If you run or manage a clinic (whether human healthcare or veterinary), this question rings a familiar bell. You’ve probably sat with staff, or thought about your own role, wondering whether staying under an employer’s umbrella or branching out on your own is the better path. It’s not just about salary—it’s about freedom, responsibility, risk and what kind of business or career you truly want.
Let’s walk through what’s really going on beneath the surface, and then I’ll give you a framework to make a grounded decision that works for your clinic’s goals and you.
What’s really going on
At first glance, being employed gives you security and fewer headaches; self-employment gives you freedom and potential upside. But the deeper truth is this: the core trade-off is control vs. safety, and whether you’re ready (or want) to build systems around that control.
- As an employee you get structure: payroll, fewer administrative burdens, someone else handling client acquisition or marketing.
- As a self-employed professional you get autonomy: you set your schedule, fees, service model—but you also take on the business side entirely.
In a clinic-context this is similar. If you’re part of a larger practice you might focus purely on care; if you run your own you wear management, marketing, HR, regulatory hats alongside clinical ones.
Here’s a simple framework I use with clinic owners:
Security-Driven Role (employee) vs Entrepreneurial Role (self-employed)
- Security-Driven = predictable income, defined role, fewer built-in business risks.
- Entrepreneurial = higher upside potential, full control, higher risk and responsibility.
Which side you lean toward will shape your operational systems, your mindset and your clinic’s future.
Practical breakdown: pros & cons in clinic terms
Here are the key considerations—with clinic-specific translation—so you can map them to your situation.
If you’re in an employed role (or running part of a larger clinic)
Pros:
- You get regular income, benefits (depending on region), less financial volatility.
- Someone else may handle major business functions (marketing, compliance, facilities) so your focus stays on care and service.
- Less burden on you to build everything from scratch—useful if you prefer clinical work over business management.
Cons:
- Your earning potential is often capped—your rate, hours and growth may depend on the parent organisation’s policies.
- Less flexibility—hours, services, ways of working may be set by the employer.
- Limited brand-ownership—your reputation may be tied to the bigger organisation rather than your individual identity.
- Dependency—if the larger entity changes (merger, cutbacks, leadership shift), your role may be impacted.
If you’re self-employed (or running your own clinic/practice)
Pros:
- You set your fees, choose your services, select clients/patients and define your working hours.
- You can build your own brand, diversify revenue (e.g., tele-vet consultations, niche human-health specialist, workshops) and scale as you like.
- Your trajectory is much more in your own hands—you decide the growth path.
Cons:
- Income is less predictable; early stages especially can see big peaks and troughs.
- You’re responsible for everything: finding and keeping clients/patients, marketing your practice, compliance, billing, staff, IT.
- Benefits and safety nets that come with employment aren’t automatic—you must build them (insurance, pension, backup plan).
- It can get isolating; you’ll need to build your support network, and maintain discipline around running the business, not just delivering the care.
What I recommend you do this week
If you’re a clinic owner or senior clinician evaluating your role or your clinic’s structure—here’s a high-leverage exercise:
- Write down two decisions:
- What level of control do you want over services, pricing, hours, branding, and business growth?
- How much of the business-back-end are you willing to own (or outsource)—marketing, operations, staff, compliance?
- Based on those answers, pick your “operating model” (employee-style vs self-employed style) clearly.
- Map one system you need to build (or strengthen) for that model.
- If you choose employee-style: maybe your system is “clear role + onboarding + performance review” for clinicians.
- If you choose self-employed style: maybe your system is “client acquisition pipeline + scheduling + billing + service delivery” for the practice.
Mindset shift: from “doing everything” → “building systems”
This is where many clinic owners get stuck: they keep hustling operational firefighting instead of stepping back. If you shift from “I have to do everything” to “I have built systems that allow me or my team to manage and grow this reliably”, things change.
- You stop being reactive (last-minute cancellations, ad-hoc pricing, uncertain income) and become strategic.
- Your clinic becomes a place where high-quality care meets consistent operations—not a patchwork of emergencies and one-man-shows.
- You free up space to focus on growth, staff development, innovation—not just keeping the lights on.
When you pick your model (employee‐type or entrepreneur‐type) and build the supporting system, you’re no longer spinning wheels—you’re steering the ship.
In closing
So: Are you comfortable with the stability of being “employed” in your clinic context? Or are you ready to embrace full ownership and the ups and downs that come with it?
Either path is valid—but clarity is power.
This week’s step: Choose your model and map your first supporting system.
If you want support mapping your processes or building the systems behind a self-running clinic, I’m here to help.
