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Services for
Physicians and Healthcare Professionals
Physicians and healthcare professionals face unique financial and tax challenges - from residency-to-retirement,
Our custom-tailored life-stage specific tax, planning and advisory services are designed exclusively for ​1) residents, 2) early-career, 3) mid-career and 4) retiring and retired
​physicians and healthcare professionals affiliated with leading healthcare organizations, including Scripps, UC San Diego and Rady's with and without 1099 side business income and physicians and healthcare professionals in private practice.
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Our clients are intent on proactively strategizing and planning to minimize tax liabilities, increasing financial and tax efficiencies, transform financial complexity into clarity, taking control of their financial future, and often - planning for financial independent and making work optional.​
Saving taxes intelligently may be easier than you think.
Work with us and benefit from a single or multi-year / muti-case roadmap coupled with tax projections and analysis - updated semi-annually - that aligns the forward trajectory of your income streams, expenses, assets, liabilities and debt (factoring in inflation, appreciation and depreciation, lifestyle and retirement goals with the most advantageous tax strategies and decision-sets available.​​​​​​
Challenges
Opportunities
Multi-Year Strategic Tax Planning for Physicians
Top Financial and Tax Challenges and Opportunities Physicians and Healthcare Professionals Face
- and How We Can Help
High income → high taxes + complexity
Physicians and healthcare professionals fall into high federal (and state) income-tax brackets, amplifying the need for multi-year tax planning, tax-efficient income structuring and proactive and intentional decisions to drive taxes down and boost retirement-savings strategies.
​Selecting the right self-employment and private practice entity structures (when relevant)
Whether to operate as an LLC, S-Corp, C-Corp (or sole proprietor), and optimizing salary vs. distribution — these decisions materially affect self-employment tax, payroll taxes, deductible expenses, and retirement contribution capacity.
​Maximizing W-2 employer, private practice and 1099 self-employment (Sch C) retirement contributions and employer-sponsored benefits can save you thousands.
Physicians and healthcare professionals can benefit from retirement plan layering for maximum retirement savings impact. Employer 401(k)s, 403(b)s, 457(b)s, private practice sol0 401(k) profit sharing and defined benefit cash balance plans, 1099 SCH C Sep-IRAs - just to name a few.
Understanding your optimal multi-layered funding strategy requires a customized funding analysis based on your current and future projected earnings income streams.
How Much Can You Save?
​Multi-year planning for capital gains / capital gains offsets
Multi-year income and tax strategic tax planning for key multi-source income, offset and deduction items is absolutely essential for those intent on avoiding overpaying taxes - period.
​Tax-efficient retirement withdrawal sequencing
Retirement, the source and timing of withdrawals (pension, 401(k)/403(b)/457(b), IRAs, taxable accounts, investments) can dramatically affect lifetime tax outcomes — yet many doctors don’t plan this early enough.
Estate planning and asset protection
With intense schedules and time demands, physicians and healthcare professionals that don't make the time for personalized and proactive estate planning face higher estate-tax risk, inefficient asset transfer, and inadequate protection of wealth to family members and for their legacy.
S-corporations for Physicians & Healthcare Professionals
S-corporations offer meaningful tax and ownership advantages to many California medical and healthcare practices, service and related owner - operated businesses - but only when structed and operated correctly under California law. ​
Natalie C. Papagni, CPA has extensive expertise assisting S-corporation owners / shareholders with new and existing S-corporations understand and comply with S-corporation IRS requirements, efficiently financially manage and control the business, make tax-smart decisions to minimize tax liabilities, file accurate and efficient 1120S and 100S tax returns and optimize the benefits of S-corporation ownership status. ​​
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General Attributes for S-Corp Candidates
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Professional services business
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Closely held or family owned
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1 or more shareholder - owner / operator - employees
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Interest in limited liability protection
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Active owner - employees
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Consistently Profitable
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30k + Net Profit annually
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Interest in pass-through business ownership
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Interest in avoiding double taxation & self-employment tax
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Interest in receiving reasonable compensation on payroll
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Flexible retirement plan strategies
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Interest in taking advantage of special elections not available to Sched C business or corporation​
Example 1
Physician — Hospital Employment + Locums
S-Corp Solo 401(k) with Profit Sharing + CA PTET
Hospital Employer
Hospital Income Type
Example Hospital Income
Outside Income Type
Potential QBI Deduction
Example 1099 Income
S-Corp Reasonable Salary
S-Corp Distributions
Self-Employment Tax
CA PTET Election
UCSD 403(b)
UCSD 457(b)
UC Pension
Solo 401(k) – Employee Deferral
Solo 401(k) – Employer Profit Sharing
Total S-Corp Retirement Contribution
Estimated Total Annual Benefit
University of California San Diego
W-2 wages
$300,000
1099 locums / moonlighting
TBD
$200,000
$120,000
$80,000
Avoided on S-Corp distributions
~$7,400 California tax credit
Available on hospital income
Available on hospital income
Employer-funded
~$23,500 from S-Corp W-2
~$30,000 (25% of S-Corp W-2 salary)
Up to ~$53,500
~$35,000–$40,000
💡Important for UCSD Physicians:
Participation in UCSD’s 403(b), 457(b), and pension does not limit Solo 401(k) profit-sharing through an S-Corporation. Hospital W-2 income cannot be used for Solo 401(k) contributions — only S-Corp wages qualify.
Example 2
Private Practice Owner
Cash balance + Solo 401 + PTET
SE Tax Optimization
CA PTET Election
Potential QBI deduction
Solo 401(k)
Cash Balance Plan
Auto & Depreciation
Estimated Total Annual Benefit​
$100,000 +/- tax savings & deferral
$350,000 distributions
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TBD
$66,000
$120,000–$200,000+
$18,000–$25,000
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S~$26,000 payroll tax savings
~$30,000 CA tax credit
Up to 20% QB Income
Tax-deferred retirement
Large current-year deduction
Accelerated depreciation
💡Note:
* Results vary based on income level, reasonable salary, and plan design.
All strategies require CPA-led coordination and California compliance.
San Diego Tax Planning for Physicians | San Diego Tax Preparation for Physicians | Tax Strategies for Physicians |
San Diego Financial Planning for Physicians | Tax Strategies for Physicians | San Diego Medical Practice Formation
Scripps Clinic John R. Anderson Medical Pavillion​ | UC San Diego Jacobs Medical Center | Rady's Children's Hospital​​​​ | Sharp
​California Medical Association | California Dental Association | CVMA
Let's Stay Connected
Natalie C. Papagni, CPA
Tax, Planning & Advisory Services
4727 Executive Drive Suite 300
San Diego, CA 92121
858.754.8277
