Business Math for Physician Entrepreneurs: Mastering Different Business Models

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, charge what you are uncomfortable charging. So maybe you decide that ultimately what I do, I want to charge $10,000 for it. But you cannot even possibly bring yourself to charge 10,000. You can comfortably charge 3,000 and 5,000 would be a stretch. That's go for 5,000. 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. Umna. One of the reasons why businesses struggle the most is that the entrepreneurs do not quite understand that the math of business. And today I'm going to be walking you through understanding million dollar math. Okay? Now the reason why this comes up a lot, especially for physicians, is we are helpers at heart and we have not actually been trained to look at the numbers and make any data driven decisions. We just make decisions based on the kind of help we want to offer people and then the pricing and the volume and all of that is an afterthought. Now, of course, within a hospital system or an employed system and things like that can work because we're shielded from the money. When you own a business, you have to look at it completely differently because business is an economic sport. Okay? Business is an economic sport. You want to remember this. Now, does that mean we put profits and numbers ahead of people? No, of course not. But it doesn't also mean that we get to disregard the numbers. Okay, so we put people first, we put numbers second. But numbers are right there. And once you understand how to marry those two things, entrepreneurship becomes so much easier. Not easy. Easier becomes so much easier. And you can really show up authentically putting people first, but then building an entity that is profitable so you can continue to stay in business. Okay? And whether you are starting up, you are your first year of business, or you're a veteran is very critical that you understand this, because I have been a student of business long enough to know that the fact that a business is bigger or more established does not mean it's more profitable. We must understand the rules of the game, and that's what we're going to be looking at. Okay, so let me start off here. Someone may say, okay, why a million? What's the thing with a million? Well, I mean, a million is a nice number. When you factor in taxes, payroll, all of those kind of things, it comes to a pretty decent number that you can take home. But if you don't want to do a million, you can take a zero off. If you're like, Dr. Una, I'm already at the 10 million, then you add a zero. Okay, but this is just, you know, there's lots of zeros. And it's easy to do the math with zeros. Now I want to, I want to play, let's, let's play a game here a little bit, okay? And I love gamifying entrepreneurship. People say, oh, well, if you have a 97 product, you can never build a successful business. And that is not entirely true. Okay, think about your Netflix subscription, right? It's not a gazillion dollars. Somebody may say, well, if you charge really high, you're not going to get enough people to say yes to you and you're not going to be able to run a successful business. This is not true either. Okay, so let's look at million dollar math, and let's just look at it as pure math, like a pure equation. If I sold something for a hundred for one dollar, and I figured out how to sell it to a million people, and you may say, well, how can you find a million people? Well, let's say that I had a book that was a book written for the general population, not for, not for physicians. And it was a really fun book. And it was Christmas time and I was going to, you know, I was going to sell it through Walmart. Walmart really wanted it. They could easily distribute a hundred, a million copies. And I'm like, I just want a dollar per copy. That's a million dollars. Do you see what I'm saying? Like, so just. Just roll with me here. Let's look at it as pure math. No arguments, no stories around it. So I can sell something for a dollar to a million people, and that's a million. I can sell something. Again, we're just moving zeros. I can sell something for $10 to 100,000 people, and that's still a million. Okay, I. And you could say, where would you find a hundred thousand people? There are a million physicians. What if I touch 10% of them? Right? Like, just roll with the math here, okay? Okay, I can take something that is a hundred dollars and I can sell it to 10,000 people. That's a million. I can take something that is $1,000 and sell it to a thousand people, and that's a million. I can take something that's $10,000 and sell it to a hundred people. That's a million. I can take something that is $100,000 and sell it to only 10, and that's a million. I can take something that's a million and sell it to one person, and that's a million. Right? And the reason why I took the time to do that is because I want you to see there are many ways to get to a million dollars. But understand that it was a tight equation. I could not say, oh, you know, like, I want to sell something at $1 and I want to sell it to one person, make a million. That is not the way this works. It is an actual equation. The same way, I can't say, you know what two plus two is 17. Is 17. How did you get there? That's what. That is not how this works. Okay? And once you can get this. Once you can start thinking this way and