Getting entrepreneurial

Like most people, physicians are either natural entrepreneurs or natural plodders.

For every physician I've met who started her own software company on the side, there's one who feels quietly victimized, moving from day to day with no sense of adventure and no real plans for the future.

But entrepreneurs are made, not born. If you feel like a plodder but aspire to hit the fast track, take matters into your own hands.

Follow your passion

Do what you love, not what makes the most money, what's trendy, or the latest "sure thing." Your passion is the only thing that will give you enough motivation to make your project work - and make you happy when it does.

Michael Janssen certainly could have made a decent living as a spine surgeon. But he couldn't contend with the inefficiencies of typical hospital-based surgery practices. So he set his own course, establishing the only clinic-based cadaver lab I've ever seen as well as a smooth-running ambulatory surgical center. The fact that he owns a Hummer and spends vacations scuba diving in exotic locales is a happy result of his success, not his driving motivation.

I'm not talking about adding a new service because the guy up the street did. I'm talking about doing something that excites you.

Most of us have a pessimist inside. As soon as we start thinking about our dreams, we also start listing the reasons why they won't come true. The excuses can be endless.

Instead of sabotaging yourself with negative thinking, dream big dreams and then work out the details. People do big things all the time; it's more of a mindset than a skill set.

Have a plan

Of course, passion can only take you so far. Planning makes it real.

Whether your idea is big or small, invest time in writing up a business plan. Set realistic objectives with
specific time frames and list the steps you'll need to take to achieve them.

Understand your market. Know where your cash will come from.

Imagine you are seeking money from investors - even if you're not. In fact, it's not a bad idea to ask others to review your business plan as if they were going to invest in your idea. Ask your father-in-law, your business-oriented neighbor, even a professional consultant to find holes in your plan. Four minds are better than one.

Make a plan that holds you responsible and helps you measure your progress. You'll need solid objectives - financial and otherwise - to help you evaluate your progress at least once every four months. That way, you'll know if something is wrong with your plan before you get in too deep a hole. Regular self-checkups will enable you to adjust your plan as necessary.

Not long ago I heard about a practice that had started offering a new type of injection to its patients. It seemed like a small move, so the physicians didn't bother with any research or planning. They just ordered the drug and started offering it. Only later did the physicians realize that managed care payers in their area either didn't pay for the injection or paid so little the practice couldn't cover its costs.

Don't forget to also do some personal planning. If starting a new commercial enterprise is going to take a bite out of your leisure time or disposable income, plan for it. Cancel your vacation plans if you have to. Sell your car. Do whatever it takes, but realize that as a small businessperson your personal and professional budget and life are intertwined. Preparation is key.

Get the basics in order

If you dream of expanding an existing practice, first ensure your foundation is strong. One allergy practice I visited wanted to open a third office to increase patient visits by making itself accessible to potential patients on the other side of town. Sounds great, but its two existing clinics were in crisis mode. Staff were bickering, revenues were down, appointment slots were going unfilled, and their accounts receivable were slow as molasses.

Opening another site simply would have added to their existing chaos.

Take time to set up the systems you need to see your plan to fruition, to think through the implications, and to surround yourself with enthusiastic, responsible staff - before you grow.

If you are feeling mired in your current situation, the only way out is to get started on something new. Don't let fear hold you back.

Pamela L. Moore, PhD, is senior editor, practice management, for Physicians
Practice. She can be reached at pmoore@physicianspractice.com

This article originally appeared in the March 2006 issue of Physicians Practice.