I’ve invited a former guest from 2020 to show us how he created the private practice of the future while simultaneously growing a business start-up.

Dr. Phil Boucher has been in private practice since 2014. He is known for integrating cutting-edge technologies into his practice, and for helping other physicians communicate better with patients, improve productivity, and understand marketing. 

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Dr. Phil Boucher Creates the Private Practice of the Future

Dr. Phil Boucher is revolutionizing private medical practices with his innovative tools, OpenSpot and Practice Leads. OpenSpot fills last-minute appointment cancellations via automated text messaging, easing the administrative burden and maximizing capacity. Practice Leads offers a HIPAA-compliant CRM that centralizes patient communications, ensuring no potential patient is overlooked and automating follow-ups.

Dr. Boucher’s approach combines technology with personalized care, advocating for physicians to embrace private practice for greater autonomy and job satisfaction. By providing tools to streamline operations and nurture patient relationships, he helps physicians create thriving, independent practices that deliver exceptional care. His vision for the future of private practice blends efficiency with a personal touch, benefiting both physicians and patients.

Revolutionizing Appointment Management with OpenSpot

Dr. Phil Boucher highlights how OpenSpot addresses the common issue of last-minute cancellations in medical practices. By leveraging text messaging, OpenSpot fills scheduling gaps without burdening administrative staff with endless phone calls. The platform integrates seamlessly with existing systems like email, Slack, or Teams, ensuring real-time updates on filled slots. Available nationwide, OpenSpot can be set up within a week, offering a streamlined solution that enhances efficiency and patient satisfaction.

Empowering Physicians to Embrace Autonomy and Fun in Practice

I think physicians are often afraid because they feel like business is too hard… There's a way to figure out how to go into business for yourself and to practice medicine or to serve the people that you feel called to serve… It can be really fun and… profitable and you can really enjoy your life more.

Summary

To learn more, book a demo, or connect with Dr. Boucher, visit findopenspot.com and getpracticeleads.com. Additionally, Dr. Boucher is accessible via text for direct communication and support. His commitment to improving private practice is evident in his willingness to engage and assist fellow physicians in optimizing their practice management and patient care.

Links for Today's Episode:

• Frontier Pediatric Care
• Phil Boucher's LinkedIn Profile
• OpenSpot SMS Platform for Replacing Cancellations Quickly.
• Practice Leads – Manage Your Leads In One Place
• Who Can Help When Private Practice Matters? – 174
• How to Save Healthcare, Satisfy Patients, and Fix Physician Burnout – 256
• Text QUESTIONS for Phil Boucher to 402-741-4494.

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 360

Building the Private Practice of the Future with Technology

- Interview with Dr. Phil Boucher

John: Today's guest has always been an innovator when it comes to adopting new technologies to make his medical practice more efficient, more accessible, and more fun for everybody. And even back in 2020 when we first met, he was developing new ways to improve the patient experience and the physician's experience with practice. And so, with that, I want to welcome today's guest, Dr. Phil Boucher. Welcome.

Dr. Phil Boucher: Thank you so much. I can't believe it's been since December 2020. What a difference, it feels like a decade makes in the past four years. Oh my gosh.

John: Went through one pandemic, there could have been two in there, I suppose, but one was enough.

Dr. Phil Boucher: No one would have noticed if there were two probably at that point.

John: Well, no. I was doing purposely, I was looking back at old guests to see what they were up to today. And then I came across what you're doing. And it's almost overwhelming to me, just jumping back in years later and go, "Whoa, what's Phil up to?"

Dr. Phil Boucher: Right.

John: Give us a brief version of what's happened since we last spoke in 2020.

Dr. Phil Boucher: Background for me, if you've missed the episode back in 2020 is I'm a pediatrician in Lincoln, Nebraska. I graduated from residency like 10 years ago now, and was in private practice partner for about eight years, left that partnership two and a half years ago to start a pediatric direct primary care practice. Also in that time came up with this software concept that we'll talk about, I'm sure.

I built a software company and have been wearing those two hats to help physicians, help my patients. So it's kind of been a mix of things that I've been up to in the big picture of things. The two biggest things on my plate have been my DPC practice and my software company.

I also do a lot of marketing help for physicians, especially private practice physicians is kind of my people. And so helping private practice owners and physicians in private practice to better market themselves to their local patient populations. Those are kind of the big picture of things. We also built a new house. We have six kids now. I don't remember how many we had back in then. I won't try to remember.

John: Four, maybe.

Dr. Phil Boucher: But we probably had four of that and we have six now and we got two more dogs in the meantime too. So a lot has happened, I guess since we last spoke.

John: Yes, that is a lot. I got to pile on a little bit because I don't know if I've mentioned this in the podcast before listeners, but as of December of this past year, I didn't have any grandkids. I have five kids between my wife and I have a family and had no grandkids. And now we have three.

Dr. Phil Boucher: Your Christmas just got a lot more expensive there this year.

John: Yeah, exactly. I don't know, but six kids now that's good. I'm from a family of 10. I'm the oldest, but I can't even imagine in today's day and age to get six or more kids.

Dr. Phil Boucher: Oh gosh. I'm sure similar to back then, once you reach a certain threshold, another mouth to feed is, you just kind of divide the plates up a little bit differently and the cost and the time does diminish after you get to a certain number. I don't know what that number is.

John: Yeah. Well, congratulations. You've done a lot here and keep moving forward in all areas of your life, which is awesome. So let's get to the business of today. The really thing that kind of interested me is when I saw that you weredoing these sort of side gig businesses with software and that kind of thing. But I do want you to just briefly tell us about the DPC because that's also a very interesting topic.

Dr. Phil Boucher: I got pulled towards DPC kind of in 2021, listening to podcasts about DPC, to be honest with you. And hearing about the way that they were able to help families and help their parent practice to really thrive. It made me really excited for, well, I see so many different ways that patients and as a pediatrician, it's mostly the parents that we're talking about here, that they're struggling regardless of the pandemic, just the way that they connect with the way that they feel herded in and out of the office, the wait times, all of those things really weighed on my heart, seeing the ways that we weren't able to care for the patients the way that I wanted to, which led me to DPC and then realizing that there's so many ways to reduce the hassle for families and for me as the clinician to really drew me to direct primary care.

We have in our state, Nebraska, several family practice, direct primary care practices that have been thriving, but ours was the first and remains the first and only pediatric direct primary care. Luckily, around the country, though, there are a number of thriving pediatric direct primary care practices and really a network of pediatricians supporting each other in direct primary care.

There's a couple specific in the DPC realm things about pediatrics, and one of the biggest is the vaccines. And so, that was one of the hard hurdles to climb. And I've been working to help other pediatricians climb that hurdle now that I'm on the other side of that and have a good setup for vaccines. But as you know, vaccines are extremely expensive and often become a huge source of cash flow issue for practices in general. And when you're talking about pediatric DPC, where the volume is smaller, all of those things that really magnifies the cash flow issues that go along with vaccines. That was a big hurdle to climb over.

