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.

In this podcast episode, John interviews TJ Oshun, founder of CallonDoc, who shares his remarkable journey from practicing medicine to fearless medical entrepreneur. 

Starting with a simple solution to help patients access care outside regular clinic hours, TJ transformed a basic telephone consultation service into a comprehensive telehealth platform now serving all 50 states. 

TJ's transition from healthcare provider to tech company CEO offers valuable insights for medical professionals interested in entrepreneurship and digital healthcare innovation.

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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 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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From Medical Practice to Tech Innovation: Building a Telehealth Empire

TJ's entrepreneurial journey began with a failing clinic in Texas, where he discovered patients struggled to access care during regular business hours. By starting with simple phone consultations and gradually developing a custom technology platform, he built CallonDoc into a comprehensive digital health solution.

The company now offers telehealth services, lab testing, white-label solutions for medical practices, and software licensing – demonstrating how healthcare entrepreneurs can scale beyond traditional medical services into technology-driven solutions.

Keys to Being a Fearless Medical Entrepreneur

Success in healthcare entrepreneurship requires both medical expertise and business acumen. TJ emphasizes the importance of gaining clinical confidence through experience before venturing into independent practice or entrepreneurship.

He advocates for continuous learning through audiobooks, coaching, and formal mentorship programs. He also recommends building strong partnerships and maintaining a focus on the patient experience and satisfaction.

Summary

TJ can be reached via LinkedIn for professional inquiries and networking opportunities, particularly from medical professionals interested in telehealth or healthcare entrepreneurship. You can explore opportunities through CallonDoc by visiting their partnerships page or contacting their business development team.

Links for today's episode:

• CallonDoc
• Light Your Entrepreneurial Fire and Create Your Ideal Life
• How to Practice Hospital Medicine and Found a Startup
• How to Start a Thriving Educational Company with Dr. Andrea Paul – 073
• How Do I Generate Awesome Income with Telemedicine Services? – 222
• What Is the Latest Telemedicine-Supported Specialty? – 173
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
• The Nonclinical Career Academy

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 382

Introducing a Fearless Medical Entrepreneur

- Interview with TJ Oshun

John: Sometimes I find myself really in awe of the healthcare professionals who, they recognize a problem in medicine or with patients or something, and then they just run full speed into trying to solve that problem. I'm talking about entrepreneurs, of course. So today's guest was one of those people that recognized a problem well before the pandemic that patients didn't have the kind of access that they needed to their medical providers. And so in spite of maybe not having a background in IT, I don't think he did, we'll talk about it, but he jumped in and started working on telehealth and telemedicine. So let's welcome TJ Oshun to the podcast. Hi, TJ.

TJ Oshun: Hello, John. How's it going today? Thanks for having me.

John: It's going well. It's a nice quiet day before Thanksgiving. For those that are listening, of course, that'll be two weeks ago, but we're still going to have fun on this otherwise relatively slow day.

TJ Oshun: Well, I wish I could say the same. It's actually quite busy on my end of town as we wind down and ready for the holiday. Usually we telemedicine around the holiday season when the clinics are closed, that's when we get our spikes. It's been a hectic week to say the least.

John: Yeah, that makes sense. While we're all trying to cool things down and go home, the people covering those off hours and those emergencies are getting busier. So it's good to have you backing us up, you know?

TJ Oshun: Yeah, absolutely.

John: All right. So you're an entrepreneur. I'm going to have you tell us a little bit about your story, but the reason I wanted you to come on today, for several reasons, you run a company that could be of value to physicians, you sometimes hire physicians, but you also support them. And as an entrepreneur, we can learn from you about that aspect because a lot of my guests, I mean, a lot of my followers really and listeners are interested in doing other things besides direct patient care. So why don't you start by just telling us what you're famous for?

TJ Oshun: Yes, absolutely. So what I'm generally, I guess, popular for, the company is popular for is the company cell, which is CallonDoc, a telehealth platform. I think we've actually grown beyond a telehealth company to more of a digital holistic medical platform, right? In the sense that we not only offer the direct patient care, we offer lab services, we offer software as a service where we're licensing our products to other doctors, we're providing provider services to all the telehealth companies. So we do a wide range of things to facilitate healthcare delivery virtually, right?

And at this point, I actually consider myself as a tech company versus a medical company. I spent 70% of my time in marketing and technology versus the medical side of things. So we position more on the technology and patient optimization component of it. But that's essentially what we do, a digital company that is out there to optimize access to healthcare in every way we can, from partnerships to optimizing technology and offering quick access to medical care.

John: Very good. Why don't you tell us a little bit about your story because I know that you started out, well, you immigrated, you started out in healthcare, going to being a PA and then going to med school. And at some point, this urge and this interest in doing what you just described started. So what prompted that? How did you start looking at even starting such a company?

TJ Oshun: Yeah, absolutely. As Will mentioned, it started when I was a hospital in a Texas hospital, UT Southwest. And so I worked there for two years. That was one of the best experience I've had, gave me all the confidence in the world to feel like I could practice independently. So I was there for a couple of years. Then I saw this failing clinic. I have a thing for buying into failing practices. It started even when I was in college where I bought a failing barbershop where I used to get my hair cut. It was closing out and I bought it and I revamped it and turned into a profitable company before I exited.

But the same concept happened. I wanted to start a practice, but then I found this local clinic in Irving, Texas that was failing. Partnered with a couple of my colleagues back then, invested and we turned it around and became profitable within a year. Because I knew what wanted it to happen was just optimizing again, the patient experience, looking for the pinpoints that patient needed and grow from there. But anyway, there were a couple of roadblocks as you can imagine, but we were able to stabilize and became profitable by year two. So as the clinic grew, and I wanted to expand, I couldn't expand past the four walls of the clinic as you can imagine.

So that's one of the things I've learned also as I grew a company, that when you start now, with a brick and mortar, you're limited to the ZIP Code, right? No one is going to travel 20, 30 miles to your clinic, even if you are the best doctor in the world, right? So to scale that, I thought, okay, it had to be something virtual. It had to have some element of technology because if you want to scale, you need to have technology involved and virtual. So it started with a phone call. I surveyed my patient at that time.

And as you can imagine, clinics open 9:00 to 5:00 and I knew there were a lot of no-shows and I started surveying my patients and figuring out why they were absent for their diabetes follow-up visit. And the primary, number one reason they gave me was that you guys open 9:00 to 5:00 when I get out of work. So I had to think outside the box.

How can I see my patient outside of the hours? I started extending hours, but obviously there were limitations to that. You can't open 24/7 at a primary care clinic. So the only way I could do that was actually reaching out to them and seeing them at home. The first thing that came to mind was a phone call because obviously technology wasn't available for telemedicine back then. So I called the medical board, Texas Medical Board of, I'm like, "Is it okay to see a patient virtually over the phone?"

They were like, "There's nothing like that. I can't really tell you what to do as long as you're establishing medical necessity and documenting that you're actually helping and documenting it." So we started that way and we just offered it to the self-pay patient only because there weren't any reimbursement for insurance at that time. So we didn't go that route. So it was only for patients that actually needed the medical service that could not make it and we can establish medical necessity for a phone visit.

And it were always the follow-ups, the patient that compliant with their medication that just needed refills, right? But couldn't make it because of office hours. So we started that way. And I remember telling the medical board on that time to email me so I can have it as an insurance in case something happened.

So I still have that email now in my inbox saying it was okay to treat patient virtually. So it started as a phone call, but I needed to do more. So I created, I went on GoDaddy, developed a website where, because -- and the reason why, yeah, let me just go back a little bit and I hate to dwell on this, but I think it's important, is even the phone call, I had to stay on the call for a long time getting the medical history.

So now the medical intake itself is about 15 minutes. So I'm like, why don't you just create a website where I can actually get all the information at hand. So the actual visit will be discussing the intake, right? And it will be sort of addressing the pain point. So create the website, collecting the data so I didn't have to need, I didn't have to involve a medical assistant. So I collected information on the website.

Then the phone visit would just be addressing those problems or areas and providing solution and refills in labs if I needed to. So that's how it started. Then we started scaling to other parts of urban Texas and Houston and other parts of Texas. And we're able to scale to neighboring states as well, providing telehealth. And this is now more from just a phone visit to more of a digital and video conferencing in some part. And COVID hit, but because we were prepared for that, we were able to scale rapidly to all 50 states within a couple of months of COVID.

And we were able to offer, I think, about 350,000 visits for a couple of months during the height of COVID in all 50 states. So that was how we were able to establish the credibility. And because I also made sure patient experience and satisfaction was the forefront of what I did, we were able to scale even faster. We retained our patient and grew from there.

John: Oh, boy. There's a lot I can ask you about in that whole journey there. So many businesses went out of business during the pandemic. You're one of the few, and I guess the other telehealth and telemedicine companies that actually exploded during the pandemic. But I would say there are a lot of physicians that have an idea and think, oh, I could do that. I'm going to solve this problem, whatever it might be. It could be recruiting, it could be patient care, whatever.

But there's always, if there's a tech component, they usually, they get stuck. Either they've got to invest a lot of money. How did you overcome that? How did you go from being a telephone and a website, which is pretty basic? I mean, now I know you've got these visits there. You can choose from the visits. You can populate the information. You can then talk to whoever you need to talk to. How did you get through that hoop?

TJ Oshun: I think the biggest thing for me, which was painful in the beginning, was actually investing in a homegrown technology. I think most people tend to license a software that may not be customizable or scalable and limiting, right? So we were able to invest in a homegrown technology that scaled with us.

So I was able to figure out what my patient wanted, the pain points, reiterate, customize it, take that out, optimize it. And I listened to the patients, right? I know exactly what they wanted, how they want it. And I gave them options, right? On how to see their doctors, right? So listening to a patient, optimizing the technology. Again, a homegrown technology will allow you to do that versus a legacy or a company that you only had what it offered you.

So that helped us a lot. And I quickly brought in, because I understand I quickly brought in, again, I see myself as a technology company more than a medical, right? So I could handle the medical side. So I was able to quickly bring in software engineers from the beginning, hire a team to power it from the beginning. So my medical, my technology team actually grew faster than my medical team.

So we were able to power that through and customize and optimize based off of that. And obviously we can analyze patient journey, optimize accordingly and go from there.

John: Now, before we got on the call, we were talking about how your company is continuing to expand and diversify and becoming more of a tech company and even supplying the infrastructure, I think, for some practices. But I guess if someone who has like an issue, whether it's an app or thinking about technology, is there any advice on where to find software engineers or where to find the tech people you might need to create something like that?

TJ Oshun: It's always a challenge. I have to go through a series of engineers, companies. There were a lot of politics that went behind that also. I had terrible experience. It wasn't always fun, by the way. One of the first technology company I actually partnered with actually sold my technology to a different telehealth company. Right, right.

So it's challenging, don't get me wrong. The good thing is I was cautious about what sort of information I revealed to them. So what they sold was actually the entry level, the MVP of my ideas. So that saved me there. So which I think the other company got stuck with that product because I was already ready to move to the next level. But it's difficult, right? It's difficult. It's about finding the right company that best fits you and has your best interests at heart. And as you can know, it's partnership.

You have to let them understand that this is a partnership. I'm with you if you guys have my back and compensate them accordingly so they can grow with you, right? If they know as you go, because the company I've been with, I've been with them for six years now and they power all my software engineers.

So I don't have to deal with the hiring process of scouting and recruiting the technology. So they do all of that for me. But as I grow, they grow also. They won multiple awards based on the growth that we've had. So they're growing with me and we continue to grow, right?

John: That's awesome.

TJ Oshun: So yeah, it's about finding the right partnership and someone that can actually grow with you, yeah.

John: I want to get your opinion on another thing because along the way you have hired physicians who actually work and do the telemedicine or answer, and maybe it's PAs and NPs as well. What's your advice for someone who's maybe just coming out of PA school or medical school residency, and they're thinking, I don't know if I want to be employed by a big hospital. Maybe I want to just do telehealth, telemedicine. It seems more flexible. What advice do you have about that for them?

TJ Oshun: Yeah, absolutely. It's always a good thing to try to be independent, but it has to be something that you want to do because starting a business is still at the end of the day a business, right? So you may be a provider, but if you don't have the knack for the entrepreneurial spirit or the ups and downs that comes, resiliency that comes with that, it may be challenging.

There are times where I've hit roadblocks and it would seem like we need to pack the things and go home, but you just have to persevere, right? So that's really, really important. That perseverance is very, very key. And if you don't have the bandwidth to be able to power through that, it may be challenging. So that's number one. It's still at the end of the day, it needs to be perceived as a business that needs to grow and be profitable.

So that's number one. Number two, I think having the medical confidence to be able to run an independent clinic is also important. So like I said, I said, I worked at UT Southwest and that gave me the confidence to be able to practice independently. So getting out of school and starting a company is definitely not advisable. Make sure you have that medical chops where you can confidently treat patients. And it could be just whatever you're comfortable with.

It could just be diabetes, but you have to be comfortable managing those patients independently. So the combination of your medical background, be confident in that, and also the medical chops of being able to run a company because you will do everything. You do everything from marketing, accounting, software development. You are going to be the first couple of years, the guy or person that will drive the force before you start bringing a team that will support you. So you have to have a thing for being an entrepreneur as well.

John: Yeah, and I think you made a good point that if you're going to be on your own and really being primarily responsible for, even if it's "during the off hours" or whatever by telemedicine, maybe it's best to do two or three years, make sure you're really comfortable practicing and then jump full-time into the remote type of telehealth.

TJ Oshun: Absolutely, because it's an isolated world there. You're by yourself, right? There's no one to call sometimes. So you have to be able to navigate independently, right?

John: I want to remind people again, the website where they could at least take a look at what it looks like when someone signs in is callondoc.com, right? C-A-L-L-O-N-D-O-C.com?

TJ Oshun: Correct, callondoc.com. Yes.

John: It's pretty interesting. And so it just gives them an idea of what you've built. But I didn't want to wait to just to the end to do that because sometimes people don't listen to the very end. All right. I want to ask you about some other things. So we've touched on this business and the entrepreneurial part of it. I know somehow, because I think you were in a podcast where you were actually being interviewed by, I think you would call this person a mentor, a coach.

She was through a very well-known company I recognize. So I just wanted your opinion as you've been going through this process. I don't know how long you've been involved with that particular, you might even call it a mastermind or coaching. What's your opinion of that? Why do you do that? And what advice do you have for other potential entrepreneurs or physicians that want to grow in there, even in their practice about that particular aspect?

TJ Oshun: Right. So being a CEO and founder of a company is isolating, you're up there by yourself. You sometimes feel like you're not getting genuine feedback or you may be doing something incorrectly and you just need that sort of reinforcement and reassurance. So even though as a company we were growing, it just felt like I was by myself.

I felt isolated. I felt that I needed to do more and reach out to like-minded thinkers like me. So I found V-Stage online for some reason and I was assigned to this amazing coach. Her name is Margaret. We meet once a month, one-on-one. And I had meet with my group once a month as well where we just talk about each other's problems and give honest feedback and how to address it.

And she takes time to dive deep into my business and try to figure out how we can resolve things, right? One of the things she asks me is, what can I do for you? What do you want to talk about today? So she's like my therapist really, where I can actually, more on the business side, but I can actually let her talk about things, right? Whether I'm struggling with an employee or try to hire someone. So it's just someone to sort of bounce ideas.

And when you talk through things, it actually gives a different perspective. And one of the things actually she gave me, advice she gave me, which actually has worked is I have a lot of ideas in my head, but I never write it down. She's like, "TJ, you have to write it down."

John: Or they just disappear. They float away for a while.

TJ Oshun: Absolutely, right. It just disappears, or you're not as organized as you think you will be. But when you start writing things down, putting things in perspective and assigning timeline and resources to things, it gives you a lot more structure. I say that to say this, that you need the support system, which you may not get from employees, right? I don't have a strong executive team like [inaudible 00:21:07]. When I say strong, it's more of, I'm the CEO and sometimes act as a COO sometimes.

So I don't have, so like a maid that can bounce ideas or an independent thinker. I think that's the best way to think. Someone independent with no vested interest in the company. So she gave me that honest opinion without bias.

John: Well, I'll tell you why I was so interested. First I was a CMO for a hospital and our CEO took advantage of the same company and we had a coach. And so he would meet with that coach and then he would meet with a group every month. And then at some point he found it so helpful that he actually brought that same coach into the organization for the senior executive team. So we were meeting as an entire group, the senior hospital team with this coach or whatever mentor. And then individually, we had the opportunity to do the same thing.

And I've always, I have addressed this on the podcast several times and the advantage or the benefits of having a coach, having a mentor, and even participating in basically what's like a mastermind where you get in a group with your peers from other organizations. So I think that's fantastic.

TJ Oshun: Absolutely, absolutely. And it highlights your strength and weaknesses. It's someone looking in and just giving you their honest opinion. So always, always helpful.

John: Yeah, I think it was that question that you mentioned and sometimes the way my mentor would put it is, what's the thing today that you really don't want to talk about that you should be talking about? And there are a lot of those. All right. So let's shift gears again, because I think what my listeners want sometimes is motivation and encouragement, which they've gotten just kind of hearing your story.

They want to learn some practical things, but some of them might need your services, not as a patient. So we were talking earlier and you have expanded your services. So explain what that's about in terms of how you can partner with individual doctors, individual practices to help cover some of their downtime.

TJ Oshun: Yeah, absolutely. And I'm happy to answer that question. I wanted to throw this in before I forget. So one of the things I do a lot of is read books. I didn't go to business school, right? I learned as I go, but to fast track that I've read a lot of books from people have gone through this already, and I just sort of like, it's like a cheat sheet in a way, right?

But I read a lot of books and I'm not the type that reads hardcore. I just listen to the audio books as I drive or walk down the street of New York. That's one of the things I do when I first wake up in the morning, take like an hour walk in New York, listening to e-book and you get a lot from there. By the time you get back, you have all these things and action plans so that you can go implement that practicable, right?

So I encourage people to actually, your audience listening to read a lot more of this sort of self-development book. And depending on your weaknesses, where I have, if I want to learn more about marketing, I pick up a book about marketing. If I need to scale or hire someone, I pick HR or HR related books. So I think that's very, very helpful. And in terms of how my software can actually help doctors.

So we have a lot of doctors willing to join our team. So I think hiring more doctors is not the way to go now. But what we do is again, we're a tech company. We're licensing our services to clinics. So we've been powering clinics throughout the U.S. Like I mentioned, you're about to retire or a clinic that is closing at six, eight o'clock. We can actually power them after hours if you need to go on vacation and you just need to keep your practice open.

We can come in, white label our platforms so your patients still have the experience as if the way we are cleaning. But it will be powered by our medical providers. You can still do the billing. We negotiate the rate, but we will power those clinics and medical practices. And we've had practices on telehealth companies, actually, that are local, but want to expand to all 50 states, but don't want to have to deal with the headache of hiring doctors in all 50 states. So we power them.

They do all the marketing. We see the patients and deliver the care for those patients, but they still own the business and practice, but it's all powered by CallonDoc. And by the way, most of the partnerships that we've actually been having are all the telehealth companies, which inherently are competition, but we negotiate rates that are not competitive, but we do all the software and medical services in the back end.

John: Nice, nice. So that's another entrepreneurial thing to do, expand really what you're offering outside of the initial services. So that's good. So how would someone that's in that situation that is looking to get someone to cover, and yet, like you said, white label or coordinate with their practice, how would they get ahold of you?

TJ Oshun: So absolutely. So just go on the website, callondoc.com. There's a tab in the menu at the top called our partnerships, our business, fill out a questionnaire, and someone from my business development will reach out to schedule an intake. The questionnaire is just learning about your practice and what sort of partnerships you want, and the right person in our BD will contact you to set you up. Very quick entry. We've done this multiple times. We can launch a platform within a day or a couple of weeks, depending on how demanding the interface is, but it's something we can quickly do just by filling out an intake form.

John: Okay, excellent. That's going to be helpful. All right. Well, I think we're getting close to running out of time here. So, well, we've covered a lot today. So before I let you go, is there any other places that you typically would, if someone had a follow-up question could they maybe send that to LinkedIn, something like that?

TJ Oshun: Yes, they can send that to LinkedIn. I'm active on LinkedIn, but that's the only social media platform I'm really active on.

John: That's cool. As long as they have a question, at least with LinkedIn you can do a little screening, make sure it's appropriate, instead of like, oh, just give us your home phone number. How about that? All right. No, we're going to let you go in a minute. So I guess the question I usually end with is if the physicians in my audience they have different things going on, some want to get out of medicine, some want to do -- they want to change, they want to do cash only, there's lots of options.

