7 Vanity Metrics That Are RUINING Your Private Medical Practice
30 Jan 2026 · 30 min
Dr. Nneka Unachukwu identifies seven vanity metrics that distract medical practice owners from what matters: social media engagement, team size, email lists, revenue without profit, costly events, large untended audiences, and expensive equipment. She argues these feel impressive but don't drive cash flow or ROI.
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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, you are not thinking about profit. You are not thinking about cash flow. Like, revenue is great, but revenue doesn't go to your bank account. What goes to your bank account is profit. 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. Well, hello. Hello, my friend. Welcome back to another episode of the On Trembly podcast. I am super pumped as always that you're here now. Today we're going to be looking at something that is so powerful. And when you apply this, this will create quantum leaps in your business. We're going to look seven vanity metrics that are killing your business. These are numbers that might could matter, but in the grand scheme of events, they're not the. They're not the ones that we look at as the measure of success, but so many people do. And this is the reason why there's a lot of effort, but the businesses are not working. So after today, you're not going to have this problem anymore. Okay, so let's look at those metrics. So metric number one. Now, you know, maybe I should back up a little bit and kind of give you a better picture of this. So if you're watching a basketball game and you're watching an elite player, the elite player has one job, ultimately is to make sure that the ball goes into their opponent's basket more often than it, you know, like, the other ball goes into the other basket. It really is as simple as that. Now, they may dribble. They may have, you know, no look passes. They may do all of those things, and those are important. Like, you know, how many times you rebound the ball, how many times, you know, did you dribble? Did you do that? Like, awesome. But at the end of the day is the number of times the ball goes into the basket that matters right now. That's because they're elite basketball players, are competing for a championship and all of that. Now, I have gone to a game by the Harlem Globetrotters, and their goal is entertainment. And so they're doing all kinds of maneuvers, all kinds of dribblings, passes, flips, and all of that. Not so much how many times it goes in the basket, right? And that's because the goal is entertainment. So I am convinced that in your business, you are not in business to be entertained. You are not in business to be distracted from your life. You are in business because you have a desire to have a huge impact in the lives of your team members and in the lives of your clients or your patients. And you want to create financial and time freedom for yourself and for your family and all of that. You want to leave a legacy, all of those things, because that is your intent. I am making the assumption that you are an elite entrepreneur. You are not an entertaining entrepreneur. Right? And because of that, it is very critical that you understand what the basket is, right? So that you can go score as. I mean, you can go score as many times as you need to score. Okay? So this is very important. Now, the numbers we talk about today, it's not as though they don't matter at all, but they're a means to an end. They're a number that requires another number to interpret them is so critical. So critical. A few years ago, I think this was two years ago, I set a goal. It was on my vision board for the number of downloads I wanted to have on this podcast, on the entrepreneur podcast. And I can't remember what number I said, but really big number. But I was very clear when I put it on there. This is a vanity metric. This is a vanity metric because there are things I want to accomplish as a whole in the business. Now, will this help me get there? Yes. But can I take my eyes off those things to focus on the number of downloads? No. So I'm very clear. It's a Nice to have. It's a vanity metric. I'll probably post about. It's probably so proud of myself, all the work I put into the podcast. Yes, But I can't measure that number. The expense of other numbers. Okay, all right, so I think you get it now. Let's look at those things. All right, the first one is your engagement on social media. Okay? So that could be views, followers, likes, comments, all of those things. Now, am I trying to say that's not important? I mean, come on, I wrote the visibility formula. We talk about social media, we talk about all of that, and we talk about it very heavily in the entrepreneur business school. So am I saying it's not a number to measure, It's a number to measure, but on its own, it's a vanity metric. Okay, so if my goal then becomes, I want to have more engagement, I want to have more views, I want to have more likes and follows, then what? That means I'm going to create content not for impact, not to attract new clients, none of that. But to keep them entertained or keep them liking and following and all of those things. Right? So my, my driving force cannot be my engagement on social media. Now am I going to create engagement on social media as a means to an end, to get more clients, to help people have more impact, to help them create wins just from, you know, my content? Of course. But that's not the target. And so if I'm measuring that, I'm not measuring profits, I'm measuring that. I'm not measuring how many new clients I got. It's a vanity metric, right? Like, so, Yes, I have 100 million followers on TikTok. So what? Right? Like, yes. And do you also have the outcome that we want to create from being on social media? Because social media is a means to an end, right? And so we want to think about that. We don't want to be like rich and dollar poor. And when we focus on those numbers, that's the kind of situation