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Employee vs contracted PA

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Just curious to see if there are any PA's out there that took the route as being contracted (1099) vs the traditional employee route. I am a surgical ortho PA I know there is a benefit as far as collecting assist fee's as such but just wanted to see how other PA's like/dislike being contracted.  Also if any PA's have started some type of business plan I'd love to hear it! Thanks

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I have done both. There are pluses and minuses but as Ventana said you have to have a certain structure to meet the IRS 20 rules for being a contract employee and mostly we don't. I was 1099 when I was a 1 man locums company and all my arrangements were temporary and contractural. You can't work for someone full time, have even a semi regular schedule, and meet the IRS rules. 

Long story short I had a staffing agency and , through a well thought out system, made all my nurses 1099 employees. One day the state and the IRS showed up unannounced and, without so much as asking a question or looking at a form, advised all those nurses were actually my employees....for the last 3 years. 300k later I was wiser for the experience.

Mostly it is a hassle for the employer and not the employee but imaging you work 1099 for 2 years and the IRS decides you were actually employed. Most of the deductions you were allowed as a contractor are now null and void and you have to re-calculate your taxes and re-file.

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Here is the general rules. How they may apply in a given situation is subject to who is doing the application. In my nurse agency I met 16 of the 20 rules but they were there to get money not discover the truth. I was invited to seek legal redress....you know get a lawyer and fight the state and the IRS. 

My personal experience suggests err on the side of caution.


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On 6/4/2018 at 3:47 PM, Walkoffshot said:

Does this still apply for surgical assist fees? Is there a difference between the clinical vs the surgical side of contract work and billing? I know of several groups that have created a contract first assist business... but mostly made up of RNFAs. 

I would think ABSOLUTELEY


to be 1099 you have to control your schedule and not use the employers tools and items...


think a computer guy sitting at home, on his computer, doing work on his own schedule...


now, as a PA you are in THEIR OR, on THEIR schedule, using THEIR tools, Supporting THEIR surgeon....  ah nope....

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I see your point, however, we could control our own schedule as we control who we work with and control when we work. Yes, the surgeon has their own schedule but I personally could control if I work with them on specific days/time. I can't argue the "supplying the tools" part. I assume this would include things such as closure material (suture, needle driver etc.) and retractors among others. That's the challenge. 

I'm curious, does anyone know if creating an LLC would allow us to avoid these restrictions? There has to be a way... again, I know of several first assist businesses (owned by RNFA's) that function... unless they haven't been audited yet..

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