In response to my question of "What is your biggest question about starting a business?", a physician whom I shall call Dr. C. emailed the following to me yesterday: "How to manage time of what would seem to be a time-consuming commitment while still in a busy medical practice?"

Well, that certainly is a legitimate and difficult question, and since I suspect it reflects one of the concerns many of you share, I decided to answer Dr. C's question in a blog post.

At the heart of my answer is the idea of passionate commitment. You have to really want to do this!

You have to long to either create an exit strategy from the current life that is no longer satisfying you, or to heed the siren call to express your creativity and experience the stimulation of building a business.

For any busy doctor to contemplate starting a business or revamp a medical practice to be more entrepreneurial, you will need to carve out three kinds of time - Thinking time, Planning time and Doing time.

Thinking time - this is the time devoted to brainstorming, mindmapping, schmoozing with colleagues and friends to test out vague ideas, doodling, doing Internet or offline research, and daydreaming. You are setting out to answer the question of "What?"

Planning time - this time is spent mapping out business and product/service production processes, setting up systems, figuring out what to delegate, filling in spreadsheets, consulting a CPA or business attorney, designing and producing prototypes, pricing products or services, writing business plans, creating marketing plans, and having someone design logos and websites. This time you are answering "How?" 

Doing time - no need to explain this one! During this time, you might be filing forms for your business name, approving a website design, purchasing supplies, organizing and setting up workspace, hiring staff, setting up your accounting systems, operationalizing your business and marketing plans, and actually delivering the goods.

In most cases, you must do the thinking and most of the planning yourself. During this time, you are not only crafting your idea for a business, but also articulating what the vision and purpose are for your business - what will this business mean to you personally, and what must this business stand for in the world?

The "Doing time" is where you have the most flexibility. Much of the doing can be delegated and outsourced, especially if you make that part of your planning.

So, assuming you are fired up with passionate commitment, how do you find the time? Here are my Top Ten Tips for you:

1. Draw strong boundaries: Time is a fixed resource - we all receive the gift of exactly the same 86,400 seconds per day. You will need to get your values and priorities very clear, so that you can begin to protect "untouchable" blocks of time with well-drawn boundaries. I truly believe the most useful word in the English language is "no". It is also one of the least well utilized with the exception of two year olds! The secret to protecting time is to decide what to say no to - otherwise, by saying yes to everyone else, you are saying no to your dreams. In order to create high-quality Thinking time, you will need to have steel-reinforced fences around the perimeter of your time to avoid distractions.

2. Cut back your work hours: If you were to stop seeing patients 60 or 90 minutes earlier or start later once or twice a week, how much time could you free up? This will only work if you are willing to protect the freed up time.

3. Schedule "appointments" with yourself: I suspect you wouldn't surf the Internet or answer email in the middle of a patient's appointment. So how would it be to schedule appointments with yourself (perhaps in those freed-up times from Number 2) that you handle like patient appointments? No interruptions except for emergencies, no idle procrastination, no socializing unless it has a specific purpose related to the development of your business idea.

4. Cut back your recreational hours: If you were to scan your life a week at a time, where could you cut back on your play time, and dedicate it instead to fulfilling your dream for an entrepreneurial venture? This may seem like too much of a sacrifice to contemplate, and it may not work for you, but it's been my experience that the creativity of fleshing out business ideas has the same recreational and "fun" value for me as going to a movie or hanging out with friends at a coffee shop!

5. Use vacation time or take a sabbatical: Again heresy you might say! And again I argue, it works IF you feel excited and energized by your business idea. What would the impact be on your ability to move your idea forward if you could set aside one or two vacation days a month and spend most of the day thinking, planning or doing? This is what Dr Dunaway did in order to complete the writing of his first commercial product.

6. Develop a process for tackling the tasks: By this, I mean having a system set up that works for you and permits you to tackle a few tasks every day, or every day that you are not on call. If you have time open up because of a patient no-show, one option is to use that 20 or 30 minutes (or 5!) to do some quick and disciplined Internet research, or set up one networking appointment. You'll be amazed at what you can accomplish if you have an updated list of Planning and Doing tasks.

7. Stop wasting time: Please take a moment to reflect honestly on how much time you waste in a day. If you are sincere in responding "none", I don't have much to offer you other than the sacrifices mentioned above.
It has been estimated that we could pay for the care of the uninsured in the US if we were to eliminate waste from our healthcare system. In the same way, you could in all likelihood build a wildly successful business AND stay in practice just by taking all that wasted time and using it efficiently. Commitment to this goal might mean taking a hard look at how you use your spare time, or an even harder look at how you work.

8. Plan ahead for only the next four or five days: Busy physicians have schedules that change frequently. It may be a challenge to plan your next few weeks. However, most people have a good idea of what their next four or five days will look like. What time might you be able to discover and set aside if you were to look ahead at your schedule every Sunday night or early Monday morning and identify those possible "appointments with yourself"?

9. Don't go it alone: As physicians, we're an independent-minded bunch of people - right? In my conversations with successful physician entrepreneurs, I learned from many of the "trailblazers" that a key ingredient for their success was the early recognition that they needed help. Help with thinking - finding a partner or buddy to brainstorm with; help with planning - involving smart business-savvy professionals early; and help with doing - hiring staff as soon as the workload called for it or outsourcing tasks to others if it made financial sense.

10. Remind yourself of your passionate commitment: No matter how willing you are to try any of the above, you will be unlikely to find the time unless you are dedicated to looking for it. if you have a dog-eared, rumpled and very handy list of excuses to pull out with the slightest mention of time, you are not committed enough!
I ask both my clients and myself, when whining that there isn't enough time, the question: "Who are you really kidding about your dreams of starting a business?" or "What kind of wishing thinking game are you playing?" That is enough to sober up any serious entrepreneur!

If any of my readers have other ideas that might help Dr. C., please write them in the comments area (see the Post a Comment section at the top of this article)!

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