Industries
Medical, Engineering, and Everyone Else
Physicians, dentists and engineers are the two largest groups in my practice, which mainly means I know which mistakes to check for before you finish describing the situation.
An employed physician opens a Schedule C to hold board certification fees, DEA registration and CME travel, because a colleague at the hospital said to. It deducts nothing that was legitimately deductible, invites a question about a business with no revenue, and props up a retirement contribution he does not qualify to make. An engineer takes a contract at a higher hourly rate without pricing in the 15.3% self-employment tax or the benefits he now buys himself, and nets less than the W-2 offer he turned down.
Both mistakes are cheap to prevent and expensive to unwind. That is all specialization means here. I have seen the same situation enough times to know where the money sits and which mistake gets made, usually before you finish describing it.
Medical professionals
Physicians and dentists are the largest share of my client base. They arrive in three tax situations that barely overlap: employed by a hospital or group on a W-2, owning a private practice, or holding a partnership interest and living on a K-1.
The employed physician's problem is that almost nothing is deductible anymore. The Tax Cuts and Jobs Act suspended unreimbursed employee business expenses, so board certification, DEA registration, CME travel and specialty society dues produce no federal deduction on a W-2 return. The fix is a negotiated stipend or an employer accountable plan, not a Schedule C built to hold them.
The new partner's problem is cash. A K-1 withholds nothing, the buy-in note comes due on its own schedule, and the first quarterly estimate has to come out of a household that was living on payroll withholding twelve months earlier. Paying in 110% of last year's tax keeps the underpayment penalty off when prior-year AGI cleared $150,000. It does nothing about the balance due on April 15. I work through all three situations on the medical page.
Engineering professionals
Engineers are the second concentration, and their recurring questions are structural. W-2 or 1099 on the next contract, and how much higher the 1099 rate has to run before it actually wins. Whether equipment and software get expensed this year or capitalized. What to do about income that lands in lumps tied to project milestones instead of evenly across twelve months.
Multi-state work is the one that surprises people. A year spent on project sites in four states can mean four nonresident returns stacked on top of the resident one, and the credit for taxes paid to another state is capped at what your home state would have charged on that same income. If home is the lower-rate state, you eat the difference. Lumpy income has a fix that rarely comes up: Form 2210 Schedule AI lets you annualize, so a heavy fourth quarter is not penalized as though you had earned it evenly since January. More of that on the engineering page.
Neither specialty changes the price. The flat fee comes off the same complexity scale for everyone: income sources, states filed, forms required, entities involved. A physician with three K-1s and an engineer with three K-1s get the same number, in writing, before I start. How the scale works.
What I look at first, in both groups
The two fields look nothing alike on paper. They fail in the same six places.
- Income arriving with no withholding attached: K-1 distributions, 1099-NEC contract work, milestone bonuses
- Work performed across state lines, and the nonresident returns that follow it
- An entity election made once at formation and never revisited as the income changed
- Retirement plan capacity left unused because nobody added up what the current structure allows
- Equipment bought in December that was never placed in service before the 31st
- Prior-year returns that need cleanup before the current one is worth filing
You do not have to be either one
Specialization helps. It is not a requirement, and most of the work does not change with what is printed on your business card: read the documents, ask the handful of questions that actually move the number, quote the price before I start. Plenty of my clients are neither doctors nor engineers.
The honest limit runs the other direction. If your return is one W-2 and the standard deduction, no industry page makes hiring a CPA worth the fee, and the consumer software will land on the same number for a fraction of it. What changes that math is a second income source, an entity, an equity stake, or a state line. The initial consultation costs nothing, and I will tell you which side of that you are on before you pay me anything.
Specialisms
Where I have seen it before.
Tax work for physicians and dentists
Medicine is the largest share of my client base, and the return looks nothing alike depending on whether you are employed, own the practice, or hold a partnership interest.
Learn more →What I Watch For
- An accountable plan, so CME, licensure, dues, malpractice and a qualifying…
- Depreciation choices on equipment and the build-out: Section 179, bonus dep…
Tax work for engineering professionals
One year on a W-2, the next on 1099s, sometimes both at once, with equipment, travel, and four states attached.
Learn more →What I Watch For
- Schedule C, or Form 1120-S if the entity election has actually been run aga…
- The de minimis safe harbor election and Section 179 for equipment, instrume…
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