In this podcast episode, John interviews the founder of a fantastic B2B Business. Dr. Nicole Rochester returns to the podcast 5 years after her initial appearance in Episode 127 in 2020.

Starting as a pediatrician who launched Your GPS Doc, LLC in 2017 to help patients navigate the healthcare system, Dr. Rochester has expanded her business to include consulting for major healthcare organizations, speaking engagements, and coaching other physicians to start health advocacy practices.

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By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

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Building a Career with a Fantastic B2B Business

Nicole's journey from clinical medicine to entrepreneurship demonstrates how physicians can leverage their expertise to create multiple revenue streams while making a significant impact. Dr. Rochester's business evolution exemplifies organic growth through network building and opportunity recognition.

Starting with board participation and speaking engagements about health disparities, she expanded into consulting for healthcare organizations and hospitals. By accepting new challenges and learning as she went – from creating scopes of work to determining consulting rates – she built a successful B2B practice.

Her approach emphasizes the importance of valuing one's expertise appropriately, with payment rates for consulting that significantly exceed clinical hourly rates.

Expanding Revenue Streams

Beyond consulting, Dr. Rochester has developed additional business streams, including coaching other physicians to start their own health advocacy businesses. Her eight-week program helps doctors leverage their medical expertise in the growing field of patient advocacy.

She emphasizes the importance of mindset work for physicians transitioning to entrepreneurship, noting that doctors often underestimate their ability to run successful businesses despite their significant accomplishments in medicine.

Her approach combines practical business guidance with strategies to overcome imposter syndrome and build confidence in their nonclinical roles.

Summary

Physicians interested in exploring health advocacy or healthcare consulting can connect with Nicole through her website or by scheduling a discovery call to learn about her coaching program.

Her journey demonstrates how physicians can successfully transition from clinical practice to entrepreneurship. Leverage your medical expertise, personal experiences, and professional networks and create innovative healthcare solutions and multiple revenue streams.

Links for today's episode:

• Your GPS Doc
• Your GPS Doc Consulting for Healthcare Organizations
• Free Discovery Call to learn about coaching to build a Health Advocacy Consulting Business
• How This Consulting Business Grew Directly From a Patient Need – 289
• How to Use Consulting and Advising to Find Freedom – 249
• How to Become a Consultant to Venture Capital Firms
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 385

How to Create A Fantastic B2B Business

- Interview with Dr. Nicole Rochester

John: Today, I'm very happy to welcome back my guest from five years ago. It's hard to believe. And at that time, she introduced us to her new innovative work as a physician health navigator. I think that's the right term; it can probably be called other things. But anyway, her business has grown and evolved since then, and so I thought I'd invite her back to talk to us, provide us some inspiration and share what she's learned and— maybe some things we can apply to our businesses. So with that, Dr. Nicole Rochester, welcome back to the podcast.

Dr. Nicole Rochester: Thank you, Dr. John Jurica. It's so great to be back. Thank you for having me.

John: My pleasure. I know people are just gonna get a lot out of this because what you do is somewhat unique, I think. I know you're teaching others to do it, so that's awesome. But it's somewhat unique and you're running businesses or your business since, I don't know, six, seven years ago. And I see you're doing a lot more speaking recently. So why don't you catch us up? What's been going on for the past five years? You can maybe mention a little bit about your medical background before that, but bring us back up to speed.

Dr. Nicole Rochester: Sure. Yeah, so I'll start a little bit at the beginning, like you said, just for those who may not have heard the prior episode. So I'm Nicole Rochester. I am a pediatrician by training, and I always like to say that I loved pediatrics because I know in this day and age, many doctors are finding their ways into non-clinical careers out of necessity, or they're kind of running away from something. And there's nothing wrong with that. There are lots of reasons to run away from medicine these days. But in my case, I really did enjoy my job and really thought that I would work there until I retired.

And for my situation, it was the life experience that led to my transition into entrepreneurship. It was a caregiving journey with my late father and seeing how difficult it was to get the care that he needed, to communicate effectively with the members of his medical team, to advocate for him. And so I found myself doing these things behind the scenes, realizing that as a physician and an insider, I was really uniquely positioned to advocate for my dad. And then after he passed away wondering, how is everybody else managing this? If it was this hard for me, who's a doctor, one of my sisters is a nurse, how much more difficult must it be?

And so I really felt this calling to advocate for other patients and family caregivers the way I had advocated for my dad. I thought I was making this up; it turns out I wasn't. There's an entire field of what's known as professional health advocates or independent health advocates. And so as I started thinking about this business model and doing research, I discovered that others were already doing it. And so in 2017, I left my academic pediatric career and launched Your GPS Doc, LLC, which started as a health advocacy company where I was working one-on-one with other patients and family caregivers, helping them understand and navigate the healthcare system, which involves a whole lot of things.

So yeah, so that was kind of how I got started. Since then, you know, since I was last on your podcast, my work has really evolved from working one-on-one with clients, which were patients and family caregivers, to working with healthcare organizations and hospitals and health systems. And that work involves some speaking, workshops, and training, as well as consulting. And then, as you alluded to, I also am coaching and teaching other physicians how to launch their own health advocacy businesses. So a lot has happened in the last five years, and honestly, things just continue to evolve. And I think I'm still learning, growing, and figuring things out as I go.

John: Good, we can learn from you and with you then as you know this continues. There are so many things that I could say about your opening comments. I'll start by saying that I bet 99% of the people that go see a physician when they're done with their visit and they go home—if they're really sick or not really sick—they can't spit back 5% of what they were told, except, "I saw the doctor and my blood pressure was okay." I have a 96-year-old aunt who doesn't live close to me, but I keep in touch with her. She goes and sees physicians, and then when she comes home, she asks me all these questions. And she's not even given a piece of paper with what her meds are or what she's supposed to do. It's just like, "Come back in two months." So that's shocking.

But the other thing I wanted to mention when you were talking about, you said there are these health advocates, but at the time you started doing this, what percentage of those health advocates were physicians?

Dr. Nicole Rochester: Yeah, that is a great question, John. I, to this day, have not been able to get reliable, validated data on that, but very, very little. And today, very, very few. You know, there are more, and I'm happy that I've contributed to that increase. But there were very few when I first started. And in fact, I was on a mission to find other physicians who were doing health advocacy, and I found a few, you know, maybe four or five. But it's something that I think most physicians continue to not be aware of. When people find out about me, specifically other doctors, they're like, "Oh my gosh, this is the part of my job that I love the most." And to your point about your aunt, these are the things that most of us went into medicine for. We liked talking to our patients when we were medical students and being able to sit and spend that time. And the reality is that we just can't do that for so many reasons. And so I always get excited when I talk to other physicians about the work because it's the communicating and the explaining and the connecting, the part of our jobs that most of us love but don't have enough time to do in the current environment.

John: Well, I wanna learn more about that aspect of what you're doing. So let's go a little deeper into your GPS Doc business and how it's changed in the last five years. How did you kind of migrate to working with organizations?

Dr. Nicole Rochester: Sure, sure. So in terms of the work now, you know, I think the biggest lesson that I've learned and that I hope that your listeners will take away is that the things I'm doing now were birthed out of opportunities to which I said yes. I didn't go back and get another degree. I didn't go back and get more certifications. And I'm not saying there's anything wrong with that but I allow myself to sit in the space that they're asking me to do these things. How can I figure out how to do them? What do I already know? What do I need to learn? And we know doctors are great at learning and finding information. And I say that because there are opportunities that I easily could have shied away from due to fear, due to imposter syndrome and all those other things that we amazing, brilliant doctors face.

And so I look at where I am now, and I think about like those first opportunities that led to this pivot. And it just reminds me that we don't give ourselves enough credit for all of the knowledge and experience that we have. So what happened with me is that I was on a board. In fact, I just finished my ninth year and just fell off of the board, but I was on the board of an organization in Maryland where I live that basically serves as the primary source of education and training, leadership education and training for healthcare professionals. And so they are deeply connected to the local hospitals and healthcare systems.

And so I was on the board, and in 2020, we had a meeting in June, just a few weeks after George Floyd had been murdered. We were in the midst of the pandemic, and so we were talking about what was going on in the world. And the meeting headed to an end, and I said, "Wait a minute, like, what are we going to do? Like, what, what can we do in this space?" And we were specifically talking about health disparities and racism in medicine. And so me asking that question kind of led to me being, I won't say voluntold, but I was asked, "Hey, what do you think we should do?"

And so I thought about how could we provide education in this space and start to educate healthcare leaders and healthcare professionals about structural racism and how that impacts the healthcare that individuals from marginalized communities receive. So then that led to, "Well, would you be willing to do it? You know, can you develop a talk?" And I have been giving, you know, all of us give talks, right? As medical students, we give talks as residents. I had definitely given a lot of talks as an attending, but I had never given a talk about this. And so this was the first time I said, "Okay, I'm going to say yes to this."

I had already always had an interest in health disparities, even as a medical student, so I kind of relied on that, did a bunch of research, found out, you know, what's going on, looked at statistics, all those things. And I developed a talk called, combating, I think it was called "Combating Structural Racism and Disparities in Healthcare" or something like that. I gave that talk for this organization, and it put me in front of a lot of hospital leaders, doctors, and other medical professionals in my state. And so then some of them reached out after the talk and said, "This was great. Can you come give that talk to my hospital? Can you come give that talk to my medical staff?" And so that led to more opportunities for speaking.

And then an organization that's affiliated with that original organization, the Maryland Hospital Association—actually, I'm sorry, it was the Maryland Patient Safety Center—they reached out, and I had been familiar with the CEO of that organization, who happens to be a pediatrician, a retired pediatrician. He and I had worked together in a hospital. So again, there's a thread here, that leverages network. So he saw the work that I was doing, he attended the talk and he said, "Hey, you know, we're in the middle of COVID. We're seeing that a lot of community members who are minoritized, marginalized are saying no to the vaccine, not only in the community, but we're even seeing healthcare workers who are Black and Brown and marginalized saying no."

And so they had a project where they wanted to address vaccine hesitancy in the context of health disparities. And so he said, you know, "We'd like for you to work for us as a consultant." At this point, John, I had never ever done a consulting job. They asked me to provide them with a scope of work. I literally didn't know what that was. Said yes, got off the phone, Googled how do you write a scope of work, and looked at a bunch of templates and examples, and basically created this scope of work around what I thought would be helpful. And that led to my first consulting gig, which then led to other consulting gigs and more speaking. And now, that has really kind of positioned me as a thought leader and an expert in health equity. And so then that led to some specific health equity projects around maternal health. And it just, you know, the snowball just keeps on going, and it all started with me asking a question in a board meeting and then developing a single talk, which has led to lots of iterations of that talk and many more.

John: All right. So I can ask you many questions about this, but I'm going to focus on two. One is, a lot of people that are trying to get something like that going find themselves having to do some kind of marketing, but it sounds to me like this thing kind of snowballed kind of on its own to some extent. So were you seeking speaking engagements, for example, or doing other things? Number one. Number two. Did you at any point charge for the speaking, or did you just use that as your marketing tool?

Dr. Nicole Rochester: OK. Yes. So I definitely—I had already been doing some speaking within the context of my business, Your GPS Doc. But because I started out primarily working with family caregivers and helping people navigate the healthcare system, the talks that I was giving were really focused on that. So I was giving talks at caregiver conferences, I was giving talks for local departments of aging around that, and some of those talks were paid. Initially, a lot of free talks, and then like many speakers, you start out free, and then finally either you get the courage to ask for money or somebody offers you money and then you go, "Oh my gosh, I can make money." And then you gradually raise your price.

So definitely the talks that I'm describing now were paid engagements. And once I did a few of them and really, really loved it, I did formally market in the sense that I put a page on my website, speaker page. I put a contact form so that people could contact me if they were interested in having me come speak. And I'm very active on LinkedIn, and so I started to post. If I would have a speaking engagement, I would post about it on LinkedIn. I would post a picture. I would usually ask somebody, "Can you please take a picture of me while I'm speaking?" And I would post that photo. I would tag the organization. Inevitably the organization would comment, "Oh, this was such an amazing presentation." You know, maybe they would share my post or maybe they would do their own post. And so that definitely led to some traction on LinkedIn. And so periodically, I continue to get requests about speaking engagements, either from people that saw something on LinkedIn or maybe they went to my website and saw it there.

So there definitely has been some intentional marketing. I will say that one of the things that I am admitting and acknowledging—and I always think about this to myself—is that I really don't market myself as much as I could or should. And I've just really been lucky, blessed all the things with the opportunities that have come my way. And I also recognize that moving forward, I am going to have to probably be more intentional about marketing and making sure that I'm top of mind and that people are continuing to find me.

John: Did you end up, at least on the marketing side and, you know, whether it's emails or posts on different social media, did you hire anyone and you have any assistance or are you handling all that yourself at that point?

Dr. Nicole Rochester: There have been a lot of iterations of having help and not having help. I definitely will say I probably waited too long to get some help in my business. And so I have had a virtual assistant at times, and I've had a social media manager. And I'll also say very transparently that at times those are my two young adult daughters. So, you know, if you have kids, teenagers, young adults, they can be amazing at helping you with those things. And then I've also had other individuals that I've worked with. But a lot of it I do and have done and continue to do on my own, just organically. And I have to, you know, social media is its own beast. Sometimes I'm really good at keeping up to date. And then other times I'll look and say, "Oh my gosh, I haven't posted in a month." And so I try to balance that.

John: Well, it's tough when you're helping patients directly, you're doing the things with an organization, and trying to manage and handle everything. And then, oh, I, got to remember to, you know, go on Facebook or Instagram or LinkedIn or whatever. It it gets overwhelming pretty quickly.

Dr. Nicole Rochester: Yes, absolutely.

John: If you're like me, then you go in cycles, though, when you really nail it for a while and then you drift away for a while. So you had to learn how to basically write a proposal, a scope of work. And actually, like you said, one of the big things was, well, how much do I charge? I don't want to necessarily ask what you charge then or what you're charging now, but maybe like, how did you figure out what? How did you come up with that number thinking, I don't want it to be so high it's crazy, but I don't want to leave a lot on the table? I mean, I'm spending a lot of time researching and doing all this work.

Dr. Nicole Rochester: Yes, that is a great question. That is something that I feel like it's hard to know, and I will say that generally—and this sounds crazy, John—but I just, I make it up. Not completely make it up, but I try to do some research. I try to ask around and see what other people are charging. As you know, a lot of times for many reasons, you don't get straight answers with that. And then I just would try something. I would say typically whether it's speaking, consulting, and even coaching, the initial price was much too low. Like I would significantly underprice my services. And then I would realize, you know, after getting feedback or seeing how it's going, it's like, "Wait, you know, I could be charging more." And then I would charge a little bit more the next time. And If I get a very quick yes, I'm like, "Uh-oh, you know, that probably was too low."

And so you kind of inch your way up as you get more comfortable, as you get more experience. For me though, like I did go in some of the Facebook groups for physicians, nonclinical careers, things like that. And you ask the question and a lot of times you would get kind of a range or people would say it depends. But I really felt strongly that as a physician, regardless of what I'm doing, whether it's consulting, definitely in the consulting space, what I was hearing from other doctors who were willing to share is that they were charging anywhere from $300 to $600, some even more, dollars per hour. And so I felt like, "Okay, let me maybe land in the middle of that and then kind of see if they say yes and then work my way up from there."

I think that we—one thing that I've noticed when coaching physicians is that they often start... When we're talking about the hourly rate, for example, with the health advocacy, they will go to their clinical hourly rate. And if they're a pediatrician like me, we're at the bottom of the pay scale and they'll say stuff like, "I don't think I should charge more than $150 an hour." And I'm like, "Absolutely not." Especially if you're working with organizations and things like that. So I think we all have a tendency to try to compare that work to what we did in a clinical setting, and the two are little like apples and oranges. And getting accustomed to the fact that your knowledge and expertise is extremely valuable and that you know the companies that are hiring you to consult or advise they're doing that because of your unique vantage point and your experience, and that deserves to be compensated. So it's not about taking advantage of anyone, but it's really kind of standing in your truth and trying to understand and figure out what you're worth.

John: That's good advice. You know, I was a chief medical officer for a hospital, so we had consultants always coming in. And, you know, a lot of times there were big consultations, so they wouldn't even give an hourly rate. It would be like just a project that would take a year, and, you know, it would be $100,000 or something like that. Now, you know, you have to do some work backwards, I guess, and see how much time you think it's going to take. But I would say, again, this is based on nothing except just talking to people like you. Like if you're a physician doing consulting and your clinical rate is like $200, $300 an hour, you know, doing whatever you're doing, you should at least double it.

Dr. Nicole Rochester: I agree.

John: What else have you learned in the last five years as you're making this, transition to doing really these bigger things and working with more of an institution? Anything you want to share with us about your mindset?

Dr. Nicole Rochester: Oh, wow. Oh, yeah, mindset. I think what I have learned—I know that what I have learned in the last seven years since becoming a business owner is that 95, if not more, percent of the work is in our own head. It's our mindset. Everything else can be figured out. The information is out there; you can find it. But having the information, like as doctors, we always feel like if I just have more information... But for us, it's here—for everybody, but particularly for us. And I've been really intrigued with my own journey and with now coaching physicians, this idea that we represent—I don't know the exact number, but we're in the top echelon, I believe, in terms of intelligence and things like that. And we do really, really hard things as physicians, like literal hard things, like intubation and putting in central lines and saving lives. And yet when it comes to starting a business—and I'm not saying it's easy, because it is not easy—but we have so many fears and trepidations.

And I've talked to so many doctors that are like, "I want to do this, but I'm afraid to start my own business. I don't think I can start my own business. I don't think I could do it." And it's like, "Are you serious? Like you save lives every day. You're an emergency room physician. You're a critical care doc." And you don't think that you can start a business? So our mindsets are so important. And you know, whatever it takes, whether it's mantras, affirmations—for me, sometimes, John, I will actually go look at my CV, and anytime I have an opportunity to update my CV, it becomes an amazing exercise in boosting my confidence because I start to look back at like all of the talks that I've given and you know, my regular job and all the work I did as a pediatrician. Then to look at the different talks that I've given, the articles that I've contributed to, and the clients that I've had a chance to work with. And that reminds me like, "Nicole, you're doing pretty well,"

And so I think that we discount ourselves so much as physicians, and we just don't appreciate that, yes, we have the medical knowledge, but there's so much more that you can do with that medical knowledge beyond the clinical arena, and really, you know, just embracing that. So mindset, I continue to work on my mindset regularly because every now and then, it's something that you don't conquer, at least for me. Like sometimes I'm thinking like, "I've got this," and then some new opportunity will come my way and I see myself, I see that old part of Nicole trying to sneak back in. So I think mindset is incredibly important.

The other thing I've noticed specifically around speaking as a doctor is that I have had to creatively and respectfully remind organizations I'm a small business owner. And I say that because I continue to speak for free periodically, but it has to be like a very small nonprofit or a very religious organization or just a cause that really aligns with my purpose in life. But there are large organizations, like large John, that will approach me about speaking and then tell me that they don't have a budget or the budget that they have is significantly below what I would charge. And I've gotten to the place now where I just politely decline. And if there is a back and forth, which sometimes there is, I will tell them, you know, they'll say, "Well, Dr. So-and-so spoke for us last year, and he or she did it for free." But they're always naming a physician who works for an employer. And so, you know, you may recall, when I worked in academia, speaking was considered, you know, you do it for "exposure."

I love when they say, "Oh, we thought you would just do it for exposure." And it's not... to sound arrogant by any means, but I don't need—well, I don't want to say I don't need exposure. I always need exposure, but I'm kind of beyond the stage of speaking for exposure. And when they bring up a physician who is employed, I remember when I was employed, absolutely, I gave talks all the time for free. But at that time, I had a goal of, you know, maybe advancing up the academic ranks; like there was something tied to that effort. And so now, you know, my CV doesn't earn me a title of associate professor or professor, and I literally work for myself; I provide for my family.

And so I think that's another thing that I want to share. You know, certainly in the beginning, again, there's nothing wrong with doing things for free. There's nothing wrong with doing things for lower cost as you are making a name for yourself. But after you've done that, you deserve to be paid. And so I just find a lot of times because we're so altruistic, there's just this attitude that we should come speak to large healthcare systems and pharmaceutical companies even just out of the goodness of our hearts.

John: Wise words there. So it's absolutely true. And when you're going your own and run a small business, you have to earn a living and you have to put money aside for when maybe it gets a little light for a while, you know.

Dr. Nicole Rochester: Yes.

John: It makes perfect sense. That's good encouragement. Okay, now there are some people that like what you're doing and, you know, different aspects, but I'm sure there are people that like the advocacy part because that's something, again, that maybe they hadn't realized they could actually get paid to do. So you're teaching other people how to do that as well, correct?

Dr. Nicole Rochester: Yes. Yes, that is correct.

John: So tell us all about that.

Dr. Nicole Rochester: Sure. Yeah. And that's another thing, you know, there's a theme I'm realizing now. There's a theme in our conversation in terms of saying yes and embracing opportunity. Because with the coaching, I started my company in 2017. I was doing health advocacy. Within a couple of years, I became known in some physician circles as the doctor who does this. And so one, when doctors would say, "Hey, I have a family member who this happened to or this happened to," they would remember, "Oh, Nicole dealt with that when she was caring for her dad," or "Nicole now works with people."

And so I would get tagged in these Facebook posts. And so initially I would get tagged for like helping someone's family member navigate the healthcare system. But then doctors would sometimes say, often in the nonclinical groups, "Hey, is there such thing where I could just like help people understand their medical conditions or maybe when they're hospitalized, I can help them understand what's going on and communicate with their doctors?" And then I started getting tagged. They were like, "Hey, Nicole does that."

And so I would get tagged and then I would reach out to someone, I would hop on Zoom calls and maybe talk for an hour or two hours and just kind of answer their questions about how I got started and all the things. How much do you charge? Do you need insurance? All these things. And so I started doing that and then as I got busier, I didn't have the time or the capacity to have these two-hour Zoom calls. And so then doctors would say, "Well, can you just coach me?" And the first four or five or six or eight maybe times, I said no. I was like, "No, I don't do that." And they were like, "Well, can you just coach me?" "Nope, I'm not a coach."

So finally, around 2020, I started saying yes. I never advertised it. I just, you know, I said, "Okay, somebody reached out and they were like, 'I really would love to learn from you.'" And so I said, yes. So similar to that consulting scope of work package where I had to figure out what it was, I started researching, you know, coaching and like, how much should I charge? And then I thought about my journey. What were the things that I needed to know in order to launch Your GPS Doc? But even more importantly, what are all the mistakes that I have made? What are the things that I wish I knew when I first started?

And so I started developing a curriculum and I took my first coaching client and I worked with her one-on-one, and that was great. Everything went great. And so then, you know, the next doctor that came, I said, yes, I do this. But I never advertised it. I was still afraid. So if somebody came to me, I would say yes. But I wasn't out there saying "Hey, you all, I'm a physician coach." So then that led to me formalizing a curriculum that went from like a three-week program to four weeks to six weeks. Now it's an eight-weeks program. And then I went from a one-on-one to a group model.

And so since 2022, I've been hosting or leading the small group cohorts of physicians who want to start their own health advocacy business. And again, as the landscape changes, as new things pop up with the industry, I go back in, we update the modules. But right now, it's an eight-week program; there are lessons and modules and videos and downloadable templates and things that live on an online platform. And then weekly during the program, we have coaching calls, live coaching calls where I answer questions, where I deal with mindset challenges and coach the individuals. And yeah, we do that, and there's even an alumni program that I started just a few months ago because what I noticed is that a lot of the doctors that would finish, some of them would just take right off. Like they would finish the program, implement everything, start their business.

But a lot of them were still kind of nervous or scared, and they still needed a little more support. And so now we have an alumni program for those who want ongoing support after the eight-week program is finished. And it's just been an amazing thing to see these doctors in various seasons of their career. Some are retired, some have been out on disability for injury or illness, and some are still working full-time or part-time, and seeing them launch their health advocacy business and helping other patients and families has just been amazing.

John: Sounds like, though, from your standpoint, I mean, looking at what you're doing, you're definitely juggling a lot of things here.

Dr. Nicole Rochester: Yeah.

John: You know, you have, but it's interesting. I mean, real entrepreneurs, that's kind of what they do. Maybe you didn't really consider yourself an entrepreneur 10, 15 years ago, but you know, you're just meeting these needs as they arise. And some are, you know, huge, you know, organizations and some are just individuals. So it's really, I think it's very—I was going to say impressive, no, but it's very—it is impressive, but it's just, it's encouraging, I guess. It's like you said, there's so many things you can do if you just have that mindset. You could do a whole thing. It's all the mistakes to avoid because that's really like the, what did a consultant provides: "Don't do any of these things; do these things, and you're going to be where I was only it's going to take one-third of the time or whatever."

Dr. Nicole Rochester: That part. That is so important. Time is compressed when you work with somebody who's already done it. They've already made all the mistakes. Absolutely.

John: So where does somebody go to learn about that part of it, the coaching?

Dr. Nicole Rochester: Probably the best way you can schedule a call with me to learn more about health advocacy and about the program and we can decide if this is a good fit. And that's bit.ly/NHAcall. And N-H-A is in all caps. And they can also just go to my website, which is yourgpsdoc.com.

John: Well, you've covered a lot and you've really given us a lot of inspiration and actual good practical advice as well. So, anything else you—I guess we're going to get to the end here. So, I just would open it up for any advice you have for physicians. You know, my audience, a lot of them are either burned out or they're frustrated or they've been in medicine for 25 years and they're like, "You know, I just don't want to work like a crazy person anymore." What advice would you have for them?

Dr. Nicole Rochester: Yeah, one, I, you know, I—sending hugs because it's really, really difficult to practice medicine now for so many reasons. And honestly, I'm afraid as I get older, like who's going to be around to take care of me because I know that so many of our colleagues are leaving. But I guess the advice I would give is really, really embrace the knowledge and the expertise that you have—not just with your medical career, although that's incredibly important—but your lived experiences, your personal experiences, your interests, your hobbies—like all of those things make you who you are. And all of those things are potentially monetizable.

And I think that's something that I've learned and continue to learn is exactly what I'm always surprised at: What is monetizable? And for me, it's not just making money. Like that's not my, that's never been my motivation: is to make money. I'm excited that I get to make money while I'm still doing things that bring me joy. But realizing that there's so much information and knowledge that we have that can help others and that other people are willing to pay for that information. So it's a win-win. I mean, you have a way of monetizing your skills and your knowledge and you're doing it in a way that helps the broader society.

John: I agree 100% and you're a good example of it..

Dr. Nicole Rochester: Thank you.

John: All right, Nicole. I don't think I'm going to wait another five years, but if I still have a podcast going maybe in two years or so, then I think we're going to have to get together again and see what else you've been up to. But this has been very interesting, fascinating, helpful. And I thank you for being on the podcast today.

Dr. Nicole Rochester: Thank you, John. Thank you for having me. And thank you for this platform. I've talked to a lot of doctors who listen to your podcast, and that's been their motivation to step out into the deep. So thank you for what you do.

John: Well, I appreciate that. All right. Well, take care. Bye-bye.

Dr. Nicole Rochester: Take care.

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Many of the links that I refer you to and in the show notes are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so does not affect the price you are charged. I only promote products and services that I believe are of high quality and will be useful to you, and that I have personally used or am very familiar with.

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. 

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The post How to Create A Fantastic B2B Business appeared first on NonClinical Physicians.

In this podcast episode, John discusses how to save your career if you wish to continue working in clinical medicine.

John shares five proven strategies for physicians to revitalize their medical careers while maintaining patient care, drawing from his experience as a Chief Medical Officer to help doctors reimagine their practice rather than abandon clinical work.

