Interview with Dr. Bart Kaczmarek – 470
In today's interview, Dr. Bart Kaczmarek explains how it is possible to see more patients and generate great income with no burnout if you learn to properly delegate most of the routine work to nonphysician staff.
He walks through the system he built to reorganize his family medicine practice without extra funding, and the software tool DoctorFlow that keeps the whole system running smoothly.
The CRAFT Framework: Enabling Great Income with No Burnout
Most physicians accept the inefficiencies of their practice as fixed. Dr. Kaczmarek's starting point was the opposite: almost everything a physician does in a typical day can be unbundled, delegated, or restructured, without waiting for a payer increase, health system reform, or extra funding.
CRAFT is the five-step framework he developed retrospectively by analyzing what actually built his practice.
- C is for clean — identifying billing that is already permissible but being undercharged, particularly for paperwork and administrative work that physicians often absorb for free.
- R is for release — delegating all paperwork to a nurse or support staff, so the physician never touches it.
- A is for assemble — using the income generated from the first two steps to fund the next team member, creating a self-building structure.
- F is for flow — managing room sequencing and patient handoffs so the physician is never waiting and never looking for staff.
- T is for throughput — measuring time and identifying where capacity is being lost. DoctorFlow addresses the final two steps specifically, and is most effective once the earlier delegation layers are already in place.
DoctorFlow: What It Does and Who It's For
DoctorFlow began as a set of flags on exam room doors in a four-room clinic. When Dr. Kaczmarek moved to a seven-room practice, the flags stopped working, so he hired an engineer on Fiverr and built the prototype himself. Seven clinics are now running it.
The system functions as a real-time coordination tool between the physician and support team. Tablets mounted near exam room doors show patient type and readiness status, allow staff to signal each other with specific commands, and give the physician a live view of who is prepped and waiting, without requiring them to search, ask, or switch tasks.
DoctorFlow is intentionally not integrated with EMR systems, which keeps deployment fast: installation takes half a day, staff training takes fifteen to thirty minutes, and implementation is typically smooth within the first session. The ideal candidate is a high-volume practice, walk-in or urgent care clinic, where team coordination often breaks down and every minute of physician time counts.
Summary
The CRAFT manuscript is a free starting point at craft.doctorflow.com. DoctorFlow information and demo booking are found at doctorflow.com, and ongoing content on this topic is available on the Dr. Bart Kaczmarek YouTube channel.
NOTE: Look below for a transcript of today's episode.
EXCLUSIVE: Get a regular dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.
Links for Today's Episode:
- DoctorFlow
- Dr. Bart Kaczmarek's LinkedIn Page
- The CRAFT Manuscript on Patient Throughput
- Dr. Kaczmarek's YouTube Channel
- Dr. Kaczmarek's Facebook Page
- How to Build Your Own Awesome and Dynamic Private Practice
- Building the Private Practice of the Future with Technology
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See More Patients and Generate Great Income with No Burnout
Episode 470
JOHN: Welcome back, Nonclinical Nation! Today I'm presenting my interview with Dr. Bart Kaczmarik, a family physician who developed a process to make his family medicine practice super efficient and fun.
Dr. Kaczmarik completed medical school in Poland and subsequently moved to the U.S. where he completed his family medicine residency. He later moved to Windsor, Ontario and in March of 2025 founded Hope Health, his medical practice.
It was at Hope Health, while trying to improve patient flow and efficiency, that he developed DoctorFlow. DoctorFlow is a company that built a system designed to eliminate wasted time in a busy physician's office, which results in better patient flow, happier patients, and more satisfied physicians working fewer hours each week than previously.
After using it to more than double his patient volumes while reducing his office hours, he turned it into a business to share with other physicians interested in reducing burnout while enhancing efficiency and income.
I'm always happy when I find a guest who has solved a problem for him or herself and then builds a business to share with other physicians. Today's guest has done just that and is here to explain how you can see more patients, enjoy your practice, and earn more, but without becoming burned out.
Dr. Bart Kaczmarik, welcome to the show.
DR. KACZMARIK: Thank you very much, John. I'm very happy to be here. I'm excited.
JOHN: I'm glad to have you, because when I read your story a little bit, I was like, "Oh, this is very interesting, and just your life is interesting, I think." But why don't you tell us a little bit about your background and your early career?
DR. KACZMARIK: Yeah, my story starts in Poland, when I went to med school. I started my medical career, I went to residency, studied residency, then I left, moved around, chased my wife who's from Canada, and we ended up kind of on the other side of Detroit in Canada. Ended up being in Detroit at Henry Ford Hospital, did a little bit of—I wanted urology back, I was doing in Poland, and I landed in family medicine. That's the kind of medical super quick wrap-up.
And for a long time I was disappointed that all I am is family doctor, right? Because all the time my mindset was on being someone like a super surgeon, and my mind was on it. It just didn't happen, and for a long time I was so, so, so upset.
Now I realize that this is the specialty that I actually can redesign the most because it all depends on me. I'm not depending on anybody's hours, schedule, on hospital politics, on salaries. I have a model where I can actually find my own efficiency.
My first job was actually at Henry Ford Hospital, a child's clinic, a community clinic. Great two years, and there it was, it was great. The only thing was that I, as much as I was excited to have this upgrade from resident to attending doctor, the salary went up. It didn't go up that much, but that wasn't the worst thing.
The worst thing I realized pretty quickly: I ran into blockages, blockages where I couldn't really run things the way I wanted to. Not that I wanted to reinvent medicine, but for example, in the first job, we had some medical assistant. It turned out there was one medical assistant for like two or three doctors, and whenever you needed this person, they weren't there, or if you had her, then she was on lunch till the second lady.
So there was such an inconsistent and unreliable support that started my kind of frustration with this. And then I moved to Canada. I inherited a family practice, like a thirteen hundred patient paper charts—mind you, it's a real good discovery. Then we transitioned to some electronics.
I graduated from there, changed the buildings a few times to a building that now I'm part equity owner in. I have from a two-room practice with these paper charts, thirteen hundred patients, now I am seven rooms plus two procedure rooms just from me, and I utilize it completely with my efficiency system, and I'm serving four thousand patients. Now I've found the way to actually make it work.
JOHN: Sounds good. And both the Canadian system and the U.S. system—I mean, taking care of patients is the same, but the system we work in is maybe a little different. So maybe explain, was it much of a culture shock to go from Detroit to Canada? I mean, or is it, once you're in the system and you understand it, you just see patients and do what you do?
DR. KACZMARIK: Yeah, I was a salary model in the States, so I understand how the billing works, how the medical decision making, how Epic works, because I was at Henry Ford Hospital. The night they implemented Epic, I was on call, so that was—no, but that was fun.
And here, things are a little different. It's a single public payer in Ontario, it's OHIP. Patients just show the card, they bill it, and every month I'm getting what I bill for. Covered, which is almost everything unless cosmetic.
So if you are unhappy with your visit that is for forty dollars, you want to upcharge them twenty to make it sixty, you can't do that because it's already on the list of what's covered. So you gotta agree with it and just charge what's available. So less flexibility.
And everybody, as much as in the States, is the picture of America. Like health systems are running it, and insurance companies are in charge of everything. They've built the channels from top to bottom and independent doctors are less and less popular. That's why the surge of the direct primary care, to get out of this machine.
But here, everything is, most, almost everything's independent owner/operator. Like the chains are rare. Someone has, I don't know, three urgent care clinics, five urgent care clinics in Toronto, maybe something like that, in the biggest places. Everything is like either a doctor owns it or a pharmacist owns a clinic, and then the doctor is kind of working in there.
It's more of like a smaller size. Fee for service is still prevalent. Some models are showing like a subscription model, capitation models, something's in the middle, and more and more popular the capitation models.
But overall, I mean, what brought me to Canada is that I've seen those doctors, because my wife studied doctor too. I've seen them like where we live in Canada, like biking, oh, it's something like some outdoors. They just had such, they just had life, right?
And when I was working at the company before, it felt like it's a great facility, but like everybody was working. So that's what attracted me originally, but it ends up that there's similar burnout problems, similar frustrations, maybe in a different aspect of it a little bit, but overall, the disillusionment and unhappiness is growing among the doctors. That's what I'm seeing all around, kind of in a similar way.
