startup Archives - NonClinical Physicians

First Consider 5 Proven Strategies To Save Your Career

John Jurica — Tue, 24 Dec 2024 12:05:41 +0000

Recent Trends Offer Options for Physicians – 384

In this podcast episode, John discusses how to save your career if you wish to continue working in clinical medicine.

John shares five proven strategies for physicians to revitalize their medical careers while maintaining patient care, drawing from his experience as a Chief Medical Officer to help doctors reimagine their practice rather than abandon clinical work.

Drawing on real-world success stories, he offers practical solutions for physicians who enjoy patient care but struggle with administrative burdens and work-life balance.

Our Sponsor

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

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

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

For Podcast Listeners

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

Taking Control of Your Practice to Save Your Career

Contract renegotiation offers a powerful tool for employed physicians to improve their work conditions. Key areas for negotiation include vacation coverage, and ensuring adequate support during colleagues' time off through locum tenens or community coverage. Working hours should account for documentation time, and supervisory responsibilities for NPs and PAs need clear boundaries.

When approaching renegotiation, physicians should review their contracts months in advance, engage legal counsel, and strategically time their negotiations, especially as healthcare systems face increasing challenges in physician retention.

Breaking Free from Traditional Constraints

You can explore various practice models to eliminate common stressors while maintaining clinical work. Options include direct primary care (DPC), cash-only practices, concierge medicine, or specialized focus areas. These models often eliminate insurance billing headaches and allow for better work-life balance.

Alternatively, you can consider micro-incorporation, forming an LLC to work as an independent contractor with hospitals, gaining tax advantages and greater flexibility while maintaining the appearance of traditional employment.

Summary

Each approach requires careful consideration and planning. However, there are solutions to the challenges in modern medical practice that preserve the physician-patient relationship.

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 384

First Consider 5 Proven Strategies To Save Your Career

- Recent Trends Offer Options for Physicians - 384

John: Okay, today I want to describe several ways that you can fight to save your clinical career. Normally, I talk about nonclinical and unconventional careers to consider when you're fed up or burned out from your practice, but I've learned that sometimes it's not practice per se, but the long hours, dwindling salaries, and unsympathetic bosses that lead physicians to leave practice. You may still enjoy seeing patients and working in a clinical practice if you could get rid of all the other nonsense.

I'm coming to believe that reimagining your practice might be a valid, maybe even a better way to save your medical career and get back on track than just abandoning it and doing something nonclinical, albeit still in the field of medicine or in the field of healthcare.

I've had several guests over the last year or two who have confirmed that belief, and I want to spend a few minutes today to provide a little bit of food for thought on a short list of strategies to get you back on track in your career, bring some happiness and satisfaction without leaving medicine. So let's get to that discussion.

All right, we're talking about considering five proven strategies, and these strategies are designed to save your career. Let me work from this premise that you're in this position and you actually still like seeing patients for the most part. You enjoy practicing medicine, and that's not the problem, but it's all the other stuff that gets in the way.

Things are happening, most of the time it's because you're employed, you feel you don't have a lot of control, and you know what's going on is not really aligned with your lifestyle desires or your values, that kind of thing. And you'd really like to be able to spend time with your patients, make a decent living, and maybe even not be sued and other factors that I'm going to talk about here in the next few minutes.

But while you're thinking about these strategies, remember several things, that most of these will require hiring an attorney, most of them or some of them will require moving at least to a new practice. You might not have to move from your city if you're in a big city where you can actually still commute, but some of these things I'm going to mention do require you leaving your current practice. And sometimes it might not only involve moving to a new practice, but it might involve starting a new practice. So those are big things if you have to sell a house and so forth, they can be a barrier.

But these are all situations where you can continue to practice. And in many of these situations, your practice is extremely rewarding. So I have five strategies for you to consider today, and I'll go through all five right now, and then we'll go through them one by one.

The simple one is to aggressively renegotiate your contract. The second is to hire an agent. Now that might seem kind of unusual. We don't think of using agents for physicians to negotiate their contract. This one usually applies for your first job, but it can apply to your second or third as well. If you can somehow eliminate the billing from insurance companies, that can sometimes eliminate a big chunk of problems in a practice.

Let's say you're in a private practice now, either alone or with others. If you can figure out a way to avoid the need to do billing, hiring staff, tracking it down, working with the big insurers, which is extremely frustrating, that might solve the problem. Possibly you can just narrow your focus, narrow your practice.

I'll give you some of my ideas on that. And then the other is maybe switching from an employee to an independent contractor, even in a similar situation, or what some people call micro-incorporation, that might solve the problem and bring you closer to the practice of your dreams.

Well then, let's talk about aggressively renegotiating a contract. Now this is for those who are already employed. And I have a fair amount of experience with this because I was a CMO for my hospital and I either negotiated or renegotiated over a hundred contracts. I even oversaw the hiring and then also the recruiting of new physicians from their own practice. In other words, we would buy their practice and we would add them to our group.

But if you're already employed, you have a contract, there are usually certain factors that cause the burnout, that cause the dissatisfaction. One could be the vacation coverage. And it's not that you don't have enough vacation. You may have two, three, four, even up to six weeks or so. The problem is that sometimes you don't take your vacation because you're so busy and you feel like your patients will be let down.

Sometimes you don't take vacation because you don't have enough coverage. And related to that is you don't take vacation because you realize the more vacation that you take, the more that the other physicians who cover you are going to take. And when they're gone, your own time is extremely stressful because you're covering for all their patients while they're gone.

So if you're in a group with six, seven, eight specialists in a certain field, it's not always a big problem to have only one person gone at a time. But if you have three and one leaves for two weeks, then that means the other two are on call every other night or every other day for those two weeks. And so, it's kind of a misnomer, and I realized this even when I was negotiating these contracts, but sometimes we just had these difficulties with the small groups of specialists that it's really not every third or every fourth call rotation.

Because let's say that you have four people working in that. Well, all four of those physicians could conceivably take off three weeks each year, which means during let's say the nine weeks when other people are taking call, you're no longer on every fourth night. Now you're on every third. So your contract is essentially in violation. What they're doing is in violation of your agreement. Really what you should be doing is plan those out well in advance and get locum tenants to come in and fill.

And it's even worse if there's only three of you or two of you, because then when one person's gone, if there are two, then it's extremely stressful. And yet they say, well, we'll work around it, but no, that can be devastating. So vacation coverage is a big deal. And that's something that should be really clarified that if you're really on every fourth, then that means when people are taking off, you should get locums in there to cover or pay somebody in the community to cover.

The hours and salary of course are big deals too, but it's mainly the hours that you're expected to work. And I think we need to start pushing back on the employer and say, okay, I'm including the hours of my documentation. So you shouldn't be seeing patients for eight, nine hours a day. And that's quote your normal office hours when you're going to be spending an hour or two at night doing your charts, there needs to be time taken during the day while you're seeing patients to do your charts. And if that doesn't work out, then you need to come up with another plan.

And the other one that came up a lot when I was doing this was working with physicians and getting enough supervisory time for the NPs and PAs that we had, because we were hiring a lot of them. And it really got to the point where we were struggling to get them coverage and sponsoring or collaborating physicians. And so they could be the designated coverage or sponsor for, let's say some PAs, it could be 5, 10, 12, 14 PAs that could be calling at any time that they're seeing patients. And this is like a minor thing in a contract theoretically, but it's really a big deal.

And so, what you need to do is look at all those things in your workplace that are making you unhappy and take the opportunity to plan for it and aggressively renegotiate your contract so that it actually provides you what you need safely and at a low risk of being sued. Some of these things lead to fatigue and leads to mistakes and all that kind of thing. So that's one option.

Now, this has always been out there, obviously. I think as hospitals and systems are having more difficulty keeping physicians, you can get a little more leverage now that maybe you had five or 10 years ago. So that's the first thing. You can definitely start by renegotiating aggressively. Obviously, you're going to need to have a good attorney and you're going to want to strategize with the months and months before it's time to renegotiate. And you're going to look at your contract and make sure that you give them enough notice that they don't just say, oh, it just rolled over for another three years because you didn't dispute it. That's enough of that one.

The next one is hiring an agent. And this is mainly for your first job and then subsequent jobs. But I interviewed a guest by the name of Ethan Encana. He was trained as an attorney and that was in February of 24. And he has a full time company job and associates who are hired by physicians as an agent to do the negotiation upfront for their jobs. And they're really serving more like they would for an athlete, a professional athlete. They're going to look after you. They're going to approach the organizations that have these jobs posted. And they're going to negotiate even before they get to the negotiation of the actual contract, the arrangement. And the arrangement is that they are going to pay the fee for this agent. And this agent is going to keep all of your best interests in mind and negotiate very aggressively to get you a contract that has all the things in it that you want and need.

And it's again, usually those same issues that include vacation, the hours and salary, the pay for supervising other medical providers, the restrictive covenant. It's tough to get rid of that restrictive covenant, but there's more and more examples where they are getting rid of that. So if for some reason you would want to go private at some point, then you can do that.

But you can actually hire an agent. And again, I had never even heard of this until earlier this year in 2024. And so, I'll put links in the show notes to any of these things that I mentioned in terms of previous guests and resources to follow up on these options.

Hiring an agent is an option. Maybe they can get you a better deal that is to your satisfaction and has a great life work-life balance and so forth. And particularly if you're willing to look not maybe rurally for sure, because they're really having trouble, but even in the suburbs and stay away from the big cities, you're going to find a lot more opportunities because they are struggling to find physicians, but you're going to have to keep them honest in terms of what their contract requires them to do.

The next one, number three is eliminate billing. Particularly if you're already in your own practice. It seems like it's that whole issue of billing and hiring more staff to do the billing and then have to go after payments that are declined, costs a lot of money, you spend a lot of time, you might have to be doing a lot of paperwork and signing off on paperwork to challenge these billing decisions. Really, there are different ways of doing that. But we know, of course, that DPC, direct primary care is a great one.

I've had, I think, two or three guests on. And let's see there. Also, I talked to someone who is doing an infusion lounge, which is cash only. Direct primary care most of the time is cash only based on a membership fee. Concierge is very similar, kind of high end, more expensive.