Drawing on real-world success stories, he offers practical solutions for physicians who enjoy patient care but struggle with administrative burdens and work-life balance.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Taking Control of Your Practice to Save Your Career

Contract renegotiation offers a powerful tool for employed physicians to improve their work conditions. Key areas for negotiation include vacation coverage, and ensuring adequate support during colleagues' time off through locum tenens or community coverage. Working hours should account for documentation time, and supervisory responsibilities for NPs and PAs need clear boundaries.

When approaching renegotiation, physicians should review their contracts months in advance, engage legal counsel, and strategically time their negotiations, especially as healthcare systems face increasing challenges in physician retention.

Breaking Free from Traditional Constraints

You can explore various practice models to eliminate common stressors while maintaining clinical work. Options include direct primary care (DPC), cash-only practices, concierge medicine, or specialized focus areas. These models often eliminate insurance billing headaches and allow for better work-life balance.

Alternatively, you can consider micro-incorporation, forming an LLC to work as an independent contractor with hospitals, gaining tax advantages and greater flexibility while maintaining the appearance of traditional employment.

Summary

Each approach requires careful consideration and planning. However, there are solutions to the challenges in modern medical practice that preserve the physician-patient relationship.

Links for today's episode:

• Why an Infusion Lounge May Be the Best New Thing
• How to Save Healthcare, Satisfy Patients, and Fix Physician Burnout – 256
• Negotiate a Great Contract, Avoid Burnout, and Be Happy
• Now Every Doctor Can Win As a Micro-Corporation
• More On The Benefits of a Professional Corporation
• Avoid These Mistakes When Seeking a New Practice
• Make Your Clinical Practice Great or Move On
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

Right click here and “Save As” to download this podcast episode to your computer.

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 384

First Consider 5 Proven Strategies To Save Your Career

- Recent Trends Offer Options for Physicians - 384

John: Okay, today I want to describe several ways that you can fight to save your clinical career. Normally, I talk about nonclinical and unconventional careers to consider when you're fed up or burned out from your practice, but I've learned that sometimes it's not practice per se, but the long hours, dwindling salaries, and unsympathetic bosses that lead physicians to leave practice. You may still enjoy seeing patients and working in a clinical practice if you could get rid of all the other nonsense.

I'm coming to believe that reimagining your practice might be a valid, maybe even a better way to save your medical career and get back on track than just abandoning it and doing something nonclinical, albeit still in the field of medicine or in the field of healthcare.

I've had several guests over the last year or two who have confirmed that belief, and I want to spend a few minutes today to provide a little bit of food for thought on a short list of strategies to get you back on track in your career, bring some happiness and satisfaction without leaving medicine. So let's get to that discussion.

All right, we're talking about considering five proven strategies, and these strategies are designed to save your career. Let me work from this premise that you're in this position and you actually still like seeing patients for the most part. You enjoy practicing medicine, and that's not the problem, but it's all the other stuff that gets in the way.

Things are happening, most of the time it's because you're employed, you feel you don't have a lot of control, and you know what's going on is not really aligned with your lifestyle desires or your values, that kind of thing. And you'd really like to be able to spend time with your patients, make a decent living, and maybe even not be sued and other factors that I'm going to talk about here in the next few minutes.

But while you're thinking about these strategies, remember several things, that most of these will require hiring an attorney, most of them or some of them will require moving at least to a new practice. You might not have to move from your city if you're in a big city where you can actually still commute, but some of these things I'm going to mention do require you leaving your current practice. And sometimes it might not only involve moving to a new practice, but it might involve starting a new practice. So those are big things if you have to sell a house and so forth, they can be a barrier.

But these are all situations where you can continue to practice. And in many of these situations, your practice is extremely rewarding. So I have five strategies for you to consider today, and I'll go through all five right now, and then we'll go through them one by one.

The simple one is to aggressively renegotiate your contract. The second is to hire an agent. Now that might seem kind of unusual. We don't think of using agents for physicians to negotiate their contract. This one usually applies for your first job, but it can apply to your second or third as well. If you can somehow eliminate the billing from insurance companies, that can sometimes eliminate a big chunk of problems in a practice.

Let's say you're in a private practice now, either alone or with others. If you can figure out a way to avoid the need to do billing, hiring staff, tracking it down, working with the big insurers, which is extremely frustrating, that might solve the problem. Possibly you can just narrow your focus, narrow your practice.

I'll give you some of my ideas on that. And then the other is maybe switching from an employee to an independent contractor, even in a similar situation, or what some people call micro-incorporation, that might solve the problem and bring you closer to the practice of your dreams.

Well then, let's talk about aggressively renegotiating a contract. Now this is for those who are already employed. And I have a fair amount of experience with this because I was a CMO for my hospital and I either negotiated or renegotiated over a hundred contracts. I even oversaw the hiring and then also the recruiting of new physicians from their own practice. In other words, we would buy their practice and we would add them to our group.

But if you're already employed, you have a contract, there are usually certain factors that cause the burnout, that cause the dissatisfaction. One could be the vacation coverage. And it's not that you don't have enough vacation. You may have two, three, four, even up to six weeks or so. The problem is that sometimes you don't take your vacation because you're so busy and you feel like your patients will be let down.

Sometimes you don't take vacation because you don't have enough coverage. And related to that is you don't take vacation because you realize the more vacation that you take, the more that the other physicians who cover you are going to take. And when they're gone, your own time is extremely stressful because you're covering for all their patients while they're gone.

So if you're in a group with six, seven, eight specialists in a certain field, it's not always a big problem to have only one person gone at a time. But if you have three and one leaves for two weeks, then that means the other two are on call every other night or every other day for those two weeks. And so, it's kind of a misnomer, and I realized this even when I was negotiating these contracts, but sometimes we just had these difficulties with the small groups of specialists that it's really not every third or every fourth call rotation.

Because let's say that you have four people working in that. Well, all four of those physicians could conceivably take off three weeks each year, which means during let's say the nine weeks when other people are taking call, you're no longer on every fourth night. Now you're on every third. So your contract is essentially in violation. What they're doing is in violation of your agreement. Really what you should be doing is plan those out well in advance and get locum tenants to come in and fill.

And it's even worse if there's only three of you or two of you, because then when one person's gone, if there are two, then it's extremely stressful. And yet they say, well, we'll work around it, but no, that can be devastating. So vacation coverage is a big deal. And that's something that should be really clarified that if you're really on every fourth, then that means when people are taking off, you should get locums in there to cover or pay somebody in the community to cover.

The hours and salary of course are big deals too, but it's mainly the hours that you're expected to work. And I think we need to start pushing back on the employer and say, okay, I'm including the hours of my documentation. So you shouldn't be seeing patients for eight, nine hours a day. And that's quote your normal office hours when you're going to be spending an hour or two at night doing your charts, there needs to be time taken during the day while you're seeing patients to do your charts. And if that doesn't work out, then you need to come up with another plan.

And the other one that came up a lot when I was doing this was working with physicians and getting enough supervisory time for the NPs and PAs that we had, because we were hiring a lot of them. And it really got to the point where we were struggling to get them coverage and sponsoring or collaborating physicians. And so they could be the designated coverage or sponsor for, let's say some PAs, it could be 5, 10, 12, 14 PAs that could be calling at any time that they're seeing patients. And this is like a minor thing in a contract theoretically, but it's really a big deal.

And so, what you need to do is look at all those things in your workplace that are making you unhappy and take the opportunity to plan for it and aggressively renegotiate your contract so that it actually provides you what you need safely and at a low risk of being sued. Some of these things lead to fatigue and leads to mistakes and all that kind of thing. So that's one option.

Now, this has always been out there, obviously. I think as hospitals and systems are having more difficulty keeping physicians, you can get a little more leverage now that maybe you had five or 10 years ago. So that's the first thing. You can definitely start by renegotiating aggressively. Obviously, you're going to need to have a good attorney and you're going to want to strategize with the months and months before it's time to renegotiate. And you're going to look at your contract and make sure that you give them enough notice that they don't just say, oh, it just rolled over for another three years because you didn't dispute it. That's enough of that one.

The next one is hiring an agent. And this is mainly for your first job and then subsequent jobs. But I interviewed a guest by the name of Ethan Encana. He was trained as an attorney and that was in February of 24. And he has a full time company job and associates who are hired by physicians as an agent to do the negotiation upfront for their jobs. And they're really serving more like they would for an athlete, a professional athlete. They're going to look after you. They're going to approach the organizations that have these jobs posted. And they're going to negotiate even before they get to the negotiation of the actual contract, the arrangement. And the arrangement is that they are going to pay the fee for this agent. And this agent is going to keep all of your best interests in mind and negotiate very aggressively to get you a contract that has all the things in it that you want and need.

And it's again, usually those same issues that include vacation, the hours and salary, the pay for supervising other medical providers, the restrictive covenant. It's tough to get rid of that restrictive covenant, but there's more and more examples where they are getting rid of that. So if for some reason you would want to go private at some point, then you can do that.

But you can actually hire an agent. And again, I had never even heard of this until earlier this year in 2024. And so, I'll put links in the show notes to any of these things that I mentioned in terms of previous guests and resources to follow up on these options.

Hiring an agent is an option. Maybe they can get you a better deal that is to your satisfaction and has a great life work-life balance and so forth. And particularly if you're willing to look not maybe rurally for sure, because they're really having trouble, but even in the suburbs and stay away from the big cities, you're going to find a lot more opportunities because they are struggling to find physicians, but you're going to have to keep them honest in terms of what their contract requires them to do.

The next one, number three is eliminate billing. Particularly if you're already in your own practice. It seems like it's that whole issue of billing and hiring more staff to do the billing and then have to go after payments that are declined, costs a lot of money, you spend a lot of time, you might have to be doing a lot of paperwork and signing off on paperwork to challenge these billing decisions. Really, there are different ways of doing that. But we know, of course, that DPC, direct primary care is a great one.

I've had, I think, two or three guests on. And let's see there. Also, I talked to someone who is doing an infusion lounge, which is cash only. Direct primary care most of the time is cash only based on a membership fee. Concierge is very similar, kind of high end, more expensive.

A lot of the DPCs, the monthly cost is reasonable and patients really are not opposed to paying that because they have such high deductibles and copays that they do better doing DPC. A med spa is another example. Or you could really narrowly focus your practice and do cash only. You could do functional medicine, I think even lifestyle medicine are ways that you can eliminate third party billing. It's not that the patient can't access their billing, they can do that. You just have to give them records that they can then submit their own reimbursement. Of course, a lot of people have health savings account and similar accounts.

So, if you're in your own practice and that's one of the things that's really making your life miserable, then you want to move to a model that doesn't require you to do a lot of billing. Well, at least not billing of the insurance companies because that's where you really get killed. Normally, if you're doing DPC or even free for service, you're going to get paid by your patients because they'll be afraid that they can't keep you as a primary care doctor. Now, if you're doing urgent care, you could do cash only urgent care. Of course, you do need to be paid at time of service for that.

So, let's move along here. Another thing you can do is narrow your focus. We'll look at this and start in a pretty general practice and that's what we get overwhelmed with. Sometimes, if you can focus on just one sub area or two sub areas of a practice, then you have the ability to systematize things. You can master the billing. So, even if you're doing billing, usually if you're only using, let's say, a handful of codes, you know how to document and how to get paid for that.

I'll give you an example. I have a friend, he's sort of pre-retirement. He's a pediatrician. Obviously, he did a lot of different things, was working in the hospital for a long time, eventually stopped doing hospital work once we got some pediatric hospitalists in town. And then he decided that he wanted to simplify his life a bit and so he started doing only care for attention deficit disorders.

Now, he's still charging fee for service and he's not using a DPC model per se, but you could. You can do either one. But the patients that he has, they are so happy to have someone who's really focusing on this area that they'll pay the money rather than go to a general pediatrician who's doing so many other things and isn't necessarily able to sit down and spend the time and doesn't have the staff in the office like this friend of mine who since we're all on the same page, we're all working on the same problems with these patients. Everyone's very knowledgeable and they get a lot of personal care and they're happy to pay for it.

And so, you can do things like that. I can imagine a neurologist focusing on Parkinson's disease or something with some other neurodegenerative disease and have just a lot of patients with that particular condition or certain cancers or certain cardiac disease. And so, think about ways you could focus down, simplify your practice. Again, you'd have to be in practice to do this. In some cases, you might be able to do it in a large group, but you may end up on your own or with a small group to be able to do this. But at least you're still practicing and your patients will really appreciate you.

The last one, number five here is what I'm going to call microincorporation. I spoke with Todd Stillman back in October of this year, 24, and he was recommending, and there's a reason why this makes so much sense too, besides the fact that it's just another option to get more independence. But you're thinking what I just described in terms DPCs and concierge and med spas and narrowly focused practices, you have to build a practice. It's expensive. You have to market it. You have to have space. You have to pay rent. You have to hire staff. You have to have someone to help you with the billing if you're doing the billing. But you can avoid all of that. And to get a lot of the benefits of being in your own practice by forming an LLC, but then using that LLC to become a pseudo-employee of a hospital system or a large group.

And basically you're a 1099, you're an independent contractor, and you negotiate a contract with the hospital. And the hospital contract is not an employee contract. And so they are alleviated of some responsibilities. They don't have to treat you as an employee. They don't have to give you any benefits. So you have to make sure on the other side of the equation that you make up for that.

But the thing is when you incorporate as an LLC or whatever other PLLC, each state's a little different. You work as an independent contractor, but you look as though you're employed by the hospital and you're not opening. As a matter of fact, you're working in one of their clinics and one of their offices. When I was talking to Todd Stillman, he was funny because he actually had owned an office. Now he was leasing that office to the hospital, which was then allowing him to work in that space. And so he was actually making money by leasing the space to the hospital and other physicians have done this.

And then granted, you've got to cover some things like your own health insurance, but you can find good policies and you have more options as an LLC or PLC to actually diversify your income. You can, through that LLC, do other things. You can have much higher limits on a 401(k) and other tax advantaged investments and so forth. And there's a lot of other tax write-offs that can be used legitimately.

If the first three or four options that I talked about involve starting your own practice, it seems too onerous and you don't want to borrow $100,000 or $500,000 to do that, then this micro-incorporation is another way to really achieve the type of practice that you want to achieve, but mostly onus of the investment on the hospital and still kind of maintaining that arm's length relationship, which enables you to do these other things that make up for it, which includes investing in other ventures and maybe even have other side jobs.

And by the way, nobody else needs to know that this is how it is. You can be doing this and to everyone else in the hospital, in the community, it will look as though you're an employee of the hospital, but you've created your own mini-corporation to get the advantages of the flexibility and so forth that you desire. And yet everyone else and you're still participate with committees at the hospital and stuff to meet all the requirements as a physician, but it does add a lot of flexibility. And I think there's two episodes. I'll put links to everything here in the show notes.

There are five ideas for trying to improve your lifestyle, improve your satisfaction without leaving clinical medicine. Some of the prep will involve really start by reviewing your contract right now, even if it's not due for a year, look in there, see what you're restricted. What can you do? What can't you do? How much notice is required? Early on in the process, as you're reaching that deadline, you need to let them know early and say, look, I'm not leaving. I have no plans to leave this organization, but I want you to know that I have some things I'm not happy with and I'm going to be renegotiating this contract. So if that requires me to give you six months notice that I'm leaving, then I'm going to then you give that notice in writing.

But even in that letter, you can say, I'm planning to stay, but I'm giving you notice as required by my contract that I might not stay if some of the concerns I have about my contract are not addressed. And it doesn't have to be anything onerous, doesn't have to be very confrontational. You go in professionally, you talk with your attorney and you go in and say, here's what I want.

From a negotiation standpoint, I would always ask for the moon. And if you have three or four issues, you start with putting it out there and say, I don't want a restrictive covenant. And then you can come back and negotiate maybe something that's much less restrictive than it was in the past. I don't want to work in this office, or I don't want to supervise 10 NPs and PAs. It's too much work unless I get a lot more compensation and cut back my hours in other areas. These are things you can do. You definitely want to talk to either an agent, as I said, or an attorney, and then discuss your options and negotiation strategy before starting that process.

That's basically it for me today. You know, if you find yourself on the way to burnout, consider taking some of these steps now and go to the show notes for links to the interviews mentioned so that you can learn more about each strategy. And to find those, you can go to nonclinicalphysicians.com/save-your-career.

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Many of the links that I refer you to and in the show notes 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. I only promote products and services that I believe are of high quality and will be useful to you, and that I have personally used or am very familiar with.

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. 

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The post First Consider 5 Proven Strategies To Save Your Career appeared first on NonClinical Physicians.

In this podcast episode, John interviews pediatrician Dr. Zhen Chan whose startup offers a new way to find a job by eliminating third-party recruiters and putting physicians at the center of recruitment.

Through his platform Grapevyne, doctors can earn substantial referral bonuses while helping colleagues find positions with unprecedented transparency and detail. With his unique combination of medical training and business school education, Dr. Chan is reshaping how physicians connect with career opportunities.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career you love. To learn more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For Podcast Listeners

• John hosts a short Weekly Q&A Session on any topic related to physician careers and leadership. Each discussion is posted for you to review and apply. Sometimes all it takes is one insight to take you to the next level of your career. Check out the Weekly Q&A and join us for only $5.00 a month.
• If you want access to dozens of lessons dedicated to nonclinical and unconventional clinical careers, you should join the Nonclinical Career Academy MemberClub. For a small monthly fee, you can access the Weekly Q&A Sessions AND as many lessons and courses as you wish. Click the link to check it out, and use the Coupon Code “FIRSTMONTHFIVE” to get your first month for only $5.00.
• The 2024 Nonclinical Summit is over. But you can access all the fantastic lectures from our nationally recognized speakers, including Dr. Dike Drummond, Dr. Nneka Unachukwu, Dr. Gretchen Green, and Dr. Mike Woo-Ming. Go to Nonclinical Summit and enter Coupon Code “30-OFF” for a $30 discount.

Reimagining Medical Recruitment Through Physician Networks

Dr. Zhen Chan noticed something broken in physician recruitment – endless vague job listings, intrusive third-party recruiters, and a lack of transparency. His solution? Grapevyne is a physician-only platform that puts doctors in control of the hiring process.

The platform incentivizes physicians to refer qualified colleagues while providing detailed job listings that answer doctors' questions about potential positions. In just a few months since launch, the platform has attracted over 315 physician members and eight healthcare organization partnerships, with 40+ new positions currently being onboarded.

Building a New Way to Find a Job While Staying Clinical

Despite the demands of launching a startup, Dr. Chan maintains his clinical practice as a per diem pediatrician while running Grapevyne full-time. He partnered with HealthWorx Studio for initial funding and assembled an expert team spanning technology, recruitment, and healthcare operations.

The platform aims to expand beyond job matching to become a comprehensive career resource for physicians, offering guidance on contract negotiation, healthcare payment systems, and professional development.

Summary

Grapevyne is the next revolution in physician recruitment through a peer-driven platform that eliminates traditional recruiters. The platform offers substantial referral bonuses and detailed job listings. It has already attracted over 315 physician members and eight healthcare clients. Physicians interested in joining can visit grapevyne.health or contact Dr. Chan directly at zhen@grapevyne.health.

Links for today's episode:

• Grapevyne.health
• Dr. Zhen Chan's LinkedIn Page
• Zhen Chan's Email Address: zhen@grapevyne.health
• Healthworx Studio – building the future of healthcare by working with founders driven by purpose, passion, and impact. 
• How to Practice Hospital Medicine and Found a Startup
• Introducing a Fearless Medical Entrepreneur
• How to Nurture a Career in Cutting-Edge Healthcare Technology – 156
• How to Fulfill an Academic Need and Spawn a Business with Dr. Jason Ryan – 081
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

Right click here and “Save As” to download this podcast episode to your computer.

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 383

This Physician Entrepreneur Offers a New Way to Find a Job

- Interview with Dr. Zhen Chan

John: Well, I like talking with physician entrepreneurs, as some of you listeners know, and today is going to be very interesting. He's a relatively young physician pediatrician who's also running a company full-time. So with that, let's just get into our conversation with Dr. Zhen Chan. Hi, Zhen.

Dr. Zhen Chan: Hi, John. How are you doing?

John: Really good. I came across, I don't know how we met, actually; I think we were introduced basically.

Dr. Zhen Chan: Yeah.

John: When I looked at your website and your LinkedIn profile, I mean, it's really interesting. You're involved with this company. But before we get into that, let's have you go ahead, like we do every podcast interview, and just tell us about your medical training, your background experience, and then kind of lead up to what you're doing now.

Dr. Zhen Chan: Sure, that sounds good. So I'm a pediatrician by training. Didn't do any fellowship, but I graduated residency summer of 2023, which I can't believe it's been that long already. Yeah, I did that up in New York Presbyterian with Weill Cornell in Brighton, Manhattan. And then the rest of my education was all back in Miami where I grew up— Miami, Florida. So, I was at the University of Miami for undergrad and medical school, and I took a year off between third and fourth year for business school as well. It was focused on health management and policy, and it really kind of expanded my knowledge of healthcare beyond just the clinical piece. So that was the seed of some of this extracurricular interest, so to speak. And then during residency, I did a lot of quality improvement work, was able to have the opportunity to lead a couple projects as well, which was super fun. And I think because of how fulfilled I was from doing that, and also some of the advocacy work too, I was like, "Oh, maybe I gotta do some more career exploration and like soul searching." I wanted to apply for Peds Hema Fellowship. Second year, I toyed with the idea of doing PICU. And then I was like, wait a minute, I really enjoy these like back end healthcare solutions. I really think that working on them allows you to really scale your impact. And so let me do some exploring. I networked people all over the field— public, private sector, you name it. And worked in venture capital actually for about a year as like a part-time associate. And that started as a fellowship position just to get to learn and get a lay of the land. And then I really, really enjoyed meeting founders. I really enjoyed people working in early stage startups because of how mission-driven they were and really trying to solve problems that are out there. And that's when I said, "Oh, I really want to build something on my own." And here I am.

John: All right. Well then, tell us what is it that you decided to build and what problem were you solving by building that.

Dr. Zhen Chan: Yeah. So the company's called Grapevyne— Grapevine spelled with a "Y". And the name comes from this, kind of comes from the song. I heard it through the Grapevine, or the saying, "I heard it through the grapevine." Because what we're doing is we're driving physician recruitment and the job matching process through physicians. So, no need for third-party recruiters. We're also, because we're physician-founded and we're building a team around understanding what doctors truly value, we're creating job posts that are fundamentally different from the other job boards that you see out there. So no more of these like vague, undescriptive listings that you're looking at this and you're honestly, you don't know salary, you don't know location, you have no idea what this job even entails. And more importantly, you don't know what it's going to be like day to day, which is very important to understand. And so, as someone who went through a job search myself, I know exactly what we need. I want to, if there's certain specialties, I'll go out and interview those specialists to say, "Hey, in your specialty, what are the things that you really want to see on a job post?" And we'll put that all there. So that's one fundamentally different piece. The other piece is that how we drive the process and that is through referrals. So, once an employer contracts with us and puts a post on our job board, we activate the network and we tell members— who are all physicians right now— to say, "Hey, look at these posts." If you're interested yourself, you can apply. But if you know someone who could be interested and you think they're a good match based on this very detailed listing, comprehensive listing, you can refer that over to them and you will actually get a significant cash payout for a successful referral, meaning like right now, the structure is if someone submits an application because of your referral and it's a qualified application, that you can get $25 on most of our posts right now. If they complete the interview process, you'll get another incremental payout. And then if they actually get hired and truly start the position because of your referral, you'll get the most significant payout. Right now on our job board, every post has a payout of $2,000. That could be different in the future, but that's what all the posts have now. So, we're driving the process through physicians. We're a company led by a doctor— not that I can speak for everybody, I do want to say that. Then we're bringing money back into the process too. So ownership, cash, everything— we're putting back into the physician community.

John: Okay. That's pretty unique and interesting. It seems like there's always processes that can be improved— made less costly, less onerous, less time consuming and so forth. So, let me just kind of think about the different stakeholders here.

Dr. Zhen Chan: Yeah.

John: So, I mean, it sounds like a physician can, if they know of a job opening, and let's say their organization, they can make a referral or put a post or something. Or do they come from directly from the hospitals and the medical groups that are looking for physicians?

Dr. Zhen Chan: Yeah, that's an important distinction. So it's not that everyone can just post whatever opening they have. We do contract with the employer. And then we look at the post that they want to give us. And we will work through because they probably already have some standard materials and bulletins that they're sharing with the traditional recruiters out there and the traditional job boards that are out there. But we will take that bulletin, inject kind of our own flavor into that. If it's an ENT job, we'll try to find an ENT member of our community and we'll try to find an ENT maybe in our personal networks and then say, "Hey, if you were to look at a job, what would actually entice you? What do you need to know? What are the questions that you probably would have had to go through a lot of intermediaries to find out before you actually get a comprehensive understanding of the job?" Let's get all those details and let's just smack them onto the job post. And then for the employers, the reason why it's a better format is- we're creating posts that are more engaging. So, doctors can see these and will say, "Wow, I actually really like what's on here. I know everything I need to know. I'm willing- I wanna apply." As opposed to somebody coming in and saying, "Hey, I have this fantastic job that's perfect for you. It's in a great location. Do you wanna hear about it?" And you're like, "I'm not gonna respond to this email. Like I get a million of those. Like what's gonna make this one any different?"

John: Yeah, I can think about some of the complaints I've heard about the usual process. Like... For some it is they find something online— a job— but they really don't know. Like they might even be blinded in the sense that they don't even really know exactly where it is because the host isn't actually revealing that until they get your name and phone number. And then they apply, they send in the resume and they don't hear anything forever. Sometimes, you know, just they don't qualify, but. So yeah, I mean, there's a lot to improve in that process. So, and the revenues for this that really is supported by the companies, the hospitals and the groups that are looking for physicians.

Dr. Zhen Chan: That's correct. That's correct. We are on that kind of contingency fee structure, but we're able to charge a much more affordable flat fee structure. And right now, since we're early, we're not charging any subscription fees, any listing fees— nothing like that. So there's no downside risk to working with us and we're not expecting any exclusivity. We really just want to solve a problem in this space and be able to reduce the administrative expense that goes out into things that frankly, we are seeing as unnecessary.

John: Interesting. I'm just kind of thinking through the process too. Like if I were, let's say working at that organization already, let's say there's 500 physicians there. I mean, would it make sense for the HR department, whoever's putting these out to actually promote let their people know, I suppose. Sometimes I like to do things, you know, like in a vacuum or quietly. But I mean, they could just let all their interns know that they've got an opening for another internist. They're probably doing it because these internists have asked for it. And so, hey, by the way, if you're gonna help us get the word out, feel free. That would, I would assume, would be something that could work.

Dr. Zhen Chan: Yeah, many groups have internal employee referral programs. What I like to say is this is an employee referral program scaled to the entire network of physicians that are out there and anyone can look at jobs and refer each other. It's not going to be siloed to your facility.

John: Okay. Awesome. Well, let me ask how are things going so far. What's the feedback? I think you are relatively new.

Dr. Zhen Chan: We are. We are. So we launched our first job post in end of September, got another— if I remember correctly— seven onboarded at the end of October, and then we had another 16 mid-November and we're currently onboarding another 40 from a larger health system. We're up to eight clients just in these short few months and in terms of member size, that's probably been the most exciting thing to see— how many physicians really enjoy the idea of this platform and want to support its growth. We've gained now over 315 members, just I would say over October, November, and these first couple of weeks of December, we've gained about three-quarters of that. So it's been tremendous growth.

