Stop Overpaying the IRS: Tax Strategies Every Physician

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Are you building a successful medical practice or healthcare business but still feeling blindsided by your tax bill every year?

In this episode of BootstrapMD, Dr. Mike Woo-Ming welcomes CPA Spencer Carroll of Gelt to discuss tax strategies that can help physician entrepreneurs maximize earnings and avoid costly mistakes. Spencer explains how tax planning becomes more complex as practices grow, highlighting key considerations around S corporations, reasonable compensation, and the differences between traditional medical practices and venture-backed healthcare startups.

The conversation dives into practical opportunities and common misconceptions physicians face when managing taxes. Spencer shares insights on hiring spouses and children within a business, owning medical office real estate, and navigating the added complexity of multi-state telemedicine operations. He also explains how tax decisions should align with broader business goals rather than simply focusing on short-term savings.

The episode emphasizes the importance of treating a practice like a true business by separating personal and business finances, maintaining accurate records, and building the right team of advisors. Listeners will learn how proactive tax planning, rather than last-minute tax preparation, can support long-term growth, wealth preservation, and successful future exits.

Separate business and personal finances completely. Maintain dedicated accounts, accurate bookkeeping, and clean financial records so your CPA can develop effective tax strategies and help you avoid costly compliance issues.

Review your tax structure as your business grows. Regularly evaluate S-corp compensation, retirement plans, real estate ownership, and other tax-saving opportunities to ensure your strategy evolves with your practice.

Plan major financial events years in advance. Whether selling a practice, expanding into telemedicine, or bringing on family members, proactive tax planning can significantly reduce future tax burdens and maximize wealth retention.

About the Guest

Spencer Carroll is a CPA, educator, real estate investor, and Account Executive at Gelt, where he works directly with high-income professionals and business owners to optimize tax strategies and long-term financial outcomes. He hosts Gelt's Tax Talk Unfiltered podcast and has been featured in publications including Yahoo Finance and Fortune. Combining expertise in public accounting with firsthand entrepreneurial experience, Spencer brings a practical, business-owner perspective to tax planning.

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