Physicians, dentists, nurse practitioners, and practice owners are among the highest-earning borrowers a lender sees — and among the most likely to be turned down by one. The reason is paperwork, not income. If you own a practice, work 1099 shifts, or write off aggressively, your tax returns understate what you actually earn, and a conventional underwriter is required to believe the tax returns. Defy is a direct non-QM lender built for exactly this gap: we qualify healthcare professionals on the income their business actually produces, without tax returns.
The Direct Answer: How Self-Employed Clinicians Qualify at Defy
A bank statement loan qualifies you on the deposits flowing through your business or personal accounts — 12 or 24 months of statements stand in for tax returns entirely. For practice owners with a CPA-prepared profit and loss statement, a P&L loan does the same job with even less documentation: with strong credit, the CPA-prepared 12-month P&L alone can carry the file. In both cases, the underwriting question changes from “what did you tell the IRS?” to “what does the practice actually produce?”
Current program parameters (full details on each program page):
- Bank statement loans: financing up to 90% LTV on a primary residence for well-qualified borrowers, with loan amounts up to $2M at that tier and larger loans available at adjusted LTVs. Typical minimum down payment runs 15–20%. Program details: bank statement loans
- P&L statement loans: up to 80% LTV, loan amounts from $75K to $3.5M, minimum FICO 640. Borrowers with a 700+ score can qualify on the CPA-prepared P&L alone; below 700, two months of bank statements support the P&L. Program details: P&L statement loans
For Physicians Building a Rental Portfolio
Many of our healthcare clients aren’t just buying a home — they’re building passive income on the side. A DSCR loan qualifies an investment property on the property’s own rent, not your personal income: no tax returns, no DTI calculation, no employment verification. If the rent covers the payment (and in many cases even when it doesn’t fully — coverage ratios down to 0.75 fit our specialty program), the deal can work, with minimum FICO 640. That means a busy surgeon’s W2, K-1s, and practice distributions never enter the file. Current pricing is at DSCR loan rates.
Why This Matters More in Medicine Than Anywhere Else
Healthcare compensation is structurally hostile to conventional underwriting: 1099 moonlighting, locum tenens work, partnership draws, S-corp distributions, student-loan balances that distort DTI, and practice write-offs that shrink taxable income. None of that reflects risk — it reflects how medicine is paid. Non-QM underwriting reads the actual cash flow, which is why self-employed clinicians routinely qualify for substantially more with us than a conventional lender could approve.
Frequently Asked Questions
Can I qualify without tax returns?
Yes. Bank statement, P&L, and DSCR programs are all designed to qualify you without tax returns — that is the core of non-QM lending.
I’m a 1099 emergency physician with heavy write-offs. What fits?
A bank statement loan usually fits best: 12–24 months of deposits capture your real earnings before write-offs.
Do student loans disqualify me?
No. Bank statement and P&L underwriting looks at cash flow rather than the conventional DTI formula that student-loan balances distort, and DSCR loans don’t consider personal income at all.
Can I buy a rental property while employed at a hospital?
Yes — a DSCR loan qualifies the property on its rent, so your employment structure is irrelevant to the file.
See what your practice’s real cash flow qualifies for — talk to a Defy advisor today. Dare to Defy.
