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Going Independent or Going Employed?

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Dr. Hoffman looks at the decision to either take an employed position or go independent as a doctor. What's the best route to go?

We all incur debt as a result of attending college and medical school. After graduation we take a residency in the field we have chosen. At that point,  many of us are married some with children. The money paid during training may not be enough to cover all the expenses plus money to begin retiring the amount of money we owe. Finally after residency, we graduate training and pass the board examination.

What do we do? If become an employee our income is fixed by the terms of the contract plus any bonus money allowed if we meet certain goals. Some contracts have short duration of 1-2years, while others offer to pay our debt but the contract duration can be five or more years. Since we are an employee there are few tax deductions and between state and federal income tax about 35-40 percent goes to taxes with another 3-6 percent to the contact retirement fund as an employee.

We still have to think about a vehicle, home, and maybe a college fund. All of a sudden that fixed income can become a real problem as expenses go up but our take home pay does not. For myself, I like the tax deductions of being independent as the saved money can go to retiring debt. My income is not capped by a contact and the harder I am willing to work the more it benefits me, not an employer.

When I finally do decide to retire, if I have a partner he gets to buy me out. If I remain solo, the hospital may offer to buy the practice. No offers means I close the office keeping the accounts receivable in my name seeing what money comes in over time. My state has a formula for the cost of medical records and transferring all my patient records to other physicians. Each of us has to make our own decision whether to work for a salary or be independent.

What do you want to do?

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