Is That Deductible? Navigating Life, Loss, and Business Structure

This week has been a profound journey, one that intertwines the personal and professional in ways I hadn't anticipated. The intersection of life’s most challenging moments with the demands of business underscores the intricate balance we, as physicians and entrepreneurs, must navigate. It’s a stark reminder that while we strive for professional success and financial efficiency, our personal lives and the bonds we hold dear remain paramount.

Visiting My Aunt: A Personal Reflection

Early this week, I visited my aunt, who has been an important part of my life since childhood when my mom was a single mother trying to make ends meet. She's now in palliative care, battling metastatic cancer. The drive to her hospital room was filled with a mix of anticipation and sorrow, knowing that these moments are precious and fleeting. My aunt was more than just a family member; she was my babysitter, my friend who always allowed me to tag along with her, and someone who always provided unwavering support. Life has not always been kind to her as she has endured two toxic marriages and multiple personal challenges. Through it all she has had an unwavering commitment to her family—which is truly admirable.

Walking into her room, I was struck by how much she had changed since I last saw her compared to prior the week when in her delirious state she still recognized me and called out to me by name. The brain mets now had destroyed all cognitive function and the once vibrant woman now lay frail. As I held her hand and prayed with my mother and my wife, I was reminded of the importance of family and the need to cherish these connections. I knew this would be the last time I saw her alive.

The visit also made me reflect on the importance of palliative care. It's not just about managing pain but about providing a quality of life, ensuring dignity and comfort in the final stages. My aunt’s situation underscored the critical role that compassionate care plays, a reminder of why I pursued medicine in the first place.

Structuring My Business: Meetings with My Business Coach and Lawyer

Balancing these emotional experiences, my week also involved pivotal meetings with my business coach and lawyer. These sessions were focused on refining and structuring my new business startup. This start-up will need a corporate structure that is much more robust with a sophistication that exceeds my prior micro-corporation architecture that I am familiar with creating. Thus I need some help with building it the right way.

Meeting with My Business Coach

My business coach and I delved deep into the vision and mission of the start-up. This innovative direct-to-consumer e-visit product will distill my 30 years of primary care experience and my pharmacy training into a proprietary algorithm to evaluate 32 common acute conditions; for a nominal fee, eligible patients receive a comprehensive medical evaluation and a prescription for the most cost-effective treatment, with the added convenience of access to work and school notes. I am currently on-boarding my COO and CTO and will excited to share more about this venture as we get closer to launching it.

Legal Consultation on Business Structure

Two significant events are occurring for me professionally and financially at the end of June. Firstly, I am retiring from the day-to-day responsibilities of operating a primary care clinic as a medical home for the members of my community. Providing high-quality, accessible, and personalized medical care has been the hallmark of my professional life for over 25 years. This meant being present and available nearly 24/7. While it was a rewarding experience, I will be happy to regain more autonomy over my hour-by-hour and day-to-day life, which was previously dominated by my clinic responsibilities.

However, the reality is that my employment contract generated over $15,000 in income each week, and that would now go away. This is not a major concern since I am financially independent (thus I can retire), but my business has always been the cash flow generator in my enterprise structure. Now that I am Coast FIREing, I will need to make some business architecture changes to account for this, and to reorganize the process of how my household spending and lifestyle will be supported.

My business coach who works closely with my lawyer and CPA reviewed my current assets that were organized on a visual board. With 11 businesses under my umbrella, my professional transition provides an opportunity to simplify my enterprise business architecture while optimizing for tax and wealth accumulation. We explored various organizational frameworks, considering factors like liability protection, tax efficiency, and operational simplicity.

We looked at different models, such as creating a holding company that would own the individual micro-corporations. This approach offers several advantages:

• Simplification: Streamlining management and operations across the businesses.

• Tax Optimization: Leveraging tax benefits by consolidating financials and utilizing inter-company transactions effectively.

• Asset Protection: Enhancing liability protection by separating business assets from personal assets.

We also discussed the importance of ensuring each business is correctly tax classified and compliant with relevant laws and regulations. This involves regular reviews and updates to our business practices to align with any changes in legislation or market conditions.

