As an entrepreneurial doctor starting out, you face a few challenging choices.

  • Firstly what is my ideal medical niche?
  • Secondly how do I position myself in terms of products/ services,pricing and image .
  • And finally where shall I practice, and is my current location acceptable for my new plans?

Consider building your business to be rather like planting a fruit tree. It takes years from planting a tree, watering it, tending to it, nurturing it and protecting it until it starts producing edible fruit. When it does do so, it’ll continue to produce harvest after harvest of fruit for year after year. At this stage, your colleagues , friends and neighbours will be envious of you.

But it will all be unnecessarily hard work if you dislike that particular type of farming. Nor will it be of much help if that type of fruit is not in demand locally . Or if you are selling high quality fruit in low quality packaging, or vice versa. And it won’t do you any good if you have to uproot and transplant that tree halfway through because the soil you chose is barren or the climate is unsuitable for that particular crop. Plan well, so you get it right first time.

Fortunately, in medicine, you don’t have to get it absolutely correct straight away, because your clinical skills, and business skills will always be transferable. And the good news is that you will succeed even if you don’t get it quite right, or change course somewhat. But you cannot change completely without having to start all over again from scratch- a monumental waste of time.

Firstly, be aware that even if you get it half right, you’re very likely to be successful. A good doctor, supplying an ethical and desired medical service, in an ethical and high-quality manner, is almost guaranteed to succeed. But you do want to be very successful, and do so relatively quickly. If you get things largely right, this will happen, but it will still take time. Changing courses will take you much longer.  So you don’t want to be changing niches, positioning or practices.

The Goal for All Businesses:

Understand this – the desired end result of your ventures, your goal, is to have a successful business comprised largely of  repeat and referral customers (the Holy Grail of all businesses). For this to happen, these patients need a consistent,reliable and quality service and product. So it is important that you don’t change course too often or too radically. This refers to your product, your positioning, and above all the place you practice. You really do not want to have to start all over again. So select your choices with the end in mind, and think long, think bigger.

Firstly, what sort of fruit do I like growing?

You do need to think very carefully about your long-term end business. What is the product or service that you most want to be associated with? What is the sub specialisation of medicine that you could happily practice for many years, and avidly read, research and study for a large chunk of your forthcoming career? This is the most important question, so , if you haven’t already done so, read our Select My Niche Action Plan.

Secondly, what sort of people will buy my fruit? Where do they live and shop?

Secondly think about your positioning. Positioning simply refers to your place in the market spectrum – your image, your pricing and the strata of society that you are going to be dealing with.

Are you going to be a Hyundai, Ford, Toyota, Audi, BMW or Rolls Royce?

Generally, you should be aiming for a medium to high quality niche and positioning- i.e the middle to higher range. This will give you the margins to pay your overheads and still make a decent profit. Don’t go too upmarket, however, there simply aren’t that many Rolls Royce buyers out there, and they tend to vanish during economic downturns. The final alternative, a low price high volume service, is very difficult to deliver for most small businesses, and private medicine is no exception. And it is unlikely you will want to be practicing this sort of medicine anyway.

Now, a final  important note. Your future patients have to be people you identify with, and empathise with. Furthermore and just as importantly, these people will have to identify and empathise with you. Life is simply too short to work with people or niches that you do not like or empathise with, and in any case you’re unlikely to be successful if you practice with patients who don’t suit you.

Where will I plant my tree to maximize my chances of survival and harvest?

Location, location, location. In real estate, you can change much about a house, but not its location. Private practice is similar, patients will not travel too far to see you, or attend a doctor in an area they are unfamiliar or uncomfortable in. And if you move, they will likely not follow you too far.

Think about the place that you will be practising. This refers to the town, the suburb and the premises in which you will open your private niche practice. Is this a good long term decision?

To some extent your niche and positioning will select that suburb for you. If not, this is where you’re going to have to be brave, and think long.

Whilst it is very tempting to set up your niche business exactly where you currently are, ask yourself – will  this location limit my success in this niche? If so, you may need to think about changing practice, town, or suburb. Or in some cases even country, although I don’t recommend the latter!

The temptation will be to model your product, your positioning, and the place you practice to suit where you were at present. And, if you can get away with this, this will be the easiest short term option. But, it may not be the best option for the long haul. Not all areas can sustain a private practice. It needs the appropriate socio – economic mix for your niche.

Remember it takes a few years to truly build up a successful niche private practice. You do not really want to find out halfway through this, that you are in the wrong place, and have to start all over again. Whilst you, your clinical skills, your business skills, and experience will be transferable, in most cases your patient base will not. The goal of this exercise is to create a large group of patients who are repeat and referral patients, who come to see you regularly, and recommend the friends and family to you. That is what all businesses in the real world are chasing as their goal.

For those of you who are still unsure of their niche, unsure of their ultimate positioning, and maybe in the wrong place for their chosen niches, don’t fear  too much just yet. Treat everything as a practice run and just get started. Repeat, just get started. Because it is better to get started, than to allow the long term implications of decisions to delay you for too long or block you from making any move at all.

Pick your medical niche well,and take your time doing this. Then build up your clinical skills and experience. Do not worry too much about your current practice or initial image or positioning. Consider it to be a test run. Much better this way than not to start at all. You may have to adjust your marketing positioning or move premises or areas at least once.

Your Niche: I would suggest you pick your niche carefully. Use our Select My Niche guide to help you match your skills and interests with what patients are likely to need and pay for out there in the real world.

Your Positioning: A medium to high quality positioning will rarely go too far wrong, and can be tweaked as you proceed.

Your Premises and Location: Ideally, you are already in an area where your new niche can thrive. If your current practice is not in such an area, do still start, as a trial run. If it becomes evident that your passion and career lie in this direction, then success is inevitable. At this point, your final choices will be that much more obvious too. You can re-evaluate your practice premises and location with much more certainty.

Think Long

Most people overestimate what they can achieve a short period of time and underestimate what is achievable over a longer period. As a doctor starting an entrepreneurial venture you’ll be no different. So think long, and get started.

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