2015 woa spring news woa...our final symposium, “let your backbone slide,” will be moderated by...

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Third There is a Practice Manage- ment Symposium where topics such as Dr. Doug Jackson will talk on evolving medical prac- tice in Fourth Dr. Kevin Leman will give the Steel Lecture about marriage, love, life and relationships. You and your significant other will both want to hear this one – together. Fifth Dr. David Teuscher, the new President of the American Academy of Or- thopaedic Surgery, give a presentation on where we are as organizations, what the trends are, and where we can get to. Dr. Robert Slater will be presenting the report from the Board of Councilors, and this is always cutting edge indeed! Dear Colleague; The 79th Western Orthopaedic Association Annual Meeting in Coeur d’Alene is on the horizon and the word for the event is ! The mix of educational and recreational time is well balanced. It is choice what the parts will be. First Dr. Payam Tabrizi has organized a very strong educational program with top notch speakers. Dr. Doug Jackson, Dr. Mike Coughlin, Dr. Chip Routt and Dr. William Maloney are just a few of who will add to your medical armament. You learn more than you thought you could. Second We will have dis- cussion sessions that combine abstract re- view and expert opinions. They are designed to be the sharp part of “cutting edge” medi- cine and surgery. www.woa-assn.org Spring 2015 Volume 17 Number 2 President’s Message Paul C. Collins, MD News Western Orthopaedic Association Sixth We will have several airplanes to fly in, from a Husky back-country plane to a pre-WW2 Navy N3N, and possibly a P-51 fighter plane! There will be opportunities for adventuresome members to see Coeur d’Alene from the air and in the N3N wave off the side to others at the meeting. Seventh the will have a time in Coeur d’Alene, both while you are in the morning classes and free in the afternoon. There are so many fantastic opportunities with things like boating on the Coeur d’Alene lake, playing golf at the fan- tastic Coeur d’Alene golf course with the I N S I D E 2015 Program Chair’s Message p. 3 Presidential Guest Speaker p. 4 Howard Steel Lecturer p. 4 Resident/Fellow Award Winners p. 4 Young Investigator Awards p. 5 Scientific Program Highlights p. 5 Upcoming WOA Meetings p. 5 Multimedia Education Sessions p. 5 Money Matters p. 6 The WOA Annual Meeting will be held July 29 – Au- gust 1, 2015 at The Coeur d’Alene Hotel in Coeur d’Alene, Idaho. For meet- ing information, view the Preliminary Program on- line at . There is something magical about a visit to The Coeur d’Alene Resort. With idyllic land- scape, year-round activities, and its spectacu- lar setting at the shore of one of America's most beautiful lakes, it is no wonder Lake Coeur d’Alene has been christened the “Play- ground of the Northwest.” With luxurious accommodations, a rejuvenating spa, sump- tuous cuisine, and world-class golf, which includes the world’s only floating green; this four-star resort continues to be the destina- tion of choice for discerning travelers world- wide. The resort ranked in the Top Twenty of magazine’s 2013 World’s Best Awards. Barbara Walters called it “a little slice of heaven.” Come check out Coeur d’Alene for yourself this summer! For everyone’s convenience WOA has re- served a block of sleeping rooms. To make a reservation at The Coeur d’Alene Hotel, call (800) 688-5253. Please mention that you are with to get the discounted rate. Cutoff for WOA Room Rates is July 2, 2015. Register online at Register Today for the 79th Annual Meeting July 29-August 1, 2015 Coeur d’Alene Coeur d’Alene, ID

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Page 1: 2015 WOA Spring News woa...Our final Symposium, “Let your Backbone Slide,” will be moderated by Dr. Garth Johnson, the man responsible for my selection of Ortho-paedics as a career

Third There is a Practice Manage-ment Symposium where topics such as

Dr. DougJackson will talk on evolving medical prac-tice in

Fourth Dr. Kevin Leman will give theSteel Lecture about marriage, love, life andrelationships. You and your significant otherwill both want to hear this one – together.

Fifth Dr. David Teuscher, the newPresident of the American Academy of Or-thopaedic Surgery, give a presentation onwhere we are as organizations, what thetrends are, and where we can get to. Dr.Robert Slater will be presenting the reportfrom the Board of Councilors, and this isalways cutting edge indeed!