Preparing for Quarterly Tax Planning Meeting

This meeting was essentially a pre-meeting for my quarterly tax planning session with my lawyer and accountant next week. These sessions are vital for ensuring that we're on track with my financial goals and obligations. Preparing for this meeting involved a detailed review of our financials, identifying opportunities for tax savings, and ensuring compliance with all tax regulations.

Re-organizing Business Structures

Re-organizing the 11 businesses involves creating a cohesive and efficient architecture. We focused on several key areas:

• Consolidation: Merging overlapping functions and entities to reduce redundancy and streamline operations.

• Tax Strategies: Implementing advanced tax planning techniques, such as income splitting, tax deferrals, and leveraging deductions.

• Wealth Accumulation: Establishing structures that facilitate long-term wealth growth, such as retirement plans, investment vehicles, and estate planning.

Business Coaching and SimpliMD Consultations

In addition to these personal and structural business activities, this week was also filled with hands-on engagements with fellow physicians. The first of these was a business coaching session with a doctor contemplating a Direct Primary Care (DPC) practice.

Business Coaching for a DPC Practice

During the coaching session, we discussed the unique challenges and opportunities of a DPC model. This doctor was drawn to DPC for its potential to provide more personalized care without the administrative burdens of traditional insurance models. Our conversation covered several critical areas:

• Business Model Viability: Analyzing the financial sustainability of DPC, including membership pricing and patient volume.

• Legal and Regulatory Considerations: Navigating the legal landscape, ensuring compliance with state and federal regulations.

• Marketing Strategies: Developing a marketing plan to attract and retain patients, emphasizing the benefits of personalized, accessible care.

• Operational Setup: Establishing efficient workflows, from patient onboarding to electronic health records management.

This session was a reminder of the transformative potential of innovative practice models and the importance of tailored business strategies.

SimpliMD Business Consultations

Throughout the week, I conducted four SimpliMD business consultations with doctors looking to optimize their professional life and entrepreneurial ventures. These consultations varied widely, reflecting the diverse needs and goals of our physician community and their micro-business needs.

1. Consultation One: Moving from a Specialty Private Practice to Locums

   • Focused on creating and operating a “practice without walls” scaling operations and providing service offerings to locums companies.

   • Discussed financial projections, personalized benefit plans, and autonomy.

   • Explored potential partnerships and networks to diversify professional revenue streams.

2. Consultation Two: Transitioning to Telemedicine

   • Assisted a physician transitioning from a traditional practice to a telemedicine model.

   • Covered technology requirements, patient communication strategies, and regulatory compliance with closing down her private practice

   • Addressed concerns about maintaining patient engagement and quality of care remotely.

3. Consultation Three: Converting To An Employment Lite Structure

   • Worked with a doctor aiming to enhance to sell his current specialty practice to a larger corporation who was interested in growing through acquisition.

   • Conducted a business analysis to identify opportunities for assimilating his medical practice as well his professional services into the larger corporation and this included multiple medical directorships

   • Reviewed options for merging as a new partner in the larger corporation, vs negotiated sale of his practice assets with a W-2 or an employment lite contractor agreement for his professional services that will be continued through the larger corporation.

4. Consultation Four: Financial Planning For An Autistic Dependent

   • Guided a physician with a highly dependent autistic child on financial planning and succession strategies and how that interfaced with her professional endeavors.

   • Discussed retirement savings plans, investment options, and trust strategies.

   • Emphasized the importance of consulting with and working with professionals who understand the laws and fiduciary structures that will allow for a long-term dependent to be taken care of.

These consultations reaffirmed the importance of personalized guidance and the diverse ways in which SimpliMD can support physicians in their entrepreneurial journeys.

The Interplay of Personal and Professional Life

This week has vividly highlighted the interplay between personal and professional life. As I navigated the emotional terrain of my aunt’s illness and the practical demands of business restructuring and consultations, I was reminded of the delicate balance we all strive to maintain.

