Acne 

Actinic Keratosis 

Aesthetics

Alopecia

Biologic Treatments for Moderate to Severe Atopic Dermatitis 

Atopic Dermatitis 

Buy-and-Bill

COVID-19

Case-Based Roundtable

Chronic Hand Eczema

Chronic Spontaneous Urticaria 

Drug Watch

Eczema

General Dermatology 

Hidradenitis Suppurativa

Melasma

NP and PA

Pediatric Dermatology

Pigmentary Disorders 

Practice Management 

Precision Medicine and Biologics

Prurigo Nodularis

Emerging Therapies Plaque Psoriasis

Treatments for Plaque Psoriasis 

Psoriasis 

Psoriatic Arthritis 

Rare Disease

Rosacea 

Skin Cancer (Nonmelanoma)

Skin Cancer

Vitiligo

Wound Care

News

Media

Around the Practice

Between The Lines

Case-Based Peer Perspective

Clinical Case Collective

DermView

Expert Perspectives

Fellows Face Off

Frontline Forum

Medical World News

Patient Perspectives

Podcasts

Readout360

Recognize and Refer

Conferences

Conference Coverage

Conference Listing

Events

Publication

Dermatology Times

CME/CE

Resources

DermIQ

Interactive Tools

Job Board

Partner Perspectives

Perspectives in Dermatology

Polls

Spot Test

Editorial Advisory Board

Partners

Subscribe

and joined the MJH Life Sciences team in February 2023. She attended Kent State University and earned a Bachelor of Science degree in journalism with minors in public relations and creative writing. She enjoys making and listening to music, reading, and spending time with her cats, Astrid and Marceline.

Articles

FDA Approves Dupilumab, First and Only Targeted Medicine for Bullous Pemphigoid

Anabela Cardoso, MD, is the senior vice president of immunology medical affairs at Eli Lilly and Company.

Anabela Cardoso, MD, shares data from the phase 3b ADmirable trial—the first study to evaluate the safety and efficacy of lebrikizumab in patients with moderate to severe AD and pigmented skin. 

Q&A Part 1: Reviewing the Significance of Lebrikizumab for Patients With Skin of Color, With Anabela Cardoso, MD

Catch up on dermatology news, highlights, and insights from the past 24 hours.

Daily Derm Times: June 19, 2025

Jennifer Fisher, MMSc, PA-C, is a board-certified dermatology physician assistant and medical writer in Connecticut.

Upadacitinib’s targeted inhibition of JAK1 offers a novel strategy for managing bullous pemphigoid, and in rare, treatment-resistant cases, may induce sustained remission following immune modulation. 

Upadacitinib Induces Long-Term Remission in Refractory Bullous Pemphigoid: A Case Report 

Dermatology Times connects dermatology professionals with key skin disorder coverage, therapeutic strategies, clinical trial updates, and expert insights.

About

Advertise

Contact Us

Do Not Sell My Information

Terms and Conditions

Privacy Policy

Dermatology Times - Dermatology News and Clinical Insights

Facebook

Linkedin

Topics

Acne

Pigmentary Disorders

Practice Management

Psoriasis

Psoriatic Arthritis

Rosacea

1rem

Authors

The Omicron variant of COVID-19 is spreading quickly, jumping continents with infected travelers. Here’s the latest on what global health officials know about it.

Omicron COVID-19 variant: What we know and what we don’t

Final Thoughts: The Importance of Comparative Studies in AD

Panelists offer concluding insights and emphasize the critical role of comparative studies in advancing atopic dermatitis treatment strategies.

clinical

Video Series

 conference in Nashville, Tennessee, Eli Lilly and Company shared final results from the phase 3b ADmirable trial of lebrikizumab (Ebglyss).

This is the first study to evaluate lebrikizumab’s effectiveness and safety in adult and adolescent patients with pigmented skin and atopic dermatitis (AD), as this population is typically underrepresented in clinical trials.

) included 90 patients 12 years and older (weight: ≥ 40 kg) with moderate to severe AD and pigmented skin, according to the Fitzpatrick skin type scale (IV, V, or VI). Participants self-identified as Black or African American, Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander. The mean age of patients was 40.7 years. Approximately 43.3% of participants had a Fitzpatrick skin phototype of IV.

