The Private Medical Practice Academy


November 8, 2022


I’m frequently asked about the benefits of hiring employees versus having independent contractors.  

Many physicians are under the impression that hiring someone as an independent contractor is going to be less expensive than as an employee. But not so fast. The IRS has rules that define whether someone is truly an independent contractor or an employee. The employer is responsible for determining if the new hire meets the criteria to be treated as an independent contractor. Choose the wrong status and you may be liable for past taxes and the associated penalties.

What does it mean to be an Independent Contractor?

The IRS and many states have adopted common law principles to define an independent contractor. These rules focus primarily on the level of control an employer has over a service or product. In other words, do you the employer defines what is being done and how it will be accomplished.

The nature of the work that you expect this new hire to perform also helps to define the employment status. When work is considered integral to the business, it is more likely that the person is an employee. On the other hand, work that is temporary and non-integral may imply independent contractor status. 

Another factor that helps define employment status is the method of compensation. For example, if a person is on your payroll and receives a steady paycheck then that person is clearly an employee and not an independent contractor. 

The Economic Realities Test

The “economic realities test” looks at the dependence of the worker on the business they work for. If a person gains a large portion of their salary from that business, chances are that person qualifies as an employee. The test also factors in such things as level of skill, integral nature of the work, intent of the parties and payment of social security taxes and benefits. 

The Right to Control Test

Courts also use the “right to control” test. When an employer controls the way work is carried out and a product is delivered, the relationship between the parties is employer/employee. 

On the other hand, if an employer doesn’t have authority over how a party accomplishes their work but simply requests or gives an outline, the person could be considered an independent contractor.

Employer Responsibilities
As an employer, your tax liability is determined by your worker’s employment status. When a worker is an employee, you are required to pay state and federal unemployment tax, social security tax, as well as workers compensation and disability premiums to your state’s insurance fund. When a worker is an independent contractor, the hiring party is not required to make any of these payments. 

The Law Is Clear

Certain factors define a worker as an independent contractor:  not relying on the business as the sole source of income, working at his or her pace as defined by an agreement, and retaining a degree of control and independence. An employee, on the other hand, relies on the business for steady income, gives up elements of control and independence and works within constraint of workplace.

Most of the staff that you would hire for your medical practice are most likely going to be employees.  I would strongly encourage you to review the IRS guidelines and have a conversation with your CPA prior to hiring any new staff.


You may also like

Top Health Podcasts. Delivered to Your Inbox and Eardrums.

Join Our Newsletter

We gratefully acknowledge the many organizations that have generously supported our podcasts and platform.

Network Sponsors and Advertisers

Event and Media Partners

Buffer LinkedIn WhatsApp