Why Physician-Owned Businesses Fail

If your business isn't working the way you expected, it's not because you're bad at business. It's because no one ever taught you how it actually works. We were trained to master algorithms in medicine, but when it comes to revenue teams and growth, we were never taught anything. We weren't even told to figure it out. We just assumed somehow we'd know. Like it would magically make sense. But it doesn't. The era of the Seven Figure Physician CEO is here. And it's not about working harder. It's about learning entrepreneurship as a system. The same way you mastered ACLs and pals, you can master the algorithm of building a profitable, scalable business. That's why I recorded the Seven Figure Physician CEO audiobook. Whether you're building a medical or non medical business, and whether your goal is your first million, first 2 million, first 5 million, first 10 million. This is where the journey starts. There is no Calvary coming to save us. We are the Calvary. So. So go get your audiobook now. Www.entremd.com sevenfigurebook and let's rewrite the narrative for physicians starting today. Hi, docs. Welcome to the Entre MD Podcast, where it's all about helping amazing physicians just like you, embrace entrepreneurship so you can have the freedom to live life and practice medicine on your terms. I'm your host, Dr. Umn. Well, hello. Hello, my friend. Welcome back to another episode of the entremd podcast. As always, I am so, so grateful that you listen to this podcast. And I'm grateful that you're committed to your success as a physician entrepreneur. Like, so grateful. Okay, so today I want us to do something that's really fascinating when you look at the data. It talks about 80% of businesses going out of business in the first five years. And for some, this makes them think, you know what? Everybody's right. I cannot be an entrepreneur. I cannot lead a successful business. But the truth of the matter is, when you look at the number of people who get into medical school, the overall acceptance rate is about 7%. So what that means is 93% of people who try to become doctors who start that process don't. Okay? And so if you think about it, you've overcome greater odds. This did not stop you from going to medical school. This did not stop you from being a doctor. So what if, as physician entrepreneurs, if it is on your heart and you're like, I really want to start a business. I want to build out my brand. I want to take control of my financial future, how about you decide, you know, what, the odds were worse for med school, and I overcame those, and why don't I just do it again? Like, the odds for this are even better. Okay. And so on this podcast episode, I'm going to be talking about why 80% of businesses fail in the first five years. But the thing is, I don't want you to listen to it as evidence to decide not to become an entrepreneur. I want you to see what some of the roadblocks are, and you can decide, okay, I know about that. I'm going to overcome that. Right? Okay, so let's get into this. And I will say this is based on my observation, after coaching hundreds and hundreds of, you know, physician entrepreneurs and even entrepreneurs outside of the physician space. This is based on my own experience having built multiple very successful businesses. And so this is my opinion. Okay? So this is my opinion, and I was going to say take, you know, like, you can choose not to listen to it, but I really hope you listen. Okay. All right, so let's talk about it. I want to give you five things, okay? So five reasons why they fail. So the first one, and I'm really going to be speaking to you as a physician like this. This is the thing. These are the things I've observed in the physician community. The first one is the thought that hard work is not required. Hard work is not required. I cannot tell you how many people I've spoken to. They are entrepreneurs, and they're just like, I don't get why it has to be hard. And I mean, there is work required. There is hard work required. That does not mean that you don't have a life. That does not mean that you now have a hard life. But one of the worst things you can do as an entrepreneur is stay in resistance, right? Like, I don't get why this is hard, this shouldn't be hard and all of that, because it will require hard work. And I think the bigger pain is being in the frustration of the fact that it requires hard work, right? Like, it's kind of like being in medical school, and you're upset that you have to study, right? Or you being in labor and delivery and being upset you have to push out the baby. Like, once you come to terms with the fact that this is hard work, it actually becomes easy. Because I've had this. I've been thinking about this, right? I'm like, entrepreneurship is hard work, but I don't feel I'm having a hard time. You know what I mean? Like, I. I'm enjoying my Life as an entrepreneur. I'm enjoying being an entrepreneur. There are, there's hard, you know, there's hard work, there are disappointments and things that will discourage you, all of those things. But overall I am enjoying the journey. And so I started thinking like, what is it? It doesn't have to be hard, but it requires hard work, right? Like once you embrace that and you're like, okay, it