6. How to Build Your Practice, Not Another Job: 5 Critical Mindset Shifts for Practice Owners

You made the leap. You left corporate medicine behind, determined to escape those soul-crushing 15-minute appointments and finally provide the kind of patient care you actually believe in.

So why does it still feel like you're stuck in the same patterns that drove you away in the first place?

If you're undercharging for your services, following outdated "industry rules," or burning yourself out trying to build something different, you're not alone. The real culprit isn't lack of skills or knowledge—it's that you're still thinking like an employee when you need to be thinking like a business owner.

This mental shift is everything. It's what separates physicians who struggle to build sustainable practices from those who create thriving businesses that truly serve their patients and support their own well-being.

In this post, I'm breaking down the five critical mindset shifts that will transform how you approach your practice—and finally help you build the business you actually want.

Employee vs. Entrepreneur Mindset

Before we dive into the specific shifts, let's be clear about something: neither mindset is inherently better than the other. Both serve important purposes at different stages of your career. The key is knowing when to use each one.

As an employee, you learn invaluable lessons about what makes a great (or terrible) boss, you understand power dynamics, and you get to build expertise on someone else's dime. Many successful entrepreneurs actually recommend working for experts in your field early in your career to glean insights about decision-making, networking, and strategic thinking.

But when you're building a business, you need to recognize when employee thinking is holding you back and consciously shift into entrepreneurial mode.

The 5 Critical Mindset Shifts

1. From Industry Standards to Patient-Centered Innovation

Employee mindset: "This is how it's always been done in our industry."

Entrepreneur mindset: "What's the best way I can serve my patients today?"

Physicians are trained to embrace standards and best practices—and for good reason. In corporate settings, everyone needs to be aligned. But as an entrepreneur, this adherence to "industry standards" can actually limit your ability to serve patients effectively.

Take appointment lengths, for example. The industry standard might be 10-15 minute appointments, but you know that's not enough time to provide quality care, get the full story, or avoid unnecessary referrals. As a business owner, you have the freedom to question these standards and design something better.

The shift here is moving from "What's acceptable in the industry?" to "What would provide the most benefit and transformation for my patients?"

2. From Spending to Investment Thinking

Employee mindset: "We have X dollars in our budget. How should we allocate these resources?"

Entrepreneur mindset: "What investments will help grow this business and serve more patients?"

When you think like an employee, expenses feel like spending—money going out with built-in constraints about what you're "allowed" to purchase. But when you think like a business owner, expenses become investments in growth.

This could mean investing in personal development, specialized training, new equipment, or expanding to a larger location. The question shifts from "Can we afford this?" to "What return will this investment generate?"

3. From Belonging to Leading

Employee mindset: "Do I fit in here? Is this culture a good match for me?"

Entrepreneur mindset: "What kind of culture do I want to create? How do I set the vision and lead this team?"

This is often the most challenging shift for new practice owners. As an employee, your focus is on belonging to the tribe: aligning with the organization's mission and fitting into the existing culture.

As a business owner, you need to flip this completely. Your job isn't to make employees feel comfortable or create a "family" atmosphere. Your job is to set clear expectations, create stable systems, and lead with vision.

Many of my clients struggle with this transition, especially when it comes to early staff members who don't work out. The shift from focusing on belonging to focusing on leadership is essential for building a sustainable practice.

4. From Optimization to Experimentation

Employee mindset: "How can I optimize this existing system or process?"

Entrepreneur mindset: "What do I need to test and experiment with to find what works?"

As an employee, you're often given a specific scope of work and asked to optimize it—extract maximum value, increase efficiency, keep costs down. But as a business owner, especially in the early stages, optimization is premature.

You can't optimize something when you don't know what "it" is yet. Do you want fee-for-service or membership models? In-person or telehealth? You need to experiment with different approaches before you can optimize any of them.

This shift is about embracing the messiness of discovery rather than jumping straight into efficiency mode.

5. From Recreating to Redesigning

Employee mindset: Unconsciously recreating the environment you just left.

Entrepreneur mindset: Intentionally designing the work environment you want.

This is the broadest category, but it's crucial. Many physicians who start their own practices unknowingly recreate the same toxic patterns they were trying to escape. They become the terrible boss they just left because that's what they're used to.

Signs this might be happening to you:

• Overworking and never celebrating progress
• Using criticism to motivate yourself or staff
• Poor planning that leads to constant overwhelm
• Feeling like administrative tasks are "beneath you"
• Blaming others when things don't go as planned

The antidote is conscious intention. Take time to identify what you didn't like about your previous environment and actively design something different.

Recognizing When You've Made the Shift

You'll know you've truly embraced entrepreneurial thinking when you start gravitating toward other business owners. There's a recognition that happens and you understand what it's like to be responsible for building something from scratch rather than just receiving a paycheck.

My clients often tell me they prefer working with entrepreneur patients because "everybody cuts to the chase." There's a focus on results and value rather than just costs and constraints.

When you start appreciating the journey other business owners have been on, you know you've made the mental transition.

Remember, this isn't about abandoning everything you learned as an employee. Those skills and perspectives are valuable. It's about being intentional with your mindset and choosing the approach that serves your current goals.

If you're building a practice, embrace experimentation over optimization. Focus on leading rather than belonging. Think like an investor, not a spender. Question industry standards in service of better patient care.

Most importantly, be patient with yourself during this transition. Mindset shifts take time, and it's normal to catch yourself falling back into old patterns. The key is awareness and gentle course correction.

Your practice—and your patients—deserve the full entrepreneurial version of you. It's time to step into that role completely.

Have you caught yourself stuck in employee thinking while building your practice? Maybe you've found yourself following industry "rules" that don't serve your patients, or struggling to invest in growth because it feels like "spending money"?

If you're recognizing these patterns in your own practice or have questions about making these mindset shifts, please send me an email to [email protected] or book a free discovery call with me by going to www.amandasabicer.com. Let's talk about how to finally break free from employee thinking and build the practice you actually want.