we create. Now, somebody saying, don't get on social media. Please do not hear what I'm not saying. I am not saying that. What I am saying is measure all the way. Don't just stop there. It's not, it's not an end in itself. Do you know that if I post a video about a cat, okay, about a cat, and it's filing down his nails and stuff like that, and I put something snarky on there, people are going to comment and like and share and all of the things. If I came and I said, oh, you know, we've just opened enrollment for the Entrepreneur Business School. Or I come and I say, you know, like, now we have tickets for ENTREMD Live. We'd love to see you, you know, as part of the live audience. If I do all of those things, I know I'm going to have less engagement. I know that, like whenever there is an ad, it could be to register for a free webinar. It doesn't matter what it is. But the bigger your ask, the less your engagement. But that doesn't mean people are not saying yes. So the question is, are you going to be so, you know, like, so determined to make sure your numbers for your likes and all of those things are going up that you won't make any calls to action? Because guess what, you may have more engagement, but nobody's saying yes to you, nobody's deciding to work with you, nobody coming to your clinic because it, because of it. Because you don't have any call to action. Right? So on its own is a vanity metric. And we gotta be clear about that. Okay, number two. Number two is the size of your team, Dr. Una, what in the world are you talking about? Like, like you always talk about, you know, bringing on a team and you know, with the team you have, you know, more capacity, more bandwidth to do more, then you can create time freedom for yourself and you can multiply impact, all of that. And it's all true. But this is a deal. Are we measuring team size? Are we measuring team productivity? Are we measuring team size or measuring team size? And also, like, this is the way this team contributes to the bottom line. Do we have a big team that is growing or at least maintaining our profit margin? Meaning that as we bring on more team, that they're bringing in more revenues? At the end of the day, it's not eating into our profit margin. Are you bringing on team that are dead weight? And so the owner is almost like killing themselves to generate enough revenue to support the team, but the team is not doing anything to support the bottom line. Right? So team size is that important? Of course. Like, we want to grow a team. I've been growing my teams and all of those things, right? Yes, we want to grow it, but just saying, oh, I have a team of 15. I mean, that's great, but how are these 15 people contributing to the bottom line? How are these 15 people expanding your impact, expanding your bandwidth, helping you to have more time off? Like, how is the team helping you do that? Your team members, do they even know what revenue generating activities are? Do they know how their role impacts the bottom line. Because if this is not in place, then your team, the size of your team, it becomes a vanity metric. Like, you have a big team. So what? Right? And it's so critical because the team does not exist for itself. You started alone. You started with a vision. You had goals for the business. You had a vision of what the business will look like. You bring team members to come work alongside you to make that vision a reality. Right? And so if you bring team members, I cannot tell you how many businesses I've reviewed and audited and coached. And you see that for, you know, the team members, they're almost like this additional thing, and they just have some tasks that they do, but there's no connection between that. The. With the vision, there's no connection between that and the overall strategy of the, of the organization. Right? And so team size alone, it's a vanity metric. It's a vanity metric. Okay. All right, let's look at number three. Number three is email list size. Okay, Email list size. I have 50,000 email subscribers. Yeah. Right. Now, Dr. Una, what in the world are you saying? Are you saying you don't want us to grow our email list? Of course I want you to grow your email list. I am actively growing my email list as we speak. Right. Like, for instance, if you're listening to this and you're not subscribed to our newsletter, our VIP newsletter where I give you tips and tricks and hacks to go to your first or next million in revenue, I want you to go subscribe now. It's on trendy.com forward slash newsletter. You get it in your inbox every Thursday. And it's like super high value as things you won't see on the podcast is just solely for the newsletter. So go subscribe. What did I do? I just grew my email list. Like, seriously, if you didn't subscribe, go subscribe. Right? I just grew my email list. So am I telling you, don't grow your email list? No, that's not the point. But the thing is this. If you have an email list but you're not sending them emails, you're not giving value, you're not nurturing them in any way. You're not using it to know, grow your know like and trust factor. You're not making any offers, you're not inviting them, whether that's to come to a workshop you're doing or if you're your. Your private practice doctor, to schedule an appointments because they might be overdue. And all of that if you're not using it for that, what does it matter that you have 50,000 people? That you're. The size of your email list becomes a vanity metric. So you may feel good telling people about it. Oh, I have 15 people on my team and I have, you know, 32,000, my email list and all that. But it's not, it's not affecting your bottom line. It's not helping you get to your goals. It's doing nothing for you. So it legit does not matter. It doesn't matter at all. Right? And so when you look at it that way, as an entity on its own, a number on its own, it doesn't matter. It's a vanity metric. It makes you happy, it makes you feel like you're super successful, but you're not doing anything. It's