005: The Safest Way to Reduce Hospital Work Without Losing Income

Discover how physicians can strategically build remote income streams without risking their current financial stability. Dr. Kristine shares practical insights on transitioning from hospital-based work to flexible, sustainable remote contracts.

In this episode:

• Why waiting for financial security delays your career transition, and how to build safety in parallel
• The concept of reducing risk strategically by building income in layers
• How direct contracts can help physicians gain autonomy and control over their work
• The importance of network-based opportunities instead of online job boards
• The role of locum tenens as a bridge, not a long-term solution
• Step-by-step guidance on how to start building remote income with just 3-4 hours weekly
• The concept of safety as foundational for long-term freedom
• How to renegotiate current contracts for more autonomy and remote work
• The internal mental block: overcoming fear and self-doubt when starting remote ventures
• The significance of precision outreach over mass applications

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Transcript

SPEAKER_00 0:01

You're listening to Doctors Abroad, the podcast for doctors who want to build remote income and create location independence. I'm Dr. Christine Gorman, founder of Nomadem Day. I've exceeded my hospital income while working part-time and living abroad, and on this show, we break down how to make hospital income optional. Let's get started. Welcome back. So, one of the things I love talking about most is how physicians can change the way they work. But most of us actually believe the safest way to change the way that we work is to wait. Wait until we feel financially secure enough to make a move. And feeling financially secure can mean different things to different people. Right? For some, it can mean having a multimillion dollar retirement portfolio before they can make a move. For someone else, it can mean having a year of their income saved or expenses saved. But either way, that approach of waiting is actually what keeps a lot of doctors stuck. Because when your income is tied to an institution, to a certain way of working that is controlling your time, controlling your energy, overworking you, in that setting and in that environment, waiting doesn't create safety. It just prolongs dependency. And so the safest way to replace your hospital work is not to wait. And it's also not to quit where you are right now, but it's actually to build income in a way that allows you to reduce risk over time. And this is the piece where I see a lot of physicians get stuck because the only models that we've ever seen are stay where you are or leave and take a huge risk. There's really no kind of middle path being taught. So it really feels like all or nothing: security or uncertainty, stability or freedom. But there is a third option, and it is the one that we're going to focus on in this episode. So I want you to think about this for a second. If you wanted to reduce your on-site in-person clinical work right now, what would need to be true financially for you to feel safe? Is it 100% of your income would need to be replaced remotely? 50%, 30%? What would need to be replaced for you to even begin to reduce your on-site clinical work? Just hold that number in your mind. We're going to come back to it. There's something else that I want to address because I think it quietly holds a lot of us back. Many physicians also believe that if they feel any type of fear, hesitation, or self-doubt when it comes to building income outside of their traditional employment, that somehow that emotion or those thoughts mean that they're not built for it, that they shouldn't do it, that maybe they're just not entrepreneurial. But that's actually not what the data shows. So studies on entrepreneurship have found that people who keep their day jobs while building something on the side actually have about a 33% lower chance of failure compared to those who quit and just go all in immediately. And it's not because those people are less committed, but because they're more strategic, right? They want to build in a way that allows them to last, that allows what they're building to be sustainable for the long term. And that's what we want. There's already so much of the work that we do right now that does not feel sustainable for the long term. That's why we want to change. So what we're building remotely must be sustainable. And so the goal here is not to become someone who is a huge risk taker and is impulsive and ready to throw everything all away. Not at all. It is to become someone who knows how to reduce risk strategically. Someone who builds stability in one area so that they can create flexibility in another. So there is a concept that explains this well. People often take risks in one area of their life while remaining conventional in others. So they tend to take risks just in one area at a time. And that balance is what allows innovation change to happen. Because when your foundation is stable, you don't have to make rushed or desperate decisions. And if you think about it, this is already how we operate as physicians. Right? We've built careers that are structured, stable, predictable. What we're doing here is not removing any of that, but rather using that stability as a foundation to build something more flexible alongside it. Okay, so security is not the opposite of freedom, but when it's used correctly, security is actually what makes freedom possible. And this is exactly why the safest way to replace hospital work is not to up and quit, but it's to build in parallel. So let's talk about how this actually works. One of the most effective ways to start replacing hospital income without losing any money is through direct contracts. Now, this is something that most physicians were never taught because if we as physicians understood how to structure our own work and contracts, who would benefit from that? Only us. And that is absolutely not what the systems that we work for want. So direct contracts means that you are working directly with an institution or an organization without being an employee. So in this model, you have your own professional LLC, and your PLLC has a contract directly with this institution or clinic or company. And what this means is that you get to define what work you do, how much work you do, how you're compensated. And often when and where you work, right? You are no longer stepping into a pre-built structure, but