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Revolutionizing Physician Work: Embracing Location-Independence

Mar 22, 2024

You can read this post on KevinMD here.

“The Calling”: One Doctor, One Job, One Location

There was a time when one doctor worked one job in one geographic location where he/she was altruistically dedicated to serving a population in the practice of medicine. This was all part of the mystical space known as your “calling”.

Employment Preserved the Good Life

For years this idea of working one job in one location was anchored within the private practice model which then gave way to the traditional employment model. The latter offered a parallel promise of a stable and long-term medical practice in one location—with the added twist of a very predictable high income without the stress of managing employees & a medical business. Generally, it preserved the good life of the physician in the evolving marketplace.

Employment became the simplest way to transfer the mindset of one doctor with one job in one location. It has become the secure, predictable, and financially enticing job option for the majority of doctors.

A Paradigm Shift To Location Independence & Quality of Life

But the underlying basis for both private practice and employment—which is a long term commitment to full time work in one location aka “your calling”—is being replaced a progressive model of physician work that is location independent.

Now physicians are using combinations of location-independent %FTE jobs that are stacked with side jobs which additively lead to a preferred quality of life. You can read about this in my previous post: Job Stacking for Doctors: A Modern Approach to Work-Life Balance.

6 Take Away Messages

Today, I will provide you with 6 key takeaways regarding this evolving landscape. Working with doctors nationwide through our SimpliMD community, I consistently observe themes that shape the future of the physician workforce.

1. Employment Is Just A Job Without Meaning

The age-old medical school interview question, "Why do you want to be a doctor?" is usually prompted by a personal story that inspires a desire to help others medically. Your response most likely wasn't, "So my employer can make a gazillion dollars for its shareholders and CEO." However, if you have worked for a large corporation, you may have realized that both you and the patients are seen as commodities. Medical care has been reduced to a transactional economic event within their profit-driven machinery.

In this depersonalized state, your work has been stripped of its purpose and meaning. It's now just a job, not a calling. Ultimately, this loss of purpose and meaning at work, coupled with the corporation's view of you as a business asset, is one of the underlying causes of burnout for doctors.

Some have mastered the ability to work mindfully within these safe harbors, while others recognize that something has to change in order to survive. The latter is what I ultimately did when I discovered the long-sequestered power I had earned — the power to use my micro-business skills in the marketplace. If you are ready to join me by starting you micro-corporation, reach out to me for a business consultation today.

2. Disruptive Changes In The Marketplace

The times are changing for physician jobs, and the status quo of traditional employment is being questioned by both experienced mid-career doctors and young physicians.

There are four broad tends that have converged to disrupt the old idea of location dependent work at one meaningful job:

  • Disillusionment with Traditional Employment—The loss of professional autonomy, growing burnout rates, elevated taxes as W-2 workers, and the loss of control over your personal/professional life has forced many doctors to look for non-employment job options.

  • Gen Z and Millenials Evolving View of Work-Younger workers tend to work multiple jobs, work independently, and are skeptical about the security of employment. Gen Z tends to question whether they can find contentment in traditional American lifestyle—which is employment focused. In the end for Gen Z doctor a preferred lifestyle is their goal and medical work with its high income is the means to get them there.

  • The accelerated adoption of virtual medicine due to COVID-19. Medicine is now more mobile and more virtual than ever. Virtual work requires virtual workers.

  • The growing physician shortage that is accentuated by a proliferation of job opportunities brought on by virtual medicine that accommodates part-time/side job/contracting work. Corporations have adapted by offering less than 1.0 FTE jobs, part-time jobs, and independent contracting jobs in order to attract doctors.

3. The New Normal of Multiple Jobs

This mindset directs young doctors in particular to abandon old paradigms for medical practice and adopt a new, modern version of a medical career that is based on working several jobs in several locations.

This is the new normal. The mixture of income sources is typically a combination of employment and self-employment jobs (W-2 and 1099 income). The decision of where to live is not based on a singular job location as much as it is based on their preferred lifestyle in a preferred location. Virtual mobility and diverse work options allow for stacking jobs to support a location based quality of life. Suburban or urban areas are often preferred.

Thus in this progressive normal and thus long term alignment with a single employer is becoming less common.

Even if you sign up for a predictable W-2 job, you can stack in location independent contracted work with it—-and by creating a micro-corporation for this side work—you will come out ahead financially. Check out my post the explains this: Case Study: How To Pay No Taxes On Your Side Job Income. 

4. Doctors Are Contractors

Many of you are starting to view your job(s) as non-permanent, and less employment based. Young doctors are particularly beginning to see the value and importance of embracing their power to identify themself as a professional micro business and thus receive non-employee 1099 income. This means they are independent contractors who are finding their footing in the gig economy. A good example of this is the space of asynchronous or chat based medicine like Hims & Hers, Ro, and Lemonaid—just to name a few.

Virtual workers need virtual business structures.

Many of you tend to shy away from opening a professional micro-corporation for your 1099 work due to their business illiteracy and your fear that it means you will be opening a private practice. You are wrong, your micro-corporation is a virtual business perfectly suited for location independent gig economy.

5. A Doctor Is A Professional Micro-Business

But what many of you don’t realize that a single member professional micro-corporation is NOT the old private practice model. Instead it is a virtual business that can be used within any job structure and goes everywhere you go. It covers you like an invisible suit that mirrors your professional services. These professional micro-corporations are simple to start and operate.

Every one of you has the power to form a virtual professional micro-corpration and it’s surprisingly inexpensive. I would be happy to work with you through our SimpliMD network to get your micro-corporation set up.

Professional micro-corporations provide multiple benefits over a sole proprietor business model including asset protection, additional business deductions, tax advantages, retained income, and larger retirement plans. You can check out my blog post on this subject: Medical Contracting: Doing Business as Sole Proprietor vs Incorporating.

6. Every Doctor Should Start A Micro-Corporation

If you are an attending physician who works more than 1 job, receive any 1099 income, or are tired of traditional employment and looking for a change, you should start a professional micro-corporation. It will help you flourish in the evolving world of physician labor—a space that is increasingly diverse, non-permanent, and locality independent-the perfect recipe for a virtual professional micro-corporation.

One of the thing that fuel’s Gen Z’s passion for starting a small business is the autonomy that it provides them to do good. This is especially appealing to Gen Z doctors who want to tap into their altruistic motives that led them to a career in medicine. While traditional medicine tends to strip them of purpose and meaning in their work, a professional micro-corporation allows one to preserve it.

For this reason, I believe every resident in the country should consider starting their professional micro-corporation before graduating from residency and taking their first job. It will place them in a position to flourish in the new world of physician work—while supporting a desired lifestyle and quality of life with the underpinnings of autonomous work. To learn more about this, check out my post: 20 Reasons Every Resident Should Form A Micro-Corporation.

Ultimately a professional micro-corporation can be used by you for any job you encounter.

Want some personal advise for your situation? I invite you to book a business consultation call with me to discuss how a micro-corporation could help you. One nice bonus of this inexpensive call is that it will provide you with an annual SimpliMD membership worth over $2500!.

If you want to read a little more about location independent work, you can also check out the White Coat Investor’s post here.