requires hard work. This is what is required. I'm going to do it. The second you accept it, everything becomes easier. It's really, really, really hard when you're fighting the fact that hard work is required. Okay, so hard work is required. And I'm not going to list all of them, but I want you to think about it, okay? When it start, when you start marketing, right, There is hard work around that. You're going to put yourself out there relentlessly until you enough ideal clients can find you for your business to serve a lot and earn a lot, right? You're going to sell, you're, you're going to tell people, come work with me. You're going to give them the opportunity to work with you. That can be work. You're going to build a service or a product that is going to give people really great results. That requires work, is going to require work. Even the transformation you will have to experience as an entrepreneur making that transition from physician to physician entrepreneur or even from entrepreneur running a six figure business business to entrepreneur running multiple, six, seven, multiple seven, eight. Each one of those stages will require work. So if you are of the thought process that this should not be hard work, I should not need to work this hard. I have paid my dues as a physician and all of that. It will cause you so much pain and so much suffering and it'll put you in a position where you won't do the work. And because of that, your business will not work. So I'm inviting you to just recognize it is hard work to build a successful business and I'm willing to do the work. The second you get there, everything becomes easier. You're still going to do the hard work, but you feel so much better about it because you're no longer fighting, fighting reality. Okay? So that's number one. Number two is not realizing that there is an algorithm, okay, There is an algorithm for business success. There are frameworks, there are blueprints, there's a strategy that it doesn't matter, matter what time we're in. It is a classic strategy. So it's not a tactic, right? And I'll, I'll give examples of this. It's not a tactic. Some things go and come and go. So there was a time MySpace was a thing, right? There was a time Facebook was all there was. There was a time. Now there's a time where TikTok seems to be on fire. But all of these things, they come and go, right? They come and go. But there is an overarching strategy. So let me give you an example. At the end of the day, a business is an entity that serves a client in a profitable way, right? Like provides services, products, all that stuff to a client in a profitable way. And so when you look at strategy, there's a strategy of how do I attract people who don't know about me? How do I get them to know, like, and trust me? And how do I get them to say yes to working with me? How do I serve them in such a way that they keep coming back and they keep telling other people around about me? This right here is a strategy that never goes away. Like, this is. It never goes away. Now, you may decide, well, as far as reaching people, like attracting, you may say, I want to use a tactic like organic marketing. I want to use a tactic like paid ads for organic marketing. I want to do it primarily on social media or primarily on my blog or primarily through my email or some combination of all of those. I want to be on Facebook. No. I want to be on Instagram. No. I want to be on TikTok. See, all. All of those are tactics. Those can. Those you can do based on your preference. But when it comes to the strategy, it's not about your preference. That is just what needs to be done. And so I would. I would have people who say, you know, I'm just not comfortable putting myself out there. That's not a decision you get to make as an entrepreneur because it is a requirement. It is a requirement that your business is out there. It is a requirement that you nurture them so they know, like, and trust you. It is a requirement that you have a call to action, so they say, yes, that you sell. It is a requirement that you serve them in such a way that they come back and they ask people to, you know, tell other people to. To come work with you. You don't get to have a preference. Okay? You don't get to have a preference that. That's like saying, you know, cpr. I'm just not about chest compressions. You know, I'm all into, you know, maintaining the airway. You don't get to choose. Do you see what I'm saying so. So when it comes to having a preference, you can choose tactics. You don't get to choose overarching strategy. That has always been. It will always be, okay. So when we pick and choose a strategy, then we're setting ourselves up to build businesses that will not work. Okay? So that's the second thing that I've noticed. Not realizing that there's an algorithm, not realizing that there's a strategy. And many people decided, you know, I'm just not going to put myself out there, I'm not going to sell. If I build it and it's really good, they will come. You don't get to choose. You don't get to choose like it is what it is. That's the nature of the beast. It comes with. It comes with entrepreneurship, right? And so. But I can't tell you how many people I've seen do that. And it just destroys business. You don't get to pick. You can