And then the other thing for pediatrics is almost all parents have insurance. They either have commercial or private insurance or Medicaid. And so, most kids are insured. So there's a little bit of a different angle when it comes to the value offer that we put to prospective patients that are considering joining our practice that isn't as required as strongly, I feel like, in the family practice realm.

It's not zero, but there is a different value offer when it comes to positioning yourself to grow your pediatric direct primary care practice from a marketing standpoint and from a way that we sell. We do the sales for patients joining our practice. So those have been kind of two of the really interesting challenges when it comes to pediatric DPC. And then just being a business owner and owning a practice, all of those sorts of things that kind of go along with starting a practice from scratch.

John: Nice. Well, that could be a whole separate episode. I think I'm going to do a series maybe two or three of you who are doing this family medicine internist, others, and maybe we can have you back on the podcast, go into that. But the bottom line is though you're charging or you have a monthly fee that people pay and they have almost unlimited access to you one way or the other.

Dr. Phil Boucher: Yes. That's how we frame it is instead of all of the copays and deductibles and you know, calling and pressing three and waiting 17 minutes to talk to a nurse, to get told to schedule an appointment. People just text us for the most part. And millennials and Gen Z who are most of our parents that are joining love texting, hate being on the phone, hate taking that time out of their day. They love the convenience factor of it. And honestly, we do too, because it's so much easier than getting voicemails and playing phone tag and all those things to just communicate in the means that works best for us and for parents. The monthly membership fee, they can pay with their HSA. It covers everything. So there's no outside expenses. If you want your kids ears pierced, that's separate, but otherwise we really don't have any other line items that people pay for.

The thing that I think I've loved probably as much as the way that I'm able to have those relationships with families with longer visits and getting to know them more and just coming to know that my patients are going to see me or one of our team members when they come into the office is that we're able to try new things at a much faster clip because we don't have 17 layers of meetings and committees and proven concepts. If we want to try something new, we can with relative ease. We fail at a fair number of the things that we try. They just don't work. But then we have successes that we're able to really jump on quickly.

One thing that we did shortly after starting our DPC practice, we were in the midst of the pandemic. We had a ton of N95 masks. We set it up so that teachers could get those. A couple of months later, we had the formula shortage. Instead of having 17 rounds of committees, we just said, well, what if we have a formula bank and we can just get people that have formula on their shelves at home. Their baby has outgrown the formula. They haven't used it yet. Bring it to the office. We can distribute it to other families that are in need.

Same thing with COVID vaccines. We're able to just really jump quickly on the things in the community that are important and respond to those by figuring things out and just having a really, we can figure this out attitude as a team. It's made a huge difference for me, just enjoying being able to practice medicine, but also to respond to parents' needs and community needs in a much more quick way where things don't have to go to vote after vote after vote and nitpicking all the details. We say we want to do this, and then we do it.

A couple of weeks ago, or no, maybe a month or two ago, we thought, okay, there's a lot of teenagers that need to learn CPR for babysitting because they have younger siblings and all those sorts of things. So we're like, well, let's just do CPR and first aid for teens.

A month after deciding this is something that we should do, we just had one yesterday where we had like 10 teenagers that came in and did CPR training and learned first aid. Just the ability to do things like that when we think of them and when we hear from our parents that this is what they need, and to be able to jump on that has been so rewarding for me.

John: That's impressive. It sounds really to be involved in that. It's fun. It's rewarding. On the parent side, it's probably fantastic as well, just to be able to access that. You mentioned texting and people's use of texting. I think that brings us to the one topic I definitely wanted to talk to you about, which was you developed and are selling a product, I think now, and it's kind of a side gig. Just tell us all about it. It's called OpenSpot, I believe.

Dr. Phil Boucher: OpenSpot. This was not on my bingo card, but a couple months after opening my DPC, an eye surgeon who works in the parking lot across the street from my practice had sent me a message on Instagram actually saying, "Hey, here's the problem I'm facing. I know that you are kind of a techie guy. Do you have any ideas?" His problem was he's booked out several months for new patients, but has a lot of last minute cancellations. Timmy's sick. We don't have transportation. We got a better offer. We're not coming in for our appointment tomorrow. He would be twiddling his thumbs not having patients to see despite being booked out three months because his staff couldn't get a hold of patients. They didn't have the bandwidth to just call and leave all these voicemails and play phone tag to try and fill tomorrow at 11:30, an opening that just popped up. He was asking, Do you have any sort of solutions?

I couldn't really find anything that did that, but had enough experience and willingness to try that I was like, I think we can create something. And so we put a MVP, a minimum viable product together where essentially they could keep a waitlist. And then when an opening arose, they could start texting their waitlist. These people are booked out two months. Hey, tomorrow we have an opening at 11:30. Does that work for you? Reply yes, if so, and it's yours or reply pass, and we'll move on to the next person.

And so, that was the concept. And it kind of took off because you could do the math of how much money that and revenue that can generate if you're filling those gaps in the appointment slots. And so what we did was we had that minimum viable product, and we tried it in some local practices. And in the process, I learned a lot about software as a service, which I was completely unfamiliar with before that, but was able to figure out, okay, here's how it works. Here's what we can offer. Here's the limitations that we have not being integrated with an EMR, which I was like, well, no one's going to want to use this. People don't really mind having two windows open. They probably use multiple software products throughout the course of their day anyways.

And so it's okay if it's not integrated, if it gets those appointment spots filled and practice managers actually like filling appointment spots, even if it creates a little bit of a headache for their staff and not having to call people on the phone really reduces that headache that could exist of, you need to get this spot filled. Well, what if we could just text people?

And so I got a little bit of some energy from the initial traction of OpenSpot and went to a couple of local venture capitalist firms and said, hey, this is what we're doing. And they were interested and invested. I went and did it's called Founder University. It was by Jason Calacanis, who's an investor, Silicon Valley guy, early stage in Uber and lots of money and interest in supporting others. And got in a cohort of his and did a pitch contest at the end, won that. So won $25,000 from him for that. And then locally, we had a startup week, Omaha startup week, did my pitch competition at that and actually won that and got another $25,000 from that.

There's a lot of money out there for people that have an idea and can spark interest and tell a good story that there's a lot of people that want to invest in those sorts of things. And then the biggest one was our Nebraska State Department of Economic Development wants to support and grow local businesses. So we got a grant for $100,000 from them to further our product development. And essentially they were paying to have it developed locally. And what that did is it allowed us to start developing the product, taking it from what I made, which was the minimum viable product, which was really the minimum viable product into something that was actually like fancy and pretty and used real code and all those sorts of things.