JOHN: Okay, that makes sense. I mean, really, unless in the U.S., unless you're in an HMO, for the most part, you're just seeing patients, you're getting paid by the patient you see, you get paid for what you do. So really, everything you're doing for ninety percent of us over here, it's the same kind of model, just you have one payer, we have hundreds of payers in that sense, some better than others.
So, and so I'm assuming that what we're going to talk about later, called DoctorFlow, I'd like to get the plug in early because even some people don't listen to the whole thing, but would apply to people working, seeing patients in the U.S. as well as Canada, I'm assuming.
DR. KACZMARIK: Yes. This is the system that I built is for basically, it's like a modern flags of 2026 when I worked the first time. In my clinic there was flags on the doors. You marked it for the nurse to come in, you marked it for the doctor to come in, and that's kind of what it does in a super advanced way where you can communicate between teams, handoff between teams, it measures your time at the end of the day of KPIs where your lost opportunities are.
And I find that it's like finding seamless lost time, and it works really well. All the clinics that are running it right now—there's seven total clinics running it in independent places—and I find that it helps the most the doctors who are running a very high volume practice with a team that prepares for them so that communication could break, and the system puts it together and allows handoffs.
So if I want something from my team and I leave the room, they prepare everything for me, but if something's missing, I leave the room and say to the patient, "I'll be back and someone will be back to take care of it." The extra paperwork, the show last minute, or "By the way, can I get a vaccine?" I say, "Of course." I leave the room, press a button, nurse back to room for vaccine, and the nurse will get there in the order while I'm seeing the next patient and I don't have to look for anybody.
That's the whole idea here. That's what makes it work, but it has to be a high volume to see that need for coordination.
JOHN: Okay. Well, yeah, we'll get into the details of that in a minute, so that's a good overview. I think it's the thing that drives physicians crazy. They're in a practice, whether it's their own or it's part of a group. And it's just the systems don't work well together.
Now let me ask you this though, because it popped into my head. You were on Epic, right?
DR. KACZMARIK: I was. Before.
JOHN: Now that isn't necessarily physician friendly. Is the system that you're on in terms of your EMR any easier to work with, and does it integrate with DoctorFlow or not? Probably not, it's just something else. But what do you think? Is that a barrier to getting more efficient using a clunky kind of—I remember when I was doing medicine still before I stopped, and it was in COVID, and so we were doing COVID tests.
Okay, so we had to have a different lab do the COVID test, and it was handed off sixteen different times, and I counted the clicks. It took me twenty-five clicks to enter the result of the COVID test. That's better now, but yeah, you can kind of relate to those kind of issues.
DR. KACZMARIK: Absolutely. Yeah, if you tell me that I could save five seconds on something with my patient care, it's like, please sign me up, I would love it.
And the EMRs have one thing to do. They weren't designed with users in the center. They were designed with anything else in the center. And the user came as the last piece saying, "Okay, here's the list of features." And that ends up being twenty-five clicks to refill a tile, right?
And that's, I think in Canada, those EMRs are a little less clunky. The one I use is—I use the name for it—the least bad that I found. There's a lot of keyboard shortcuts. I don't have to touch a mouse. That's super helpful.
Although I think it is easier than, because we don't have to connect diagnosis to the treatment. Seeing the newer emerging EMRs in the market that are small—they're just like twenty, thirty clinics and they're just starting—they are finally designed like an iPhone with a user in the center. And I tested a few of them and I think the future's promising.
It's EMRs with AI integrated inside by default. It's not a patch-up. Workflows are flexible. You can not only make the workload to be remembered, but also kind of have the system learn what you like to do. I think future's right.
JOHN: That's good, that's good. Okay, but that wasn't the main problem you were solving for yourself. It was just this flow of patients to you, to the other members, back to you or not back to you, to the lab, to the X-ray, whatever. So tell us what is it.
What was the first thing or the first step you took when you said, "Okay, I gotta figure out how to make this flow better"? Just tell us what popped in your head and then how long you've been working on this and what were the main issues that you had to resolve.
DR. KACZMARIK: Yeah, so it grew from my own need, from the necessity to communicate, because the first clinic I was in had two rooms. This is a classic example of who doesn't need it, right? Because I don't need to know what my next room is if I have room one and two. It's all good for me. Nuclear, right? There's no electronics involved.
And if I have no one prepping and helping me, even easier. There's no communication with the team, but you end up doing the same tedious things, seeing fifteen patients a day, and leaving after eight hours of work, and making hundreds of dollars a day.
JOHN: Yeah, right.
DR. KACZMARIK: When I graduated from this original two-room clinic, then I went to a four-room clinic, different building, and then I realized I need to know because my manager was upset saying, "Hey, you're seeing room one and two all the time, room three and four are always waiting. They're upsetting us. We can't afford it. Can't do it."
So I said, "Well, do I know from head of court, flags on doors." So I brought flags on doors, and then the first flag meant that I'm first for the doctor, ready. The third flag, and then there was a flag for the nurse, and the flag for new patient, so we had like six, seven flags on the—and it was kind of somehow, it sounds like madness, but it was working.
But then I moved to a new building, and I knew there was—I actually have like sixteen rooms here, I use now seven plus two, and we thinking, "Hmm, that same thing won't work anymore." You can't even see the flags probably from some other rooms around the corner.
And it was important for me to see people in order, as taught by my manager. So I realized, I was thinking, what can I build? Do I build some light system on the door, above the doors? Do I get the passport system? They have the passport office, you come in a room like B31, 312. Do I get that?
And it turned out to be like fifteen hundred dollars per door. I said, "That's a lot of money." And then I realized, what if I connect tablets? I put them somehow in the patient's door and create my own software, and those tablets will tell me who's next, and I can press the button, and the nurse can press the button when they come in, and if we want something from each other, we press the button back to each other with the specific command. Let's do it.
So it became a necessity. I tested it. I found an engineer on Fiverr. I paid him two hundred dollars, Fiverr, yeah, and he built me the first prototype, and then we started using it.
And then we used it for a while happily. I moved to the bigger clinic, it started working. Someone saw my clinic visiting and said, "What is this?" I said, "This is how I communicate with my team." And they said, "Are you selling it somewhere?" I said, "No, this is just for me."
And that thought was growing on me, and then I realized maybe I can start. It's a challenge, and then I went for it, tried to like, I had to rebuild this, make it applicable for every clinic separately, create accounts.
Now I started learning things I wasn't aware exist called marketing. I wasn't aware of sales. All this, I'm not saying I do it well, but I'm a humble student in this. Being slapped on the face with what else I don't know all the time. But it's exciting, and then I would exist in many outside places, and of course I have some challenges, it's ups and downs. I fix one thing and another thing pops up. But I think that's the path I'm excited to continue with.
JOHN: So tell us for you, what did you notice? I mean, you built it for your own needs. So tell us, like, maybe what some of the outcomes are in terms of how many patients you can see effectively and whether it's adding to your bottom line.
DR. KACZMARIK: Yeah, it definitely adds to my bottom line. Now, it doesn't exist in isolation with what I do. I created this because I looked retrospectively on my clinic. I think I'm maxing out the ability for me to bill in Ontario. I'm billing five times the average of a family practice doctor in Ontario, and I work about my doctor on time, and the way I do this with metrics that are higher than average and with availability for my patients the next day or in two days sometimes.
So I'm not cutting corners. My reviews are good, my quality metrics are good. Of course, not everybody loves me, and it's not the point. I think I'm keeping quality high enough that I don't think it costs me quality deficiency. That's what I wanted to say.
And I retrospectively analyzed what has built this, and I created a five-step kind of manuscript, which is available at craft.drflow.com for anybody to download for free.
So first thing I've done is C for cleaning: what can the doctor do that's not salary but on their own to make sure they can bill higher for the extra features they already charge. Often you charge not enough for extra paperwork. You can double that or triple that, and patients don't leave you if this happens, and you suddenly get more income. It was just sitting there.
It's like you have a car and it's not drivable, but you pump up the tires, get the leaves out of the seats, and you can drive it. That's the whole C letter.
