7 Steps to Building a Million-Dollar Private Medical Practice

If your business isn't working the way you expected, it's not because you're bad at business. It's because no one ever taught you how it actually works. We were trained to master algorithms in medicine, but when it comes to revenue teams and growth, we were never taught anything. We weren't even told to figure it out. We just assumed somehow we'd know. Like it would magically make sense. But it doesn't. The era of the seven Figure Physician CEO is here. And it's not about working harder. It's about learning entrepreneurship as a system. The same way you mastered ACLs and pals, you can master the algorithm of building a profitable scalable business. That's why I recorded the seven Figure Physician CEO audiobook. Whether you're building a medical or non medical business, and whether your goal is your first million, first 2 million, first 5 million, first 10 million, this is where the journey starts. There is no calvary coming to save us. We are the Calvary. So. So go get your audiobook now. Www.entremd.com 7Figurebook. And let's rewrite the narrative for physicians starting today. The beautiful thing about being a physician is that you have a relatively high earning power and you can use that to self fund your business. Sometimes I'll see people who talk about doing, you know, locum and stuff like that, and they feel ashamed because they're like, it's because I'm not doing the business thing right. That's why I'm needing to do this. And I'm like, no, that's actually what's happening. What's happening is you're funding your business. But of course you have to learn to use your time in such a way that you're doing the most important things in your business so you can stop needing to self fund. Hi docs. Welcome to the Entre MD podcast where it's all about helping amazing physicians. Just like you embrace entrepreneurship so you can have the freedom to live life and practice medicine on your terms, I'm your host, Dr. Una. If you are somebody who is running a private practice and you've been looking to break into your first or next million dollars in revenue, and you feel like you're doing all the things, you're doing everything and it is not working, I have a treat for you. Today we're gonna be looking at the million dollar private practice. I'm actually gonna walk you through what I would do if I was starting over and I had to get to my first million or. And you can extrapolate it for the next million. Okay, so this is going to be so much fun. I want you to lean in. This is an episode right off the back. You wanna share with the doctors in your life. You wann you want to grab paper or if you're listening in your car, you definitely want to go like, okay, I'm coming back to this one. Okay. All right, so let's break this up to put this in context. You know, my very first business was, was a private practice. It is 14 years old at this point. And I had set an intention that I was going to retire from it when I turned 40. And so over a nine year period, we launched the practice, we grew it to seven figures and exited the practice. Okay, so this is something we've done and over the last five years I have helped hundreds and hundreds of hundreds of doctors build their practices. Many of them got their businesses to seven figures, multiple seven figures. So this is something that we've done. This is kind of the entre md. This is our thing, our bread and butter. And I'm excited to share it with you. Okay. All right, so I'm going to walk you through a seven step process that you can do starting out your practice. And it doesn't matter if you've already crossed seven figures. Like these are things you can come and look at as things that you can dial up or dial down and complete create a completely different, you know, like experience in your business. So let's start. Okay, so the very first thing, step one is that I would set the goal that I want to hit a million dollars in revenue. I want to hit multiple million dollars in revenue. And that's the starting point. And you might say, Dr. Una, don't be captain Obvious. Of course I, of course I would set the goal. But this is the deal. Many people do not like to own the goal. They can have it as a wish, like, you know, it'll be nice someday. But they don't own it as a goal. Because when you own it as a goal, there are other things you immediately have to do. Like you become aware, okay, I' doing this, I'm not doing that. Or you're like, what if I don't hit it? And you know, like, then that means I'm a failure and all those kind of things. This is a deal. The goal is yours. Okay? The goal is yours. And if you set it, chances are you hit it. If you don't, chances are you won't. Right? Like, so just own it. Like I want to build a million dollar practice or I want to build a multimillion dollar practice, right? Just set the intention. Set the intention, set the goal, write it down, create a vision board. The first time I own that I was going to build a million dollar practice, I did not actually believe that I could. I didn't believe. Not. I didn't believe. I. I didn't see how I could do it. I did not see any pathway. I was just like, well, you know, but I was like, I'm gonna. I'm gonna decide to do it. I'm gonna decide to hang out with the idea. I'm just gonna own it. Right? And, you know, it wasn't long after that that we hit that. Okay? So the very first thing is to set the goal. Okay. All right? The next thing I would do if it were me is that I would do the math. Okay, so let us say that. I say, okay, how? If. If we create a million dollars, how are we