A lot of the DPCs, the monthly cost is reasonable and patients really are not opposed to paying that because they have such high deductibles and copays that they do better doing DPC. A med spa is another example. Or you could really narrowly focus your practice and do cash only. You could do functional medicine, I think even lifestyle medicine are ways that you can eliminate third party billing. It's not that the patient can't access their billing, they can do that. You just have to give them records that they can then submit their own reimbursement. Of course, a lot of people have health savings account and similar accounts.

So, if you're in your own practice and that's one of the things that's really making your life miserable, then you want to move to a model that doesn't require you to do a lot of billing. Well, at least not billing of the insurance companies because that's where you really get killed. Normally, if you're doing DPC or even free for service, you're going to get paid by your patients because they'll be afraid that they can't keep you as a primary care doctor. Now, if you're doing urgent care, you could do cash only urgent care. Of course, you do need to be paid at time of service for that.

So, let's move along here. Another thing you can do is narrow your focus. We'll look at this and start in a pretty general practice and that's what we get overwhelmed with. Sometimes, if you can focus on just one sub area or two sub areas of a practice, then you have the ability to systematize things. You can master the billing. So, even if you're doing billing, usually if you're only using, let's say, a handful of codes, you know how to document and how to get paid for that.

I'll give you an example. I have a friend, he's sort of pre-retirement. He's a pediatrician. Obviously, he did a lot of different things, was working in the hospital for a long time, eventually stopped doing hospital work once we got some pediatric hospitalists in town. And then he decided that he wanted to simplify his life a bit and so he started doing only care for attention deficit disorders.

Now, he's still charging fee for service and he's not using a DPC model per se, but you could. You can do either one. But the patients that he has, they are so happy to have someone who's really focusing on this area that they'll pay the money rather than go to a general pediatrician who's doing so many other things and isn't necessarily able to sit down and spend the time and doesn't have the staff in the office like this friend of mine who since we're all on the same page, we're all working on the same problems with these patients. Everyone's very knowledgeable and they get a lot of personal care and they're happy to pay for it.

And so, you can do things like that. I can imagine a neurologist focusing on Parkinson's disease or something with some other neurodegenerative disease and have just a lot of patients with that particular condition or certain cancers or certain cardiac disease. And so, think about ways you could focus down, simplify your practice. Again, you'd have to be in practice to do this. In some cases, you might be able to do it in a large group, but you may end up on your own or with a small group to be able to do this. But at least you're still practicing and your patients will really appreciate you.

The last one, number five here is what I'm going to call microincorporation. I spoke with Todd Stillman back in October of this year, 24, and he was recommending, and there's a reason why this makes so much sense too, besides the fact that it's just another option to get more independence. But you're thinking what I just described in terms DPCs and concierge and med spas and narrowly focused practices, you have to build a practice. It's expensive. You have to market it. You have to have space. You have to pay rent. You have to hire staff. You have to have someone to help you with the billing if you're doing the billing. But you can avoid all of that. And to get a lot of the benefits of being in your own practice by forming an LLC, but then using that LLC to become a pseudo-employee of a hospital system or a large group.

And basically you're a 1099, you're an independent contractor, and you negotiate a contract with the hospital. And the hospital contract is not an employee contract. And so they are alleviated of some responsibilities. They don't have to treat you as an employee. They don't have to give you any benefits. So you have to make sure on the other side of the equation that you make up for that.

But the thing is when you incorporate as an LLC or whatever other PLLC, each state's a little different. You work as an independent contractor, but you look as though you're employed by the hospital and you're not opening. As a matter of fact, you're working in one of their clinics and one of their offices. When I was talking to Todd Stillman, he was funny because he actually had owned an office. Now he was leasing that office to the hospital, which was then allowing him to work in that space. And so he was actually making money by leasing the space to the hospital and other physicians have done this.

And then granted, you've got to cover some things like your own health insurance, but you can find good policies and you have more options as an LLC or PLC to actually diversify your income. You can, through that LLC, do other things. You can have much higher limits on a 401(k) and other tax advantaged investments and so forth. And there's a lot of other tax write-offs that can be used legitimately.

If the first three or four options that I talked about involve starting your own practice, it seems too onerous and you don't want to borrow $100,000 or $500,000 to do that, then this micro-incorporation is another way to really achieve the type of practice that you want to achieve, but mostly onus of the investment on the hospital and still kind of maintaining that arm's length relationship, which enables you to do these other things that make up for it, which includes investing in other ventures and maybe even have other side jobs.

And by the way, nobody else needs to know that this is how it is. You can be doing this and to everyone else in the hospital, in the community, it will look as though you're an employee of the hospital, but you've created your own mini-corporation to get the advantages of the flexibility and so forth that you desire. And yet everyone else and you're still participate with committees at the hospital and stuff to meet all the requirements as a physician, but it does add a lot of flexibility. And I think there's two episodes. I'll put links to everything here in the show notes.

There are five ideas for trying to improve your lifestyle, improve your satisfaction without leaving clinical medicine. Some of the prep will involve really start by reviewing your contract right now, even if it's not due for a year, look in there, see what you're restricted. What can you do? What can't you do? How much notice is required? Early on in the process, as you're reaching that deadline, you need to let them know early and say, look, I'm not leaving. I have no plans to leave this organization, but I want you to know that I have some things I'm not happy with and I'm going to be renegotiating this contract. So if that requires me to give you six months notice that I'm leaving, then I'm going to then you give that notice in writing.

But even in that letter, you can say, I'm planning to stay, but I'm giving you notice as required by my contract that I might not stay if some of the concerns I have about my contract are not addressed. And it doesn't have to be anything onerous, doesn't have to be very confrontational. You go in professionally, you talk with your attorney and you go in and say, here's what I want.

From a negotiation standpoint, I would always ask for the moon. And if you have three or four issues, you start with putting it out there and say, I don't want a restrictive covenant. And then you can come back and negotiate maybe something that's much less restrictive than it was in the past. I don't want to work in this office, or I don't want to supervise 10 NPs and PAs. It's too much work unless I get a lot more compensation and cut back my hours in other areas. These are things you can do. You definitely want to talk to either an agent, as I said, or an attorney, and then discuss your options and negotiation strategy before starting that process.

That's basically it for me today. You know, if you find yourself on the way to burnout, consider taking some of these steps now and go to the show notes for links to the interviews mentioned so that you can learn more about each strategy. And to find those, you can go to nonclinicalphysicians.com/save-your-career.

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Disclaimers:

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

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

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

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The post First Consider 5 Proven Strategies To Save Your Career appeared first on NonClinical Physicians.

This Physician Entrepreneur Offers a New Way to Find a Job

John Jurica — Tue, 17 Dec 2024 13:27:48 +0000

Interview with Dr. Zhen Chan – 383

In this podcast episode, John interviews pediatrician Dr. Zhen Chan whose startup offers a new way to find a job by eliminating third-party recruiters and putting physicians at the center of recruitment.

Through his platform Grapevyne, doctors can earn substantial referral bonuses while helping colleagues find positions with unprecedented transparency and detail. With his unique combination of medical training and business school education, Dr. Chan is reshaping how physicians connect with career opportunities.

Our Sponsor

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

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

For Podcast Listeners

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

Reimagining Medical Recruitment Through Physician Networks

Dr. Zhen Chan noticed something broken in physician recruitment – endless vague job listings, intrusive third-party recruiters, and a lack of transparency. His solution? Grapevyne is a physician-only platform that puts doctors in control of the hiring process.

The platform incentivizes physicians to refer qualified colleagues while providing detailed job listings that answer doctors' questions about potential positions. In just a few months since launch, the platform has attracted over 315 physician members and eight healthcare organization partnerships, with 40+ new positions currently being onboarded.

Building a New Way to Find a Job While Staying Clinical

Despite the demands of launching a startup, Dr. Chan maintains his clinical practice as a per diem pediatrician while running Grapevyne full-time. He partnered with HealthWorx Studio for initial funding and assembled an expert team spanning technology, recruitment, and healthcare operations.

The platform aims to expand beyond job matching to become a comprehensive career resource for physicians, offering guidance on contract negotiation, healthcare payment systems, and professional development.

Summary

Grapevyne is the next revolution in physician recruitment through a peer-driven platform that eliminates traditional recruiters. The platform offers substantial referral bonuses and detailed job listings. It has already attracted over 315 physician members and eight healthcare clients. Physicians interested in joining can visit grapevyne.health or contact Dr. Chan directly at zhen@grapevyne.health.

Links for today's episode:

Grapevyne.health
Dr. Zhen Chan's LinkedIn Page
Zhen Chan's Email Address: zhen@grapevyne.health
Healthworx Studio – building the future of healthcare by working with founders driven by purpose, passion, and impact.
How to Practice Hospital Medicine and Found a Startup
Introducing a Fearless Medical Entrepreneur
How to Nurture a Career in Cutting-Edge Healthcare Technology – 156
How to Fulfill an Academic Need and Spawn a Business with Dr. Jason Ryan – 081
Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)
The Nonclinical Career Academy

Podcast Editing & Production Services are provided by Oscar Hamilton

If you liked today’s episode, please tell your friends about it and SHARE it on Facebook, Twitter, and LinkedIn.

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

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 383

This Physician Entrepreneur Offers a New Way to Find a Job

- Interview with Dr. Zhen Chan

John: Well, I like talking with physician entrepreneurs, as some of you listeners know, and today is going to be very interesting. He's a relatively young physician pediatrician who's also running a company full-time. So with that, let's just get into our conversation with Dr. Zhen Chan. Hi, Zhen.

Dr. Zhen Chan: Hi, John. How are you doing?

John: Really good. I came across, I don't know how we met, actually; I think we were introduced basically.

Dr. Zhen Chan: Yeah.

John: When I looked at your website and your LinkedIn profile, I mean, it's really interesting. You're involved with this company. But before we get into that, let's have you go ahead, like we do every podcast interview, and just tell us about your medical training, your background experience, and then kind of lead up to what you're doing now.

