What it Takes to Be a Clinician Entrepreneur: Lessons from the Field

Have you ever thought about clinician entrepreneurship?

I left the Department of Veterans Affairs several years ago with a laptop, a consulting contract, and more questions than answers. What followed was a crash course in everything clinician training never taught me: sales, marketing, tax structures, business development, and the relentless challenge of building something from nothing. Today I run both a multidisciplinary PT/OT clinic and work as an independent healthcare consultant, and I get asked regularly by practicing clinicians how to make the leap into entrepreneurship. This article is my honest answer.

Whether you’re thinking about opening a private practice, launching a consulting service, or expanding into non-clinical work, here’s what I’ve learned about what it actually takes — and what the field rarely talks about.

The Skills Clinical Education Didn’t Teach You (But You’ll Need)

Let’s be honest: most clinical programs do an excellent job preparing you to be a clinician. They do not prepare you to run a business. When I went out on my own, I quickly realized I had no framework for direct-response marketing, writing sales copy, or closing a deal. None of that was in my curriculum.

The non-clinical skills that matter most:

Risk tolerance — You won’t have a guaranteed paycheck or a schedule handed to you. You need to be comfortable sitting with uncertainty.
Self-management — No one is telling you where to be or what to do. Time management becomes your most critical daily practice.
Sales and marketing — You are the marketing engine, the sales engine, and the delivery engine, especially early on.
Value communication — The ability to confidently articulate what you offer and why someone should pay for it is foundational. This gets easier as your marketplace acceptance grows, but you need to develop it early.
Interpersonal connection — I’ve found this to be the single biggest driver of my business growth. Being a connector — someone who links people across networks — generates referrals and opportunities that no ad campaign can replicate.

My OT program did not teach me a whole lot about direct response marketing, sales copy, or the process of closing a sale. You have to learn that on your own.

What Makes an Healthcare Business Actually Successful

A lot of clinicians think about building a practice in terms of clinical quality — and clinical quality matters. But it won’t keep the lights on by itself. From a pure business standpoint, there are two things that determine whether an healthcare practice thrives or struggles:

1. Revenue Diversification

If your only source of revenue is you in the clinic providing direct OT services, you are vulnerable. What happens when Blue Cross Blue Shield drops their reimbursement rates? What happens when you get sick? You need to diversify your revenue streams and your payer mix early. That might mean group programs, digital products, consulting services, or other offerings that don’t require one-to-one clinical time.

2. Business Development + Client Retention

Every successful business lives or dies on two things: getting clients in the door, and keeping them. On the front end, that means understanding lead generation, marketing, and sales. On the back end, it means recognizing that much of what we do as OTs — behavior change, habit formation, functional improvement — is exactly what drives long-term client retention. We’re better at this than we often give ourselves credit for.

How I Actually Developed Business Skills: The Real Answer

I didn’t take an MBA. I called a friend.

When I was leaving the VA, I reached out to a friend who had been running a marketing agency for several years. Over a beer, he gave me a practical framework for structuring my business and handed me a reading list. That conversation was more valuable than any course I could have taken.

From there, I intentionally built a network of local entrepreneurs — none of them in healthcare — who were running small businesses with somewhere between zero and twenty employees. We met informally for Friday lunches, no agenda. But because we were all business owners, it always came up. Those people had already hit the stumbling blocks I was about to hit. That network gave me confidence, resources, and perspective I couldn’t have found in a professional association.

I also invested in formal training. I spent eight or nine months with an organization called Win Without Pitching, a sales training program for professional services firms. We covered positioning, marketing, proposal writing, and the mechanics of actually closing a consulting engagement. It was eye-opening and had a direct impact on my revenue.

A rising tide lifts all ships. There are more people who need OT services than there are clinicians to serve them. Competition in healthcare is less zero-sum than most people think.

The Financial Mistake I Made Early (So You Don’t Have To)

In my first year of consulting, I came into a large chunk of revenue quickly and had no framework for handling it. I paid around $15,000 in taxes I didn’t need to pay because I didn’t understand how to structure a business of one — how to properly categorize business versus personal expenses, how to draw a salary, how to set up the right corporate structure.

It was a one-time mistake, but an expensive one. My advice: before you land your first client, sit down with a tax advisor who has worked with small business owners. Not just an accountant — someone who can help you structure the business correctly from day one. The cost of that conversation is a fraction of what you’ll pay if you wing it.

