ER Doc Advisor - Financial Planning & Taxes for Emergency Physicians

EP 275: Understanding the QBI Deduction in 2026: A Guide for ER Physicians

If you’re a 1099-earning ER physician, the Qualified Business Income deduction—or QBI—can be a meaningful tax opportunity, but it comes with some very specific rules you need to understand. One of the biggest factors is whether your income is considered a Specified Service Trade or Business, or SSTB, which directly impacts whether the deduction is available at higher income levels.

In this episode, we’ll break down how QBI works, why ER physicians almost always fall into the SSTB category, and because of this, what the most effective planning strategies are to get around this obstacle. We’ll also walk through real examples to show how these rules play out in practice.

Topics Discussed   

  • Why most ER physicians don’t qualify for the QBI deduction at higher income levels.
  • How the SSTB rule blocks QBI for clinical medical income.
  • The income thresholds where the QBI deduction phases out completely.
  • Why S-corp and entity structure alone won’t unlock QBI savings.
  • How lowering taxable income can bring QBI back into play.
  • When non-clinical roles may qualify for non-SSTB income.
  • Why coordinated tax planning is the key to using QBI effectively.

Resources Mentioned:

Tags:

 

ER docs, emergency medicine, QBI deduction, tax strategy, 1099 physicians, SSTB rules, physician taxes, retirement planning, income thresholds, S corp planning, financial planning for doctors