Financial planning for doctors means running hospital W-2, locum 1099, practice equity, and malpractice exposure as one plan instead of four advisors who never talk. K&K does it through the Doctors Family Office, our Virtual Family Office model built around physician complexity, with one quarterback owning tax, wealth, risk, estate, and practice strategy.
Roughly 40% of our physician clients are W-2 only. The rest own a practice, hold partnership equity, or run a hybrid of hospital W-2, 1099 locum, and practice income inside the same year. The planning work for each track looks different.
Advanced personal tax planning above the employer 401(k) ceiling, own-occupation disability and life insurance scaled to a peak-earnings curve, after-tax wealth building outside qualified plans, and an estate plan that catches up with the household you actually have.
Add a second layer: entity structuring, owner-comp strategy, retirement plan design that uses the practice as the lever (cash-balance, defined-benefit overlays, profit-sharing tiers), buy-sell and key-person coverage, and a clear-eyed view of what the practice is worth.
Estimated-payment timing, multi-state exposure, retirement-plan stacking across roles, and entity strategy for the 1099 stream are live questions every year. The Doctors Family Office is built for this by default.
Proactive work before December 31 using entity strategy, retirement-plan design, real-estate depreciation, charitable structures, and equity-and-bonus timing. We plan alongside your CPA, not instead. See advanced tax planning and personal tax strategies.
Malpractice premiums, tail coverage, occurrence-versus-claims-made, and own-occupation disability reviewed inside one coordinated plan. Many physicians carry hospital group disability without reading the specialty definition, then discover at the worst possible moment that it pays a fraction of replacement income. See risk mitigation and professional liability.
Quarterbacked alongside your existing CFP or CFA, or introduced through our vetted network of over 120 specialists if you don't have one. That network complements the advisors you already trust and includes the specialties physician complexity demands:
See wealth management.
For practice owners, the Business Advisory discipline runs as Practice Enhancement: enterprise value, cost remediation, entity and owner-comp strategy, buy-sell and key-person planning, and runway for an eventual transition. See exit planning and succession planning.
Wills, trusts, and beneficiary coordination facilitated through partner attorneys, designed to match the household and practice equity you actually hold.
Travel, philanthropy, and the high-touch logistics that quietly fall on a spouse when the household has no operations layer.
Your CPA stays your CPA. Your malpractice broker stays your malpractice broker. The wealth manager keeps that seat, or we facilitate introductions to credentialed CFPs and CFAs through our network. K&K is the planning layer above them. Quarterly cadence, proactive reviews, full transparency on fees and projected impact before you commit. Our process walks through the first 90 days.
The Doctors Family Office is built for physicians earning roughly $500K+, though that's a guideline. Practice equity, locum hybrids, deferred comp, or a household income tier that combines to meaningful complexity all qualify. The entry question is complexity, not a single line on a W-2.
For the longer read on physician-specific tax planning, Tax-Efficient Whitecoat is Paavan's book.
Physicians earn top salaries but face unusual complexity: malpractice exposure, practice ownership decisions, student-loan balances that stay material despite high income, and a tax burden generic advice isn't equipped to optimize. A coordinated team that understands medical context resolves most of it before it becomes expensive.
Over-reliance on a 401(k), under-built own-occupation disability, no estate plan well into the attending years, and three to five disconnected advisors with nobody coordinating. Most dollar leakage lives between the advisors, not inside any one of them.
A portable individual policy travels when you change hospitals or open a practice, where group coverage usually does not. It also locks in your rating while you're young and healthy, and the benefit is tax-free when you pay the premiums yourself. We size the coverage to your peak-earnings curve and revisit it as your income and household change.
Premiums vary widely by specialty, state, claim history, and policy structure. The Doctors Family Office reviews the policy alongside the broader risk and asset-protection plan rather than treating it as an isolated line item.
The Doctors Family Office serves physicians across all 50 states from our Richmond, Virginia headquarters. The model works remotely through scheduled virtual meetings, secure document workflows, and one planning team coordinating with your local CPA, attorney, and brokers.
The conversation walks through where your plan stands today and the highest-leverage gaps across tax, risk, wealth, estate, and practice.
Or call (804) 372-8307
Important disclosure: Kotini & Kotini coordinates planning across tax, wealth, risk, estate, practice, and lifestyle concierge disciplines through a Virtual Family Office network of credentialed specialists. Tax filing, legal documents, malpractice and disability policy placement, practice valuations, and investment management are provided by those credentialed specialists operating in their licensed capacity. K&K does not provide legal advice, does not file tax returns, and does not perform business or practice valuations. See our disclosures page for the full description of the coordination model.
