Over the past two weeks, we’ve talked about what it takes to start your own practice. First, we discussed personal considerations, and second, some of the practical steps involved.
But there’s another side to the story that doesn’t get discussed nearly as often.
Why is it that so many NPs, despite wanting to start their own practice and work for themselves, never actually take the leap?
If you’ve thought about starting your own practice but haven’t moved forward, for whatever reason, you’re not alone.
Many feel the pull toward going out on their own, but lack the knowledge of how to do it; the impact on their emotional well-being can be significant.
The lack of know-how holds them back and often leads to fear, uncertainty, and sometimes impacts other, very tangible challenges.
Let’s take a closer look at the most common reasons why NPs, and perhaps that’s you, don’t move forward—and what you can do about it.
Overwhelm and Confusion
Starting a practice involves a multitude of not only clinical, but also legal, financial, and business decisions.
The numerous steps required to start a practice leave many confused and overwhelmed, unsure of what actions to take and where to start.
When you don’t know which actions to take and how they may affect your practice in the future, you may find it difficult to move forward.
What if you make mistakes? How might it affect your practice?
For some, confusion and overwhelm make the dream of starting a practice seem too complex and out of reach, ultimately causing them to abandon their plans.
How do you fix this?
You do your best to work with a clear, step-by-step roadmap.
Instead of stringing together random pieces of information, NPs would be better served using proven checklists, structured guides, or step-by-step courses, which increase the likelihood of building a successful practice.
Fear of …
Fear comes in many forms, amongst them fear of failure and fear of success.
Some refer to fear as “false evidence appearing real.”
When we don’t know or understand something, we tend to be afraid of it. Sometimes, we may even be too fearful to make use of something or engage with it.
For example, many years ago, I taught introductory computer classes at a Community College Adult Learning Program. Most students were timid and afraid around the computer; their biggest fear … breaking it.
But once they understood basic computer operation, the difference between hardware and software, and that it was virtually impossible to break the machine, they felt more comfortable and began to explore the possibilities.
How does this relate to business?
When starting a business, you’re working with both concrete and often nebulous concepts, which can be intimidating and evoke fear.
For example, income and taxes are simple and easy to understand. However, concepts like revenue cycle, legal entity structures, or efficient cash flow management are more complex and become easier to understand with experience and time.
But regardless of your level of understanding, decisions such as entity structure should be made at startup and not be delayed.
When you’re working with things you don’t fully understand, it’s only natural to be afraid of making mistakes and causing a mess.
Unfortunately, the lack of knowledge can amplify fear and keep you from taking any steps at all.
Again, education is the key…
Once you learn basic business concepts and understand the areas critical to operating a medical practice, you begin to build knowledge and with it comes confidence in your ability to start and grow a practice.
Self-Doubt
Many NPs have years of clinical experience before ever considering going out on their own.
How much experience do you bring to the table?
Chances are, you have years of experience and feel confident about your clinical skills (unless you’re fresh out of school, in which case you shouldn’t start a practice yet).
But what about the business side of things… how much experience, if any, do you have?
Sadly, aside from their clinical training, most NPs don’t get any business education.
But without any business know-how, NPs often question their ability to run a practice.
“I’m a good clinician, but what about the business side? Can I really start and run a practice and be a successful business owner?
Unless you learn to control the dialogue in your head, it will chip away at your confidence. It may lead to procrastination, bring up thoughts of self-doubt, and make you feel like an imposter.
The antidote to chasing negative self-talk out of your head is getting knowledgeable, getting educated… even if only at a basic level.
Aside from the legal requirements, you wouldn’t consider working in a specialty without getting the proper training, right?
Education goes a long way, even just a little.
And once you have some basic business concepts under your belt, another world opens up to you, and you no longer worry about feeling like an imposter.
Frustration and Discouragement
Anytime you’re overwhelmed, afraid, and doubt your own abilities, it’s easy to get frustrated and discouraged.
Knowing that others succeed while you continue to struggle and feel stuck can add to your frustration and eventually leave you discouraged.
Some may even start to believe the dream of independent practice isn’t for them and give up trying. They think that starting a practice is too complicated and not the right thing to do for them.
But starting a practice doesn’t happen overnight; it takes time.
It’s also important to recognize there will be challenges and perhaps even setbacks along the way.
However, understand that more often than not, you’ll be dealing with a knowledge gap, not a capability gap or some insurmountable problem.
Get the training and information you need to solve any challenge. Reach out to other independent NPs in your network for help and support.
Comfort with the Status Quo
Finally, let’s face it, staying employed often feels safer and easier.
And who can argue with a steady paycheck, health and educational benefits, sick time, vacation, predictable hours, and seniority?
These perks can be hard to give up, even when the desire for independence is strong.
For some NPs, the comfort of the status quo outweighs the risks and challenges of business ownership.
And that’s okay…
Starting and running a practice isn’t for everyone, but at the same time, it’s the only option for some.
So, get clear on your “why.” If you know deep down that you want more freedom, independence, and control over the way you practice, don’t let comfort keep you stuck.
Identify your reasons for wanting your own practice. It will help you find the courage and resolve to step out of your comfort zone.
To Summarize…
Feelings of overwhelm, fear, self-doubt, and discouragement are real and happen to the best of us.
These feelings are normal and to be expected. After all, you’re developing new skills, testing unknown waters, and venturing out of your comfort zone.
While it may be troubling at times, as you begin to develop and incorporate new skills, your comfort level will increase.
So, acquire the knowledge you need, reach out for help and support, and, above all, be patient with yourself.
We’d love to hear from you… leave us a comment below
By Johanna Hofmann, MBA, MAc., regular contributor to the NPBusiness blog and author of “Smart Business Planning for Clinicians.”