The Second Annual Summit is Here – 348

In today's episode, John provides an overview of this year's Summit designed to make your clinical practice great or move on to a better alternative.

With a lineup of expert speakers and a comprehensive agenda, the Summit aims to equip attendees with actionable strategies for improving job satisfaction and exploring nonclinical opportunities.

The second annual Nonclinical Career Summit runs this week. It’s not entirely nonclinical in its scope, however. We have several presentations about starting and running a cash-based private practice. It features twelve experts who share inspirational messages and valuable know-how live over three nights.

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 participate in the Summit, you can purchase the All Access Pass videos (only $39 until April 16, 2024, when the price increases to $79).

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.

Trends in Addressing Physician Burnout

Physicians have faced increasing stress and burnout in recent years due to corporate employment structures in the healthcare industry. There are several basic approaches to preventing these common consequences of clinical practice.

1. Aggressive Contract Negotiation: Physicians are placing a greater emphasis on negotiating employment contracts to safeguard against burnout inherent in corporate settings. While not discussed extensively in the summit, this strategy is crucial for those considering employment.
2. Identifying Root Causes of Dissatisfaction: Physicians are focusing on identifying and addressing the underlying causes of dissatisfaction, whether it's related to the nature of their vocation, organizational policies, or interpersonal dynamics. Analyzing these factors allows for targeted solutions to alleviate stress and improve job satisfaction.

Highlights of the NonClinical Career Summit

The Nonclinical Career Summit starting on April 16th features a lineup of expert speakers covering various aspects of nonclinical career options for physicians. Here's a sneak peek at what attendees can expect:

1. Speaker Sessions Overview: The Summit will host twelve live presentations, spanning topics from evaluating the need to leave clinical medicine to exploring diverse career paths outside traditional practice settings. Each session offers actionable insights and practical advice tailored to physicians and other clinicians seeking alternative career paths.
2. Logistics and Registration Details: The Summit will run over three consecutive evenings, starting on April 16th, with sessions starting at 7 p.m. Eastern Time. Live attendance is free, but registration is required to access the sessions. Attendees can opt for the All Access Pass for $39, providing access to session recordings and bonuses.

Summary

This week's podcast previews the 2nd Annual Nonclinical Summit featuring 12 expert speakers addressing ways to create a clinical practice outside of the corporate style of healthcare and nonclinical career options. Attendees are encouraged to register early to secure their spot and gain access to valuable resources aimed at supporting career transitions and enhancing job satisfaction.

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:

• Reserve Your Free Spot at the 2024 Nonclinical Career Summit
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit
• Information about the Nonclinical Career Summit
• Dr. Debra Blaine's Coaching Services

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Episode 348 Transcript

Over the past few years, I've noticed that there is a backlash to the increasing stress and burnout in physicians resulting from employment by large corporations. It seems like the burnout's getting worse and it's related to being employed, losing their autonomy, and really working in that sort of healthcare industrial complex, seeing as many patients as you can in every hour. So in response to that, I think physicians have begun to implement various strategies to prevent or address the burnout, the stress, and the dissatisfaction that's coming.

So these are some of the four trends that I have seen. It's not everything, but I see these as something that's getting more and more common. So first is a bigger emphasis on aggressively negotiating employment contracts.

After all, if you understand that employment leads to dissatisfaction and burnout, and maybe if you've been through it once already, to some extent, you should be able to address the cause of that burnout by building safeguards into your contract. We won't be addressing that in this summit, but it is something I've noticed, and you can take a listen to my interview with Ethan Encana, who's an MBA slash JD, which was posted in February 13th of this year. So if you listen to that, we'll be talking a lot about trying to protect yourself from the things that cause your burnout in your contracts, if you decide to go with the employment route.

Now let's move on to the next one, which is more in keeping with what I want to talk about today. And that is a big thing that physicians are focusing on now, and people are teaching about is finding, identifying, and somehow preventing the root causes of your dissatisfaction and addressing it in new ways. So is it your vocation itself? Is it the practice of medicine? Or is it the organization you're working for and their policies and procedures? Maybe they don't staff properly.

Is it the boss that you report to that's causing your stress and anxiety? Sometimes a fierce conversation can solve the problem. Sometimes moving to a different clinic or hospital will work, but you need to spend the time really analyzing what's, what, what it is about the work that's making things worse. And is it something that you can resolve either in the current situation or at a future one? So that's something we don't talk a lot about on the podcast, although I have had one of our summit speakers, Dyke Drummond, on the podcast to talk about that, but that was several years ago.

Number three is the physicians are implementing new or updated practice models that put more control in the physician's hands. Things such as direct primary care, concierge medicine, and other forms of cash only medical businesses. And this can solve the problem in two ways.

Number one, a lot of times doing that requires you to be in your own practice. So you're starting your own business. So you're not working for someone.

Doesn't mean it's not busy. Doesn't mean it's not challenging, but now you have that autonomy and you're in control. And the other reason is that it's oftentimes the insurance companies, which are driving this whole approach to medicine, where you've got to see as many patients as possible, because they have certain schedules, payment schedules that are difficult to, you know, earn a living on.

And a lot of the drive to see a lot of patients is because of either Medicare and counting it worked RVUs or trying to see so many patients an hour. And that can be overcome by starting your own business and taking cash. And you figure it out in that setting.

Since you don't have to hire two or three people per physician to do the billing, you can cut costs in that way and you can generate income. So it's another thing that I see growing in the past two or three to five years, even. And then the other one is just finding a part-time job.

It's something you can do on the side because you can then either cut your clinical back to part-time also. And then you get to do two different types of jobs. One, a clinical, one, a non-clinical.

You can find, you know, you feel like you're seeing a little more variety of things. You have better hourly compensation sometimes with the non-clinical side, especially those we're going to be teaching at the summit. And again, if it involves starting something like either a practice that just doesn't bill insurance or a med spa or an infusion lounge or a weight loss clinic, you're still at the end of that able to sell it.

And that's a big asset that can really be a big chunk of your retirement and really builds to what I would call it through that process, some career diversity. The other thing that's nice about doing something like one of these side gigs or side jobs is that they can grow to be a little more part of your week as you retire from clinical, let's say, as you get older. The other is it's protecting you so that if your clinical job, which may depend on employment by a hospital or part of a group, that would be protected.

That gives you that leverage, that independence that you otherwise wouldn't have if someone decides to fire you. Okay. So that's why, because of those last three issues that I've been noticing, Tom and I both, that's why we're calling this year's summit clinical practice, make it great or move on.

So there are ways to improve your practice as it is, where it is, or ways to improve it by moving and doing other things. And there are ways to make it better by splitting it with another non-clinical career. And so that's what we're talking about at the summit this year.

And I think it's very apropos. And the tagline is recognize dysfunction, fix it and protect yourself or seek better opportunities. So you can see, as I go through what we're covering during the summit, it kind of brings all of those in and those kinds of terms will probably make better sense to you.

So let's get into the specifics of this year's summit. Last year, we were, just like last year's summit, we're holding it on three consecutive evenings, starting the day after this episode, day or two after this episode is released. I might be releasing it a little early to give people a chance to go through this before the summit actually starts.

And we're doing it that way in the evenings live to enable as many clinicians to attend the free event. So as many people can come for free, making it because we know that Tuesday, Wednesday, Thursday evenings are the best time. If we do it during the day or on a weekend, people usually cannot even come for one or two of the hours of presentations.

But by doing it in evenings and doing it live at night, people can carve out some time and maybe at least watch one or two or three of the sessions each night. Now it starts on April 16th at 7 p.m. Eastern time with four live presentations at the top of each hour. They'll end 50 minutes later, followed by a 10-minute break.

And each presentation includes a live Q&A during the last 10 or 15 minutes. It continues on Wednesday, April 17th and Thursday, April 18th, obviously each night starting again at 7 p.m. Eastern. We're holding it on a typical Zoom meeting platform that most of you are very familiar with.

Questions will be submitted using the chat. It could get a little bit confusing if you got a we're going to use the chat and either myself or Tom Davis will curate the questions. You know, sometimes we get two or three that are very much similar and we'll kind of bunch those together.

But that way we can spend 10 minutes at least getting, you know, answers to really the burning questions that come up during the presentation. I think I mentioned earlier, live attendance is absolutely free, but you have to register in advance to attend. That's the only way we can get you the link to attend.

