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. 

Our Sponsor

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

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

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

For Podcast Listeners

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

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.

Download This Episode:

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

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

Email Download New Tab

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.

Scroll back to top

Sign up to receive email reminders, news, and free stuff every week!

Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.

powered by

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 opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

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

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

Interview with Dr. Adam Robison – Episode 333

In today's episode, Dr. Adam Robison explains how he was able to found a start-up, AI Medica, while practicing hospital medicine full-time.

This interview will reveal the impact of AI Medica's software on healthcare efficiency, its integration with Electronic Health Records (EHRs), and its role in enhancing clinical decision-making. Adam provides his firsthand account of navigating the complexities of healthcare technology while practicing medicine.

Our Show Sponsor

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

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

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

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

Revolutionizing Healthcare Efficiency with AI Medica

During our interview, the founder of AI Medica discusses the journey of his software optimization company and its groundbreaking role in transforming healthcare data accessibility. With a focus on integrating with Electronic Health Records (EHRs), AI Medica streamlines medical calculations, provides coding review, and enhances clinical decision-making while using your EHR.

Navigating Entrepreneurship in Healthcare Technology

Adam also delves into the challenges of founding a company while maintaining a thriving clinical career. From overcoming the limitations of existing EHR systems to securing investments and building a business, he shares insights from his entrepreneurial journey. During our conversation, he highlighted the major steps he followed: 

1. Identifying a universal problem,
2. Leveraging personal experience,
3. Describing the technological solution,
4. Collaborating and investing,
5. Navigating the complexities,
6. Continuous learning, and
7. Balancing clinical practice and entrepreneurship.

These steps resulted in the creation of AI Medica, a company poised to streamline healthcare data accessibility and decision-making. Doing so, helps physicians work more efficiently and improve quality of care.

Summary

To learn more about AI Medica and connect with Dr. Adam Robison, you can visit the official AI Medica website. For inquiries and demonstrations, you can contact Adam directly via email at adam@aimedica.ai. Additionally, you can reach out to him on LinkedIn for further information.

AI Medica offers a revolutionary solution to streamline healthcare data accessibility within Electronic Health Records (EHRs), making clinical workflows more efficient for physicians. If you're interested in exploring how AI Medica's tools can benefit your healthcare institution or clinical practice, feel free to reach out and schedule a demonstration.

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

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

Links for Today's Episode:

• AI Medica website
• Apply Discovery, Innovation, Value, and Execution to Launch Your Business – 319
• Here is the Designer of the Best Medical Image Repository Ever – 125
• Top Five Start-Up Secrets for the Physician Entrepreneur – 087
• How Blockchain Technology Can Protect Your Credentials with Dr. Leah Houston – 045

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

Email Download New Tab

Transcription PNC Podcast Episode 333

How to Practice Hospital Medicine and Found a Startup

- Interview with Dr. Adam Robison

John: I'm really happy to meet today's guest because besides being a hardworking hospitalist, he's a hospital manager and leader and founder of an EHR optimization startup company, which we'll talk about for sure. Hello, Dr. Adam Robison. Thanks for coming today.

Dr. Adam Robison: Thank you so much for having me.

John: I am very happy that you're here. This is going to be very interesting. People know that I have an affinity for hospital management work. I was a CMO of a hospital and I know a lot of physicians are always trying to get away from it, but I always like to talk to people like yourself who are in hospital leadership positions and of course, also an entrepreneur. So this is going to be fantastic.

Let's just start by you telling us a little bit about your background, education and clinical career, and then we'll get into the other stuff after that.

Dr. Adam Robison: Yeah. My name is Adam Robison, like you said. I am an internal medicine doctor. I trained at the University of Louisville. I'm a big Cards fan. We did pretty good this year in football, so I was pretty happy about that. I've been working as a hospitalist clinically for the past seven and a half, almost eight years now. I work in a small community hospital out in the middle of nowhere in Idaho, in Twin Falls, Idaho. It's a great place to practice and I've been out here for a while and we are here for quite some time.

On top of that, I do work as a lead hospitalist for my group. There's about 120 providers and we cover about four or five sites right now. And so, that's been interesting work. I took that role all about almost three years ago, right at the middle kind of beginning stages of COVID. That was a very interesting time to take over as a leader of a large hospitalist group and try to navigate through that. That was good learning experience.

John: Yeah. I'm tempted to say, "Well, okay, how did you solve all those problems of people being too sick to work and not having enough PPE?" But we won't get into that. But it's been interesting, huh?

Dr. Adam Robison: Yeah, it's been interesting work. And then yeah, as you said I did found a software optimization company about five years ago, almost five years ago, 2019. And so, that's been a lot of work too. It's been a lot of interesting stuff that keeps me busy and a lot of different things to focus my attention on for sure.

John: Well, it's that second part that really got me interested. And I think our listeners are interested in things like outside work, side gig, side jobs, new careers, passive income, active income. Tell me what inspired you to start a new company? We'll see if your story jives with the others I've heard in terms of what makes people do crazy things like that.

Dr. Adam Robison: Yeah. I've been happily married for almost 20 years, and my wife, I asked her one day this crazy idea. I said, "Hey, I want to take some money. And I have this idea of how to make the EHR better." And she said, we'll have at it. And so, basically I remember sitting in front of my computer, I was using Epic at the time, using an electronic health record and going "I have to go to a third party website to finish some work. I have to go outside the EHR on a regular basis." I'm like "I have to take data from here and go kind of chart and go over here. This seems kind of stupid. Is there a better way of doing this?"

And so, initially I tried to do what I did initially within the EHR with some templates and stuff like that. And what I was looking to do wasn't actually possible within the EHR framework, the logic and the kind of advanced computing I wanted done. And so, that's what caused me to think about is there a way of doing this? And I did a lot of research. I was reading all sorts of websites, educating myself on interoperability standards. How does that work? Is there ways of doing this outside the EHR without really tight integration customized integration? And then that's what we came across. I came across something called HL7, which if you're out there is fire. And then we learned a lot about that. Really what was interesting to me was a problem that I had clinically and could I solve it. And that's what led me to found the company, realizing that we are founding a company to develop the software and to go from there. So, that's what we did.

