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Empowering Autonomy: The Role of Micro-Corporations as a Secondary Control Measure For Doctors

Jan 26, 2024

I spoke to a dermatologist recently who has been in practice for 10 years. His group had been bought out by private equity and he was feeling the pains of their control over his life including the re-structuring of his contract. He experienced a revolving door of administrators who all seemed uninterested his personal situation as he tried to negotiate with them. It was a frustrating experience that caused him to reflect on his eroding professional autonomy. He was also reminded of the small medical business advise that his father, who is and orthodontist, had shared him about how much he loved the autonomy of owning his own business.

It all added up, after reading my book, and he contacted me with the hope that I could offer him a business consultation about his situation. He said the $99 consultation was a gold mine of information for him and well worth it.

If you are wondering if you might benefit from a consultation about how a micro-corporation could help you, please reach to me here. You’ll a free SimpliMD membership as part of the deal.

Your Professional Autonomy Is Eroding

In our profession, the concept of professional autonomy holds great significance. It pertains to the ability to make independent decisions and maintain control over one's professional life. However, in today's rapidly changing healthcare landscape, employed physicians often encounter challenges that can jeopardize their professional autonomy. In case you didn't know, one of the fundamental elements that the IRS and Department of Labor use to define an employee is the lack of control over their work. When you sign up to be an employee, you are essentially signing up for a slippery slope of erosion of your autonomy.

Oddly enough, many of you are aware that this is the case when you sign onto a financially incentivized employment contract and essentially sell your soul to the C-suite. My lack of awareness regarding this paradigm almost resulted in irreversible burnout, and it serves as the fundamental cause of our ongoing burnout crisis in the field of medicine. I am still amazed by the herd mentality exhibited by thousands of residents every year who refuse to believe that they will be among the 1 out of 2 who experience burnout due to signing on as a traditional employee.

I had certainly had that mindset for years, as I had confidence that I could influence and change the system, so I dedicated countless hours to hospital governance and fought for systemic change. However, it turned out to be a losing battle, and this is a common mistake and path that many of you may take in an attempt to fix things. Many of you may have had a similar experience of attending a governance meeting, thinking that the administration was genuinely interested in your input, only to discover that they simply wanted to inform you of their decisions and spin them as collaborative directives from the medical staff. It could be quite mind-numbing at times.

Eventually, I came to my senses and made the decision to step away from governance roles. I embarked on a journey to prioritize my personal and professional well-being, with the goal of thriving within a broken system. It's not that I didn't care about the success of my corporate employer, but rather, I wanted to ensure mutual success. The real transition occurred when I shifted my mindset from that of an employee to that of an individual micro-corporation. This change in perspective was truly transformative and made a significant impact—as I now began to exert my powers of secondary control.

Let me not assume anything here, and take a minute to explain the theory of control.

The Theory of Primary & Secondary Control

The theory of primary control and secondary control provides valuable insights into how individuals perceive and respond to challenging situations. Primary control refers to the efforts made by individuals to change their external environment in order to align it with their goals or desires. On the other hand, secondary control involves adapting one's internal thoughts, emotions, or attitudes in order to effectively cope with situations that cannot be changed.

Understanding these concepts can shed light on how you can navigate through various professional circumstances that pose threats to you—like the erosion of your professional autonomy. By recognizing the distinction between primary and secondary control, you can better understand why some of you may choose to take action and actively seek change, while others may focus on acceptance and adaptation.

I this post I am going to explore the theory of primary control and secondary control in the medical marketplace and how that can affect your overall well-being. I want to highlight the importance of both active engagement with the external world as well as internal resilience in facing challenges.

Preserving Your Autonomy-Primary Control Measures

One approach to preserving professional autonomy is by seeking to control the powerful influences that come between you and your patients. This can include employers, insurers, the government, or the free economy. When you make these primary adaptations, you must learn how to assert your authority and decision-making power. You should advocate for yourself and your patients, ensuring that you have a say in important decisions regarding treatment plans or resource allocation. Primary control measures often involve seeking systemic changes—that most commonly play out in corporate governance and corporate citizenship spaces. While you are a stakeholder with influence, it can sometimes feel like an exhausting individual battle that is easier to give up on. Primary control involves your efforts to directly influence your work environment, workload, and organizational structures. While primary control is essential, its limitations in the face of systemic issues contribute to the persistent prevalence of burnout.