Dr. Zhen Chan: Sure, that sounds good. So I'm a pediatrician by training. Didn't do any fellowship, but I graduated residency summer of 2023, which I can't believe it's been that long already. Yeah, I did that up in New York Presbyterian with Weill Cornell in Brighton, Manhattan. And then the rest of my education was all back in Miami where I grew up— Miami, Florida. So, I was at the University of Miami for undergrad and medical school, and I took a year off between third and fourth year for business school as well. It was focused on health management and policy, and it really kind of expanded my knowledge of healthcare beyond just the clinical piece. So that was the seed of some of this extracurricular interest, so to speak. And then during residency, I did a lot of quality improvement work, was able to have the opportunity to lead a couple projects as well, which was super fun. And I think because of how fulfilled I was from doing that, and also some of the advocacy work too, I was like, "Oh, maybe I gotta do some more career exploration and like soul searching." I wanted to apply for Peds Hema Fellowship. Second year, I toyed with the idea of doing PICU. And then I was like, wait a minute, I really enjoy these like back end healthcare solutions. I really think that working on them allows you to really scale your impact. And so let me do some exploring. I networked people all over the field— public, private sector, you name it. And worked in venture capital actually for about a year as like a part-time associate. And that started as a fellowship position just to get to learn and get a lay of the land. And then I really, really enjoyed meeting founders. I really enjoyed people working in early stage startups because of how mission-driven they were and really trying to solve problems that are out there. And that's when I said, "Oh, I really want to build something on my own." And here I am.

John: All right. Well then, tell us what is it that you decided to build and what problem were you solving by building that.

Dr. Zhen Chan: Yeah. So the company's called Grapevyne— Grapevine spelled with a "Y". And the name comes from this, kind of comes from the song. I heard it through the Grapevine, or the saying, "I heard it through the grapevine." Because what we're doing is we're driving physician recruitment and the job matching process through physicians. So, no need for third-party recruiters. We're also, because we're physician-founded and we're building a team around understanding what doctors truly value, we're creating job posts that are fundamentally different from the other job boards that you see out there. So no more of these like vague, undescriptive listings that you're looking at this and you're honestly, you don't know salary, you don't know location, you have no idea what this job even entails. And more importantly, you don't know what it's going to be like day to day, which is very important to understand. And so, as someone who went through a job search myself, I know exactly what we need. I want to, if there's certain specialties, I'll go out and interview those specialists to say, "Hey, in your specialty, what are the things that you really want to see on a job post?" And we'll put that all there. So that's one fundamentally different piece. The other piece is that how we drive the process and that is through referrals. So, once an employer contracts with us and puts a post on our job board, we activate the network and we tell members— who are all physicians right now— to say, "Hey, look at these posts." If you're interested yourself, you can apply. But if you know someone who could be interested and you think they're a good match based on this very detailed listing, comprehensive listing, you can refer that over to them and you will actually get a significant cash payout for a successful referral, meaning like right now, the structure is if someone submits an application because of your referral and it's a qualified application, that you can get $25 on most of our posts right now. If they complete the interview process, you'll get another incremental payout. And then if they actually get hired and truly start the position because of your referral, you'll get the most significant payout. Right now on our job board, every post has a payout of $2,000. That could be different in the future, but that's what all the posts have now. So, we're driving the process through physicians. We're a company led by a doctor— not that I can speak for everybody, I do want to say that. Then we're bringing money back into the process too. So ownership, cash, everything— we're putting back into the physician community.

John: Okay. That's pretty unique and interesting. It seems like there's always processes that can be improved— made less costly, less onerous, less time consuming and so forth. So, let me just kind of think about the different stakeholders here.

Dr. Zhen Chan: Yeah.

John: So, I mean, it sounds like a physician can, if they know of a job opening, and let's say their organization, they can make a referral or put a post or something. Or do they come from directly from the hospitals and the medical groups that are looking for physicians?

Dr. Zhen Chan: Yeah, that's an important distinction. So it's not that everyone can just post whatever opening they have. We do contract with the employer. And then we look at the post that they want to give us. And we will work through because they probably already have some standard materials and bulletins that they're sharing with the traditional recruiters out there and the traditional job boards that are out there. But we will take that bulletin, inject kind of our own flavor into that. If it's an ENT job, we'll try to find an ENT member of our community and we'll try to find an ENT maybe in our personal networks and then say, "Hey, if you were to look at a job, what would actually entice you? What do you need to know? What are the questions that you probably would have had to go through a lot of intermediaries to find out before you actually get a comprehensive understanding of the job?" Let's get all those details and let's just smack them onto the job post. And then for the employers, the reason why it's a better format is- we're creating posts that are more engaging. So, doctors can see these and will say, "Wow, I actually really like what's on here. I know everything I need to know. I'm willing- I wanna apply." As opposed to somebody coming in and saying, "Hey, I have this fantastic job that's perfect for you. It's in a great location. Do you wanna hear about it?" And you're like, "I'm not gonna respond to this email. Like I get a million of those. Like what's gonna make this one any different?"

John: Yeah, I can think about some of the complaints I've heard about the usual process. Like... For some it is they find something online— a job— but they really don't know. Like they might even be blinded in the sense that they don't even really know exactly where it is because the host isn't actually revealing that until they get your name and phone number. And then they apply, they send in the resume and they don't hear anything forever. Sometimes, you know, just they don't qualify, but. So yeah, I mean, there's a lot to improve in that process. So, and the revenues for this that really is supported by the companies, the hospitals and the groups that are looking for physicians.

Dr. Zhen Chan: That's correct. That's correct. We are on that kind of contingency fee structure, but we're able to charge a much more affordable flat fee structure. And right now, since we're early, we're not charging any subscription fees, any listing fees— nothing like that. So there's no downside risk to working with us and we're not expecting any exclusivity. We really just want to solve a problem in this space and be able to reduce the administrative expense that goes out into things that frankly, we are seeing as unnecessary.

John: Interesting. I'm just kind of thinking through the process too. Like if I were, let's say working at that organization already, let's say there's 500 physicians there. I mean, would it make sense for the HR department, whoever's putting these out to actually promote let their people know, I suppose. Sometimes I like to do things, you know, like in a vacuum or quietly. But I mean, they could just let all their interns know that they've got an opening for another internist. They're probably doing it because these internists have asked for it. And so, hey, by the way, if you're gonna help us get the word out, feel free. That would, I would assume, would be something that could work.

Dr. Zhen Chan: Yeah, many groups have internal employee referral programs. What I like to say is this is an employee referral program scaled to the entire network of physicians that are out there and anyone can look at jobs and refer each other. It's not going to be siloed to your facility.

John: Okay. Awesome. Well, let me ask how are things going so far. What's the feedback? I think you are relatively new.

Dr. Zhen Chan: We are. We are. So we launched our first job post in end of September, got another— if I remember correctly— seven onboarded at the end of October, and then we had another 16 mid-November and we're currently onboarding another 40 from a larger health system. We're up to eight clients just in these short few months and in terms of member size, that's probably been the most exciting thing to see— how many physicians really enjoy the idea of this platform and want to support its growth. We've gained now over 315 members, just I would say over October, November, and these first couple of weeks of December, we've gained about three-quarters of that. So it's been tremendous growth.

John: Interesting. So those what do you find? Are they all actively looking, or are they thinking, "Wait a second, doesn't cost me to join? I might need something six months down the road. Why not just join now and find out?" And then when they see the right position, they say, "Maybe I should jump on that."

Dr. Zhen Chan: Yeah. combination. So we have a combination of members who came because they were looking for some things right now. And, you know, frankly, we're because of how new we are, we may not have the right opportunity for that specific person actively looking. But most physicians are passive job seekers, meaning and that I think there's a paper that was put out that it's around 80% of physicians are passive job seekers with a survey from it wasn't a paper sorry, a misnomer. It was a survey of about 1,500 hundred doctors and so what passive means is "I'm not actively looking but if something nice rolls my way, maybe I'll pay attention to it" and so, I'm not gonna be on job boards; I'm probably gonna ignore those text and calls from outside recruiters but if someone I know sends me something that's interesting I'll take a look and that's how our process works so we have a lot of those individuals to and my hope is that as we bring on more employers have more jobs going to be more opportunities for everybody to see. And if they want to apply for themselves, they can. If they feel like there's someone else that's in their network, that's a good fit, they can refer that out. And I see it as a potential to make significant cash too, when you're making a lot of referrals. And I don't think doctors are going to be out there spamming and trying to scam each other for a quick buck in this way. You can lose a lot of trust in that process. And that's exactly why there's so much lost trust in traditional recruitment.

John: Yeah, I guess it'll be interesting how things pan out, but I would assume that most physicians have a lot of integrity and they're not going to be even making a referral to something that they think is at an organization they're not really fond of or something like that. So, that's awesome. Well, let's pause on this for a minute. Tell us how to go to Grapevyne and do that, and then I want to come back to something else.

Dr. Zhen Chan: Sure. So you can find us at our website, grapevyne.health. That's Grapevyne spell with a "Y", dot health. Our websites allows you to take a look at what we're all about, and then you sign up for our platform. Really the onboarding process, I would say it takes about maybe three minutes-ish to just give some basic info. We use a cell phone number for the sign-on, so we can have that one-step verification with you. We're really keen on not having anybody that's not a physician, be excluded from the platform. So it's a physician-only platform. We have an NPI right now that you use, which the NPI is out there, but that's how we verify. Once you're on, you'll see a dashboard with featured jobs. There's another page with all of our jobs, and we're working on a couple extra features to make sure that what you see is most relevant to you, and that there's a way for you to search, and filter, and everything like that.

John: Awesome. That's good. No, it sounds— I went on there and I only went so far before I thought, "Well, I'm not really looking for a job," but yeah, it was well-designed. And that brings me back to this other question I wanted to ask you. It has to do with running this business, practicing at the same time, that piece of it. And we also like to hear about the business building itself. And, you know, who did you pick out - how did you get this thing built and all that? So we kind of want to know a little bit about the business and what it takes to run this thing while you're still practicing.

