small business Archives - NonClinical Physicians

How to Apply the Visibility Formula to Become Known

John Jurica — Tue, 30 Apr 2024 11:45:14 +0000

Interview with Dr. Nneka Unachukwu – 350

In today's episode, Dr. Una returns to the podcast to teach us how to use her visibility formula and to tell us about her new book.

Two years ago, Dr. Una introduced us to the transformative power of entrepreneurship for physicians. Now, she shares the strategies that have propelled her clients to success, with practical advice for physicians ready to embark on their entrepreneurial journey.

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.

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 Visibility Formula: Unlocking Business Success for Physicians

Dr. Una explains the core principles of her latest book, The Visibility Formula. The book aims to empower physicians to overcome challenges in marketing and branding their businesses. From redefining introversion in entrepreneurship to practical strategies for increasing visibility, she offers valuable insights into building a thriving medical practice.

Practical Strategies for Physician Entrepreneurs

Dr. Una shares actionable tips and strategies for physicians venturing into entrepreneurship. She provides concrete steps for building a sustainable and successful medical practice or business, from identifying target audiences to leveraging social media. Drawing from her own experiences and those of her clients, Dr. Una offers valuable insights into overcoming common challenges and achieving long-term business success.

Summary

From homeschooling her children to leading The EntreMD Business School, Dr. Una's journey is filled with insights for physicians seeking to navigate the entrepreneurial world.

In her latest book, “The Visibility Formula,” Dr. Una unlocks the secrets to business success for physicians, offering practical strategies to overcome introversion, master visibility, and build thriving practices.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 350

How to Apply the Visibility Formula to Become Known

- Interview with Dr. Nneka Unachukwu

John: I found that one of the best ways for physicians to thrive in today's healthcare environment is to opt out of the traditional corporate employment. That just doesn't do it for most of us. And as an alternative, build your own practice or a healthcare-related business. And to do that, of course, you need business knowledge and marketing knowledge. And that's why I brought on today's guest because she is an expert in both. Maybe we'll get she's taught so many people how to start a business, run a business, optimize a business, market a business. And so, I want to welcome back to the podcast, Dr. Nneka Unuchukwu.

Dr. Nneka Unachukwu: Hi, John. Thank you so much for having me back. This is a treat.

John: Yeah. And of course, you are being a presenter at the summit, which starts a week from now, but it's actually in the past by the time this is posted. I do want to mention it though, because people can still buy the videos after the fact. You are our kickoff speaker next Tuesday. I'm very thankful that you're going to be doing that for us.

Dr. Nneka Unachukwu: Yeah. And I think it's a gift to the physician community really, because we really do need all hands on deck and for people to see examples of what is possible. And you really gathered a really great group of speakers who are speaking on so many different things and everybody should be able to find something that resonates with them. And then hopefully just change the trajectory of their lives really.

John: Yeah. And not the least of which is just get to know some of these speakers who maybe they've never met before or seen and just say, "Wow, I didn't know there was someone doing that, that I could emulate or I could reach out to." Because pretty much all of us, if we're doing this for mentors or coaches or something along those lines too.

All right. Let's see, you were last here about two years ago. Of course, I can never go back and remember where things were two years ago, but just give us an update on maybe how your life has changed and some of the newer things you've been doing since we last spoke back in, I think 2022.

Dr. Nneka Unachukwu: Yeah. A lot has changed since then, but on a personal note, I started homeschooling my older two kids, which has been so good because they get a full education. They get the academic piece. I'm teaching them business, leadership, real estate, character development, and they get a lot of hands-on because I have them hands-on in the business. They're 16 and 14. It's been so rewarding. And some of the things we're going to talk about today are the things that made that possible because I was able to create that space so I could do that. That's been really good.

From a business perspective, I've done a lot, but really focused. As you know we have The EntreMD Business School, which is really about helping doctors build six, seven, multiple seven figure businesses. And for the last two years, I could have started many, many other programs, but I really poured a lot of energy into that. How can I help the doctors get bigger results? How can I help them get results faster? How can I help them see as many examples as possible of what is possible?

And really over the last two years watching them, we're talking docs, building multiple seven figure businesses, taking vacations once a quarter. Their marriages are better. Their relationships with their kids are better. Their health is better. Everything is better because they're back in control. They're back in control. And so just watching that has been so great. I'm really glad. The school is almost four years old now. Just the sheer amount of focus that I've put on that.

And then I really took to writing. I figured we didn't get a business education and everybody's not going to come into the business school, but I did really want physicians to have all these blueprints of how they can change their businesses, how they can grow really great brands and things like that.

This year I was like, "I'm going to do a book a quarter and we see how that goes." For the last two years, I've done a book a year. But then this year I was like, "I'll do one a quarter." That's my tall order for my own self.

John: That sounds like a challenge. It's hard. The way through that and with everything else you're doing, but it's a good challenge.

Dr. Nneka Unachukwu: Yeah, I'm up for it. I committed for a year, so we see what happens after that.

John: Yeah. Well, maybe by then you'll have written everything that needs to be known by anybody. So that'll be good. But that's why we're here. We want to talk about your latest book. You wrote The Visibility Formula recently, and published it. I've had a chance to look through it, but why did you write that and what aspect is it focused on?

Dr. Nneka Unachukwu: Yeah. I started off in entrepreneurship as a socially awkward, super shy introverted introvert. And I think many physicians are introverts and all of that. The problem with that is if we adopt the traditional sense of an introvert, it's almost impossible to make a business work because then the introvert will say, "Well, I can't go out and ask for referrals because I'm shy and I can't speak on stages because I'm shy. I can't ask for reviews because I'm shy." And it goes on and on and on. And I had treated that like a handicap, but being able to show up and promote your business and promote your brand and all of that, it's not really a personality type. It's like a skillset. It's a skillset. And I found so many physician owned businesses struggling, not because they don't have a great service because we lead with service. We have amazing services, but the thing is nobody knows about them. Obscurity is the big problem.

And so, I wanted to create one book where you can go end to end and discover how to build a business that is like a household name where people start saying you're everywhere, where all the people you want to serve can find you because there are so many people who have the problems that our businesses fix, but again, they don't know we exist and if they don't know we exist, they can't say yes to working with us. And so I wanted every doctor to be able to lay their hands on something that they can follow, their team can follow, and it will take them over the course of time from obscure to household name.

And then once we get to that place, we're in a position where we can help the people we're called to serve and we can create financial freedom at the same time. So that's kind of what drove me to write the book.

John: Oh yeah, I think most physicians, it's not something they're aware of or exposed to the idea of marketing or sales or, I don't know, branding even, that kind of thing. Maybe you can walk us through the components of the book or of the visibility formula. Obviously we should all go by the book if we want the details, but you can at least give us a high level overview of at least two or three, or maybe all.

Dr. Nneka Unachukwu: Yeah. The starting point of all things visibility is really recognizing how powerful it is. And when I talk to people about them, if your brand is visible, you get to attract more people that you can work with, which is what you want to do. You get to attract more people who refer people to you, because again, there are people looking to refer to people just like you. They just don't know you exist. You'll get to attract people who will come work for you.

I have so many doctors in The EntreMD Business School who now have one of them over the last three months has had six doctors from different states reach out and say, "You're the person I want to work with. I will move my family cross country to come work with you." Visibility does that.

And then one of my favorite things is that the visibility formula will do for you is it sets the stage for what I call the unknown. There's so many opportunities that can fall in our lap. That could be investments, that could be partnerships, that could be so many things, but they're not things that are on a vision boards and not things that are goals, but they can fall in our lap if people can find us. And so, if we understand how valuable visibility is, we'll be willing to embrace some of our discomfort to be visible. And so, that's the starting point.

Then the second thing, especially for physicians, because when I started out as an entrepreneur, I thought sales marketing, all those things are sleazy things, that used car salesmen did, not professionals like me. But redefining what that is. For instance, I could see selling as something you do to manipulate people to take their money, which is not what selling is. Selling or even being visible is really putting yourself out there loud enough and long enough so the people who have a pain that your business solves can find you. And so, the truth of the matter is putting ourselves out there is sometimes some of the best service we'll do to the people we're called to serve, because they have real problems.

Dr. John, if you think about it, there are problems in maybe your life, your business and things that you're thinking, "If I could just find somebody who does this, I'm willing to pay them whatever. Whatever they want, I'm willing to pay them. I just need the person." But there's somebody else who has a business who solves that. The reason why you're not working with them is because you don't know they exist. And it's the same thing for us.

If that person were to come to you and the person tells you, this is what I do, you're not going to say, "Oh my goodness, this person is sleazy and manipulative." You can even almost hug them and say "I've been looking for somebody like you." And so, being visible is not a slimy thing at all. It's a good thing. It's you serving your people. And if we can just reframe the way we think about it, everything becomes better. These are almost like prerequisites. Once these two are here, it makes embracing the formula, it makes it much easier.

As far as the actual formula, the starting point is who do I serve? Who do I serve? Who is the person? And a lot of times people will tell me, "Well, I can't choose. What I do will help everybody." And I'm like, "They're 8 billion people. You're not going to help everybody." And they're like, "No, but I really can't choose." I'm like, "Yeah, but you're an OB-GYN. You're not a pediatrician, you're not a dermatologist, you're not a heart surgeon. You chose a specialty so you can choose."

Really identifying who is the person my business serves, because when we talk to everybody, we're talking to nobody. And that's the rule of the game. You want it so that this way, everything you're doing is strategic. You're talking to your person at all times. That's the first part of the formula.

The second part of the formula is the person you serve already exists. They're not going to be born. This is someone who's going to swipe a credit card or swipe a card to work with you. They already exist. And so, they're out there in communities and groups and tribes where they've been gathered.

The second part of the formula is identifying where they are already gathered and going to them. For instance, Dr. John, I'm on your podcast and there are people who are listening now who have never heard of me, but they hear of me because I'm here. And the same thing, if you go on somebody else's podcast, there are people who've never heard of you, but they're gathered and you show up there and they're like, "Oh, now I've met Dr. John. Let me go find his podcast. Let me go attend his conference."

And so, we go show up where our audience already is. Because a lot of times what people do, they start a business, they open a social media account and they're talking there all day, every day, but nobody knows them. You have to go find the people. The second stage is going to find the people.

The third stage is then creating what we call a headquarters where people can come and binge on your stuff. Think about Netflix for business. If we use this example, Dr. John, I'm here on your podcast. Some may listen to this and be like "I find what she's saying is really fascinating." They could come to my podcast. My podcast has 414 episodes at this point. So they can binge away. They can see, "Oh, this is what it's like when people work with her." They can see, "Oh, this is what she's about." These are the principles to stand for. "Oh, she showed me this. I can go apply it in my business now and get wins and all that." Everybody kind of wants to own that so people can come home, if you will. They come to the headquarters and really experience you.

And done right, your podcast, YouTube, blog, those are the three main types of headquarters. They really can be a full-time employee in your business because while you're asleep, Dr. John, someone just listened to you talk about the conference. So someone's like, "Yeah, I heard you say the conference has passed, but I'm going to buy the replays and stuff like that." This could be happening at 02:00 A.M. You're asleep where your podcast is working like a full-time employee. Identify who you want to serve, go out there, go find them, build an HQ for them.

And then the fourth stage is really around "How do I set this up in a way that it doesn't take over my life?" I don't want to spend all day every day doing the podcast, creating, pitching where I'm going to go, all of that. Because sometimes people hear about this, they're like, "It's too much. It's a lot of stuff." And that's why we talk about things like repurposing, batching, getting a team, delegation, all of those things.

You can do it because I've had a whole month period where I didn't record a single podcast episode because I wanted to take a break. But I batched and I created six episodes, which is for six weeks. So of course I can take a break. My podcast didn't take a break, but I took a break. So there are ways to do all of these things and it will look like you're everywhere doing all the things at all times, but not really. That's not what's really happening because you've learned to leverage all these other things.

And the truth of the matter is we put ourselves out there long enough, loud enough, and we're strategic with inviting people to work with us and all of that. We will just build a brand. We will build a business where we can serve all the people we want to serve and really create massive change, which is what we really want to do. That's a long answer to your question, but that's kind of the formula.

John: That's a good overview of the formula. Now I'm going to get into the specifics of a couple of questions. One of the things I've become more interested in is instead of pulling people into just these nonclinical jobs, working for UM or an insurance company or something, but going back and saying, "Look, just start your own practice. Maybe do a cash only business of some sort or concierge or whatever you want to call it."

I just want to know when your experience, when you're working with those people, are there certain techniques that they use? Looking for patients geographically around them, do they go out on LinkedIn on social media or do they just do ads in newspapers or what?

Dr. Nneka Unachukwu: That's a great question. There's a lot of things they can do, but I'll tell you almost in order of importance, if you will. I'll give you some. When you have a brick and mortar and you're going to be serving people locally. When we talk about going out to where the people are, a lot of times they're local referral sources.

I'll give you an example. I'm a pediatrician and a great referral source for me would be an OB-GYN because we serve the same person in different ways. The OB-GYN will take care of the mom. I will take care of the mom's kid. And so, there's no competition there because we do completely different things.

Now, if I were to have build a relationship with six OB-GYNs and they're all preferentially referring to me, I'm busy, the end. The end. Because their moms are going to keep having babies and they're going to keep sending them to me. So I just have this constant stream of new people who are coming in.

I will give you an example of one of the docs in The EntreMD Business School, she does weight loss, brick and mortar, and she had been courting this orthopedic surgery group. Because they would need for their patients to have some weight loss to qualify for certain surgeries and stuff like that. And it took her a minute, it took her about 11 months of following up with them and all of that, but it's a big group. And so, the day they said, "Oh, come do a lunch and learn from us. We want to learn more about what you do." She ended up with 42 new referral sources, 42. If they sent you one patient a month, that is 42 new patients a month from one referral source. You see what I mean? And so for brick and mortar, that right there, it's so powerful, it's super powerful. That's number one.

Number two, because private practices tend to be high volume for the most part, except they're concierge like DPC, they tend to be larger volume than say a coach would have. Unleashing your current patients is so powerful. Many of them will refer, but they don't refer because they don't know you're accepting new referrals. Case in point, I was taking care of a patient one day and she said, Dr. Una, are you accepting new patients? Because I had this friend, she has three kids. She asked me who my doctor was and I was like telling her how you were amazing and all of that, but you're busy, I'm sure you don't take new patients. Here she is thinking she's doing me a favor by not referring patients. Meanwhile, I'm actively recruiting and accepting new patients. If we don't tell them, they won't refer. Now sometimes they will, but we won't experience the real magic of it if we're not telling them.

It's as simple as maybe I see 12 patients a day and I decide every day I'm going to ask four people to refer people to me. Especially when they're like, "You're the best thing since sliced bread." What they're literally telling you is ask me for something. Ask me for something. When they tell you that, oh, that's so amazing, that we're looking to build this practice up with patients just like you. Do you have any friends or family who you think deserve to be in a practice like this? And then they're like, of course, yes. And there they go. Because again, one person may give you five people. One person may be someone who's very influential, leads an organization, may give you 20 people. But if we don't ask, that's not happening.

Now people can do ads, but for me, I usually say ads is like gasoline on the fire. You want to make sure there's a fire. You want to make sure there's something already happening and you're doing the ads. I usually put that as last. And social media is also really powerful. Even if you're not getting a whole lot of engagement, do not be confused by it. People are watching, people are referring, people are sharing the video because they're like, oh yeah, this is my doctor and stuff like that. It's so powerful.

I've had clients who they're like, "I'm not getting a whole lot of engagement", but they keep hearing their patients say, "Oh, I see you. I see you online all the time and I shared your video with somebody else." They've gotten paid speaking gigs from that. They've had speaking gigs where they were in front of their ideal audience. They went to speak somewhere and got 20 new patients from one Facebook video that 25 people watched. It's really powerful. If they do the referrals, internal and external, and they do the social media, it's amazing what can happen.

John: All right. Well, let me shift gears to another. As you were talking, I thought, "Well, this whole idea of automating is a good one, because otherwise we just get overwhelmed." Do you have like a one or two of the things that you found that really just made a huge difference in any aspect of your business or your practice?

Dr. Nneka Unachukwu: Yeah. For me, delegation is one that's made the biggest difference. And I like to talk about it because I struggled so much. Because I'm good at a lot of things like most physicians are. And so, I'm like, yeah, I can do it. It'd take too much time to train somebody else to do it. But the problem is that one is too small a number for greatness. There's no way to build a great company with one person. And if you do the opportunity cost is pretty high.

And so, if you can always ask yourself this question, "Is this the best use of my time?" Either as a physician working clinically, or if you're working as a CEO in your business, you are the most expensive person on your team. The question is, would I pay somebody else what I will have to pay me to do this task? I had a client who loved to play on Canva. And if she listens to this, she'll laugh, she knows herself. Loves to play on Canva, loves to create graphics and do all this stuff. I'm like, "Look, if your hourly rate is $350 an hour, and you spent two hours creating this graphic, that's a $700 flyer. Would you ever in this lifetime pay somebody $700 to do that?" And she's like, absolutely not. I'm like, "So stop it. Find somebody else who you can pay appropriately to do that. It's too expensive."

Delegation is it, but one of the struggles with delegation is then we don't want to train the person to do it. They should come, they should know what to do, and they should read my mind and all of those things. The rules that make delegation work are really around you have to be very clear on what you want them to do. You have to be very intentional about training them to do it. You have to be willing to do some hand-holding in the beginning so you can set them free. And it's kind of like you're free for a really long time.

I'll give you an example. The last time I onboarded an executive assistant, I knew she was going to have a lot of tasks to do for me and all of that. I did a 30-day bootcamp with her. 30 days. 30 days, I met with her. I'm like, "This is how you do this. This is why we do this. This is my thinking about this." I did that every day for the first 30 days.

Now, after the first 30 days, she has been able to take so much off my plate. I kid you not, I probably have 12 hours a week back. But the cost for her to be able to do that, do it so efficiently, I represent the brand so perfectly, is a 30-day bootcamp.

John: Yeah. I appreciate what you're saying because I hired a podcast coordinator/assistant. And one of the things she said, "Hey, do you want me to do some of those images, those graphics for your social media and for your podcast?" I'm like, sure. Of course, she does them 10 times better than I ever would. And it actually takes her less time than I was spending doing them. And so, yeah, it's just amazing. You can't get away from having that human person that replaces what you do in spite of all the automated tools we have these days. Ciara, if you're listening to this, helping me with my podcast, then I'm giving you a shout out right now.

Dr. Nneka Unachukwu: That's awesome.

John: Okay. I want to hear more about everything that you do, starting with the book, so we know where is the best place to get the book and so forth.

Dr. Nneka Unachukwu: Yeah. To get the book, it's really simple. You can go to entremd.com/visibilitybook. And you can get the book there. We have other books that we've written, The EntreMD Method, and then Made for More, which is a compilation book from 40 doctors from the EntreMD Business School came together to tell their stories and stuff like that. So, that would be the place to get the book.

John, the way we like to look at this is we call the EntreMD podcast the free MBA for physicians. We deliver a lot of high value talking about business principles, how to scale, what you need to do to take your practice, for instance, to the seven figure mark, how to build a formidable team, all those kinds of things. We talk about all of that there. And it costs nothing. You're on a podcast platform already, just pop in entremd.com and go there.