just extra work collecting all those email addresses. It's a vanity metric. Okay, all right, so we looked at, number one, your engagement on social media. Number two, the size of your team. Number three, your email list size. Number four would be. Let's talk about this one, your revenue. Oh, my goodness. Dr. Una. What? What are you talking about? Right? Like, what do you mean revenue is a vanity metric? When you look at revenue and you look at it as a number on itself and that by itself, and you're like, by all means, we're going to make this number go up. You know, we're all about the revenue this year and all of those things. If you're only thinking about that number a lot of times it makes you do crazy things. It makes you do things so crazy that you might find that, find out that, oh, it was a great year. Oh my goodness, we did 2 million in revenue. And then you find out that you spent. Well, you spent 1.8 million though, right? Like, at the end of the day, you're looking at profit of $200,000. And that's because you are not thinking about profit, you are not thinking about cash flow. Like, revenue is great, but revenue doesn't go to your bank account. What goes to your bank account is profit, right? Revenue is great, but if you don't have cash to run your business, you don't have cash flow. You don't have cash flow, right? And so the revenue by itself, just so you can say, oh, yes, we're a multiple seven or whatever, and there's nothing wrong with that. Please don't misunderstand me. I talk nonstop about us building seven figure businesses or adding another seven figures and all of those things. We work relentlessly on that with the entrepreneur business school. So I'm not saying revenue is not a good number to track, but in isolation, it becomes a vanity metric, right? It's when you think about profit, when you think about cash flow, then you start looking at how do I increase my revenue in a profitable way? I want you to think about that. How do I increase my revenue in a profitable way? That's where you can start looking at the ROI of the things you do. Like, I'm spending a gajillion bajillion dollars in ads, but I can't link anything to it, right? So is that something that needs to stay? That's what will make you go look at your profit and loss statement. And I will be the first to tell you, like, I used to break, you know, imaginary, but I used to break out in hives in my mind when I would think about looking at my accounting in any way, shape or form. But this is what will make you look at it, right? It's not just enough to see what came in through the stripe account or what is in the bank account. Like, we're looking at that we're looking at unnecessary expenses are expenses with no roi. Now, to be very clear, I'm not talking about investments, right? Sometimes people look at their team as an expense. Your team is not an expense. And I did a whole podcast episode on how to convert your team from an expense to an investment. So if you're thinking your team is an expense, I really want you to go listen to that. So you're not necessarily cutting the things that generate revenue, but you're cutting the things that they're not maintaining the revenue and they're not creating an roi and they're just there. You know what I mean? It makes you think about it differently, right? It makes you think about it. And that is what will benefit your team. Your business does need to be profitable for them to continue to have a job. That is what will benefit your family. Because all this time they, you know, loaned you to your business to go do all this work. At least there's an ROI for it. There's something that comes back home, and then your business can continue to exist. So revenue is great, but think about profit, think about cash flow. Okay? So that's number four. Number five, this is, you know, like events with tons of bells and whistles, right? And this could be in the private practice world. This could be in the coaching space, or if you're a speaker and you host events and things like that. I want you to hear me really clearly Right. This is a place where I see people making the most unbelievable mistakes because they look at an event forgetting that this person they're looking at has been doing events for 10 years, 12 years, 15 years, they're cash flow positive. They, they have great relationships with vendors, they have an in house team that handles a lot of things. And somebody who's starting off is, you know, less than five years into it decides, oh, I want to do the event at the, the same magnitude as this person. And at the end of the day, I've seen events where people have lost twenty thousand, thirty thousand, a hundred thousand on an event, especially with no clear roadmap to creating an roi. So it's not like after the event there's something they can do to. None of that, right, none of that. And so it's just like, oh yeah, you know, had my fans and it was in the Four Seasons and I'm just, you know, nothing wrong with the Four Seasons. Amazing chain. But I was in the Four Seasons and I had, you know, this kind of, you know, swag and these kind of bonuses and that kind of experience and all of that. Just to say I had it. Now, am I saying don't do that? Absolutely not. I host events. I host a ton of events, right? Whether that's through my business or through the church and all of those kind of things. And we do our best to pull off a show, right? But we also have to do it understanding that we're not the federal government, we don't have a limitless budget. And also with the understanding of this concept that I call the pace of grace, my job is to do the best, best to do an excellent event. Okay? Now an excellent event means that I do the best possible event I can do with the resources that I have available to me. That's what that means. And so I put on the absolute best event that I can put and then debrief with my team and then we already have plans on how we're going to make the next one even better. And we're doing this in a profitable