pick the tactic, you cannot pick the strategy. The strategy is a strategy. Now, somebody will be listening to this and say, yeah, but you know, with my business, I didn't have to sell, right? The business just worked. Now we're not talking about flashing the pan businesses. We're not talking about businesses, you know, that succeed for a year, two years, three years, five years. We're talking about businesses that will succeed for the long run. And you want to build something, you want to build your business from the ground up in that way. Okay? You want to build it like something. I want it to be here 10 years from now. I want it to be here 20 years from now. I want to build it right. I want to build in such a way that I can sell it. I want to build it right. So you may be, say somebody starts a private practice and they start in a really underserved area, so they are the only specialists there. Will they have to do a lot of selling? Probably not. They'll do some, but probably not, right? The question is, are you building a business that can survive if the hospital came and put another specialist in your area? Because you can go from zero, you can go from 60 to 0 right now, not 0 to 60. You can go from 60 to 0 really quick if that's what you do, right? And so you want to build a business that will survive in the good times and survive in the bad times, or quote, unquote, bad times, right? So if there is a pandemic with what you've built, will it work if there's a recession with what you've built, will it work? If there's a great resignation with what you've built, will it work? Because there will be times that are really, really good, and you can get away with, you know, being lazy as an entrepreneur and violating the strategy and violating principles. But the thing is, when those other times come, when the downtime comes, when the shrinking economy comes, will it still survive the test of time? Okay, so we don't want to build businesses that all it takes is one little shaking and it's gone. You want to build businesses that will survive, okay, so you don't get to choose strategy. You don't get to choose. It comes with the territory. I want to be an entrepreneur. Boom. These are the strategies. Okay? All right. So in the entrenched business school, we drill down on those, right? Like, so we have the revenue generation framework, like, end to end. How do I take someone from they don't know about me till to all the way to where they brought me so much business and things like that. It's end to end. Why do we drill down on that? Because it's the mastery of that that puts you in a position where you have what we call revenue confidence. Like, I know how to create revenue in my business. I know how to attract clients in my business. I know how to serve them in such a way that, you know, keep coming back. Okay, so that's number one. So that's number two. Number three. Number three is ignorance of numbers. Ignorance of numbers. I almost call this magical thinking, right? Like, oh, yeah, I'm gonna buy this building for. For my business. And we don't really have the details. We don't know how much it will cost. We don't know how much the mortgage will be. We don't know if our business can handle that, right? We just, like, yeah, because it will be good. I am building this, you know, I'm building. I'm, you know, private practice coming up a lot, but I'm building this private practice. But my patients, I want them to have access to nutritionists, and I want them to have access to a mental health care professional. I want them to have access to this other. So I'm going to hire all these people. I'm going to hire all of them. But you don't. You don't even have two patients. But, but, yeah, but this will be good for them, right? And so there's no concept of what. What are the numbers, right? Like, how many patients would I need to see to make payroll? And sometimes, unfortunately, we have these huge loans that we Take out, right? So it seems like all is well because we're blowing through money that we, quote unquote, didn't work for, right? You have to understand your numbers, you have to understand your profit margin. You have to understand how many clients you have to, have to break even. You have to understand, like, you have to know the numbers. Business is an economic game. It's a numbers game right now. It's not all about the numbers, of course, people come before numbers, but it's like people number one and numbers number two. Like it's right next to people, okay? So you want to know what those numbers are? What are my startup costs? What is my profit margin? One of the mistakes I see a lot of is a massive overhead in the beginning. And I'm like, why don't we grow the overhead as we grow the business? Why don't we start off as lean as possible, right? But you have to understand the numbers. You have to understand how it plays out. Sometimes when you put the numbers on paper, your decision becomes obvious, right? It means I, rather than hire this person right now, I need to hire them in two months rather than bring on this new big expense in my business, why don't we make that a six month project and we're going to do 1, 2, 3 to generate the revenue to cover that, like you, is what will make you think strategically. You have to know your