"Skin pigmentation matters in evaluating patients with atopic dermatitis, because from a medical perspective, the disease presents differently in darker skin tones vs lighter (eg, redness can be more subtle, pigmentation more prominent, and diagnosis and evaluation more challenging). Additionally, in the next 20 years, people who identify as American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian, or other Pacific Islander are projected to represent more than half of all Americans, which drives our urgency to invest in clinical research that helps address longstanding medical gaps in these populations. ADmirable is the first dedicated study to evaluate the efficacy and safety of Ebglyss in adult and adolescent patients with AD in these patients frequently underrepresented in clinical trials," said Anabela Cardoso, MD, senior vice president of immunology medical affairs at Eli Lilly and Company, in an interview with 

The patients received lebrikizumab 250 mg (500-mg loading dose at baseline and week 2) subcutaneously every 2 weeks for 16 weeks. Then, from weeks 16 to 24, those who responded to treatment received lebrikizumab 250 mg once every 4 weeks; those with inadequate response continued with the dosage every 2 weeks.

Respondents were defined as having an Investigator’s Global Assessment score of 0 or 1 with a 2-point or greater improvement (IGA 0/1) or 75% or greater improvement in Eczema Area and Severity Index (EASI 75). The primary end point of the study was achieving an EASI score of 75 at week 16. Secondary end points revolved around safety and efficacy using PDCA Derm, assessing cutaneous postinflammatory hyperpigmentation and hypopigmentation.

Approximately 68.9% of patients began the trial with moderate disease (IGA = 3) with a mean EASI of 26.4 and an average Pruritus Numeric Rating Scale (NRS) score of 7. At week 16, EASI 75, EASI 90, and IGA 0/1 were achieved by 69.2%, 44.9%, and 44.9% of patients, respectively. This includes more than 88% of patients with the darkest skin tones (Fitzpatrick V and VI). Approximately 73% of respondents were able to switch to a once-monthly maintenance dose after 16 weeks.

Nearly 60% of patients observed a 4-point or greater improvement in Pruritus NRS. These numbers increased at week 24 with EASI 75, EASI 90, and IGA 0/1 achieved by 78.4%, 47.3%, and 54.1% of patients, respectively. Moreover, 61.5% of participants had a 4-point or greater Pruritus NRS improvement.

"This new data demonstrating improvement in signs and symptoms (including itch) through 24 weeks of treatment helps confirm the efficacy of lebrikizumab in patients with skin of color – a population for which data is often lacking. Being able to communicate to my patients that the treatment I am recommending has established efficacy and safety in populations that reflect their background goes a long way in establishing trust and encouraging adherence to therapy," said Andrew Alexis, MD, professor of clinical dermatology and vice-chair for diversity and inclusion at Weill Cornell Medicine, in a statement to 

Additionally, 4-point or greater improvements in the Dermatology Life Quality Index were reached by 71.7% and 72.9% of patients at weeks 16 and 24, respectively. More than 64% of patients with hyperpigmented lesions and 25% with hypopigmented lesions showed improvement after 24 weeks. Most treatment-emergent adverse effects were mild or moderate, with only 1 reported case of conjunctivitis and injection site reaction. None of the adverse events were serious, and the drug did not need to be discontinued. This safety profile is consistent with previous long-term trials of lebrikizumab, regardless of dosage and frequency.

"Being able to communicate to my AD patients with skin of color that treatment with lebrikizumab has a high success rate in improving not only the signs and symptoms of AD, but also the sequela of postinflammatory hyperpigmentation, is extremely impactful and aligns with their treatment goals," said Alexis.

Overall, patients with skin of color and moderate to severe AD severity responded well to lebrikizumab after 24 weeks, with improvements in symptoms such as itch and hyperpigmentation. Response was noted as early as week 16 and continued to improve throughout the trial with a favorable safety profile.

"These new, 24-week data from ADmirable—the first dedicated study for evaluating the efficacy and safety of Ebglyss in adult and adolescent patients with pigmented skin and moderate-to-severe atopic dermatitis—reinforce the efficacy and safety of Ebglyss as a first-line biologic, following prescription topicals, with once-monthly maintenance dosing after the 4-month initial dosing for adults and adolescents, regardless of skin tone. These add to the robust and extensive data supporting Ebglyss's value for a broad range of patients with moderate to severe atopic dermatitis," Cardoso concluded.

