Wealth Planning for the Modern Physician

In this episode, host David Mandell welcomes back attorney Jason Greis for his third appearance. Jason, a healthcare business attorney with extensive experience advising physician practices, discusses one of the most pressing issues for independent groups today: physician compensation models and partnership structures. With generational shifts and economic realities reshaping the field, many practices are rethinking what it means to become a partner and how to fairly compensate both younger and senior physicians.

Jason explains how compensation models have evolved from the 1980s and 1990s to today. Younger physicians increasingly favor employment arrangements with health systems over partnership tracks, which creates challenges for groups that need to recruit. To compete, practices must clearly articulate the benefits of partnership—including higher long-term compensation, decision-making authority, and ancillary investment opportunities—while balancing the responsibilities and risks that come with ownership. He outlines the growing popularity of three-tiered structures (associate, non-equity partner, equity partner) as a way to create flexibility and manage risk tolerance.

The conversation also explores buy-in and buy-out models, the shift away from high dollar amounts, and the trend toward productivity-based (“eat what you kill”) compensation rather than common pot models. Jason highlights potential red flags, including outdated “founder’s models” that rely on new doctors funding senior physicians’ retirements, which often result in disputes. He emphasizes the need for practices to proactively revisit their structures—ideally years in advance of retirements or potential sales—to remain competitive, avoid pitfalls, and position themselves for long-term success.

Learn more, including additional show notes, links, and detailed key takeaways, by visiting physicianswealthpodcast.com.

Click here to get your FREE copy of our latest book, Wealth Strategies for Today's Physician!

In the Season 6 premiere of the Wealth Planning for the Modern Physician Podcast, host David Mandell welcomes Dr. Cynthia Matossian, an accomplished ophthalmologist, entrepreneur, and industry leader. Dr. Matossian shares her unique journey into medicine, starting from an initial interest in political science and international relations before ultimately discovering her passion for ophthalmology. She discusses the early challenges she faced in starting her own practice in 1987, particularly as a woman seeking financial backing in a male-dominated field, and the resilience and determination that fueled her success.

Dr. Matossian reflects on the growth of her solo practice into a thriving multi-location enterprise with 14 physicians and over 90 employees. She emphasizes the importance of delegation, transparency, and staff empowerment in building an efficient, patient-focused practice. Her insights into practice management include implementing scribes to reduce physician burnout, investing in proper business education, and hiring skilled managers to bring structure and professionalism to the organization. She also highlights her personal approach to financial planning, beginning with small investments guided by a trusted advisor, which laid the foundation for long-term financial success.

The conversation also explores Dr. Matossian’s involvement in industry innovation, her leadership in clinical trials, and her founding of GPOptho, a group purchasing organization designed to help practices lower costs through collective buying power. She shares valuable advice for physicians considering private equity transactions, stressing the importance of preparing years in advance and selecting the right advisors. Ultimately, Dr. Matossian underscores the critical need for physicians to educate themselves on the business of medicine early in their careers, pairing clinical excellence with sound financial and practice management strategies.

Learn more, including additional show notes, links, and detailed key takeaways, by visiting physicianswealthpodcast.com.

Click here to get your FREE copy of our latest book, Wealth Strategies for Today's Physician!

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 and 4 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 4.1 | Originally Released: September 21, 2023

To kick off Season 4 of the podcast, David welcomes a very special guest – his father, radiologist Dr. Charles Mandell.  David begins by asking Charlie, as he does with all physician guests, where he is from and what led him to become a physician in general and a radiologist in particular.

Charlie shares a bit about his first job out of training and his move to become chairman of a group radiology practice after a few years, including what he learned about the business of medicine.

David and Charlie discuss Charlie’s various entrepreneurial business ventures during this phase of his career, including real estate development and alternative energy.

Charlie then talks about the second phase of his career – a locums practice that has allowed him to travel around the U.S. and maintain an ideal work-life balance for him and his wife. He relates some advice to other physicians who may consider this option. Charlie also discusses the telemedicine-medical software firm he co-founded, which continues to operate and grow today.

The episode concludes with Charlie sharing some insights from 50 years in practice, why he still works and enjoys it, and what younger physicians should ponder when they consider their future retirement. 

Learn more and listent to this and past episodes by visiting www.physicianswealthpodcast.com.