Then R for CRAFT is for release. Get your first hire to take care of complete paperwork. Usually it was my nurse in my case, and I have done no paperwork for myself. In my family medicine practice, she's delegated all those tasks to do for herself, and the patient walks in with paperwork, say "Fantastic paperwork, I love paperwork." I take it, I put it in her box, and I continue with the patient through the discussion what we need to go for.
And it's a lot of up-mark on this. So my nurses are making less per hour than myself. I got in trouble for saying how much less they get paid than me, so I'm not going to say that. But overall, there's a leverage instrument here, so I can make in some instances it breaks even, the worst case scenario, but in some instances I'm making three hundred dollars an hour when my nurse is filling paperwork while I'm sleeping or playing with my kids, and I never touch it.
The main thing is paperwork we hate to do, just delegate to somebody. That's R, release for CRAFT.
Then A, assemble bigger team where your newfound efficiency funds the next member of your team that helps you run even more efficiently. It's kind of like a self-building machine.
And then so CRAFT, the last letters versus F for flow and T for throughput. This is where the flow, room management and throughput, which is measurement of everything, where DoctorFlow fits.
So usually it's for someone who has released all the early parts and wants the extreme delegation system in place where you can see a lot of people in a short amount of time because your appointments are just touch points. Everything's taken care of for you, and you come in to see patients for just less than five minutes, but it's the meaningful interaction where I don't start, I don't do any paperwork, I don't do vaccines, I don't do vital signs, I don't write notes, I don't list concerns, I don't review preventive care.
This is all guardrailed to my prepping team, so I come in for this like whenever you have a resident, maybe this comparison. You have a resident, you come in, you just say, "Hey, things are okay." It feels like so that five minutes is a lot of time suddenly, right? Took care of things for you, so it's like, take it off my plate.
So DoctorFlow looks in the last two pieces of it, where the flow needs to be arranged and the throughput needs to be measured for opportunities. That's kind of how I would see it.
Not alone as an instrument, it would probably work in a very busy urgent care or walk-in clinic, but for a family doctor, I would recommend to first organize their work according to what works for me, is the CRAFT manuscript, and then for the last two letters, it's where it shines.
JOHN: All right, so I did pull that up. I don't have it in front of me, but I'll definitely put that in the show notes if people want to figure out or to read about your CRAFT method for organizing things in an office, then they can do that.
Do you, as part of making this now more publicly available as far as the software goes, and the flow-through, are people to like come and watch you work for a while or look at, come on site and see how it's working in your real world, or is that not been a thing yet?
DR. KACZMARIK: Actually, yes and yes and yes.
JOHN: Okay, good.
DR. KACZMARIK: What has happened actually this Monday, which is what, three days ago, when I worked at CHASS, a federally funded health care clinic, one of my past teachers is Dr. Felix Valbuena, who was my teacher during residency. He's the CEO of CHASS.
And now what I realize, he's the president of this federally funded health centers in all America, which is fifteen thousand clinics. He just was the CEO elect of the whole organization.
He came to visit me Monday to see how the clinic works for me, because he learned that I'm doing some efficiency frameworks, and this isn't to show how awesome I am, but to show how humble and amazing he is. He crossed the border from Detroit to Windsor to see his former student run the clinic.
He shadowed me like I would shadow him years ago, and everybody liked him. He's an amazing teacher, amazing doctor, and just to see how it works, whether it will fit the FQHCs in CHASS or any other places.
So yes, and that's a kind of very recent fresh story. I still, I'm taking it in. It's a humbling moment and grateful for that recent experience.
JOHN: So now, just so we're clear, my listeners are clear, so what's your normal day like? When do you come in? You're not doing any in-patient work, I'm understanding, I think, and so what's your day like? And how many patients are you seeing? And when are you getting to go home, like you said, and help your kids and do things at home?
DR. KACZMARIK: Yeah, so that's a good question. So I'm coming in to work with my dog, who is actually here with me as we speak, at about 8:45. Patients start to get roomed.
My team consists of three nurses and three secretaries. Everybody is just working for me. That's how everyone takes the work off my hands. It's like I'm working and just like everybody just dances around me. Not that I want to be the guy on the red carpet, but I designed my role so they strip everything from the doctor. I call it unbundling.
I feel that we, as doctors, have traditionally gotten into a bundle of things that don't have to belong to a doctor. And there's suddenly a way, I found a way to see it as a bundle and just strip it, strip it to the maximum.
And I often look, what are we paid for? In Ontario, we are paid for a meaningful interaction with the patient. So why can't you just say hi to them in a hallway and bill? But I have to have a meaningful interaction with some sort of decision. That we're listening has to happen.
Everything else can be delegated if I trust my nurse to listen to the heart and check through the lungs and refill prescriptions with guardrails. I think we should all do that.
So that's the context of how I'm seeing so many patients in a day. So I'm starting at 8:45. I take an hour lunch, usually running about twenty-five, thirty minutes behind on lunch time, so I'm having like thirty minutes, and I'm leaving, and I'm ending things about four o'clock.
Then I'm having what I call inbox rounds where me and my three secretaries—there's like phone calls and labs, so there's like ten phone calls and like twenty labs for me to review. My nurse reviews first batch of labs first, and whatever she's not sure, she leaves for us.
And the phone call rounds look like everybody's dialing, everybody in the room's dialing and putting them on hold, and they tell me, "Well, this patient is here for cough for two days." So I, on hold, say, "Hello, okay, cough for two days. Okay, I'm just making sure it doesn't look like pneumonia or so." And we make a decision, and I just hand the phone to my nurse.
And I go for the next one, and their job is to open the chart, type what I talked about, bill it, and make next step while I'm already two patients forward. Just because the system of handing me the phone works, I never dial a number, I never wait for someone to come to the phone, I never type anything.
So those inbox rounds happen from four to four fifteen where we handle a lot of calls and lab questions, and then I go home for 4:15, 4:30. I'm in my car with my dog Elton, and we're just on our way home, happily, living happily ever after to the end of the day, where I can take care of my son's basketball and my daughter's volleyball, and it's great.
JOHN: Nice. As you're saying these things, as you're explaining this, if you're employed as a physician in the U.S., probably or anywhere, if you ask for help, like, "I would like to have two secretaries, I would like to have this or that"—how many patients maybe, or how many contacts did you have with patients during that one day that you were just describing? What would that be? How many?
DR. KACZMARIK: Then the number without the context is shocking, and all people will say, "Oh, this isn't possible." But I want to hear the—
JOHN: Impossible.
DR. KACZMARIK: It is, it is because everything is stripped from me. I'm coming in for just beautiful interaction with just fun and chat. Sometimes I counsel, or sometimes I am doing counseling.
I'm seeing about eighty patients a day on a full day, and living in time, people come with multiple problems. Like today, I had people with like seven, eight problems. There was like two or three of them. I did counsel. I just had the morning session today. I counseled two or three people. We talked about how to go to the gym, what exercises to do, how to do deadlifts and things like that.
So I have time to chat things about, like, I believe doctors who take twenty minutes for an appointment, they don't have time to chat about how to do deadlifts.
JOHN: Right. Only you can do with your team, right? That's just your role as a physician. There's only certain people can do that, and that's people that are physicians to do it, and everything can be delegated. So you're not writing any notes.
DR. KACZMARIK: I am typing because the notes is, I would say it's like pre-digested for me. It has list of concerns, vital signs, everything is listed. I'm just filling in when I have to, and I just close the note briefly, and if I don't, my secretaries stay longer and they know what I mean, and they know what to bill. They know me by now.
So I actually do touch-typing, so I touch, look at the patient, and I type if I have to. There's nothing mouse-based thankfully for this. We tried scribes, but it doesn't work for me for the environment that my nurses prepping half the visit. None of the scribes I know pauses. It's a partial note and that allows me to continue, so we never really used it well.
But the system we have, it's still lots of gaps. It's an ongoing project. I'd love to talk to other doctors to see what they do so I can learn from them. The inbox routed to the telephone is actually an idea of mine by another doctor I talked to. Just like—
JOHN: Fits me so well, I'm going to do it.
