The Weight of Expectation and the Reality of Risk in Healthcare Practices
This article is Part 1 of our four-part series, “Treat or Be Treated: Four Common Reactions to Practice Failure in Healthcare.” In this first installment, we explore the weight of expectation and the reality of risk. Future parts will cover the Shame Spiral, the Deflection Reflex, and Overcompensation leading to burnout.
Everyone Has an Opinion
Expectations in Healthcare Careers: What Professionals Hear
If you’re a healthcare professional, you’ve probably heard it all:
- “You’ll spend your twenties (and maybe early thirties) in school.”
- “You’ll be drowning in student loans.”
- “You’ll never have time for a personal life.”
From the moment you decided on a healthcare career—whether as a physician, dentist, chiropractor, therapist, or any other type of provider—these warnings were likely part of the package. Family members might have gasped at the length of your academic journey; friends might have envied or pitied your workload. However, you pressed on, buoyed by a calling to help people and perhaps by the allure of doing meaningful work.
When it comes to starting your own practice, though, those cautionary voices can suddenly feel deafening. The stakes are higher than they’ve ever been, and the risk is all yours. If the practice fails, it’s your financial loss, your reputation, and your dream on the line.
Why the Risk Feels So Personal
Why the Risk of Practice Failure Feels So Personal in Healthcare
Healthcare professionals are often taught to be risk-averse—for good reason. Lives depend on precise decisions, thorough knowledge, and a commitment to “do no harm.” But the reality of running a practice introduces a whole new level of uncertainty: overhead costs, insurance negotiations, staffing challenges, regulatory compliance, and so on. It’s a different kind of risk, and it can clash with the conservative mindset many clinicians have cultivated (Korn & Faure, 2021).
- Financial Risk: Everything from lease agreements to purchasing expensive medical equipment can quickly spiral your overhead costs.
- Reputational Risk: A failed practice can impact your name in the community, which is especially damaging in a field built on trust.
- Emotional Risk: The sense of personal loss or embarrassment can be overwhelming if things do not go as planned.
A Real Story of High Risk and High Reward
Case Study: High Risk and High Reward in Starting a Healthcare Practice
Consider our example: A married couple in the healthcare field—one a physician, the other a business-savvy partner—set out to create a clinic that delivered personalized, holistic care. They started with only $5,000 in savings and secured a $15,000 investment from a mentor who believed in them. Despite numerous challenges, they scaled quickly. Within two years, the practice was netting seven figures in revenue.
This meteoric success came with a level of pressure they had never experienced. They were employing staff, juggling patient care, and trying to keep the business afloat financially. When you’re at the top, any misstep can cause a domino effect that takes your entire operation down. That’s exactly what happened to them when they made a critical hiring mistake that led to a trusted employee embezzling over a million dollars.
The Reality of Risk vs. The Perception of Failure
The Reality of Practice Risk vs. the Perception of Failure
Most healthcare professionals understand risk conceptually—it’s part of medical training to manage clinical risks. But there is a stark difference between:
- Theoretical Risk: Reading about malpractice suits, hearing stories of struggling clinics, or taking a class on medical ethics.
- Lived Experience: Watching your bank account get drained, coping with betrayal from a trusted team member, or losing faith in your ability to run a successful business.
When failure is abstract, it’s easy to maintain confidence. When it’s personal, it can be paralyzing. Studies suggest that risk perception changes dramatically when the outcome is linked to personal identity, social status, and financial security (Ahmed et al., 2019). In private practice, your name is literally on the line—clinic signage, prescription pads, business cards, and all.
The Four Common Reactions to Practice Failure
Four Common Reactions to Practice Failure in Healthcare
Failing in your business venture can trigger a visceral reaction. As we’ll explore in Parts 2, 3, and 4, healthcare professionals often cycle through these four responses when failure hits:
- The Shame Spiral – Internalizing the setback as personal incompetence.
- The Deflection Reflex – Pointing fingers, lashing out, or masking pain with humor.
- The Blame Game – Redirecting fault to external forces.
- Overcompensation – Working harder and harder, risking burnout without strategic change.
Each reaction has psychological roots grounded in human behavior and stress response (Lazarus & Folkman, 1984). Understanding these roots is the key to shifting from a reflexive, damaging response to a proactive, growth-oriented mindset.
This is Part 1 of our series on practice failure in healthcare.
