Envision a plane, full of passengers, forced to make an emergency landing on a deserted island with no hope of rescue for months. You’re the only doctor on board. It won’t be long before the injured and sick begin to seek help, regardless of your specialty back home.

While you’re competent, you are by no means well suited to treat all the ailments and injuries your survivors will present. You may not have delivered a child, performed an emergency appendectomy, treated a cardiovascular emergency or cared for a trauma patient since completing your residency decades ago. Now, you would give anything to have a trauma surgeon, ER doctor, pediatrician, neurologist, immunologist or a family physician on the island to help.

With people living longer, getting less 401K matching from employers, helping their children and grandchildren more than ever before, is it possible to create a stress free retirement?

The questions abound: will my retirement investments perform well? Will I retire when I’m planning to and will my money last? Asking the right questions seems easy; however, the answers may be more complex.

The changes in Employee Retirement Income Security Act (ERISA) regulations governing retirement plans affect everyone — including physicians. In order to comply with the rules, you first must be aware of them.

Last summer, rather quietly, new rules from the Department of Labor (DOL) governing 401(k) plans went into effect. At the deadline all “covered service providers” must have presented the newly required fee disclosures to plan participants. The service providers were also required to disclose earnings (i.e. fees) in excess of $1,000 since every participant has the right to see an accurate breakdown of costs and fees.

“What’s in a name? That which we call a rose by any other name would smell as sweet.” —William Shakespeare

I recently congratulated a friend and colleague who sent me an email containing a new title in his signature line. It pleased me to see what I thought was a step up on the ladder of success and I offered my congratulations.

“No,” he said, “I’m doing the same bullsh** I’ve been doing since we last spoke — but we are using new titles here.”

Did you work your way through medical school, pay off debt, make tremendous sacrifices to end up in a successful medical practice, and believe that wealth would just “happen” once you started earning the salary you envisioned?

It seems like common sense: save more, have more. But the way most people handle their finances is broken.

Take note: If you don’t plan to accumulate wealth, you may not. With the monumental changes ahead in the practice of medicine, lack of financial planning for physicians can saddle them and their families with unseen burdens.

If less than 1 percent of all advisers are legally obligated to hold your interests above their own, do you feel confident that your financial advisers are looking out for you? As professional money managers, we want to debunk widespread, commonly held, yet wrong beliefs for you to make more informed decisions as your wealth increases. Below is our first “true or false” quiz.

Attention physicians: Do you have a 401(k) plan for yourself and your staff? There are some recent changes from the Department of Labor that you need to be aware of, especially if your plan has not been audited in the past 5 years. As of July 1, 2012, changes in the Employee Retirement Income Security Act (ERISA) regulations governing such plans hold you, the employer — also called the plan sponsor — accountable for complying with new regulations. If you fail to do so, your employees may be eligible for damages. That could mean money out of your pocket.

By Jan. 1, 2013, not only will millions of people owe up to 20 percent more in estate taxes, but their options for asset protection will be significantly worse, as everything over $1 million will be subject to the highest rate of taxation. Not fully exploring your options now could prove very costly.

Senator Charles Schumer (D-N.Y.) was recently quoted stating, “The old style of tax reform is obsolete in a 2012 world.” In 2013 taxes will increase with the expiration of the Bush tax cuts.

All of the data we have seen, and the intelligence we are hearing from our advisors in Washington, leads us to believe that the next 20 years are going to be a lot tougher than the past 20 years for physicians.

Medical doctors will still continue to make a comfortable living. According to the New England Journal of Medicine, the median specialist in this country earned just over $350,000 in 2011. What will differentiate the successful physician of the next 20 years will not be their prowess in medicine, as was historically the case, but rather decisions made outside the practice of medicine.

In the past, it was simple: Get through the rigors of a medical school education, training, interning, residencies. Become a physician. Earn a great living. Right? Not so these days. Being a physician just isn’t as “easy” as it used to be.

The Physician Family Office recently completed an extensive study that confirmed what we all know to be true: Reimbursement is falling while the costs of operating a practice are rising.