And so that's kind of been the journey of OpenSpot. The biggest thing that we added now, one of the functionalities, aside from like building the whole product from scratch, was if somebody if you text and say, Hey, John, does tomorrow at 11z;30 work to see Dr. Smith? No. Perfect. We'll keep you on the list. And then it just automatically goes to the next person. Hey, Mary, does tomorrow at 11:30 work? Yes. Perfect. It's your spot or no. Perfect. We'll go to the next person on the list. So really automating that for practices so that once they start and they say, Dr. Smith has an opening tomorrow at 11:30, it will just keep asking people until it finds somebody that will take the spot.

And so functionality like that has really made it easier for practices to get on board with. This is kind of like a set it and forget it. And it's going to keep asking and putting people asking for the next person in line over and over again until it finds somebody for that spot so the staff are really hands off.

John: So how does it get the list of people that are on the list? Does it integrate with the EMR now or with some scheduling?

Dr. Phil Boucher: It either integrates with the EMR or the schedulers just add them to the list for people that want to be on the list. Most practices nowadays will have a very rudimentary wait list functionality. It's often like a three ring binder or a notebook in a drawer. And so we elevate that by just having them have a place where they can put in the relevant information. This patient needs in with Dr. Smith. This patient doesn't care. They'll see whoever's available. This is how much time they need for their appointment, whatever the relevant details are that the schedulers used to make those appointments. We get them to capture that information. They sit on the list and then they can start just pinging and going down the list when they tell us that there's an opening available.

John: Very nice. It reminds me this whole idea of queuing theory people lining up. Family medicine for a while was really pushing for basically an open schedule with no appointments. In other words, you have to call within a day or two of your appointment because the longer your list is, the more you'll have no shows. It's just a correlation. So it sounds like you've solved the problem, get the best of both worlds, have a decent list of people out there. So you're sure you're going to use your resources and then show up. So was this you had to like start a separate business, an LLC or something and you just hire a bunch of software programmers or what?

Dr. Phil Boucher: I really started leaning with this, which was developing it myself and sitting at the computer until I figured out and practiced and made it work. That's part of the nice thing about being in DPC is I see fewer patients per day, which means I have more time for all of these other side things for good and for bad. We had to start a separate LLC, then we had to convert it to a Delaware C-Corp because what I learned is that VC firms want you to have a Delaware C-Corp something. I don't know the specifics, but that's a thing. Like if you think you're ever going to take investors money, then start with a Delaware C-Corp and you'll save yourself a fair amount of lawyer fees and hassles in that regard.

But yeah, those were the biggest things and just all the business stuff behind that, which is pretty typical and people set up businesses all the time. So, there's not anything that a doctor can't learn to do or hire somebody to help them do. But from there, then just figuring out how to market it and get in front of the right people. That's been a lot of trial and error is like who the decision makers are, who are the ones that are actually going to implement this, who's going to maintain it.

And it has mostly come down to the people that we need to talk to, maybe to get initial interests or physicians that say, yeah, this is a problem. I do have a lot of gaps in my schedule that I would like to fill because I don't really want to work more days and I don't really want to just pile more patients in. What if I could just be more efficient in the time that I have, which is filling those gaps in the schedule that creep up.

Because honestly, I think people are less enthusiastic about going to the doctor than in years past. Like you do see a lot more no-shows or last minute cancellations because I think the weight of going to the doctor has less meaning than it used to. And so people are more likely to skip or bail or take a better offer or cancel at the last minute.

And so, if we can get those people to make sure that they tell us within 24 hours, at least 24 hours notice, then we can usually fill those gap spots without having to spend hours on the phone and playing phone tag and all those sorts of things.

John: Well, one of the things that's probably threatening the most physicians is marketing, advertising, promoting, that sort of thing. So just to learn about that, why don't you just market your product to us right now? Tell us, I have physicians that are practicing here. So what are you doing to market it? But just tell us about the website and what we'll see if we go to the website and what we can expect from the product and that kind of thing.

Dr. Phil Boucher: Yeah, essentially for most physicians, it's something that you're going to tell your office administrator, "Hey, we're really busy. We have a waiting list out the door, but we have a lot of unfilled appointment spots at the end of the day because of last minute cancellations." And what OpenSpot does is it allows you to fill those holes in the schedule without having your staff overburdened with trying to make phone calls and play phone tag. And it meets patients where they are, which is text messaging. And it just makes it easy for them.

Most physicians task their administrator of looking into it and taking those next steps when it comes to, is it the right fit for us and does it work with our practice workflow? And then the schedulers are the ones that are using it on the day-to-day basis. And so we try and make it make sense for schedulers to see the value of filling those spots, which makes everybody happy. And also not adding to their burden of making phone calls or who's talking to this one, or did somebody already offer this appointment? It just streamlines that entire process so that you know that there's something and it's not a person that could be doing other important work that's working to fill those spots.

John: Is this available nationally? Right now I can call you or go to your website?

Dr. Phil Boucher: Absolutely. Yes, findopenspot.com.

John: findopenspot.com. That's the website. Okay. And how long does it take to implement?

Dr. Phil Boucher: Less than a week. We do all the training and everything along those lines. Once people get set up, we find out what types of appointments they need and what types they have. Because one of the things that I've learned, being a pediatrician, I don't know how everybody else's scheduling flows work. Learning that dermatologists need more time for fillers than Botox seems like something that's intuitive to dermatologists, but it wasn't intuitive to me. And so, learning about the practice and the way that appointments are scheduled, which is just a quick Zoom with your scheduling team to figure out what that looks like, what the relevant information is, because it's all very specific for practices.

Some practices have really wide open schedules, some have very regimented schedules. And so, we're able to work with all of those, but it just takes a quick understanding from your schedulers, how they schedule, what they need to know to make a good appointment, what they don't care about when it comes to scheduling appointments, and then fine-tuning the system so that it gets the relevant information and can make good matches.

John: And let's see, it seems like in the old days, some software would sit on someone's server at their office, but I assume this is actually an app that gets integrated.

Dr. Phil Boucher: Yes. It's all browser-based. Chrome browser, Safari browser, whatever browser you're using, it's just a different tab that you would have open that you would switch back and forth to. We've also set it up because it's working in the background. You don't want to have to kind of like tend to it. And so whatever system your practice uses, whether it be email or Slack or Teams, it integrates with those too. So it can say, hey, we filled the spot at 11:30 tomorrow and let this practice know so that they know that that booking has been made when it gets made.

John: And are you doing something actively to promote this besides, I don't know, just talking about it? How do you actually get the word out short of going person to person and calling them and say, hey, do you want this?

Dr. Phil Boucher: That's been the biggest challenge is figuring out the best way to get in front of the decision makers. Some of it's on LinkedIn, some of it's on podcasts and video. Some of it is trade shows. We've done some trade shows where you're talking at the Medical Group Management Association and those sorts of things. Those are all different routes of getting it out there, but it's kind of the approach which I've learned as a pediatrician and marketing my practice. You have to connect. You have to have a lot of touch points before people make that next step. It's not something where they just see it and they go and they sign up.