John: Interesting. So those what do you find? Are they all actively looking, or are they thinking, "Wait a second, doesn't cost me to join? I might need something six months down the road. Why not just join now and find out?" And then when they see the right position, they say, "Maybe I should jump on that."

Dr. Zhen Chan: Yeah. combination. So we have a combination of members who came because they were looking for some things right now. And, you know, frankly, we're because of how new we are, we may not have the right opportunity for that specific person actively looking. But most physicians are passive job seekers, meaning and that I think there's a paper that was put out that it's around 80% of physicians are passive job seekers with a survey from it wasn't a paper sorry, a misnomer. It was a survey of about 1,500 hundred doctors and so what passive means is "I'm not actively looking but if something nice rolls my way, maybe I'll pay attention to it" and so, I'm not gonna be on job boards; I'm probably gonna ignore those text and calls from outside recruiters but if someone I know sends me something that's interesting I'll take a look and that's how our process works so we have a lot of those individuals to and my hope is that as we bring on more employers have more jobs going to be more opportunities for everybody to see. And if they want to apply for themselves, they can. If they feel like there's someone else that's in their network, that's a good fit, they can refer that out. And I see it as a potential to make significant cash too, when you're making a lot of referrals. And I don't think doctors are going to be out there spamming and trying to scam each other for a quick buck in this way. You can lose a lot of trust in that process. And that's exactly why there's so much lost trust in traditional recruitment.

John: Yeah, I guess it'll be interesting how things pan out, but I would assume that most physicians have a lot of integrity and they're not going to be even making a referral to something that they think is at an organization they're not really fond of or something like that. So, that's awesome. Well, let's pause on this for a minute. Tell us how to go to Grapevyne and do that, and then I want to come back to something else.

Dr. Zhen Chan: Sure. So you can find us at our website, grapevyne.health. That's Grapevyne spell with a "Y", dot health. Our websites allows you to take a look at what we're all about, and then you sign up for our platform. Really the onboarding process, I would say it takes about maybe three minutes-ish to just give some basic info. We use a cell phone number for the sign-on, so we can have that one-step verification with you. We're really keen on not having anybody that's not a physician, be excluded from the platform. So it's a physician-only platform. We have an NPI right now that you use, which the NPI is out there, but that's how we verify. Once you're on, you'll see a dashboard with featured jobs. There's another page with all of our jobs, and we're working on a couple extra features to make sure that what you see is most relevant to you, and that there's a way for you to search, and filter, and everything like that.

John: Awesome. That's good. No, it sounds— I went on there and I only went so far before I thought, "Well, I'm not really looking for a job," but yeah, it was well-designed. And that brings me back to this other question I wanted to ask you. It has to do with running this business, practicing at the same time, that piece of it. And we also like to hear about the business building itself. And, you know, who did you pick out - how did you get this thing built and all that? So we kind of want to know a little bit about the business and what it takes to run this thing while you're still practicing.

Dr. Zhen Chan: Yeah, yeah, yeah. So I'll talk about the practicing piece. I do still practice part-time. I am on a per diem contract, here in D.C., and this is a really good balance for me, based on my interest. Is it going to be the balance for the rest of my entire career? I don't know. But I do enjoy what I'm doing right now and the full time, running a startup aspect of things. It's- I would say hours-wise, it's as intense as I think I had residency. Like, yeah, it's as many hours as it was in residency. Now, do I get to do my work remotely? Do I have my puppy sleeping next to me and I can have my lunch and everything like that? Of course! I'm not going to compare it to the physical exhaustion I was experiencing in residency, but it's a full-time 24/7 type job. I'm working on the weekends, all that kind of thing. And The business side, building out a team is super important. So one of the first things I personally had to recognize was where are my gaps— where are things that I'm not an expert in? I won't be able to be the best person to do this part. And that was dealing with the lawyers, like the legal side, the day-to-day operations. I've never built a business from the bottom up before as a first-time founder, so I wanted to go out and find someone, and I found an amazing co-founder. His name is Drew Mayer, has been a repeat founder of early-stage companies, has been working in the healthcare startup space for a long time and worked with physicians. His father was a physician. So, when we were talking to him and I was developing that relationship, just felt like we were really aligned on the physicians take back medicine kind of push and that sentiment. And then as we move forward, we brought on an engineer. I can't do product development; I can't code. So went out and looked for someone there, brought on an individual who he worked on Indeed job board. And so, you know, had experience and expertise there. And then finally, you know, as much as we are trying to replace the third party recruiters, I have to be sensible and say, "Well, if there's established recruiters out there who are good and who really do care about physicians. Is there someone out there that can give me that expertise and has been in the industry for a long time?" And we did bring someone on just like that who's been working in health systems, in the exec positions and can really, and just bring her expertise and experience in ways that I personally like. So, finding what I don't have and being able to find the others to come in and help team up kind of building this "Avengers-like group" is the way I see it. And building this business— I have to give credit where credit's due, the concept of Grapevyne came from a venture studio. And so that venture studio is based here in D.C. It's called HealthWorx Studio, spelled with an "X". Yeah, we both have like words that are spelled differently. And so HealthWorx Studio, and they are always incubating and coming up with new ideas. And when they think they have enough research to say there's something here, they go out and look for founders to really come in and build out the concept. Like it's like you start with one puzzle piece and then you want someone to come in and build the whole puzzle. So they come out and look for founders that align with the vision or can give their own vision, build out the business strategy, build out the team, and then take it out of the studio. So that's the model that we're working under right now.

John: So are they the ones that provide the capital to support some of this? Or do you do a separate, you know, fundraising? How does that work?

Dr. Zhen Chan: Yeah, so from the conceptualization up to today, it's all been funded by the studio. And we are going out and looking for outside investors. We really want to find well aligned investors, specifically in the physician community— those that are going to be, I think ideally our end users too, right? Because then they can give us feedback, they can be the users of the product, whether if it's for their own practices to help them hire more. physicians or it's going to be physicians who are like, "wow, this is something I can really use." Those are the types of well-aligned investors that we are looking for, but we're starting those conversations now for angels, VCs, etc.

John: Okay. So with the studio, would it be people have used "incubator" as a term, you know, with other is that a similar type of idea that kind of get ideas, get people together?

Dr. Zhen Chan: Yeah. The way I like to explain it using what I understand is typically in venture capital, and you usually associate venture capital with earlier-stage companies or growth-stage companies, there's traditional venture capital firms, which is all about, you know, we're going to financially analyze you, we're going to do our diligence on your product, make sure that you have the right team, all that, and say, "All right, we're willing to give you capital for whatever returns expectations." That's traditional VC. And then you have the accelerators and incubators out there that outside founders will come up with an idea and then apply in, in exchange for equity. They apply in to obtain the expertise, to obtain the support resources, et cetera. Then you have now what's, there's more and more of them coming out, venture studios, which act like this reverse incubator or this reverse accelerator. They come up with the idea, start funding it. When they feel there's something there, they'll go out and bring in founders to take it out of the studio. That's my understanding. There may be listeners who will say, "I don't know if Zhen's right about that."

John: Well, it seems to be your experience, you know? So things do evolve over time, but it's a good explanation. It helps me understand really what's going on a little bit better.

Dr. Zhen Chan: Yeah.

John: Okay. Well, we're going to get to the end pretty soon here. So I want you to go back and kind of re, just restate, like, what do you think, like the big advantages to Grapevyne over, the current way of trying to find a job.

Dr. Zhen Chan: Yeah. So for us, recognizing that traditional recruitment, it's not efficient, it's not effective, and it's costly. And there's not really great guarantees for finding the right candidate. So our process, because it's referral-based through the physician community itself, and we're crafting job posts fundamentally different than the bulletins and posts that you see out there, we believe we're gonna be better, where our posts are gonna be better in engaging. And your jobs are going to be more visible by a larger swath of physicians that are out there. And on the physician side, the source of truth or the, not the source of truth, but the person who's going to be reaching out to you and giving you anything is always going to be someone you are already connected with— a trusted existing connection. So, driving trust, driving transparency, and ultimately for us as boots-on-the-ground clinicians, if I can improve job matching, if I can say doctors will be put into jobs that they are better fit for because the sourcing is inherently better, we can reduce burnout, we can reduce churn and turnover, doctors will stay in these jobs for longer and especially in fields like primary care or especially in practices that are in rural and underserved settings. Physicians are likely to take those jobs, stay in those jobs, and you have better access and better continuity. That's a hypothesis. I hope that plays out that way. But those are all the, I would say, the value props for what I, to me are the three different stakeholders, the employers, the physicians, and the patients, to be honest. And we're also, you know, for physicians, the job board for me, that's one piece of the puzzle. I want to also build out a career center, provide all of those resources that frankly in residency and medical school, we just didn't get that education. We didn't get that training on how to negotiate contracts. What are the different payment systems that are out there? Everybody talks about value-based care and a fee for service and all these kinds of things, the trends. How do I provide education on all of that we missed that I think is very important practicing medicine in the modern day. Because also, if I can provide more of that education in a way that it's digestible and people will actually view it and take it and absorb it, then I think we will also be able to practice medicine better, take back that ownership again— it's aligned with that sentiment— and not be burnt out as much as an entire industry of workers.

John: Now that sounds like a good plan. I think we were talking earlier before we started recording that looking to the future, I think a lot of physicians are looking to do maybe a nonclinical and a clinical.

Dr. Zhen Chan: Yeah.

John: And there would be no reason why that couldn't be something that just normally kind of evolves on this site.

Dr. Zhen Chan: Yeah, absolutely. We are open to posting nonclinical positions on our site. Physicians are looking for them, you know, extra avenues, not just in the form of side-gigs but thinking the similar vein to me— where there are things in healthcare that I also wanna work on. What are the jobs that are out there that can allow me to do that? I think more physicians need to be in those positions. And then you have physicians that are burnt out and are looking for an alternative while still making a difference. Those are out there. So we wanna be a supportive platform for every doctor, no matter what they are looking for in their professional careers.

John: That makes me think of another issue, which maybe you've already reached out to, but what about locums, which is a different kind of clinical job, but it is a clinical job and just need to find them.

Dr. Zhen Chan: Yeah, there are a lot of agencies that are out there in the locum space. And we just felt from a business strategy standpoint, let's not go into them. Would we ever go into them? I don't have an answer for that right now. But for me. There's also an element where Locums is an expensive band-aid to provide access to care. Now, don't get me wrong; it's a great gig for a lot of physicians that are looking for them. And I would never stop someone who is looking for them to, I would never stop them from doing so. But for us, we wanna drive more of those full-time positions right now. And I think that's the right strategy. But again, I think in business, it's not like medicine where we try to be as— well, we do try to be as surefire as possible— but a lot of these strategy decisions, I think, some may say that it's the right call; some may say it's not, and right now we're making the call to not do locums just yet.

John: Got it. Got it. Okay, what if someone wants to reach out to you personally for a question or something?

Dr. Zhen Chan: Yeah, so my email address is Zhen, Z-H-E-N@grapevyne.health. Again, reminder Grapevyne with a "Y". And so you can reach me by my email, and then I'm on like every social media platform. Too many, I think. It's been great. I love engaging with the community on social media. So, I'm on LinkedIn. I'm on TikTok, Instagram, and there's a Grapevyne account and my own personal account. And maybe we'll just link it in the show notes. It'd be it'd be a doozy to list.

John: OK, I'll put a few in and I'll definitely put grapevyne.health. I kind of used the dot com at first when I was looking for you. But no, Grapevyne with a y dot health. I'll put that in the show notes. And I think pretty much people can get information, everything they need to know. Physicians, if they're really thinking they're gonna access this kind of service, your service, then just go to grapevyne.health and do it. Check it out.

Dr. Zhen Chan: Yeah, yeah, yeah.

John: All right, well, this is pretty exciting. I'm glad you could be here and answer my questions. I think it's inspirational to people— physicians who are thinking, "Well, maybe I could do something entrepreneurial. I could do a startup," or maybe not something as this, is a pretty big deal. This is a big thing. You're devoting full-time to it. So it's not like starting a little side gig on the weekends or something. So, I'm really glad you could join us and I'll be watching the growth of this thing. And it should be pretty interesting. And it sounds like that a lot of planning and a lot of investment of time and effort in this. So, you're to be congratulated.

Dr. Zhen Chan: Yeah, well, I really appreciate the support. I really appreciate you inviting me on. And I have to plug this podcast because I forgot to mention that when I was in my exploration journey, I love learning by podcasts. And this was one of the first ones, if not the first one, I hopped on to listen to a whole slew of episodes to learn just what else is out there for physicians to do. And yeah. So, so anybody who anybody who's listening I hope you share this with more physicians out there.

John: Well, I appreciate those comments. All right, Zhen, we're gonna let you go then. And with that, I'll say goodbye. And hopefully I'll catch up with you again, maybe a year from now.

Sounds great. Have a good one.

John: All right. Bye bye.

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The post This Physician Entrepreneur Offers a New Way to Find a Job appeared first on NonClinical Physicians.

Own a Business – 324

In today's episode, John delves into the exciting world of clinician entrepreneurship, offering insights into various paths to business ownership and shining a spotlight on healthcare franchise opportunities.

Whether you're looking to create wealth, escape burnout, or take charge of your career, this episode unveils valuable strategies for clinicians seeking new horizons beyond traditional practice.

Our Show Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Paths to Business Ownership

If you're a clinician considering a shift from patient care to business ownership, there are several routes to explore. These paths include starting your own business from the ground up, purchasing an existing business, or leveraging the power of established franchises. Each approach has its unique advantages and challenges, and making the right choice largely depends on your goals, resources, and level of risk tolerance.

1. Starting from Scratch
   This path involves creating a business entirely from the ground up. It allows for complete creative control but demands substantial time, effort, and financial investment. You have the opportunity to build a unique business from your vision.
2. Buying an Existing Business
   Purchasing an established business is a way to bypass the initial setup phase. You'll still need to invest resources, but you inherit an existing customer base and revenue stream. It's essential to perform due diligence and ensure the business is a good fit for your goals.
3. Franchising
   Opting for a franchise provides a shortcut to business ownership. You buy into a proven business model with established branding and support. This route generally offers a faster start-up, but it comes with franchise fees and rules you must follow.
   

Franchise Opportunities in Healthcare

The healthcare industry offers diverse franchise options. These categories include senior care businesses, urgent care centers, medical spas, weight loss clinics, and aesthetics businesses. Investing in a healthcare franchise can provide a higher chance of success as the business model is typically proven. Consider factors like your expertise and marketability when selecting the right healthcare franchise.

Remember, researching and thoroughly assessing each opportunity is crucial to ensure it aligns with your business goals and values.

Summary

John emphasized the importance of choosing a path of business ownership that aligns with your skills and interests while considering factors like scalability, profitability, and insurance complexities in healthcare-related businesses.

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• How This Consulting Business Grew Directly From a Patient Need – 289
• How to Build a Terrific Freelance Consulting Business – 145
• How to Improve Your New Business Odds of Success by Buying a Franchise- 292
• Want to Buy Your Own Senior Care Business? – 314
• Entrepreneur and Business Owner – Interview with Dr. Mike Woo-Ming – 019
• How to Start and Grow a Profitable Cash Based Medical Practice – 293
• From Here to There: Leveraging Virtual Medicine
• NewScr!pt

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 324

What Is the Best Way to Generate Income and Create Wealth?

John: Here's a question. What is the best way to generate and accumulate wealth? I guess I could add as a clinician or as a physician. There are lots of ways people have done it in numerous ways. The bottom line is you either have a very well-paying job that you do for a long time, that you put away a high percentage of your income, and then invest that in real estate or stocks and bonds. And at the end of your 30 or 40 years, you will have quite a nest egg and you can retire or it can be a legacy for your family. The more you save, the more it will accumulate and also the faster it will grow, particularly if it's in the stock market in general over a long period of time. But that's kind of a generic answer. The first part of the answer was that you have to have a high paying job. So you can kind of do that if you're in an average type of level of payment.

But for the average person in general, the way that I would normally answer that question, thinking a little bit deeper, is to do one of two things. And that's either to start investing in real estate early because it's usually an appreciating asset. And eventually, although it might require some active management in the beginning eventually, later you can switch over to more passively managed real estate investments. And it has a lot of tax advantages, which by saving the tax money, that accumulates also and accrues to your wealth.

But the other one that's probably more common than actually real estate ownership as a category, and that's owning your own business.

The difference between owning a business and working for someone else, which is basically working for a business is generally as the head of that business, you're probably the highest paid person in the business. So, that's number one. Number two, you are creating something that if you do it right, you can leverage other people. You can sell products. In other words, the income isn't just based on the work that you're doing, but the value that you're creating. That's why it's so good at creating really even high levels of income.

And the third part is that, like real estate, it's an asset that you can sell when you are ready to stop working that business. Now you can hire someone to run the business and it can continue to be an income source even after you retire from that business. But what most business owners seem to do, unless they want to pass it on to their kids, which in that situation, you should probably sell it to your kids at a reasonable price. But anyway, most people generally are going to cash out. So, it's kind of like a substitute for a 401(k) or Roth IRA or something like that.

So, you get that cash out at the end. Now, it might have accrued in value quite a bit, but at least at the time that I am recording this, capital gains taxes are much lower percentage than income taxes. You actually prefer to have the money instead of coming as income over time, going into the business, growing the business more quickly, and then selling that and then paying the lower capital gains taxes.

Now, I'm not a real estate expert. I'm not an accountant or CPA. These are just things that I've learned that I think are in general true. And there might be certain nuances that I'm not really going to address today, particularly since there are different types of business, some in which you're selling a product, you have the cost of the product and then what you earn on it. And of course, all the money you spend purchasing the product for sale is part of your overhead and expenses, so on and so forth. And selling a business, depending on whether it's mostly a service business or a product producing business, can be quite different.

But let's focus for a few minutes on that. Let's say that you are working clinically, you're in a hospital or you're in a group, you're a physician, you're a nurse, an APN, a PA, pharmacist, a therapist of some sort, and you're getting burned out and you're thinking I've got to do something else.

And again, from an employment standpoint, I could say, well, if you can get into a job where you have the opportunity in a nonclinical position to move forward over a short period of time, hopefully, or medium, to more leadership, directorship management, ultimately let's say as a physician to chief medical officer or as another type of clinician going from manager to a VP level job, that's going to set you up pretty well over time to make an income that's in the top 1% or 2% and you could end up becoming the CEO of some healthcare organization. Perhaps you get another degree. Nurses are typically often found as CEO for a hospital, nursing homes, things of that nature.

But I think as a clinician, if you're a little bit burnt out and you know you're going to want to change, one of the things you might consider doing is owning a business. How do I get from A to B? From doing what I'm doing, working for someone else as a clinician to owning a business?

Now, I say owning a business because there's different ways to get to the point where you own a business. Now, if you're a physician or even an APN in many jurisdictions, does owning a practice count as owning a business when we're trying to answer this question that I posed at the beginning. And my answer to that is yes and no. The problem is owning a small practice, a one person practice or a partnership, it's basically like being a craftsman or being an artist, meaning that the only time you earn money is by providing the service that you are personally providing.

In a family medicine practice, for example, you earn money by seeing patients face-to-face, writing them prescriptions, ordering them tests, and then having them come back and discuss those results. And you get paid for seeing patients face to face. Now you can do that on telemedicine and telehealth as well. Sure, you might have a small lab, sure, you might do some procedures, but the reality is that's a kind of business that's almost impossible to sell.

In fact, there was a time back 15, 20, 30 years ago where medium to larger practices were being bought out by basically investment companies. And they were paying high dollars because they had this feeling that they could leverage all those patients they were collecting, so to speak by buying those practices.

But the reality is that the whole thing collapsed and they ended up all selling the practices back to those physicians. And even now, if you were to buy, let's say a practice of an internist or family physician or someone who's not a proceduralist, someone who doesn't own a lot of equipment, like as opposed to let's say a dentist or someone that's doing a minor surgery in their office and or even in a surgery center. A hospital can only pay you a small amount for your practice because there's no intrinsic value because they need to take all the earnings from the practice and pay someone to do what you were doing, which leaves no excess income. No real bottom line if all your money's going to the salary of the staff and to the physician that's seeing patients.

And so, it's not really a good business unless you can do two things among others. But these are the two most important in my mind. One is you need to be able to have that business generating income, whether you're there or not. So, you need to have maybe other types of providers, medical providers, or some type of service that they can do that doesn't depend on you doing it. And then you can actually run the business rather than work in the business yourself. So, that's one.

And the other big one is to have more flexibility in your pricing. Basically to me that means doing a job, maybe owning a practice of a different sort, particularly one that does not have to deal with insurance companies. Because you know that payers want to pay as little as possible. And whether it's Medicare or private payers, big national payers, they really have been lowering your payments. In that sense, medical practice is not a great standalone business when you compare it to other businesses. So, that's my answer to that part of the question.

Now let's say that you're in that practice or you're working for a large corporation and you want to start a business. You could break that down into four subcategories of ways to get going. One is to start a business from scratch. Obviously that takes a lot of time and it will take money, not only because the business will take money to set up, pay accountants and pay your accountant and your lawyer to set it up. That's minimal. But then to pay for staff and pay for supplies, depending on what business you're going to do. And businesses take a while till they get going if you start from scratch.

You can get a little bit faster traction if you have some money saved up. And that's to buy a business. So, to just go out there and look for maybe one of the businesses I'm going to talk about in a moment and just talk to a broker or go online and try to find a business that the owner is trying to sell. And there's a whole process for doing that.

And mainly for that, the time factor is not a big one, although there is a time involved in investigating and vetting the business and doing your due diligence before you actually buy it. But in that timeframe you can be well under a year. It might be up to a year, but it can be well under a year. And when you do that, you're basically taking on a business that's already generating a sizable either salary for the owner, if they're kind of an owner operator or a bottom line that you can use to pay yourself, or to continue to reinvest in the business so that it grows more quickly or both.

Now, there's one way to cut the timeframe on starting a business, and that is to start a franchise. Because a franchise is a business that has already been demonstrated to be successful. And if you're considering a franchise that's been around for a while, they've developed and perfected all the policies and procedures, they put together marketing plans, and they've done other things to get this off the ground. They'll explain to you what the business structure should be. If you're going to need an office, the size of the office, if you're going to need supplies, if you're going to have to hire. Everything will be spelled out for you. That cuts down the time of starting a business from scratch, particularly if you want to do it in a field where there are a lot of franchise opportunities.

And the way to really accelerate that even further is to buy a franchise. You would buy a franchise business from the current owner, and that current owner or whoever started the business already spent the first 2, 3, 4 or 5 years getting it to be profitable. Hopefully has put in another five years or so demonstrating that the profits are growing or the net income, if you want to call it that, is growing every year. And so, while the time factor there is quite a bit less, the cost could be quite a bit more because you're going to pay some premium for purchasing that. You could buy the rights to a franchise for $40,000 or $50,000 and then fund it as you go along.

Depending on what you're doing by investing over a period of a year $200,000 or $300,000, and not taking a salary during that sometimes, you can get things going. But when you buy a business that's generating, let's say a year salary plus, I don't know, $100,000 or $200,000 of net income, then that business is probably going to cost at least two and a half to three and a half times the combination of those two. So, if you're paying yourself $100,000 and you have a net income of $100,000 on top of that, then you're going to end up paying anywhere from two and a half to three times that amount, which would be, three and a half times, $600,000 or something like that.

Most people in that situation are going to get a loan, either an SBA loan or use your own cash or maybe if you own your home outright, you could use that as collateral and get a pretty low interest loan. Banks like the SBA loan. A lot of businesses are sold with 80% of the cost being an SBA loan, which has paid off up to over 10 years, I think is the average. You of course could pay it off quicker.

That's something really to consider when you're in this situation where you've made a decision something has to change as long as it's not urgent. If you can hopefully make some adjustments in your current position to where you get some free time to work on this over time. And if you do that and you decide to go with the buying a franchise route, then it's just a matter of really vetting that sale and verifying that the gross revenues are stable and increasing, that the expenses are under control. And that there is a bottom line net income also that's going up over time. And even with an SBA loan for five or 10 years you should be generating income over that time to offset the payments you'll have to make to pay back that loan. And when you're done, you'll own the business outright and it will be generating income and additional bottom line, hopefully for you and your family.

You do that for 5, 8, 10, 12 years. And if it continues to grow, then the asset that you're going to have at the end of that time is going to be at least double what you paid for the business. So let's say you paid $600,000, it'd probably be worth $1.2 million or $1.5 million depending.

Now, things don't always go as planned. Most businesses fail within a year or two. Using a franchise or buying a franchise has a much higher rate of success because it's been proven. They still fail sometimes, but they do have a much higher chance of success. I think if you do something in the realm of something you know or you have easy marketability. I'm thinking for someone in healthcare, there are many franchises that you can get into that have existed for years. And I did some research and I obviously know about senior care because I've talked about that before and my wife owns a senior care business, which is basically in the home health field but it does not involve nursing care. It's simply for seniors in home caregivers.

But you can look at these different things and find that there's at least five major categories that are very popular now, the categories themselves are growing. And if you think about it, and I learned this from Mike Woo-Ming, the most successful businesses generally fall into one of three categories. First is that they involve working in some kind of relationship related business. Number two would be health and fitness related business. And number three would be something that has to do with learning about money or investing your money.

These are the three big ones, for example, for courses, for podcasts, for online businesses, for coaching. Relationships, health and fitness, and weight loss you could throw in there. And then the other one would be money. Making more money, avoid losing money, things like that.

Some of the franchises that I saw that fell into each of these categories were pretty interesting. Let's see, I've got a list here. In the fitness realm, there are just dozens and dozens of very successful franchises that have been out there for a long time. I'll just list off some names here off the list I created earlier. There's an F45 Training. There's Anytime Fitness, there's the Exercise Coach, Club Pilates and D1 Training.

Another one would be all the home healthcare type businesses. That includes things like Home Instead, Homewatch CareGivers, Amada Senior Care, Visiting Angels. That's the one that seems to be doing a lot of national TV advertising. My wife runs Home Helpers and there are dozens of other ones. These are all franchises.

Now, there are franchises in urgent care. And the thing about urgent care is it suffers from the same issues that can be found in working in a small practice. You can get busy, you can get burnt out. But I think if you could come up with an urgent care where you limit the risks and you do a cash basis only, and you just say, "Look, we're not going to be billing Medicare and Public Aid and even the insurance companies, because I've got to add two staff to do the billing. You get into arguments, you get huge accounts receivable that can go on for years and years, and sometimes don't get paid at all."

And so, if you could do an urgent care type of business where walk-ins come in, they pay cash, you provide whatever services you feel are comfortable. And maybe you don't call it urgent care. Maybe you call it quick care, maybe you call it something like the Walgreens and CVS used to have. I don't know if they're still doing. MedExpress is an urgent care that is franchised.

And so, if you want to get into that and the really Colorado small niche, they'll show you how to do it and it tends to have a lot less headaches, particularly if you can avoid billing those insurance companies.

There's a lot of controversy about whether you should jump on the Med Spa bandwagon. In a really extensive or complex med spa you're doing a lot of procedures, you've bought a lot of equipment. At least two people on my podcasts have started their own med spas without a franchise. I might put that off of the franchise list, but you could buy an existing med spa. In fact, there's a lot of sales these days of med spas selling to other individuals or to private equity firms, something like that.

Weight loss has been around forever. There are franchises for weight loss clinics. Some of them have their own proprietary high protein solutions. Some use regular diets, but there's something called Physicians Weight Loss Centers, obviously designed for physicians. Medi-Weightloss, InShapeMD, which is a newer one. I'm not vouching for any of these, by the way, but there are plenty to choose from, and you should go through and look and see if any of those are attractive to you.

