Lecture by Dr. Nneka Unachukwu – Episode 450
In today's presentation, Dr. Una explains important principles to follow to build a profitable practice on your own terms.
Dr. Nneka Unachukwu is a pediatrician and founder of EntreMD. She received her medical degree from the University of Nigeria College of Medicine and completed her pediatric residency at Newark Beth Israel Medical Center.
Sponsor the Physician Nonclinical Careers Podcast
Did you know that you, too, can sponsor the Physician Nonclinical Careers Podcast? As a sponsor, you will reach thousands of physicians to sell your products and services, or to build your following. Your message will be heard on the podcast, seen on our website, and in our newsletter and social media posts.
It’s amazing how a direct invitation to thousands of physicians on this podcast can attract listeners eager to try out your products or services.
To learn more, go to nonclinicalphysicians.com/sponsorships or just set up a short call to learn more about sponsorships at nonclinicalphysicians.com/zoomcall
We’re booked with long-term sponsors, but can offer a complimentary 2-week pilot for select partners we believe are a perfect fit for our physician audience. If that describes your business, then set up a call at nonclinicalphysicians.com/zoomcall
Sharing Her Expertise
Dr. Una has been coaching, speaking, writing, and helping physicians all over the world. She does this through her podcast and her EntreMD Business School. And she has published nine books so far. Her books unlock the secrets to business success for physicians, offering practical strategies to overcome introversion, master visibility, and build thriving practices.
In this presentation, Dr. Una shares actionable tips and strategies for physicians venturing into entrepreneurship. She provides concrete steps for building a sustainable and successful medical practice or business, from identifying target audiences to leveraging social media.
Build a Profitable Practice
Her EntreMD Business School is a year-long program designed to make up for the business education you didn’t receive during your medical training. Whether you are employed or own a medical practice or a nonclinical business, this school will give you the tools you need to build a business that helps you serve and earn at the highest level.
Dr. Una draws from her own experiences and those of her clients. She offers valuable insights into overcoming common challenges and achieving long-term business success. And she describes how she stepped away from managing the day to day aspects of her clincal practice, yet it continues to thrive and grow. And she wants to help you to do the same, whether for a clinical practice, or a nonclinincal business.
Summary
I always get energized and inspired when I talk with Dr. Una. I’m inspired because she is making it possible for physicians like you to thrive in private practice or a nonclinical business. I’m excited to read her complete series of business books and share them with you. They are available on Amazon and on her website at EntreMD Books.
NOTE: Look below for a transcript of today's episode.
Links for Today's Episode:
- Dr. Una's EntreMD Business School
- Dr. Nneka Unachukwu's LinkedIn Profile
- Here is a list of Dr. Una's Books
- How to Be a Successful Physician Entrepreneur – 123
- Nonclinical Career Academy
- 19 Presentations from the 2023 and 2024 Nonclinical Summits
Download This Episode:
Right Click Here and “Save As” to download this podcast episode to your computer.
Build a Profitable Practice on Your Own Terms
Lecture by Dr. Nneka Unachukwu - Episode 450
Thank you very much Dr. John for that very kind introduction and we've known each other for years. I'm very honored to be here. so a big thank you to you and a big thank you to Dr. Tom Davis and the entire team for putting this together. the state of healthcare now, all hands are needed on deck and all the support that physicians can get will take all of it.
So thank you for this. And we are, in for a treat. I am just gonna take a moment. I. Have some slides I'm going to use here and we are going to get into this. Okay? So please let me know in the chat or maybe, maybe John, you can tell me if my screen is okay, you guys. Yep, it's looks great. Okay. Excellent.
Okay. All right. So today we are going to, we're gonna look at something that is, I think is very critical, for the physician, for physicians in general, for the entire community. And that is really around. building a, a profitable business and practicing medicine on your own terms, and, we're really going to delve into how you can do this.
I do believe that entrepreneurship is one of. The things that we do need to do if we're going to, reclaim our autonomy, get rid of burnout, turn the healthcare space right side up and all of that. And so I wanna invite everyone to lean into this with a really open heart and just be curious. and, and, and we're gonna talk through a lot of things here and it's not designed to be,
It's not designed to just be a lecture. It's designed to be something that you can walk away with and completely change the way you think about things and the way you operate. Okay? So, I put this picture here because, this is the way I want us to approach this. So every time I get to stand by the ocean, I don't see the end of it, and it just represents something that is very limitless.
And as physicians after years and years of training, we are tempted to think we are one trick ponies and, we can only do things a certain way. And the state, we, the state of the space right now, we're stuck. And I just want to invite you to think like limitless. I can have many iterations of myself.
I can totally reinvent myself. I can change the way things are. I'm not stuck, and it, that's really the way I want us to think about this. So we're, we're gonna look at a lot of things like, best practices for successful entrepreneurs. We're gonna look at why branding's important and how to build so that you can sell all those kind of things.
