Self-Employment: It Takes a Plan to Be Successful

 In Practice Building

Matthew Jacobsen

According to a recent survey of alumni by AANMC (Association of Accredited Naturopathic Medical Colleges), 92% of respondents are practicing in their chosen field of study.1 In addition, 67% of them are self-employed in some manner – independent contractor, earning by commission only, or other.

Unfortunately, the current curriculum of medical school does not have the focus on business that some two-thirds of the graduates need to help them be successful in their self-employment post-graduation. No doubt this is, at least in part, a product of the sheer volume of information that must be covered in natural medicine, combined with the fact that most medical students loathe business-speak about as much as I disliked chemistry. However, I’ve never needed to know Chemistry 101 in my career. When you’re self-employed, though, you’d better know a little more about business than a few cursory classes if you want to increase your opportunity for success.

Start Writing

The best way I know to begin increasing your opportunity for success in any endeavor is to start with some decent planning as the foundation. An important thought to keep in mind is this: if it’s not in writing, it’s not going to happen. Simply put, this means that you have to have a written plan of action to follow as you go down your path of self-employment. In other words, you need a business plan as your foundation. The good news is that you don’t need to be a business major to write a business plan.

In my June 2016 NDNR article, “Starting a New Practice: To Thine Own Self Be True,”2 I wrote about the importance of placing your practice somewhere you would “fit in,” and one where there is enough population and infrastructure to support it. Even if you never articulated that to yourself before, the concept was probably not difficult to grasp. When writing your business plan, you should keep in mind the principles outlined in that article. You will find it is much easier to research, write, and ultimately implement your personal business plan.

Finally, keep in mind that business plans should be in writing but they are not carved in stone. They should be reviewed, amended, and results measured frequently – every 3-6 months – until you get established. Then, perhaps as little as once a year would suffice.

Nuts & Bolts

So, what should your business plan consist of? A starting place could be Googling something like “Core Elements of a Business Plan.” That will get you plenty of suggestions for a template, most of which are fine. There is no singular right way, after all. The important thing is that you get a plan in writing. This forces you to think about what you are doing, why you are doing it, what you want to accomplish, and how you plan to accomplish it. Additionally, SCORE ( and the SBA ( offer business plans that you may find useful.  

The major problem I find with business plan advice on the internet is that it is usually designed for school project business plans or the “take-over-the-world” plans, rather than for the single-person-owned, stand-alone medical practice, or independent contractor. The other problem is that it’s often based on the assumption that the audience is an external 3rd-party (ie, a bank or an investor). This dynamic tends to cause you to lie to yourself by making misleading statements or writing things you think the readers would want to hear. Instead, the goal of this endeavor is to be completely thoughtful and honest with yourself about what will lead to your success, not to sell anyone on your ideas.

Seven Important Tips

Toward that end, the most important factors for you to address, from my perspective, are these:

  1. Start with your goals.
  2. Include a brief description of what you are planning to accomplish, how, and by when. Set at least 3 goals, but no more than 6. Challenge yourself by making at least 2 of them difficult, but not impossible, to obtain. Be brief but specific here, eg, “I intend to be working full-time as an acupuncturist by January 2017,” or “I will have successfully launched my own naturopathic clinic downtown by June 2017.”
  3. Then, list a more in-depth business description. Answer the “who, what, when, where, why, and hows.” For instance:
  4. Why am I doing this, how will I do this, where will I be working, how will I make money doing it, and when will I reach certain milestones along the path?
  5. Know your audience.
  6. Who are the people using your services? Where do they live? How do they find out about you? What motivates them to come back? Patient retention is far more important for long-term success than patient acquisition, yet it often gets ignored.
  7. Know your competition.
  8. Who are they? Where are they? What do they charge? How do they charge (ie, insurance vs cash)? Why do they do what they do? I often see an arrogance of thinking in new entrepreneurs that they are going to do something dramatically different than anyone else, and therefore better. Don’t fall into that trap without the appropriate data to back it up. You may have found that “something” that is unique, but realize only a few people in a generation are actually able to turn that unique idea into something wildly successful. Finally, answer the question of why you are better than, or at least different from, your competition. Not to be confused with my prior statement of uniqueness, this last question is solely a question of geographic location. Doing something proven to be successful “somewhere else” is often a recipe for local success.
  9. Know your village. In other words, determine who will help you be successful in your endeavors, and list them and what they will do to help. For example:
  10. Sales and Marketing companies
  11. Employees, 3rd-party services
  12. Referral sources
  13. Friends, relatives, and loved ones
  14. Address the potential roadblocks in your path to success and how you plan to overcome them.
  15. Realize that profit or increasing your income is not a 4-letter word; if you make no money, you have no mission. As such, you need to answer the question: How will I make more money doing this in the future? Include some basic projections.

I’ll leave you with this: When you review your plan, remember its OK if you didn’t meet all of your goals; they are supposed to be difficult to attain. In fact, if you met all of them I’d say you are not challenging yourself enough.

I would love to hear any comments you might have: [email protected]


  1. Association of Accredited Naturopathic Medical Colleges. 2015 Graduate Success and Compensation Study. May 9, 2016. AANMC Web site. Accessed July 15, 2016.
  2. Jacobsen M. Starting a New Practice: To Thine Own Self Be True. Naturopathic Doctor News & Review. June 2016;12(6). NDNR Web site. Accessed July 1, 2016.

MatthewJacobsenMatthew Jacobsen, Business Operations Provider, has a bachelor’s degree in business administration, and an associates degree in accounting. Over the last 18 years, Mr Jacobsen has developed practical, on-the-job experience in various facets of business, including banking, finance, and healthcare. Prior to launching MTSL Group, he held the titles of Credit Manager, General Manager, and COO in locally-owned, small-to-midsize companies, serving several different sectors.

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