The other one is sort of related, it's the beauty industry. You might call it the skincare aesthetics industry. These kind of overlap. Palm Beach Tan is a franchise. So, it's basically a tanning salon, but they do other things related to the skin. You've got Body Bright, Heyday Skincare, The Lash Lounge, which deals mostly with eyelashes. There's always beauty/skincare, sort of related to med spa, where the med spas usually have some of the more invasive procedures, like even liposuction and things like that.

These are just some ideas and if you ever were in private practice and did enjoy the business side of it, then I think starting a business, starting a franchise, buying a business, buying a franchise, or somehow converting your practice if you are in private practice, either to concierge medicine or direct patient care, something where you can get rid of the billing part of it, you can get paid basically for your services in almost real time with maybe doing some billing and you might have an accounts receivable that would extend to 15 or 30 days. That's a lot better than fighting with Blue Cross Blue Shield over some bill from a year and a half ago that they clawed back their payment for, which is what they commonly do to hospitals.

When that happens, of course, the bottom line is the hospital is going to ultimately have to pay the physicians less or they'll go out of business. That's what usually happens, and that's why you're seeing 30 patients a day, five days a week, and doing medical records at night and on weekends. So, that's what you want to get away from.

All right, that is everything I have to say today.

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The post What Is the Best Way to Generate Income and Create Wealth? appeared first on NonClinical Physicians.

Today's guest describes why buying a franchise is a wise approach to starting a new clinical or nonclinical business. 

Alan Goldberg is a franchise consultant and specialist. He is the Founder and Chief Connecting Officer of Fran-LINK. This national franchise business consultancy organization assists entrepreneurial professionals to achieve financial independence through franchise ownership.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Benefits of Buying a Franchise

Building a new business from scratch often requires a steep and expensive learning curve. In a franchise, however, you are part of a community. And you'll enjoy the benefits of being a part of a system with an established framework, policies, and procedures.

There are numerous options in the healthcare and nonhealthcare domains that have proven track records of success. On the clinical side, there are opportunities in:

• urgent care clinics,
• physical therapy,
• dentistry,
• vision,
• mental health, and
• other typical medical enterprises.

In alternative care, there are opportunities in:

• regenerative medicine,
• medical spas,
• cryotherapy,
• massage, and
• skin and beauty business. 

SUMMARY

You can reach Alan via his LinkedIn page, email address, or phone number. He is ready to get in touch with anyone who might be interested in exploring the possibility of buying a franchise. And, as he indicated, users pay nothing to locate a franchise that meets their needs because the franchisor pays his fees.

An Additional Opportunity from Alan

There are lenders who offer business loans specifically to physicians at very favorable rates. These are loans at low-interest rates, with 100% financing to acquire existing or startup businesses, no closing costs, often interest only, and unsecured.

If interested, you can contact Mr. Goldberg directly to learn more about these business loans.

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Alan Goldberg's LinkedIn Page
• Alan Goldberg's Phone Number 646-505-8252 and email address agoldberg@fran-link.com
• Small Business Administration
• The Exciting Life of the Home Care Franchise Owner – 129
• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 292

How to Improve Your New Business Odds of Success by Buying a Franchise

- Interview with Alan Goldberg

John: One of the ways that physicians seek more freedom and autonomy is by starting a business. But most businesses fail in the first year or two. However, there is a set of businesses with a much higher rate of success, franchises. Today I'm happy to present my interview with a franchise expert and consultant. Welcome to our show today, Mr. Alan Goldberg.

Alan Goldberg: Thanks, John. Great to be here. I would love to talk about this topic because next to myself, this is my favorite subject. I'm happy to share it with everybody. And I'm not sure how familiar many of you are with franchising, so I'm going to try to give you a good flavor for what the total space looks like, but more importantly, how it may be really relevant to you and what you presently do or what you currently are looking to do. I think this might be a very active and robust discussion today.

First, let me say that nobody, I mean nobody dreams about going into franchising when they're growing up. It seems everyone who becomes involved in the franchise industry has stumbled into it along the way and didn't fully understand how it might change their life. My journey began back in New York City when I was a young turk on Madison Avenue. I built a 25 year career at some of the iconic global ad agencies on the street places like great advertising, DDB Needham, BBDO, where I developed strategy and marketing campaigns for our top clients. Companies like Revlon, Pfizer, WeightWatchers, Seagram, Kentucky Fried Chicken. I love the vibe and the creative process.

First, plowing through consumer research and understanding the data, finding gaps in the market, determining how to position our products, and then overseeing the development of compelling ad campaigns which could move the needle and drive consumers to buy or try our products in the marketplace. It was great fun helping these huge Fortune 500 companies build their brands and grow business.

I thoroughly enjoyed my agency experience, but I had a need to extricate myself from the desk and I wanted to get out more often. So I decided to go over to the dark side and I got into sales working with some major media companies where I could drive sales of marketing programs that integrated many or all of their media assets such as print, broadcast, online properties to create integrated programs that could be sold as a six or seven digit program to marketers. It wasn't a bad deal.

I started at USA Today. In fact, I was part of the launch team for Gannett. And we showed marketers how the nation's newspaper, as it was called, the only colored newspaper, could be used to introduce new products, support promotions, and key in on events like news and sports, and can pinpoint the release date of the campaign on a specific day, weekend or event to maximize the impact and use a large page format to really blow it out.

So it was really great fun coming up with creative ideas on how to use this usually flexible and created product. And I was responsible for consumer packaged goods and big pharma business, and we really crushed it. My advertising and media life was a lot of fun. I later went on to do similar things at other media companies. I worked in the young family market at Meredith Publishing for a group called American Baby. I worked in the pharmaceutical world for marketers at a business called RX Remedy.

But I reached a point in my career where increasingly, or should I say increasing the market share for a brand in Detroit or launching a new flavor in Minneapolis was really not all that fulfilling. I wanted to pivot and focus on the small business arena where I could really make an impact and really help people start a business and grow a business. I loved the franchise model back from my days on KFC, Kentucky Fried Chicken, and I saw it as a way to help entrepreneurs leverage other people's brilliant ideas as a blueprint for launching and operating a new business and minimizing risk along the way.

I launched my first company called Fran-LINK as a consulting group in New York City in 2009. And we followed the 3 trillion franchise industry and trends of emerging brands with the potential to become category leaders and tomorrow's blue chips. We thought the economic meltdown and financial disruption in 2008 would be the biggest monumental upheaval of our time. Little did I know that down the road a bigger event was coming, but who would have thunk?

Our focus is on franchise sales, development, consulting and business brokerage. And our goal is really helping aspiring entrepreneurs find strong business opportunities in the franchise arena. Concepts that would best leverage their professional background, experience and skillset, and businesses that align well with their financial goals and income requirements and fit personal interest within a prearranged budget.

I would also serve as a transition coach sitting on the sidelines, introducing these candidates as we call them to great business opportunities guiding their way through the awards process and referring attorneys, CPAs and lenders that can help validate the business and help them feel more comfortable with their decision.

It's been an interesting experience for me going from corporate to business ownership. And I really feel it's been a wonderful chapter in my life. The sense that when you work for yourself, you're building an asset. You are in complete control. You are responsible for all decisions and best yet, if something messes up, it's not because somebody else did it, it's because you did.

And so, you don't have to feel like you've got to take it on the chin because of somebody's mess up. Being in your own business is a wonderful opportunity and if you're good at it, you can grow it and open more and really scale and build wealth. It's not just about running a corner of an ice cream shop, it's really about having 15 of them. And entrepreneurial people who can really wrap their head around a business and be passionate about what they're doing could have fun in the process of getting wealthy. I think it's a win-win and I'm glad we're all here to talk about it today.

John: Oh, that's great. Yeah, I think most of my listeners, if they've been listening long enough, know that I'm fond of franchises because my wife runs two territories for in-home care franchise. And it's been really interesting. I ask her all the time, "Okay, you've been doing this long enough, you know how to do this. Let's say we move out of town. Would you go back and pay your annual royalty fee and use the company you're using now or would you just start your own? Because you pretty much have everything you need." And she routinely says, "No, I would want to be part of that franchise. There's a lot of things. A lot of support I get that I wouldn't have. I get to commiserate with the other franchise owners." And so, I think you've touched already on some of the benefits, if not all the benefits of a franchise, but anything you missed in terms of what's so great about being part of a franchise as opposed to just trying to start your own small business?

Alan Goldberg: Well, there are a lot of good things. I think similar to your wife's sentiments, when you own your own business, you're basically on your own. When you're in a franchise, you're part of a community. And what I find one of the big pluses of being a franchise owner is you're part of a system. You meet regularly with the other owners, you share best practices.

What does that mean? Other people in the system aren't competing with you. They're your neighbors and they'll be happy to share with you what works and what doesn't work. So even if you are the newbie on the block, there's somebody there who's going to be available to share what their experience has been and help you avoid pitfalls and help you capitalize on opportunities. I think being part of a system is really a wonderful way to be in business because you're not on your own. And secondly, you have a system you're following. When you're on your own business, you're winging it, you're basically figuring it out as you go. Building the plane as you fly it. And all these clich�s are fairly accurate because it's a big learning curve when you start your business and it's an expensive learning curve.

By being part of a franchise, you have an opportunity to really benefit by other's knowledge. You're buying intellectual property, essentially. You're starting out way down the road versus launching your own business from scratch and having to build every brick and lay and learn every step of the way. Being part of this community, you get to go with their business system, which if you're with a good franchisor, it's been tweaked and tested and refined and improved every time they do it.

And if you have hundreds of franchisees you can fill and take great comfort in knowing that you're not flying blind. This has been done before, it works. Otherwise a hundred different owners wouldn't be involved in this business. So, you step into a business model, a system, you have a neighborhood, a community of other support. Plus being a part of a franchise has a lot of benefits. Not only do you get constructive training and support along the way, they give you access to tools and resources that you wouldn't have if you owned your own business. If I'm a business owner, I get marketing, but I'm not really great in social media, the company might bring in a specialist who does your social media. They provide a supply chain.

So, if I have to go by product to sell to customers or I need certain equipment, they have that all mapped out. They have partnerships and they have contracts so they can leverage their whole system size to negotiate better deals for the individual franchisees. When you're an independent running your own business, nobody's cutting you deals because you're a one-off. But when you're part of a major system, you have got some clout in the marketplace.

NetApp doesn't only work with merchandise and products you're going to sell, but media that you're going to buy. And when you're going to negotiate in media and you're part of a franchise, you have a national platform and you'll also have a regional platform. So you can become part of the Cook County local franchise association and get to use media that covers that area and share the cost with other franchisees.

Don't forget, you're not competing with them because you all have your own assigned territory and it's protected. No other franchisee's going to come into your territory because the franchisor has guaranteed you this is your geography. And they will choose territories for you based on the number of potential customers that you may have. It's not just by households or population, it's now done by demographics. If my customer is typically a male-oriented 25 to 34 affluent, you'll get to buy a territory which has a high population of that demographic. So, we're not just selling you a whole large piece of turf and go find and good luck with your customers. They want you to find an area and working area that's going to have a high concentration of your target market.

A lot of these things go in behind the scenes that you're not even aware of when you get involved with the company. If you have a brick-and-mortar business, they'll help you negotiate the lease and find the location for your store or retail outlet. If you have to negotiate with an attorney, they have contracts you can use and templates for all different forms and things that you're going to use in the business that otherwise you got to go out and buy one by one by one.

And all this costs money, takes time. And the worst part is that you have to learn by your mistakes. And sometimes it's timely and sometimes it's very costly. So, here you can quick step the start of your business by stepping into something that's established and you have all these resources and people to help you and you're not doing it alone.

Also, franchising is a relatively easy way to become an entrepreneur. You're getting a turnkey operation, you're getting all your marketing, all your day-to-day operations are mapped out for you. You have a playbook. The franchisor gives you an operations manual. It's like a phone book if people remember what phone books look like. And it's a dense and comprehensive collection of all the things you need to do and all the situations you may face and how to operate the business.

And don't be intimidated by the phone book concept because everything's done digitally now. So they can update the information, they can distribute the information, and you have access to anything on your phone or on your computer that can help you run and operate the business. Which reminds me, technology is also a real big part of the business. How do you track customers? How do you know what customers want? How do you know who your customers are? Also as the owner of a business, you can see how your business is doing remotely on your phone. Do we have any bookings today? What's coming up tomorrow? What are our three top teams working on this afternoon? So, you have access to a lot of information and the technology package that comes along with your business makes it easier to operate.

Oh, by the way, did I talk about call centers? You could have a business where your marketing is reaching people either across the country or across the neighborhood and all the calls that come into their 800 number has a call center operator answering politely in the name of the business. And if that call is generated from your neighborhood, they're assigning that call to you. And they might even go into your calendar and schedule a first time introductory call with that individual and you go into your calendar, "Oh my God, who's Susie Smith?" And you're going to be talking to her at 10 o'clock because your operators scheduled that call.

You have a lot of perks on getting into the business. Another big plus is the speed to which you can really get to a cash flow positive situation. Now we all know that everything in life has risks, especially businesses. So, what we're talking about here is trying to minimize your risk. And I think having all these pluses going for you will help you optimize the business, minimize the risk. Also it will help your learning curve because you can get in and really jumpstart the learning process by having all these tools and resources around you.

Did I mention you don't need industry experience? And that's really true. In fact, sometimes a franchisor prefers you don't have industry experience because if you do, you may come into the business with predispositions on how things are done. Maybe we don't want to do it the way a competitor does it. We have our own model, we have our own culture and our own style and they want you to follow along.

Sometimes not having experience is a plus and you're teachable. And when the franchiser takes you through that training program and gives you how they do it kind of direction, you can really understand and get your head around how to operate this business. Experience isn't always a necessity. Sometimes it's actually a negative. Not to say that if you have sales experience or marketing experience or management experience, that's a bad thing. But don't feel like you have to have an experience that's very specific to a business to be successful.

And so, just to recap. So many advantages of going the franchise route. You have lots of choices. People are astounded when they hear there are about 4,000 different franchise businesses out there. And so, they cover about 91 industry verticals and there are about 700,000 operating units. There are lots of choices. You can pick things within the medical arena, you can pick things outside of the medical arena. Sometimes it can be a hybrid. A little bit outside, but not completely. There are lots of choices. You also have some good senses of what the business will perform because you have all these other owners who've been doing that business.

And as part of the due diligence process, I'm going to ask you to go through validation. And validation is really a huge learning opportunity where you're going to talk to current and former owners of that business and they'll be able to answer the tough questions. Like tell me, Joe, how long did it take you to make money? How much money did you make in year one, two, and three? What are the net margins on this product? And did you like that franchise owner? Was he good? Did you get good training? Are they helpful? Did they give you support? By talking to other people within the community, you're going to learn a boatload about what to expect down the road. And by the way, they don't have an agenda. If you join the system or don't join the system, they're not going to make a nickel more or less as a result.

Franchisors on the other hand, if they like you, they're going to want to sell you, come on board, we'll take care of you, yada, yada. But you want to hear it from the people who've been getting it from the franchise organization because they'll tell you the truth. And they won't hold any punches and they're going to really give you a good insight into what you can expect, what you can make, and what the experience is like.

And one of my favorite questions whenever we conduct an interview with a validation call is if you had it all over to do again, would you? And that's kind of a very compelling question. And if they say, "No, thank you, you run the other way", take their advice, don't do it. But if you're hearing consistently across the board that this is a great company, a great opportunity, I'm making money, I like what I'm doing, and the franchiser is terrific, then it's a wonderful opportunity. And it's got to check off all your boxes too. But at least you know you're talking to a solid organization.

Another thing that comes into consideration is the management team. In the early stages when you're talking to the franchise and talking to the other owners, the next step in the process is talking to the leadership team from the company. It's called Discovery Day. And they have you come into corporate headquarters and give you a lovely dinner the night before and everybody sits down in the conference room and you get to meet the CEO, the CFO, the CMO, and they all get up and give you their little dog and pony show, but they're telling you everything you may not know about the business from their perspective. They're filling all the blanks.

You're getting a chance to not only see the leadership and hear the leadership, but to meet them and you'll also get a sense of what the corporate culture's about. And that's an important thing too. These are going to be your partners in business for 5, 10 or more years. You want to know, what am I getting into and who are the people running this organization?

And you know what? They want to know the same answers about you because this is the only thing in life you're going to buy that's a mutual consent process. If you go into a car dealership, and I like that Buick, the seller's not going to say, "Well, I don't like you, so move on." This is a case where it's a partnership and they have to be enamored by you and your skills and the kind of culture you bring to the table as you are by them and the organization they built and their vision for the future and how they go to market and how much money they're making.

It's really a mutual consent process. And as you get to the end of the line, everybody is going to have a comfort level. Either it's going to be high or low. And if both sides are really juiced about the opportunity to work together, they're going to offer you a territory or a license to join their system.

And you'll know that probably within 48 hours of that discovery meeting. And then you have about a week to 10 days to make a final decision before you go to contract. When I work with people and take them through this process, I'm introducing professionals along the way. Usually the first one I introduce you to is a lender. Because that's always a big question, like how am I going to pay for this? How much is it going to cost?

So, you're going to learn how much money you need as you talk to the franchisor. They're going to give you a document called the FDD, the Franchise Disclosure Document. It's got 23 sections, another dense read, but it's very informative. It gives you a prospectus on the business and it'll explain to you what the expenses are and what the fees are and what it's going to cost you the average investment for that business. So you'll know when I want to introduce you to a lender, how well capitalized am I and do I need to borrow money or do I have the funds available? And there are a lot of resources in the market that could make this a lot easier.

If you haven't heard of the SBA, remember those initials because the SBA, Small Business Administration is part of the government and the government wants to stimulate new business growth. And they're doing that by making capital available to potential new business owners. You can go to the SBA and if you have a 680 credit score or higher and you have collateral realizable assets, they will ask you for 10% to 20% cash down and they'll finance the balance, which could be a five or 10 year term at very favorable rates.

And by the way, right now everybody's talking about interest rates going up and maybe more to come, but they also go down. This is a business cycle. When they raise rates to tighten up the economy, they also loosen rates to make cash available. When the rates come down, your interest rates on any loans you have will come down if they're adjustable rate loans.

Anyway, there's lots of opportunities for you to get funding for your business. The SBA likes franchises because they have a track record, they have a history, they've worked with them before. And in fact the SBA has what's called the SBA Registry, which is a list of about 200 to 300 businesses that are essentially pre-approved. And if the franchise company approves you, there's a very high chance the SBA will as well.

There's a lot of opportunity to get capital to fund your business. And as we get closer to the finish line, I'm going to introduce you to attorneys who are going to look at the agreement. And you don't want to be signing off on a multi thousand dollar agreement with the business that you're going to be owning without knowing what you're signing off on. I always recommend don't get Uncle Phil who's a real estate lawyer to take a look at your franchise agreement because he knows squat about franchises. A franchise attorney's a great find and a good one won't cost you that much money. And considering the investment, it's going to be a good time and dollars spent.

And finally, I'll also introduce you to CPAs who can take a look at the business opportunity from the CPA's perspective. He is going to tell you what kind of entity you need and what kind of money you potentially can make and your tax obligations. And between all the professionals, you can have a pretty buttoned up story of what this business opportunity represents.

And when it comes judgment day, you'll be more comfortable knowing that you're buying something that's been blessed by the professionals who are objective third party professionals. And you've got to meet the leadership team, you know the concept and you have spoken to the owners. So, you've really covered your bases.

Oh, and did I mention? You should get your partner involved with this decision because the last thing you want to do is fall in love with this opportunity and get to contract day and your partner says "What? You're going to do what? Not with our money you don't." And blows up the whole deal.

I always recommend trying to get your partner, if you have one, involved early in the process so they too can learn about what you're doing, why you're doing it, what it's going to cost us, and they can be on board with you. And I think that's a very valuable piece of information. If you're making a big financial commitment, you want to make sure your partner agrees and you don't want any fighting. So you want the support of your family and you want your partner to be on board.

John: So much good advice there. It's kind of a tutorial on franchises. That's fantastic. And as you were going through those things, I was thinking back to 15 years ago when my wife and I got involved in her franchise. It was everything you said, the visit, the paperwork, the FDD, the lawyers, the accountants. That was really excellent. I couldn't have even come close to describing the process the way you just did.

But we have another big thing we need to talk about for a few minutes because now the question is are there franchise opportunities out there that would be attractive to physicians? It could be a clinical thing where there's franchises to actually provide some kind of care, but also some of my listeners want to leave medicine per se, but they want to use their medical background to at least help them in the next business they choose to pursue. I'll open it up and just have you tell me any thoughts you would have on either side of that equation in terms of something a physician might be interested in.

Alan Goldberg: The good news is there are lots of choices out there both within the healthcare and with the non-medical, non-healthcare arena. Just to give you an idea if you wanted to stay in the medical lane, there are some businesses that are franchised medical businesses that might be interesting to you. It could be things like urgent care. There are a lot of successful urgent care systems that you can just dive into and they've got a great history and making good money and it's a great business to be in.

You can get into other health and medical businesses. It could be physical therapy, it could be mental health, it could be dental, it could be vision. There are lots of opportunities in more traditional medical businesses. There's also some alternative care businesses that I find are kind of interesting. And although physicians aren't necessarily practicing these areas within their practice, they're kind of tangential to what you're doing. They're not traditional, but they're not way out there.

So let me give you some thoughts. In the alternative care arena, there's regenerative medicine. There are companies that are doing miracle work, missionary work. They're avoiding having to go into surgery, having to take painful opioids. And if you have a bad shoulder, a bad hip, they can extract fluids, spin it down, reinject it, and miracle stimulate growth of healthy tissue and really avoid a lengthy recovery period and a painful surgery.

These are concierge services. They're not paid by insurance, so they're out of pocket. Your customers are either very wealthy or very desperate. And I don't mean that in a negative way. There are a lot of people who do labor, they work on whole buildings or they're in construction or whatever, and they can't be out of workforce three or six months recovering from a surgery. And they'll pay the money to come in and get well quicker and not have to go through the whole surgical process. And then there are people who would gladly avoid surgery and can afford to pay for it. I'm just saying there are all kinds of individuals who are coming in for regenerative medicine.

Further down the line, under the alternative care umbrella, there are med spas, which are kind of like a hybrid medical/beauty environment. People are getting liposuction and Botox and vitamin drips and all kinds of fun things. And some of these practices are requiring a medical license or a physician on board day-to-day at the practice but it really varies state to state.

As you dive in on a concept you like, one of the first questions you're going to want to know is, "Do I need to have a physician present or physician as an equity partner in this business in order to operate legally in my state?" Since there's so many different laws around the country that's going to be a state specific question.

And another interesting arena that some people are jumping on board for that also have lots of regulations and state laws following is something like cannabis. Cannabis is the Wild West. There are maybe 20 states that have medicinal cannabis that's legal and maybe there are 10 or 15 that have recreational. And the universe is growing. Although it is in a transition stage, it's got a big upside. And if you're into healthcare in the healthcare space, this could be an interesting opportunity. But it's also a risky one because we're not sure how the government's going to roll this out or if they're going to. But as you dig in and learn more from the franchise, you'll see if this is a risk that is manageable for you or it's off the charts.

There are also other alternative care things that are less radical. Massage therapy is a big area. I didn't mention acupuncture yet, but acupuncture, salt therapy, cryotherapy, drip therapy are all kinds of therapies that are in the alternative care arena, and are emerging as new kinds of concepts that may be exciting to get into. And the mental health world is exploding as you know. More and more people are stressed out or in crisis or going through huge life transitions and need professionals to help steer them. So the mental health world is even being franchised now as well.

Outside of health related things, there are some beauty related things. If you want to be in a beauty business, there are lots of interesting things and aesthetics where skincare is very hot right now in terms of not only getting facials, but all the skincare products. There are a lot of salons opening up. We have opportunities to do services and some merchandise. There are lash lounges. If you haven't noticed, there are a lot of people out there who suddenly their lashes have gotten a lot longer. So, you can go in every three to four weeks and get a tune-up and get your lashes extended and repaired and whatever they do in there.

But a lot of these businesses have membership models where you get a series or you belong and you get discounts. And so, they keep you coming back. It's something like your hair. You're coming back on a regular schedule for routine maintenance and there's a lot of money in routine maintenance because your customers are a recurring revenue stream like in a hair care market, they're loyal to the ones who are doing the service and they want to see you all the time. You are the one. So, lashes, blowouts. Women who want to look the best on a date or at work or for a meeting or whatever it is will go in and get their hair blown out. And all they're doing is puffing, you're out the door in 15 minutes, but they'll charge you $20, $25, whatever the number is, and you're looking great and you can look great every day.

So, that's been a big segment of the beauty market and an area that's not expensive to get into and could be something that you guys might be interested in.

Outside of beauty, fashion and health, there's some other really interesting opportunities in real estate. There are businesses called salon suites, which I guess is still in the beauty world where there are people who are going in and buying large spaces. If you haven't noticed, stores like Macy's and Bloomingdale's are pretty empty these days. And the mall operators want more traffic in the mall and the store operators can't afford the leases.

So, they're converting a lot of large space retail environments and creating a salon suite, which could be 40 different operators each having their own unit. And one is doing pedicures and one is doing manicures and one is doing blowouts and one is doing hair coloring and one is doing a massage. And you have a whole suite of these beauty services.

And it's really a real estate play because the investor who comes in and takes over a lease for this large space is subletting space to all these operators. If you own the property, it's a real estate play because you have property that could appreciate, plus if you're leasing a large space, you are getting checks every month from the sub-leases and you have a nice thriving business with recurring revenue stream. And it's very low maintenance because the tenants of these salon suites don't want you coming in. They feel like you're looking at them and inspecting what they're doing, so they're happy that you're not there.

And you could do this as a semi absentee business where you don't have to show up every day and be marginally involved. And you have a manager who operates day-to-day operations. And so, you could be involved in a nice investment like this, which has a recurring revenue stream and doesn't even require you showing up at work.

What I'm saying here is in the franchise world, there are semi absentee opportunities where you can keep your day job and do this as a side gig and essentially make good money. And you love your practice, love your patience, and you don't want to give all that up, but you want to make some extra cash. And this is a business that's purposeful and will create a revenue stream for you.

There are lots of combinations and permutations of how to make money, where to make money and how to grow wealth. We didn't talk about multi-unit development, but I'll quickly just hit on that. If you are in a niche that you really like, has good upside potential, maybe the goal for you is to have three of those, or five of those, or 10 of those so you can get involved with the business, fall in love with it, and then tell the franchise you're interested in expanding into adjacent territories and become a multi-unit operator.

And now you're in a role where you're managing the manager. You've got somebody running day-to-day operations at unit one and unit two and unit three, and maybe you'll decide, well now is the time. I've got three operating units, I'm generating meaningful cash flow. Maybe now I'll get more fully involved in the business and help open up units four through 10. And your decisions now are new hires, marketing expenses, site location, site selection.

Instead of being involved day-to-day with customers, you're looking at expanding the business and growing your little fiefdom. And by the way, once you have all your units operating, you can lay back and chill and collect all the proceeds from these businesses and not be involved day to day. For somebody looking to make a lifestyle upgrade and be getting good money at the same time, you have an opportunity to build yourself a little empire and also not be totally involved with managing it.

Just some thoughts. And clearly if you have areas of interest, there are lots of different opportunities in the franchise world that you can dig in on. I personally like recession resistant businesses, which I guess you could say are essential services. Home healthcare, I'm sure you guys have heard about this. The population's getting older. People want to age in place. And so, seniors are a real important compelling market. Home healthcare gives you a chance to send the providers to the right patients and they can get all the services they need 24/7 on a contract basis. And you're basically an agency who's recruiting different types of providers and servicing their patients or their clients with care at home. Senior care is a great market. It's booming. There are 10,000 people turning 65 every day. That's scary. But the boomers are coming of age and they would like to age at home, this is a great way they can do it.