1. Alexis A, Moiin A, Waibel J, et al. Efficacy and safety of lebrikizumab in adult and adolescent patients with skin of color and moderate-to-severe atopic dermatitis: final 24-week results from the phase 3b, open-label ADmirable study. Presented at: 2025 Revolutionizing Atopic Dermatitis (RAD) Conference; June 6-7, 2025; Nashville, TN.

2. Lilly's Ebglyss (lebrikizumab-lbkz) single monthly maintenance injection achieved completely clear skin at 3 years in half of patients with moderate-to-severe atopic dermatitis. News release. Eli Lilly. March 7, 2025. Accessed June 7, 2025. 

https://investor.lilly.com/news-releases/news-release-details/lillys-ebglyssr-lebrikizumab-lbkz-single-monthly-maintenance

Lebrikizumab demonstrated efficacy and safety in treating moderate-to-severe atopic dermatitis (AD) in patients with pigmented skin, a group often underrepresented in clinical trials. The phase 3b ADmirable trial included 90 participants aged 12 and older, with significant improvements observed in Eczema Area and Severity Index (EASI) and Pruritus Numeric Rating Scale (NRS) scores by week 16, which further improved by week 24. The study reported a favorable safety profile, with most adverse effects being mild or moderate, and no serious events necessitating discontinuation of the drug.

At RAD 2025, Eli Lilly revealed promising results for lebrikizumab in treating atopic dermatitis in patients with skin of color.

Late-Breaking Data: Lebrikizumab Demonstrates Efficacy in Patients With Skin of Color With AD

As we begin 2025 with a new president and a Republican majority in both houses of Congress, it is a good time to consider aspects of the current tax law that are set to expire at the end of 2025, as well as various tax proposals President Donald Trump made throughout his campaign. Understanding these potential changes will help you implement tax planning for 2025 and beyond.

The Tax Cuts and Jobs Act (TCJA), enacted in December 2017, introduced substantial amendments to the US tax code, aiming to streamline tax processes, provide economic stimulation, and foster investment. These changes affected various aspects of individual and corporate taxation. While some provisions are temporary, others offer long-term shifts in taxation policy. Here, we will examine some of the temporary provisions set to expire December 31, 2025, along with proposals President Trump has made regarding those provisions.

The TCJA reduced tax rates for most individual taxpayers, with the top rate falling to 37% from the previous 39.6%. This reduction benefited high-income earners but was designed to cover a broad swath of income brackets, providing financial relief across socioeconomic groups.

A significant change under the TCJA was the doubling of the standard deduction to what is for 2025 $15,000 for individuals and $30,000 for married couples. These adjustments reduced the number of taxpayers itemizing deductions, simplifying the tax filing process for many.

The TCJA doubled the child tax credit to $2000 per child and expanded its eligibility criteria, allowing more families to qualify. Up to $1400 of the credit became refundable, enabling low-income families with little tax liability to benefit.

The TCJA capped the state and local tax (SALT) deduction at $10,000, significantly impacting taxpayers in high-tax states. Critics argued that this disproportionately affected those in states with substantial state and local taxes.

The TCJA essentially doubled the estate tax exemption, which has since been indexed for inflation to its current 2025 level of $13.99 million per individual. Estates with taxable assets above this amount will be taxed at 40%.

Barring passage of any new federal tax law, as of January 1, 2026:

Individual tax brackets will revert to previous levels, with the top tax bracket at 39.6%.

The standard deduction will be halved, making it more beneficial for many taxpayers to itemize deductions again.

The cap for mortgage acquisition debt on which interest is deductible will go back to $1 million from the current $750,000.

State and local income taxes and real estate and property taxes will again be fully deductible.

The federal estate tax exemption will be cut in half.

During his campaign, however, President Trump presented proposals that could modify these provisions or eliminate the year-end expiration date. These include making permanent the lower tax brackets and increased standard deduction, as well as increasing the child tax credit to $5000 per child without income limits, an adjustment intended to provide more support for families, particularly in light of rising childcare costs. He also mentioned allowing the cap on state and local income tax (SALT) deductions to lapse, restoring higher deduction possibilities, and proposed additional deductions for interest on loans for US-built cars and for home generators in natural disaster-prone areas. He has also suggested making the higher estate tax exemption permanent or repealing the estate tax altogether.