It's gonna be amazing, but I want you to think limitless, not stuck. Not a one trick pony. I'm not a tree. I can change. I, I just wanna invite us to think that way. so this is me. I'm Dr. Una, and I wanna give you a little bit of my background just because it will, it will put everything that we're gonna talk about here in context.
so I'll take us back to 2016. in 2016, I had run my private practice for about six years At that time. And private practice was great. I had somebody who worked with me. she worked every Friday, and so that mean, that means I had a long weekend, every weekend. I had understood quite a bit of the business of medicine, so yes, I was serving my patients at the highest level, but also we were building a practice that was thriving.
I was profitable and all that, so everything was good. And then I remember being in my office, my home office one day, and I just had this aha moment. So this is almost eight years ago. And the aha moment is, was that medicine, as we knew it at the time, had changed fundamentally. And if the only thing I knew how to do was to doctor in the way I had been doctoring.
I was going to be out of luck. It, it was, there was a, there was a lot of urgency with it. I don't know which other way to describe it was like you have to reinvent yourself. Like imagine if you could no longer. Put your hands on patients, you could no longer examine patients and do that. How would you still have a career that is very meaningful in, in, in the sense of you're still able to serve people, you're still able to serve patients, you're still able to make a, a difference, you're still able to, maintain your financial freedom and all of that.
Like, what would you do? And so I didn't know anything about anything. I didn't know anything about coaching. I didn't know anything about speaking. I didn't know any, I was just a, I was a great pediatrician. I put my hide down. I did the work that, that's, that's who I was at the time. And so I'm grateful that at that point I was curious.
I was coachable and I decided that I was gonna chase this line of thinking down and I was not gonna quit. and so, the first thing I did was, I, I enrolled in, in, in a program to learn about speaking. because that was a, the next opportunity that was in front of me, I was like, well, what if I became a speaker?
What if I became a consultant? I mean, I run a successful practice. Maybe I can teach other people how to do that. I could be an author. I could be, I, I could write, I could write books. I can do all these things and I'm gonna give some of the process later on in the talk. But to go from that person who, yes, I understood some of the business of private practice, but.
To go from that person to a speaker podcast or a bestselling author, building a business school, being featured in Forbes, making it to the Inc 5,000 list of fastest growing companies is just a testament to the fact that we can change, we can evolve, we can create life on our terms. We are not stuck.
Things can change. And that is the, that's the whole essence of that. and so really I want us to stay in that space. I mean, I started off entrepreneurship as a really, really socially awkward, super shy, introverted introvert. And I, I had the makings of a worker be like, like, that that's what I was going to do.
I did not think entrepreneurship was a thing. I would never be on stage. I wouldn't, I wouldn't be speaking to you. I wouldn't be doing any of those things. And so it does sound a little cliche, but the truth of the matter is, if I can do what I do now, it is something that is available to physicians. It, it really just is.
Okay. All right. So now. Sometimes people say, don't get your hopes up. And I put this here because I want you to get your hopes up. I want you to get your hopes up. I want you to see what is possible for physicians. And I put this here because you may be thinking, well, I really just wanna have a direct primary care type of practice.
So I direct specialty care, ki kind of practice. Or I just, I like my job, I wanna work my job, but I also wanna speak, or I have this product I wanna develop. Right? And I, I put this here because. This represents like it. It's part, it is not everything, but these show you so many different options. So these are real life people.
These are people that I've personally, that I personally work with. Okay. And I wanna show, these are all doctors who've decided I'm going to build a successful business. A dream business and I'm gonna be build my dream life concurrently. Right? So they're living life, I'm practicing medicine on their terms.
And I just wanna show you this. So whatever your dream is, there's space for it, right? Okay, so, so here is Dr. Vlad. Dr. Vlad is a pediatrician and what he wanted to do as a direct primary care practice. And he's doing that and he is crushing it. Okay? Dr. Karen Kaufman is, is an allergist in, in Virginia, and she has had her practice for about three years at this point.
Started off as, uh, when we started working to get started as an employee. and she's built this practice and even though it's insurance based, she's making it work, right? She's making it work. And we're gonna talk about some of those things. this is Dr. Uh, Maisha. Clairborne, and what she does is corporate consulting, and speaking in the hospital setting.
And so not directly, hands-on patients, but she's supporting the teams that are getting the job done and she's thriving in that role. Okay, Dr. Rachel Rubin. She is, a urologist fellowship trained in, in, in sexual medicine. And she decided she wanted to do a direct specialty care practice.
And she is doing that. She was profitable from day one. Dr. Theresa Mann, she is an ob, GYN. She's working her job. And then while she was there working her job, she's like, it's unbelievable that these women postpartum have to sit in diapers, right? Like, with the ice and all that stuff to aid the healing.
And she went on and developed a product. She went on and developed. Something that brings back the dignity to women in the postpartum period where they no longer have to use diapers. They have special panties created for them that can house the ice and all that stuff. She created that and she's working her job.
Dr. Alicia Shelley, she is a family medicine doc with, they're really big focus on obesity medicine and she, she works her job and she says, I wanna be a speaker. I wanna be a paid speaker. And so she's a paid speaker talking about all things, weight loss and all of that. Really having a humongous impact.