Anybody out there have a pet at home? Well, pets is a huge market and you know as well as I do, if you have pets, you're spending ridiculous amounts of money on caring for them. Their food, their grooming, healthcare. Pet business is really hot. Kid business is very hot. They're buying them either services like recreation or activities or tutoring or education. There's a great market for children if you want to get into the kid market.

With everybody being at home through the pandemic, people are starting to look around and say "Honey, I think it's time to paint the house. We need a new tile in the den, or the bathroom really needs an upgrade." Home services have mushroomed into a huge business because everybody's home. Hybrid people are working from home. Home offices have been booming everywhere. A lot of people are looking around the house and looking for ways they can make it more attractive and more serviceable. Just a couple more I'll throw out there.

John: Okay, a couple more and then we'll wrap it up.

Alan Goldberg: Damage restoration, companies that come in if you have a flood or fire or smoke or mold. These are services your insurance is going to pay for, but they're important services. So, if you're inclined, there are great opportunities in those kinds of businesses and the list goes on.

I'm just saying don't feel because you are in a medical practice or you're in healthcare this is your world going forward. You can pivot and learn a completely new business that you never even dreamt of, and not feel like you're going to fall on your face or get punched in your nose because there's somebody looking over your shoulder to help you succeed.

John: That's excellent, Alan. There's so many options there and just a lot to chew on. I think we're pretty much near the end of our time together. I want you to spend the next couple of minutes explaining if we want to learn more about what you do or potentially even get your help, where do we go to do that?

Alan Goldberg: Well, I'm happy to give you my email and phone number if you'd like to call me and reach out by phone. Those are great ways to contact me, get on my radar. You can also go to LinkedIn and I believe John is going to put my contact information in the notes following our podcast today. So you can feel free to reach out to me and I'm happy to give you some insights and a free consult on what kind of opportunities might be available for you.

Oh, by the way, I didn't mention this, but a good part of working with me is not only working with me, but you don't pay me. And I'm not doing this for charity. I get paid by franchise organizations for helping them find well-qualified candidates for their business. I'm helping vet the businesses for you and I'm helping vet the candidates for the company. I work much like executive search. They try to put the right peg in the right hall and if it fits everybody's happy. And me too because I get a fee that's paid by the franchisor much like a real estate transaction. When you buy the home, the seller will pay the intermediary who makes the deal happen. So, I get paid in a similar fashion. If you want to talk to me and want to learn about the business, I'm happy to help you and get you engaged in this process and try to get you in front of the right opportunities. And it's not going to cost you at the end of the day for my services. It will unfortunately cost you for the business, but you know that going in.

John: Yeah. Oh, that's fantastic. I hadn't even thought about that. I wasn't even thinking about it like who pays for this help? And when my wife and I did this, we just did it on our own but it would've been great to have someone like you in your position that could really give us a much broader idea of what's available when we're thinking about doing this process.

Yeah, we'll definitely have the phone number, the email, and LinkedIn in the show notes. I got to look and see which the show notes will be. It's episode 292. So listeners, obviously I'm going to send you all emails if you're on my list, and we're going to get that information out there so that you can contact Alan if that's something that you're thinking of doing, or just want to learn more about it before making a decision whether to go franchise or non-franchise.

All right, Alan, this has been fantastic. I feel like I've been flooded with information about franchise. I loved them before, but I think after listening to you, I'm thinking maybe I should get into another one. I don't know.

Alan Goldberg: Well, you could see I get animated about this topic and I talk it every day. It's something I enjoy talking about, but let me just leave a party nugget. These businesses not only provide great opportunities to do new things and give you a chance to be more entrepreneurial, but you can create a business that's a lifestyle business. Something that doesn't require a lot of your time, something that you enjoy and adds to your lifestyle. It could supplement your income, like the side gig we talked about. It could replace your income and potentially grow it. And also it could be a multi-generational legacy business. If you have kids, family down the road, you like them to get involved, it creates an opportunity for them as well.

So, lots of different ways to go, lots of different price points, lots of different opportunities. I wish you all well and I'm glad I had a chance to talk with you today and hopefully I can help you down the road.

John: That'd be great. We'll have to follow up sometime down the road and see what else is new in franchises maybe next year or something. Thanks a lot Alan. We really appreciate it. I think the listeners are getting a lot of information that's going to be very helpful for them. I want to thank you again for being a guest today on the podcast.

Alan Goldberg: I loved it. Thank you.

John: All right, bye-bye.

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The post How to Improve Your New Business Odds of Success by Buying a Franchise- 292 appeared first on NonClinical Physicians.

Today's guest describes how to build a rewarding online business. He is the host of The Affiliate Guy Podcast, your source for affiliate marketing news, tips, and strategies to take your online business to the next level.

Matt McWilliams is also the author of the best-selling book Turn Your Passions Into Profits. He has worked with some of the world's most successful businesses and entrepreneurs, including Shark Tank's Kevin Harrington, Tony Robbins, Ryan Levesque, Michael Hyatt, Brian Tracy, Jeff Walker, and others.

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The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Matt's Journey in Affiliate Marketing

Matt is the owner of an agency that runs affiliate programs for high-level entrepreneurs and businesses. The things he learned building that and other businesses led him to write his book about building a rewarding online business. 

Affiliate marketing enables business owners to sell without taking any risks. Matt refers to this as paid-to-practice (PTP).

Startup of Affiliate Marketing

Matt introduced his ‘Affiliate Donut' approach, in which you focus on your main services. You can establish an affiliate relationship with your audience by providing supplements or other products that will benefit them in numerous ways, which will lead to them becoming recurring buyers.

There are certain advantages to using Matt's approach:

1. Start monetizing immediately
2. Training your audience to buy before you have your own product.
3. Serve your audience by recommending products right in your niche or tangential ones.

And if the performance is strong, one will be able to generate more revenue early in your entrepreneurial journey. 

Building a Rewarding Online Business

Matt touches on other business principles during our interview. And his book, Turn Your Passions Into Profits, provides detailed instructions outlining his proven path to a rewarding online business.

It covers all of the other necessary aspects of building any business, from identifying your niche, describing your avatar, building authority, creating a marketing plan, and building a team.

Summary

Turn Your Passion Into Profits is available at booksellers nationwide. But the best place to get Matt's book is at passionsintoprofitsbook.com/jurica. There are extra free bonuses for you using that link, including courses such as Matt's Email Marketing Masterclass and others. 

NOTE: Look below for a transcript of today's episode. 

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Links for Today's Episode:

• Turn Your Passions into Profits by Matt McWilliams
• The Common Path to Uncommon Success by John Lee Dumas
• The Positioned Physician by Mike Woo-Ming
• How to Get Started on Your Nonclinical Online Business
• How to Select the Best Online Business Niche – 110
• How to Become an Author, Consultant and Online Authority with Dr. Tom Davis – 047
• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 288

What Is the Proven Path to a Rewarding Online Business?

John: If you've been reading my emails recently, you'll recognize today's guest. I've been helping him get the word out about his new book "Turn Your Passions into Profits", and I'm really pleased to be able to talk to him personally about the book today. Matt McWilliams, welcome to the show.

Matt McWilliams: Hey, John. I appreciate that and thanks for having me today.

John: And I think we were talking before we got out, we're kind of like neighbors. You're one state over Indiana and I'm in Illinois. So, we're Midwest guys.

Matt McWilliams: Yes, yes. I don't sound like it just because I grew up in the south, but I've been up here long enough, I'm getting that little bit of that, that twangs gone away. And my accents become a lot more neutral. It's kind of funny when you combine a dad from New Jersey, a mom from California, you grow up in the south, but in an area with mostly relocated Yankees, then you move up to Fort Wayne, Indiana. You end up with a weird accent. Apparently, I've been told I have a neutral to slightly strange accent because I say certain words like I'm from Boston. Other words like I'm from Indiana. Other words like I'm from Mississippi. So, I like the mix in that.

John: It sounds pretty Midwestern today, but we'll see. I'll be looking for those rare words that come out that are a tip off to some other area. All right, we're going to be talking about your book today. And I'd let you give us a little background about what you do and then we'll get into why you wrote the book. But tell us a little bit about yourself.

Matt McWilliams: Yeah. Today I'm so blessed, John. I get to live out both ends of the book. There's a reason why we titled it what we titled it, you turn your passions into profits. It's not about just having a business you're passionate about. It's not about just changing the world. I've been there, done that. My third business. Man, I was making an impact on people, changing people's lives. I'd get emails and, and blog comments and social media comments every couple of days. "Matt, you saved my marriage. Matt, I was thinking about killing myself and I didn't. Matt, you changed my life." And I'm like, "That's awesome. Yay."

Here's a funny thing though. Our kids are both in high level soccer now and it's thousands of dollars a year. And the soccer association sadly does not take blog comments as a form of payment or tweets and Facebook posts as a form of payment. The mortgage company, they never took. I tried once forwarding them an email saying, "Look what somebody said about me. I saved a guy's life." And they're like, "You still owe us $1,800." Dang it, that's not how this is supposed to work.

And I've been on the flip side, I've had a business where I made more money than I know what to do with John. The reality was, when I was in my early twenties, I was making between $8,000 and $10,000 a week teaching golf schools. At that age, full disclosure, don't ever make that much money when you're that young because you'll do what I did and do a bunch of stupid stuff with it.

John: Yeah, to squander it.

Matt McWilliams: Yeah. May or may not, I had a lot of nice stuff there for a few years though. But yeah, I made more money that I knew what to do with, but I was miserable. I hated what I was doing. And so, today I'm able to do both. I've got a great business. We have an agency where we run affiliate programs for some high-level entrepreneurs and businesses and I love that. Got an amazing team there. Got our platform at mattmcwilliams.com. Got the podcast The Affiliate Guy, got the book now "Turn Your Passions into Profits."

The interesting story behind the book because I know you said you were going to ask about it anyway, but not the reason why I wrote it, but the reason why I was able to write it is because I was in that position. If I didn't have such an amazing team, if I hadn't gotten to the point where we built the systems for the business to run, if we hadn't gotten to the point where it provided an income.

Because here's a funny thing about a book. Newsflash everyone, you're not going to make any money for a long time off the book. This was actually financial, we lost money so far, we're in the red. Even with a pretty significant advance from the publisher, we're technically in the red, if you compare it. I think we're in the red unless you count my wage at about one third of minimum wage, in which case, if you'd pay me that, we might be breakeven.

And so, we wouldn't have been able to do that. How do you do something like this? How do you invest all this time and energy into writing, editing, producing, launching all the things that we did for this book without the financial reward. It's because we have the rest of the business doing so well financially that we're able to do that. So, huge kudos, again, to the things that I've learned that put us in that position and obviously, my team, which is amazing.

John: No, it sounds like it's a great story and I think it's definitely ranking extremely high on Amazon and the other list. I've seen some of the numbers and definitely you're going to be one of those few authors that actually make money off their book. Because I've interviewed many and a lot of people write a book to promote their products or to serve their audience.

But yeah, I really like the book. I've gone through it and I get a lot of questions because I send out surveys to my listeners and my readers and one of the things they're looking for is what's the roadmap? How do I build an online business? And again, I'll say, hey, here's the book. It's out. You can get it now. And the subtitle is "The Proven Path for Building a Rewarding Online Business." I'm not going to tell my readers how to do it or listeners. It's like, just get the book. Now we can get that pretty much everywhere, right? Anywhere that books are sold.

Matt McWilliams: Yeah. If they sell books, they sell my book. Amazon, Target, Barnes & Noble. It's in stores, most Barnes & Noble, there's a few that are sold out. Some of the smaller Barnes & Noble will not have it. We have two Barnes & Noble in Fort Wayne. One is massive and then the other is not even the size of our house. It's a tiny little Barnes & Noble and that one doesn't have it. But yeah, we got a deal with Barnes & Noble nationwide. Right now, at least for the next few weeks, it's front and center in almost all the Barnes & Noble we've been into. You walk in and it's right there under the new non-fiction.

So, you can grab it anywhere, but the best place to grab it, you go to passionsintoprofitsbook.com/jurica. If you go there, that's the best place to get the book because John, we've got some special bonuses for your listeners there. You can go buy it in a store, that's great. Go to the store and grab it. That's awesome. Then go back to that URL and make sure you redeem for your bonuses there. So, we've got over $500 in bonuses. Stuff you cannot get anywhere else. And so, that's the best place to do it, of course, because it's just easy peasy. But yeah, if you're walking through the store one day, you see the book, it's about the only book with that color scheme.

My mom, of course, this is a funny story. When it went on sale in stores, she had ordered a couple copies or 20 through Amazon. I was like, "Mom, we got it in Barnes & Noble." And she's like, "What's in the Wilmington and the Jacksonville one?" And she lives an equal distance between the two. This is in North Carolina. She's like 40 minutes from both of them. And she's like, I got to go. And she goes and grabs the copies and she's like, it was so easy to see. I walked in and that is the only one out of like 80 books that are front and center at the store. The only one that looks like that. There are half a dozen white books and some green books and black books. And she's like, it is the only one with that color scheme. So, I wish I could say we did that on purpose. It's actually just because that's our color scheme as a company. But it worked.

John: Yeah. It's on the logo for the podcast, I think are those colors.

Matt McWilliams: Yeah. Obviously, it's just funny. It's one of those we're behind the scenes weird stories. The iterative process for a cover, because I'm sure there's people out there, somebody listening or watching you, you want to do a book. What we did was about 14 months in advance, we started pulling my followers, my fans, my email list, and I also did it with some friends and stuff. I started pulling them on here's six covers that the publisher designed. And it was a very iterative process because the original version of this, there were a couple of things that were different. The original version of this exact one was a completely different color scheme. And the words were not tilted and none of these were tilted here. It was straightforward.

Well, what we found as we did this was the ones that had the slanted words kept doing better. That became the next iteration. We narrowed it down to slanted words. And then the two that did well were this with a completely different color scheme and a different design with this exact color scheme. And so, we were like, we combined them and that ended up being the winner.

And so, it was a very iterative process. I think we did like four rounds. Now number one, I ended up with the best cover. The actual colors that we ended up with there's a slight fade if you look closely from the bottom to the top. The bottom is our official company color. The top is actually from a course of ours, and it's a fade from those two colors. And that was the only reason why we even bothered doing like, "Hey, try that, whatever." Number one, we got the best cover. We ended up with over a thousand votes across the board. A thousand people are voting on it, you can be pretty sure it's going to be the right cover. Secondly, it's pre-marketing for the book in advance. Third, the people who voted, and even if they voted for a different cover, they were a part of the process. So, they were invested in it. So they're much more likely to buy the book.

John: Right. Good marketing, man.

Matt McWilliams: That's what it is.

John: That's what you're an expert at. When I have someone who's an author or does other things, but I obviously get a twofer. So, the twofer part of our conversation is let's use a little bit of your expertise. I have physician friends and colleagues who have started small businesses, coaching, consulting, courses, what have you. Maybe one of them uses affiliate marketing in any way, shape, or form for their business. So, since you are the expert on this topic, maybe you can just give us an overview of what is affiliate marketing? Why is it so cool? And why business owners should start doing it? Maybe to get people to help promote their products.

Matt McWilliams: Yeah. Now I will preface this by saying I don't know any states' laws about physicians and how you can operate. So please check on all that stuff. And I did not stay at a holiday express last night. So, take everything with a grain of salt in that these are basic rules and principles for business owners that I'm sure in some random state, what I'm about to tell you might even be illegal. I'm just going to preface that. So, that is not to save my butt, but to save yours. Whoever's listening, you live in whatever, you live in California and you are not allowed to do this, okay, then don't do it.

The basic premise of affiliate marketing has been around for thousands of years, John. If you think about it, I don't know, ancient Rome. I can't name anybody from ancient Rome other than Julius Caesar, but so-and-so and so-and-so are walking down the street in ancient Rome. One of them is looking for a good cobbler. And he's like, let me take you to mine. And he takes them to his cobbler and the cobbler's like, hey, thanks for referring whoever. I'm going to give you your next pair of shoes 50% off. That's affiliate marketing. If you think about it. There's no technology.

All we did 30 years ago is add technology to the basic concept of referral marketing. And then in advance, because we added that tech piece, before technology, Joe had to walk Sam to the store and say, let me introduce you to this guy before the advent of the telephone. Then we got the telephone, and the telephone allowed us for Joe to call up the shoemaker and say, hey, I got my friend Sam, he's on his way over. And boom, Joe got some credit for those shoes that Sam bought.

About 30 years ago, we added technology. So now we don't even need to know our affiliates, and our affiliates don't need to necessarily have us. But ultimately this comes down to, there's a concept I use called the affiliate donut. In the physician world, your core, if you can picture a donut with the core, the whole there, that's your core offerings. I'm simplifying this, John, but people come to you, if let's just say you're a general practitioner, they come to you when you're sick, when you have injury. That's pretty much the only time people ever unfortunately go to their doctor unless you go for your annual checkup, which reminds me, I'm due for an annual checkup last November. But I was launching a book, so I need to schedule that.

And so, that's when you go to your doctor. Annual checkup or you're not feeling well in some way, shape, or form. That's your core offer. You solve problems and perform annual checkups. Again, I'm simplifying this. I'm not diminishing what physicians do. I'm just saying that's the core offer. But think about all the other things. Do you sell supplements? Are you going to create as a doctor in Fort Wayne, Indiana or Kansas City for that matter? Are you going to create a supplement line? No. But do you recommend supplements to your customers? Maybe.

Well, why not form an affiliate relationship with those and create a single page on your site that says here's all the supplements. I'm just going to say drjohnsmith.com/supplements. And on that page are all the supplements that we recommend. In fact, you can narrow them down. For my patients that are men under 40, here's what I recommend. For my pregnant mothers, here's what I recommend. For my seniors, here's what I recommend. And so on and so forth. And you can recommend those supplements.

Now, if one of your patients become recurring buyers, for let's just say three supplements each fish oil, multivitamin, and one other. They become recurring buyers and you make $3 a quarter off of those 10%, that's $9. That is now a 90-cent increase per quarter in your average customer. You go, "Well, that's not a ton of money in the grand scheme of things." I'm just using round numbers here. Probably a little bit more than that. A $1.50, $2 more.

But those are the type of things at the end of the year, all of a sudden, your affiliate commissions could pay for an entire team member. Let's say you have three front desk staff. One and a half of those could be paid for by your affiliate commissions. That's kind of cool. $50,000 - $60,000 a year. That's a nice little vacation last time I checked. Or I don't know, you could pay off most of your mortgage, whatever it is. That's just off supplements.

There are other types of things you could recommend, whether it be various products that would serve your audience in different ways. Again, I'm making this up as I go here because I'm not super familiar with that world. But if you're a chiropractor, for example, recommending certain products. There's a one that I bought recently called Chirp. I don't know if you've heard of these, John, but think of a foam roller on steroids. My chiropractor years ago gave me a PVC pipe. He's like, don't use a foam roller too soft. Get the PVC pipe. And I'm like, it hurts. And it doesn't dig in. This chirp thing kind of digs up in there and I get on it, I just hear stuff popping. And I get up and I'm like my posture's better.

Could you recommend that as a doctor and make $10 a sale off those chirps? If 5% of your patients buy a chirp, how many patients do you have? Multiply it by 5% times $10 and it starts adding up and it creates that side income that, again, I've heard of people, specifically chiropractors who literally their affiliate commissions pay for their entire administrative staff. Their entire admin staff is paid for, not from their client fees, not from anything else they sell directly, but just from their affiliate offers.

John: Well, let me jump in here for a minute because a lot of my audience, they're getting burnt out. And so, what they're doing, they're creating side gigs that are in the healthcare realm, but it's not under their license. They're not actually practicing. So, they're building consulting or coaching or something. And obviously they can find products and actually other coaches or learning about something that affiliate marketing would be perfect for. And I've done it myself, the things I'm doing affiliated with the podcast and so forth. So, what are the other advantages of affiliate though? Because it's not simply the fact that you have this. You don't have to have any product, right?

Matt McWilliams: Yeah. That's a big one. In that instance, John, think about it. If your practice, though, is bringing in more revenue, yeah, you're burned out. But if you can increase the value of a patient $10, you could reduce your patient load by 10% and make up for that with affiliate marketing. That's one thing.

Number two, if it's bringing in more money on the side, it's building up that reserve. And I know a lot of people when they're switching careers, I have a particular client I'm thinking of, a coaching client. And she's burned out with her current platform. She's building this other platform. And I said, "Okay, the first two coaching sessions, I'm not focusing on your new platform." And she's like, "What do you mean? I want to focus on my new platform." She's doing about $250,000 a year in her current platform. I said, "I want to get that to $300,000 in the next year." She's like, "I don't want to grow that Matt."

And I'm like, "No, listen to me. If I can tweak a few things that don't require any extra work or involvement from you, but get that to $300,000 for the next two years versus going down to $150,000, you have an extra $300,000 in the bank at the end of two years. What could you do if you have an extra $300,000 in the bank at the end of two years?" And for most of us, the answer is pretty much whatever the heck we want to because we have such a load of money sitting there that it frees us up. Because one of the things, what's the thing about a side hustle? "Oh, I want to leave my practice. I'm burned out." Okay, can I just go to making $0? No. Could you go to making $0 if you had a half a million dollars in the bank? Maybe.But with that thing, we're not going to go to $0. We're going to build the side hustle. Maybe that side hustle is only bringing in $3,000 a month. I'm going to go out on a limb and say most physicians make a little bit more than that.

John: Yeah, that's true.

Matt McWilliams: But the physician side is now bringing in an extra $75,000. I don't want to be unrealistic. $75,000 from affiliate marketing. Over two years that's $150,000. Plus $3,000 a month for two years is $72,000 if I'm doing my math right. We're now at $200,000 some. You could go full-time on that side hustle now. It's currently bringing in $3,000. What would it do if you were full? Plus, you have over $200,000 in the bank. So, think of it that way.

To answer your question, what are some of those benefits and what does it do for our business? Number one, you can start monetizing immediately. This is the big one. When you start that side hustle, maybe you're building a platform around your passion and maybe your passion is, we'll just take John's for example, his passion was helping other burnt out physicians. But maybe your passion is around something that has nothing to do with medicine but sort of does. Maybe your passion it's about youth sports and the science of helping youth athletes become better. I'm just making this up.

Well, initially you might not have very many product offerings. You're certainly not going to go create physical products because physical products, I had an idea recently for a physical product and I was told the CAD design alone was going to be $18,000. I'm like, I want to do this, but not that bad. I think I'm just going to pass on that physical product.

So, we start promoting other products and I'm going to get to some of the other benefits that are tied to that in just a second. We don't have any fulfillment, any customer service. You do not need any space in your garage. For those men out there, this is less applicable to the women, just to be honest. But for the men out there, the last thing you want to do is start a business and then your wife can't park in the garage.

John: Right. Absolutely.

Matt McWilliams: Do not do that. I'm giving you marriage advice right now. Never, ever, ever do that because you will not be married in about a year. And so, we don't have to do that. And we don't have to worry. If my promo goes bad, if they don't buy, at least I don't have a garage full of crap. There's no hidden cost. When I sell stuff, I sold a couple of courses today. We sold like a thousand dollars' worth of courses today. Here's the thing. $994 is what my payment processor says we made. $994. And you go, "Hey, $994." I didn't. Not only did I have to pay my affiliates for both of those sales, $400 and change out the door. I paid 30 cents plus 2.9% on both of those transactions and credit card processing fees. So, $60, if I'm doing the math right out the door.

Almost half my revenue is gone. Our customer service manager has to email both of them and make sure that they're set up in their logins. Statistically one out of four is going to have an issue with something. Trying to log in or something's not going to work. An email's not getting delivered. That cost another $10. I'm over $500 on a $ $994 purchase. There's a lot of hidden costs. There's no risk like we talked about.

This is a big one. Affiliate marketing teaches you how to sell, it teaches you how to sell without all those risks and stuff. And so, my favorite kind of practice, I call it PTP, paid to practice. You get paid to practice selling online. You start to learn what works for your audience. Okay, what price points is your audience going to buy it? What sales strategies work? What topics are they going to buy at? What are the best promotional methods? I can send four emails or go live on Facebook for 30 minutes and sell the same amount of stuff. What are you going to do? Write four emails or go live for 30 minutes? You learn those things when you're doing affiliate marketing, it trains them to buy. That's another big one. You are training your audience before you even have a product of your own. You're conditioning them to buy. And I go through a bunch more reasons why, benefits in the book.

But the last one, this is the most important one, it serves your audience. So, let's just go with that example. I don't know it very well, but let's just go with that example. You have a physician. They're a pediatrician and they have a passion for working with kids on things like nutrition and healthcare for kids that are youth athletes.

So you go, okay, this is who I work with. Now I can create a course that teaches parents how to help their kids in these areas, but what supplements do these kids need? Well, you're not going to probably start a supplement company in your first couple of years with this business. You may not even have the money to. And even if you did, again, what did I tell you? Don't have a garage full of stuff.

So, we're not going to do that. We're going to serve our audience though, because your two options, John, are A) serve my audience by recommending supplements and recommending exercise equipment and recommending the things that the kids need to be healthy at their athletic peak. Or tell them, screw you. I'm not going to recommend anything to you because I don't have it myself. Those are your two options.

Again, you become an affiliate for the supplement company. You become an affiliate for the equipment company. Our daughter has a lingering knee issue and it's not structural, she's not going to injure it worse, but because she's having her growth spurt right now, every time she plays soccer it hurts. So, the doctor recommended just a simple knee brace. It's nothing, not clunky or anything like that. This isn't like reconstructive knee surgery. It just takes a little bit of the pressure off the knee. That's all. Well, he was like, I recommend this. I'm like, okay, so I went to Amazon and I bought it. He could have sent me to a link and I would've gladly have clicked on his link and he would've made $5.

John: Right.

Matt McWilliams: I do not make the $5. What's the point of not making the $5? Am I better or worse served by him making the $5? Actually, the truth is, I would've been better served if he'd sent me to drjohnsmith.com/resources because I wouldn't had to have Googled the complicated name of this thing and clicked the link and bought it that way. I would've been better served and he would've made actually probably more like $8. It's a free $8. That's not quite lunch these days, but it's close. It's half a lunch. Half of lunch at Jersey Mike's.

And so, my point there is it serves your audience because you're recommending products right in your niche or in tangential niches. So, when I think about, I'm going to go with this example because I'm on a roll with this example, and even though I don't know it very well.

Even though we have two youth athletes, I don't know that particular niche, but if you've got youth athletes, here's what I also know. They need to learn goal setting. Are you a goal setting expert because you're good at teaching kids how to take care of their bodies? No. Do you know a little bit? Sure. But are you going to create a course? No. But could you recommend a goal setting course for athletes? Yeah. What about time management? I know this with an 11-year-old who's in seventh grade.

The last season, last fall, we homeschooled, but she takes courses outside of the home. And we overwhelmed her, we accidentally signed her up for too much stuff. And she was doing five hours of homework a night. What about a time management course for teens? Does somebody have that course? Can I sign up for it? And it's a $200 course and I get an $80 affiliate commission. Think about that. Other products that they could buy and things that they could do that not only serve them in my direct area, i.e., supplements or braces or things like that but also in those tangential areas.

John: It sounds like there'd be an infinite number of possibilities the way this can work. And like you said, it's a way to get going much more quickly and with less investment. So, we could go through the whole book today, I'm sure you'd love to do that. But no, this has been really helpful. I like to get something tangible from and just that little lesson was tangible and useful. So again, I just want to thank you for coming on this show today. mattmcwilliams.com is the website. You can get the book there. You can probably find the podcast there. But that's called The Affiliate Guy podcast. And boy, I hope all the best with the continued sales of the book.