going to do that? Okay, so let's say pediatrics, okay? Not the highest pain specialty. I want to use that because I want you to know it doesn't matter what the specialty is. And let's say, you know, the reimbursements, the payments, whatever, are $150 per patient visit. Okay? So let's say that's what it comes to. Simple math, okay? So we have a million dollars. We divide it by 150. That gives us 6,000, 666 visits. I would need a year to pull off a million dollars in revenue. And so I divided that by 12. That means 555 visits per month. And I divide that by 20 working days. It comes to 27.7. Okay? So there's no point. Let's say it's 28, okay? So that means if I want to hit that number at the. At the. The revenue points that, you know, like, that I'm able to generate per patient visit, I'm looking at 27. So not 27.7, since we have no point 7 humans, but 28 patient visits per day. Okay? So that is the math. That is the number that's going to get me there. Okay. All right. Why is this important? Because, again, so many people don't do this. They set a goal, which is more like a wish. Like, it'll be nice to do this. What's the pathway? What's the math? What's all that? I don't know. Okay, so this is my math. All right? So what would I do after I do the math? After I do the math, I will then audit my math, right? Like this math, Is it feasible? So, for instance, can I see physically 28 patients per day? Right? And everybody's answer is different. Somebody will say, absolutely. Someone else will say, I don't have time for that. I only want to see, you know, 25 patients or 23 patients or whatever. Okay, but let's say I'm like, you know, 28 patients. Like, yeah, I could do 28 patients a day. But then I may say, but wait, I could. But the only way that's feasible is maybe I have a scribe, right? So if I have a scribe, that buys me some time, that takes away a lot of the time that would require for charting and some administrative tasks and all those things. So if I got all of those off their plate, I could see 28 patients a day. I may say, okay, maybe I don't want to see 28 patients a day, but I could increase the amount of revenue that I'm generating per patient visit, so then I don't have to see 28 patients a day. So, for instance, we're using pediatrics as an example. Now, the, the. The visits that, for the most part, the visits that are wells. Well visits and require vaccines and all of that will typically generate more revenue than, say, somebody who came in with a, you know, sore throat or cold or something like that, right? And so I may say, okay, like, understanding that I would. Which, again, we're. We're doctors. We lead with people, not profits, right? But we're talking about numbers. So that's why you hear me talking about numbers a lot. But I can say, you know, I would prioritize well, check visits because I understand how the numbers play out. And of course, as a pediatrician, I would prioritize, well, check visits anyway, right? Like, that's what I would do anyway. Because, you know, like, the more we do that, the healthier they are, the less they need all the other stuff and all that, okay? So I say, okay, so maybe I do that and I'll be able to increase my revenue per visit. Or I could say, I don't really want to see 28, but what I could do is I could add another vertical that does not require me, that does not require my time. And with that vertical, I can offset the need to see 28 patients. So, for instance, if I am, you know, as a pediatrician, I may decide I want to add an ear piercing service, and I charge a hundred bucks per ear piercing, right? Like, if I do that and I don't have to do it, I can have somebody on my team do it. Then all of a sudden, I've created bandwidth for more revenue to be created that doesn't require my time. Right? So again, that's auditing the math. There's no right or wrong. It's just like, this is the math that will get me to the number. Is this feasible? You know, maybe. Maybe my. My revenue per visit is even lower. And so maybe the numbers are higher. Do I need a whole other team member? Or maybe it's still 28 and I. Well, I'm going to bring somebody to work once a week. And so that way I don't have to have 28 a day. Maybe I can then have 25 a day. Right? Because that, with that, I can get 15 patients off my schedule onto the other person's schedule, and I don't have to see that many. Right? So I'll set the goal. I'll do the math. I'll audit the math, okay? So do I like this math? If I don't like the math, what can I do to shift it? That's number three. Number four. Okay? Number four is where it becomes a lot of fun. If I'm going to have 28 patients a day, where are they going to come from? Like, where. Where are they going to come from? Are they going to magically appear? Am I going to hang the shingle and they will come. I will warn you, I took one for the team, okay? I did the hang the shingle and they will come thing. It does not work. It does not work. It did not work. Okay? So I would look at it and say, okay, let's talk about two marketing plans, okay? So there's an external one and there's an internal one. And I'll tell you why I talk about both in a second, okay? So, so, so marketing external one would be, what am I doing so that new people will find me, okay? And in. In a. In a B2B kind. If we look at it in a B2B type of setting, one of the things that I can do that would give me the biggest bang for my buck is I could build a referral base, right? Like, so If I have three to six OBGYNs for my example, I'm a pediatrician. OBGYNs. Why OB GYNs? Because they have my patients, so my clients. So think