Right. And and creating other streams of income and all of that stuff while she's practicing medicine the way she wants to. And I put this here for you to see. There's space for what you wanna do. There's space. We just need to learn how to build the business systems around them, right? So, Alicia Shelley, I think she just did her second TED Talk.
She's been on CNN. and, and she's done multiple paid speaking gigs and all of that, and that's just the way she wants to do it. So we, we can create and we can practice medicine the way we want to. We're all different. my, my dad, my and my sister, both physicians and we both treat medicine in three completely different ways, and it's all good.
Okay. So that's the space we're in now. Okay. So, I hope your hopes are up, but now I wanna look at, I want us to look at the practices of the ultra successful entrepreneurs. And the reason why I'm bringing this up is because, entrepreneurship is not something, to be taken lightly. It's doable.
And if you're someone who listens to my podcast, or you've heard me speak anywhere, you'll know that I'm a very, very, very optimistic person. Okay? Very optimistic. But you see with entrepreneurship, the, the failure rate is high. It's not higher than the failure rate of getting into residency, okay. Or getting into medical school.
So we've been there, done that. We have evidence that we can do hard things and we can beat the odds. So this is not an issue at all. But I do want to, I, I do want to show you the best practice. For the people who are thriving. So we can not copy and paste. We can model and paste. Okay? And so I really want you to lean in.
I became a student of business about 14 years ago. I study everything from startups to, one-on-one. We're talking one-on-one conversations with people who are running $500 million businesses. 'cause I'm so curious, I'm like, I wanna know what are the things that make them work. Okay. So I'm gonna give you three of the best things, and if there are questions and all of that, please feel free to post them in the chat and then we'll get to them at the end of it.
Okay, so I'm gonna give you three. The first one and the most important one maybe for right now, is making that transition from physician to physician, entrepreneur. So, so, so this is the deal. So starting a practice does not make you an entrepreneur. It makes you a physician who has a practice. Becoming an entrepreneur is what makes you run a successful practice.
There's a process there. Okay. So there was a doctor, I met her, in 2020 and she says, Dr. Una, I wanna start a practice. I wanna start a practice. I'm gonna start a practice the following year, so maybe in five months or so. And she's like, do I start working on, like the business, like the business thing to start working with you, for instance.
Now, or do I wait till when I start my practice and I'm like, opening your doors does not make you an entrepreneur, right? Like what you want to do now is acquire, like, acquire the skills that will make you an entrepreneur. So when you start, you're ready to hit the ground running. Now for this particular person, she did go on, to, she spent about four months right before she started her practice.
Learning about marketing, learning about selling, learning about operations, learning about how to understand finances, how to lead a team, and all of those things. And she did go on to start her practice and she started her practice with 350 patients on her waiting list, like literally waiting for her to open her doors.
She started on day one with 16 patients and has not slowed down since. Right. Is that transition the things that we did to become physicians? Did not prepare us to run successful businesses. The sooner we come to terms with that reality, the better. Okay? So that is the very first thing, their mindset shifts that need to happen and their skills that need to be acquired.
So let me give you, let me give you an example. as a, as a very good professional physician, back in the day when I would think about marketing. I would think about something slimy and sleazy that maybe people who sold used cars, used car salesmen would do. That was my interpretation of marketing salary.
Those were bad words. Okay, well, let me ask this question here and please indulge me and let me know in the chat. How many of you here right now, like right this moment, you have a problem that, or let's call it a challenge? You have a challenge right now that you would happily pay somebody to make go away marketing your business.
Making your business visible is not about promoting yourself. That's what a lot of doctors, they're like, I don't wanna promote, I don't want it to seem like I'm promoting myself. It's not about promoting yourself. It is about putting yourself out there. So the person who has the problem that your business solves can find you.
They already, they already know they have the problem. They already want to solve the problem they're willing to pay to make the problem go away. So, for instance, if you're here and you have a direct primary care practice, there are people who are tired of the 15 minute appointments. They really want somebody who will sit down and listen to them and work through their problems.
And they would have access to, they don't have to go to the office every single time 'cause they can do some telemedicine. They can text for easy, quick things. They, they have no idea you exist if they knew you existed. They would, they would sign up to work with you yesterday. And so I want you to think about that simple mind shift, mindset shift, how it affects the way you show up, how it affects the way you invite people to work with you, how it affects the way you think about social media.
You think about speaking and all of those things. That's just one shift we have to make the transition from physician to physician, entrepreneur, physician entrepreneurs. Are people who, they don't say, I'm gonna hang the shingle, and people will come. They understand there are things that need to be done.
So that means talking about things around marketing, uh, things about, for instance, hiring a team, leading a team. I cannot tell you how many people I've spoken to, they have private practices, but they're scared to lead their team. They're scared to have team meetings. They're scared to talk to their biller even though the billing is not working.
These are all things that we have to, we have to understand. We need to gain competence in. We have to have competence, okay? So I'm a physician. I studied for over a decade to become a physician. Very good. But if I am going to be somebody who builds a profitable, successful business, that gives me the opportunity to help a lot of people and create financial and time freedom.