So you just sign up on the link that I'll give you in a minute. And once you're registered, you can come and attend as many or as few sessions as you like. To save your spot, you're encouraged to register using the link that one of our speakers may have sent you.

You know, you might be watching this, but maybe you're already a student of Dr. Drummond's or Dr. Unachukwu or anybody that's helping us here, which I'll be going through in a minute. And you definitely can use their link and then they get credit. If it's easier or if you don't have any link from anybody else, then you should just go to nonclinicalcareersummit.com and you'll be given an option to sign up for the live free event.

And that's also the same link for purchasing the All Access Pass, because we understand that not everybody can attend all the live sessions. So we're making the recordings available for a very low price. That's just $39.

And given all the work that goes into putting this together, that's pretty darn reasonable. Now it does increase on the day that the summit starts. On Thursday morning, the price goes up to $79.

I'm sorry, not Thursday morning, on Tuesday morning, when the summit is starting later that day. But in the morning, it jumps to $79. That's on April 16th.

So if you want to get that really best price, you should sign up for the All Access Pass by Monday, April 15th. And again, it's $39. So you have to get that registration in by midnight on that date.

And again, it's also available at nonclinicalcareersummit.com or by using any speakers affiliate link if they're sending those out to you. All right, well, let's get into the details about the speakers and the lectures. Basically, like I said, we have four presentations per evening.

They're all live except one is being recorded ahead of time because the speaker is actually not available during the summit. But we didn't want to not include him in this thing. So let's just start with the first one.

And I'm going to say that these are not in the order in which they're being presented, but kind of in the order that they flow in my mind in terms of addressing the main thing we're trying to do for the summit. So for example, Dyke Drummond, Dr. Dyke Drummond, very well known. HappyMD is what he's known for.

He's got a podcast. He's been doing this a long time. He's coached thousands of physicians.

And he's going to be speaking on Tuesday night, the first night. And he's going to be answering this question. Do you really need to leave clinical medicine or is it just the job? And the official title, is it just a shit job or boss you want to escape? So really, it's not necessarily clinical medicine or clinical nursing or other clinical specialties that you're working in.

It's oftentimes other things that lead to the dissatisfaction and the burnout, the anxiety, things like that. So he's going to take that question head on. And how do you determine if this is really you should leave medicine or whether you should stick with it, but resolve the problem in a variety of ways.

And some of the ways he's going to talk about is just how you take control of what you're doing, listing the alternative practice models that might solve the problem. And if it is time to leave, let's put out that ideal job description process. So you can assess when you're going somewhere else, is it likely to be a better situation? So the next speaker I want to talk about is Mike Wu Ming, a very good friend of my podcast and myself, and he's written a book.

And he's going to build on what Dyke is telling us from the standpoint of what his experience has been with owning cash-based medical clinics. Okay, so it's still a practice. It's a medical clinic.

And he just describes sort of the mindset changes you have to go through to make this happen. He'll list the four or five financial levels of a physician, what that means, what it means to be a CEO, not only of your business, but of your life. He'll talk about ways to provide medical services outside the insurance industrial complex, if you want to call it that.

Let's see, he'll compare different types of cash-based medical clinics and where he sees future growth. All right, the third one, again, an expert on business in general, Dr. Una, Dr. Nneka Unachukwu. She goes by Dr. Una.

She has one or two podcasts. She's coaching a lot of physicians, and she's got many courses. And she's an expert and does a lot of speaking about creating a successful business.

In her case, I think is a good mix of people she's worked with who have created healthcare businesses, not necessarily a medical practice. Some have created different medical practices. And so she's going to talk about the business practices you must adopt to be successful, to get into a little bit about the importance of branding and marketing.

And again, she likes to focus, and I think she'll touch on this as well, how to build a practice or a business or both that has value and then eventually sell that business for cash out at the end, which again, I've mentioned earlier, is a great way to help segue into your retirement. And I've got just a hint of this because I'm currently in the process of helping my wife sell her own business, which she's been running for 15 years. And so we're going to just find out what it's worth at this point.

And it wasn't really something that we dwelled on up until the last couple of years. And I guess I'd mentioned now that if you do build a business of any sort, you should really always try to think of the eventual selling of that business because we all eventually go away. And even if it means turning it over to a partner in a medical practice, how does it happen? What's the value? Thinking about those things.

So those are the kinds of things that Dr. Una are going to be talking about. Then to kind of round that out and from another perspective, Joe McMenamin, who just was on my podcast, I think last week, but yeah, and he's going to be talking about corporate entities, meaning, you know, LLCs, corporations, things, how to create a legal situation for your business that makes it safe, protects you financially, keeps the tax concerns in mind. He's also going to touch a little bit on contract negotiations or starting a new business, other things to consider besides just the corporate structure.

And he'll be comparing those different legal entities that can help make your business successful. So the next is we're going to get even right into the nitty gritty of some of these cash-based businesses. See now a med spa, many physicians are familiar with, I wouldn't call that a medical practice.

And I don't think you need a license to run a med spa, although it helps if you're a medical director, if you're doing procedures that obviously are licensed and you have insurance for that. Now practice insurance, but she's going to talk about this. I believe she owned her med spa for 15 years.

She started it from the ground up. She grew it, she marketed it, she branded it and she sold it. And they happened not too long ago.

And she actually was able to segue into staying on as a part-time medical director. And so it really worked out well. She's very happy with how things went.

And again, I don't think she was thinking about the sale of it when she started it, you know, 10 or 15 years ago, but it worked out well for her. So she's going to share some of her experiences with that. Next two guests, our speakers are Jennifer Allen and Kimberly Lowe.

Now they're actually each doing an individual presentation because Jennifer is a physician and Kim is a nurse. They're going to discuss their particular experiences and reasons for going into starting an infusion lounge or an infusion center. And both of them will spend a little bit of time talking about what the heck is an infusion lounge.

And it turns out it can be a lot of different things. And let's see for Jennifer, she's going to be focusing too on the basic services they usually provide and how hers is different and who's sort of best qualified, or let's say has the best background and personality to do something like this. And a little bit about the first three steps, prepare to open your own infusion lounge if you decide to do that.

Now during Kim's session, and Jennifer's I think is on the first day, Kim's is on the third day. Again, she's going to tell you why she thinks it's a great investment and describe how the partnership model, you know, is working for them, for her in particular. She's going to hopefully mention some of the other businesses that nurses might be able to get into in healthcare that, you know, not everything is open to a nurse, you know, medical practice per se isn't.

But even in some places as an NP or an APN, you can do something like that. But she's going to talk about, you know, nurses and kind of side businesses that they might be doing that are similar to what she's doing. And she might end there with three mistakes that you should avoid when starting an infusion lounge.

Well, that brings us up to Paul Hercock. He's been on the podcast twice. He's from the UK.

And he created, well, he has a business that uses medical regulatory consultants or medical affairs, regulatory consultants to help meet the needs of the MDR regulations, medical device regulations in the UK and in the EU. Paul is a physician and he's been working in this field for a long time. And so he started hiring people to do this for him, for his business, which is called Mantra Systems, I believe, Mantra Systems.

And then because he was having difficulty finding people, he created a program to teach people how to become medical regulatory affairs consultants. So that's what he's talking about. And I think it's going to be very interesting.

You'll be working remotely for companies that are mostly in the UK and the EU, but you can work from the United States. In fact, we have a lot of people that contact me that are from the EU. You know, they maybe have traveled, they've immigrated to Europe and then they decided to come to the US and they may have a degree from somewhere in Europe, UK, France, you name it.

And there's no reason why they can't continue to do work back there remotely because things are just so easy to do in that way these days. And in fact, Paul told me that they often look to hire American physicians to do this because they have a lot more experience in dealing with the FDA. The MDR regulations are actually relatively new in Europe and the UK.

So that's going to be an interesting one. Very useful, very practical. Then Dr. Armin Feldman is going to come on.

He's been on the podcast a couple of times and he's going to tell us all about medical legal pre-litigation, pre-trial consulting. And I've discussed this before, but it's an awesome side hustle. Don't have to be licensed to do it, but you definitely have to have a medical background.

And he's going to explain exactly how that works, why there's a growing need for the service and how to get the necessary skills to do it. That brings us to Gretchen Green, who's pretty well known for teaching hundreds of physicians, how to become expert witness consultants. She's run her course nine or 10 times.

