ER Doc Advisor - Financial Planning & Taxes for Emergency Physicians

Ep 49: The Hidden Tax Cost of Capital Gains for MedSpa Owners

For high-earning MedSpa owners, capital gains aren’t just about investments. They’re about control. The way gains stack on top of business income can change tax outcomes, risk exposure, and even growth decisions in ways that aren’t obvious at first glance.

Today, we’re unpacking how capital gains actually work in the context of MedSpa income — and why small strategic choices can make a disproportionate difference over time.

WHAT YOU’LL LEARN:

  • Why capital gains often cost more once business income fills tax brackets first.
  • How gains stack on top of owner pay, K-1 income, and bonuses, raising true marginal rates.
  • Why many MedSpa owners drift into the 23.8% capital gains bracket once NIIT applies.
  • The trade-off between diversification and permanent tax costs when selling concentrated positions.
  • How shifting risk inside retirement accounts can reduce exposure without taxable sales.
  • Why spreading sales across multiple years improves control over capital gains brackets.
  • How bonus depreciation and timed purchases can strategically offset capital gains.
  • Why managing income over a 3–5 year window reduces taxes, risk, and stress.

Tags:

medspa, capital gains tax, medspa taxes, NIIT tax, bonus depreciation, tax planning for med spas, K-1 income, taxable brokerage accounts, marginal tax rate, diversification risk

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