CERTIFIED MEDICAL PLANNER™
(“Informed Voice of a New Generation of Fiduciary Advisors for Healthcare”)
For most lay folks, personal financial planning typically involves creating a personal budget, planning for taxes, setting up a savings account and developing a debt management, retirement and insurance recovery plan. Medicare, Social Security and Required Minimal Distribution [RMD] analysis is typical for lay retirement. Of course, we can assist in all of these activities, but lay individuals can also create and establish their own financial plan to reach short and long-term savings and investment goals.
But, as fellow doctors, we understand better than most the more complex financial challenges doctors can face when it comes to their financial planning. Of course, most physicians ultimately make a good income, but it is the saving, asset and risk management tolerance and investing part that many of our colleagues’ struggle with. Far too often physicians receive terrible guidance, have no time to properly manage their own investments and set goals for that day when they no longer wish to practice medicine.
For the average doctor or healthcare professional, the feelings of pride and achievement at finally graduating are typically paired with the heavy burden of hundreds of thousands of dollars in student loan debt.
You dedicated countless hours to learning, studying, and training in your field. You missed birthdays and holidays, time with your families, and sacrificed vacations to provide compassionate and excellent care for your patients. Amidst all of that, there was no time to give your finances even a second thought.
Between undergraduate, medical school, and then internship and residency, most young physicians do not begin saving for retirement until late into their 20s, if not their 30s. You’ve missed an entire decade or more of allowing your money and investments to compound and work for you. When it comes to addressing your financial health and security, there’s no time to waste.
And you may be misled by unscrupulous “advisors”.
For example:
Question: What is a fiduciary advisor?
Much like a physician, a fiduciary advisor must:
- Put their clients’ best interests before their own, seeking best prices/terms.
- Act in good faith and provide all relevant facts to clients.
- Avoid conflicts of interest and disclose actual conflicts of interest to clients.
- Do their best to ensure the advice they provide is accurate and thorough.
- Avoid self-dealing, such as purchasing securities for their own account before buying them for a client.
- DOL: https://tinyurl.com/yeydam3j
Physician Financial Planning
Question: Do you know the difference between a “Fee-Only” and a “Fee-Based financial advisor?
- Fee-only financial advisors are only paid an advisory fee by their client. They do not receive commissions, fees, or other payments from any other source related to their services.
- Fee-based financial advisors can receive fees and commissions for their services.
- Fee-based compensation is split into two parts: An advisor does receive a fee for services from their clients. The same advisor also has access to financial products that they can sell to clients and earn a commission.
- Fee-only advisors earn no additional compensation beyond the fee that is paid to them by clients, whereas fee-based advisors may earn commissions on the sale of certain products.
So, not knowing may cost you tens of thousands of dollars, or more, in excessive advisory fees. Of course, all of this compounds physician stress and burnout related issues, as well.
Physician Risk Management
FINANCIAL PLAN MANAGEMENT FLIP-BOOK: https://tinyurl.com/2z5a258p
Perhaps the most official measure of lay American retirement savings comes from the Federal Reserve System. The Fed calculated average retirement account balances for individuals in 2019, the latest year for which figures are available. Broken down by age, those balances are as follows:
| Age | Average Retirement Account Balance |
| 35-44 | $131,950 |
| 45-54 | $254,720 |
| 55-64 | $408,420 |
| 65-74 | $426,070 |
For many people, a 401 (k) plan is their largest retirement account. In 2022, financial app Empower calculated the average 401(k) balances of its users:
| Age | Average 401(K) Account Balance |
| 35-40 | $59,399 |
| 40-45 | $90,774 |
| 45-50 | $123,686 |
| 50-55 | $161,869 |
| 55-60 | $199,743 |
| 60-65 | $198,194 |
| 65-70 | $185,858 |
However, average workers should go deeper than looking at averages when determining their own savings goals. They must review their Social Security and Medicare benefits, too.