way. Because remember, at the end of the day, the job of a business is to serve a customer, serve a client, serve a patient, and to do it in a profitable way, right? So that they continue to have the privilege of serving those clients. And so you don't have to have every bell, you don't have to have every whistle. You can grow into the bells and you can grow into the whistles. But we don't want to just do it so we can say oh, yes, I had that kind of event. Right. So it's just something to think about. Right. I cannot tell you how many times people are like, you know, the way it is, you know, events are. Most of the events are just done. You're going to lose money on the events and, you know, in the, in the, in the buy and buy, you recoup it. And I'm like, yeah, I'm not, I'm not the federal government. I don't, I don't make those kind of decisions. Right. Because I have the privilege of serving hundreds and hundreds of, of some of the most phenomenal physicians and helping them build amazing businesses and amazing lives. I think about a dream business and dream life concurrently. Right. I serve them to the best of my capacity. I invest so heavily in myself. I invest, you know, like I invest over six figures in myself every single year. Why? To be better, to serve them better. The last thing I'm going to do is put myself, my, my business in a position where we're not serving, we're not profitable, and maybe, you know, have to go out of business or anything like that. Like, I'm not willing to sacrifice that because the work I do is just too important for that. Okay, so bells and whistles, you know. Yeah. And I'm not saying, please don't misunderstand me. I'm not saying don't do the bells and whistles. Do them. Do them in a profitable way. Do them in a profitable way. Okay, so that's number five, I think. I don't know what number that is, but we'll just roll with it. Okay. The other is your community size or an audience size. So that's kind of. Say you have a group. Like for instance, I'll see people and they're like, oh, I have a Facebook group and there are 20,000 people in it. And it's a metric and it's measured and is bragged about and all of that. But guess what? There's no nurture happening in the Facebook group. There's no call to action in that group at all. There's no invitation to come for a masterclass. There's no invitation to schedule an appointment. There's no invitation to come work directly with a per. There's nothing happening. And so what you'll find is you have another group that's an itty bitty group with a thousand people or 2000 people that is really a million dollar Facebook group and you have another group that has 400,000 people and there's. It's an. It's a not a dollar group, okay? I just made up a phrase. It's a not a dollar. Okay? So then it becomes a vanity metric because the number of people in the group doesn't matter if we are not doing the things to reap the reward of having that number of people in the group. Right? And so when you think about it, right, if it's a. It's just a community that's built to support your business and you're measuring that number, you also want to ask, like, the. The store. The number on its own is not. It's not a complete thought. The complete thought is like, this is the number and these are the activities we do. And because of that, this is the percentage of people who are active in the group. And these are the number of times that we make calls to action. And because of that, this is the number of people who come for our master classes or who schedule appointments or who have come to work with us and stuff like that. When you measure that, then that tells the complete story, because just the number of people in the group doesn't tell a story at all. A group a fifth of the size of that managed properly could give more of a result. So then it becomes a vanity metric. Okay. All right, let's see how we're. See how we're doing here. The final one. The final one would be, you know, like equipment, right? Like, I have this kind of laser or I have that kind of machine. So equipment, devices. I have this kind of facility and all of that powerful. And of these seven things I've mentioned, they're all seven things that I want. They're all seven things that you want, but they're not. They're not the end all be. All right, like, the whole point of dribbling is to get the ball to the basket. The whole point of the. No, look, pass is to not allow the opposing team intercept the ball so your team member can get the ball into the basket, right? And so imagine. Imagine measuring the number of dribbles and just completely losing count of what the score is. The score is, is. That's what matters, right? And so the dribble needs to be interpreted in light of the score. Okay, so back to the equipment. So I have this kind of equipment, this kind of device, this kind of facility, all of those kind of things. Great. Okay, so this wonderful device that we have, and we're the only ones who have it, or one of five people who have it, what's the ROI on it? What is it doing? Is it. Is it Is it some laser that I bought that I'm literally paying for? Like it's a house mortgage and I haven't had a single patient use it. Then it's a vanity. Like it's a vanity of vanity metrics. Right? Okay, Yes. I got the new building and for my practice and it's X hundred thousand square square feet. Great. But I'm not doing any marketing. I'm not going after any referral sources. I don't have patience. Like literally one third of that space is being used. It's a vanity metric to keep talking about it and keep focusing on, keep celebrating it when I'm not doing the thing to make it useful. Right. So it's a different way of thinking. It's like critical thinking for physician entrepreneurs. Critical thinking for seven figure physician entrepreneurs. Doctors who have decided I'm going to have a huge impact. I'm going to create financial freedom and time freedom. This is the way we think. We're going all the way to the end. My job as a business is to impact