And so she's going to give us a quick overview of how to become an expert witness, how to build the business side of that, what to do, what not to do, what it entails. And so this is going to be really interesting and an overview for what she does. And then the last one is Tom Davis, known to many of you, I hope, as my past business partner in Newscript, which we've closed down back a few months ago.

But he's here helping with the summit. And he's been involved with companies that provide social security disability reviewers. And it's something that I didn't quite understand or wasn't well aware of.

I'm definitely aware of an independent medical examiner, but there are also other layers of the process of becoming, let's say, qualified for disability payments from social security. And it's a very niche area, but you can definitely get a remote position as a social security disability application reviewer. And it really piqued my interest.

I want to learn more about that. And so this is something that almost any physician can do. I believe they need to be licensed to start out, but I'm not sure you have to remain licensed.

And there are full-time jobs available as well as some part-time jobs, from what I hear. So I'm really interested in hearing Tom describe exactly what that entails and who's qualified and how we would apply for that. And then finally, did I say finally with Tom? There is one more, and it's kind of the icing on the cake.

And it's a little different, but we thought it would be nice to have Dr. Pranay Parikh talk about real estate and how it can make physicians' lives better. So we're not talking about becoming a full-time real estate investor or manager, but as I spoke about earlier, when you can build different sources of income, different sources of assets over time, then why not do that and add that to your portfolio of income streams? And so we thought, well, it's not a clinical type of thing. It's something many physicians are interested in.

So he is going to be talking about real estate. He spent, I don't know, the last five or 10 years in real estate. He actually has a real estate company that he's partnered with.

He's worked with others that you have heard of on the physician side of things. And there's so many different ways of investing in real estate. We thought, okay, Pranay, come on this summit and talk about how a side hustle in real estate can bring emotional and financial rewards, list the benefits and challenges of investing in real estate and describe, we're going to have him describe the three most popular approaches to investing in real estate.

That wraps it up. That covers the 12 lectures that we're bringing during the summit. I'm really looking forward to learning from all of our speakers.

They'll be sharing their wisdom. You'll be able to follow up with them later if you want to. Some of them are going to probably be promoting the summit with us.

Some of them are going to be providing their own bonuses. So if you are already following some of them or on their email list, watch out for their emails because they will be helping to promote it. So even if you're using the free version, if you register through them, you can get any bonus they might be providing as being part of this.

Our team is really excited to bring you this year's summit. We're doing our very best to bring you actionable advice that will help you to improve your current situation, establish your own practice or healthcare business, or create a lucrative side gig so that you can maintain your autonomy, improve your income and satisfaction and support your transition when you withdraw from clinical practice. So there's a lot of benefits to this year's summit.

Sign up for free right now or purchase your all access pass by going to nonclinicalcareersummit.com. The day that this is being released, the all action pass still only costs $39. And I think it'll be that way for another day or two. But if you're listening to this later, you'll have missed that $39.

So on Tuesday, April 16, the price will jump up to $79. Still a very reasonable price if you need to get the recordings. And then after that, when the summit's done, they'll actually jump up in price again.

But for right now, if you want to get in early, go to nonclinicalcareersummit.com. And to make things easier for you, instead of remembering that link, you can find the show notes and some other links by going to nonclinicalphysicians.com/make-your-clinical-practice-great.

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The post Make Your Clinical Practice Great or Move On appeared first on NonClinical Physicians.

Interview with Dr. Morgan Leafe – Episode 338

In today's episode, John interviews Dr. Morgan Leafe to help you determine if you will love medical writing as much as she does.

Dr. Morgan Leafe shares her journey from clinical medicine to medical writing, emphasizing the flexibility and opportunities the field offers.

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 john.jurica.md@gmail.com and include SPONSOR in the Subject Line.

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.

Exploring the Diverse World of Medical Writing

Dr. Leafe discusses the wide spectrum of medical writing, starting with the distinctions between regulatory and non-regulatory writing. She delves into various roles, from crafting content for Continuing Medical Education (CME) activities to covering advisory boards, web content creation, journalism, and manuscript writing. Dr. Leafe provides valuable perspectives on the creative aspects, work pace, and client interactions, offering a comprehensive overview for aspiring medical writers.

Navigating the Path to a Freelance Medical Writing Career

Morgan also outlines the steps for physicians interested in entering the medical writing field. From joining professional organizations like the American Medical Writers Association to conducting informational interviews and gaining practical experience, she highlights the significance of networking and connecting with fellow medical writers.

The discussion extends to the advantages of having a medical background, efficient work practices, and the potential for recurring relationships with clients. Dr. Leafe offers insights into maintaining a freelance business, emphasizing the role of flexibility and adaptability in the dynamic field of medical writing.

Dr. Morgan Leafe's Advice

I am so enthusiastic about medical writing. Changing careers was one of the best things I've ever done in my life. And it's a great fit for folks who want to travel, part-time, full-time, freelance, employed. There's so many different options and I'm just a big advocate of getting as many physicians as we can into the field, especially because so much of the content that is generated is intended for us.

Summary

You can visit Dr. Morgan Leafe's Personal Website and for more information about Dr. Morgan Leafe and her work in medical writing, you can check her portfolio.

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:

• Morgan Leafe MD, Website
• Dr. Leafe's Writing on Turning Over a New Leafe Website
• American Medical Writers Association
• Association of Healthcare Journalists
• Why Build Your Own Rewarding CME and CE Writing Business?
• Add Discipline to Creativity to Be a Successful Medical Writer – 179
• How to Shine as a Technical Medical Writer – 155
• How to Weave Medicine into a Dedicated Writer’s Life with Dr. Andrew Wilner – 075
• How to Find Freedom as a Freelance Medical Writer with Dr. Emma Nichols – 056
• How to Become a Medical Writer with Dr. Mandy Armitage – 022
• Dr. Debra Blaine's Coaching Services

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 338

How To Know If You Will Love Medical Writing

- Interview with Dr. Morgan Leafe

John: Medical writing is a good field to understand because it offers you a way to leverage your education background and training in a variety of genres. It's got a lot of flexibility and it's generally done remotely. And it's also one of the things you can do part-time to see if you like it. So it's really a good career or side gig for physicians and other clinicians. Today's guest is perfectly suited to tell us about that and see if she agrees with my assessment. And so, I want to welcome to this show for the first time, Dr. Morgan Leafe. Thanks for being here.

Dr. Morgan Leafe: Hi, John. Thanks for having me. I'm happy to be here.

John: Yeah. I really like talking to medical writers. Everyone has a different way of doing things. Some specialize, some do a lot of different things. I do want to pick your brain today specifically so that we can get a little bit into that. But why don't you just start by telling us a little bit about your background and how you made your way into the world of medical writing?

Dr. Morgan Leafe: Sure. Like a lot of your guests, I would say my path from clinical medicine to where I am now was not a direct route, which is not a surprise to anybody probably listening to this podcast. I did know for a while, I'm a pediatrician by training, and I did know that staying in the clinical world was not my ultimate goal in my career. And so, I started to think pretty early on in my attending career about what I wanted to do nonclinically. And actually, initially I was interested in informatics. Interested enough that I got a master's degree and became board certified and I thought my career path was taking me maybe into a leadership role within informatics.

And then one thing led to another. I was always that kind of person, probably also like a lot of your listeners who always had a side gig going on. And I ended up with a side gig where I was the pediatric medical editor for a board review company. Not even knowing that that really was in this world of medical writing that I didn't quite yet know about. And as the wheels were turning and I was saying, "I'm getting ready to leave clinical medicine, what should I do?" I found myself at the SEAK conference which you're very familiar with. And through the SEAK conference I learned specifically about the field of medical writing from Mandy Armitage, who's a fellow physician medical writer, who's been in the field for a while. And I said, "Wait, I'm kind of already doing that and I really like it, and this can be a whole career." And from there, all the pieces of the puzzle fell into place.

In 2020 I had my planned exit from clinical medicine, which ended up being very fortuitous because I actually planned to leave my job at the time in April of 2020. And my job happened to be connected to the school systems here in California. And so, when COVID hit in March of 2020, I would've been out of a job anyway.

John: Wow, great timing.

