W2 vs 1099 for a physician professional corporation

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Eyefixer

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I am in the process of switching practices. I have an S-corp that I formed a few years ago when I finished my fellowship. The owner of the new practice stated that her accountant does not mind if she hires me as a 1099 independent contractor and pays to my corporation rather when a W2 employee. My accountant says this may be beneficial tax-wise since I can have more deductions for unreimbursed expenses. Can someone comment of pros and cons of doing this? Is I go with 1099, does that mean the practice can not provide benefits such as vacation, CME, etc?

Any advice is appreciated.

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I am in the process of switching practices. I have an S-corp that I formed a few years ago when I finished my fellowship. The owner of the new practice stated that her accountant does not mind if she hires me as a 1099 independent contractor and pays to my corporation rather when a W2 employee. My accountant says this may be beneficial tax-wise since I can have more deductions for unreimbursed expenses. Can someone comment of pros and cons of doing this? Is I go with 1099, does that mean the practice can not provide benefits such as vacation, CME, etc?

Any advice is appreciated.

Yes, it means that. But the practice can pay you the money it would have spent on those benefits as 1099 payments, and you can pay for them and deduct the costs yourself. What you don't want to do is get the same paycheck 1099 as you would get W-2. Your 1099 paycheck should be A LOT bigger. But it's all fungible. It really doesn't matter all that much if your employer pays the employer half of social security and your benefits or if you pay it, as long as you compare apples to apples.

Personally, I like being in control of my own retirement plan, my taxes and my own benefits, so I would lean toward the 1099 side. If you prefer not to deal with that stuff, you might be better off as an employee.
 
I am in the process of switching practices. I have an S-corp that I formed a few years ago when I finished my fellowship. The owner of the new practice stated that her accountant does not mind if she hires me as a 1099 independent contractor and pays to my corporation rather when a W2 employee. My accountant says this may be beneficial tax-wise since I can have more deductions for unreimbursed expenses. Can someone comment of pros and cons of doing this? Is I go with 1099, does that mean the practice can not provide benefits such as vacation, CME, etc?

Any advice is appreciated.

There are more deductions for C corporation owners than any other type of corporation, which is why the large corporations are able to pay their executives such lucrative tax-advantaged fringe benefits. Doctors should and can have these too. Why don't they? Typically it it because they cannot agree to the same benefits and therefore going it alone with a 1099 which gives you the opportunity to utilize whatever benefits you choose is the better financial/tax alternative, in every case where you are making a high amount of income. As to whether it is better for you personally to deal with the issues and decisions you will need to make, that is another question, as ActiveDutyMD points out. Going it alone with a 1099 also allows you to be nimble with tax law changes which can and will occur, and you won't have to take another vote on what to do. 1099 is a golden opportunity for a doctor. You should consider carefully whether you want an S corp as many benefits are limited to owners thereof, and also, if you are taking depreciation, you can be prevented from switching to a C corporation when you need to, which should be soon if you are successful, because you will have "recapture" of previously deducted amounts. With a C corp you can have better health benefits, better retirement benefits, etc., even as an "owner". Congrats & good luck.
 
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not an expert on this, but I think you or the practice owner will need to make sure you meet the IRS definition of independent contractor- including things like providing your own equipment.

Dr. Rack makes a good point, but its the application of the law that makes this the tricky question that it can be. While equipment can be a factor, it isn't necessarily a deciding factor, as, for example, a hair salon can rent a chair to an IC stylist and pay them 1099 based on their own work with their own clients. Medical and radiation oncologists may see the same patients in connected offices labelled a "cancer center" but be unnconnected from a business standpoint. Or, they can both be employees of the clinic which may have other specialists as well. Or, they could be IC service providers to a single clinic under contract. As a business, you can choose to hire an employee to work for you or you can choose to outsource, hiring a service from an independent contractor, such as locum tenens, or a nighthawk service. These are not employees, and so long as the IRS is getting its taxes paid, employment taxes, or self-employment taxes, it is not going to matter a lot to them how you operate your business. Where the issues come up are situations in which businesses try to pick and choose the advantages of employees and the advantages of indpendent contractors, and you can't have both. With an employee you retain control and have liability for their actions, but with a contractor you give up a measure of control but also aren't typically held to be as responsible. Since in medicine, your responsibility as a doctor is so extensive, this doesn't tend to matter, since you will, in a case of negligence by one or the other, Ee or IC, be sued anyway, for the acts of each other, since the responsibility for patient care is so important and delegating it is its own responsibility. Also, in this case, a new practice, setting up two doctors together as independent contractors is more sensible than splitting them up after they have practiced as employee/employer, so the best time to do it is before you ever enter the other relationship, as the definition of the relationship can be cleanly set up and followed for both tax and state law purposes. Or, for example, the IRS might care if there is discrimination occurring among employees and they think the arrangement was set up to avoid responsibility for the employees of the doctors in a "related service group," for example. This would be improper from the get-go, however, so isn't an employee/IC problem per se. So, there isn't really any question that two doctors can enter into an agreement to work on an ongoing basis together each on 1099 income from a single employer corporation, which can pay each doctor individually, or better yet each doctor's own practice corporation.

