Doctors Can Love Medicine and Love Something Else

The Entrepreneur's Life

Doctors Can Love Medicine and Love Something Else

A note on the story below: it is a composite drawn from several coaching conversations. The specialty, employer, location, numbers, and personal circumstances have been changed or removed, and nothing here describes a single identifiable person.

In a coaching call not long ago I asked a physician how things were going, and I got a good answer about their clinical work and a decent one about their practice. Then I asked about the craft business they had been building on the side, and the whole conversation changed. Their voice picked up. They talked faster. They described a technique they were learning, a commission they were proud of, and a design problem they could not stop thinking about. Nobody had to prompt them to say they loved it. It was obvious.

That physician had started the business a few years earlier on purpose. They did not wait until retirement to find out what would come next. They began building skills, customers, and a portfolio while they were still practicing medicine full time, so that when the day came to step back from clinical work, they would be stepping toward something already running. Medicine was the engine. The craft was the destination. Job stacking was how the two fit into the same life.

I want to use that story to make a point that I think many physicians never hear: you are allowed to love medicine and love something else, and the something else can become a business.

The Permission Nobody Gave You

Medical training teaches a single identity. For a decade or more, the culture rewards total commitment, treats outside interests as indulgences, and asks you to define yourself by your license. Plenty of physicians finish training having quietly abandoned the music, the making, the writing, or the building that once gave them energy. They tell themselves they will return to it later. Later tends to be a long way off.

The research suggests that the sacrifice is a costly one. A survey published in the Journal of Wellness asked more than 3,000 physicians and trainees about their participation in 117 different hobbies, grouped into 15 categories. In every category, burnout was significantly lower among those who were active than among those who were not. The highest burnout was associated with giving hobbies up, and it rose with the number of hobbies a physician had abandoned. Nearly 94 percent of respondents said outside interests were a substantial buffer against burnout and disengagement. The authors are careful to say the study shows association, not cause. Still, the pattern matches what I see in coaching: the physicians who keep something of their own tend to stay more alive in their work.

What the hobby research found

• Who was surveyed: more than 3,000 U.S. physicians and trainees, asked about 117 hobbies in 15 categories.

• The pattern: burnout was lower in every category for those who were active, and highest among those who had stopped.

• The belief: about 94 percent of physicians said outside interests are a substantial mitigation for burnout.

• The caution: the study found associations, not causes.

Now take the next step. A hobby protects you. A hobby with a business shape can also pay you, give you purpose beyond the clinic, and become the thing that makes your later decades look forward instead of backward.

Related resources

Blog: Beyond the Paycheck: The 5 Kinds of Wealth Every Doctor Must Build

Blog: Building Wealth Means Nothing If You Neglect This

Blog: Asynchronous Medicine Is Rewriting the Physician Career

Free eBook: Job Stacking for Doctors: Modern Medical Lifestyles (PEA Explorer)

Job Stacking Has a Destination

When I talk about job stacking, most physicians picture a list of income channels: a primary role, a locums shift, a remote channel, some consulting. That picture is accurate and incomplete. It treats every channel as equal, and it misses the question of where the stack is going.

A passion business gives the stack a direction. Clinical work pays well and funds the build. The passion business starts small, often unprofitable, and grows as you learn. Over years the proportions shift. At some point you can reduce the clinical side, because the other side already has customers, a reputation, and a way to pay you. You are not retiring into nothing. You are moving from one thing you built to another thing you built.

Ellen and I have lived a version of this. Ellen runs a scrapbooking business, Scrapping in My Sleep, with a YouTube channel where she teaches the craft she loves. It began as something she did for joy, and it grew because she kept showing up and teaching. The trips we take, like the Lambeau weekend I wrote about, feed content for the channel and become part of the business. That is what it looks like when a household stops separating the work it enjoys from the work it is paid for.

"Medicine can be the engine and a craft can be the destination. Job stacking is how you carry both at once, until the proportions shift."

Four Stages From Passion to Business

Stage 1

Explore with small, cheap experiments

Do the work for yourself and a few friends. Learn what you actually enjoy, as opposed to what you imagine you would enjoy. Spend little. At this stage the goal is information, and the profit is optional.

Stage 2

Prove that someone will pay

Take a few paid commissions. Notice what people ask for, what they will pay, and what you would happily make again. Open a separate bank account and start keeping records. This is also when the business-versus-hobby question starts to matter, which I address below.

Stage 3

Build skill, price, and process

Invest in training that deepens your craft, price your work for the value it delivers instead of the hours it takes, and develop a repeatable way to quote, schedule, and deliver. Most makers underprice at first. As skill and demand grow, revisit your rates in steps.

Stage 4

Choose the destination deliberately

Decide how the stack should look in five and ten years. Maybe the craft stays a joyful part-time channel. Maybe it grows into a primary income after you step back from clinical work. Either is a good outcome. The point is to choose it on purpose and start building the runway early, with customers, a portfolio, and a reputation that exist before you need them.

