, do you realize that, after the tax increases of recent years -- between income, capital gains, Medicare, self-employment and other taxes -you likely spend between 45 to 55 percent of your working hours laboring for the IRS and your state? That is a lot of time with patients for someone else’s benefit. Given this, shouldn’t your advisors be giving you creative ways to legally reduce your tax liabilities? How many tax-reducing ideas does your CPA regularly provide you? If you are like most physicians, you get very few tax planning ideas from your advisors.
thousands of dollars annually with the right analysis and implementations. Issues here include:
Given these sobering facts, the purpose of this article is to show you four ways to potentially save and possibly motivate you to investigate these planning concepts early in the year when you can best take advantage of them. Let’s examine them now:
• Using the legal entity with maximum tax/benefits leverage – whether that is an S corporation, C corporation, LLC taxed as S, C, partnership or disregarded entity • Using a multi-entity structure to take advantage of two types of entities and their tax/benefit advantages • Managing the payment of salary, bonus, distribution, partnership flow-through to take advantage of maximum retirement benefits and minimize income, social security and selfemployment taxes • Considering benefit plans beyond the typical profitsharing/401(k) with which most medical practices start and end their benefit planning
1. Use the Right Practice Entity/Payment Structure/Benefit Plans These areas are where the vast majority of tax mistakes are made by doctors today – and where many of you reading this could benefit by tens of
2. Don’t Lose 17-44 percent of Your Returns to Taxes; Explore Investment Managers Who Manage with Taxes in Mind It is quite well known that most investors in mutual funds have no control of the tax hit they take on their
mandell@ojmgroup.com
YOU SPENT 45 TO 55% OF YOUR WORKING HOURS LABORING FOR THE IRS? funds.What you might not know is how harsh this hit can be. According to mutual fund tracker Lipper, “Over the past 20 years, the average investor in a taxable stock mutual fund gave up the equivalent of 17 to 44 percent of their returns to taxes.” 17-44 percent! Obviously, over 20 to 30 plus years of retirement savings, losing one sixth to about half of your returns to taxes can be devastating to a retirement plan. Nonetheless, too many physician investors settle for this awful taxation.
3. Gain Tax-Deferral, Asset Protection through Cash Value Life Insurance Above, you learned about the 17-44 percent tax hit most investors take on their investments in stock mutual funds. Similar funds within a cash value life insurance policy will generate NO income taxes – because the growth of policy cash balances is not taxable. Also, nearly every state protects the cash values from creditors, although there is tremendous variation among the states on how much is shielded.
While a 17-44 percent tax bite is unpleasant, these numbers will likely be worse now as compared to the prior time period, as federal capital gains and dividend rates now reach 20 percent for some taxpayers (where they were 15 percent before) and the Affordable Care Act tax added another 3.8 percent for high income taxpayers as well. Of course, state taxes are an addition to these federal taxes. Such tax increases will only exacerbate the issue.
4. Consider Charitable Giving There are many ways you can make tax beneficial charitable gifts while benefiting your family as well. The most common tool for achieving this “win-win”is the Charitable Remainder Trust (CRT). A CRT is an irrevocable trust that makes annual or more frequent payments to you (or to you and a family member), typically, until you die.What remains in the trust then passes to a qualified charity of your choice.
How to avoid this problem? Consider working with an investment firm that designs a tax-efficient portfolio for you and communicates with you each year to minimize the tax drag on that portfolio. In a mutual fund, you have only one-way communication – the fund tells you what your return is and what the tax cost is. Working with an investment management firm, you get two-way communication, as the firm works with you to maximize the leverage of different tax environments, offset tax losses and gains, and other tax minimization techniques.
Conclusion This article gives you a few tax-saving ideas. For larger practices with $3-5 million or more of revenue, there are additional techniques that could offer significantly greater deductions. These are outside the scope of this article, but are mentioned in the articles on our website and are topics of our free e-newsletter. If you want to save taxes, the most important thing you can do is start looking for members of your advisory team who can help you address these issues in advance. Otherwise, you will be in this same position this April 15th…and next April 15th and the one after that.