Also, this is a legal question, often confused with an accounting question. Ideally, it should be made in consultation with lawyer and accountant on same page BEFORE you get very far down the road. Accountants are often comfortable assisting with the decision and often know a lot more about tax than GP attorneys who will defer to them, but its an important and often long term decision about the structure of the practice and can get you locked in, so its important to get it right from the outset.

BTW, the AMA has a excellent sample model employment contract (on its website, availabe as PDF download) with lots of things to consider when making an agreement to enter a practice and it could be very helpful as a checklist to make sure you are covering your bases in your new practice setting. Definitely worth a look.

Here's the required disclaimer (see IRS Circular E): I am required to tell you this isn't legal advice and can't be relied on to avoid any IRS penalites, and that you should consult an attorney...make that a tax attorney IMO.
 
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Dr. Rack makes a good point, but its the application of the law that makes this the tricky question that it can be. While equipment can be a factor, it isn't necessarily a deciding factor, as, for example, a hair salon can rent a chair to an IC stylist and pay them 1099 based on their own work with their own clients. Medical and radiation oncologists may see the same patients in connected offices labelled a "cancer center" but be unnconnected from a business standpoint. Or, they can both be employees of the clinic which may have other specialists as well. Or, they could be IC service providers to a single clinic under contract. As a business, you can choose to hire an employee to work for you or you can choose to outsource, hiring a service from an independent contractor, such as locum tenens, or a nighthawk service. These are not employees, and so long as the IRS is getting its taxes paid, employment taxes, or self-employment taxes, it is not going to matter a lot to them how you operate your business. Where the issues come up are situations in which businesses try to pick and choose the advantages of employees and the advantages of indpendent contractors, and you can't have both. With an employee you retain control and have liability for their actions, but with a contractor you give up a measure of control but also aren't typically held to be as responsible. Since in medicine, your responsibility as a doctor is so extensive, this doesn't tend to matter, since you will, in a case of negligence by one or the other, Ee or IC, be sued anyway, for the acts of each other, since the responsibility for patient care is so important and delegating it is its own responsibility. Also, in this case, a new practice, setting up two doctors together as independent contractors is more sensible than splitting them up after they have practiced as employee/employer, so the best time to do it is before you ever enter the other relationship, as the definition of the relationship can be cleanly set up and followed for both tax and state law purposes. Or, for example, the IRS might care if there is discrimination occurring among employees and they think the arrangement was set up to avoid responsibility for the employees of the doctors in a "related service group," for example. This would be improper from the get-go, however, so isn't an employee/IC problem per se. So, there isn't really any question that two doctors can enter into an agreement to work on an ongoing basis together each on 1099 income from a single employer corporation, which can pay each doctor individually, or better yet each doctor's own practice corporation.

Also, this is a legal question, often confused with an accounting question. Ideally, it should be made in consultation with lawyer and accountant on same page BEFORE you get very far down the road. Accountants are often comfortable assisting with the decision and often know a lot more about tax than GP attorneys who will defer to them, but its an important and often long term decision about the structure of the practice and can get you locked in, so its important to get it right from the outset.

BTW, the AMA has a excellent sample model employment contract (on its website, availabe as PDF download) with lots of things to consider when making an agreement to enter a practice and it could be very helpful as a checklist to make sure you are covering your bases in your new practice setting. Definitely worth a look.

Here's the required disclaimer (see IRS Circular E): I am required to tell you this isn't legal advice and can't be relied on to avoid any IRS penalites, and that you should consult an attorney...make that a tax attorney IMO.

What an incredible comment. Thank you for your contribution.

I am going into radiology (specifically IR) and have been considering whether I should try and find a group down the road that’ll pay me as an Independent Contractor or as a W2. I just don’t know enough despite my business background to make a decisive choice what is better.

There are definitely perks to 1099/paid via my corporation like self directed 401k that I can contribute like 3x more to as well as further liability protections and supposedly better options for health insurance (I doubt this is true being that I’d be the only executive/employee of the corporation).

The downsides are obvious: higher frustration and cost in filing taxes.

Good point about necessity of tax attorney. I know that is certainly true as accountants have become increasingly simple minded catering to average Joes that work as W2.

Any more thoughts or links would be appreciated.
 
I am going into radiology (specifically IR) and have been considering whether I should try and find a group down the road that’ll pay me as an Independent Contractor or as a W2. I just don’t know enough despite my business background to make a decisive choice what is better.

I would probably make that about last on your list of things to look for in a group. Long term you need to find the group that will be most successful as a business, not that one that pays you by 1099 or W2, since that is what will most impact your total compensation.

For my 2 cents, most benefits are cheaper as part of a group compared to something you buy on your own. Now if they have a lot of excess benefits you would never need, that is a different story.
 
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