Seven Reasons to Think Twice Before Starting a Business in 2021

In today’s episode of the NP Business Matters Podcast, I talk about some reasons that should give you pause if you are considering starting a business or practice.

Now I wrote about this previously, but it needed to be updated for this year.

You can read below, or if you prefer, you can listen to the podcast.

Starting a practice is a popular topic. And while I am passionate about teaching NPs how to do it, it may not be for you right now, or perhaps at all.

I wrote an article a while back on this, but right now in our current healthcare environment, it’s time to talk about this again. So in no particular order, let’s get started.

You plan to only work for a few more years before stopping to have children, travel, or retire.
Getting started takes a lot of time and energy. Think about a plane. Most of the energy and fuel is spent during takeoff and far less is spent when flying at cruising altitude.

If you plan to leave your business after a short time, you may want to delay it until you are ready, or avoid starting it all together.

You want to focus strictly on your patients.
I’m seeing more business start-ups promising NPs they will manage the business aspects for them and all they need to do is start to see patients.

While that sounds good, because taking care of patients is what we all want to do, it’s not a good idea. First of all, consider this…you are paying someone to manage all the business aspects of your business. So how are you the business owner? It’s like paying an employer to manage your practice.

Another reason why this is not a good idea is that as a business owner, you need to understand every aspect of your business. Who is managing your money? How do you know they are doing a good job? Do you understand how the billing is being done, and do you have an idea if it’s being done correctly?

Is there ever a reason to have someone manage your business? Yes, you may want to hire a practice manager or others who take care of some aspects of your business, people that you supervise. People who are going to follow your vision, your policies, and procedures. But you should NEVER hand over the operations entirely to someone else who wants to use their proprietary systems.

Running your own practice means you will focus on your patients, but you’ll also have to pay attention to your staff, bills that need to be paid, your outstanding AR, and what’s happened to the plumbing… just to mention a few things.

Taking care of your business is your responsibility – to your patients, employees, and community as well as your family, and yourself.

You are a recent graduate of a Nurse Practitioner program.
I receive a lot of questions on this. I hear from new or recent graduates who cannot find a job, so they want to start a practice. If this is you, I invite you to go back to episode # 14 of the NP Business Matters Podcast and listen to my interview with Renee Dahring on Finding Your Perfect Job. She talks about things you can do to increase the likelihood that your application makes it in front of human eyes, things to consider when looking for a job, and more.

Beyond that, I always recommend that new grads take the first few years, or more, following graduation to really hone their skills as a nurse practitioner, get your “NP legs” if you will.

Of course, there are always exceptions to the rule, which I discuss further in the podcast.

You work hard all day and expect to go home at 5 pm. 
Starting and operating your own practice, in all likeliness, means that you’ll not be able to go home at 5 pm – at least not in the beginning.

Many of us, self-employed or not, often stay to finish up patient calls, documentation, and other paperwork. However, as a business owner, you’ll also have a number of other responsibilities that must be attended to on an ongoing basis.

Will it always be like that? No, it doesn’t have to be. You can design your practice to fit your lifestyle, as well as your personal, financial, and professional goals. Even so…. you may still be working ON the business in your no clinical time, including at home.

You are risk-averse. 
If you need and want a guarantee that everything will work out perfectly, then this is not for you. And if the thought that cash flow might be a challenge at times causes you to have an anxiety attack before you even open or start, you may want to reconsider.

Of course, the goal is to reach a level in your business where this is a non-issue, but the truth is that all businesses experience cash flow issues from time to time. That is why good planning and financial management are key.

You have no money, no job, a poor credit rating, and no way to obtain a startup loan.
Stop right here. Starting a business with no money or resources sounds too good to be true right? It is. While you can start a practice on a shoestring budget and bootstrap the entire thing, you still have to have that shoestring budget.

You need money for living expenses, rent, supplies, equipment, insurance, staff, and more. Save up your money, repair your credit, and explore various funding options.

Many clinicians work full time while starting a part-time practice. The last thing you want is to take on more debt.

You have huge debt and poor financial habits.
One of the keys to managing a business is to understand finances and how to manage them. Your household is like a business if you will and your financial habits in how your run your “home” often carries over to your business. Many success coaches over the years have said “how you do anything is how you do everything”.

If this is an issue for you, take a class in financial management, budgeting etc. There are a lot of programs available today that can help you get a handle on your home finances so you are better prepared for business.

Related to this, I often here from NPs who are desperate to start a business and make money immediately. It rarely happens. It takes time to get patients, credentialed, reimbursed etc.

Do not expect to leave your 6 figure job and make 6 figures in your practice in 3 months.

And for a bonus reason…
Finally, let’s talk about where we are at the time of this recording. It’s early 2021. We’ve just come out of 2020 and for many, it feels like we are still there. We have a huge public health crisis going on that will not end any time soon.
As unbelievable as it sounds, many NPs have lost their jobs and there are practices that have failed.

At the same time, there are businesses that have done well, even thrived. I believe that those businesses had good plans and financial management behind them. They also possessed the vision and creativity to see how else they could meet the needs of their patients and clients and the agility to pivot and adjust as needed.

Does that mean you should not start a business right now? Nope, that’s not what I am saying. And while my crystal ball is a bit murky right now, you can increase your chances of success.

Do an assessment (which is always the first step in starting any business – go back to episode #1 of this podcast). Make sure your own house is in order. Plan, plan, and plan again.

Get the help you need from a business coach and perhaps a financial coach. Gather a team around you.

Think big, plan, and start small.

Links Discussed:

• 7 reasons NOT to Start a Healthcare Practice
• Renee Dahring on Finding Your Perfect Job
• What To Do Before You Start A Practice
• Clinician Business Institute – business courses for NPs

More Resources

• Catch up on all the NP Business Matters podcasts here.
• Check out the Nurse Practitioners in Business Facebook Group
• Become a Member of the NPBO™
• Ready to start your own practice?

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