Good Decision/Bad Decision: Being Your Own Boss

Good Decision/Bad Decision

Today’s subject will hopefully be part of a regular series of Monday posts.  As you recall, I recently started Gratitude Wednesdays.  This series will focus on my past decisions to shed light on some financial wins and losses.  My hope is to discover what I did right, and help others avoid my mistakes.  Whether epic fail or triumphant victory, these were my decisions. The topic for today is being your own boss.

Do you work for yourself or do you work for the proverbial man?

Good Decision

There are two major economic models for most physicians.  You can set out on your own, start your own business, hang a shingle on the door, and begin seeing patients.  This was the predominant method for the greater part of the twentieth century.  Changes in compliance and the advent of electronic medical records have transformed the landscape.  Being your own boss has become a lot more difficult.  For this as well as other reasons, most physicians now opt to join a preestablished practice owned by a medical center or other corporate entity.

I have worked in both environments.

By far, the greatest accelerator to my yearly income was moving from being an employee to a business owner.  As an employee, I became very efficient at seeing patients, and very popular in the community.  The problem was, however, that no matter how hard I worked, I would only see a small portion of the newly generated revenue.  Before I got paid, there was a bevy of both non-medical and medical administrators who got their share of the till first.

When I transitioned from employee to owner, my income jumped from X to 5X.  I was neither seeing more patients nor working longer hours, I was simply allowed to keep every cent that I made. There was no intermediary to pay off.

Furthermore, there was no longer anyone telling me what to do.  In my previous job, I was constantly being ordered around: when to work, when to take call, and how to practice.  Being my own boss has allowed me to create a situation where I have complete control.  I have to answer to myself and my patients, no one else.

 

Bad Decision

When I transitioned into my own practice, I quickly learned that being your own boss is difficult.  Running a business is time-consuming.  On top of trying to give excellent care to my patients, I now had to worry about such things as payroll, hiring and firing, and health insurance.

The daily annoyances can be far more than trivial.  And when things go wrong, you are completely on the hook.  You forget to renew your medical license. Looks like someone isn’t getting paid until that is taken care of!

The tradeoff for some is too steep.  In order to be your own boss as a physician, you have to accept that you will spend less time taking care of patients and more being a CEO.  This is a hard pill to swallow, and definitely is not a good idea for someone who is disorganized and doesn’t pay attention to detail.

In Summary

Leaving corporate medicine is one of the best decisions I have ever made.  I was able to pay myself more, gain control of my schedule, and feel the exhilaration of being an entrepreneur.  The cost, of course, was time and anxiety.

When you strike out on your own, you take a risk.  There is no way to predict the troubles that will befall you once you become the name and face of a business.  This is the choice you make when you take full responsibility for your work life.

I would be interested in hearing from physicians and non physicians who have struggled with this issue.  Did you go into business on your own?  How has the experience been?  Would you do it again?