MEDICARE/SOCIAL SECURITY FLIP-BOOK: https://tinyurl.com/mws75v54
For example, the amount needed for retirement can vary based on factors such as lifestyle choices and local cost of living. However, we suggests lay people save for retirement using the following rule of thumb based on their annual income:
| Retirement Savings Based on Your Annual Income | Age |
| 1x | 30 |
| 3x | 40 |
| 6x | 50 |
| 8x | 60 |
| 10x | 67 |
Non-physician focused financial planners may have their own variation of this recommendation and should not omit insurance and risk management planning [health, property-casualty and automobile, etc] .
INSURANCE FLIP-BOOK: https://tinyurl.com/5xtumftr
Now, for the following retirement savings goals:
| Retirement Savings Based on Your Annual Income | Age |
| 1x | 35 |
| 5x | 50 |
| 7x | 70 |
While all these rules of thumb vary slightly, it is apparent that many lay Americans are falling short. According to the Bureau of Labor Statistics, the average American’s annual wages across all occupations as of May 2022 was $61,900. That means the average lay retirement account at age 67 should be $619,000. Investing acumen is low.
INVESTING BASIC FLIP-BOOK: https://tinyurl.com/2ytb2syr
DOCTORS ARE DIFFERENT
However, despite the above, doctors are very different and have varying other needs.
BUSINESS MEDICINE: https://tinyurl.com/2y98bhmh
For example, here is a chart of physician compensation by medical specialty:
| Specialty | All Physicians | Starting | East | West | South | North |
| Allergy and Immunology | $207,278 | $154,080 | $193,480 | $210,802 | $204,870 | $206,241 |
| Anesthesiology | $315,300 | $250,000 | $275,000 | $298,000 | $334,200 | $334,033 |
| Cardiac & Thoracic Surgery | $421,620 | $310,000 | $387,298 | $343,050 | $421,240 | $469,860 |
| Cardiology | $336,000 | $280,000 | $264,900 | $343,646 | $386,957 | $369,566 |
| Colon & Rectal Surgery | $327,927 | **** | $300,000 | **** | **** | $350,798 |
| Critical Care Medicine | $228,740 | **** | $220,235 | **** | $227,242 | $228,740 |
| Dermatology | $274,014 | $200,000 | $225,000 | $289,409 | $322,138 | $263,201 |
| Diagnostic Radiology – Interventional | $410,250 | $320,000 | $345,860 | $410,000 | $537,942 | $410,250 |
| Diagnostic Radiology – Non-Interventional | $364,899 | $257,367 | $330,000 | $350,224 | $383,319 | $383,256 |
| Emergency Care | $230,930 | $175,500 | $200,327 | $228,814 | $225,905 | $239,984 |
| Endocrinology | $185,000 | $140,000 | $166,675 | $185,000 | $177,665 | $201,241 |
| Family Medicine | $164,209 | $120,000 | $141,225 | $166,750 | $163,417 | $168,488 |
| Family Medicine – with Obstetrics | $163,334 | $125,000 | $140,643 | $162,352 | $161,421 | $167,222 |
| Gastroenterology | $308,246 | $250,000 | $263,594 | $325,698 | $325,033 | $306,994 |
| General Surgery | $294,000 | $200,000 | $250,028 | $275,336 | $301,761 | $330,903 |
| Geriatrics | $159,492 | **** | $150,000 | **** | $158,400 | $170,278 |
| Gynecological Oncology | $334,009 | **** | $290,795 | $345,355 | **** | $347,005 |
| Gynecology | $217,283 | **** | $220,794 | **** | $224,420 | $217,256 |
| Gynecology & Obstetrics | $250,196 | $180,000 | $232,276 | $240,118 | $258,756 | $275,419 |
| Hematology & Medical Oncology | $255,007 | $200,000 | $207,300 | $261,004 | $293,043 | $255,007 |
| Hospitalist | $171,991 | $150,000 | $153,515 | $175,084 | $183,775 | $171,913 |