Dr. Morgan Leafe: Just with all this interesting series of events. And here I am working as a full-time freelance medical writer now.

John: Okay. Have you ever been employed as a medical writer or have you always done it as a freelancer?

Dr. Morgan Leafe: I have not. For me, freelancing was my goal from the get-go. My husband works from home, he runs his own business. I also have a sister who runs her own business from home. And so, to me, that lifestyle aspect of it was very appealing. I never considered an employed role because of that.

John: I see. Now, just as a side note, you and your husband are both kind of not tied to an office. Do you ever just travel and work while you're traveling? Can you do that?

Dr. Morgan Leafe: Absolutely. All the time. I'm talking to you today from Santa Barbara, California, where we primarily live. We're originally from the East coast and we have our house in Philadelphia still where we met. And we rent that out on a short-term basis. And then for a few months out of the year, we drive cross country with our dogs and stay at our house in Philly and see our family and friends there.

John: Nice.

Dr. Morgan Leafe: Everything I dreamed of when I was working those 80 hours weeks.

John: Every once in a while I talk to someone who has a remote job, but they have a remote job that they have to do from home. It's kind of a weird scenario. But if you work for an insurance company they might give you a computer and say you have to work from that site. And it's like, "Well, what's the point?"

Dr. Morgan Leafe: Yeah. Not in medical writing. You're your own boss. You're a freelancer.

John: All right. Well, let's see. We're going to get into learning a little bit here. Just from your perspective, maybe you can describe the types of medical writing. And I kind of got the feeling from reviewing your LinkedIn. You've done a lot of those, so you could either go through it as an academician or just the different things you've done. You take your pick.

Dr. Morgan Leafe: Yeah. When I'm talking to folks, from the get-go, what is medical writing? I always say I like to divide it into two buckets from the top. And those buckets are regulatory writing and non-regulatory writing. The regulatory writing bucket, as you know John, is writing sort of very official paperwork, submissions for the FDA, working for pharma, for biotech. And there are certainly physicians who do that. I would say out of all the physician medical writers out there, more sway towards the non-regulatory areas. But regulatory writing is an option. Most people will tell you it's a little bit easier to get started in regulatory writing by taking an employed position because there's just so much to learn. It's a little hard to pick up on your own. And then the other bucket of the non-regulatory writing is really a very large bucket with many, many items in it.

Those of us in the non-regulatory world, one of the primary things that I do is create content for CME activities. I write a lot of blogs, I cover advisory boards. If folks are familiar with the advisory boards that take place, maybe when a new medication is coming out and all the key opinion leaders get together, usually in a nice city, and have a big meeting about it, they usually hire a medical writer to cover that event for the day and then write up a report.

Web content is a big thing for various kinds of websites. And by the way, I'll add because I think it's important to your listeners, you just never know where your experience is going to come in handy. And believe it or not, that's where informatics has really come in very handy. Even though I would not consider myself in practicing information at this point. People see my background in informatics and ask me to write about health IT issues a lot, which has been great.

There's journalism. And some people focus just on writing content for patients or light audience. And some people kind of vary between, "Oh, I write some for clinicians, I write some for patients." And of course, manuscripts are another big area of medical writing. Grants manuscripts, anything in the academic publication realm. I shy away from the manuscripts. That's a little bit of just a big long project for me. I like things that are a little bit shorter, quicker and more creative. But there's options for everyone.

John: Now, what would some typical kind of journalistic type of writing be?

Dr. Morgan Leafe: Yeah. It's interesting because journalism in the sense as it relates to medical writing can have a few different definitions, I would say. And by the way, if that's something that interests anyone who is listening, there is, I hope I don't get the acronym wrong, the American College of Healthcare Journalism - ACHJ. I think there is a professional organization for healthcare journalists. And when you think healthcare journalist, what might come to mind is Sanjay Gupta or somebody on the ground reporting on the news. And that's certainly part of it too. There's also a lot of web content to be generated in the journalism and news area.

And then the other angle too would be covering conferences. All the big meetings for the different specialties have somebody cover them for the different internal outlets for that specialty. That's actually another aspect of journalism that I don't think comes to mind for some people when they think about that area.

John: Yeah, that's interesting because I know someone who actually spent 10 years as a physician doing just that while he traveled and scuba dived and did other things. He made a living and then he went back into clinical medicine, if you can imagine that.

Dr. Morgan Leafe: Wow. Those meetings are fascinating. Those big oncology meetings and all. There's so much excitement and the stories are so big. Yeah, it's a really interesting world.

John: Now, let's see. Can you give me some more comparing and contrasting? Because it was pretty obvious that the regulatory it's just, I don't know, I would call it tedious. It's very particular. A lot of rules or regs. And if you can't do it, they're not going to hire you. You got to be right on. But what are some of the differences in your mind between the other types of writing that you have done? And then I'll get into more questions once you take this first stab at it here.

Dr. Morgan Leafe: Yeah. There are a lot of angles to consider when you are thinking about what type of medical writing you like. And one thing is how fast do you like to work? How fast do you like to turn around things? I like writing journalistic pieces, but to be honest, I'm so busy I don't do a lot of them because they have a quick turnaround. And right now my calendar is booked out a month. Nobody wants a new story a month from now. How much pressure you like to work under as part of it.

I think how creative you like to be in your work is a big part of it. What I love about making CME content is I'm getting the opportunity to make some really fancy slide decks and help a graphic designer make interesting graphics and really make content kind of come to life in that sense. So, if you have that sort of creative side to you, I think CME content is really appealing.

I think a lot of physicians come into medical writing with a passion for communicating with patients because that's ultimately why a lot of us became physicians. There is definitely room for that as well. It's a skill to hone and there are courses out there on that. But if you feel like my passion is really talking more to patients and helping them understand disease processes, then it is maybe teaching or informing my fellow clinicians. I think that's one thing to consider.

Who you want to work for and with is probably another consideration too. What kind of clients do you like? If you're a freelancer, do you want to freelance for a large medical communications company? I prefer smaller clients I have a personal relationship with, and that definitely plays a factor and is part of the learning curve of becoming a medical writer.

John: Yeah. When you were talking earlier, and I just want to expound on that and have you expound on that a little bit. The way I was thinking about it too is for my limited exposure, some things tend to be a little more involved. You were saying that you like the creativity of let's say the CME writing. Now I do some editing for a CME provider. And I would never write an article for them because they're a hundred pages long, they're 10 hours of CME and they have usually 100 to 200 references. And I'm like I would blow my mind.

Dr. Morgan Leafe: That's not what I do.

John: Yeah. And also tell me what you think about this in terms of how efficient can you be in certain genres and how's the pay associated with that? It kind of always boils down to an hourly rate, I guess, but what's your thinking on that?

Dr. Morgan Leafe: That's a great question, and it's funny to hear you say that about the long CME content. I'll tell you what I was working on before I came on our call today is CME activity that's on Twitter. I was writing CME activity in little 285 character bites, which I love it. It's just a totally different way to think. I think it's a lot of fun. There's so much variability out there. You're absolutely right.

And as far as efficiency and pay, to me, being a physician has a huge advantage in the field no matter what you do because of that. Because it's important to know that medical writing as a whole, I always tell people, if you went to our professional conference, the American Medical Writers Association, and you looked around the room, I don't know for sure, I'm sure the statistic exists somewhere, but I'm going to say 10% of people in there are physicians. Maybe 20, 30% are PhDs and maybe the other half bachelor's or master's in some type of science or bachelor's or master's in journalism or English.

And so, it's a very varied group of folks, which is awesome. I have just amazing colleagues that I work with. And it means that when you are coming from the medical profession where your medical knowledge is really top tier, you're going to save yourself a lot of time. People ask me a lot, "Well, do you only write on pediatric topics?" No. I write on everything.

But I can guarantee you that even as a pediatrician, when I do a project on prostate cancer, which never came across my radar as a practicing clinician, I can still read and absorb and understand the topic and the data and generate something from it a little faster than somebody who doesn't have that medical school background.

John: Yeah, that makes a lot of sense. And in fact, the ones that I edit, I'd say at least half of them are written by non-physicians. They're equally good but I can envision the fact that maybe the physicians are a little bit quicker at writing the CME that they're doing. The other thing that's kind of cool there, I believe, is that the way they work is that when it's time to review it, every two or three years, they're a lot more efficient because they actually get paid well, almost as much for the initial writing of it. But I'm sure it takes them a fraction of the time to review it.