numbers. In the medical world, if we're going to have somebody do a treatment that is, especially if it's life changing, they're going to do chemo, things like that. And even in the minor things like if somebody you're going to do a spinal tap, there is this thing you do. You want the patient to give you informed consent, you want them to give you consent, you want them to make an informed decision. Right? Okay. In the same way in entrepreneurship, that's the same thing, right? But you're not going over the risk and the benefit and all of those kind of things and what the procedure will entail, what you're going through is all the numbers. This is how much we're bringing in, this is how much is going out. This is what the projection is, this is what our profit margin and this is what our overhead looks like. This is how long it will take us to get to even and we start making a profit. This is like, this is the number of clients I need to hit my revenue goal. We must know the numbers. You must know the numbers. The number one reason businesses go out of business is cash flow. Right? And so if Cash flow is the thing. We must understand cash flow. We must understand numbers. We must, we must know all those things. Okay? So that's number three. Number four. Number four is ignorance of the math of business. So it's very closely linked to number three. But I'll tell you what I mean by this. I have a whole podcast episode on it. You can pull it up. Is the. Is the math of business. That's what it's called. And it's, it's, it's very simple, but it is such a game changer. Okay? There are two primary business models, okay, Two primary business models. One model is high ticket, low volume. The other one is low ticket, high volume. So I'll give you examples. So say you were, you have a program, and your program is a $20,000 program that is high ticket. And it means that you have the luxury of having low volume. Okay? You can decide. I want to serve everybody. I want to have 100 clients, right? That's, that's the number that I want to have for the entire year. And I'm good. Okay? Now what you think about it? If you have 100 clients, that's a $2 million business, sorry, 100 people, okay? You may say, you know what, I'm a coach. I just want to do one on one coaching. I just want to have 10 clients. I'm going to charge them 20 each. That's 200,000. You're like, that's what I want. That's all I want, okay? Because I want to spend all this quality time with them. I want to do all of this. Now, if you look at that, right, it does high ticket, low volume, does it work? It works. The math works, okay? The math is nothing. Okay? Now if it's a low ticket thing, right, say I have a product, or I have a course, or I have something, and I'm just picking this number because it's easy to do the math. And it's $100 with $100, right? You have to understand that you're going to have to have volume if you want to hit your revenue goals, okay? Because if you have a hundred clients for $100 product, do the math, that's ten grand, right? So the question is, is that what you want? Right? Probably not. Okay? If you have a thousand, that's 100 grand. If you have 10,000, that's 1 million. Okay? Now I'm saying all that to say this. A lot of times people tell me, I just want to spend a lot of time with my people, and I don't you know, I don't have the time, so I don't want to have a lot of clients and all of this, but I want to price what I do at a hundred dollars or $49 or whatever. I'm like, you can't eat your cake and have it right. Like that doesn't it. That's not how it works. You're high ticket, low volume, low ticket, high volume. You only get to pick one of those two. One of those two various variables. So if you say, you know what my core value is aligned with working with a few people, spending all the time with them, and all of that. So you're saying I want to be low volume, then you don't get to pick the second variable. It's fixed, okay? So if you want low volume, it means you're high ticket, okay? And then if you're like, you know, no, I want. I want something that's a hundred dollars. I want, you know, everybody to be able to afford it all that well. Understand? If you say low volume, low ticket, you're gonna decide to let everybody work with you. You're gonna go for high volume, right? If you want a profitable business, okay? So you must respect the business of math. You cannot choose. It is one variable and one fixed, okay? You cannot make both of them variables. They can't both be variables, okay? So you're gonna pick. What do I want? I want high ticket. That means I. I get to do low volume, right? I probably have to do low volume, or do I want low ticket, Then I have to do high volume, okay? All right? So don't pick. Don't make it two variables. You can't have two variables in the equation. One is variable, one is fixed, okay? But it's a mistake. I see all the time. And again, if you go back to number three and you, You. You. You understand the numbers. You can crunch the numbers. If I'm saying this is what I want to price it at, and I'm claiming that this is what my revenue goal is, how many people do I need to see to pull it off, right? If I say, no, I only want to serve 10 people, but this is my revenue goal, how much do I need to charge to pull it off? Do