How assumptions can destroy your business
30 Jan 2026 · 13 min
Dr. Nneka Unachukwu shares how wrong assumptions nearly killed her telemedicine pivot at Ivy League Pediatrics. She explains three fixes: ask your patients directly, listen to what they actually say, and test your assumptions before you build. Over-communicate and match your marketing to what clients want, not what you think they want.
Chapters
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.
Hi docs. Welcome to the Entre MD Podcast where it is all about helping amazing physicians just like you. Embrace entrepreneurship so you can have the freedom to live life and and practice medicine on your terms. I'm your host, Dr. Una.
Well, welcome back to another episode of the Entre MD podcast. I hope you are having an amazing day and I hope this just makes it even better. Today we are going to have a really fun episode I'm gonna be telling on myself. We're gonna be talking about how assumptions can destroy your business. And. And I'm going to be telling you how I did that in my business and how it didn't go nicely. But we fixed it. But it didn't go nicely in the beginning. Okay? And I don't want you to make the same mistake. So here we go. Now, before we get into the meat of it, this episode of the Entre MD Podcast is sponsored by the Freedom Formula Masterclass, which is a 12 week course hosted by Entre MD that is designed to help you through even in the midst of the crisis that we're facing. Okay, Now I want to read you a review from a doctor who wrote this at the end of another installment of the Freedom Formula Masterclass. And she said, Dr. Una, thank you for completely changing my paradigm. I literally went through a transformation. I can't fathom the person I was before. You have a God given talent to empower people And. And my life is now drastically different because we crossed path. You are making such a huge difference for us doctors. Thank you for your passion for us and working with us to remove those blinders so we can see the greatness we were really meant to achieve. It doesn't stop at medicine. All right? And as someone who is a listener to this podcast, during this season of the COVID 19 pandemic, you can sign up for the Freedom Formula masterclass at literally 50% off. Off. Just use the coupon code podcast. It is not case sensitive. So go to entre md.com freedom to check it out and I'll see you on the VIP side. So back to assumptions that can destroy your business. Now, we are in a time when, you know, pivoting your business, innovating and all of that is what we should be doing. I mean, I talk about this all the time, but even more so now that we're in the middle of a pandemic and the business world has changed and it's probably changed forever. Okay? So, you know, that's something we should do. But remember this, pivoting is great, but it needs to be based on the right information. So one of my businesses is a private practice called Ivy League Pediatrics in Lawrenceville, Georgia. And once the stay at home order came to the county that we're in, a lot of the insurances were like, okay, finally, we'll now pay for telemedicine visits and all of that stuff. And we were like, woo hoo. Now, I made the assumption that all my patients were just waiting for me to start offering telemedicine and they'll come running to me, right? So we sent out an email, we sent out a text blast. We're like, guess what? Ivy League Pediatrics now offers virtual visits. And we sat back and we waited for the phones to ring and for the portal messages to explode. Crickets. None of that happened. None of it. Okay? So assumptions are dangerous. And all across the nation, actually, a lot of people experienced that. They were shocked. They were like, yeah, now I do telemedicine, but I'm doing maybe two visits a day. So that's my telemedicine story. I'll tell you the rest of it at the end of the podcast. But let me tell you, when you're pivoting, you need to do this based on facts. And these are three ways to get facts, okay? Because my assumption was everybody's at home waiting for telemedicine like me. They didn't understand why insurance wasn't paying for it. And now that I say we're offering telemedicine, they're like, oh, my gosh, I've been waiting, and they'll burst my doors. That was my assumption, okay? That assumption, so wrong. All right, so these are three ways to get facts, because your pivoting needs to be made. Made from facts. Number one, it's a shocker. Ask them. Ask your patients, Ask your clients, ask your customers. Ask them what their perceived needs are, what their perceived problems are. It doesn't matter what you think they need, right? They know how they feel. They know what's going on with them. So you can do this. It could be in person, you know, so you see them in person. You're like, hey, you know, we're. We want to offer this. What do you think about it? And you'll be able to get a feel for what they think about it. What the objections to it would be, the reasons why they wouldn't use it if they don't even understand what it is, you know? And I'll tell you what we had to do. You can do it virtually, so you can do, you know, like