I stumbled across a fascinating ChatGPT result while batting around ideas for this piece. My query: “What are entrepreneurial areas particularly suited to physicians?” Its second suggestion floored me: private practice (along with medical technology R&D, media presence, medical tourism, etc.).
I honestly have never thought of opening my own practice as entrepreneurial. I understand it is by definition; it just didn't seem that way to me. For the past 20 years, I have been fortunate to establish and grow my independent practice. But in 2005, the pendulum was already swinging well away from the antiquated idea of completing training and “hanging your shingle.”
In my last newsletter, I tried to establish why the balance of power in our healthcare system needs the pendulum to swing back to include more independent and autonomous physicians. Our ability to practice good medicine and effectively advocate for our patients hinges on it.
Most of us know well the difficulties of private practice, even if not from personal experience. Instead, I think it may be more useful to consider why being an entrepreneur is so difficult for physicians. Having completed (at least) “23rd grade,” the problem is certainly not a lack of aptitude or initiative! Answering that it is a lack of business training or time constraints is the low-hanging fruit, but neither feels quite right.
What about fear of failure? That rings more true. I shudder to think back on the sheer quantity of tests we’ve taken in order to get to and through medical school. Then in residency, the constant demand of increased precision required in order to avoid mistakes and provide the highest quality care for our patients. It is no wonder the part of our brain that dares to dream and adventure withers into near nonexistence.
May I ask about the status of your business network? Healthy and robust? There have been times in the trajectory of my practice when I would have laughed at the preposterousness of this question: “When in the world am I supposed to do that?!” I have thankfully gained wisdom into the absolute value of saving mental energy to learn about individuals in other areas of business, the challenges they face, and how they are striving to overcome them. It is in our best interest professionally to seek mentorship in this area, either from experienced physician-entrepreneurs or other respected business leaders.
Lastly, may it be related to the psychological challenge of defining a professional identity beyond the accepted norm? Something akin to imposter syndrome? Honestly, through the normalization of personal sacrifices we’ve made and the fear of life beyond the familiar structure to which we have adapted, it almost conjures something closer to Stockholm syndrome. The phrase “medicine is a cruel mistress” is attributed to Dr. William Osler, and I think we can all acutely feel the truth in it, but that should motivate us all the more to fight to maintain our humanity in some degree beyond this noble profession we’ve chosen.
The upshot? You are brave and incredibly smart. You have overcome so many obstacles to reach where you are now. Do not allow the grind of your daily routine to smother your passions and curiosities. Fear of uncertainty should not hold you back from taking small steps toward a new professional goal. Start small, find a mentor, and leverage your strengths. I believe our patients and our healthcare system will be better served if we refuse to simply be a widget; we need to utilize all our potential energy. I believe our communities will benefit most when we offer our expertise, leadership, and problem-solving skills to their full extent, but we will have to push against the constraints that have been created around us.
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