I'm kind of that way. I'm like an early adopter. I got the first Apple Watch and I'm still going strong with Apple Watches when I first heard about them. I don't have the Apple Vision Pro thing yet, but I think most people need a lot of touch points before they realize, hey, this is something that I need to look into.

I know that like the people that are listening to this, it's probably unlikely that they're going to go and just put in their credit card information and sign up. But if they hear from me and they see me on a bunch of different channels on a regular basis, then that probably is going to nudge them and eventually they're going to be like, hey, let me forward this to my office administrator. We should look into this because I frequently have all of these gaps in my schedule and I know the schedulers are too busy to be calling patients. And that's what it's going to take to actually get that first phone call and that discussion rolling.

I think that's something that I intuitively knew and was reminded of over and over again, is that it takes a lot of touch points for people to do something about it. And also when there's a little bit of change involved, that it's going to take a lot of time from a change management perspective.

John: And if they go to findopenspot.com, is there a contact form or do they sign up to do a call with you or how does that work?

Dr. Phil Boucher: Usually people just book a demo. We chat through and figure out if it's a good fit even, and then from there decide how to integrate it into their workflows if that's something that they're looking for. But the easiest way is just to book a demo that's free and you just book it straight from there and it's a Zoom call where we can talk through what they're looking for.

John: And you told me as we were organizing this meeting that, oh, you thought you'd create some other software, another tool. So why don't you quickly give us a rundown on where you are with that, what it does. Are you in the same business or is this now another business?

Dr. Phil Boucher: I'd say this is just a spinoff of OpenSpot, in terms of lie the hierarchy of businesses. OpenSpot is great for busy practices that are full and they've got a wait list of at least four weeks and they're really trying to fill those gaps. They're trying to increase efficiency.

As a DPC pediatrician, I get to talk with a lot of DPC doctors, both in family medicine and internal medicine and in pediatrics and specialty care. And one of the things that they need, they don't have full practices and long wait lists. I don't have a wait list. We don't use OpenSpot in my practice. If you need an appointment today, John, you would just text and say, hey, my son fell and I think he needs stitches. And we would just text back and say, come on over. There's not a wait in that capacity for DPC.

But what they need to do is they need to really have a lot of touch points with prospective patients to get them to say, okay, this is the practice for me, or I understand how this works and how it'd be beneficial. And so, what we created then for that side of practices, small practices, growing practices, startup practices, is essentially a HIPAA compliant CRM. CRM is Client Relationship Manager in business speak. But essentially it's a way to manage the relationship and manage the outreach and touch points with potential customers, potential patients in a way that helps them stay organized, know who's reached out, know where people are at in the pipeline of their customer journey of initial reach out, learning more, book a meet and greet, join the practice, loss to follow up, those sorts of things.

And so, what practice leads does is it allows for small practices to manage those leads as they come in and nurture them along to the point where then they're taking that next step. Because what I found was a lot of practices are really good at the first touch points or meeting patients at the baby expo or the health convention or whatever it might be, but then they were losing them to follow up because they just weren't making enough touch points with them to stay top of mind.

Because most people today aren't looking for a new doctor and you really have to convince them that there's something better for them. But over time, you can do that if you have enough touch points, enough nurture points, if you're able to talk to them on a regular enough basis to say, hey, maybe there is a better way, or maybe we offer something that your regular practice doesn't, or maybe we have a special evaluation that we do that we need to explain in a little bit more depth to you how we do it and what we do.

And so, what Practice Leads does is it allows you to track those leads as they come in, nurture them along, have one place, one inbox that has text message, email, contact us forms, Instagram, Facebook, all of that in one continuous stream of information so that you're not looking in seven different places to remember where somebody contacted you and how they reached you and what their deal is. That's what Practice Leads is. It's a HIPAA compliant CRM for small and growing practices.

John: Very nice. So that is up and running now and accessible to the practicing physicians?

Dr. Phil Boucher: Yes. And the thing that I love about it, one, is that it's HIPAA compliant, and two, is that it lets you do it all in one place, and three, is it's completely customizable. And so, the way that we use that in my practice is we've been doing a lot of ADHD evaluations. Before somebody books an ADHD evaluation with me, they probably want to know that I know what I'm talking about and that I'm not just going to push medicines on them because most people these days want to try things other than medicines.

The way that we work that is they start with a webinar that's free and on demand, and it's about how food impacts our child's behavior and attention and focus. And then from there, they get a series of emails and text messages that share more about our process and what we do and how we do it and what an evaluation looks like and what it doesn't look like and who it's good for and who doesn't really need it. And here's some other strategies that you can implement before you get to an evaluation.

And over time, we build trust, we build rapport, we build that trust factor that really is important before somebody decides, I'm going to book an evaluation. And so, what Practice Leads does is allows us to monitor those parents, as they're going through the process of watching the webinar, opening emails, reading blog posts, reading news articles that we send them. It allows you to automate that process so you know where they're at in that funnel that you've created to get them to eventually, over enough touch points, decide they're the right practice for me. I want to get an ADHD evaluation. This is timely because school is starting sooner. We're really struggling with this and that or the other thing. You build that relationship and you're the one that they turn to then when they actually need something.

John: Excellent. Well, what's the website for that?

Dr. Phil Boucher: GetPracticeLeads.com.

John: GetPracticeLeads.com. Okay, obviously, I'll put that in the show notes along with the OpenSpot link as well. And actually, the link to your practice because I think people will find it interesting just to see what you look like online when people are thinking about joining your practice.

Well, this is very interesting. I'm definitely going to follow up with you down the road here and see how things are going. Any last advice? I guess I'm going to stop there. Any last advice though about, I don't know, it seems like things are exciting with what you're doing. Just practicing in the US, is it possible to make it fun and profitable at the same time for physicians?

Dr. Phil Boucher: I think it is, but I don't think that you're going to find as much fun stuck in an organization or a large institution. And I think more physicians are getting really hip to that. This that we've been sold, the large employer, they often trade autonomy and care for more RVUs. And what that means for physicians often is that they feel like they're not anywhere near the top of the food chain. And they're often feel very replaceable and just like a cog in the wheel. And I think that you can have a lot more fun and enjoy medicine and practice medicine the way that you want when you have more control over the way that you practice it. And I think physicians are often afraid because they feel like business is too hard.

Because I graduated from medical school 15 years ago, 16 years ago, something like that. We got no business training at all. And it feels like maybe it was intentional because they want to grow academics and they want to grow large institutional employees. And so, why would we tell you about business? Business is hard. How are you going to figure out your books? How are you going to do bookkeeping and taxes? Those things sound hard. Let's just keep you at the academic center or at the large organization and you'll be miserable. But at least you won't have to do those things.