Dr. Zhen Chan: Yeah, yeah, yeah. So I'll talk about the practicing piece. I do still practice part-time. I am on a per diem contract, here in D.C., and this is a really good balance for me, based on my interest. Is it going to be the balance for the rest of my entire career? I don't know. But I do enjoy what I'm doing right now and the full time, running a startup aspect of things. It's- I would say hours-wise, it's as intense as I think I had residency. Like, yeah, it's as many hours as it was in residency. Now, do I get to do my work remotely? Do I have my puppy sleeping next to me and I can have my lunch and everything like that? Of course! I'm not going to compare it to the physical exhaustion I was experiencing in residency, but it's a full-time 24/7 type job. I'm working on the weekends, all that kind of thing. And The business side, building out a team is super important. So one of the first things I personally had to recognize was where are my gaps— where are things that I'm not an expert in? I won't be able to be the best person to do this part. And that was dealing with the lawyers, like the legal side, the day-to-day operations. I've never built a business from the bottom up before as a first-time founder, so I wanted to go out and find someone, and I found an amazing co-founder. His name is Drew Mayer, has been a repeat founder of early-stage companies, has been working in the healthcare startup space for a long time and worked with physicians. His father was a physician. So, when we were talking to him and I was developing that relationship, just felt like we were really aligned on the physicians take back medicine kind of push and that sentiment. And then as we move forward, we brought on an engineer. I can't do product development; I can't code. So went out and looked for someone there, brought on an individual who he worked on Indeed job board. And so, you know, had experience and expertise there. And then finally, you know, as much as we are trying to replace the third party recruiters, I have to be sensible and say, "Well, if there's established recruiters out there who are good and who really do care about physicians. Is there someone out there that can give me that expertise and has been in the industry for a long time?" And we did bring someone on just like that who's been working in health systems, in the exec positions and can really, and just bring her expertise and experience in ways that I personally like. So, finding what I don't have and being able to find the others to come in and help team up kind of building this "Avengers-like group" is the way I see it. And building this business— I have to give credit where credit's due, the concept of Grapevyne came from a venture studio. And so that venture studio is based here in D.C. It's called HealthWorx Studio, spelled with an "X". Yeah, we both have like words that are spelled differently. And so HealthWorx Studio, and they are always incubating and coming up with new ideas. And when they think they have enough research to say there's something here, they go out and look for founders to really come in and build out the concept. Like it's like you start with one puzzle piece and then you want someone to come in and build the whole puzzle. So they come out and look for founders that align with the vision or can give their own vision, build out the business strategy, build out the team, and then take it out of the studio. So that's the model that we're working under right now.

John: So are they the ones that provide the capital to support some of this? Or do you do a separate, you know, fundraising? How does that work?

Dr. Zhen Chan: Yeah, so from the conceptualization up to today, it's all been funded by the studio. And we are going out and looking for outside investors. We really want to find well aligned investors, specifically in the physician community— those that are going to be, I think ideally our end users too, right? Because then they can give us feedback, they can be the users of the product, whether if it's for their own practices to help them hire more. physicians or it's going to be physicians who are like, "wow, this is something I can really use." Those are the types of well-aligned investors that we are looking for, but we're starting those conversations now for angels, VCs, etc.

John: Okay. So with the studio, would it be people have used "incubator" as a term, you know, with other is that a similar type of idea that kind of get ideas, get people together?

Dr. Zhen Chan: Yeah. The way I like to explain it using what I understand is typically in venture capital, and you usually associate venture capital with earlier-stage companies or growth-stage companies, there's traditional venture capital firms, which is all about, you know, we're going to financially analyze you, we're going to do our diligence on your product, make sure that you have the right team, all that, and say, "All right, we're willing to give you capital for whatever returns expectations." That's traditional VC. And then you have the accelerators and incubators out there that outside founders will come up with an idea and then apply in, in exchange for equity. They apply in to obtain the expertise, to obtain the support resources, et cetera. Then you have now what's, there's more and more of them coming out, venture studios, which act like this reverse incubator or this reverse accelerator. They come up with the idea, start funding it. When they feel there's something there, they'll go out and bring in founders to take it out of the studio. That's my understanding. There may be listeners who will say, "I don't know if Zhen's right about that."

John: Well, it seems to be your experience, you know? So things do evolve over time, but it's a good explanation. It helps me understand really what's going on a little bit better.

Dr. Zhen Chan: Yeah.

John: Okay. Well, we're going to get to the end pretty soon here. So I want you to go back and kind of re, just restate, like, what do you think, like the big advantages to Grapevyne over, the current way of trying to find a job.

Dr. Zhen Chan: Yeah. So for us, recognizing that traditional recruitment, it's not efficient, it's not effective, and it's costly. And there's not really great guarantees for finding the right candidate. So our process, because it's referral-based through the physician community itself, and we're crafting job posts fundamentally different than the bulletins and posts that you see out there, we believe we're gonna be better, where our posts are gonna be better in engaging. And your jobs are going to be more visible by a larger swath of physicians that are out there. And on the physician side, the source of truth or the, not the source of truth, but the person who's going to be reaching out to you and giving you anything is always going to be someone you are already connected with— a trusted existing connection. So, driving trust, driving transparency, and ultimately for us as boots-on-the-ground clinicians, if I can improve job matching, if I can say doctors will be put into jobs that they are better fit for because the sourcing is inherently better, we can reduce burnout, we can reduce churn and turnover, doctors will stay in these jobs for longer and especially in fields like primary care or especially in practices that are in rural and underserved settings. Physicians are likely to take those jobs, stay in those jobs, and you have better access and better continuity. That's a hypothesis. I hope that plays out that way. But those are all the, I would say, the value props for what I, to me are the three different stakeholders, the employers, the physicians, and the patients, to be honest. And we're also, you know, for physicians, the job board for me, that's one piece of the puzzle. I want to also build out a career center, provide all of those resources that frankly in residency and medical school, we just didn't get that education. We didn't get that training on how to negotiate contracts. What are the different payment systems that are out there? Everybody talks about value-based care and a fee for service and all these kinds of things, the trends. How do I provide education on all of that we missed that I think is very important practicing medicine in the modern day. Because also, if I can provide more of that education in a way that it's digestible and people will actually view it and take it and absorb it, then I think we will also be able to practice medicine better, take back that ownership again— it's aligned with that sentiment— and not be burnt out as much as an entire industry of workers.

John: Now that sounds like a good plan. I think we were talking earlier before we started recording that looking to the future, I think a lot of physicians are looking to do maybe a nonclinical and a clinical.

Dr. Zhen Chan: Yeah.

John: And there would be no reason why that couldn't be something that just normally kind of evolves on this site.

Dr. Zhen Chan: Yeah, absolutely. We are open to posting nonclinical positions on our site. Physicians are looking for them, you know, extra avenues, not just in the form of side-gigs but thinking the similar vein to me— where there are things in healthcare that I also wanna work on. What are the jobs that are out there that can allow me to do that? I think more physicians need to be in those positions. And then you have physicians that are burnt out and are looking for an alternative while still making a difference. Those are out there. So we wanna be a supportive platform for every doctor, no matter what they are looking for in their professional careers.

John: That makes me think of another issue, which maybe you've already reached out to, but what about locums, which is a different kind of clinical job, but it is a clinical job and just need to find them.

Dr. Zhen Chan: Yeah, there are a lot of agencies that are out there in the locum space. And we just felt from a business strategy standpoint, let's not go into them. Would we ever go into them? I don't have an answer for that right now. But for me. There's also an element where Locums is an expensive band-aid to provide access to care. Now, don't get me wrong; it's a great gig for a lot of physicians that are looking for them. And I would never stop someone who is looking for them to, I would never stop them from doing so. But for us, we wanna drive more of those full-time positions right now. And I think that's the right strategy. But again, I think in business, it's not like medicine where we try to be as— well, we do try to be as surefire as possible— but a lot of these strategy decisions, I think, some may say that it's the right call; some may say it's not, and right now we're making the call to not do locums just yet.

John: Got it. Got it. Okay, what if someone wants to reach out to you personally for a question or something?

Dr. Zhen Chan: Yeah, so my email address is Zhen, Z-H-E-N@grapevyne.health. Again, reminder Grapevyne with a "Y". And so you can reach me by my email, and then I'm on like every social media platform. Too many, I think. It's been great. I love engaging with the community on social media. So, I'm on LinkedIn. I'm on TikTok, Instagram, and there's a Grapevyne account and my own personal account. And maybe we'll just link it in the show notes. It'd be it'd be a doozy to list.

John: OK, I'll put a few in and I'll definitely put grapevyne.health. I kind of used the dot com at first when I was looking for you. But no, Grapevyne with a y dot health. I'll put that in the show notes. And I think pretty much people can get information, everything they need to know. Physicians, if they're really thinking they're gonna access this kind of service, your service, then just go to grapevyne.health and do it. Check it out.

Dr. Zhen Chan: Yeah, yeah, yeah.

John: All right, well, this is pretty exciting. I'm glad you could be here and answer my questions. I think it's inspirational to people— physicians who are thinking, "Well, maybe I could do something entrepreneurial. I could do a startup," or maybe not something as this, is a pretty big deal. This is a big thing. You're devoting full-time to it. So it's not like starting a little side gig on the weekends or something. So, I'm really glad you could join us and I'll be watching the growth of this thing. And it should be pretty interesting. And it sounds like that a lot of planning and a lot of investment of time and effort in this. So, you're to be congratulated.

Dr. Zhen Chan: Yeah, well, I really appreciate the support. I really appreciate you inviting me on. And I have to plug this podcast because I forgot to mention that when I was in my exploration journey, I love learning by podcasts. And this was one of the first ones, if not the first one, I hopped on to listen to a whole slew of episodes to learn just what else is out there for physicians to do. And yeah. So, so anybody who anybody who's listening I hope you share this with more physicians out there.

John: Well, I appreciate those comments. All right, Zhen, we're gonna let you go then. And with that, I'll say goodbye. And hopefully I'll catch up with you again, maybe a year from now.

Sounds great. Have a good one.

John: All right. Bye bye.

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How to Practice Hospital Medicine and Found a Startup

John Jurica — Tue, 02 Jan 2024 13:17:44 +0000

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.

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

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

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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:

Identifying a universal problem,
Leveraging personal experience,
Describing the technological solution,
Collaborating and investing,
Navigating the complexities,
Continuous learning, and
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.

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Today's PNC Podcast Transcript

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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.

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Apply Discovery, Innovation, Value, and Execution to Launch Your Business – 319

John Jurica — Tue, 26 Sep 2023 14:45:44 +0000

Interview with Dr. Kasia Hein-Peters

In today's episode, Dr. Kasia Hein-Peters explains the 4 important factors to consider to successfully launch your business. She is a consultant for “sciencepreneurs,” helping them design successful commercialization strategies.

Dr. Hein-Peters is a physician with over 30 years of experience working for pharmaceutical and medical device companies. She helped introduce new drugs and vaccines to the market. Her career highlights the impactful nature of nonclinical careers like hers. In her case, she helped develop and market innovations that reduce disease prevalence and mortality.