Yeah, I mean, what you said there a minute ago, as you were describing the flow, it, like you said, if someone says eighty encounters, it kind of blows their mind, but you're not really falling behind. You said, well, maybe you're thirty minutes behind at lunchtime, you just have a shorter lunch, you get back in, and then you're leaving by whatever four thirty. That's, even though it seems like it might be pretty intense, at the same time, it doesn't sound overwhelming when you can stay and then you're going home for dinner.
DR. KACZMARIK: Absolutely. And here's the thing about the behind. I think it's, here's my philosophy. I run a lot of rooms myself, and someone says I work two, three rooms. What my seven rooms allow me is to room patients ahead of me, and what DoctorFlow allows me is to have those patients prepped by my nurse, and I see my caller about two, three tiles away. It means like three patients are prepped and waiting for me all the time, and that allows me to know I call it their pride. Timed for me.
Because there's some visit that'll be super quick, I can jump to two or three, and if I have not prepared, someone will say, "Well, then I do phone calls," and/or I do some other, I do lab review. But to me, it's a poor use of my time.
Here again, this five seconds saved, which I love, it keeps in really strongly here, because I feel like if we switch tasks, I divided my day in sessions. Morning is just flow, boom, patient. You're using up much more gas, brake, gas, brake, gas. Your attention has to be more careful, you have more accidents. It's just not optimal use of that time.
And then that's partly why we get exhausted because this isn't ready, I'm going to do this, I'm going to—it's just confusing, cognitively exhausting I feel.
So for me, and I think it works for everyone, given human psychology is the same, I think batching your work. That's why my labs and calls are at the end of the day. Pure patient session that there's just me in the room going, "DoctorFlow, who's next, who's next, who's next." I allow myself five seconds to travel from one room to another. That means I'm using my time 100%.
And I've taken it to that extreme of not wasting not only time but also cognitive attention switching is something I'm avoiding as well.
JOHN: That's nice. Okay, let me ask you this. If I were to come and talk to you, and apparently we can buy DoctorFlow now and implement that, what's that like? What, like, how is the implementation for someone that wants to use this tool? How do they learn about it? Who installs it? What have you worked out for that so far that you've been selling this?
DR. KACZMARIK: So thank you, thank you for asking this. Yeah, so there's several tools that are actually—first time I learned that there's tools like that, I felt disappointed. Oh my god, someone has my idea, how bad, right?
But then I realized it's a proof that the market exists, and I didn't invent this, okay, but I kind of invented it parallel for myself out of need. That kind of counts for me.
The existing tools are usually heavy on integration. They take, at least in Canada, they're like several months of mapping and then connecting, and all the APIs are closed or just partially open. It's just a heavy, heavy IT job with hardware on site.
Our philosophy is that it's not EMR integrated, but it helps us move with appointment types, showing not exact name of the patient, so it won't show that it's Mr. John Smith. But it showed it's a diabetic patient for a follow-up, for doctor XYZ, and I walk in the door knowing what type of encounter I'm seeing. I don't need to know the patient's name. That's actually even more helpful.
And so we decided to do it this way, and our deployment is very brief. We install it in about half a day. We train staff. It's super intuitive in about fifteen to thirty minutes. We have our champions staying for the whole day to make sure there's no questions, and clinics implemented really quickly. It's very easy.
JOHN: Is there a certain type of practice? I mean, I'm assuming if you're by yourself and you only have one staff working with you, well, that doesn't need your product, DoctorFlow. But at the same time, you might say this would work great for your type of practice, but you don't have enough people because part of the issue is we need to use the people to do what they can do with their license and not try and do it, but part of it is separating the physician from what the physician doesn't have to do.
So part of it maybe would be natural. It would just, once you start using the product, then you'll see there's these opportunities. Well, if I hire someone else, I can offload this and then I can expand the number of patients and so forth. That is what I'm guessing.
DR. KACZMARIK: Yes, you definitely allow you to see the opportunities. Oh, I don't want to leave now and leave it to my staff. I don't have to look for her, because I remember one of the issues was like, okay, I have paperwork for Connie, where is she? She's in room with patient, which one? I don't know. And I talked to secretary, I said, "I can't tell you, I'm on the phone." And it's like, "Where are you on?" It's this feeling that I had too many times.
If you have that feeling I think the most classic ideal customer profile would be walk-in clinics and urgent cares, high volume, lots of movement, lots of traffic, every few seconds counts, and that coordination between teams is, I think, the most—shines the most, 100%.
JOHN: Interesting. I remember I actually am part owner of an urgent care network of four, but I'm not, I'm semi-retired, so I don't set my foot in there. But before we opened those clinics, twelve years ago, we went to a site out east, and I couldn't believe it. They had like seven or eight providers, whether it's PAs or physicians, and this thing was massive, and things were flying all over the place, and I have no idea how they managed it, but I think this would have been helpful because a lot of times I would see the PA sitting, because we did a visit, and they're just like waiting. It's like, okay, that can't not be efficient there. They may have a lot of flow, but they probably have a lot of overhead too.
DR. KACZMARIK: That's right, and the whole concept here that I have is that it's okay if patient waits for it, which comes back to the question you asked before. I think the ideal thing, the patient waiting for a doctor, like twenty minutes in the room or so, sometimes thirty, it's not wrong. It's to be expected, I think, after seeing a nurse.
But the worst thing for the clinic economics and for the doctor's mind is when you have to wait, wait for the patients to be prepped. And someone waiting twenty, thirty minutes doesn't have to be feeling abandoned. We can make sure give them like estimate of a time, and patients aren't upset if I find up to thirty minutes of the wait. This is kind of okay from the first touch from the nurse. For me, it happens usually less, but if they do, I think it's not wrong, and just the day is completely different.
JOHN: It sounds good. Let's see, tell us again the website so I know. I think we can get the CRAFT document and learn more about your software, your system at where?
DR. KACZMARIK: So my website is drflow.com, and for anybody interested in this kind of free manuscript, how to grow the clinic without any extra funding to the size that I was able to grow, I believe it's completely reproducible, it's a step-by-step system, you can find it. CRAFT.com, craft.c.r.a.f.t.dot.drflow.com. I would love if you use it and maybe give me some feedback on how it works. I'd love to learn from you as well.
JOHN: Excellent. Let's see if I have any other last minute questions here before I let you go. No, this is very interesting. I think if they go to your website too, they can, if they're really interested, there's going to be a way for them to contact you, obviously.
DR. KACZMARIK: Absolutely.
JOHN: Is there someone else they would talk to? Are they calling your office or is there like a marketing guru out there working for you or something?
DR. KACZMARIK: I haven't actually. Realized that my efficiency mindset got me to have someone help me, and it's actually there, and it's working better for me, since I'm involved, still have a full-time family practice.
I do a joint injection procedure for American patients, with the injections not available in the United States yet. I'm building sales funnel for that too.
So I do have someone helping me out in my marketing, but if you give us a call, they contact me. The email goes—and listen, there's no—I'd love even if you book a demo to just chat, that'll be great. I can guide you through how it works for me. Yeah, looking forward to connecting.
JOHN: All right. Okay, well, I think we're a little bit out of time here, so Bart, this has been fantastic. It sounds like this is just exciting, really, because it's, who knows what's going to happen with this, but I know it sounds like your practice is running very well, so that part's great, and you're home for dinner most nights, so it's gotta be working.
So, anything we forgot to ask about or you want to tell our listeners before you go? I mean, if, let's say they're in a busy practice, maybe there's three or four of them, and they just, they're getting burned out and it seems like they just can't keep up. I mean, any just general advice for someone in that situation who's kind of feeling like, I don't know if I want to practice anymore?
DR. KACZMARIK: Yeah, and I'm sure my colleagues thinking the same, and that's why I have my whole YouTube channel just about that.
And I think the main thing is that we stuck—we're a little stuck in the past on how we see outpatient medical practice. It can look completely different, and it doesn't need extra funding, and it's just reorganizing, rebuilding things that we—it's a beautiful thing. It's all in our power, and we don't need to wait for health reform for some payer to give us five percent raise or 5% raise. This isn't a meaningful thing for anybody.
With what I built, I give myself three times the raise, 300% raise with how I found capacity in what I do, and I want to encourage doctors to do that.