What advice do you have maybe for these physicians who are maybe a little frustrated with corporate style medicine, or they don't have the control, whether it be your advice for telemedicine, telehealth, or just doing something entrepreneurial, just any advice you might have for those people who are frustrated and don't know where to go?

TJ Oshun: Sure, absolutely. I think with healthcare, there's tremendous ways you can actually optimize or improve patient care, or even the healthcare as a whole, not necessarily just patient, just healthcare as a whole. I think it's just identifying a problem, and not necessarily try to follow what everyone is doing.

Identifying a problem, that's what I did, identify what the problem was, and solving it. Just in your own space find what the pinpoint is, whether it's a problem with a hospital system, or the clinic system, or a patient, right? Identify a problem and try to solve for that problem. If you can solve, you would definitely create a business out of that. And it will be organic. It will be an organic process because you're actually addressing a problem that no one wants to address and not necessarily be trying to be competitive with a hospital system, or I want to change the whole hospital system. No.

Well, how can you optimize whatever deficiencies they have and they will pay for that? Figure out a problem. Your patient will pay, the hospital system will pay, the clinic will pay. How can I help with a deficiency. Like I said, an example is, we know clinics open 9:00 to 5:00. How can I help the clinic after hours rather than competing with them? So that's what I try to do. Find a problem, help them, and be successful at it organically.

John: Nice. Well, that's good advice. And there's so many, I mean, people are getting frustrated because of the insurance payments and so forth, which you have to deal with that I guess in most situations, however, so a lot of cash pay, a lot of people have savings, health savings accounts and other ways that they can pay for the things. And so there's a lot of new ways to solve the problems, as you said.

TJ Oshun: Absolutely. And actually we don't accept insurance for that reason. One of the things that we try to do is offer a quick, easy access to healthcare. Once you introduce insurance, then you have to go through verification, eligibility check. That takes hours sometimes. But we want our patients to be seen quickly within minutes and done. So our constitution fee is average of $40, which is about your copay anyway. So we've never been incentivized to accept insurance. Our patients can still pay for their medication at their pharmacy with insurance, though. They can pay for labs with insurance. But the medical service itself is self-pay.

John: Yeah, good point. You're right. A lot of the urgent care visits, the people pay out of pocket even if they have insurance. Because you're right, they don't meet their deductible and they're going to have to go through so many hoops and we're going to have to go through so many hoops. We both say, you know what, let's just do that $99 visit and move on.

TJ Oshun: Move on. Absolutely. Absolutely. And it works out. Yeah.

John: Yep. And people get taken care of much more timely. All right, TJ, this has been great. I appreciate you coming onto the podcast. We'll have to catch up with you again down the road and see if you've dominated the entire landscape by two or three years from now.

TJ Oshun: That's the goal. That's the goal. That's the mission one patient at a time. Thank you so much, John, for having me. This was fun. I enjoyed the interaction.

John: Me too. You've been a good, great guest. So with that, I'll say goodbye.

TJ Oshun: Bye-bye, John.

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Interview with Dr. Sharon Hull – 351

In today's episode, Dr. Sharon Hull explains why exploring what matters most is critical to designing your career.

From her early experiences in small-town medicine to her role as a pioneering leader in physician coaching, Dr. Hull's story resonates with professionals seeking greater fulfillment and meaning in their work lives. Today, she empowers listeners to embark on their personal journeys of self-discovery and intentional career design.

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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.

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.

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Navigating Leadership in Medicine

As a seasoned coach and mentor, Dr. Hull recognizes the importance of leadership development for physicians and other professionals. She discusses the unique challenges physicians face in leadership roles, from communication barriers to institutional politics. Drawing from her coaching experience, Dr. Hull offers practical advice on cultivating essential leadership skills, including effective communication, time management, and strategic decision-making.

Professional Careers by Design

Dr. Hull's forthcoming book, Professional Careers by Design: A Handbook for the Bespoke Life, serves as a roadmap for professionals seeking to design their careers with intentionality and purpose. Through a blend of practical strategies and thought-provoking exercises, the book guides readers through self-discovery and career planning. Dr. Hull emphasizes the importance of aligning career choices with personal values and aspirations, encouraging readers to embrace change and pursue meaningful work that reflects their authentic selves.

Dr. Sharon Hull's Mantra

Start with what matters and then figure out how you can get more of that in your life.

Summary

To connect with Dr. Sharon Hull and explore her insights further, you can visit her website at www.mettasolutions.com. You'll find valuable resources there, including her blog and information about her book, Professional Careers by Design: A Handbook for the Bespoke Life. Additionally, you can follow Dr. Hull on LinkedIn for updates and insights into career transformation and intentional career planning. Whether you're seeking guidance on navigating career transitions or crafting a purpose-driven career path, Dr. Hull's expertise and resources offer invaluable support on your professional journey.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 351

Explore What Matters Most and Design Your Professional Career

- Interview with Dr. Sharon Hull

John: One of the things that comes up very often when I'm speaking with physicians who are looking for what to do with the next chapter of their life because they're unfulfilled or unhappy is they have this question, "How do I figure out what I should be doing or find out what my passion is?"

Anyway, they've never done that introspection before and that's why I'm so happy to have today's guest, Dr. Sharon Hull with me today. She's written a book, she's been doing coaching for years and she's addressed this particular problem many times with her clients over the years. With that, let me welcome Dr. Sharon Hull.

Dr. Sharon Hull: Thank you, John. It's a delight to be here. I've been following your work for several years and happy to talk to your audience of people who are trying to figure out how to make peace with this career choice.

John: Yes, and how to make the best of it maybe and continue it, maybe get rid of the bad parts of the particular situation and keep the good parts. Tell us about your background, what you've been up to and then we'll get into my questions and about what you've been doing. So tell us about your journey.

Dr. Sharon Hull: I'm delighted to tell you a bit of my story. I'm a family physician. I tell people by initial training and by my DNA. It was my natural fit when I went through medical school and had a wonderful 30-plus year career in family medicine, most of it in academic medicine but I did start in solo rural private practice near my hometown which was its own wild ride of an experience. People that were my second parents, my best friend and my babysitter as a child helped me paint the trim on my office the night before we opened. That's a classic small town family medicine story.

I had a great career as a physician and I realized that my life was going to need to make some shifts along the way to deal with family needs and for that reason I entered early a career of coaching kind of as a side gig with medicine. Everybody in my medical world and my academic world knew that I was doing it and I figured I would go full-time into it when I retired in my mid-60s. That was my mental plan.

And life happened and in my early 50s I got the opportunity to become a full-time coach within an academic center and build a program for coaching physicians and scientists in that center and had a wonderful time doing it but I found myself in my encore career about a decade before I expected to and I haven't looked back. No regrets about medicine and no regrets about an early transition to an encore. So, that's the short version of my story. I'll answer any questions you have.

John: That was very interesting and listeners, I recommend you look at Sharon's LinkedIn profile because you'll get a fuller picture in some ways. It's not the full story obviously but it just shows the number of transitions that Sharon has navigated. Before we get into my other questions, Sharon, can you just tell me the name of your hometown in Southern Illinois?

Dr. Sharon Hull: I grew up in a little town called Ridgeway which was the popcorn capital of the world as it claimed itself. There were 1,200 people in town and 23 people in my high school graduating class. It was a classic small town experience.

John: Do you have any idea how far away that is from Metropolis? Have you ever heard of that town?

Dr. Sharon Hull: I do. I know exactly where Metropolis is. Are you from Metropolis by the way?

John: I'm not but my wife's family is from there and some of them still live in that area.

Dr. Sharon Hull: I grew up probably about 60 miles from Metropolis, just a little bit north.

John: That's definitely Southern Illinois. It's almost Kentucky.

Dr. Sharon Hull: People think that Illinois is all Chicago and there's a whole bunch of the state left.

John: All right, let's get back to the interview. One of the things I wanted to comment on is it looked like because you're involved with academics and you're doing it with coaching, it looked to me a lot like it was leadership coaching and I think that the part they don't necessarily teach in med school and residency, you have to be some type of leader when you're a physician but it's not always the right type of leader. Any comment on that observation?

Dr. Sharon Hull: I have some comments about it. I don't think we get taught how to be leaders and I think leadership is a profession in and of itself that has a certain skill set that you might have if you're a physician and you might not have. I worked with a lot of physicians who found themselves in leadership roles because of their clinical expertise or their scientific expertise and they didn't know what to do with humans in a nonclinical setting.

Usually I wasn't working with people who were in trouble. I was working with people who were new to leadership roles and trying to build the skills. We focused a lot on communication skills, on time and energy management as a new leader and what I sort of jokingly call the institutional perspective or the politics of the whole thing. That's where I spent most of my time in leadership coaching. It's that perspective taking and communication skills.

John: Yes, as you know physicians are often put in leadership role for a team or a committee but if we work in a corporate environment, it's different, or any kind of big hierarchy. It's a whole different way of interacting with people. A lot of people are focusing more on servant leadership for the last 10 or 20 years and so that means it's not like the military approach, the way medicine used to be. That's an important thing. And you must have been contributing heavily to your organization. I don't think there are that many that were doing that kind of coaching at the time.

Dr. Sharon Hull: We were one of the early institutions. I won't say we were the first but we were among the first to really put in place a program that wasn't about people being in trouble. It was really an investment in mid-career talented people who were rising up the ladder and helping them be successful. It was a lot of fun.

John: Sounds like it would be fun. That was a thing that brought me to you when we connected on LinkedIn a month or two ago. And at the time I was setting this interview up with you I didn't actually realize you were on the verge of releasing your book and it addresses all these issues around leadership and designing one's career. I thought this was definitely something we have to talk about. So tell us what's the name of the book and why did you write it?

Dr. Sharon Hull: I'm happy to do that. The title of the book is Professional Careers by Design: A Handbook for the Bespoke Life. This book is kind of a distillation of about a dozen years of coaching professionals about how to help them make their career what they want and need it to be at that moment. Helping them realize that their needs and wants change over the course of a lifetime and that's okay. It's really kind of a guidebook to a lifelong process of being intentional about your career.

I came to write it because I kept coaching people who were asking these questions. How do I know what I want? What do I do? I've trained to do one thing and I can't imagine not doing it but I can't imagine keeping on this path. And I kept looking for the book that I could have them read and I couldn't find the book that covered what I was covering. And after about eight or nine years I decided I probably was going to just have to write it. And that sounds arrogant and I don't mean it to but I couldn't find anybody who was talking about it the way I was coaching people. So I decided to put that in print and maybe leave it as a guidebook.

John: I'm glad you did and the thing is the book hasn't been released yet as we're recording this but it's coming out very soon.

Dr. Sharon Hull: Launch day is tomorrow, John. April 30th. By the time your podcast goes live it will be live and released. We're going to do a big launch event tomorrow where I'm doing interviews of people about their career journey and we're going to have a lot of fun. By the time your listeners hear this it will be available to the public.

John: Okay, we'll get to how to get the book in a minute but it struck me as I was looking at the index for the book there's so many different areas they think are right on in terms of what we need to learn about it. Probably any professional in a similar situation. I don't know if you'd agree but there's a big group that's a lot like us physicians and that's professional athletes. They work really, really hard for a long time. They get burned out and they face things even more in a compressed way because their careers are usually shorter.

That's what I'm going to ask you about today. Some of the things in the book and you can educate me and our listeners and then go off in any direction you want but just to get things started you know what I hear a lot is that physicians say they're just unhappy. I can't really keep this kind of pace up forever. I'm just overwhelmed. I've experienced the same thing myself and that even if you enjoy medicine there's a certain point as you get older you just can't keep up that pace. You can't be on call and work long hours forever. And so, the question is always what do I do next? How do I find out or figure out what I should go towards rather than running away from something?

Dr. Sharon Hull: I'll respond to that first by saying it is good to go towards something rather than just run away. I think that's a hallmark of the early conversations when I meet with somebody who wants to think about changing careers.

The next things I do because I'm a family physician by training is I try to assess the degree of burnout and the degree of mental health compromise and assuming that people are stable and not in urgency about those things. Then we have a conversation about what matters to you. I remember asking one man in his early 50s that question and said "What matters to you right now?" And this was a kind of a classic stoic man who looked at me and just started crying and it surprised the heck out of him that he cried but when he was able to gather his thoughts he said nobody's asked me what I wanted in 40 years. And I think as professionals, it's not just men it's men and women, and it's not just physicians but as professionals we don't ask ourselves what matters very often.

And so, at the beginning of my book the front section is about discernment and it starts with that question, "What matters most to you at this season of your life?" I think that list changes over our seasons. It changes when you're early in your career when you have young children if you have children, when you have caregiving responsibilities or health issues. That's what I mean when I talk about the seasons of people's lives.

When I give them this exercise and it's the first exercise in the book, make your top 10 list of the things that matter. And I tell people, I quote a dear friend and mentor who's recognized in the book, personal and professional, it's all one life. You have a finite amount of energy. What you do with it's up to you. And so, that's kind of the ground state for the book and then I ask them to make that list of what matters and I tell them the only rule is you have to have some personal and some professional things. And there's no right ratio, just make your list. You can't be wrong it's your list.

I bring people back to talk about that and I ask them what they learned and what surprised them. And almost invariably what surprises them is the top five to seven things are personal they're not professional. For all of us, it's kind of near universal human experience with the exception of people who are very early in their careers or at a very high competitive time in their career. I have a professor who's trying to get tenure and trying to get their grants written or somebody who's trying to get through residency or fellowship. Those people it's mostly professional at the top. But for most of us once we're through that, it's about person and nobody gives us permission to do that conversation in our own heads. I feel like I'm preaching to the choir here, let me be quiet and let you do any follow-up if you want to.

John: Well, I think it's ironic sometimes when I talk to people, for example, someone who's working 60 hours a week they're trying to generate a lot of money so they can donate it or contribute it to some venture to be able to share the income to get access to and support that other thing that probably is what's important to them. And to me it's like "Well, why don't you just do something that somehow brings these together if that's really what matters to you?" And like you said life and the career aren't necessarily separate. So that's just an observation that I've made and I'm sure you've seen different versions of that same kind of thing.

Dr. Sharon Hull: Well, you do too. You reach a lot of people and you've talked to a lot of people. I have seen some of the online conversations you've had and these are common questions and you're seeing the same variations on a theme that I see. I will say they extend beyond just the profession of medicine and I tried to write the book or any professional however they define themselves but particularly people who have studied for a long time to enter a profession and have a set of expectations that they'll stay with it from society or from their family or from income needs or whatever. That's who the book is written for is the people who feel like they might be stuck.

John: I'd like to go back to something that you mentioned earlier and it's this whole idea of a life and a career by design. Maybe that's something everyone should be taught either in high school or college about actually taking time to try to design your career, design your life and maybe go back to it from time to time. Growing up I was good at math, I was good in science, I got good grades, so I guess I was going to be a physician. So, how should we really look at that? How should we conceptualize that?

Dr. Sharon Hull: I devote some time in the very beginning of the book to talking about the idea of design thinking, kind of the idea that you make the best first choice you can make and you keep tinkering. And it's people who design furniture or design machine parts do that. Thomas Edison did that when he invented the light bulb. He had 1,500 ways he failed and he said "I didn't fail, I had 1,500 ways not to do it." Sometimes I meet people that feel that way about their careers. And so, the idea that we're designing always gives people that sense of agency to reassess.

And my real unstated goal, I guess I'm stating it here so it will be out of the bag is to get this book in the hands of young trainees as early in their careers possible. I actually think that people younger than you and me have handle on this that we didn't have and they're going to reiterate their careers multiple times. This is just a guidebook to how to do it.

John: Well, I have to agree with you. I have seen some examples that I thought "Wow, they had so much insight in an early age and they were really thinking two or three steps further than I ever thought." Again we're such old school I think, we're from a different era but I couldn't see past that horizon so I just kind of plugged along and did my thing until maybe I felt like it just wasn't the right thing anymore.

Again, I mentioned this earlier but if people look at your LinkedIn profile I think it was a good example yourself and again it might not have all been by design at the beginning but it does demonstrate that you can make significant changes, you can evolve, you can shift from you know patient care to some non-patient care position but still doing what you love and maybe like you said what matters.

Dr. Sharon Hull: It doesn't have to be static but people do have constraints on their decisions. And we talk about that in the book. Perhaps when you're young you have fewer constraints. And we enter a time in our late 20s early 30s to maybe our 40s mid 40s where there are a lot of personal constraints. They might be financial, they might be child rearing, they might be geographic. There are lots of reasons people feel stuck in that period. But if they can see light at the end of the tunnel or see that they do have choice, they can come through burnout a little differently, I think. At least that's my hypothesis, we'll see.

John: I think that's right on at least from what I observed. You mentioned the term "agency" a minute ago. We don't use that term very often. Maybe in a corporate environment I might have heard it once in a while it's a bit of jargon but has a certain really applicable meaning to what we're talking about. So, can you explain what that means to you?

Dr. Sharon Hull: I will. I will first say that as a young family physician I was taught the term self-efficacy, the ability to believe I could do something about a problem I was facing. And to me agency is maybe a just a different term, maybe it's more corporate speak, maybe it's more ethical psychological speak. We are the agents of our own lives and we don't talk about that much. That doesn't make us selfish. It does make us responsible for the choices. I have a coffee mug on my desk over here that says "Never complain about what you permit." And when I first saw that quote it hit me right between the eyes. It's like yeah, if you don't like something, figure out how to change it without just creating chaos around you. And the book is about how not to create chaos but to do it intentionally.

John: Yes, it's odd to me that we feel that in spite of being part of one of the most educated professions on the planet we don't feel we have any options and we don't have any control over life once we get locked in and we've finished residency or fellowship, whatever it is. And you kind of feel like "I have to do this, I've invested so much into this role." And that whole thought process holds us back. But we're not actually obligated to do anything.

Dr. Sharon Hull: I actually have two things I'd like to say about that if I could. The first is that I spent a number of years as the dean of students for a medical school. And my job was to run orientation for the first year students and it was about three weeks long. And at the end of three weeks I would meet with them in small groups and I would say "If in the last three weeks you've figured out that this is not the place for you, and this is not the profession for you, could you say that?" And in eight years six or eight years of doing that job no one ever said yes. Three weeks in people felt stuck.

Now the second thing I want to say about that is our friends in law will tell you my law degree teaches me how to think but it doesn't mean I have to be in the courtroom. They see the skills as a doorway to do all kinds of things. And for a long time I was envious of my law colleagues and then I thought "Well, I have some skills that could open some doors for me too. I just need to think about it differently." So, I got fascinated talking to my law friends.

John: When you were just talking about that question you asked your students as a dean, I always kind of looked at it as a conspiracy. I can't imagine any of my instructors professors or other teachers would tell me "Oh, yeah, after you get into this or maybe eventually you want to do something else outside of medicine or something that applies medicine in a different way where you're not subject to being stuck with dealing with insurance companies and all the regulations and the long hours doing in the EMR."

It seems like they're part of that system and they want to continue this system. They don't want to let anybody out of the system and that might be overly cynical I'll admit. And at least you were there asking that question. I personally have never talked to anyone who's had a positive response to a physician in training who was thinking about leaving medicine. They'll usually do whatever they can to keep them there for a lot of practical reasons too.

Dr. Sharon Hull: Some of the earliest informal coaching I did was with medical students who really did figure out the answer to that question that they really didn't want to do clinical medicine. And much to the chagrin sometimes of my superiors I became a safe place for them to talk. And that may have been where I kind of learned my pathway was going to have a place here.

John: As I suspected your superiors weren't necessarily real enthusiastic about that.

Dr. Sharon Hull: There's this whole mentality of societies investing in your training and you owe society back. They've invested in you and this is a calling. There are lots of parts of that myth and it's not entirely mythical you have to decide what part of it applies to you.

John: It shouldn't be a surprise though when you consider that most of us made a decision to go into health care when we were children.

Dr. Sharon Hull: That's where the term agency comes in. I'm the agent of my own career. And sometimes the choices before us aren't great but we make the best one we can in the moment and get really intentional about what's next.

John: Well, there's more about that in the book, and I am going to ask you one more question before you go. But first let's talk about where they can find the book and then tell us the title and the easiest way to get the book when it comes out.

Dr. Sharon Hull: They can find out more about me obviously through LinkedIn and I'm assuming you'll put my LinkedIn in the show notes. But my website is www.mettasolutions.com. Metta, that's the name of my company, Metta Solutions. And on that website they'll find my blog, they'll also find a page devoted to the book which is titled Professional Careers by Design: A Handbook for the Bespoke Life. On the book page are several options for buying it. You can also find it in the common places like Amazon or Barnes & Noble or Goodreads. But that book page on my website collects all of those in one place.

