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  • Writer's pictureND-B

Deciding Where to Work

I've been trying to figure out if I should go out on my own or start with a team...

There are three types of clinicians that I learnt about in school

1- The Employee

2- The Associate

3- The Business Owner

All throughout my education, elder NDs advised us to become associates. We should work in a clinic when we are getting started because it decreases our overhead and we can just focus on doing what we love – helping people. One major pro and con: It gives us the freedom to work independently, but there is a cap on your earnings. I hear a bunch about the “time-for-money” exchange and how “it’s not scalable” which I’m sure is true – I mean, all the Business Coaches talk about it – so we should be looking for other options.

Now, in the world of telemedicine, it’s a lot easier to actually START on your own; as an ND, I can start seeing patients from my home, and essentially service all of Ontario. I can set up my own EMR (electronic medical record) and see all my patients virtually in my first year of practice. Naturopathic doctors care most for foundational work and counselling. We talk about lifestyle and diet changes that can be discussed over video or phone and can easily send blood requisitions, supplement recommendations or full care plans online through the confidential EMR platform. If we need to have an in-person appointment, there are systems put in place to do that now – clinical room renting businesses and the like.

The easiest way, however, is to be an associate because clinics offer both in-person and virtual appointments with their own EMR. On top of that, they usually have reception, marketing and a dispensary that you can use for your patients as well; you just have to give them a slice of your pay. Well that’s not all true, I’m being crude. If you’re lucky you find a clinic that is either integrative or with multiple NDs which allows for that sense of community and collaboration – a really valuable asset when you’re starting out. There aren’t that many multi-ND clinics out there but I’ve been lucky enough to find one that I can sign on with. The issue right now is:

Do I want to?

Will this continue to lead me towards my ultimate goal of owning my own business?

I’m going back and forth in my head about the decision. On the one hand, I love the security of having the clinic and a team that I can collaborate with – a way to take some of the pressure off of building a practice and getting my first few patients. I’ve heard from my classmates and colleagues how, only one year in, they are already switching the clinics they work at or working at multiple because they are struggling to make it at one. Business will be slow at the start, I know that, so anything that can speed it up is key. Speaking NOT from a place of scarcity though, this is also a good move in terms of having all the systems in place to easily market myself to the population I want; the clinic owner has already given me some great contacts and I can really see myself growing here – something that the owner really wants as well; less turnover = better business.

On the other hand, I have this incredible idea that I’m developing and have a job right now that allows me some extra time to keep developing it. I’m not in private practice at this job though, and to get some “street cred” and start gaining experience with the people I want to serve I should start seeing my own patients. It will give me a better sense of their needs and how I can create an offer that they want to buy. I’ve also already gone through the leg work to build out some of the Operations necessary to go out on my own, because that was my plan before this clinic kind of fell into my lap… so the only missing link is starting to market to my ideal client and actually starting to see them (as initially planned).

You, reader, might be thinking “well, you could do both? Work at the clinic and keep doing your own thing, what’s stopping you?”. Right now, hours in the day. Later, a contract. Depending on how negotiations go, my ability to do virtual care might be limited. Especially with this clinic allowing me to work from home using their EMR and resources it means there’s no reason why I should have to use any others (of course except, you know, wanting to have my own clinic for my dancers and performers).

My brain right now is trying to convince me that it’s fine and I can sell it to myself as “I’m working at two separate clinics – it’s just, I own one of them…”. We’ll see if the owner of the other clinic is on board with that. Which, I mean, why not, because I’m going to be an independent contractor and it’s a non-exclusive contract.

I’m making this more complicated than it has to be. The most important thing is being confident in my decision when meeting about the contractual obligations. Staying firm and being okay with whatever consequences come from the decisions made.

The next mission, then, will be how to re-manage my time in order to keep developing my business, maintain the duties at my current job and build my practice at this clinic. Time management might be my next post…

The beauty of working for yourself is that you can create your own hours and choose when to work and who to work for. I am currently an employee building to be an independent owner. As long as the contract is right, the associate position could be the best next step…

In Health and Wellness,


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