you see what I'm saying? Okay? So the math has to. Math, okay? That's the business of math. Finally, finally, and I think this is even one of the most important ones is the ignorance of the requirement for metamorphosis. The version of you that exists right now is not the version of you that's going to create the results you want to see. The version of you that exists now has created the results, results that you see now. That's just the way it is. And for every time you choose to up level, right, you are going to need to change. It's an intentional thing. If you think about the way the world works, weed will grow by default. Okay? You get a garden, you don't do anything there. Weed will grow by default. And so for you becoming you, you acquiring vices or you not growing and you know, maybe even getting worse, that can happen by default. But if you're going to see a garden and you have all these beautiful plants, the flowers and all of those things, somebody, when you look at that garden, you know, somebody did the work here, you don't go like, wow, I wonder how that just grew out of nowhere. No, you know, someone did the work in the same way. If you're going to become the kind of entrepreneur, the kind of CEO that runs the kind of business you are dreaming of, you're going to do that intentionally. You're going to set a goal. This is what I do. I'll give you an example. I said, okay, I want to build a multiple seven figure business. What version of me do I have to become to pull that off? And then I pay the price to become that version of me. You see what I mean? And then once I do that, then I start, you know, I start thinking like that kind of person, I start acting like that kind of person, start getting those kind of results. There's internal work that needs to happen first. And so metamorphosis, it's required. And you know, I'll tell you this because this is, this is my story. And you, you'll say if it resonates with you or not. I didn't realize how much I fought to be the version of me, to stay the same version, right? Like when thoughts would come, I fight the thoughts. This was, this was happening in the, in the background. Like it's not something I was aware of but you know, I'm fighting thoughts. I'm like, yeah, I don't do stuff like that. And you know, all of that. And one day, you know, I think I've talked about this on the podcast while driving to church and this thought just came to me. If you produce on the outside who you are on the inside, if there's a match up there, if that is true, then if you truly want things to change, your business to be better, right, you to be better at leading your staff you're producing better results and all of that. Doesn't that mean that you're in like the way you see yourself, the way you think, like, you need to change. And I thought about, I was like, yeah. And then, so, so then it was like, so why do you fight for your current thoughts? Like you should constantly be looking for how to upgrade the way you think up level, the way you think up level, all of that, right? Like it's something you should fight for daily, knowing that the more I up level my thoughts, the more up level the way I reason, the more I up level the way I see myself, the more everything else on the outside changes. Right? And so that took me on. So that was the first time became aware of how much by default I just fight to keep my thoughts the same. If somebody told me I was doing that, I'd be like, of course not. I'm always trying to get better. No, no, like new thoughts, the first things. Yeah, we don't do like all those people, like, you know, all of those things. I started fighting every single day to up level the way I think. Right? Knowing that the ripple effect shows up everywhere. So as an entrepreneur, metamorphosis is required. The way you think now has produced the results you have now. The only way to have new results is to change the way you think, right? So these are five things that I pulled up and these are things that I've noticed like with the metamorphosis. So many people that just go, they open a business like, okay, I'm a coach or you know, I'm a, I'm a private practice, this owner, I'm a, I'm a paid speaker and things like that. But they haven't made any journeys on the inside. They just made a decision like, hey, this is what I'm going to do. And I'm going to take all the old skills, all the old ways of thinking, all of that, and bring it into this new entity. I cannot tell you, I cannot tell you how that does not work. You know what I mean? It just doesn't work. People that decide, oh, this is my year, I'm going to do multiple seven figures. But their operating system is the operating system of a multiple six figure business owner, right. Which creates nothing but, you know, heartache, burnout, frustration, because you have to evolve. You really do have to evolve. And so I share this with you because I, I really hope that you would look at this and you're like, oh, look at all this opportunity, all this opportunity to switch some things up and Set myself up to be that person who's building a business that will thrive in the good times and the bad times and continue to crush the milestones that I have. Continue to serve my clients at the absolute highest level. Become a category of 1 in