Matt McWilliams: Go to passionintoprofitsbook.com/jurica. Connect with me at mattcwilliams.com. Guys, you can reach out to me anytime, connect with me there. It's got my phone number on there so you can text me if you got questions or anything like that. But if you go to the passionsintoprofitsbook.com/jurica, I know you'll put that in the show notes for everybody, John. But if you go there, that's the best place to get the book.

John: And the bonuses really support even what's in the book, because I've seen some of the bonuses when I was helping promote it. So, this is fantastic.

Matt McWilliams: That's exactly what it is. The reality is my first manuscript was 117,000 words.

John: Oh boy.

Matt McWilliams: And the publisher wanted to get it down to 75,000. We ended up about 82,000 but there's still 35,000 words missing. And so, some of these bonuses, essentially, we created a little course around some of the stuff that we took out there. We took some deep dives into some stuff and then there's some bonus stuff. It's like, hey, once you have a list, we have an email marketing masterclass. That's one of the bonuses. You got a list, you got some subscribers. What emails do you write? Well, that's another 15,000 words. I didn't have time to write that in the book. So, we created a course around that though. It's one of the bonuses.

John: This is going to really kickstart people's pursuit of this. This is fantastic. Okay, Matt, thanks a lot again. I really appreciate it. It's been great talking with you.

Matt McWilliams: Hey, thanks for having me, John.

John: Okay, bye-bye.

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The post What Is the Proven Path to a Rewarding Online Business? – 288 appeared first on NonClinical Physicians.

In today's episode, Dr. Armin Feldman returns to update us on creating a medical legal consulting business, and new resources for learning how to do so. He first appeared as a guest on Episode 227, which was released a year ago. 

Dr. Feldmman attended the University of Colorado Health Sciences Center for his psychiatric residency after graduating from the University of Wisconsin Medical School. For more than 20 years he practiced psychiatry and ran outpatient head injury rehabilitation centers around the nation.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Medical Legal Consulting Business vs. Expert Witness Consulting

Dr. Feldman started formal consulting of this nature 15 years ago. His unique pre-litigation/pre-trial consulting aids attorneys in managing the medical elements of cases, raising case value, and saving time.

By supporting medical opinions with documentation from medical literature, he assists attorneys in helping their clients negotiate and settle legal disputes. In most cases, this enables patients to obtain necessary medical care.

Launching a Medical Legal Consulting Business

You need two skill sets to successfully pursue this career.

First, you must be able to research the literature regarding evidence-based medical care and explain your medical knowledge and experience to others. Second, you will need the business skills necessary to launch and sustain a long-term medical consulting firm.

During our interview, Armin describes how to obtain those skills.

Additional Resource – Dr. Feldman's Podcast

Armin and a former student, Dr. Michael Bummer, also produce Physicians Helping Attorneys (Helping Patients) a podcast that helps attorneys understand this new medical forensic field. It is also a great place for physicians who are interested in studying this type of work to learn more about it.

Dr. Feldman's Advice

If you love medicine and you want to… help people, injured people that really need this help… this is something you should consider.

Summary

In today's interview, Dr. Feldman helped us to understand this burgeoning new medical field.

He also describes his new online course, Start Doing Medical/Legal Consulting, which opens later this month. In it, you will learn how to start your own medical legal consulting business. The 16-video course is divided into 4 modules, each lasting two weeks, with a live Q&A with Dr. Feldman following each module.

If you want to begin this lucrative nonclinical full- or part-time consulting business, learn more by clicking this link. (This is NOT an affiliate link.)

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Feldman's Course
• Physicians Helping Attorneys (Helping Patients) Podcast
• How to Do a New Kind of Medical Legal Consulting as a Part Time Gig – 227
• NewScr!pt

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 281

Why You Must Consider Starting a Medical Legal Consulting Businesses

- Interview with Dr. Armin Feldman

John: About exactly a year ago, I had today's guest on my podcast for the first time, and I was really interested and enthralled by the conversation because what he discussed was something I had never really been aware had existed. And since that time, he's been doing some new things, he's been increasing the availability to teaching other physicians to do what he's done. So, I want to welcome back Dr. Armin Feldman. Thanks for being here today.

Dr. Armin Feldman: It's a pleasure, John. It's always good to see you and it's always fun to be on your podcast. Instead of just listening, I actually get to do one.

John: Yes, I always find it fun to be a guest on another podcast. It's just like a normal conversation, just getting to know somebody. So, it's a lot of fun. You were on last time, about a year ago, and we were talking about this career that you have had for the last 15 or more years and a career teaching others to do it. So just tell us what that is and then you can segue a little bit into what's kind of new with what you've been doing.

Dr. Armin Feldman: Okay, great. As you know I do medical legal consulting. And what that really means is I work as a medical consultant in legal cases. I don't work as a medical expert. I'm working pre-trial, pre-litigation on those approximately nine out of 10 cases that these attorneys negotiate and settle. So, we work as medical legal consultants on the strategic development of medical issues in legal cases. And we're primarily working with personal injury and worker's compensation attorneys who work on the claimant side.

Now, although I'll say that any physician in any specialty can learn how to do this work. As you know, I owned outpatient head injury rehabilitation clinics around the country. I was fortunate enough to sell them. Thinking about what I wanted to do next. This was 15 years ago. I had testified as an expert witness more times than I want to remember, and I was thinking about what to do next, I thought maybe I could consult attorneys on any kind of medical question that comes up in a case. And I guess now the rest is history.

I've done over 3,000 cases. 13 years ago, I started training other physicians how to do this kind of work. And I've now through my coaching program, my conferences, my online training, I've now trained a little over 1,600 physicians around the country. We always work on the side of what I call the little guy going up against the insurance companies. These are injured people, injured no fault of their own, who then need to acquire legal counsel to get the appropriate damages and more importantly, from our point of view, to get the medical care that they really need. And this kind of consulting, really, in a formalized way was not done until I started doing this years ago.

John: Okay. That is definitely a different kind of animal from the usual expert witness consulting. And so, I want to tell you the way I look at it, some of the differences between this medical legal consulting and expert witness. And you can tell me if I'm right or you can add to it. So, let's do that. The expert witness generally is going to be involved in either a chart review, case review, and or a deposition rarely, and then even less rarely, testifying in court. And from my understanding the second two of those never happen in medical legal consulting that you do. Is that correct?

Dr. Armin Feldman: Yes, that's right. Another big difference is obviously if you're working as a medical expert in a legal case, you're working in your specific field. As a medical legal consultant, you're a generalist. You're answering any kind of medical question that comes up in a case. And our legal system allows and actually encourages this. A physician can answer medical questions in legal cases. And what makes what we do viable in many ways, is not only are these cases negotiated and settled, but we always back up our medical opinions with evidence from the medical literature.

In fact, when I first started doing this, my reports would go over to opposing counsel and the opposing counsel would call the attorney that hired me and say, "Why should I pay any attention to this? Dr. Feldman isn't an expert in, whatever, rotator cuff injuries." And the attorney would say, "Well, Dr. Feldman acts as a medical consultant for me in my cases, and if we can't get this negotiated and settled and you forced me to take it to trial, when I hire my retained orthopedic specialist, they're going to say exactly what Dr. Feldman said in his report. In fact, Dr. Feldman is relying on the same medical literature that my medical expert will rely on."

John: Yes. Very interesting. So, let me distinguish another thing here. Medical experts generally are still in active practice, not a hundred percent, but most of them are. And it's usually sort of expected. In this situation, do most of the people doing this, the physicians doing what you do, are still in practice? Still in practice, not in practice. Some are, some aren't. What's that like?

Dr. Armin Feldman: Some are, some aren't. But I'll tell you the majority are. Some physicians do this full-time. Some do it in lieu of retiring, but the vast majority of physicians do it as a part-time gig and they continue to do clinical work, and then they add this piece of nonclinical work to what they're doing. So, most of them are practicing.

John: Okay, good.

Dr. Armin Feldman: It makes a nice transition too for people that want to transition to nonclinical medicine. You can do it on a part-time basis. What I always say is you really need to have a minimum of about eight hours a week in order to do this justice and make it fly. And then from there, you can do it as many hours a week as you see fit and as you enjoy it and build up your medical legal consulting business.

John: Now, it seems that for the physicians that I know that do expert witness consulting, the rate of pay is significantly above their usual clinical pay unless there's some very subspecialized thing. A lot of them, when they do the expert witness, they will like you said, do that part-time too, work fewer hours, generate enough that they can cut back on their clinical. Would you say the same is true of this aspect?

Dr. Armin Feldman: Yes.

John: Okay.

Dr. Armin Feldman: Both things are true. Yes. The remuneration is handsome, and it does allow you to cut back on your clinical work.

John: Okay. Now I know that you have been teaching this and coaching people and so forth. I'm kind of interested in maybe a high-level view of what it would take for a physician to do this. What kind of training, what do they need to learn to do this? You can obviously get into much detail, but what kind of things are important in doing this kind of career?

Dr. Armin Feldman: Yes. I think for me and for the physicians that do this, this is what makes it interesting is that there are really two skill sets that you need to learn. One, of course, is you need to learn the medicine that you need to know to do this. Now you can do that as on the job without training. And when I say the medicine, you also need to understand how the legal system works, how law offices work, what things to do, what things to watch out for.

And I often tell physicians that are in my coaching program, my training program, almost everything that I teach is based on mistakes that I made over the years that you won't have to make. That's part one. And part two is you have to learn how to successfully not only start up, but successfully run a long term medical legal consulting business.

And the training is really on both of those things. So how do you go from zero, no business to up and running with your medical legal consulting business? How do you market that business? Meaning how do you get your attorney clients, how do you keep them long term? How do you operate your medical legal consulting business on a daily basis? That kind of thing. And then on the other side, how do you write the reports? What goes into the reports? What are the services that you're going to offer? Medical service, medical consultation services you're going to offer, and so forth.

John: Yeah, there's a lot of nitty gritty in there. I think I gathered from our last conversation and from listening to your podcast, which you can mention here in a minute. As a physician, we can understand what goes into a particular case. Doing this, you would've to research and oftentimes share that with the attorney you're working with. But like you said, it's something that each case is a little different. And so, I think the training that you've done in the coaching shows people how to do that too, how to collect that and put it together for the attorney.

Dr. Armin Feldman: Yes, yes. There are actually 15, 16, 17 different types of services that I've developed for attorneys over the years. And so, every case is a little different. Every kind of service you're going to offer is different. So, for example, one attorney may want you to put together a comprehensive medical summary report that talks about the entire case, the medical damages in the case, the future medicals that are going to be needed and so forth that they'll submit with a settlement demand, a letter.

Another attorney may want you to do liaison with a treating doctor. Let's say the person develops severe migraine headaches after being rear-ended in the accident. And you get to the medical records and they had some headaches five years ago. And so, you might need to talk with the injured person's PCP or gynecologist or whatever, and say, "Hey, that headache that you treated them for five years ago, is that really a preexisting condition? Was that something different than what, well, I would call them a client, but their patient is experiencing now?

John: Okay.

Dr. Armin Feldman: A client of the attorney. There are a wide variety of services that you can provide as a medical legal consultant. That will depend on what the attorney wants, what the case indicates, and so forth. You're speaking about medical expert work. One thing that makes it different is our average case takes maybe somewhere between five and 12 hours. It's not as involved as being a medical expert. I would say probably maybe 80%, 85% of the time you're going to be writing a report. And that report, it's not behind the scenes. They'll be seen by insurance adjusters. They'll certainly be seen by opposing counsel in every case. They're often seen by judges treating doctors, IME doctors and others.

John: Very good. You are kind of really filling an important niche, an important step in this process. And like you said, most of the time they don't go to any kind of trial which most attorneys try to settle, almost every case at least in my recollection. One of the things I want to mention or ask you earlier, because you're so passionate about this, you spend so much time developing this, it's like a new specialty. And so, why do you love this so much? Why do you like this? You seem very enthusiastic.

Dr. Armin Feldman: Yes. Well, that's a good question. And I think the absolute bottom line on that is, I think as physicians, one of the big reasons we all get into doing this is we want to help people. And this is a way that you can really, really help injure people in a way that they never had helped like this before in a nonclinical setting. And you get to see the tangible results of that help. The other thing is, if you love medicine, when you were in medical school, if you were enthused about it and you love medicine. This is a way to get involved in all kinds of various aspects of medicine and learn. Of course, the attorneys are paying you to do your research, but learn about all kinds of very interesting things.

Now, obviously, I'm in no position to do any orthopedic or neurosurgery, but I would put my knowledge base of spine injuries, rotator cuff injuries, complex regional pain syndrome, you name it, up against anybody because this is what I do day in and day out. I learn about various things that have come up in accidents and then what are the conditions? How do you treat them and stay up to date on all of the medicine?

I'll tell you a very quick story. I was talking to an attorney client last week and he said, "Hey, I have a case in which a woman developed a very bad hiatal hernia and esophageal reflux after being reared. She had two surgeries. She still can't swallow properly. Is that accident related?" And I said, "Well you don't know this, but I've done over 3,000 cases. Nobody has asked me that before." And so, I said, "I don't know if that's the case or not, but I'll go do some research for you."

I did that research, and sure enough it's well documented in the medical literature that trauma, and sometimes in some of these articles specifically, auto accident trauma can cause... I thought it would have to do with physical wrenching, but actually has more to do with internal pressure that's developed in the abdomen and pushes on the diaphragm and tears it.

And so, I was able to go back to this attorney and say, "Hey, yeah, you got a case here. Let me do some more research on this and write it up." And I was kind of thrilled because I learned something new, that physical trauma like this could actually cause these kinds of problems. And that was a damage in the case that this poor woman needed to be compensated for and get treatment for.

John: I bet even though your family and other friends know that you're maybe not practicing, I bet they still come to you with all the medical questions.

Dr. Armin Feldman: My sister-in-law flew in from Minneapolis for the annual Christmas cookie baking experience here in our house with my wife and her other sister who lives in Boulder. And she showed me, she twisted her ankle before she came. She asked me to take a look at her ankle. And I had some suggestions for her.

John: Of course, you did. Yeah. Excellent. All right, now I want to learn more about how we can learn more from you in various ways. And let's talk about the podcast for a minute. I believe that was developed really for attorneys, perhaps, but I think it can be useful to anyone who's thinking about doing this kind of work.

Dr. Armin Feldman: Yes. I developed this podcast with one of my former students who is Dr. Michael Bummer in Pittsburgh. He is just going gangbusters. I'm doing medical legal consulting, and he's a smart and awfully nice guy. We teamed up and we're doing this podcast. It's called Physicians Helping Attorneys Helping People. The URL is physicianshelpingattorneys.com or any place where you listen to podcasts. But it was initially intended for attorneys so they could understand this better because like you said, it's a new field. But what I've learned is that there are a number of physicians that actually also tune in to the podcast and as you suggested, John, particularly physicians that might be interested in learning to do this kind of work.

John: Yes. The podcast, it's not been out all that long, but I had at least a dozen episodes that I listened to while I was on a recent trip. Yeah, it really helped clarify for me really what you do. And it was nice hearing the cases that you described in the podcast because it just makes it more real. If there's someone listening, and again, my audience typically are physicians thinking about various nonclinical careers or pseudo clinical careers, part-time side gigs and all that. So, this definitely fits into that. And just listening to the podcast will give you a much better understanding of what we're talking about in this short interview today.

Dr. Armin Feldman: Great.

John: Yes. But now you also have an even more direct way of helping us learn how to do this. I know you've been sort of coaching and teaching for a long time. Tell us what's new in that venue.

Dr. Armin Feldman: Right. Yes, that's right. I do have a training program, coaching program that physicians have been participating in for years. Last year I started a new online course, and this is really a crash course in how to do medical legal consulting. It's all online, do it at your own pace. And the next run of this course is coming up on January 30th, 2023.

The course is 16 videos. The course is broken into four modules of two weeks each. So, only four videos every two weeks. It's really tailored for a physician schedule. You can certainly watch four videos in two weeks. And the associated downloadable materials for each topic is there for you.

And then at the end of each two-week module, I do a live Q&A where everyone participating in the online course can save up their questions over those two weeks and I'll answer questions for an hour. The course is worth 15 category one CMEs.

John: That helps.

Dr. Armin Feldman: Yeah, it does help. I'm happy to say that the first two rounds of the online course were well received. I'm happy to say the technology actually worked. No problems there. And so, I'm expecting a nice turnout for run number three starting in January.

John: Well, I can't wait because I did sign up for the course.

Dr. Armin Feldman: Yes, you did.

John: If you knew that or not. But I'm going to tell my listeners, look, I'm going to put my money where my mouth is and I'm not an affiliate for this thing. I just think it's so interesting that I'm going to take the course and ask you a few questions. So, if anyone wants to join me, just let me know that you've joined and we'll be in it together.

Dr. Armin Feldman: Oh, that's just great. That's just great. When you're running an online course like that and it's on-demand videos, it's so nice to do a live Q&A because you actually get to interact with the physicians that are in the course, answer their questions and get to know who's actually taking the course.

John: Yeah, that's great. And I've got some courses online, but I'm currently not doing a live version of any of it, including a Q&A. That sounds like it's definitely a value and will help the students immensely.

Dr. Armin Feldman: Yeah. In fact, one thing I say right at the beginning is when you finish this course, you will have all of the tools and all of the instructions that you need to go out and actually do this. It's not just a cursory introduction. It's, "Hey, here's how you do it."

John: Yeah. I think that people, professionals that have made a decision to change and to do some coursework or something, they really want to get into the details. They want to know "Do I have everything I needed? If I truly want to do this, I can do it." And so, I know other course creators that do the same thing, and it's always well received. So, I've got to hand it to you.

Dr. Armin Feldman: Good.

John: All right. Is there anything else you need us to know? We talked about the podcast, the course. Either any other information or just advice for us? You've talked to a lot of physicians who've done transition.

Dr. Armin Feldman: Yeah. I think if you love medicine and you want to learn a lot about medicine, help people, injured people that really need this help, I don't want to sound too grandiose about this, but help the lawyers and help our legal system to some degree who are looking for some kind of nonclinical work, that you can sink your teeth into, and know that not only is it going to be helpful in terms of the income, but also helping people and something that's fun and you can enjoy, then this is something that you should consider.

John: I get a lot of people that are just early in the course of trying to find something new to do and they feel like "I've wasted my education or I'm not going to be helping people." But this is another really excellent example where "No, you are going to be using your education a lot." Reading these research papers, trying to figure out which ones really apply to this case, learning something new, because we're not all experts in every field, but we have that medical background and you're helping somebody. It's not so much that you're helping the attorney, it's the next level, which there's a patient behind that attorney that maybe has been unjustly denied certain services or treatment. Again, it's just a great thing to do and it keeps us still the mind going and using our medical skills.

Dr. Armin Feldman: Yeah. Right, right. That case I mentioned earlier, her medical bill so far to date had been denied by her own insurance company. And that's why she had to hire the attorney. And now that attorney is going to help her to say, "Oh, no, no, this was accident related."

John: Excellent. Yeah. And I bet you had a real sense of accomplishment when you discovered that, in fact, that's a real thing.

Dr. Armin Feldman: Yeah. Right. That's true. Yeah.

John: All right. Well, I really want to thank you again for being here, Armin. This has been fun. I'm going to get the word out to my listeners about this and we'll see what happens. But I hope all the best for the coming year with this iteration of your course, and I'm sure it gets better every year.

Dr. Armin Feldman: Yeah. Thank you. Thank you, John. You always ask such good questions too.

John: All right. That's because I'm really interested. So, thanks again and I'll be looking forward to seeing how things go with your course.

Dr. Armin Feldman: Great.

John: Bye-bye.

Dr. Armin Feldman: Bye.

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The post Why You Must Consider Starting a Medical Legal Consulting Business – 281 appeared first on NonClinical Physicians.

Podcast listeners ofter ask about engaging a physician career coach. They have heard that coaching can substantially improve the chances of finding a nonclinical career.

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We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

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By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Which Physician Career Coach Is Suitable for You?

We'll start by listing the career coaches who have appeared on the podcast. As noted in the discussion, some of them have special expertise that can be helpful. I have included a link to each episode below.

A coach is an expert who is hired to help you solve a certain problem, for example, to find a new job. – Dr. John Jurica

Physician Career Coach Guests

Here is a list of the 23 physician career coaches, who are physicians themselves, who have appeared on the Physician Nonclinical Career Podcast:

1. Michelle Mudge-Riley
2. Heather Fork
3. Maiysha Clairborne
4. Laura McKain
5. Dike Drummond
6. Starla Fitch
7. Marjorie Stiegler
8. Jarret Patton
9. Mike Woo-Ming
10. Dianne Ansari-Winn
11. Michelle Bailey
12. Errin Weisman
13. Francis Yoo (soul coach)
14. Jonathan Vitale (home-based careers)
15. Jattu Senesie
16. Yvonne Ator
17. Ryan Bayley
18. Randall (Randy) Cook
19. Nerissa Kreher (pharma)
20. Stephanie Freeman (locums)
21. Mario Mendoza (biotech careers coach)
22. Nana Korsah
23. Charmaine Gregory

[BONUS Physician Coach: Andrew Tisser. He has interviewed me twice but has not been a guest on the PNC Podcast. I plan to bring him onto the podcast soon. – JJ]

Nonphysician Coaches

Here are two, very capable nonphysicians who coach physicians:

• Charlotte Weeks
• Marsha Caton

As you can see, the number of experienced physician career coaches is large and growing. Luckily, a career as a physician coach is fulfilling and popular.

Next Week's Episode

Part 2  of this discussion will be presented next week. In it, I will list the three directories that offer lists of physician coaches. And, I will describe my advice on how to find, evaluate, and hire your own coach.

Summary

A physician career coach can be a valuable partner in your career transition. In the past, coaches were sometimes difficult to find. Now there are many well-trained and successful coaches available. Therefore, it is often worthwhile to hire a physician career coach to help advance your career.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

“Iconic” Physician Coaches

• How to Survive the 5 Stages of Career Transformation with Michelle Mudge-Riley – 055
• Personality Types and Physician Burnout with Heather Fork
• How Does Mind Remapping Help with Nonclinical Career Transition? – 212
• How Does a Physician Land a Pharma Clinical Development Job? – Interview with Dr. Laua McKain – 214
• Root Causes of Physician Burnout – Interview with Dr. Dike Drummond – 028
• Why You Need to Get an Executive Coach Now – Interview with Dr. Marjorie Stiegler – 102
• How to Employ Powerful Online Strategies with Dr. Marjorie Stiegler – 084
• This Coach Is the Ultimate Physician Advocate – Interview with Dr. Jarret Patton – 118
• How to Build a Terrific Freelance Consulting Business – Interview with Dr. Mike Woo-Ming – 145
• How to Help Committed Colleagues Heal the World Interview with Dr. Dianne Ansari-Winn – 186
• The Interesting Life of the Professional Development Coach with Dr. Ryan Bayley – 064
• Dr. Charmaine Gregory Ends Burnout Through Health and Fitness Coaching – 030

“Recently” Discovered

• Should I Work for a Contract Research Organization? Interview with Michelle Bailey – 124
• How to Go From Burnout to BadAss Interview with Dr. Errin Weisman – 150
• To Pursue Freedom Tomorrow You Must Imagine Your Eulogy Today – Interview with Dr. Fancis Yoo – 192
• How to Find a Top Remote Nonclinical Career – Interview with Dr. Jonathan Vitale – 188
• 5 Big Steps on the Path to Career Success – Interview with Dr. Jattu Senesie – 104
• How This Survivor is Helping the Helpers Thrive – Interview with Dr. Yvonne Ator – 103
• Top Reasons Why Coaching Is So Essential for Healthcare Leaders – Interview with Dr. Randy Cook – 197
• How to Claim Your First Job in Industry – Interview with Dr. Nerissa Kreher – 168
• Why Locum Tenens Is the Best Way to Practice on Your Own Terms – Interview with Dr. Stephanie Freeman – 202
• How to Find a Job in Pharma That You Love – Interview with Dr. Mario Mendoza – 184
• How to Free Yourself Using Locums and Coaching with Dr. Nana Korsah – 074
• How to Be a Remarkable Resume Writer – Interview with Charlotte Weeks – 136
• Use These Simple Tactics to Land a Fantastic First Pharma Job – Interview with Dr. Marsha Caton – 209
• Dr. Andrew Tisser's Website

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 215

How Do I Hire a Suitable Physician Career Coach or Consultant?

John: Today I want to respond to listeners who send me emails asking about coaches. I get a lot of these really. Usually there are questions encompassing one or more of these concerns - Should I use a coach? Where do I find a coach? A coach is expensive. What do they usually charge? Do you recommend certain coaches?

I've spoken on the podcast in the past about coaching and how it fits in with mentors and online courses. And in the process of doing the podcast, I have interviewed approximately 40 coaches, although not all of them were career coaches, which is what I'm focusing on today. And some of the coaches also came on to talk about a topic completely different from coaching. So, we'll get into that in a little bit.

Since I'm not a certified coach and I don't provide regular coaching myself at the present time, I don't want to lead you as strained to your decision to hire a coach. But after observing my coaching colleagues, what they do and the great results they get, I do have some opinions about whether to engage and how to engage a coach.

Now, the first thing I want to do is define this topic of coaching, what is coaching. Just giving people advice is not coaching. Being a mentor is not the same as being a coach. And I've written about that and talked about that before. And in a nutshell, a mentor is usually free, usually informal, it could be ongoing. And a mentor is usually there to provide free direction advice, have you avoided landmines, and is really geared towards your growth and development long term.

A coach on the other hand is usually a paid person who may have certain certifications, who is engaged to help you solve a certain problem. Just like an athletic coach, a swing coach for tennis or golf or pitching coach or something like that, they're usually going to focus on a certain thing. What we're talking about is coaches who are focused on careers mostly. Although in the physician world, we have burnout coaches, wellness coaches, life coaches, business coaches, professional coaches, career coaches. There are probably at least six other designations. And many of these actually overlap quite a bit.

But let me quote something I pulled off the Physician Coaching Alliance website. I hope they don't mind. It's a definition that incorporates part of the International

Coaching Federation or ICF. Let me read that to you.

"Broadly a coach supports his or her clients as a work through a problem or issue. More specifically, a coach creates time and space for an individual or group to increase awareness and clarity around their habits and strengths to move towards a more idealized vision of themselves.

The International Coaching Federation defines coaching as "partnership with clients in a thought provoking and creative process that inspires them to maximize their personal and professional potential, which is particularly important in today's uncertain and complex environment".

A coach is different from a counselor, mentor or therapist. A coach guides a client through a process of self-discovery. However, the client, not the coach, is in the area to be coached on. The coach is there to act as a mirror for the client".

That's the end of the quote from the Physician Coaching Alliance. I think it's a good definition and it's kind of the classic version of a coach, which is almost like a therapist. It's more than mentoring. It's distinct from consulting and it's not therapy. But notice how the definition includes language that sounds like therapy. It makes it sound like the growth is going to come from within the coachee, it's not coming from advice or a direct list of things to do by the coach. As you get more directive, I think that fits the definition of a consultant a little bit more than of a coach.

But anyway, the other thing is that therapy is used to treat an illness obviously, and coaching is used to actualize a client, assist them in reaching a professional or personal goal or help them overcome a problem. The terminology can get confusing at times because you may have heard there are career coaches, consultants and career strategists. And I'm not sure whether that moniker makes much difference really. People will use it in different ways. And I guess I wouldn't be too concerned about that.