understand there is an equation and there are laws to the equation, then everything becomes better. So the models work. So many different models work, but you have to play according to the game. Okay? So, for instance, what you will notice is the lower the dollar amount was, the higher the volume, right? The higher the dollar amount was, the lower the volume that I would need to. Need to serve to get to a million dollars. Now, there. There are many business models, but I want to make it really simple. And we're going to look at two, right? Like, it's just a way of thinking. And. And please roll with me here, okay? So if I decide, you know, I want to serve a certain audience, and I decide that they. What I want to charge for my service is $100, but I want to make a million this year. What I am saying is I want to charge $100, and I'm willing to do the work of selling this to 10,000 people. So it is low ticket. It is high volume. I cannot say that I only want to sell it to 100 people, and it's $100. Okay. Because that is going to give me $10,000 for the year, which is. But what happens a lot of times is people pick these kind of numbers, and at the end of the year or the end of a quarter, they're frustrated. And I'm like, but if you do the math, there's no way the math was going to take you to your goal. The goal and the math don't line up. They don't line up at all. Okay, okay. If I said that, you know, I really want to, you know, take the time, invest a lot in my people, serve them at the, at the highest level. It doesn't mean you can't serve at the highest level for low ticket. But you, you know, like, I want to have touch points and all of that stuff, and I want to, you know, I want to charge $20,000 for what I do. Okay, that's, that's okay. You, you, you can get away with it, right? I want to charge 20, $20,000 is what you're going to have to do. I'm not the exact number, but a higher ticket. Because what you're saying is I want to serve a smaller volume of people. So in a broad sense, what this means is if I want to go low ticket, there's no problem with it. That can work. But, but I need to go high volume for the equation to work. It is an equation. It also means that if I decide that I want to go low volume, then I have to go high price to get to that equation. Okay? Now you may say, yeah, I set my goals for the year, It's a million, or it's not a million, it's less than a million, Whatever. But whatever that goal is and whatever you've decided your model is, you want to reverse engineer it. Okay. And then say, okay, based on what I've decided my goal is and how I want to work or how I want to price, this is what is required of me. This is a requirement. This is not a suggestion. You don't get to do it if you like and not do it if you don't like. Okay? So if you say, I want to serve just a few people, you're saying, I want to do high price. If you say, I want to do low price, you're saying, I want to do high volume. End of story. Okay. All right. So now if. If that's the case, then I want you to think, you know, like, there are different types of challenges that come up based on the model that you pick. Okay, so let's talk about that for a second. So if I decide that I only want to serve a few people, that means I'm also saying that I want to be high price. Now, if I want to be high price, where do I anticipate the challenges would be? Well, the first challenge that I see a lot with that is the money drama around raising prices. Right. And I talk to doctors a lot, and I serve a lot of doctors, and I've done this for a lot of years. So a lot of times, there's money drama that comes up. Is drama around your greedy doctor. How much is enough? You're manipulating people and taking their. Their money. This is something that is simple for you to do, so why are you charging so much for it? And all of that that comes up. So if you're going that model, if you are in that model, I need you to understand this is a challenge that comes up. And a lot of times, every time you raise your prices, the challenge rears its ugly head again. And so now you're savvy. You know, that's what's coming. So you prepare for it. Okay. How do you prepare to overcome the mind drama that. Because you're charging maybe higher than somebody else would? So, for instance, one of my clients, she is a direct primary care doc. Her first year, she did over $500,000 in revenue, and she's a little higher price than her peers. And there's a lot of, you know, guilt. She got guilted. Many times people say, how can you charge that much? And all of those kind of things? And. And that's on one side. And there's the internal money drama. There's, you know, there's drama everywhere, Right? But she was able to own it. She was able to own what she did in an ethical, authentic way. And then she built the business that she wanted to build. Okay, so if you know that that's gonna come, what do you do? Well, I'll give you a few things you can do. Number one is really leaning into the value of what you do. Okay. Because the kinds of people who will go high ticket are the kinds of people who typically place more value on the ROI than they do on what they're paying. Okay? So for instance, when I want to work with somebody, I am not necessarily thinking about the sticker price that what I'm thinking about is this is the, this is the value I want to get. This is the return on investment I want to get. And this person has