| Hypertension & Nephrology | $214,751 | $165,000 | $186,683 | $238,750 | $253,228 | $214,751 |
| Infectious Disease | $185,920 | $140,111 | $161,206 | $179,402 | $175,000 | $203,640 |
| Intensivist | $231,111 | **** | **** | $230,391 | **** | **** |
| Internal Medicine | $169,569 | $120,000 | $158,824 | $171,246 | $167,740 | $170,511 |
| Neonatology | $229,486 | $165,000 | $242,492 | $222,750 | $223,312 | $232,738 |
| Neurological Surgery | $465,006 | $400,000 | $352,352 | $495,266 | $553,500 | $465,006 |
| Neurology | $201,241 | $151,960 | $180,882 | $199,614 | $204,000 | $201,241 |
| Nuclear Medicine (M.D. only) | $268,450 | **** | **** | $277,193 | **** | $267,500 |
| Obstetrics | $240,165 | **** | **** | $228,813 | $280,145 | $232,180 |
| Occupational/Environmental Medicine | $181,716 | $140,000 | $157,611 | $182,159 | $173,541 | $187,470 |
| Ophthalmology | $264,422 | $177,500 | $232,863 | $254,743 | $276,280 | $304,994 |
| Oral Surgery | $308,320 | **** | **** | **** | $283,476 | $320,007 |
| Orthopedic Surgery | $381,429 | $250,000 | $336,163 | $374,942 | $390,270 | $393,249 |
| Orthopedic-Medical | $252,803 | **** | $326,938 | $250,650 | **** | $219,502 |
| Orthopedic Surgery – Joint Replacement | $450,000 | **** | **** | $456,912 | **** | $449,839 |
| Orthopedic Surgery – Hand | $389,997 | **** | $335,000 | $378,000 | **** | $393,497 |
| Orthopedic Surg.-Pediatrics | $389,997 | **** | **** | **** | **** | $389,999 |
| Orthopedic Surgery – Spine | $518,937 | **** | **** | $574,345 | **** | $433,658 |
| Otolaryngology | $303,000 | $210,000 | $250,390 | $282,966 | $303,011 | $320,007 |
| Pathology (M.D. only) | $250,000 | **** | $245,422 | $247,764 | $252,000 | $268,500 |
| Pediatric Allergy | $186,523 | **** | **** | **** | **** | $186,523 |
| Pediatric Cardiology | $219,992 | **** | **** | **** | **** | $221,492 |
| Pediatric Endocrinology | $169,958 | **** | **** | **** | **** | $168,000 |
| Pediatric Gastroenterology | $193,193 | **** | **** | **** | **** | $190,345 |
| Pediatric Hematology/Oncology | $195,249 | **** | **** | $193,387 | $198,940 | $196,897 |
| Pediatric Intensive Care | $200,000 | **** | **** | **** | $200,000 | $200,000 |
| Pediatric Nephrology | **** | **** | **** | **** | **** | **** |
| Pediatric Neurology | $185,212 | **** | **** | **** | **** | $192,528 |
| Pediatric Pulmonary Disease | $158,429 | **** | **** | **** | **** | **** |
| Pediatric Surgery | $326,399 | **** | **** | **** | **** | $354,871 |
| Pediatrics & Adolescent | $169,267 | $115,000 | $155,916 | $168,301 | $191,511 | $168,609 |
| Pediatric Infectious Disease | $173,993 | **** | **** | **** | **** | $173,993 |
| Perinatology | $341,922 | **** | $246,597 | $336,537 | **** | $399,360 |
| Physical Medicine & Rehabilitation | $193,468 | $145,000 | **** | $183,362 | $204,775 | $201,993 |
| Plastic & Reconstruction | $328,764 | $220,020 | $273,000 | $344,059 | $344,998 | $353,983 |
| Psychiatry | $177,000 | $135,000 | $155,673 | $197,021 | $168,160 | $177,000 |
| Psychiatry – Child | $192,416 | **** | **** | $220,055 | **** | $183,621 |
| Pulmonary Disease | $222,000 | $163,626 | $199,831 | $249,865 | $225,400 | $228,359 |
| Radiation Therapy (M.D. only) | $334,171 | **** | $285,940 | $343,844 | $328,350 | $368,240 |
| Reproductive Endocrinology | $263,568 | **** | **** | **** | **** | **** |
| Rheumatologic Disease | $188,260 | $150,000 | $153,000 | $192,026 | $181,525 | $193,301 |
