Just my two cents, and a different point of view: Pracice medicine. Practice acupuncture. You are not a lawyer. You may be smart enough to have become a lawyer, but you DIDN'T. I am a tax lawyer. I don't superglue my teeth--I go to a dentist. I don't get DIY medical books and treat myself. The sensible use of human capital is to apply yourself to your highest and best use. Be a doctor. You can probably build a practice website, and do your own bookkeeping, and the janitorial work as well, but obviously you are better off practicing medicine and letting a professional janitor clean your office. Just like a great cleaning service, a great bookkeeper is a godsend, and can reduce your accounting costs significantly. They can work remotely now, which is awesome, so you can look over everything after hours, compare bank records, etc. It is the initial set up of practice that is so important in tracking money, but a good one knows just how to do this. Re: corporation--this is an important and potentially long-lasting legal issue with significant tax implications for your future. One reason for a corporation is to isolate liability to the entity, but you don't need one until you have something to protect, some assets, bank accounts, accounts receivable. It takes about 15 minutes in many states to form a corporation and a few minutes online to get a tax identification number, but at that point you are responsible for more paperwork, more tax returns, corporate maintenance requirements, business licenses, etc. And you have to choose the entity, C corp, S corp, LLC, PA or PLLC? Liability depends on the state and state laws are changing, as in NOW. Tax treatment is also a big issue, and making changes, for example, from an S corp to a C corp can be very costly. Most successful medical practices should be C corps, but if you have more than one practice at the same time, the choice of entity becomes complicated. What you need for your acupuncture practice will depend somewhat on what the group has, if you join a group. If you are going to start the acupuncture practice before you join a group practice, then you will want a corporation to protect your non-practice assets, if you have any. (Most groups prohibit outside patients in your contract, as it creates liability for them with no return). If you have only debt, there isn't much to protect, and since you will be functioning as a health care professional, you can't escape malpractice claims by use of a corporation anyway. A creditor is entitled to 25% of your gross under bankruptcy law (last time I checked) so your choice after a big case going against you would be to quit working, or reduce your income. This is why doctors get so nervous about money. They should. Your most devastating risk ( though certainly unlikely) is disability--if you become disabled long term, you will be a terrific burden to your family, so that is the first risk to eliminate if you can. If others are dependent on your income, then your life needs to be insured(but I think you don't yet have kids, so your risk of waiting to do this is that you may become uninsurable for some reason). You should try to build qualified retirement assets as soon as possible, as these are protected from creditors by federal law, so contribute what you can to 403(b), 401(k), or simple 401K or even SEP IRA if not eligible yet for others.
You will hear a lot of get-out-of debt advice in the popular media, and here too, because there is so much in the popular media. Doctors are late earners of high income, some of them later than others. But debt is not so simple for doctors. Some of my retired doctors are living in expensive homes with mortgages they will never pay off, so they have the benefit of a lifestyle with an overall lower cost. Student loan interest is not deductible, which is a shame, but I would not get overly aggressive about payoff. You should NOT give up another ten years of compounding savings in order to aggressively pay down the SL, even with some negative arbitrage, since no one can predict the future. You may be able to negotiate other loans to pay down the highest interest rate SLs you have. Then put the loan payments on a reasonable schedule, make them part of your monthly budget and go on autopilot. For example, if you can buy a house with a lot of equity in it (which you should be able to do now, depending on where you areI said a house, not a McMansion), a home equity loan that is deductible interest can be used to pay off part of your SL, the highest rate part. Over time you may be able to increase your line of credit and reduce the SL further.
Dave Ramsay is not a doctor's advisor. He has some great things to say, but probably not so much for you. A family practice doctor can make a LOT of money. I know some who make over $1M a year, and some who barely make $100K. In order to make a lot, you need a really smoothly functioning office which leverages YOU. Lots of good help, as in nurses, assistants, PAs, NPs, so that patients can flow through as quickly and comfortably as possible, feeling cared for well with a minimal amount of time spent by you. Highest use of each person in the line of contact. If you can see 1 patient every 1/2 hour alone, then with a PA or NP double that, do it. If you can double it again with good assistant and good patient flow, do it. You are the top line person for medical issues. Doesn't mean you need to do everything. It means you need to streamline to do what you do best. This, IMO, is what you should be studying. What makes a medical office profitable? What distinguishes the most profitable from the least? Real world. You should also be looking at contracts, time to partnership, thinking about how to allow a practice to help you buy-in, without borrowing, and without making too large a "payment" in foregoing too much compensation or for too long. Consider tying your deal to productivity. Consider if you really are able to do this alone. Perhaps you can associate with a practice, share call, but BE your own practice. Sometimes you can get a hospital to subsidize a new practice, they may guarantee an income for a couple of years, and forgive the debt if you agree to stay on for 3-4 years. So you won't have out-of-pocket costs for setting up an office, and they will market you but not "own" you.
I am not saying don't read any and everything to educate yourself about going forward. You are to be commended for this effort. Graham is brilliant, but you are not going to be a money manager, you are going to be a doctor. I advise doctors on all aspects of finance, but I don't even manage investments myself, I manage managers. Investing is serious business and full of pitfalls over a lifetime, especially for a busy doctor, even one as hardworking as you. Corporate Tax? Wow. That is ambitious. I can't even remember how many law school and tax courses I have taken that relate to the workings of that subject. And continuing legal education. Plus it overlaps with accounting in VERY confusing permutations. And it changes, dramatically changes at random and sometimes on short notice. My point is that you should focus on the aspects of income and expenses you can control. There are not many doctors who, out of the gate, want to set up a practice. My experience is that they know that about themselves early on. Since you want your own practice, and are not 30 years old, I expect you could do it from scratch. I think the hospital subsidy route would be great for you and I have seen many versions of it, especially where hospitals need to attract admitting doctors, you get the best of both worlds if you negotiate the contract well--an independent practice where you reap all the profits right away and a "salary" to prop you up while starting. The downside is that it is often set up as a "loan" to be forgiven, and forgiven debt creates income when forgiven. That can be addressed later with deductible benefits you pay yourself from your corporation. So priority one is to study profitable practices (top line) and expenses. I know coding is king, and many doctors need to stay hands-on with this for quite a while. Remember that no one watches your money like you do. Figure out what kind of population you want to serve-rural is probably going to be more profitable for reasons of underserved and little competition, but that is a lifestyle choice too. A less urban setting with opportunity to travel is not a bad way to go. One very successful FP I know in a small but not too small city, gives free physicals to football players at junior high and high schools. Takes him a day, gets a lot of goodwill going to school and doing that, town loves him, parents respect it, coaches love him, and the kids who dont even have a doctor think of him as their doctorso he is the go-to guy there. I hope some tidbit in here helps you out. Best of luck to you.
Books: Nudge, Fooled by Randomness, look for marketing books NOT directed at medicine to see what can apply. For example, I recently went to an imaging center for a mammogram that had both pre-heated fluffy robes in a nice peach color, pre-heated armpit wipes, and a doctor to pop in and quickly tell me that at first glance my study looked ok, tech who did study was great at explaining why it hurt--she was making sure to get deeper to see pit lymph nodes--I will NEVER go anywhere else. Usual experience is paper "robe", cold wipes, bored tech, and I now know the studies before weren't as good either. Wowed me. I have told everyone I know about the place.