John: That is the common thread that I've heard before. I talked to an urologist who started a company producing underwear for patients, and whatever, other different entrepreneurs. And it's always that itch that has to be scratched. You have a problem, but you're on your own, and it's like there's got to be a solution to this problem. That is very consistent. But I'm sure the way you went about it is going to be different from others because there's a myriad number of ways of doing that. We'll get into what it does exactly, but what was your next step? You had this idea, what did you do?

Dr. Adam Robison: Yeah. Whenever you have any idea, we're trying to find is there a market out there for it? Is this something that people would buy? Is this a universal or at least a broad enough problem that people run into it? I talked to lots of different physicians and people I knew, people at different hospitals I had connections with and asked them "Is this a similar problem you run into, or am I just dumb and nobody else has it?" And see if somebody else has already had a good solution for that. And realize, no, this is a fairly universal problem that everybody else has experienced. There's not a lot of solutions out there in the market. And so, that's when I go, okay. Now I don't know how to code or software. I don't have any experience with that. And I knew it would probably take me quite some time to do that. That's when I was looking around for people that knew how to do that and I was able to find some developers that had some of those skills. So, it's a lot.

There's stories about how to get licensing and getting approval through different EHR vendors. That was an interesting experience to go through, to try to convince a certain ethic that I was a company and that I wanted a license to put myself on there. Learning how to navigate all that, security protocols, yada, yada, yada. Just a lot of learning new things that I didn't know before.

John: Interesting. I just want to make sure I didn't miss another point. You checked around to see if this was a universal problem, and did that include other EHRs and the one that you were using?

Dr. Adam Robison: Yeah. I talked to a bunch of physicians because of what I have learned about, and it sounds like you talked to other doctors that have used this, but physicians are the best people at solving physician problems. Not some sort of a Silicon Valley startup by two guys out of their twenties. Like "Oh, they know how to fix our problems for us." It needs to be physicians fixing physician problems. And so, I talked to a bunch of other doctors that have been in a myriad of different EHRs. I talked to people that used the big ones in the market as well as like the VA. A bunch of colleagues worked at the VA. Is this something that you'd experienced out there? And it was a pretty universal experience.

John: Tell us about the company. Let's start there. Tell us what the company is designed to do, or what kind of product or service it provides. And then I'll come back to some of these little questions in here.

Dr. Adam Robison: Yeah. The problem that we're trying to solve was how to get data out of the EHR. It was the problem. That's a big issue. Healthcare data and how it's siloed right now is a big problem. And that's why I touched on briefly something called the HL7, which is a group, they develop these interoperability standards. It was very serendipitous timing with what I was trying to do, because during that same time, the 21st Century Cures Act had come out. And the 21st Century Cures Act for those that are familiar opens up the chart. For a lot of physicians, that meant that patients now could access certain notes in real time, which has got a lot of physicians from heartburn. All of a sudden the chart became a lot more. It used to be My Note, now it became the patient's note as well as My Note. And that was some heartburn around that.

But if you actually looked into what the 21st Century Cures Act was doing, it wasn't just making notes available to our patients, even though that's how we allowed, as physicians interpreted, it actually made the data in the EHR transparent and accessible. It had to be accessible. And it turns out, the government had adopted these things called the HL7, the standard called FHIR. And it just happened the same time while that was going on that I was trying to look to solve the same problem of how to pull data out of the EHR and do something with it meaningfully.

And so, what our tool does is it integrates directly with the patient's chart. It looks at what's going on with the patient's chart, and then pulls all the information that would be relevant to pull out, reviews the chart essentially for the user, and then provides information like MELD scores and things of that nature as well as coding recommendations all within the context of the patient's chart.

John: Interesting. Because earlier I was going to jump on the bandwagon and bad mouth some of the EHRs and EMRs. It's like you would think after helping physicians doing this for 10 or 15 years, they would've figured this out. But what you're telling me was the system wasn't necessarily ready for it and it became ready as this was implemented.

Dr. Adam Robison: Yeah. It's been interesting. I will tell a story. I have a good friend of mine who's not a physician, and him and his wife, they recently had a child and they were receiving care locally to smaller hospitals. But the child's medical condition required it to go to seek care at a tertiary care center. And what they described, even though both centers used the same EHR, they're separate EHR instances. And so, the mother and the child had two separate records that were actually very important, but then needed to talk to each other because the conditions they were seeking care for were the same at both sites. And this is just recently.

And so, for whatever reason, there hasn't been a lot of interest in the major EHR vendors to make even within their own EHR network or broadly between EHRs, that hasn't really been an interest that they've wanted to go down either maybe for economic reasons or technical reasons, for whatever reason that may be. That interoperability standard piece has been a big problem. And they haven't been willing to fix it and the Cures Act did mandate they had to open that up. But it's going to be important on companies like mine and other companies out there to do that work for them.

John: Okay. That's good. That things are progressing, and like you say, your timing was perfect. Now, I was looking at your website and reading a little bit about this, so I just want to make it clear for the listeners because some of them might actually need to use this tool at some point or tell their hospital or somebody about it. There are different kinds of metrics, there's algorithms, there's sometimes formulas that have to be used by a clinician and trying to do something. And right now you have to either do that by hand or use a separate piece of software or an app on your phone or something, and you're integrating that. So, give us more about how that works and why it's potentially a profound app.

Dr. Adam Robison: Yeah. Our two applications right now, we have two software pieces called Aicalc, Aicode that live within our Aimedica platform. And what they do is the Aicalc, you can imagine it just being your medical calculator, your cirrhosis scores, your chads bask, you name it. There's a million of these out. And they're actually propagating pretty rapidly now. With the advent of big data and smart computers, these models are coming out pretty rapidly. And our software basically looks at the patient's context, what kind of medical problems they have, is there other criteria, and says, oh, not only we'll calculate, oh, patient's cirrhosis, you'll need a MELD score. And then we'll give you the most up to date MELD score, give you that sort of stuff. You don't have to click around. You just click the button. You don't have to think of why you need the MELD score. We'll just review the patient chart and give you all the relevant scores and pull the data in to calculate the scores for you automatically.