The second thing we call our $15 MBA, and that will be our books. The Visibility Formula, Made for More, The EntreMD Method, and all the other ones I'm going to write this year. And then the third thing really is for the doctor who is committed to building a six, seven, multiple seven figure business. They're committed to their goals, but they're like, I need some mentorship. I want to be in a community of people who are doing the same things. I don't feel like I'm a unicorn doing something that nobody else has ever done and I can be inspired by people who are doing that. I need accountability because I'm not always motivated and nobody is.

And so, that would be the EntreMD Business School. That's our year-long program. It is a place where it's an alternate reality in medicine really, because you'll see people from starting up to all the way to eight and a half million in revenue, people who are monetizing their personal brand. So, they're working jobs, but they're building their personal brand as their business to private practice, DPC, DSC, speakers, event hosts, people with products, all kinds of businesses in there. The results that they're going on to create are just unbelievable, because you know what I think. Doctors, we make some of the best entrepreneurs, but all in one community creating those results. And so, all of these you can find on the website entremd.com, but these are the ways we support physicians. Those are the three MBAs.

John: Excellent. I think that's fantastic. We know what we know clinically, we're all well-trained. I think there's a big fear of venturing into the practice environment, but I think that's going to be our only saving really. Yeah, there's some good organizations that treat their physicians well, but you don't have the autonomy. Someone is telling you what to do, and you have this 15-page contract, and it's like, who wants to live like that? I would definitely take advantage of this if I was starting my practice, just to learn those business and marketing and promotional things, and just the common sense things that people that have already run a business know about.

Dr. Nneka Unachukwu: Yeah, you talk about fear, but I think that we should be afraid if we don't evolve. Because with the way it is, the burnout is at an all-time high, loss of autonomy is there, and there's no way to explore your full potential, which is one of the things that entrepreneurship allows you to do. There's no financial stability, let's not fool ourselves, because anybody could be fired any day. And so, yes, there may be a fear to venturing out, but you never know. That could absolutely work, and there's so many evidences of people it's worked for, but this other one is a guaranteed fear. We know this is not working. Choose your heart, choose your fear.

John: Yeah, think of a strategy. Maybe you're coming out of residency or fellowship, and you think, "Okay, let me be employed for a while, but make sure that I can get out of that in two or three years, and in the meantime, learn all these other things I need to know, so I can create the perfect situation for myself." But I tell you, I never thought about things that way back in the day, but maybe it's an option for some of the newer grads to consider.

Dr. Nneka Unachukwu: Yeah, very different times. We've had a lot of new grads in recent times, fresh out of fellowship, fresh out of residency, and watching them thrive in private practice, now that's been something. We have what it takes. I always joke, and I say, if we could learn the Krebs cycle, we can learn business.

John: Exactly. All right. Well, I think we're going to be out of time here momentarily. Any last bit of advice, just because you know my audience, it's a lot of physicians, some of whom are unhappy, some are frustrated, some are just looking for fulfillment. But what's your advice for my audience these days?

Dr. Nneka Unachukwu: Yeah, I think the best thing I could say now is with the way the healthcare space is now, the requirement for our evolution, it's a mandatory requirement. We have to change, and we have the capacity to. We're not fixed, we're not stuck. The way it is, it's not the way it always has to be. We can change. We can learn business skills, we can learn speaking skills, we can learn how to monetize brands. The things we're uncomfortable with, we can become comfortable with them. But I want to invite everybody to embrace becoming different, becoming an upgraded version. If you would like 2.0 because the healthcare space and you having autonomy, living without burnout, having financial freedom, having time, freedom to do what you really want to do requires that you evolve. The old model is not working, it's not going to get better. We have to change.

John: Very good, wise words. All right, Dr. Una, thank you for being here today and we'll get you back on in a couple of years again, if I'm still around. But I'm looking forward to hearing your first presentation at the summit and on a future podcast I will definitely give everybody a review of how things went. So I thank you for being here again today.

Dr. Nneka Unachukwu: Thank you so much for having me. And thank you so much for what you do for physicians everywhere. We appreciate you.

John: Thank you for that. All right, with that I'll say goodbye.

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The post How to Apply the Visibility Formula to Become Known appeared first on NonClinical Physicians.

How to Prepare to Sell Your Growing Healthcare Business

John Jurica — Tue, 14 Nov 2023 13:35:35 +0000

Interview with Dr. Lisa Jenks – Episode 326

In today's episode, Dr. Lisa Jenks returns to the podcast to describe what she did to prepare to sell her MedSpa, a major milestone in her entrepreneurial journey.

Dr. Jenks' initial interviews with John, in 2018 and 2020, delved into the founding and growing of her MedSpa business. This episode unveils the third major milestone in the life cycle of her business.

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

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Physician Entrepreneurs: Building a Business Beyond Clinical Practice

In this interview, Dr. Lisa Jenks shares her inspiring journey from emergency medicine to founding and selling a successful MedSpa business. Dr. Jenks recounts the challenges of entrepreneurship, emphasizing the importance of meticulous financial management, maintaining tight operations, and the necessity of good business practices.

She also highlights the rewarding aspects, such as creating a valuable asset, contributing to the growing field of med spas, and achieving a seamless transition into retirement.

Prepare to Sell Your Healthcare Business: Insights from Dr. Lisa Jenks

Dr. Lisa Jenks describes crucial insights you must understand as you prepare to sell any business.

Financial Management:
Dr. Jenks places a high premium on meticulous financial management as a cornerstone of successfully selling a healthcare business. She stresses the importance of impeccable financial records, guided by a skilled financial advisor. A robust financial foundation, including well-documented operational systems and inventory management, enhances the perceived value of the business and streamlines the selling process.
Flawless Business Practices:
To maintain a tight ship throughout the life of the business, she encourages constant vigilance. She highlights the subtle yet persistent rise of expenses if not kept in check. Lisa reminds us that potential buyers are keenly observant of how a business is run. This emphasis ensures that the business's value is in its profitability, bolstered by streamlined and efficient operations.
Unforeseen Time Commitment:
Dr. Jenks candidly shares her experience regarding the time commitment inherent in the sales process. She points out that the process is more protracted and paperwork-intensive than many entrepreneurs anticipate. From the initial discussions with potential buyers to the finalization of contracts, the timeline can extend over many months. Dr. Jenks notes that having a realistic expectation of this time commitment is crucial. Moreover, she highlights the need for patience as negotiations unfold.

Summary

Dr. Lisa Jenks can be reached via email at lisa@genesis-medspa.com, and her work number is 719-579-6890. Additionally, you can explore more about Genesis MedSpa on their website: genesis-medspa.com. Feel free to connect for her insights into the world of MedSpa ownership and how to prepare to sell your business.

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

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Transcription PNC Podcast Episode 326

How to Prepare to Sell Your Growing Healthcare Business - Interview with Dr. Lisa Jenks

John: I've always been fascinated by physicians who left clinical practice to build a business of their own. And while it can entail some long hours and usually a sizable investment of cash to get any sort of major business going, I think to be able to control your own business and to create a valuable asset is definitely something to think about. That's why I'm so pleased to be able to welcome Dr. Lisa Jenks back to the podcast today. Hi Lisa.

Dr. Lisa Jenks: Hi, John. Thanks for having me back. I've been looking forward to this.

John: I'm just in the middle of so many weird things that are similar to this. My wife owns a business that she's in the process of selling and this whole concept of physicians building some business that's related to healthcare, related to medical care where you have the expertise. And then at what point does it become an idea that, "Oh, I'm going to sell that because it is a valuable asset?" Just remind us about your transition from emergency medicine to starting the med spa, all those years back. I think that was more than 15 years ago, wasn't it?

Dr. Lisa Jenks: It was. Yes, I started life as an emergency room physician, which I loved. But when baby three came along several decades ago, I threw in the towel. It was just unsustainable. I stayed home for a few years and then opened Genesis in 2007 and sold it in June of this year.

John: Wow. That is a very long story scrunched down into one sentence. But it's fantastic. Time flies and before you know it, we've got to make decisions like that. If I remember correctly, and I'll encourage the listeners to go back to our previous two episodes. I think one was in 2018 and one in 2020. They can get a lot more detail about the startup and the management of it. But give us a little taste of what you envisioned at the beginning and did you think about selling at the beginning when you opened it?

Dr. Lisa Jenks: John, I am embarrassed to tell you how naive I was when I opened my own business. I had no idea what it would entail, and I don't think at that point I was thinking about the end game. I was just thinking about what I could do within medicine, but with not within traditional medicine that would allow me to have a work-life balance and still feel like a doctor. And I decided to open a med spa and really didn't think through it very much.

About three or four years after I opened, another physician who was a pathologist started working very part-time for me. And another one or two years after that, she started buying into the business with the end goal being at that point that she would eventually take over. However, in 2020 for various reasons, she had me buy her shares back and she transitioned out of Genesis.

That was my original plan. And then in 2020 that proved not to come to fruition. And right about the time of 2020, certainly 2021, PE firms started acquiring med spas across the country. And it wasn't unusual for me to get two or three emails a month from a PE firm asking if I was willing to talk to them. And just about a year ago, 18 months ago, I started to think, "Okay, maybe I should talk to a couple of these guys." Because I knew that within the next three to five years I would like to sell, especially if the buyers would want me to stay on for two to three years. And so, then I started thinking more seriously about talking to these PE firms.

John: Nice. Well, when you talked about at the beginning, you had never thought about it. I think most of the people that I've talked to, physicians and non-physicians, when they're starting a new business, it's because they have this idea they want to do it. They want the freedom, although it does take a lot of work, running their own thing, and they never really think about that.

Now, if you talk to people like brokers, they'll tell you, "Well, from the day you start your business, you should think about how you're going to sell it." But very few people in my experience do that really. That's very common. Yeah, this is a very interesting story. Then it became apparent. Of course, you've been so involved in the med spa industry, I'm sure it all matured while you were doing this. And then there's meetings and all of a sudden you start hearing about, "Oh yeah, these private equity firms are buying people out, or people are selling, or maybe they're merging." I don't know. Were those kinds of things talked about in the meetings you would go to when you were with your cohorts who do the med spa business?

Dr. Lisa Jenks: Yes, they were, to some degree. Yes. But I think most of what really made me aware of how this was moving forward with PE firms across the country is, like I say, I just started getting a lot of emails and a lot of interest being shown towards Genesis.

John: Now, are there other entities from what you've learned since this all began, that have been looking at buying med spas or do maybe others? I guess I look at it like the urgent care business. That's how I can compare it. I know that in the old days, everyone just started their own little urgent care and somebody would put two or three together. And then lo and behold, about five or 10 years ago, now you're getting these mega groups where there's 20 and there's 50, and now there's a hundred of these things, and some are bought up by investors, but some are just bought up by larger networks that want to get bigger. Have you heard of other opportunities for those who are interested in maybe leaving or selling their med spa?

Dr. Lisa Jenks: Absolutely. I definitely know here in Colorado of multiple instances where, for example, there's a dermatologist who does aesthetic derm in Vail, and she recently bought a med spa, an existing med spa in Grand Junction. And I know that that has happened here in Colorado Springs in Denver, where a successful med spa owner buys another med spa either in the same area or the town over. But I think most of what's going on right now is PE acquisitions.

John: Tell me about that, when that first started and you said, "Okay, I think I'm going to talk to a couple of these just to learn what I can learn and figure out what's going on." What did you learn at that point that you didn't expect? Or were there things you thought, "Oh, I got to change things a little bit now because they're looking for X, Y, and Z that maybe I only have X and Z or something?"

Dr. Lisa Jenks: The thing that I learned is how long the process takes.

John: Okay.

Dr. Lisa Jenks: How much paperwork it involves and how important it is to have a good, good financial banker on your side who can help you go through your numbers. I have been really fortunate because I have worked with a phenomenal bookkeeper, accountant, and business advisor pretty much since I opened Genesis.

And to anyone who runs any business, and certainly once you start thinking about selling, having your financials just in absolute impeccable order is so, so important. And I feel very grateful that mine have been, and that made the process easier.

Keeping track of inventory and having a history of having done that, is so, so important. And having all of your operational systems written down is critically important too. So, those were the things that I was really proud and happy to realize that I had in good shape.

John: Now when this whole process started, and you were considering this, you had a pretty large team at that point already. Is that correct? From what I remember, you had all kinds of professionals working with you.

Dr. Lisa Jenks: Well, I have for the last, whatever, five years or so, had a staff of 17.

John: Okay.

Dr. Lisa Jenks: And then, as I say, just had a business advisor, outside bookkeeper and outside accountant working alongside of me ever since my inception.

John: Now, did you change anything once you really started getting serious about selling? Was there something you had to change or did you have plans that maybe you either accelerated or decelerate? Did that affect that process?

Dr. Lisa Jenks: One thing that I changed, on the advice of my business advisor, I increased the hours of my nurse injectors and decreased my hours a little bit. And the reason that I did that is I did not want new owners or potential buyers, potential owners, looking at my business and thinking that everything depended upon me being here. That I was the one bringing in all of the income. And because I've worked full time in the practice, I am responsible for a large amount of the income, but obviously new buyers know that I'm selling because I want to not be here in the near future. And so, having them able to look and see that other people are bringing in large amounts of the income is important. That was the one thing that I changed probably in 2020.

John: Okay. That makes sense. Yeah. This is kind of like the issue that comes up with trying to sell a medical practice, let's say a family physician or a pediatrician. They're generating all the income. So, what is the asset really worth? Without you committing to stay for the next 10 years it's not much you.

Dr. Lisa Jenks: Exactly.

John: Because you're going to have to hire your replacement or they're going to have to. Luckily the planning in businesses like you're doing, you can leverage yourself and to where you're supervising and other people are doing a lot of the face-to-face work. That definitely helps a lot.

Dr. Lisa Jenks: Yes, yes. And I'm sure you know that the way this works for businesses is they take your income minus things like taxes and interest and they multiply it by a certain multiple. And that varies from industry to industry is what that multiple typically is. And that's the rough idea of what you're selling price is.

To have a good financial banker that can help with this is really critical as well. For example, I give my staff, I've always given my staff a certain number of free services as part of their wages for working here. And we always subtract that from our income on our P&L. Because then to the IRS, it looks like I'm making less money, which is what I want to have happen in a perfectly legal way. But a good financial banker will then look at potential buyers and say, "You don't have to continue giving these free services. And if you had not, if you choose not to, then your potential income would be even more than the P&L is showing." So, having somebody to guide me through things like that was incredibly helpful.

John: Now, I know with some businesses that sell, a small businesses in particular, they'll use a broker, but it sounds like you didn't need to use a broker because you had enough of that expertise in your banker and your advisors and the other people you were working with.

Dr. Lisa Jenks: Well, that and these PE firms were searching me out. And I think if I had two years from now, been really, really ready to retire and nobody is contacting me, I would've had to have gone to a broker to try and put me in touch with interested buyers. It worked out very well. Yes, yes.

John: Good planning on your part.

Dr. Lisa Jenks: Thank you.

John: I think the planning is getting into a business that's very growing and popular. And luckily, definitely there were buyers out there looking to get what you had created. I was going to ask you what you would do differently at the beginning, but it sounds like you've covered everything in terms of how to prepare for the sale. Just good business practices, good policies and procedures, making sure everything's written down as far as how things are run. And once all your ducks are in a row.

Dr. Lisa Jenks: Another important thing, it's easy as a business owner to fall into a sense of complacency, especially if you're running in the black and if you feel like you're growing a little bit every year. But it's so important just to maintain a tight ship and it constantly astounds me how easy it is for expenses to just balloon a little bit and then balloon a little bit more. And it's nothing big, it's nothing extravagant. It's not that any of the staff are buying things that they shouldn't buy necessarily, but if you, as the business owner aren't really keeping track of all of that and aren't perhaps calling the phone company once a year to argue against the 20% increase that they're trying to give you, how the expenses can take over.

And so, I think just keeping those as low as possible at all times, which is tough when you're running a business and you want to provide your staff and your customers with the very best experience that you can, which takes money to do, but really, really trying to run a tight ship is so important.

John: You alluded to this earlier, but what was the whole process, the time of it? Did it take a year? Did it take two years, nine months? Where did you fall?

Dr. Lisa Jenks: August of 2022, they first approached me and they were a relatively small company. They seemed very personable. I had several phone conversations with them. They talked about their philosophy of maintaining the atmosphere. They buy successful med spas and they want to help them be more successful. They don't want to come in and change everything. And I really like that attitude. Then I sent them all of my financials, and we signed an agreement that I would not talk to other companies for, I think it was 90 days or 120 days while we went through the process. And probably December or so came up with a mutually agreeable price, but then it was not until June that all of the paperwork, all of the details got hammered out and it was June 9th that the actual sale occurred.

John: Well, the nice thing about selling to let's say private equity firm rather than let's say someone else that owns a little network or something, is they're going to have the process down pretty well from their previous purchases and they can pretty much demand it. This is what we'll do and this is what we need to see. If we can see this and we feel good about it, then we'll buy it. It's a little different when you're working with let's say someone else who owned two or three med spas and were doing things however they were doing it and never bought another one.

Dr. Lisa Jenks: Exactly. And this has been great for my staff. I was not able to offer health insurance to my staff, and this company is offering health insurance. Their benefits package is a little bit better as far as vacation and PTO and things like that. So, that's been nice to see.

John: Very nice. And it doesn't sound like... I would expect about a year on average for a relatively smooth just from the people I've spoken with.

Dr. Lisa Jenks: I think it went very well. And our plan is that I signed a contract to continue working about 25 hours a week for two years, and then we will reassess. And I'm working both as medical director and then also still seeing patients and doing what I love to do. But this has just worked out great. The money from the sale has allowed me to do some fun things like buy a cabin up in the mountains and spend more time with my grand babies. And yet I was not ready to completely stop working. So, this has just been a really, really nice way for me to ease into retirement.

John: Now, did you get a sense that if you were in let's say a lot bigger of a hurry to leave, did they seem to be flexible to do maybe a year or six months? Were they pushing for an extended period where you're there or was that pretty flexible?

Dr. Lisa Jenks: That's a great question and I'm not sure I know the answer to that because I think they were the ones that floated two years, and I was like, yeah, that sounds great. So we really didn't have any discussion or debate about that. I'm not sure what would've happened if I had said, "Sorry, you've only got me for six months." Or if I had said I want to be here five years, I don't know. They may not have wanted either one of those, or they may have been fine with either one of those. I don't know.

John: It sounds like the timing was just perfect though, because you were both looking at the same number in terms of "Oh yeah, this will work out." The only reason I ask is because for some people, it's like when you're in medicine and you get burnt out, you reach a point where you're done and you want to sell. And we think it takes a long time to get out of your practice when you've been in it for several years, but most people can get out in six months or less if they really push it. But you cannot get out of your own business in less than a year unless you have someone lined up ahead of time to buy it and they're going to want you to stay for a while. So, you just had everything worked out so great. You're just the prime example of how to sell your business.

Dr. Lisa Jenks: Well, thank you. It really did. I feel very, very blessed. And it did, the timing could not have been better.