| Sports Medicine | $193,573 | **** | **** | **** | **** | **** |
| Surgical Pathology (M.D. only) | $ | $ | **** | **** | **** | **** |
| Surgical Sports Medicine | $391,497 | **** | $485,670 | $459,592 | **** | $389,997 |
| Transplant Surgery – Kidney | $345,000 | **** | **** | **** | **** | $379,995 |
| Transplant Surgery – Liver | $349,788 | **** | **** | **** | **** | $379,995 |
| Trauma Surgery | $312,272 | **** | $265,457 | **** | $310,385 | $352,352 |
| Urgent Care | $176,353 | $125,500 | $179,300 | $179,357 | $180,395 | $173,683 |
| Urology | $324,690 | $219,229 | $270,493 | $302,600 | $351,585 | $358,008 |
| Vascular Surgery | $335,642 | $221,500 | $297,636 | $318,388 | $337,762 | $350,000 |
Source: MGMA Physician Compensation Survey, 20017.
And, according to our research, there are 50,000 physicians with a net-worth of more than 5 million dollars; controlling more than 375 billion dollars. But, what about their tax burden?
TAX BURDEN FLIP-BOOK: https://tinyurl.com/3wz38rvf
So, as fiduciaries at D. E. MARCINKO & Associates, we adhere to the traditional personal financial planning best practices described above. This includes board Certified Medical Planner™ practices for all health care professionals. We may not know exactly where stocks, bonds, alternative investments and interest rates will go, but we are here to help navigate the road ahead. We can assist physicians in the following additional specific ways:
- Facilitation of Professional Goal Setting
- Medical School Loans and Debt Management
- Crafting a Medical Practice Business Plan
- Securing Practice Loans and Financing
- Launching a Private Medical Practice and Clinic
- Venture Capital Investors.
- Investment Bankers
- Concierge, Retail and Private Pay Medicine.
- Assist with Sale, Merger and/or Medical Practice Transition
- Investment Policy Statement Creation and Analysis
- Asset Management [traditional and alternative investments]
- Risk Adjusted Rate of Returns and Asset Performance Review
- Wealth Management with Investments Review
- Risk Management [home, office and clinic]
- Health Insurance and Annuity Analysis
- Auto, Home and Property Casualty Insurance Reviews
- Asset Protection Strategies
- Offspring Education and College Planning
- Retirement and Disengagement Planning
- Estate and Mortality Planning
- Legacy and Philanthropic Planning
- LEGACY PLANNING FLIP-BOOK: https://tinyurl.com/4eh5fu2r
- CERTIFIED MEDICAL PLANNER™: http://tinyurl.com/yzteapf6
- PHYSICIAN FINANCIAL PLAN BOOK: https://tinyurl.com/t3h7zxpc
- PHYSICIAN INSURANCE BOOK: https://tinyurl.com/4smmhur2
- NOTE: If applicable, we work directly with your personal CPA, financial planner and/or estate attorney; etc.
FEES: We offer holistic fiduciary focused financial planning that covers everything you may need. No product sales, no commissions, no conflicts—just a flat fee tailored to your needs, not tied to your investments.
In addition to our fixed-fee hourly flat-fee financial advisor services and educational assistance, we may arrange work on a pro bono basis with medical colleagues as needed.
HOW MAY WE SERVE YOU?
Contact: MarcinkoAdvisors@outlook.com
© Copyright: Institute of Medical Business Advisors, Inc. All rights reserved, USA. Present to 2025.
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D.E. MARCINKO & Associates, Inc 