John: Okay, excellent. Well, we are going to run out of time pretty soon now so I'll put those links to everything you mentioned in the show notes, of course. In thinking about your kind of typical clients or my listeners, any last words for any professional who might just be frustrated or unhappy in their career and how to maybe be better at designing it.

Dr. Sharon Hull: Start with what matters. That is my mantra. Start with what matters to you and then figure out how you can get more of that in your life systematically every day and let the list change as your life changes. That sounds like airy fairy kind of stuff but it's really not. It's common sense. My grandmother would understand it. Just start with what matters and the rest does come. The book can be a guide to the technical parts about what you need to deal with.

John: Yes, that's very helpful. Let's start with what matters. Maybe just sit down and start writing your list.

Dr. Sharon Hull: Top ten list.

John: And if you need help you can start by getting the book. All right, Sharon, this has been fun.

Dr. Sharon Hull: It has been fun, John. Thank you.

John: Thanks again for coming. Bye-bye.

Dr. Sharon Hull: Bye-bye.

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Interview with Dr. Jennifer Allen and Kimberly Lowe – 346

In today's episode, Dr. Jennifer Allen and Kimberly Lowe describe how they grew their Infusion Lounge business together.

Dr. Allen and Kim Lowe were both fed up with conventional approaches to patient care. And they found that they shared a vision for a more upbeat joyful atmosphere. They describe their innovative approach to healthcare delivery, combining facets of direct primary care (DPC) and integrative medicine. Together, they discuss the evolution of their Infusion Center, The Well, highlighting its diverse services, including IV infusions, hormone therapy, and aesthetic procedures.

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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.

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.

In only 2 weeks from today, the second annual Nonclinical Career Summit will be starting. It’s not entirely nonclinical in its scope, however. We have several presentations about starting and running a private practice free of insurance companies.

It's called Clinical Practice: Make It Great or Move On

And beyond building your cash-based practice, our speakers will show you how to create an asset that can be sold later. Other experts will discuss MedSpas, Infusion Lounges, and other cash-only businesses, using Real Estate to diversify your income and assets, and several nonclinical side gigs including Expert Witness and Medical-Legal Prelitigation Consulting, Medical Affairs Regulatory Consulting, and remote SSDI Application Reviewer.

To learn more check it out at nonclinicalcareersummit.com. Remember that there is NO cost to attend the live event. And if you can’t attend all or part of the Summit, you can purchase the All Access Pass videos for only $39.

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Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Dr. Jennifer Allen's Journey to Direct Primary Care

Dr. Jennifer Allen shares her unique career trajectory, from nurse to family physician and eventually transitioning to direct primary care (DPC). She recounts the challenges of traditional healthcare and the liberating experience of offering membership-based primary care outside the constraints of insurance.

In her candid discussion, Dr. Allen highlights the pivotal moments that led her to embrace DPC, emphasizing the benefits of alternative healthcare models for physicians and patients.

The Evolution of The Well: A Nurse-Physician Partnership

Kim and Jennifer discuss the inception and growth of The Well, an integrative health practice offering services like IV infusions, hormone therapy, and aesthetic procedures. They detail the journey from conception to expansion, reflecting on the challenges and rewards of their collaboration.

The duo shares insights into their holistic approach to healthcare delivery, emphasizing personalized care, patient education, and the impact of integrative medicine on their rural community.

Navigating Challenges in an Infusion Lounge

Our guests discuss the challenges they faced in establishing The Well, reflecting on legal considerations, business aspects, and the treatments available through integrative medicine. They share their strategies for fostering growth, emphasizing the importance of flexibility and focusing on patient-centered care.

Summary

Dr. Jennifer Allen and Kim Lowe shed light on their innovative approach to healthcare. For those intrigued by their integrative healthcare services, they direct readers to The Well's website. This platform showcases their range of offerings, including IV infusions, hormone therapy, and aesthetic procedures.

Additionally, for individuals seeking an example of a DPC practice, Dr. Allen points to New Freedom Family Medicine's website. Listeners are encouraged to reach out to 636-629-8444 for inquiries about The Well and 573-271-2927 for New Freedom Family Medicine.

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

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Links for Today's Episode:

• The Well Infusion Lounge Website
• Dr. Allen's Practice Website
• The Well Infusion Lounge Facebook Page
• How to Start and Grow a Profitable Cash Based Medical Practice – 293
• Reserve Your Free Spot at the 2024 Nonclinical Career Summit
• Dr. Debra Blaine's Coaching Services

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Today's PNC Podcast Transcript

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Episode 346 Transcript

Why an Infusion Lounge May Be the Best New Thing

Interview with Dr. Jennifer Allen and Kim Lowe

JOHN: Today's guests have not been on the podcast before, but they are both speakers at the upcoming summit that I mentioned at the introduction of this episode today. And I thought it would be helpful to bring them on, introduce them to you and hear about what they're up to, give you a little groundwork for the summit. And especially I'm really happy to have them here because I've been fascinated by healthcare professionals who have found new ways to deliver care or deliver healthcare in new ways that does not involve insurance companies.

So there are different ways of doing that. We're going to learn a bit about that today. So with that, I would like to welcome Dr. Jennifer Allen and Ms. Kimberly Lowe. Welcome to the podcast.

DR. ALLEN: Hi, thanks for having us.

JOHN: This is going to be fun. I'm going to learn a lot because this is one area where I think I've had one guest that talked about DPC about two years ago and other associated sort of cash-based practices. So we're going to learn a lot today.

So the first thing I'll ask you both is to take turns and tell us about each of your backgrounds, your training, and maybe a little bit about your work history, and then we'll get into how you got together.

DR. ALLEN: Okay. Well, I'll go first. So I'm Jennifer Allen.

I'm a family physician board certified. I started as a nurse back in the early nineties. Life sort of intervened.

I was going to wash you with the idea of going to medical school, and I sort of had a midlife crisis at 20 and was like, no, I don't want to do that. So I left school for a year, did a few things. When I was ready to come back, I just, I graduated with my degree and I didn't know what I wanted to do.

So I did medical research. Then I was cooling my heels and was bored and still didn't want to go to medical school at that time. So I became a nurse and that was great.

I was a nurse for about nine years and then I became a nurse practitioner. I did that for nine years. And then an amazing thing happened that would be a topic, I guess, for another time.

I was given a gift to go to medical school. And so a patient of mine really wanted me to be a doctor. And she said, if I would go back, she would pay for it.

So, so I did. And, and then I did my residency at Mercy Family Medicine in St. Louis and went back into hospital-based practice after that. I hated it.

I just, I could, I love my patients, but I couldn't deal with the mess that that is. And so I had learned about direct primary care along the way, which is, membership-based practice. We don't bill any insurance.

Our patients join our practice as members and pay a monthly membership fee and get basically all the primary care I can give them. Kind of like Netflix, you know, you pay your bill, you rent movies and, you know, you don't have to pay at the time of service. So that experience got me out of the system.

There's a lot of healthcare knowledge that we are not exposed to when we are in the box of traditional Western healthcare that is controlled by the powers that be. And so in that knowledge gathering, I, I learned about other things like IV nutrition and hormone therapy and things like that. And then I met Kim and we had some similar ideas.

And so we joined a partnership and that's where the well came from.

KIM LOWE: So mine's not nearly as exciting. I was a nurse. I've been an RN now for, I guess, oh, going on 16 years.

I graduated first with my associate's degree in nursing, went straight into the workforce at the hospital. I started out in labor and delivery, newborn care, had worked at some big hospitals. I worked at smaller hospitals.

I decided to go back and get my bachelor's degree in nursing in 2015. I too, like I said, have the whole experience, the hospital experience. I love my job.

I love my patients, but the bureaucracy of it all is just a little too much. So I ended up going to work for an integrative medical physician down in St. Louis. And it was a fantastic time in my life because I learned so much.

And he also, he wasn't necessarily direct primary care but he had the same fashion of ideas of how we do things here. So we do the IVs and the hormones and also the direct primary care portion of it, where you come in for regular clinical visits. So I learned a lot there and just, you know, it's an hour commute back and forth.

And I got tired of that life. I did, during COVID, work for a very short amount of time just prior to COVID, I should say, starting. I worked for the insurance company as a case manager because I thought that would be a great way to work at home and to help raise my kids and things as they got older.

Not ideal. So the company was great. I mean, they cared for me as an employee, the benefits were great, but it was just very difficult with the position that I was put in, knowing the things that I knew with integrative care and there was a different world out there.

I started seeing Dr. Allen, I think it was actually in COVID, probably 2020, as a patient of hers. And I wanted to get out of the world of doing insurance and case management and all of that stuff. And I came to her with this idea and I said, hey, I have all this unused, untapped potential and skill.

How would you feel about opening up an infusion lounge? Let's do IVs. Let's do some things.

Let's, you know, get this kind of show on the road for this side, which has been great. I mean, we've gotten some major expansion, I think here, and we've just grown together kind of as business partners, like learning new things. I help her out in the clinic sometimes when she needs, she helps over here.

Like we just kind of scratch each other's back. So it works really well for us all, but that's my background. Not as exciting, but it's just a lot.

JOHN: No, it's good. I mean, it's, you know, we all have different stories. And so, so you were both, you know, working in different ways.

And so it sounds like, Kim, you kind of were the one that said, well, maybe we could do something together where we can expand and both benefit from that. So what was it, was it complicated creating this at the beginning, even from just a legal standpoint? I assume, you know, that your partners in this, in a business sense, as well as in, you know, just socially and so forth.

DR. ALLEN: Yeah. So we actually, I was looking into IV infusion. One of my nurses in our Herman location was talking about doing some IV infusions in our Herman office, and I knew it was a great idea, but I didn't have the, the free time, essentially, to be able to build that by myself.

And it wasn't, I mean, it was literally like a month later, Kim came to me and I was like, you know, we've been considering this. So, so she really was the physical energy that was able to come in and, you know, put the paperwork together and, you know, the literal physical plant, if you will, of it. We just formed an LLC 50-50 partnership and pretty easy, opened our doors.

KIM LOWE: So the moon, the sun, and the stars aligned like all at the right time for this to happen, because it just, it was meant to be, it just was a meant to be practice and things just worked out how they were supposed to.

JOHN: All right. Well, one of the questions, you know, I, I'm kind of, when we were talking and, and even in the summit, you know, I keep throwing this term around, you know, infusion lounge, infusion center. And I understand that you're, the well does a lot of different things and maybe even shouldn't be pigeonholed.

And I understand things like, you know, aesthetic services and med spa type services. I mean, a lot of these clinics have different mixes of what they do. So tell us like what you do, what the technical definition of an infusion lounge is and anything else you want to tell me about the actual business and how, how you take care of people.

KIM LOWE: So I think it's, it's kind of sprouted more from the initial idea was of course the IVs, right? And so as time went on, you know, you start getting to know more things, you see more things, you research more things. Integrative medicine is one of those things that's forever expanding and there's always new things out there that's better and more healthier.

And we actually after, I would say, probably a year of doing IVs and things like that, we were approached by a rep for hormone therapy replacement. And at first we weren't necessarily cool on the idea. I'm like, I don't know, this is somewhat new.

I had heard of it before. I'd never actually done the pellets myself, but at the integrated medical center where I worked, they did those. And I really kind of pushed.

I was like, I think we should, you know, maybe look at this, right? So we got some books, we got ideas. They offered to do pellets for us and give us the information and send us to all these locations to go to watch these things and talk to the actual patients that have gotten them placed before.

And the more we knew about it, the more research we ended up landing on, it probably took, I don't know, three or four months before we were really like, yeah, let's do this.

DR. ALLEN: And so go ahead. Sorry. That's okay.

I mean, again, I, in my separate journey as the DPC doctor, I was looking for new ways to help my patients be healthier. I'm not a box checker. I don't, I don't like a lot of big pharma kind of medications.

And so I was coming on this information on my own in my other practice with nutrition and hormone replacement therapy. And so I was already learning about it. And literally the rep came in the door one day and was like, Hey, what do you think about pellets?

And so the, you know, you either love pellets or you don't, there's a, we live in a very, um, delineated, you know, culture and hormones are not bad. And, but unfortunately the last generation of us as healthcare providers have been educated that they are bad because of bad science and bad research. And that, that stuff gets perpetuated.

And until you delve in on your own and start learning about these things, we just don't know, you know, we're, we have these preconceived notions. And so I was gaining this knowledge. And again, Marla walked through the door and I was like, you know, let me look at this because it's, it's just a different vehicle for the same kind of hormone replacement as patches, creams, and pills that everybody is okay with.

So once, once I realized that it was just a different vehicle and it's not scary and there is a lot of good science behind it. Um, I was like, yeah, let's try this.

KIM LOWE: And so I would say it's, it's probably a different topic for another day, but, and maybe even in the summit, we can talk about this, but hormones are one of those things that I think are absolutely life changing for people. I mean, it is, it literally been a life changing thing in our practice. And, you know, just to see people come in and actually tell you that they feel better.

We're able to get people off of medications that they've been on for years for anxiety and statins and all of these things that have all these eroding side effects to your body later on in life, all in place of a bio-identical hormone pellet. And so to me, it gives you some really warm and fuzzy feelings that we're actually doing good for people out there.

JOHN: Can you give me a one example, just a type of person, client, patient, if you call them in terms of with the implants that what would be like their, the problem that they have, you identify it, how do you identify it? And then, um, what was the impact of, you know, using the implants?

DR. ALLEN: Well, so for a lot of women who are going through menopause, I see it as a continuum. You'll have people who have symptoms early on with the, the loss of testosterone that, that starts actually in our early thirties, women have testosterone. That's the first thing.

Oh, really? Yes. Women have testosterone and it's a very important hormone for us.

And when, when you're coming into your forties, you start to, you start to get the brain fog, you start to get anxiety, you start to get depression and, you know, nobody has a, um, venlafaxine deficiency. Nobody has a Prozac deficiency, right? So, um, when you start looking at those things and how people are interacting in their interpersonal relationships, they're tired, they have no libido, sex doesn't feel good anymore, things like that.

That patient, if you could get somebody to open up, they come in and they just say, I don't feel well. And so you have to sort of peel off the layers and figure out what's going on. And then you approach the subject of hormone replacement.

And I've had women tell me, you gave me my life back and tears streaming down their face. So it's so rewarding to see that.

JOHN: All right. Well, the next question is just kind of a follow-up on sort of the business aspects and just the lifestyle. It's just, you've been doing this, I think three or four years.

And so just kind of, other than that story, which is a very positive one, like, just give me a, what your sense is you're feeling about how it's been going. And do you really think looking back now that it's definitely been something that you're glad you got into?

KIM LOWE: Yeah, absolutely. I mean, I think we laugh now because we were at another location last year, roughly about this time, and it was an 800 square foot clinic. It was tiny.

We were on top of each other. The amount of people that we were seeing was steadily climbing, you know, every day we were seeing more and more. And so we had expanded now to our new location, which is fantastic.

It's 3000 square feet. The regenerative medicine side, the well side is on one side. And then we have the primary clinic on the other side with a conjoined waiting room.

So our patients feel like they have access to both places. The amount of awareness I think has really skyrocketed. And to be honest, you know, the best way that we get patients is word of mouth.

People are really happy with our services. We're a small town, I would say we're rural still. We're not a big town.

We're, you know, we have, we don't have a Chick-fil-A if that tells you anything. So we're not that big. We would still have a rural population and our Hermann office is very rural.

But I would say our, our clientele is just continually going uphill because people are so happy with the services. They come out, they feel better. They don't feel like every time they walk in here, they're just wrote another prescription.

JOHN: Now you've expanded the services even beyond what you've mentioned so far, right? I mean, it seems like there's new things. They probably aren't maybe, you know, 30% of your activities, but what, what other things are you doing besides what we've already talked about?

DR. ALLEN: So we have some radio frequency devices. We do aesthetic procedures like wrinkle reduction, skin tightening, body contouring. We have a cryotherapy machine.

Stress incontinence. That's huge for women.

JOHN: So now if I think about like what would be checking my boxes, it'd be something that, you know, I enjoy doing making a decent income. My patients are happy and I don't, I might be busy, but I'm, you know, I'm happy to do the work because it's, it's part of a mission. So that's what I'm kind of hearing from you that it's kind of checking all those boxes.

DR. ALLEN: Yeah. From, from my point of view, because I have both responsibilities, I mean, I, I work more than the average person who's probably watching this podcast would like to work, but from on the well side of it, it's not something that I have to do on Saturdays and Sundays or at night. And, and that's really, you know, that's really nice.

Now on the direct primary care side, I work a lot, but some of that is me. I'm kind of a workaholic, but I am getting better at boundaries. And if you just teach people, you know, Hey, I am a human being and I deserve my Saturday and Sunday, then they're okay with that.

And if they're not, then they can find somebody else. So.

JOHN: Yeah. And that reminds me when we, when we're finished and when I post this, I'll put links to everything, you know, about the well as of course, but then I'll also put links about your practice, you know, just, you never know. It might be some physicians that maybe don't even live too far from you that might want to look at, you know, what you're doing and maybe call with a few questions or send some patients over.

But, uh, you know, I, I, I've found that even physicians who are busy, if they're doing things, they love, they actually don't have burnout. I mean, they might be tired, but they're not fried the way, you know, it was back in, you know, the corporate style of medicine that most of us physicians and nurses at least learned in our training and, and dealt with. So it sounds like you'd agree with that.

DR. ALLEN: Absolutely. Yeah. Everything about it is different.

KIM LOWE: Yeah.

DR. ALLEN: The documentation is different. The requirements, the environment's just different.

KIM LOWE: The interaction with patients. I mean, just the, the doctor nurse, everything about it is completely different than an intense setting where you feel like you're constantly under a pressure cooker to do more, excel more, be better, take more patients, like all of these things where you don't, you don't have time to actually sit and talk and get to know your patient and build a rapport with your patient. And in the end, that's how you start to peel back the layers is to, to have them feel comfortable enough to talk to you because they are feeling better.

Then you really start getting to the core of a lot of the problems. Right.

JOHN: And the model that you're using with a, you know, a partnership between a physician and nurse that seems to be working out well also. Right. Because a lot of the delivery requires, you know, someone in nursing, obviously that really knows what they're doing and, you know, the physician can deal with the things that require that license.

But it makes sense to me that that would, that partnership would work out.

DR. ALLEN: Yeah, we do things. I mean, a lot of what she does in the clinic is delegated by protocol. You know, so there's established steps, but you know, she's a bachelor's prepared nurse with a lot of experience, so she can use her clinical judgment and problem solve.

And she knows her limitations and she calls me if she needs recommendations or advice.

JOHN: Yeah. Excellent. Well, go ahead and give us the links, the URL or the phone numbers, anything you want to share with anyone who might want to contact you about The Well.

KIM LOWE: So the website is thewelliv.com. And then our phone number is 636-629-8444. And we're responsive to either call or text, so we welcome either.

JOHN: All right. And so some of my listeners might want to see, you know, an example of direct primary care. So what's the website for your practice?

DR. ALLEN: It's newfreedomfamilymed.com. And our phone number is 573-271-2927.

JOHN: Okay, great. Well, we're going to get into a lot more detail during the summit. In fact, I've split this couple up for the summit, Tom Davis and I, because we want to get the perspective, you know, individually from the nurse and the physician, you know, but I think there's just so much interest in doing things like this that are novel and not your run of the mill type of practice.

And, you know, a lot of us are saying we need more individual, you know, family physicians and internists and others who are going into practice outside of the big corporate style of medicine and healthcare. So this is a really good example. So I'm really happy you were able to join me today as guests.

DR. ALLEN: Thank you. Well, thanks for having us. We, I'm very passionate about it.

And I really think that direct primary care could save our healthcare system and keep practicing physicians practicing instead of retiring early, you know, because they can't do it anymore.

JOHN: I think I have to, I might put you on the spot right now and tell you that I'm going to definitely invite you to come back and just talk about that topic sometime as someone who's been living it. And so I just throw that out there. So listeners keep that in mind.

If you want to learn about that, we'll get Dr. Allen back here sometime to talk about her practice in more detail. All right. Any last words of advice for our listeners who might be frustrated, upset, burned out, any of the above, and they're just thinking about maybe just leaving medicine completely or nursing for that matter.

Any advice?

KIM LOWE: I mean, I was there once. I mean, I thought for sure. I'm like, I'm going to go be a veterinarian or something.