John: I think this is just a great inspiration for physicians who have maybe thought about the idea, "Well, can I do my own business?" And really just hearing your story reminds us, "Okay, not only can I find something good that I want to do, that I'll enjoy doing, that'll pay well. And if I think in advance I'll have this asset I can sell at the end." I think it inspires all of us to kind of plan ahead and say, "This might be a definite option."

Dr. Lisa Jenks: Well, thank you. And I hope that anybody who has questions or wants to talk to me more will feel free to contact me. My email is lisa@genesis-medspa.com. And my work number here is 719-579-6890. I love, love, love talking to anyone about starting a med spa, running a med spa, and now I can speak to selling to a med spa.

John: Fantastic. I appreciate you sharing that. The website for the spas is genesis-medsspa.com, and they can use that phone number. I'll put all this in my show notes. They can use your email. They could find you on LinkedIn. And what else are you up to? I know in the past you were doing some mentoring, coaching, that kind of thing. So, tell us more a little bit about that, which is obviously part and parcel of your involvement as a med spa owner.

Dr. Lisa Jenks: One weekend a month I hold classes here at Genesis, and alternate months between teaching injectables, meaning neurotoxins and fillers and then teaching PDO threading. And I love doing that. The students for the class range from estheticians to MDs and everybody in between. They're very small classes, a lot of hands-on. And so, those are really, really fun and I would love to tell anybody who's interested more about that.

And then I do some consulting and mentoring, John. I love doing that. It hasn't really taken off as much as I had hoped perhaps it would in the early days, but I do every so often get emails from doctors who are wanting to start med spas and we'll have conversations with them. Some of them even have flown out to shadow me here at Genesis and just see a little bit more about what this world is like, which I really enjoy.

John: Well, that'd be a fantastic resource. If I was thinking of starting a med spa, that would be perfect. The old shadowing, like we did when we were in med school or thinking of going to med school and really see how things run. That'd be fantastic. And they can reach you just through the phone number and the emails that you talked about a minute ago.

Dr. Lisa Jenks: Yes.

John: All right. Well, I just want to say congratulations. You're making this fantastic transition, as you will, as you want to. Whether you retire or not retire, who knows what you'll do 3, 4, 5 years down the road. But this is really again, it's an inspiration to all of us. I appreciate you taking the time to come today.

Dr. Lisa Jenks: Well, thank you. I appreciate you inviting me and allowing me to share this exciting news with everybody.

John: It's been great. I was going to say who knew when you were going to emergency medicine residency that someday you'd be a business owner and med spa practitioner?

Dr. Lisa Jenks: I can tell you I sold my med spa for way, way, way more money than I would've sold my ER scrubs to the next doc coming in when I retired.

John: Yeah, there would've been no equity in that business. All right, Lisa, thanks a lot and maybe we'll follow up again sometime down the road but it's been a pleasure.

Dr. Lisa Jenks: Thanks so much, John. It's always good talking to you. Bye.

John: Bye-Bye.

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

John Jurica — Wed, 01 Nov 2023 11:08:17 +0000

Own a Business – 324

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

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

Our Show Sponsor

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

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

Paths to Business Ownership

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

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

Franchise Opportunities in Healthcare

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

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

Summary

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

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

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Transcription PNC Podcast Episode 324

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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This Family Doctor Successfully Merged Medicine and Marketing in a Medspa – 318

John Jurica — Tue, 19 Sep 2023 12:30:36 +0000

Interview with Dr. Rachael Degurse

In today's episode, Dr. Rachael Degurse describes how she escaped corporate-style practice by merging medicine and marketing to open a medspa. She shares her inspirational journey from traditional medical practice to successful entrepreneur in the MedSpa industry.

Dr. Rachael Degurse is a board-certified family physician who took a bold leap after years in traditional medical practice. Her journey led to the creation of Pearl Skin & Body Rejuvenation, an intriguing MedSpa in Colorado. There she masterfully merges her medical skills with entrepreneurial acumen.

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This week's episode sponsor is the From Here to There: Leveraging Virtual Medicine Program from Sandrow Consulting.

Are you ready to say goodbye to burnout, take control of your schedule, increase your earnings, and enjoy more quality time with your family? You’re probably wondering how to do that without getting a new certification or learning a whole new set of nonclinical skills.

Here's the answer: The quickest way to achieve more freedom and joy is to leverage virtual medicine.

Dr. Cherisa Sandrow and I discussed this in Podcast Episode 266. Cherisa and her team are now preparing to relaunch their comprehensive program for building and running your own telehealth business.

If you want to learn the tools and skills you need to live life on your own terms – then you should check it out today. After completing the 10-week program, you’ll be ready to take your career to the next level.

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

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

Medicine and Marketing: An Entrepreneur's Journey

Dr. Degurse's decision to start her own business, Pearl Skin & Body Rejuvenation, stemmed from her desire for greater control over her life and medical practice. She valued the ability to manage her schedule and time spent with each patient, which she felt was slipping away in the traditional healthcare system.

While considering entrepreneurship, Dr. Degurse explored various business ideas but ultimately settled on the medspa industry. This decision was driven by her belief that aesthetic medicine, particularly in a traditional medspa setting, offered her the opportunity to retain her medical identity while owning a small business. She found this choice to be the best of both worlds, allowing her to practice medicine and run her business her way.

Growth & Vision: Inside Pearl Skin & Body Rejuvenation

When starting her medspa business, Rachael embarked on a steep learning curve. Apart from the intricacies of running a business, she had to acquire new skills related to various cosmetic procedures. She began with entry-level treatments like facials and Botox. She gradually expanded her skill set by attending courses, conferences, and self-learning. This ongoing education allowed her to offer a wider range of services over time.

Pearl Skin & Body Rejuvenation, started with basic procedures. It now offers a comprehensive range of aesthetic services. These services include facials, neurotoxin injections (such as Botox), laser procedures, microneedling, radiofrequency noninvasive body contouring, and medically supervised weight loss.

She has plans to introduce more complex procedures like fillers in the future. Dr. Degurse's vision involves continuing to expand her service offerings as her business grows. And she really enjoys the procedural aspects which benefit from her education and training as a physician.

Summary

Dr. Rachael Degurse's entrepreneurial journey highlights the benefits of autonomy and aligning one's business with personal and professional values. Her commitment to continuous self-improvement and expanding her services fulfills her meeting her clients' needs.

To connect with Dr. Degurse and explore insights into opening a med spa or business, you can find her on LinkedIn under Dr. Rachael Degurse. For more information about her medspa and services, visit pearlskinbody.com.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 318

This Family Doctor Successfully Merged Marketing and Medicine in a Medspa

- Interview with Dr. Rachael Degurse

John: I'm really happy to have today's guest here because for some reason I'm drawn to people that start out in medicine and they have to follow this entrepreneurial bent that they have. Going to school and residency for 11 to 15 or 20 years isn't really necessarily the way to become an entrepreneur, but there's a small set of physicians that do it because they want to control what they're doing, and they want to get away from the hassle and the burden of the corporate style of medicine. I'm really happy to have today's guest here. Welcome, Dr. Rachel Degurse.

Dr. Rachael Degurse: Hi, John. Thank you for having me. I'm excited to be here.

John: Yes. I've been talking recently on the podcast a couple times about small businesses in general, and what you do obviously is a startup small business, and it's hopefully going to grow a lot. But you've already taken that plunge and you've done a lot of the work to get this thing going. And so, I like catching up with physicians that have done that. I'm just glad that you're here to answer my questions today.

Dr. Rachael Degurse: Thanks. Thanks. I'm excited to be here and talk about what we're doing.

John: Also a favor because you're a family physician, which I am too. So, why don't we start like we always do with a little bit of your story in terms of your education and practice, and then how and when you started this new venture?

Dr. Rachael Degurse: Okay. As you mentioned, I'm a family medicine physician trained, and I've been doing this since 2013. I came to Colorado, I'm a native from Colorado and came back here after residency and got a job in a federally qualified health center. I worked that for two years and then I went into a group practice setting that was physician owned and led, and I've been there since, but it's no longer physician owned. It got purchased by a large corporation, twice actually.

And since then, my clinical career has been much different than what I envisioned when I joined medicine. And that's when I decided to open my med spa because it gave me an opportunity to get some of the control back and taking care of my patients and the more autonomy that I enjoyed. That's why I decided to open this. And I officially opened the doors April of 2022 but it's been in the work since December of 2021. So it took me a couple months before I actually opened my doors. But I've been doing that part-time in addition to my clinical work at my day job is what I like to call it, ever since.

John: Well, from what I can tell from the website and maybe LinkedIn and other things that I've seen, you've got a pretty broad array of services. You've got come a long way. It takes at least six months to a year to really plan a business. So it sounds like you're right on schedule as far as the planning part, like you said, you had to spend a few months.

But before we get into that in detail, I want to just talk about you as an entrepreneur. There are a lot of things a physician can do when they get frustrated or they just want to make some kind of a change. So, how did you come to think, "Okay, I think my own business." Is it the control issue? Is it just the flexibility? What is about that?

Dr. Rachael Degurse: Well, firstly, I never grew up wanting to be a business owner. In fact, I had an opportunity to join a practice right out of residency that was owned by a physician who wanted to retire and turn it over to kind of like some fresh blood. And I turned down that opportunity. It just didn't seem like something that I would necessarily want to do. However I have learned that being in control of your own life is very important.

And that's something that I've learned to value more and more especially as there's been changes in the way healthcare is being run. So, not only control of my schedule and my day, but control of how many patients I want to see and how long I feel like I need to take with them. And just being able to have that time to develop my relationships with my patients again, where I feel like I've lost a lot of that in my current clinical, traditional family medicine.

There was definitely a time when I thought, "Well, maybe I just go to a different office or different practice", but I just felt like the face of medicine was changing so much that I couldn't guarantee I would be able to regain some of that back that I had lost in a different setting that might get sold.

The only way I could control that completely, was to be my own boss and decide whether or not I would sell my business. And yeah, it's been a real joy, learning all the ins and outs of how to grow a business. It's also been a huge challenge, but that's kind of part of it.

John: A couple questions about that then. First, going way back. Many of the people that listen, let's say have been in practice longer than you, perhaps. I have all ages and lots of different locations around the world and in the US and so forth, but there's a lot of people that have been 20, 30 years in practice. And so, my question to you is, back 13 years ago and you're in the middle of that transition and coming from residency, was there any evidence, any inkling that at that time, either during your training or even early into your practice that you thought this might all just go away because of the changes, or was it just like a brand new concept?

Dr. Rachael Degurse: Perhaps I'm naive, but I did not expect healthcare to go quite as much the way it has. I grew up going to a doctor who was a private practitioner, worked solo, didn't have a partner, and wasn't owned by an organization. And that's all I knew growing up. I just assumed that there's some practices that were affiliated with hospitals, but for the most part a family medicine doctor was a business owner essentially, or they worked in a group with other people and they had a shared business. So, that's what I fully expected to go into. And like I said, perhaps that was naive of me, but it has not turned out that way.

John: Well, the reason I ask is because I think even to this day it seems pretty obvious to someone who's gone through it. And I've interviewed many guests who actually made a change because of the very issue you brought up, which is their company was bought or whether it was a practice or maybe it was more of a small hospital based practice, but then there was some large corporation that bought it.

And I still think that the med students and the residents, depending on where they are, they have no idea that this corporate takeover of medicine is well underway. And if it hasn't affected them yet, it probably will. And I almost blame the faculty for not letting their students and residents know that what we're in right now is kind of a bubble and life's going to be different. But I don't know.

Dr. Rachael Degurse: Well, thank you for not assuming I was naive to not know that.

John: No, I think it's still happening, which is really frustrating to my colleagues and some that I talked to about this. Okay. Now the other thing. You came to the realization that you need more control, more freedom to do things the way you want to do and not be threatened by the next takeover or the next merger, whatever. Did you consider any other businesses besides the med spa and how did you come to that choice?

Dr. Rachael Degurse: Yeah. Well, I sort of jokingly considered some other businesses. There was a brief time where I talked about becoming an alpaca farmer. I did toy with local honey, but in all honesty, this was the only business that truly made me feel like I could still practice medicine, and own my own business because the aesthetic medicine realm is still relatively untouched by corporations, although that is changing sort of.

There are some private equity companies that are trying to acquire med spas and there's definitely some larger chain med spa type places. Most likely laser hair removal and that sort of thing, but for the most part, a traditional med spa is still very much like small business ownership. And it still feels like medicine to me. Because I didn't want to just give up on my dream of being a doctor. I still felt like I needed that and wanted that in some capacity. And interacting with patients is very important to me. This gave me kind of what I felt like was the best of both worlds.

John: Yeah, that makes sense. I kind of equated somewhat to becoming a coach, but that's more like in the realm of the mental health wellbeing. A coach is a couple steps away from a therapist, but you know what I'm getting at.

Dr. Rachael Degurse: Yeah.

John: And it's something you can do independently and build a business around. But I could see the interest in being sort of someone that's taken care of, what is the largest organ in the body. Isn't it the skin, the largest organ?

Dr. Rachael Degurse: Absolutely.

John: And so, skin and beauty and hair and all that kind of thing. And you get to do some procedures. So, to me that makes perfect sense. Did you have to do anything to prepare or let me just put another way. What were the things you had to learn the most about let's say at the beginning in terms of beginning this venture?

Dr. Rachael Degurse: Yeah, it's actually been quite a steep learning curve. Let's just forget about all of the learning how to run a business part because that I did not know anything about. I just thought you just come up with a name and put out your shingle and then it's all good. But it's not.

I definitely had to learn a whole new set of skill sets. I had to take courses specifically for all of the procedures that I perform. And I started with, still to this day, because I'm the only one doing any of the procedures, everything we offer, I have to learn how to do. I started with the easiest most entry level procedures possible. Facials, Botox.

And then I've just gradually increased my skills since then, doing a lot more conferences and lectures and book learning and breeding and podcasts and all of those things I do in all of my free time, what limited it is, to just become better and better honing my craft so to speak. But it's definitely out there. There's a lot of opportunities to go to courses all over the country, and a lot more online and digital resources compared to maybe in the past. So, it's definitely possible to do.

John: That helps. That helps. As far as the business side, one of the things that I hear about is, and that physicians typically don't think about unless they're really aggressive in their practice, and that's marketing. Was that a big part of the business aspect that you had to learn more about?

Dr. Rachael Degurse: Absolutely. I hadn't even heard the term SEO before. Just things like that that I didn't even know. I didn't know. I had to learn. Fortunately, I am very lucky to have my husband who's been a real big partner with me in this. He has a business background. He comes from an entrepreneur family, so he's just been huge and helping me with a lot of that. He does most of our social media marketing and SEO. I'm lucky in that I haven't truly had to learn all of that information. Of course I still know the terminology and that's still very important, but marketing is essential as far as getting your name out there because I just thought it would be easy to open up and have people come in. And that is definitely not the case. So, that's been really a big factor in getting us off the ground.

John: Most typical entrepreneurs have a great idea and decide they're going to start something, they're not good at everything. And so, they always rely on other people to fill in. My wife runs a business so I know exactly what you're talking about. And she's excellent at certain things and then in other things maybe she needs a little help, but that's just every business owner.

I've talked to, like I said, other med spa owners and there are, like you said, so many conferences and they probably go into pretty great depth in terms of marketing for that type of business, which helps a lot.

Dr. Rachael Degurse: Absolutely. A lot of the conferences are kind of a combination of business development and learning. So, that's very helpful.

John: Nice. Nice. Okay. Now tell us more about the actual med spa and also you're doing a lot of different procedures now. Tell us about which ones you really enjoy or which ones do you think are the most helpful? Just to get into kind of the nuts and bolts of what a med spa does, at least in your case, so that people who are thinking about this can get some ideas.

Dr. Rachael Degurse: Sure. My med spa is in a professional complex building with other suites. I just have a small suite in this building. It's about a thousand square feet, so it's very efficient so to speak. I have just me, I've got my chair and I offer facials, neurotoxin injection. I have three different devices. I have a laser that can do IPL procedures. I can do microneedling, radiofrequency microneedling and I have a non-invasive body contouring machine. I do offer medically supervised weight loss. And I'm getting ready to offer my filler.

Filler by far is in my opinion the riskiest procedure you can offer. So that's why it's taken me the longest to add it on because I just want to make sure that I am a hundred percent solid in being comfortable with that procedure before I add it.

That's pretty much almost everything that you can offer in the aesthetic world in just a very small space. It doesn't take a lot of footprint to offer most of these things. You just have to be efficient with your space and your time.

Anyone that I would suggest who wants to offer or start a med spa, they need to be able to offer neurotoxin. That's what we call kind of the gateway drug to aesthetics. Most people will start with wanting to do Botox or something very similar to that just to relax the wrinkles. And then that kind of opens the door to discussing other procedures and services that people might want. And then sometimes people say they want Botox, but they want it to treat a problem that isn't actually resolved with Botox.

It's just a very important thing to be able to offer right away. I started off with offering facials and Botox, and those were the only two things that I offered for quite a while. And then about eight months ago, I purchased my first laser device and that really expanded how much I could offer. And then about a month ago is when we brought in the radiofrequency microneedle and the non-invasive body contouring right around when I started my weight loss program. So, it's kind of been ramping up in the past couple of months offering more things.

John: Well, this is another question. It's a little bit off the topic in terms of the actual services you're providing, but as you're trying to ramp up, as you are ramping up and you're obviously committing a lot of time and effort and of course, investment as well. How does that work in terms of negotiating with your current employer? Just any tips on how to... People are usually fear having that conversation. Now usually when they have the conversation it goes better than they thought because we just tend to be pessimists when we're talking about that. What is your advice and what is your experience in trying to slowly make that change?

Dr. Rachael Degurse: Well, when I decided to open this, I had already had a day off during the week. I was working there four days a week, and then I started being able to work in my med spa three days a week. Yeah, that's a seven day work week but if you're going to be building your business, you kind of have to work every day. Even if you're not open every day, you're working every day.

John: Right.

Dr. Rachael Degurse: So, that's how it initially started. And then for better or worse, we did have some attrition in our office where we had some providers leave, and that kind of helped me to open the door and be like, "I'm planning on opening this business and I need a little bit more time to do that. Now I will stay committed to you for a period of time as long as you let me have a little bit more time to do my business."

And it's really only another half a day a week, which is not a lot as far as me leaving my other job for that half a day. But it does allow me to be open a whole other day here, which time is money when it comes to having a business, so you got to be open as much as you can.

That's how I started, kind of scaling back. Now I think I've probably maxed out the ability for cutting down my hours there. The next step is going to have to be the leap of leaving there if I'm going to, and I do have kind of a timeline where that might be a possibility. We'll see if that actually pans out. But so far I don't know that I have a great solution to have that conversation unless you have a lot of leverage like I did.

John: Well, it's good to use that leverage and plan ahead. We didn't discuss this beforehand, but I'm going to ask this question in that. Do you have much of a notice requirement, I guess? Some people think I'm going to do this, and they realize they have a nine month or a year notice for leaving a job, which is ridiculous, obviously. But you've already kind of considered that and have that worked into your plan, I'm assuming?

Dr. Rachael Degurse: Yes. I have a 90 day notice, so it's very generous on my end.

John: Yeah. Yeah. That's better than most. Most people are stuck for six months unless someone's trying to kick them out. Because there's a shortage of physicians and it's because of the changes in medicine, but it sounds like you're positioned well to pull a trigger when you get there.

