Doctor’s Rounds™

*The views expressed by the authors below do not represent the views or opinions of MD Preferred Services.

Home Prices Skyrocketing

Friday, December 09, 2016

By Cyndi Carver

Home prices have been skyrocketing in the Puget Sound area these past few years, rivaling the increases seen in California prior to the boom. Now with the interest rates edging upward (we knew this would happen), home buyers will be finding out they are losing buying power. What they qualified for in 2016 and did not buy because they couldn't find what they wanted. These same buyers will find that they lost buying power with the interest rate going up.

With 4.25% for a 30 year loan with $2000 a month payment, they qualify for a $400,000 loan. At 4.5%, they now only qualify for a $388,359 loan, a loss of $11,641 in buying power. at 5.25%, they will only qualify for a $356,347 loan, a loss of $43,653 in buying power.

This article from the Seattle Times gives a summary of the price increases in the Puget Sound area. The map is great for showing how each area around the sound for the month of November. 

If You’re So Smart, Why Aren’t You Rich?

Friday, September 02, 2016

By: Anthony J. Ogorek, Ed.D., CFP
Ogorek Wealth Management LLC

As we slide into the Labor Day holiday after the summer of summers in Buffalo, NY, the presidential election cycle is shifting into high gear. The bromide that ‘people don’t pay much attention to the race until after Labor Day’ may not hold true today with seemingly blanket coverage of the major party candidates. There is one major story or insight that has gone unreported until now. Let me share it with you.

The singular qualification that Republication presidential nominee Donald J. Trump cites in his quest for the Oval Office is that he is rich. Further, he extrapolates that since he is rich, he must also be smart; and by extension being a billionaire – he is very smart. Hence, only a very smart individual can straighten out the problems that so many of us view as intractable. 

I am not trying to rag on Mr. Trump, but his candidacy does bring up an interesting point that deserves further exploration. How many of us accept the precept that you have to be smart to have a lot of money? That many people may talk a good game about their smart ideas, but only the really smart are able to convert ideas into net worth. Is money the ultimate IQ test? 

Residency to Retirement: A Physician’s Guide to Financial Health

Monday, May 16, 2016

Here is a great article brought to our attention by Stephanie Arcelay of SunTrust Mortgage.  As the title suggests, it really goes through the process of being a student to retiring in your twilight years.  

Click to be taken to Nashville Medical News' site.
Residency to Retirement: A Physician’s Guide to Financial Health 

Life Insurance is not a Retirement Plan

Friday, May 13, 2016

By David I. Katz, AAMS®, COO, CFO Financial Planner

Recently I was asked, to weigh in on life insurance policies in general and more specifically, their place in the retirement planning process.  While at first the topic might not seem directly on point for a retirement planning, many life insurance policies are sold under the guise of saving for retirement.

Should life insurance be a key part of your retirement plan? Life insurance should be a vital part of your overall financial plan, specifically, if people depend on your income (e.g. your children and your spouse). A sizable income tax free life insurance death benefit payment is the best way to maximize the chance that your dependent's standard of living is not dramatically reduced due to your untimely demise. In fact, income replacement is the number one factor couples site as a reason for purchasing life insurance.

Then the question becomes, what type of insurance should you purchase and is it a good idea to use insurance as an investment for retirement. If you listen to Suze Orman, Rick Edelman or other self proclaimed financial gurus the answer you will get is that there is no reason to buy anything other than term insurance and that permanent insurance helps no one except the agent/advisor that sold the policy. Others will argue that term insurance is a temporary fix and since in generally offers no equity it is like renting an apartment versus buying a home and that you are throwing you money away. Insurance industry legend Bob Castigione, creator of the LEAP selling system, will posit that every investment dollar that you have should be invested in permanent whole life insurance. The truth actually is somewhere in between.

When you purchase life insurance to protect your family, you'll want to be sure you buy adequatecoverage.  First and foremost, you want to make sure that if you die there is adequate funds available to take care of your family financially. For many people, that means purchasing Term Insurance which is the most affordable type of life insurance.  Others may still consider permanent insurance (Whole Life, Universal and Variable Universal) because they are drawn to the cash value (equity) that the policy builds over time. The problem is that purchasing the cash value insurance, however well intentioned may leave the family at risk. Let’s take an example of a male age 35 that is in good health and purchases a $1,000,000 whole life insurance policy from a (A+) rated insurance company. His premium as a select preferred rating will be approximately $10,960 per year. The policy will build cash value on a guaranteed basis and may build additional cash value based on what the policy owner chooses to do with any non-guaranteed dividends the company may pay each year.  Over time, the policy will build cash value in excess of the actual premiums that were paid. But what if he dies? As Shakespeare so aptly put it, “there’s the rub”. The family will still receive only the death benefit portion (which may increase over time if dividends are paid and used to purchase additional insurance) and not the cash value/savings portion.  

Why is long term care insurance important for you?

Monday, May 02, 2016

No retirement plan is complete if it has not addressed long term care.  We work so hard to accumulate assets for a secure retirement. Too many of us fail to build a fence around those assets so that health care events won’t needlessly erode our family’s lifestyle.

What is long term care?
Think of how you started your day.  You bathed, dressed, had breakfast, drove to work or used public transportation.  What if you couldn’t do these every-day activities for yourself whether as the result of an accident, an illness or just the frailty of old age?  Who would be there to help and how would you pay for it?  What would the consequences be to you and your family if you were to require care for an extended period of time?

