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I Discovered The Holy Grail For Doctors: Unlocking Professional Autonomy

Mar 27, 2024

This post was originally published on KevinMD January 8th, 2024.

And as a bonus I am including the YouTube video where Kevin and I discuss the post and the importance of professional autonomy.

I Discovered The Holy Grail For Doctors

A recent post on KevinMD really resonated with me, probably because I am a doctor who grew up in a rural area and returned to a small-town practice in my home county. Like the author, I experienced the suffocating grip of traditional hospital employment slowly draining the life out of me.

Before burnout consumed me, I took proactive steps to start a micro-corporation and transitioned to a more flexible employment contract. While I still worked for the hospital, I became a long-term independent contractor, and this change made a world of difference.

It freed me from their total control and restored my autonomy as a self-employed doctor. In the process of regaining professional control, I also realized that this change had a significant positive impact on my tax planning, compensation, retirement funding, and ultimately accelerated my net worth rapidly.

I felt like I had discovered the holy grail of modern medicine when I regained my professional independence and simultaneously accelerated my net worth, all without having to relocate or manage a practice-office-clinic.

The remarkable thing is that this option is available to virtually every doctor in America. However, it remains relatively hidden from their sight due to a lack of small business literacy and the preference of corporate employers for maximum control over their employees in traditional employment roles..

Based on my personal experience, as well as the countless stories echoed by doctors nationwide, it is clear that preserving professional autonomy is of utmost importance. One effective way to achieve this is by forming a professional micro-corporation.

A micro-corporation empowers you to maintain independence in the marketplace, allowing you to methodically stack jobs and create professional income streams without compromising control over your life.

My Dream

Growing up in a small town in the Midwest, I had the opportunity to observe various professionals who were deeply connected to the community and genuinely cared for its people. One individual who particularly inspired me was a pharmacist who ran an independent pharmacy. I was inspired by the way he used his small business to make a positive impact on people's lives. This experience fueled my ambition to pursue a pharmacy degree and ultimately establish my own independent practice in Indiana.

Through a series of experiences, I was led to leave pharmacy school and pursue medical school with the goal of establishing a practice in rural America. My vision for work was inspired by my hometown, where a few groups of private practice doctors not only managed a small independent hospital but also delivered babies and lived lives that were deeply intertwined with the community.

My dream had a wrinkle: I yearned to escape the Midwest and immerse myself in the vast open spaces adorned with hills and mountains. Consequently, I completed my training in Southwest Virginia and chose to practice in a small town nestled along the Blue Ridge Parkway. The experience of working in a private practice was truly fulfilling, and I flourished in that environment. However, life took an unexpected turn when my spouse was diagnosed with metastatic breast cancer while pregnant. In light of this, we made the difficult decision to relocate to Indiana to be closer to our families for the support we needed during this challenging battle for her life.

A Broken Dream

I accepted a traditionally employed position with a small county seat hospital in Northern Indiana. I chose the simplicity of a salaried position so that I could provide maximum support for my wife—and not worry about running a small business. Unfortunately, she eventually succumbed to her cancer in her early 30s, leaving me widowed with two young children. Despite the challenges, I continued to practice full spectrum rural medicine, from OB to inpatient care to ICU management.

I remarried and fully embraced the rural medical life that I had always dreamed of. With my natural drive and high emotional intelligence, my practice thrived as I immersed myself in small-town living. I found myself roaming the sidelines of high school events and diagnosing rashes in the aisles of Wal-mart. I would often say to my wife, "I can't believe I am getting paid this much to do something I love!"

But then, the changes happened one after another.

Hospital mergers, contractual changes, the introduction of the EHR, and chronic under-staffing.

Now, my dream began to fade as the burden of uncompensated calls, helping in the ER, and the horrible feeling of being undervalued by my employer weighed heavily on me. The icing on the cake came when they unilaterally made a contractual change that would result in a massive pay cut, while still expecting me to work at my 99% MGMA productivity level. I felt like a haymaker for them, yet they claimed they had to make "budget cuts" despite their annual profits.

The loss of my professional autonomy was always offset by my generous fair market compensation. However, when this stability crumbled and I found myself working harder than ever, burdened with growing administrative tasks, and then asked to take a significant pay cut, it nearly broke me emotionally.

Fortunately, before I completely burned out, I sought the assistance of business consultants who helped me discover a hidden path. This path not only restored my professional autonomy but also ensured that I would receive fair compensation.

The path, in many respects, involved a return to my original dream of operating as a small businessperson in healthcare, while utilizing my talents to assist others.

No, I didn't completely abandon the system and jump into direct primary care. Instead, I took a different approach. I started a micro-corporation and used it to modify my traditional employment contract into a business-to-business contract known as a professional services agreement, also referred to as Employment Lite. Essentially, I transitioned into a long-term independent contractor within the same practice, while still caring for my existing patients. At the same time, I made the decision to purchase a medical office building for my practice and proposed that the hospital rent it from me. Lastly, I insisted on implementing a staffing model that involved multiple nurse-scribes.

I am grateful that I discovered this path, as it has helped me thrive over the past decade.

Now, I am on an awareness campaign to let our physician tribe know that there are job options beyond traditional employment—and that the holy grail of professional independence along, great compensation, and not having to managing a practice/clinic—is available to all doctors.

With private practices vanishing from the landscape, micro-incorporation provides the marketplace structure that is needed for doctors to hold onto their autonomy and support their fair market value.

Stop The Insanity

Before resigning yourself to accepting that you can't change the current broken system while being herded into traditional employment, I invite you to consider an option that is often overlooked by most doctors. You can choose to micro-incorporate and utilize your professional micro-corporation in the marketplace through a variety of options, including:

Your primary job through Employment Lite
Your primary job as a single member Direct Primary Care-Medical Practice
Your primary job as a Locums
There are numerous professional Side Hustles that pay you 1099 income as an independent contractor. The options for these opportunities are growing every month, especially as the physician shortage looms and location-independent job opportunities continue to expand.

You can mix and match all of the above in Job Stacking to reach the lifestyle your prefer and the attain the quality of life that you have come to expect as a doctor.

It is time to put an end to the insanity of traditional employment and the perpetuation of a system that is pushing more than 50% of doctors into burnout.