When you leave a W2 for 1099 locums work, one thing quietly disappears: the invisible machinery that was pulling taxes out of every paycheck. As an employee, you never had to think about it. Payroll withheld federal, state, Social Security, and Medicare before the money hit your account. As an independent contractor, that machinery is gone, and you are now the payroll department.

At some point over the course of your 1099 work, someone will tell you that you're leaving money on the table by not setting up an S-corp. It could be a colleague, a guy at a conference, or even a CPA. It gets repeated like dogma. For some locums derms an S-corp is a clear benefit. For others, the overhead eats the savings and you've bought yourself a pile of paperwork and administrative headaches for a few hundred dollars. It all comes down to the numbers.

Credentialing and tax prep are easily some of the most tedious parts of working locums. Between the constant requests for paperwork and the need to track every single travel expense, it's easy to get buried in files. If you're mucking through a messy "Downloads" folder every time someone requests a document, you're wasting your time.

If you’re looking to pick up assignments in multiple states quickly, you need to know about the Interstate Medical Licensure Compact (IMLC). I’ve personally never used it because only one of the three states where I practice participates, but it's useful to know about for any locums derm.

This post is geared towards locums derms who have decided to set up their business as a sole proprietorship. Getting the foundation right early on saves you from a massive headache during tax season.

Tracking mileage is boring to do and boring to write about. But you can save money by doing so.

I find this to be a really complicated topic. I’m going to cover the basics and try to give you a high-level overview of the Solo 401(k): what it is, why it’s useful for locums physicians, and the three ways to set one up.

I’ll start by saying what is probably obvious to a lot of you: there is no "one-size-fits-all" health insurance plan for a locums physician. Your optimal choice likely depends on your budget, your health status, your family’s needs, and your travel schedule.