The Challenges Nobody Talks About

Everyone talks about the freedom of entrepreneurship. Fewer people talk about what it costs.

The real challenges I faced:

Losing employer-sponsored health insurance — When I left the VA, I had two young kids. The psychological weight of not having a safety net was significant. It wasn’t just the money; it was the anxiety. Research your options thoroughly before you make the leap.
Work-life balance in knowledge work — When you’re paid on deliverables instead of hours, the temptation to crank out an 80-hour week is real. I did it. It didn’t work long-term. Having an honest ongoing conversation with your partner about priorities is not optional — it’s infrastructure.
The stakes grow with your team — When it was just me, a bad month meant my family felt it. Now I have 12 people on my team. A bad month means 12 families feel it. The responsibility of being someone’s employer is something I didn’t fully understand until I was inside it.

What I Know Now That I Wish I’d Known Then

I’ve been through years of very good revenue and years of finishing in the negative. And the honest truth is that the money — while necessary — was never what mattered most.

What mattered was purpose. There’s a concept in Paulo Coelho’s The Alchemist about every person having a role to play in the history of the world — a personal legend they’re driven to fulfill. I think that framework applies to why people choose entrepreneurship. I left stable employment not because I was chasing income, but because I felt called to play a bigger role than the one I was in. That drive sustained me through the hard seasons in a way that financial motivation alone never could have.

The second thing I know now is about impact. In twenty years, the patient I treated this morning probably won’t remember my name. But the OTs and PTs and support staff I’ve employed and worked with — the new grads who used this clinic as a stepping stone, the team members who have grown here — I’ve had real, lasting influence on their careers and their lives. As a business owner, that responsibility is not just a title. It shouldn’t be taken lightly.

Don’t Think Small About What Clinicians Can Do

Here’s the thing that frustrates me most about how we talk about clinician entrepreneurship: we almost always frame it as private practice ownership. Open a clinic, build a caseload, grow your practice. And that’s a great path. But it’s one path.

I’ve worked with clinicians who are consulting with SaaS companies. Clinicians advising organizations building out EMR systems. Clinicians doing organizational consulting for healthcare systems, policy work, operations. I recently signed a client building an EMR platform — they’re not hiring me because I’m a great clinician. They’re hiring me because I understand how healthcare systems work and how technology fits into them.

Your clinical education, like I received in my Occupational therapy program, gives you a lens for understanding how people function within systems — physical, cognitive, environmental, organizational. That lens has value well beyond the clinic. Don’t let the conversation about clinician entrepreneurship stop at private practice ownership.

If You’re Thinking About Starting: Two Questions to Answer First

Before you get into business structure, branding, or any of the logistics, answer these two questions:

What is your reimbursement model? Cash pay/private pay, out-of-network, or traditional in-network insurance? This decision will shape almost every subsequent business choice you make.
What is your secondary revenue stream? Clinical services are necessary but fragile as a sole revenue source. From day one, think about what you can offer that doesn’t require your one-to-one clinical time.

Final Thought

Entrepreneurship in healthcare is not for everyone, and it shouldn’t be. But if you feel the pull toward it — if you’re sitting in a salaried position thinking there’s a bigger role you’re capable of stepping into — take it seriously. Build your network outside of healthcare. Find an accountant before you think you need one. Invest in learning sales and marketing. And don’t let anyone tell you that clinician entrepreneurship has to look like a private practice.

The field needs clinicians thinking in a lot more places than the clinic.

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I help healthcare startups, SaaS platforms, and forward-thinking provider organizations develop clear positioning strategies, identify high-value offers, and build go-to-market plans that actually resonate with both users and buyers.

Whether you're launching a new product, scaling an existing service, or navigating digital transformation, I bring 12+ years of experience across clinical operations, healthcare innovation, and strategic development.

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I’ve consulted on projects from multi-million-dollar state initiatives to early-stage product launches. My work’s been featured in Forbes, and I also speak at healthcare events and conferences on topics like innovation, digital health, and humanizing care. I also speak and train at healthcare conferences, events, and organizations on topics related to technology-enabled care, healthcare innovation, healthcare positioning, and humanizing the healthcare experience.

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