Again, one thing I say to people all the time, I use this tool every day in my practice. I developed it for myself, and so I'm constantly trying to improve it. And then we also do the same thing with medical diagnosis codes. We try to optimize the best highest weighted codes for DRG waiting for hospitalizations, which is important because we can look at a patient's chart and say, "Oh, the patient actually meets sepsis criteria and you are treating of infections. That should be the code you put in the chart. Let's provide that." And that has a huge ramification. And anybody knows in the healthcare space, those DRG waiting is huge for hospitalizations reimbursement.

John: Yeah, absolutely. And someone like you, or many hospitalists kind of have looked at the Medicare guidelines and they realize that for some DRG level, whatever, it's like a three paragraph description of what goes into it. Oh, yeah, we have time to really learn all that.

Dr. Adam Robison: Doctors don't care. I tell us that you've got to optimize it and make it easy for me because I don't care if the patient needs sepsis or pneumonia or what. I know they have an infection, I know I want to treat it and I'm going to treat them appropriately. And I don't really care what came from the chart. All I care is that my patient got better because I gave appropriate care.

John: Well, this is really going to impact the CDI people, if this is going to really help them a lot. So, that's interesting. It sounds to me this business really is like a software business. And you said you're not a programmer.

Dr. Adam Robison: No.

John: So, how did you overcome that issue?

Dr. Adam Robison: Yeah. It was interesting. I had this idea, I got to fix this problem. This is a universal problem, how do I fix it? Well, oddly enough, I had been reading in our local newspaper, and I came across this guy here locally that I knew. I didn't know him at the time that he had a development for hire company. And so, I just kind of reached out to him and I said, "Hey, I got this problem. What do you think?" And he said, "Oh, yeah, I could do that. And by the way, I'm a partner of a venture fund. Let's see how this goes. And we may invest in your company if you like the idea." And so, I pitch it to them. And then that was kind of very serendipitous. We build a minimum viable product. And after they were comfortable with me and they're kind of filling me out to see if I was not as a fly by night operation, they decided to invest in the company my idea with me as well. And so, that was how we got married with a venture fund. It was very interesting how that kind of worked out. But just from a paper article, I just happened to come across it.

John: Sometimes things just work out. I always say the RAS in our brain, the reticular activating system, once you're thinking about something, it finds things that you otherwise would never notice. Now, how did you sort of protect or did you the intellectual property of the fact that you had come up with this idea? Was it built in your partnership? How do you do that?

Dr. Adam Robison: Yeah. That's an interesting thing. That's something we've still wrestled. When you develop software, you really can't patent software unless your approach is really unique. If you developed blockchain, if that's a whole new software thing, you could potentially pat that. But just patenting software, it's almost like copywriting software. You can copyright it, but anybody can write a piece of code. It's not a unique idea if you're writing this code using a typical programming language. That was a difficult problem. We have now developed a proprietary knowledge base and an ontology, if you will, that is IP and that is patentable. And we will be patenting that.

What has helped us right now and why we're five years into this right now, or almost five years into it, is what I'm doing is so ends up being very technically difficult. We have a bit of a mode around us because even the developers I hired, they didn't know how to do this because it's not a skillset you can hire off the shelf. And so, it was going through a lot of that. It's ended up been, like I said, a lot of it is been very serendipitous that turns out this isn't something you can even hire very easily for. And we had to train a lot of people up and work through it. But I think one thing we did was when protected the IP, we had that written to our contract with the development company. This is our stuff. And we had all well demark within the contract negotiations.

John: On the plus side, the more complicated it is, the less competitors you'll probably have doing it.

Dr. Adam Robison: Yeah. And we're many years into this. At this point, in this SMART on FHIR space, and unfortunately I'm saying it on a widely broadcast podcast. It is a brand new space. People are starting to understand and realize that that's how you talk to these EHRs. And what's great about it's EHR agnostic. Every EHR has to be compatible with these standards.

John: Now, one thing I'm not an expert on at all, and I've heard there's different ways of getting investors, like venture capital, angel investing, this kind of thing. But did you end up just getting the one entity to support this when you got your partner? Or did you go beyond that?

Dr. Adam Robison: No. We've had a raise. We've done a few raises now. It's been interesting. That's been a lot of work to raise money. I funded the initial development of the minimum viable product, but to actually bring on employees full time, that's not something I could afford to do. I don't have those kind of deep pockets. And so, what we did, we raised it through the initial investor network that we were introduced for that venture fund, and then raise through their network. And that got us a certain point.

And then when you raise money, every time you raise money, you're looking to say, "I'm going to raise money to hit these milestones." And so, every time we raise money, "This money was raised to hit these milestones. We've hit those milestones, now help us, we're going to raise money again to hit these milestones." You're trying to show forward momentum every time you're raising money that you've got this money. We did X, Y, Z with this money, and now we're going to do these next set of milestones, which you're going to further grow the company or hit these metrics and milestones. When we've raised money through different networks, that's how we've done it. And so, that's where we're at right now. We've raised I think about a million and a half over the last two years to expedite development and move to things forward.

John: Nice. Yeah, it's not like something you can build in your basement.

Dr. Adam Robison: No. And it's a lot of learning. I think anybody looking to start a business, just be prepared to learn a lot, because even though you may be smart as a doctor and you're very intelligent, be prepared to be very humble because you have literally no idea. You're going to have to learn a lot, fly by the seat of your pants. And that's kind of why people become entrepreneurs. They are interested in learning that stuff. But yeah, I've had to learn a lot and I've made a lot of dumb mistakes and all sorts of stuff. Lots of stories to share about that.

John: Oh, I can imagine. But it can be exciting and physicians can learn anything really as long as you have the time. That might be an issue for you as the thing gets bigger. Tell us where it is right now. You've been doing this for five years. Obviously, there was a whole ramp up. Do you have clients? Is this being live? Is it working?

Dr. Adam Robison: Oh yeah. Like I said, we have two clients right now. We have two head systems right now. The biggest thing actually, we just finished up our installation at the VA. That was a big deal to get our software working. If you're familiar with the VA or worked at VA, they have an antiquated system called CPRS. It's been around for a long time. And they've just recently built on a platform onto their CPRS that's called Lighthouse, that's compatible with SMART on FHIR. And so, our tool, we're the first third party vendor. They were looking for a solution like ours, and we met them and talked to them and they talked to some other people that could do something similar, but we were a better fit just because of our tight integration with the SMART on FHIR standards. And that has allowed us to work with them.

