Most healthcare professionals dream of one day opening up their own practice, enticed by the prospect of independence—making their own decisions, setting their own schedules, and increasing their income. Having witnessed the entrepreneurial journeys of our predecessors, including faculty members, mentors, and even our own parents, it’s only natural that we feel inspired to follow in their footsteps. But is this path truly right for us?
What many people fail to mention is that healthcare entrepreneurship is not only challenging but also demands specific skills—particularly business knowledge—that most healthcare professionals typically lack. Many of us in healthcare did not receive formal business education during our time in school. We simply became proficient at learning the technical and theoretical aspects of our respective professions. In other words, we became very good at being dentists, physicians, surgeons, pharmacists, etc. Although many of us would eventually become small business owners, our curriculum lacked any real business training. Aside from a few informal discussions about practice management with mentors and the occasional business course in our senior year, we were not adequately prepared. This limited exposure hardly equipped us to grasp the complexities and nuances of running a business, including managing a team, understanding accounting principles, or effectively marketing a practice.
If we think of a business as akin to the human body, we can recognize that it consists of interconnected systems that must function harmoniously. A deficiency in any one area can disrupt the entire organization. Similarly, businesses rely on various systems—such as accounting, marketing, human resources, and compliance—that must work together seamlessly for the enterprise to thrive. But how can healthcare professionals, who often lack formal business training, learn these essential skills? Unfortunately, the answer often lies in trial and error, accompanied by plenty of frustrating and anxiety-inducing moments.
My wife, Richelle, a pharmacist, and I, a board-certified pediatric dentist, experienced this firsthand. We aspired to become practice owners and eventually expand into a multi-location organization. However, aside from my Master’s in Business Administration and Richelle’s corporate training at Target Corp. in pharmacy mergers and acquisitions, we had little real-world business experience. What we did possess was a strong passion, an altruistic desire to serve our community, and a commitment to hard work.
How did our journey begin? Well, we nearly faced bankruptcy within the first three months of opening our practice—a significant blow to our confidence. Yet, through perseverance, dedication, and a stroke of luck, we managed to turn things around and became profitable within our first year. Eventually, we opened six de novo offices, acquired an existing practice, generated over $11 million in revenue, and built a team of more than 140 members, including twenty dental specialists.
So, how did we transform our initial struggles into a thriving, multi-location enterprise? You might be surprised to learn that we didn’t hire expensive consultants or rely on an angel investor to bail us out. Instead, we concentrated our efforts on implementing the following ten key strategies:
1. We had a vision for our company. The most successful businesses thrive by addressing real problems for people. When we opened our first practice, we identified a significant gap in access to dental care, particularly for patients on Medicaid and those with special needs. Our vision was built around providing quality services to everyone in the community, especially underserved populations. Because there was a pressing demand for care in this demographic, our practice was able to grow quickly. Additionally, by prioritizing exceptional customer service, we soon became the preferred choice for many in our community, solidifying our reputation as the “go-to” dental provider.
2. We had a growth mindset. A growth mindset is one in which an individual understands that problems, challenges, and even failures are not permanent setbacks but valuable opportunities for learning and growth. A fixed mindset, on the other hand, assumes that nothing new can be learned and views problems as obstacles to be avoided. People with this type of mindset tend to give up easily. We were committed to making our business a success, knowing that failure was not an option. We saw every setback as a setup for an even greater comeback—words we borrowed from Pastor Joel Osteen that became central to our approach.
3. We created a list of guiding principles. We created a list of nineteen principles, which we called our “Credo”, based on our personal beliefs and values. This Credo outlined the expectations for everyone within our organization. Some of our core principles included, “We are NOT a tooth business, We are a PEOPLE business”, “Be open to change–we are constantly evolving!”, “Team first mentality–our patients come second.” These values shaped the culture of our practice and ensured that every team member understood our mission and priorities.
