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.
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 and 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
But the underlying basis for both private practice and employment—which is a long-term commitment to full-time work in one location—is being replaced by a progressive model of physician work that is location independent. Now physicians are using combinations of location-independent %FTE jobs stacked with side jobs that additively lead to a preferred quality of life.
I offer six takeaways for physicians when it comes to this shifting landscape. As I work with doctors all over the country , I see the following consistent themes that inform what the future physician labor force will look like.
1. Employment is just a job without meaning. The age-old medical school interview question of “Why do you want to be a doctor” is typically framed by a story that inspires you to want to help others medically. Your answer likely was not “so my employer can make a gazillion dollars for its shareholders and CEO.” However, if a large corporation has employed you for any period of time you will realize that you and the patients are just commodities. Both are ingredients in their money-making machinery as medical care is now reduced to a transactional economic event.
Your work has become stripped of its purpose and meaning in this depersonalized state. Now it’s 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 mindfully working within these safe harbors, while others recognize that something had to change to survive. The latter is what I ultimately did as I discovered the long-sequestered power I had earned —using my micro-business powers in the marketplace.
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.
Four broad trends 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 have forced many doctors to look for non-employment job options.
- Gen Z and millennials’ evolving view of work: Younger workers tend to independently and are skeptical about the security of employment. Gen Z tends to question whether they can find contentment in the traditional American lifestyle—which is employment focused. In the end, for Gen Z doctors, 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 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, this progressive normal and, thus long-term alignment with a single employer is becoming less common.
4. Doctors are contractors. Doctors are starting to view their jobs 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.
Virtual workers need virtual business structures. Doctors tend to shy away from opening a professional micro-corporation for their 1099 work due to their business illiteracy and their fear that it means they will be opening a private practice.
5. A doctor is a professional micro-business. But they 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 they go. It covers you like a suit. These professional micro-corporations a simple to start and operate.
Every doctor has the power to form a virtual professional micro-corporation, and it’s surprisingly inexpensive.
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.
6. Every doctor should start a micro-corporation. If you are an attending physician who works more than one job, receives any 1099 income, or is 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—an increasingly diverse, non-permanent, and locality independent- the perfect recipe for a virtual professional micro-corporation.
One thing that fuels Gen Z’s passion for starting a small business is the autonomy it provides them to do good. This is especially appealing to Gen Z doctors who want to tap into the altruistic motives that led them to a medical career. 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.
Ultimately a professional micro-corporation can be used by a doctor for any job they encounter.
Tod Stillson is a family physician and founder, of SimpliMD and can be reached at Dr. Incorporated. Follow him on Facebook and Twitter @DrInc9, on his regular YouTube and podcast episodes, a blog called The Truth, or join his Facebook community for doctors, Every Doctor Is A Business. Reach out to him for professional agency services at SimpliMD. He is the author of Doctor Incorporated: Stop the Insanity of Traditional Employment and Preserve Your Professional Autonomy. Book a free business coaching appointment with Dr. Stillson to discuss whether a professional micro-corporation would be helpful for you.