Dear Colleague;

The 79th Western OrthopaedicAssociation Annual Meeting inCoeur d’Alene is on the horizon

and the word for the event is ! The mixof educational and recreational time is wellbalanced. It is choice what the partswill be.

First Dr. Payam Tabrizi has organizeda very strong educational program with topnotch speakers. Dr. Doug Jackson, Dr. MikeCoughlin, Dr. Chip Routt and Dr. WilliamMaloney are just a few of who will add toyour medical armament. You learnmore than you thought you could.

Second We will have dis-cussion sessions that combine abstract re-view and expert opinions. They are designedto be the sharp part of “cutting edge” medi-cine and surgery.

www.woa-assn.orgSpring 2015 Volume 17 Number 2

President’s MessagePaul C. Collins, MD

NewsWestern Orthopaedic Association

Sixth We will have several airplanesto fly in, from a Husky back-country plane toa pre-WW2 Navy N3N, and possibly a P-51fighter plane! There will be opportunities foradventuresome members to see Coeurd’Alene from the air and in the N3N wave offthe side to others at the meeting.

Seventh the will have a time in Coeur d’Alene, both while you

are in the morning classes and freein the afternoon. There are so many fantasticopportunities with things like boating on theCoeur d’Alene lake, playing golf at the fan-tastic Coeur d’Alene golf course with the

I N S I D E

2015 Program Chair’s Message p. 3

Presidential Guest Speaker p. 4

Howard Steel Lecturer p. 4

Resident/Fellow Award Winners p. 4

Young Investigator Awards p. 5

Scientific Program Highlights p. 5

Upcoming WOA Meetings p. 5

Multimedia Education Sessions p. 5

Money Matters p. 6

The WOA Annual Meetingwill be held July 29 – Au-gust 1, 2015 at The Coeurd’Alene Hotel in Coeurd’Alene, Idaho. For meet-ing information, view thePreliminary Program on-line at .

There is something magical about a visit toThe Coeur d’Alene Resort. With idyllic land-scape, year-round activities, and its spectacu-lar setting at the shore of one of America'smost beautiful lakes, it is no wonder LakeCoeur d’Alene has been christened the “Play-ground of the Northwest.” With luxuriousaccommodations, a rejuvenating spa, sump-tuous cuisine, and world-class golf, which

includes the world’s only floating green; thisfour-star resort continues to be the destina-tion of choice for discerning travelers world-wide. The resort ranked in the Top Twentyof magazine’s 2013 World’sBest Awards. Barbara Walters called it “alittle slice of heaven.” Come check out Coeurd’Alene for yourself this summer!

For everyone’s convenience WOA has re-served a block of sleeping rooms. To make areservation at The Coeur d’Alene Hotel, call(800) 688-5253. Please mention that you arewith to getthe discounted rate. Cutoff for WOA RoomRates is July 2, 2015. Register online at

Register Today for the 79th Annual Meeting

July 29-August 1, 2015Coeur d’AleneCoeur d’Alene, ID

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Western Orthopaedic Association News

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Paul C. Collins, MD

John R. Tongue, MD

Robert R. Slater, Jr., MD

Valerae O. Lewis, MD

Brian A. Jewett, MD

Nitin N. Bhatia, MD

Patrick J. Halpin, MD

Omer A. Ilahi, MD

Jay R. Lieberman, MD

Basil R. Besh, MD

Jeffrey E. Krygier, MD

James Van den Bogaerde, MD

Jennifer M. Van Warmerdam, MD

Cindy Kelly, MD

Lawrence R. Housman, MD

Robert R. Slater, Jr., MD

Payam Tabrizi, MD

“floating green” (view details online at(http://www.cdaresort.com/discover/golf),the Silverwood Theme Park (details online athttp://www.silverwoodthemepark.com/) foryou and the kids, and so, so much more to do.Multiple options indeed!

The stars are aligning to be a trulyevent for everyone with and around you!Again, this is July 29th through August 1st inCoeur d’Alene, Idaho. I hope you have it on

the schedule already. You can view all of themeeting information at the WOA website;www.woa-assn.org.

I look forward in seeing you in Coeur d’Alene!

