Imagine Dr. Fiona. She finished her residency thanks to her hard work and her family’s support, and in the process had to take on some debt. Starting her professional practice already seemed like a steep uphill road. Filled with enthusiasm, fresh ideas, a desire to make an impact on her community, and a clear vision of the practice she dreamed of building in five years, she rented a prime office space, bought the most modern equipment, and furnished it elegantly with the guidance of a top architect.

However, after six months of operation, the office remained empty most of the time. Bills became impossible to pay: high rent, underused equipment, expensive software that nobody really knew how to handle, and not enough patients to cover those fixed costs. Fiona felt her dream slipping away. What went wrong?

This situation is more common than it seems. Many new practices make attractive but poorly thought-out investments that eventually become obstacles to growth. These mistakes are recurring, and it’s worth taking a closer look at some of them.

When a physician finishes their training and takes the first steps toward independent practice, they usually face a financial dilemma filled with high hopes but also external pressures. Many feel they must immediately show success and stability. Yet, rushing often leads to choices that limit growth rather than accelerate it. The same story repeats itself: a young doctor buys an office right after graduation, furnishes it with the best the market can offer, drowns in debt, and then faces the empty reality of not having patients, staff, or any marketing strategy in place. Loan payments don’t wait, liquidity is minimal, and true stability can take anywhere from two to five years—or even a decade. That “safe” investment quickly turns into a burden that ties the doctor to a place, to a forced pace, and to a false sense of progress.

Another common mistake is spending much of the initial capital on expensive medical equipment—lasers, private operating rooms, or high-end aesthetic devices—that don’t match real demand. The result is machines sitting idle, interest payments piling up, and frustration from the lack of return. Something similar happens with the obsession over collecting diplomas and certifications in areas already mastered, rather than seeking new knowledge and skills that could actually create independence and differentiation. To this, we add the classic lifestyle trap: celebrating the first paychecks with a luxury car or a high-end apartment, getting locked into debt long before the practice has a solid foundation.

But just as there are misguided choices, there are also decisions that can make all the difference between being financially limited and building true independence. One of the smartest investments is hiring an assistant with knowledge in sales and patient management. In addition to managing schedules, such an individual can serve as a strategic pillar for growth if chosen wisely.. Equally valuable is investing in personal branding and strategic medical marketing: a professional website, well-managed social media, good photography, and authentic storytelling are the starting points for strong positioning. Added to this is the importance of having a mentor or business coach in healthcare, someone who has already walked the path and can help avoid costly mistakes, speed up the learning curve, and open doors to new opportunities.

Instead of buying an office right away, it’s often better to start with shared space or flexible rentals. This approach allows you to test different locations, audiences, and services without being tied down. Complementing this with education in business skills is essential. Personal finance, ethical sales, human resources, negotiation, team management, and leadership are competencies not typically taught in medical school, yet they are crucial to sustaining an independent project. Building a network of strategic allies—other doctors, clinics, labs, or complementary colleagues—multiplies referral opportunities and builds trust in the market. Finally, thinking about scalable products or services such as webinars, eBooks, courses, or wellness programs helps diversify income beyond the hours available for patient consultations.

In the end, the real risk is not in investing, but in doing so without a strategy or awareness of the professional and personal stage you’re in. The early years of an independent medical career should focus on validating the business model, building a reputation, and creating a solid patient base. Avoiding investments that turn into chains and instead choosing those that multiply capacities and opportunities will mark the difference between a practice that merely survives and a career that truly thrives.

JUAN ESTEBAN SIERRA, MD – COLOMBIA
ISAPS National Secretary

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