The TCJA introduced a 20% deduction for qualified business income from pass-through entities (eg, LLCs, partnerships, and S corporations). This provision is also temporary, expiring in 2025. President Trump proposed making this deduction permanent, citing its importance for small businesses. However, medical practices are considered a specified service trade or business (SSTB) and are not eligible for this deduction unless an individual taxpayer’s income is below certain threshold amounts ($494,600 for married taxpayers filing jointly in 2025).

Tax rates for C corporations were permanently reduced to 21% under the TCJA. President Trump, however, has proposed a further rate cut for corporations to 20% or even 15%.

The general expectation is that President Trump will try to pass a new tax law early in his term since Republicans have a majority in both houses. If individual tax rates continue at a top rate of 37%, with expanded brackets of lower tax rates, continuing to fund Roth IRA accounts will make sense for many taxpayers. Recent gains in the stock market have increased the balances in qualified retirement plans. Traditional plans such as 401(k)s, 403(b)s, and IRAs will have required minimum distributions (RMDs) when taxpayers reach age 73 or 75, depending on their year of birth. Roth accounts do not have such requirements. For those who have more savings in retirement plans than they will need, converting some of the funds to a Roth, or adding current funding to Roth accounts, could make sense.

If the SALT cap is allowed to expire while standard deduction increases are extended, many taxpayers will again find it more beneficial to itemize deductions rather than take the increased standard deduction. Allowing the mortgage interest deduction on up to $1 million of debt would further enhance itemized deductions for many taxpayers. Itemizing deductions will also make charitable contributions more beneficial; thus, donating appreciated assets to charity can be a key component of efficient giving.

For taxpayers who are owners of pass-through entities, an extension of the Section 199A qualified business income (QBI) deduction will extend the tax cuts on business income. If that business is an SSTB such as a medical practice, utilizing tools such as a cash balance plan to increase deductions may help bring taxable income below the threshold amounts, thereby making the QBI deduction allowable.

Efficient tax planning in 2025 will require paying attention to proposed tax law changes and working with your advisers when any new legislation is passed to make sure you fully understand how to create a tax-efficient wealth plan.

 is a certified public accountant and author of more than a dozen books for physicians. She is a partner in the wealth management firm OJM Group (

) and can be reached at 877-656-4362 or 

OJM Group, LLC (“OJM”) is an SEC-registered investment adviser with its principal place of business in the State of Ohio. SEC registration does not constitute an endorsement of OJM by the SEC nor does it indicate that OJM has attained a particular level of skill or ability. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered or qualifies for an exemption or exclusion from registration requirements. For information pertaining to the registration status of OJM, please contact OJM or refer to the Investment Adviser Public Disclosure web site 

For additional information about OJM, including fees and services, send for our disclosure brochure as set forth on Form ADV using the contact information herein. Please read the disclosure statement carefully before you invest or send money.

This article contains general information that is not suitable for everyone. The information contained herein should not be construed as personalized legal or tax advice, or as a recommendation of any particular security or strategy.

There is no guarantee that the views and opinions expressed in this article will be appropriate for your particular circumstances. Tax law changes frequently; accordingly, information presented herein is subject to change without notice. You should seek professional tax and legal advice before implementing any strategy discussed herein.

As 2025 begins with a new administration and Republican congressional majority, attention turns to the expiring provisions of the Tax Cuts and Jobs Act (TCJA) and President Trump's tax proposals. Key TCJA provisions set to expire include lowered tax brackets, increased standard deductions, and enhanced child tax credits. Trump's proposals aim to make these changes permanent, increase the child tax credit, and adjust SALT deductions. Tax planning strategies should consider potential legislative changes, focusing on Roth IRA conversions, itemized deductions, and qualified business income deductions for pass-through entities.

Key 2025 tax law changes for dermatologists include expiring TCJA provisions, potential rate adjustments, and new deduction policies under Trump.

Potential 2025 Tax Law Changes: What Dermatologists Should Know

Thus far, 2025 has been a challenging year for investors. Pullbacks in the US and other stock markets due to tariff policy and the fear of trade wars have cost investors dearly over the first 2 quarters. Some dermatologists may see this increased volatility and be fearful of what comes next. They might even consider selling their investments and “going to cash.”

An emotional reaction to a stock market decline is natural, but as we hope to show you in this short article, reason should rule the day. Fortunately, we have decades and even centuries of data to call upon when looking at market downturns, which can be helpful to calm even the most worried physicians. In fact, we often come back to the short adage that summarizes what history tells us when it comes to investing: “Time in the market beats timing the market.”

