An LLC or PLLC is what your practice is under state law.
An S-corp is how it’s taxed.
They aren’t competing choices.
A physician usually forms a PLLC or PC for licensing and liability, then elects S-corp taxation on top once profit justifies it.
The real question is which state entity, plus when to add the election.
The Confusion Is Baked Into the Question
People treat LLC-versus-S-corp as a fork in the road, which is the first mistake.
An LLC is a legal entity your state recognizes.
An S-corp is a tax status the IRS recognizes.
One says what your business is.
The other says how its profit is taxed.
You can, and often should, have both at once.
What an LLC or PLLC Actually Does
An LLC separates your personal assets from the practice’s obligations, which is the liability shield everyone’s after.
By default, a single-owner LLC is taxed like a sole proprietor, so every dollar of profit meets self-employment tax.
That default is fine when profit is thin and simplicity matters.
It stops being fine the moment your practice is genuinely profitable, which is where the S-corp election walks in.
For physicians, most states require the professional flavor, a PLLC, rather than a plain LLC.
That’s a licensing rule, not a tax one.
What Electing S-Corp Changes
Elect S-corp treatment and your practice starts paying you a reasonable salary through payroll, with the rest coming as distributions.
The salary carries payroll tax.
The distributions don’t, and that’s the whole savings.
Nothing about your legal entity changes.
You’re still a PLLC, just one that’s chosen a different tax lane.
So Which Do You Choose?
Choose the state entity your license requires first, which usually settles the LLC, PLLC, or PC question for you.
Then decide whether to layer the S-corp election on top, based on profit, payroll appetite, and how long you plan to run this way.
For a lightly profitable side practice, a PLLC taxed as a sole proprietor may be all you need.
For an established practice throwing off real profit, the PLLC-plus-S-corp combination is usually the one that pays for itself.
One Honest Caveat
The S-corp election adds real obligations: payroll, a separate return, and a salary you can defend.
If you won’t run actual payroll or keep clean books, the election creates exposure rather than savings.
The structure is only as good as the discipline behind it.
That part isn’t optional.
If you want the version of this with your entity, your state, and your actual numbers plugged in, that’s what we can do for you together.