But then I talked to physicians and there's a million new small businesses that open in the US every single year. Most of the small business people that are opening these businesses don't have the training, don't have the cash flow, don't have the connections that every physician in the country has.

And so, I always encourage people there's a way to figure out how to go into business for yourself and to practice medicine or to serve the people that you feel called to serve, which for me, I love taking care of parents and families locally. I love helping other physicians to grow their practices. I love helping thriving practices to thrive even more or to get physicians their time back so that they can do with it what they like, whether it's being more efficient in their day to day, whether it's growing their practice with marketing, whatever it might be to give them more autonomy and more freedom to do what's really important to them and to focus on those sorts of things.

There's a way to figure all those things out. But it does take a little bit of risk, but you've done risky things before. It does take a little bit of learning, but you've learned for decades now. You can do all these things if you just feel like, okay, maybe there's another way to do it because there's a lot of people out there that are really unhappy in their practices. I can't spend that much time on the physician Facebook groups anymore because there's so much negativity and it's not their fault. It's the system that they're a part of and that they're forced to work within that's really causing a lot of that burnout and a lot of that cynicism that you see in a lot of the Facebook groups.

But there's another way and it can be really fun and it can be really profitable and you can really enjoy your life more. I wake up and I am ready to go and I have these long lists of things to do. I wish I could do all the things that are on my list every day, but I have a really good team that helps me to hone down what I actually need to do and then they do the other things that help me to thrive. It's just such a fun way to practice and it's such a fun career of helping everybody that I can help.

John: Fantastic. Very inspirational. You rock, man. I love what you're saying. I agree with it. If I was 20 years younger, I might jump in myself, but I can at least get the word out and you've been very helpful in getting that word out today, Phil. Please do.

Dr. Phil Boucher: Please do. I know I give you my cell phone number. You can put that in the show notes and just tell anybody that wants to. I'm decent in email. I'm getting better at email, but the best way to reach me is to text because it's hard for me to ignore when my little green box on the thing says one or 12 or whatever. Text me. Anyone out there, any physician out there can absolutely text me to chat and figure out how to help them.

It's not to get you to join OpenSpot or Practice Leads or anything like that. It's just I love helping and I love brainstorming for physicians. I think that there are very few specialties where you can't do something outside the box of what you're doing right now. I don't know how heart surgeons can work outside of a large center, but everyone else that doesn't require a cardiopulmonary bypass can figure out something outside of the hospital if they're sick of being an employed physician and want to do something else.

John: I'll definitely put that in the show notes. You listeners look in there and they have the number. You can text Phil or reach out and check this out however way you want to. I will do that. All right, Phil. With that, I am going to say goodbye and let you go. I hope to talk to you again in the near future.

Dr. Phil Boucher: Yeah, let's not have four years pass between our next chat.

John: Okay, bye now.

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The post Building the Private Practice of the Future with Technology appeared first on NonClinical Physicians.

In today's interview, Dr. Kirsten Limmer describes how she built an indispensable smartphone app.

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

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

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

Physician, Entrepreneur, and Real Estate Investor

Dr. Kirsten Limmer completed her medical degree and Ph.D. in Molecular Biology at UCSD. Then she pursued her pediatric residency at Harvard Medical School / Massachusetts General Hospital. She joined a pediatric practice and worked full-time until the COVID pandemic hit in early 2020. During the pandemic, she reduced her work duties to manage and assist in schooling her children at home.

However, Kirsten is also a real estate investor and entrepreneur. She has been buying investment real estate in her spare time. And she plans to claim Real Estate Professional Status (REPS) for tax purposes this year (2021). Documentation of time logs is super-important for claiming tax deductions and preparing for an IRS audit. Kirsten looked but could not find any online tool to help keep track of the hours she devoted to her real estate investing and management. 

Solving Her Own Problem and Developing a Smartphone App

She was already aware of the costs of hiring a programmer to build an app because she had tried doing so once before. She spent a lot of money before realizing it was not worth the expense for what she was trying to develop at the time. So, she decided there must be a better way to develop an app that did not involve spending lots of money, or learning how to code.

She discovered that there are now companies that provide tools and coaching that enable clients to create an app without coding or paying high programming fees. So Kirsten enrolled in an intense software development coding course and built an app herself from the ground up. If you want to develop your own custom app without coding or outsourcing, you might use the service she used: Coaching No Code Apps.

Physicians do hard things… If you have an idea that you think is going to be successful, the worst thing you can do is just sit on it and let somebody else do it.

During our conversation, Kirsten gets very detailed about how she built her app. She describes each of the major steps and the time and expenses that might be involved. If you've been thinking about developing a similar tool, today's interview may inspire you to make it happen.

Summary

Kirsten believes that any physician can learn to create an app like hers. With tools like the one she used, anyone can learn to put one together and get support and coaching, if needed.

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

Links for Today's Episode:

• RESPtracker
• Coaching No Code Apps
• How to Get Started on Your Nonclinical Online Business
• Dr. Kirsten Limmer's LinkedIn Page
• How to Select the Best Online Business Niche – 110
• How to Validate Your Business Idea

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription - PNC Episode 199

How Did This Clever Physician Build an Indispensable SmartPhone App? - Interview with Dr. Kirsten Limmer

John: I enjoy bringing guests on the show who are doing something different from the usual nonclinical side hustles. And today's guest is a physician who found a way to launch a useful smartphone app. And guys, people have talked about apps for forever, and I've yet to find someone who really has got an app out there that's being used and serves a purpose. So, with that, I want to welcome Dr. Kirsten Limmer to the podcast. Hello.

Dr. Kirsten Limmer: Hi, John. Thanks. It's great to be here.

John: Yes. This is going to be fun because, I think people are going to think, "Oh, finally, someone found a way to make an app and make it really simple". Probably is not going to be as simple as one might think, but it's definitely doable. Right? That's what we're going to find out.

Dr. Kirsten Limmer: Absolutely. Absolutely. Especially for your audience. I think you've got a lot of overachievers in your audience building an app is doable.

John: Okay. Now the thing is, most of my guests do multiple things and you do, for example, you're a real estate investor because your app has to do with real estate, but we're not going to talk a whole lot about the real estate side. You also are a semi-professional dancer. We're not going to talk about that today too much. And we're going to try and focus on the app. But why don't you give us a little bit about your clinical background and then how you kind of got interested in all the different things you're doing and then we'll go from there.

Dr. Kirsten Limmer: Yeah, absolutely. So, I have an MD and a PhD in molecular biology. I'm a board certified pediatrician, now working as a newborn pediatrician in California in San Diego. And I graduated from University of California, San Diego, and did my residency at Mass General.

