I would think its because of the support/know how. I believe its a moment where you have to "jump" and see where it takes you. People including RN's are more comfortable with the "paths already made" than to make their own. It involves risk and would be my opinion. I have been wanting to start a business and its been hard to come up with an idea. My initial is to start an adult day care center. But having worked in a Cardiac floor specializing in Heart Failure, theres so much room for improvement in the elderly/geriatric part of health care.