Emotional Resilience

The emotional resilience required to handle personal challenges while steering a business cannot be overstated. It’s about finding strength in vulnerability, about using personal experiences to fuel professional growth. My mother’s courage and strength in facing her sister’s (my aunt’s) illness have been a source of inspiration, reinforcing the values of compassion and dedication that are at the heart of both my medical practice and business endeavors.

Support Systems

Building and maintaining robust support systems is essential. My business coach and lawyer are critical components of my professional support network, providing guidance and expertise. Similarly, having a strong personal support system—family, friends, and mentors—helps navigate the emotional complexities of life.

Reflecting on Purpose

Ultimately, this week has been a profound reminder of purpose. In medicine, our purpose is to heal and care. In business, it’s to create value and empower others. For SimpliMD, the mission is to inspire and support physicians in becoming successful entrepreneurs. This duality of purpose reinforces the importance of aligning our professional goals with our personal values.

Moving Forward: Lessons and Reflections

As I move forward, several key lessons stand out from this week’s experiences:

1. Cherish Personal Connections: Amidst the hustle of professional life, it’s crucial to make time for loved ones. These connections provide emotional grounding and perspective.

2. Invest in Professional Guidance: Leveraging the expertise of coaches, lawyers, and accountants can significantly enhance business outcomes. Their insights help navigate complex decisions and optimize business structures.

3. Continuous Learning and Adaptation: The business landscape is constantly evolving. Staying informed and adaptable is essential for sustained success. Your best next step for this is to move from a SimpliMD subscriber to a SimpliMD member—where for only $99 you will unlock over $2500 in micro-business products!

4. Integrate Personal and Professional Values: Ensuring that our professional endeavors align with our personal values creates a more fulfilling and impactful career.

5. Plan for the Long Term: Effective tax planning and wealth accumulation strategies are vital for long-term financial health. Regular reviews and adjustments ensure we remain aligned with our financial goals.

Is That Deductible?

Now is the time to review all of these experiences through the filter of whether there were any business purposes involved in these activities and therefore the would be consider pre-tax business expenses.

Visiting My Aunt:The 1 hour drive each way, the visit and ongoing support to my aunt, mom and family are not business expenses. They are personal and moral obligations that are part of our human experience on the earth. I would add that my wife and did use the evening component to conduct a business meeting to shop and discuss setting up her etsy shop for her sole proprietor business Scrapping In My Sleep

Scrapping In My Sleep: Dinner meeting, product(s) purchase, and business purpose mileage all qualify for business deductions.

Stillson Enterprise & Business Start-Up: Business expenses generated for the professional business coaching and consultation. Multiple pre-launch expenses associated with e-visit start up.

SimpliMD Consultations and Coaching: Lot’s of overhead expenses associated with supporting SimpliMD including the website, content creation, building a professional network, Zoom meetings, Calendly scheduling, etc..

Conclusion

This week has been a journey of contrasts—balancing the emotional weight of a personal loss with the strategic demands of business restructuring and consultations. It’s a reminder that life’s complexities often require us to navigate multiple roles simultaneously, as caregivers, professionals, and entrepreneurs.

Visiting my aunt reminded me of the profound impact of personal connections and the importance of compassionate care. At the same time, my meetings with my business coach and lawyer, along with the hands-on coaching and consultations, highlighted the necessity of strategic planning and professional guidance in achieving business success.

As I prepare for my upcoming tax planning meeting, I am more committed than ever to ensuring that my business structures are efficient, sustainable, and aligned with my long-term goals. This dual focus on personal and professional growth underscores the holistic approach needed to thrive in both areas.

I encourage all of you to reflect on your own journeys. Cherish your personal connections, invest in professional guidance, and always strive to align your actions with your core values. Together, we can navigate the complexities of life and business, finding strength and purpose in each step.

Join the SimpliMD Community

For those of you who are physicians looking to explore the world of micro-businesses, I invite you to join the SimpliMD community as a member, and if you use coupon code “MEMBERSHIP50” at check out, you’ll get a special value of 50% off—so today is a great day to become a member! Our mission is to inform, inspire, and support you in your journey towards professional empowerment and entrepreneurial success. Let’s build a future where every physician is empowered to thrive both as a healer and an entrepreneur.