But I was there. All I can say is I, I prayed on it. I thought about it.

I, I found somebody who I knew I could trust. I mean, I think, I mean, kind of the same thing. You just see the burnout was high enough.

We just, we wanted something different. We wanted more.

DR. ALLEN: I think you keep it simple. You think of an idea of something, you know, that makes sense to you and then just put one foot in front of the other and see if you can make it happen. It's scary when you keep it in here, right?

Down, look around other people.

KIM LOWE: I mean, we are more, I have people all the time that ask me, how do you do this? And I'm like, well, it's, it's simple. It's really not that hard, but if you ever want help by all means, let me know.

I don't mind giving you a hand up on something information you need to get started, or you have the idea, you have the practice, but you're looking to expand on stuff. And we do that quite a bit. I think we have a couple of practitioners that come to us and Hey, we're trying to start IVs.

Can you help us like figure out where we need to go and what we need to do? So, I mean, I just one physician, one nurse helping each other, I think is fantastic. It works out really well.

Just be willing to help.

JOHN: Yeah. I think when you're in it, you can't even see the light, you know, that there's an option. And then once you actually break through that and you start doing it, it's amazing.

It's not like easy. It's kind of simple in a sense, there's just steps you have to do and it takes work, but I think you're a good example of that making it work. Okay.

Well, thank you so much. I, with that, I am going to say goodbye and thanks again for being here.

DR. ALLEN: John, thanks for having us.

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Interview with Dr. Lara Salyer – 344

In today's episode, Dr. Lara Salyer explains how she integrates the best of traditional and functional medicine in her practice. In the process, she takes listeners on a journey of career reinvention and personal empowerment. 

Dr. Salyer shares valuable insights and practical advice for practitioners seeking fulfillment and career balance. From the transformative power of creativity to the importance of storytelling and self-expression, listeners are inspired to try something new.

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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.

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It's time for the Second Annual Nonclinical Career Summit. It’s called Clinical Practice: Make It Great or Move On. We have 12 top-notch speakers such as Dr. Dike Drummond, Dr. Nneka Una, Dr. Gretchen Green, and Dr. Tom Davis.

We'll learn about creating a cash-based practice, MedSpa, Infusion Center, or other business, protecting yourself legally, and learning a lucrative side gig or investing in real estate.

Admission to the live event is free. If you prefer, you can purchase the recordings and bonuses for a small fee. Please join us on the evenings of April 16 through 18.

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Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

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Reimagining Healthcare and Integrating the Best Parts

In this engaging podcast episode, Dr. Lara Salyer reflects on her transition from burnout in family practice to discovering functional medicine. During our interview, she emphasized the importance of aligning one's career with personal passions and values. Dr. Salyer highlights the transformative power of creativity and innovation in revitalizing professional and personal fulfillment.

Empowering Practitioners and Cultivating Her Speaking Engagements

Lara describes her new role as a mentor, guiding practitioners through strategies for reclaiming joy and autonomy in their careers. She shares practical tips for crafting impactful speeches and navigating the speaking circuit, emphasizing the value of storytelling and authenticity. Additionally, she explores the significance of boundaries, self-expression, and embracing “messy” progress.

Dr. Lara Salyer's Advice on Career Fulfillment

Find your path to fulfillment with WARM: If I'm feeling stuck, overwhelmed, unhappy, I start with “W.” Whose voice is in my head right now making me feel bad?… then Aim low with tiny steps, Remember your ‘why', and “M” is “Messy moves the needle,” you don't have to be perfect.

Summary

Through engaging anecdotes and actionable tips, Dr. Salyer offers a roadmap for reclaiming passion and purpose. Whether you're navigating burnout or seeking to reignite your professional spark, Lara provides hope and guidance, reminding us that it's never too late to design a career that aligns with our deepest values and aspirations. To get in touch with Dr. Salyer you can find more information and contact her directly on her website drlarasalyer.com.

And if you wish to access any of her programs, you can use the Coupon Code “CATALYST” for a $50.00 discount off the usual price.

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• Freed.ai Medical Scribe App
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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 344

Integrating the Best of Traditional and Functional Medicine

- Interview with Dr. Lara Salyer

John: Sometimes when rebooting your practice, it's helpful to speak with someone who has a lot of imagination, and that describes today's guest to a T. She first appeared in the podcast in December of 2019, and she was about two years into reimagining herself, at least her approach to patient care. And she's continued to innovate since then, and she's now mentoring clinicians, more than she was at that time. I think that she's a great one to talk to today about remastering, recreating your life and your career. Dr. Lara Salyer, hello and welcome to the podcast.

Dr. Lara Salyer: It's a pleasure, John. I was so excited to receive your email invitation again, and mind blown that it's been four years. I feel like it was just yesterday. We were talking about innovation and transforming healthcare, and look, it continues. I'm happy to talk to your listeners about reimagining healthcare.

John: Yeah, I couldn't believe it either, because I just made a point a few months ago to say, well, I got to go back to my old guests and see what they're up to. And in my mind, your name just stands out. It isn't like something I had to dredge up. It's like, yeah, Laura, she's in the Midwest, she's been doing all these things in Wisconsin. Four years. That is crazy.

Dr. Lara Salyer: It's crazy. We're practically neighbors. But see, this is the beauty of what we've all been through in this global pandemic in the last four years, the world is made larger and smaller. I feel like it's really exploded our ability to connect across the seas and virtually. With the advent of telemedicine laws changing, there's so much cool things and innovations and AI that it's really inspired me. And yeah, I'd love to dive in and just talk about all the changes. Where should we start?

John: Well, let's see. We don't have to redo everything we did last time. I will have a link to the previous episode that has a lot of the information and how you found functional medicine and got involved in that, which I think has escalated exponentially. But anyway, start from there maybe and where we were then. And just touch on some of the things that are new about you and your practice and what you're doing with patients and other physicians.

Dr. Lara Salyer: Sure. Well, this is sort of the example of creating your own career that is a self-expressive vote of the future you'd like to see. And that's really what I embody and I try to use this as my compass as my mantra every day. Just in a one sentence nutshell, I was a burned out family practice doctor, realized I was burned out, not sure if I wanted to stay in medicine, but then fell in love with functional medicine on my last CME and decided that's what I wanted to do. I opened up my practice and we had our interview in 2019 and I talked about what that entailed being an entrepreneur in this space and learning those ropes.

Well, since 2019, I've really enjoyed embracing this creativity of educating patients with online courses and having online group visits every week that provides an ecosystem of support for my patients and really exploring this sandbox of tools that we have right at our disposal to make medicine fun again. And it's naturally been sort of an attracting beacon to other practitioners looking to innovate and to explore some of these options.

I've really amped up my mentoring, not just in the functional and integrative space. I help those practitioners grow and scale a membership practice in their own community using a lot of AI and tech. But I also mentor colleagues in burnout, those that want to tap back into creativity. I graduated from the flow research collective in their high flow leadership, so I can coach how to get that flow acquisition, which for those that don't know, flow is the only time your brain produces all five neurochemicals of happiness. The more you learn how to make your day flow channeled, the happier you are, the more easeful life feels.

And so, I'm enjoying this renaissance of my own personal career, helping practitioners learn how to become and embody their ideal self. And then that naturally just extends into my international speaking career. I had the honor of being invited to the center stage in London last year, last summer, on the largest European medical conference and was able to stand beside some greats that I was honored to have shoulder to shoulder. It just keeps expanding and it's just fun. And like I tell my teens when it stops being fun, now that's the time you need to think of making a shift. But I'm still having a blast.

John: That's a lot to talk about and to consider, but it sounds very positive. I don't know if we're going to get into the flow thing a lot, but maybe we will. But maybe just for our purposes, is that flow state, whether you're working or at home doing something, I'm assuming that's the same thing that in general we talk about when you're in that zone.

Dr. Lara Salyer: Yeah, in the zone. Yes. Just simple. Mihaly Csikszentmihalyi coined the term and it's anything from being in a sport or you're doing Tetris or you're balancing your books. It's just being in deep work.

John: Okay. Cool. I wanted to talk about the speaking a little bit because a lot of my listeners ask me about how to get into that. It seems to be kind of a black box. They don't know how to start. And just some tips on becoming a recognized speaker and getting some of the big types of engagements that you've talked about already today.

Dr. Lara Salyer: I've got lots of tips, John. I think I'm a shameless kind of person who is open to feedback all the time. So, be prepared to speak and make mistakes and fumble and keep getting up and trying again. But the key to establishing your own speaking career is finding your story. You have to have a story and everybody has a story. And once you find the story that is underlying this anchoring mission of why you feel compelled to speak, what are you speaking about? For me, it's speaking about healthcare burnout and the intersection of creativity and how we've lost that piece in healthcare.

And I really believe that physicians, if we could be allowed more autonomy to be self-expressive in the way we deliver medicine, we wouldn't have as much burnout. Of course, it's not that simple. If you look at my message, anybody could look at it and go, "Well, that's not the cure to burnout." No, I'm not saying it is. But it gives me the platform to tell my story, to offer things that I've learned that have helped people. I work with residencies and medical schools and I travel and do workshops. I'm able to craft this around my central story, which is I'm a physician who burned out and found a second career. Or third or fourth, however many you want to count. For anybody listening who's thinking, "How can I develop my speaking career?" start looking at your story. What's your story say? What are you passionate about? If anybody stopped you on the street and said, "You have 40 minutes to tell me something that you're passionate about without any slides, without any prep." That is what you need to talk about.

And so, right there, getting the topic and then second, crafting your PowerPoint, working with a mentor. I had my own public speaking coach, and I believe firmly in coaching. And that's part of the underlying result of my mission with working with so many residencies in medical schools and in my mission that I want to make coaching a part of medical school. That every medical student has a coach assigned. Everybody's got somebody there because we are not above needing that kind of executive help.

And so, when you work with a coach, like a public speaking coach, it can help save time and unlock some of the things that you didn't know you were doing and fidgeting. It makes such a difference. I would start there with knowing your story. What does that say about your mission and your vision in the world? And then working with a coach to help you craft that narrative and really make it professional.

John: I think that's awesome. Because when I think about things that successfully communicate, whether it's a book or a presentation, it always includes a story. Either the speaker's story, the writer's story, or somebody else's story, but it always ties back. That gives that great example of the point you're trying to make and it pulls people in, and they want to hear how the story ends. So, that's cool.

Dr. Lara Salyer: Yes. At least for me, I hated being in, and this is just my preference. Whenever I would be in a lecture or in some kind of presentation and listening to the speaker, it always felt empty to me when there wasn't some kind of transformative takeaway. And so, I like having all of my talks have something at the end that the listener gets, whether it's something that they can download or something that they can walk away with and remember you by. If you're looking to make a speaking career, develop that signature talk. Have some kind of takeaway. Like something downloadable. And if you don't have any of the fancy things like a CRM or an autoresponder, if those words don't resonate with you, you can simply just ask them to give you their email and you can send them something. You can be very old school about it. You don't have to be super polished and professional.

John: I think there are other people that think, "Okay, I'd love to have a speaking career." I don't think they're necessarily as committed because they're a little nervous to have a little stage fright. So, how do you get ready? That UK presentation, that was a big deal.

Dr. Lara Salyer: That was a huge deal. Oh my gosh.

John: How did you prep yourself for that?

Dr. Lara Salyer: Oh goodness. Well, it's that fine line of delusional almost OCD prepping and then trusting the universe that it'll be okay. I love the books. TED Talks, Chris Anderson, or Talk Like TED. Those are the two favorite books I have. I also like Rule the Room is another book, that's a resource. And I often listen to a podcast by Grant Baldwin called Speakers Lab. And believe it or not, that has taught me more than anything because he goes into the business of speaking of how to invite people or pitch to people and follow up and all those kinds of things.

I've learned a lot about the business, but when you're coming down to the wire and you're practicing, it's a combination of I would look at my slides because I was allowed to have some slides, but it was a TED style talk. I had 20 minutes to give my one message. And so, I would practice with the slides and then I would go on a walk and I would listen to myself because I recorded myself and I would listen and imagine the slides on my walk. And then I would try to see if I could anticipate the next sentence. I'd pause the recording and see if I could anticipate the next sentence, not so that it was rote memorization because a lot of public speaking coaches would say, "That's awful. You do not want to memorize your talk." You want it to feel like a conversation. And you want to allow for inflection and for moments of improv in a way.

What I would do is divide my talk into four segments of main points and I would try to anticipate, "Oh yeah, there's that next point. I'm going to talk about this." And that's all it was, was a summer of walks with my dog and just really memorizing the next point that was going to happen until I became comfortable that I felt like I could do it without any help.

John: No, that's awesome. Because you can tell, I watched a lot of TED talks in some of the smaller venues. You can tell the speaker is glancing at a monitor or screen or something to remind them of what they're doing. It doesn't really flow and it's okay, the message is good, but when you have a really good speaker, it flows and it's engaging and it goes by like in two minutes.

Dr. Lara Salyer: Yes. And don't be afraid to practice. Before that UK talk, I had other opportunities where people said, "Could you just give a 20 minute? - Oh yes, absolutely." And I remember in Toronto, I was asked to speak at a very large event for naturopathic doctors, and it was going to be broadcasted and I had no teleprompter, nothing, no slides. I thought, "This is even harder than UK. I am on it. Let's do this. This is going to be gritty test time." And I did it. And guess what? There were interruptions. Somebody walked in front of the feed when it was being recorded. There was a person that interrupted the door and I got put off. I didn't remember my next line, but guess what I did? It just took a moment. And that's the thing is when you face that kind of awkwardness and you realize you're not going to evaporate into ashes, it's okay. And you chuckle and you learn how to sidestep.

Everybody wants you to succeed. Nobody is sitting in the audience waiting for you to mess up and going, "There it is. I'm glad she's messing up." They want you to have a great time. So if you fake it till you make it in that moment and be like, "Okay, here we go", that's when you get to be that elevated speaker that people want to hear from because you're relatable.

John: That's great. That's awesome. I love that. And a lot of resources, I wrote those down and we'll put those in the show notes so people that are really interested can take advantage of those.

Okay. We're going to move into helping other clinicians, but I think before we get into that and how you're doing that, I think our listeners need to understand exactly what does your practice look like now? Functional medicine, not everybody even know what the functional medicine is and kind of tied to that. I think you still call what I would call clients patients but there's a distinction that some people make. And I think it's easier in functional medicine than let's say in doing something like yoga. You're not going to call them. If you can capture all of that in the opening of this next section here on how you help physicians.

Dr. Lara Salyer: Sure. Real quick, I do have a license to practice medicine in Wisconsin and Illinois. I have my attorney that comes in and teaches inside my mentorship for practitioners. I stay very, very close to the law. I don't want to call my patients clients. I'm still a physician, so I have a physician patient relationship. But my practice is very tiny. I call it very cozy. And I keep it that way because I have a lot of other hats I wear. Last year I was invited to be the director of practitioner activation for the School of Applied Functional Medicine. Basically I am the mentor for their school. And so, that is a job that I do part-time, but I also have my own mentorship, the Catalyst studio.

And these are practitioners that come in for 12 months and they're with me and they have a bunch of resources online. And we work one-on-one, and we also have weekly masterminding. We call it studio time. And the reason I've created this artistic metaphor is because I want physicians to create their masterpiece, their work-life masterpiece. I don't believe in work-life balance. I don't think that is something we can achieve. I believe it's a masterpiece. It's an integration of work and life. And so, they're with me for 12 months. And then in addition to that, I have one off session.

People that aren't even in functional medicine, they don't even care about integrative medicine. They might be a medical student, a resident, or just an attending who's like, "Hey, I need some inspiration on how can I pedal through some of these emotions, this burnout." I use solutions focused, positive psychology, a little bit of acceptance commitment techniques that help them tap back into flow. And I give ideas and resources and really get them back into what are they doing here. And helping them with decisions. It can be making a decision on the next step for their career or just how to play again as an adult. We forget that and kids are so good at that. I love being almost that little inspirational fairy that can help my colleagues get back into that childlike wonder.

John: Can you give me an example? And it could be even amalgam of many people, but what is the type of person that shows up at the beginning, either for the one-off mentoring or the 12 month? And then how does it look different at the end of that period? I'm just trying to get that so the listener can say, "Hey, that sounds like it's right up my alley."

Dr. Lara Salyer: Yes. That's great. I like to call this the average practitioner. They are frantic, they're rushed, they're stressed. They're feeling almost hopeless and wondering why they chose this career. But they feel stuck like "I have to be in this track." They don't see many options. They've probably not played or had their hobby dusted off the shelf for years. They probably look at you with blank eyes when you said, "When was the last time you did something fun?" They don't even know. They don't have free time. They really are a victim of their calendar. They're really reactive in their calendar planning instead of proactive. That's the typical practitioner.

And then at the end of my programs, I call them the catalysts. The catalysts, they are expansive, open-minded. They're innovative. They are very much in control of their calendar. They're very autonomous. They see those elements in their calendar and time and space and energy. They're boundaried. They're able to really keep and protect that energy and spend it on things that give them joy. They are more tapped into gratitude and creativity. And these catalysts are such a joy.

And so, I can take people through this journey. In fact, I have a 10 hour CME course that people can take online. Completely self-driven. And it helps them kind of walk through the standards that I've found have worked really well for my clients. I call those clients, my mentees, my catalyst. And it helps walk them through some of the basic foundations of finding your flow and finding your anchoring down into your "why" and how to use that throughout your day to bring joy back into focus.

John: On average, is that group of people employed at a large organization where a corporatization of medicine has kind of driven most of them crazy? Or are they in a practice and they're just overwhelmed? They may own it, but it's out of control because they're trying to handle everything.

Dr. Lara Salyer: That's great. For the functional integrative physicians and practitioners inside my 12 month mentorship, those people usually are solopreneurs. They might be employed, they might have a hybrid practice of insurance and cash pay. And these people are really looking how to strategically move that business. How to make it more streamlined and flow channeled. The one-off catalyst advantage, those are the people that sign up for just one or two or three sessions.

I have bundles of packages where they can meet with me one-on-one, and there's nothing to do with business. It's more about personal development. And those come from all walks of life. I have discounts for students and residents because I remember those days, you can't really afford much. And then it can be attendings, it can be nurse practitioners, people that are just curious about personally developing themselves. And they come from all walks of life as well. They could be independent, most of them employed.

My grand goal in my future, my five to 10 goal is I would love to be a chief wellness officer at a large organization because I've enjoyed working in this high level systemic change and seeing the results of what some of these modalities can do for practitioners is really life affirming for me. So, it's just been a wonderful journey.

John: Now as a secret in some of those to really focus on doing what you love and where the flow can occur potentially, and getting rid of the stuff that just drives you crazy. And does that require delegation? Does that require, or can it enable one to say, "Look, I'm a family physician, but I'm not going to do 100% of what a family physician could do. I'm going to focus on something that I like to do and I'm going to get rid of the rest."

Dr. Lara Salyer: Yes. Oh, I love this. It is getting comfortable disappointing other people. I think as physicians, especially family physicians, we are the bottom of the totem pole. We get everything dumped on us and we just get used to serving our patients, saying yes, doing it all. And it's time to push back. And it's okay to have boundaries. This is where I help people with those boundaries in saying, "Listen, if you are literally burning up and you are a miserable shell of a human, you're going to work, you're coming home from work and you are just not happy at all, something's got to change."

Now you can't change overnight the whole system. The system is slowly changing. But we are at a dawn of a new healthcare with AI helping. I love freed.ai. It's a wonderful program that is a charting program where all it does is listen to you and your patient and creates a beautiful SOAP note. I actually interviewed the founders. It's a resident and her husband who's a computer guy, they founded this company. It's phenomenal. And it's things like this that are going to help us fall back in love with medicine and do what we do best, which is being a healer. We are right now data entry clerks and we're not able to delegate because a lot of hospitals are saying, "No, you have to enter in those lab results. No, you have to do it all." And it's crumbling.

I really believe if we hang on, we are almost through the dark ages of medicine and we're about to enter the dawn of where AI can help us and it's suddenly going to be so much fun. It's like driving a Tesla. It's just, "Wow, everything's done for me." And so, hanging on, I think that's my role in this whole structure is helping our colleagues just to hang on and let's find a way through this that can help you stay human while we wait for AI to help. And it might mean take a day off every week and you go to your administrator saying, "I need to be different RVU. I need to back it down." Because we want to want to save you before you go out with the ship.

John: What was that link again to that AI tool?

