I find myself standing in front of six first-year medical students. They’re waiting for me to tell them something about how to become a physician entrepreneur.

These students are now elite amongst their peers. They’re the ones who’ve had the courage to sign up for my course. And, perhaps unbeknownst to themselves, they’re also among the 1 percent of early adopters to lead the way for health care change.

How do I explain to them that they’ll need to change their mindset and think in a very different way than what they’re currently being taught? How do I tell them to develop strength in the face of ridicule, impassivity or condemnation by their teachers, classmates, and preceptors who don’t or can’t think in this way?

It’s a difficult thing to teach someone how to change the way they think, especially when they’re still being taught by institutionalized teachers on fixed salaries who don’t know how to dissolve the economic illusion they’re selling to these same students.

Everyone these days wants to be cool and think “out of the box.” But very few today have what it takes to live out of the box. It’s an increasingly lonely place, as systems demand that you conform to the average. And suddenly, when you have the courage to stand up and be a change agent, your very job is threatened. It’s a scary thing to really change oneself these days.

So I tell them the story of the Harvard-trained kidney transplant surgeon. He was top of his class a decade ago and on his way to fame, fortune and happiness.

He telephones his lead medical assistant, a good friend of mine, on a particularly depressing day.

“Mary,” he says. “I never thought I’d be here, lying in this dingy hotel room eating taco from a truck and pulling regional call for these huge hospital systems. What the hell’s wrong with this world?”

She asks him this: If someone had told him in medical school that this was going to be his future, would he have listened and chosen a different route?

“Probably not,” he replies.

So how do I tell these bright, young stars that the richest sixty-year-old orthopedic surgeon who’s generously teaching “free” small group classes on success, is not the economic icon to look up to anymore? His success is now a financial relic based on crumbling business structures of past paradigms. Their future cannot be built on such a fractured model.

For these students, the future is white-water rafting, as Stephen Covey wisely phrased it, long before it actually started happening. These students will need to fight every day against a mindset of dependency inside a healthcare system that wants to hog-tie them down to a future of debt and servitude.

Conformity comes with a steep price.

As our world falls apart, Dr. Covey’s wise words take on a new meaning.

If we want to change an entire system, we have to be the change. And if we want to be the change, we can’t shut off our minds, believing that the money’s going to be there in 10 or 15 years as it was for the sixty-year-old orthopedic surgeon.

We have to step up to our lives and feel the burn of how to change in every moment. We have to ignore yesteryear’s indoctrination and seek to create our own educational systems.

This is what it means to be a real physician entrepreneur.

1. Understand yeah but’s rule. The number of “yeah but’s” is inversely proportional to a physician’s income. The more “yeah, but’s” that come out of your mouth, the less money you’ll have in the long term.

2. Learn how to work for yourself, not for the man. Take some advice from Vishen Lakhiani, CEO of Mindvalley. He was lying on the beach when his company hit the highest number of sales ever.

3. Sell something now. In a culture built on instant gratification, it’s amazing how long doctors are willing to wait for their perceived income gratification. Change your mindset now. Stop focusing on spending money for education for some fictitiously huge income stream. Figure out how to make it today.

4. Learn how to keep on selling. Selling in medicine seems to be a dirty word. But, we’ve now got huge billboards advertising sickness, injury, death and disease for local emergency rooms. Isn’t that making money on sickness, death and disease? Change your mindset now. Learn that healthy sales are part of life. Make a conscious living by selling transformational products and services which actually help people heal, instead of making profits on keeping people sick through more Band-Aid care.

5. Stop thinking in straight lines. Learn to think in 3-D. The standard physician income formula goes something like this:

doctor + practice = income

It’s got you believing that if you “invest” 10 or 15 years in a very expensive education, you’ll be able to set up a lucrative practice and bring home a great income.

So what happens when the key variable, your “income” becomes independent of the formula? What happens when your government, corporation or health insurance company squeezes your payments — again and again and again as the years go by? How does that affect your practice, your health, your relationships and you? Get rid of linear thinking and find multiple streams of income.

6. Skip the time and expense of an MBA. Get business street smarts now. A student asked me if he should enroll in the new-fangled MD-MBA path. I told him this is a well-worn belief system that universities love to sell to doctors who are dead set on spending a lot of money over a ridiculous amount of time, and never really learning any practical business skills. Learn business by doing business. Now.

7. Fail and fail again. Know what this feels like and you won’t fail at the same thing twice. There’s another odd belief we have as doctors, that if we collect degrees, we’re somehow not going to fail at whatever we choose to do, be it business or medical practice. Is that necessarily true? No. So get out there and learn how to sell something now. Fail and then pick yourself up again. You’ll start to learn a few business skills pretty damn quickly, for a lot less than the cost of an expensive MBA.

8. Stop whining about how bad it is and go change your own life.  A lot of people — doctors, residents, and medical students especially — know deep down inside that they shouldn’t be doing what they’re doing. Why? Simply because they’re not happy. But they won’t actually do what it takes to change their lives. Why? Simply because they feel they’ve “invested” so much time, money and effort that they can’t change now. But will it really get any better if you’re burning yourself out doing something you hate until you retire or drop dead?

9. Feel what it’s like to change. Don’t just think about it. Do what you need to do to change you now. And then, feel exactly how uncomfortable it is at first. Change anyway. Once you get used to changing, you’ll discover that staying stuck in the same place is a lot more painful. And, it’s the only path to success.

10. Finally, stop working for the man. Just stop already. On day one, my courageous group of first-year medical students are introduced to the concept of not working for the man. They learn how to set their thoughts, goals, and actions on becoming independent from the entire medical system. I suppose this might be sacrilege among university teaching circles. But, it’s exactly why a budding physician entrepreneur is going to have to find a deep sense of inner strength if he wants to financially succeed.

So, are you brave enough to see a different future for yourself? Will you start now to chart a course through Grand Rapids white-water, and do what it takes for personal change — today, and not tomorrow?

Your future hasn’t been written. The choice right now is entirely yours.

Natasha N. Deonarain is CEO and founder, Conscious Health Solutions.  She is the author of The 7 Principles of Health and can be reached on Twitter @HealthMovement.

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