That's what my whole YouTube channel is about, to make sure that I think the first thing is to dare to unbundle, dare to think differently about how things can be practiced, how we can practice medicine.
And I would love if more of us just realize that there's a lot more in our power. And I know everybody tried, everybody tried to be more efficient, but this is a little different. It's just delegation that people, the doctors don't do because logically they would agree with me that they can hire a nurse to do their paperwork, but anybody asks it, logically I agree with you, but I'm just not comfortable doing it.
So there's a lot of emotional barrier there to doing this, and I'm trying to show how this is doable, how this isn't harmful, how this increases not only my satisfaction but the quality of my care and patients are actually happy to have next day appointments. So I think it's a big win at the end that we don't see.
And as I say, my philosophy is there to unbundle and just have a better practice and be more satisfied.
JOHN: How do I find the YouTube channel?
DR. KACZMARIK: Dr. Bart Kaczmarek is my handle. I can put it here in the—
JOHN: I'll get it. You're going to send it to me, okay? And I'll make sure I put those links in with the others.
So, this has been really interesting to me. I think my listeners are going to love it. And yeah, this is great. I'll probably follow up with you down the road if I'm still doing this podcast in a year or so and see what the heck you're up to. Maybe by then you'll own Windsor itself, huh?
This has been great, thanks a lot, and with that, I will say goodbye.
DR. KACZMARIK: Thank you, John.
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See More Patients and Generate Great Income with No Burnout
Episode 470
JOHN: Welcome back, Nonclinical Nation! Today I'm presenting my interview with Dr. Bart Kaczmarik, a family physician who developed a process to make his family medicine practice super efficient and fun.
Dr. Kaczmarik completed medical school in Poland and subsequently moved to the U.S. where he completed his family medicine residency. He later moved to Windsor, Ontario and in March of 2025 founded Hope Health, his medical practice.
It was at Hope Health, while trying to improve patient flow and efficiency, that he developed DoctorFlow. DoctorFlow is a company that built a system designed to eliminate wasted time in a busy physician's office, which results in better patient flow, happier patients, and more satisfied physicians working fewer hours each week than previously.
After using it to more than double his patient volumes while reducing his office hours, he turned it into a business to share with other physicians interested in reducing burnout while enhancing efficiency and income.
I'm always happy when I find a guest who has solved a problem for him or herself and then builds a business to share with other physicians. Today's guest has done just that and is here to explain how you can see more patients, enjoy your practice, and earn more, but without becoming burned out.
Dr. Bart Kaczmarik, welcome to the show.
DR. KACZMARIK: Thank you very much, John. I'm very happy to be here. I'm excited.
JOHN: I'm glad to have you, because when I read your story a little bit, I was like, "Oh, this is very interesting, and just your life is interesting, I think." But why don't you tell us a little bit about your background and your early career?
DR. KACZMARIK: Yeah, my story starts in Poland, when I went to med school. I started my medical career, I went to residency, studied residency, then I left, moved around, chased my wife who's from Canada, and we ended up kind of on the other side of Detroit in Canada. Ended up being in Detroit at Henry Ford Hospital, did a little bit of—I wanted urology back, I was doing in Poland, and I landed in family medicine. That's the kind of medical super quick wrap-up.
And for a long time I was disappointed that all I am is family doctor, right? Because all the time my mindset was on being someone like a super surgeon, and my mind was on it. It just didn't happen, and for a long time I was so, so, so upset.
Now I realize that this is the specialty that I actually can redesign the most because it all depends on me. I'm not depending on anybody's hours, schedule, on hospital politics, on salaries. I have a model where I can actually find my own efficiency.
My first job was actually at Henry Ford Hospital, a child's clinic, a community clinic. Great two years, and there it was, it was great. The only thing was that I, as much as I was excited to have this upgrade from resident to attending doctor, the salary went up. It didn't go up that much, but that wasn't the worst thing.
The worst thing I realized pretty quickly: I ran into blockages, blockages where I couldn't really run things the way I wanted to. Not that I wanted to reinvent medicine, but for example, in the first job, we had some medical assistant. It turned out there was one medical assistant for like two or three doctors, and whenever you needed this person, they weren't there, or if you had her, then she was on lunch till the second lady.
So there was such an inconsistent and unreliable support that started my kind of frustration with this. And then I moved to Canada. I inherited a family practice, like a thirteen hundred patient paper charts—mind you, it's a real good discovery. Then we transitioned to some electronics.
I graduated from there, changed the buildings a few times to a building that now I'm part equity owner in. I have from a two-room practice with these paper charts, thirteen hundred patients, now I am seven rooms plus two procedure rooms just from me, and I utilize it completely with my efficiency system, and I'm serving four thousand patients. Now I've found the way to actually make it work.
JOHN: Sounds good. And both the Canadian system and the U.S. system—I mean, taking care of patients is the same, but the system we work in is maybe a little different. So maybe explain, was it much of a culture shock to go from Detroit to Canada? I mean, or is it, once you're in the system and you understand it, you just see patients and do what you do?
DR. KACZMARIK: Yeah, I was a salary model in the States, so I understand how the billing works, how the medical decision making, how Epic works, because I was at Henry Ford Hospital. The night they implemented Epic, I was on call, so that was—no, but that was fun.
And here, things are a little different. It's a single public payer in Ontario, it's OHIP. Patients just show the card, they bill it, and every month I'm getting what I bill for. Covered, which is almost everything unless cosmetic.
So if you are unhappy with your visit that is for forty dollars, you want to upcharge them twenty to make it sixty, you can't do that because it's already on the list of what's covered. So you gotta agree with it and just charge what's available. So less flexibility.
And everybody, as much as in the States, is the picture of America. Like health systems are running it, and insurance companies are in charge of everything. They've built the channels from top to bottom and independent doctors are less and less popular. That's why the surge of the direct primary care, to get out of this machine.
But here, everything is, most, almost everything's independent owner/operator. Like the chains are rare. Someone has, I don't know, three urgent care clinics, five urgent care clinics in Toronto, maybe something like that, in the biggest places. Everything is like either a doctor owns it or a pharmacist owns a clinic, and then the doctor is kind of working in there.
It's more of like a smaller size. Fee for service is still prevalent. Some models are showing like a subscription model, capitation models, something's in the middle, and more and more popular the capitation models.
But overall, I mean, what brought me to Canada is that I've seen those doctors, because my wife studied doctor too. I've seen them like where we live in Canada, like biking, oh, it's something like some outdoors. They just had such, they just had life, right?
And when I was working at the company before, it felt like it's a great facility, but like everybody was working. So that's what attracted me originally, but it ends up that there's similar burnout problems, similar frustrations, maybe in a different aspect of it a little bit, but overall, the disillusionment and unhappiness is growing among the doctors. That's what I'm seeing all around, kind of in a similar way.
JOHN: Okay, that makes sense. I mean, really, unless in the U.S., unless you're in an HMO, for the most part, you're just seeing patients, you're getting paid by the patient you see, you get paid for what you do. So really, everything you're doing for ninety percent of us over here, it's the same kind of model, just you have one payer, we have hundreds of payers in that sense, some better than others.
So, and so I'm assuming that what we're going to talk about later, called DoctorFlow, I'd like to get the plug in early because even some people don't listen to the whole thing, but would apply to people working, seeing patients in the U.S. as well as Canada, I'm assuming.
DR. KACZMARIK: Yes. This is the system that I built is for basically, it's like a modern flags of 2026 when I worked the first time. In my clinic there was flags on the doors. You marked it for the nurse to come in, you marked it for the doctor to come in, and that's kind of what it does in a super advanced way where you can communicate between teams, handoff between teams, it measures your time at the end of the day of KPIs where your lost opportunities are.
And I find that it's like finding seamless lost time, and it works really well. All the clinics that are running it right now—there's seven total clinics running it in independent places—and I find that it helps the most the doctors who are running a very high volume practice with a team that prepares for them so that communication could break, and the system puts it together and allows handoffs.