Tax Returns
Income Tax
DAVID B. MANDELL, JD, MBA, is an attorney and author of five national books for doctors, including For Doctors Only: A Guide to Working Less & Building More, as well a number of state books. He is a principal of the financial consulting firm OJM Group www.ojmgroup.com, where CAROLE C. FOOS, CPA is a principal and lead tax
YOUR MEDICAL SPA IS TAXED AS AN S-CORPORATION
A COMMON TAX MISTAKE COULD BE COSTING YOU THOUSANDS ANNUALLY
consultant. By DAVID B. MANDELL, JD, MBA They can be reached at
CAROLE FOOS, CPA
877-656-4362 or mandell@ojmgroup.com
A
re you an owner of a medical practice taxed as a flow-through
The key difference between income earned as employee compensation (W-2) and that earned as a K-1 profit distribution is that you pay FICA (Medicare and Social
entity… such as an S-corporation?
Security) tax on the income earned as an employee but not
Most physicians are – in working with over 1,000
necessarily on K-1 profit distributions. While the large Social Security portion of FICA phases out after income of
doctors, we estimate that 70% of medical practices operate as S corporations.
$117,000 in 2014, the Medicare tax has no phase-out. Also, the Medicare tax increased from 2.9% to 3.8% in 2013 for higher income taxpayers, under the Affordable Care Act.
As such, you may be paid both as an employee of the practice – receiving a W-2 – and as an owner
While this is only a 3.8% tax, we have seen poor advice here cost physicians $10,000 or more each year, every year of their career. Over one’s career, this can amount to nearly
of the practice –through a K-1 distribution.
MEDI CAL SPAS • April/May 2015
half a million dollars of lost capital… for no good reason!
www.medicalspasreview.com
70% OF MEDICAL PRACTICES OPERATE AS S CORPORATIONS LET’S LOOK AT TWO EXAMPLES.
so many physicians come to us in the same position
DO YOU SEE YOURSELF IN ANY OF THESE?
–having all, or most, of their income treated as W-2 compensation when in fact much of it is earned because of
1. Dr. Smith is part of a three-doctor cardiology
the profitability of the practice rather than the doctor’s
practice. He earns about $400,000 annually as a
personal services.Wouldn’t all of us prefer to be in Dr. Jones’
cardiologist. He calls the two other doctors “partners” but
situation? If we are allowed to be – yes. So, the question
technically they are co-owners of the practice, an S-
really comes down to – what are the tax rules that govern
corporation. Each month, Dr. Smith gets paid $20,000. Then
this situation?
at the end of each six month period, he gets another $80,000 based on the practice’s performance. His
In discussions with a number of CPAs with over 15 years of
accountant deems both the monthly and semi-annual
experience, the consensus is that one should follow a simple
payments to be salary payments. Thus, he pays Medicare
rule: basically that one can reasonably be paid as a W-2
tax on all $400,000 for a tax of $12,950 at the new 3.8% rate
salary what one would need to pay an associate
on wages exceeding $250,000 and at 2.9% on the first
physician with the same training to come join your
$250,000 of wages. This, of course, is in addition to state
practice. The rest of your compensation can be
and federal income taxes, property taxes, etc. If he works for
characterized as distributions. One CPA, practicing for over
25 years earning the same income, he will have lost over
20 years, commented “this is what I do for my clients, and
$645,000 in Medicare taxes, assuming a 5% growth rate.
when the issue has been discussed in audits over the years, the IRS finds it very difficult to argue that our client should
2. Down the road, Dr. Jones is in the exact same economic situation. However, his CPA treats the monthly
be paid more on their W-2 than a staff member doing the same job.”
payments as W-2 wages and the semi-annual payments as K-1 distributions of the profit earned by the practice. Thus,
Looking again at the examples above, Dr. Smith could easily
he pays Medicare on $240,000 for a cost of $6,960. If Dr.
attract another cardiologist to his practice paying $250,000
Jones works for 25 years earning the same income, he will
salary. This would allow him to avoid Medicare tax on
have lost about $350,000 in FICA taxes, assuming a 5%
$150,000 – saving over $5,500 annually. Not coincidentally,
growth rate – an improvement of $295,000 over Dr. Smith.
