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Estate Planning for Physicians – Your Complete Guide

doctor working on computer

While nearly everyone can benefit from estate planning, physicians have unique needs. It’s important for doctors and their families to plan deliberately for the orderly management and distribution of estate assets and liabilities during periods of lifetime incapacity and at death. In addition to considerations about who will get what and who is in charge of the process, physicians face additional challenges including ever-present litigation risk from malpractice lawsuits, heavy student loan debt, and the complexities that come with owning or otherwise being associated with a medical practice.

Benefits of Creating a Tailored Estate Plan

Your estate plan, when tailored to your personal situation, goals, and objectives, should provide you and your loved ones with valuable peace of mind. For starters, planning how and to whom your assets will pass, and identifying who will oversee making sure your wishes are carried out, can go a long way in limiting or avoiding arguments between heirs and loved ones.

If you own an interest in a medical practice, doing some pre-planning can also help ensure continuity for your loved ones, business partners, and employees in the event you become incapacitated and cannot manage your own affairs, or if you die prematurely.

Many physicians have accumulated sizable student loan debt. If that describes you, it is critical to look at your financial, estate, and tax planning through the lens of a comprehensive plan designed to ensure your loved ones will be able to meet financial obligations no matter what the future brings.

What Does Estate Planning Entail?

Most people think of “estate planning” as little more than “getting a will.” And, while wills are certainly a part of many effective estate plans, they are generally insufficient on their own when it comes to meeting the complex planning needs physicians and their families face.

Your estate plan should contemplate two main questions:

  • What will happen if I become incapacitated?
  • What will happy to my assets, liabilities, and legacy when I die?

Planning for Incapacity

No physician wants to contemplate becoming incapacitated, becoming the patient rather than the provider. However, as a physician, you likely know that incapacity resulting from an illness or injury accident can strike any of us, at any time.

Planning for potential future incapacity means creating advance directives for health care and finances, giving a trusted family member or friend the legal authority to be your voice and handle your affairs if you cannot do so yourself.

It can also mean purchasing disability income insurance to provide a steady income stream to help keep your family’s budget healthy and creating agreements with other physicians in your practice to provide for seamless operation and continuation if one of you is alive but cannot work due to a disability.

Planning for Death

Doctors also need to carefully consider how their assets will be managed and distributed when they die. This aspect of estate planning for physicians often includes creating and funding revocable and/or irrevocable trusts with pour-over wills, carefully structuring ownership of real estate and other assets, ensuring beneficiary designations on life insurance and retirement accounts are in line with goals and wishes, and entering into buy/sell agreements with business partners to ensure there is a ready buyer for a deceased physician’s share of their medical practice can continue.

While the federal estate tax exemption is high ($11.4 million for an individual/$22.8 million for a married couple in 2019), several states have lower exemption amounts. Creating a tailored estate plan using strategies designed to minimize the impact of estate, gift, inheritance, and generation-skipping transfer taxes can result in meaningful savings for your heirs and devisees. In other words, tax planning for your estate can mean your ultimate beneficiaries inherit more of the wealth you want to pass on to them, rather than your money going to unintended heirs like the IRS and state tax authorities.

If you are charitably-minded, there are also powerful strategies you could employ using trusts, life insurance, annuities, private foundations, donor-advised funds, and more to leave a legacy to the organizations that are most important to you. Sometimes, people assume their loved ones know their charitable intentions when in reality, those wishes are not clear. Incorporating your wishes into your estate plan can ensure everyone is on the same page.

Special Considerations for Physicians with Minor or Disabled Dependents

If you have minor children or others who depend on you for support, it’s even more critical to make sure you have an up-to-date estate plan. Your plan should address who would have physical and legal custody (guardianship) for minor children if you and your children’s other parent were to both die prematurely. This provision is generally included in a will.

Your will or trust instrument should also provide for management of assets for minor or financially-irresponsible beneficiaries. You can name a trustee to manage assets, giving the trustee broad or limited discretion to use the funds for the beneficiaries’ health, education, support, and maintenance. Estate planning using trust instruments can be extremely flexible, giving you the ability to implement guardrails around how and when your assets could be used, and dictate when the beneficiaries could receive lump-sum distributions. When structured properly, these types of provisions can protect the assets you’ve worked a lifetime to accumulate from spendthrift beneficiaries or from beneficiaries who simply are not prepared to manage an inheritance while grieving your death.

Steps Involved in Planning Your Estate

Just as with practicing medicine, there are no “one-size fits all” solutions when it comes to estate planning. The right strategy for you will depend on the type, size, and makeup of your estate assets and liabilities, your distribution wishes, and goals.

In addition to considering how your financial affairs should be managed in the event of your incapacity or death, you should also spend time thinking about who is in the best position to oversee your estate plan when the time comes to implement it. This could be a trusted family member or friend, or it could be a professional fiduciary. Again, there is not any single “best” solution.

The important thing is to put some thought into your plan and work with legal, tax, and financial professionals who can help implement it. Finally, remember to review your plan regularly and adjust it as your situation changes or as major life events occur.