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

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

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

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

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

The program starts soon, and there are a limited number of openings. To help you get a glimpse into the program, Sandrow Consulting is offering a series of FREE Webinars. Go to nonclinicalphysicians.com/freedom to sign up and learn why telehealth is the quickest way to begin your career journey.

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Launch Your Business: A Conversation with Dr. Kasia Hein-Peters

Dr. Kasia Hein-Peters embarked on a remarkable journey from her beginnings as a psychiatrist to her current role as an advisor and consultant in the dynamic realm of MedTech and digital tech startups. Her transition was driven by a passion for healthcare innovation in the pharmaceutical and medical device industries.

Over the course of three decades, she played pivotal roles in launching groundbreaking drugs and vaccines that visibly impacted disease rates and mortality.

Recognizing that innovation thrives in startups, Dr. Hein-Peters pivoted to support emerging companies in achieving their strategic goals. Her mission became clear: to bridge the gap between innovative ideas and commercial success.

Drawing from her wealth of knowledge, she developed a strategic framework called DIVE (Discovery, Innovation, Value, and Execution) to guide startups to launch their business through the steps needed to bring healthcare solutions to the market. Kasia helps those whom she calls sciencepreneurs translate their innovative visions into tangible successes.

Seize the Moment: Empowering Advice for Aspiring Entrepreneurs

It's a difficult but rewarding path. And I would say that with the most structured approach, diving into it, it's not so difficult. I am encouraging everyone who thinks about entrepreneurship to try to dive with my help. – Dr. Kasia Hein-Peters

Summary

The BEST way to contact her is to connect with Dr. Kasia Hein-Peters on LinkedIn.

You can also explore her website, abantescientific.com, for valuable healthcare entrepreneurship resources that will help you launch your business. She highlights common pitfalls in healthcare startups and the key role of marketing. Dr. Hein-Peters also discusses the growing impact of Artificial Intelligence in healthcare, making her an invaluable resource for clinicians interested in AI applications.

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

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 319

Apply Discovery, Innovation, Value and Execution to Launch Your Business

- Interview with Dr. Kasia Hein-Peters

John: I'm really excited about having today's guest here. She started as a psychiatrist, moved into the pharma industry. We did a lot with marketing and promotion of new drugs. And lately, in the last, I don't know, since 2014, she's been involved with consulting and teaching entrepreneurs how to start and promote their businesses. So, with that, let me just introduce Dr. Kasia Hein-Peters. Hello and welcome.

Dr. Kasia Hein-Peters: Thank you. Thank you so much for having me on your podcast. I'm really honored.

John: Oh, this is going to be fun because we do have physicians who are thinking "I'm just kind of ready to move beyond my clinical practice", whether it's because of burnout or because they have a great idea. We've interviewed many entrepreneurs in the past, people that have done startups and even involved venture capital and so forth. You have a lot of experience and you have a model I want to talk about today. So why don't you start by just telling us a little bit about your background, and then we'll go from there.

Dr. Kasia Hein-Peters: Great, thank you. As you already said, I am trained as a physician and did residency in psychiatry, and it was a long time ago in Poland. And there after a few years of practicing as a psychiatrist, I started working for the pharmaceutical industry and eventually moved to the United States with my employer. I worked for Merck, I worked for Eli Lilly, Sanofi, Novartis. And finally I worked for a medical device company called Terumo. It's a Japanese company. All in the United States.

And it was probably very lucky in my career because I was always doing very interesting things. And this is introducing new drugs and new medical devices to the market. And what really kept me in the industry for so many years, about 30 years, is the fact that we did have a massive impact on diseases and mortality. And especially my 12 years in companies that manufacture vaccines was very rewarding because each time when you introduce a vaccine on a massive scale, the disease starts going down and it's very visible and it's visible rather quickly. So I think very rewarding career and a lot of product launches.

John: Now, the vaccines that you work on, just to kind of give us some kind of conception of this. Were those vaccines that we would recognize? Were they pretty niche or were they something that's pretty broadly?

Dr. Kasia Hein-Peters: One definitely you would recognize. It was Gardasil in 2006, the cervical cancer vaccine. And then other vaccines that I launched was one of the meningitis vaccines. I launched one of the combination pediatric vaccines, but they are probably not so easy to recognize. And also at dengue vaccine, which was not launched in the US. It was launched in dengue endemic countries.

John: Yeah. There's been a lot of controversy with COVID vaccines but we sometimes forget if you go back, vaccines have improved health and preventive a lot of disease when it's done properly.

Dr. Kasia Hein-Peters: Exactly, yes. Yes. That's very true.

John: Now you decided though, at some point, like you said, you were doing this for I don't know, 30 years, more or less, and then you started taking that knowledge and helping others. So how did that happen?

Dr. Kasia Hein-Peters: It was also kind of a reflection during the pandemic. And this was somehow based also on the COVID vaccines. I think we all probably noticed that the most successful companies that introduced the COVID vaccines were actually starting companies. And I obviously don't forget that BioNTech partnered with Pfizer to get a bigger scale, and it worked very successfully. But Moderna and BioNTech are the big heroes of developing very new and very effective COVID vaccines and very quickly. While some very established companies, vaccine manufacturers actually didn't, despite trying.

And actually to some degree, it proves the point that the real breakthrough innovation is happening in startups. Bigger companies are very good at taking some of the innovation that was developed, turning them into platforms, optimizing these platforms. But breakthrough innovation happens in startups, and yet, startups are not very successful. Only 10% of new technologies actually are successful in the market. Because there are also many other companies like Moderna and BioNTech, and they did not succeed.

I kind of always knew that breakthrough innovation happens mostly in startups and smaller companies. But I think at this point I said that I really want to make these smaller companies, emerging companies more successful. Because on one hand, they develop these breakthrough innovations. On the other hand, they are at a disadvantage versus bigger companies who have thousands of people and million dollars in budgets.

So, how can I use the knowledge that I acquired over the last 30 years and really help the startup founders to be more successful with their breakthrough innovations? This was the goal of leading the corporate world and working with them.

John: Okay. You identified a lot of the success strategies and tactics and so forth. I think basically from what I know, just looking at your website and LinkedIn where people can find you, which we'll talk about later is that you've actually kind of developed a model that you use when you're helping these entrepreneurs. I suppose each one's a little different as to what they really need, but I thought it would be interesting to hear at least an overview of your model and might give people ideas of how they can help their own businesses.

Dr. Kasia Hein-Peters: Yeah, definitely. I come at this with the idea that you should not divide your strategy too much between different functions. Sometimes during many incubators that these founders belong to, they are taught the IP strategy and the regulatory strategy and the commercial strategy, and yet another strategy. And this all feels a little bit separated different strategies.

What I try to do is to show the founders that they really need to have one well connected horizontal strategy. I call it horizontal because it connects all these different aspects of the strategy, but at the same time, they cannot disintegrate into silos. This has to be connected.

I developed a framework that I call DIVE, and it stands for Discovery, Innovation, Value and Execution. And these are four aspects that any enterprise strategy, any startup strategy should have.

Discovery is for market discovery. What do you need to know about the market, your future customers, the patient journey, the unmet need? How do you understand it on a qualitative level, but also how do you quantify the unmet need, which then leads to quantifying the market? That's one big piece. And you have to do it all the time. You have to be connected with the market all the time.

The biggest piece of the discovery comes at the beginning when a startup founder, a sciencepreneurs, as I call them, starts developing a kind of focusing on the specific unmet need, trying to understand it better, and then trying to develop the product. When the product gets into the research and development, I call it innovation phase, because you really are developing an innovative product and how to develop the innovative product.

What are these unique things that your product needs to have to be differentiated in the market? Then the value piece is still a marketing strategy. How do you increase the value of your product or service if you are maybe a SaaS company, your product or service in the marketplace? So that's a classical marketing strategy.

And then execution is how do you execute your strategy. There are two aspects of it. There's a go-to market strategy, and then there is a scaling up of the company. This all kind of constitutes the company strategy, and as I said, it has to be one whole strategy well connected between different functions than kind of contribute to it.

John: A question that came up when I was thinking about this, and as you were talking is I guess what I don't quite understand, and you can explain is what type of clients would you be dealing with? In other words, where do they come from? Are there many physicians involved in this? Just sort of describe the type of people and clients that you work with.

Dr. Kasia Hein-Peters: I specifically address my consulting to people who may not have in the past a very deep commercial experience. I think as I mentioned before, I call them sciencepreneurs. These are the doctors, scientists, engineers, some data scientists who have fantastic ideas. They do have some understanding of the healthcare ecosystem, and they do have understanding of the unmet need. But they actually never commercialize the product.

And I think that lack of commercialization experience may negatively influence even the way how they develop their product. I think I mostly address this DIVE framework to people who have scientific minds and want to continue doing science. I'm trying to avoid the marketing lingo. I'm trying to avoid some buzzwords. I'm not trying to teach in the marketing per se. I'm trying to show them how to think strategically about the entire enterprise and different steps that they have to take on their path toward successfully commercializing their product.

John: Interesting. Now, some of the guests I've had, and actually listeners have talked to me about, it seems like one of the biggest struggles is putting that all together when you're looking for cash, you're looking for an investor. And there's different types. I'm not an expert by any means. So, I'm assuming that what you're doing is assisting in that because you're helping them sort of structure and strategically plan and do all these things. How does that help with getting money? And are these angel investors, are these some kind of private equity? Is it all in between? It'd be kind of interesting to hear what your comments are about that.

Dr. Kasia Hein-Peters: It actually helps enormously because there are many consultants who focus on pitch decks, and they say "I will help you with the pitch deck." Fine. They are probably very good communication specialist, and they can help with the pitch decks. I'm not saying that founders shouldn't do it, they should.

However, without a strong strategy behind a pitch deck, we are still pitching maybe the wrong strategy, and it's visible to investors. I think that the pitch deck has two components, actually. It has a strategic component and it has a communication component. And I think that we shouldn't forget about that. So I do help with pitch decks as well. But I always try to reorient the founder on having a really good strategy, really well communicated, and not just a well communicated, but strategy, because it'll not get them funding anyway. Because the investors, they can see through it.

John: Can you give us some examples? It may not have to be the examples of someone you're actually working with now, because that would probably not be appropriate, but I'm just trying to visualize what kind of life scientists or physician entrepreneurs would maybe get to a point where they might say "I need some help." Just examples, maybe from the past.