Sincerely,

Paul C. Collins, MDWOA President

President’s Message continuedWOA 2014-2015Board of Directors

The WOA MissionThe Mission of the Western Orthopaedic Association is to promote high quality ethical care formusculoskeletal patients in the western region of the United States by providing educational programs,fostering collegiality and supporting professional development among its members and physicians-in-training, and by influencing health care policy.

79th Annual Meetingand Allied HealthConcurrent Meeting

July 29 - August 1 | Coeur d’Alene Resort | Coeur d’Alene, ID

Register online at www.woa-assn.org

Call 1-800-688-5253 to book your hotel room

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2015 Program Chair’s Message

I’m sure quite a few peoplehave seen the movie .This film “is Marjane Satrapi’s

inventive, wry, and tragic memoir of growingup in Tehran in the 1980s - the tumultuousyears when the Islamic Revolution took hold inIran and the country fought off an invasionfrom neighboring Iraq. Using a striking black-and-white comic strip format, Satrapi chroni-cles daily life from the perspective of a middle-class schoolchild, as well as cataclysmic eventssuch as the overthrow of the Shah and the long,bloody war with Iraq. is at once astory of growing up and a reminder of the per-sonal costs of war and repression, convincinglyrelated by a perceptive girl caught up in theraging currents of history, who also has time tolisten to Michael Jackson and dream of a betterlife.”

I lived my own version of this film. My familyimmigrated to Canada in 1978, shortly beforethe political turmoil and the American hostagecrisis. Being Middle Eastern during this timewas rather difficult (and actually still is at times).Not only was there the negative and somewhatignorant stereotype of being associated with thispolitical regime, but not speaking English well,and certainly not knowing the culture of theWestern world made it a little difficult for alittle boy (and my sister as well) going to school.

Just like in the movie, however, I found that popculture and sports bridged the gap. Learning totalk about Guy Lafleur, Larry Robinson and theMontreal Canadiens winning their 4th consecu-tive Stanley Cup allowed me to make newfriends. But I found what crossed the boundaryof being from a different part of the world was alove of music, which to this day is an importantpart of my life.

I have had an enjoyable time putting togetherthe Scientific Program for this meeting (alongwith too many people to mention individually).I have tried to tie in the music of the 1980’s witheach of the individual sessions. From the cuttingedge Basic Science Symposium on the Thursdaymorning, Susan Bukata from UCLA will give anupdate on Metabolic Bone Disease. A few of mycolleagues have heard her lecture before, andwere known to say afterwards “She Blinded Me

with Science.” My current partner Dr. Krygierand one of my attendings from my own residentdays, Dr. “Big Guy” Feibel will follow with lec-tures on Bisphosphonates and Orthopaedic In-fections.

The next day, there are two outstanding sympo-sia on problems affecting both the young andthe old, with internationally recognized faculty.I felt that the appropriate song for the session onHip Arthritis was the 1986 hit by Huey Lewis &the News, as a lot of these degenerative condi-tions indeed cause the “Hip to be Square.” Thetrauma lectures for the afternoon session will beequally impressive, as we concentrate on notjust simple lower extremity periarticular frac-tures, but ones that are “Shattered.”

The Resident and Young Investigator awardscommence on the final day of the meeting.From our brilliant young colleagues, who arelearning how to be “Like a Surgeon” to the“Smooth Operators” of our next generation, wewill be amazed at their scientific endeavors. Inthe Practice Management Symposium, Brian S.Kern, Esquire will advise us on how to avoidlitigation, when we are indeed “Bad to theBone.” John Tongue (our incoming Presidentfor the 2016 Annual Meeting - shameless plugby me), Jeff Smith, and Lisa Cannada will talkabout the “Social and Economic Value of Ortho-paedics,” “How to Build a Successful Practice”and “Women in the field of Orthopaedics,” re-spectively.

Our final Symposium, “Let your BackboneSlide,” will be moderated by Dr. Garth Johnson,the man responsible for my selection of Ortho-paedics as a career choice. Chip Routt will dis-cuss his extensive experience with the “Good,the Bad and the Ugly of Sacral Injuries” over aremarkable career. Michael Briseno will simpli-fy the spine lingo in “Spine Surgery for Dum-mies – What do all those Acronyms Mean?”And forget about all the conspiracy theories ofwhom shot JFK: the real controversy is whathappened with “Jack’s Back – Failed Spine Sur-gery in the life of John F. Kennedy.”