Dr. Rachael Degurse: That's the goal. The goal is to be able to replace as much of my income as possible with med spa income before I officially leave. Hopefully it will happen.

John: It's always a good plan, right? You don't want to have that dip that lasts longer than you need to. Now you were talking about fillers. I'm going to switch back to the medical side in my mind. What's a medical part of it? That sounds like it's a little more complex. Is it typically done by non-physicians? Are they technicians? Are they some kind of licensed professional normally? How does that work?

Dr. Rachael Degurse: That's a good question. It's actually state by state dependent on who can perform what procedures. Some states are more strict than others. New Jersey being an example of a very strict state that most procedures, including operating of a laser, needs to be performed by a physician. That's a state where it's great if you are a physician to open a med spa. Not so great if you're not a physician or you want to be opening a med spa, but not doing all of the procedures yourself and having extenders.

You really need to look up the state specific laws about what you can do yourself and what you can delegate to other people. But in some states, a filler can be injected by anybody that you delegate to, that you say is qualified to perform that procedure. In most cases, the lowest level of training that you're going to encounter with that is like an RN performing a filler procedure.

John: Is there a license for med spa where you're working? Or is that just another business?

Dr. Rachael Degurse: You just need a business license. So, it's a little gray area.

John: The reason I ask, I'm familiar with what I talk about in the podcast, like senior care business. And those didn't used to be licensed, but in most states now they are licensed. So, it's just something to remember another licensed, another hoop to jump through.

What do you think long term, looking forward, are there any more procedures that can be done down the road that you might be interested in? For that matter or other, I've seen med spas bring all kinds of services in. What are you planning for the next few years once you ramp up even more?

Dr. Rachael Degurse: Yeah. Once I'm able to expand into a more medical sterile space, then there are some procedures that are more invasive, that are essentially like a nonsurgical face lifts and body lifts that I would be very interested in offering. And those do really need to be performed by a physician because it's kind of like liposuction in the office. So you have to be a little bit more trained and qualified to perform something like that.

John: Okay. Well, it sounds like you're on your way. Tell us more about how to find you in your spa, where you're located or where the website is and that sort of thing.

Dr. Rachael Degurse: Well, I would love to connect with anybody who's interested in opening a med spa or has questions about what it might look like for them or even if they just had questions about opening business. And they can find me on LinkedIn under Dr. Rachel Degurse. And certainly if you have more interest in our business itself or med spa, you can look for us on our website at pearlskinbody.com.

John: All right. I'll definitely put those links in, for sure. And if people have questions or if they're geographically anywhere within distance they can talk to you and maybe even visit you, at some point.

Dr. Rachael Degurse: Yeah, I would love that.

John: I'm just thinking if there's anything else that I've forgotten today. Any advice you have for my listeners, basically who may be where you were a few years ago in terms of either this opportunity or just doing something outside of a corporate style of medicine.

Dr. Rachael Degurse: Absolutely. Firstly, I think one of the things that I hear from some physicians who are hesitant to just do something else but they're interested is I hear a lot that "I don't have any other skills", but when it comes down to it, that's just never true. When it comes to being a doctor, you've developed a massive amount of skills over years of training and just fortitude and diligence and like working hard. You can translate that into just about anything that you want to do. You just have to put your mind to it and you can do it. Because if you got through residency, then you can get through just about anything else. So, that's one thing I would say to people.

And then secondly, I sort of jumped into this completely headfirst. I don't know that I did a ton of planning about the business part before I started. I wish I would've done a little bit more of that, learned about business taxes before I actually opened my business. That would've been great.

I would just encourage people to plan a little bit. While in advance of opening your doors, make sure you've researched the laws in your state, how to set up your books, all of those things, before you actually start working. I've kind of learned a lot of the things on the way and it would've been maybe a little bit easier for me to research more ahead of time, but for what it's worth, I was committed to doing it and I just jumped in and made it happen. So there's pros and cons to that, but I would just encourage people to do more research.

John: When I talk to other people, and I've been advised what I'm going to say here in a second, it's hard when you're starting a business because you don't want to spend money upfront that you could be used for building your business and so forth. But I'd say in most cases it makes sense to consult with an attorney and an accountant. Even though your books might not really seem like they're going to be very complicated, but to me it's worth a thousand bucks or a few hundred bucks just to have that conversation. They might tell you, "Look, all you got to do is fill this paper out, sign here and you're done" or set up your books a certain way, but you just never know. You're getting coaching basically when you do that. So, I would agree with what you said.

Dr. Rachael Degurse: Yeah. And like I said, I'm happy to answer any questions for people because I did sort of learn about these things on the fly.

John: Yeah. It's always good to be able to say here's the thing I did wrong, so I want you to do it just a little bit better than I did because I didn't plan it out completely, or I didn't know what I didn't know. That's very common. Which actually brings me to another question that I wanted to ask you earlier.

I see on LinkedIn and maybe on your website more so that you're doing some more speaking and I think even on the website mentioned that you don't mind sharing with others about your story. So tell me, are you doing some formal speaking? Is some of that for marketing purposes? Is that some of that to connect with other entrepreneurs? It just sounded pretty interesting when I saw that.

Dr. Rachael Degurse: Yeah, I would love to do more speaking and more podcasts like this or even more in-person formal engagements. One of the things that I'm pretty passionate about is hopefully finding a way to change the face of healthcare. I think that corporate takeovers of healthcare doesn't do anybody any service in the long run for our patients or for us as providers.

And I think part of what might change some of that is talking about what is this healthcare landscape that we're encountering now, just like you said, but I think a lot of people coming out of training don't realize that this is happening. And certainly our patients don't know what's happening.

I would like to talk more about that and talk about how people can participate in change for that and hopefully providers and physicians and patients can find a better experience for all of us and not be ruled by the big corporations anymore.

John: Yeah, we look at it as physicians and it's frustrating because we're running patients through, we don't have enough time to spend with them and really hear what their issues are. But I can't imagine that for the patients, it's just as bad. People that I know that go to the doctor, I was not rewarding at all. I went in there, the nurse was rude, pushed me through, I had three minutes with the doctor and then I had to move on. And it's not like the doctors are choosing to do that just with the RVUs and other things, it's not a good system.

Dr. Rachael Degurse: It's not, and there's far more patients out there than there are physicians. And I think that as physicians, most of us are, for lack of a better word, people pleasers. We don't want to make waves or none of us picture ourselves as being the leaders of businesses or large organizations. We just want to see our patients and take care of them and go home. But for us to be able to continue to do that and do it well, something needs to change and I'm pretty passionate talking about that.

John: Good. That's also very helpful to your community to get the word out and also to other prospective medical students who maybe really don't know what they're getting into. And they have to think long and hard about that, especially if they're going into huge levels of debt, which kind of binds them into something that they may end up not enjoying.

Dr. Rachael Degurse: Absolutely.

John: All right, Rachel. I guess I've taken up enough of your time today. So, this has been really good though.To

Dr. Rachael Degurse: This is a good conversation. Thank you.

John: You're welcome. It's been fun. I hope I can follow up with you sometime down the road. I like to follow up with the people particularly that have started new businesses. Because you just never know, a year or two down the road, you can learn a lot more from my guests when they've been doing something like you have for a longer period of time. I guess with that I'll say goodbye.

Dr. Rachael Degurse: All right, thank you.

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Want to Buy Your Own Senior Care Business? – 314

John Jurica — Tue, 22 Aug 2023 12:15:22 +0000

An Opportunity to Hit the Ground Running

In today's episode, John describes the process of buying a small senior care business. He'll cover the key criteria buyers consider when evaluating a small business.

The senior care business sector has evolved significantly over the past 15 years, with franchisees becoming a big part of the industry.

Our Sponsor

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

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

With 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.

Unveiling the World of Franchises and Small Businesses

Owning a small franchise business offers a dual pathway to financial success. This endeavor combines income generation with the creation of a valuable and transferable asset. This makes it a compelling prospect for creating financial freedom.

Unlike a physician practice, nonmedical businesses produce a product or offer a service that is not based on your medical license. And there is no need for you to provide the services directly. As the owner, you can generate more revenues and profits by leveraging the skills of your employees.

When the business is large enough, you can transfer management duties completely. The business then becomes a passive income source that does not require day-to-day management.

A senior care business is well suited to physicians, nurses, social workers, and others in healthcare because they:

have an interest in improving the health and wellness of clients;
understand the healthcare system, and how senior care fits in; and,
have an advantage in identifying referral sources for clients (e.g., nursing homes, hospices, assisted living facilities, physician offices, and hospitals).

Factors Behind Senior Care Business Success

The senior care business has firmly established itself due to several key factors. Strong and growing revenues and profits are the foundational elements sought by potential buyers. This reflects a proven track record of financial success and demonstrates the business's value proposition. Here are the basic components of the business:

caregiver recruitment, screening, and training;
client recruitment and scheduling; and
billing and collections.

In contrast to unproven startups, a senior care business's consistent growth and profitability make it a solid contender for investors.

The operational simplicity of the senior care model contributes to its popularity and viability. Additionally, its ability to generate positive cash flow, minimize accounts receivable, and avoid debt, enhances its financial stability.

Summary

A small business can be an effective way to generate income and value. Opting for a franchise enhances success. And acquiring an established franchise can expedite the process. Senior care services have been one of the fastest-growing franchise opportunities in the U.S. over the past 15 years.

For those interested in exploring a successful senior care business, there is an opportunity in the greater Chicago area. Interested qualified buyers, can learn more by sending an email expressing your interest to seniorcareoffer@gmail.com.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 314

Want to Buy Your Own Senior Care Business?

John: All right, nonclinical nation. Over the past 15 years, I've come to know a half a dozen or so owners of what is often called a senior care business. All of them are franchisees of a large national senior care franchise. Now, this is also called an in-home care business, and it's to be distinguished from home healthcare because it's non-medical, non-nursing type of care.

Three of those owners that I've known have since sold their franchises to a new entrepreneur. And today I will describe how these owners prepared to sell their businesses based on what a buyer looks for when buying such a business. And then finally, I'll tell you about a franchisee who's offering to sell their franchise and how to contact that owner if you're interested in learning more about buying it yourself.

So, let's get started talking about franchises and small businesses and that kind of thing. When you think about it, if you look at how an individual can generate a sizable amount of income more than you can generate generally in a typical salary situation, unless you're an attorney or a physician or a highly compensated person.

But if you want to generate income and create a valuable asset at the same time, probably owning your own small business is the best way to do that. Usually by doing so with a lot of hard work, you can create a company that pays you well, but in a combination of both W2 type of salary plus and owner's draw. And there's some flexibility and you structure that in order to minimize your taxes to some extent and achieve some other benefits.

But if you look around you at those who have been running a small business for 5, 10, 15 years, chances are the owner takes a salary plus has some leeway in drawing funds off of the business depending on how successful it happens to be. Sometimes that's seasonal, sometimes that goes in cycles. But most small business owners like to run their business in a way that increases revenues, increases profits over time for the long term.

And then you have that asset that you've created that you can eventually sell, usually creating a pretty sizable cash out. And most of the time the cash out results in money in your pocket or in your bank account. And generally that if it's a capital gain, it's going to be taxed at a much lower rate than let's say income of a similar amount.

So, if you were in a salary situation, you're nearing the end of your career and somehow you got a raise and made $400,000 or $500,000 during that final year, you're going to pay income tax on that. Whereas if you have a small business and you cash out and you generate $500,000 value and cash at the end when you sell it, then of course, that's going to be taxed at a much lower rate. That's another benefit.

Many physicians over the years I've worked with have tried to sell their practices and actually the hospital that I worked at bought many practices. But funny that it didn't really pay so much in terms of the value of the practice because almost all of the profits, if any, were really paid out to the individual physician as salary. And unfortunately, you cannot replace that physician in that practice with anyone other than another physician who's also going to want to take that amount, if not more than the previous owner. And so, usually you end up buying just the assets of the practice, which oddly enough, you'll earn less than maybe selling a small franchise.

Ideally, if your small business grows sufficiently, you can hire a manager to run it and then you have now turned that asset into something that's like a passive investment. Of course, you'll have to keep track of what the manager's doing and watch the certain parameters of performance, but it's kind of like having real estate that throws off some net proceeds every year. But usually a small business again generates more for the amount of money that's invested. We'll talk about that in a minute.

Now, if you're a person that wants to build a huge business based on some new invention, new process or technology, then you're probably going to have to go the public route. Meaning ask investors, angel investors and others to invest in your idea. Give away a lot of shares to do that, but that usually pays off even more but it's a much lengthier process and probably has a lot more risk.

Now, I did want to talk a little bit about franchises as one way to get into a small business. I'm not going to go into great detail. I think we've talked about at least once or twice before on the podcast. But what happens with a franchise is in exchange for paying a regular franchise fee, monthly, quarterly, or annually, you get the benefit of all the experience of the person that created the franchise itself. I'll call it the parent franchise if you want to call it that, or franchisor and ideally all the policies and procedures, all the tools that are used and approach to marketing.

Everything you would need to start a small business already has been worked out. And so, you pay 4% or 5% or 6%, 7% annual franchise fee off the top of your revenues generally in exchange for getting all of that know-how, which makes it much easier to start the business and to grow the business than if you were creating all of those policies and procedures and deciding on which software to use to run your business and so forth on your own.

Now, you could take it one step further, and if you believe in a franchise as a way to find and develop a small business that grows rapidly and is likely to be more successful than something you start on your own, then you might really like the idea of purchasing an established franchise with one or two territories. Most franchises have a territory that delineates where or to whom you can sell your product or services.

And while it's a more expensive way to go, if you can buy an existing franchise that demonstrates that it's growing, that it has significant revenues, that it's expenses are contained, and therefore there is a history of profits that are also growing over time, that can be a good way to get into a business more quickly.

Essentially if you buy an existing growing viable business, the day you take it over, it will be profitable because it was probably profitable for the three or four or five years before you bought the business. The downside of that is that you have to pay a much higher fee than you do to start a franchise from scratch in which you dedicate sort of your sweat equity and pay for expenses as you go, maybe with a loan or you've got savings, that kind of thing. But the cost of that is much lower than actually buying an existing franchise business that's been in place for a while and is currently profitable.

Again, I don't want to belabor the point of franchise businesses, but I think many people don't understand or realize how many local businesses that provide services and products that they use on a regular basis are actually franchises. Let me just list some of the companies that use franchisees to grow their network of businesses. And of course, we all know McDonald's, Taco Bell. Ace Hardware is a franchise, the UPS store, Subway, Pizza Hut, visiting angels, other senior care businesses, there's at least a dozen of those that are franchises. Great Clips, Wendy's, Planet Fitness, Dunkin Donuts, Dairy Queen, and the list goes on and on.

They're all over the place and there's a reason for that. And that's that they tend to be successful. They're not 100% when you start, if you don't do your homework or you're in a market that for some reason doesn't work, you can lose. But when you're in a market that's been demonstrated to be successful, then buying an existing franchise can be the way to go.

Before you get into that it would be nice if you had at least some business background personally, or at least have a partner or someone you can hire to help you manage the job. Although with any franchise, and particular the senior care franchises, they offer extensive training immediately after the handoff occurs from the previous owner.

And again, this is the reason why franchising is such a great option for a small business and why purchasing a franchise usually ensures that you have all the software you need. You already have plans for how to market, you have plans for how to run the company, how to structure it, the types of employees you'll need, and also how to train new employees.

But there are some other considerations that you should keep in mind. These are the things you'll probably be thinking about when you are approaching this issue. One of my favorite quotes is "Begin with the end in mind." That's from Stephen Covey. And so, I think if you are thinking about buying a franchise and running a franchise yourself, then you should probably know what most other people that have already done that look for when they're buying such a business.

Now, before I do that, I want to just say the reason that senior care is such a popular franchise. There are several, and this isn't based on any study, but I can tell you just from talking with people that first of all, it meets the need that some people have to help others. And of course you can help others. Pretty much any business you do, you're helping others in some way.

But I've heard several franchisees who own senior care businesses say that they got into it because their own parent needed help when they were getting older or another relative and they couldn't find help. And wouldn't it be great if there was a place where you could go and get that kind of help from people who were trained to do it and in a way that they had some backup if they were sick or holidays and so forth. Or there was a place where you could fill in that schedule. And so, that's why these businesses originally were created.

That's why I think a senior care franchise business is really a good one for anyone who's been in healthcare. It could be a physician, it could be a nurse, psychologist, social worker, you name it. They're already familiar. They already also have potential sources of referrals. Not only friends and relatives that have elderly parents or grandparents, but also hospitals, nursing homes, independent living facilities, attorneys who work with estates. You might know those people. And so, that's a source of new clients if you do open such a business.

The other thing is with the demographics, we're still having the baby boomers. I guess the average baby boomer just hit 65 in the last year or so. So we have this massive number of elderly people who need more support at home. And that plus the idea that most of us now really don't want to even consider going into a facility if we can help it because of the disastrous situation that occurred during the pandemic when a novel virus could run through a nursing home.

So, people want to live at home as long as they can. Sometimes people want to die at home. And so, these businesses are there to help them do that. And that's why I'm focusing on that to some extent today.

The first thing you want if you're looking to buy something like this is you need a business that has strong and growing revenues and profits. That's kind of the bottom line. If it's a rock solid investment because of demonstrated improvement over time in growth and revenues and profits, then at least it passes the initial sniff test.

When you or any other buyer is looking to buy something like this, it's a type of investment. And so, you're comparing it to other investments from those that are extremely safe, like buying government bonds for the most part to those that are extremely shaky like investing in a startup in the very early years before there's demonstrated proof of concept.

And so, investors will put some money in those kinds of things and hope that one out of 10 ends up maybe even making a profit. And who knows, it might even be less than one out of 20 or 30 that actually have an IPO and go public.

So, you got to figure where you are in the continuum but again, what we're talking about is someone like yourself who either personally or has someone that they can hire to run this new business from the get go because we're buying something that's already an ongoing venture and you'll have to hit the ground running and hopefully it'll take off.

Most senior care businesses meet this threshold. They wouldn't be so popular if they weren't successful. And the model is very simple. Your purpose or what you're doing through your business to provide care to the seniors is number one, hiring and training capable, reliable caregivers. They could be completely lay caregivers with special training. They could be a CNA or some other associated type of position. Maybe a medical assistant who's now doing this in-home work and matching them up with people at home.

And that home can be anywhere. It could be at their actual home, it could be in a family member's home, it could be in a nursing home, it could be in an assisted living. But since that's their home anywhere they are, sometimes they need this extra help and you're just matching up the caregivers with the people that need help. And then you just need processes for scheduling people, tracking people, monitoring them, and also for doing assessments of potential clients and then billing them. So, it's pretty straightforward.

The other thing that you want to make sure is that besides just revenues and profits, you want positive cash flow, some working capital, no delinquent taxes, no debt and accounts receivable that are current. There aren't bills from six months ago. And in this kind of business, the AR is generally fairly low.

Some senior care businesses will actually take a deposit, particularly when they're just starting out, so that in essence, the client is prepaying for their care because if they decide not to pay for two weeks, then you've already got the deposit to cover that and there's still no AR. Once you get going, most companies don't do that. But because you're on a two week cycle, usually if someone fails to pay a bill then you can just cancel services immediately until they get caught up. And so, the AR is never really all that high and the vast majority of clients pay as they go on a very timely basis.