John: Nice. So, now you're practicing, but then you have all these side things going on. So, tell us, we're going to get this dancing thing out of the way first, to figure out about that. How did that get squeezed into everything?

Dr. Kirsten Limmer: Oh, that's a really good question. So, I've been a dancer my whole life, and I have been lucky enough to join a dance crew, a professional dance crew, where we are still going strong, putting on performances, granted we've had some time off during the pandemic, but do a lot of performances on stage. The same stage is like the Rolling Stones have been on before. So it's really fun. I love it. It's one of my most enjoyable side hustles for sure.

John: It's nice to have a vocation or an avocation, whatever you want to call it, that actually keeps you in shape too. So, that's got to be a plus.

Dr. Kirsten Limmer: Absolutely. Absolutely.

John: All right. Now the thing that we're leading up to is, at some point you got involved in real estate because that's why you eventually developed an app. So, tell us about the real estate adventures that you've been involved in.

Dr. Kirsten Limmer: Yeah. So, I've been a real estate investor now for several years. But with the pandemic, I should also say I have three young kids, and like many parents across the world my kids have to be pulled out of school, the schools shut down and they were virtually homeschooled for many, many months. And because of that, I had to really scale down my clinical time. And it's continued to be scaled down because my kids are not fully back in school yet.

So, I was already doing real estate investing on the side, but when I scaled down my clinical time, I really started to scale up my real estate investing because I found that that was something that I could do from home. And essentially, what really became almost by accident was that I had the formula in place in order to call myself a real estate professional in the eyes of the IRS.

And what that is, I'll give you a very high-level overview of this because this is not what the podcast is about. But essentially, it's a tax designation in which you were telling the IRS that you spend more time doing real estate activities on your own, real estate endeavors, than you do in any other career. So, for me right now, that would be medicine.

What that does is, to back up, normally, as a real estate investor, any sort of losses that you have from your real estate investing activities, or any deductions or depreciation can only be deducted against other real estate activities or other passive investments. And so, for example, you cannot rehab an entire house and then declare those losses against your W2 income in a normal sense. But by calling yourself a real estate professional in the eyes of the IRS, that essentially takes your real estate activities from the passive bucket and makes them into the active or the non-passive bucket.

But in order to do this, there are several things that you need to satisfy in the eyes of the IRS. And of course, it's such a powerful tax deduction strategy that there really becomes a lot of responsibility in declaring this on your tax return. So, there are a number of things that you have to satisfy and the main thing is the hour requirements. So, the IRS requires that.

Real estate professionals spend at least 750 hours. It's not just a roundabout thing. It's a very, very precise thing. 750 hours of participation on real estate activities that have to do with their own real estate. And if you are audited later on by the IRS and you've declared yourself a real estate professional, you need to show them exactly where you spent those hours. And in the eyes of the IRS, as some people know who have unfortunately been audited or had any sort of dealings with them, you are guilty until proven innocent.

John: So, it's on you to prove it. I want to stop there for a minute and kind of do some math in my head. So luckily, thank God, it's not a percentage of your work time because the average physician works like 3,000 hours. A full-time job is 2,000 hours, 2,080. I just happen to know that, that's how it was at the hospital I worked at. So, definitely it's less than half of that, 750, right? Now I'm sure there are physicians that work 3,000 to 4,000 hours. I mean, they do the equivalent. So anyway, if you can carve out the 750 and keep track of it, you get the benefit of the tax deductions and allowances and other things that otherwise you wouldn't get.

Okay. So, I have another question. I think we understand that because we all talk about all the great tax advantages of home ownership and of investing in real estate. But some of those are limited to certain people as you're describing. Now, I hear that there are different ways to invest in real estate. I mean, you can get involved in syndicates, you can go in with a fund. That's real passive as opposed to doing active real estate investing. So I think if I understand it correctly, you're talking about the active form of real estate investing, which really needs that to get all those tax advantages.

Dr. Kirsten Limmer: Yeah. That's absolutely correct. And I should say that there are tax advantages without declaring real estate professional status of course. But the real powerful tax advantages can come because of real estate professional status. And I should also clarify that if you are a full-time physician, so let's say you work 2,000 hours, you will need to work more than 2,000 hours as a real estate professional. So, you have to show not only those 750 hours, but you have to show that you're working more than your clinical hours on real estate.

John: So, it's the two. It's both of those. You have to be doing more than half of your professional activities in real estate.

Dr. Kirsten Limmer: That's correct. Yeah. So that's why the part-time clinical status, at least in my story, has really been helpful in this because that portion of it has not been so hard to satisfy for me. But for full-time physicians, as you can imagine, it can be quite challenging to satisfy.

John: Okay, good. That's what I need to clarify for myself to really understand that piece of it. And of course, when in doubt check with an accountant or an attorney or a tax attorney, if you really want to get picky.

Dr. Kirsten Limmer: Yes, yes, absolutely. Yes, please, if you're going down this road, you should have a great real estate CPA on your side and really be having somebody that you can have conversations with every day if you want. Sometimes I email my CPA every day. I'm sure she gets really annoyed. But yes, if you're so down this road that you're calling yourself a real estate professional, please have a good real estate CPA on your side.

John: Okay. So now we still haven't gotten to the point, how did this lead into you developing an app? So, what happened there?

Dr. Kirsten Limmer: Yeah, good question. So, basically, like any good physician I knew that I needed to have a system in place before I embarked on this very big endeavor. And kind of like before you do a procedure, you lay out everything, you have a timeout. And so, before I embarked on this, I looked around and I said, "Okay, I'm going to start with a great system. And then just go forward from there".

And I looked around and I was like, oh my goodness, the people were using Google calendar, Excel spreadsheets. Some people were using just paper journals. And I asked so many people, so many CPAs, so many investors, there's got to be something better out there for this.

I mean, this is such a powerful tax deduction strategy but also you have to be really meticulous. And also, kind of, I don't want to say dangerous, but you have to be really careful about it. So, there's got to be something else out there and there's got to be an app at least.

So, I looked around forever, could not find anything. And I do have an entrepreneurial spirit. So, when I have that kind of situation that comes up and I see that the market has a hole in it, I think, "Well, maybe I'm the one to fill this hole. Maybe this is the ding-dong moment".

John: So, what you really needed or what you thought other people might need is a way to track the actual time you're devoting to real estate, at least for those people where it's on the border. I mean, if you're full time, it's not a big deal, right?

Dr. Kirsten Limmer: Right.

John: But if you're trying to add this as one of your part-time side hustles or whatever, whatever you're doing, you just want to be able to track it all. And it might come down to being important to just track those extra hour or two per month that is going to put you over that number. And that does not exist.

Dr. Kirsten Limmer: Right. That does not exist. And it's funny if you look up some of the old cases and the tax court about people being audited for this, just that tends to be the thing that really gets people, is showing those hours that they committed. And there's lots of kind of funny tax cases that we can talk about another day about this, but people are trying to go back and fudge things, but I did not want to be that person.

