Entrepreneurship is a Test of Endurance
Entrepreneurship is more than a professional endeavour; it's a maximal stretch of personal fortitude, especially for healthcare entrepreneurs. While stepping out of the confines of large healthcare systems promises much needed freedom and autonomy, the reality is that it is an unpredictable and stormy sea, full of challenges and high stakes that these caring and high-achieving business owner try to navigate without support. While entrepreneurial innovation requires us to take risks and fail, the people who are admitted to the highly competitive graduate programs to become healthcare professionals are not accustomed to failure and haven't built the resilience required to embrace these necessary learning opportunities.
The Hard Truth of Entrepreneurship
Many of healthcare professionals are drawn to start businesses for more flexibility and choice in the way we work. While this shift toward more control is helpful in reducing some of the factors that put us at risk for burnout, the autonomy of entrepreneurship brings a new set of challenges that contribute to others.
Health professionals, like occupational therapists, physical therapists, speech pathologists, psychologists, and social workers typically receive little to no business education. We're experts in clinical things like CNS, LTGs, and ADLs, but KPIs, RFPs and ROIs are learned while sailing the choppy sea of business ownership. Waves of administrative tasks, marketing, and long client waitlists can transform the entrepreneurial dream into a relentless pursuit, where failure is inherent to the process and can threaten not just profits but livelihoods.
The Internal Struggle
When faced with business challenges and project failures, achievement-oriented individuals like entrepreneurial healthcare professionals tend to internalize problems, questioning our competence and worth. Being high achievers served us in university and in employment, but when the going gets tough, this trait tends to grow into paralyzing perfectionism and self-doubt.
Fail-Learn-Repeat is a healthy process in business, but many of us get stuck at the first step, experiencing experimental project failure as personal failing, blocking the creative problem solving and innovation process. It can also manifest more subtly, in not pursuing helpful collaborative relationships, undercharging, or marketing hesitance.
Self-employed people experience greater stress than employees...
While entrepreneurship is associated with greater stress than traditional employment, it also paradoxically can lead to increased income despite a negative impact on physical health (Cardon and Patel, Is Stress Worth it? Stress-Related Health and Wealth Trade-Offs for Entrepreneurs, 2013). This dualistic nature of stress highlights the importance of resilience and positive affectivity (PA) in moderating these relationships. As the study suggests, "self-employed people experience greater stress than employees, and they experience a positive impact of stress on income despite a negative impact on physical health". This underscores the need for programs that build psychological flexibility, resilience, reflective practice, and a community of support which help in managing stress but also in leveraging it for personal growth and business success.
Embracing Entrepreneurial Resilience as a Requirement
Acknowledging the stressful nature of entrepreneurship is crucial. The next step is cultivating entrepreneurial resilience, meeting challenges with a growth mindset and developing a system that supports your continued growth. Resilience won't reduce stressors but it will change our response to them.
Supportive Community and ACT Skills Come Together for Growth
For several years, I've used Acceptance and Commitment Therapy (ACT) concepts as a framework to build psychological flexibility in my mental health occupational therapy private practice. When internal obstacles to occupational performance arise, integrating ACT to clarify values and change the relationship to the difficult thoughts and feelings that inhibit engagement is very effective, even in the most stuck clients.
In more recent years, I developed an ACT-based group coaching program and mastermind called ACTivate Vitality to support clinicians who are business owners. Individuals have joined the program for a variety of reasons such as support in clarifying business and life direction, taking steps to start a private practice while addressing the unavoidable self-doubt, making adjustments to busy businesses to make them fit their lives and needs better, and to support their social and emotional needs as lone rebel therapists who are charting their own unique path. What they all have in common is an awareness that they needed community, psychosocial skills and business collaborators to navigate the emotional ups and downs of running a healthcare business.
I've learned to not lose my cool amidst chaos. The stakes are high, but so is my capacity to navigate them with grace.
Personal and entrepreneurial resilience has emerged as a major outcome in the ACTivate Vitality community members. At a recent mountain retreat, a few participants laughed with animated statements of agreement when an OT exclaimed, “One of the biggest changes since joining ACTivate Vitality is that I don’t lose my sh!t as much anymore!” As part of a community of heart-centred entrepreneurs, these clinicians learn to apply ACT skills to their business practices, engaging in self-compassionate, reflective practice individually and on mastermind calls. These individuals become less reactive and learn to respond to life and business storms more intentionally, and in alignment with their values and they support each other in doing so.
One healthcare entrepreneur shared, "I've learned to not lose my cool amidst chaos. The stakes are high, but so is my capacity to navigate them with grace." Another reflected, "ACTivate Vitality has shifted my perspective. I now approach business hurdles with curiosity rather than dread." Through this supportive community and ACT-based program, they learn to hold their thoughts and feelings lightly, to act in alignment with their values, and to engage with challenges from a place of curiosity and openness. This generalizes to their roles as parents, partners, and children of aging parents. It results in clearer boundaries and priorities in how they use their time and energy and how they nurture themselves compassionately.
The Role of Community and Reflective Practice
In learning ACT, there is a two mountains metaphor for the client-therapist relationship: The client and the therapist are each climbing their own mountain with their own challenges and, from their own vantage point, the therapist can see things on the client's mountain that they cannot see. In the group coaching setting, there is a whole mountain range of entrepreneurial clinicians looking out for each other from many vantage points, amplifying the effect. The community of therapy business owners in ACTivate Vitality learn from the collective experiences of the community, reminding of learned skills and new applications of the ACT core processes. Reflective practices like journaling and group discussions normalize the challenges and bring humour and compassion to defuse obstructive reactions when entrepreneurial storms arise, fostering a supportive environment for personal and business growth.
Take the Resilient Entrepreneur Quiz - A Trigger for Reflective Practice
Evaluate your resilience as a healthcare entrepreneur with our Resilient Entrepreneur Quiz. The value of this quiz is more in the curious reflection that the questions prompt than in the result so be sure to take notes as you go.
Owning and running a business is challenging, particularly for those of us who are natural helpers and achievers, but with support, new skills, and reflection, we can learn to surf the entrepreneurial storms skilfully.
~Carlyn Neek, Occupational Therapist, Coach, Author, and Owner of Balance Works OT
What do you need to transform from Stressed Survivor to Thriving Therapist?
If you'd like to explore how ACT skills and a supportive community could bolster your resilience in business and in life, please contact Carlyn. Empowering healthcare entrepreneurs to THRIVE without HUSTLE is her passion and she is now accepting applications for the ACTivate Vitality program from OTs, PTs, SLPs, RAs, Psychologists, and Social Workers.