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Introduction 

The entrepreneurial world is full of like-minded individuals, all from different backgrounds, technology, finance, marketing and yet, a critical sector is under-represented: healthcare. Despite knowing best what patients’ needs are and the systemic inefficiencies, you will rarely find healthcare personnel in start-ups or as entrepreneurs. From navigating complex legalities and insurance hurdles to the sheer demands of their clinical roles, we delve into the barriers that stifle the innovation of healthcare workers.

The challenges of a healthcare career

Early on in education, we learn that doctors and nurses are in hospitals, paired with an apple a day keeps the doctor away. While we grow out of the latter, the former remains ingrained within us. It is a fact that most healthcare professionals are found in hospitals; however, outside of hospitals is another story. The reason why is simple: being a healthcare professional is not just 48 hours a week, and the shift work on its own makes handling life outside work nearly impossible. Navigating life as a healthcare professional, there are all kinds of tolls, physical tolls from working 12-24 hour shifts in a roster, mental tolls from dealing with the daily paperwork while keeping up to date on protocols, emotional tolls, as more often than not, as human beings, we form connections. The concept of work-life balance as a healthcare professional is like walking a tightrope, treading carefully to keep their patients safe, and keeping themselves going; one misstep may be career-ending. Now add to this pursuing entrepreneurship with all its challenges and difficulties.

Society and its involvement

On the other hand, education itself may also be an influencing factor, while most students are encouraged to focus on entrepreneurship skills, in healthcare, not only is it barely mentioned, but seen as useless by the general public. When healthcare students show interest in entrepreneurship, most people ask questions such as “Why even bother if you have work guaranteed in a hospital?” and “ You should focus on studying!”. This mindset, paired with the intensity of the course load, deters students from building entrepreneurship skills. Even as students, most courses include placement hours, which are mandatory to graduate, and which, while instilling skills that are only learnt through practice, already start limiting the time to foster entrepreneurship skills.

Regulatory & legal labyrinth

Furthermore, for healthcare professionals, getting insurance is a battle in itself. The strict regulatory and legal landscape in healthcare poses a formidable barrier for entrepreneurial healthcare professionals. Locally in Malta, obtaining insurance as a midwife is expensive, as the premiums necessary are high. Healthcare professionals promise to “do no harm” at the end of the day, no matter how many TV shows romanticise working in healthcare, each healthcare professional is responsible for the lives of their clients. When a professional works in a hospital setting, the insurance cost is not placed on them. And thus working in a hospital is almost logical, because it helps to:

  1. Get started in life
  2. Be able to afford the financial and legal tolls to be an entrepreneur
  3. Avoid burdening the responsibility alone

These three reasons may be disheartening many healthcare individuals from starting their entrepreneurial journey.

Pioneering paths

In Malta, healthcare entrepreneurs are few and far between; however, one group, Positive Birth Malta, is founded and led by a team of midwives who aim to promote midwifery beyond the hospital setting. Together, they venture to educate and support their clients to achieve a positive birth story.

Moving forward

After gathering all the facts, you may be asking: “So how do we move forward?”. To start, let us encourage healthcare students to pursue building entrepreneurial skills. Let us, as a society, encourage all students to build entrepreneurial skills. Entrepreneurial skills such as adaptability, time management and critical thinking are all skills which are highly valuable in healthcare settings. The skill to think critically comes to the forefront during an emergency, where time is of the essence. In a recent report, the World Health Organisation expressed the concern that by the year 2030, there will be a shortage of 4.81 million nurses and midwives combined, and it is already being felt today! Now, while entrepreneurial skills will not directly lessen this significant challenge, they can serve as a door to new possibilities. Whereas at least professionals who leave the hospital setting do not leave the profession completely.

Second, let us push to give healthcare professionals a proper work-life balance. This way, they can offer better care and use their time to expand on their ideas. After all, all those hours at the frontlines of care, they know what patients need to not just recover but thrive. With more time on their hands, healthcare professionals can not just hope for something that can better the lives of patients. But think about it, brainstorm it, and start it! Through working directly with their patients, they can bridge the gap between research and clinical application.

Conclusion

In conclusion, let us be the generation to encourage equity within entrepreneurship. Where medical devices or services can be offered by healthcare professionals themselves, both in and out of a hospital setting. And most importantly, a society that is healthy both physically and mentally.

References

World Health Organization. (2025, July 17). Nursing and Midwifery. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery

Additional readings

Babu, D. K. R. (2021). Challenges faced by healthcare start-ups. Archives of Business Research, 9(8). https://doi.org/10.14738/abr.98.10601

Paunović, I., Apostolopoulos, S., Ivana Božić Miljković, & Miloš Stojanović. (2024). Sustainable Rural Healthcare Entrepreneurship: A Case Study of Serbia. Sustainability, 16(3), 1143–1143. https://doi.org/10.3390/su16031143

Rahmanianaraki, H., Sadeghi Meresht, F., Hojjati, H., & Manouchehr, B. (2024). Challenges of entrepreneurship in nursing: A narrative review. Journal of Nursing Advances in Clinical Sciences, 1(4), 219–225. https://doi.org/10.32598/jnacs.2408.1057

Vannucci, M. J., & Weinstein, S. M. (2017, September 22). The nurse entrepreneur: empowerment needs, challenges, and self-care practices. Nursing: Research and Reviews. https://www.dovepress.com/the-nurse-entrepreneur-empowerment-needs-challenges-and-self-care-prac-peer-reviewed-fulltext-article-NRR

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