In this second part of a two-part episode, host David Mandell continues his discussion with Dr. Jack Bert, a board-certified orthopedic surgeon and former president of the Arthroscopy Association of North America.
In this conversation, Jack emphasizes the importance of ancillaries in building a financially successful medical practice. He explains how orthopedists and other specialists can significantly increase revenue streams through owning or participating in ambulatory surgery centers (ASCs), imaging services, physical therapy, and durable medical equipment. Dr. Bert stresses that physicians should strive for ownership and control rather than settling for minority stakes in ventures that disproportionately benefit outside management companies.
(Video Available October 29, 2025 at 6 AM Eastern)
The discussion transitions to contract negotiations, where Dr. Bert highlights common pitfalls and best practices for physicians. He explains how employers often use national databases like MGMA to undervalue physicians and why local market comparisons are far more accurate benchmarks. He also warns against restrictive clauses—such as intellectual property ownership—and underscores the importance of seeking professional review of employment agreements. Dr. Bert strongly advocates for negotiation, pointing out that physicians only get the deals they negotiate, not the ones they are simply offered.
In the final portion, Dr. Bert shares advice on long-term financial planning and retirement. He stresses the importance of consistent saving—at least 25% of income—early in one’s career, aiming for at least $10 million in retirement assets. He also discusses his transition into retirement, finding fulfillment through part-time independent medical evaluations, entrepreneurial ventures like MD Direct (which bypasses insurers to reduce costs), and leadership in orthopedic conferences. He concludes by underscoring the importance of not only saving wisely but also having meaningful pursuits in retirement.
INSIGHTS:
- Delegation and a strong support team allow physicians to maximize patient flow and efficiency.
- Owning ancillaries like ASCs, imaging, PT/OT, and DME can significantly boost practice revenue.
- Physicians should pursue majority ownership of ASCs rather than accept standard minority deals.
- Negotiation is essential—contracts should reflect local market rates, not just national averages.Beware of contract clauses that grant employers ownership of intellectual property developed by physicians.
- Healthcare attorneys or specialized tools should be used to review and negotiate employment contracts.
- ‘Easy in, easy out’ buy-in structures can make ancillary ownership more accessible for younger physicians.
- Physicians should aim to save at least 25% of their income to build toward a $10 million retirement goal.
- Having meaningful pursuits in retirement—such as consulting, business ventures, or teaching—prevents dissatisfaction and boredom.
- Direct-to-employer healthcare models, like MD Direct, can reduce costs, improve efficiency, and provide new opportunities for physicians.