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 and 4 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 3.13 | Originally Released: March 9, 2023

In this episode, Dr. Shaminder (Shammi) Gupta joins David to discuss his career path, the impact of Hurricane Katrina on that path, and what he is learning from being a business executive as well as a clinician.

Shammi begins with his background – where he grew up, what got him interested in medicine why he gravitated to internal medicine & nephrology. He explains why his first job out of training was not a fit for him and how hurricane Katrina changed his path completely – as it did for many living in New Orleans at the time – opening up a career path he would not have considered otherwise.

Shammi also covers how he built a significant dialysis practice in a smaller town setting, became president of the Kidney Foundation, and built a reputation throughout the state.  This led to his practice being acquired by Monogram Health, where he works today as an executive and clinician.

Shammi then shares what he is learning from the “business side” of medicine, as he builds out a multi-state medical platform for kidney health, and describes the value CEOs see in physicians who can communicate well and know their field of medicine intimately. 

Next, David gets Shammi’s insights on wealth management, including building the right advisor team and why to potentially change advisors as you grow, and Shammi concludes with his three pieces of advice for fellow physicians, especially those starting out.

Learn more about our guest, including additional show notes and more, by visiting www.physicianswealthpodcast.com.

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 3.11 | Originally Released: February 9, 2023

In this episode, plastic surgeon Dr. Richard Bartlett joins David to discuss his career, academic and private practice, financial decisions and more.

Richard begins with his background—where he grew up, what got him interested in medicine and surgery in particular—and his lack of interest in finances as he went through medical and surgical training.  

Richard explains the process for choosing his first job, including the benefit of learning to “balance the books” even in an academic setting.

He and David then cover his 15 years as an academic surgeon, what he learned financially in creating a plastics foundation from scratch, as well as his decision to create a private practice and the value of “being a good citizen” in making that transition easier.

Richard then spends a few minutes relating the types of financial advice he gives to fellows at Harvard and the advice he would give to all doctors.

Learn more about our guest, including additional show notes and more, by visiting www.physicianswealthpodcast.com.

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 3.5 | Originally Released: November 3, 2022

In this episode, orthopaedic surgeon Dr. Scott Sigman joins David to discuss his career path, business and entrepreneurial endeavours, marketing, podcasts, and more.

Scott begins with his background – where he grew up, what got him interested in medicine and orthopaedics.  He explains how both of his parents were entrepreneurs and how he realized early on the need for leveraging the expertise of others. 

David and Scott then discuss the important factors Scott considered when choosing his first job out of training and Scott’s view on the importance of branding and marketing, especially for younger physicians looking to build their practices.   Scott then relates the value he sees in finding great advisors and the importance of changing to new people if needed.  

David and Scott then delve into Scott’s various entrepreneurial activities, from lasers in orthopaedic surgery, an orthopaedic mutual fund, the Ortho Show podcast, his #followthefro social media hashtag and more.

Finally, Scott gives David two important pieces of business advice for fellow physicians, especially younger doctors.

You can find show notes and more information by visiting www.physicianswealthpodcast.com. 

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 4.3 | Originally Released: October 19, 2023

Listen in as David chats with healthcare real estate expert Colin Carr.  Colin begins with his background in real estate in a variety of settings. He then tells the story of how, after seeing physicians do so poorly in deals, he decided to launch a firm dedicated to helping doctors.

Next, Colin explains the top mistakes he sees physicians and practices make when it comes to their real estate—including do-it-oneself, not performing adequate due diligence and more—and what that will cost them in the long run.

Colin delves into the choice between leasing and purchasing for a medical practice and relates the importance of having a multi-factor decision process as the key to fostering long-term peace of mind.

He then discusses the significance of timing, in terms of when to make the ‘rent vs. own’ decision, when to contact a landlord on a possible lease renewal, and even when to reach out to potential real estate agents.

Colin wraps up by sharing how physicians can find an ethical, competent real estate agent they can trust.

Learn more and listent to this and past episodes by visiting www.physicianswealthpodcast.com.

This summer, join host David Mandell as he revisits and highlights episodes from Season 3 of The Wealth Planning for the Modern Physician podcast, in our 2025 Summer Rewind Series.

"I genuinely believe there is a lot of information to gain from all of our episodes deliver, but for the summer, I've handpicked a few that offer intriguing ideas and a unique perspective for physicians in 2025," says David. "I hope you enjoy this Season encore series. Have a great summer!"