The other thing as a buyer you want to be certain there are no pending or threaten lawsuits about the company. That can be hard to determine, but usually you can do some due diligence with others in the community, looking at newspaper articles and other things to look for any pending lawsuits. But it's very unusual that a senior care company would be sued. Of course, the owners have insurance to help cover any losses related to a lawsuit. And you can get a good sense of the reputation and standing in the community for most of these companies.

Now, we've talked about this next one, but buyers want to buy a business that has a clear product or service with a strong demand and continued prospects for growth. Well, because of the aging population that one is met. The other thing is that some of these companies will also, besides selling just the one-on-one service, some will expand into transportation. And most of them also offer remote monitoring services and medical alert systems that also help seniors to remain independent in their homes.

Another consideration that buyers have, particularly if there is a need for a visible business in the community is the location. Buyers want an office that's conveniently located and maybe in a prominent location where it offers the ability to market through signage.

A buyer also wants to be sure that the equipment that's owned by the business, that supporting software licenses can be easily transferred to them at the time of a sale. They want clear cut training and a clear set of policies and procedures. And of course, that's again one of the big advantages of buying a business that's part of a franchise.

Prospective buyers want to see that the client list is stable and growing in a business like this. And that's pretty easy to demonstrate over time. The model is good because usually it takes a little bit of effort to get a new client, but once you have a new client, they tend to stay for months or even years. And the rate of accumulating new clients far outpaces the timing of loss of patients, either because of moving away or because of passing away generally because there are so many seniors in this group that you just accumulate more and more clients over time. And so, part of your work is simply keeping up with managing them and hiring new caregivers to meet that need.

Finally, and again, this is addressed by it being a franchise, the buyer of a small business wants to make sure that everything involved in that business, every policy, procedure, process, staff, software, equipment, hardware can be transferred to the new owner at the time of the sale.

And again, that is absolutely simple with a franchise. And in fact, the new owners will for a senior care franchise end up going to anywhere from two to six weeks of training to make sure that they fully mastered the process that the franchisor has created.

And one of the things about a franchise is you must follow their rules. That's for the most part a good thing so that there's consistency. And then if they're doing any kind of national marketing, then you can benefit from that and spend your time learning how to do other things.

I was looking at the website BizBuySell, which is at bizbuysell.com. And I was just looking at some recent sales of senior care businesses in the Midwest in recent years. And as I was looking at those, they have a pretty broad range, but it is a small business. So, most of them were sold at the time when they had anywhere from $650,000 to well over $2 million in revenues. I didn't see any that were above $5 million. And I suspect that the ones at that level are actually home healthcare agencies that actually do some senior care non-nursing type of business as well.

And in this situation, usually you're going to sell based on a ratio to either EBITA, which is earnings before interest taxes and amortization, or the seller's discretionary earnings, because that gives a good figure to look at for those small businesses in which the owner is also the manager. So, you can't separate the CEO from the owner because they're usually doing both roles and businesses of this size.

They use seller's discretionary earnings as the thing to look at. And the definition of the SDE is really adding up the bottom line profit that appears on the P&L statements plus the owner's compensation if they're getting compensated as a W4 type of employee or W2. Plus paid interest expense, depreciation and amortization and the discretionary expenses that are really designed to support the owner only like cell phones, meals, entertainment, travel, things like that. Plus adjustments for any non-recurring expenses that shouldn't show up on an annual basis like a lawsuit or flood damage.

So, you take that SDE, which is basically what you take out of the business on an annual basis, and usually, depending on how fast the company's growing, you apply some ratio and that's the asking price for the business.

If you have basically a combination of all the above things that I mentioned, it comes out to $150,000 a year, you might sell that for two to three times the SDE, which would be $300,000, or $450,000.

When I looked online at BizBuySell, I would see that most of the businesses did fall between that two to actually three and a half times SDE depending how well established and growing they were and whether or not the seller was willing to finance part of the sale or not, which is another big factor that comes into play when you're selling a business.

I guess I will end my discussion of small businesses at this point. I wanted to let you know that a small business is a very effective way to build value in something, to invest your time and money in something and at the same time, generate income.

Going the franchise route is a way to increase your odds of success. And if you have sufficient funds, then buying an existing running franchise is possibly an even better approach to get things moving quickly.

And finally, if you're looking for a franchise, there are hundreds of different types of franchises and thousands of individual companies within those different types. And a senior care or in-home care franchise is definitely one that have been successful for many, many business owners.

And before I close completely, I do want to mention that one of the reasons that I've decided to address this issue today is because I am aware of the sale of a fairly mature senior care franchise in the greater Chicago area.

The business has been going for about 15 years. Its revenues in recent years have consistently been in the low seven figures like most of the other similar businesses in the Midwest that I'm aware of. And there was a lot of pressure during the pandemic, but the growth in activity, in clients, in hours of service and in revenues and profits has increased since the pandemic. And so, I think this is something that if you're interested in getting into this kind of business and want to buy a business, then you can check into this.

And the way to find out more about this opportunity is to send an email to seniorcareoffer@gmail.com and let the owner know that you might be interested and then they will take it from there. Again, that email address is seniorcareoffer@gmail.com. Well, that's all I have for today.

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Do You Want to Live Life and Practice Medicine on Your Own Terms? – 237

John Jurica — Tue, 01 Mar 2022 11:00:06 +0000

Interview with Dr. Nneka Unachukwu

This week Dr. Una returns to teach you how to practice medicine on your own terms. She will also be announcing the release of her new book.

Dr. Nneka Unachukwu is a pediatrician and founder of EntreMD. She received her medical degree from the University of Nigeria College of Medicine and completed her pediatrics residency at Newark Beth Israel Medical Center. Dr. Una has been coaching, speaking, writing, and helping physicians all over the world. She does this through her podcast and her EntreMD Business School.

The EntreMD Business School is a year-long program designed to make up for the business education you didn’t receive during your medical training. Whether you are employed or own a medical practice or a nonclinical business, this school will give you the tools you need to build a business that helps you serve and earn at the highest level.

Our Sponsor

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

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

Writing Her Book

There are many physicians who really struggled for years. They studied and overcame barriers to get into medical school and the residency they wanted. And after all that struggle and work, they still find themselves unhappy with where they are.

Dr. Una's book, The EntreMD Method: A Proven Roadmap for Doctors who Want to Live Life and Practice Medicine on Their Own Terms, teaches us how to do more of what we like to do, and less of what we don't want to do. It teaches us how to take back control of our lives and careers.

Practice Medicine on Your Own Terms

Here are some key points to Dr. Una's book:

Why entrepreneurship is a must for physicians?

“the more you think like an entrepreneur, the more you can connect what you do to the bottom line, the more you can objectively say, this is my value to this institution, the more you can negotiate. If you think like an entrepreneur, you realize, even though I'm employed, I work for Dr. Me incorporated. And the more valuable my company is, the more they'll have to pay me. You build your personal brand… you have people coming to your institution because of you… you become a force. And you become in control and people have to treat you differently because if you leave, they hurt. The end. So that's even for an entrepreneur.”

Top mindset issues that need to be addressed:
– One-trick pony
– Fear of failure
– “I have to do this perfectly” mindset
Habits and attitudes. Things that we should learn to be successful:
– daily routine
– the habit of “becoming comfortable being uncomfortable”
– love for personal development

Words of Encouragement

“The truth of this is physicians as a community, we are amazing. We have been sold a lie, that we're one-trick ponies, that we should stay in our lane, that we're not good at business. We're not good at investments. And they're all lies. They're all lies.

“And the second thing I will say is explore that for yourself, but explore that for your colleagues as well. There are so many physicians who have never seen anybody succeed as a physician entrepreneur, succeed as a physician, period. And the more we set the example of what is possible, the more we create a tsunami of change.

“My vision is by 2025… we will be calling it the year of the physician. a time when doctors are the leaders in the healthcare space, we have unprecedented levels of career satisfaction, and we have financial freedom. It seems like “how in the world,” but it is going to happen. And it starts with you listening.”

Summary

I always get energized and inspired when I talk with Dr. Una. I’m inspired because she is making it possible for physicians like you to thrive in private practice, or in a nonclinical business as well.

She hit us with so many value bombs today. But one quote I really liked is that to succeed, “we must be comfortable being uncomfortable.”

I’m excited to read her book and share it with you. It’s available the day this podcast is being released. And the best way to find it is to go to her website at Entremd.com. You’ll also find her coaching program, EntreMD Business School, right there too.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 237

Do You Want to Live Life and Practice Medicine on Your Own Terms?

John: I noticed that this former guest has written a book that should be of interest to you, many of you, my listening audience today. So, I can't wait to hear all about it. Hello, Dr. Nneka Unachukwu, otherwise known as Dr. Una.

Dr. Una: Hi, thank you so much for having me on here. I'm so excited to be here again.

John: Well, I'm glad to have you here fellow podcaster and entrepreneur. I think your episode was pretty darn popular when I think back it was about two years ago, and then you came back to interview me for my podcast. That was interesting. So, I love that. I did hear something about a book coming out, but let's bring everybody up to date because not all my listeners now may be the same. So, tell us a little bit about you, a little bit about your background, what you've been doing up to this point, and then we'll get into the whole book thing.

Dr. Una: Yeah. My name's Dr. Una, as you said. I am a pediatrician by training and a serial entrepreneur and a podcaster and an author at this point. Really, what I do is I help doctors learn how to build profitable businesses so they can live life and practice medicine on their terms. So that's at the heart of what I do. That's the heart of what I do.

And John, it's really interesting because I'm like the last time I was on here, I had just started the EntreMD podcast. So, it's a little over two years old now. It's really been a great vehicle for getting the word out there. We've had, I don't know, 186,000 downloads at this point, which I could not have imagined starting to podcasts on my cell phone, in my basement. That's been really great.

I launched a second podcast, called the Doctors Changing Medicine podcast. And I did that because I was really like, there are a lot of examples of physicians who are in control, who are living above burnout, who are starting running profitable businesses, and who are living life on their terms. But I couldn't find a place to find all of them when I started off. I'm like, a Google physician entrepreneur. And I'm like, where are they?

And so that podcast is primarily an interview show just to showcase doctors who are living outside the box and stuff like that. And someone can go there, it's like a buffet, just go through them and like, "Wow, that's interesting. I'd like to do that." That seems like something I would want to do.

I did that, and then started the EntreMD business school, which is a year-long program. And I just walk doctors through all the classic algorithm-proof ways of building profitable businesses. And it's a wonderful community. We have live sessions every week. I mean, it's been so wild. I'm so grateful for the journey. We've had a lot of things go on, live events, all of that. It's been amazing. Really amazing.

John: That's cool. Let me ask you about the business school. It's a year-long thing. Do you only start it once a year or do you have openings? How do you get new people into the business school?

Dr. Una: Yeah, we are open a few times a year. Last year we opened twice, this year we may open three or four times. And so, everybody kind of has their own cohort, if you will. Many people do end up re-enrolling, there was a cohort, it was like a 100% or like, yeah, I'm doing a second year. So, people tend to stay.

John: Yeah. I think I was looking at your website or looking at that, and so basically there's a waiting place for now because it's not open at this moment, but if they're interested in that, they get on that waitlist, they learn more. And then when you open it, they have that opportunity.

Dr. Una: Absolutely.

John: That's pretty cool. That will keep you busy between that and two or three podcasts or whatever. And some speaking and some book writing.

Dr. Una: But it is fun because I'm getting to do what I want. It's like I get to help doctors do that. So, watch someone who's like, "I'm not the kind of person who can run a private practice", go from that to "My first year in private practice, we were completely profitable. I paid off all my loans and all." It's so insanely crazy and rewarding to see somebody like "I negotiated at my job, now I have a scribe. Now I work a four-day workweek. I say no to things that do not serve me." I mean, it's amazing. It's work, but it's work that I love.

John: Now, wait a second. You're saying that I'm a physician. I can start my own practice and be happy and not get crushed by Medicare and all these other things. I think it is coming back. So, what's your experience with that?

Dr. Una: With private practice?

John: Yeah.

Dr. Una: Well, the thing is for a lot of it, it's starting to think of a practice. Physicians as a community, we've thought about a practice like a practice, not a business. "Business destroyed medicine, so I'm not into the business thing." But the second you start applying business principles to it, it's a very different experience. You have more control over how many people you see, have more control over being the sought-after person in the marketplace, you have more control over hiring, firing, culture. Boundaries, all of that. Like saying no to things that don't serve you. If there's an insurance company that pays you below what it costs you to serve the patients, you say no, because you know the numbers.

Learning to run it as a business, which for physicians, I will say, we lead with service. We lead with helping. So, we make the best entrepreneurs. Period. Because we put people before profits, but you have to have both. Once you start thinking in that way, then everything gets better. I'm not trying to say it's not hard work, but it's hard work that's rewarding.

John: It sounds to me like you get to do more of what you like to do or want to do, and less of what you don't want to do because you're in control.

Dr. Una: Yes.

John: Okay. I'm assuming that some of that is going to be addressed in "The EntreMD Method: A Proven Roadmap for Doctors who Want to Live Life and Practice Medicine on Their Own Terms", which is the book we're here to talk about today. Is that right?

Dr. Una: Yes.

John: Okay. Just tell us a little bit about the process. Let's start with why. Why did you decide you're going to write a book?

Dr. Una: This is the deal. One of my BHAGs, my big hairy audacious goal is that I'm going to help 100,000 doctors learn how to build profitable businesses.

John: I think you mentioned that before. Yes.

Dr. Una: Yeah, right? And when I started talking about it, I was not clear on how, but I was like, this is what I'm going to do. And I'm like, what better way is there to create an avenue for the mass business education of doctors, by then having a book? And so, I have the podcast and there are so many people who listen to it. There are so many people who get so much out of it, but I'm like, "If I have a book I can say, okay, I want to put this book in every final year resident's hands. I want to give this book to anybody who wants to start a business." The thought has been, "I have to go do an MBA", and MBAs are great, but we already have multiple six figures in debt. We're already strapped for time. We're already burned out. We don't have time for another MBA.

And so, I was like, I'm going to put something that is simple enough, a simple enough roadmap that someone who is like, "I don't even know what entrepreneurship is", they can take that roadmap and start their journey and succeed on their journey. And they are timeless principles. So even if you're at a stage where, "Oh, I have a business that's doing well". Well, this book can help you make it so much better. That's my agenda. I want to help physicians get the empowerment they need to practice medicine on their terms and live on their terms. Enough is enough with all the stuff going on.

John: Yeah. I think a lot of us feel like, "Look, we're here to help people, obviously, that's why we went into medicine, but we're not here to kill ourselves. We're not here to be miserable and unhappy the majority of our lives. And we need to just take control and we should get paid for what we do and we should enjoy what we do." So, if this book is going to tell us how to do that, then I'm definitely in on that. We're not going to get an author. We don't let our authors get away without teaching us everything that's in the book before they leave. Well, we'll hit a few of the high points. That's going to be the rest of this conversation if that's okay.

Dr. Una: Yeah, let's do it. I'll give you all the things, John, just for you.

John: Just for me. Yeah. This is just a private podcast today. I'm not really sending this out. I'm just going to ask all the questions I have. First of all, you kind of alluded to this about entrepreneurship. Just tell us, I think in one of the first sections of your book, you're talking about why entrepreneurship is a must for physicians. So, why don't you summarize it kind of, why is that?

Dr. Una: Well, the truth is that we are one skill away from careers or businesses that we enjoy. Because we are super smart. We have that downpack. We have an incredible work ethic. We have the ability to put people before profits. We're experts in this space, but the thing that is missing is the business skill. If you look at it, it doesn't matter whether you're employed or whether you own a business. This is something for every physician.

For instance, the employed physician, well, you're going to learn how to negotiate. People don't pay you what you're worth. Nobody's going to say, "You know what? I think you're worth 30% more. I'm going to pay you 30%." That's not how this works. You're going to negotiate for that. You're the one that's going to say, "I want to scribe." You're the one that's going to say, "I want a four-day workweek."

And the more you think like an entrepreneur, the more you can connect what you do to the bottom line, the more you can objectively say, this is my value to this institution, the more you can negotiate. If you think like an entrepreneur, you realize, even though I'm employed, I work for Dr. Me incorporated. And the more valuable my company is, the more they'll have to pay me. You build your personal brand. You have people coming to your institution because of you. You become a force. And you become in control and people have to treat you differently because if you leave, they hurt. The end. So that's even for an entrepreneur.

If you look at doctors who own private practices, for instance, there are many kinds of businesses we can own, but just that, for instance, I can't be the lead pediatrician in my practice and then make my practice thrive. There's a different skillset that is needed. I need to be the CEO. I need to understand marketing. I need to know how to dominate the market. These are all things I need to learn if my business is going to work.

And if I'm like, well, I want to have an impact outside of the exam room. I want to have a podcast. I want to be a coach. I want to be, whatever that thing is. No margin, no mission. Doctors, we love to help. We come up with all these ideas like, "Oh, I want to do this." But if you can't figure out how to monetize it, then you don't get to do it. Any way you look at it, we are one skill away. It's business skills. Just one. And if we can master that, which by the way is so much easier than anything we've had to do. We've memorized a Krebs cycle. We've learned how to intubate babies. We know how to replace hearts. Entrepreneurship is easier, but we have to learn it.

John: Yeah. We haven't really spent time learning that because we didn't have the time necessarily. I will point out also that if you go back 50 plus years ago, most physicians were in their own practice. I think things were much less complicated. But with the corporate entities taking over, the insurance companies taking over, then obviously we just were overwhelmed, but I'm just happy to see that there's a resurgence of this because I think physicians are much happier when they're in control and they're meeting patient's needs and addressing the entrepreneur side of things as well. So, this is awesome Dr. Una. I love it.

Dr. Una: Yeah. I'm glad you brought that up because it's not thinking like an entrepreneur that made us give up a lot of these things. Until today people say, "You can just see the patients. We'll take over your company, we'll put you on a guaranteed salary. Just see the patients, we'll take care of everything else."

The reason why we say yes to those things is we don't evaluate those deals as entrepreneurs. We get the worst of deals. Actually, these deals are called doctor deals. The only people who will accept them will be doctors. Because they don't think that way. And so, the more we can think strategically and like entrepreneurs, the more we're like, "Yeah, you make that sound good. And that's a really pretty brochure, but that does not serve me in any way. That's me signing up for burnout, loss of autonomy, and career dissatisfaction." You're absolutely right. We need to figure this out.

John: Well, the next big section of your book has to do with mindset. Why is that important? What kind of mindset issues have you found that need to be addressed and which are the top ones that I think you talk about in the book?

Dr. Una: Yeah. I think the top of the top of the tops, well, maybe, is we are almost conditioned and I'm not saying this is some conspiracy and it's intentional, but we're almost conditioned to not think like entrepreneurs. Like I'm a one-trick pony. The only thing I can do is doctoring. You're burned out, but we can switch this. This is the only thing I know how to do. This is the only way I know how to do it. And it's not true. It's not true in any way. And if you look at the evidence, okay, this is not a paper, but this is evidence in your life. If you look at the evidence, you've done a lot of things. You've learned a lot of things. You have the capacity to change.

