Common Pitfalls in New Practices: #2 Pitfall When Starting a Medical Practice
By Dr. Ugochi Okoroafor, Board-Certified Orthopedic Surgeon |Owner, Niche Hand Surgery and Orthopedics
Your Name Is on the Door. But Are You Really Running It?
You opened your own practice for a reason. Freedom. Autonomy. Control over how you care for patients. The chance to build something that reflects the kind of medicine you actually believe in.
But here's what I've seen happen to a lot of physicians: it's surprisingly easy to slip back into an employee mindset even when your name is on the door.
You hand off the "business stuff" to a consultant, a spouse, or an office manager. You tell yourself you'll circle back to it when things slow down. They never slow down.
That's how physicians lose control of the practice they worked so hard to build.
How to Truly Own Your Practice
Ownership is not simply a title. It's a set of habits. Here's what has kept me grounded as the owner of Niche Hand Surgery and Orthopedics:
1. Know Your Numbers
Review your revenue, overhead, and collections every month. Not once a quarter. Not when your accountant flags something. Every month.
If you don't understand where the money comes from and where it goes, someone else is effectively running your practice. You do not have to be a CPA. You do need to be able to read your own financials.
2. Stay Close to Operations
You don’t have to do everything, but you should know how everything works. Scheduling, billing, credentialing, staffing, patient intake, etc. These aren’t someone else's problem. They directly shape what patients experience when they walk through your door.
3. Make the Hard Decisions Yourself
Vendor contracts. Hiring. Firing. Pricing. Insurance participation.
Delegating tasks is smart. Delegating accountability is dangerous. The final decision on anything that affects your patients, your team, or your bottom line belongs to you.
4. Protect Your Vision
Your practice should reflect the kind of care you want to deliver. Consultants, partners, and well-meaning staff will all have opinions about what you should change.
Listen carefully. Then decide. Don’t let anyone quietly reshape your practice into something you did not sign up for.
Ownership Is a Daily Habit
I started Niche Hand Surgery and Orthopedics because I wanted to practice hand surgery the way I believe it should be practiced. That vision only survives if I show up for the business side of it the same way I show up for my patients.
Owning your practice isn’t a one-time thing. It’s a daily habit of staying informed, staying involved, and making the decisions only you can make.
If you are a physician thinking about going independent or already there and feeling like your practice is running you instead of the other way around, now is the time to take ownership.
Stay tuned for Pitfall #3. Next, we will talk about the risks of overhiring and how growing your team too fast can hurt more than help.
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