John: Okay. So, there you go. You've got your need and you thought, "Well, I'll just hire someone to do an app". What were the steps that you took and what did you find out as you went down that rabbit hole?

Dr. Kirsten Limmer: Yeah. Yeah. Really good question. So, I have actually had an app idea previously. So, my prior experience with developing an app was going down the very traditional route of trying to find a software developer, an app developer, and pitching my idea and having them kind of echo back the idea in a way that I was like, "Nope, that's not it at all". And also, with the price tag that was really astronomical.

And so, I knew that I'm going down the traditional app development route that had some drawbacks, and it wasn't exactly what I wanted to do for this app. I guess what I really did was I had a little bit of mindset work and I told myself "If these app developers can do it, why can't I do it? I'm a doctor, I've done hard things before. I should be able to develop an app myself".

So, I started watching YouTube videos and started to think about teaching myself code. And it was not as linear as I was kind of picturing it to be. So, eventually I had watched enough YouTube videos where I started coming across kind of the same names and the same schools. And I found basically a no code app development school that's on a platform called Bubble. And it was really kind of the wave of the future, I think. It's visual coding. So, it's coding logic, but not coding language. So, an app developer does not have to learn JavaScript or anything like that, but they do have to be able to use those building blocks in order to code the app or to build the app themselves. So, I saw that there was a school that you could essentially enroll in to help you build this app. And so, I actually enrolled in this school.

John: Okay. Now let's see when you say school, I mean, that could be anything from a year to four year university or some online carpetbagger that has 30 minute videos. So, you have to vet that, or how did it really look once you got into it?

Dr. Kirsten Limmer: Yeah, yeah, yeah. So, this school in particular, the one that I did was called The Coaching no-code apps built to scale programs, in case any of your listeners are wanting to find that. And essentially the school is for 12 weeks, it's as intensive as you want it to be. It has a curriculum in which I really started with a blank screen and like a blinking mouse. Like you start from nothing. From just a blank screen and building up from there, teaching you the skills as you build your app.

So, the thought, and the reason why this appealed to me too, was that not only was I going to build an app, but I was going to have the skills that I would need to troubleshoot it later on if something came up, if I wanted to iterate, if I wanted to scale or grow, then I could do it myself. Or I could at least have the expertise to oversee somebody and be more hands-on with it.

So, the school is not only building the app, but also teaching you the skills in the no code platform route. Depending on the complexity of people's apps, some people took a lot longer than 12 weeks. So, they kind of had to add onto the 12 weeks. I really put my nose to the grindstone and took about six weeks on this app. Going into it, I had a very clear vision of what I wanted it to look like. And I think that that was probably the most helpful thing. And I also had a timeline that I wanted to hit as well.

John: So, let me ask you a question. I'm assuming that depending on, like you said, the complexity, you might have to learn certain things that other people wouldn't have to learn if it was a fairly straightforward or simple type of tool.

Dr. Kirsten Limmer: Yes, that's correct. The skills were essentially tailored towards what app idea you had. And the cool thing about this program was that it was very collaborative. So, I would have conference calls several times a week with other app developers who were doing things that were just totally different across the board. And so, seeing how they develop their skills. And not only kind of enhancing just general education and life, but also seeing how they approached problems and sometimes I was able to integrate that approach into my own app.

John: Now, as an entrepreneur sometimes we talk about, what do we call it? Proof of concept. But I think you have already kind of proved the concept yourself. I mean, you were going by, "Okay, I need this, so I'm going to build it and I'm sure other people will need it". Or did you have any kind of survey or anything you did from other people saying "I would use that"?

Dr. Kirsten Limmer: Yeah, it was very informal. It didn't have a survey or anything, but I did ask other people and it did seem to resonate with other people. It definitely resonated with me. So, the whole time that I was going through this, I thought, "Well, if nothing else, at least I will have a great tool for myself to use".

John: If I was doing something like this, the thing that would slow me down, for sure, in addition to the technicality would be the design of it. I Like logos and pictures. Do I do some cartoon figures? Do I just do a text? How did you decide on the actual design in the way it looked?

Dr. Kirsten Limmer: Yeah, really good question. And actually, you touch upon a pretty major point. And that is something called a minimum viable product. So, this is something that, as an app developer, or as a lot of kinds of tech developers, somebody should have gone in. And that is having a very bare bones version of the app that you will eventually want to create. Because like you touched on before, you will need a proof of concept. And this minimum viable product is your proof of concept.

So, what app developers that are successful will do is try to get out their minimum viable product as soon as possible, because the most powerful thing you can do with your app is get it into the hands of users. Because those users are going to be ultimately the people that give you your best feedback.

And I got my minimum viable product out within about six weeks, like I said, to a handful of beta users. And really their feedback helped shape what my app was going to look like before I launched it publicly. Some of their feedback was stuff that I didn't expect. I didn't think it would be important, or I thought a feature would be important and it turned out to be not very important. And so, you can save yourself a lot of time by trying to get out a bare bones' version first.

So, when you ask about logos and graphics and stuff like that, sure, you can do all that, but that should not be where your mind is focused. That can all come later. I mean, you look at a platform like Craigslist, it's like the ugliest website, and yet so many people use it, right? Like the functionality is what's important. And the graphics and the bells and whistles can come later once you've really iterated to your product to be what users really want to use.

John: Let's stop here for a minute because I'm going to stop and give the website or let you give it for how to download this thing only because I've gone on and I've seen it. It looks very professional. I see the design is there and there are images and things. It's not just a text-based thing. So first of all, tell us where we can access this right now and how that works.

Dr. Kirsten Limmer: Yeah. So, users can go onto www.repstracker.com. And they can download either if they have an Apple device or the Google Play Store, we have it in both.

John: Okay. So then, when doing that, that is where you actually get the app that enables you to interface with it. But then you need to have a subscription I understand to actually use it or to get certain features. How does that work?

Dr. Kirsten Limmer: That's correct. So, you can register for a free trial. So, try it, if you love it, great, continue to use it. It is a paid subscription, and if you don't love it, that's fine as well. So, yes. And those users can also have access to the desktop version. And there's a couple other features that the desktop version incorporates as well. So, they have access to both the mobile and the desktop versions.

John: And for those that are really into real estate and into wanting a tool like this, how does this tool actually make it easier to keep track? Why is it better than just me scribbling some dates and times down, and maybe the address of a property than just this? What's so good about it?

Dr. Kirsten Limmer: Yeah. So, the fact that it's a mobile app, I think that is number one. I can't tell you the amount of times that I have gone to Home Depot or been kind of on the go and done something kind of related to my real estate activities that then I forgot to record later on or with receipts or whatever else like that. So, having a mobile app that you can use on the go to record your hours as you go is really helpful in that kind of recall of the actual detail of your hours.