Once upon a time, you were a high schooler who said, "I'm going to be a doctor who transplants hearts." And so, if you could go from a high schooler to that, you can go from that to whatever else you need to go to. We are not one-trick ponies. We can learn what we need to learn and we can thrive everywhere we find ourselves.

There's a lot about the fear of failure. Again, part of it is our education. Nobody wants to do brain surgery and go like "Oopsie. Well, I guess that didn't work. We'll just try the next one." You cannot have that attitude in medicine. You aim for perfection. It's not that there are no errors, but that's what you aim for. Entrepreneurship is the complete opposite. It's like, "Is this B worth it? Amazing. Let's go."

And so, it's a big shift because if we walk in with that doctor "I have to do this perfectly" mindset, we stall as entrepreneurs. We can't make progress. We can't innovate. We can't problem-solve. We can't do anything. So, there are few mindsets that we have that have served us really well as physicians that we have to start thinking another way, if we're going to thrive as entrepreneurs. It's a completely different world.

John: Yeah. Although it's ironic to me that there are many physicians who really struggled for years and studied and had overcome some barriers to get into medical school and to get in the residency they wanted and then to get into the practice they wanted. And so, the fear of failure, it just seems so counterintuitive, I think. But it's just a different entity.

Now, I will say too, while you were talking it occurred to me that there's a lot of reasons why other people don't want us to realize this. There's a lot of reasons why the corporate practice of medicine and the insurance companies and the large systems, they don't want us to realize that this business side is not all that complicated and that people can help you. We've got that going against us, but you've got to break free of that and move forward, like you said.

Dr. Una: Yeah. For those of them who are not serving in integrity and all of that, it is in their best interests that we don't learn any of this because what will happen is, a lot of the lids we experience as physicians are not real. They're make-belief, what we believe they're there. And so, the second we figure out this business thing, the lid disappears. The whole "stay in your lane, do what you're told, this is all you can earn", all of that stuff, all of that disappears because the lid is imaginary. It's not real.

John: I was talking to someone yesterday, she's not a healthcare provider. She's a coach for physicians at a university in the medical school. Not in the med school itself, but in the MBA program. She has a relative who's a physician who is killing himself in an ER and he doesn't feel like he has any options. And it's like, "Are you kidding me?" He's just been so brainwashed and he's so stuck that he really needs to hear what you have to say, I think. I'm going to have to send him to you.

Dr. Una: Yeah. That's the reason why this book exists. The way the students in the business school, the way they describe it's like, this is an alternate reality. Like we're not having the experience our colleagues are having. There's a whole new world out there. And so many doctors have no idea it exists.

John: All right. Now, in the next big section of your book, you're talking about habits and attitudes. Things that we should learn to adapt to be successful. What are some of those?

Dr. Una: Yeah. The first one I talk about is a daily routine. And in a business book, you'll be like, "Well, what does that have to do with business?" But the idea is this. We are busy and we'll get less busy at some point, but the bottom line is we are busy. And part of the dissatisfaction and the trauma and all of that stuff comes from not living in alignment with what we consider our most important goals. Not just in the business, but in every aspect. And so, one of the habits that we have to adopt is a daily routine that makes it possible for us to move in the direction of the most important goals we have every single day.

John: That would help.

Dr. Una: Yeah. That would help. Because it's part of the cure for burnout in a way. Because when you're doing meaningful work, you work hard, but you don't get burned up because you're like, "This is amazing." You know what I mean? I know that's a general statement, but for the most part that's what it is. And so, for instance, for my daily routine, I'm like, "Okay. What's most important with me? My relationship with God, my relationship with my kids, learning and becoming better, being healthy, being okay mentally, and all of that stuff." I have a daily routine where I spend time praying. I literally have on my calendar "Spend meaningful time with kids." Not all of us, on the device in the same space, but meaningful time with kids. Reading, reviewing my goals, listening to a podcast, exercising. And when I do these things every day, what it does is even if it was a bad day, I'm still moving in the direction of my most important goals. I'm somebody who can say "Bring it on world, I can take it because I'm grounded and all of that."

I talk about the habit of becoming comfortable, being uncomfortable. And that's the life of an entrepreneur. It's one challenge after the other. One big thing that you have no idea how to do after the other. And the more you fight to be comfortable, the more you resist moving forward. So, it's like "Give that up, become comfortable, be uncomfortable." This is the way. That's the way we were in med school. Once you get comfortable with one procedure, they throw a new one at you. Once you get comfortable with one specialty, they throw another one at you, and you just roll with it.

Then the third one is that love for personal development. I don't know about you John, but when I was done with residency and all that stuff, I was like, I'll do my CNEs. But I was like, in a way I've arrived. You know what I mean? I don't have to study really hard. I'm done. And the thing is wherever we are at our level of personal development, that's the cap for what we can produce in our lives. That's it.

And so, if we want to be people who would build businesses, businesses that'll be successful, businesses that'll be cutting edge, that'll be innovative, that will help people, that will change our communities, that will be movements, we have to always be improving. Always, always. That's something that we have to fall in love with. So that's a new habit. I'll tell you something funny that happened to me a few years ago. It was November and I had made up my mind I was going to read 52 books. And at the beginning of November, I was at 40. And I was like, oh, well, I mean, November, 40? 40 is not a bad number, but clearly, I can't do 12 books in two months. So, I'll try that goal again next year.

And then I had this thought, I was like, well, what if this was med school, though, you won't say that. You will read those 12 books and go take your exam and do a good job. Is your medical degree more important than your life and your business and all this other stuff? I was like, I guess not. It's like, okay. How you'd have done it at school, do it now. I read 12 books in November. I may or may not have cheated and picked a few small ones, but the bottom line is, I got it done, but it's just that attitude "I need to be better" because when I'm better, everything gets better.

John: And I like the point about it's good to have goals, but if you don't have systems in place that are going to enable you to achieve those goals, they're not going to happen most likely because we're human and we get to push things aside. And so, that's great. You need both really. And building that in, I do that to myself. I actually have a daily note on my phone to talk to my daughter.

Dr. Una: I love that.

John: It's not like I talk to her every day, but it reminds me, "Okay, I'm going to talk to my daughter." It's like, why would you need a reminder for that? Well, because we live in a whirlwind. I mean, that's what it is. And unless we remind ourselves in some way or carve out the time or make it a habit, it won't happen.

Okay. Let's see. We're going to run out of time here pretty soon. What do we get? Then I think the fourth part of the book is talking about getting down to business. That should be a thing, getting down to business. So, what is that about?

Dr. Una: Well, that's about the tactical aspect of it. We took care of the mindset and the habits that would support it. But now what do I need to do? What do I need to do in the simplest ways that any physician can apply this, whether you're a start-up or you have a $5 million business? Any physician.

It's really three core things, I go into the details of it in the book. But the first part is identifying that profitable business idea. Because not every idea is profitable. Not every idea should be a business. How do I even know if I have a business in me? Which almost every physician does, but how do I know and how do I know that this will be profitable? I talk about that.

And then I talk about how I get clear in how I communicate about it? And sometimes when it comes to messaging, people are like, "Hey, I don't really need that." But the better you are at it, the better your people can find you. They know exactly what you do. Exactly the problem you solve. They know you're the guide, you're the man or woman for the job.

And the third thing is how do I amplify that message and put it everywhere? How do I go from best-kept secret to household name? This is where a lot of doctors are like, "I don't like promoting myself. I don't like selling. I don't like marketing" and all of that. I'm an introverted introvert so I totally feel your pain. But there's a way to do it that's professional, that's classy, and where people are actually inspired just watching you market. So how do you do that?

Because doctors, again, we're people, people. We know how to serve people. We know how to help people, but then we're best-kept secrets. Nobody knows. And if nobody knows, you cannot have a profitable business. And so, this takes care of that, where you have all the people you consult, looking out for you. And are like, "Can I work with you? Can you help me?"

John: Nice. Well, at some level you're doing your potential patients, customers, clients a disservice if you don't do the right kind of marketing because you are just keeping them from you. They don't even know that you exist or that you have these skills or that you have this service or product. You're not like a snake oil salesman or something. You're just trying to get the word out that here's something that you might really need and want. Something like if you were to do an educational session for a group of seniors somewhere, that's marketing. You're not selling anything there. You're just there and, "Oh, wow. He or she knows a lot about this thing and I need it." So yeah, that makes sense.

Dr. Una: And we sell. It gets a little weird when money is involved. I'm a pediatrician. I sell parents on giving their kids vaccines all the time. Even though vaccines will make their kids cry and all that stuff. I tell them. An oncologist is like, "Yes, you're going to lose your hair and all this stuff, but you absolutely need this chemo." We're great at selling. We just don't know what good selling is.

John: Okay. Well, I need to know where we can get your book and where we can find you. My audience may know that entremd.com is your website, correct?

Dr. Una: Yes. Yes. Entremd.com is where it will be. And then from there, if you want to go to Amazon or wherever, all the links, everything will be there.

John: Okay. And there's also information about the business school. And of course, the podcast, they can look up on any smartphone, but there's information there about the podcast too. And about the book The EntreMD Method. And you can learn more about the things we just touched on today for sure. And that will be coming out the day that this episode is released. Great timing.

Dr. Una: It's so amazing. So amazing.

John: Isn't that crazy? How did we plan that so well? Okay, well, before we go, though, last words of encouragement just from what you know stops people and what they need. Tell them something that'll be helpful to get them started.

Dr. Una: Yeah. The truth of this is physicians as a community are amazing. We have been sold a lie, that we're one-trick ponies, that we should stay in our lane, that we're not good at business. We're not good at investments. And they're all lies. They're all lies. I want to invite you to embrace the possibility that the things you've always dreamed of, that you can actually do them. The career you dreamed of having, you can actually have it. The business, the level of impact and revenue that you've wondered, could I do this? I want to invite you to explore that, to really explore that.

And the second thing I will say is to explore that for yourself, but explore that for your colleagues as well. There are so many physicians who have never seen anybody succeed as a physician entrepreneur, succeed as a physician, period. And the more we set the example of what is possible, the more we create a tsunami of change.

John, I don't think I've told you this yet, but my vision is by 2025, we keep pushing at this by 2025, we will be calling it the year of the physician. At a time when doctors are the leaders in the healthcare space, we have unprecedented levels of career satisfaction and we have financial freedom. It seems like "how" in the world, but it is going to happen. And it starts with you listening.

John: Very nice. We're shooting for 2025 to be the year of the physician. If we all do this affirmation every day for the next three years, it'll happen.

Dr. Una: It'll happen.

John: So, this is the year we get past COVID. 2025 is the year of the physician.

Dr. Una: Yes. The tides would've turned, the tides would've turned.

John: All right. That is awesome. Dr. Una. I've learned a lot today and I really appreciate you taking the time to be with us. I'll have to have you come back in another couple of years, maybe you'll be running for president or something then, I don't know. You keep busy. You never know what you can accomplish.

Now this has been great. I always like to talk to you. And I hope listeners, you just really take to heart what Nneka is telling you today. We should be happy. If you're in bliss, doing whatever you're doing clinically now, then just keep doing it obviously. But if you're not happy, then something has to change. And what we've talked about today is something that you can do. All right. Well, I guess I have to say goodbye then to you now, and thanks again, and we'll be talking to you in the future.

Dr. Una: Thank you so much for having me on. Thank you.

John: Okay. You're welcome. Bye-bye.

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The Best Healthcare Leaders Never Give Up and Never Stop Learning – 196

John Jurica — Tue, 18 May 2021 10:00:42 +0000

Interview with Dr. Harvey Castro

This week, I present my interview with Dr. Harvey Castro in which we discuss the attributes of the best healthcare leaders.

Harvey is an emergency room physician and leader. He thrives on motivating teams by providing the most technologically advanced healthcare services to communities throughout the state of Texas. He believes in building sincere trust with patients, doctors, staff, and community leaders. And Harvey does this by consistently displaying compassion, care, and understanding.

Harvey graduated from the University of Texas Medical School at Galveston. He then completed his Emergency Medicine Residency at St. Luke’s University Health Network in Bethlehem, Pennsylvania. He has been practicing Emergeny Medicine for about 16 years.

Our Sponsor

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

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

Healthcare Leaders Never Give Up and Never Stop Learning

Along the way, he completed his MBA and took on leadership and business roles. He started as a medical director. Then he devoted his energies as a smartphone medical app developer. However, he hit his stride as a freestanding emergency room founder and CEO. That business has now grown into a network of freestanding ERs and other healthcare facilities.

Harvey is the first in a series of guests who completed the UT Physician Executive MBA Program at the University of Tennessee.

Leveraging Medical Training and Entrepreneurial Skills

We covered a lot of ground. Harvey has effectively leveraged his emergency medicine training and entrepreneurial skills to build a remarkable business. And it has happened because of a desire to serve patients better. But it requires the ability to take more risk than the average physician does.

I sincerely think being an ER doctor… you tend to be a risk taker, and that kind of evolves into the business world.

He also believes that the best healthcare leaders never give up, but continuously strive for better quality, safety, and service to patients.

Summary

You can find Dr. Castro on LinkedIn. And if you want to check out his business, go to trustedmedicalcenters.com. You can contact Harvey through LinkedIn or using his email address at harveycastro4@gmail.com.

And don’t forget that Harvey is looking for franchisees to start freestanding emergency rooms in other states. And he has also developed an investment fund for those interested in investing in his growing network.

NOTE: Look below for a transcript of today's episode that you can download or read.

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If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription - PNC Episode 196

The Best Healthcare Leaders Never Give Up and Never Stop Learning

John: I was recently talking with the executive director at the University of Tennessee physician executive MBA program Kate Atchley, and of course they're a big longtime supporter of the podcast. And I asked if she had any suggestions for guests since obviously the physicians involved in their program are trying new things, advancing their careers, and many of them are doing nonclinical things or combinations. So, she introduced me to today's guest who is an emergency medicine physician, businessman and entrepreneur from Texas. Welcome to the podcast, Dr. Harvey Castro.

Dr. Harvey Castro: Thank you so much.

John: Hey man, it's good to see you live. We're looking at video today, even though this is a podcast, but it's good to see you and finally get a chance to spend a few minutes here and what you've been up to.

Dr. Harvey Castro: Yeah, I'm excited to be on the show and I'm excited to finally get to see you in person.

John: This is how we usually start. Just tell us a little bit about your background as far as your education, past clinical practice, and then we'll get into some of the nonclinical activities.

Dr. Harvey Castro: Well, I'm going to go way back. Literally, I couldn't afford college. So, I had to join the army to help fund college. I went to Texas A&M. I received two degrees there, a bachelor's of science and bachelors of art and political science and biomedical science. Because back in the day, I had this big aspiration of becoming a lawyer, a doctor, and a businessman. And so, I marched on and got into medical school and went to UTMB in Galveston, Texas.

Then I went to emergency medicine in Pennsylvania and started practicing medicine as a board-certified emergency physician. Loved it. But I always had this almost like a tickling to do something else. During residency, I was selling books that I wrote in med school. And then in residency, I started my heart vitamin company that I sold.

And then when I graduated, I started this thing called iPhone app. It was a new thing out there and I started trading apps. And so, I started combining medicine and whatever else I wanted to do with it. And at that time, I was combining technology with medicine. And so that was my educational background.

And then having all those accolades and things that I was doing, I started thinking, "Well, heck what if somebody taught me the business side of things? What if I actually got a degree in business?" Because all the things that I know of business, it's kind of like the streets of business. Like the street accolades is what I was learning and doing, but I thought if I had formal education, maybe I would be a better provider/business person in healthcare.

John: All right. But I know for a fact, just looking at your background that you are doing a lot of management before you decided to get the MBA, for sure. So, what kind of roles were you doing? We use this term commonly "medical director". That can mean a lot of things, but I kind of got the sense that there you, yourself or others were putting you in positions of helping them manage things. So, give us a little bit more detail on some of those positions you held.

Dr. Harvey Castro: Yeah. Excellent question. Early on, thank God, I was identified as the future leader. So, at the time the organization I was working with said, "Hey, we'd like you to go to the ACEF academy of leaders and go through all the phases. Phase one, phase two, phase three. And that leadership, learning that training, learning how to even talk to people. They put me as the assistant medical director, and then later I became the actual medical director of a free-standing ER in Dallas.

And that position helped me so much because I have had the leadership training. And so, then I was able to start free-standing. And within the first month I turned it around and made it profitable. It was literally from zero patients to profitable. And those leadership skills, going out to the community, talking to doctors, telling them about our business, looking at the different things.

And then later, I became a consultant in Texas. I literally would drive around or fly around the state of Texas and different companies would hire me to come and help them start their free-standing. And then after a while I thought, "I've been doing this so long. Why not start my own brand?" So, my business partner and I, we were in the business of rehabbing ERs that were failing. And so, we did one, within three months we rehabbed it, we had it profitable. It went very well. We were returning money back to our investors that have helped to start it. And then I said, "Why don't we start a company?" And we just came up with Trusted ER. And literally this was about three years ago. And in over three years, we've expanded to eight locations.

John: That's pretty rapid growth right there.

Dr. Harvey Castro: Yeah. It's crazy to turn around and see. We have about 350 employees, doctors, non-doctors, front office, different branches of the business. And to your point, you're right. We did all of this and then last year I went to school to get my MBA.

John: Okay. So now let's go back a little bit again. I want to kind of get the idea when you were doing the consulting and teaching others like how to improve their ERs? How long ago was that?

Dr. Harvey Castro: That was probably about seven years ago and it probably stopped about three years ago in the sense that I was just working for myself and just helping my own brand.

John: Now, at what point, have you stopped practicing? Or do you do the occasional shifts? How does that work for you and what was that transition, if there was one?

Dr. Harvey Castro: Yeah. That's an excellent question. I can honestly say I was working too much. I was working as an ER doctor. I was working in three different cities plus consulting. And literally I felt like I wasn't resting. Literally, I remember getting off at seven in the morning and then driving two hours and then going to a board meeting because there was this company, I started calling Trusted ER.

And I remember thinking "I can do this". And finally, after a year of doing that, I said, "You know what? This is not life. I'm just burning it on both ends". Then I took the leap of faith of saying, "You know what? I'm saying no to emergency medicine as far as a paycheck. And I'm going to put all my eggs into this Trusted ER and this'll be my daily bread". And it's really tough. Especially as other doctors know that it took so hard to get here. And then to say, "You know what? I'm going to stop practicing medicine and do more on the business side".

And so, now as far as clinical, the only way I would come into cover shift is if the medical director can't and then the chief medical officer can't and the regional can't. And then at that point it's me. But then at that point they usually fill up shifts. I really don't get to practice unless I want to go in and work a few hours.

But I'm more involved in teaching medicine and teaching the concierge portion of how we do emergency medicine, looking at the business side, looking at locations. And interesting enough over the years, especially with COVID, NBCUniversal, all the major networks have been calling me to do medical segments. And so, through peer reviews and looking at different cases in my experience in emergency medicine, which is over 20 years, I'm able to go in and talk about X and Y subjects. And so, last year I actually did about a hundred interviews on TV.

John: Really? Okay. I was wondering about that like, "Oh, maybe one a month for a few months", but a hundred interviews. I mean, that's actually something where that could be a whole career itself in terms of just being seen as the expert and promoting yourself and doing those kinds of interviews on a regular basis. But I see that it feeds into what you're doing from an ER standpoint, of course, and a business standpoint to promote what you're doing in Texas. That's awesome.