my industry. Become a trailblazer in my industry. Because you can. But you just need to know, okay? All right? So I want you to embrace these five things. I want you to do a little audit, you know, like, come to Jesus version. Like, you're honest with yourself, okay? And this piece is. Is not for everybody, right? But if you truly are committed, like, I am going to get this stuff done, please hear me when I say this, okay? I want you, even if you're like, I'm not entirely sure, I want you to book a call, okay? I want you to book a call with one of our business strategists to see if the on trendy business school is a good fit for you. And the reason why I say that is because the on trendy business school is designed to help you avoid these pitfalls. We will talk to you about hard work, okay? We talk about it. We will talk to you about the strategy all day, every day. We're not into fads. We're not into new, exciting, shiny things. We are into the timeless strategies that always work, okay? We will always hold you accountable to your numbers. In fact, in the on trendy business school, we chose starting 2023. We chose to live 90 days at a time. So we have our 90 day sprint plan. This is what. These are my top three goals. One of them must be revenue. Okay? So these are my top three goals. So let's reverse engineer that. What does that mean? What do I need to do? Where? Whose help do I need? Like, we reverse engineer it and go after that. So we're working hard. We're working hard strategically. We're doing it in community. So it's not, you know, it's not painful. Because once you start embracing, it is not painful, okay? We talk about the math of business all the time, okay? And then it is a place where you will experience metamorphosis. People saying, I don't recognize myself is a normal saying in the entrepreneur business school, where people go from I don't think I can do a business to now I've crossed the six figure mark. And we have people who, you know, cross the seven figure across the multiple seven, and all kinds of things are happening in there. There is a place for you. You don't have to do this by yourself. You don't have to struggle through this. You can increase your odds of thriving as a physician entrepreneur. And you get to see all these entrepreneurs who are literal vision boards. Right? They are evidence of what is possible. In fact, there was a doctor in the school who wrote a post about some wins that she created. And it was so amazing because the inspiration for those two wins were two different doctors in the entremity business school. It didn't even have anything to do with me. We call it the EBS Commonwealth. Right? The Commonwealth is the. Is the wealth of all the combined experiences and wisdom and connections and all of that of the doctors in the group. And so there's a place for you. Okay? So ontramd.com forward/call on trendy.com forward slash call. Go fill out that little intake, get your call scheduled, and let. Let's help you make a decision. Nobody's going to manipulate you or put you under pressure under the call because we are committed to bringing doctors who should be into. In the business school to the business school. The people is a. It's a. It's a fit for the people we're most equipped to serve. Okay? We don't want to bring you in if we're not equipped to help you reach the goals that you want to achieve. So there is no pressure. There's no manipulation. Okay? But I want to invite you to go schedule that call. I want you to get to that point where you're like, absolutely, I should be in the business school. I'm going to be there, or absolutely not. I just love the podcast. I love the Facebook community. I love the books Dr. Una writes. I even refer people to her. I love what she does, but the school is not for me. Okay? Do you see what I mean? We just want to help you to get to a decision. There's no pressure. So entremity.com forward/call now. I'm going to leave you by telling you what I say in the ontremity business school every evening, every Wednesday evening when we do our live sessions. As physicians in this community, we are building the most innovative, most impactful and most profitable business businesses. That's what we're doing. I want you to start thinking about yourself that way. Yes. There's a narrative about entrepreneurship being hard and all of those things, but you can thrive. You defied bigger odds before. Okay, so is it hard work? Yes. Is it rewarding work? Yes. Is it hard work that sets you up? Like, you build your business in such a way that it gives you your time and it gives you financial freedom. I mean, like, it is 1000% worth it. So I invite you to embrace it all. I invite you to keep that picture top of mind, and I cannot wait to celebrate all your successes. Share this episode with another doctor that will thank you forever. And I'll see you on our next episode of the ontremity Podcast. Hey, if you love listening to the ontremd podcast, I want to invite you to join Entre MD On Demand. It is my signature subscription program that gives you access to a library of business courses designed to help you do one thing as a physician entrepreneur, and that is to thrive. Just head out to entremd.com entrepreneur demand and I'd love to have you join us. See you on the inside.