of it this way, right? Like, even though the baby is my patient, the baby is not the one making the buying decision. The baby is not the one who made the decision to come work with me. That was the mother who made that decision. So that person is the client. Right. And that person also works with ob gyn. So we share a client, which is the mother, but we serve them in different ways. Right? Okay. So I, I'm, I'm. If I have three to six people who have my people and I have a good relationship with them and they choose to refer to me, that's like magical, like completely magical. Right. And so one thing would be, okay, I'm going to build a referral base. I'm going to build a relationship with six OBGYNs who preferentially send patients to me. I decide I'm going to establish myself as a thought leader in that community. One of the fastest ways to do that is to speak is to show up on camera. So I'm going to start a YouTube channel. I may decide I'm going to show up on social media. It may not give me like a gazillion impatience directly, but when people start searching for me and all of that, I'm easier to find. They get to hear my voice, they get to hear my philosophies. They know, like, and trust me before they even come to my website or before they come into the office. And so I can decide, you know, for my, my external plan, that's what I'm going to do. And I'm also going to do some ads. Okay. So these are things that will put me in front of people who don't know me. They'll build my brand and they'll get me a lot of patience. Okay. Okay. Then on the internal side, I'll say, because you want to think about this, right? There is internal marketing that gets missed all the time. If somebody has come to me before, they already know me, like me, trust me, is so much easier for me to get them back than to get a new person. Right. So my babies would have visits at, you know, you know, the newborn period, first month, second, second month, fourth month, sixth month, ninth month, first year. Right. Like, so they have a bunch of visits, and it's up to me to put a system in place so that they keep coming back for their visits and all of those things. Otherwise, that's just tons of revenue that I'm throwing away. Let's not even talk about terrible patient care. Okay? So I have my external marketing plan, and I picked the referral one, and it's the one that people avoid the most, but it's the one that has the biggest return on investment. Right? Okay. So I have the external plan. I have the internal. The internal plan. Okay, good, good. We're Heading in the right direction. All right. The next thing that I'll look at, number five would be the team plan. What's the team plan for this example? Let's say I would get a front desk person, I would get a medical assistant, maybe two medical assistants, I'll get a biller, maybe I'll get an office manager. Because, you know, I have four children. And even though I'm building a dream business, a million dollar practice, I also want to build my dream life at the same time. Right. I want to build these two things concurrently. Okay, so that's the team, you know, I'm going to need to pull that off. Okay. Okay, good. Then number six, I'm like, okay, how are we going to fund this? How are we going to fund this? We, we're launching this. We need to pay people, we need, you know, startup costs and all of those things. And really there are a number of ways. I'm sure there are many more ways. But basically it is I can choose to self fund it or I can choose to take personal loans or I can take the, you know, the traditional commercial loans, if you will. Right. Okay. So for me, I may decide I want to self fund it. And what does that even mean? Right. What does self fund, self funding me? Okay. When I started my practice 14 years ago, I did not really qualify for any loans. It's a very long story. But I, you know, like I spent half of my life growing up in Nigeria and all of that. So when I graduated residency, I'd only been back in the United States for three years. I didn't have a credit history, I didn't have all of these things. And they're like, yeah, yeah, we're not loaning you money for, for a practice. And so I had a mentor who, so I did a hybrid. I had a mentor and I was going to ask her for $10,000 for startup costs. Oh my goodness, you would think that I was going to ask her for 72,000 million dollars. Right. The palpitations I had, the fact that I was like, oh my goodness, I cannot actually ask for this and all of those things. But eventually I asked her for $10,000 for some of the startup costs. And I'm so grateful that she believed in me and believed in what I was doing enough to say, yes, I will give you the money. And she sent it to me. She didn't even think about it. I almost died like many, many, many times. The other thing I did, we did, is I got a part time job at the local urgent Care where, you know, and I, in the beginning, you know, if I didn't have patience, I was clocking hours there, and if I had patients, I was clocking less hours. That's just, you know, that's just the way we did it. And so that way I didn't have to take a ginormous loan. And then I was able to run my practice very leanly. Right, okay. So you can, you can do, you can self fund. The beautiful thing about being a physician is that you have a relatively high earning power and you can use that to self fund your business. Sometimes I'll see people who talk about doing, you know, locum and stuff like that, and they feel ashamed, they feel shame because they're like, is because I'm not getting, I'm not doing the business thing, right? That's