Dr. Harvey Castro: And it's fun. I feel like I can get back and it's a different medicine. When COVID hit and everybody was freaking out and scared, I hit the TV station up and said, "Hey, can we do a hotline? A free hotline, just call this number and we'll answer all your COVID questions". And we did this in March and we were on NBC and Telemundo. And I didn't realize that their outreach was all the way out to El Paso. So, we were getting thousands of calls and I had it literally on a list of doctors in the room together just calling and returning calls and just going through all their COVID questions.

But this was the fun part of medicine. When everybody's freaking out, I was able to get on TV and say, "Hey, let's look at X, Y, and Z. Let's talk about this". And it was actually a fun way of practicing medicine. Way different, but it's medicine.

John: Yeah. I think as physicians, we have no inkling of what things could be like if we kind of just open up to the possibility of whether it's expanding your own practice or creating something that has multiple sites or even opening a small hospital. I think you mentioned it is now part of this network.

Dr. Harvey Castro: Yes, sir. We opened our first hospital in Mansfield, Texas. And that was great because now we have the license to do other things. And so, for example, when COVID hit, we were able to start doing mobile testing. So, we were going to the employers. We were the first in Dallas to go out to the employers and test everybody at their location.

And then we were lucky enough to get the first PCR tests and antibodies tests and everything that one was coming out in Dallas. And we were able to show that on TV and have people come to our locations and get these tests and having that outpatient clinical license to be able to do these things. It was perfect timing. So, we actually started our own testing center. But again, I love being able to combine medicine and business and then trying to do something different.

I think it's hard and it's hard almost for us doctors to respect non-doctors in the business world, because they tell us to practice medicine in a certain way and we're like, well, you never help us at the scope and you never talked to a patient, you've never been in those situations. But when another fellow doctor is like I've been there, we've done this, I get that issue. And as the business side, these are the reasons why we want to fix it. And these are the things. So, it's actually been a different medicine that I feel honored and blessed to be able to do every day now. It's just different. No red tape.

John: Yeah, right. When you make a decision, I guess it's going to be implemented pretty quick if you're the CEO. But I do think there is a big need for more physician leaders. There was a time when more than half the hospitals in the country were actually owned by physicians. That's way back in the old days in the 50s. But now I think it's less than 5% or 6% that are led by physicians. And I think we do a whole lot better in medicine and in healthcare as an industry, if we had more physicians in charge of more things.

So, I think physicians should not shy away from that. Especially if they're interested, if they have an aptitude for it, like you've done, then just keep moving forward and you can contribute so much more doing that. I mean, in terms of the numbers of people you're affecting, I would think.

Dr. Harvey Castro: Yeah, it's been fun. I would encourage everybody to do that. Whatever you're good at and whatever medicine you're practicing, take it to the next level.

John: Absolutely. Now you talked about getting a little bit maybe burnt out while you're doing all these things and you say, "Well, maybe I got to cut the practice back at some point, if I'm doing all these business things", but then you decided, "Well, I'm going to go ahead and get this MBA". So, I want to hear what it's like from a student. I don't know that I've actually spoken directly to a graduate of the UT PEMBA before. I mean, I've talked to people and it's a common question I get about advanced degrees.

So, tell me what that was like and how did you carve out the time to do it? Because it's a pretty intense program. Go ahead and just run with that. Tell us about it, what your experience was and how you were able to manage that.

Dr. Harvey Castro: Honestly, I felt like I was going back to med school in that here's all this information being taught to you. I'm going to date myself. I'm going to school and being there and seeing just all the technology and laptops and plugins. I was like, "Whoa, this is so much more fun going to school now than back in the day when I went to school".

And the information was actually fun because we were given PowerPoints, we were given summaries, the books we were told to read. It was even more fun for me because it's like, "Wow, here's medicine and here's business. This is what I've been doing." So, I felt like I was able to get so much more out of it because now I was like, "Okay, now that makes sense".

And it's funny, it's kind of like riding a bike. It's hard to describe how to ride a bike, but once you start doing it, you do it, but then you don't really know why. Going to school was like finding out the "why". Why was I making these decisions? Why was I negotiating in a certain way? Why was I doing things? And it was great to get the Booksmart.

So having these professors talking to me about accounting and one-on-one and entrepreneurship, it was great hearing. Marketing was awesome, listening to different marketing ideas and theories and why things are done in a certain way. And then it's like, "Wow, that's just reinforcing some of the things I'm doing". And now I can actually improve my practice or running my business by using these tools.

As far as the time demands, oh my gosh. It was hard, because running a practice, running eight businesses, having the employees, being the leader, I would literally make time. So, every time I'd come home, I'd say, "Okay, I got to read this book. I got to summarize. I got to think about this". Or working on projects was really hard. Because imagine getting three busy physicians all together on a Zoom saying, "Okay, we are working on this project", it was hard. And then going to class every Saturday and then having a life for the Saturdays. I remember saying, okay, I want to go on vacation, but technically I have classes on Saturdays. So, it's going to be tough.

With that said, I'm glad I did it. Back in the day when I was in the army, I thought I really wanted my MBA one day and my MD. So, that was part of my goal and I wanted to get that. I'm glad I got it because I felt like I had the street-smart, but not the book-smart. And having both just gave me an extra layer of knowledge. And I was able to talk to my classmates and say, "Hey, the reason the professor is pointing X, Y, and Z is because this is how you'll see it in the real world. These are the accolades. These are the things that you need to focus on".

So, I can't say enough about the experience. I thought it was great. I think one of the things about me, I feel like I'm a lifetime learner so I'm all about going back. And today after this podcast, we are having a talk at the University and I'm going to be on it, just listening as a participant to learn more from the University. So, it's fun.

John: Yeah. We're going to try and actually put some of the things that they're presenting there. Dr. Kate Atchley said that we could actually promote that on the podcast. So, I'm going to be putting notices for some of those business-related courses for physicians or just the seminars because they are CME accredited. So, it sounds like it's a really good opportunity for those that are outside to kind of let them get familiar with the program.

But I know this is kind of a leading question. I kind of know the answer, but some physicians are like, "Well, I should've gotten my MBA back when, because then I would know how to run my practice better or run this group better". But I get the feeling that the virtue of an executive MBA is you're coming in when you've already had enough exposure to something that you actually know what you're looking for, when you hear it, it makes sense. I mean, you were talking about marketing before you did the MBA for your organization. And so, I guess my question is, would you agree with that? That there is some advantage to that?

Dr. Harvey Castro: There's a lot of advantages to having the experience of having a business. With that said I wouldn't preclude it as a prereq to go into getting your MBA. I always feel like it's important to have an end in line. If you're getting an MBA just to get an MBA, if that's your goal, that's fine. But if you're getting an MBA because there's X, Y, and Z, that you're wanting to get out of it, then you're going to get that out of the MBA. If you decide I just want to go through it and just see the bigger picture, then you'll get the bigger picture.

But I went into this very razor focus, like, "Okay, these are the things that I need to work on. These are the things I needed to do better on. These are the things that I should be open-minded to". So, every time certain lectures came, I was just taking it all in or pre-reading or trying to get the most or reading the notes. Actually, yesterday I spent some time looking at some of the old notes from our marketing professor and just reading through them I'm like, "Man, this is really good stuff that I need to apply". And so, I think it's important to have an end in mind. Why do you want the MBA? What are you going to get out of it? And then you'll get even more out of it.

John: Yeah, I think you could do either. I get that question all the time. Should I do this MBA or MHA and some other degree? It's a personal decision, but there's nothing wrong with trying to dabble in it a little bit in terms of the business side and then if you feel like you really want to pull the trigger. The other thing is if you can get an employer who will pay for part of it, that can be helpful.

Dr. Harvey Castro: Yes. Yeah, for sure.

John: The other thing I was going to mention is I'm assuming you had a pretty decent team that could at least free you up a few hours when you need to be freed up. It sounds like you have a pretty extensive well-run organization. So, I'm sure that helped.

Dr. Harvey Castro: It does. It does help. I felt bad for some of my classmates that said, "Hey, I just got off a shift and I'm here. I'm in a small group". And I'm like, "Oh my God, bless your heart. I can't complain. I was in bed last night. I slept in my own bed". And interestingly enough, I would say at least 40% of the class was emergency room. And so, that just tells me, I think there is a lot of burnout out there. A lot of doctors are like, "Man, holidays, weekends, I can't do this". And I think early in life, it's fun. And then later you're like, "Whoa, I have kids, I have this and that. It's not as easy to work a midnight shift as it used to be". So, I think doctors are looking to do something else.

John: Well, I've had a lot of guests on here who are ER docs. There seems to be something about the ER docs. I mean even urgent care, right? That's what I do very part time now. Half of them are either owned by ER docs or family docs. I mean, you got to have that broadest exposure to clinically. And of course, the ER docs usually have the more aggressive urgent cares where they do an IVs and things and do more procedures. But even beyond that, I can't tell you how many ER docs have been in start-ups or investing in some new company. So, I know there's something about the excitement I think of ER work and maybe the business excitement.

Dr. Harvey Castro: Yeah. I agree. I sincerely think being an ER doctor and I love all the professions, but being here, I think you tend to be a risk taker and that kind of evolves into the business world. And then you're more likely to say, "You know what? I'm going to jump in and start my own urgent care, even though I don't know anything about urgent care", because you're that risk taker. And sometimes to be successful, sometimes you need to take risks, calculated risks. And I think you see that in ER doctors.

John: Okay. Now I got to segue us into another business topic related to what you're doing. From what you told me before we got started today, you are in the process of franchising, what you're doing and maybe even looking for investors. So, explain that to us in some detail because I think we've talked about franchises, like being a franchisee and just signing on with somebody. But if somebody has a practice, a group practice, ER practice, something like that and what you're doing, how could you possibly consider franchising? Explain that to us.

Dr. Harvey Castro: Yeah. Well, it all comes down to what we're talking about today - Business. We all are healthcare providers. We spent hours and hours of taking care of patients. We know how to take care of patients, but do we know how to buy a business? Do we know how to negotiate a business? Unfortunately, when people see MD/DO behind your name, they're like, "Oh, that's a premium. We're going to charge you a little extra here".

So, what we decided is why not create a product that we can franchise and create that business. And in that way, we are negotiating, we know what the prices are. We already have the vendors. We have the system in place. Every organization that we've started, every ER, is very meticulous how we do procedures. We have a handbook. We have HR, accounting. We spend a lot of time making sure that when we opened and we grew so fast, we had to create these folders and processes.

And so, we've got it down to a science. And now we have our own HR, accounting, billing company, our own physician company, our own staffing company. So, we thought, why not create a franchise so that if another doctor wants to do the same thing, but do it in their community, here we go. We can support you. Not to promote myself or our company, but it's really hard to start a business, especially if you're going to make a lot of mistakes. And those mistakes sometimes cost a lot of money.

So, to me, it makes sense. And I'm personally looking actually at other franchises out there to say, "How can I invest in franchise X and Y?" Because they've already fine-tuned this. They've already fixed all the issues. They already know what issues are coming and how to avoid them. So, I would gladly pay a company to say, "Hey, come in and help me". I'm looking at some food industry places. And I'm like, I don't know anything about food, but this franchise is known. And that's why I thought, why not do the same thing?

On the Dallas side, we have eight locations. And we're about to launch basically a fund that if someone outside of Dallas wants to invest in Trusted ER, they can buy a share of the ADRs. And we're selling that. We have two parts of our business. One is an investor side and one is a doctor side. We're consolidating basically all the doctors into one fund and then letting other people come in and buy into that fund that is representative of all the eight locations. So, we're doing that and we're doing the franchise separately. So, it's been fun. I think it's a good tool. And I think as a physician, I wish I had that tool early in my career to be able to say, "Hey, I want to invest in X and Y. And this is run by another doctor or a nurse or someone that knows the business".

John: We'll have to have you come back on in a couple of years and see how things are going. But I did want to say the following. As my listeners know, my wife owns a franchise for a home helpers' business and she's been doing it for 12 years now. And we're thinking of semi retiring to another state. And I asked her, I said, well, if we move somewhere, you could easily open your own in-home care business, you know how to do it. Would you bother with the franchise? And she said, I wouldn't do it unless I was part of a franchise. Because there's so much support and it's not just the protocols and the procedures and things they've worked out. It's the ongoing support. You've got people that you're in touch with on a regular basis, you can ask questions, they have quarterly meetings, they have annual meetings.

So, I think a franchise really simplifies the process of getting into that business. Yes, you have to pay a fee for it. It's not free, but, boy, I'm going to be really interested in seeing how this works out over the next few years.

Dr. Harvey Castro: Yeah. Thanks. And I'm excited. I'm really excited.

John: You're going to be a busy man for a while I think probably for the next couple of decades, the way things are going. But it does keep you young, huh?

Dr. Harvey Castro: It does, it does. I do want to shed some light. No matter what you're doing, I think it's important to just have fun. I love medicine. I love practicing. I loved the business side of it. So, I'm having fun. I love being on TV and just doing it. It's not for everybody. But once you find something that you love, I would just say, take off with it.

I have a big heart for single parents out there with kids, single kids out there that are just teenage kids, teenagers having kids. My mom had me at an early age. And so, I literally wrote a book called "Success Reinvention" to kind of help others out there. I'm in the process of writing my own course. I'm hoping in the next two months that course will be out to just help other parents that are out there trying to struggle, but trying to improve themselves.

And in November, we're doing a video tape with Amazon. Basically, I'll be on TV on Earth Day next year. For the pandemics, I'll be on an Amazon TV series called The Social Movement. So, I'm kind of excited.

But whatever it is, I'm sharing these things, not to brag at all. It's just to say, "Hey, you can use your MD, but do it with different things". Here I am, I wrote a book. I'm doing a course. I'm going to be on a TV series next year. It's just about wanting it and then whatever it is that you enjoy, just go with it.

John: Yeah. It's so much easier to create things these days. Imagine going back 30, 40 years before the internet. I mean you can create courses, you can get online, you can collaborate, podcasts weren't even a possibility. I guess it could be on the radio. But yeah, that's good. That's absolutely true.

Well, before we go. We're going to run out of time, a couple of things. To get a hold of you, probably a simple way might be through LinkedIn. Would that be appropriate?

Dr. Harvey Castro: Yes, sir. I'm on all the social networks, Facebook, Instagram, but LinkedIn, I check a lot. And so, if you don't mind, LinkedIn me, and if you don't have LinkedIn, then my email is harveycastro4@gmail.com. And I answer all my emails myself. So, feel free to contact me about anything.

John: That sounds good. And they can see what the company's up to at trustedmedicalcenters.com.

Dr. Harvey Castro: Trustedmedicalcenters.com. It has all our locations. It got some great blogs. We started our own podcast actually called Trusted Talks. It just talks about health care specific to Trusted ER, and we have our own marketing media. You'll see lots of videos that we do in house. It's actually pretty progressive.

John: All right, trustedmedicalcenters.com. And the podcast is sort of geared for patients?

Dr. Harvey Castro: Yeah, it's for patients. Exactly. Trusted Talks.

John: Okay. I'll get that down and I'll put that in the show notes as well and send that out. All right, I'm going to give you a chance to just give a little advice to a physician. A lot of the listeners are sort of like struggling. They're obviously listening to this podcast because we're talking to people that have done new things and they haven't all left medicine, but they've started something maybe with medicine or built on their background in medicine, but they're scared sometimes of fear of failure, all kinds of things. So, any last words of advice for people that are thinking about trying something new like that?

Dr. Harvey Castro: Yeah, so much to say. I think at the end of that, I want to make sure everyone knows that you need to just stop and smell the roses. Take time for yourself, take time for you because if you're running, running, running, you're not going to be able to build anything.

But if you have time for yourself, even if it's simple, like I know I sound like I'm crazy busy and I am, but at the end of the day, I make sure I do something for me. It may be calling my kids and maybe going for a walk. It's important for you to just take time.

Sometimes I literally turn off everything when I'm driving to work and I just enjoy the solitude and quietness. That's something that helps me get the energy. And then when I'm at work, I'm ready to go or whatever task I need to do, I have full of energy and get to do that.

Make sure you take time for yourself so that you can make it sure that you have the energy to do whatever it is that you're trying to do. And don't be scared. It's all about calculated risks. So just take time and research, whatever it is that you're trying to do and then do it.

One other quick advice is, look at life like a ladder. It doesn't matter about you getting there quickly. It's about you going up that run. And it can take you 10 years, 20 years. Here I am, I'm in my late 40s. I'm 47, I just got my MBA. And so, I always wanted to do that. I thought that back when I was 18 and I personally want to get my JD and I'm pretty sure I'm going to go get it when I'm 65. So, I'm still going to go up on that ladder.

John: All right, we're going to hold you to that now. You put that date out there. All right. Well, I really appreciate those comments and I think we've had a fun talk today and very motivational, inspirational. I appreciate that. We'll be in touch again in the future, I am sure, Harvey. So, thanks a lot for being here today.

Dr. Harvey Castro: I'm honored to be here. Thank you, sir.

John: You're welcome. Bye-bye.

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The post The Best Healthcare Leaders Never Give Up and Never Stop Learning – 196 appeared first on NonClinical Physicians.

How to Create Uncommon Success In Business and In Life – 187

John Jurica — Tue, 16 Mar 2021 10:00:24 +0000

Interview with John Lee Dumas of Entrepreneurs on Fire Podcast

In this week’s episode, John Lee Dumas, of Entrepreneurs on Fire, explains what it takes to create uncommon success.

JLD is the founder and host of the award-winning podcast, Entrepreneurs On Fire. With over 1 million monthly listens and 7-figures of annual revenue, he is spreading Entrepreneurial FIRE on a global scale.

His first traditionally published book, The Common Path to Uncommon Success is available for pre-order now at UncommonSuccessBook.com

Our Sponsor

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

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

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

Podcasting Icon

JLD is an icon in podcasting. He created his online empire starting with his daily podcast, now with over 3000 episodes. And anyone producing a podcast, or any online platform from blog to YouTube channel, will do well to emulate what he has done and what he shares with us each day on his show.

Most people are going to die in this world, having never identified their Big Idea. – John Lee Dumas

During our interview, he gave us a glimpse into his story and how it is reflected in the book. For example, 10 years ago, when he started out, he knew he wanted to produce a podcast. But he wanted to really stand out, so he did his research. He decided to focus on a topic in the business realm. But as he describes in the interview, he needed to niche down so he could dominate in his chosen subject. So he decided to focus on podcasts dealing with entrepreneurs.

You are going to win by creating the best solution to a real problem. – John Lee Dumas

But there were 7 such podcasts already addressing the topic. So, he niched down further, becoming the one and only DAILY podcast dedicated to bringing stories about entrepreneurial topics to his listeners every single day – something nobody else was doing.

How to Create Uncommon Success

Here are some of the 17 steps to create uncommon success that he mentions during our interview:

Find your BIG IDEA and your Zone of Fire (Chapter #1)
Overcome existing competition by discovering your niche – a void not being filled by anyone else (Chapter #2)
JLD's favorite chapter: creating a content production plan with Kate Erickson (Chapter #7)
The final chapter: keeping the money you make with Remit Sethi (Chapter #17)

This is the culmination of his 3,000 interviews, all boiled down. These are the tactics he has used to achieve success. And, according to JLD, the book outlines in detail how to implement the right tactics as you follow his 17 steps to create uncommon success.