a lot of people and do it in a profitable way, impact a lot of people, build this asset that touches many lives and creates financial freedom. For me, it's a win win situation. Right. And so all these other things that we need to measure, do we need to measure them? Yes, but we need to measure them and hold them to the outcome we ultimately want. So, yes, I have the big building and because that I'm able to bring in more patients and because of that, my outcomes are better. I'm able to serve more people, I'm able to earn more. I have this huge engagement on social media, which is awesome. And I nurture them. I'm giving them content that literally they're like, oh my goodness, you're in my head. How did you know I needed that today? I needed that. So I'm growing my know, like and trust factor. And I have a schedule, so I'm making offers. Come to my masterclass, buy my book, come see me in my private practice, all of that. And because of that, from social media, we can say that a third of our revenue is coming from social media. And this impact on people are telling people and all of that. Do you see, like, so it's not as though it doesn't matter, but we have to have it connected to the outcome that we want. Right. So when you think about the revenue, ooh, the revenue is amazing. And in addition to that, you know, our overhead was 50% and we've succeeded in bringing it down to 40%. So our revenue is higher, profit is higher, right? And you know, like, our efficiency is better. And did all that with me taking more time off and all that. Like, you tell the whole story and then you can make really critical decisions. Now why is it important that we understand these seven things that are vanity metrics? Because if we take our eyes off the ultimate goal and we start looking at those, we start making decisions that don't make sense. For instance, creating content for views and likes as opposed to for impact and conversion. Right? Like impact on conversion. You can still create the engagement, but the intent is clear. Like as an entrepreneur, you know what you're doing, right? As opposed to people are tickled because this is the deal. The person who gets entertained, the person who wants to be entertained is probably never going to work with you because they're there to be entertained. So imagine not talking to the person who is really, who really wants to get the work done. But it's like, let me know, I'm just on social media, so follow this person. Kind of get a feel for if this is the person I should be talking to. Is this the person I should be working with? Let me grow my know, like and trust factor. You're a pediatrician. They're checking out, checking out what your, your values are, your philosophies are, seeing if there's that connect and then you're entertaining them. Like, and then the person you're entertaining is not going to work with you because they're not looking for a pediatrician, they're just looking for entertainment, right? So when we don't have the right pictures, when we don't have the right focus, then we cannot, it is not possible for us to make the right decisions. If I understand, you know, like, what my team is for is to help me accomplish the vision that I want to accomplish. Then from the beginning I talk to them about revenue generating activities. I show them how what they do affects the bottom line. Their bonuses and all that is tied to how they help me do what I need to do. As far as the vision and all of that, it's not just the number. Like, who else should I hire before you hire? And if you're here and you're thinking about hiring, how about I give you this freebie before you hire, stop and ask, how am I leveraging the team I have right now? What percentage of their activities are spent doing revenue generating activities? How much time are they spending browsing on Facebook when they're at work? Because they're, they're bored silly because they don't even know what to do. Fix that and then hire the person you need to hire. Right? And so what I would love for you to do is really take this episode. This is one of those. You want to, you know, start over, maybe workshop with a friend and say, okay, where have I lost my focus? And I'm. I'm driving my business based on these numbers that are in the middle instead of the outcomes that I ultimately want. Right? And you make these tweaks, and they're little tweaks, but they will turn your business right side up. They will turn your business right side up. So do that. And if you find that, oh, my goodness, like, I. I made so many changes based on this, I want you to send me a DM or a PM on Facebook or Instagram and say, oh, my goodness, Dr. Una, you will not believe it, and I'll believe it. Okay. You tell me what you did with it. Okay. And the other thing I want you to do is take this episode. I want you to share it with the doctors in your life, because it would be complete. Such a complete game changer. Complete game changer. Because then we go on to be these people who create more revenue and more profit, build bigger teams, are more productive. We have email lists that are bigger, but create more ROI for us. We have events that are amazing, but create more roi. You know, like, our people are really being impacted and, you know, like, the revenue and all of that is happening, and we just have this business that's bigger and better because many businesses get bigger and worse. But now you'd be setting yourself up to have a business that is bigger and better and is creating more impact, more revenue, more time off. More impact, more revenue, more time off, more significance, more legacy, because you don't have your eyes locked in on the vanity metrics. Okay. All right. So go share this episode with the doctors in your life. They'll thank you forever. I'm rooting for you. I'm so excited for you. As you apply this in your business, you'll be blown away by what happens. And I'll see you on the next episode of the Entrepreneur Podcast. It.
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