We just finished our deploy there. We are in the process of several other health systems. We have relationships with the biopharmaceutical company as well as a clinical research company that's looking to use our tool to help automate and augment a data retrieval from the EHR to help expedite clinical research. And so, that's what we're working now.

John: Okay. Is it to the point now where some of the medical caregivers, the physicians, APNs, whoever, are they seeing the benefits at this point?

Dr. Adam Robison: Oh yeah, we have. People love the tool. It's being used. We have some business intelligence software. We monitor the use of software, how are people using it so we can make sure we can improve it. It's not quite exponential growth in users, but we're seeing lots of people using it almost on a regular basis. And it's now becoming the way you do things now with our sites, because why would you go to a third party website or go to some other site if it can go to HER? And it's a button click, you don't have to do more work. So, it's obviously much more efficient.

John: Yeah. Nice. Do you have different formulas or different tools available over time? Or is there a list of 10 or 20 or 1,000?

Dr. Adam Robison: Yeah. Right now we have 50 or 60 medical functions automated within the chart. The ones that are commonly used. We're adding more as they come out in literature writing more. We're branching up a behavioral health space now with some of those assessments that need to be done. They're often done on paper or through PDF forms, so we're bringing them to the platform as well.

We are really just looking depending on what the clients need. Really I tell people all the time, the hardest part with this is actually just being integrated in the EHR and getting data out of it. For building a medical function, a medical calculator form, you need to get data out of HER. That's easy now. We can build that in a few days. You name it, we can build it because that's not hard. The hard part is actually integrating the EHR. That's the hard part.

John: I like that interface. That might not be the right term. But are you doing studies to see if this improves the efficiency of the physicians?

Dr. Adam Robison: Yeah, we will be. That's going to be next year. We have a couple sites that are interested in doing that. Our Richmond VA site, which we're in the process of finalizing that, they're interested in doing that kind of work. We'll be working with them to hopefully show that this is efficient, which anecdotally, of course it is. But we'll be able to show that and prove that with the data collected.

John: Yeah. The thing I hear from physicians, I have to go home and do an hour or two of notes or whatever. Now that's oftentimes the clinic, but still even hospital notes sometimes, you just can't get them done. You have to go back. Do you have a lot of capacity now? If people listen to this, we don't have a million listeners, but a lot of these physicians might still be working clinically. How do they get ahold of you or the Aimedica to learn more about this? Is it ready for that?

Dr. Adam Robison: Yeah. We're ready. We're actively taking on clients now. Like I said, we're in the process. That's going to be our big Q1 push. We had a couple clients that we're working with. Now, we're ready to go live with everybody else. And so, that's Q1, we're working on lining them up. You go to website aimedica.ai. It's easy. Easy website to remember. Just go there to contact our page, we'll be happy to do a demo for our clients.

John: Okay, aimedica.ai.

Dr. Adam Robison: That's correct.

John: All right. And if they have more questions, they can throw a note in LinkedIn to you, perhaps. Do you have time for that?

Dr. Adam Robison: Yes. Or you can email me at adam@aimedica.ai. It's very easy.

John: All right. This has been very interesting. I don't think I have a lot of other questions. Let me ask you this. What if I was going to go to my local hospital and say, "Hey, this thing sounds pretty cool." Who would I go to?

Dr. Adam Robison: You want to go to your chief information officer. They would request us through. Most of the EHR vendors have some sort of app store lineup that we would go through.

John: And what kind of presentation do you do at a system or at a hospital in terms of do you go on site, do you do it online? Do you just send some written materials? I'm just curious about how you're handling that part.

Dr. Adam Robison: Yeah. Typically, we'll do a demo on Zoom or some sort of video conferencing site. Wherever they want to use, we'll use that and we'll demo the software in a real environment so you can see how it works.

John: All right. Did I forget to ask any questions or is there anything else you want to tell us either about juggling being a hospitalist and a co-founder? Technically you do have a partner, but you were the one that created it, so I guess you are the founder. Juggling those things or about Aimedica?

Dr. Adam Robison: No. I do have hobbies that I use to not do work. I think it's important to have those so you're not doing it. I play piano. I do a couple of things to get my mind off when I have a couple minutes of downtime, which is I think important as you're looking to try to do other things with your time.

John: What do you think is going to happen with you? If this gets really big, it's going to take more and more management. Hopefully your employer at the hospital is not listening, but they probably know you got this thing going on. What do you kind of think will happen long term? Are you going to become like a CMIO in a hospital informatics in this technology? Or do both for a long time? What do you think?

Dr. Adam Robison: I'll tell you John. I actually love being a clinical doctor. I love taking care of patients. Maybe not as much as I've had in the past. I'd probably wind that down a little bit because I do work quite a bit. What I see myself probably doing the next 5, 10 years as they see guys up and it's profitable and we're able to keep lights on, is probably work for them full-time and work for my company full-time and then still see patients. Because as a chief medical officer of the company and using the tool, I find by me using the product and practicing patients, I really understand what are the problems we're trying to solve. I feel like if I remove myself from clinical practice 100%, my utility, the company to help make these tools better, I think it becomes limited as well.

John: That reminds me. Cleveland Clinic, it's a pretty big place. And I don't know about the current CEO, but the former CEO is still clinically practicing while he was running that monstrosity. So, you can keep practicing probably as long as you like, and if you're enjoying it.

Dr. Adam Robison: I do enjoy it.

John: All right. Well, I think that's all the time we have. I really appreciate that. I'm going to put the links in the show notes. Again, it's Aimedica and I've been talking to Dr. Adam Robison. I'm going to have to have you come back in a couple years and see where things have gone. And maybe by then I'll have invested in it as it'll be a listed stock or something. All right. Thanks for being here, Adam. I really appreciate it.

Dr. Adam Robison: Absolutely. Thank you.

John: Okay. Bye-bye.

Dr. Adam Robison: Bye.

Scroll back to top

Sign up to receive email reminders, news, and free stuff every week!

Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.

powered by

Disclaimers:

Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. I only promote products and services that I believe are of high quality and will be useful to you. As an Amazon Associate, I earn from qualifying purchases.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

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

The post How to Practice Hospital Medicine and Found a Startup appeared first on NonClinical Physicians.

