11 things I learned in my first year of a medical startup

Early in 2018, I was in what could only be described as a sweet spot.

Eighteen years in medicine working as a GP, GP Obstetrician and GP Anaesthetist had culminated in me taking a role in medical administration while maintaining an anaesthetics practice.

I was Acting CEO of St John of God (SJOG) Mt Lawley and thoroughly enjoying the role. Meanwhile, I was undergoing an MBA, learning everything I needed to embark on a successful career as a healthcare CEO.

For all that studying an MBA while working full-time can be brutal, I felt like I was operating in a nice little comfort zone. My commitments were clear and defined. My career path was clear and defined.

The only problem was, whenever I’m in a comfort zone, opportunities to scratch an itch tend to appear. And so it was that during my MBA, after basing one of my assignments on a new obstetric model, something that had always been in the back of my mind suddenly placed itself front and centre.

Over the ensuing months, I refined the model, using it as the basis for all relevant assignments. And a new path opened up for me — one where that model came out of my mind and became a reality.

So, 18 months ago, I decided to step out of my comfort zone.

I quit my lovely secure role at SJOG and committed to heading up a new medical startup, One for Women. We launched in February this year, and today I wanted to share 11 things I’ve learned so far about heading up a medical startup.

1. It can be hard to communicate your vision

Or, in other words, what’s clear to me is not so clear to others.

It is difficult for existing providers and hospitals to understand why you want to do something different. It’s also often hard to explain what that something different looks like. Many things that were so clear to me proved hard to communicate to the most important people: the patients and the GPs who would be our main referrers. GPs, in particular, battled to understand why they should embrace this new concept. To them it looked like just another GP practice trying to push into their territory. It took six months for me to show we were a complimentary service rather than competition for their existing practice.

2. It is relentless

When you’re establishing an entire clinic from scratch, you never stop thinking about it. You never stop talking about it. As fast as you address one challenge, another will arise. I thought I was eyes wide open regarding how consuming it would be. (I’ve been through medical school after all, and that was pretty relentless!) I had no idea.

3. You cannot have a down day

Everyone involved in your startup will use your mood as a determinant for how well things are going. A bad day for you can send the message that everything is a failure. So even if you’re having a bad day, you have to keep your energy levels up because everyone is keying off you.

4. You have to play the long game

When you have six patients in your first week and 30 in your first month, it’s okay. You have to back your model and resist the temptation to change.

5. You have to pivot quickly

This might seem to contradict point four. And it illustrates how tricky a startup can be. While your vision is what gets you started and what drives you, you must be open to the idea that what you thought would be the best way and what patients want, may not be the case. You have to be willing to adapt, change and evolve.

6. People want to speak to YOU

It doesn’t matter how great your practice manager or business development manager is, if you want people to buy into your vision, you’re the one that needs to be delivering that vision, in person. If you don’t have the time, you need to make time. And, speaking of time …

7. The time commitment is insane

Whatever time you think it will take to commit to establishing your business, double it.

8. You need more startup capital than you think

Whatever capital investment you think it will take to commit to establishing your business, double it.

9. Previous history counts for less than you think

When projecting cash flow and patient numbers, you need to ignore what you have done before. The fact that you have been fully booked for the last 15 years of your life counts for nothing. You are a new practice, with no active word-of-mouth or existing reputation. You’re starting with nothing, and it takes time to establish a patient load.

10. The most important things will always come back to you

There’s a time and place for delegating tasks. And you’ll have so much on your plate you have to delegate tasks. But there will be many times when you’re looking for someone to do something, and you’ll realise the only person who can do it is you.

11. It takes a village

This has been my biggest learning. And it’s a little ironic given the major goal of One for Women is to provide new mothers with the ‘village’ modern-day society isn’t able to offer them.

Every medical entrepreneur needs a village of support. And I’m not just talking about you co-founders, colleagues and employees. Those people are obviously important, but what you most need are:

  • Support people who will prop you up when you’ve had a difficult day
  • People who will push you to keep going when that little light seems a mile away
  • People who will reassure you that you are not crazy
  • People who will forgive you when you are working 40 hours a week on top of your clinical commitments. Who understand why you’re now working harder than you’ve ever worked, at a time where you could be cruising
  • People who will remind you to look after yourself when they see you losing the qualities that make you the person you aspire to be
  • People who will listen without judgement when you wonder out loud why you left something safe and easy to embark on something difficult and new.

Most importantly, however, you need people who ‘get it’ when you achieve the patient outcome that you dreamed of when the clinic was only a concept on a page. People who recognise what ‘success’ looks like and will delight in it as much as you do.

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