As is my habit, I haven’t taken the beaten path.We will try two new methods of presentation atthe WOA this year. The first will be debate typelectures on both upper (scaphoid / proximalhumerus) and lower extremity (proximal tibia /calcaneus) controversial fracture cases in theearly morning hours to get your blood circulat-

ing. The Foot and Ankle debate on the treat-ment of ankle arthritis will hopefully stir upcontroversy, as I can assure you that their pro-con arguments will be anything but “Footloose.”

Each day, we will offer the participants a widechoice of concurrent Rapid Fire Sessions, wherean enthusiastic and knowledgeable moderatorwill engage the presenters through their sub-specialty lectures. The success of both the de-bates and the Rapid Fire sessions will rely onactive audience participation. We would hopethat with the new Audience Response systemthat we incorporate, you can vote for the win-ners of each debate, as well as ask real-timequestions through the use of your own SmartPhones.

Finally, to wind down each evening, there willbe guided Poster Tours, where a moderator willchoose a few of the more intellectually stimulat-ing posters, and lead a discussion amongst thoseenergetic enough to follow. And to incentivize,you can walk around while enjoying refresh-ments.

There is so much more that will keep everyoneeducated and entertained through a wonderfulfour days. We will have Saw Bones labs to honeyour surgical skills, pediatric case presentationson how to survive the nights and weekends oncall, as well as Orthopaedic Practice Patternsand National Trends. So much for everyone.Now only if the San Jose Sharks would shape upand win at least one Stanley Cup?

On behalf of Paul Collins and myself, I wouldlike to thank you in advance for coming to ourAnnual Meeting in Coeur d’Alene.

Payam Tabrizi

Dedicated son to my Mom and Dad, who sacri-ficed their own happiness and security to givemy sister and me a chance at a brighter future.

2015 Program Committee

The Western Orthopaedic Associationgratefully acknowledges the following or-thopaedic surgeons for their contributionto the development of the scientific pro-gram.

Payam Tabrizi, MD, ChairMelvyn A. Harrington Jr., MDOmer A. Ilahi, MDBryan S. Moon, MDSteven J. Morgan, MD

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Western Orthopaedic Association News

2015 WOAResident/Fellow

Award RecipientsWOA is pleased to welcomeDouglas W. Jackson, MD asthe 2015 Presidential GuestSpeaker. Dr. Jackson, early inhis career, established theLong Beach Knee and Ortho-

paedic Sports Medicine Fellowship Program.

He trained over 50 orthopedic surgeons dur-ing their time in that program. In addition,he ran a very busy private practice for over40 years and was Medical Director of South-ern California Center for Sports Medicine formost of those years. He established a freestanding private research facility, the Ortho-

paedic Research Institute at the MemorialMedical Center in Long Beach, California.

Dr. Jackson and Timothy Simon, PhD pub-lished extensively on their vast research inthe areas of the meniscus, ligaments, tendonsand allografts. He went on to serve as presi-dent and in leadership roles of many medicalorganizations including being President ofthe American Academy of Orthopaedic Sur-geons. The past ten years, he served as theAnnual Course Director and Editor of

. We look forward to his presen-tation at WOA’s 2015 Annual Meeting.

2015 Presidential Guest Speaker

WOA is pleased to havepsychologist Dr. Kevin Le-man, as its Howard SteelLecturer for the 79th An-nual Meeting. Internation-ally known psychologist,business consultant, award

winning author of nearly 50 books and NewYork Times Bestselling author of

, radio and television personal-ity, and speaker, Dr. Kevin Leman has taughtand entertained audiences worldwide withhis wit and common sense psychology.

A frequent contributor to , Dr.Leman has made house calls for hundreds ofradio and television programs including

. Dr. Leman has served as aconsulting family psychologist to

. Dr. Leman has shared theplatform with such diverse personalities asSteve Forbes, Bill Cosby, and Regis Philbin.He has been a featured speaker at Top of theTable, YPO University and several YoungPresident’s Organization chapters around theUnited States and Canada. Dr. Leman haspresented to IBM School of Management,Cincinnati Financial Corporation, Pennsyl-vania Banker’s Association, Pepsi-Cola, PizzaHut, Million Dollar Round Table, Tambrandsand McDonald’s, to name a few. Dr. Leman is

2015 Howard Steel Lecturer

the founder and president of “Couples ofPromise,” an organization designed and com-mitted to helping couples remain happilymarried.

