What retirement plans work best for clinic owners?

Plan selection depends on practice structure and income. For a solo practitioner with no employees, a Solo 401(k) allows up to $72,000 in 2026 contributions ($80,000 with catch-up at age 50+, and $83,250 at ages 60 to 63), combining elective deferral and employer profit sharing. A SEP-IRA is simpler and allows up to $72,000 but only as employer contribution. For practices with non-owner employees, a 401(k) plan with safe harbor or new comparability profit sharing can disproportionately allocate contributions to owners while satisfying nondiscrimination testing. The largest deductions for high-income partnerships come from a 401(k) plus cash balance plan combination. A cash balance plan is a defined benefit plan, so the IRS caps the benefit rather than the contribution: an annual benefit of up to $290,000 for 2026. The contribution needed to fund that benefit rises with age. In Fidus Actuarial's 2026 illustrations for an owner at the $360,000 compensation cap (pay above the cap does not raise the figure), a cash balance plan paired with a 401(k) profit sharing plan allows about $252,000 a year at age 50, $307,000 at 55 and $382,000 at 60, and each plan's own actuarial valuation sets its real range. Sorso estimate: for an owner whose income stays in the 37 percent top federal bracket, $251,639 to $382,466 of contributions defers roughly $93,000 to $141,500 of federal income tax a year ($251,639 x 0.37 and $382,466 x 0.37), and less if part of the deduction falls in lower brackets.