Let us begin with the opposite concept: attempting to “time” the market by buying before run-ups, selling somewhere near the top, and then buying back in once prices have come down. In essence, market timing means selling assets when one thinks the market will continue to decline and then buying back in when it feels safe that the market has bottomed out. This may sound enticing in theory.

In practice, however, the evidence is overwhelming that most investors diminish their long-term returns by trying to employ a market timing strategy. They are more likely to chase the market up and down and be whipsawed by buying high and selling low. Market timing, although tempting, involves getting 2 nearly impossible decisions right: when to sell and when to buy back in.

 shows that the 15 best days for the S&P 500 (through December 31, 2023) all occurred within bear markets, not in bull markets as you might expect.

In other words, the best days to be in the market have been when it is hardest to remain invested or most tempting to exit the market and wait for better days. Looking at these dates, you will find the “who’s who” of dark times for the stock market: the 2008 financial crisis, the dot-com crash, and the Black Monday crash of 1987. A handful of these best days happened in the first quarter of 2020, during the onset of the COVID-19 pandemic.

This trend continued in a recent market pullback in spring 2025. In the midst of a significant downtrend in April, the S&P 500 index had one of its highest 1-day returns ever on Wednesday, April 9, 2025—a 9.5% rise.

Missing just the 10 best days in a 20-year period can have a significant long-term effect on a portfolio. For example, an investor who invested $10,000 in the S&P 500 in 2003 would have finished with a portfolio value of more than $64,000 (as of December 31, 2022) if they had remained fully invested. However, the portfolio value for an investor who missed the 10 best days is much lower: less than $30,000. Of course, the results worsen as more of the market’s best days are missed. In fact, returns on the portfolio were almost entirely eliminated if the investor missed just 30 of the market’s best days in the 20-year period (

One does not necessarily need a 20-year period to experience the lost opportunity from missing just a few trading days. In fact, the concepts illustrated in 

 were well defined in the single year between January 1 and December 31, 2020. For example, a portfolio valued at $1 million on January 1 would have been reduced to $695,730 at the market’s lowest point on March 23. If no withdrawals were made throughout the year, the portfolio’s balance on December 31 would have reached $1,184,000. For this hypothetical portfolio, exiting the market at its low point vs remaining invested all year would have resulted in the difference between a 30.4% loss and an 18.4% overall gain.

 Of course, it is unlikely an investor will miss only the best days if they attempt to time the market. They might also be able to miss some of the historically bad days. However, the cautionary tale of attempting to time the market is the same: There can be an enormous cost to pay if the market swings to the upside while you are on the sidelines. It would take a crystal ball to enter and exit the market perfectly, particularly because it needs to be done in short order given the market’s best and worst days tend to cluster close to one another. Investors should also be aware of the tax implications associated with selling assets in an attempt to time the market.

When an investor experiences losses beyond their acceptable threshold, the temptation to abandon the current strategy intensifies. Every investor is likely to lose money in their lifetime. A key to success is avoiding the urge to lock in losses when times appear the bleakest. Cashing out your investments can be costly because the recoveries are often sharp and swift. Once the news is positive, a sizable portion of the gain is likely in the rear-view mirror. Missing the bounce may teach an expensive lesson.

 are the reason astute investors do not engage in all-in and all-out strategies. Timing the market once is difficult, but timing it twice is nearly impossible.

By encouraging you to spend “time in the market,” we mean for you to adhere to your long-term financial and investment plan. Although this may mean adjusting allocations (and thus selling and buying portions of a portfolio), the key is that the actions are taken with a long-term view and time horizon. Rather than trying to predict what will happen in the market tomorrow or next week or even next year, you invest for long-term financial goals, such as children’s education or retirement, which can be decades away. In doing so, you can benefit from the long-term upward trends of markets rather than the up-and-down bumps and dips along the way.

, is an attorney and author of more than a dozen books for physicians. He is a partner in the wealth management firm OJM Group.

Morningstar data and analytics. Morningstar. Accessed April 29, 2025. 

https://www.morningstar.com/business/brands/data-analytics

YCharts database. YCharts. Accessed April 29, 2025. 