Then it means that I'm going to need to stack on other skills. Okay. So when I was done with my medical training, I kind of had this feeling like, shoot, I've paid my dues. Okay? But as a clinician, you have, but if you're gonna go into the world of entrepreneurship, more dues are required. Okay? But I can promise you that everything you'll need to learn to be a successful entrepreneur will be easier than what you had to do to become a doctor.
Okay? So making that transition, coming to terms with it. Coming to terms with the fact that I have to learn new things, being coachable, being curious, being willing to read the books, being willing to have ask questions, will being willing to get mentors. Some will be people who will mentor you. Some of the people will be people.
You'll be coaches that you have to pay, whichever. But an education is required. A metamorphosis is required. Your evolution is required. The version of you that exists now is different from the version required to build a successful business. Okay? And I can't emphasize this enough, but it's is very important that we understand this.
I wanna give you one more example that before I move on, so this will make sense to you. And this is from a mindset perspective. One of the things that a lot of times as doctors we don't wanna talk about is money. We don't want to ask for the money. I, I cannot, I I, I recently was talking with a doc who said, like I've, I've, I've used $200,000 in loans for my practice and we're still not turning a profit.
And then we start running a diagnosis and he's not collecting any deductibles and he's not collecting any copays. And I'm like, why are you not collecting deductibles and copays? And he says, because. sometimes the patients don't have it, or when we ask for it, they get upset and all of that.
I'm like, at the end of the day, if there is no margin, there is no mission. You will have to shut this down. Like you, you'll have to, you don't get paid because you saw patients. You get paid before because you got paid. You asked to be paid, and you got paid. And so. We have to, we have to get more comfortable.
So things come up like, oh, you're a greedy doc. Oh, you're already doing better than these people and you're taking money from them. How much is enough? And all of those things. But the truth of the matter is businesses, in economic sport, the numbers have to work. The math has to math, okay? An entrepreneur will understand like, if, if, if I cannot make this business profitable, I have to go out of business.
The end. What is the number one reason why private practices go out of business? Cash flow problems, right? It's like the aorta of your, your business. If you nick it, it dies, And so we have to make that transition where we're comfortable. Money's not a bad thing. It's, it's mercury paper with dead man's faces on it.
It's not good or bad, it just is. Right? So the very first thing I, I hope you got it, is making a transition. The transition needs to be made from physician to physician entrepreneurs. So physician is great, but we need to stack something else on that. Okay. All right. Let's look at the second thing. Okay.
This right here, this right here will change everything for you when you start thinking this way. So I think this was four years into my private practice. There was an older, pediatrician. She had been in practice for about 30 years, and she decided that she wanted to solve her practice. And so her broker came to my practice and said, Hey, there's a, there's a doctor, she's, she's a, she's about, 20 miles from you or so, and she wants to sell her practice and she wants to sell her practice for $40,000.
Now I'm thinking, okay, so that may or may not be a good deal. We don't know what we're working with, and, and I was curious, so I was like, okay, let's go, take a look at the practice. I went with my husband and we went. To look at the practice and what I saw literally broke my heart. Well, not literally, I'm still here, kind of sorta.
And when I went there, this is what I saw. She was the only doctor working there. There was still on paper charts. She did not have any documented systems, processes or anything. It was not a building that she owned. It was a lease, and the lease had a year left on it. There was nothing to sell. What she had done for 30 years is that she owned a job.
She owned a job for 30 years, and so she eventually had to close the practice. Now I need you to think about this and let's step out of healthcare for a bit. I want you to imagine, and I, and I don't know about her family, so I'm making up this part, but I want you to imagine having a husband that had to sacrifice a lot as they built up this practice.
Having children who maybe she missed games and all of those things because she was building this practice. maybe in the beginning she had, so much revenue. She like income. She had to give up because she was building this practice and at the end of the day, she couldn't even sell it for 40.
She could sell it for nothing. And so she had to shut it down, which means it cost her money because she would still have to store records and do all of those kind of things. And in the, on the, on the, on the other side, in, in the business world, I was talking to, a ba, a personal banker. So she's a personal banker for people of ultra high net worth.
So in their books, that's 20, 25 million and above. She says, most of the people there came into their money through a monetization event. They sold a business. And I was like, isn't that fascinating that in healthcare we're paying, we're building businesses that at the end of the day are worth nothing. And then on the outside, people are building businesses that when they're done, it makes them right.
And now understand that we're talking about business here. So that does not mean we put patient care first at all. Right? But I'm talking to doctors. I've, I've talked to a lot of doctors. We have the patient care people before profit being down. Like that's the way we operate. Okay? So, so I'm focusing on the business part because this is not a piece that we, we tend to be aware of.
And so at the end of the day, please hear me when I say it doesn't, it doesn't seem like it matters as much in the beginning, but at the end of the day, we are all going to exit our businesses. Every last one of us. We're gonna build them, we're gonna exit them. We can exit them based on, we just shut it down.
That could be the exit. The exit could be we pass it on to a family member. The exit could be that we sell it, but there is going to be an exit. And if you're gonna take the time to build a business, then from the very beginning, you want to build the business in such a way that the business can work without you.