Dr. Lara Salyer: Yeah, it's freed.ai. And what I love about them is they give you 10 free visits to try them out. You don't even have to put a credit card in. The proof is in there, amazing algorithms and AI. And then when you do, it's really affordable. You can get an industry, your whole institution can get a license, or you can get your own. If you use the code CATALYST, you get $50 off. I'll just give that out there so people can get a discount if they want it.

John: Excellent. I'll tell you and our listeners here why I am so interested in this is because my thing in the past has been "What other options can you do if you're a burned out physician?" But really, 15, 20 years ago, there wasn't a lot of focus on fixing within your own practice or something like your practice. Now I'm trying to get more people like you to say, let's go back to the beginning and take all the good things that you wanted to be when you went through med school and residency. And let's try and get rid of the other crap that doesn't help.

Dr. Lara Salyer: Yes.

John: That's just holding you down. And as we push this, I think we're going to see more of it. So, I appreciate what you're saying.

Dr. Lara Salyer: I'm glad that you've recognized that. I think there is an exodus of people. Their pendulum swung where people were leaving. Sadly, we lose a lot of people to suicide, a whole medical school class worth every year. And there's a lot of physicians that are just retiring early. But I think the pendulum is going to swing back the other way. Like you said, I want to save the career of medicine. I want to make the career of medicine something that still honors the joy and the creativity and the self-expression. Nobody wants to go see a robotic doctor. And so, I really think that we're almost there. We just got to hang on a bit and keep working at it.

John: The thing is not only are physicians frustrated and upset, the patients aren't happy. They're not happy with a five minute visit for something it takes 20 minutes normally and the doctor spends all their time documenting and sending notes in and blah, blah, blah. The whole thing has to change for patients as much as for physicians.

All right. Why don't you spend a couple minutes telling us about your website and what's on your website and how to get ahold of you and all that kind of stuff?

Dr. Lara Salyer: Oh, sure. Absolutely. We'll start to different things. If you're a patient in Wisconsin or Illinois, you can find me on my website, drlarasalyer.com. But I do keep a very, very long waiting list because I devote a lot of my time and passion to our colleagues. So, if you're a physician, a nurse practitioner, and you're curious about what creativity and flow can do to enhance your happiness and joy, again, go to my website, drlarasalyer.com and you'll be prompted through a series of buttons. It'll ask "What are you here for?" And it will direct you to the practitioner page.

And I would encourage you to take the Catalyst Archetype quiz. It's a free quiz. You'll be matched to one of the four archetypes. Are you a fervent flame, a resolute rock, a wise wind, a reflective river? And then it matches you to a two-page plan that will give you suggestions on adult play activities, things that you could do to enhance your hobbies and self-expression.

And also on that page, you'll find opportunities to do a sample session with me, a real one-on-one working session where we can just dive in and start getting you aligned with your best self. And all my stuff is there. If you need a speaker for your next conference, you need a keynote, again, I have a speaking page on my website. I love speaking. I'd love to connect with you. And there's an application form there as well.

John: Excellent. Well, listeners, I think you should take advantage of that, even if you have to skip the next few weeks of podcast listening. Spend that time checking out Lara's website and make a plan to change your life if you're not happy.

All right, Lara, we're going to run out of time here. So, just some more advice, some last minute advice before we go to our listeners who might be unhappy, out of balance, just frustrated and not enjoying their careers in particular. What advice do you have before we go?

Dr. Lara Salyer: I love little acronyms. I'm going to give you an acronym that I use when I'm feeling stuck, when I'm feeling unmotivated or overwhelmed. It's WARM and it goes like this. If I'm feeling stuck, overwhelmed, unhappy, I start with "W" and I ask, "Who's talking? Whose voice is in my head?" Is it the administrators saying, "You need to see more?" Whose voice is in my head right now making me feel bad? Is it my family of origin? Maybe it's an auntie or a grandma or something. Who's talking right now? Am I listening to my own voice or is it someone else?

The next is "A", which is aim low, not aim high. Aim low. Use Tiny Atomic Habits. James Clear is famous for that book. Atomic Habits. Do one tiny thing. Aim Low. What can you do in the next moment, even if it's just your next breath? Aim low. You're looking for tiny evidences of progress that you can find your way out of this mess.

Then "R" which is reason. What is your reason? What is your reason for medicine? Anchor yourself back into your "why." Why are you doing this? And there's many reasons. And it can shift, it could be stability. I wanted a predictable career. I wanted travel, whatever. But look at your reason because it may have shifted and maybe you're aiming towards the wrong North Star. But just look at that reason.

And lastly, "M" which is messy moves the needle. You don't have to be perfect, you don't have to have the answers all right now. You don't have to figure it out, but you can be messy and show up messy in this spot. When you're feeling overwhelmed, stressed, just remember WARM. Who's talking, aim low, find that reason, and then just be messy and give it another day. It's always going to be better.

John: Thanks for that. I'm going to write that down and see if I can apply it to something I'm doing today.

Dr. Lara Salyer: Perfect. It works every time for me.

John: It sounds like it does. I like the last one too. You're saying in there messy moves, avoid perfection. Don't let perfection drive you so much. Just do something in the right direction. I like that.

All right, Lara, this has been fantastic. We're going to have to get together again, probably in less than four years, if I'm still podcasting.

Dr. Lara Salyer: Another leap year.

John: Oh yeah. No, that's not good. All right. I want to really thank you for being here, and I'll put all those links in the show notes and share it. And with that, I'll say goodbye.

Dr. Lara Salyer: Thank you, John. Bye.

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The post Integrating the Best of Traditional and Functional Medicine appeared first on NonClinical Physicians.

Interview with Dr. Chelsea Turgeon – 343

In today's episode, Dr. Chelsea Turgeon describes her unique career as a coach and digital nomad. This episode is an excerpt from Chelsea's popular lecture from the 2023 Nonclinical Career Summit hosted by John Jurica and Tom Davis.

The narrative explores the internal conflicts, moments of self-discovery, and the decision to step off the conventional path. The blog provides a nuanced view of the highs and lows of the digital nomad experience, dispelling myths while offering practical advice.

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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.

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Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Dr. Chelsea Turgeon's Journey

Dr. Turgeon recounts the challenges she faced during her medical education, exploring the mismatch between her interests and the demands of hospital-based rotations. As she grappled with the internal conflict of wanting more freedom, she took a leave of absence to focus on her next steps.

Her journey took an unexpected turn as she resigned from residency, eventually finding herself teaching English in South Korea.

Embracing the Digital Nomad Lifestyle

Chelsea shares her experiences with the digital nomad lifestyle, both the invigorating aspects and the challenges. She emphasizes the importance of intentional routines to maintain stability despite the transient nature of her lifestyle.

She shares her observations on nurturing relationships while traveling. And she provides insights into earning an income remotely, with examples of healthcare professionals thriving in unconventional roles from telehealth to health tech consultancy.

Navigating the Road to Financial Freedom and Fulfillment

Dr. Turgeon provides valuable insights into financial strategies for sustaining a digital nomad lifestyle. She discusses fellow healthcare professionals who have successfully transitioned into remote roles, such as speech-language pathologists conducting virtual patient sessions and veterinarians specializing in remote image analysis. Additionally, she explores alternative career paths demonstrating that lucrative remote opportunities exist outside the traditional medical sphere.

Summary

Dr. Turgeon recounts her transformative path, from teaching English in South Korea to embracing the life of a Digital Nomad, building her own successful business, and achieving a six-figure income across 20 different countries. Her presentation concludes with insights into how she and others discovered meaningful work, creating a life that is both fascinating and deeply fulfilling.

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

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Links for Today's Episode:

• Dr. Chelsea Turgeon's Website
• Pathway to Purpose Coaching Program
• Dr. Chelsea Turgeon's LinkedIn Profile
• How You Can Forge a Wonderful Life After Medicine – 246
• How to Go from Surviving to Thriving in a Remote Healthcare Job – 278
• Light Your Entrepreneurial Fire and Create Your Ideal Life
• Reserve Your Free Spot at the 2024 Nonclinical Career Summit
• Dr. Debra Blaine's Coaching Services

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 343

The Extraordinary Life of the Physician Digital Nomad

- Presentation by Dr. Chelsea Turgeon

John: This is Dr. Chelsea Turgeon. Chelsea, is it true that you're coming to us from Bulgaria today?

Dr. Chelsea Turgeon: It is true.

John: Oh, my gosh. Well, the wonders of technology make this all possible, so I'm going to be really interested in hearing what you have to say. And so with that, I'll just turn it over to you for the next 30 minutes or so.

Dr. Chelsea Turgeon: Yeah, absolutely. Thank you so much for having me. I'm so happy to be here. I'm going to just go through and talk about my story and how it is that I got to be having this conversation with you guys from Sophia, Bulgaria, where I have been learning to ski for the past few weeks, which is something I'm totally new at. I literally had never put those on my feet before. And just a quick doctor reference that people will get. When I first put the skis on and started to ski, it literally felt like laparoscopic surgery with my feet. Because in laparoscopic surgery the instruments are these extensions of your hands that are really clumsy and it's hard to figure out how to navigate them. And you have to figure out if you move it this way, it goes up, and if you move it this way, it goes down. And it literally felt like having laparoscopic instruments on my feet until I learned how to navigate it better. That's just something I thought that I told some of my surgeon clients that and they were like, "Yeah, we totally appreciate that."

My story. I initially started out, I grew up in Alabama, born and raised there. I always have been interested in psychology. I was somebody who was quite a nerd growing up. I would have my parents drop me off at Barnes & Noble and I would say I was going to study. And I would study, but then I would go to the self-help aisle and just browse the aisles, looking at all of the books on happiness and how to deal with rejection and overcoming depression. And I was just so interested in that whole world. I was interested in how the mind work, how to become happier, how to live better. And that was an interest that I always took with me. In college I majored in psychology and I was trying to decide my career path going forward.

And I did what most people do when they're trying to figure out their career path, which is I pulled the audience. I pulled anyone and everyone around me, which is how a lot of us are taught to approach our careers, is looking outside of us for approval, for advice, for other people's ideas of what we should do with our own lives.

I would tell people, "Okay, I'm majoring in psychology. I think I'm either going to be pre-med and become a psychiatrist, or go to grad school and become a clinical psychologist." And every time I presented those options to people, I would get met with this insane amount of validation around the idea of going to med school, becoming a doctor. "Oh, you must be so smart. What a noble profession." I just slowly started to lean towards that as my career path.

I didn't totally know this at the time, but I was very much craving this external validation and basing a lot of my career decisions from this place of what is going to impress other people and what is going to make me feel important and significant. And so, I was making my career decisions from that place, which is so common. A lot of people do that. I wasn't really going into myself and asking, "What would I really love to be doing?" And I also think from a young age, we're taught to look at what do college admissions want to see on their application? What kind of test scores are you supposed to have? What sort of extra curriculars are you supposed to have? We're just used to basing everything we do on these external metrics that other people are putting on us and then we conform to those metrics.

And so, that's what I was doing and that's what I did for years. I went through medical school. I actually didn't mind my first two years. I do really like learning and studying and I liked that there was a lot more kind of location independence in med school actually. We didn't have to go to classes. We only had to go to 20% or maybe 50%. We had this small percentage where we actually had to be in class. We could actually do a lot of it on our own time, watch the recordings of classes.

I actually spent a lot of time in cafes and being on my own schedule. Like I could go to the gym in the mornings and I only had to be present for a few things. And I actually did really enjoy that flexibility. That was in first and second year. And so, I think having that sort of lifestyle was enough for me at that point to get through the hard parts of the rigorous curriculum, the long hours of studying and all of that.

But then I got to third and fourth year, and the way my med school was structured third and fourth year are very hospital based. You're on rotations, you have a set schedule. You're there for very long hours, 12 hours at a time in the hospital sometimes. They expect you to work weekends even as medical students.

And so, that was the first time I really started to feel this sense of rigidity and like I'm being boxed in. And I couldn't wait until I got off every day. Every day, as soon as my attending said I could go home, I would just feel this huge weight off my shoulders, this relief, just excessively happy to be leaving. And I was starting to question it at that point, "Do I want to be working in a job where all I'm doing is looking forward to the moment I can leave every day?" And there were things I liked about interacting with the patients, but I didn't really love the hospital setting as a whole. I had a hard time with the hours. I require so much sleep. I sleep eight hours a night at least. And then I take a nap during the day. And so, just having that sleep deprivation, I know it's challenging for so many people, but I was really struggling with not getting enough sleep, with just the rigidity of the schedule.

And I started to realize I'm not really that interested in all of the evidence-based medicine and all of the science and the studies and the research. Going and having to learn about the research and the evidence just felt like such a difficult thing to do. It was something I didn't want to learn about. What I was more interested in were things like motivational interviewing to help patients with smoking cessation. I was much more interested in the psychological aspect and the behavioral change. But again, these are things I noticed after the fact and not things that I was paying attention to as much at the time.

I kept going on, I carried on through, I went to residency. I decided to do OB-GYN residency and I made it through my first year. And after the first year, I was really having these big doubts around if medicine is the right career path for me. I was able to push off the nagging thought for a while. I had this thought, "Maybe medicine is not right for me." I was starting to have all these other ideas of what I wanted to do. I started to listen to podcasts about people who are traveling the world and making money online. And I was like, "Wait, this is a thing."

I learned about the world of coaching. My sister actually introduced me to the world of coaching. She got a life coach. And when I was making the transition from med school to residency, I was feeling a lot of anxiety, a lot of imposter syndrome, a lot of just fear, uncertainty. I felt like I was on this conveyor belt that was going and it was like there was no exit of the conveyor belt and I was just stuck on it. And I was leaning back and it was just moving forward. And I was going into this factory, or into this whatever, that's going to crush me. That's how I was feeling as I was going into residency. And I was like, "I think I need some help, but I don't know if it's therapy."

My sister referred me to her life coach and I started working with a coach myself and remember feeling so jealous of her. Because at one point she was emailing me from Rome and I was like, "Wait, you're in Rome and you're working and you're just traveling there for fun." And so, all these little moments of me sort of noticing, this is one thing I tell my clients all the time, is to pay attention to your jealousy. Because while we experience it as an uncomfortable emotion, it is actually a very powerful indication of what we want. It doesn't always mean we want the exact thing that we're jealous of, but within that we can dig in and say, "What does this mean about what I want?"

And for this, I was like, "I think this means that I want more freedom. I love the idea of being able to travel. It feels expansive." And so, all of this is happening as I'm starting residency. And I was like, well, I'm just going to try residency anyways. I'm going to give it a proper try. I'm going to see if the reason I didn't like being in the hospital in the first place was because as a med student, you don't really have many responsibilities. You're just kind of there shadowing and you don't really know where you fit in.

And I was like, "Maybe I just feel awkward and I feel like I don't know what to do. And so, maybe when it's my actual job and I have a role, I'll feel useful, I'll feel helpful." You just really give it a try and see if it's truly that I don't like medicine or if I just don't like this awkward role of med student. I did my first year of residency and it was pretty clear to me by the end that this was not something I wanted to do. However, I kept meeting with my program director to try to tell her, "I don't like this. I think I want to leave medicine." And they kept convincing me, "Just try this next rotation. Just try this next thing." And so, I did these two rotations in a row that just kind of broke me in a sense. Because if you're already on the fence about something, your heart's not fully in it at that point anymore. And then you go through this rigorous schedule and hours. I did OB nights rotation, which is I did seven emergency C-sections in one 24 hour shift at one point. You're just going and going and it's really rigorous. And then I did gyn onc. There's some really sick patients on gyn onc and it's pretty emotionally devastating. That was a really hard rotation to be on as well.

And by the end of that rotation, I was just fried. My program director, we met because she knew I was already on the fence and already struggling. We met and she suggested I take a five week leave of absence from the hospital. And so, I took five weeks off, was able to catch up on sleep finally, journal a lot, connect with my intuition. I went on a camper van road trip around Utah. And during that whole time, what really came to me is I just want to be out in the world. And it didn't make sense. There wasn't a super logical plan around this, but I just had this feeling, this connection from my intuition that was just telling me I just want to be out in the world. I want to be outside, I want to travel. And I didn't have a great idea of what that was going to look like, but I had a very clear sense of knowing that I didn't want to go back. And so, I made the decision that I was going to leave residency and I was going to give this traveling thing a try.

And also I just want to share I was not a traveler before this. I wasn't the friend who took the summers off and went to Europe. I had never really traveled. I went to Nicaragua once for a week on a medical service learning trip in undergrad, but I wasn't a big traveler. And so, it was very strange that I was having this draw to travel the world. And so, I decided to follow it and I turned in my resignation letter and decided to get a job teaching English in South Korea, which sounds a little bit weird, why would I do that?

The way that it kind of came to me was I wanted to travel. I already made that clear. I also wanted a source of income while traveling. I'm a resident, I wasn't stuck in the savings. I didn't really have a lot of leeway where I could just take a sabbatical or anything. I needed to be able to make money. I wanted to travel.

And so, I came upon the concept that you can get this online certification and start teaching English in abroad. And there's a very high need in Asian countries, but you can also do that in Spain and other European places, Latin America, anywhere. I got this online certification, I got a job teaching English in South Korea. I don't know why South Korea to be honest. I don't know if I just wanted to get as far away as possible, but that's just sort of what ended up happening. And I spent a year there teaching English.

And during the time I also went to basically Google Academy or Podcast Academy. I listened to every single podcast I could about building an online business, learning about marketing and strategy, SEO, websites, blogging, all of that. And I initially thought I was going to be a travel blogger. I made my first website and I called it the turquoisetraveler.com and I was like "I'm going to become a travel blogger. I'm going to build a six figure business travel blogging, and that's just what I'm going to do and it's going to take some time to build up the income. So, in the meantime I'm going to teach English." It just felt like, "This is it, this is the plan."

But I realized pretty quickly that I didn't really like writing about travel. I love writing itself, I love traveling. I don't like them sort of being intertwined. I really liked writing about my journey and personal growth and spirituality and so then the idea of life coaching sort of came back into my life. I just had this email that popped into my inbox that was like, "Do this free 30 day life coaching bootcamp and then see if you want to become a coach." And so, I signed up for that. I ended up doing a yearlong life coaching certification program.

I decided to shift from travel blogging more into life coaching and started doing that as my business. After a year of teaching English, I made $2,000 the first year in my business. I was teaching full-time, had the full-time job and I was charging people $60 a session, super casual.

But it was a start. I was getting started. And so, I made $2,000 that first year and then decided I wanted to be fully location independent. And so, I started teaching English online, and was able to make $24 an hour doing that, which was not terrible. I was living in Vietnam at the time. I decided to go to Vietnam. This is when the pandemic happened. I ended up getting stuck in Vietnam during the pandemic and was teaching English online and also starting my coaching business. And so, from there, transitioning from doing these online side gigs and coaching part-time to making coaching my full-time source of income.

And as I've been doing that, I just celebrated my four year travel bursary as I've been traveling the world. I've lived and worked in 24 different countries on five different continents. And I have now successfully built a six figure coaching business where that is my full-time thing and I'm able to really support myself and not just in the backpacker way, where I'm really struggling and staying in hostels, which is where I was initially. And I love that phase of my journey. It was so special to me and I'm really glad I had that time. And now I'm able to really focus more on growing a full business and supporting people in a bigger way, and I get to do all of that while traveling the world.

Let's talk about what does that actually look like? Because that's a big question that I get asked from people is, what does it look like to be a digital nomad? It does seem really glamorous and there are so many good parts of it there. Overall, it's a lifestyle that I love and I wouldn't trade it. However, I think it is important to talk about some of the realities of it because it's easy to look on Instagram at somebody living this lifestyle and think it's all just sunset photos and hikes and all these glamorous things. But there can be difficult parts of travel.

And I don't say any of this to complain. I say this because I know that can be annoying. Like, "Oh, what a sad life that you have. You have to deal with traveling and all of these things." I totally understand that it's such a privileged lifestyle and I'm so grateful for it.

And I think it's important to just be super honest and clear about what it actually entails because it can take a toll on your mental health if you're not being super careful about, because it can be disorienting. You're flying all over the world, you're changing locations all of the time. Really having to be intentional about the routines that you do to ground yourself is so important because there's times where I was in five different countries in two weeks and trying to run a business at the same time. And that is really hard.

And so, being a digital nomad, it's different. You're not traveling. You're not a backpacker, you're not on vacation. Having to figure out how you balance your work and then your self-care, the things you need to do to just maintain your sanity. And then also the fun stuff, the sight-seeing and the tours, there's all of that too. There can be a lot of pressure and I think it just really comes internally, but when I'm in a location, I'll feel pressure of, "Oh, I need to go to this museum and see this site and do this thing and check all these things off." But sometimes I just want to lay in bed and watch Netflix because when you're traveling long term, as I have been, I've been traveling for four years now, you're not always going to want to see things in the same way. You're not going to want to do the same things.