Dr. Morgan Leafe: Yeah. And it's a big advantage in the CME world too, because you're often asked to come up with patient cases to accompany an activity. And I think that can be a real stumbling block if you've never seen a patient before. So, it's nice just to have that, obviously, information that you don't even think of as an advantage necessarily, but that's in your head, you know what it is to see a patient, what they're going to say, what they're going to ask. So, that comes into play probably more than you even think about as a medical writer.

John: I'd never thought of that. It never even crossed my mind. That is a very good point. Okay. Now I know that you do some mentoring, coaching, advising and so forth. I'm going to kind of flip it around and say, okay, let's say that someone has a penitent for writing of some sort. Is there a way that you can help them figure out other than just doing all of it for a while, which is going to be very inefficient, how to pursue this. You already mentioned some of the characteristics, but maybe there's a way we can approach it logically from the beginning.

Dr. Morgan Leafe: Absolutely. If you're interested in medical writing and you are saying, "This seems really interesting to me. I don't know what field, how do I go forward?" I think a couple of things. First step is definitely do your research. Go to the American Medical Writers Association, consider joining. It's only like $250 a year, and it's really an amazing professional organization. I can't say enough good about it. It's very, very supportive people. And there are a lot of racist sources on there about the different areas where you can learn more. You can also join your local chapter and connect with people there to learn more.

And then there's a wonderful book written by Dr. Mandy Armitage about going from clinical medicine to medical writing. That's a great resource. You already know Dr. Emma Hitt Nichols has a course that teaches you backgrounds in journalism, CME, manuscripts and other things you might want to know.

Just by starting out and trying to hone your skills, I think that's a good first step. That might make you say, "Oh, okay. Yeah, I didn't really like writing that whole manuscript. That was too much for me. Or the CME, I had to look up all those references. That wasn't for me." That's a good place to start.

I always want to caution people that you don't need to go overboard with training or investigating things. There absolutely are certificate programs out there for medical writing. University of San Diego has one. University of Chicago has one. If you really want to pursue that, go for it. But don't do it because you feel like it's a requirement under the profession, because it is not. Most of us don't do such multi-year programs to get into the profession. So, it's not a bad thing, but it's not a necessity. And then I think you get out there, you try it out, you see what you like. And the fact of the matter is what happened for me and how I continue down the path of CME writing is that was the work that was coming to me.

A lot of the work that you're going to get in medical writing comes from networking. You meet, you network, you introduce to people and they offer you work. And sometimes that pushes you along your path as well. Really networking and talking to people, especially about what they do is a great way to learn if that's the field for you. "Oh, you do advisor role. How much do you have to travel for that? How much notice do they give you? What's the pay like?"

And most medical writers are super happy to talk with you on any specific topic. They're very sharing groups. So, anything that you can ask questions about, do. And it's a process and you can change. It's not like going into residency where you're stuck. You can change your mind.

John: Excellent. Now let's see, one thing I was going to ask you. Are most of the projects that you're doing now from recurring relationships with a given company or firm or whatever it might be?

Dr. Morgan Leafe: They are, yes, which is really exciting. And that was a big part of the growing process for me over the past four years or so, expanding my business, because of course, when you start out right, you're like, "I'll take any client that will pay me anything." And then you reach the point, "Okay, I have this many clients and maybe I'm even getting more work than I can handle."

And then for me, I came to just a really lovely position of being able to choose who I wanted to work with and work with people who really reflected my values and who I have a lot of fun working with. I have just the nicest clients. I can't say enough about all of my current clients and how wonderful they are. And that is really a breath of fresh air, I think, especially for maybe the burned out physician out there who's just having a tough time in your office environment. It's a real change of pace because I think everybody in medical writing is very cognizant of the fact that lives are not hinging on what we do. And it just is a lot more relaxed and it's really laid back. So, recurring clients and maintaining those relationships is key.

John: Yeah. And you'll probably... Well, I'm not going to say "probably". You'll never be sued as a medical writer.

Dr. Morgan Leafe: I hope not. I have insurance in case I do.

John: Just in case. Okay. But yeah, it's very cheap compared to medical malpractice.

Dr. Morgan Leafe: Yeah. Well, I'll tell you something, John. My errors in omissions insurance actually costs more money per year than my malpractice did my last year in practice.

John: Really? Are you high-risk pediatrics or what?

Dr. Morgan Leafe: I was only practicing part-time, so that affected the malpractice insurance. But you know what happens when you get into these nonclinical roles that aren't well understood by the general public is the insurance company just hears that you're a doctor and that's all they can hear.

John: It's inflated.

Dr. Morgan Leafe: It's one of those things you learn along the way about running a business. You just figure it out.

John: Yeah. There are always some expenses in that, of course. The other thing, just to give us an idea, about how many regular relationships for recurring work do you have at any given time?

Dr. Morgan Leafe: Okay. I'm a little ambitious. I would say I'm working usually for a project at some stage or another, maybe for 10 different clients at a time. That's going to totally vary depending on the type of work that you do though, and how many hours and what types of projects. CME projects tend to span a number of months to put together. It's a little more feasible to be working on multiple of them at once because they're all at different stages. It just totally depends.

Some people will, and I don't recommend this to tell you the truth. Some people will take on a freelance client that's giving them 30 hours a week of work. Then that person is kind of giving you 75% of your work hours. And that's fine. Again, it's a good way to get started, but I feel more comfortable having multiple streams of income in case one of them goes away. To me, that's really the comfort in freelancing as opposed to employed work. I'm not sure everybody's answer would be the same, but I would say for me give or take 10 clients at a time.

John: And I have to assume you have some kind of master calendar where you can figure out, "Well, this is a three month project, this is a six month or two month, and so let's fit it here." Like you said, these things are scheduled in advance, not like I need an article on this next weekend.

Dr. Morgan Leafe: Flexibility is key as a medical writer, especially in the CME realm, because ultimately all the content I am creating is usually going to a key opinion leader in the field to review and to maybe present as a webinar. Those people are very busy. And so, delays happen all the time. And I'm going to show you since we're on video, but the listeners won't be able to see. I'm showing you right now my paper calendar that I fill in with a pencil because things change. And that was a technique my business coach taught me. That has been very useful. You have to be able to roll with the punches. If it's going to throw you for a loop, that somebody says, "Oh, this is delayed a week", then you want to consider that when you are specializing within the medical writing realm.

John: Very good. Now that helps a lot. I'm going to go back to something you talked about at the very beginning of the types of work that you do, because to me, I couldn't figure out how you would find those jobs. And you were talking about working for advisory boards.

Dr. Morgan Leafe: Yes.

John: And that seems like something that wouldn't have an easy way to find, but is there a way?

Dr. Morgan Leafe: It doesn't because it's kind of a popular thing to do. You get in there and you get to know people. It's a networking thing. The way that people are recruited for advisory boards is often through medical communication companies. I have been contacted before because some of these advisory boards are filmed or audio recorded, I have been contacted by the companies that are doing the recording. They've been asked to hire a medical writer. So, it just kind of depends, but yeah, it's not the easiest one to chase after. It's a little more falling into it and making connections over time. Because it becomes one of those relationships with your fellow medical writers kind of thing. "Oh, I got caught about this. I can't do it. It's a date I already have something else. Are you able to go?"

Interestingly, advisory boards all used to be travel. Then, of course, during COVID they went to Zoom. It's not a huge piece of what I do right now, but I know people who do many. And what I'm told is, it's kind of split now. Some are still on Zoom, but some people are back to traveling. Depending on how you feel about travel, that's going to influence whether covering advisory boards are interesting to you or not.

John: Okay. Good to know. Well, let's see. We're going to run out of time here soon. Any other tactics or things we should know about if we're thinking about getting into this field?

Dr. Morgan Leafe: This is similar to a lot of nonclinical fields. I know I've said this already in the podcast, but really networking and putting yourself out there to meet people is really the key. I have a lot of people who come to me and say, "Oh, I found all these medical writing jobs on LinkedIn and I applied and I never get a response." And I'm like, "Yeah, you're not going to. That's just not the way to get a job in medical writing."

