Special rules apply to doctors with regard to their professional law. They mean that a doctor can hardly save taxes in the same conventional way as other freelancers. But a lot has changed in the past two decades. Therefore, we now consider how a doctor can save taxes by establishing a medical center (MVZ) in the legal form of a GmbH. In addition, we want to find out whether they, like other entrepreneurs, can also set up a holding company. This project in particular presents particular obstacles. Nevertheless, we want to show a way in which a doctor can save taxes via such a holding company.

Doctors are already special people. One certainly thinks primarily of the great responsibility they bear for the life and limb of their patients. Others, on the other hand, may think more of the lavish fees that doctors sometimes earn. You quickly forget that the medical profession is not a job that you do every day from 9 a.m. to 5 p.m. and then enjoy the free time. In fact, many doctors often do double the workload. They have certainly earned their fees.

But what actually distinguishes them from many other professional groups is the extent to which they can save taxes. Although it treats tax law in the same way as other freelancers, doctors are subject to special restrictions at the level of professional law, which also affect taxation. Therefore, we thought about how even a doctor can be able to save taxes in the same way as other entrepreneurs.

We have already narrowed down a part of the topic. Because our contribution should be about doctors who work as freelance entrepreneurs. They therefore conduct a practice on their own responsibility, which they operate according to the rules of the respective professional law applicable to them. The regulations of the professional law of the doctors depend on the respective federal state in which they work, as well as on the medical chamber to which they belong. However, since a description of all these peculiarities goes far beyond the scope of what is present here, let us focus only on general aspects that doctors can use to save on taxes. In addition, peculiarities with regard to the different specialist orientations remain out of the approach, for the sake of the extent of the contribution.

First of all, we would like to present the differences in taxation to which doctors are subject compared to other freelancers. Only when we understand what these differences are will we be able to find solutions to these challenges.

Above all, one aspect represents a significant tax disadvantage for doctors compared to other professional groups. In the past, they have always acted as individual practices. Only in the past two to three decades have community practices become increasingly established. Usually the reason for this was that you could save costs in this way. As the equipment of modern practices became more and more expensive, this was an effective way to share the costs. Especially in radiology, innovations such as modern magnetic resonance scanners are so cost-intensive purchases that for a long time only the large clinics could afford such devices. In the meantime, the prices of such devices have fallen comparatively, but only in certain situations are individual practices able to make such expensive purchases. Operating them cost-effectively and profitably is another hurdle.

But this has also spread the insight in other medical fields that one can operate a practice with several doctors more efficiently than a single practice. In addition, several related disciplines can be bundled in a community practice in this way, so that they ideally complement each other. Consequently, the concept of the medical care center came up, in which at least two doctors work together.

But it also depends on the legal form. A joint practice with several doctors can be founded as a GbR or as a partnership company. On the other hand, an MVZ can also be founded as a GmbH or a stock company. Various factors play a role. For example, there are some differences in the company structure and management as well as liability, which depend on the chosen legal form.

What a doctor is denied in comparison to commercial companies is the possibility of founding a GmbH as a sole shareholder. In order to establish an MVZ in this legal form, at least two doctors are required. Similarly, one must therefore also consider the option GmbH & Co. KG. Since at least two doctors are required to establish the Komplementär-GmbH, this legal form is practically excluded for physicians. Because as a complementary, only a professional can be considered.

In the same way, one must also consider the establishment of a holding company. There is also a restriction here, because the holding company itself is subject to the same rules for founding the GmbH as the MVZ.

It is precisely the holding company that combines considerable tax and other advantages. But it is precisely these doctors, unlike professionals, are practically denied. We now want to see if there are still ways to obtain these benefits.

So, as we just discovered, bringing an MVZ into a holding company is not a real option for doctors. At least it is not a corporate structure, as it is self-evident for commercial entrepreneurs, for example. Because if doctors want to start a corporation, then they must always decide this to several people. However, this circumstance is contrary to the common concept of a holding company. It is precisely the purpose of a holding company to introduce an intermediate stage between the operative business, in this case the MVZ, and the entrepreneur indirectly associated with it. Even at a GmbH in which several entrepreneurs are involved as shareholders, each entrepreneur establishes his own holding company. Such a structure is therefore excluded for a doctor or doctor.

Nevertheless, we want to try to realize this as far as possible for doctors. For this purpose, two or more doctors, in addition to an MVZ, set up another GmbH, but this time as a clinic.

A clinic sounds strange at first, because at first glance it seems completely oversized as a holding company. Don’t worry, since we only need the clinic as a holding company for the MVZ, it is enough to equip it on a really small scale. It is conceivable, for example, that it only has a few beds available for patients who come to the MVZ located in the same building for an outpatient operation. On the one hand, this would have fulfilled the conditions for holding doctors according to the regulations of their professional law and at the same time created the conditions for taking advantage of the many advantages of holding companies.

What are the advantages of an MVZ in the legal form of a GmbH? The main advantage is certainly that the GmbH gives the MVZ the ability to reduce its taxes to about 30% of the profit. In all medical practices run as partnerships, doctors pay income tax according to the personal income tax rate. Because doctors earn quite a high income, they usually apply the top tax rate of 42%. If they have to finance new acquisitions from this taxed profit, for example, this is significantly less favorable compared to the GmbH. Sure, a GmbH pays its dividends to its shareholders also by applying a taxation. But you can control them yourself as a shareholder. In addition, you can set a managing director salary that leads to the GmbH as operating expenses the taxable GmbH profit.

And now we look at the advantages that an MVZ gains with a parent holding. On the one hand, it is a question of the box privilege which applies to the taxation of the holding company. If a limited liability company receives the profit distribution of another limited liability company in which it holds at least 15 % at the beginning of the year, then only 1,5 % of taxes are incurred at the level of the holding company. Both conditions are easily met in the constellation MVZ and Holding. Thus, the holding company is free to invest in expensive purchases much faster than if a doctor had to finance this for their individual practice from their privately taxed profit.

Furthermore, the holding company can now lease the acquisition to its MVZ. The rental costs are then also tax deductible at the level of the MVZ as operating expenses. However, it is even nicer that the holding company now also has considerable depreciation potential. This also leads to a lowering of the taxable profit, this time at the level of the holding company. Although indirectly, a doctor or a doctor save taxes in this way.