Now as I'm planning my travels, I don't really look at a list of top 10 things to do in this destination because you just get a little bit burnt out and jaded from going to the newest waterfalls and seeing all the churches and the mosques. I know all of this can sound very privileged to say these things but what I'm trying to get at is it's important to really, again, not fall into this external pressure of, "I'm in this location, this is what I should be doing." But really just checking in with yourself and seeing, "What do I want to be doing here? What is going to be nurturing for me?" And giving yourself time to just live your normal life and be a person and know that it doesn't always have to be adventure and travel all the time.

Actually, just to share a little bit more about that for me personally, next week I'm actually sort of moving to Albania. And I say "moving" loosely because I have a suitcase. It's not really moving anything except for myself. But I'm really looking forward to doing several months and potentially even getting a yearlong lease in Albania and having some heads downtime, having a bit of a home base and having more stability because there is that aspect of all the transient, all the variety that it is important to just check in with yourself as you're doing this and set up a routine that works for you.

Some people, we call them slowmads, they travel slower. They go for three months, six months in a location. But I have not been slowmading at all. I've been fast, fast, fast. I've been doing one month in each country and just going around. It's been great and it's what I needed. But yeah, part of that is really just planning out and checking in with what works for you.

Those would be I would say the main cons that I can think of. You're designing your whole life. And so, there's no 09:00 to 05:00 structure. There's nothing set up externally. You really have to do what you think is going to be best for you. The pros are endless. It's such a satisfying, fulfilling lifestyle.

I'm open to being wrong about this. Maybe one day I'll change my mind. As of right now, as I look at my future, I don't think I'll ever be somebody who permanently lives in one location. I imagine myself having multiple home bases around the world because it's a very expansive lifestyle. To me it feels like I'm living to the fullest in the biggest way. I'm seeing the world, I'm doing things that people only dream of doing. I don't even have a bucket list because the moment I want to do something, I can just go do it. The list doesn't build up, I just get to go do the things that I want to do. And so, there is so much freedom, there is so much expansion.

I've just met so many people and you grow and you change and there's so many experiences I've had that wouldn't have been possible if I was still in a hospital tied to a mortgage and having to commute to work every day and just sort of living in this structured routine. It's really shaken me up in a lot of ways. I've grown, I've learned a lot of things about myself. I've changed a lot of patterns.

Some people can digital nomad within the US and that's great too. But for me, being outside of the US has really introduced me to other ways of living and shown me a lot of the conditioning that can happen in the US and allowed me to just step outside of the box and really start to formulate my own ideas about things, which I don't know if that level of independent thinking would've been as possible if I was surrounded by people who were all thinking the exact same way, which can happen in the states more often. My mind is expanding, my heart is expanding in a big way. It's just a very expansive lifestyle.

I would say another con that is just coming to me as well is relationships. Community, romantic relationships, friendships, all of those things are very possible as a digital nomad. There's lots of hubs around the world of big digital nomad communities. And there's a lot of transient nature within all of those. And so, when it comes to cultivating community and meaningful relationships, there has to be a high level of intentionality around that. For a while I was just a free wheel and solo traveler and then I realized, "I need friends. This is something I really need." The cool thing about being a digital nomad though is many people that you meet and who are living a similar lifestyle, they also really need friends. So, they're really open.

In the US I think we can get into some of these really established patterns of no new friends because we have my group, it's kind of a closed situation. As you travel, I meet a lot of people and they're all very open to connecting and you're able to make these deeper connections because everybody that you meet has a leaving home story too. So, that's another cool thing. Every time you meet someone and they're not from around here and they're just traveling the world, it's like, "What got you out here?" That's always really cool because you can go deep pretty quickly. Because people don't just leave everything they know and start traveling the world for no reason. There's usually a deep motivator or some sort of wake up moment they had. That's really powerful to connect with people like that and meeting people from all over the world too. I can recognize the subtleties of different South African city accents because I've just met so many people from so many places. And so, that's a cool thing too.

I think one thing a lot of people want to know is, "How do you make money? How do you support yourself while doing this?" I think a lot of people, especially within medicine, they worry like "I don't have any skill sets that are transferrable to this. I don't know how I can make money remotely doing healthcare." I just want to talk through some of the other healthcare professionals I've met out here, because there's other ones out here and that's so fun.

What I want to share is there's ways to make money potentially using already the skills that you have as a healthcare professional or you can do what I did and come up with a totally different way to make money. I'll just talk through some of the main roles and jobs that I see people doing so that you guys can have some ideas of where to start.

As I've been traveling, I've met a speech language pathologist who was actually an independent contractor and she was seeing her patients virtually. She was doing patient work, was seeing patients virtually and billing. She said she's in a gray area and isn't sure if it's 100% kosher, but she has been doing this as an independent contractor working with patients in the California area. And she took it on the road and is doing it virtually.

I've met a veterinarian. She does consultations, she looks at radiology images and she reads the images and that's her full-time job. You walk by her computer and she's just looking at images of animal insides all day. And so, she's doing that. She's able to take that skill working for a company that just reads the images and is makes her living that way.

I've met several nurses and I don't remember exactly what they were doing, but some sort of patient care role that they were able to do remotely as well. And then I have a friend right now who I've actually been traveling with and she's not medical, but she works at a health tech company called Cerebral. And within that, she's said they have a whole clinical team full of people who are clinicians who consult on the operations and consult on different aspects and they're all remote as well. And so, there's lots of opportunities within health tech, doing either clinical things like telehealth or even just working on the consultant side.

So, that's some of the medical areas that I've seen. Obviously there's another route like I did. I just created my own business. There's a lot you can do in the online space, and especially like physicians, other clinicians, having something like a coaching business or a consulting business and just having any sort of face-to-face interactions with people, I just want to see more physicians making their own businesses and being able to help people on their own terms because they're just such bright, incredible people. And having that ability to just help people in the way you want to, is really powerful. I think it's a really natural transition for physicians to become coaches if that's something they're interested in. And there's a lot of resources to that. Obviously, for me, it was a longer trajectory. I wasn't able to support myself with that right away, but totally worth it.

Other potential income sources that you could quickly learn and master. There's ways to do things like coding bootcamps, which you can do. I just want to go into things that are good ways to make good money that don't require you going all the way back to school. You could do a six month coding bootcamp if you're somebody who's into computers and or into coding in that way. And you can get a six figure job pretty much right out of that six month coding bootcamp. And the bootcamps are a couple thousand dollars. But if that is something that you're interested in doing, it's a really reasonable way to get yourself into a remote position.

Another thing that's similar to that is UX/UI, which is user experience, user interface. It's a little bit like website design, but you're consulting, you don't have to know the coding behind it, but you create what apps look like. When you look at an app and you see what it looks like, the appearance, all the images and the way that it's all laid out, that's UX/UI. That's another thing where you can do a short bootcamp and get a six-figure job pretty quickly after that. I have another friend who's doing that. Those are just some ideas.

I think as we're in medicine, we get this tunnel vision and we think that in order to have these high salaries, we're going to have to go all the way back to school again. If we wanted to change and to do something totally different, we think we'd have to go all the way back to school and it'd be this rigorous process. But I wanted to share with you some of the people I've met who are doing things that they didn't actually go to school for and they're able to find a way to make good income as they're traveling as well.

And that's just the start. I think there's a whole Facebook group for remote careers for physicians. Especially with after the pandemic and the way telehealth has blown up now, there's so many ways to support yourself financially through the internet. It's actually really incredible.

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The post The Extraordinary Life of the Physician Digital Nomad appeared first on NonClinical Physicians.

Interview with Dr. Angela Mulrooney – 342

In today's episode, Dr. Angela Mulrooney explains how to create your ideal life and shares her inspirational career journey. 

Dr. Mulrooney's unique journey began as a gymnast turned dancer and choreographer while studying dentistry. She built a thriving practice following graduation. However, she developed an illness that made it impossible to practice. So she transitioned into coaching dentists, leveraging her experience to build a successful coaching company.

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.

Clinical Practice: Make It Great or Move On

Recognize dysfunction, fix it, and protect yourself, or seek better opportunities

In only about one month from now, the second annual Nonclinical Summit will be starting. It’s not entirely nonclinical, however. Sure, we’ll be presenting topics related to fully nonclinical work, such as freelance Medical Legal Prelitigation Consulting, Expert Witness Consulting, and Medical Affairs Regulatory Consulting. But we’ll also have experts talking about whether it’s medicine you need to leave or your job or current boss. And we will discuss several types of clinical businesses that make you the boss, opt out of insurance participation, and build an asset that you can sell later.

If you’d like to learn more, check out the 2024 Nonclinical Career Summit, with a complete list of speakers, topics, and objectives for each presentation.

And just like last year, you can attend the live sessions for FREE, so block your calendar on April 16, 17, and 18 from 7 to 11 PM Eastern/4 to 8 PM Pacific.

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is much happier now as a professional writer and a coach. Debra says, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

From Dilapidated Practice to Referral-Based Success

Angela pursued her dental career dream by working primarily with children. She took over a rundown practice, revitalizing it over six months by implementing physical and aesthetic changes. And she converted from insurance-based to non-assignment services.

By investing in her skills, including IV sedation, full-mouth rehab, and implants, she transformed the practice into a referral-based success, targeting patients afraid of the dentist.

LinkedIn Mastery and Unleashing Influence

Recognizing the power of LinkedIn in reaching professionals, Dr. Mulrooney strategically utilized the platform to build her coaching businesses, rejecting conventional choices like Facebook and Instagram. Unleashing Influence, her coaching company, emerged from her experience coaching dentists.

Leveraging LinkedIn's Sales Navigator, she refined her approach to connecting with the right professionals. She guided them through a transformational process in her events, ultimately leading them to join her coaching programs. This approach has proven highly effective, resulting in significant success for her clients.

Dr. Angela Mulrooney's Advice to Create Your Ideal Life

If you have been plateauing for a while, you've got to decide if you want to stay plateauing or if you want to get out of your way.

Summary

Dr. Angela Mulrooney's career evolution serves as an inspiration for frustrated clinicians. To connect with her, reach out through her LinkedIn profile, where she actively engages. Additionally, search for her on popular social media platforms or visit her website Unleashing Influence for more information.

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:

• Unleashing Influence Program
• Dr. Angela Mulrooney's LinkedIn Page
• How to Start and Grow a Profitable Cash Based Medical Practice – 293
• Do You Want to Live Life and Practice Medicine on Your Own Terms? – 237
• How to Be a Successful Physician Entrepreneur – 123
• Top Five Start-Up Secrets for the Physician Entrepreneur – 087
• Entrepreneur and Business Owner – Interview with Dr. Mike Woo-Ming – 019
• 2024 Nonclinical Summit – 12 lectures & Attend for FREE
• Dr. Debra Blaine's Coaching Services

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 342

Light Your Entrepreneurial Fire and Create Your Ideal Life

- Interview with Dr. Angela Mulrooney

John: For those entrepreneurs listening and watching today, I have a real treat for you. Our guest was working as a dentist and somehow her entrepreneurial side kicked in and she created a very successful referral-based dental clinic, and then later a professional dance company, and then a coaching company for dentists. And then this is morphed into what she's doing now, which we'll get into in today's interview. I'm very pleased to welcome Dr. Angela Mulrooney to the podcast. Hello, Angela. How are you?

Dr. Angela Mulrooney: Hi. Thanks for having me. I appreciate it.

John: And I appreciate you being here. Another healthcare professional who has veered off in a direction which I think my listeners would love to hear about. Like we usually do here, why don't you just start by telling us about your background, how you went from being a dentist to doing what you're doing today. You don't have to go into too much detail, but just an overview of what you've been up to the last decade or so.

Dr. Angela Mulrooney: Sure. I originally was a dentist and I wanted to be a dentist since I was two. It was really a dream come true. And every day that I got going into practice it felt like I was just playing. Power tools and blood. Pretty cool. I did that for the first four and a half years. I worked as an associate, primarily working with children because I was so ridiculously shy. I couldn't look adults in the eye. I focused on kids because I could just tell them stories. And then I happened to run into one of my old bosses who was working in a locum for a 78-year-old dentist. And he was like "I really don't like doing this dentistry. Do you want to take a couple of days off my hands?" So I said, "Sure." That was on a Friday. By Sunday night he called me, he is like, "Ang, can you just take the whole thing? I really don't want to be practicing dentistry." I was like, "Okay."

I had no idea what I was getting into and walked into this practice. It was the most rundown, broken down practice I'd ever seen. The carpet was black because it had never been cleaned. Pretty gross. But every day I walked in there I just stopped and it turned into me going from always saying "I was never going to own a practice" because I was still a professional dancer at that point to me thinking, "Wow, there's potential in everything here. I think I can turn this place around."

I ended up going and seeing the 78-year-old dentist. He unfortunately was dying of bladder cancer and asked him if he was okay with me putting a bid on the practice. And it was funny because before he had always said there was no way he was going to sell it to a woman. He was very old school. And he had heard enough good things from the patients who had come to visit him like they were family. He was like, "Yeah, I would actually love for you to take over the practice." So I did.

And six months into owning it, I really scraped everything that was in there. Rebuilt the whole practice physically and aesthetically and also went from taking insurance to not taking insurance. I went from an assignment practice to a non-assignment practice and went and started investing in my skills to be able to serve.

What I saw was potential in the practice was these people who were terrified of the dentist because the old dude was pretty rough. I went and got my IV sedation. I did my full mouth rehab, implants, all these things. And that's how I created a referral based practice because most people do not want to work with patients who are afraid of the dentist because it takes a lot of time.

I had really a blue ocean market and started just sending out letters and referral pads. And every month on the week that the referral pads went out, we got a whole rush of referral of patients who either needed IV sedation or who were terrified of dentists.

So, that was awesome. I got the practice to the point that I wanted it to be at. And then I got injured out. I ended up with focal dystonia, which had been kicking in slowly over time. And then finally during the middle of a surgery, my hand completely stopped working. I couldn't pick up my drill. So, it was the last day I practiced dentistry, which was a really scary day. And so, that put me on a completely different path to start doing other things with my life.

John: All right. Did you say you were a professional dancer in there?

Dr. Angela Mulrooney: Yes.

John: Explain a little bit about that. We got to know.

Dr. Angela Mulrooney: Yeah. Actually, I was originally a gymnast as a kid and then when I went to university, the biggest social club was the University of Saskatchewan Ballroom Dancing Club. I was like, "Okay, well, that's where everyone else is so I'll go there." And the first year after I was in the club, they started asking me to teach. And I'm like, "No, no, I'm trying to get into dental school. Don't distract me." And then I got into dental school and I'm like "Please distract me, let me have a position." I started teaching and then I turned pro the day that I graduated dental school. And so, I had those two parallel careers. I would go into the studio at 05:00 or 06:00 in the morning, go and train until my shift started. And then when my shift was done, I would go back to the studio and teach. I had two careers going at the same time pretty much until I got injured.

John: Did that interfere then with the dance as well or did you end up teaching that later or at the same time? How did that fit in?

Dr. Angela Mulrooney: With the dystonia, it affected styling because it was actually this very famous picture of me with my hands are supposed to be like this. So, it affected styling and sometimes control of my arm, but we just built choreography around it and got it. We just made it work.

John: Okay. Then what did you do after that? You got very entrepreneurial after all this happened from what I know. So, go on from there.

Dr. Angela Mulrooney: After I got injured, everyone was telling me that you built this brand, you're known in the market, you're known to patients, you're known to the dentist to keep going with it. You can run this as a CEO and not practice clinical dentistry. I was like, "Okay, I guess I can do that." The unfortunate part was I had invested so much in my skills, I had to bring in four different associates part-time to try and cover off the skills that my patients were used to receiving. That was a bit of a headache. And after two and a half years, I'd been through the global financial crisis when I first bought the practice. And then I was in Calgary, which is an oil-based city. And the 2015 oil crash, the economy was dropping super fast. And I just was like "You know what? Every time I go into the practice my heart hurt because these people don't care as much about patients as I did." It didn't feel that way.

And so, I decided it was time to just pass the torch to someone else and start moving on with my life. I decided to sell the practice, I fire sold it, and passed it on to someone else. And honestly, the day that the deal went through, official ownership transferred, it was like this weight was lifted off me and I felt released to go and do new things. So, it was interesting how much that weighed on me trying to keep this thing alive that just wasn't a fit anymore.

John: Okay. Now I know ultimately you began at some point teaching other people how to become entrepreneurs and pursue their dreams. But take us through the way that developed or the steps to getting to that.

Dr. Angela Mulrooney: Yeah. After I sold the practice, I took a year away from dentistry because everyone knew who I was and what had happened. And everyone that I met in the dental world was pity. And I didn't deal very well with pity. I was having enough problems just keeping it together. So, I stepped away, spent a year just building my professional dance company.

And in that time what happened was the pieces of "why" things had happened started to make sense. I was like, okay, I've been through some really strange things from the owner dying halfway through me buying the practice to getting sued by my team to worst case scenario of being injured out of my career. So, I decided to take all the lessons of what I've done and create my coaching company for dentists. And really what my goal was, it was to help them to build a brand but also find their passion in dentistry. Because a lot of dentists really don't like dentistry and they're doing things on a daily basis that they don't like. My goal was to help them to get passionate.

That went on for about two and a half years. And how I built that company was actually getting on LinkedIn, posting content, starting conversations. And in a year of putting effort into LinkedIn, I went from 200 to 12,000 industry followers.

John: Wow.

Dr. Angela Mulrooney: And so, then people started to go, "How did you do that? And can you do that for me?" I started to take a few different colleagues' accounts and I said, "I don't promise anything. I don't know if what I did was a complete unicorn or if I can replicate this, but I will try." I started working on their accounts that I was actually able to replicate the results. So that's where unleashing influence, the original iteration of it was a social media agency for professionals.

And so, that came out of me building my business coaching company for dentists. And that became an official company on January 17th, 2020. March 17th, 2020, Canada got shut down and so exactly two months the day I had some big decisions to make because I had a couple of team members. I had three different companies. I had my dance company, the business coaching company, and the social media agency. And I told the people in the social media agency to buckle in, keep yourself healthy, get lots of sleep because we are going to take this to the moon. And by 10 months into the pandemic we had gone from two and a half full times to 14 full-time team members. So, it just took off.

The dental coaching company got shut down because dentistry got shut down. Dance company got shut down because we weren't allowed to be near each other. I definitely picked the right pony at that point. And then by the end of the year I was like, "I don't want to be in lockdown in snowbank anymore in Calgary." I made the decision that I was exiting Canada to go hang out in a tropical place for at least 12 months. I want to avoid snowflakes for 12 months. So, I bought a one-way flight to Nicaragua and arrived there on January 21st, 2021.

John: Wow. That's a lot. Now I could ask you a thousand questions, but I want to go back because your experience with dentists applies I think to physicians as well. And so, I'm just curious when that thing was working and you were going to even expand it, what were the things that dentists could do with their practices that were unique to each of them? In other words, it's like with physicians. We're cookie cutter. We are family medicine, we all do the same thing, we get bored, that gets tedious and so forth. But I can imagine there are things you can specialize in certain things or you can focus on certain things. So, just give me a glimpse of some of the things that you helped dentists do before we get into the rest of it.

Dr. Angela Mulrooney: For sure. Well, what happens is we're trained in university to be generalists and you're not going to be good at everything. And so, if there's things on your schedule that make you go, "Ugh, do I have to do this today?" Or if there's a patient that you see that you feel that way about, why are you doing that to yourself?

John: Oh boy, I've had those feelings. Yeah.

Dr. Angela Mulrooney: Yeah. Life is way too short. So, if you can be comfortable saying, "Okay, I no longer do root canals. Maybe I don't do surgery anymore, maybe I don't do kids." And focus in on the skills that you're actually talented at and passionate about. Yes, you're going to have to send some people out or you're going to have to bring an associate in to cover that stuff. But what's going to happen is you're going to get better, you're going to get more niched into your genius in that skill and you're going to be so much happier doing it and patients are going to feel that.

So, if you are not a good jack of all trades, which let's be honest, nobody is. If we can start getting away from that jack of all trades, they have to give us a jack of all trades education in university because they have to expose us to everything, but it doesn't mean we have to do everything forever. If you can hone it down to the things that you actually like doing and focus around that, you can build a practice, you can make money doing anything, let's be honest. But you have a professional degree, you have a designation that is recognized by the public. If you say you're a doctor, you say you're a dentist, people have the gist of what you're doing. It's pretty easy to market it and just focus on exactly what you like to do and then either fill in the gaps with an associate, as I said, or refer those patients out. But you can design a practice around anything that you want. There's no legalities about saying no to root canals, saying no to surgery, saying no to whatever you don't want to be doing.

