After selling my minority partnerships in my previous hospitals and finishing business school, I genuinely believed I was prepared for the startup-practice world. I knew it would be hard, but I thought experience plus an MBA meant I would launch with confidence and a clean plan.
What I know now is simple: even with experience and education, you will get hit with surprises you could not have mapped out. In my prior partnerships, I had a team behind me that had opened, acquired, and operated practices for 20-plus years. This time, my wife and I chose a different path. We wanted to learn every step ourselves so we truly understood how the machine works.
Here is the takeaway after living it: opening a practice is hard. You will feel like you do not know what you are doing. You will hit roadblocks constantly. But you adapt. You learn. And if you are built for it, you would still choose it again.
Also, the hardest part was not opening the doors. The hardest part happened 18 months before opening day. It was the decision to walk away from the security of a high-paying partnership and clinical leadership role and bet on ourselves. The hardest part was taking the entrepreneurial leap.
Why I Started This Practice
Being fully transparent, I did not open this practice just to open a clinic. I opened it as a platform to build from. This first location is our proving ground. It is where we test workflows, technologies, and leadership systems in the real world, not in a slide deck.
Yes, the platform has to serve clients and pets with excellent medicine. But it also has to serve the team. I wanted a place where Veterinary careers could actually bloom, where burnout is not treated like a personal weakness, and where a fulfilling career is designed on purpose. That is why access matters. We built around getting clients and pets care when they need it, and we fully embraced spectrum of care so we can recommend the best medicine while staying grounded in what families can afford.
The bigger goal is ownership and partnership. I want to mentor people not only on medicine, but on leadership and business. I never wanted True.Vet to be a practice alone. I want it to become an ecosystem that pushes Veterinary medicine forward through the care we deliver and the sustainable business model behind it.
Lesson 1: Innovation Needs Anchors
When you are trying to build a new concept and truly harness innovation, technology, and new workflows, there is a temptation to do everything differently. I was all in on rethinking what a traditional Veterinary practice should look like. I wanted a clean break from the way I had managed practices before.
In theory, trying everything new sounds like progress. In reality, it can create chaos. I learned quickly that some of the systems I used in prior practices worked because they were battle-tested. They created clarity for the team and consistency for clients. When I tried to reinvent every wheel at once, I made it harder to execute the basics. One of the first places this showed up was trying to have every team member focus on cross-training, and it created confusion and put the wrong people in the wrong seats. I still believe cross-training is valuable, but I learned quickly that if roles are not clear, the client experience suffers.
That was a big reality check for me: innovation is not always about flipping the script entirely. Sometimes it is about keeping what already works, then improving it with intention. The win is not “different.” The win is “better.”
Lesson 2: Culture Is Built in Small Moments
Culture has always been a driving factor for me, and one of our core values is embracing innovation with a growth mindset. This is where I have to call myself out.
When we implemented a brand-new practice management software, I knew it would be hard. What I underestimated was the pressure of being the initial “expert” while also training an entire team in real time. No system is perfect, but relearning everything from scratch while trying to operate a startup practice is humbling. More than once, I had the thought, “Why are we doing this to ourselves?” It was tempting to revert back to what was familiar and easy.
I also made a mistake. I let my frustration show to the team. That is not a growth mindset in action. It is a signal, even if unintended, that discomfort means we should quit. Leaders set the emotional temperature, and I momentarily reset the standard in the wrong direction.
The good news is we pushed through. We learned from mistakes, tightened training, and now we are operating far more smoothly. The bigger lesson for me is simple: if I want a team that embraces growth, I have to model it first, especially when I am the one struggling. Calm, consistency, and living the values matter more than the words on the wall.
Lesson 3: Bandwidth Was the Constraint
In the earliest stage of a startup, I actually think it is important to be the bottleneck for a little while. When you are setting the tone, defining standards, and building the first version of your systems, too much delegation too early can create confusion. But that approach has a shelf life. If you stay the bottleneck, the practice never truly thrives.
Delegation only works when trust is earned, and trust starts with who you hire. I learned quickly that early hires matter even more in a startup, especially when you can bring in people you have worked with before and are willing to invest in. That is what makes it possible to hand off real responsibility without the wheels coming off.
Here is where I had to check myself. I talk a lot about an ownership mindset, but it took me time to fully live it. I had to stop routing every decision through me and start pushing trusted team members to think like owners and act in the best interest of the hospital and the client experience.
Once trust was established, it became easier to do this the right way. Decisions still get made inside clear guardrails: our mission, vision, and core values. Within those parameters, I trust the team to lead. I am happier, the team is more confident, and the clinic runs smoother. One of the first responsibilities I truly let go of was inventory management and ordering. Once I built trust with my practice manager, and saw she was better at budgeting it than I was, it freed me up to focus on higher-value parts of the business.
Lesson 4: Clients Buy Clarity
Because our model is a hybrid between walk-in and scheduled appointments, we had early confusion from new clients who assumed we were an emergency hospital. We started getting comments and reviews about how great we were for emergency care. I take that as a compliment, and during business hours, we will absolutely see emergencies. But that is not the full story of what we are building.
We opened in an area where some clinics were booked out six to eight weeks. Our intention was to be the place families could actually get care when they need it, for everything from a rabies vaccine to a cruciate surgery. Early on, we did not make that message clear enough. Clients filled in the blanks, and “walk-in” quickly became “emergency hospital” in their minds.
