When physicians and other business owners elect S corporation status, one of the first questions they ask is:

"Should I put my car in the business?"

It seems logical. If the business uses the vehicle, shouldn't the business own it?

Surprisingly, the answer is often no.

While there are situations where S corporation ownership makes sense, personally owning your vehicle and using an accountable plan is frequently the cleaner, more tax-efficient option.

Most solopreneur physicians are familiar with the self-employed health insurance deduction. If you are self-employed and pay for your own health insurance, you may be able to deduct the premiums above the line instead of treating them as an itemized medical expense. That is valuable, especially for physicians buying coverage on the individual market, but it has limits. It generally does not allow you to deduct all out-of-pocket medical expenses, and it does not turn every family healthcare cost into a business deduction.

Most people quote their marginal tax rate from the federal tax brackets. But your true marginal rate is the sum of several layers of taxes—federal, state, payroll, and sometimes even city. And your marginal rate can differ depending on whether the income is earned (salary or self-employment), passive (investments), or from a business.

In other words, the changes to the SALT deduction by themselves change how we look at charitable donations.  What’s more, the OBBBA has introduced a couple of fairly minor changes to how charitable donations are deducted.  Importantly, these take effect in 2026 (the change to the SALT deduction takes effect in 2025).  Because they are both calculated on the same schedule of the tax return, and the total is compared with the standard deduction, there is significant interplay between them in a holistic tax plan that optimizes for 2025 and future years.

For most taxpayers, the largest tax obligation they pay at the state/local level is their state income tax.