John-: Yeah. I can imagine in the US where you'll say a family physician, you're on some kind of Medicare panel, you can't necessarily refuse. But if you say, "Look, okay, I'm just not going to do that anymore. I'm going to do this part of my practice. And if you don't like it, go somewhere else." That's fine. I've not really heard anyone really emphasize that aspect, but it sounds very effective. I appreciate that.

Okay, now jump forward. Basically you had started this agency, it was a social media type company. What does that really look like? I'm trying to imagine who were on that team, and maybe just explain a little more detail as to what that business looked like and was comprised of. It sounds interesting.

Dr. Angela Mulrooney: Sure. There was 14 full-time creatives. I had everything from copywriters to graphic designers to people who were doing video editing for me. I had one manager in place. But yeah, pretty much it was almost 14 full-time creatives. And so, there was pods working on different clients. There was lots of little moving pieces in it. And I'll be honest, there's a reason I sold the agency. It's a lot to manage because there's so many moving pieces and you have to be relying on people to keep up. And I found I had to build a lot of redundancy in because at that time there was so much turmoil in the employment market as well. So, someone would get offered another job and they'd be like, "Okay, I'm moving over there." So then you're quickly replacing. We always had two of everything and a backup plan for that, which was really stressful, especially when there was a shift. So, I was losing a lot of sleep over my agency, which is why I ended up selling it.

John: Now, who are the clients? What type of people or companies were they?

Dr. Angela Mulrooney: Most of my clients were actually coaches, consultants, and speakers. Because what happened when we had the shutdown, all the events were gone. Their way of being able to go and hang out and have coffee with people or speak from the stage and get clients, all those in-person marketing tactics were off the table. And a lot of the speakers as well, and even the coaches, sitting in front of a camera and trying to be entertaining when you don't have a thousand people in the room who are giving you energy, there was people who were losing their career because they couldn't pull it together on camera.

A lot of them were coming to me to be training, "How do I use my hands? How do I use the space? How do I use the actual camera to be engaging so that I can get back on track?" Because the pandemic landing zeroed the field for speakers. These people who were famous for 30 years, who were amazing in a room were terrible on camera and they realized it very quickly. And so, they had to develop a new skill set. I acquired a lot of those coaching them on camera as well as building out their social media presence so they could go out and reach and hunt new people into their business.

John: All right. Very good. Now that brings us up to almost the present here, unleashing influence. Is that right?

Dr. Angela Mulrooney: Yes.

John: Okay. Tell us about that in more detail and then I'll have some more questions about that.

Dr. Angela Mulrooney: Sure. After moving to Nicaragua, I started to really realize I did not want to work hundred hours per week. That had been my norm for the past two or three years. And so, I started to realize, "Okay, this social media agency with all these team members is just not good for my health." I sold it to one of the team members and then I was like, "Hey, this coaching company for dentists, this is not really where my heart is." Because every time I walk into a practice and or talk to a practice that's not as passionate about dentistry as I am and I'm like "I want people to practice on my behalf because I couldn't anymore" it was like someone ripped a scab off my heart. So, I decided to sell that one as well and just go all in on what I did best, which was really cracking clients open, helping them to see their potential, see what they could be in the marketplace. And also helping them to really step into their genius and fully own that and be able to burn away everything that didn't belong.

So, that's what I hunkered down to. And for three months after I made that decision, there was money coming in after selling the other two companies, but it wasn't super confirming that I'd made the right decision. So, I was a little scared. And then about three months to the day after selling the last company I got a deposit from a client which was paying in full for my services. And it was more than I would've made full-time working as a dentist. I was like, "Okay, that's a sign. This is going to work." The ball is rolling so I let it keep rolling.

I let that develop out and because I changed what I was showing on LinkedIn, people started to contact me saying, "How can I work with you?" And suddenly my book of business increased and I was like, "Oh geez, if we keep going down this path, I'm going to be back to working a hundred hours a week, back to being addicted to be an entrepreneur." And that's not what I want.

So, I took a step back and looked at what I was doing and really I was saying the same thing multiple times a week. I had these really talented clients who were feeling very alone in their journey. When you step out of corporate and step into being an entrepreneur, people think you're insane because you've taken a massive risk, especially after you've had a 30, 40 year career and now you're like, "Yeah, I'm going to do what I want instead." They had a lot of misunderstanding from the community and they also had a bunch of genius.

I decided to have some hard conversations and say, "Okay, this one-on-one thing is not working and I want you to trust me to do this group coaching thing and let's just see what happens." And it was like magic. What used to take so many years to get people through, in 90 days, we could collapse two years' worth of work into 90 days and get the massive outcomes. So, that's what Unleashing Influence became, is a coaching company and that's what I do for a living now.

John: Awesome. I think the next part is going to sound to my listeners perhaps as an advertisement for you, but really I want to hear the cases. Give us specific examples of some of the success that your clients have had just because it's fascinating and we can learn from what they learned. So, just a few cases would be fantastic.

Dr. Angela Mulrooney: One of my clients, she was former CIO of NASA.

John: That's a minor job. Yeah, right.

Dr. Angela Mulrooney: After 40 years in the tech industry, she came to me and she's like, "Okay, I don't want this anymore, I want to pivot." And originally she thought she wanted to be a professional speaker and I'm like, "Well, let's have a conversation about professional speaking looks like." Because I had done that before the pandemic had hit. And so, after our conversation, she's like, "Okay, I want to do what you're doing." I'm like, "Okay, let's do that."

She went through the accelerator with the other people in the group and she was able to close $150,000 the first month of working out of the accelerator. She was able to pivot fast and get her programs up and running.

I'll give you a dental specific one. She was making good money but she was working all one-on-one. So, she could only take on 10 practices and she was also traveling to the practices. And we have taken all the travel off the table and made it all online because she was like, "I want to be able to be geographically free like you. Not necessarily traveling the world, but at least have some freedom to move around without being stuck. I have to go to this practice this week, I have to go to this practice this week."

We were able to redesign her program to 10 times her hourly rate and decrease how many hours she was working a week by a 10th. Then that freed her up to design a new program that allows her to keep condensing things and stay with the group programs and be able to move that into the future.

So, what I really like doing is helping people to get away from the one-on-one because if you've done any one-on-one, you go in with your idea and someone comes in with whatever happened that day and they're knocking you off.

John: I see.

Dr. Angela Mulrooney: Off your path. And you're like, "Okay shoot, we didn't stick to the curriculum." But with group, especially if you're doing a high caliber per group, and I recommend creating boutique groups, not your down sell of "Oh, I'll do one to a thousand." No, these are six people in your group and they start together and they finish together and they're going through a very specific curriculum and there's a very specific outcome that they are going to be achieving. People are so dedicated to that because no one wants to show up being the kid who's like, "Well, the dog ate my homework." They're all high caliber individuals. The dog didn't eat your homework, you just didn't do it. So, it's a very different approach versus one-on-one. And what I found is what I help people to do is some of the fluff that they were putting into their one-on-one coaching, we get rid of that. It's like, "What is the 5% that is creating 95% of outcomes?" That's all that goes in your program. So, that allows us to time collapse because they're not spending time on fluff and then the outcomes become huge.

John: Okay. I hear questions coming in right now. One of the question is going to be without going into too many specifics is what did the NASA person do in terms of just what was the general feel that they went in where they could generate that with just refocusing and reapplying some of the things that you've taught her?

Dr. Angela Mulrooney: She stayed in the tech industry. As a woman in tech, she shouldn't have been able to achieve what she did achieve with being the gender that she was being in the generation that she was. She goes in and works with Fortune 500 companies and helps a cohort of women to be able to raise their hand be like, "Okay, here's the innovation I want to bring into this company. Here's what I want for it." They're helping to elevate the company and they're also helping to elevate their own status within the company because that's what she did her whole career. So, we just took what she naturally did. This is what I do with everyone is, "What do you naturally do? How can we take what's happening in your beautiful brain and turn it into a curriculum that we can teach other people how you naturally did that?"

John: One thing I would add to that, and it sounds like I'm maybe disagreeing with her, but actually if you're a minority, if you're gender is woman or whatever, anything that's different companies are looking for that.

Dr. Angela Mulrooney: They are now. Yeah.

John: Don't let that hold you back. Let's boom, let's do it. All right. That's awesome. Okay, other examples? Have you worked with many clinicians as a background doing something like this, abandoning the old?

Dr. Angela 0Mulrooney: Yeah, I've worked with a few dental clinicians as well. Some of them are getting injured out and they're like, "I can see the end coming" which is nice if you can see the end coming. And some of them are just like, "I'm just done. I just want to move on to other things." And again, take what they naturally do that is so unnatural to everyone else and be able to teach them a process to get to the next level.

John: Okay. Now let me ask you, there was another question I had. I'm going to ask you about LinkedIn for sure.

Dr. Angela Mulrooney: Sure. That's my favorite topic.

John: Yeah, that's what I thought. The groups, and I think you mentioned this on your website, but what you sounded like you were describing is what some people call a mastermind. It's like group coaching but you're all holding each other accountable. Is that a separate thing, the mastermind, or is that just basically part of this process?

Dr. Angela Mulrooney: The first thing that they have to go through is the pivot accelerator. That gives them the foundation. I'm taking whatever they've got. If they already have one-on-one coaching or if they're coming from corporate and building out a new program, I do what's called a "crack you open" session. They always say that it's like "You took a look at my soul." And then you look at my experience, your expertise, passion, and then I package them and give them their brand in the marketplace. Then the accelerator is building out everything from building out their personal brand, learning how to be good on camera to create awesome content, building out their curriculum, learning how to actually sell themselves because selling for another company versus selling for themselves is a different story. And then also all the tech that they need behind it so that they can run a seven figure company with a part-time VA supported by a tech platform for it. That's the first level that they have to get through. And then once they graduate, then they can qualify to become part of the Badass Entrepreneurs Club, which is what we do to continue to become masterful at the program that they created while also scaling it to the next level.

John: Very nice. All right, we're going to get on LinkedIn, but why don't you go ahead and tell us your website URL so we at least have that now before the end of the episode.

Dr. Angela Mulrooney: Sure. It's unleashinginfluence.com.

John: Okay. That's easy. Unleashing influence. Of course, that'll be in the show notes. Now tell me why do you like LinkedIn so much? It sounds like you use it a lot. And I don't know if you use it to find clients or to just promote yourself. Just tell me your LinkedIn story.

Dr. Angela Mulrooney: LinkedIn is a beast. And a lot of professionals, including medical, dental, avoid LinkedIn. When I was first building my business coaching company for dentists, they're like, "You need to be on Facebook, you need to be on Instagram." I'm like, "My bet is on LinkedIn." Because no one else was using it. I was able to build a six figure company in six months just leveraging LinkedIn. And all I was doing was sending out messages, putting out content that was speaking to what I believed in and that got me clients. Then when I built the social media agency for professionals, LinkedIn again was our main tool. And I have dabbled with Facebook. I've tried Facebook ads. Meta has now eaten my lunch a few times without giving me a single client. $60,000, $70,000 worth of ads with no return. Yeah. I'm not a fan of Meta. But it's still a good platform, it's just not good for me and for the clients that I'm going after.

You have to really pick your platform based on what are you offering and who are your clients. There's tons of people who do well on Facebook. There's tons who do well on Instagram. For the clients that I work with, they're professionals speaking to professionals. That's why LinkedIn is so powerful. Yeah, that's how I built a social media agency. That is how I've built Unleashing Influence as it currently stands. All my clients come from LinkedIn.

John: Now, when you are using LinkedIn, I've never used an add-on software or tool for LinkedIn. You are just using basic LinkedIn, maybe Premier. How do you use LinkedIn and how do you reach people? Are you just one at a time reaching out?

Dr. Angela Mulrooney: We use Sales Navigator. With all my clients we get really specific about what are the degrees that we should be going after. Sometimes it's gender specific. Some of my clients only work with men, women, some of them only work with men. And then it's also figuring out what year would they have likely have graduated to be a certain age. We comb through those details. Sometimes it's also specific to a part of the country. Sometimes it's specific to a part of the world. It depends on the time zones that they want to work in and whatnot.

But we do get very specific about those things because LinkedIn has taken away people's ability to spam and behave badly. Now you only get 20 new connections per day on average. And so, you want to be very careful with how you're spending those 20 connections, especially if you want to get profitable fast, you want to be getting in touch with the right people. The more drilled down you can get into that as to the things that I talked about, the better off you are. And then not only do you need to be finding the right people, you need to be sending the right message to them.

I always talk about being polarizing, and it's not to be a badass or anything like that. It's just to be like you either want people to be a "yes" or "no." Not a "maybe." Because you don't have time to be talking to people who are "no." The people who are "yes", that's what you want to figure out. And you want to slowly get them dialed down by having conversations with them, getting them into an event and then getting them onto a call to become part of your program. And the faster you can push people out who are not appropriate, the faster you're going to get the result.

And a lot of people, I'm going to refer to my nationality here, are very Canadian about this and they're like, "But I started a conversation so I have to finish it." And it's like, "Well, you don't actually." You can politely find your way out of it. And lots of people, they don't come back onto LinkedIn for like six months. The fact that you didn't respond to someone who was not appropriate to you, it's not going to be a big deal. No one's going to shoot you over that.

John: I like it. Good advice. What I noticed when I'm looking at your website, and I actually signed up for one of your courses, I think it was one of the intros, but I think you used that. So, explain how that works for those that might be the right process. You have something out there, you have a LinkedIn profile, maybe you're reaching out to people. I gather the thing you want to do is just get them into that first exposure to you at some level. So, just map that out for our listeners.

Dr. Angela Mulrooney: Right. After we found the right people, we're going to send a message, start a conversation, and then I take over the conversation until I get them to the point where I'm like, "Okay, this seems like the right fit of person." If they're like, "I really need to talk to you because I've shown them what I do", then I will get on a call with them. But I don't really want to close them on that first call because I want them to have time with me in the room. That's what my events are for. I do five day challenges and five hour intensivess. And what those are is me taking people through what it would be like to be in my classroom, and helping them to move into a transformation. Usually what I focus on is a mindset transformation. I'm going to give you technical things to do as well, but the biggest shift is getting out of your own way. And we talk a lot about burning things away, which is usually what's holding people back. Because they're like, "Oh, but I've always done this" and so I need to keep doing it. They carry all this garbage with them and they keep redoing the things that aren't actually making a difference. So it's like how do we pair this down to the 5% that's giving you 95% results.

And so, when people experience that, they're either a "yes" or a "no" for actually becoming part of my program, which makes it easy for me. And I'm also a "yes" or a "no" for them being part of my program because I'm seeing how do they behave in the room? Do they play well with others? Are they willing to be vulnerable? Because I ask some pretty hard questions in it. So, I want to make sure that they are actually going to be willing to be truthful, not posture about what is actually happening in their life.

And also are they responsive to inputs? If they're like, "Oh no, no, no, I already knew that", they're not really likely to be coachable. That's going to make it not very fun when they're in my accelerator, or intensely trying to get through things, resistance is not great. For people who are resistant, I'll recommend that they do the Unleash Your Badass Self Profitability, it's a 30 day mindset program, and to see how they come out on the other side of that. Because it really makes it clear what your programs are, what your resistance is, what has been holding you back. But yeah, it gives people, for my clients to use it as well because of the same reasons. You get to see who's in the room, you get to see how they act, you get to see if you're a good chemistry together or not and decide whether you want them in your program.

John: Interesting. Yeah. It reminds me of someone I heard say when asked the question of whether they're interested in something. If it's not a "hell yes", then it should be a "no." That's the old adage. Okay, we are actually out of time. We went over a little bit, not a big deal, but we are going to have to wrap up. Actually, if you want to tell us anything more about what you do and convince some of the listeners to get off their something and take action, I'll give you a couple minutes to do that and then we'll wrap up.

Dr. Angela Mulrooney: Sure. My suggestion is if you have been plateauing for a while, you've got to decide if you want to stay plateauing or if you want to get out of your way. And if you come to one of the events, either the five day intensive or five day challenge or five hour intensive, you are going to see things about yourself that you can't unsee that are going to propel you forward. It will make you break through your plateau. It's really hard to go back to what you were before the event started. So, if you are feeling stuck and you're looking for possibilities and want to get some ideas, I highly recommend that you attend one of those.

John: And that would apply to even someone who's maybe unhappy in their clinical situation now, but still wants to see patients somehow, but just needs to have a breakthrough or something that would apply to them as well. Correct?

Dr. Angela Mulrooney: Absolutely. Absolutely.

John: Okay, good. Because I tend to get focused on taking people out of practice and move them into utilization management or this or that or starting some kind of company. But there's really no reason why they can't apply these principles to what you're doing now and just make it like you said, something that you love to do and get rid of all the stuff you hate. Okay. Again, how's the best way to get ahold of you?

Dr. Angela Mulrooney: The best way to get ahold of me is on LinkedIn. My profile is Dr. Dr. Angela Mulrooney.

John: Okay. That's easy to find and I'll put that in the show notes. We've got your website, unleashinginfluence.com, which I'll put in the show notes as well. We've learned a lot here in the last 30 minutes. This has been fantastic, Angela. I really thank you for taking time on your world travels. We didn't tell the listeners when we started, where are you right now?

Dr. Angela Mulrooney: I'm currently in Paris and in two days I will be moving to Greece.

John: Paris, Illinois. No, I don't think so. Paris, France, and going to Greece next. Oh, that is awesome. And I guess you are working obviously.

Dr. Angela Mulrooney: Yeah.

John: All right, with that Angela, don't hang up on me, but we're going to say goodbye for the podcast. I really appreciate you coming here and I hope to talk to you again soon.

Dr. Angela Mulrooney: Perfect.

John: All right, bye-bye.

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The post Light Your Entrepreneurial Fire and Create Your Ideal Life appeared first on NonClinical Physicians.

Interview with Dr. Luissa Kiprono – Episode 334

In today's episode, we explore the entrepreneurial journey of Dr. Luissa Kiprono who recently decided to start a new telemedicine service. She is a maternal-fetal medicine specialist who transitioned her traditional practice into telemedicine with the creation of TeleMed MFM.

The interview delves into the pivotal moments, challenges, and strategic decisions that led to the establishment of this innovative healthcare model. During our conversation, Luissa describes the importance of self-discipline and adaptability when making such a significant commitment.

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.

Did you know that you can sponsor the Physician Nonclinical Careers Podcast? As a sponsor, you will reach thousands of physicians with each episode to sell your products and services or to build your following. For a modest fee, your message will be heard on the podcast and will continue to reach new listeners for years after it is released.  The message will also appear on the website with over 8,000 monthly visits and in our email newsletter and social media posts. To learn more, contact us at nonclinicalphysicians.com/sponsorships.

Our Episode Sponsor

Dr. Debra Blaine is a physician like many of you, and her greatest challenge was fear. The whole concept of leaving clinical medicine was terrifying. But she is so much happier now as a professional writer and a coach. According to Debra, “It’s like someone turned the oxygen back on.”

If fear is part of your struggle, too, she would like to help you push through those emotional barriers to go after the life you really want. Click this link to schedule a free chat.

Or check out her website at allthingswriting.com/resilience-coaching.

Evolution of TeleMed MFM: Dr. Luissa Kiprono's Entrepreneurial Journey

Dr. Luissa Kiprono faced challenges when her previous practice closed unexpectedly, leading her to choose the less-traveled path of starting TeleMed MFM. Motivated by a desire for independence and the vision to extend high-risk pregnancy care globally, she committed to a telemedicine-centric approach.

Her strategic decisions included establishing TeleMed MFM as the first to integrate telemedicine into maternal-fetal medicine services so completely. The practice adopted a hybrid model, combining consulting and procedures. Dr. Kiprono started by partnering exclusively with a prominent organization in Kansas City.

Push, Then Breathe: Dr. Luissa Kiprono's Memoir and Thought Empowerment Platform

Dr. Kiprono also described the other major project she has been working on for the past few years, her memoir, “Push, Then Breathe: Trauma, Triumph, and the Making of an American Doctor,“ revealing her experiences from the time she was a 19-year-old immigrant to becoming a successful American doctor. 