Investors have faced challenges in 2025 due to market volatility driven by tariff policies and trade war fears. Emotional reactions to market declines are common, but historical data suggests that maintaining investments is more beneficial than attempting to time the market. Market timing often results in missed opportunities, as the best market days typically occur during downturns. Missing just a few of these days can significantly impact long-term returns. Instead, a long-term investment strategy focused on enduring market fluctuations is recommended for achieving financial goals.

Market pullbacks tempt investors to time the market, but history shows staying invested beats guessing the highs and lows—time > timing.

Time in the Market: What History Tells Us About Investing During Volatile Markets

1. Qualified retirement plans (QRPs) and IRAs

QRPs include defined contribution plans, like 401(k)s or 403(b)s, and defined benefit plans, such as cash balance plans, which we have previously covered in this column. From a tax point of view, these tools all provide a current tax deduction against a dermatologist’s income, making them extremely attractive for tax planning. These tax deductions can vary from the $20,000 range for 401(k)s to $200,000 or more for certain types of defined benefit plans.

In terms of asset protection, these plans often have the highest level of creditor protection under state law. Of course, there are variations throughout the 50 states, and some states provide the highest level of protection only for a limited dollar amount. Nonetheless, for most states, this protection is at an unlimited dollar level. Be sure to check with an asset protection expert on the protections in your state.

IRAs are technically not QRPs, although they perform similarly in many financial and tax respects. A Simplified Employee Pension (SEP) IRA can provide the same tax deduction level as certain QRPs, whereas a Roth IRA has a different tax treatment but is also beneficial. A Roth acts more like a nonqualified plan in that there is no deduction for contributions, but the assets grow tax-free and come out tax-free (see our discussion below). We have found that most physicians participate in some type of QRP or SEP IRA during their working years.

Nonqualified plans are used by working dermatologists much less frequently than QRPs, and this is unfortunate. For tax purposes, as referenced above, nonqualified plans work like Roth IRAs: You get no deduction for the contribution, but the funds grow tax-free in the plan and can come out tax-free at retirement. Most dermatologists, when asked, would like to put more into a Roth IRA–type vehicle yet ignore the tool that could achieve this objective—the nonqualified plan.

Nonqualified plans often fund into a permanent life insurance vehicle. Thus, the level of asset protection is dictated by state rules regarding permanent (also called cash value) life insurance policies. See more details under tool No. 4.

The other benefit of a nonqualified plan is that it is quite flexible. Unlike a QRP, the nonqualified plan does not need to be offered to any employees. It can be completely discriminatory. In this way, a practice can sponsor a nonqualified plan just for the physicians, partners, or just a few doctors who want to participate. We have seen physicians set up a nonqualified plan for side hustles like locum work or moonlighting. If you have further questions about this, please do not hesitate to contact the author.

Whether a dermatologist owns their practice, is employed by a group with a path to partnership, or is an employee of a large institution, 2 wealth planning goals are likely reducing taxes and shielding assets from potential liability. These goals are common among physicians, irrespective of their practice environment. In this article, we will examine 2 tools that can provide tax and asset protection benefits at the practice level and 2 that can do so in personal planning. Some dermatologists may be able to take advantage of all 4, whereas all should be able to take advantage of at least 2.

Many doctors already own a primary home or will in the future. Regarding asset protection, nearly every state protects some or all of a home’s equity from lawsuits and creditor claims. As mentioned above, state laws do vary significantly here, ranging from no protection to protection of an unlimited amount of home equity. Be sure to check with an asset protection expert to better understand how your state’s homestead law protects home equity.

The tax benefits of homeownership are consistent in all states and include the ability to write off mortgage interest (with limitations), as well as a $500,000 capital gain exclusion for a married couple on the sale of a home ($250,000 for single filers). In addition, local property taxes on a primary home can be deductible against your federal income tax, although that deduction has become more limited in recent years.

As mentioned above, permanent, or cash value, life insurance is shielded from creditors under state law. Once again, these exemptions vary significantly throughout the 50 states.

From a tax point of view, the benefits are also consistent throughout the US because they emanate from the federal tax code. These include the ability for the cash value inside such policies to grow tax-free and, if managed properly, be accessed tax-free. Death benefits paid to beneficiaries are also generally income tax–free under Section 101 of the code.