In today's interview, Dr. Chase DiMarco explains how physicians can earn extra income teaching medical students.

Our Sponsor

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

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

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

Who Is Chase DiMarco?

Dr. Chase DiMarco holds an MS and an MBA. And he is an MD/Ph.D-candidate. Additionally, he is the Founder of MedEd University and the CEO of Find A Rotation, a clinical rotations platform.

There is an expanding number of international students every year. We need to focus on increasing the number of rotations available.

He hosts the Medical Mnemonist Podcast and Rounds to Residency Podcast. He is also co-author of Read This Before Medical School, published in 2019. Chase is a consummate entrepreneur, author, teacher, and businessman.

Earn Extra Income As a Preceptor

As a medical student in a non-U.S. based school, he personally experienced the difficulty of arranging rotations. The process was expensive and time-consuming. At times, the rotations fell through. Painfully, he was often unable to recoup the high fees he paid to the Rotation Agencies.

As a result, he decided to solve that problem. He created Find A Rotation to link medical students to willing preceptors at a much lower cost. And he has systems in place to ensure that arrangements are secure and reliable.

To try it out, go to FindARotation.com. Click on the Register for Free Button and sign up by clicking on the Preceptor Link in the right column of the sign-up window. Chase will do the rest.

Closing

Dr. DiMarco is a good example of a medical entrepreneur who developed a business to solve two problems: finding rotations for medical students and helping physicians earn extra income. You can register as a preceptor using the above information. Or you can contact Chase directly at chase@findarotation.com or on LinkedIn.

Links for Today's Episode:

• Find A Rotation
• Chase DiMarco's LinkedIn Page
• MedEd University
• Medical Mnemonist Podcast
• Rounds to Residency Podcast
• How to Be a Successful Physician Entrepreneur – 123
• Top Five Start-Up Secrets for the Physician Entrepreneur – 087
• Want to Establish a Concierge Practice Before Finishing Your Fellowship? – 210

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

Email Download New Tab

Transcription PNC Podcast Episode 217

What Is the Newest Way to Earn Extra Income While Seeing Patients?

John: Today's guest is a very interesting chap. He's a physician who always seems to be creating new services or products to help his colleagues. And today he is going to describe a service that I really didn't even know existed or could exist. Although, now that I think of it, there's definitely going to be a need for this. Dr. Chase DiMarco, welcome to the podcast.

Dr. Chase DiMarco: Thank you so much for having me. This is going to be an interesting talk.

John: Yeah, I've been looking forward to this. Again, a lot of my guests serve two purposes. Number one, they're entrepreneurs. They're creating something which I think is very inspirational to the listeners. And then number two, the thing they're creating, the thing they're doing might actually be a service or product that my listeners could benefit from. This definitely falls into that category today. So, we're going to learn a lot, I'm sure.

To get started, why don't you share a little bit about your background and what you're doing now?

Dr. Chase DiMarco: Sure. That's always the tricky one because there are so many different levels. How far should I go back? Well, I guess the summarized version is that I went to a Caribbean medical school and that really enlightened me to different ways of doing things than maybe some of the physicians that went to US schools.

Well, there are gaps in all of medical education, all education in general, that could be filled. And the ones involving what I went through personally are vast. I would say that, as you mentioned, a lot of people just don't know that they even exist.

I tried to work on different projects that are going to help students through this process, through these gaps that they might run into. And a lot of US students do as well. From a lot of my colleagues, I've heard some of the same issues. Finding rotations in certain specialties or learning how to learn or just how to bridge those basic sciences to clinical sciences to residency. And that has been the focus of my books, podcasts, and now FindARotation for the clinical rotations' aspect of things. That's kind of the summary of all the different projects going on.

John: All right. Well, let's take a break here and talk about your podcast then. You have at least two. I don't know if they're both active right now. So, tell us about that.

Dr. Chase DiMarco: Sure. The Medical Reminisce was the first one I started back in the beginning of 2019. And it was kind of a self-exploration as well. I knew that I was having trouble with certain types of material. My memory has never been the best. There is so much material you have to memorize for the board exams, especially when step one was still a scored test, which it's going away from in the next few months. And it didn't seem to matter what materials I used, how many times I went over materials. I couldn't necessarily remember everything.

I started looking into different ways of learning. And that's really where this podcast came from. It's using more mnemonic techniques, advanced mnemonics, not just acronyms because those generally don't stick very well. You can use them for the next exam, but then you forget them unless maybe they're raunchy or violent or something like that.

And at the time, things like Picmonic and sketchy medicine were really becoming more popular. There is medicine and medical. I always mix it up. As visual representations of these mnemonic devices, memory palaces, visual markers. So, I started learning from a lot of them, from people that teach them mnemonic and from cognitive psychologists, and would have them on the show discussing how we learn, discussing different ways to implement these techniques.

That's gone on for quite a while now, and there are a lot of variations in the types of guests there from physician educators to these mnemonics trainers, to cognitive psychologists, and just kind of a fun way to learn more about how our learning works and effective learning techniques.

John: All right. Let's stop there for one second because I want to do a fun thing. I want to challenge my listeners to say medical mnemonics. Is that how you do it?

Dr. Chase DiMarco: Yes. Like mnemonics.

John: Exactly. That's worse than saying, I don't know, something else, chrysanthemum or something. So, medical mnemonics. Okay, go on.

Dr. Chase DiMarco: Yeah. A lot of people can't get that word and Google doesn't recognize it as an official word either, so it's perfectly fine. And then later that year I started the rounds to residency. It used to have a different name, but now it rounds to residency. And that really was trying to bridge sort of the basic science to clinical science gap.

That mostly interviews physicians that either currently do precept students or used to precept students and helps to give those clinical learners a little insight into all the different specialties into the different demographics of patients of geographies and what is expected from them.

Because that's just something that at least at the time didn't seem like it was really covered. At least for a lot of the students I know and have worked with, you finish your basic sciences, and then you're just kind of tossed into your clinical rounds and not necessarily know what to expect or how to do your best or how to stay motivated, how to ask for a strong letter of recommendation and all of these things that are very important for your residency.

That podcast really helps to guide them on some of the different terrain, different questions. And just with the hope of making them more prepared for their clinical rotations.