4. We marketed effectively. Marketing is essential for any business, especially in the early stages. It's how the world learns about your services and what you offer. However, like most things, marketing can be done effectively, or it can drain your budget without delivering meaningful results. Successful marketing hinges on three key factors: understanding your budget, identifying your target audience, and knowing how to reach them. For our pediatric dental practice, connecting with parents and children in a cost-efficient way was crucial. At the time, social media and community events emerged as the most effective channels to engage our audience.
5. We learned from our mistakes. As I mentioned earlier, we learned business through trial and error, and we certainly made our fair share of mistakes! Embracing a growth mindset meant acknowledging that not every initiative would succeed and that failure was part of the journey. For instance, when we initially marketed our practice, we invested heavily in billboards along busy freeways and advertised on radio. While it sounded like a promising strategy, the costs were steep, and the return in new patients was underwhelming. In contrast, social media advertising proved to be far more effective, yielding an exceptional return on investment. Which leads me to my next point….
6. We reiterated what worked. When an idea was tested and received positive results, we often doubled down and continued along that path. For example, social media ads turned out to be a game-changer for us, so we allocated almost 80% of our marketing budget to this initiative. The return on investment (ROI) was remarkable, playing a significant role in driving our early business growth.
7. We listened to our team members. One of our guiding principles was to be humble and approachable. There was no hierarchy, no bureaucracy, no formalities, no one working in silos, and we checked our egos at the door. Everyone, including my wife and I, went by first names, and we operated with an open-door policy for anyone who wished to discuss any issues. When challenges arose, we organized ad-hoc meetings to openly address the concerns, inviting our team to share their honest opinions and suggestions for improvement. Our mantra was, “There are no bad ideas in a brainstorming session.” We encouraged a judgment-free environment where the best ideas could be implemented, regardless of their source.
8. We took the time to create operational systems and processes. One of the biggest causes of frustration and anxiety within an organization is team members’ uncertainty about how to perform certain tasks, what is expected of them, and whom to report to. To address this, we meticulously outlined every operational process in our business—from greeting patients to submitting insurance claims—ensuring that our team clearly understood our expectations and how to execute their responsibilities effectively. This initiative streamlined our operations, eliminated bottlenecks, and enhanced overall efficiency. As a result, our team was happier and it also significantly improved the patient experience.
9. We made it a priority to train (and retrain) our team members constantly. Employee training is vital for maintaining high team morale. While developing operational processes is important, without proper training, these procedures may end up gathering dust in a manual on a shelf. Whenever a new policy is introduced or a process is modified, it’s crucial that your team receives the necessary training. Additionally, training should not be a one-time event; it needs to be ongoing and regular. As a CFO once posed to the CEO, “What if we train our employees and they leave?” to which the CEO replied, “What if we don’t train them and they stay?” It’s essential to equip your team members with the knowledge and skills they need to execute key tasks effectively and confidently.
10. We implemented strict cost controls. One of the key principles to remember in business is that revenue means little if your expenses are out of control. If you’re overspending, your business will have to compensate for the shortfall through loans or cash investments, which can ultimately lead to insolvency. To prevent financial difficulties, it’s crucial to monitor your company’s finances closely by mastering the profit and loss statement and balance sheet. This was an area we prioritized. Our leadership team reviewed financials daily, and we met with our financial director each month to analyze the company’s financial statements. By maintaining a solid understanding of our financial health, we were able to make informed decisions that positively impacted our bottom line.
In conclusion, starting your own healthcare practice can be an incredibly rewarding endeavor, but it’s far from easy. As a healthcare professional turned entrepreneur, you’ll quickly realize that clinical expertise alone isn’t enough to guarantee success. Business knowledge, strategic vision, and a willingness to learn from mistakes are all critical components for turning your dream into a reality. From understanding financial statements to creating operational processes, every aspect of your business requires careful attention and constant adaptation. With perseverance, a growth mindset, and a solid support system, you can overcome the inevitable challenges and build a thriving practice that not only serves your community but also grows into a sustainable and profitable enterprise. Remember, success doesn’t happen overnight, but with the right tools and mindset, it’s certainly within your reach.
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