why I'm needing to do this. And I'm like, no, that's not actually what's happening. What's happening is you're funding your business, but of course, you have to learn to use your time in such a way that you're doing the most important, important things in your business. So you can stop needing to self fund, but you're self funding your business. And you know, like, it's, it's a brilliant thing to do. Okay, so, so here, you know, you could self fund, you can take a personal loan, you can do a hybrid, you could take a commercial loan, whichever, doesn't matter. But I would think about like, what will I do to fund? So for me, I would self fund. I could do a hybrid, you know, either or. Okay, all right. Now number seven is typically where people completely, completely miss it, right? And number seven is your personal evolution plan. Okay? Now maybe when I was talking about this, you would have thought of some things. You're like, I can't do this because. Or I said something. You got like complete mind drama and all of those things. Everything that triggers you, right? Or makes you feel like, I can't do this or make. Puts you in resistance, where you're like, I don't want to do this. I shouldn't have to do this. That is a pointer of something that needs to be in your curriculum. That's what it is. It's just a pointer. So for instance, if I go back to when I started my business, when I thought about referrals, like building a referral base, like I'd rather die, right? Like I'd rather just shut this business down and be done with it, right? But that doesn't mean stop. That's Just a marker that this is something that is going to hold you back. Because this is a deal if you don't deal with it. If I don't deal with it, I don't deal with it. If I don't deal with it, I don't do it. If I don't do it, the business doesn't work. Why is this important? Because 80% of businesses will go out of business in five years, right? Like, so this is not a joke. Like, this is a real thing. Like, when we do these episodes, what we're trying to do is to empower you to not be a statistic, right? But the odds are, like, if we go based on the odds, the odds are you will be a statistic, right? And so if the odds are against you, then you want to set yourself up to succeed. Like, this is real business. And, you know, if you've listened to the podcast, you watch me on YouTube, you know that I'm an optimist, right? Like, I'm not going around saying, oh, businesses will fail. Like, like, even in the middle of the pandemic, I come out and I say, hey, guys, listen, we're gonna thrive. How are we gonna thrive? I'm working on that part. Haven't figured it out yet. But we are going to thrive because it starts with the decision, right? So this is not about being a pessimist. This is about understanding that the. The sport of business is a serious sport and we have to take it seriously. When we ignore our personal evolution, we set ourselves up to fail. That is, that is literally, literally what's happening. Right? Okay, so. So let's play around with some of these things. So I think about referrals, like building a referral base. And I can't. I can't. I can't do that. And then I have to stop and add that to my curriculum. Like, I have mindset drama around building a referral base. I try to identify what it is, and it is the fear of rejection. Because, you know, what if they tell me no, you know? And when I identify that, I know, okay, I need to build this muscle. I have to understand the mindset of the person who builds solid referral base basis. I have to understand what the strategies are, right? Like, I. That's. That's something that's part of my curriculum. Then if. If I thought about YouTube, it would be the same thing. Oh, my goodness, YouTube. Like, you mean my face with me talking on the world wide web and, you know, with my thoughts out there, and people would be able to judge Me. And people can leave nasty comments like, I'd rather not. But the thing is, there's so few doctors are speaking that if I had a YouTube channel and I was posting consistent, consistent content posting every week, the truth of the matter is, I'll stand out. It's so easy to stand out as a physician, entrepreneur, because many people are not going to do it. They're not willing to. So the question is, what is the mindset again, the fear of rejection, right? The fear of the critics and the naysayers and the haters coming for me on YouTube and all of those things and really being like, oh, my goodness, I don't want my thoughts to be out there. So, again, it gets to my curriculum. It gets into my curriculum. What is the mindset of the person who's a content creator? What's the mindset of a person who's a thought leader? What is the mindset of the person who's proud of their. Their line of thought, their message, you know, their mission and all of those things? What is the skill behind it? What is the skill of showing up on camera? How to frame a talk. How to frame a talk in such a way that it grows my business and all of that. I recognize that these are things I must, must acquire. Okay, then I may think of social media again, same thing. Fear of rejection, putting myself out there. Maybe it's not professional. Don't want to be on social media. All of that. It's a pointer. Got to add it to the curriculum. Like, you know what I'm saying? It could be around a team. When I think. When I thought at the beginning of my business of hiring a team, I was so terrified of it. When people tell me, oh, I don't, I don't. I'm not a business person. I don't have natural instincts. I'm not like you. I'm so amused because my first