What the work involves
Extra income from locums, consulting, expert work or other gigs may arrive without tax withheld. You may need to pay tax during the year and may owe self-employment tax in addition to income tax.
Who the work may fit
This matters for any physician with 1099 income or other income that is not subject to withholding. Your own facts decide the answer, so use a tax professional for numbers.
Questions before you say yes
- Is the payer treating me as an employee or an independent contractor?
- Is tax withheld from any of this pay?
- Do I need to make estimated payments during the year?
- Which expenses can I document?
- Should I increase my withholding at my main job instead?
Your first step
Find out how the payer will classify you and whether any tax is withheld. Then ask a tax professional whether you should make estimated payments or adjust your main-job withholding.
What can go wrong
Spending the full amount you receive and finding out later that you owe tax and may owe a penalty for not paying enough during the year.
How to get started, step by step
Turn the idea into a specific next action. These are preparation steps, not approval to perform a role.
- Confirm whether each payer treats you as an employee or contractor.
- Track every payment and every related expense from the first dollar.
- Ask a tax professional whether to make estimated payments or raise withholding on your main job.
- Learn how self-employment tax is figured on Schedule SE.
- Set aside money for taxes each time you are paid.
Where to look and who to ask
Use search terms and contacts that fit this work. Check the actual source and current requirements; these suggestions are not verified openings or Saile inventory.
- Read the IRS pages on estimated taxes and self-employment tax.
- Ask a CPA who works with physicians about your specific mix of income.
- Use the IRS Tax Withholding Estimator for your main-job paycheck.
JAMA Career Center — professional search resource, not an opening endorsement
Scheduling and payment realities
Estimated payments follow set payment periods during the year. Ask your tax professional which dates apply to you.
Keep gross pay and taxes separate
For federal employment taxes, the IRS considers control and the relationship, not only the contract label. Self-employed individuals generally pay income and self-employment tax and may need estimated payments. Keep payment and expense records and ask a tax professional about your actual arrangement; this guide does not calculate take-home pay.
IRS: Independent contractor or employee
IRS: Self-employed individuals tax center
Before you say yes: a final checklist
Do not let an unanswered question become an assumed term.
- Do I know how each payer classifies me?
- Do I track income and expenses?
- Have I asked about estimated payments?
- Have I asked about adjusting withholding?
- Is money set aside for tax?
Work types to compare
Telemedicine
Compare visit type, patient states, schedule and clinical support.
Locum tenens
Compare assignment duties, onboarding, travel and written terms.
Per diem / PRN
Compare minimum commitments, offered shifts and cancellation rules.
Consulting / project work
Compare eligibility, deliverables, conflicts and review deadlines.
Frequently asked questions
How much does this work pay?
This guide does not quote a market rate or promise earnings. Compare a verified written offer, including all required work and expenses.
Does Saile have this work available now?
Check the Saile app for current openings. This educational guide does not claim that a particular role or project is available.
Can I do this alongside my main job?
Check outside-work approval, conflicts, confidentiality and scheduling obligations before accepting.
What should I get in writing?
The work, deliverables, schedule, payment terms, coverage responsibilities, cancellation terms and the steps required before starting.
What should I do next?
Request a sample task without unnecessary patient information, a review policy and an escalation path. Read confidentiality and liability terms before taking access to records.
What the primary sources say
The IRS says taxes must be paid as you earn or receive income during the year, through withholding or estimated tax payments, and that income such as self-employment income can require estimated payments. Individuals, including sole proprietors, generally use Form 1040-ES to figure them, and you may face a penalty if you do not pay enough or pay late. If you receive wages, you can avoid estimated payments by asking your employer to withhold more on Form W-4. The IRS also explains that self-employment tax is made up of Social Security and Medicare taxes for people who work for themselves, and that you calculate it on Schedule SE. This guide does not calculate your tax.