And as you know, networking can sound like a very intimidating term. I don't mean it in the sense of schmooze people. Very direct people reach out to me on LinkedIn like, "Do you have any work for me?" No. That's not the way to do it. But the way to do it is to reach out to other physician medical writers, "Hey, do you have 15 minutes? I can pick your brain about your career or sort of an informational interview type of situation." And just getting involved, getting to meet people. You never know where a connection is going to lead.

I'll tell you that a few of my first clients, how I got them was I was on a Facebook group for women physicians. And this was during COVID and I had just embarked on my full-time medical writing career. And a woman posted in the group about being a medical director for a CME company. And their conference was being canceled, and what do people think? And I said, "Oh, you're a medical director for a CME company. I've been writing needs assessments for CME, but I don't really know what a medical director is. Could I talk to you about that?" And we talked on the phone and it turns out we went to the same medical school. She's like 20 years older than me, but we went to the same school and she's lovely. And I now call her my godmother of medical writing and she connected me with now three of my current clients.

So, you just don't know. You can't expect something from every conversation that you have with somebody because it's not going to be the case, but you can expect to make friendly contacts and something is going to lead somewhere. So, it really is just that putting yourself out there is going to be more productive for moving your career forward than clicking that apply button on LinkedIn.

John: Yeah. But LinkedIn is another place to do research, and my recommendation is that they go to, for example, your LinkedIn profile and other medical writers' profiles because they will see the names of a bunch of companies that they could possibly talk to.

Dr. Morgan Leafe: Absolutely. Absolutely. And I'm the first person to say, and I didn't mention this, besides being a medical writer, I'm also a resume writer and LinkedIn profile writer. But I'm always open to say to people, if you're not sure what to put in your LinkedIn profile, go to mine. Check it out. You can borrow it, please don't copy it exactly. But if you need an idea of what to put in a LinkedIn profile to get noticed as a medical writer, yeah, please look me up. Absolutely. And importantly, AMWA, the American Medical Writers Association also has a freelance directory that is a similar, tiny version of LinkedIn. And if you join and get the freelance membership, you can have a listing in there. I get tons of clients from there.

John: Nice.

Dr. Morgan Leafe: That's another good place to get your information out there because yeah, networking is key, but people are also going to find you as long as you put the right information out there.

John: And I'm thinking if the listeners are interested in medical writing and they might want to actually talk to you directly. So, why don't you tell us where we can find you? Of course, we know LinkedIn and actually I think it's just your name so they can look that up and find you pretty easily.

Dr. Morgan Leafe: And my last name is Leafe. My website is morganleafemd.com and you can reach me by email morgan@morganleafemd.com. And if you're interested in what medical writing portfolio looks like for collecting your samples or what types of pieces you might be interested or wanting to write and how to put together a portfolio for yourself, you can check my portfolio out, which is turnoveranewleafe.com.

John: Excellent. Yeah, I looked at both of those and it was pretty nice the way you've got it broken down on the portfolio page. It's a lot more detailed than looking at your LinkedIn profile, but looks very nice.

Dr. Morgan Leafe: Thank you.

John: Let's see. I think that's all that we need today. A lot of information there. I will put links to everything that we talked about in terms of some of those resources at the beginning and AMWA and anything I can capture. And so, that'll make it easy for listeners and viewers if they're looking at the YouTube version of this. Any other last bits of advice for our listeners before I let you go?

Dr. Morgan Leafe: I would just say I am so enthusiastic about medical writing. Changing careers was one of the best things I've ever done in my life. And it's a great fit for folks who want to travel, part-time, full-time, freelance, employed. There's so many different options and I'm just a big advocate of getting as many physicians as we can into the field, especially because so much of the content that is generated is intended for us. I hope that some folks who are listening today are inspired to check out medical writing because it's a lot of fun.

John: Yes. I think you've been very inspirational. I like your story and your enthusiasm. It's been fantastic. Thanks Morgan for being here. With that, I'll say goodbye.

Dr. Morgan Leafe: Thanks John.

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The post How To Know If You Will Love Medical Writing appeared first on NonClinical Physicians.

Interview with Mr. Eric Miller – Episode 337

In today's episode, John describes why you must treat your practice like a valuable business asset if you want to be successful.

This episode serves as a valuable resource for healthcare professionals looking to enhance their business acumen and secure the long-term prosperity of their practices.

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 john.jurica.md@gmail.com and include SPONSOR in the Subject Line.

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.

The Business Side of Healthcare Practices

In this engaging segment, John and Eric shed light on the often overlooked dimension of running a healthcare practice – treating it as a business. Drawing from his extensive experience working with physicians and other healthcare business owners, Eric underscores the critical need for an understanding of the financial dynamics inherent in medical practices. The discussion unveils some key aspects, including common pitfalls to avoid and the need for astute financial planning.

They also explore the importance of seeking professional advice, collaborating with financial experts, and understanding the unique economic challenges within the healthcare industry. Eric shares success stories of physicians who have transitioned from viewing their practice solely as a profession to adopting a business-centric approach, resulting in increased financial stability and ongoing growth.

Building Value and Planning for Practice Exit

They explore the issue of planning for the sale of the practice from the very beginning of its inception. Eric recommends building a practice that is not solely dependent on the owner, with multiple revenue streams, and ongoing strategic planning from its beginning. 

This concludes with insights into optimizing the sale of a practice, ensuring financial security for physicians nearing retirement, and the potential for substantial returns with proper planning and execution.

Eric Miller's Advice on Pursuing Your Practice

I one-hundred percent say “do it.” You'll never regret it. But also make sure that you teach yourself or you learn the business side of the type of healthcare that you deliver so that you can maximize what that would be for yourself.

Summary

Miller, a seasoned financial advisor specializing in healthcare practices, delves into the essential aspects of financial planning for healthcare professionals. His book “How to Become a Financial Beast” [this is an amazon affiliate link] covers a comprehensive range of topics relevant to practice owners, offering practical guidance on optimizing personal and business finances.

To connect with Eric Miller, you may visit his company's website. You can explore the available resources and services offered by Eric Miller and his team at Econologics Financial Advisors. 

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

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

Links for Today's Episode:

• How to Become a Financial Beast, by Eric Miller (this is an Amazon affiliate link, so I'll receive a small payment if you buy it using the link)
• Econologics Financial Advisors
• Contact Eric Miller directly using this email address: bfff@econologics.com
• How to Start and Grow a Profitable Cash Based Medical Practice – 293
• Want to Establish a Concierge Practice Before Finishing Your Fellowship? – 210
• The Best New Business Solves a Problem – 171
• How to Be a Shrewd Business Coach and Consultant – 111
• Dr. Debra Blaine's Coaching Services

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Transcription PNC Podcast Episode 337

Manage Your Practice Like a Valuable Business Asset

- Interview with Eric Miller

John: I've noticed that many physicians who start non-traditional practices like med spas and weight loss clinics, they truly treat that as a business. In fact, I had a guest recently who sold her med spa, and she really did well. But many doctors failed to treat a medical practice that way.

When I was a CMO, I helped recruit physicians and bought some practices, and they were usually very disappointed in what they got. I was really happy when I came across Eric Miller, who's going to join us today because this is the thing he does, trying to bring value to practices and prove their business acumen and producing income and so forth. So, hello Eric and welcome to the show today.

Eric Miller: Hey, John. Thanks so much.

John: I've done a little intro prior to us starting here that's separate. But just tell us about yourself and how you got into helping clinicians of various sorts.

Eric Miller: Yeah. When I first got interested in personal finance I took the direction that a lot of people do. I work for an investment company, I focused on retirement planning and 401(k)s and such. And at some point in time, I just decided that's not really what I wanted to do in this field. I really wanted to be more of an advisor, a financial planner, and not just sell investment products.

And then having a background where my family was in healthcare I was like, "Well, here's what I've seen. These are people that desperately need financial help because it's really not taught to them in school." We started in 2008, which was a heck of a time to start a financial planning company, if you remember back then.

John: Yeah.

Eric Miller: We started working with healthcare owners and I learned really early on because all the questions that I would get from them had to deal with their practice. "My practice is struggling. I'm not making enough cash." Here I'm trying to get their personal finances in order and they're asking me all these questions about their practice. And I'm like, "I don't really know about your business. I've never seen your financials or I don't know how it works. I don't know how you guys get paid." It was just kind of an "aha" moment where I realized that if I was going to be a financial advisor that was going to cater to healthcare owners, I better understand something about their biggest investment, which is their practice of course. And that's where it started. Then we started working with veterinarians and physical therapists and optometrists. And then anyone that had a private practice, these are the types of people that we focus on.