Summary

I am so glad I was able to connect with JLD. He tossed out numerous value-bombs for us to consider. And I enjoyed getting a glimpse of what went into writing and publishing the book.

I recommend you pre-order a copy now because there are many awesome bonuses that disappear after the 23rd of March. They include a copy of the Podcast Journal, Mastery Journal, and Freedom Journal, each one a bestseller itself.

NOTE: Look below for a transcript of today's episode that you can download or read right here.

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Download This Episode:

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

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Today's PNC Podcast Transcript

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PNC Podcast Episode 187

How to Create Uncommon Success in Business and In Life

Interview with John Lee Dumas

John: I really love guests who can teach us something, who can inspire us and also have some resources for us to take advantage of. And so today my guest is John Lee Dumas. You podcasters will know this guy for sure, JLD. And with that, I want to welcome you to the podcast, John. Thanks for coming.

John Lee Dumas: I am fired up to be here. Thank you for having me. I love everything you have going on and you promise you're going to play the guitar later. So that's pretty fun.

John: Yeah, I'll do that right after you take off. All right. Well, we're going to get right into it. Part of the reason you're here is because you have a new book, which by the way, I've already pre-ordered and started to access the bonuses. So, we have to talk about that in a few minutes, but first I need to pick your brain.

One of the things that I hear from you from time to time is talking about this Zone of Fire. So, can you explain that concept to us?

John Lee Dumas: Most people are going to die in this world having never identified their big idea. I mean, it is literally within all of us, we all have a big idea. It is unique to us, just like a snowflake is unique, your big idea is unique to you. And all it takes is for you to sit down and really identify and uncover that big idea, because that is your Zone of Fire. That is what you want to be waking up every single day, excited to dive into and work the kind of work that you want. That lights your soul on fire. This excites you.

And guess what? This world needs more of that. This world needs more people waking up every day fired up to live in their Zone of Fire, to identify what that big idea is and execute it every single day. The world needs less of people waking up miserable, going to do something they really don't want to do or are burned out doing. We need the prior less of the latter.

John: That's awesome. There's no question about it. It's something that maybe when you wake up in the morning, you're not dreading, but you're actually looking forward to it and you jump out of bed and you want to do it. But that’s not enough because I think this is mentioned in your book. I heard you talking with Chris Ducker and some others in anticipation of this call. So, what does it take beyond just that Zone of Fire?

John Lee Dumas: So, here's the problem. So many people will identify their big idea. They'll identify their Zone of Fire and they get really excited and they're going to be like, “Oh yes, this is the thing. It's a great idea”. And guess what? It really is a great idea, but it is just step 1 of a 17 several map. That's it. So, it's like 5% of this journey. And so many people will just stop there and just be like, “Okay, I've got my big idea. Let's go”. But guess what? Their big idea is a great idea. Therefore, other people have identified that. Other people are living your big idea right now. You have competition that is crushing it right now in your big idea, which is a good thing if you look at it with the right mindset. Because that's proof of concept, that is validation that your big idea can really be something cool in this world. Something exciting, a real business, a lifestyle.

But here's the problem. You're going to be like a lamb walking into slaughter if you just identify this big idea and go all in because there's entrenched competition. So, you got to go to step 2 in this process of the 17 steps and you've got to discover the niche. Now, what do I mean by that? There's a void within your big idea that is not being filled. There's a market within your big idea that is not being served. And it's small, but guess what? It's an opportunity. It's going to give you the opportunity to get momentum, traction, to actually get moving forward. That is the niche that you need to discover. This can allow you to get that initial proof of concept, that initial traction, that initial momentum like a real quick step back.

My big idea back in 2012 was to launch a podcast. I would've gotten slaughtered. So, I niched down into the business podcasts. Okay, there's hundreds of them. Niche down a third time into a podcast interviewing successful entrepreneurs. Okay, there were seven. But still do I want to be the eighth best podcast interviewing entrepreneurs? I want you to be the best. So, what were they missing? What was a void in that entrepreneurial interview podcast space? Well, everybody was doing one day a week. What if I 10 X their quantity and became the first daily podcast interviewing entrepreneurs?

Filling a void that I knew existed because I knew there were other people like me who wanted to listen to a podcast every day of an entrepreneur. And so, I filled that void and you and I are talking now 10 years later, 3,000 episodes later, a hundred million listens later, over 1.4 million listens because I found a void, I found a niche and I filled it. And by the way, I've turned that into a thriving media empire business as well that's generated well over $20 million since the launch of this podcast.

John: That's crazy. I think I'm going to do two podcasts a day. How about that? Will I get to where you are in a few years doing that?

John Lee Dumas: We'll be talking about that soon. We'll talk about it.

John: All right. Well, I have a ton of other questions, but it seems like every question I asked you is kind of related to something in the book. So, we kind of touched on what? The first two chapters of the 17. So, just go ahead and lay it all out for us any way you'd like to. Because I know as you describe what's in the book, we're just going to pick up these pearls. So, let's just do it.

John Lee Dumas: Well, let's just talk about my favorite chapter. Step seven, chapter seven. The average chapter in this book is 3,500 words. That's the average. This chapter is 13,500. It's like 5 X. All the other chapters combined. Just this alone is 5 X the average chapter, this one chapter. It is a business book in and of itself. And this is creating a content production plan. And this is going to be specifically relevant to your audience by the way, because listen, your audience is busy. They have jobs, they're doing this or doing that. They have a lot of things going on. What they need desperately is a content production plan.

So that time that they do have, that hour, that 30 minutes, that 90 minutes, whatever it is per day, to create the content they need to be creating has to be efficient, has to be planned, has to be repurposed, has to be so meaningful. And so, this 13,500-word chapter step seven, chapter seven, “Creating Content Production Plan”. That is the chapter your audience needs. I'm telling you they need to do chapters one through six to make sure they are ready for chapter seven. But once they get to chapter seven, hold onto those afterburners, because this is the book for you.

John: So, is this the secret behind execution, at least for an online business?

John Lee Dumas: So, what this is, is the culmination of the 3,000 interviews that I've done with over thousands of thousands and thousands of hours of these conversations boiling down to the 17 core foundational principles that all these entrepreneurs have been executing for decades and decades and saying, “Hey, these are the foundational principles that make a successful business. That turns somebody from a common success to an uncommon success”. Like let's get you there. So, this is the roadmap to follow for that. And it's not inspirational. It's not motivational. These are tactics. These are strategies that work in real businesses right now.

John: All right. So, this is the “How-to”. So, that's going to be fantastic because I think a lot of people are inspired, but it's the “How-to” that they lack. And especially if they've never done anything like this. Well, tell us why we should buy the book now? I bought it on pre-order because of all the bonuses, it was one of the reasons, but tell us about that process and when does it actually come out? Let's go from there.

John Lee Dumas: So, the book is released March 23rd, but like you're amazing host here do not to wait for March 23rd because we have five insane pre-order bonuses for anybody that pre-orders. And they all disappear by March 23rd. But just one of those pre-order bonuses, I'm shipping all three of my journals, The Freedom, Mastery and Podcast Journal to your door. We won't get into details about them. Just know that they are amazing, awesome journals. One is going to accomplish your number one goal in a hundred days. Another one is going to help you master productivity, discipline, and focus in a hundred days. The other one's going to help you create and launch your podcast, if you so desire in 50 days.

And this is the one bonus of five, that is absolutely insane. Because again, on my dime, I'm shipping all three of them to your door if you live in the USA. For those people outside of the USA, I still love you. I'm sending you immediate access to the digital packs via email which you’ll get, they are amazing, billable.

And then there are four other insane bonuses at uncommonsuccessbook.com. When you go there, you'll see the endorsements from Seth Godin, Gary Vaynerchuk, Neil Patel, Eric and Mandy Dorie Clark. I have a whole chapter there, chapter one. You can read it to see if you jive with my writing style. There's a video there of me explaining in more details about the book, explanations of all five bonuses, uncommonsuccessbook.com.

John: I probably would have just taken my time and bought the book. When I saw the bonuses, I'm like, you got to be kidding. Those journals have been out and have been so popular and I thought, “Oh, this is going to be my chance”. I already got one, but I didn’t get the other two. And then I've already looked at a couple of the videos, everything is fantastic. They're great. And the people you interview, of course, most of us know who they are. They are so well-known and they're experts.

Well, I'm excited. I want to read the book. I can't wait for the 23rd. So, I don’t know, I guess at this point, I just wonder if you have any last advice for physicians or anyone who's thinking of trying something new. How do you close the book out exactly? Maybe I'd want to get a little preview of that.

John Lee Dumas: Well, how I close the book out real quick is the final step, the final chapter is “Keep the money you make”, which believe me is so much harder than most people think. They look at these people that are making millions of dollars and are like, “They must have it made in the shade”.

Those people are struggling, not all of them, but they're struggling because guess what? After payroll and after expenses and after infrastructure and office space and taxes and all this jazz, there's never any money left over, believe me, unless you know how to do it, unless you know how to actually keep the money you make. So, I get into all the details there. I brought in a great financial guru. His name is Rami Satie, fantastic entrepreneur when it comes to that stuff. And it's just such an important chapter. That's how we close things out. Because listen, if you're going to work that hard to actually be making all this money by chapter 16, step 16, let's teach you how to keep that money that you're making, please. Like that is my final gift to you.

And the thing I want to end off is, is like this. You are going to win by creating the best solution to a real problem. So, whether you're a physician and you want to maintain there and you want to just find a better niche within that, when you become the best solution to a real problem, people beat a path to your door. Period. You see it in the physician world all the time.

And if you're looking to do a side hustle and kind of get out and expand your horizons and try something new and try this online entrepreneurial business world, that's the way you do it. You identify a void in the marketplace that needs a solution and you become the best solution to that problem. And people will find you, they will beat a path to your doorstep and you will win because you're the best. People don't want the second best. They don't want the 10th best. They want the best solution to a real problem that they have. Be that number one solution.

John: Very cool. “The Common Path to Uncommon Success” it's at uncommonsuccessbook.com. Check it out. I thank you so much for being in here today, JLD. I really appreciate the time and just sharing your wisdom with us. Thanks so much.

John Lee Dumas: Thanks, John. I appreciate you.

John: Alright, take care. Bye-bye.

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The post How to Create Uncommon Success In Business and In Life – 187 appeared first on NonClinical Physicians.

How Can We Run a Healthcare Business in a Scary Pandemic? – 138

John Jurica — Tue, 14 Apr 2020 10:30:35 +0000

Reflections on Two Businesses During the Pandemic

On this week’s episode of the PNC podcast, I provide a brief overview of the impact of the Coronavirus pandemic on two of the businesses I'm involved in: my urgent care business and my wife's home services agency.

On the positive side, both businesses have remained open, which highlights one of the benefits of owning a healthcare-related business. The need for services is very consistent, especially for essential services like those provided by hospitals, emergency rooms, urgent care centers, hospices, home health providers, nursing homes, and ambulance services. Even in-home nonmedical care must continue for frail seniors, especially.

Our Sponsor

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

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country, with over 650 graduates. And, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Recently, Economist Magazine ranked the business school #1 in the world for the Most Relevant Executive MBA.

While in the program, you'll participate in a company project, thereby contributing to your organization. As a result, University of Tennessee PEMBA students bring exceptional value to their organizations.

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

By joining the University of Tennessee physician executive MBA, you will develop the business and management skills needed to advance your career. To find out more, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Challenging Environment

During the initial stages of the pandemic, public health experts told us to avoid coming into contact with infected persons. After all, there was no treatment, and no way to test. So, the patients were advised to remain at home if they felt they had a COVID-19 infection, unless they were very ill. In that case, they were advised to go to the emergency department for evaluation.

This, of course, led to reduced patient volumes in our clinic. And we considered closing one of our two clinics because of the reduced volumes.

However, we soon found access to testing through one of the large national laboratories. And we decided to take a completely different approach to the problem.

Shifting Gears

Once the testing became available, we decided to dedicate one clinic to evaluating patients with potential COVID-19 infections.

The other clinic could then focus solely on evaluating patients with no infectious symptoms. Such patients included those needing drug screens, work physicals, and injury and non-respiratory illness care. Those patients were very low risk for infecting staff. In the low-risk clinic, we also spend significant time contacting patients with lab results for the testing done at the “respiratory” clinic.

In that second clinic, we set up a tent in the parking lot, and perform brief histories and physicals and lab tests. Our staff work in full personal protective equipment, outside the clinic, with patients still in their cars.

Effects on the Home Helpers Franchise

The primary challenges facing Kay's in-home care business during the pandemic relate to the constant fear of a caregiver or a client becoming ill. In fact, the week before I recorded this episode, one of her clients became ill, was hospitalized, and found to be COVID-19 positive.

Since this client had been cared for by three or four of her caregivers, they needed to remain in quarantine at home for 14 days. This led to cascading issues with insufficient numbers of caregivers in an environment in which recruiting new caregivers is very difficult.

There is also the constant fear that a caregiver will be infected at home, and infect clients. This means that they must be especially diligent in wearing appropriate personal protective equipment (PPE).

Finding PPE in a Pandemic

And to compound matters for both businesses, the availability personal protective equipment is often not readily available. We have been able to make due in the urgent care clinics by aggressively locating and purchasing PPE. However, the situation for Kay's business ultimately required her caregivers to use home-made face masks. Luckily, Kay has sufficient supplies of gloves during this pandemic so far.

Finding Help

Kay has already applied for the Economic Injury Disaster Loan, which provides a $10,000 “advance” that will not have to be repaid.

My urgent care business has applied to the Paycheck Protection Program. It is helpful that we have a relationship with an SBA lender, because we previously accessed SBA loans to fund our start-up.

Summary

Ultimately, both businesses remain open and in fairly stable financial condition. Both will likely see a decline in revenues over the short term. But they will survive and, I believe, later will thrive.

This experience reinforces several lessons. First, small business owners are often called upon to make difficult decisions with little information. And they must respond quickly to external threats.

Second, keeping retained earnings as an emergency fund is a very wise practice.

Let me close by telling the apocryphal story that triggered me to post today's episode.

Some of Kay's caregivers work with clients in assisted living and nursing home facilities. The facilities where her caregivers were caring for clients invoked a policy that all caregivers wear protective face masks, even if neither party was ill, as a precaution during the pandemic. However, the facilities are unable to provide the personal protective equipment for them to wear while on duty.

So, Kay and I scrambled to make home-made face masks that the caregivers could wear when visiting their clients in those facilities. Kay also provides them to her other employees working in clients' homes.

Ironically, the home-made face masks came in handy, because our daughter, a social worker, who works at a large academic medical center, also needed to bring her own personal protective equipment to wear in non-patient contact areas.

What a world we live in!

Thanks for listening.

Links for Today's Episode

Download This Episode:

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The Nonclinical Career Academy Membership Program is Now Live!

I've created 14 courses and placed them all in an exclusive, low cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course that normally sells for $397.00. And I'll add more content devoted to one of these topics each and every month:

Nontraditional Careers: Locum tenens, Telemedicine, Cash-only Practice
Hospital and Health System Jobs
Pharma Careers
Home-based jobs
Preparing for an interview, and writing a resume
And more…

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

Many of the links that I refer you to, and that you’ll find in the show notes, are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you, that I have personally used or am very familiar with.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counsellor, or other professional before making any major decisions about your career.

The post How Can We Run a Healthcare Business in a Scary Pandemic? – 138 appeared first on NonClinical Physicians.

What Makes a Physician MedSpa Owner So Happy? – 131

John Jurica — Tue, 25 Feb 2020 02:44:50 +0000

Interview with Dr. Lisa Jenks

On this week’s episode of the PNC podcast, I’ve invited physician medspa owner Lisa Jenks back for a follow-up interview about medical aesthetics and her business, Genesis MedSpa.

Lisa is a former emergency room physician who went into medical aesthetics 13 years ago. She joined me on this podcast about a year ago. This week we catch up, learn more about her business, and about a new consulting business she started.

Our Sponsor

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

Graduates have taken leadership positions at major healthcare organizations. And they've become entrepreneurs and business owners.

Medical Aesthetics

There is a broad range of services that a physician medspa owner can provide. But generally, a MedSpa is any business that offers medical-grade aesthetic services. That includes procedures such as PDO threading, radiofrequency skin tightening and micro-needling.

Lisa explains that when she first began practicing medical aesthetics, she admittedly suspected that she was dealing in the business of vanity, serving people on a quest to look marginally more attractive. But she quickly realized that she had oversimplified the situation.

She has since found that the people who seek medical aesthetic services are doing so in an act of self-care, to feel better about themselves, to be more confident and improve their self-image.

A lot of what I see every single day is real people with real issues, just wanting to feel a little bit better about themselves.
Dr. Lisa Jenks

Two Paths to the MedSpa Business

The safest way for a physician medspa owner to experience the business is to dedicate a part of their time to aesthetic services while still in private practice, if possible. Dermatologists, plastic surgeons and OB-GYNs already treat patients who may be interested in those services. After a trial period, they can decide if they want to dedicate their practice completely to medical aesthetics.

The other path, the one that Lisa took, is to jump right in. As an ER doctor, the safe choice was not an option for her. She just concentrated on opening a MedSpa, giving her new entrepreneurial pursuit all of her time and energy.

Being a small-business owner is not for everyone. There are personal financial risks you must take, and not everyone enjoys being involved in financial and HR responsibilities. Ultimately, though, she loves the work, and she loves being her own boss.

DermAesthetic Consulting

Lisa is in the process of opening a new consulting service, DermAesthetic Consulting, to teach physicians the business skills they need, as well as procedural training with lasers, injectables, neurotoxins and fillers.

During our conversation, Lisa offers advice for physicians interested in opening a MedSpa that applies to any small business, including:

Surround yourself with good people and know when to consult with them.
Hire a business consultant who is an expert in the areas of your weaknesses.
Don’t micromanage! Delegate responsibility where you can.
Learn how to market yourself.

Conclusion

Opening a small business requires energy, creativity and teamwork. Lisa has heard many doctors complain that they feel trapped in their jobs. And she wants to encourage them to know that they have options if they are interested in making a career change. One of those options is to become a physician medspa owner.

Nonclinical Career Academy Membership Program in Now Live!

I've taken 12 courses and placed them all together in a low cost membership program. I'll be adding more content devoted to these topics each month:

Nontraditional Careers – Locum tenens, Telemedicine, Cash-Only Practice
Hospital and Health System Jobs
Pharma Careers
Home-based jobs
Preparing for an interview
And more…

Check it out at no obligation using this link:

Nonclinical Career Academy

Links for today's episode:

DermAestheticConsulting.com
Email Lisa at Lisa@Genesis-medspa.com

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It might be just what you need to prepare for that joyful, well-paying career. You can find out more at vitalpe.net/physicianmba.

I hope to see you next time on the PNC Podcast.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton.

Disclaimers:

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counsellor, or other professional before making any major decisions about your career.

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

Here are the easiest ways to listen:

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The post What Makes a Physician MedSpa Owner So Happy? – 131 appeared first on NonClinical Physicians.