When a Urologist Read Doctor Incorporated and Decided to Act

This Week’s Real Life Lesson

Where I Was

There is a particular moment in my work that never gets old.

It happens when a physician shows up to a PEA business consultation already fluent in the language of autonomy. Not because they were taught it in training, but because they took the time to read, reflect, and decide that the way medicine is usually practiced is not the only option.

That was the case when I met an East Coast urologist I will call Dr Marcus Reed.

Before our call ever started, I already knew something about him. He had read Doctor Incorporated: Stop the Insanity and Preserve Your Professional Autonomy. He was not browsing. He was not daydreaming. He was already moving. He was holding the book up with pride to show me how much he loved it!

You can feel that difference immediately.

What Happened

Dr Reed did not come to our consultation asking whether he should leave traditional employment. He came knowing he would.

What he wanted was clarity.

He was a high-earning employed urologist. On paper, everything looked fine. Strong income. Benefits. Stability. But when you listened closely, the tension was obvious.

His life was shrinking around his schedule. His autonomy was narrowing. His sense of professional ownership was eroding, even while his compensation remained high.

Rather than complaining about it, he did something different.

He began designing his exit before making it.

Dr Reed had already formed a professional entity. He was negotiating a hospital coverage agreement. He was planning to provide urology call coverage using a small group of independent physicians rather than stepping into another employed role.

This was not rebellion. It was architecture.

What I Learned Watching This Unfold

There is a myth that physicians leave employment because they want more money.

In reality, most physicians leave because they want alignment.

Dr Reed did not want chaos. He wanted structure that respected his training, his family, and his long-term goals.

Our conversation centered on one question that almost no physician asks early enough:

“How do I build this so it holds up five years from now?”

We walked through the realities of physician-led coverage entities. Not theory. Not motivational slogans. Actual decisions that either reduce risk or multiply it.

The most important shift for him was understanding that he was not building a job replacement. He was building infrastructure.

Once you see that distinction, your decision-making changes immediately.

Case Study

Dr Marcus Reed, Urology, Northeast

Dr Reed’s model was simple and thoughtful.

His professional entity would contract directly with a hospital for call coverage. The entity would then engage several independent urologists who retained full clinical autonomy.

The entity sold availability and reliability to the hospital. It did not manage physician labor.

That distinction matters.

By structuring the business this way, Dr Reed preserved flexibility, reduced misclassification risk in regard to employee vs independent contractor status, and he created a model that could grow without trapping him inside it.

The most telling part of the conversation was not technical. It was emotional.

He said, “I want my son to remember me as present.” He has special needs, and I want to be there for him.

That is not a tax strategy. That is a values statement. The business structure followed naturally once that was clear.

The Surprising Micro Business Insight

Physicians often think that autonomy comes from leaving medicine.

In reality, autonomy comes from owning the structure through which you practice medicine.

Dr Reed did not need to stop being a urologist. He needed to stop being a renter of his own expertise.

When you practice through a professional micro business, several things quietly change:

You negotiate instead of comply You design schedules instead of inheriting them You manage risk intentionally You build optionality into your career

None of this requires a massive practice or dozens of employees. It requires thinking like an owner before you ever scale.

This is why I am always flattered when physicians read Doctor Incorporated. Not because of the book itself, but because it signals readiness.

You do not read that book casually. You read it when something inside you is ready to change.

What This Means for You

If you are still employed and thinking, “I am not ready yet,” consider this.

Dr Reed did not wait until everything was perfect. He started while still employed. He built quietly. He asked better questions earlier.

That is the pattern I see again and again among physicians who transition well.

They do not jump. They design.

If you want to explore this mindset further, I encourage you to spend time in the archive where many of these ideas have been unfolding for years. Check out this post: The Three Phases of a Doctor’s Life: Why Your Autonomy in Phase 2 Matters

Is This Deductible?

On a recent business trip to Maui, we added a short stop in San Diego to visit our son and his family. Transportation from the airport to their home was by Uber.

Is that deductible?

The answer depends on allocation.

When a trip is primarily business-related, travel expenses directly tied to business activity are deductible. Personal side trips require reasonable allocation.

In this case, the Maui portion related to business qualifies. The Uber ride associated with the personal visit does not.

Good bookkeeping is not about squeezing every dollar. It is about being clean, boring, and defensible.

This is exactly the kind of nuance physicians miss without business education.

If you want help learning how to think about deductions the right way, start with the free PEA resources available through the membership portal.

Join the Movement

“The goal is not to escape medicine. The goal is to practice it without surrendering your life.”

Physicians like Dr Reed are quietly reclaiming autonomy by building professional micro businesses that reflect who they are and what they value.

If you are ready to think this way become a PEA member:https://www.simplimd.com/PEAMembership"

Inside PEA you will find free physician e books, practical business education, and clear pathways into strategy consultations and coaching.

If you want to pressure test your own plan the way Dr Reed did, you can also schedule a PEA Business Strategy Consultation directly through PEA SimpliMD.