What does QBI change mean for medical practices and agencies?

It does not create an automatic deduction for every owner. The IRS explains that eligibility and limits depend on factors including taxable income, business type, wages and property, and excludes employee wages and C corporation income from QBI. IRS — Qualified business income deduction

Ask the adviser to identify the business classification, owner-level inputs and interactions with other proposed actions. Do not label an agency or practice as eligible or ineligible solely from its trading name. If a proposal sells a new entity as the entire solution, request the reasoning and the anti-abuse/aggregation analysis where relevant rather than accepting the label.