John: It kind of worries me when you talk about the second podcast and the need for going from that basic to the clinical because I think it has been almost 40 years since I did my first rotation and talk about being thrown to the wolves. I had no clue. I showed up at the VA and I was going to be on call every third night. I didn't even know I was going to be on call till the first day I showed up and they said, "This is what you're doing". And much less the clinical side. So, I think every bit helps to get that transition. That sounds cool.

Dr. Chase DiMarco: Yeah, there's definitely still a huge gap in a lot of schools, whether they be foreign or US schools. So, hopefully, that helps students that aren't really prepared for another.

John: Well, there's so much now available, whether it's blogs, there's a lot written, there are a lot more books. There are eBooks, there's all kinds of things that can help medical students and actually students getting into medical school, medical students getting into residencies. It's definitely a lot better than it was 30, 40 years ago. Now you were also the founder of MedEd University. Maybe you can tell us about that.

Dr. Chase DiMarco: Sure. That's recently gone through rebranding. It used to be freemeded.org. And if anyone listens to my old podcast or anything, you'll hear that term thrown around a lot.

But that was something I started with my first semester in med school as just a repository of information on websites, of free quizzes online, of YouTube videos that were very popular to act as a supplemental resource. And after a few years, I started being knowledgeable enough to start making my own content for it and have partnered with others that are now making content for it as well. So, the podcasts are kind of a part of that, so I started off there.

We have a new academy that's like Coursera or Udemy that allows any instructor that would like to join us, to host their courses for free, charge if they want to, and just act as sort of an online MOOC - Massive Online Open Community for just strictly healthcare education. So that is kind of the new direction that is going.

John: Okay. I never heard of a MOOC before, but that's a good one. Massive, now that's interesting. But I say this because actually one of my partners and I are in the process of opening a community for physicians. I should know a term like MOOC.

Dr. Chase DiMarco: It's mostly something that I heard used a lot when Coursera, some of those college-based university-based courses, were becoming freely available for the masses. So, Massive Online Open Courses because anyone can join them.

Now, ours is set up similar to that, but it's really closer to Udemy where you have independent instructors and whatever material they feel comfortable in teaching, or want to teach, want to get out there, we can help support them with tools, with free hosting and really just trying to help more educators in healthcare produce the content that they want to. A lot of people want to create a podcast or want to create a course, but there's a huge barrier to entry. So, we are trying to limit that and support them with our services.

John: That's very interesting. You're really into education, but definitely from an entrepreneurial point of view. It seems like every time maybe there's an itch you need to scratch for yourself, once you master that, you're going to share it with other people. That's a pretty common trait of an entrepreneur.

Dr. Chase DiMarco: Yeah. And I always say collaboration is much better than competition. We can do a lot more working together with similar goals than fighting against each other and trying to win on Google ranks or something along those lines.

John: Yeah. All right. Well, that's a good bit of background and these things of course are ongoing. I'll put links in the show notes to all of this if people want to check it out. Of course, many of our listeners are a little bit past the med school stage and residency, and now they're in practice. Many of them are looking for maybe something else to do or a side gig and that kind of thing.

That's where the next issue comes in, the next topic, which is something called FindARotation. Tell me what that is and what it provides and why you decided to start this latest venture.

Dr. Chase DiMarco: Depending on the background of most of your audience, they might be slightly aware of this and some might not have any idea what this is about. But basically, what happened for me and happens with a lot of schools, whether they be newer US schools or foreign schools, they have trouble finding affiliate agreements with hospitals to send their students for clinical rotations.

What a lot of them will do is hire third-party agencies, these rotation agencies to fill the spots. And of course, the problem with any sort of agency, with any sort of agent is they take a huge cut themselves.

I ended up using some of these agencies in my third and fourth years, and some of them through the school, some independent, because there are just limitations in which types of rotations or which locations that I wanted to try to practice in, to network with.

And actually, in the end, I ended up spending around a thousand dollars per week on some of these rotations. There was no cancellation policy and I ended up not even securing the last four or five rotations through one of these companies. And that's when I said there is definitely a better way to do this. These really come off in my mind as predatory. And a lot of companies do take advantage of foreign students because they need help and they don't have options. They don't have any power locally to do much. So, I said, "Well, what are some of the really big companies right now that help to really automate as much of the process as possible to reduce costs for everyone and allow more people to get involved?" And the ones that come to mind are Rideshare, Lyft, Uber, or something like Airbnb or VRBO.

These companies allow anyone with the right credentials to join their service. They don't need to set up their own company or set up their own website or try to compete for a share of the market. And by allowing more people to be crowdsourced and offer the resources that were previously untapped, you allow for cheaper affordable services for the client, in this case, the student.

The whole goal is in the past few years we've been doing R&D for this. I have been manually matching physicians to students free of charge, but obviously, that's not scalable. We've done a lot of different I'd say alterations and updates, and it'll allow physicians, clinicians to host their sites, whatever clinical site it is. They can set the requirements they need from the student, the types of students, the number of students, and whatever their compensation is. So, it's completely up to them.

It's meant to be as simple as renting out your house or a room on Airbnb or something along those lines. And then the students can go on and search by location, specialty price range, and find what's proper for them, what they want to. Whether it be a certain specialty that is too competitive that they can't get through their school. I know my school used to offer lotteries for competitive specialties. And also, if you're trying to find a certain location, this'll give you more of a variety of options than you might have through your local university.

John: It matches people up. I've seen this with services that match, let's say a physician looking for locums to a site. Again, try to cut the middleman out, try to get enough of a number of sites and physicians to make it work. But when it works, it works great. As you said, the costs are less, it's more convenient. You're doing the work of matching things up so they don't have to call a hundred people.

Let's just see how this would work. Just correct me if I go through this improperly, but we just go to findarotation.com. When we open that, we will see a landing page or sales page or whatever you want to call it, it's the homepage. And then there is some information you can look at and download some things, and then you can hit the "register for free" button. And then that takes you to the page that has signups for students and preceptors. And obviously, if you are a preceptor, then you should just put that information in, and then boom, you'll be in the system. And can then from that point, interact with you or whoever the system, and start to look for students to fill in rotations.

Dr. Chase DiMarco: Yeah. And they can go to the Preceptors tab. They can reach out through there or to sign up for the newsletter, be updated when there are updates to be had, contact me directly. And still, at the moment, I'm matching everyone individually, but hopefully, that'll become much more streamlined when the new one is released.