Preserving Your Autonomy-Secondary Control Measures

On the other hand, secondary control adaptations focus on adapting to internal factors that may limit your professional autonomy. This involves prioritizing your personal well-being and finding alternative ways to maintain control over your professional life within the constraints of the system. For example, you can collaborate with colleagues in a community like SimpliMD and engage in personal mindfulness and resiliency measures that support your autonomy and well-being. In general, secondary control measures involve making decisions about how you can successfully interface with a broken system that you may feel powerless to change. Ultimately, you have the freedom to choose what is best for you.

Finding a balance between primary and secondary control adaptations is crucial for you as you navigate the complexities of modern healthcare systems. While primary control adaptations empower you to assert your independence as you separate from the system or change the system from within, secondary control adaptations allow you to adapt and thrive within existing structures. The latter is the choice I made over 10 years ago through creating my micro-corporation and engaging in a business to business contract called employment lite. My entire story is chronicled in my best selling book “Doctor Incorporated: Stop The Insanity of Traditional Employment and Preserve Your Professional Autonomy”. You can get a copy here.

Ultimately, preserving your professional autonomy requires constant vigilance and proactive measures from every one of you. By recognizing both primary and secondary control strategies, I encourage to focus on the aspect that you have the most control over—secondary control measures that will adaptively help you flourish.

The Need for a Paradigm Shift: Secondary Control

On of many goals at SimpliMD is to create an awareness campaign for doctors all over the country that they DO have options for preserving their autonomy and well-being in a broken system. You need strategies that will empower you to adapt to circumstances beyond your immediate control. One such powerful measure is the establishment of a micro-corporation, which not only provides financial benefits but also serve as a means to regain control over your professional life and autonomy.

Micro-Corporation Defined

A micro-corporation, in the context of medical practice or services, is a single member corporation, physician-owned business entity. It allows you to organize and manage your professional life and professional services in a way that aligns with your values and personal & professional goals

One of the key advantages of a micro-corporation is the flexibility it offers. You can individually tailor the structure of your micro-corporation to meet the unique needs of your professional life including your primary job and side hustles— and thus your preserving autonomy in decision-making, patient care, and overall management of your professional life.

Unlike a private practice, you don’t need to have a building, nor do you have staff, equipment, or overhead to manage. The only person you must manage is yourself.

Your micro-corporation can be used to engage in business to business contracts rather than individual to business contracts. Virtually every medical job on the market offers both an W-2 employee contract version as well as a 1099 contractor version. By having a micro-corporation, you have the power to choose the latter every time. You can also use your micro-corporation for blending W-2 and 1099 jobs through what is called job stacking.

The Benefits of Micro-Corporations for Doctors

By establishing a micro-corporation, you will gain a greater degree of financial independence. This autonomy extends beyond mere income to encompass control over personalized benefit plans, business expenses, corporate distributions and includes the ability to explore diverse revenue streams beyond one primary job—reducing dependency on a single source. A nice blend of active and passive income sources will benefit your financial health and accelerate the growth of your net worth.

Micro-corporations empower you to prioritize patient-centered care. With autonomy over decision-making, treatment plans, and service offerings, you can focus on providing the highest quality of care without being subject to external pressures that may compromise patient well-being. This control can vary depending on the particular structure of the contracting work that you are doing, but in the end you have greater power of your clinical decision making when you are a self employed contractor.

Micro-corporations enable you to customize your professional life to align with your professional values and personal preferences. This ability to tailor the places you work and the type of work that you do- fosters a sense of fulfillment and professional satisfaction.

Next Steps To Empower Yourself

In the end, the establishment of micro-corporations emerges as a potent secondary control measure for you to preserve and enhance your professional autonomy. By navigating the challenges and adapting within the marketplace you can reclaim control over your professional life. I encourage you to embrace this paradigm shifts towards micro-incorporation and the associated benefits to your personal and financial well-being. The journey of establishing a micro-corporation stands as a beacon of empowerment for each of you who is committed to shaping your professional destinies.

The process of starting a micro-corporation is not without challenges. Building a supportive network of advisors, mentors, and fellow physicians who have successfully navigated similar journeys can provide valuable insights and guidance. This is why I have created our SimpliMD and why my mission is to inform, inspire, and support you to flourish through micro-business competency, which in turn will empower you to thrive in your roles as both healers and entrepreneurs.

My crazy goal this year to grow our online community from 2000 physicians to 10,000 physicians who all embrace the importance of empowerment through micro-incorporation. But I recognize that I need your help to do this—so please invite a friend or peer to join our online community by sharing this link with them.

And you even take things a step further and sign up to be an SimpliMD affiliate here and start making money for those referrals!

If you know it’s time to join our ranks, reach out to me today for an inexpensive consultation and let me you get your micro-corporation started, it is the best secondary control step you can take to protect and preserve your professional autonomy and personal well-being.