Locum tenens physicians are independent contractors, not employees of the healthcare facilities where they work. This status affects how they report income and pay taxes. Unlike traditional employees who get a W-2 form, locum tenens receive a 1099 form. This difference isn’t just about paperwork; it reflects a separate employment category with its own set of responsibilities. Independent contractor status grants more autonomy over work conditions and terms, but it also excludes them from many labor protections and benefits provided to regular employees. Understanding this distinction is crucial for several reasons:


As independent contractors, locum tenens physicians are responsible for paying their own taxes, including self-employment tax. They do not have taxes withheld from their pay by their employers, unlike regular employees. This means they need to set aside money for taxes and be aware of deadlines for quarterly tax payments. The responsibility of understanding and applying tax deductions relevant to independent contractors also falls on them, potentially affecting their net income. This independent status requires them to manage their finances more actively than they might in a traditional employment setup, including being diligent about saving receipts and tracking expenses for deductions. Additionally, they must be aware of state and local tax obligations, which can vary widely depending on where they practice. Proper tax planning is essential to avoid penalties and ensure compliance with all tax regulations.


Independent contractors generally do not receive the same benefits as employees, such as health insurance, retirement plans, or paid time off. This requires locum tenens to independently seek and fund their health insurance and retirement savings, which can be both costly and time-consuming. The absence of paid time off means that any time not working, whether for sickness or vacation, directly affects their income. Consequently, locum tenens must be proactive in securing their financial future and health needs without the cushion of employer-provided benefits. They might need to explore individual health insurance plans or join professional associations that offer group health benefits. For retirement planning, options like SEP IRAs, solo 401(k)s, or traditional IRAs can provide valuable tax advantages and help build a secure financial future.

Control and Flexibility

Locum tenens often have more control over their schedules and choice of assignments compared to traditional employees. This flexibility allows them to balance work with personal life and preferences. However, they may not have consistent work, which can lead to income instability. The need to constantly look for new assignments and negotiate contracts is also a part of their professional life. On the positive side, this autonomy enables locum tenens to explore diverse clinical environments, enhance their skills, and avoid burnout by taking breaks between assignments. They can also choose locations that align with personal interests or family needs, providing a unique opportunity to tailor their career to their lifestyle.

Liability and Insurance

Locum tenens physicians typically need to provide their own malpractice insurance, although some staffing agencies might offer this as part of their contract. The responsibility of ensuring adequate coverage lies with them, and they must be aware of the terms and limits of such insurance policies. The cost of insurance can be a significant expense and varies depending on specialty and location. This means they often need to independently assess risk and secure appropriate coverage, unlike traditional employees who might have these provisions handled by their employer. Additionally, understanding the nuances of malpractice coverage, such as occurrence-based versus claims-made policies, is crucial to ensure they are adequately protected throughout their career.

Regulatory Compliance

They must ensure they are compliant with various legal and professional standards independently, though the staffing agencies they work through often provide assistance in this area. This autonomous compliance requires staying updated on medical regulations and continuous professional development to mitigate risks and maintain licensure. Locum tenens physicians should regularly engage in continuing medical education (CME) and stay informed about changes in healthcare laws and best practices. Maintaining an active license in multiple states can also enhance job opportunities and provide greater flexibility in choosing assignments.

What Being a 1099 Independent Contractor Entails

As a 1099 independent contractor, you are essentially running your own business. This status means:

  • Self-Employment Tax: You are responsible for paying both the employer and employee portions of Social Security and Medicare taxes. This is often referred to as self-employment tax, which is higher than what traditional employees pay, as it encompasses both contributions.
  • Quarterly Taxes: Instead of having taxes withheld from each paycheck, you’re generally required to estimate and pay your taxes quarterly. This can be a significant shift for those accustomed to traditional employment and demands a good understanding of one’s yearly income to avoid under or overpayment.
  • Business Deductions: The silver lining is that you may be eligible for business-related deductions, such as travel expenses, continuing education, and necessary equipment. These deductions can significantly reduce taxable income, but they require good record-keeping and an understanding of what expenditures qualify.

Keys to Managing Your Independent Contractor Status

Managing your finances as a locum tenens requires diligence and planning. Here are some tips to stay on track:

  • Understand Your Tax Obligations: Familiarize yourself with the requirements for quarterly tax payments. Missing these can result in penalties. Keeping up with tax regulations can help minimize legal risks and ensure financial stability.
  • Seek Professional Advice: Consider consulting a tax professional who understands the nuances of 1099 independent contractor status, especially within the healthcare field. Professional advice can help optimize tax payments and deductions, providing significant financial benefits.
  • Keep Impeccable Records: Document all your expenses and income meticulously. This practice is vital for accurate tax filing and taking advantage of eligible deductions. It also serves as a critical defensive measure in case of audits.
  • Plan for the Future: As an independent contractor, benefits like retirement plans and health insurance are your responsibility. Explore options like SEP IRAs or solo 401(k)s for retirement planning. Preparing for long-term financial security is essential, given the absence of employer contributions.
  • Budget Accordingly: Remember that your income might fluctuate more than a traditional salaried position. Budgeting and financial planning become crucial. Setting aside funds during more lucrative periods can safeguard against times of reduced income.

It’s always important for locum tenens professionals to understand the specifics of their work arrangement, including their status as independent contractors and what that means for their taxes, benefits, and professional responsibilities.

While the locum tenens arrangement offers flexibility and variety, it also brings the responsibility of managing your status as an independent contractor. Understanding the implications of being a 1099 worker, staying organized, and seeking professional advice when needed are critical steps to successfully navigating this career path.

Embracing the locum tenens lifestyle is not just about adapting to different clinical environments; it’s also about adeptly managing your role as an independent business entity in the healthcare industry.

Similar Posts