010: Do You Actually Have to Start a Business to Work Remotely?

Dr. Kristine explores the three flavors of remote work for doctors—employee, owning a practice, and direct contracts—helping physicians find the best fit for their lifestyle and goals. She debunks myths about business ownership and offers practical insights to build remote income without overwhelm.

Key Topics:

• Three flavors of remote work: employee, practice owner, direct contractor
• Debunking myths about business ownership in medicine
• How to choose the right remote work path based on personal goals
• The benefits and trade-offs of each remote work flavor
• Practical steps to start remote work without overwhelm

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Transcript

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Most doctors think they only have two choices: stay in the hospital or become some stressed-out entrepreneur. But neither is true. There is a third path that can give you remote income, flexibility, and more control. And if you already have an idea of what you'd like to do remotely and want help implementing it in a way that increases your income and your flexibility, book a one-to-one freedom call with me at thnomadmd.com. You're listening to Doctors Abroad, the podcast for doctors who want to build remote income and create location independence. I'm Dr. Christine Goins, founder of NomadMD. 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. Today we are talking about something that stops a lot of doctors before they even begin to think about a different way to do medicine. Because a lot of physicians hear conversations around remote work, flexibility, living differently, making money outside of the hospital, and immediately think, yeah, but I don't want to have to start a business. And I get that because when many doctors hear the words start a business, what they picture is becoming some online influencer, dancing on social media, hiring a giant team, dealing with payroll, taking huge risks, doing something that feels completely outside of medicine or outside of what you're already doing, what you've been trained to do. And if that's what you think it means, of course you'd say no. But the honest truth is no, you don't have to start a business to work remotely. Absolutely not. You can work remotely as an employee. You can work remotely as a contractor. You can work remotely through your own practice. There are different ways to do this. And depending on the kind of freedom you actually want, one path may fit you far better than another. So today I want to simplify this conversation and break down what I call the three flavors of remote work for doctors. Think of it like ice cream: vanilla, chocolate, strawberry. And once you understand these three flavors, you'll have a much clearer sense of what remote work could look like for you. So flavor number one is vanilla. Vanilla is the remote employee. This is the most common version people think about. You work for a telemedicine company, maybe a startup, an employed virtual care role, sometimes even a utilization review company. You log in, you do the work, you get paid, somebody else owns the system, someone else sets the rates, someone else determines the policies and often controls your schedule expectations. Now, for some doctors, this is the exact right fit. Maybe you simply want to get out of the hospital building. Maybe you want to stop commuting. Maybe you want to work from home, be around your kids more. Maybe you want less friction in your day. And that is valid. There is nothing wrong with this route. If that is the version of freedom you want, vanilla will be enough. But the trade-off is usually less financial upside, less leverage, less control over your day-to-day, a capped compensation, and being under someone else's rules and schedule. And depending on the company, sometimes it means having less flexibility than people expected. Because I know doctors working remotely right now as employees, and a lot of them are still exhausted. Some are still burnt out, working 60 plus hour weeks, dealing with quotas expected online from eight to five, still asking for permission to take off, making less than they should, less than what they think they should be valued at. So yes, they're remote, but are they experiencing the type of freedom that they really want? That is a different question. Flavor number two is chocolate. This is owning your own practice. This is where you own the patient panel. Let's say you own a telemedicine practice or your own direct care practice, your own private practice model, whichever you choose. The patients are your patients. The systems are your systems that you created. You set the rates. For the right doctor, this can be amazing, especially if you've ever thought, I wish I could just do medicine my way. I want to build the system. So if you want your own standards, your own company culture, your own schedule creating the patient experience that you want them to have and full ownership of the revenue, this path can be beautiful. And yes, it also carries with it more responsibility because ownership comes with responsibility. Now, some people hear this path and they light up immediately. Others hear it and instantly they feel tired. Know yourself, right? Neither reaction is wrong. Now, flavor number three is strawberry. It is direct contracts. Now, this is one many doctors don't realize even exists. And honestly, for a lot of physicians, this is the sweet spot. It's the middle ground. This is where you create your own professional LLC, your own entity, and you contract directly with clinics, organizations, and other companies. You are not an employee, but you're also not running a full patient-facing practice with all of the same responsibilities over the infrastructure, right? This can look like contracting with clinics to provide telemedicine care or specialty consulting, collaborating with other practices, doing advisory work or clinical review work, being the physician expertise for other organizations or individuals. I have a client right now who contracts with primary care offices to provide specialty consultations. That is a real model with flexibility. And what I love about this path is that it often gives doctors more control over their schedule, more control over their rates, more flexibility, leverage, portability, the ability to work from anywhere without requiring them to build a giant business empire, right? Sometimes starting a business simply means establishing your LLC, having the right malpractice insurance, signing a contract, and invoicing for your expertise. That's it. And I think many doctors would feel much less intimidated if they understood that this middle ground existed. Now let me tell you something personal. When I first explored remote work, I absolutely looked at employee telemedicine roles. I interviewed, I considered them, I was very open. But many of them did not offer the level of flexibility or compensation that I actually wanted. And that mattered to me because I didn't just want to sit at home. I was trying to redesign my life. And those for me were two different goals. And the strawberry or direct remote contract path really gave me more of what I was looking for. One of my contracts lasted over five years. That is real stability as well. People talk about employment as though it is the only stable option, but it isn't. Now, why do so many of us as doctors resist the word business? I think a lot of it comes down to identity. I think we hear business and think that's not me, that's not what I was trained to do. That's outside of my skill set, outside of my depth. But let me ask you something. If you were doing the same work that you're currently doing under an employer, but now you get to negotiate directly for your expertise, choose your own schedule, choose your patients or clients, decide your compensation, structure your work around your life. Why is that out of your depth? Why hand over those important decisions to an employer by default? It's worth reflecting on. I had to reflect on those things as well. Because sometimes we're not resisting the business. We are resisting stepping into ownership, ownership of our time, ownership of our value, ownership of our choices and our expertise. So how do you know what path is right for you? Ask yourself honestly. Do I mainly want to be out of the hospital building? Then vanilla may be enough. Or do I want total control and ownership of a patient panel? Then perhaps chocolate may be your lane. Or do I want flexibility, leverage, and a strong income, but without full-scale ownership, then strawberry may be exactly what you need. And let me say this really, really clearly: there is no superior path, right? It's not about ego, it's about alignment. It is about the best model being the one that supports the life that you actually want. Not the one that sounds impressive to colleagues or on social media, not the one the other doctor next to you chose, not the one medicine told you was the respectable route. A lot of doctors say they don't want to own a business or start a business. But when we unpack it, what they usually mean is I don't want overwhelm. I don't want more work. I don't want to take on unnecessary risks. I don't want to fail publicly. I don't want to do something that feels foreign or new. I don't want to market myself. And those are real fears, but they are solvable. And sometimes the business that you are resisting is simply establishing an LLC, signing a contract, and getting paid directly for your expertise. And finally, having more say in your time, your income, and your life. And that's a very different picture. Right? You don't have to become some entrepreneur stereotype to work remotely. You need the model that matches the life that you actually want. So if this episode helped you understand which flavor of remote work is best for you, but you're still thinking, okay, but specifically, what would I actually do remotely? I want you to listen to episode seven, which is titled, If you don't know what you do remotely, start here. That episode helps you figure out the type of remote work that fits your skills, interests, and lifestyle. Then go to episode eight so you can learn how to build this path without quitting your day job and in just four hours a week. 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.