So if I want something from my team and I leave the room, they prepare everything for me, but if something's missing, I leave the room and say to the patient, "I'll be back and someone will be back to take care of it." The extra paperwork, the show last minute, or "By the way, can I get a vaccine?" I say, "Of course." I leave the room, press a button, nurse back to room for vaccine, and the nurse will get there in the order while I'm seeing the next patient and I don't have to look for anybody.
That's the whole idea here. That's what makes it work, but it has to be a high volume to see that need for coordination.
JOHN: Okay. Well, yeah, we'll get into the details of that in a minute, so that's a good overview. I think it's the thing that drives physicians crazy. They're in a practice, whether it's their own or it's part of a group. And it's just the systems don't work well together.
Now let me ask you this though, because it popped into my head. You were on Epic, right?
DR. KACZMARIK: I was. Before.
JOHN: Now that isn't necessarily physician friendly. Is the system that you're on in terms of your EMR any easier to work with, and does it integrate with DoctorFlow or not? Probably not, it's just something else. But what do you think? Is that a barrier to getting more efficient using a clunky kind of—I remember when I was doing medicine still before I stopped, and it was in COVID, and so we were doing COVID tests.
Okay, so we had to have a different lab do the COVID test, and it was handed off sixteen different times, and I counted the clicks. It took me twenty-five clicks to enter the result of the COVID test. That's better now, but yeah, you can kind of relate to those kind of issues.
DR. KACZMARIK: Absolutely. Yeah, if you tell me that I could save five seconds on something with my patient care, it's like, please sign me up, I would love it.
And the EMRs have one thing to do. They weren't designed with users in the center. They were designed with anything else in the center. And the user came as the last piece saying, "Okay, here's the list of features." And that ends up being twenty-five clicks to refill a tile, right?
And that's, I think in Canada, those EMRs are a little less clunky. The one I use is—I use the name for it—the least bad that I found. There's a lot of keyboard shortcuts. I don't have to touch a mouse. That's super helpful.
Although I think it is easier than, because we don't have to connect diagnosis to the treatment. Seeing the newer emerging EMRs in the market that are small—they're just like twenty, thirty clinics and they're just starting—they are finally designed like an iPhone with a user in the center. And I tested a few of them and I think the future's promising.
It's EMRs with AI integrated inside by default. It's not a patch-up. Workflows are flexible. You can not only make the workload to be remembered, but also kind of have the system learn what you like to do. I think future's right.
JOHN: That's good, that's good. Okay, but that wasn't the main problem you were solving for yourself. It was just this flow of patients to you, to the other members, back to you or not back to you, to the lab, to the X-ray, whatever. So tell us what is it.
What was the first thing or the first step you took when you said, "Okay, I gotta figure out how to make this flow better"? Just tell us what popped in your head and then how long you've been working on this and what were the main issues that you had to resolve.
DR. KACZMARIK: Yeah, so it grew from my own need, from the necessity to communicate, because the first clinic I was in had two rooms. This is a classic example of who doesn't need it, right? Because I don't need to know what my next room is if I have room one and two. It's all good for me. Nuclear, right? There's no electronics involved.
And if I have no one prepping and helping me, even easier. There's no communication with the team, but you end up doing the same tedious things, seeing fifteen patients a day, and leaving after eight hours of work, and making hundreds of dollars a day.
JOHN: Yeah, right.
DR. KACZMARIK: When I graduated from this original two-room clinic, then I went to a four-room clinic, different building, and then I realized I need to know because my manager was upset saying, "Hey, you're seeing room one and two all the time, room three and four are always waiting. They're upsetting us. We can't afford it. Can't do it."
So I said, "Well, do I know from head of court, flags on doors." So I brought flags on doors, and then the first flag meant that I'm first for the doctor, ready. The third flag, and then there was a flag for the nurse, and the flag for new patient, so we had like six, seven flags on the—and it was kind of somehow, it sounds like madness, but it was working.
But then I moved to a new building, and I knew there was—I actually have like sixteen rooms here, I use now seven plus two, and we thinking, "Hmm, that same thing won't work anymore." You can't even see the flags probably from some other rooms around the corner.
And it was important for me to see people in order, as taught by my manager. So I realized, I was thinking, what can I build? Do I build some light system on the door, above the doors? Do I get the passport system? They have the passport office, you come in a room like B31, 312. Do I get that?
And it turned out to be like fifteen hundred dollars per door. I said, "That's a lot of money." And then I realized, what if I connect tablets? I put them somehow in the patient's door and create my own software, and those tablets will tell me who's next, and I can press the button, and the nurse can press the button when they come in, and if we want something from each other, we press the button back to each other with the specific command. Let's do it.
So it became a necessity. I tested it. I found an engineer on Fiverr. I paid him two hundred dollars, Fiverr, yeah, and he built me the first prototype, and then we started using it.
And then we used it for a while happily. I moved to the bigger clinic, it started working. Someone saw my clinic visiting and said, "What is this?" I said, "This is how I communicate with my team." And they said, "Are you selling it somewhere?" I said, "No, this is just for me."
And that thought was growing on me, and then I realized maybe I can start. It's a challenge, and then I went for it, tried to like, I had to rebuild this, make it applicable for every clinic separately, create accounts.
Now I started learning things I wasn't aware exist called marketing. I wasn't aware of sales. All this, I'm not saying I do it well, but I'm a humble student in this. Being slapped on the face with what else I don't know all the time. But it's exciting, and then I would exist in many outside places, and of course I have some challenges, it's ups and downs. I fix one thing and another thing pops up. But I think that's the path I'm excited to continue with.
JOHN: So tell us for you, what did you notice? I mean, you built it for your own needs. So tell us, like, maybe what some of the outcomes are in terms of how many patients you can see effectively and whether it's adding to your bottom line.
DR. KACZMARIK: Yeah, it definitely adds to my bottom line. Now, it doesn't exist in isolation with what I do. I created this because I looked retrospectively on my clinic. I think I'm maxing out the ability for me to bill in Ontario. I'm billing five times the average of a family practice doctor in Ontario, and I work about my doctor on time, and the way I do this with metrics that are higher than average and with availability for my patients the next day or in two days sometimes.
So I'm not cutting corners. My reviews are good, my quality metrics are good. Of course, not everybody loves me, and it's not the point. I think I'm keeping quality high enough that I don't think it costs me quality deficiency. That's what I wanted to say.
And I retrospectively analyzed what has built this, and I created a five-step kind of manuscript, which is available at craft.drflow.com for anybody to download for free.
So first thing I've done is C for cleaning: what can the doctor do that's not salary but on their own to make sure they can bill higher for the extra features they already charge. Often you charge not enough for extra paperwork. You can double that or triple that, and patients don't leave you if this happens, and you suddenly get more income. It was just sitting there.
It's like you have a car and it's not drivable, but you pump up the tires, get the leaves out of the seats, and you can drive it. That's the whole C letter.
Then R for CRAFT is for release. Get your first hire to take care of complete paperwork. Usually it was my nurse in my case, and I have done no paperwork for myself. In my family medicine practice, she's delegated all those tasks to do for herself, and the patient walks in with paperwork, say "Fantastic paperwork, I love paperwork." I take it, I put it in her box, and I continue with the patient through the discussion what we need to go for.
And it's a lot of up-mark on this. So my nurses are making less per hour than myself. I got in trouble for saying how much less they get paid than me, so I'm not going to say that. But overall, there's a leverage instrument here, so I can make in some instances it breaks even, the worst case scenario, but in some instances I'm making three hundred dollars an hour when my nurse is filling paperwork while I'm sleeping or playing with my kids, and I never touch it.
The main thing is paperwork we hate to do, just delegate to somebody. That's R, release for CRAFT.
Then A, assemble bigger team where your newfound efficiency funds the next member of your team that helps you run even more efficiently. It's kind of like a self-building machine.
And then so CRAFT, the last letters versus F for flow and T for throughput. This is where the flow, room management and throughput, which is measurement of everything, where DoctorFlow fits.
So usually it's for someone who has released all the early parts and wants the extreme delegation system in place where you can see a lot of people in a short amount of time because your appointments are just touch points. Everything's taken care of for you, and you come in to see patients for just less than five minutes, but it's the meaningful interaction where I don't start, I don't do any paperwork, I don't do vaccines, I don't do vital signs, I don't write notes, I don't list concerns, I don't review preventive care.
