Firm Eases Financial Pain Points of Orthopedic Surgeons

During an operation, it’s the critical job of the “first assist” to anticipate the surgeon’s needs for specific instruments and the like.

Vestia Personal Wealth Advisors’ orthopedic surgeons practice serves as “financial first assist” to its clients, Kameron Helmuth, partner and co-leader of the practice, told ThinkAdvisor in an interview.

Vestia’s client niche is high-income doctors, mainly orthopedic surgeons and female physicians.

The firm has about $500 million in assets under management, and more than 500 physician families are clients.

In the interview, Helmuth, co-founder of the orthopedic surgeons practice with Brad Quick, Vestia partner and president, describes a few of the complex financial issues facing these short-on-time surgeons, who are one of medicine’s top three highest-paid specialists.

The other two specialties are neurosurgery and invasive cardiology, according to the U.S. Bureau of Labor Statistics.

In the e-book “5 Financial Pain Points for Orthopedic Surgeons,” Helmuth co-writes about bone surgeons’ most critical financial concerns.

Not the least of these is asset protection. Orthopedic surgeons “have a higher propensity for litigation,” he points out.

So “it’s extremely important to keep their assets out of the crosshairs of a potential lawsuit,” he says.

The lawsuits typically arise not from the doctors’ clinical work but from outside business activities with which they become involved, such as investments in startup companies and real estate ventures.

Another area where these surgeons need plenty of advice is tax strategies, partly because many are independent contractors with multiple income sources.

Further, because they’re “consistently in the highest tax bracket, it’s very hard to use creative planning to get them into lower brackets,” notes Helmuth, 33, who was previously an advisor with PNC and The State Bank & Trust Co., in Fort Wayne, Indiana, where his clients were physicians, dentists and business owners.

ThinkAdvisor recently interviewed the certified financial planner, who was speaking by phone from Fort Wayne.

Vestia, a virtual advisory, also has locations in Indianapolis; Los Angeles; Nashville, Tennessee;  and Omaha, Nebraska.

“Doctor’s Eyes Only” is a podcast Helmuth co-hosts that discusses topics relative to “the life of a surgeon,” as he describes it.

A recent interview with two attorneys produced info on how to protect innovative devices and other intellectual property that physicians may create.

“There’s big money to be made [with these], but doctors aren’t familiar with the legalities that come with them,” Helmuth says.

Here are highlights of our conversation:

THINKADVISOR: I imagine that with the aging population, more folks are needing knee or hip replacements, for example. Is that a factor in the success of your specializing in orthopedic surgeons?

KAMERON HELMUTH: Orthopedics is a growing industry. We know there are going to be more and more physicians that need to be served.

The surgeons are in their early 30s before they start practicing. So they have a condensed window to save [money] and avoid mistakes.

Are your clients located nationwide?

Yes. Most physicians tend to transition jobs regularly. So about 50% of orthopedic surgeons will leave their first job in the first five years. We can work with them wherever they go.

You co-wrote the free e-book, “5 Financial Pain Points for Orthopedic Surgeons.” What’s the biggest one?

The No. 1 pain point is that they try to do too much themselves. With high-caliber orthopedic surgeons’ average [high] production [operations], there’s very little time left in their day to focus on personal financial matters.

Orthopedic surgery is one of the three highest paid specialties in medicine — and the surgeons are [among] the most in-demand, short-on-time physicians.

Our thesis is that we can be an outsourced CFO for them. We call ourselves their “financial first assist” [like a surgical “first assistant” anticipating physician’s needs].

[Performing surgery], when a doctor puts their hand out, the first assistant presumes what tool or instrument they need to make the next incision or take the next step.

We play that role so the physicians can focus on what they value most, which is their practice, family and the world of medicine.

We administer all the financial aspects of their lives, which adds time to their day.

What are some financial needs of orthopedic surgeons that might be different from those of other physicians?

Because they’re very entrepreneurial and a number are self-employed, there are tax and planning needs around [being an independent contractor].

It’s understanding the legal and tax structure of their practices and how they and their employees are compensated.

What’s another pain point?