John: Okay. Now give us a little background on this. You've talked about why there's a need for this. What would be reasonable? We don't want people to go in there "Oh, good. I can make a couple of thousand dollars a week spending a couple of hours a day with a student". I mean, it doesn't seem to make sense to me. So, what would be reasonable? What is being paid now? If you're going to compete with those rotation agencies, I guess you call them, then they need to be competitive. So, what would you ask or expect a physician to do? Let's say I'm a specialist, there might be a bigger need for that. Tell us in more detail.

Dr. Chase DiMarco: Sure. There's a lot of variation, obviously, depending on which specialty it is, and also which geographic location you're in. Some cities and states are going to be more expensive. Sometimes the hospital you work for might have more paperwork that you have to go through and just the process is longer.

But from my experiences and those of other students that I know that have used these rotations in the past, there are occasionally some physicians that will donate their time for free. And that is definitely welcomed. We would love to have a host of physicians that are offering their services that currently accept students. And we can at least take some of the work away from them. So, they don't need to worry about the paperwork and the scheduling at all. It'll all be done in that.

But those that are looking for that extra revenue stream, again, depending on the specialty and other factors, usually a few hundred dollars per week is pretty normal. Say maybe $200, $400 a week for something like a private practice family medicine, and up to around $1,000 a week plus or minus for certain specialties.

Now, granted that price also includes the agency's fee, which from our calculation is based on their numbers that are publicly available, it's about a third of the price. That right there makes it much more expensive for the students, unfortunately. Some schools will cover X amount per week as part of your tuition, but that's something that definitely needs to be discussed with them beforehand. And as soon as our new version comes out, we're going to try to form more of these partnerships, more affiliations with schools so that everything can be done more easily for the students.

John: Now, I have done some precepting in the past. I'm still working clinically very limited and I don't do any more precepting or teaching. Mostly I was with NP students, but my recollection was they had contracts. They had agreements that you have to sign and of course, have to provide them with some information so that they knew as a faculty, technically you met certain requirements, but they were usually fairly minimal. So, is the same thing applying in this situation?

Dr. Chase DiMarco: Generally speaking, yes. Especially in hospitals, they're all going to require certain types of documents to be signed. Some are pretty general and standardized. Some are very specific to that hospital system. The good thing is once a preceptor signs up, they can upload these documents and everything can be done electronically. The student or school in the future when we have school accounts, can upload any documents and send them to the preceptor.

And the preceptor or hospital can upload any of their documents, send them to the school or student and everything can be signed and documented very easily within the app. Of course, that's with the next version of it. So that's not available quite yet.

But hopefully with automating a lot of these e-signatures and the process in general, not having to print everything out, and also being able to keep records of everything, that really helps for students when they apply to residency and need proof of everything that they've completed.

John: Thinking ahead a year or two or three down the road, what do you think the scope of this would be in an ideal situation? I'm assuming that the demand for placement is going to continue. There is no other national free registry of any sort that will get people into those rotations apparently. What do you envision things looking like in a year or two down the road?

Dr. Chase DiMarco: The ability of this thing to really grow and expand is nearly exponential per year. The only thing close to this that we're aware of is VSLO - The Visiting Students Learning Objectives is what it's called and that's through AAMC. That system was really, really bad. And I know they've redone it recently and hopefully, it's better, but I've talked to dozens of physicians that used it for their schooling and never heard a positive thing about it. It was just clunky. It was usually outdated.

And even when you try to use the search criteria from them, it would always bring you to a separate website for that school, for that hospital and any kinds of fees and paperwork didn't translate. It just became quite burdensome from my understanding of it.

This can definitely replace something like that, but also there is an expanding number of international students every year. Current IMG, FMG foreign medical students, international medical students, and graduates make up something like 25% to 30% of the current physician working workforce. And the number is constantly expanding. And there is more competition between mid-level providers and MD/DO students.

There is still a lot of need for more clinicians. We need to probably focus on more ways to increase the number of rotations, increase the number of residencies and not decrease them. I think that it's going to prove to be so much easier. It's going to reduce hospital administration and school administrator time so significantly that there is no reason not to use it.

John: Excellent. I had a specific question about it as I was thinking about this and if I was in the position. Are there any sort of areas or workarounds or what do you have to do, let's say, if you want to be a preceptor and you want to make some extra money, but you're let's say one of a thousand doctors working in a large more or less corporate environment? Are there barriers to that? Do you leave that to the physician to figure out when doing a contract with the organization, and then they forward whatever fees to that doctor? Or have you even encountered that?

Dr. Chase DiMarco: Well, if I'm understanding the question right, there are a lot of different ways that a physician can be set up, as far as an independent contractor, work in private practice, working in a group setting. It does vary quite a bit, but let's say we'll take the hospital setting for instance. A lot of hospitals and university hospitals are some of the more strict ones that will have limitations. For instance, a lot of hospitals won't accept international students at all, or will only do so in a limited fashion.

But most of them do have a loophole where they will allow a physician to independently sponsor a student. You really would have to check with your institution or your group for that to see exactly how they work, but usually, there is a way around it. And it's becoming more and more common even for specialists to have independent practices and private practices. Those types of sub-specialties who it's been harder to find generally rotations are now leaving hospitals in greater numbers, which is providing more opportunities for students as well.

John: Well, certainly more care is being provided in the outpatient setting. Everything is moved out of the hospital compared to 10, 20, 30 years ago, for sure. So, you're going to need a lot of those rotations.

All right. I wanted to ask you. We're just shifting gears here to this whole entrepreneurial thing. What were some of the biggest challenges? You've done different things and this one seems to be potentially pretty complex. But if you were giving our listeners some advice, because I'm sure many of them have ideas or how to improve things, maybe this should be a business or it could be a business. So, what did you discover going through the process of the latest enterprise?

Dr. Chase DiMarco: I would say at least for this one, the biggest issue has been just the app development itself. Anyone that has actually listened to me talking about this concept in the past few years will probably follow the chronological order of, "Oh, we're using a new company" because that constantly seems to be happening.