This is all guardrailed to my prepping team, so I come in for this like whenever you have a resident, maybe this comparison. You have a resident, you come in, you just say, "Hey, things are okay." It feels like so that five minutes is a lot of time suddenly, right? Took care of things for you, so it's like, take it off my plate.
So DoctorFlow looks in the last two pieces of it, where the flow needs to be arranged and the throughput needs to be measured for opportunities. That's kind of how I would see it.
Not alone as an instrument, it would probably work in a very busy urgent care or walk-in clinic, but for a family doctor, I would recommend to first organize their work according to what works for me, is the CRAFT manuscript, and then for the last two letters, it's where it shines.
JOHN: All right, so I did pull that up. I don't have it in front of me, but I'll definitely put that in the show notes if people want to figure out or to read about your CRAFT method for organizing things in an office, then they can do that.
Do you, as part of making this now more publicly available as far as the software goes, and the flow-through, are people to like come and watch you work for a while or look at, come on site and see how it's working in your real world, or is that not been a thing yet?
DR. KACZMARIK: Actually, yes and yes and yes.
JOHN: Okay, good.
DR. KACZMARIK: What has happened actually this Monday, which is what, three days ago, when I worked at CHASS, a federally funded health care clinic, one of my past teachers is Dr. Felix Valbuena, who was my teacher during residency. He's the CEO of CHASS.
And now what I realize, he's the president of this federally funded health centers in all America, which is fifteen thousand clinics. He just was the CEO elect of the whole organization.
He came to visit me Monday to see how the clinic works for me, because he learned that I'm doing some efficiency frameworks, and this isn't to show how awesome I am, but to show how humble and amazing he is. He crossed the border from Detroit to Windsor to see his former student run the clinic.
He shadowed me like I would shadow him years ago, and everybody liked him. He's an amazing teacher, amazing doctor, and just to see how it works, whether it will fit the FQHCs in CHASS or any other places.
So yes, and that's a kind of very recent fresh story. I still, I'm taking it in. It's a humbling moment and grateful for that recent experience.
JOHN: So now, just so we're clear, my listeners are clear, so what's your normal day like? When do you come in? You're not doing any in-patient work, I'm understanding, I think, and so what's your day like? And how many patients are you seeing? And when are you getting to go home, like you said, and help your kids and do things at home?
DR. KACZMARIK: Yeah, so that's a good question. So I'm coming in to work with my dog, who is actually here with me as we speak, at about 8:45. Patients start to get roomed.
My team consists of three nurses and three secretaries. Everybody is just working for me. That's how everyone takes the work off my hands. It's like I'm working and just like everybody just dances around me. Not that I want to be the guy on the red carpet, but I designed my role so they strip everything from the doctor. I call it unbundling.
I feel that we, as doctors, have traditionally gotten into a bundle of things that don't have to belong to a doctor. And there's suddenly a way, I found a way to see it as a bundle and just strip it, strip it to the maximum.
And I often look, what are we paid for? In Ontario, we are paid for a meaningful interaction with the patient. So why can't you just say hi to them in a hallway and bill? But I have to have a meaningful interaction with some sort of decision. That we're listening has to happen.
Everything else can be delegated if I trust my nurse to listen to the heart and check through the lungs and refill prescriptions with guardrails. I think we should all do that.
So that's the context of how I'm seeing so many patients in a day. So I'm starting at 8:45. I take an hour lunch, usually running about twenty-five, thirty minutes behind on lunch time, so I'm having like thirty minutes, and I'm leaving, and I'm ending things about four o'clock.
Then I'm having what I call inbox rounds where me and my three secretaries—there's like phone calls and labs, so there's like ten phone calls and like twenty labs for me to review. My nurse reviews first batch of labs first, and whatever she's not sure, she leaves for us.
And the phone call rounds look like everybody's dialing, everybody in the room's dialing and putting them on hold, and they tell me, "Well, this patient is here for cough for two days." So I, on hold, say, "Hello, okay, cough for two days. Okay, I'm just making sure it doesn't look like pneumonia or so." And we make a decision, and I just hand the phone to my nurse.
And I go for the next one, and their job is to open the chart, type what I talked about, bill it, and make next step while I'm already two patients forward. Just because the system of handing me the phone works, I never dial a number, I never wait for someone to come to the phone, I never type anything.
So those inbox rounds happen from four to four fifteen where we handle a lot of calls and lab questions, and then I go home for 4:15, 4:30. I'm in my car with my dog Elton, and we're just on our way home, happily, living happily ever after to the end of the day, where I can take care of my son's basketball and my daughter's volleyball, and it's great.
JOHN: Nice. As you're saying these things, as you're explaining this, if you're employed as a physician in the U.S., probably or anywhere, if you ask for help, like, "I would like to have two secretaries, I would like to have this or that"—how many patients maybe, or how many contacts did you have with patients during that one day that you were just describing? What would that be? How many?
DR. KACZMARIK: Then the number without the context is shocking, and all people will say, "Oh, this isn't possible." But I want to hear the—
JOHN: Impossible.
DR. KACZMARIK: It is, it is because everything is stripped from me. I'm coming in for just beautiful interaction with just fun and chat. Sometimes I counsel, or sometimes I am doing counseling.
I'm seeing about eighty patients a day on a full day, and living in time, people come with multiple problems. Like today, I had people with like seven, eight problems. There was like two or three of them. I did counsel. I just had the morning session today. I counseled two or three people. We talked about how to go to the gym, what exercises to do, how to do deadlifts and things like that.
So I have time to chat things about, like, I believe doctors who take twenty minutes for an appointment, they don't have time to chat about how to do deadlifts.
JOHN: Right. Only you can do with your team, right? That's just your role as a physician. There's only certain people can do that, and that's people that are physicians to do it, and everything can be delegated. So you're not writing any notes.
DR. KACZMARIK: I am typing because the notes is, I would say it's like pre-digested for me. It has list of concerns, vital signs, everything is listed. I'm just filling in when I have to, and I just close the note briefly, and if I don't, my secretaries stay longer and they know what I mean, and they know what to bill. They know me by now.
So I actually do touch-typing, so I touch, look at the patient, and I type if I have to. There's nothing mouse-based thankfully for this. We tried scribes, but it doesn't work for me for the environment that my nurses prepping half the visit. None of the scribes I know pauses. It's a partial note and that allows me to continue, so we never really used it well.
But the system we have, it's still lots of gaps. It's an ongoing project. I'd love to talk to other doctors to see what they do so I can learn from them. The inbox routed to the telephone is actually an idea of mine by another doctor I talked to. Just like—
JOHN: Fits me so well, I'm going to do it.
Yeah, I mean, what you said there a minute ago, as you were describing the flow, it, like you said, if someone says eighty encounters, it kind of blows their mind, but you're not really falling behind. You said, well, maybe you're thirty minutes behind at lunchtime, you just have a shorter lunch, you get back in, and then you're leaving by whatever four thirty. That's, even though it seems like it might be pretty intense, at the same time, it doesn't sound overwhelming when you can stay and then you're going home for dinner.
DR. KACZMARIK: Absolutely. And here's the thing about the behind. I think it's, here's my philosophy. I run a lot of rooms myself, and someone says I work two, three rooms. What my seven rooms allow me is to room patients ahead of me, and what DoctorFlow allows me is to have those patients prepped by my nurse, and I see my caller about two, three tiles away. It means like three patients are prepped and waiting for me all the time, and that allows me to know I call it their pride. Timed for me.
Because there's some visit that'll be super quick, I can jump to two or three, and if I have not prepared, someone will say, "Well, then I do phone calls," and/or I do some other, I do lab review. But to me, it's a poor use of my time.
Here again, this five seconds saved, which I love, it keeps in really strongly here, because I feel like if we switch tasks, I divided my day in sessions. Morning is just flow, boom, patient. You're using up much more gas, brake, gas, brake, gas. Your attention has to be more careful, you have more accidents. It's just not optimal use of that time.
And then that's partly why we get exhausted because this isn't ready, I'm going to do this, I'm going to—it's just confusing, cognitively exhausting I feel.