Dr. Kasia Hein-Peters: I will tell you what questions I'm getting, what discussions I'm getting into the most. One discussion I'm very frequently getting into when I discuss the strategy with sciencepreneurs is actually the regulatory strategy. And I'm talking specifically about devices that are FDA regulated.

And so, this question comes up with early startups because they are trying to design their data generation strategy for clinical trials if they have to do clinical trials or any other demonstration project. And the discussion that we typically have is "What is the goal of your regulatory strategy?" And they're like, "Oh, I want to get my product to the market as soon as I can."

But then what is your differentiation of your product? What is your label? What your label will say about your product? And they frequently choose that path of the least resistance which is somehow understandable. But on the other hand, they're losing the ability to drive the value of the product in the market through a very strong label.

That's usually the first discussion that we have. Is it better to get to market fast but have an undifferentiated product? Or is it better to get the market a little later, will cost a little more, but then having a differentiated product? And that's a trade-off, but that's very rarely on top of their mind because many regulatory consultants, maybe they don't ask them the right questions. They say how can I get to the market fastest, not how can I be the most successful in the market. That's a very interesting question that comes up.

The second type of questions come around go-to market strategy. Is it better to position my product in the outpatient clinic? Is it that position in an inpatient setting? And there are a lot of data that have to come into informing a decision like that. That can be both, but it probably cannot be both at the same time, because again, companies have to prioritize which market segments they want to go after.

And here we are frequently dealing with FOMO, the fear of missing out. It almost feels like if I pick one market segment, I will lose the opportunities in the other. But it's really not true. Especially a small company, focusing the resources in one market segment that has reasonable potential and high ability to win is a better strategy than trying to scratch the surface of multiple market segments. I think these are types of decisions and discussions that I am having most of the time with the founders.

John: Now, you kind of touched on the idea of going in the wrong direction. Maybe even I could take it from another perspective and look at it differently, just simply, what are the most common mistakes that you see? Maybe you've already mentioned a couple of them, but what would you say are the mistakes that really overzealous entrepreneurs say, "Okay, I'm going to bring this new device?" And I do want to ask you about AI in a minute, but what are those mistakes that you've identified?

Dr. Kasia Hein-Peters: I think a very classical mistake is to focus on product at the expense of focusing on the commercial strategy. And again, commercial strategy does influence the product development. So let's not forget about that. That's why developing at least some basics of the future commercial strategy early on, during product development is necessary. And I see that the founders frequently try to do it in a very linear way. "I do my product first. I don't have time now to focus on commercial. I'll do it later. Let me focus on the product first."

I understand that of course, there is a time when the most of the focus is on the developing of the product, but this has to be with a specific goal in mind. So, how will I market this product? What will be my profile target? What is my target product profile in the market? So, is my minimum viable product actually differentiated enough that I will succeed when I launch it?

All these questions should be answered earlier. And then obviously a company should focus on the product development, but not really push the commercial discussion for later. That's one. The second really big mistake is to jump from product development to sales immediately. So if a founder has a product, it's reaching the regulatory stage, most likely will be approved.

And then they start thinking about sales without thinking about marketing. What does it do to a product? Marketing is the return on investment function. Marketing helps founders to get the highest return with the lowest investment. While if you skip this stage, basically do not develop the value piece in the DIVE framework, jump directly to execution, I think that there's a lot of churn happening with the sales team who doesn't necessarily have clarity about the target segment, may not have clarity about messages, may not have clarity about target customer personas, et cetera.

Because that's all the value development piece. That's another one. Thinking that sales and marketing is one, but it's not. Marketing is a very separate function, and marketing also helps to develop the market itself. Sometimes there needs to be some medical education for prescribers because it's a new solution.

AI is actually a great example of somehow this thing that's coming at us and very few prescribers, clinicians understand that, understand how it works. It's kind of a black box for many. So, how do we educate them in a way that makes them comfortable using some of the AI enabled solutions?

John: Okay. AI. You brought AI up. Because I do have several listeners actually, people that I've been on Mastermind calls with that are really interested in AI. Some have certifications in various types of AI, I guess. But what is going on? How can physicians get more involved in AI if it's something that really interests them? Do you have any advice about that?

Dr. Kasia Hein-Peters: I do actually, and I'd like to recommend the organization that is called AIMed, Artificial Intelligence in Medicine. This organization runs trainings and conferences specifically for physicians. I know that there's a lot of education and events around AI. I would say that many of them are highly technical and their audience is mostly people that already have some data science background or IT background. And they're run by data scientists and IT specialists.

Now AIMed took a different approach and I think it's much more suitable for doctors. It's actually doctors in collaboration with data scientists who run these programs. And they are specifically meant for doctors and also for healthcare administration. So I think that's a good organization to be associated with. And in addition to that, there is kind of a sister organization called ABAIM, American Board of Artificial Intelligence in Medicine that runs trainings and board certifications for physicians. So, that's the one that I did.

Obviously, it does explain the technology behind, but is much more focused on the clinical uses of AI. And I think that's what physicians need. They need to understand where AI is really good already, where is it going and how they can kind of start using this without creating risk for their practices or clinics.

John: Okay. I'll put links in the show notes to those organizations if the people have a specific interest in AI. So, what kind of client that might be listening, we have physicians who have some clinical background. Not all of them, some of them have done med school and really didn't do a residency. They could be doing different things, but I know some of them are interested in starting their own businesses or developing a startup. What would be the ideal person to come to you? Someone who hasn't even started yet, or someone who really has something, they have an idea, they maybe have a prototype if it's a product or if it's a software or whatever? And how far along in that journey would they probably be most help by getting someone like you to help them kind of pull it together? Because most of us have some kind of narrow focus, as you said.

Dr. Kasia Hein-Peters: Yeah. I think that the services that I offer and help that I offer to sciencepreneurs can help them at any stage. And I think it's very important to adjust what I do to what they need. I would say that anyone can contact me, and we definitely can have a discussion. There are no strings attached. I will not try to sell them services that they don't need. I will try to assess their strategic thinking at the stage where they are and see if I can help them at that stage.

Now, some of my more developed services are better suited for companies that already exist. A company needs to exist, and I can help with things like building capabilities, assessing their capabilities versus their strategy. Is there any gap there? Building capabilities, scaling up the company.

I think probably the most value they can get from my services is when they start scaling up the company and when they start thinking about commercialization. These two stages. Now if they want to pick up my brain at earlier stages, I'm very happy to have a chat.

John: Okay. You can be found on LinkedIn.

Dr. Kasia Hein-Peters: Yes.

John: And then you have a website?

Dr. Kasia Hein-Peters: I do have a website, abantescientific.com. I just would like to say that I'm redeveloping it right now, so it's not completely to date in terms of my services. That's why I encourage to connect with me through LinkedIn at this point. My website should be much better developed within a month or so.

John: Now, the other thing I would mention because we talked about it and you have actually done some live events and actually created something that's even asynchronous. It's courses or something like that.

Dr. Kasia Hein-Peters: Yeah.

John: Which you say right now, you can get them to that if they need that or if you feel that's appropriate, but first contact you and then see if they're appropriate for using those kind of resources. Is that correct?

Dr. Kasia Hein-Peters: Yes, definitely. I have also some free resources that I'm very willing to share. I have a newsletter on LinkedIn as well that I encourage everyone to subscribe to. It's specifically meant for founders of life science and digital health startups. And there are a lot of free resources that I'm very, very willing to share.

John: Okay. If somebody out there is really creative, they've got some great ideas, maybe they've already started developing a new business, something in tech, something related to delivering whether it's medical devices or pharmaceuticals or tech, then it would make sense to at least follow you on LinkedIn and then at some point even reach out and pick your brain and maybe even engage you for consulting, if they think that's useful.

Dr. Kasia Hein-Peters: Yes. Or just an initial discussion. As I said, I don't charge anything just to chat with someone about the strategy and understand them a little better and maybe give some expert advice during the initial conversation as well. And then if we find out that I can help, then we can definitely sign some consulting agreement, and I'll be very happy to help.

John: I think that's really useful because I get calls sometimes and they'll say "I'm interested in doing this. And I started working on it, but I don't really know where to go and I don't really have any of that expertise." And so this is a good resource to have. I'll definitely put your LinkedIn and the website at least for now, because you know what? Once it's on there, it's on there forever.

Dr. Kasia Hein-Peters: Yes.

John: Hopefully that will get them wherever they need to go, even a year from now. All right. I think we've covered everything I want to talk about today. Any last minute advice or just last advice for people that have been sort of thinking about doing something crazy with a new device or a new business and they've just been putting it off? In any words of wisdom or encouragement?

Dr. Kasia Hein-Peters: I think it's a very rewarding path. It's a difficult but rewarding path. And I would say that with the most structured approach, diving into it, it's not so difficult. I am encouraging everyone who thinks about entrepreneurship to try to dive with my help.

John: Can they, at least at the beginning, do this thing part-time and try and see if they're getting some traction before giving up other income? Even though it may be burning out a little bit, but I would think you could at least start part-time.

Dr. Kasia Hein-Peters: Yes, it's possible. And I see a lot of founders starting part-time. It's very difficult to quit your job and put all your eggs in one basket, especially it's so risky. I actually wouldn't even recommend that. I think doing this part-time is fine at the beginning.

John: And then you can just get a sense of okay, this looks like it's going to catch on. It looks like it's going to be successful. Nothing's guaranteed, but at least then you have something to base a more reasonable decision on.

Dr. Kasia Hein-Peters: Yeah.

John: All right, Kasia. This has been really interesting and fun. I thank you very much for being with me today. I'm going to have to check back with you in about a year from now or so and see how things are going.

Dr. Kasia Hein-Peters: Very gladly. Thank you, John, for inviting me. It was a pleasure.

John: You're welcome. Bye-bye.

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Want to Establish a Concierge Practice Before Finishing Your Fellowship? – 210

John Jurica — Tue, 24 Aug 2021 09:30:30 +0000

Interview with Dr. Brook Choulet

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.

Brook is the founder of Choulet Wellness. She completed her medical degree at the University of Missouri Kansas City’s rigorous six-year BA/MD program. Then she pursued training in General Psychiatry at the University of Arizona College of Medicine at Phoenix.

She is currently in her last year of training in Child and Adolescent Psychiatry through Creighton University’s fellowship program in Phoenix, Arizona.

