Tax Planning for Physicians, Dentists, and Practice Owners

Physicians, dentists, and other healthcare professionals often have significant W-2 income, practice ownership income, and an investment portfolio at the same time, each with different tax treatment. We help medical professionals reduce self-employment tax through entity structuring, maximize retirement contributions, and manage practice ownership alongside personal wealth.

Practice Ownership and Entity Structure

How your practice is organized affects self-employment tax, retirement plan options, and how much of the QBI deduction you can keep. Health care is a "specified service" under Section 199A, so the deduction phases out at higher incomes, which makes planning around the limits especially important. We review your structure, model an S corporation election where it fits, and handle the practice's business returns along with your personal return.

Retirement Plans That Shelter More Income

High-earning medical professionals can often contribute far more than a standard 401(k) allows. Depending on your situation, that may include solo 401(k)s, defined benefit plans, or cash balance plans. These can allow much larger deductible contributions, and in the right setup they can sit alongside a hospital or group plan, though some limits are shared, so we check how your plans interact. We help you size contributions to your income and goals each year.

W-2, 1099, and Practice Income Together

Many physicians earn a hospital or group W-2 salary plus 1099 income from call coverage, locum work, medical directorships, or consulting. We make sure business expenses are deducted against the right income, set estimated payments so the 1099 side doesn't create a surprise in April, and plan for the additional Medicare and net investment income taxes that apply at higher incomes.

Physician and Dentist Tax FAQ

I'm a W-2 physician with some 1099 income. Is planning worth it for me?

Usually, yes. The 1099 income can open the door to a retirement plan and business deductions that a W-2 alone doesn't, and estimated payments need to be set correctly.

Should my practice be an S corporation?

Often, but not always. We compare the self-employment tax saved with payroll costs and the effect on your QBI deduction and retirement contributions before recommending it.

Can you handle my practice and personal returns together?

Yes. We prepare both, so the strategy works across both.