You want to build the business as your product, like your business is your product. So you're building the systems, you're building the team, you're building the processes, you're documenting things. You have your legal stuff in order, right? You have your revenue in order. Why? Because you, you don't have to sell it.
That's not the point, but if you do decide to sell it, it is typically to you. You can't decide and be ready, right? Because it's a multi-year process to get a business ready to sell, or a business ready to exit. Please understand, I'm not talking about you must exit, but you do want to have options. Okay? So for instance.
For me personally, I knew that, I would want to be in a position where I don't have to work where I work because I want to. I knew I wanted to be in a position where I gave myself space so I have the time to do what I really want to do whenever that is. And so from the very beginning, from the very beginning of my private practice.
I built it in such a way that if I am not there, it works. And I tested it many times. I would go away for a month, I would go away for five weeks. I would drop to three days a week. I would do all of these things. And two and a half years ago, I was like, man, like I the way REM D is going, like. I run, I run four podcasts.
I run three companies. I co-pastor church with my husband. I have four kids. I'm over. I'm, I'm homeschooling the older two. Like all of these things. And I was like, I need to go all in on that. And it was literally a decision I made that, okay, in the next three weeks, I'll do my last shift and I'm done.
And that was in 2020, no 2021. And, and the practice has grown every year since I've been away.
Sign up to receive email reminders, news, and free stuff every week!
Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.
Build a Profitable Practice on Your Own Terms
Lecture by Dr. Nneka Unachukwu - Episode 450
Thank you very much Dr. John for that very kind introduction and we've known each other for years. I'm very honored to be here. so a big thank you to you and a big thank you to Dr. Tom Davis and the entire team for putting this together. the state of healthcare now, all hands are needed on deck and all the support that physicians can get will take all of it.
So thank you for this. And we are, in for a treat. I am just gonna take a moment. I. Have some slides I'm going to use here and we are going to get into this. Okay? So please let me know in the chat or maybe, maybe John, you can tell me if my screen is okay, you guys. Yep, it's looks great. Okay. Excellent.
Okay. All right. So today we are going to, we're gonna look at something that is, I think is very critical, for the physician, for physicians in general, for the entire community. And that is really around. building a, a profitable business and practicing medicine on your own terms, and, we're really going to delve into how you can do this.
I do believe that entrepreneurship is one of. The things that we do need to do if we're going to, reclaim our autonomy, get rid of burnout, turn the healthcare space right side up and all of that. And so I wanna invite everyone to lean into this with a really open heart and just be curious. and, and, and we're gonna talk through a lot of things here and it's not designed to be,
It's not designed to just be a lecture. It's designed to be something that you can walk away with and completely change the way you think about things and the way you operate. Okay? So, I put this picture here because, this is the way I want us to approach this. So every time I get to stand by the ocean, I don't see the end of it, and it just represents something that is very limitless.
And as physicians after years and years of training, we are tempted to think we are one trick ponies and, we can only do things a certain way. And the state, we, the state of the space right now, we're stuck. And I just want to invite you to think like limitless. I can have many iterations of myself.
I can totally reinvent myself. I can change the way things are. I'm not stuck, and it, that's really the way I want us to think about this. So we're, we're gonna look at a lot of things like, best practices for successful entrepreneurs. We're gonna look at why branding's important and how to build so that you can sell all those kind of things.
It's gonna be amazing, but I want you to think limitless, not stuck. Not a one trick pony. I'm not a tree. I can change. I, I just wanna invite us to think that way. so this is me. I'm Dr. Una, and I wanna give you a little bit of my background just because it will, it will put everything that we're gonna talk about here in context.
so I'll take us back to 2016. in 2016, I had run my private practice for about six years At that time. And private practice was great. I had somebody who worked with me. she worked every Friday, and so that mean, that means I had a long weekend, every weekend. I had understood quite a bit of the business of medicine, so yes, I was serving my patients at the highest level, but also we were building a practice that was thriving.
I was profitable and all that, so everything was good. And then I remember being in my office, my home office one day, and I just had this aha moment. So this is almost eight years ago. And the aha moment is, was that medicine, as we knew it at the time, had changed fundamentally. And if the only thing I knew how to do was to doctor in the way I had been doctoring.
I was going to be out of luck. It, it was, there was a, there was a lot of urgency with it. I don't know which other way to describe it was like you have to reinvent yourself. Like imagine if you could no longer. Put your hands on patients, you could no longer examine patients and do that. How would you still have a career that is very meaningful in, in, in the sense of you're still able to serve people, you're still able to serve patients, you're still able to make a, a difference, you're still able to, maintain your financial freedom and all of that.
Like, what would you do? And so I didn't know anything about anything. I didn't know anything about coaching. I didn't know anything about speaking. I didn't know any, I was just a, I was a great pediatrician. I put my hide down. I did the work that, that's, that's who I was at the time. And so I'm grateful that at that point I was curious.
