Doc Wealth, Q3 2026 Newsletter

Section 01 · Extension Season

Extension Season Is On

Summer is the quiet stretch on the tax calendar, which is exactly why it matters. If your return is on extension, the next eight weeks are when the planning actually gets locked in. Here is what that looks like depending on where you stand.

Scenario A

Extension Filers

October 15 is your real deadline. An extension is a planning window, not a delay. It gives your tax team the time to capture late documents, run the numbers fully, and file a complete return instead of a rushed one. A few things are still open to you right now that close the day you file.

Get your final documents into TaxDome.

The sooner they land, the sooner we can give you a target date.

Some retirement contributions are still on the table, but timing matters.

A SEP can still be set up and funded for the year right up to your extended filing deadline, so if that is in play, this is the window. A Solo 401(k) is more time-sensitive, because the plan and the employee contribution piece generally had to be in place earlier in the year. Do not assume it is still open. Tell us and we will confirm exactly what you can still do.

The extension moved your filing deadline, not your payment deadline.

If anything is owed, we will tell you exactly what to pay. And the mid-year checkup in Section 02, the withholding and estimate review, is for you too. It is not only an April-filer move.

Nothing gets rushed. Nothing gets missed.

Scenario B

April Filers

You are not behind. You are early.

Filing in April does not mean you are done for the year. Mid-year is the right time to make sure your withholding and estimates are on track, so next April is boring. More on that in Section 02.

If the retirement note above made you wonder whether you missed a window, you did not. The contribution deadlines extension filers are working toward are tied to the filing date, so for most early filers they were handled when you filed. If you think you may have left one on the table, tell us and we will check whether anything is still open for you.

Either way, the moves that matter most are the forward-looking ones in Section 02, and on those you have more runway than anyone.

Keep a personal copy of your return and supporting documents.

TaxDome stores them, and we recommend you keep your own set too.

If anything material changed this year, a new job, a practice move, a jump in 1099 income, tell us now while there is still room to adjust. You are ahead, not behind, and nothing is sitting unfinished.

Section 02 · Mid-Year Planning

The Moves That Need Runway

The most valuable tax planning is not what you do in December. It is what you set up now, so that December is just execution. These are the moves that need lead time, and the clock on them is already running.

What we are reviewing with our physician clients this quarter

Topic 01

Accountable Plan Setup

If you run your practice as an S-Corp, an accountable plan is how you reimburse home office, vehicle, and phone use the right way and move those dollars from after-tax to pre-tax. It has to be documented and in place before the expenses run through. Set it up now and you capture the rest of the year. Wait until December and you are reconstructing receipts.

Topic 02

Retirement Plan Setup and Pacing

Solo 401(k), SEP, defined benefit, and cash balance plans all shelter serious income. The bigger two, defined benefit and cash balance, are built for high earners who want to set aside far more than a 401(k) allows, and they generally have to be established well before year-end, with payroll funding that needs runway. Checking your pacing now is far easier than fixing it in December.

Topic 03

S-Corp Reasonable Compensation True Up

If you run an S-Corp, the IRS expects you to pay yourself a reasonable salary before taking the rest as distributions, so the number has to hold up. It is a balance: set it too low and you invite scrutiny, set it too high and you give away payroll tax savings. If your salary was set early in the year and your income has moved, the right number moved with it. Mid-year leaves room to adjust payroll cleanly. December does not.

Topic 04

Entity Decisions

A new practice arrangement, a jump in 1099 income, or a move can change which entity actually fits. These decisions take time to set up correctly, so fall is the moment to look, not the week before filing.

Deadline

Sept 15

2026 · Q3 Estimated

Q3 Estimated Tax Payment

If you are a 1099 physician, S-Corp owner, partner, or have meaningful investment income, you likely owe by September 15.

Do not let the two fall dates run together. September 15 is a payment toward this year’s taxes, your third 2026 estimate. October 15, back in Section 01, is the deadline to file last year’s return if you are on extension. Different year, different purpose. And if you are on extension, remember the balance on last year’s return was already due in April, because an extension moves the filing date, not the payment date.

A few things worth knowing as the deadline approaches:

This payment covers income earned June 1 through August 31.
Underpayment penalties apply if you fall short of safe harbor. For higher earners, meaning your prior-year AGI was over $150,000, that safe harbor is generally 110% of last year’s total tax. Meeting it keeps you penalty safe, but you still owe any remaining balance when you file.
If your income lands unevenly this year, a big bonus, a late year locums block, a partnership distribution, there is a method (annualizing) that can match your required payments to when you actually earned the money, which can reduce a penalty. Tell us and we will run it for you.
We will send your specific number through TaxDome before the deadline.
If your income changed materially this year, tell us so we can adjust the calculation.

One mid-year move worth doing today: the withholding and estimate checkup

This is the most Q3 thing on the list. If your withholding or quarterly estimates are off, you still have two quarters to fix it. Find out in April and you are writing a check with a penalty attached. A quick mid-year review now is the cheapest insurance there is.

