top of page
  • Writer's pictureJohn A. White

The Impact of the Department of Labor's Independent Contractor Rule on Self-Employed Medical Professionals

The U.S. Department of Labor (DOL) has recently issued a Final Rule that addresses the classification of workers as independent contractors under the Fair Labor Standards Act (FLSA). This new rule aims to determine whether a worker is economically dependent on an employer or is in business for themselves. The implications of this rule are far-reaching, particularly for self-employed medical professionals who operate as independent contractors. This article will explore the critical aspects of the DOL's independent contractor rule and its potential impact on self-employed medical professionals.

Understanding the DOL's Independent Contractor Rule

The DOL's Final Rule establishes six factors to assess whether a worker is an independent contractor or an employee under the FLSA. These factors include:

  1. Opportunity for profit and loss: This factor considers whether the worker's managerial skills and business acumen contribute to their potential for profit or loss.

  2. Investments made by the worker and potential employer: The DOL examines the investments made by both the worker and the employer to determine the level of economic independence.

  3. Degree of permanence of the work relationship: The nature and duration of the work relationship between the worker and the employer are evaluated to assess the level of dependence.

  4. Nature and degree of control: The DOL examines various control aspects, such as setting the worker's schedule, supervising performance, and controlling pricing and marketing.

  5. Extent to which the work is integral to the employer's business: The DOL considers whether the work performed by the worker is essential to the employer's core business operations.

  6. Use of the worker's skill and initiative: This factor assesses the worker's skill and initiative in performing their tasks.

It is important to note that these factors are not given predetermined weights and are considered in the context of the overall economic reality. The DOL emphasizes that the rule is not intended to disrupt the business of actual independent contractors, self-employed individuals, and freelancers.

Potential Impact on Self-Employed Medical Professionals

The DOL's independent contractor rule has raised concerns among self-employed medical professionals, including doctors, nurses, and other healthcare providers. Commenters have highlighted potential challenges and uncertainties that this rule may pose to their independent contractor status.

Concerns Raised by Medical Professionals

Medical professional organizations have expressed concerns about the potential implications of the new rule. They argue that the rule may threaten the independent status of agents, brokers, and advisors in the healthcare industry. These professionals assert that the rule's requirements, such as the ability to set prices, may conflict with existing regulations and industry practices.

Furthermore, medical professional groups have raised concerns about the impact on workers' business investments. They argue that requiring substantial investments may disadvantage smaller independent contractors, such as solo practitioners or those with limited financial resources.

DOL's Response and Clarifications

In response to these concerns, the DOL has sought to provide clarifications and address potential issues. The department has emphasized the role of the "totality of the circumstances" analysis, which allows for flexibility in evaluating the worker's status. The DOL also acknowledges that the factors provided in the rule are not exhaustive and that additional factors may be considered.

To address concerns about the integral factor, the DOL states that it will assess the specific circumstances of each relationship rather than making broad determinations for entire sectors. This approach aims to ensure fairness and avoid undue burden on particular industries, including the healthcare sector.

The Impact on Self-Employed Medical Professionals

The DOL's independent contractor rule has the potential to impact self-employed medical professionals in several ways. Here are some key considerations:

Determining Independent Contractor Status

Self-employed medical professionals must carefully evaluate their work arrangements to ensure compliance with the DOL's criteria for independent contractor status. They should assess factors such as their level of control over their work, the degree of permanence in their relationships with healthcare institutions, and the extent to which their services contribute to the core business operations of those institutions.

Potential Reclassification as Employees

If self-employed medical professionals are deemed employees rather than independent contractors under the DOL's rule, they may become subject to various employment laws and regulations. This could include minimum wage requirements, overtime pay, and other employee protections under the FLSA.

Financial Implications

The reclassification of self-employed medical professionals as employees may have financial implications. It could result in changes to compensation structures, benefits packages, and tax obligations. Professionals may need to consider how these changes could affect their financial well-being.

Flexibility and Autonomy

One of the key advantages of being an independent contractor is the flexibility and autonomy it offers. Self-employed medical professionals may value the ability to set schedules, choose clients, and have greater control over their work. The DOL's rule may impact this flexibility and potentially restrict the independence of these professionals.

Compliance and Legal Considerations

Self-employed medical professionals should ensure they understand and comply with the DOL's independent contractor rule to mitigate the risk of legal consequences. Seeking legal advice or consulting with professional organizations can help navigate the complexities of this rule and ensure compliance.


The DOL's independent contractor rule introduces a new framework for determining the classification of workers, including self-employed medical professionals. While the full impact of this rule remains to be seen, medical professionals must understand the criteria and considerations outlined by the DOL. By carefully evaluating their work arrangements and seeking appropriate guidance, self-employed medical professionals can navigate the evolving landscape and make informed decisions about their independent contractor status.

121 views0 comments


bottom of page