I was coachable and I decided that I was gonna chase this line of thinking down and I was not gonna quit. and so, the first thing I did was, I, I enrolled in, in, in a program to learn about speaking. because that was a, the next opportunity that was in front of me, I was like, well, what if I became a speaker?
What if I became a consultant? I mean, I run a successful practice. Maybe I can teach other people how to do that. I could be an author. I could be, I, I could write, I could write books. I can do all these things and I'm gonna give some of the process later on in the talk. But to go from that person who, yes, I understood some of the business of private practice, but.
To go from that person to a speaker podcast or a bestselling author, building a business school, being featured in Forbes, making it to the Inc 5,000 list of fastest growing companies is just a testament to the fact that we can change, we can evolve, we can create life on our terms. We are not stuck.
Things can change. And that is the, that's the whole essence of that. and so really I want us to stay in that space. I mean, I started off entrepreneurship as a really, really socially awkward, super shy, introverted introvert. And I, I had the makings of a worker be like, like, that that's what I was going to do.
I did not think entrepreneurship was a thing. I would never be on stage. I wouldn't, I wouldn't be speaking to you. I wouldn't be doing any of those things. And so it does sound a little cliche, but the truth of the matter is, if I can do what I do now, it is something that is available to physicians. It, it really just is.
Okay. All right. So now. Sometimes people say, don't get your hopes up. And I put this here because I want you to get your hopes up. I want you to get your hopes up. I want you to see what is possible for physicians. And I put this here because you may be thinking, well, I really just wanna have a direct primary care type of practice.
So I direct specialty care, ki kind of practice. Or I just, I like my job, I wanna work my job, but I also wanna speak, or I have this product I wanna develop. Right? And I, I put this here because. This represents like it. It's part, it is not everything, but these show you so many different options. So these are real life people.
These are people that I've personally, that I personally work with. Okay. And I wanna show, these are all doctors who've decided I'm going to build a successful business. A dream business and I'm gonna be build my dream life concurrently. Right? So they're living life, I'm practicing medicine on their terms.
And I just wanna show you this. So whatever your dream is, there's space for it, right? Okay, so, so here is Dr. Vlad. Dr. Vlad is a pediatrician and what he wanted to do as a direct primary care practice. And he's doing that and he is crushing it. Okay? Dr. Karen Kaufman is, is an allergist in, in Virginia, and she has had her practice for about three years at this point.
Started off as, uh, when we started working to get started as an employee. and she's built this practice and even though it's insurance based, she's making it work, right? She's making it work. And we're gonna talk about some of those things. this is Dr. Uh, Maisha. Clairborne, and what she does is corporate consulting, and speaking in the hospital setting.
And so not directly, hands-on patients, but she's supporting the teams that are getting the job done and she's thriving in that role. Okay, Dr. Rachel Rubin. She is, a urologist fellowship trained in, in, in sexual medicine. And she decided she wanted to do a direct specialty care practice.
And she is doing that. She was profitable from day one. Dr. Theresa Mann, she is an ob, GYN. She's working her job. And then while she was there working her job, she's like, it's unbelievable that these women postpartum have to sit in diapers, right? Like, with the ice and all that stuff to aid the healing.
And she went on and developed a product. She went on and developed. Something that brings back the dignity to women in the postpartum period where they no longer have to use diapers. They have special panties created for them that can house the ice and all that stuff. She created that and she's working her job.
Dr. Alicia Shelley, she is a family medicine doc with, they're really big focus on obesity medicine and she, she works her job and she says, I wanna be a speaker. I wanna be a paid speaker. And so she's a paid speaker talking about all things, weight loss and all of that. Really having a humongous impact.
Right. And and creating other streams of income and all of that stuff while she's practicing medicine the way she wants to. And I put this here for you to see. There's space for what you wanna do. There's space. We just need to learn how to build the business systems around them, right? So, Alicia Shelley, I think she just did her second TED Talk.
She's been on CNN. and, and she's done multiple paid speaking gigs and all of that, and that's just the way she wants to do it. So we, we can create and we can practice medicine the way we want to. We're all different. my, my dad, my and my sister, both physicians and we both treat medicine in three completely different ways, and it's all good.
Okay. So that's the space we're in now. Okay. So, I hope your hopes are up, but now I wanna look at, I want us to look at the practices of the ultra successful entrepreneurs. And the reason why I'm bringing this up is because, entrepreneurship is not something, to be taken lightly. It's doable.
And if you're someone who listens to my podcast, or you've heard me speak anywhere, you'll know that I'm a very, very, very optimistic person. Okay? Very optimistic. But you see with entrepreneurship, the, the failure rate is high. It's not higher than the failure rate of getting into residency, okay. Or getting into medical school.
So we've been there, done that. We have evidence that we can do hard things and we can beat the odds. So this is not an issue at all. But I do want to, I, I do want to show you the best practice. For the people who are thriving. So we can not copy and paste. We can model and paste. Okay? And so I really want you to lean in.
I became a student of business about 14 years ago. I study everything from startups to, one-on-one. We're talking one-on-one conversations with people who are running $500 million businesses. 'cause I'm so curious, I'm like, I wanna know what are the things that make them work. Okay. So I'm gonna give you three of the best things, and if there are questions and all of that, please feel free to post them in the chat and then we'll get to them at the end of it.