App development for most physicians, if they're talking to us a programmer or an engineer talking to us is kind of like us talking to a kindergartener about the intricacies of pathophysiology. There is just such a knowledge gap there. They'll always promise they can save the world and give you everything that you want. It usually doesn't end up being the case.

Due diligence and really finding someone in the know that you trust to help you out can save some of those headaches. And there are a lot of new alternatives now with this kind of piecemeal DIY app development software. I don't have a lot of experience with those. Obviously, if you need something very, very complex, like my idea, it's probably not going to work out so well, but if you have a simple platform or an e-commerce site or something along those lines, go easy first. And then if nothing else, you have a concept to bring to an app development team later on and they will be able to understand how it should work better.

John: Yeah. I recently sent an email talking about creating your own app and it used to be like, "Wow, let's just create an app. It's simple. You can learn how to do it, and you can make a lot of money". Those days are long gone.

I had one guest, Dr. Kirsten Limmer. She ended up developing her own app, but she had to do a lot of studying. And she used one of the sites, I think that you're relating and mentioned where it's kind of a combination of a course/limited consultation and they'll help you, but you really have to learn how to code at some level or you just farm it out and pay a lot of money. So, that's basically your choice at this point from what I understand.

Dr. Chase DiMarco: Yeah. I think bubble.io is one that's pretty popular right now. They do have some walkthrough tutorial videos to give you a basic understanding. So, you can go through that, see if you enjoy it. And if not, then you're not going to continue making something yourself.

But it's really hard finding a company too. The first one I went through was a recommendation from a company that I was working with at the time. When they gave me a "good deal", I thought, "Oh, awesome", because we know the same people. Just to find out that they really couldn't provide anything close to what they promised.

If you can find someone that does know, that might be able to explain certain things to you and translate your entrepreneurial idea into an engineering understanding, then that's a good way to go about it.

John: I've seen some people take the approach that they would basically partner with somebody as or like their chief technical officer or something. Although I have heard many people tell me that you should never have a partner in a business. So, you have to figure that one out, I guess, for yourself. My wife owns a business and she's like, "I will never have a partner. I want to make the decisions. And that's the end of that conversation".

Dr. Chase DiMarco: I tried to do that with a friend of mine that he's very knowledgeable about computers. He's basically a CTO at another company, but he doesn't know too much about app development. So, he was like, "Nah, I wouldn't feel comfortable there".

John: Yeah. That probably doesn't help much. Okay, we talked about FindARotation, how to find that, and how to sign up there. How about just getting a hold of you? What would be the best way? I think you gave me an email earlier.

Dr. Chase DiMarco: Yeah, chase@findarotation.com is fine to email any questions about that. Of course, any social media accounts for myself or for the company is perfectly fine. I usually get to them pretty soon if I see them. Chase DiMarco, FindARotation, MedEd University. I know there are too many things to mention.

John: Some people like using LinkedIn, some people like using email directly to you. Was it chase@findarotation.com?

Dr. Chase DiMarco: Correct.

John: Okay. They'll figure it out if they have questions, but I think if they're interested in being a preceptor, just sign up. It's working now, you're connecting students to rotations. So, if someone wants to make a little bit of extra money and enjoys teaching, this would definitely be something they can do. And particularly if they're thinking about it and they need to make a little extra money and why not.

Dr. Chase DiMarco: Exactly. And if the beta version app is glitchy, then just email me directly and I'll help you out.

John: All right. Well, this has been very interesting. Any closing thoughts before we let you go today, Chase?

Dr. Chase DiMarco: Well, I would just leave it with this. There was a huge need for this type of service prior to COVID and now with nearly two years of in a lot of instances, students not being allowed in hospitals still in many states, there is definitely a need for more individuals such as your audience to participate in this and to share their knowledge and wisdom. So, I definitely hope to see more of you participating.

John: Yeah. That kind of blows my mind. One of my kids is in nursing school and her clinical rotations have consisted of no patient care whatsoever for the last nine months. And I'm thinking seriously? Well, that's going to cause a real backup.

Dr. Chase DiMarco: Oh yeah. We have a couple of years.

John: It's been really fun. This is interesting. I love talking to physicians that are entrepreneurs. And so, with that, I'll just say goodbye.

Dr. Chase DiMarco: All right. It's been great sharing these ideas and I hope it's interesting. And thank you so much for having me on.

John: You're welcome. Bye-bye.

Scroll back to top

Sign up to receive email reminders, news, and free stuff every week!

Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.

powered by

Disclaimers:

Many of the links that I refer you to 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.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

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

The post What Is the Newest Way to Earn Extra Income While Seeing Patients? – 217 appeared first on NonClinical Physicians.

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

Our Sponsor

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

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

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

How to Establish a Concierge Practice 

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

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

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

Growing Her Business

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

Summary

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

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

Links for Today's Episode:

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

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

Email Download New Tab

Transcription PNC Podcast Episode 210

Want to Establish a Concierge Practice Before Finishing Your Fellowship?

Interview with Dr. Brook Choulet

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

John: And how long has she been doing that?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Brook Choulet: Definitely.

John: All right. Bye-bye.

Scroll back to top

Sign up to receive email reminders, news, and free stuff every week!

Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.

powered by

Disclaimers:

Many of the links that I refer you to 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.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

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

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

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

Our Sponsor

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

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

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

The Classic Silicon Valley Approach

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

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

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

Revenue Cycle AI Saves Small Group Practices

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

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

Summary

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

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

Links for Today's Episode:

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

Download This Episode:

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

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

Email Download New Tab

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

John: Does that include your parents?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Fisayo Ositelu: Omar.

John: What is his official title?

Dr. Fisayo Ositelu: Head of growth marketing.

John: There's a lot of going on.

Dr. Fisayo Ositelu: Yeah.

John: So, how's it going?

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

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

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

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

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

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

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

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

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

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

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

Dr. Fisayo Ositelu: Exactly.

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

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

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

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

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

Dr. Fisayo Ositelu: Right. Go for no.

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

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

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

Dr. Fisayo Ositelu: Thank you. Bye-bye.
{"mode":"full","isActive":false}

Scroll back to top

Sign up to receive email reminders, news, and free stuff every week!

Enter your name and email address below and I'll send you reminders each podcast episode, notices about nonclinical jobs, information about free and paid courses, and other curated information just for you.

powered by