A quick housekeeping note for practice owners

If you own your practice and pay contractors, the 1099 rules got easier. Starting with payments made in 2026, you generally issue a 1099-NEC or 1099-MISC to a contractor only when you pay them $2,000 or more for the year, up from the old $600. Fewer forms to file. One thing did not change: the income is still taxable to the contractor whether or not a form goes out, so keep your records clean. The mid-year move is simple. Collect W-9s as you go and tidy up your vendor list now, so January filing is smooth. (A few states have not adopted the new threshold, so a practice with out-of-state contractors may still file some at the lower amount.)

Why this matters

Every move above either lowers your tax bill, lowers your audit risk, or both. The physicians who gain the most year over year are not the ones who filed earliest. They are the ones who treat tax planning as a year round conversation. If you have not had a planning touchpoint with your tax team since filing, this is your nudge to message us in TaxDome.

Section 03 · Resources

Featured Planning Guides

A few of the planning guides our team is using most this quarter. Click any cover to open the full guide.

NEW · CME

Guide · Deductions

The Physician’s CME Deduction Guide

Conferences, courses, licensing, and travel. The rules on what actually counts are narrower than most physicians assume, and they hinge on how you are paid. If you are an employed physician and your CME is unreimbursed, it generally is not deductible, so the real move is having your employer reimburse it. If you have practice or 1099 income, it can be deductible against that income. This is our newest guide, built to take the guesswork out of CME ahead of fall conference season, including which path applies to you.

SUMMER

Guide · Planning

The Physician Summer Tax Playbook

Seven moves, from hiring your kids to the Augusta Rule. On the hiring move, the guide warns that many physician practices are S-Corps, where the FICA exemption does not apply: it covers a sole proprietorship or a disregarded single member LLC. Also inside: the 2026 estimated tax calendar with the safe harbor math behind the September 15 date above, the new $7,500 Dependent Care FSA limit, and the five move mid-year review worksheet. It also maps the seven moves onto an annual calendar covering all four quarters.

47 WRITE OFFS

Guide · Deductions

The Ultimate 47 Tax Write-Offs

Nine categories, from scrubs and loupes to malpractice premiums and Healthgrades listings, each with the IRS rule attached. It opens with the ordinary and necessary test and closes with the audit traps: double dipping on a CME stipend your employer already reimbursed, which the guide calls the number one mistake, deducting your commute, and writing off street clothes. It ends with a quick reference table of special rules, including the $5 per square foot home office method capped at 300 square feet.

REPS

Guide · Real Estate

The Physician’s Guide to REPS

Two tests, and the first is where full-time physicians get stuck: more than half your working hours in real estate, plus more than 750. The guide walks the grouping election under Reg. 1.469-9(g) that has to be on a timely filed return, the contemporaneous hour log the Tax Court accepts, and what changes on Schedule E, Form 8582, and the 3.8% NIIT. It also covers the spousal route, the most common structure for physician families, and how cost segregation fits the update below.

Section 04 · Policy

What’s New + What to Watch

A short set of updates, with the part that actually affects you up front. These build on what we covered in Q2, so the focus here is what has moved since then.

Trump Accounts Are Now Open

Status

Open now

Federal Seed

$1,000

Annual Cap

$5K / child

We flagged these last quarter as coming. They are now live, and you make the election by signing in to your IRS individual account and submitting Form 4547. The headline for families is the one time federal seed deposit for eligible children born in the qualifying window. If you have a child in the eligible range, the first decision is simply whether to claim the seed and open the account, and how it fits alongside a 529.

Funding is the next question: beyond the $1,000 seed, you and family can add up to $5,000 a year. Those contributions are not deductible, but the account grows tax deferred. Worth a look before year end.

Bonus Depreciation: The IRS Guidance Is Out

Rate

100%

Status

Permanent

Catch

Placed in service by year end

We noted last quarter that 100% bonus depreciation was back under OBBBA. The update for Q3 is that the IRS has now issued guidance confirming how it works, which removes the wait and see. For physicians who own a practice, are buying equipment, or are running a cost segregation study on a medical office or rental, this is a real lever. (A cost segregation study breaks a building into shorter life parts that depreciate faster, which is what lets bonus depreciation do the heavy lifting.) Equipment and qualifying improvements can be written off in full the year they go into service.

Vehicles are the part most people get wrong: an ordinary business car, truck, or van is capped each year by the luxury auto limit, so even with bonus depreciation you cannot write off the whole cost in year one. Heavier vehicles follow different rules, so the vehicle math is specific. Ask us before you buy.

The other catch is timing. To use any of this on this year’s return, the asset generally has to be placed in service before December 31, which makes this a fall decision, not a December one. If a purchase or a cost seg study is on your radar, loop us in before you commit, not after. The timing is where the value is.

The SALT Cap Is Bigger, but It Shrinks for High Earners

SALT Cap (2026)

$40,400

Catch

Phases down for high earners

PTET

No federal cap

The SALT deduction cap rose to $40,400 for 2026, but here is the part that matters for most physician households: it phases down as income climbs, back toward a $10,000 floor. So for many of you, the personal SALT deduction is more limited than the headline number suggests.

That is exactly why the pass through entity tax is the bigger lever for practice owners. Many states let your practice pay state income tax at the entity level, which is deductible federally and sidesteps the personal SALT cap. The election and payment windows are state specific and several fall in the back half of the year, so this is worth a look now. If you own your practice and pay meaningful state tax, ask us whether a PTET election makes sense for your state. The math is specific to where you practice.