you are defining that structure for yourself. Now, I remember the moment that I got my first contract. This was right out of fellowship. And it was the first time that I even realized that you could structure work differently as a physician. I didn't get my first direct contract from a job board. I didn't get it through any agency. I got it through direct outreach and strategic networking. Now, by direct outreach, I mean knowing what type of position that I was looking for and knowing where to find it. Right. And strategic networking, talking to people that I knew, talking to people in my world and people that were outside of my world that maybe were connected to my field, connected to medicine, connected to my specialty, in the area, in the locations where I want it to be. That's how I got my first contract. And when I secured it, I was like, what? Wait, I don't need a middleman. I don't need someone else between me and an institution. That is how I actually learned that we could structure work differently. Nowhere in training did they ever teach me how to do that or that it was even possible. But here I was designing my own schedule, how many hours I was going to work a week, how much I was going to make, who I was going to treat, who I was not going to treat. Choosing my patients alone was a vastly different scenario than anything I had learned or saw, you know, in training. My attendings, they weren't even choosing their own patients. And I thought, wow, we can do things that we were never trained to do that allow us to have so much more autonomy over our work. And I've even had clients do this right where they are without even changing their employer, but rather renegotiating their current contract to switch from an employer status to having a direct contract, right? To switching to a contractor or consultant status right where they were. It changes everything about the way you work. And so here's what surprises most doctors that you don't need twenty extra hours a week to begin this. You need three to four hours a week. That's it. And those hours are not about working more clinically, they're about identifying opportunities, reaching out strategically, and positioning your expertise. Because the thing is, the process itself is simple. Doctors just don't do it because it's scary to do things that you've never been taught how to do. And as physicians, we pretty much only do things that we've been shown how to do. But when someone is helping us, guiding us, showing us the way, it just feels more doable. Kind of like doing your first spinal tap, if anybody out there can relate to that. I still remember my first one. Right? So going back, ask yourself, ask yourself, do I have three to four hours a week to change the trajectory of my career? For most of us, that's gonna be a yes. Right? But the way that we go about it has to be directed strategically. Another misconception is that these opportunities are gonna be posted online. They are not. You have never been on LinkedIn and found a posting that said, okay, you're gonna make multiple six figures working less than 20 hours a week, decide who you want to see, when you want to work, design your own schedule. Like you will not find that on Indeed or LinkedIn job boards or in recruiter emails. They will come from your network, referrals, professional organizations, strategic outreach. This is why most physicians never access them, because no one has shown them where or how to look. And so the process becomes very simple when you know where you want to work, which states, which states are you licensed in, what type of work you want to do, who your target institutions, clinics, or companies are, how to position your expertise in the market, and how to start the right conversations with the right people. This is not about mass applying, it's precision. It's precision. Now let's bring it back to safety because that is the real concern. The safest way to go about a shift like this looks like not quitting your job, right? But you're able to maintain your current income and you carve out a few hours per week to begin building additional remote income. And then as that income grows, you gradually reduce your hospital work. That is the entire transition model. That is how it works. And this is also where something like locums can actually be helpful. I never really thought of locums as a long-term solution for work because many times physicians work on working in locums positions, they are working long hours, typically in places or areas where they don't really want to be located and they have to spend time away from their family and the people that they love. And so I don't think it's a long-term solution. But in situations like what we're talking about right now, I do think locums can be a bridge because a locums position can allow you to maintain income, create flexibility, and reduce pressure while you build something more aligned and remote. So in summary, we're really not talking about quitting everything overnight. We are talking about building a transition that is financially stable, strategically sound, and sustainable long term. And we're not starting from scratch, right? We're not becoming brand new people, doing brand new things. We are repurposing what we already know. You're using your same clinical skills, the same work, the same talent, the same expertise that you would be using as an employee. You're now using in a different structure. So I want you to come back to that number you thought about earlier. How much income would you need to replace to feel safe reducing your hospital work? Now ask yourself, what if you could create that number, that income, with one contract within 90 days without losing the income you currently have? That is the safest way. The safest way to replace hospital work is not to take a risk, but it is to remove risk over time by building remote income streams that do not depend on anyone else's system. And once you do that, hospital work stops becoming something you rely on and becomes something you can choose. If you want help structuring direct contracts and building a remote income model that can realistically replace your hospital income, you can book a one-to-one call at the Nomadmd.com. Thanks for listening to Doctors Abroad. If this episode was helpful, share it with a colleague who's been thinking about building more freedom and flexibility in medicine. And if you're ready to make hospital income optional, book a one-to-one freedom consultation at thenomadmd.com. I'll see you in the next episode.