What is important is whether you can find a coach, if you decide to use one that really aligns with what you need, your personality and has the skills to help you advance your career. So, you need to use one that aligns with your values basically, and also has a personality that aligns with yours.

One of the things that I can do that might help you to find a coach is to provide you a list of the coaches that I've interviewed, because I can't vouch for them to some extent. And the other thing is if you're looking for a coach and you'd like to hear the philosophy of a coach, or at least hear them talk and see them and or hear their voice and get a sense of how they relate to people in a conversation, then by all means that might be helpful as you're looking to select a coach.

I've got a list I'm going to go through today. I've checked and confirmed that each of them is still coaching, at least until recently. You never know when things are going to change. And for each of those that I mentioned today, I'm going to put a link so you can go and link to that episode and listen to it if you like.

I think listening to the interview will help you to learn a little bit more about that coach or consultant. And realize again that during the interview, we may not be talking about coaching specifically. We may be talking about a topic that is tangential to coaching because some of the coaches are experts in different areas, and that's why I brought them on the podcast. But invariably, we're usually at least talking a little bit about the kind of coaching they do and what they look for in terms of aligning with their clients when they are coaching, but not in all cases.

So, here's a list of the coaches I believe you might check out after maybe listening to the podcast episodes. I apologize before we get started to anybody that has been on my podcast once or maybe twice even. I don't think I missed anybody that has been on twice, but if you're a coach and you're doing career coaching and I didn't include you is because I'm under the impression maybe that you're mostly doing wellness coaching or burnout coaching, or some other version of coaching. So, I'm happy if you contact me, call me, or send me an email at john.jurica.md@gmail.com. Let me know that I missed you, and I will be happy to add you on my blog. I'd be happy to mention you in one of my upcoming podcasts, let's put it that way.

So, here's a list of about 20 or so that I can go down and just make a comment about each one. And let's see if this rings a bell, or if any of these would relate to you and work with you in a good way.

Michelle Mudge-Riley is one of the longest working coaches around. These are all physicians the next 20 or so that I'm going to list after Michelle Mudge-Riley. I don't think she does a lot of individual coaching now. She does at least two or three online or live conferences a year. Physicians Helping Physicians - phphysicians.com is her website. She has been around a long time and she has helped a lot of people.

Heather Fork, she is iconic also in coaching. She has been doing it for at least 10 years. She has been on my podcast at least twice. She and I are pretty good friends. We have a lot in common. She creates a lot of good things and I refer her to people all the time. She has gotten into podcasting lately. I think Michelle Mudge-Riley also has a podcast. She has something that she sells for helping you write a resume, which is awesome.

Maiysha Clairborne, of course. I've had her on my podcast two or three times. She has her own podcast. She has done a lot of coaching. She does consulting, she does courses. She is an expert in basically branding and Facebook Ads and building an online business. She's got a new podcast that I mentioned an episode or two ago. She is a great one to look for resources, although she still does some one-on-one coaching. She also teaches people mainly doing coaching and or NLP, which is Neuro Linguistic Programming and mind mapping, she calls it. There is a lot going on with Maiysha.

Laura McKain, the founder of the Physician Nonclinical Careers Hunters Facebook group. She is doing coaching now more than ever because she retired from her pharma job. Although I think she's still doing consulting. She's got the Facebook group and she's expanding that and really spending more time on that. She's an expert in resume writing and she does a lot of that with people. And I actually have a recent episode just released a week or two ago with her.

Dike Drummond. He has been on the podcast once. It's been a long time, but he was fascinating. And most of you know him as The Happy MD. He also tends to associate with other coaches that are on his list of referrals where you can go at his website, which I'll talk about in a minute. He is a coach that focuses on really helping physicians stay in their practice. Most of his coaching clients have been able to stay in practice. Now they may have changed to a different practice, different location or different type of practice but he has been very successful and he's well known. He's been around for a long time.

Starla Fitch is another physician coach for physicians who's been around a long time. I've referred several people to her, so you can look her up. She is often in the Facebook group interacting with many of these people that I've mentioned so far.

Marjorie Stiegler. She hasn't been around quite as long. She does some individual coaching, I believe. She has courses, she is devoted a lot to careers though, and she focuses a lot on pharma careers.

Jarret Patton. Jarret is a great guy, a great coach, and a great physician. He tends to focus on those things that are related more to the legal or license related. If a physician really is forced to stop practicing for some reason, although he works with everybody really. He has written a book "Licensed to Live". His podcast is "Licensed to Live". He had a conference in Philadelphia recently where I spoke. Again, listen to his podcast. He's one that will do some individual coaching as well.

Now I'm going to list Mike Woo-Ming here. Mike and I kind of see eye to eye on this next topic I'm going to talk about for a minute. He likes to call himself more of a consultant than a coach. It's a fuzzy line. And I think I tend to fall on the consulting side more than the coaching side, meaning that I think both of us tend to want to get into the "how to" make changes and "how to" move your careers forward.

And particularly for him, careers involved in entrepreneurship and starting your own practice, cash-based practices, things like that. And if you need a plan, he's going to tell you the plan to follow and the process to follow to be successful. Now that's a little bit different from a classically trained coach who will use more of a therapy-like approach in terms of asking you questions and getting you to think more and to develop your own "Aha" moments. But again, all coaches and consultants do a little bit of both.

Mike Woo-Ming also has a directory I'm going to mention in a minute. His resources can be quite helpful. I don't think he does a ton of one-on-one coaching, although he does a lot of consulting still, depending on how you wanted to define that.

Dianne Ansari-Winn actually is another one that has been around for years. She has written a book, she has been coaching for a long time, and now she is teaching others how to coach as well. I had her on the podcast not too long ago.

Michelle Bailey. Now I'm moving more into the physicians who are a little bit in that second wave of coaches. The first 9 or 10 are concerned to be more seasoned. They're not really that old, but this next group is really some more recent physician coaches. Now they're all very experienced. We're talking anywhere from three to five years and they've been around and done a lot of work, but I'm moving into that. Michelle Bailey is one who was a pediatrician. She has been on the podcast and she's certainly working with individual physicians and working on their careers.

Errin Weisman is an excellent coach. She has at least two podcasts that she does. She also runs a directory or a group of her own. I guess I shouldn't say it's hers. I'm not sure exactly the structure of it, but she happens to be the CEO of it right now. And I'll talk about that in a minute, but she's an excellent coach and she's got a great, like I said, a podcast or two.

Andrew Tisser. He has been on my podcast at least twice. He's definitely a career coach. He does a lot of work with physicians moving from burnout to overcoming the mindset issues and really moving out of clinical medicine into nonclinical. But he'll help physicians with any kind of transition related to their career. Many of these physicians will do that.

I have to mention Francis Yoo. He calls himself a coach of the soul. He definitely helps physicians' transition. He tends to spend more time on finding meaning in life and that kind of thing, but he definitely can help you if you need a coach to help move you from a really unfulfilling and unsatisfying career to one that brings you more joy.

Jonathan Vitale is another one. He is actually trained as a therapist. I think he's got a degree and maybe is even licensed as a therapist in the past. But he uses that knowledge and his work as a family physician to help physicians. He's got a large Facebook group. He tends to focus a little bit more on home-based careers, which is what his Facebook group is about, but I think he can help with almost any career transition.

Ryan Bayley, I've known him for two or three years. I have interviewed him and was introduced to him by Michelle Mudge-Riley. He's a physician who has been doing a lot of professional and business coaching for physicians, but he also does career coaching. And he also addresses burnout and provides training for hospitals and large institutions to help prevent physician burnout. But he's definitely an advocate for physicians.

Randall Cook, or Randy Cook. I met him through the DPN, the Doctor Podcast Network. He's a fellow podcaster and he works at a coaching company. So, you can look up his episode and if you like what he does, you can contact him. I think he's definitely taking new clients.

Dr. Nerissa Kreher. She's in the pharma industry. She tends to focus on that, but she's an excellent coach and she has courses and coaching and different programs for physicians who want to move into pharma. As does Mario Mendoza, although he calls himself a biotech careers coach, but a lot of that is in pharma. And he does an excellent job as well. You can listen to his very interesting story.

Stephanie Freeman. She's a career coach. She tends to focus a lot on locums. And you'll find that if you listen to the episode. She is really a promoter of locums as sort of a lifestyle choice and an alternative for physicians, but she'll help anybody that needs career assistance, career strategies.

Nana Korsah. Another doctor nephrologist who has done a lot of different things. She has been coaching for several years. And so, you might want to listen to that episode.

Charmaine Gregory. I interviewed her way back three or four years ago. She is still speaking and coaching and writing and podcasting. And I think she falls more in the category of wellness and life coach, but she also helps with career transition.

I've also interviewed at least two people who are coaches for physicians who they're not physicians. One is Charlotte Weeks. I think I've interviewed her at least twice. She's also presented in my Nonclinical Career Academy. Basically, she is a career coach and resume expert. She has got multiple certifications. She has helped many physicians, but she also helps other professionals. If you go to that episode, you can get all the details or in the show notes.

And then Marsha Caton. She is a recent guest who is a PhD and works in pharma and she helps physicians and other professionals move into pharma jobs if they're not already in those. And I assume that includes people like pharmacists and other PhDs, but definitely physicians are her expertise. She's got a particular way to help physicians make that transition.

Those are the main ones I can really think of today. And you know what? I actually have a whole lot more to say on this topic, and I think it's going to go too long. So, I am going to stop at that point. And then I will pick this up in episode number 216 a week from now, and I'll finish it up.

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Is it possible to establish a concierge practice while still in training? Dr. Brook Choulet is still in her child and adolescent psychiatry fellowship and runs a growing practice in Scottsdale Arizona.

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How to Establish a Concierge Practice 

Brook starts by explaining why she started her concierge practice. Then she explains how she boot-strapped the practice, starting with just one associate, while still in residency. She also explains the basic steps, from forming an LLC to finding her first location to see patients.

Just go for it… If I can do it with very little experience… then I have no doubt anyone can do it at any stage of their career. – Dr. Brook Choulet

We also discuss which other specialties would work best in a concierge model like hers. She runs a cash-only practice and is funding the growth of the business organically. And she explains how this model eliminates most of the headaches of typical employment.

Growing Her Business

Brook has hired therapists and wellness experts to meet the needs of her patients and clients. She started by sharing office space and has now moved the business into a dedicated office. The practice is now expanding to a second location.

Summary

If a psychiatric resident can open a concierge practice, certainly other physicians should explore this type of practice. It generally provides for a more balanced lifestyle that can also be quite lucrative. As the physician shortage grows, and insurance deductibles increase, patients will be more willing to use a direct-pay model to meet their healthcare needs.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

• Choulet Wellness
• Brook Choulet MD Website
• Dr. Brook Choulet's LinkedIn Page
• Entrepreneur and Business Owner – Interview with Dr. Mike Woo-Ming – 019
• How to Help Committed Colleagues Heal the World – 186
• Can Meditation Offer Help for Burned-Out Physicians? – 172

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 210

Want to Establish a Concierge Practice Before Finishing Your Fellowship?

Interview with Dr. Brook Choulet

John: When we as physicians become bored or frustrated with our practice or burnt out, our first instinct might be to leave clinical medicine. But we should stop to consider whether a different boss or maybe different partners or a different department in a big company or a different corporation or practice setting itself might be a really effective alternative. I know we talk about nonclinical careers here, but definitely non-traditional practice is another alternative. So, today we're speaking with a physician who has created a practice that avoids many of the traps of corporate medicine while she's still in training, if you can believe that. So, Dr. Brook Choulet, welcome to the podcast.

Dr. Brook Choulet: Thank you so much for having me here today.

John: Once I heard your story and I was talking with Brent Lacey, one of my podcasting friends, I thought this is really interesting because the things that you've implemented, I think are very instructive for many physicians who maybe feel trapped. And I thought, "Wow, this will be very good to share". Before we get into the specifics, why don't you tell us a little bit about your background and education?

Dr. Brook Choulet: Sure. I grew up in Cleveland, Ohio. And after many winters, my family moved to California. I finished high school in California, and then I ended up going to Kansas City, Missouri for the six-year bachelor MD program. My mom had actually done the same program and she really thought it was valuable and a good use of time. So, I was excited to head out there. I spent several winters again in Kansas City, and then I matched out in Phoenix for adult psychiatry residency at the University of Arizona College of Medicine, Phoenix. I did three years there, and then I transitioned to a child and adolescent psychiatry fellowship. And I'm currently in my last year of fellowship.

John: Awesome. That should be keeping you pretty busy but I think you have some other what we might call a side hustle or side gigs that you've been doing. Why don't you tell us what those are?

Dr. Brook Choulet: Sure, just to name a few. The first thing I did when the pandemic hit was I used some of that downtime when the clinic was in transition and residency to become a real estate agent. And that initially took me about a month and a half to complete that process and get my Arizona real estate license.

Then I started kind of thinking about what I wanted to do with the rest of my life after I was done with training and really decided I wanted to build a practice where things were on my terms and not the insurance company's terms. And I could actually spend time with my patients and spend valuable time hearing what was going on, hearing what their current life situation is. And that really led me to build this concierge psychiatry practice out here in Scottsdale. I started working on that in residency and it kind of took off from there.

John: Help define for us what concierge psychiatry would be?

Dr. Brook Choulet: Sure. There are a lot of different definitions of what concierge medicine is. I think to a lot of people, they might assume that it's a membership-based practice where you pay a retainer or you pay a certain monthly fee for access to the clinic. I think that psychiatry is such a unique field where you really have to connect with the person and the physician that you're going to. I wanted to avoid that model and I ended up just choosing a fee for service hourly rate model to really give not only the patients flexibility of where they wanted to get their treatment but also to make it more approachable for many patients who might struggle with the thought of a large retainer or membership-based fee.

John: Okay. That's awesome. And listeners, I want to make it clear. We are not going to go back and talk about real estate today. We're going to be talking about this aspect of concierge practice and maybe the general topic of just designing a practice that really meets your needs as a physician, rather than being sucked into corporate medicine, I guess, as some of us call it.

So, your concierge model is you have an hourly rate and you deal directly with patients. What about the payment? Is there any middleman in that payment model or not?

Dr. Brook Choulet: The clinic collects payments directly through credit card, we use Square and we use an EMR system where actually Square is integrated into the EMR system. So, there are actually no manual payments being run. You can set up a service, set up the price for it. And an hour after that visit it automatically charges for that service fee. And it really cuts out even anyone in the clinic having to run cards.

John: There's no billing per se or anything like that. Can patients take the information and then file a claim with their insurance company if they have one?

Dr. Brook Choulet: Yeah. There are a couple of companies out there. There are reimbursed five, better claims and they can assist kind of expediting that out of network claim, but that is up to the patient to do that part. The clinic is just responsible for providing that superbill.

John: That sounds like how it was maybe 30, 40 years ago when we would just have a paper, superbill and we would give it to the patient and say, "Well, this is what you owe us". And going through this, the rigmarole of trying to build these days, oftentimes even a small practice has hired like two or three people just to do that.

Dr. Brook Choulet: Yes, that is exactly why I looked at several different systems. And I really wanted to make things as efficient as possible, both on the clinic end and for the patients, because even nowadays I get invoices from outpatient clinics that are coming in paper mail, it has some access code. It wants you to go to a website, enter it, manually enter the payment. And for both the clinic and the patient, that seems really inefficient.

John: From what I know a practice like that is, like you said, it's more efficient and I use the word parsimonious, but you don't have to have a lot of staff to run it because you're spending the time with the patient generally and you have maybe a little bit of support. Tell us what that practice actually looks like in terms of staffing at this point.

Dr. Brook Choulet: We actually just went through a little bit of a hiccup, where the one staff we did have decided not to answer the phone and that's a pretty critical role in a clinic where we are providing such a high level of service. And so, we're currently in transition, but we have new staff starting on Monday. To answer your question, other than the physicians and the therapists that are talking directly to their patients, we just have one other staff member at all times.

John: There was a model in family medicine a while back, I forget what we called it, but it basically eliminated all the support. And there was actually a physician who was answering the phones, doing the billing, and running the EMR, but it was very limited and he spent basically 90% of his time seeing patients and didn't have to leave and have a receptionist, even though the office was open four or five days a week. There are ways of doing this in an efficient way that still serves patients very well. right.

I feel like there's still a lot of unknowns in how you put this together. How did this come about? You were in your residency, now you're in your fellowship. Maybe walk us through the steps, the "a-ha" moment, or what really inspired you to do this. And then what were some of the smaller steps in making this happen?

Dr. Brook Choulet: Sure. The smaller step is kind of what happened initially. That's building an LLC, getting a tax ID, opening a bank account. Kind of just some of those basic necessities of starting a business. Then you have to have your malpractice in place, consult some attorneys to figure out a business structure since there are so many different ways to structure a business. I think that's really critical. Without that step, you don't know where to go and don't know how to hire people. So, I think that was a big step.

And then really how this came about was almost random if you want to say. I had already started the practice myself, just seeing patients. I have an office and executive suites, very low overhead, just kind of doing my own thing. I was getting a facial and talking to the girl that was doing the facial about how unhappy she was in her current location. Just hearing some of the struggles she was going through. And I was talking to her about my desire or passion to build a large wellness center here.

We started talking and I kind of offered her a position on the spot. I'm like, I think it would be great if you join the center. I am not sure what I'm building yet, but I think you'd be a great addition. So, that's really the moment that put almost all the pressure on me. Like now I have to figure something out. I have to expand. Executive suites won't work because, in the state of Arizona, you need a sink and an aesthetician's room and executive suites don't have sinks. So, I started considering a larger plan. So, it really kind of grew from that point.

John: Okay. So, you're hitting on different things, mental health and then wellness and aesthetics. Has that grown from there to more services? You mentioned earlier like a therapist. So how does it kind of look now from the involvement of staff?

Dr. Brook Choulet: Initially it was really just me. Then I started talking to the facialist and then I started thinking, "Well, now we're focusing on mental and physical health and mind and body wellness and seeking inner peace and self-love and gratitude". So, I started thinking of what other services would be nice for that kind of space. Because right now, in Scottsdale at least, there are a lot of therapy clinics with a lot of therapists. And there are a lot of psychiatry clinics with psychiatrists, but there's no kind of wellness center with those two. And then separately, there are meds that fall on almost every block of Scottsdale. So, it grew into adding therapists, the facial aesthetician, a nutrition coach, and gathered this big team of people. And we're planning to move into a large space on north Scottsdale Road in November.

John: Okay. Is it the kind of thing where the patients will, and I guess clients if you're talking more of the med spa type thing, but they'll kind of self-select what they need and want? If you've got therapists, of course, there's going to be a lot of overlap with the psychiatry side of things. So, how do you anticipate that will work or has it worked?

Dr. Brook Choulet: Sure. I think a lot of times people have been calling saying, "I'm looking for a psychiatrist" and then you kind of triage them on the phone "Are you looking for medication management? Are you looking for therapy?" And then come to find out, maybe they meant therapy. So, I think the triaging part is really important because sometimes clients won't know what they're calling for. They'll just call because they want one of the services and then it's kind of our job to help match them to what they're looking for.

I think that's where that staff is really critical to the whole process because a lot of the private psychiatrists, at least here, will have all their new patient calls go to voicemail. And then they'll just answer them at the end of the day. But what I'm finding these days, as people want that kind of instant reward or instant kind of answer, so when they call, they really expect to talk to someone and that's something I wanted to provide.

John: Well, we all have our own experiences and our families and so forth where there's a need and when you need help, you need help. You want to get some kind of an answer or direction, even if the answer is "Well, we can't help you, but we can send you somewhere else". And it always amazed me why the psychiatrist didn't have closer relationships with therapists because invariably, oftentimes they're going to be making a referral, and pretty much they might give you a list or something and say, "Well, here pick one". It just doesn't make sense.

Dr. Brook Choulet: Right. I totally agree. It's much nicer for not only us because we know who the patient's seeing, we know kind of what their care looks like, but it's also nice that they can schedule their med check and then the next hour, they can see their therapist in the same office. One other reason I started considering some of those other services to add is that sometimes I have a lot of teens coming in and their parents are just usually waiting in the waiting room. So, if there's some other service they can be doing or preoccupying their time and making it a fun experience for them too, I think that's the ultimate bull.

John: How do you find time to organize and run this thing while you're in fellowship now? Or how did you do that when you were in your residency?

Dr. Brook Choulet: I now wake up very early. I go to bed very late. But pretty much outside of the hours where I was in residency year and fellowship, I'm constantly taking meetings on the phone, making sure admin stuff is running smoothly, making sure the people that are working at the clinic are happy because ultimately all I want is for this to be a happy positive environment where both the patients and the staff are really happy being there. That's my ultimate goal.

John: Now I'm going to digress for one minute because I forget sometimes that I have listeners who have never started a business. Maybe they went straight out of residency and they're working for somebody. And let me just run this by you. I mean, this is what I've done. If I want to start a business, I go to my accountant. I say I need an LLC or whatever structure you'd tell me. And I need a license to open a business in Illinois. And then I get an accountant to help me set up my books. That's basically it. Is that pretty much the same in Arizona?

Dr. Brook Choulet: It's pretty similar. Actually, what I tell all my friends too, who dabble in real estate or a side hustle or whatever it is, is make your own LLC. Don't pay someone else to do it. I think it took me a grand total of 25 minutes to fill out the form online. And you have an active LLC. Maybe in Arizona, they have a nice online system. I don't know what it is, but it was pretty simple. So, you do that, you talk to an accountant, you talk to an attorney and you open a bank account and you are kind of ready to roll.

John: Yeah. I think people think it's some kind of big mystery, but we have the benefit in most states in the United States that opening a business is easy. Now you still got to follow all the rules where it might get a little complicated later on. But if you have a good attorney and a good accountant, you can pretty much manage anything.

Dr. Brook Choulet: Right. And I tell people starting out too, if you go to executive suites and you rent an office there, you don't need a business license because the suite itself has the business license and you're just renting space out of there. So that is the lowest overhead way you could really get started with about $1,500 a month really, with all the things you need to kind of put in place between the suite, the accounting, all of these various aspects, and you could start out with pretty low overhead.

John: Okay. We're past that part. You've got this vision and you've started this. Now, you said you're in the process of moving into a bigger space now, where most everyone is going to be located, co-located.

Dr. Brook Choulet: Yes. We are moving into an office that's about 2,800 square feet and it has eight offices total. Everyone will be able to finally all be together rather than some of us are virtual right now, some have an office here. So, it'll be nice to be in the same space and for all of our clients to just come there.

John: What do you envision this will look like? Pick your number, two years from now, five years from now?

Dr. Brook Choulet: Yeah. I'm really hoping to have multiple locations in the next few years. I know I'm working with my mom right now who's a concierge psychiatrist on opening something similar there. So hopefully within the next year, we'll have something in San Diego as well.

John: Okay. Now we had talked a little bit before the interview. You brought up your mom as being a concierge psychiatrist, but from what I remember, her practice is different from what you're doing. And so, maybe you can compare and contrast the two and maybe the pros and cons if there are.

Dr. Brook Choulet: Sure. That's kind of where I got my idea of how to start everything really. She is in LA Jolla. Her name's Donna Kashani, she's an MD. She rented an executive suite and she does all of her own calls, billing, scheduling. It's really only her. She has someone that helps out with the billing at times. But other than that, she's the only one in communication with her patients.

John: And how long has she been doing that?

Dr. Brook Choulet: She has been doing that since we moved from Cleveland. So over 20 years.

John: Okay. I'm kind of working my way to asking you a leading question or one that will take some brainstorming. Maybe what other kinds of physicians do you think this would be doable for? We know concierge practices exist, but given that you're in the middle of it and kind of have lived it, do you think this translates to other specialties?

Dr. Brook Choulet: It definitely does. I did some coaching with someone in Florida who is an obesity medicine. My husband is also boarded in obesity as well as internal medicine. And obesity is something that could do really well. And I think it's a boutique practice. You just need an office. You need very minimal supplies and little overhead costs. So, I think that would be a good one. Integrative medicine, lifestyle medicine, functional medicine. And then really, I think some of the subspecialties could also probably do that, like endocrinology, rheumatology, maybe some of those too.

John: Okay. And I think what I was going to mention before when you were talking about the structure is basically, this is a cash-based business of which you've just mentioned others, the weight loss or the obesity and med spas and all that. So, would it be possible for an internist or a family physician who just wants to keep a small cadre of patients, would you say for them, would it be more of a membership model or the hourly type of model or either?

Dr. Brook Choulet: Right. I think that's why you do see so many internists and primary care docs with the retainer model because it's a little bit easier with internal medicine to know what you'll need throughout the year. You need an annual physical and you need certain kinds of sick visits, certain lab work. So, I think it's kind of a little bit more tangible to figure out what a package should include for internal medicine. With psychiatry, I have some patients I see every week, some patients I see every two weeks, some I see every month or every three months. So, to give a price on what that would actually look like would be really difficult. So, I think if a psychiatrist were to do a retainer model, they would have to have a kind of based number of services included and then an additional rate for any add-ons throughout the year.

John: All right. Well, before we get too far, I want to go ahead and put in the websites that the listeners might want to check out just to get an idea of what you're doing. And even if they're in the area, they could even look you up. So, you have your professional website brookchouletmd.com, which I think would probably have more directions to other things and links and so forth. But as far as the practice, it's at chouletwellness.com. Is that right?

Dr. Brook Choulet: Yes, that's correct.

John: It's very professionally done and very interesting. Well, stepping back, what do you think about physicians in general? Just sort of taking the bull by the horn and just trying to do something that isn't the standard cookie-cutter approach to medicine in general.

Dr. Brook Choulet: Yeah, I think it's amazing. I think at any point in anyone's career, whether you're in training, out of training, looking towards retirement, it's never too late. And I think it goes to show I'm kind of telling my mom like, "Hey, it's time to do something like this in San Diego". And she's used to her ways of doing things and it may seem really kind of scary or unknown to a lot of people, but once you start moving through it, you'll figure it out and put the pieces in place. So, I think it's amazing to kind of get out of corporate medicine and just make your own schedule and decide what you think would be a good work environment to go to every day.

John: It's hard to do because we sort of have this tunnel vision. We're focused on the traditional, what we thought was traditional, although once we get into the so-called traditional, it's never really what we thought it was going to be. So, we kind of break that mindset, I think.

Dr. Brook Choulet: Yes. And I see it because my husband is in corporate medicine in a large hospital system, and he's in the PSLF loan forgiveness program. So, he's kind of tied to that for a while, but there are pros and cons with the corporate jobs. There's security and income, you have a set schedule, but then the cons are that you're really not in charge of your own schedule. There's a certain way to do things. And some of the politics of the corporate medicine system may not be fun at times.

John: Well, that's absolutely correct, but I think a lot of people are fearful because of the financial aspects. Obviously, there's a risk involved, although if there's not massive overhead, the risks are minimal. But have you found in looking ahead, does it seem like from a financial standpoint and what the market will bear? Obviously, you've got to set your fees however you set them, and you have to find patients, you have to market. Maybe you could talk a little bit about that and then what's the response been once the patients see that you're out there.

Dr. Brook Choulet: Right. I think going to the first point, it's very important to think about finances when you're going into building something like this or something else because you really have to map out how much is this going to cost, what are the fees associated? And even though there's a lot of upfront costs, you don't want to kind of fall too far behind or put too much money and then not get that money out. So, I think it's really important to do that. And can you repeat the second part of that question?

John: Yeah. How did you get patients and clients? Is there a marketing plan? Was it kind of grassroots? How did that work out?

