How to Keep More of What You Earn 

“One thing is clear: The Founding Fathers never intended a nation where citizens would pay nearly half of everything they earn to the government.” 

Ron Paul

As physicians, we are generally fairly high income earners. That said, the money you earn is one thing, but the money you get to keep is another. We all know this, and year after year swallow our bitter medicine and pay the tax man what we “owe”.

Us docs are notoriously bad at personal finances. We mostly don’t have the access to the tax attorneys and CPAs that our business minded, non-medical professional friends employ to protect their assets come tax time. The fact of the matter is, we are dumb money.

To avoid overpaying your fair share, tax planning must be done proactively throughout the year prospectively, not after the year is over retrospectively. Certified Tax Coaches focus on year-round strategic planning methods so you are in the best position to save money at tax time.

“Anyone may arrange his affairs so that his taxes shall be as low as possible; he is not bound to choose that pattern which best pays the treasury. There is not even a patriotic duty to increase one’s taxes. Over and over again the Courts have said that there is nothing sinister in so arranging affairs as to keep taxes as low as possible. Everyone does it, rich and poor alike and all do right, for nobody owes any public duty to pay more than the law demands.” 

- Legendary Judge Learned Hand

The U.S. tax code is an astonishing 67,204 pages long with over 1,638 forms and there are many changes each year. Because of this complexity, the United States Government Accountability Office (GAO) reports that taxpayers overpay $1 billion per year to due missed tax reduction opportunities. Physicians are definitely a huge contributor to this “overpaying”. You won’t hear anyone in the government complaining however.

“The hardest thing in the world to understand is the income tax.”

- Albert Einstein

The bottom line is that taxes in general are a complex game that most physicians are losing. We are so focused on our practices, that we don’t really have the time or motivation generally to protect ourselves and keep more of what we earn. Moreover—and this was a huge problem for me—we don’t have the professional network to actually find “a guy”. Many of us go to the first CPA we can find right out of residency or ask another doc who they use. It’s the blind leading the blind.

Employing the proper strategies with actual top tax professionals can create asset protection, far more money in your pocket, and the ability to achieve financial freedom at a much earlier point in your life such that you can focus on the practice of medicine for professional fulfillment instead of for revenue generation.

“I am in favor of cutting taxes under any circumstances and for any excuse, for any reason, whenever it’s possible.” 

- Milton Friedman

Key Steps to Paying Less Tax

  • Tax laws aren’t fair. They’re written to favor people who make money a certain way - through businesses and investments, primarily real estate investments. 1099 income is a far superior to W2 wages for tax planning and strategies.
  • The best way to pay less tax is to do what the government wants you to do. Why try to fight the IRS when it’s actually pretty easy to just follow their rules, keep more money of the money you earn and pay less in taxes.
  • It’s not how much you make that determines how much tax you’ll pay - it’s how you make it. Earned income (ie: W2 wages and salaries) is the highest taxed income there is. Tax strategies work the best for locums tenens docs and physician groups that allow for 1099 compensation. Discuss with your group changing to an independent contractor status. This is usually far easier than people realize and many of our non-medical professional colleagues are set up this way. The lawyers certainly are.
  • Proactive Tax Strategy only works if you develop a custom plan for your own circumstances with the help of trained professionals. Get a team in your corner. It’s worth it. Make sure they are Tax Coach Certified and associated with CPAs and tax attorneys. Tax Coach Certification is a designation that only about 700 tax professionals have in the United States out of over a million tax preparation professionals.
  • Tax laws are constantly changing. To pay the least amount of tax legally possible, have periodic meetings with your Certified Tax Coach and their team to make sure they are keeping current on the tax law changes.
  • Your Proactive Tax Strategy only works if you act. The sooner you and your team put your customized tax plan into action, the sooner you'll put money in your pocket. This money can be used for investment and passive income generation. With a team of professionals on your side, physicians can save up to 6 figures on their tax liabilities.
  • Retirement strategies are a vital part of your financial goals. After you save money on tax day, you can spend it on a porche or a yacht, or you can do the smart thing and put that money to work for you in tax advantaged ways. Your tax solution team should have the ability to guide you through that process. Various solutions here include Defined Benefit Plans, High Cash Value Insurance vehicles, Annuities and many other tax advantaged strategies. Estate planning is also critical to any long-term financial plan.

The Income Tax was designed to be a game of rules and regulations with built in loopholes and strategies such that high earners and entrepreneurs can save an incredible amount if they take the right proactive steps to position themselves appropriately.



There are great Tax Coaches out there, and it is so important that physicians take advantage of the laws that put them into the best financial situation possible. With burnout at an all time high and physician suicide an actual problem, we need to focus as a profession on physician satisfaction and happiness. It is more important than ever to have a sound financial plan—and a team of experts behind it—and focus on freeing physicians from financial stress as quickly as possible so that they can enjoy what they do best; taking care of people.