The fix was not complicated, but it mattered. We tightened our marketing language and made our scope obvious, including the everyday services we want to be known for, not just the urgent ones. As clarity improved, so did the mix of cases coming through the door. Same-day visits, walk-ins, and surgery are still our “bread and butter,” but we are steadily growing into the full-service identity we intended from the start.
Lesson 5: Access Is an Operational Commitment
From day one we built a hybrid model where walk-ins are always welcome. The upside is obvious: access. The downside shows up fast, especially on days with one doctor on duty. Walk-ins are impossible to predict, and they can fill every exam room quickly, even when you have clients who booked ahead and expect a smoother experience.
I learned that you cannot promise same-day care and then try to staff like a traditional appointment-only clinic. If you do, you end up paying for it in wait times, team stress, rushed decisions, and client frustration. The guardrail I had to put in place was simple but expensive: hire to the promise. That meant investing earlier than I wanted in additional doctors and team members so we can deliver access without sacrificing the experience for people who scheduled in advance. One rule that helped immediately was keeping Sunday hours as walk-in only, because it prevented frustration for clients who would have scheduled less urgent appointments. Being one of the only locations open on Sundays, it lets us lean fully into the walk-in model and deliver the most value to the community.
Making hires in a startup is stressful because every payroll decision feels heavy. But I would rather carry that stress than break trust with clients and burn out the team. So far the changes are working, and we will keep refining. Accessibility is not a marketing line. It is an operational commitment.
Lesson 6: Transparency Creates Ownership
Before opening, I read The Great Game of Business by Jack Stack. The core idea is simple: open the financials to the team and teach them how the business actually works. I took that seriously and started building it into our routines.
To be honest, I have not had the bandwidth yet to go as deep into the P&L with the team as I want to. But I do share monthly financial goals and talk about daily performance. Money is not the only scorecard that matters, and it is not the only thing I measure. But it does create a simple, objective way for the team to understand whether we are winning the day.
I also share what I consider just as important: client feedback. We talk about reviews, we celebrate wins, and we treat criticism like data. It keeps us grounded in why we are here and where we need to improve.
Last month, we hit our financial goal on the very last day of the month, and the team was more excited than I was. That moment reminded me that transparency, done the right way, does not create pressure. It creates ownership.
Lesson 7: The Founder Reality Check
Startup life has been a cycle of highs and lows. Some days it feels like everything is clicking. Other days you get a reality check and realize how much room there still is to grow. Even with my background managing and co-owning practices, I thought getting this off the ground would feel easier than it has. But regardless of experience, starting from scratch is harder than it looks from the outside.
The biggest shift for me has been accepting that early-stage will never feel perfect. A startup does not launch polished. It launches honest. I have learned that being open with the team about what success and failure actually look like helps a lot, because it keeps us focused on progress instead of pretending we have it all figured out.
I also put a lot of pressure on myself to build something that excels fast. The hard truth is that excellence is built through consistency, not intensity. The moment I really felt this was when I could sense the team felt stretched thin and confused about their roles, and it forced me to professionalize our systems and bring in the right people to standardize how the practice runs day to day.
If I stay committed to the growth mindset I talk about, we will keep improving the systems that serve clients and the team. The entrepreneurial roller coaster is real, but if we stay steady and keep learning, the highs get higher and the lows get shorter.
What Comes Next: Partners, Not Employees
If you have read anything I have written before, you know this is a core theme for me: creating veterinarian owners. That belief is not separate from this startup. It is the point of it, and it is what brings us into the next phase.
Over the next couple of months, our first veterinarian partners will step into this location to start their ownership journey. I am beyond excited, and I will admit I am also nervous. It feels like going back to the beginning in a good way, because onboarding partners requires a new level of structure, clarity, and leadership. New systems will need to be built so partners can learn, lead, and actually succeed on the path to ownership.
I am bringing partners on early because I value partnership as a multiplier. It is good for me because it builds a leadership bench and creates long-term sustainability. It is good for the associate-turned-partner because it turns a job into a career with autonomy, meaning, and a real stake in what they are building. It is good for the hospital because more people are invested, more people are empowered, and the work improves when ownership is real.
I have said it before and I will keep saying it: I am not building a Veterinary group. I am building a leadership development platform that happens to live inside Veterinary medicine. If we do this right, it creates a better future for veterinarian owners, teams, pet owners, and the communities we serve. When doctors have a stake, continuity improves, standards stay high, and the teams, pet owners, pets, and the communities they serve win.
Closing Challenge
Startup life is hard. It is one of the hardest things I have ever done, and I definitely underestimated what it would require. That said, I would not choose a different path. My wife and I invested in ourselves, and we get to dictate our own future.
Veterinary medicine is a hard profession no matter where you practice, but autonomy changes the experience. When you have real control over what you are building, how you deliver care, and how you lead a team, it adds a new dimension to the work. It is still difficult, but it becomes deeply intentional.
So here is my challenge to anyone thinking about ownership: take action. The hardest part is the first commitment, the moment you stop debating and start building. Yes, it will be hard. But the regret, years from now, is rarely that you tried and failed. The regret is that you never tried at all.
Who do you want in control of your professional and personal life? For me, I am betting on myself every time.
TLDR
The first 150 days of building a startup Veterinary practice humbled me more than I expected. The real work was not opening the doors. It was choosing the leap, then learning how to build systems, culture, and clarity that protect access, quality, and team sustainability. Next up is the most exciting part: bringing veterinarian partners into ownership early and building a leadership development platform through the hospital.