So for me, and I think it works for everyone, given human psychology is the same, I think batching your work. That's why my labs and calls are at the end of the day. Pure patient session that there's just me in the room going, "DoctorFlow, who's next, who's next, who's next." I allow myself five seconds to travel from one room to another. That means I'm using my time 100%.
And I've taken it to that extreme of not wasting not only time but also cognitive attention switching is something I'm avoiding as well.
JOHN: That's nice. Okay, let me ask you this. If I were to come and talk to you, and apparently we can buy DoctorFlow now and implement that, what's that like? What, like, how is the implementation for someone that wants to use this tool? How do they learn about it? Who installs it? What have you worked out for that so far that you've been selling this?
DR. KACZMARIK: So thank you, thank you for asking this. Yeah, so there's several tools that are actually—first time I learned that there's tools like that, I felt disappointed. Oh my god, someone has my idea, how bad, right?
But then I realized it's a proof that the market exists, and I didn't invent this, okay, but I kind of invented it parallel for myself out of need. That kind of counts for me.
The existing tools are usually heavy on integration. They take, at least in Canada, they're like several months of mapping and then connecting, and all the APIs are closed or just partially open. It's just a heavy, heavy IT job with hardware on site.
Our philosophy is that it's not EMR integrated, but it helps us move with appointment types, showing not exact name of the patient, so it won't show that it's Mr. John Smith. But it showed it's a diabetic patient for a follow-up, for doctor XYZ, and I walk in the door knowing what type of encounter I'm seeing. I don't need to know the patient's name. That's actually even more helpful.
And so we decided to do it this way, and our deployment is very brief. We install it in about half a day. We train staff. It's super intuitive in about fifteen to thirty minutes. We have our champions staying for the whole day to make sure there's no questions, and clinics implemented really quickly. It's very easy.
JOHN: Is there a certain type of practice? I mean, I'm assuming if you're by yourself and you only have one staff working with you, well, that doesn't need your product, DoctorFlow. But at the same time, you might say this would work great for your type of practice, but you don't have enough people because part of the issue is we need to use the people to do what they can do with their license and not try and do it, but part of it is separating the physician from what the physician doesn't have to do.
So part of it maybe would be natural. It would just, once you start using the product, then you'll see there's these opportunities. Well, if I hire someone else, I can offload this and then I can expand the number of patients and so forth. That is what I'm guessing.
DR. KACZMARIK: Yes, you definitely allow you to see the opportunities. Oh, I don't want to leave now and leave it to my staff. I don't have to look for her, because I remember one of the issues was like, okay, I have paperwork for Connie, where is she? She's in room with patient, which one? I don't know. And I talked to secretary, I said, "I can't tell you, I'm on the phone." And it's like, "Where are you on?" It's this feeling that I had too many times.
If you have that feeling I think the most classic ideal customer profile would be walk-in clinics and urgent cares, high volume, lots of movement, lots of traffic, every few seconds counts, and that coordination between teams is, I think, the most—shines the most, 100%.
JOHN: Interesting. I remember I actually am part owner of an urgent care network of four, but I'm not, I'm semi-retired, so I don't set my foot in there. But before we opened those clinics, twelve years ago, we went to a site out east, and I couldn't believe it. They had like seven or eight providers, whether it's PAs or physicians, and this thing was massive, and things were flying all over the place, and I have no idea how they managed it, but I think this would have been helpful because a lot of times I would see the PA sitting, because we did a visit, and they're just like waiting. It's like, okay, that can't not be efficient there. They may have a lot of flow, but they probably have a lot of overhead too.
DR. KACZMARIK: That's right, and the whole concept here that I have is that it's okay if patient waits for it, which comes back to the question you asked before. I think the ideal thing, the patient waiting for a doctor, like twenty minutes in the room or so, sometimes thirty, it's not wrong. It's to be expected, I think, after seeing a nurse.
But the worst thing for the clinic economics and for the doctor's mind is when you have to wait, wait for the patients to be prepped. And someone waiting twenty, thirty minutes doesn't have to be feeling abandoned. We can make sure give them like estimate of a time, and patients aren't upset if I find up to thirty minutes of the wait. This is kind of okay from the first touch from the nurse. For me, it happens usually less, but if they do, I think it's not wrong, and just the day is completely different.
JOHN: It sounds good. Let's see, tell us again the website so I know. I think we can get the CRAFT document and learn more about your software, your system at where?
DR. KACZMARIK: So my website is drflow.com, and for anybody interested in this kind of free manuscript, how to grow the clinic without any extra funding to the size that I was able to grow, I believe it's completely reproducible, it's a step-by-step system, you can find it. CRAFT.com, craft.c.r.a.f.t.dot.drflow.com. I would love if you use it and maybe give me some feedback on how it works. I'd love to learn from you as well.
JOHN: Excellent. Let's see if I have any other last minute questions here before I let you go. No, this is very interesting. I think if they go to your website too, they can, if they're really interested, there's going to be a way for them to contact you, obviously.
DR. KACZMARIK: Absolutely.
JOHN: Is there someone else they would talk to? Are they calling your office or is there like a marketing guru out there working for you or something?
DR. KACZMARIK: I haven't actually. Realized that my efficiency mindset got me to have someone help me, and it's actually there, and it's working better for me, since I'm involved, still have a full-time family practice.
I do a joint injection procedure for American patients, with the injections not available in the United States yet. I'm building sales funnel for that too.
So I do have someone helping me out in my marketing, but if you give us a call, they contact me. The email goes—and listen, there's no—I'd love even if you book a demo to just chat, that'll be great. I can guide you through how it works for me. Yeah, looking forward to connecting.
JOHN: All right. Okay, well, I think we're a little bit out of time here, so Bart, this has been fantastic. It sounds like this is just exciting, really, because it's, who knows what's going to happen with this, but I know it sounds like your practice is running very well, so that part's great, and you're home for dinner most nights, so it's gotta be working.
So, anything we forgot to ask about or you want to tell our listeners before you go? I mean, if, let's say they're in a busy practice, maybe there's three or four of them, and they just, they're getting burned out and it seems like they just can't keep up. I mean, any just general advice for someone in that situation who's kind of feeling like, I don't know if I want to practice anymore?
DR. KACZMARIK: Yeah, and I'm sure my colleagues thinking the same, and that's why I have my whole YouTube channel just about that.
And I think the main thing is that we stuck—we're a little stuck in the past on how we see outpatient medical practice. It can look completely different, and it doesn't need extra funding, and it's just reorganizing, rebuilding things that we—it's a beautiful thing. It's all in our power, and we don't need to wait for health reform for some payer to give us five percent raise or 5% raise. This isn't a meaningful thing for anybody.
With what I built, I give myself three times the raise, 300% raise with how I found capacity in what I do, and I want to encourage doctors to do that.
That's what my whole YouTube channel is about, to make sure that I think the first thing is to dare to unbundle, dare to think differently about how things can be practiced, how we can practice medicine.
And I would love if more of us just realize that there's a lot more in our power. And I know everybody tried, everybody tried to be more efficient, but this is a little different. It's just delegation that people, the doctors don't do because logically they would agree with me that they can hire a nurse to do their paperwork, but anybody asks it, logically I agree with you, but I'm just not comfortable doing it.
So there's a lot of emotional barrier there to doing this, and I'm trying to show how this is doable, how this isn't harmful, how this increases not only my satisfaction but the quality of my care and patients are actually happy to have next day appointments. So I think it's a big win at the end that we don't see.
And as I say, my philosophy is there to unbundle and just have a better practice and be more satisfied.
JOHN: How do I find the YouTube channel?
DR. KACZMARIK: Dr. Bart Kaczmarek is my handle. I can put it here in the—
JOHN: I'll get it. You're going to send it to me, okay? And I'll make sure I put those links in with the others.
So, this has been really interesting to me. I think my listeners are going to love it. And yeah, this is great. I'll probably follow up with you down the road if I'm still doing this podcast in a year or so and see what the heck you're up to. Maybe by then you'll own Windsor itself, huh?
This has been great, thanks a lot, and with that, I will say goodbye.
DR. KACZMARIK: Thank you, John.
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