Some of his best-selling titles include:

Dr. Leman received his Bachelor’s degree inpsychology from the University of Arizona,where he later earned his Master’s and Doc-torate degrees. Former Head Resident andAssistant Dean of Students at the Universityof Arizona, Dr. Leman is the recipient of thehighest award given by the University ofArizona to their own, the Alumni Achieve-ment Award. Dr. Leman also attended NorthPark University, where he was the recipientof North Park’s 1993 Distinguished AlumnusAward and was also awarded a Doctor ofHumane Letters degree in 2010. Dr. Leman’sprofessional affiliations include the Ameri-can Federation of Television and Radio Art-ists, and the North American Society ofAdlerian Psychology. Originally from Wil-liamsville, New York, he and his wife, Sande,live in Tucson, Arizona. They have five chil-dren and two grandchildren.

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Congratulations to the following 2015WOA Resident/Fellow Award Recipients.The award papers will be presented dur-ing the Scientific Program on Saturday7:35 am – 8:25 am.

The Lloyd Taylor, Vernon Thompson,Harold and Nancy Willingham, Sanfordand Darlene Anzel, and Resident AwardWinners will be announced Saturday eve-ning.

Christopher Bui, MD VA Long Beach,Long Beach, CABiomechanical Stability Of GlenohumeralBipolar Bone Lesions After Soft-Tissue Re-pair

Paul M. Lichstein, MD, Stanford School ofMedicine, Redwood City, CAStatic Spacers For Periprosthetic Knee In-fection: Inferior Flexion To ArticulatingSpacers?

Alexandra Stavrakis, MD, University ofCalifornia at Los Angeles, Los Angeles, CAA Novel Antibiotic Coating In PreventingPeriprosthetic Infection

Calvin Schlepp, MD, Harborview MedicalCenter, Seattle, WARadiographic Predictors Of Posterior WallFracture Instability

Lucas A. Anderson, MD, University ofUtah, Salt Lake City, UTPrevalence Of Radiographic AbnormalitiesIn Senior Athletes With Well-FunctioningHips

Ryan Fader, MD, University of ColoradoSchool of Medicine, Denver, COFresh Osteochondral Allograft versus Au-tograft: 12 Month Results In Isolated Ca-nine Knee Defects

Pascual Dutton, MD, The Taylor Collabo-ration, San Francisco, CAWhat Is The Most Effective Technique ToStabilize Patients On The Operating TableDuring Total Hip Arthroplasty?

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Scientific Program Highlights

– Distal Fe-mur Fractures (Plate versus IMN)

– Upper Extremity Trau-ma Debates (ARS)

– Orthopaedic PracticePatterns & National Trends – Part 1

– Basic Science;Hip; Pediatrics; Sports (Knee)

– Howard Steel Lecturer,Kevin Leman, PhD

– Basic Science “She BlindedMe with Science” – Thomas Dobly (1982)

– Foot & Ankle “Footloose” –Kenny Loggins (1984)

(Open daily to all participants before andafter the Scientific Program.)

– Upper Extremity(Following

Scientific Program)

- Lower Extremity Trau-ma Debates (ARS)

– Orthopaedic PracticePatterns & National Trends – Part 2

– Academics; Foot& Ankle; Spine; Shoulder

– Presidential Addressand OREF Update

– Hip Arthritis “Hip to beSquare” – Huey Lewis & the News (1986)

–Complex Periarticular Frac-

tures of the Lower Extremity “Shattered” –Rolling Stones (1982)

(Open daily to all participants before andafter the Scientific Program.)

– Lower Extremity(Following

Scientific Program)

– WOA/OREF YoungInvestigator Awards “Smooth Operator” –Sade (1984)

– WOA ResidentAwards “Like a Surgeon” – Weird Al Yank-ovich (1985)

– Nights And Week-ends: What To Expect On Pediatric Ortho-paedic Call At Trauma Centers / How to StayOut of Trouble

– Practice Management Sym-posium “Bad to the Bone” – George Thoro-good (1982)

– BOC, AAOS and Pres-idential Guest Speaker, Douglas W. Jackson,MD

– Sports Medicine / UpperExtremity“Hurts So Good” – John CougarMellencamp (1982)

– OrthopaedicImaging; Hand, Wrist & Elbow; Knee; Trau-ma

– Spine Symposium “Let YourBackbone Slide” – Maestro Fresh Wes (1989)

(FollowingScientific Program)

(Open daily to all participants before andafter the Scientific Program.)