either done it for themselves or done it for themselves and done it for so many, so many other people. There's a clear path and I go for it, right? Because I know that whatever I'm paying is an investment and I'm going to get a huge return on investment. So I'm willing, I'm willing to pay, right? And so there are many things that I pay really high value for. And I'm not bothered by the price. I don't mean I don't talk about the price. I don't talk about that. Because the same way if I'm going to go buy real estate, if I see the path to ROI or I'm going to go invest in stock, I see a path to an roi. I'm not crying over what I'm investing, right? Not, I'm not, I'm not crying about that at all. What I'm focused on is, oh my goodness, look at this return that I'm going to get. So when you go into the high ticket arena, those are the kind of people that you're, you're typically talking to. So you need to be clear on what that ROI is, right? And so let me use myself as an example. I run the entremd business school, one of the greatest honors of my life. We've done that for almost four years at this point. And it is not low ticket. It is not low ticket by any chance, however, when people come into the school, they make that transition from physician to physician entrepreneur. They build a brand that is profitable. There are people who build businesses. They come in, they do their first hundred thousand first multiple, six figures, first seven figures. First multiple, seven figures. They're able to do that. They're able to, they learn how to build teams. They're building these teams and buying their time back, time that they use for themselves, times they use to rest and refresh and recharge, times they used to spend with their family. They put themselves in a position, especially those who've been in, we call them evs masters who've, you've been at it for a minute. They're the people who, you know, also have set up businesses that are entities that can run without them. So say they're, you know, there's a death in the family. They're able to go and take care of their family and do what needs to be done. Meanwhile, their business is still running because they've built the teams, they've built the systems and all of that. And so the return on investment is huge. The personal transformation is so dramatic that there are people who are like, I wonder if I should renew. And their husbands, their spouses are like, oh my goodness, you're a completely different person. Of course you should renew. Of course you should do another year. These are all the things. It's not just, oh, when you come, you learn about business. You see, I can trace it all the way to the impact on their marriages, the impact on their kids, many of them, their kids, their kids are learning so much about entrepreneurship. They're reading the books, their parents are reading, all of that stuff. It's, it's so amazing. They have these successful businesses, they're building teams, they're take, they're able to take time off. They have a community of people they can lean on where there's no competition, there's a lot of collaboration. That's all they get. Do you see how that's very different from, you know, what will you get? Well, what happens when people work with you? They build profitable businesses. I'm able to trace it all the way. So the profitable business, so what? Right? And the more you lean into that, the more you're able to fall in love with what you do. And you can say like, so if someone pays 30 grand to be in the Entre MD business school, but in the end they turn out like that. Like the ROI is priceless, right? And so I don't feel bad. I don't have the drama around doing what I do. Okay, you could be somebody that your lifestyle medicine and maybe you have a concierge style practice or your lifestyle medicine, but use a coaching model and you're high ticket. It's not just about I help you transition to a plant based diet or I help you figure out your diet and your exercise or whatever. You want to trace it all the way. Finally, the weight that you've been trying to get off for X number of years is coming off. You feel like you're in control. You're no longer, you know, like a victim of your, of, of your diet. You feel stronger than you've ever felt. You're able to sleep better. You feel so good in your, in your skin, your skin, you know, like in your skin, your skin is glowing. You're able to run around with, with the grandkids and the kids. You're like, you trace it all the way, right? You trace it all the way. And because you've learned these things, it's affected your spouse, it's affected your children. And so not only are you in a healthier space, you're leaving a legacy of health. Do you see what I mean? Like, you trace it all the way. The more you do that, you. The more you see I'm not overcharging. I'm not overcharging. What I'm charging is an ethical price. So that's one of the things, you know, that you would do to fall in love with that. The other thing that you will do is, I don't know that there's any amount of mindset work you do that will completely eliminate the drama. It would just help, you know, like, help you hold it together. But one of the best things you can do is then start charging. And sometimes, you know, the way I look at it is this charge what you are uncomfortable charging. So maybe you decide that ultimately what I do, I want to charge $10,000 for it, right? But you