Dr. Jones is in the right situation.
The above cases are hypotheticals and any change or
As hard as physicians work, throwing away hundreds of
deviation from the circumstances discussed above could
thousands of dollars over a career – for no good reason – is
affect the outcome. However, obviously, you would not want
a shame.Yet it happens every day. ■
to be Dr. Smith. Yet, we are continually astounded when see
www.medicalspasreview.com
MEDI CAL SPAS • April/May 2015
Income Tax
Investment Taxes
CAROLE FOOS, CPA IS AN ACCOUNTANT AND CO-AUTHOR OF FOR DOCTORS
ONLY: A GUIDE TO WORKING LESS & BUILDING MORE, AS WELL A NUMBER OF STATE BOOKS. SHE IS ALSO TAX CONSULTANT AT OJM GROUP
(WWW.OJMGROUP.COM).
ANDREW TAYLOR, CFP®
MEDICAL PRACTICES ARE MOVING INTO AN ERA OF HIGHER TAXES
SIX STEPS
TO REDUCE
TAXES
ON INVESTMENTS CAROLE C. FOOS, CPA ANDREW TAYLOR, CFP®
Individuals in the highest income tax brackets discovered unpleasant surprises this year when they learn of their
IS AN INVESTMENT ADVISOR AT
investment tax liability. In 2013 domestic equities provided investors with returns they have not witnessed since the
OJM GROUP.
late 1990s. This successful year for U.S. stocks was accompanied by the implementation of The American Taxpayer Relief Act of 2012 that caused an increase in the top marginal tax rate to 39.6%, an increase in long term capital
THEY CAN BE REACHED AT 877-656-4362 OR CAROLE@OJMGROUP.COM
gains and dividend tax rates to 20% for those same taxpayers, and a 3.8% surtax on net investment income (commonly referred to as the Medicare Tax). The confluence of these two events may mean higher taxes for you.
Proper tax planning becomes more critical as we move into an era of higher taxes. Five years of a rising stock market equates to many traditional investment vehicles holding large amounts of unrealized gains that can become realized gains if you are not careful. In this article, we will provide you with six suggestions that could save you thousands of dollars in investment taxes over the next several years.
1. Account Registration Matters: If you are reading this
when you enter the distribution period of your investment
article you likely have a reasonable amount of investment
life cycle. Master Limited Partnerships offer a potentially
experience and have become familiar with the benefits of
advantageous income stream for a brokerage account,
security diversification in your portfolio. However, a
while it is generally preferable for qualified accounts to own
common mistake investors make is failure to implement a
high yield bonds and corporate debt, as they are taxed at
tax diversification strategy. Brokerage accounts, Roth IRAs,
ordinary income rates. There are countless additional
and qualified plans are subject to various forms of taxation.
examples we could discuss, but the lesson is it is important
It is important to utilize the tax advantages of these tools to
to review the pieces of your plan with an advisor who will
ensure they work for you in the most productive manner
consider
possible. A properly integrated approach is critical during
diversification as they relate to your specific circumstances.
your accumulation phase. Further, it is just as important
both
tax
diversification
and
security
6 SUGGESTIONS THAT COULD SAVE YOU THOUSAND OF DOLLARS 2. Consider Owning Municipal Bonds in Taxable
structured properly, the securities typically will not move in
Accounts: Most municipal bonds are exempt from federal
tandem. This divergence of returns among asset classes
taxation. Certain issues may also be exempt from state and
creates a tax planning opportunity. Domestic equities
local taxes. If you are in the highest federal tax bracket, you
experienced tremendous appreciation in 2013. However,
may be paying tax on investment income at a rate of 43.4%.
emerging market stocks, commodities, and multiple fixed
Under these circumstances, a municipal bond yielding 3%
income investments finished the year in the red. Astute
will provide a superior after tax return in comparison to a
advisors were presented with the opportunity to save clients
corporate bond yielding 5% in an individual or joint
thousands of dollars in taxes by performing strategic tax
registration, a pass through LLC, or in many trust accounts.
swaps prior to yearend. It is important to understand the
Therefore, it is important in many circumstances, to make
rules relating to wash sales when executing such tactics.
certain your long-term plan utilizes the advantages of
The laws are confusing, and if a mistake is made your loss
owning certain municipal bonds in taxable accounts.
could be disallowed. Make certain your advisor is well versed in utilizing tax offsets.
