Physician Tax Solutions

Doctors with 1099 income, private practices, or locum tenens shifts: you owe quarterly estimated taxes.

If that sentence made you pause, read this guide.

We covered the 2026 deadlines, the safe harbor rule for high earners, and the seven most common mistakes we see physicians make.

Tax season hits different when you're a physician. 🩺

W-2 from the hospital. 1099 from locum shifts. Maybe a telehealth side gig. A rental property or two. And then April rolls around and the bill makes you want to lie down on the floor for a minute. 😅
Here's what most doctors learn the hard way: regular tax software and generalist CPAs aren't built for physicians with multiple income streams. You end up overpaying. Every. Single. Year.

Our newest guide breaks down:

✔️ What to look for in a physician CPA (and what to run from)
✔️ The difference between tax prep, planning, and advisory
✔️ Deductions you're probably missing, including CME, malpractice, and home office
✔️ Why locum tenens income is its own tax animal
✔️ Red flags when hiring help

If tax season feels like a stressful surprise every year, that's a sign.

Got a W-2 hospital job AND a 1099 side gig? 🩺

Locum shifts, telehealth, medical director roles... that extra income feels great until April rolls around and you're staring down a surprise tax bill plus penalties you didn't know were coming.

Here's the thing most physicians don't realize: the IRS expects you to pay taxes as you earn, not just once a year. Miss the safe harbor rules and you'll owe penalties on top of what you already owe.

Our latest guide breaks down:

✅ What the IRS safe harbor rule actually means (in plain English)
✅ The 110% rule for high-income physicians
✅ Quarterly payment deadlines you can't miss
✅ The most common mistakes doctors make with mixed W-2/1099 income
✅ When it makes sense to set up an S-Corp

If you're winging it on taxes this year, this is the post to read before your next 1099 check hits.

What's the biggest tax question you have about your side gig income? Drop it in the comments.

🩺 S Corp vs PC vs PLLC Which One Actually Saves Physicians the Most Money?

If you're a doctor running a practice, doing locums, or building side income, your business structure is quietly deciding how much you hand over to the IRS every year.

Here's the truth most physicians don't hear in med school:
✅ A PC keeps you compliant but comes with heavy paperwork
✅ A PLLC offers similar protection with way more flexibility
✅ An S Corp election on top of either can save you thousands in self-employment tax

The wrong setup? You could be overpaying by 5 figures a year. Every year.

👉 Read the blog in the comments

If you haven't reviewed your entity setup in the last 2-3 years, now's the time. Your future self will thank you.

Most physicians running an S-corp are quietly leaving $3,000–$9,000 on the table every year.

Not because they're careless. Not because their CPA is bad.

It's the accountable plan. Either they don't have one, or they have one that's been sitting half-asleep for years, reimbursing a flat $100/month for phone and nothing else.

Home office. Cell phone. Vehicle use between hospitals. CME travel. Scrubs. Internet upgrades for telehealth. All of it can be reimbursed tax-free through your practice when the plan is set up correctly.

We just published a step-by-step guide that breaks down exactly how to set one up, what to put in it, and the traps that quietly turn the whole thing into taxable wages.

Earning $500K+ as a physician with both W-2 and 1099 income?
Your retirement plan choice could be quietly costing you tens of thousands of dollars every year.

Most docs we talk to are running one of three setups:
→ SEP-IRA (easy, but usually leaves money on the table)
→ Solo 401(k) (the default winner for most physician S corps)
→ Defined Benefit Plan (where high earners really pull ahead with $100K+ deductions)

In our latest blog, we walk through a real ER doc scenario, $400K W-2 plus $100K in 1099 income, and show three different outcomes:
The bad setup: $3,200 in tax savings
The better setup: $16,500 in tax savings
The best setup: $55,000+ in tax savings

Same income. Same physician. Different retirement plan strategy.
If you're an S corp owner, there's one mistake that quietly destroys your contribution room before you even start. We cover it in the post, along with the combo strategy that gets high earners to six-figure deductions.

Paying the IRS online sounds simple until you wire $80,000 to the wrong tax year.

We've seen it happen. More than once.

High-earning physicians get hit with five-figure penalties every year, not because they're careless, but because nobody told them the rules.
Quarterly deadlines slip. Direct Pay vs EFTPS gets confused. Credit card fees eat thousands in rewards points.

Our latest guide breaks it all down in plain English:
✓ The 4 ways to pay the IRS online (and which one fits your situation)
✓ The safe harbor rule that keeps you penalty-free
✓ The mistakes we see doctors make over and over
✓ When a Physician Tax Advisor actually pays for itself

If you've got W-2 income, 1099 work, or a piece of a practice, this one's for you.

Paying yourself too little as a physician S Corp owner? The IRS is watching.

That "reasonable salary" rule isn't just a suggestion. Get it wrong, and you could be looking at back payroll taxes, penalties, and an audit that wipes out years of savings.

The tricky part? There's no magic number. The IRS won't hand you a chart that says "anesthesiologist in Texas equals $X."

So how do you pick a salary that actually holds up?

Our latest guide breaks it down in plain language:

✔ How to use MGMA data to set a defensible benchmark
✔ The factors that justify going higher or lower
✔ Real audit cases and what they teach us

If you've been guessing at your salary or just rolling with what your accountant set up years ago, this one's worth a read.

Most physicians overpay on taxes for one simple reason. Nobody told them an S Corp could save them five figures a year.
If you're running a private practice, doing locums, picking up telemedicine shifts, or any combination of the three, your business structure matters more than you think.

Here's what an S Corp actually does for you:

✅ Cuts your self-employment tax bill by splitting income into salary + distributions
✅ Opens up better retirement contribution strategies (Solo 401k, defined benefit plans)
✅ Lets you reimburse yourself for home office, internet, and business expenses tax-free
✅ Keeps health insurance premiums working harder for you

A dermatologist earning $300K through her LLC could save $4,000 to $8,000 a year just by making the switch.

An anesthesiologist doing $250K in locums?

Even more.

But it's not magic. There's a "reasonable salary" rule, payroll requirements, and compliance stuff most DIY filers get wrong.

We broke down the basics in plain English. No jargon. No fluff. Just what every physician earning serious self-employment income needs to know before tax season hits.

Read the full guide in the comments

Think your physician side income is “extra money”?

Tax season may tell a different story.

Telemedicine, locums, consulting, expert witness work, medical director fees, and speaking income can create real tax planning issues once the numbers grow.

A strong plan can help you review:

1099 income tracking
Business deductions
Estimated tax payments
LLC vs. S corp options
Retirement plan opportunities
Year-round tax strategy

If your side income is growing, don’t wait until tax season to sort it out.