Following in the footsteps of her mother and grandfather, she will be a third-generation adult, child, and adolescent psychiatrist. She built her own business during her residency training and began to expand and hire other practitioners while still in fellowship.

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.

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.

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Today's PNC Podcast Transcript

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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.

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The Best New Business Solves a Problem – 171

John Jurica — Tue, 24 Nov 2020 11:30:31 +0000

Interview with Dr. Jessica Lubahn

Our guest, Dr. Jessica Lubahn found that the best new business solves a problem. In her case, it's a problem experienced by her own patients.

Jessica is a urologist, health writer, and consultant. She is also the founder of ONDRwear. It's her new apparel company that sells luxe leakproof underwear. She created this company to destigmatize urinary, menstrual, and other leakage problems. To do so, she has created products that are effective and beautiful.

Dr. Lubahn received her medical degree at the Washington University School of Medicine in St. Louis. Then, she completed her surgical internship and urology residency at the University of Texas Southwestern Medical School.

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, unlike other programs, this program only takes a year to complete. Economist Magazine recently ranked the UT Haslam Business School #1 in the world as the Most Relevant Executive MBA.

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

A Common Problem Emerges

Jessica helps patients with incontinence in her practice. However, she discovered a large percentage of patients with mild incontinence. And they did not want to risk surgery for a minor problem, albeit a very annoying one.

In medicine I'm very risk-averse… In the entrepreneurial world there is nothing like that… You just realize the world is so big, and there is so much out there that you can do. – Dr. Jessica Lubahn

So, it became her mission to find a solution.

The Best New Business Solves a Problem But It's Not Easy

Here is a very abbreviated list of steps that Jessica had to complete in creating her new apparel company:

Identify a problem experienced by her patients.
Conceptually design the product.
Create a hand-made prototype of a potential solution.
Research the industry, network with experts, and determine if creating the product is feasible.
Establish her business, and engage an accountant, attorney, and other professionals.
For her physical products, create a pattern, and find a manufacturer.
Create a website, social media accounts, and develop a marketing plan.
Start selling and delivering the product.

If you’d like to check out Onderwear, go to ondrwear.com. The website is well-designed. The products are presented tastefully. And at the time of this podcast episode, you can get a 15% discount on its clothing.

Summary

Dr. Jessica Lubahn is an excellent example of a physician entrepreneur. She identified a problem and created a business to solve it. Like many physicians, she had no intention of becoming a designer and owner of a nonclinical business. But she was compelled to help patients with a problem that extends beyond her medical expertise.

Links for Today's Episode:

Ondrwear.com
Email Jessica Luban at hello@ondrwear.com
Dr. Jessica Lubahn on LinkedIn
LinkedIn Ondrwear Page
Ondrwear on Instagram
Ondrwear on Facebook

Download This Episode:

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

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And to make it even easier, listeners to this podcast can get a one-month Trial for only $1.00, using the Coupon Code TRIAL at nonclinicalphysicians.com/joinnca. The $1.00 introduction to the Academy ends on November 28, 2020.

Thanks to our sponsor…

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

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Disclaimers:

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

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

The post The Best New Business Solves a Problem – 171 appeared first on NonClinical Physicians.

How to Validate Your Business Idea

John Jurica — Sat, 21 Nov 2020 15:19:28 +0000

The Problem

In this post, I want to explain why it is important to validate your business idea. You may recall that in my previous blog post in this series, I described the factors needed to select a product or service to offer future customers:

It's an area that you’re passionate about (or reflects your purpose),
You have expertise or skills to share,
There are customers with a problem to solve, and
The customers are willing and able to pay for the product or service.

Then ask friends and family for feedback. And discuss the idea with potential customers in your practice if it's a clinical topic.

However, there are hundreds of businesses that fail each year in spite of a good idea for a product or service. Ideally, you should validate the idea further by actually selling a product or service, even if it is a scaled down version.

Try Selling a Prototype or Presell a Course

This trial run does not necessarily have to be a fully developed product. Let's look at an example.

Imagine that you're a general pediatrician with an interest in attention deficit disorder, and you want to help parents take care of such children. Start to think of products to offer and a way to validate your nonclinical business idea.

You attend many conferences about ADD, and you've researched evidence-based medical treatments, and also nutrition, and behavioral methods. And you want to share your expertise with the parents of such children. So, it's an area that you are interested in, and there is a need for education of parents of children with ADD.

You still ought to verify the other two factors, that

there are parents of these children looking for online help, and
they’re willing to spend money to meet that need.

And, there's only one way to really know that someone is willing to invest in your product, and that's to sell them something.

Yes, you can talk to your friends, colleagues, and family members. You can send out a survey. And you can solicit feedback on Facebook and other social media sites. That can be encouraging, and sometimes useful.

However, until you've actually sold a prototype, or pre-sold something you’re making, you won’t have any proof it’s likely to succeed. And you don’t want to invest thousands of dollars and countless hours in something that won’t sell.

Validate Your Business Idea

You can do a small pilot. Let's say that there's a Facebook group for parents with children with ADD. Then you engage in the group, provide valuable information, and build a following. You see that there's some interest in what you have to say. Maybe you start a newsletter, which you can do basically for free. You might even use a funding platform like Kickstarter to presell a product.

You invite people to sign up for your email list in order to get some free information, like articles that you have written. Then you can create a small test of their willingness to buy in some small way. You might sell them a simple guide to ADD management. Or a short video course on the subject.

If you can demonstrate that someone's willing to pay for something along these lines, then you're going to know you're on the right track.

Examples in My Niche

I’ve since found that there are products and services that physicians are willing to purchase to expedite their career transitions. This became evident when I started helping with a Facebook group (Physician Nonclinical Career Hunters) devoted to nonclinical careers two years ago, which now has over 15,000 members.

I now recognize that there's a demand for coaching, mentoring, and training. Several books have been published on the subject of nonclinical careers. There is a growing interest in this niche. And I’ve started to sell my own products.

I created a course dedicated to finding a job as a medical science liaison. That sold fairly well. So, I created more courses. Since I planned to continue developing courses, I decided to accelerate that process and open a membership site. I started with a minimal viable product (in my mind that was 12 courses).

I was able to sell an encouraging number of memberships. Now I've put more time into improving the first 12, and have added 6 new courses. I've recruited several affiliate partners to sell my course to their followers. And I'm relaunching the Nonclinical Career Academy Membership program very soon.

Several physicians I have interviewed who are coaches have followed a similar path. They started with one-on-one coaching. After building a sufficient following, they added group coaching. Some of them later created a course developed from their coaching experiences, which scaled their business, while serving more clients.

Examples include:

Summary

As you plan your nonclinical online business, be sure to validate your business idea by confirming the demand for your product or service. Begin by looking for others who seem to be successful.

Then sell a prototype, or begin with a limited run of whatever you're selling. If you are a coach, sell a few discounted sessions to get going. Assess the response of your clients and the success of your coaching.

If you're creating a course – develop the first few lessons, then try to pre-sell the soon-to-be-finished course. But only finish creating it if there is interest confirmed by sales. Then use the feedback from your first few students to help direct future lessons.

Coming Next

In the next blog post, I will answer this question: What are the legal and business issues I should address before moving on?

Next Steps

Please add you're thoughts and questions in the Comments. I will respond to them all.

Contact me: john.jurica.md@gmail.com

Thanks for joining me.

Until next time.

The post How to Validate Your Business Idea appeared first on NonClinical Physicians.

What Is the Latest Way to Connect Doctors with Interesting Jobs? – 170

John Jurica — Tue, 17 Nov 2020 11:00:05 +0000

Interview with Dr. Greg Hanson

Dr. Greg Hanson decided to start a business and created the latest way to connect doctors with interesting jobs.

Greg is a PGY-3 interventional radiology resident in Philadelphia. He graduated from UCLA with his BS in Atmospheric and Oceanic Sciences before moving to New York City. While in New York, Greg obtained his Master of Public Health degree in epidemiology with an advanced certificate in applied biostatistics.

He obtained his medical degree from the Dartmouth Medical School in Hanover, New Hampshire. In June 2018, he started his surgical internship. One year later he began his integrated interventional radiology residency.

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, unlike other programs, which typically run 1 – 1/2 to 2 years, this program only takes a year to complete. Economist Magazine recently ranked the UT Haslam Business School #1 in the world as the Most Relevant Executive MBA.

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

Solving His Own Problem

Like most of us, Greg found that attending medical school and internship were very busy times. However, once he entered the first year of radiology residency, the intensity and tie commitment diminished. So, he decided to use the time to moonlight to earn extra income.

But it was not the clinical moonlighting that usually comes to mind. He looked for opportunities to use his medical, science, and statistical backgrounds. He found several time-limited freelance positions. And several of them paid very well.

But the process of finding those jobs was difficult. He believed there should be a better way to link physicians with side jobs. And that sparked the idea for flipMD.

Latest Way to Connect Doctors with Interesting Jobs

It’s a pretty straightforward business. Find businesses that need the expertise of physicians. Then connect them with appropriate physicians looking for side jobs. It reminds me of what Upwork does for other freelancers.

That's really all we're trying to do… create opportunity for physicians and then also for the clients that are looking for those physicians. – Dr. Greg Hanson

Implementing a new business was not easy. He and his wife, who now handles many of the day-to-day responsibilities, had to set up the business structure and create a business plan. Then they had to engage programmers to design the platform to connect physician freelancers with prospective clients. And developing and implementing a marketing plan followed.

But they were able to pull it off. The business officially opened its doors earlier this year (2020). It has started linking physicians to clients. And it is aggressively growing both groups.

Summary

Greg has demonstrated that it is possible to start a new business part-time. And it will certainly take continued dedication to make it work. But it seems to have proven the concept that inspired it. I'm also excited because it is a tool that you and other physicians may find very helpful as you explore nonclinical and nontraditional careers.

I encourage you to check out Greg's business at flip-MD.com. Give it a try if you’re in the market for a part-time gig advising start-ups or other freelance work.

Links for Today's Episode:

Download This Episode:

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

The Nonclinical Career Academy Membership Program recently added a new MasterClass!

Thanks to our sponsor…

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

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The post What Is the Latest Way to Connect Doctors with Interesting Jobs? – 170 appeared first on NonClinical Physicians.