Upcoming WOA Meetings

79th Annual MeetingJuly 29 - August 1, 2015Coeur d’Alene Resort

Coeur d’Alene, ID

80th Annual MeetingSeptember 28 - October 1, 2016Renaissance Indian Wells Resort

Indian Wells, CA

81st Annual MeetingAugust 2-5, 2017

Grand Hyatt Kauai ResortKoloa Kauai, HI

The 2015 WOA Young Investigator Award will be selected at the Annual Meeting from the five top papers. The contenders for Young Investi-gator Award will present during the Scientific Program on Saturday 7:00 am – 7:35 am. The three Award Winners will be announced Saturdayevening.

Young Investigator Awards

Multimedia Education SessionsThe WOA will provide a multimedia education session following the Scientific Program on Thursday, Friday, and Saturday, July 29-August 1.A comprehensive selection of AAOS DVDs will be available for your review. These DVDs will highlight surgical procedures and current con-cepts in orthopaedics. Registered attendees should find these DVDs informative and helpful in their practice.

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Western Orthopaedic Association News

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Over the past few years, we have addressedpotential strategies that a doctor can use toreduce income taxes, increase benefits, orbuild retirement savings. In that time, wehave also had the opportunity to consultwith hundreds of medical groups on how toimplement such strategies for their practice.Unfortunately, the outcome of such consul-tations can sometimes turn out to be lessthan fruitful because of office politics relatedto the age-related perspectives of practicepartners.

Typically, while the younger members ofmedical groups are often very motivated toreduce their income taxes, the older doctorsare typically uninterested. Either the olderpartners are already so close to retirementthat they don’t need extra retirement plan-ning or they may be simply set in their waysand don’t want to change anything, i.e., sub-scribing to the old “if it ain’t broke, don’t fixit” mindset. The result in such situations canbe a planning gridlock.

Unfortunately, for the younger physicians,the long-term costs of such practice planninggridlocks are significant – as they will haveto work more years to reach the same retire-ment goals as their older partners. The so-called golden days of medicine are over, andthe new times demand more creative plan-ning. Nonetheless, each year we meet withhundreds of motivated doctors who cannotimplement the planning we recommend be-cause the powers-that-be in their groupstand ready to thwart attempts at change.

We decided to write this article to suggestsome alternatives to this dilemma. If you seeyourself in this situation, please do not hesi-tate to contact us. Three solutions to theproblem described above follow.

You should consider using a hybrid benefit

plan, in addition to a traditional qualified plan(401(k), profit-sharing plan, and defined ben-efit plan). The main attraction of a hybridbenefit plan is that each physician can choosethe amount he/she wants to contribute in theplan formula. This can vary from $150 to$100,000 per year.

Simply because physicians can participate attheir desired level, this plan is the only ad-vanced technique (and it’s not really very ad-vanced) that we have successfullyimplemented for a medical group larger than5-6 doctors. The reality is that each physicianin a group has different cash flow needs andsavings ability. Logically, each doctor needsmore/less spending money than others. Phy-sicians who feel like they are hamstrung bytheir group in their ability to reduce taxes andsave for retirement may have a hybrid benefitplan as a practical alternative. Other benefitsto this type of plan include:

● Utilization of the plan in addition to aqualified plan, such as pension, profit-sharing plan/401(k) or SEP IRA

● Contributions can qualify for currenttax deductions

● The plan acts as an ideal “tax hedge”technique against future income, andcapital gains tax increases

● Balances can grow in a top asset pro-tected environment

● Employee participation requires a min-imal funding outlay

● There are no minimum age require-ments for withdrawing income (no ear-ly withdrawal penalties)

Despite the availability of an elective benefitplan described above, we still see medicalgroups stuck in planning gridlock. Anotherway to address gridlock is to alter the prac-tice’s legal structure so that it accommodates

planning flexibility on the part of individualphysicians.