John: Yeah. And it is a different world in healthcare, and even subsections of it are different. The practice is one thing, a hospital environment is a totally different thing. And there's a lot of billing and there's a lot of write-offs because you only get part of what you bill unless you're in the cash based business. So, that must have been an eye-opener.

Eric Miller: Yeah, it was. I was like, "Oh, no wonder we have a screwed up medical system. I'm looking at all these, how reimbursements work and I'm like, oh my gosh, this is crazy." But I did learn how the business runs, and that really made us more of an ally for that owner. Because I could show them "This is what this thing should be providing for you, and this is how much you should compensate yourself." And just gave them some certainty on that, because most of them just have no idea how to even pay themselves.

John: Yeah. They don't even know how to set up a structure. They've got to learn if they're starting their own practice, obviously, but it's like, "You better sit down with the attorney and the accountant and figure that out." But they don't really have a business background.

Eric Miller: That's right. Yeah. That was another thing I realized too, is just how much they didn't really understand. They understood the practitioner side, they just didn't really understand the business side of it very well.

John: Yeah. And that's I think why we see more and more that just come out of the residency and go and work for a hospital or something. But I think a lot of them do that for a while. They get really frustrated. They feel like they're in some kind of futile system or slavery where they're getting beat up to work 10, 12 hours a day and they say, "Forget it. I'm going to go on my own." But then we come back to this problem. So, you've talked with a lot of different people in healthcare that have these practices from doctors to physical therapists and so forth. Are there certain things that you see are kind of the biggest mistakes, or I guess I had a question here I was going to ask you about. Why their practice isn't sound and why their personal finances aren't secure?

Eric Miller: Yeah. Well, I'll say it goes back to that principle I just taught you. Almost all of these people went to school for seven or eight years to learn how to be a practitioner of some kind. But they never learned how to be a good owner, a good investor. And I think when you start thinking about the moment you own your practice, you're a business owner, and that means you have different roles and functions. And those are just things that would never taught. Any management skills, any owner skills, or how to invest money. How much should I be making? Where do I allocate it? That was never taught to a doctor. He's got to figure that out on his own. But the ones that are really well off today embraced that they are owner investors and it really guided how they made financial decisions.

John: Do you end up having to walk them through how to even look at a P&L and figure out if they're generating enough income to cover their expenses and what would be considered a reasonable salary?

Eric Miller: Oh, yeah. We definitely look at the profit and loss statements and I can see where there's money leaks at, how much are they spending on staff wages, cost of goods and other things that we'll look at. But I think the primary thing is that most people just underestimate how much they need to bring in every month. If I ask a doctor "What's your make break number?" They give me a number. But then I say, "Well, does that include your owner profits, business reserves, money for taxes and money to reinvest back into the business?" They're like, "No." I'm like, "Well, then that's not your make break number." Once we really show them, this is how you should be operating, then it lights a little bit of a fire in them. Like, "Oh my gosh, we need to see more patients. I need to do more services." Because we get them on a road to real financial solvency, not just getting by.

John: Yeah. I think things have changed a little bit. Maybe people are a little bit more astute today, but especially back when I was starting out and even just 10 years ago, basically they would just figure, "Okay, if I just see enough patients, I should be able to cover my overhead." And they wait to see if it works. It's probably not a good way to go into business without knowing how to market and how many patients do they actually have to see? What do they have to charge to actually make enough income to take care of their family?

Eric Miller: Well, I even look at it a little differently. I'm like, all of you have a facility. I don't know how many square foot, 3,000 square foot, 4,000 square foot, 2,000 square foot.

John: Yes.

Eric Miller: How many patients could you see in a month? And how much room do you have for other practitioners in here as well? And really start to get them thinking about treating this business like an investment and not a job. And I think that is a key thing that a lot of owners need to look at is that their practice is an investment. It's not a job. And really trying to get max value out of it should be a primary goal that they have.

John: It's funny you say that because they may kill themselves practicing and trying to generate enough, but then they always are looking at outside investments, which isn't necessarily a bad thing, but they're looking at the outside investments differently than they're looking at their own business, which I think is the point that you're making. It's like return on investment.

Eric Miller: I'll ask them what their biggest expense is, and you ask a practice owner what their biggest expense is, and they're going to say it's staff wages or some kind of overhead expense. And I'm like, "Nope. It is money you had the opportunity to make and you didn't." It is lost income. If I have a facility that could be doing $200,000 a month because the size of it allows for it, and I'm only doing $100,000 a month, well, you're giving up $100,000 of income. At a 40% profit margin or 30% profit margin, that's a big number.

They don't have to look very far to go out and chase shiny objects to create more income. They just need to look at their current facility and say, "How do we build this thing up so that I can maximize its use?" I think that's the big difference that a lot of practitioners aren't doing, but that's how corporate works. That's their "How do we fill this thing up to the brim as fast as we can?"

John: Right. Well, I think you alluded to it earlier, but I'm going to get specific and ask you this. It seems like whether you're a family physician or maybe you're a gastroenterologist or a surgeon of some type, a lot of this comes back to maybe hiring other staff that can do things and create revenue for the practice. Is that one of the big options to try and use that space and expand?

Eric Miller: Yeah, for sure. You have so many hours in a day. You guys are open so many days a week. How much room do you have for multiple practitioners in there? That gets terrifying for a lot of owners or for a lot of practitioners because they're like, "Oh my God, now I have to teach this other person how to do." But it's not as bad as what they think. And once they do adopt that viewpoint, not everything is on their shoulders and start giving away responsibilities to other people that are competent, then that gets them the most valuable resource, which is of course, their time back. And that is something that I think a lot of owners dream about, but it never really happens for them.

John: When I was in practice, I did hire other physicians and it worked out kind of nice because they generated enough to cover their salary and maybe contribute to the bottom line a bit. I just had a glimpse of that before I went into basically hospital leadership. But are there other things that they can do? Have you seen any practices that...? I don't know, I get some physicians who think, "Well, maybe I should also sell things like vitamins or other products." Have you seen any success in that area?

Eric Miller: Well, sure. Anything that you can. When you look at your business, just don't rely on one of anything. Write down every single service that you provide, whatever that is. I actually have an exercise on this that we do with owners, and then I have them rank them, which are the highest profit margins, which are the most in demand and which are the easiest to deliver? And have them go through an exercise and start looking at, "Okay, these are the four income sources or services that we do that seem to generate good profits, are fairly easy for us to deliver, and people want." And I think everyone could do that exercise and really it would be eye-opening in some cases. But yeah, certainly looking at alternative lines of revenue are always a good thing. But like I said, I think just your existing services just doing a higher volume of what you're doing right now, more than make up for any deficiencies that you have.

John: I think sometimes when the physicians think of that, they're thinking, "Well, if I'm going to do more volume, it's just going to take up more of my time."

Eric Miller: Yes.

John: But I guess what you're saying is, well, find out a way to do that, but also do it with other people working for you, rather than you doing everything yourself.

Eric Miller: And this is where it becomes an investment and not a job. Because now I'm looking at "How do I bring someone in? I'm terrified to bring on an associate. I'm not sure he is going to have enough business." And that's where you have to start thinking like a businessman. How do I market to get more patients? How do we increase the outflow so that we can get more known in the community and get more referrals and all those things. I just think it's going to force you to do things that you're not used to doing, but then you're going to have a result that's 10 times better than what you thought you were going to have. And if you can have that viewpoint, I think it's going to lead to a lot of financial success.

John: I think most of the family doctors, they think of, "Well, that's easy for a dermatologist or someone that's doing procedures", but I think if they just look at it closely as you've said, and really dig into it. When I was in practice, sure, I had one NP that worked for me for years. But nowadays, I am affiliated with an urgent care center, and basically 99% of the care is provided by a non-physician provider. So, you can definitely adopt something like that.

Well, this leads me into the next phase, which is the other thing that just blows my mind is most physicians, when they get to the near retirement, they kind of just fade away. They might sell their practice to a hospital, but they're usually very disappointed by them. Because basically unless they stay and are the provider, usually they want to leave. There's not really much that they're selling at that point. So, how do you think about that? When should you start planning for that exit, and how do you optimize maybe actually getting something for the practice?