How to Introduce Transparency to the Healthcare Marketplace – 113

John Jurica — Thu, 17 Oct 2019 19:37:11 +0000

Interview with Dr. Jawad Arshad

On this week's episode of the PNC podcast, John interviews Dr. Jawad Arshad, an emergency physician looking to bring much-needed transparency to the healthcare marketplace. He and his partners also intend to disrupt the health insurance industry by removing insurers from the physician-patient interaction.

Background

Dr. Arshad is an emergency medicine physician. He completed his medical training at SUNY Upstate Medical Center and his emergency medicine residency at Henry Ford Hospital.

He worked as an EM physician, and became involved in the administrative side of medicine early in his career. First, he served as the director of the Emergency Department at Henry Ford West Bloomfield Hospital.

Next, he left corporate employment and worked as an independent contractor at the Beaumont Dearborn Emergency Department, and started an urgent care clinic. As a business owner, he interacted directly with payers, and experienced the frustration associated with billing and collections.

Our Sponsor

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

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

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

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

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

Entrepreneur Version 1.0

Jawad's exposure to the world of business came through a combination of administrative work and an investment in property with a friend. The investment brought him face to face with the world of contracts and business operations and spurred him to set up his own urgent care clinic.

“If you are looking for compensation at first, you will miss out on opportunities.”
Dr. Jawad Arshad

Jawad noted the importance of seizing opportunities when they present themselves, even if they do not offer significant compensation at first. “If you are looking for compensation at first, you will miss out on opportunities.”

Jawad learned about healthcare tech startups by investing in a telemedicine company. While the experience was hugely valuable to Jawad, ultimately it did not work out. But the experience taught Jawad some valuable lessons in entrepreneurship:

Know your limitations – don't try to do everything yourself.
Make sure everyone has skin in the game. People without their own money on the line are less motivated to see something succeed.

Those experiences inspired him to start WoW Health Solutions about three years ago. With his team, he developed and deployed all of the necessary back office systems for the company. Together, they are now rolling out their services to patients, physicians and employers as they begin to enter the healthcare marketplace.

During our interview, Jawad explains how WoW Health Solutions is bringing transparency to health care costs, while eliminating third party insurance companies from most of the physician-patient encounters.

Entrepreneur Version 2.0

One of the problems that sank the telemedicine offering was the payer system. It was so unwieldly, that patients sometimes opted out to pay directly rather than going through insurance and billing companies.

” Entrepreneurship is a bit of a bipolar experience. There are up days and down days. As long as you are accepting of that you are going to do great. “
Dr. Jawad Arshad

This problem sparked an idea for Jawad. He envisioned an alternative solution to the payer system, along the lines of Uber and Airbnb. He developed a vison, whereby patients could pay providers directly and providers could save on ancillary costs and time. This idea would eventually become WoW Health.

The goal that drives WoW Health is bringing transparency to the healthcare payment industry. They want to do this by finding a way to connect patients directly with providers, cutting out the costs of the numerous middlemen involved in the current system.

Right now Jawad estimates that 25-30% of effort by physicians is eaten up by ancillary fees, not to mention the time it takes to process payments. WoW Health aims to reduce that level of wastage while vastly reducing the number of hours spent processing payments.

Ready to Enter the Healthcare Marketplace

It has taken three years and a lot of work to bring WoW Health to the precipice of launch. It was not just a question of how to pay the doctor, but how do you find a doctor to pay? What interface do providers use? How do you remain HIPAA compliant? And most importantly, how do you bring patients into the platform?

The WoW Health team faced a chicken-egg situation of whether to bring in providers or patients first. Then they realized that most people get their healthcare from their employer. “Starbucks spends more money on healthcare than they do on coffee.”

It was an easy sell to employers. By their current estimates, Jawad believes that employers will save between 20-40% on healthcare costs. On top of that, employees will not have to pay any premiums and will incur less overall out of pocket costs.

“Starbucks spends more money on healthcare than they do on coffee.”
Dr. Jawad Arshad

Now the team is working with a number of employers to have a guaranteed pool of patients ready towards the end of the year. They will then bring in providers simultaneously to ensure that providers have patients and patients have options.

Jawad's Advice

Jawad sold his urgent care clinic six months ago and is now working a few hours per month in clinical with most of his time focused on WoW Health. Taking some time to reflect on his journey thus far, he had some choice pieces of advice for physicians thinking about taking a business idea to the next level.

Ask yourself – what are your strengths?
Look for collaboration – it’s better to have 5% of $100 than 100% of $1
Have a clear understanding of what the problem is that you are solving.
Understand that seeing a problem and implementing a solution are two very different things.
You have to be patient.
You must persevere.
Look for mentors and people that are willing to share their experience.

Summary

As is the case for most entrepreneurs, Jawad's journey has not been all smooth sailing. He seized opportunities, learned from failures, and finally found the right problem to solve. And had the experience to build the right team to do it. Now WoW Health is poised to launch and may well change the healthcare marketplace forever.

Jawad is a firm believer in the power of collaboration and mentorship. He has extended an offer to our listeners to reach out to him with questions or for advice. You can find his contact information and more information about WoW Health in the links below.

Links for today's episode:

Thanks to our sponsor…

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

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

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

Podcast Editing & Production Services are provided by Oscar Hamilton.

Disclaimers:

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

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

Here are the easiest ways to listen:

vitalpe.net/itunes – vitalpe.net/stitcher

The post How to Introduce Transparency to the Healthcare Marketplace – 113 appeared first on NonClinical Physicians.

How to Find Success in a Healthcare Technology Company with Dr. Jonathan Larson – 067

John Jurica — Tue, 01 Jan 2019 12:35:46 +0000

Find a Problem and Create a Solution

Dr. Jon Larson and his partner started a healthcare technology company because they wanted to improve medical care. They realized that there was an opportunity to use technology to improve the lives of both physicians and patients, so Medspoke was born.

MedSpoke is a physician-centric company, focused on solving healthcare credentialing challenges. It eliminates credentialing headaches, by keeping credentialing data automated, organized, current, and available.

Giving Physicians Mobility and Flexibility

Any physician or healthcare organization that has licensing, credentialing, or enrollment needs can use MedSpoke as an end-to-end solution.

It's a need born out of Jon’s own experience and pain. He wanted to be mobile and flexible to work in multiple places. But each new employer would ask for the same information in a different form.

There's a major physician shortage with lots of open positions. Delays are aggravated by excessive credentialing paperwork. There had to be a better way of quickly placing medical professionals into available opportunities. MedSpoke solves three problems that every physician deals with when wanting to work:

Obtaining a state license.
Being credentialed with an employer.
Being credentialed with health plans.

The University of Tennessee Physician Executive MBA Program

I'm very thankful to have the support of the University of Tennessee Physician Executive MBA Program offered by the Haslam College of Business. You’ll remember that I interviewed Dr. Kate Atchley, the Executive Director of the program, in Episode #25 of this podcast.

The UT PEMBA is the longest running, and most highly respected physician-only MBA in the country, with over 650 graduates. Unlike most other ranked programs, which typically have a duration of 18 to 24 months, this program only takes a year to complete. And, it’s offered by the business school that was recently ranked #1 in the world for the Most Relevant Executive MBA program, by Economist magazine.

University of Tennessee PEMBA students bring exceptional value to their organizations by contributing at the highest level while earning their degree. The curriculum includes a number of major assignments and a company project, both of which are structured to immediately apply to each student’s organization.

Graduates have taken leadership positions at major healthcare organizations and have become entrepreneurs and business owners. If you want to acquire the business and management skills needed to advance your nonclinical career, contact Dr. Kate Atchley’s office by calling (865) 974-6526 or going to vitalpe.net/physicianmba.

Where There's a Problem, There's an Opportunity

After completing residency, Jon practiced clinical medicine as an ER physician. He just wanted to find a good group and ride off into the sunset.

But only a few years of practicing emergency medicine, Jon wanted to see what else was out there. So, he took a job as a Medical Director at Aetna.

Later, he wondered if healthcare administration might be the thing for him. He noticed that most physicians who made the transition to healthcare administrator usually had an additional degree. So, he went back to school to get an MBA.

As his career progressed, he noticed that there were process and system inefficiencies everywhere. And he realized that wherever there's a problem, there's an opportunity. He developed a strong entrepreneurial urge to solve those problems.

Jon knew he always wanted to do something with his MBA. Making the switch to be a full-time entrepreneur gave him that opportunity. But he learned that the MBA did not fully prepare him for his new role.

“Let's get these physicians where they need to be, so they can deliver and provide that access to care.”
Dr. Jon Larson

Thoughts on Running a Startup

The only way you learn to lead, is to get in front of people, make decisions, fall on your face, learn from mistakes, and keep going.

Nine out of 10 startups fail. Companies that stick with their original idea, that no one's paying for, go down in flames. To be successful, they need to pivot, reconfigure and focus on execution.

Jon notes that “your best marketing tool is word of mouth, which is predicated on customer success.” Give your customers the outcomes they want. Otherwise, your business won’t survive.

And entrepreneurship is all about action. It's 10% idea, but 90% execution. The execution part is where most ultimately fail.

Day-to-Day Life of an Entrepreneur

Every day, Jon has a “To Do” list. There are many things going on that he must handle, and he’s pulled in different directions. Every day is about prioritizing and setting goals. Yet, no two days are the same.

He’s also a catalyst who pushes initiatives forward and looks for opportunities to continue to grow his business.

Starting a healthcare technology company might be an option for physicians wanting to do something beyond clinical medicine. However, starting a business has been the toughest thing Jon has ever done. He says he usually feels one of two emotions running a startup business: Euphoria or Terror.

Jon reminds us that running a new business is not glamorous. There are many day-to-day mundane things that have to be done. If you're going to do it, you must be willing to get your hands dirty. Nothing is above or below you. You’ve got to be willing to do whatever it takes to move the company forward.

Links for today's episode:

Learn more about Jon Larson and Medspoke here:

Thanks to our sponsor…

Thanks again for listening. I hope to see you next time on Physician NonClinical Careers.

As always, I welcome your comments and feedback.

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

Podcast Editing & Production Services are provided by Oscar Hamilton.

Disclaimers:

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

Here are the easiest ways to listen:

vitalpe.net/itunes or vitalpe.net/stitcher

The post How to Find Success in a Healthcare Technology Company with Dr. Jonathan Larson – 067 appeared first on NonClinical Physicians.