In the typical medical group structure, thereis one legal entity – whether it is a corpora-tion, LLC, or professional association (PA).Physicians are either owners of the entity(informally referring to themselves as part-ners) or non-owner employees. In all suchcases, the physicians have no ability to sepa-rate themselves from the central legal entity.If the central entity does not adopt a plan-ning strategy, no individual doctor has anyflexibility to adopt it on their own.

If this is the case in your practice (as it is thecase in many practices), you might consideran alternative structure when the centralentity is neither owned by, nor employs, thedoctors directly, but rather is structuredthrough their own professional corporations(PCs) or PAs. In this way, after the group ispaid by the insurers, the group, in turn, paysthe physicians’ PCs – the payments are struc-tured as 1099 independent contractor in-come.

From a tax standpoint, there is almost nodownside to the central entity or to the doc-tors who are not motivated to engage in anyadditional planning. However, for the physi-cians who want to implement planning strat-egies, they may do so through theirindividual PCs. Their strategies will be im-plemented at the PC level, leaving the cen-tral entity unchanged, thereby avoidingconflict with partners. More to the point,such planning can give individual physiciansthe ability to put away $10,000-$50,000more for retirement each year.

In our business, we speak to over 1,000 phy-sicians each year, many of whom experiencethe planning gridlock described in this arti-cle. Many practices that rely on internal re-sources to tackle financial gridlocks will endup identifying no solution to their dilemma.In such situations, outside help can be usefulin helping physicians realize their financialplanning goals. Outside help can consist of

Statements and opinions expressed in the advertisements and information regarding products or services herein are those of the author(s) and do not necessarily reflectthose of the Publisher or the Association. The Publisher and the Association do not assume any responsibility or liability for such material and do not endorse,guarantee or warrant any product or service advertised in this newsletter.

Avoid Financial Gridlock When Partners Disagree:3 Ideas For Every Group Practice

David B. Mandell, JD, MBAJason M. O’Dell, MS, CWM

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is an attorneyand author of five national books for doctors,including,

, as well anumber of state books. He is a principal ofthe financial consulting firm OJM Group(www.ojmgroup.com) along with

who is also a principaland author. They can be reached at 877-656-4362 or [email protected].

Disclosure:

advisors or consultants who convince thegroup to implement creative planning (in-cluding the solutions described here). Theseexperts in the field of tax, benefits planning,or corporate law have the credibility andexpertise to enlighten practice partners;much more so than fellow physicians. Addi-tionally, outside financial consultants canexplain the nuances of legal and accountingissues invoked by careful financial planningthat can address the needs of individual part-ners. Thus, nearly all practices should strong-ly consider using a firm or advisor who canbring in financial and legal expertise so thatproductive discussions can begin amongpartners.

If your practice is grappling with financialgridlock in a group practice or would like toexplore advanced planning options, it may bethat differential needs of the various partnersare at odds with each other. This article haspresented some basic methods of dealing withsuch gridlock. Nothing can take the place of aprofessional trained and experienced in thefine points of financial planning for physi-cians. Authors welcome your questions, andcan be contacted at (877) 656-4362 or at<http://www.ojmgroup.com>.

Money Matters continued

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110 West Rd, Suite 227Towson, MD 21204E-mail: [email protected]: www.woa-assn.org

Member Incentive

Refer and sponsor new memberand receive 1/2 off the registration

fee for the next annual meeting.

Refer and sponsor new mem-bers and the registration fee for the

next meeting is waived.

Do You Know a Qualified MD or DOOrthopaedic Colleague Who Is Not a WOA Member?

Apply formembership

online at

or call

and ask foran application.

The Benefits of Being a Member:

1. Self-Assessment Exam worth 10 CME creditstoward your Maintenance of Certification(MOC) requirements

2. 24 FREE CME credits through the

3. Eligibility to participate in Ortho–Preferred®, aprofessional liability insurance programexclusively for orthopaedic surgeons

4. Meeting registration fee waived for new mem-bers’ first year

5. Free subscription to the

6. Annual meeting discount for members7. Substantial discounts to other regional society

meetings8. Diverse annual meeting content9. Awards and scientific recognition

10. WOA newsletter

Completion of an accredited residency program and privileges topractice as an orthopaedist in a local hospital are the

requirements for both MD and DO candidates.