But the real beauty or the power of my app is that it essentially guides the users to hit all of the points that the IRS needs, if you one day need to hand over your time logs. And along with that, comes the generally acceptable activities that real estate can declare in their time logs. And for those activities I've had the help of some really great real estate CPAs to vet this part of the app. And so, I'm really grateful for that part of it.

And as well, the app records the hours as the real estate professional adds them in. So, they know exactly where they stand throughout the year in terms of how many hours they've recorded and how many hours they have left. And that can be really helpful when talking to your CPA, when making decisions throughout the year as a real estate professional, "Do I need to buy another house?" maybe. Because this is such a powerful tax strategy, that actually could come into play.

What really results from the app is a really large searchable database that an investor can go back and look through, print out, export, import into if they want, and really keep them organized in a way that will be acceptable if they get audited by the IRS. And of course, my disclaimer for that is please talk to your CPA along the way. I am not a CPA, please talk to your CPA about all of this strategy.

John: So, I'm trying to imagine there are certain activities that would count and certain activities that might not count. So, it already kind of lays out what those types of activities are like, "Okay, put this in this box or in this box". So, for example, if I was sitting on my sofa helping to read an article about real estate in Washington, DC, and I live in Illinois, I spend an hour reading that article, do I get to count that hour as part of my real estate activities?

Dr. Kirsten Limmer: Well, okay. So, there is some discrepancy between CPAs actually. So, the activities that I included in my app were ones that are generally acceptable by most CPAs that I talked to. And I should say most real estate CPAs because there is a kind of a big difference, that's a specialty.

One of the more powerful benefits of this is as you record your hours, you can print this all out or export this all and send it to your favorite CPA that you're working with and have them very quickly look at it and say, "You know what? I don't feel comfortable with you declaring that as an activity. I don't think that you reading a New York Times article about real estate should be something that you should put on your log". And actually some CPAs might be okay with it. So, this is a really kind of diversified area of the tax code and I guess maybe not quite hammered down area. So, that's actually one of the more powerful benefits of this app.

John: Okay. That sounds really neat. So, that value as well is just the convenience. Anyone that has their phone with them, they're going to be able to keep track. It basically is what you're saying from the convenience standpoint. Okay, so now you've talked about the beta users and the feedback, and I think you pretty much have been working on this, but it was officially released earlier this year, right? And people are using it in real time. So, can you give us a little hint about how things are going so far?

Dr. Kirsten Limmer: So far so good. I mean, every day I have a couple more customers that sign on. It's definitely growing in the positive direction. And thus far, I haven't had to do any paid marketing. I've just done grassroots type of marketing. And hopefully I can stick with that. If not, then I'll kind of change my route a little bit, but thus far it's going pretty good and it has not been released for very long. So, definitely growth in the positive direction.

John: Awesome. Now we're going to have to end pretty soon, but there's another question that I didn't quite get to the bottom of. We were talking about money before and the cost of paying someone. So, now you obviously had to pay for the course that you took and that was a six week or however long it took you to do that. So, how did that cost compare to just saying, "Okay, I'm just going to pay someone to write this thing and they may not even make it look at the way I want". So, give me the bottom line on that kind of feeling on using this approach.

Dr. Kirsten Limmer: Absolutely, absolutely. So, a traditional app developer, when I had my previous app idea, they were quoting me $20,000 to $40,000 for the MVP.

John: That's the minimum viable product.

Dr. Kirsten Limmer: Yes, the minimum viable product. So that was something that I would have to sink more money in as I iterated it later on. People would talk about like hundreds of thousands of dollars for that, the traditional app development route. So, I knew that price tag was out there.

And then the way that I went is the built to scale school, at the time that I enrolled, I'm not sure if they've changed their pricing at all, but it was about $4,000, a little bit more than $4,000. So really quite reasonable in comparison to the quotes that I was getting for the app developers. And then of course, you have to pay that to host your app. There are lots of little costs here and there, but really nothing compared to that traditional app development route.

John: Okay. Okay. And then you had the hours that you had to put into it. Do you have a sense on any given day or week, how much time you were spending on this during that process?

Dr. Kirsten Limmer: Yeah, probably anywhere from like three to six hours a day. Usually in the wee hours of the morning before my kids woke up, I would put in some real dedicated time onto that. And for about seven days a week for six weeks. So it was a decent amount of time.

John: Yeah. Well, we all have to consider that and if we don't have the time, obviously it's not going to work out. We don't want to invest all that time at the front end and then sort of trail off and never finish it. So, it's good to know though.

Because before we had gotten on this call, I thought, "Okay, I'm going to have a hard time figuring out exactly the cost benefit on this". But no, you really explained it well, it made sense. It was definitely an alternative to forking out $50,000 or whatever. And you got it done. It's great to hear from someone who is a physician because I've had other physicians talk about developing an app. And I think you're the first person. Well, I have one guest that had done it in the past but I think they were trained as a programmer.

All right. Well, you want any last bit of advice for someone who might be thinking of doing this? Any things you've learned along the way that you haven't already shared with us and some pitfalls to avoid or things like that?

Dr. Kirsten Limmer: Yeah. Yeah. So if you have an app idea, the best thing that you can do is try to get as granular as possible with your app idea before going either direction. Whether you want to go the traditional app development route, or do you want to make it yourself, think about exactly how you want your app to look. How does a user's journey go through your app when they log in? Where do they go, what happens?

And even just taking out a sketchpad and sketching it out can really help develop your idea and also can help you think, "Well, is this actually doable? Is this something that somebody will want to do?" It'll make it less abstract. And then in that way, when you're communicating it to anybody, you could communicate it a lot better.

Number two and probably most importantly, especially for your listener base is, "You guys can do it". You do hard things. Physicians do hard things. If you have an idea that you think is going to be successful, the worst thing that you can do is just sit on it and let somebody else do it. Just do it. See where it goes and get that minimum viable product out there and just push it out and have confidence in yourself.

John: I think that's great advice. And it's true. Even a lot of my audience, whether they're going into a nonclinical career, there's this fear, this feeling like "we can't do it". And yet, while you've been through, whatever, 11, 12, 15 years of education and training, and you've learned a lot and you're applying a lot, so you should be able to do something outside the field of medicine, if that's what you want to do. So, don't be too shy about it.

Dr. Kirsten Limmer: Absolutely. Absolutely.

John: All right. Well, Kirsten, I think this has been really fun and fantastic. I might have to have you come back and tell us about the results of your real estate investing at some point in the future. But I think everyone that's listening will get something out of this and I really appreciate you for being with us today.

Dr. Kirsten Limmer: Thank you so much, John. It was great.

John: All right. With that then I will say goodbye and hope to talk to you again soon.

Dr. Kirsten Limmer: Thank you.

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