cannot even possibly bring yourself to charge 10,000. You can comfortably charge 3,000, and 5,000 will be a stretch. Go for 5,000, right? Like, rather than doing nothing. I've seen people do this where they're paralyzed. I know I should charge this, but I can't. I'm like, who made these rules? Like, what are you doing? Right? Like, charge what you're uncomfortable charges. So you want it to be a stretch. You don't want it to be a break. So if 10,000 paralyzes you, 5,000 stretches you, and 3,000 is comfortable. Go for 5,000, right? And after you serve a number of people, go for 7,500. Serve another number of people, go to 10,000 where you are going anyway, right? But I would rather do that than not do anything at all. I cannot tell you how many people just live in undercharging world because they cannot bring themselves to go that, you know, like, to do what they think they can, but there's a whole middle ground. The idea is to be uncomfortable. If you're uncomfortable, you're growing. There's a lot of money drama that goes with that, with a high ticket, okay? So fall in love with your offer. Charge a stretch price, like, regardless. And one other thing is you want to, when you're communicating, articulating what you do in the market and all of those things, you're not articulating based on price because your people are not Price shoppers, you're articulating based on value. If you work with me, this is what happens. If you come to my concierge practice, this is what happened. If you sign up for my coaching thing, this is how your life will be different. This is the pain, this is how life will be different. Because what they pay for are not the things that are cheaper. They pay for the things that give them what they want. Okay? So if you are in a high ticket model, you're constantly talking about discounts and all of that is they're not those kind of people. They're just not those people. Okay, that works more with the low ticket model, not as much with the high ticket model they're looking for. Okay? If I am looking for somebody to work with, to create and let's say I wanted to, I decided this is the year that I'm working on my nutrition and I want to treat my body like an athlete would treat their body. I want to treat my body like it's, like it's a machine, like it's a tool and I want to, I want to nourish it properly and all of those things. I am not going to go for the cheapest person who can help me do that. I'm not going to do that. I know the result I have. I know I want to be a peak performer. I know I want to be strong at 90 and all of that. So what I'm going to do is look for the person who's the best of the best. I'm not expecting the best person to be the cheapest. So what I'm looking for when, so if I'm reading someone's copy, I'm following somebody on social media, I'm reading their emails or whatever. What I'm looking for is, does this person have the expertise, have they helped other people do this? What are their philosophies around nutrition and all of those things? What, you know, like that's what I'm looking at, not primarily the price. So you have to get really good at articulating value. Value return on investment, value. This is what can happen. Value, return on investment. Because I would care much, much less about the price. I would care a lot more of, can you take me there? Can you help me nourish this body in such a way that I will be strong at 90? Can you do that? That's what I would be after. Okay, okay. So. So that's where we tend to have the challenge with the high ticket model is the money drama. Don't ignore it, don't pretend it's not. You don't say, oh, I've overcome that before. Because a lot of times, every time, every time you come up there, it will show up again. Okay, now for the low ticket model. Does it mean, oh, we don't give value, we just charge low ticket? Of course not. Okay, we give value all over, but that buyer is a little different. Okay? So first of all, if we decide we're going low price, we are going high volume. And so if you think about it, say primary care private practice, that is a low ticket model, right? You're talking $130, $150, $200 average payments per encounter. It's a low ticket model. And so this is why when people tell me I'm in an insurance model, I'm primary care and I really want to take, you know, my time with my. And I'm not saying don't take your time. I'm going somewhere. I want to take my time with my patients. And I only want to see a patient an hour. Well, you know, let's do the math. Okay, so if you have, if you're getting $150 per patient and you decide, I want to see a patient an hour, and you work for eight hours, two hours, that would be $300 times two, that's $600. That's $600. Did I get that right? $150 an hour for four hours is $600. So that's $1200 a day. Now, many private practices, like I've surveyed a lot of private practices, I've looked at the data, they're looking at overhead of 50%. Right? So before your salary and all of that, your overhead is already, your overhead is already $600 before your salary. So the question is, is that sustainable? And the answer to that is no. The answer to that is no. Right. And so it means that the volume has to be there. You might say, okay, but what of the care? That is where you need to start thinking about efficiency, thinking about systems, thinking about processes and all those things, which is a completely different conversation, which