Taxstra Logo
Physician reviewing chart
High-Income W-2 Strategy

The "W-2 Trap" Is Real.
But You Have Options.

You earn $400k+. You have zero business expenses. You take the standard deduction. Is this really it? No. We help W-2 physicians find the "hidden" tax code chapters written just for them.

Why You Feel Like You're Losing Half Your Paycheck

As a W-2 physician, you are the IRS's favorite customer. Your income is reported to the penny, your taxes are withheld before you even see the money, and the Tax Cuts and Jobs Act (TCJA) eliminated almost all the deductions you used to hear about (unreimbursed employee expenses, home office, dues, etc.).

Most CPAs look at a W-2 doctor and say, "There's nothing you can do." They file the return, tell you to max your 401(k), and send you a bill.

This is lazy advice. While you can't deduct scrubs anymore, you CAN change the nature of your income and where you put your savings.

The W-2 Physician Scorecard

Federal Tax
32% - 37%
State Tax
0% - 13.3%
FICA (SS + Medicare)
~2.35% + Caps
Total Drag
40% - 50%+

*Without a strategy, you work January through June just to pay the government.

The Playbook

Strategies That Actually Work For W-2s

We can't invent expenses, but we can structure your wealth building to be tax-efficient.

Real Estate (STR/REPS)

The only high-power deduction left. Using the 'Short-Term Rental Loophole' or spousal 'Real Estate Professional Status' to create paper losses that offset your W-2 wages.

The 'Super' Accounts

Going beyond the 401(k). We optimize HSAs (triple tax-free), Mega Backdoor Roths (after-tax 401k), and 457(b) plans.

Tax-Loss Harvesting

Your brokerage account shouldn't just grow; it should generate losses. We work with your advisor to harvest losses that offset up to $3,000 of ordinary income and unlimited capital gains.

Asset Location

Putting high-tax assets (bonds, REITs) in IRAs and tax-efficient assets (ETFs) in brokerage. It sounds boring, but strict asset location adds ~0.5% to 1% after-tax return annually.

Side Gig Optimization

Do you do surveys? Expert witness? Medical direction? Even $10k of 1099 income unlocks a Solo 401(k), home office, and business expensing.

Charitable Bunching

Instead of giving $10k/year and taking the standard deduction, giving $50k every 5 years via a Donor Advised Fund to itemize huge amounts periodically.

Deep Dive

Can Buying A Beach House Lower Your Hospital W-2?

Yes. It's called the **Short-Term Rental (STR) Loophole**, and it's the #1 strategy we use for high-income physicians who can't quit their jobs.

Normally, rental losses are "passive" and can't offset W-2 income. But if the average stay is **7 days or less** and you **materially participate** (100 hours + more than anyone else), it's treated as a business.

Combine this with **Cost Segregation**, which lets you depreciate 20-30% of the building in Year 1. A $1M property could generate a $250k tax loss—wiping out the tax liability on $250k of your hospital salary.

Read The Full STR Guide
Example Math

The "STR" Effect

Physician W-2 Income$500,000
Standard Tax (Approx)($150,000)
STR Cost Seg Loss($180,000)
New Taxable Income$320,000
Tax Savings~$60,000+

*Hypothetical example. Requires active participation and precise logging.

Our Process

How We Tax Plan For W-2 Doctors

01

The 'Leakage' Audit

We review your paystubs and last 2 returns. are you over-withholding? Are you missing HSA contributions? Are you messing up the Backdoor Roth?

02

The Savings Waterfall

We design a flowchart for every dollar: 403(b) match -> HSA -> Backdoor Roth -> 457(b) -> Brokerage. We automate your wealth flow.

03

The 'Big Swing'

We evaluate if you're ready for real estate (STR/LTR) or a side gig. If yes, we set up the entities and coordinate the purchase strategy.

Physician Tax FAQ

Stop Overpaying.

You worked too hard for your income to let it leak away. Let's build a W-2 tax plan that actually fights back.