Summary

To connect with Dr. Luissa Kiprono and learn more about TeleMed MFM and her upcoming memoir, “Push, Then Breathe: Trauma, Triumph, and the Making of an American Doctor,” you can reach out to her at (210)-660-9906 or via email at DrK@TeleMedMFM.com.

Visit the TeleMed MFM for information on the practice. For updates and insights, explore Dr. Luissa Kiprono's thought empowerment platform at drluissak.com and sign up for her newsletter by emailing hello@drluissak.com. Stay tuned for the release of her memoir on February 13, 2024, available in hard copy, audiobook, and Kindle formats through major retailers in the United States.

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

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Links for Today's Episode:

• TeleMed MFM
• Dr. Kiprono's New Book Website
• Push, Then Breathe: Trauma, Triumph, and the Making of an American Doctor on Amazon
• How to Be a Leader and Humanitarian Improving Maternal-Fetal Health – 204
• How Do I Generate Awesome Income with Telemedicine Services? – 222
• What Is the Best Way to Leverage Telemedicine? – 181
• What Is the Latest Telemedicine-Supported Specialty? – 173
• Debra Blaine's Coaching Page

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 334

- Interview with Dr. Luissa Kiprono

John: Today's guest first appeared on the podcast in July of 2021, and since then a lot of things have changed. She's a maternal fetal medicine specialist who's now providing care using telemedicine. I definitely wanted to hear about that. She's a University of Tennessee physician executive MBA graduate and holder. I just remind you of that because that's one of our sponsors. And she's also the author with a soon to be released memoir. This should be fun and interesting. Welcome back to the podcast, Dr. Luissa Kiprono.

Dr. Luissa Kiprono: Good morning, John. I'm very excited to be here. Thank you for inviting me back to your podcast, Physician NonClinical Careers.

John: Yeah. I think it was very inspirational last time, what you were doing then. And now some new things have happened, which I find extremely interesting and again, inspirational. Let's just get right into it. For the listeners, if you go back to episode, I think it was 204, you can learn more details of Dr. Kiprono's background and so forth. But to get us started, just go through a little bit of a list of what's happened since we talked back in 2021, if you would.

Dr. Luissa Kiprono: Okay. In August, 2022, right at the conclusion of the COVID pandemic, my organization pediatrics decided to shut doors of the practice I was leading at the time, Texas Perinatal Group. That came as a surprise, I have to say. And at that time, I really came at a crossroads, whether to sign another agreement with another organization or to take a different road, that less travel road, and that is to open my own practice. And really I realized how exhausting has been to invest in someone else's dream and in someone else's endeavor. I said I might as well just start investing in my own. So that is how TeleMed MFM was born.

John: Now, was that from the very get go going to be heavily involving or solely involving telemedicine type of interactions?

Dr. Luissa Kiprono: It was started a hundred percent with a vision to become telemedicine. I have to say that I had plenty of experience in the matter due to the way COVID kind of pushed us with medicine and medical practices. But also I was the first practice in both CompHealth agency, which is the Locum Tenants Agency, and in pediatrics medical group that as a maternal lymph fetal medicine practice would hire and maintain telemedicine in their services. Not only during the pandemic, but also up to the day that the practice closed in August, 2022.

I did have experience in the matter, and I think that's where it kind of started. I was like "I know what to do, I know how to handle it, and it works." But it was scary. I have to tell you, it was exciting and it was scary, to both start a new practice in my fifties and also to start not only just any practice, telemedicine in maternal fetal medicine.

John: Yeah, anytime you make a change like that, it's both. You've got all the business aspects of it, and then also like, "Okay, how am I going to deliver care? What's the best way to do it?" And in telemedicine, I have zero familiarity with. That's like how in that environment you deliver your services. You're to be commended for that and I think when you do that, while it's very stressful, and it probably takes some time and some money, as you mentioned, you have more freedom and independence. So, it's a trade off.

Dr. Luissa Kiprono: Yes, it is. You are your own boss. You also are doing telemedicine, you practice medicine from the comfort of your private office, home office. But I always give award to the wisest, to the newly grads, and the newly grads are excited. Let me tell you. This generation is like, "Oh, yes, this is so exciting, we're going to do telemedicine" and so forth. It does take a lot of self-discipline, and it does take a lot of fortitude to not cut corners because it's easy. Just think about what used to happen during COVID. When Zoom meetings start, you're like, "Oh, I got all this freedom. I can also check an email. Oh, I can also do this. I can also do that." So here you are at the end of the meeting, you're like, "What exactly the meeting was all about?" Those same dangers come when you do telehealth. But it comes with a price.

So you do have to be self-disciplined, you have to say "How it would be if I am the patient and the physician that can renders care on the other side, doesn't pay attention, and they don't give me the best care that is because they do it through telemedicine or they miss something?" You do have to have respect, and also you be yourself like your watchdog, "Hey, I got to do it, this is my job." It's only the place that's different. The care, the connection with the patient, the services render for the patient. They should always be there just like I would be physically in the same office with them.

John: One of the things that attracted me to want to talk to you about this, that prompted me is that I get questions all the time from I'll just say specialists. Some of them are surgeons, some are medical subspecialists. And in their minds they're like, "Well, yeah, primary care, urgent care, that's fine. Telemedicine is very common. People have low risk, colds and respiratory, and they can get treated over the phone or the telemedicine service for a UTI or something."

But it's a different type of telemedicine when you're a consultant. And I've seen surgeons and other specialists do this, but never have I talked to a perinatologist that has done this. And so, my question is, tell me a little bit more about what the interactions are like. Since you have really a close relationship normally with the obstetricians as well as the patient, are you interacting with both and do you do some consults with an obstetrician in which you don't actually talk to the patient? Or are they always involving the patient directly?

Dr. Luissa Kiprono: It is very involved. Communication is the key, at least when it comes from me. My advice is always, always communicate. I'm an over communicator. I speak with my obstetrician, that if I make any changes to the care and we switch gears, I call my referring OB provider, and I say, "Hey, this has come up. This is how I recommend." Then I speak with my patients after I discuss it with the obstetrician. Just imagine everything the same like you would go in a doctor's office. The only difference is through the screen. We are talking live here doing a podcast. Same thing I'm talking live with my patient. Patient comes in, whether it is a video consult from the comfort of their home, or it's a telehealth consultation that is in the practice in the hospital or in the MFM practice where the patient is scheduled to come.

The patient gets an ultrasound. I read the ultrasound, and then we have a consultation. And I conveyed the findings to the patient. We discuss just like you would talk face-to-face with the physician. Medical history, go through the entire finding of the ultrasound, counseling, render an assessment and discuss the plan. And then I finish a consultation through the EMR and sign it. And that's it. It's very, very doable. It goes very seamless. There will be things. Think about it when you are in the office. Does your computer need an update? Sure. Is your computer maybe going to crash and you need to reboot? Yes. Do you have EMR when you go and work in a brick and mortar office? Yes. Or in the hospital? Yes.

All those are happening. The only difference is I am not physically with the patient in the room but my sonographer are by my nurses. If I need to send the patient to the hospital, I call the nurse, let her know. I call the obstetrician and the nurse calls the hospital and the patient shows up just like that.

There are a couple of procedures that obviously I cannot do like amniocentesis, DBS. Those are for prenatal diagnosis of congenital or genetic abnormalities. But that is when the physician who is physically in the office comes into place. And that brings me to my next point, hybrid practice. The hybrid medical practices of healthcare are here to stay because you have to have the hybrid. Think about if you have a team that some of them do just consulting, but some of them do also procedures. People who do procedures have to be during the procedure in that room, in the operating room, or if I have an amniocentesis, the physician, the MFM that is in the office that day, they will go ahead and they take care of that for us.

John: Ah, okay. I've talked to people that are doing telemedicine as primary care. They're constrained by where they're licensed, states they have to be licensed in multiple states, although I know some of that during the pandemic was a little loosened up a little bit. It was a little easier to get. Do you focus on certain locations? Is it kind of local, even though it's telemed or is it countrywide? How does that work?

Dr. Luissa Kiprono: I am licensed in multiple states. Every state has its own slight differences. Now we have Compact. Compact made it easier and more streamlined to be able to be licensed faster in different states. I personally hold multiple licenses, but right now, as a matter of fact, my practice has signed an agreement, an exclusive agreement with a very well-known large organization in Kansas City, Missouri. TeleMed MFM is providing maternal fetal medicine services virtually for their patients.

John: Okay. Yeah, that kind of segues into my question I had about how do you get the word out and where do you find business? And so, it sounds like at least one way is to identify a particular organization, work directly with them. Tell me a little bit more about that.

Dr. Luissa Kiprono: We did a lot of marketing, but when I say marketing, it's not like you've got to put an ad in the paper or an ad in YouTube. That doesn't work that way. A lot has to do with your expertise. Maternal fetal medicine, it's a very close knit environment. The MFM subspecialty really was formed 50 years ago. 50 years ago next year. It is a relatively new specialty. And there are about 1,300 of us, but only about 900 to 1,000 that practice full-time. Now, if you take that to 340 million United States citizens and 77 million women between the age 15 and 49, which we consider the fertile age, you can imagine how big the need is, how tiny the group that we are in of specialists.

To go back to your question, when it comes to marketing or advertising, I started working for this organization through an agency, through my company. My company was contracted by the agency to work for this organization, and they learn how I work, they learn my practices. They were very impressed with my ethics and my expertise. They say we just would like to contract directly with you and do partnership between your company and our organization. Without saying, I was extremely excited. And we actually just executed the partnership last month.

John: Nice. Excellent. How does the lifestyle for you doing your practice this way, have you stuck pretty much to the same kind of hours? Or is there more flexibility doing it this way? That's one of the things that attracts certain physicians to telemedicine because they don't have to travel, obviously. It's very much more efficient. Tell me how it's affected your lifestyle.

Dr. Luissa Kiprono: I worked the same hours that I were before. Actually, I worked more. I work more now than I worked before. When you look at any company, any business that you start, I want to make a caveat, you will work a lot more in the beginning to start it. It just has to. It's just thinking about building momentum to have this business going. But I do work the same, if not more, because when I'm done with my clinical duties, then I start working the administrative duties after hours for my practice. And also now with my adventure, you do have to have the electronic capabilities. I do have literally six monitors in my office. And so, I high grade monitors. I have to have a high speed internet, camera video equipment, audio equipment. That is my livelihood. That's my job is to read ultrasound. I just don't have small screen laptops and have large screen monitors because I read ultrasound about 90% of the time with or without consultations.

That are the requirements that have to be in place in order to do this kind of endeavor. Yes, it is more relaxed because I work from my home office, from my private office. But again, going back to that same caveat that I made the beginning of the podcast, be your own watchdog. Stay disciplined. Because it's easy to become relaxed because you are at home. Well now, you're still at work, you are not at home, you are at work. Home is you go to the other room after your work is done.

John: I'm not exactly sure how your practice worked before. This question might be stupid, but I can imagine especially in MFM, maybe you're doing the ultrasound yourself physically, or you have ultra-sonographers that you typically work with. And now I'm assuming that you're actually getting a lot of different ultrasounds that you're reading from different ultrasonographers maybe. How is the quality? I know you've got the technology, I'm just wondering if it's affected your ability to feel the confidence in what you're looking at.

Dr. Luissa Kiprono: It is an excellent question. It is not a silly question. As a maternal fetal medicine physician, we do have highly trained sonographers. They are not radiologists and they are not OB-GYN sonographers. They are sono techs who spend about 18 months to specialize in fetal ultrasounds. When it comes to that, I had other offers prior to this and they said, "Well, you're just going to read the ultrasound, that an OB tech is going to do it." And I said, no, it just doesn't cut it because I am not there to be able to troubleshoot and I need certain images.

What happened is the maternal fetal medicine, sonographers are going by strict guidelines, imposed by AIUM. They are ARDMS certified and fetal echo certified. Think about this. Just like everything else, if you have a radiologist that reads general X-rays or general MRIs, then he'll have a radiologist who specialized in fetal MRIs, and then you go further, radiologists that have specialized in neuro fetal MRIs. That is so important for me to be able to have this at my fingertips, to trust my staff. I have to trust my sonographers because they are my eyes. And let's say they didn't get the image. I would just ask them, "Hey, can you get another image for me?" And they know exactly what I'm looking for.

Otherwise, the learning curve is very steep. Especially if I'm not there, the trust is not there. Just like you said, the liability is very high on my end because if they miss something, then I miss something, then the patient doesn't get the counseling they should have. The follow-up is not the proper follow-up. And then at delivery, the baby doesn't get the care that they should have been anticipated otherwise.

John: Yes, we don't like surprises in medicine and we really don't like surprises in maternal fetal medicine. I happen to have two daughters that are pregnant at the moment. I'm hearing a lot of things third hand. And one thing is not an ultrasound that's not given the right answers. That was very interesting. We're going to run out of time soon and we're not going to run out quickly because I have a whole other topic I want to talk to you about, but I do want you to go ahead and give the website for the telemedicine MFM business just in case there's physicians listening who may need your services or want to learn more or even contact you on LinkedIn if they're starting something similar.

Dr. Luissa Kiprono: Sure. My practice number is (210)-660-9906. My website, you can find me at telemedmfm.com. And my email is DrLuissaK@TelemedMFM.com. If you go to my website, you can always find there the contact info. And please send me an email, ask me a question. I'll be very, very happy to share my knowledge with you and my expertise. Both how to launch a telemedicine practice, and also how to navigate through the intricacies with both medical but also insurance and licensing.

John: Excellent. I will put all those in the show notes, of course, and even in the email that I send out about the episode. We'll have all those links and a few others that we're going to talk about. But in the process that you've described, you've been busy starting this, but in the meantime, you've also had another activity. I guess I wouldn't call it a hobby, something going on, and it's about a book, a memoir. And so, we definitely want to hear about that as well. When did that start to come up as something you wanted to do?

Dr. Luissa Kiprono: Five years ago I embarked on this journey writing my own memoir. This memoir takes the reader on a journey that I have started back in 1987 as a 19-year-old woman immigrant who came to America for two months. I came to America to meet and know my father. And that turned into a lifetime. And without spoiling the drum roll and transferred the book, it's been a journey. It's been a journey of a lifetime. And that journey of 15 years really takes me and it takes the reader all the way to my graduation date in 2002.

And at this time, I'm thrilled to announce the debut of this first nonfiction book. Its name is Push, Then Breathe: Trauma, Triumph, and the Making of an American Doctor. At the same time, I'm launching my platform, it's called Dr. Luissa K. And it is a thought empowerment platform in both leadership and overcoming trauma and thriving by achieving one's own potential. Date of release is February 13th, 2024, and it's going to be launched at all the major retailers in the United States in hard copy, audiobook and Kindle format.

John: Nice. Is this like a traditionally published book through a large publisher?

Dr. Luissa Kiprono: It is a hybrid publishing. The publisher is Greenleaf Publishing Group.

John: Now, we always have questions to address with authors and writers. It's not easy, it's not easy to organize. What method did you use to write? Some people will do blocks three or four hours at a time. Other people will maybe work on a weekend. How did you actually sit down to create this book?

Dr. Luissa Kiprono: I started the first chapter of this book 35 years ago in Romania. Then I wrote that first chapter and I put it aside because life got in the way big time. About five years ago, I found myself recording every morning for about half an hour. I was very intent into doing it. And it lasted about two weeks. When you run a practice, at that time as I was running that huge 52 employee practice. And then also you have a family, children. Life, let's call it. I said I really want to write this book, but there is no way I can write this in my lifetime at the pace I'm going. I started looking at ghost writers and I partnered with my book coach and ghost writer. And that is how the book was finally written through both our collaborations.

I want to tell you something that we all physicians and really some non-physicians, but usually type A personalities, we feel that we must write this book like as if I have to physically write it. But what I can tell you is that the thought out there is that it's actually smarter to work with a book coach and a ghost writer than trying to do it yourself.

It's like delegating. Think about if you are in your office and you're trying to do everything. Trying to vitalize somebody, take fetal heart tones, put the patient in the room, do the ultrasound, be the physician, check out the person, and start that again. How long can you last? You won't last. It's not sustainable. Probably you'll last about three days.

Same thing here. Can you be a full-time physician and write the book and be a mom or a dad and do it all perfectly? No, you can't. You have to A) prioritize, B) work smart. It still took us a couple of years. The book was finalized in December, 2022, which was last year. And then in March was accepted for publication by Greenleaf Publishing Group. And it's now in print, the audiobook is on the way. And it's happening. It's really, really close. The hybrid publishing it's very, very convenient. They work very well in many, many ways. It's hybrid. You do have to put your buy-in and you have to do work and also financially you will have an interest in it.

However, they will put all the wills in motion for publishing and marketing the book. You tell them how much or how little you want them to do, and they will do it for you, and you will approve everything along the way. I would be more than happy John to have a separate podcast to just talk about the process. It is an amazing process that I knew nothing about, like literally nothing. It's unnerving. And I can say it's like rapid fire sequencing. We have to do this, we have to do this, we have to do this. Why? It has to be approved by you, the author. Because at the moment, they accept you and then you sign the agreement with them. We'll also sit down and figure out when do you want this book to be released? And now everything starts dominoing backwards because you are on a schedule. And everybody's going to know that your book comes out, in my case February 13th. Well, we don't want to arrive on February 12th and realize there is no book to be presented.

John: Yeah, absolutely. If I'm not mistaken, and I've talked to other authors, some of the benefits of doing the hybrid is you definitely have more control. If you do a big publisher, one of the big three or four, number one, you lose pretty much all control and they're going to tell you what title they want and how the chapters are going to be put. And it takes a lot longer. And in a hybrid, I think you get to reserve a little bit more of the income that comes into. I'd say most of the guests I've had that have written books have gone that route. Now I've got a few that will self-publish, but I think most everybody's going the route you've gone, especially with one of the really good top-notch hybrid publishers. Boy, this sounds fantastic.

Dr. Luissa Kiprono: Well, just to put a little bit of data out there. 80% of people want to write a book. Out of which 1% finish writing the book. Out of which 1% get accepted for publication. Even with all that, there are about a million books coming on the market every year in the United States, and 4 million all comers, meaning 1 million that are accepted for publication and four millions that includes also self-publishing a year. It's crazy. That's just amazing to me how much influx it is.

John: Well, congratulations.

Dr. Luissa Kiprono: Thank you.

John: Here's what we're going to do. You're going to have to remind me about a week or two beforehand so we'll promote that at that time. And we can obviously promote it through this podcast, which it'll probably be the beginning of January when people see this and hear this. But definitely do something special for that February date. That'll be fun. Tell us where to go to look for that.

Dr. Luissa Kiprono: Okay. To learn more about my book and my platform, my website is www.drluissak.com. My email is hello@drluissak.com. If you sign up for my newsletter, you're going to get it in the mail, but also bring up the updates, any news that come out. And also just to put it out there, just in case anyone wants to join me, February 13th, that will be a destination book launch.

John: Okay. You're going to have to send me the specifics on that so I can put that in the show notes.

Dr. Luissa Kiprono: Sure, we can do that.

John: All right. I think we are getting out of time at this point, but this has been a very interesting episode. We learned a lot about how to implement telemedicine, the pros, the cons, some things to keep in mind. Definitely some good advice. And then about a memoir that's coming out... From the time this is posted about a month after this is going to be posted. So, maybe we'll have some people follow you for that as well. Any last words of advice to our listeners about anything that we've talked about today before I let you go?

Dr. Luissa Kiprono: What I would like to say is that my advice regarding personal growth, follow your heart's desire. If there is something that keeps you up at night, an idea or a goal, whether it is opening a practice, starting a business, or just open up a flower shop. And if that is what you really truly want, if when you talk about it, your eyes are sparkling and your heart starts beating faster, do it. Just do it because you'll never regret it. And don't be afraid that you're going to fail because you know what? You are never going to know unless you try something, especially when you really, really are passionate about it.

John: Thank you for that advice. Very inspirational. You've got this book pretty much in the can we would say. Are you thinking of doing another book later? I'm going to ask that question. Or are you going to rest for a while and think about it?

Dr. Luissa Kiprono: I am going to rest for a while. These last few years have been quite eventful, especially last year with the practice and the entire book publishing. So I will take a break and let's just see. I won't smell the roses for a couple before I decide where am I going to move, what's my next steps are in life.

John: Yeah. Okay. Well, I'll be watching from the sidelines and if you do something else really interesting, I'll have you back on the podcast. Thanks a lot for being here today, Luissa. It's been very fun and educational really.

Dr. Luissa Kiprono: Thank you. I really appreciate the time. And thank you for inviting me for this conversation, John. Happy holidays.

John: You too. Bye-Bye.

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