Okay, so I'm gonna give you three. The first one and the most important one maybe for right now, is making that transition from physician to physician, entrepreneur. So, so, so this is the deal. So starting a practice does not make you an entrepreneur. It makes you a physician who has a practice. Becoming an entrepreneur is what makes you run a successful practice.
There's a process there. Okay. So there was a doctor, I met her, in 2020 and she says, Dr. Una, I wanna start a practice. I wanna start a practice. I'm gonna start a practice the following year, so maybe in five months or so. And she's like, do I start working on, like the business, like the business thing to start working with you, for instance.
Now, or do I wait till when I start my practice and I'm like, opening your doors does not make you an entrepreneur, right? Like what you want to do now is acquire, like, acquire the skills that will make you an entrepreneur. So when you start, you're ready to hit the ground running. Now for this particular person, she did go on, to, she spent about four months right before she started her practice.
Learning about marketing, learning about selling, learning about operations, learning about how to understand finances, how to lead a team, and all of those things. And she did go on to start her practice and she started her practice with 350 patients on her waiting list, like literally waiting for her to open her doors.
She started on day one with 16 patients and has not slowed down since. Right. Is that transition the things that we did to become physicians? Did not prepare us to run successful businesses. The sooner we come to terms with that reality, the better. Okay? So that is the very first thing, their mindset shifts that need to happen and their skills that need to be acquired.
So let me give you, let me give you an example. as a, as a very good professional physician, back in the day when I would think about marketing. I would think about something slimy and sleazy that maybe people who sold used cars, used car salesmen would do. That was my interpretation of marketing salary.
Those were bad words. Okay, well, let me ask this question here and please indulge me and let me know in the chat. How many of you here right now, like right this moment, you have a problem that, or let's call it a challenge? You have a challenge right now that you would happily pay somebody to make go away marketing your business.
Making your business visible is not about promoting yourself. That's what a lot of doctors, they're like, I don't wanna promote, I don't want it to seem like I'm promoting myself. It's not about promoting yourself. It is about putting yourself out there. So the person who has the problem that your business solves can find you.
They already, they already know they have the problem. They already want to solve the problem they're willing to pay to make the problem go away. So, for instance, if you're here and you have a direct primary care practice, there are people who are tired of the 15 minute appointments. They really want somebody who will sit down and listen to them and work through their problems.
And they would have access to, they don't have to go to the office every single time 'cause they can do some telemedicine. They can text for easy, quick things. They, they have no idea you exist if they knew you existed. They would, they would sign up to work with you yesterday. And so I want you to think about that simple mind shift, mindset shift, how it affects the way you show up, how it affects the way you invite people to work with you, how it affects the way you think about social media.
You think about speaking and all of those things. That's just one shift we have to make the transition from physician to physician, entrepreneur, physician entrepreneurs. Are people who, they don't say, I'm gonna hang the shingle, and people will come. They understand there are things that need to be done.
So that means talking about things around marketing, uh, things about, for instance, hiring a team, leading a team. I cannot tell you how many people I've spoken to, they have private practices, but they're scared to lead their team. They're scared to have team meetings. They're scared to talk to their biller even though the billing is not working.
These are all things that we have to, we have to understand. We need to gain competence in. We have to have competence, okay? So I'm a physician. I studied for over a decade to become a physician. Very good. But if I am going to be somebody who builds a profitable, successful business, that gives me the opportunity to help a lot of people and create financial and time freedom.
Then it means that I'm going to need to stack on other skills. Okay. So when I was done with my medical training, I kind of had this feeling like, shoot, I've paid my dues. Okay? But as a clinician, you have, but if you're gonna go into the world of entrepreneurship, more dues are required. Okay? But I can promise you that everything you'll need to learn to be a successful entrepreneur will be easier than what you had to do to become a doctor.
Okay? So making that transition, coming to terms with it. Coming to terms with the fact that I have to learn new things, being coachable, being curious, being willing to read the books, being willing to have ask questions, will being willing to get mentors. Some will be people who will mentor you. Some of the people will be people.
You'll be coaches that you have to pay, whichever. But an education is required. A metamorphosis is required. Your evolution is required. The version of you that exists now is different from the version required to build a successful business. Okay? And I can't emphasize this enough, but it's is very important that we understand this.
I wanna give you one more example that before I move on, so this will make sense to you. And this is from a mindset perspective. One of the things that a lot of times as doctors we don't wanna talk about is money. We don't want to ask for the money. I, I cannot, I I, I recently was talking with a doc who said, like I've, I've, I've used $200,000 in loans for my practice and we're still not turning a profit.
And then we start running a diagnosis and he's not collecting any deductibles and he's not collecting any copays. And I'm like, why are you not collecting deductibles and copays? And he says, because. sometimes the patients don't have it, or when we ask for it, they get upset and all of that.
I'm like, at the end of the day, if there is no margin, there is no mission. You will have to shut this down. Like you, you'll have to, you don't get paid because you saw patients. You get paid before because you got paid. You asked to be paid, and you got paid. And so. We have to, we have to get more comfortable.
