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W-2 vs 1099 for physicians (overview)
Locum tenens discussions often collide with tax structure. This page gives a clean, citation-friendly comparison table and FAQs—without pretending one path is universally better.
| Topic | W-2 employed (typical) | 1099 / IC (typical) |
|---|---|---|
| Tax withholding | Often withheld via payroll | Often pay quarterly estimated taxes |
| Benefits | May include health, retirement match | Often self-funded; sometimes stipends |
| Malpractice | Employer-provided structures common | Must confirm tail, limits, and covered acts |
| Expense flexibility | Less direct expense control | May deduct ordinary business expenses (CPA-dependent) |
| Operational feel | Closer to traditional employment rails | More admin overhead; more autonomy potential |
FAQs
- Is locums income always 1099?
- Not always. Some arrangements use W-2 through a staffing intermediary; others use 1099-style independent contractor structures. Your agreement and payer flow determine reporting—verify with your contract and CPA.
- What should physicians compare beyond headline rates?
- Malpractice coverage type, tail obligations, benefits (or stipends in lieu), cancellation terms, call burden, documentation load, and tax complexity (estimated taxes, retirement contributions, insurance).
- Does Locum Career Hub provide tax advice?
- No. We help you understand common tradeoffs in recruiting conversations and when to escalate questions to licensed tax professionals.
Pair this overview with the locum salary estimator and your state hub on locum tenens jobs.