Eric Miller: You should start thinking about the exit the moment that you started the practice, which maybe isn't necessarily practical or real, but it is one of those things that you have to start planning ahead of, "How do I want to exit this practice? Do I need to sell to a hospital? What are my options first and foremost?" And then making sure that you build it so that it's valuable to someone else. And to your point, there's not going to be a lot of value there if all the production of the practice is on you. It's just not. There are certainly things you can do to minimize your production. When I say that, make sure that the business isn't 100% reliant upon you. Even if you get that down to 50% or 40%, you would be amazed at how much the value would increase of the overall practice by doing that. It's staggering.

John: Again, in my experience, someone might be lucky to get $100,000 when they're ready to retire as they turn over their practice that they're not going to work in. You would say though, the amounts you could get if you do a little planning and hire some people that can do some of the things you were doing, it could be some multiple of that.

Eric Miller: Yeah. I'll just choose one, which is the veterinary industry. You wouldn't think that a veterinary hospital on the corner street that you have right there with three doctors in there would be worth $5 million.

John: No, I wouldn't.

Eric Miller: But they are. Yeah, they are. Depending on the type of healthcare industry that you're in, there's always bigger groups out there that want to absorb and buy. And if they're going to want to acquire you, and they see that the production is just you and you're not willing to stay on for a period of time, you're going to get pennies on the dollar. But if you have maybe one or two other associates in there, maybe you're doing 20 to 30% of the production, then you may get a multiple of six to eight times your profit. It could be maybe one to one and a half times your earnings, depending on the method that they utilize. If I have a million dollar asset, I'd rather get a million dollars out of it than get $100,000 out of it.

John: When I think of a veterinarian too, I don't think they're doing much different from let's say a physician or some other person. They're prescribing, they're dispensing.

Eric Miller: It's not different at all. Somebody comes in, it's just with a human being. It's a dog that gets treated. They go back, they go into a treatment room and exam room, there's surgeries that are done. It's almost the exact same thing. But yet because a practice has multiple veterinarians doing that, it's worth it. What did I have? I think the largest veterinary sale that I saw was someone that had six doctors. And he sold for $22 million.

John: Oh my goodness.

Eric Miller: Yes.

John: Wow.

Eric Miller: That was a business. There was multiple people, there was executive, that's a business. That's going to sell for a high multiple. If it's just one person with one assistant, you're not going to get as much. That's just unfortunately how business valuations are governed.

John: Yeah. We talk about burnout here a lot, and physicians getting all excited about a side gig or doing something else, but if you knew that you could build something like that, it'd be exciting and you'd put a lot of work into it, but you'd get the satisfaction knowing that not only are you going to have a good income, but at the end of the road, you're going to have this nice asset that you're going to sell for whatever you sell it. But it's going to be definitely something worth doing.

Eric Miller: Absolutely. And you don't really have to sacrifice your current income all that much and you can still save plenty of money and create other income sources outside of the practice. But if you just put a little bit of effort into treating the practice like something that has more significant value than what maybe you thought it did, then it really can reward you down the line. And it can be life changing money in some cases.

John: I want to switch gears for a second. I don't know if I'm really switching gears, but you did write a book called How to Become a Financial Beast, and I took a look at it. I think you cover a lot of these things in that book. Is that right? We're just talking about how to build something that's an actual business that can be sold.

Eric Miller: Yeah. I really do cover the financial journey of a practice owner, someone that owns a healthcare practice. I talk a lot about exiting, how to make sure you're paying yourself correctly, how to build wealth outside of the practice, how to create a maximum value exit, what your options are. We definitely dig into everything related to a healthcare business.

John: By the way, to my listeners, you've got a pretty big outfit going on in terms of looking at your website. You've got a lot of people working with you. Tell us more about what you do, the full extent of what you and your team does for people working in healthcare.

Eric Miller: We are financial advisors. Most physicians that I know have worked with maybe a local advisor like an Edward Jones or Merrill Lynch or somebody like that. We do a lot of the same things that most of them do. Most of them have one to two meetings a year, go over your portfolios, look at your current investments, and it's pretty much the extent of what the conversations are. Maybe do some retirement planning. I think the big difference is that we focus on making sure that we're talking to you every single month about your finances, not just your personal finances, but your business finances.

Because one thing I've learned is that your money doesn't take time off, and there's always going to be some kind of decision that you're faced with or something that you have, "Okay, what should I do here?" And I wanted a service model that was different from the traditional financial advisor model. That's really our niche, is working with practice owners in the healthcare space, understanding how their business works, looking at your business financials, making sure that you're operating on the right targets, and most importantly, that you're taking enough money home from the practice to build other income sources and live the life that you want to live.

John: Excellent. Because I can imagine a group of let's say two or three, and this happened to me when I joined a partnership. They had no retirement plan. I'm in there for two or three years. I'm like "There's something missing here." It's like "Not that I'm an expert, I just know we should be putting money aside and we should be doing it in a way that makes sense." You can advise the practice owners on that kind of thing as well?

Eric Miller: Absolutely. Yeah. We tell them how much they should contribute if they do have a current retirement plan. Most of these physician groups do, pretty rare that I see right now they don't have some kind of 401(k) plan or retirement plan. But that shouldn't be the only source that you have. And I think that's where a lot of people get in trouble is that they're just pouring money inside something like that, and then all of a sudden, it becomes a giant tax bomb when you start distributing money from it.

So, you have to be a little bit more prudent and figuring out, "Okay, I need to also think about taxes when I'm looking at my cash flow, and how am I going to do that?" So, it's looking at qualified plans. It's certainly looking at traditional stocks, bonds, dividend paying stocks. We look at insurance based products for guaranteed income and tax-free income, and then of course, real estate for cash flow. I don't believe that there's one size fits all. I think all of these different sources can provide you what you need. And I don't get pigeonholed into just doing one thing.

John: Yeah. It sounds good to diversify anyway because these things go in cycles and it's nice to not have everything in the same cycle going down at the same time.

Eric Miller: That's for sure.

John: Econologics is the company. Is that correct?

Eric Miller: That's correct.

John: Econologics Financial Advisors. Where can we find the website for that?

Eric Miller: They can just go to www.econologics.com. We have plenty of financial assessments and downloads that you can have.

John: Okay. I'll put that in the show notes for sure. I'll also put a link to the book. How about any last advice? Someone who's maybe they've been in practice, as an employee, they're thinking of starting their own practice, or maybe there's a couple of docs together thinking of doing something. Any sort of closing advice for people thinking about doing that?

Eric Miller: I 100% say do it. You'll never regret it. But also make sure that you teach yourself or you learn on the business side of the type of healthcare that you deliver so that you can maximize what that would be for yourself. I love it when people do that. I love it when people get entrepreneurial like that, and they should, but you also have to understand the business side of it. And that's what I would recommend that they all do.

John: I know of physicians who have the acumen and teach other physicians how to do that, but it would make sense though, if you could just get your accountant, your attorney and a financial advisor like you on board to discuss these issues, you pretty much have things covered in terms of what you need to do to start a practice.

Eric Miller: You would 100%. You have to build a really good team. And I would recommend everyone work with a competent CPA, an attorney. Probably you don't need them as much, you'll need them later on. And then 100% a financial advisor but one that understands your business. That's a big key. One that understands how your practice works. Because otherwise they're going to fall into the same traditional model that you experienced before. But that team is really important to build.

John: I like the idea that you're doing monthly checkups with your clients and catch things. It might be going off the rails.

Eric Miller: I'm telling you. I learned that early on. It's about every four weeks someone calls me up and has some crazy idea about something to do. I was like "Let's make sure that we're talking to them really routinely so that we just keep them on track. This is what you're doing. What about this, what about this question? Okay. We'll handle this." And it really has been a very workable service model for us.

John: Excellent. I appreciate the time you spent with us today, Eric. This has been really helpful. I think physicians who have been staying away from the idea of maybe going out on their own might give it a second thought at least, that it can be done, and there are ways to optimize it. So, I really appreciate that.

Eric Miller: Yeah, I hope so. Thanks for having me on, John.

John: It's been my pleasure. All right. With that, I will say goodbye.

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