Medicolegal Issues

Succeed in Business


You may have an idea for a business you’d like to start, perhaps attracted by the prospect of controlling your time and work, chasing extra income, or fulfilling the dream of having an alternate career. Should you try turning your dream into reality—and if so, how?

Philippa Kennealy, MD, MPH, has guided hospitalists and other physicians along this path. She heads The Entrepreneurial MD, a Los Angeles-based coaching service for physicians who want to become more entrepreneurial with their practices or start a side business. She has a unique perspective on how physicians can add a satisfying second career to their practice of medicine. “I myself am a physician-entrepreneur,” says Dr. Kennealy.



Young hospitalists who volunteer for committee work can reap big rewards. “A committee is a good place to demonstrate expertise as you support your statements and positions,” writes Rebecca Parker, MD, attending physician for Centegra Health Systems in Illinois in “A Little Committee Work Goes a Long Way” published online by the American College of Emergency Physicians. “You can learn a lot in the process ... and it also enhances your credibility,” she writes.

Conflict Resolution

Hospitalist leaders must resolve conflict between staff and/or fellow physicians. In his article “Comm­unication Skills Predict Success,” in Physician Executive, George Linney says it’s critical to be able to listen impartially to all sides, help forge win-win solutions, and know when to say, “I have decided.” For example, if physicians are at odds over whether senior members should take less, or no, after-hours call, a resolution might let senior physicians pay younger physicians to take extra call.—JJ

Why Increase Workloads?

What makes busy hospitalists seek a side business? Why overload your schedule with the extra hours and responsibilities of running a business?

“It’s an opportunity to do something that feels creative, that gives you control,” explains Dr. Kennealy. “I feel that physicians don’t get to use creativity, and they don’t have much control. Their daily actions and decisions are quite regulated. Owning their own time is attractive to physicians. Hospitalists in particular are at it all day in the hospital.”

Is it really possible to continue to work as a hospitalist while shaping a second business? Yes—and others have done it.

“A lot of physicians dream of [entrepreneurship] but feel trapped by their existing time commitments,” says Dr. Kennealy. “But there are some who take the necessary steps, who carve out the time to do it. Many of them hook up with someone to form a partnership—often this is with a non-physician.”

Types of Endeavors

Some physicians are interested in a start-up business that goes hand in hand with their patient care; others may go in a completely different direction.

“There’s an enormous array of [physician-owned businesses] out there,” says Dr. Kennealy. “Many of my clients go into consulting, mostly within healthcare. Some have developed a software application that supports some aspect of healthcare.” Other physicians open health and wellness centers. One of Dr. Kennealy’s clients has developed a sculpting business and is ready to open her own gallery.

Lucia Ferreras-Cox, MD, works as an independent contractor in urgent care and hospital medicine while she runs her company, Ejerce Medecina USA, in Gilbert, Ariz. Ejerce offers Web-based training for Spanish-speaking physicians in other countries to help them pass the U.S. medical board review, then serves as a recruiting firm for those physicians once they get their U.S. licenses.

“I went back to business school for three months to refresh my skills,” says Dr. Ferreras-Cox, who previously had a pediatric practice. “I had to relearn—to learn that I was not a not-for-profit anymore.”

Marica Pook, MD, is a full-time hospitalist in Superior, Colo., and president of ExtraMD PC, a company that provides short-term physician staffing. Her start-up was quite simple. “I’ve been a hospitalist for seven years now, and of course part of my job is to call primary care physicians about patients,” Dr. Pook says. “I started thinking about what it’s like for those physicians and how they can get some help when they’re at their busiest.”

She decided to provide that help. In 2004 she used her contacts to start a kind of mini locum tenens job, working for different physician groups and hospitals. “Nine months into it, I started bringing in other physicians,” she says. Today, the business is thriving, with a growing number of local physicians involved, as well as some much-needed staff.

“I have an excellent bookkeeper, who does all the financials, invoicing, and budgeting—almost like a controller,” says Dr. Pook. “And I just hired a virtual assistant last week. I’ve found that it works best when I farm out the calling and scheduling and I just focus on the marketing. And I include talking to the physicians in that.”


"A Challenge for a New Specialty: A White Paper on Hospitalist Career Satisfaction," is available for download at under the "SHM Initiatives" section. The white paper, prepared by SHM’s Career Satisfaction Task Force in December 2006, details the four pillars of job satisfaction. Find more information on guiding your career at SHM’s Career Center ( Browse opportunities and post or view resumes.

Get Started

So how do you begin your transformation from hospitalist to hospitalist-entrepreneur?

“The basic steps begin with identifying whether this is an escapist fantasy or a deep, abiding interest,” stresses Dr. Kennealy. “It will take a deep interest to get you through the difficult times—it’s a real commitment.”

Once you determine you’re willing to invest time and expense in your own business, Dr. Kennealy advises you to assess your skills and acquire any new ones you’ll need. One way is to meet businesspeople, learn how they think, and understand the language of business. You can also study business and marketing books and journals or take business courses.

“I think physicians don’t know how to run a business,” says Dr. Pook. “We’re not trained to do this. What really helped me was a business coach. I’d advise others to either get a coach or get hooked up with someone who knows a lot about business.”

Before you make too deep a commitment, consider an important component. “You need some sense of the marketplace,” says Dr. Kennealy. Who will buy your product or service? Is there enough interest to support your efforts? What is the competition like in your area?

The next step, she says, is to develop a business plan. “There are free resources available at [the Web site of SCORE, Counselors to America’s Small Business],” she says. “As you start on your plan, you may see that you require further analysis. You need to close those knowledge gaps before you start the business.”

And finally, you have to have marketing savvy to make it work. “Wrap it all up in a sound marketing plan,” concludes Dr. Kennealy. “How will you reach your target audience, and how will you do it efficiently? You must learn the art of marketing, and most physicians don’t have a clue. You have to shift your thinking from a physician whose patients basically come flocking to someone who has to attract and keep customers.” TH

Jane Jerrard also writes “Public Policy” for The Hospitalist.

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