Further, the Internal Revenue Service allows for the tax-free exchange of these types of policies, using what is known as a like-kind exchange. You may have read about such tax-free exchanges regarding real estate, but life insurance is another asset class favored with this tax benefit. This technique can be beneficial, as one could move cash value from one policy to another over time with no taxation. This might be appealing if costs come down, new policies are more attractive, or new features of competing policies are more aligned with your planning. As just one example, one of the authors has like-kind exchanged his cash value policies 3 times over the last 23 years, moving from what he perceived as good policies to great policies and reducing costs.

Asset protection and tax planning are 2 leading wealth planning goals for many dermatologists. In this article, we have described 2 tools that can achieve both goals at the practice level and 2 that can do so in one’s personal planning.

, is an attorney and author of more than a dozen books for doctors. He is a partner in the wealth management firm OJM Group (

, is a partner and tax consultant. They can be reached at 877-656-4362 or 

OJM Group, LLC (“OJM”) is an SEC-registered investment adviser with its principal place of business in Ohio. SEC registration does not constitute an endorsement of OJM by the SEC, nor does it indicate that OJM has attained a particular level of skill or ability. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered or qualifies for an exemption or exclusion from registration requirements. For information about OJM, please contact us at (877) 656-4362.

This article contains general information that is not suitable for everyone. The information contained herein should not be construed as personalized legal or tax advice or a recommendation of any particular security or strategy. Investment involves risk and possible loss of principal capital. There is no guarantee that the views and opinions expressed in this article will be appropriate for your particular circumstances. Tax law changes frequently. Accordingly, the information presented herein is subject to change without notice. You should seek professional tax and legal advice before implementing any strategy discussed herein.

Qualified retirement plans (QRPs) and IRAs offer dermatologists significant tax deductions and asset protection, with variations across states. Nonqualified plans, though less utilized, provide tax-free growth and flexibility, often funding into permanent life insurance. Personal wealth planning tools include primary residence ownership, offering tax benefits and asset protection, and permanent life insurance, which is shielded from creditors and allows tax-free growth and exchanges. Dermatologists can leverage these tools to achieve tax efficiency and asset protection, with state-specific considerations for optimal planning.

Explore effective tax and asset protection strategies for dermatologists, including retirement plans and life insurance options for wealth management.

Practice and Personal Planning: Tactics That Reduce Taxes and Protect Assets

Many physicians identify their No. 1 financial goal as achieving a comfortable retirement on their terms.

For both practice owners and employed dermatologists, a qualified retirement plan (QRP) will likely be a fundamental factor in achieving retirement financial goals. This article provides an overview of QRP basics. For a more in-depth discussion, we encourage you to use the 

code found at the end of this article to get a free copy of our latest book.

There are 2 types of QRPs utilized in medical practices:

Defined contribution plans: These plans, such as 401(k)s or 403(b)s, allow participants to contribute a portion of their salary into individual accounts, with contributions often matched by the employer. One advantage of defined contribution plans is their flexibility, allowing participants to adjust contributions based on their financial situation and retirement goals. Additionally, these plans typically offer various investment options, empowering participants to tailor their portfolios to their risk tolerance and investment preferences.

 Alternatively known as pension plans, defined benefit plans promise a specific benefit upon retirement, typically based on salary and years of service. Although less common in the private sector than they once were, defined benefit plans can provide a predictable and secure source of retirement income, particularly for physicians who anticipate long careers with a single employer. These plans often appeal to employees seeking stability and guaranteed retirement benefits for long-term planning, but they may require significant employer contributions and can be complex to administer.

Example of a Defined Benefit Plan: Cash Balance Plan

A cash balance plan (CBP) is a type of defined benefit plan that combines several features of both defined benefit and defined contribution plans.

Qualified retirement plans (QRPs) are essential for dermatologists aiming for a comfortable retirement. Defined contribution plans, like 401(k)s, offer flexibility and investment options, while defined benefit plans, such as pension plans, provide predictable income. Cash balance plans combine features of both, offering security and flexibility. QRPs offer tax-deductible contributions, tax-deferred growth, and asset protection. However, they also have drawbacks, including contribution limits, administrative complexity, and tax implications. Understanding these aspects helps dermatologists make informed decisions tailored to their financial goals and circumstances.

QRPs are key to dermatologists' retirement plans—learn the benefits, drawbacks, and how to choose the best strategy for your financial goals.

Grace Halsey

Articles

Latest Updated Articles