The Entrepreneur’s Life: When Your Career Stops Serving You — And How You Take It Back

This Week’s Real-Life Lesson

Sometimes a coaching call stays with you long after you hang up the phone. This week, I had one of those moments—one that reminded me why the work we do inside the Physician Entrepreneur Academy is so crucial. It centered around an anonymized coaching case I’ll call Dr. Sam, an OB/GYN physician navigating a toxic practice, a crushing workload, and a growing realization that the life he intended to build was slipping away.

His experience mirrors what many physicians silently endure: being overworked, under-supported, professionally boxed in, and unsure how to reclaim agency without blowing up their entire life.

But here’s the truth, as physicians, your career is one of the most powerful entrepreneurial assets you own, and you deserve the ability to shape it intentionally.

And that’s exactly what this story is about.

Where I Was When the Lesson Hit Me

I was sitting at my desk, reviewing the Wheel of Life assessment he had completed before our coaching call. This a tool we use to measure the alignment of your work, finances, time, and well-being. As I scrolled through his responses, I could feel the weight of his situation:

• Low scores in professional satisfaction

• Low scores in job structure

• Low scores in time and business management

• Particularly low confidence in business deductions and benefits optimization

Almost every category revealed the same truth: Dr. Sam wasn’t living a physician-led life, he was surviving a system-led one.

And that’s where our call began.

What Happened: The Coaching Story of “Dr. Sam”

As we talked, the picture sharpened.

He was stuck in a deeply unsustainable practice environment.

• A solo OB/GYN workload with no partner in sight

• A toxic service line culture reinforced by an "untouchable" husband–wife duo whom he shares call with.

• No progress on his repeated requests for help from administration.

The workload was draining him personally and financially.

• No PTO as a 1099 contractor

• Lost income every time he took a break

• Delayed strategic wealth building moves, including a 1031 exchange—due to his professional uncertainty

• No energy left for basic micro-business admin like QuickBooks

• Extra uncompensated work from administration that included directorship over the OB/GYN education for the family medicine residency.

His contract was a leash—but also a key.

He was 1.5 years into a 5-year agreement, but it included a 90-day no-cause termination clause, meaning he had leverage he hadn’t fully considered.

Together, we built an exit strategy:

• January 2026: Press leadership for a real hiring plan

• March 2026: Send a formal letter setting clear expectations

• April 2026: If still no progress—submit his 3-month notice

And most importantly, we identified credible alternatives that aligned with his family’s geography and lifestyle:

• A nearby opportunity a facility where he did periodic weekend locums work who will have an opening due to a pending physician retirement

• A possible partner candidate internally within the health system that he was currently working in

• Long-term potential with a health system that was building marketshare in a nearby urban community.

What hit me hardest, though, was this: He wasn’t trapped. He just hadn’t seen the exits yet.

What I Learned (Again): Autonomy Isn’t a Gift—It’s a Discipline

Coaching physicians like Dr. Sam reminds me that autonomy in medicine doesn’t arrive neatly packaged. You have to build it: professionally, contractually, financially, and psychologically.

Physicians often assume that if the job is toxic, it’s still safer than leaving. But reality is the opposite:

If you’re a 1099 contractor with a micro-business, you often have more leverage, optionality, and negotiation power than you realize.

This is why I write extensively about physician autonomy, including: 👉 Preserving Your Professional Autonomy: The Power of The Micro-Incorporation

👉 Why Every Physician Should Form a Micro-Corporation

As you build entrepreneurial competency, you start seeing your career the way business owners do:

• Contracts become strategic tools

• Tax structures become levers

• Business deductions become optimization opportunities

• Time becomes a managed asset, not something stolen from you

• Toxic environments lose their power

The surprising insight this week?

Entrepreneurship gives you clarity long before it gives you escape. And clarity alone can change everything.

The Micro-Business Insight: Your Life Cannot Flourish When Your Work Is in Survival Mode

Dr. Sam wasn’t suffering because of medicine, he was suffering because of misalignment.

His work didn’t match:

• His goals

• His family needs

• His professional expectations

• His micro-business structure

• His financial optimization

And his Wheel of Life scores reflected that across nearly all categories.

Once we mapped his exit options, his deductible strategies, his contract leverage, and his career alternatives, his posture changed. He wasn’t powerless; he was simply under-informed.

Physicians don’t need more grit. They need more entrepreneurial literacy.

Is This Deductible? — Vehicle Edition (Section 179 & Bonus Depreciation)

Scenario: A physician wants to trade in their current car and purchase a new SUV. They ask: “How do I ensure it qualifies for Section 179 and the 2025 bonus depreciation rules under the OBBA?”

Quick Guidance: You can generally leverage Section 179 + bonus depreciation if:

• The vehicle is over 6,000 lbs GVWR

• It is used >50% for business within your micro-corporation

• You document mileage and business purpose

• The SUV is titled in your S-Corp or properly reimbursed through an Accountable Plan

Want the full step-by-step guide? 👉 Download the free PEA E-Book: “Write Off Your Car Strategically: A Guide for Physicians”

This resource walks you through high-impact tax strategies and vehicle deductions

Join the Movement

“Clinicians everywhere are breaking free through micro-business ownership. Ready to join them?”

👉 Join the PEA Explorer Membership → https://www.simplimd.com/PEAMembership