3. Be Cognizant of Holding Periods: Long term capital gains rates are much more favorable than short term rates.
5. Think Twice about Gifting Cash: This is not to
Holding a security for a period of 12 months presents an
discourage your charitable intentions. Quite the opposite is
opportunity to save nearly 20% on the taxation of your
true. However, a successful investor can occasionally find
appreciated position. For example, an initial investment of
themselves in a precarious position.You may have allocated
$50,000 which grows to $100,000, represents a $50,000
5% of your portfolio to a growth stock with significant
unrealized gain. If an investor in the highest tax bracket
upside. Several years have passed, the security has
simply delays liquidation of the position (assuming the
experienced explosive growth, and it now represents 15% of
security price does not change) the tax savings in this
your investable assets. Suddenly your portfolio has a
scenario would be $9,800. Although an awareness of the
concentrated position with significant gains, and the level
holding period of a security would appear to be a basic
of risk is no longer consistent with your long term
principal of investing, many mutual funds and managed
objectives. The sound practice of rebalancing your portfolio
accounts are not designed for tax sensitivity. High income
then becomes very costly, because liquidation of the stock
investors should be aware that the average client of most
could create a taxable event that may negatively impact
advisors is not in the highest federal tax bracket. Therefore,
your net return.
it is generally advantageous to seek the advice of a financial professional with experience executing an appropriate exit
By planning ahead of time, you may be to gift a portion of
strategy that is aware of holding periods.
the appreciated security to a charitable organization able to accept this type of donation. The value of your gift can be
4. Offset Gains by Realizing Loss: One benefit of
replaced with the cash you originally intended to donate to
diversifying across asset classes is that, if the portfolio is
the charitable organization and, in this scenario; your cash
Investment Taxes
Investment Taxes
PROPER TAX PLANNING BECOMES MORE CRITICAL TODAY will create a new cost basis. The charity has the ability to
successful investing. A poorly timed fund purchase can
liquidate the stock without paying tax, and you have
result in acquiring another investor’s tax liability. It is not
SPECIAL OFFERS:
removed a future tax liability from
FOR A FREE HARDCOPY OF
your portfolio. Implementing the
FOR DOCTORS ONLY: A
aforementioned gifting strategy
GUIDE TO WORKING LESS & BUILDING MORE, PLEASE CALL 877-656-4362.
IF YOU WOULD LIKE A FREE,
offers
the
potential
to
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NOOK EBOOK VERSION OF
6. Understand your Mutual Fund’s
FOR DOCTORS ONLY,
Tax Cost Ratio: The technical detail
“HIGHLIGHTS” EDITION AT www.
behind a mutual fund’s tax cost ratio is beyond the scope of this article.
fordoctorsonlyhighlights
Our intent today is to simply bring
.com
this topic to your attention. Tax cost ratio represents the percentage of an investor’s assets that are lost to taxes. Mutual funds avoid double taxation, provided they pay at least 90% of net investment income and realized capital gains to shareholders at the end of the calendar year. But, all mutual funds are not created equally, and proper research will allow you to identify funds that are
add diversification to a portfolio while creating the opportunity to
an
investor
to
experience a negative return in a
MUTUAL FUND
the receiving end of a capital gains
calendar year, yet find themselves on distribution. Understanding the tax
WILL ADD DIVERSIFICATION TO A PORTFOLIO
cost ratios of the funds that make up portions of your investment plan will enable you to take advantage of the many benefits of owning mutual funds.
WHILE CREATING The above steps are by no means the
THE OPPORTUNITY TO OUTPERFORM ASSET CLASSES
only tax strategies an experienced advisor can execute on behalf of their clients. This article highlights several strategies you should discuss with your advisor to determine if
WITH INEFFICIENT MARKETS.
YOU DO
NEED TO BE AWARE OF FUNDS WITH
tax efficient. A well-managed mutual fund will
for
A WELL-MANAGED
thousands of dollars in taxes over
SHORTER KINDLE, IBOOKS OR
PLEASE DOWNLOAD OUR
unusual
implementation is appropriate for your unique portfolio and overall financial
situation.
Successful
investing requires discipline that extends beyond proper security selection. While gross returns are important and should not be
EXCESSIVE TURNOVER.
outperform asset classes with
ignored, the percentage return you see on your statements does not tell the full story. In
today’s
tax
environment,
inefficient markets. You do need to be aware of funds with
successful investors must choose an advisor who will help
excessive turnover. An understanding of when a fund pays
them look beyond portfolio earnings and focus on strategic
its capital gains distributions is a critical component of
after-tax asset growth. ■
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The report “World Analgesics Market - Opportunities and Forecasts, 2015-2022” projects that the world analgesics market would reach $26.4 billion by 20221. Pain sufferers have long regarded plant botanicals as a source of healing; there are more than 100 plants known to have pain relieving properties2. Consumers have sought retail brands of topical pain relief with menthol as an active ingredient3. There is a “new” botanical that consumers need to be aware of for pain relief: cannabidiol. In a study published by the National Institutes of Health4, it is stated that, “The nonpsychoactive cannabinoid, cannabidiol (CBD), has great potential for the treatment of chronic and 'breakthrough’ pain.” The study also states, “Chronic pain relief can be best achieved through the transdermal route.” Today, the United States faces a health epidemic: prescription opioid addiction. To address this problem, manufacturers are producing a new topical combination of CBD with menthol. These non-habit forming ingredients are a welcome solution for consumers who do not wish to pursue prescription opioid pain medications or are looking for an alternative to prescription pain medicine. The irony is that CBD is anything but “new”. CBD is a naturally occurring component of the hemp plant. Hemp is from the cannabis genus and cannabis for medicinal use dates back to the ancient Chinese emperor, Shen-Nung (c.2700 B.C.). Having compiled the medical encyclopedia called, Pen Ts'ao,5 Shen-Nung is regarded as the Father of Chinese Medicine. Cannabis or “Ma”was used by the Chinese to treat weaknesses (menstruation), gout, rheumatism, malaria, beri-beri, constipation, and absentmindedness. During the second century A.D., the Chinese surgeon, Hua T'o, began to use cannabis as an anesthesia. CBD is activated in the body through CB2 receptors located in the skin. CB2 receptors play a role in antinociception, or the relief of pain.6 Menthol is a known active ingredient with cooling properties. Working similar to ice, menthol binds with temperature-sensitive receptors in the skin and is thought to modulate pain signals within the body’s natural pain relieving systems. CBD, known to be hydrophobic and lipophilic, does not dissolve or emulsify readily in water, but will dissolve in fat. Bioavailability of CBD depends on the way that the cannabinoid is delivered into the human body. Today, science has enabled CBD to be water soluble as well as time-release. The new topical pain cream, RapidCBD™, delivers a powerful combination of micro-encapsulated time-released CBD called Cebidiol™. In Cebidiol™, consumers will benefit from menthol plus eight additional homeopathic ingredients including lavender and rosemary essential oils to relieve pain. The RapidCBD™ Cooling Pain Cream is ideal after strenuous activity and has been proven to be as effective and work as fast as an FDA approved OTC topical pain relief solution. The immediate availability of RapidCBD™ is welcome news for consumers who are seeking a non-opioid solution for muscle aches, strains and joint pain. 1 -http://www.prnewswire.com/news-releases/analgesics-market-is-expected-to-reach-264-billion-globally-by-2022-575688921.html 2 -http://www.motherearthliving.com/health-and-wellness/the-best-herbs-for-pain-relief.aspx 3 -http://health.usnews.com/health-products/top-rec-topical-analgesics-arthritis-joint-pain-135 4 -http://www.ncbi.nlm.nih.gov/pubmed/20545522 5 -https://www.psychologytoday.com/blog/the-teenage-mind/201105/history-cannabis-in-ancient-china 6 -https://en.wikipedia.org/wiki/Cannabinoid_receptor
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