The employer paid wages to the employee. The employer had the power to dismiss the employee. The employer had the power to control the conduct of the employee. Of these, the power to control conduct was recognized as the most important. Whether or not someone is an employee depends not only on the exact nature of the relationship but also on the context in which the question is asked.
Many nurse anesthetists work in varying degrees of collaboration with surgeons.
Rarely will the relationship between nurse anesthetist and surgeon embody the four elements listed above. For example, employers are required to collect withholding taxes on wages but not on amounts paid to independent contractors. Because the question has such ramifications, the IRS has published a number of comprehensive rulings. The IRS also recognizes control as the most important factor determining whether the employment relationship exists. An employee is one who is subject to the will and control of the employer not only as to what shall be done but also as to how it shall be done.