I think we're going to come back and have. But it is a high volume model. Okay? It is a high volume model. Is there a way to make it work? Absolutely, there is a way to make it work, but it's a high volume model. So let's just talk about the equation here, okay? Now, what is the biggest challenge that I see in the high volume model? It is marketing. Now, does it mean that the high Price model. They don't have to market. They do have to market, but it is even more critical for the low, for the, for the low ticket model. Like marketing, Marketing, marketing and marketing for volume, right? And so that means that we're extroverting into the marketplace quite a bit. It means that we're building a referral base. We're doing like, we don't have time to slack on the volume, on the marketing for volume. We just don't, right? And so if you run a private practice or you know, like especially, or you know, your primary care insurance model, all of that stuff, and you're like, I don't like marketing. I want to invite you to like marketing, right? And I'll tell you this. When I started as, when I started as an entrepreneur, when I started medical school, you know, that was great. But before that I did not like biology, okay? And I was like, I don't like biology. But the problem is there is no pathway to medical school without biology that I know about, okay? So what did I have to do? I had to like biology because I'm like, oh, I don't want to read about amoeba and all these weird things. Things like I, I just want to be a doctor. Good, good. The pathway to that is biology. The pathway to success in a low ticket, high volume model is marketing, marketing, marketing, marketing and more marketing, okay? And if you don't like it, I invite you to like it and I invite you to learn about it and I invite you to decide, you know what, I'm going to master this stuff. Because you can't. You can become really good at it, right? And you can build a system, and you can build a marketing system that runs without you, but you just have to get out of resistance and embrace it and go, like, marketing is my thing. Marketing is my thing. Marketing is my thing. And so I hope this has helped you look at your business very differently. So first of all, decide how much it is you want to make. Decide whatever it is, however you want to operate, you want to serve a few people, or you want to offer something at a low price, or understand that by choosing that, you've chosen something else. So if you choose low ticket, you have chosen high volume. One go. They're twins. They're Siamese twins. They go together. If you have chosen low volume, you've chosen high ticket. Those two things go together. They're Siamese twins, okay? So I want you to understand that, I want you to understand the challenges that tend to come up with those two models. And decide I am going to overcome them. I am going to be a rock star. I work in both models. My private practice is low ticket, high volume. And then entremd is high ticket, lowish volume. You know, compare, you know, it's relatively low volume, right? And so both models work. Both businesses are doing really well, but they're different models. So your model can work, but you must play by the rules. You must anticipate the challenges, get ready for them, overcome them and win. I'm inviting you to win. I'm inviting you to win whatever model that is. Okay? So this is your homework. I want you to go, I want you to run an audit. Like, what model is your business and are you obeying the rule? Right? So if you're low ticket, are you high volume? If you're high volume, if you're, if you're low, low volume, are you high ticket? Right? So I want you to, to audit and say, am I, am I playing by the rules? Am I playing by the rules? And I want you to anticipate the challenges and I want you to start strategically, proactively overcoming those challenges so you can thrive. Let me tell you, the physician community needs people like you. You listening to me? To thrive and be an example of what is possible. There's so much of a narrative that private practice is dead. It's not. And you can be the example of what is possible. There is a narrative that, oh, you can't even replace your physician salary as a physician coach, which is a lie. And you know, somebody's waiting for you to be the example of that. There are so many narratives around. We cannot build, you know, like really great businesses. We cannot, you know, build businesses we can sell at a premium. We cannot. And it's not true. We can learn to do these things. Okay? We can learn to do all of these things. And you're learning that. I want to invite you to implement what you are learning so you can be a bigger and bigger example of what is possible. You can be a vision board for the physician community because they need to see you thrive. So I'm inviting you to do just that. I'm inviting to do that. I'm rooting for you as you use this to create changes. I want you to, you know, you can send me a PM DM. Let me know, like, oh my goodness, Dr. Una, you will not believe what just happened. And I'll say, uh huh, I will believe it. Tell me all about it. Okay. All right. So as someone who loves physician entrepreneurs, I want to invite you to take this episode, share it with all the doctors in your life, because it will absolutely change their lives. And I will see you, my friend, on the next episode of the Entrepreneur podcast.