Dr. Brook Choulet: Yeah. So again, when you start a business, you want to run things as lean as possible from an expense standpoint. I just did it the old-fashioned way. I reached out to a bunch of therapists. I reached out to a bunch of the internal medicine docs I knew in town. I met with them for coffee, met for lunch, told them what I was doing. I ordered a bunch of postcards and sent them directly to physicians that were in private practice medicine or private OB-GYN and things that I thought my services would be helpful for. I really just tried to do it as kind of lean expense-wise as possible, and then also Google pay-per-click ads, and then having an SEO optimized website. Other than that, I didn't do anything really fancy.

John: All right. Well, I think there's a demand for that and there's getting to be more of a demand for a lot of these cash-based services because people are just tired. Well, they got huge deductibles to begin with anyway. So, sometimes you really feel as though you're uninsured. So, I think there's a growing demand. And then there's also the physicians who I think are going to be much more enthusiastic about running something that they control and not feel like they're being told how they're going to practice and when they're going to practice.

Dr. Brook Choulet: Right. I think that the most important point for the listeners to really consider is have you thought about days where you can decide when you go in and decide when your first patient starts and decide how you want to deliver care to the community, what you want to offer, what you don't want to offer? All the things that people get frustrated with when they work in a big outpatient setting or a big inpatient setting is a lot of those things are just out of your control.

John: Has there been much of a response from the medical students or residents or fellows around you that have seen what you're doing?

Dr. Brook Choulet: I try not to bring it up too much in training because it's just so different from what anyone else is doing or even has thought about. I mean, people are trying to get their medical license just to moonlight. So, I haven't talked too much about it and training, but I think maybe more people should, more people should know what the options are. I think it's definitely something that may be in my own fear of it not working out was holding me back from sharing it. But now that it's kind of up and running and things are going smoothly and we're getting a really good turnout of new patients for all of these people I've hired over the last two months then now I feel kind of more confident that this was a really good idea and I'm super glad I did it.

John: Do you feel like you're going to be involving other psychiatrists in the future?

Dr. Brook Choulet: Yes. I actually hired three psychiatrists in the last few months, so I have a few other MDs and a DO working in the clinic as well.

John: Okay. How was that from a contracting standpoint? Was that a challenge or is it pretty straightforward?

Dr. Brook Choulet: Pretty straight forward. Again, if you from the start have a business plan with your attorney and you knew what you wanted things to look like as you scale, then it becomes pretty straightforward. You go in knowing what you're offering, you know what's a good deal, you know it's really fair to the other physicians and it'll allow them to break free from the environment they are in.

John: That sounds good. They've started, right? So, they kind of know what they're getting involved with, and they've already been exposed.

Dr. Brook Choulet: I think that was a little interesting for a few of them. They're like, "Can I just ask how old you are and tell me about where you are in your training?" I think it was a little different for them definitely, to see that I was trying to scale this and grow this and that I really was confident and knew what I was doing. But they trusted, they jumped on board and it worked out really well for them.

John: Are these people that had been in practice for a short time, a long time, a combination?

Dr. Brook Choulet: Yeah, I think all three of them are in their forties.

John: Okay. So that must've been a little bit of a shift that none of them had tried their own concierge practice in the past.

Dr. Brook Choulet: A few of them are in other states. So, a few of them are providing remote services here and then another one is in person here and she has tried. The administrative part of things is very challenging. So, I think allowing that flexibility where you don't have to worry about scheduling and billing is really the best fit for some people.

John: Well, this has been fascinating. Any last bits of advice for any listeners today before we let you go?

Dr. Brook Choulet: Just go for it. That is my only advice. There's a lot to figure out and a lot to navigate. But if I can do it with kind of very little experience compared to some of the people who have been in practice for a long time, then I have no doubt anyone could do it at any stage of their career.

John: Yeah. That's very inspiring. You do have to be the type of person that wants to understand how to run a business. It is a business and you need to know those business principles. And that can be challenging, but it's certainly rewarding at the end of the day if you're not, basically, serving someone to someone else, some big corporation and you get to make the decisions and provide the best care that you can. All right, let me do those links again - brookchouletmd.com and chouletwellness.com. Check those out and see what Brook is up to. I guess that's all I have for today. It was very interesting.

Dr. Brook Choulet: Thanks so much for having me on today.

John: Oh, you're welcome. It's been a pleasure and I will have to check back with you in about a year and see how things are going.

Dr. Brook Choulet: Definitely.

John: All right. Bye-bye.

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The post Want to Establish a Concierge Practice Before Finishing Your Fellowship? – 210 appeared first on NonClinical Physicians.

In this week's interview, Dr. Fisayo Ositelu explains how technology, including artificial intelligence (A.I.), can help save small group practices.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

The Classic Silicon Valley Approach

During our conversation, Fisayo explains how he followed the classic Silicon Valley approach to starting the company. 

I always wanted to be an entrepreneur. And at that time there was a lot of excitement about tech and it just made a lot of sense. – Dr. Fisayo Ositelu

He tapped into his network of investors, including former MBA program classmates, and identified a few key angel investors. And he explains in detail the start-up of his company, should we wish to emulate what he has done.

Revenue Cycle AI Saves Small Group Practices

Some employed physicians dream about returning to private practice. But the hassles of running a practice can be overwhelming. And if a practice cannot quickly bill and collect for its services, it will struggle to succeed.

Fisayo describes how his company is helping to save small group practices by improving their revenue cycle management and cash flow. Gentem has gone a step further, by offering some clients the ability to access current accounts receivable when needed, rather than seek expensive short-term loans.

Summary

Gentem and companies like it can simplify the business side of private practice. By making them easier to run, they might save small group practices.

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

• Gentem
• Dr. Fisayo Ositelu's LinkedIn Page
• Gentem Webinar featuring John Jurica: Life Outside Medicine: Top NonClinical Income Streams for Physicians
• Gentem Blog Page
• The Best Healthcare Leaders Never Give Up and Never Stop Learning – 196
• How to Nurture a Career in Cutting-Edge Healthcare Technology – 156

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Episode 205
How Revenue Cycle AI Can Save Small Group Practices
Interview with Dr. Fisayo Ositelu

John: I was introduced to today's guest by a previous guest, Omar Khateeb from episode 194, because he works for today's guest who's the CEO of Gentem. So, I would like to welcome Dr. Fisayo Ositelu. Welcome to the podcast.

Dr. Fisayo Ositelu: Thank you, John. It's a pleasure to be here.

John: This is going to be fun. It's cool to have a couple of guests from the same place. We had Omar on because we were talking about branding and marketing and that kind of thing. But as soon as I was doing the background check on him, I found that, oh, wait, he works for a company that is founded and run by a physician. And let's see, who's the CEO and so forth. So, this would be really interesting today.
We're going to get into the details, but why don't you start by telling us a little bit about your background, your education in particular. And I'm sure my audience is going to want to know how and why you decided to go the MBA MD route rather than pursue let's say a residency.

Dr. Fisayo Ositelu: Absolutely. It's nice to be here and thank you for having me. I'm originally from West Africa, a country called Nigeria, and I came out here for college back in the day. The whole idea was to become a doctor. I came here to the United States to become a doctor from the get-go. My parents were in the medical field and so, I had a lot of context and background to this space.

I did my undergraduate at Johns Hopkins pre-med, molecular cell biology and then decided to come out to the west, which is where I am today. I did my MD at Stanford School of Medicine, over in Palo Alto. And one of the reasons why I chose Stanford instead of some other medical schools is because it had a very, we called it open campus policy where you can essentially take classes at any department.

So, I ended up taking classes in law school, engineering school, and of course the business as well. The curriculum was also way ahead of his time in my opinion. It was all pass/fail. That might've changed now, but at the time I was there, it was all pass/fail. And so, I really got a chance to really explore and really see all the cool things that the university had to offer. And Stanford is a world-class university, so I definitely got a lot of exposure to those other spaces. My idea in being a doctor was not just to be a clinician, but also to do something more, more than that. Especially coming from another country and seeing how much things can be improved on a systems level.

I went through my first couple of years to take step one, all that good stuff. And when I started, when I got into clinics into my rotations, I noticed something that would essentially make me pivot away from clinical care while I loved my patients and I did enjoy interacting with them. I just could not really get over the fact, overall the administrative work that I was doing even as a med student. I look over at my attending and they're not doing that much better than I am with respect to the notes and running all over the place and all that stuff. And at the end of the day, I could not really put myself in their shoes long-term. I could not see myself doing what they were doing in the long term. And so, I decided to long story short, take a different approach and go in the nontraditional route, so to speak.

John: Very interesting. You must be a really quick learner because I think in medical school and even in residency, we're kind of shielded from all that paperwork sometimes. And at least in my experience, personally, of course, that was in another century, but the way med students and occasional residency interface with now, I still don't think they know what they're in for when they really get into practicing. They're going to be basically spending two-thirds of their time doing things that don't really directly affect an individual patient. And a lot of them are going to be upset.

Dr. Fisayo Ositelu: Yeah, that's crazy.

John: You notice that early on, so that's awesome. And then when I was looking at your LinkedIn profile, I thought, well, maybe he did an MD-PhD program because there are schools that say, okay, you come in to the program, but you obviously were kind of on a mission to learn what you could and then you were just drawn to the business side of things apparently.

Dr. Fisayo Ositelu: Yeah, yeah, absolutely. So, as I said, I learned a lot in my time at Stanford, especially in the first couple of years when I still had some time. And once you end up in clinics, it's all-consuming. So, around the end of my third year, I decided to actually apply to business school and to see if I got in and just keep my fingers crossed about that possibility.
I had also looked into consulting. So, the usual suspects, McKinsey, I think they had the professional non-traditional sort of pathway. So, if you're an MD or a PhD, you have a master's and those kinds of things. I looked into that as well but I ended up being lucky enough to get into the business school of Stanford, which was a fantastic place.

I think one of the reasons why it really stands out even amongst other business schools is it's focused on entrepreneurship and really how immersed the school is in the broader tech ecosystem. And so, I was lucky to have the opportunity to be a part of that, and definitely immersed myself in the venture capital world and the startup world and more so to be able to vary in a good network of people that can help out.

John: So, that was part of the experience in the business school. It was getting involved with, like you said, the venture capital or at least learning about it and being exposed to that.

Dr. Fisayo Ositelu: Oh yeah, yeah, absolutely. The interesting thing is that with business schools, most of what you learn is fairly standard. Finance, accounting, strategy. It's really the relationships you build that count. So, the network of people, the relationships, those are the softer things that really make the difference in my opinion.

John: Well actually that's something that I hear about all the time in almost any MBA program, is that one of the biggest things is just the networking and getting to work with a team or you've got projects you're working on.

Even our sponsor, Haslam College of Business - The University of Tennessee, they have 700 grads. So, in a way, they have a network of like 700 and they're all physicians. That's a physician-only executive MBA. So that's what I hear a lot.

Dr. Fisayo Ositelu: Yeah, the MBAs are very interesting. Coming from the medical space, I had not done any kind of business before I went directly from high school to college then from college to med school directly. So, I was fairly young, being in a class with seasoned professionals, people that run companies or executives. It was intimidating. It was not a cakewalk. And you are expected or you were expected to actually share your thoughts and opinions and analysis on things on business problems in front of everybody. We did a case approach where they give you a case and they'd ask you questions and you'd have to speak about these things.

Now coming from med school, we just sat and listened to our professors and memorized a bunch of stuff to pass the exam. It's kind of different. And it took a lot of getting used to. So, there's just one thing for the folks listening, there's a difference in how you approach things in medicine versus business or in a business school setting.

John: Now you made it through. So, what was your next step? Obviously, you never planned on going to residency. So, you were looking for that next thing after you graduated. So how did you make that segue? What were the first one or two things you were involved with?

Dr. Fisayo Ositelu: Yeah. I did not apply to residency at all. And a lot of people thought I was crazy and maybe still think I am crazy.

John: Does that include your parents?

Dr. Fisayo Ositelu: Yeah. Initially, they were skeptical, especially while you spent all this time when I just went through it. But after business school, I started off my career at a startup. It is now a much bigger company called NerdWallet. It's a FinTech company here in San Francisco and their whole mission is to provide the best financial advice for all of life's financial decisions. They provide you very detailed advice on financial products to bring transparency into just financial decisions.

And so, I got my start there. It was a really great opportunity because I joined early on and there were growing and I had a chance to wear many hats. In that startup, I worked with some great people. I learned a lot. And thinking about the transition from academia or medical school to the business world, that was another thing working outside of a lab or in the medical university setting to actual fast-growing, fast-based startup. It was another big transition that I had to work on surmounting.

John: Now was that something where you thought, "Well, I'll probably be here for a few years". Did you always have an idea in the back of your mind that you were going to start something yourself?

Dr. Fisayo Ositelu: Yeah. I've always had that in the back of my mind. In fact, right after school or after business school, I was working on some ideas, but it didn't quite pan out. And so, I joined NerdWallet. I always loved entrepreneurship. Stanford really exposed me to a lot of great, great entrepreneurs. Some of them were my classmates. So, for instance, DoorDash, Tony Xu was my classmate in my class. We sat together in a couple of classes, my class, my section. A lot of companies were started around the time I was at Stanford. So, between 2007 and 2013. Snapchat and just a lot of great companies that came up. And so, yeah, I always wanted to be an entrepreneur. And at that time there was a lot of excitement about tech and it just made a lot of sense.

John: How did you feel like it was going to be something in the healthcare field originally, or is that still an open option and then maybe something else? How did you actually decide to get into what you're doing now?

Dr. Fisayo Ositelu: Yeah. I always liked healthcare as a space, especially for innovation entrepreneurship, because there's just a lot of need. There's a lot of waste. There's a lot of opportunity. There's a lot of frustration, especially with doctors and physicians who are really at the front lines and really trying to affect a change in their patient's lives. And so luckily, I had some exposure to their frustrations because I had worked in FinTech. And it's going to segue into what I'm doing right now with Gentem. I could really wear many hats of understanding the FinTech world, financial technology, as well as the healthcare world, and then the intersection between FinTech and healthcare to provide value.

One big thing, one big problem we're solving is this problem of reimbursements, reimbursement to doctors and all the administrative hassle and overhead and complexity that goes into getting paid. I'm sure you know it seems to be always one new hoop to jump and one new technology and it's just a little hodgepodge of stuff. And so, that's essentially what we're trying to solve at Gentem. Really simplifying, accelerating, and just really bringing some clarity to this financial experience for doctors.

Whether they are solo practitioners, whether they are a group of doctors, whether they're surgery or just medical groups and things like that, how do we help those doctors thrive financially? How do we help them stay independent? How do we help them take away the burden of these administrative hassles? We're starting with RCM, the revenue cycle, but we have much bigger plans. So yeah, essentially at Gentem we are focused on really removing those administrative burdens and getting doctors paid what's on time and in full.

John: Okay. Well, you bring up a sore topic there, as far as billing and reimbursement, because to a physician most of us, there's definitely some barriers that are built-in, maybe inadvertently, the technology is not that good, mistakes are made. On the other hand, sometimes it seems like they just make it complicated so they don't have to pay us. So, that might only be a small part hopefully, but if you can automate something and design a system that can kind of get through all those hoops in a quicker way, then definitely will help, especially the small practice owners.

Dr. Fisayo Ositelu: Yeah. Yeah. And prior to starting Genten, which we started a couple of years ago, I worked briefly in private equity and I was responsible for running some revenue cycle businesses that work with large health systems. And so, I got some exposure there as well. But I still wanted to come back to the doctors, the non-acute care, the folks that are really on the front line. How do we provide an infrastructure?

So, a lot of people talk about automation. We do automation as well, but how do we bridge in that FinTech side of the house whereby for instance, we can provide access to capital, right? Instead, you have to wait weeks, months to get paid. Why not just get paid after seeing the patient? The technology is there, it's being done in other industries, why do we have to wait weeks? Why not whenever you submit a claim, have the opportunity to get the funds or the revenue associated with that visit?

And so, that's what we've done. We're innovating not only in the pure deep technology side, we are using automation and artificial intelligence to really understand the data and optimize that process, but also to start deploying capital using that data that we have. So, we understand the kinds of claims you're sending, we understand the risk behind every single claim because of how we're using the data. And then deploying capital based on that data.

So, in that respect, we have skin in the game because we're deploying our capital while on the backend, we are trying to be covered by the insurance companies. We're seen more as partners versus just your random billing company. And that's essentially what we want to do, because we were looking at this stuff more holistically. And how do we actually empower our doctors, our physicians, our healthcare providers to be able to thrive, to be able to grow, to be able to stay independent, to resist the tides of being acquired, because that's just what happens these days. And we've seen the numbers around how much private practices are dwindling down.

But we know it's not good for the system because care is actually more expensive in those hospital settings. It's way more expensive. The reimbursement is different for the same exact thing, and the quality is not always better. Some are actually mostly worse. And so, we see these things and it's imperative for us to try to really support our doctors.

John: Oh, you hit on so many things there. I just got to reflect on my own situation. My wife needs an MRI and she's been denied twice for a foot MRI that a
rheumatologist ordered. So, ultimately, I picked up the phone and I called the freestanding center, and I got her foot MRI for $350. Even at the hospital I said, I'm going to pay cash. What's it going to cost me? Well, it's going to be $1,000 plus we don't even know what the professional part is going to be. I said, okay. That's just one example.

And I think on the other side, the physician side, the other option is if you're not near retirement you really don't want to give up your practice. It's like, I'm just going to go to a cash-only practice. I just can't deal with this. And we're going to hire three people to do my billing. And I get paid only 70 cents on the dollar to begin with. And then there's a whole lag that you've mentioned. So that'll be awesome if Gentem can really help solve some of those problems.

Dr. Fisayo Ositelu: Yeah, yeah. I think you made a good point. And this is what the industry needs, even the cash-only direct primary care, just different ways to drive innovation, whether it's telehealth and all these things. Yeah, I think these are all good developments in the industry and everyone needs to be on their toes, even the payers or the insurance companies. And the more options people have, the better. It's always better the more options you have.

John: Absolutely. Okay so let's take a little detour now since you're the CEO and you're an entrepreneur and a startup expert.

Dr. Fisayo Ositelu: I don't know about an expert but...

John: You have been through it so I'm assuming there's a lot of technology in this and programming maybe and other things. And so, I'm assuming you didn't fund this yourself unless you have this big equity firm or something on the side that we don't know about. Tell us about that, the real big, tall steps. What was the process? Where did you get the idea, who did you partner with and why? And then what'd you guys do in terms of trying to get this thing off the ground, just to get it started?

Dr. Fisayo Ositelu: So, my co-founder is a buddy of mine, from college. He didn't go to the same college, but he was college buddies with my younger brother. And he was an engineer at Facebook, just living the dream and somehow, I convinced him to quit that nice job and come to Gentem for nothing. That was probably the most important step in this whole thing, finding a good co-founder, a good team aligned in vision and just willing to really stay in the trenches with you when things get bad, because they're always some rough patches. Like I said, I've worked in private equity where I was running some of these RCM companies and I'd also worked at NerdWallet.

So, a lot of the ideas came from those two places. That's the importance of really looking at whatever you do, you just have to learn and try to get the most out of it. It might not be obvious but in hindsight, you'd find that you're gaining something that could be helpful. To always try to maximize your experience and learnings from anything.

And part of the thing that really helped me out was the co-founder of NerdWallet. I had gotten to know him when I was there and we kept in touch. His name was Jake Gibson and he has a firm called Better Tomorrow Ventures. He was an active angel investor. And I reached out to him and shared the idea and he liked it. I feel that most people understand the friction, even as patients, they face their medical bills. And so, he could relate to that piece and this small piece. And then there's this whole other thing of eligibility, profit realizations, and all of these other things that you have to manage. He was an early backer of ours. I also was lucky too, to have some other entrepreneurs that were also very, very excited to work with me.

The lesson there is to have a good team, obviously a good team of executives and people that you work with, but also a good team of backers and finding folks that believe in what you're trying to do, to solve the problem. In the early stages, you're selling yourself. In the early stages is the team that really counts because you don't have anything, you don't have any data, you don't have any revenues or anything like that. You have some data, but you don't really have something that is as big yet.

So, it's really the team, one, and believe it or not, the idea is good, but it's not the most important thing. The exact idea is not the most important thing, because that could change. You could iterate on that, but it's really the vision. What is the future state of the world you want to see, or you are pushing towards? How you get there might be different. So, those are the milestones. A great co-founder, and also working with some really strong angel investors that were really able to open the doors for us.

John: I'm not really that familiar with this kind of startup situation, but the investors oftentimes are also bringing a lot of expertise in, in terms of maybe they know someone that solves a problem you have, or they have another solution they're working on, or maybe they spend some time actually working. I don't know how that works. It's a question I have. So, explain that a little bit.

Dr. Fisayo Ositelu: Yeah. Different investors bring different things. Some bring expertise, some just give you the money and get out of your hair which sometimes is great. In fact, it's more often than not great. Some offer expertise in sales and strategy and whatnot, or even product development.

So, in our case, we got a lot of strong FinTech investors. So, Jake Gibson, some really great, great folks and our seed investor Susa Ventures, they were investors in RobinHood for instance. They invested in RobinHood, the popular app for investing. We also worked with a series A investor, a group called Vulcan Capital, which is based out of Seattle. Great, great, great folks there as well.

John: Well, I'm going to shift gears again, and just ask you, how has it been going? You started roughly two years ago. I don't know at what stage that was. I'm looking at your website. I see you've got a head of marketing.

Dr. Fisayo Ositelu: Omar.

John: What is his official title?

Dr. Fisayo Ositelu: Head of growth marketing.

John: There's a lot of going on.

Dr. Fisayo Ositelu: Yeah.

John: So, how's it going?

Dr. Fisayo Ositelu: Yeah, it's going well. So, in 2019, when we launched the company, we did a proof of concept that year. Just really validated the idea and did some pilots. We really launched last year, which was interesting because COVID hit, but it's been going well, it's been going well. I think we are really staying true to our mission to focus on helping doctors and healthcare providers stay independent. We continue to build very great products, whether it's in automation and how we're using the data to how we deploy capital to these practices.

We're really focused now on building a holistic infrastructure whereby we can support practices at different stages of their evolution of whether or not they're starting, or they are in steady state, or they want to grow. We have different solutions for those practices. Whether they have a specific problem, wherever they are leaking in revenue, whether it's an efficiency problem, whether it's really helping up level the staff, whether it's consulting. And so, in some regards, we're really looking at these holistically so that we can help them thrive and remain independent. That's literally what our vision is. How can we help them thrive while being independent?

And yeah, we're always learning. I feel like every day we don't have all the answers. We really relish engaging with doctors. Because I am a physician, even though I didn't go through residency, I think our team, our DNA is a little bit different from just the other folks, because we have context, we have that deep empathy into what's going on. And one of our values is just having a low ego. It's literally one of our values, no ego, because that just enables us to listen and listen fully and be able to not mind rolling up our sleeves to do what needs to be done to make an impact. So, yeah, that's how things are going.

John: If I had to force you to say, who would your ideal customer be? What would be the picture of that person? Would it be a three-person group? Would it be any particular specialty? Someone who's struggling to collect more than, whatever? An AR that's at some level that's not working, what would you say?

Dr. Fisayo Ositelu: Yeah, we work with a range of practices. We do a lot of work with surgical subspecialties. We do a lot of work with vascular surgeons for instance, orthopedic surgeons. We also work with pain doctors. And lastly, we have quite a few customers in behavioral health. As you can imagine, it's a growing space, whether it's psychiatrist or therapists. It's a growing space.

For us, like I said, our ideal customers today are folks that are working really hard, getting revenue, but they know something is not quite right. They know that there is some frustration with really optimizing their revenue and feeling like they are doing the right thing. And so, for us, we come in there and really help them identify the leakage money left on the table, plug those, and then really amplify them for growth.

So oftentimes even like 15% - 20% bumps in revenue, which is where we benchmark in terms of our incremental benefit working with these groups. That can mean a lot of things. That can mean investing for instance, like a TMS chair, for those doing transcranial magnetic stimulation, as some of our customers. It could mean just more investing in marketing or growing to a new practice, opening a new center, which we've done for a couple of our customers.

So, those things really count. It could mean giving your staff a bonus. These things really count. And so, it really depends on where they are as folks that mostly know that there's a problem and they know that things could be better. And so, once we give them our value proposition, we have great, great folks, professionals, certified coders and billers that have decades of experience in some cases. They know that we have the technology and they also know that we have the capital. So, we have the capital, we have the people, we have the process and the technology. And then bringing all those things to bear is what really makes this a really revolutionary way of helping these practices thrive.

John: Now, just one other final question on Gentem itself and where you are. Healthcare is kind of local. A lot of insurance carriers, people we're dealing with are local and there're rules and regs at each state. So, is this currently more of a California thing, a regional thing? How does that work for Gentem?

Dr. Fisayo Ositelu: Yeah. Believe it or not, we're nationwide. So, we have customers all over the country from California to Florida, to Massachusetts to Texas, all over the country. I think the key thing is really understanding the payer policies and understanding, as you mentioned, things can be different with each state and each region, while you just have to have the ability to do that at scale and nationwide to build a big company. And for us, we're venture backed. So, the way we think about the business, it has to be big and we're not just building a mom-and-pop type operation.

John: Right. Well, I just want to make sure if someone's listening and they're in New York or they're in Texas, and they're like, "Oh, I don't know if this applies to me because they're in Silicon Valley". You're saying, basically you put the contracts from the payers and what have you, all that can be done, it doesn't really matter where you're located.

Dr. Fisayo Ositelu: Exactly.

John: So, let me see. We're going to run out of time. But tell us, the easiest way to get a hold of you and learn more is just to go to gentem.com is that right?

Dr. Fisayo Ositelu: Definitely go to gentem.com if you are interested in learning more about our company, our startup. And if you want to see a demo of what we built, we would love to show you. You can also reach me personally on LinkedIn. I'm pretty active there. Fisayo Ositelu on LinkedIn and Twitter as well. I'm pretty active. I try to check those channels, but mostly LinkedIn. We'll be happy to chat about Gentem, career advice and any way that I can be helpful. I know I learned a lot from mentors and people that really helped me out when I was coming up as well. And I still am.

John: Oh, before we let the listeners go and let you go. Any advice for someone who is thinking, "I think I could do something like this". Maybe they have a little business background, maybe they need to go get the MBA first. But if someone really had an idea that they thought "Well, I could have an impact on healthcare" whether it's payments or delivery or whatever it might be, what would you advise them to do to get started?

Dr. Fisayo Ositelu: Well, you don't need to get an MBA. I'll tell you that. But one thing that really helped us out or help me out is you're going to get a lot of "noes", unless you're lucky. But we got a lot of "noes". The key thing there is to have the ability to transmute these "noes" into fuel that energize you. It's sort of a weird thing, but we use the "noes" as a way to energize us even more. Obviously, you have to listen to the feedback and be close to feedback, but the noes can be brutal in this game. But the key is to find a way to transmute those noes to fuel that power your vision. And it's not as easy as it sounds, but once you can do that, your whole perspective changes as regarding this entrepreneurship or trying out a new endeavor, a new venture. And it's almost like a superpower, if you can get it right.

John: If you have the right mindset, you can probably do almost anything I suppose.

Dr. Fisayo Ositelu: Right. Go for no.

John: Go for no. All right. Well, I appreciate that. And I will put links in the show notes to everything there, the website and the LinkedIn and all that. And I guess with that, I want to thank you for spending the time describing your story to us and giving us some good advice and encouragement.

Dr. Fisayo Ositelu: Thank you, John. I enjoyed the time as well.

John: All right. Well, you take care, Fisayo. I will talk to you again soon hopefully. Bye-bye.

Dr. Fisayo Ositelu: Thank you. Bye-bye.
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