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Quitting My Job in the ER to Open a Med Spa Was a Shock. But I Made it Work. If you're transitioning from lifetime employee to first-time entrepreneur, you've got to decide who you are, set boundaries and never confuse struggle with failure.

By Susan O'Malley

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I come from a long line of employees. My father worked in the maintenance department at Belmont Park Racetrack. He wore a green laborer's uniform every day. My mother stayed at home raising five children and waited tables at night to supplement his income.

No one in my family owned a business. They were all employed by someone else. As a little girl, I didn't even realize that you could own a business!

Related: How My Days as a Chef Prepared Me to Grow a Startup

As an adult, I was initially employed as a secretary. Years later, I became an emergency room doctor. Physicians in private practice owned their own business, but I was employed by the hospital. I wore blue scrubs instead of a green uniform -- but I was an employee just like my father. When I left mainstream medicine at age 50 to open a medical spa dedicated to helping women age without surgery, I became the first entrepreneur in my family.

I thought my new business would be an extension of my old job. I would still go to work and take care of people, but now I would be working for myself. It would be different -- but not that different. I was in for a big surprise.

Now, I had to do more than just take care of people. Not only did my patients need to be nurtured, but my business needed to be nurtured as well. Before I could become a successful entrepreneur, I needed to change the way I thought about work.

I spent my years as an ER doctor giving things away. I gave you my undivided attention, I worked tirelessly to solve your problem, I handled your feelings with great care, and as you were leaving, I filled up a bag with supplies so you would be more comfortable at home. As an entrepreneur, things were different. The first time I had to look into someone's face and say, "That will be $100," I cringed.

Fifteen years later, I have a profitable business that does good work and brings me great joy. I was able to develop a different way to look at work.

Here are a few lessons I learned along my journey. If you are planning a transition or are new to the world of entrepreneurship, maybe they will help you too.

Related: 6 Tips to Successfully Transition From Your Day Job to Your Own Business

1. Don't confuse struggle with failure.

When I first opened my business, I thought I would be up and running within six months. I wasn't prepared for the uphill battle, the sleepless nights, the anxiety and the humiliation of potential failure.

Over the years, I learned that everyone struggles -- but not everyone shares their struggle. The temptation in starting a new business is to compare yourself with others in your field. Maybe they really are as successful as they sound, but maybe it's bravado.

Early in my career, I would go to networking events. Someone would always ask, "How's business?" I made a conscious decision to tell the truth. "It could be better." It took less energy for me to let people know I was struggling than to pretend I had it all figured out. It didn't mean I was failing. That honesty opened the door for others to share their struggles as well.

2. Decide who you are.

It's important to define exactly who you are and what you want from your business. At the beginning, I tried to be everything to everyone. I would compare what I offered to other businesses and finally realized I was contorting myself to fit someone else's business model.

When I decided that I didn't want to compete on a larger scale, things fell into place. I have simplified my offerings, but deliver consistent quality. I treat people the way I would want to be treated. I worked harder at the beginning, but have now cut my hours to three days a week. I don't work weekends or evenings. I have never lost a patient to scheduling, and I guarantee you won't lose any clients either. If you do right by your client, they will find a way to get to you.

3. Set boundaries -- and honor them.

Within three months of opening my business, I was running out of money and was operating from a position of fear. If someone made a fuss about the price of a service, I would immediately lower my price. If they couldn't come during my working hours, I came in earlier or stayed later to accommodate them.

The turning point came when I sat at the spa for 11 hours to accommodate two women who needed early-morning and late-evening appointments -- and neither one showed up. I was humiliated and angry. I went home and secured loans from family and friends to see me through the start-up process.

Then, I honored my business decisions. If you're operating from a position of financial fear, do what needs to be done to give yourself a cushion -- barter with someone, borrow from family and friends. Don't wait until you're sitting alone for 11 hours to honor yourself.

Related: Is It Time to Step Out of Your Comfort Zone?

Transitioning from employee to entrepreneur is an exciting time, with many new adventures ahead. There will be joyous days and days when it's all just too much. On those days, breathe out, navigate the struggle and put yourself on the list. Now go build a business!

Susan O'Malley

Medical doctor, entrepreneur, speaker and author

Dr. Susan O’Malley is a medical doctor, entrepreneur, speaker and author. As owner and medical director of Madison Med Spa, she is dedicated to helping women look younger without surgery. In her book and keynote presentations, she distills lessons learned from her transformational journey starting as college dropout and secretary to emergency room doctor and entrepreneur and applies them to challenges in business and in life. To learn more about Dr. O’Malley, purchase Tough Cookies Don’t Crumble: Turn Setback into Success or book her to speak at your organization, please visit

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