What It Takes To Run A Small Business

What does it take to succeed at running a small business? This is a question I am asked frequently, both by fledgling medical writers and curious academic clients. Here is some advice based on what has helped me be successful:

1.     Work Long Hours. This may be the single most important piece of advice. In my first week in the graduate program at Mt. Sinai Medical School, I attended a student mixer and was chatting with an MD/PhD student who was in her third or fourth year. She asked why I had applied for the program and I gave some rambling, youthful, starry-eyed answer that included a statement about being able to work whatever hours you choose. Suzie smiled sweetly and responded, “That’s right. You can work whatever 120 hours of the week you choose.” That captures what it’s like to run a small business. And when I hear my friends in salaried positions express their envy of my flexible hours, I remind them that my hours, though somewhat flexible, are usually very, very long.

2.     Maximize Efficiency. A corollary to the above. It is not enough to work hard, you also have to work smart. Given the long hours, it is critical to maximize efficiency, especially if you plan on having a life outside of your career. For example, I make sure I always have podcasts loaded on my smart phone pertaining to whatever issue I am trying to master in my business. That way, a wait in traffic or at a doctor’s office is never time lost.

3.     Know When And How To Delegate. Also related to the above, if you work long hours and need to maximize efficiency, eventually you will need to hire help. And if you become very successful, you may need to hire a lot of help. I started out simply by placing a post-it note on my computer screen, stating “Can I delegate this?” I am now so far down that road that I have a small army of people who run my personal and professional life so that my time is freed up for billable hours. The concept of hiring and paying for help was extremely difficult at first for the daughter of can-do immigrant-types, but I have gotten over it. I now gratefully hand over any/all non-billable work to others.

4.     Know when you lack expertise, and hire a person who has that expertise. I once spent several hours one evening tinkering with an online program trying to create a business card, only to come up with a mediocre design. I needed revised cards for an upcoming business trip so I was pressed for time, and I took these unproductive tinkering hours from time I could have spent with my children. Afterward, I realized I knew a talented graphic artist, contacted her, and within a day or two she had a half-dozen gorgeous designs that took her a fraction the time it took me to make a lousy one. Most of my contract workers make less than I do per hour, so if they free up my time to bill, the math is rather straightforward in terms of the value added. But sometimes I hire people who make more than I do per hour because I lack a critical skill. For example, I came to this field as a medical researcher, and freely admit I know nothing about running a business. I hired an outstanding business coach early on, on the sage advice of a successful acquaintance. My work with her continues to be one of the greatest assets to my professional life.

5.     Know How to Hire—And Fire. These are not skills that come naturally to me, nor tasks I particularly enjoy (although my guess is that few people enjoy firing someone.) I don’t have salaried employees but have myriad contract workers: personal assistants, web designer, tech support, bookkeeper, accountant, financial advisor, business coach, graphic artist, contract writers, project managers, and others. In addition I am contacted almost daily by recruiters and medical writers interested in contract work. How do I make decisions about hiring and firing? Simple: I ask my business coach. She has helped me develop the rubric for identifying promising candidates from duds, and helped me develop a questionnaire for interviewing people—contract writers in particular.

6.     Choose Great Health Insurance, Save For Retirement. I have spent most of my professional life working in and around medical centers. One thing I have learned is that if you become gravely ill, you don’t want bad health insurance. So even when I was starting out in this business, I paid for high quality health insurance (you can do an internet search to find comparisons and ratings of different health insurance plans.) There was a time when my health insurance premiums accounted for over half my net income each year (thankfully that day has passed.) In addition, from day one, I auto-paid every month from my checking into my retirement accounts. Always make the maximal contribution to your retirement, both in the form of a Roth and whatever self-employed retirement program you choose. These should be the first two expenses you list when you create a budget. Build your budget around these expenses, even if it means drastic cuts elsewhere. And while you are at it, pick up some disability insurance, and make sure you have six months salary in the bank. Yes, really. Self-employed folks have no benefits, so you need to create them. It is completely, totally, non-negotiable.

7.     Be Disciplined. My first semester of college, my roommates were just coming home from partying when I was getting up for my early morning chemistry lab (an elective—I had no idea why I was taking it, other than I found it interesting.) I have always had an enormous amount of discipline and was always a self-starter. I have no difficulty whatsoever facing an unstructured day and filling every minute with productivity. But I know a great many intelligent, motivated people whose businesses hit the shoals because they lack this sort of discipline. Be honest with yourself. If you are not a disciplined self-starter, consider whether running your own business is right for you.

8.     Get Organized. Related to being disciplined. This is where a little OCD can be a beautiful thing. My brother’s college roommate took the most impressive class notes I have every seen, they even rivaled mine and my brother’s. Bob’s science notebooks looked like well-organized little masterpieces, each page numbered and items cross-references. This careful note-taker went on to become a successful cardiothoracic surgeon, and I sometimes wonder if his notes in the medical charts are as beautiful as those college notebooks (realistically, probably not, given what most doc notes look like.) That said, surely his level of organization has helped him tremendously in a challenging career path.

9.     Take Risks. Risk-taking is enormously important if you are going to be successful. And by risk, I don’t mean living without good health insurance or not saving for retirement. You must have nerves of steel and be willing to take chances, even big ones, when a situation requires it. I once gave up lucrative contract work because the situation had become exploitive—even though that work at the time comprised 70% of my gross income in the previous year. That difficult decision made for some sleepless night, but it turned out to be a very smart move, as it led to the gross earnings in my own business quintupling the following year.  Actually this topic is so important I think I will write a separate blog post on it.

10.  Love what you do. None of the above is viable unless you are passionate about what you do. I absolutely adore my work. If I could have been paid to go to school forever I would have done so. This is the next best thing. I have a very low tolerance for boredom and I find my clients’ work endlessly fascinating. I love to learn about the clever ways that smart people are trying to help others (it’s the opposite of the discouragement of reading the morning paper, where you read about terrible people who are doing unspeakable things to hurt others.) My clients are almost universally passionate about their work. God knows they don’t go into medical research or public health for the money and job security. And I enjoy getting to know (almost) every one of them, and learning about why they are passionate and what intelligent approach they have to a pressing medical concern. Thankfully, although I have no business background, I find that I enjoy running a business a great deal, far more than I ever thought I would. And I find I am rather good at it (or at least, my excellent business coach makes me look good at it.)

If you think you have what it takes, why not consider the possibility of running your own business? I never thought I would be a small business owner, but now it is difficult to imagine living another way. It has brought me a great deal of happiness and satisfaction.

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