Episode 3.2 | Originally Released: September 22, 2022

Listen in as David chats with Trisha Talbot, real estate advisor and entrepreneur behind DocProperties.

Trisha begins by explaining what her training, certifications, and experience in real estate were before launching her own firm.  She then relates her motivation to launch DocProperties and delves into the unique aspects of healthcare real estate and the challenges for physicians looking to own it.

Trisha then shares her answers to a few common questions she hears from physicians and discusses a typical first step for a doctor considering a new office or piece of real estate.  Finally, Trisha explains when a practice might consider selling a property, and important factors affecting that decision.

You can find show notes and more information by visiting www.physicianswealthpodcast.com. 

In this final episode of Season 5, host David Mandell recaps the season’s key themes and previews the upcoming Summer Rewind series, which will highlight standout episodes from Seasons 3 and 4. The podcast will continue on a biweekly schedule over the summer, with new introductions to previously released episodes, allowing listeners to revisit valuable content over the Summer.

David reviews each of the 18 episodes of Season 5, including a quick recap and highlights.

The goal of this episode is to help listeners catch up on missed episodes or revisit important insights they may have forgotten. He invites feedback and topic suggestions for future episodes as the podcast continues to grow its audience.

EPISODE SNAPSHOTS:

5.1 & 5.2 – Dr. Jay Foley: After a life-altering snowboarding accident, Dr. Foley transitioned from surgery to medico-legal consulting, highlighting the importance of disability insurance and leveraging a medical license in new ways.

5.3 – Andy Taylor: Explored how election cycles influence market behavior and how physicians can remain calm and strategic with their portfolios.

5.4 – Nolan Bradbury, CPA: Covered KPIs, practice delegation, legal/tax structure for side hustles, and exit planning from a CPA’s perspective.

5.5 – Dr. Ben Ostrander: Applied hospitality industry lessons to healthcare to enhance patient experience, employee satisfaction, and operational efficiency.

5.6 – Jessica Jones, Consultant: Shared insights on aligning practice models with physician passion, wellness trends, and diversification within practices—especially cash-based models.

5.7 & 5.8 – Dr. Sue Keller: An unflinching look at financial mismanagement, the emotional toll of bankruptcy, and finding meaning in a reinvented career after decades in dentistry.

5.9 – Dr. Jay Zigmont: Introduced “child-free wealth” as a growing financial niche, challenging traditional planning assumptions and offering guidance tailored to child-free individuals.

5.10 – Dr. Jude Pierre (Pt. 1): Talked about geographic and specialty shifts, mentorship, and the creation of a physician coaching practice to fight burnout and debt.

5.11 – Carole Foos & Greg Heimkreiter, CPAs: Discussed looming tax law expirations, industry-wide challenges in accounting services, and what physicians should know about finding quality tax advisors.

5.12 – Kristy LaGourgue & Rachel Varga: Focused on brand building and marketing strategy for all doctors, not just those in aesthetics—emphasizing the importance of digital presence and patient communication.

5.13 – Dr. Pat St. Pierre: Reflected on a military-to-medicine career, financial planning, industry involvement, and proactive retirement through wine education to avoid post-retirement difficulty.

5.14 – Attorneys Byrd & Adatto: Covered major legal trends including compounding pharmacy scrutiny, the evolving legal landscape around non-competes, and internal practice exits.

5.15 – Dr. Jude Pierre (Pt. 2): Discussed optimizing workflow through scribes, practice innovation via Medicare Advantage, and financial/lifestyle balance to avoid physician burnout.

5.16 & 5.17 – Cory Kleinschmidt: Provided a comprehensive look at locum tenens work for physicians—ideal for both early-career flexibility and late-career freedom—including licensing, contract tips, what to look for in an agency, forming LLCs for tax purpose and more.

5.18 – Drs. Mark Figgie & Joel Press: Shared a mentorship model from HSS that helps young physicians with career planning, finances, wellness, and leadership development.

5.19 – Bob Goettling: Introduced ESOPs (Employee Stock Ownership Plans) as an innovative, tax-efficient practice exit strategy increasingly relevant in the medical space.

Learn more, including additional show notes, links, and detailed key takeaways, by visiting physicianswealthpodcast.com.

Click here to get your FREE copy of our latest book, Wealth Strategies for Today's Physician!