Some people think they have enough assets to self-insure the risk of requiring care but fail to understand the extensive costs that can result from the extended need for long term care support.

The best way to address this important financial issue is to ask some basic questions: 

Medical Office Location Analysis

Tuesday, April 26, 2016

By Ernie Anaya, MBA 

Location for a medical office is of the utmost importance to the success of the practice it supports. Due to changes in regulations and the market, healthcare providers are now seeking locations near where their patients live. This trend has resulted in a “retailization” of care. Medical office seekers can learn a lot from the retail industry, which has made site selection a science.

The following are factors that need to be taken into consideration when selecting a location for your medical office: 

Presidential Candidates Tax Plans

Monday, April 25, 2016

By Scott W. Cody, MBA, CFS
Partner, Latitude Financial Group

With both the Republican and Democratic debates heating up now, it is probably a good time to attempt to separate fact from fiction when it comes to the future plans of the nominees on how they will change the tax code.  With our national debt soaring to 19 trillion dollars, it is certain we will need a way to balance our budget and right the ship of the financials in this country.  As a finance and accounting guy, I full well know that you cannot run a negative debt situation in perpetuity.  It just doesn’t work.  So, here are the cliff notes to some of the tax plans being bandied about by the front-runners. 

Does Your 401(k) Have One of These?

Monday, April 11, 2016

Self-directed brokerage accounts have been around for quite some time but don’t be surprised if your company’s human resources department and other plan literature doesn’t offer much information about it.  The reason: the company who hosts your 401(k) plan is often not the company who handles the self-directed brokerage account.  Therefore, when participants opt to allocate assets to the brokerage window, the core plan’s custodian loses out on the fees they earn on those dollars. 
But that should not be a reason not to use it.  Self-directed brokerage accounts are a great way to diversify your retirement account and gain access to stocks, bonds, mutual funds, exchange traded funds, and even add your financial advisor to your account for oversight and personalized service.  The investments available in the core plan are usually limited to a list of 5-20 different mutual funds.  Within the self-directed brokerage account, there are thousands.

Every employer offering a self-directed brokerage account has implemented different rules surrounding the use of the self-directed brokerage account.  To understand the basics, first consider your 401(k) plan as having two separate compartments; the core account and the self-directed account.  These are both within the 401(k) so do not worry that using the self-directed brokerage account is somehow creating a taxable event by taking a withdrawal. 
The core account is the one that you’re probably accustomed to using.  It commonly consists of 5-20 pre-selected mutual funds that are (hopefully) periodically reviewed and occasionally replaced for poor performance.  This lineup will hopefully cover some of the spectrum of investments and include some U.S. large company stocks, U.S. small company stocks, international stocks, corporate bonds and government bonds.  Almost always, these investments are in the form of mutual funds; active and passive (index).  Commonly, 401(k) plans core accounts will offer target-date retirement funds that are supposed to be a single solution that simplifies investing.  By selecting the target retirement date fund near your target year of retirement, you get a pre-made mix of investments.  While these may help you to get a better mix of investments, there are shortcomings to this approach as well.  A primary critique of these solutions are their often high management fees. 

5 Things Every New Physician Should Do to Lower Taxes and Protect Assets

Monday, February 01, 2016

When speaking with physicians, whether it is one on one, or in a group setting, two topics of conversation are a virtual constant, taxes and asset protection. Notwithstanding the litigious environment we live in, I can clearly see why physicians want to do whatever possible to protect their assets. Reducing taxes is something everyone wants to do.

Even if someone pays very little in taxes, they still want to pay less, so it only make sense that physicians want to keep more of what they make, especially after paying insurance and education costs. So if you would like protect your assets and pay less in taxes, read on.

Form a Physician Corporation

Establishing a Physician Corporation will allow you to pay various expenses from the corporation. Since these expenses are paid before you take your salary, they are deductible from your overall income, and are not taxed at all. Owning a Physician Corporation will also enable you to take advantage of other options which are only available to corporations. Pay Yourself a Salary – Of course you want to make as much money as possible, but in the end, it is really about how much you get to keep. By paying yourself the lowest possible salary, your overall tax burden will be lower, because you will not have to pay FICA taxes on the dividends you take from your Physician Corporation.

Contribute to Retirement Accounts

Your retirement accounts aid you in both reducing your taxes and protecting your assets. From a tax perspective, retirement plan contributions are not subject to income or FICA taxes, so the more you can contribute, the lower your tax bill. As it pertains to protecting your assets, in most states, retirement accounts are not subject to levy as payment in the event of a civil judgment. Therefore, the more you contribute to these plans, the more assets you have protected. Create a Physician


As the owner of your Physician Corporation, you are able to establish a Physician Pension for yourself. This does two things. First, it allows you to fund a retirement vehicle for yourself as an expense to the business. These funds are not taxed, and do not require you to take a significant salary in order to make the contributions. Second, as a retirement account, these funds are also protected from civil judgment in most states. 

What IF you need Long Term Care

Friday, January 29, 2016

Favorable tax treatment helps to reduce the “pain” of paying the premium.  Planning ahead by having a conversation about aging before you age is a gift to your family.  What your preferences are on issues such as housing, caregivers and how you would pay for long term care (LTC).  Your health, age, family history and finances will determine which option(s) you have to pay for care.  
Health insurance does not cover long term care, since it is custodial care.  Medicare will cover somelong term care for a very limited time provided that you meet the requirements.
There are favorable tax advantages for LTC premiums based on how you file taxes: