What planning for physicians and dentists actually looks like
The financial life of a doctor or dentist runs on a delay. Training is long. Income arrives late. Debt arrives early and compounds while the income is still small. Then the income jumps, and the planning that should have started in residency has to be built in a hurry while the new household is also paying for daycare, a mortgage, and the buy-in to a practice.
On top of that, the work itself carries financial risks most professions never see. A malpractice claim. A career-ending shoulder injury for a dentist who relies on fine motor work. An ownership dispute inside a practice. A patient base that can move when one partner leaves. None of these get addressed by the standard household financial plan.
We treat the medical and dental life as its own planning category because the math really is different.
Medical and dental clients are one of several audiences we treat as their own planning category — see the broader list of the people and businesses we sit down with most often.
The questions we hear from doctors and dentists
Most of the questions are practical, urgent, and underexplained by the people who should have explained them years ago.
- Is the disability policy I bought in residency actually going to pay if I cannot do my own specialty anymore?
- Should I be aggressive on student loan repayment, or is the math better the other way?
- I am being asked to buy into the practice. How do I know if the number is fair, and how do I finance the buy-in without wrecking the household?
- What kind of retirement plan should the practice run, and how much can I shelter compared to what I could shelter as an employee?
- If something happens to me, what does the practice owe my family, and what does my family owe the practice?
Where most advice gets doctors and dentists wrong
The standard playbook for medical professionals is built around insurance products. The advisor finds the doctor in residency, sells a permanent life policy disguised as a tax strategy, sells a disability policy with the wrong definition of disability, and earns a commission on both. Ten years later the doctor finds out the life policy is a poor investment and the disability policy will not pay out for the work she actually does.
We are not paid commissions on disability insurance, and we have opinions about the policies most colleagues sold them. Own-occupation language matters. Specialty-specific language matters more. The benefit period matters. The carrier's history of paying claims matters most.
On the practice side, the failure mode is usually advisors who treat the practice as a footnote to the household plan instead of as the asset it is. The buy-in, the retirement plan design, the eventual exit, and the relationships with the other partners all deserve their own conversation.
The disability conversation is the one we have first and most often. Our notes on why disability coverage is the policy medical professionals most often get wrong walk through the specific language that decides whether a claim gets paid.
The work we do for doctors and dentists
We start by reading the documents already in place. The disability policy, the life insurance, the practice operating agreement, the buy-sell, the retirement plan documents. Most clients have never seen all of it laid out together.
From there we build a written plan in three layers. The first layer is protection — fixing the disability coverage, sizing the term life appropriately, putting an umbrella policy in place above it all. The second layer is the practice — the buy-in math, the retirement plan design, the cash flow, and the eventual transition. The third layer is the household — the loan strategy, the savings rate, the tax planning, and the long arc of getting from the early-career years to the eventual decision to slow down.
All three layers live inside one document that gets reviewed at least once a year because the practice and the policies almost always change.
The umbrella sits above everything else as the second policy we want every doctor and dentist to read. Our piece on the personal liability layer most professionals carry too little of explains why.
For practice owners, the retirement plan choice is one of the largest tax decisions you make every year. Our page on the retirement account self-employed professionals most often overlook is a good first read for solo practices.
The day you stop practicing is closer than it feels in the middle years, and the cleanest exits are drafted long in advance. We treat the years before a practice transition as the years where the eventual price is built.
Tax is the connective tissue underneath the practice and the household, and the planning runs all year — see our notes on a year-round tax conversation that treats the return as a byproduct.
What working with us looks like
First meeting — bring the policies
We meet between cases, in the evening at your home, or at our Paramus office. Bring whatever you can find — the disability policy, the life policy, the buy-sell, the most recent practice tax return. We spend the hour reading the documents back to you and pointing at the items that need attention first.
Second meeting — the written plan
We come back with a written plan that covers protection, practice, and household, with specific recommendations and numbers. The plan is yours to keep whether or not we work together. If your existing policies are doing their job, we will say so in writing.
A note on fit
When this might not be right for you
Not every physician or dentist is a fit for our work. Some of the people we are not the right firm for:
- Anyone looking for a one-stop shop that also sells the disability policy. We do not sell insurance, and we will not pretend the conflict is small.
- Anyone hoping for an advisor who will tell them every old policy needs to be replaced. Sometimes the right answer is to keep what you have.
- Anyone whose partners want a single plan covering the practice and the household with no consent from the household. Planning is a one-on-one conversation in our office.
- Anyone who wants someone to actively trade their portfolio. We do not market-time, and we will not pretend to.
If any of that describes the seat you're in, we would rather say so on the first call.
Frequently asked questions
Why do doctors and dentists need a different kind of financial advisor?
Because the financial life is different. Long training, late income, big debt, practice ownership, malpractice exposure, and specialty-specific disability risk all change the planning. A generalist household advisor often misses the items that matter most to a physician or dentist, particularly around insurance and practice ownership.
What is own-occupation disability insurance?
Own-occupation coverage pays a benefit if you cannot perform the specific duties of your own specialty, even if you can still work in some other role. For a surgeon or a dentist, that distinction is the entire reason the policy exists. Many policies sold to medical professionals are written with weaker definitions, and the difference only shows up at claim time.
Should I refinance my student loans?
Sometimes yes, sometimes no. If you are pursuing public service loan forgiveness or any income-driven repayment forgiveness, refinancing can disqualify you. If you are not on a forgiveness track and your interest rate is high, refinancing may save real money. We model both paths before recommending one.
How does buying into a practice affect my financial plan?
Buying into a practice usually means taking on debt, sometimes large, in exchange for an ownership share that is worth what the next buy-in says it is worth. The cash flow during the buy-in years is tight, the tax treatment is specific, and the buy-sell agreement matters more than most owners realize. We model the buy-in inside the household plan, not next to it.
What retirement plan options work best for medical and dental practices?
It depends on the size of the practice, the age mix of the team, and how much the owners want to shelter. Solo practices often do well with a Solo 401(k). Group practices may use a 401(k) with profit sharing or a cash balance plan layered on top. The right answer comes from running the numbers against the actual census.
Do you accept commissions on insurance products you recommend?
No. We are fee-only fiduciaries and we accept no commissions on any product. When disability, life, or umbrella coverage is the right tool, we introduce you to independent agents we trust, and we are paid nothing for the referral.
Can I meet with you outside of business hours?
Yes. Many of our doctor and dentist clients meet with us in the evening or on weekends, at the office or at home. We work around the clinical schedule. In-person service is part of how we work, not a premium upcharge.