So things come up like, oh, you're a greedy doc. Oh, you're already doing better than these people and you're taking money from them. How much is enough? And all of those things. But the truth of the matter is businesses, in economic sport, the numbers have to work. The math has to math, okay? An entrepreneur will understand like, if, if, if I cannot make this business profitable, I have to go out of business.
The end. What is the number one reason why private practices go out of business? Cash flow problems, right? It's like the aorta of your, your business. If you nick it, it dies, And so we have to make that transition where we're comfortable. Money's not a bad thing. It's, it's mercury paper with dead man's faces on it.
It's not good or bad, it just is. Right? So the very first thing I, I hope you got it, is making a transition. The transition needs to be made from physician to physician entrepreneurs. So physician is great, but we need to stack something else on that. Okay. All right. Let's look at the second thing. Okay.
This right here, this right here will change everything for you when you start thinking this way. So I think this was four years into my private practice. There was an older, pediatrician. She had been in practice for about 30 years, and she decided that she wanted to solve her practice. And so her broker came to my practice and said, Hey, there's a, there's a doctor, she's, she's a, she's about, 20 miles from you or so, and she wants to sell her practice and she wants to sell her practice for $40,000.
Now I'm thinking, okay, so that may or may not be a good deal. We don't know what we're working with, and, and I was curious, so I was like, okay, let's go, take a look at the practice. I went with my husband and we went. To look at the practice and what I saw literally broke my heart. Well, not literally, I'm still here, kind of sorta.
And when I went there, this is what I saw. She was the only doctor working there. There was still on paper charts. She did not have any documented systems, processes or anything. It was not a building that she owned. It was a lease, and the lease had a year left on it. There was nothing to sell. What she had done for 30 years is that she owned a job.
She owned a job for 30 years, and so she eventually had to close the practice. Now I need you to think about this and let's step out of healthcare for a bit. I want you to imagine, and I, and I don't know about her family, so I'm making up this part, but I want you to imagine having a husband that had to sacrifice a lot as they built up this practice.
Having children who maybe she missed games and all of those things because she was building this practice. maybe in the beginning she had, so much revenue. She like income. She had to give up because she was building this practice and at the end of the day, she couldn't even sell it for 40.
She could sell it for nothing. And so she had to shut it down, which means it cost her money because she would still have to store records and do all of those kind of things. And in the, on the, on the, on the other side, in, in the business world, I was talking to, a ba, a personal banker. So she's a personal banker for people of ultra high net worth.
So in their books, that's 20, 25 million and above. She says, most of the people there came into their money through a monetization event. They sold a business. And I was like, isn't that fascinating that in healthcare we're paying, we're building businesses that at the end of the day are worth nothing. And then on the outside, people are building businesses that when they're done, it makes them right.
And now understand that we're talking about business here. So that does not mean we put patient care first at all. Right? But I'm talking to doctors. I've, I've talked to a lot of doctors. We have the patient care people before profit being down. Like that's the way we operate. Okay? So, so I'm focusing on the business part because this is not a piece that we, we tend to be aware of.
And so at the end of the day, please hear me when I say it doesn't, it doesn't seem like it matters as much in the beginning, but at the end of the day, we are all going to exit our businesses. Every last one of us. We're gonna build them, we're gonna exit them. We can exit them based on, we just shut it down.
That could be the exit. The exit could be we pass it on to a family member. The exit could be that we sell it, but there is going to be an exit. And if you're gonna take the time to build a business, then from the very beginning, you want to build the business in such a way that the business can work without you.
You want to build the business as your product, like your business is your product. So you're building the systems, you're building the team, you're building the processes, you're documenting things. You have your legal stuff in order, right? You have your revenue in order. Why? Because you, you don't have to sell it.
That's not the point, but if you do decide to sell it, it is typically to you. You can't decide and be ready, right? Because it's a multi-year process to get a business ready to sell, or a business ready to exit. Please understand, I'm not talking about you must exit, but you do want to have options. Okay? So for instance.
For me personally, I knew that, I would want to be in a position where I don't have to work where I work because I want to. I knew I wanted to be in a position where I gave myself space so I have the time to do what I really want to do whenever that is. And so from the very beginning, from the very beginning of my private practice.
I built it in such a way that if I am not there, it works. And I tested it many times. I would go away for a month, I would go away for five weeks. I would drop to three days a week. I would do all of these things. And two and a half years ago, I was like, man, like I the way REM D is going, like. I run, I run four podcasts.
I run three companies. I co-pastor church with my husband. I have four kids. I'm over. I'm, I'm homeschooling the older two. Like all of these things. And I was like, I need to go all in on that. And it was literally a decision I made that, okay, in the next three weeks, I'll do my last shift and I'm done.
And that was in 2020, no 2021. And, and the practice has grown every year since I've been away.
Sign up to receive email reminders, news, and free stuff every week!
Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.
Disclaimers:
*Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.
The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.
The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career.
Leave A Comment
You must be logged in to post a comment.