Is It a Hobby or a Business? The Tax Answer Matters

This is the section most physicians skip, and it is where money gets lost. The IRS treats an activity differently depending on whether you carry it on to make a profit. The rule comes from Section 183 of the tax code, and the stakes changed in recent years.

Treated as a business

Income is taxable and expenses are deductible

If you operate with a genuine profit motive, you report income and deduct ordinary and necessary expenses. In many cases a net loss can offset other income, subject to the usual limits. That treatment is the advantage of running the activity as a real business.

Treated as a hobby

Income is taxable and expenses are not deductible

If the IRS decides the activity is a hobby, you still report the income, but you cannot deduct the expenses. Before 2018, hobby expenses could be deducted up to the amount of hobby income. The 2017 tax law suspended that deduction, and the 2025 tax law made the suspension permanent. In 2026, a hobby means you pay tax on gross receipts with no offset.

Two things help you stay on the business side. First, the tax code includes a presumption: if the activity earns a profit in three of five consecutive years, it is presumed to be carried on for profit, and the burden shifts to the IRS. Second, if you do not meet that test, the IRS weighs nine factors, such as whether you run the activity in a businesslike manner, keep accurate books, have the expertise or are developing it, spend time and effort on it, expect assets to appreciate, have success in similar ventures, show a history of income or losses, make occasional profits, and depend on the income. No single factor decides the outcome.

In practice, this means treating the craft as a business from day one: a separate account, clean records, written quotes and invoices, a plan to price for profit, and attention to permits, sales tax, and liability insurance where relevant. As profits grow, the entity question comes up, and I covered how to think about it in When the S-Corp Makes Sense and When It Doesn't. Ask your CPA about training costs too. Education that maintains or improves skills in an existing business can be treated differently from education that qualifies you for a new trade.

Related resources

Blog: When the S-Corp Makes Sense and When It Doesn't

Blog: From S-Corp to LLC to C-Corp: How to Layer a Physician Business Enterprise

Free eBook: Tax Deduction Guide for Micro-Business Owners (PEA Explorer)

Affiliate: Cerebral Tax Advisors: physician-specialized tax planning

Affiliate: DocWealth: accounting for physician micro-businesses

The Real Constraint Is Time

When physicians tell me why they have not started, they usually name interest, talent, or money. When physicians who have started tell me what is hard, they name one thing: time. Clinical responsibilities have a way of expanding without notice. Staffing changes, extra coverage, and a growing panel can eat the hours that a craft business and its training need.

The answer is not to wish for a longer day. It is to manage capacity the way a business owner does.

Five habits that protect a passion business from a busy clinical life

1. Protect the training time. If you are building skill through classes or a structured program, put those hours on the calendar first and arrange clinical commitments around them, not the other way around.

2. Budget the hidden hours. Practice, design, and project work usually take more time than the class itself. Count them before you commit.

3. Choose projects with a filter. Score each opportunity on how much you enjoy it, how profitable it is, how complex it is, how tight the deadline is, and how well it fits your clinical schedule. Say no to the ones that fail.

4. Price for the real cost. Include your true labor time, materials, and overhead. Many makers start with a simple hourly rate plus materials. As your expertise and demand grow, raise the rate in phases and move toward pricing the value of the finished piece.

5. Refer out what you should not do. A specialist who handles the complex or off-skill work protects your reputation and your calendar.

I would add a caution of my own. A passion business can become a second job and drain the joy that started it. If every project turns into a deadline you dread, you have built a worse version of the thing you were trying to leave. Keep part of the craft just for you, and protect the reasons you started.

Is your passion ready to become a business? Five questions

1. Would I do it for free? If the answer is no, it will not survive the hard stretches.

2. Does anyone pay for it? One paying customer is more information than a year of planning.

3. Can I price above my costs? Count materials, labor, and overhead honestly.

4. Do I have protected hours? If your clinical schedule can take them without asking, they are not protected.

5. Do I know where the stack is going? Name the destination, even if it changes later.

Build the runway while you are still practicing

You do not have to choose between the physician you trained to be and the person who builds, writes, makes, or teaches on the weekends. You can be both, and the second can grow into the destination of your career. The earlier you start, the more of a runway you have. A few years of customers and skill before you step back from clinical work are worth far more than a plan you begin on the day you retire.

Start with the free digital copy of Doctor Incorporated and the Dare to Dream guide, which helps you decide what you want the second half of your career to look like. The Job Stacking for Doctors eBook covers how to fit another channel into your life, and the Creating a Practice Without Walls course at $497 covers the entity and tax setup.

Book a $500 Business Strategy Session and we will talk through your passion, your clinical commitments, and a stack you can build around both. Join the PEA community at $99/year for Explorer membership for the guides behind each step. Medicine can stay one of the things you love. It does not have to be the only one.