W2 vs 1099 for PAs: The Real Pros/Cons + What No One Plans For

A lot of surgical PAs are quietly asking the same question: Is there a way to earn more and build real flexibility… without leaving the OR?In this episode, Kristin sits down with Dan Payson, founder of All Star Surgical, to break down what it actually looks like for surgical PAs to go independent (1099), how the pay structures work, and what you need in place so the extra income doesn’t turn into chaos—especially on taxes and backend systems.Inside, you’ll hear:The difference between “freelancing” and building a real surgical PA businessHow independent surgical PA pay is often structured (and what makes rates vary)The biggest blind spot that blows up 1099 income (and how to avoid it)What it takes to be successful outside your “home hospital” comfort zoneWhy backend infrastructure matters as much as clinical skillWant to know if your current income plan is leaving money on the table?Book an application call with the Millionaires in Medicine Team and we’ll assess where you are, identify the biggest gap, and outline what coaching would change for your situation: https://www.millionairesinmedicine.com/coachIf you’re a PA thinking about going 1099, here’s the real question:Will the extra income actually turn into wealth… or just a bigger, messier version of your current life?That’s exactly why I wrote The PA Millionaire Path — because most PAs don’t need “more hustle.” We need a real system for what happens after you earn more: how you structure income, handle debt, and invest in a way that actually builds freedom.👉 Grab The PA Millionaire Path on Amazon here: https://www.amazon.com/dp/B0GW8SXJ5R(If you’ve ever felt like you’re earning a solid income but still barely keeping up, start there.)GuestDan Payson — founder of All Star Surgical, helping surgical PAs create more income flexibility through independent work and backend support.Links:All Star Surgical: https://allstarssurgical.com/Dan on LinkedIn: https://www.linkedin.com/company/all-stars-surgical-assist/DisclaimerThe Millionaires in Medicine Show is for educational and informational purposes only. The content shared is not intended as medical, legal, financial, or investment advice and should not be relied upon as such.