Stop Working Your Ass Off to Make Someone Else Rich.

You went through medical school, residency, sleepless nights, impossible shifts, and years of making decisions that affect people’s lives. You earned the right to practice medicine.

So why are you spending your career building someone else’s business?

In the ER, the hospital bills for your work. In a large primary care group, the organization owns the patient relationships, sets the schedule, and decides how much time you get in the room. In an employed specialty practice, your name and reputation bring patients through the door while someone else owns what you helped build.

You get a salary. Maybe a productivity bonus. You work harder, see more patients, take another shift, and wait for the next compensation review. Meanwhile, the practice grows in value because of the care you deliver.

If you love that arrangement, stay. But if you spend your drive home thinking about the practice you could build, I have a question for you:

What is actually stopping you?

You tell yourself you need another year. A little more savings. A better market. One more conversation with a banker. You can find a reason to wait every year for the rest of your career.

At some point, the obstacle is you.

That is uncomfortable to hear, but doctors are used to hard truths. You may have the clinical skill, the reputation, and an idea for a practice that patients would choose. What you have not yet done is face the fear of losing a guaranteed paycheck. You have not made yourself responsible for whether the doors open, the staff gets paid, and the patients show up.

You are waiting to feel certain before you act. That day is not coming.

Maybe the obstacle really is capital. Have you spoken to a lender? Maybe it is the business side. Have you found people who can help you build it? Maybe the timing is wrong. How long have you been saying that?

Opening a practice takes money, planning, and work. Those are real problems to solve. But you cannot solve them while refusing to find out what the answers are. Calling your hesitation “being practical” does not make it a plan.

Think about what you ask of yourself in medicine. You make consequential decisions with incomplete information. You take responsibility when the stakes are high. You walk into difficult rooms because someone needs you to.

That courage is already in you. Why does it disappear when the decision concerns your own future?

I am not telling you to quit tomorrow or sign a loan you cannot repay. I am telling you to stop using the existence of risk as an excuse to do nothing. Run the numbers. Test the demand. Talk to lenders. Build the right team and structure. Find out whether the practice you keep imagining can actually work.

Then put a date on your decision.

The physician who owns the practice gets to build its culture, shape the patient experience, and share in the value the practice creates. The employed physician can work just as hard, care just as deeply, and still go home having built that value for somebody else.

You cannot research your way around the moment when preparation has to become action. If the plan holds up, move. Take the loan you can responsibly carry. Take the leap. Build the practice.

The iron is hot. You have spent enough of your life proving what you can do for someone else. Find your courage and build something of your own.

Joe Janssen, Esquire

Janssen Private Counsel