business, I answered my own phones. Like, thank you for calling Ivy League Pediatrics. This is Ella. Ella was my alter ego. I answered my own phones. I worked up my own patients. I checked the patients in, I did their vitals. Then I saw them as the doctor. Then I came back and did their shots. And after they were gone, I did my billing myself. I was so terrified I would hire nobody, right? And so part of my evolution is, okay, like, what is the mindset of the person that hires? How can I bring myself to believe that I'm worthy of an A team? I'm worthy of a rockstar team? How do I do that? What is the Skill of hiring. What is the skill of interviewing? What is the skill of marketing for a position you want to fill? What is the skill of de hiring, otherwise known as firing? What is the skill of building company culture? This is part of my curriculum. I must learn it. Because if I don't, beautiful as my plan is, right, like step one to six, beautiful as it is, I cannot execute on it because I have not evolved to become the kind of person who can do it right? Okay. Since I decided that I was going to self fund, then part of my curriculum becomes the mental fortitude to do the hard work. Because it is hard work to build a business and self fund, right? So when those hard days are going to come, when I'm tired, like what am I going to do? What am I going to do to show up at a high level for my business and my locum position? Like what am I going to do to do that? How am I going to take care of myself so I can be a high performance business at athlete? This is evolution that needs to happen. So the mindset, the strategy, the skill, these are things that I stop and say, okay, I have the plan for the million dollar practice, but in order to pull it off, this is the evolution that's required. And so I'm going to do it. I'm going to lean in and evolve so I can become the kind of person who runs a million dollar practice, right? So I want you to think about this, right? These are, these are seven steps. These are seven really simple, right? I didn't say easy, but they're simple steps that I can take and say, okay, I'm ready. I'm going to take my business to seven figures, right? I'm going to take my business to seven figures. When you get here and you're like, I'm going to take my business to multiple seven figures, guess what you're going to do? You're going to come with plans 1, 2, 6, 1 through 6 and then you're going to come up with, this is the personal evolution required and you're going to go for it. I want you to understand that this is something that we as physicians can do. We do live in a time where people make it seem like, oh, you cannot build a seven figure medical practice. And the truth of the matter is you can. Can you set the goal? Yes. Can you do the math? Yes. Can you work the math and see, like audit the math and say, will this work for me? Yes. Can you create a marketing plan? Absolutely. Funding plan? Absolutely. Team plan? Absolutely. The hardest Part of it is the personal evolution. But can it be done? Absolutely. Okay. You went from somebody who was regular folk to a person who's a physician. And think about the impossible things you do, but you do them. Okay? And so you can evolve to become the entrepreneur who can pull off the steps to build a seven figure practice. Okay, so what do I want you to do? I want you to workshop this. I want you to look at it. I want you to make a decision that this is my new floor. Like, this is what I want to do, right? This is the result that I'm going to create. I want you to do that. I want you to do that. And if you're here and you're like, oh, my goodness, I see how this can work. I see the yellow brick road, but I need support for this. Come join us in Altium, the business school. This is what we do in the Entre MD Business school. We go from physician to physician entrepreneur to the version of us that is required for every stage of our business. You get the identity shift that needs to happen. You get the strategies that need to happen. We focus heavily on marketing, on selling, on building your team, on managing your time. So at the same time, you are building your dream life, right? We don't want you to sacrifice your life anymore. You did that to become a doctor. So if you need support, reach out entremd.com forward/call. And my team will be happy to help you see if this is your best next step. Okay? Now, regardless of whether you work with us or you do this on your own, either way, I just want you to create the result. I want you to think about this. You can build a practice that impacts a lot of people, that creates financial freedom for you, that gives you your time back, and it is within your power to do this. I want to invite you to do it. I want to invite you to take it to the next level, to build a business that can then work without you. Right? And you can do it. Physicians before you have. And I'm just putting this, I'm giving you all of this so you can take your very next step and begin to build the practice you only dreamed of. Okay? So this episode, I want you to send me a private message on Instagram, Facebook, LinkedIn and say, Dr. Una, I got it. I got the yellow brick road. I'm working the yellow brick road. Thank you so much for creating this episode. And I'm gonna pay it back by creating the results and I'll come let you know all about it. Okay? That will absolutely make my day. But I want you to take this episode, share it with the doctors in your world, because it will change the their lives. And I will see you, my friend, on the next episode of the Entrepreneur podcast.