survey monkey, so you can get surveys out. That way you can do polls and questions on social media. The thing about people is they love to tell their opinion. They love it, all right? But you just have to set it up for them to do that. So the first thing is ask them. That's how you get that. The second thing is pay attention to their conversations. Okay? So one of the things that dawned on me after I made this wrong assumption, I sat and I thought, I was like. They called back some patients and were like, hey, you know, Johnny has a rash. We can take care of that by telemedicine. And they're like, so what does that mean? Is that a phone call? And in paying attention to the conversation, I was like, wait a minute. They don't even know what that is, right? So I literally had to send out an email and say, hey, Ivy League Pediatrics now offers virtual visits, right? And in this video, I talk about what that is. And then so I shoot a video. We now offer virtual visits. It's like FaceTime with your doctor, right? Doing something that they already know about. It's like FaceTime with your doctor. Your doctor can see you from the comfort of your home. And I don't even thing they paid attention to. The other part is, comfort of your home. Wait, Dr. Una can see me at home. Hey, wait. Right? But I had to do all that stuff because they didn't Know what it was? So I did subject titles like, Dr. Stokes, who's the other doctor that works with me? Dr. Stokes can see your kids today from the comfort of your home. Open rate of that email, 50%, right? And they're like, so now they want to know how, right? So they're interested to learn about what telemedicine is. Another conversation I had to pay attention to was. So this was, in retrospect, I thought about, like, you know what? A lot of times when I go to write prescriptions, the patients will go like, will my insurance pay for that? I was like, maybe they don't even know that their insurance will cover telemedicine visits. So I'm doing telemedicine visits, but good for me. I was like, huh? So I sent another email. And the subject of the email is, yay, exclamation mark. Your insurance now pays for virtual visits. Ha. That open rate was about 60%. And the phone started ringing, right? So if I hadn't paid attention to that, I could have offered a service, made an assumption, and just not seen anything happen. Okay, so that's the thing you have to do. The third thing you need to do is you need to test your assumptions. Okay? So yes, you can make them, but then you have to test them. So I sent the first email, didn't get a response. Guess when the next email went out the next day. You have to test it. So I've put it out there. No, it didn't work. I course correct. You don't do one thing and then just walk away. Okay, so these are the three things you need to do. You need to ask your people, your patients or your clients. You need to pay attention to the conversations you have with them. It will tell you what they know, what they don't know, what the objections are, what barriers are. And the third is you need to test your assumptions, meaning that when you send out something or you make a decision based on an assumption, it's not a final decision. It's not like it is written like the Bible. Like, you need to test it and course correct quickly. So back to my story. All right, so the phones didn't ring, and then I started sending out these emails. I literally had to do. So I did emails like, this is what telemedicine is like. I did another email, put somebody on the other side of a telemedicine visit, and I recorded that, you know, so I sent out an email like, hey, behind the scenes of a telemedicine visit. What it's like. So I Did that, I did the stuff of the insurance covering it. So you can realize that I over communicated because it takes that much, it takes that much time, it takes that much, that many touches. So in my practice we've probably been doing emails about three days a week. And no, it's not like, hey, we're doing telemedicine. I, some of those emails are, hey, do you know there's now a stay at home order in Georgia? That means you can't do this, you can't do that, you can only do essential services. Okay, Just so you know, we are essential services. So we're open, we're available for you. And hey, but if it's something like a rash and all that, you don't even have to come. We'll see you from the comfort of your home. So I'm giving them information that's valuable to them and in exchange, they're open to listen to the information I want to give them that's valuable to me. Right? So that's like content marketing. I'm not just shoving telemedicine down there, their faces, right? So we did that and you know, we'll do some videos and say, hey, this is what we're doing to keep the office safe and you may or may not need to come in and you know, like, stuff like that. So over communicated. All right, so this is the end result of that though. So I have to give you the happy side of the story. So the first part of the story is sent out the email, nobody cared. And the second side was two days ago, we was our first day of doing 19 telemedicine visits in one day. Right? So it worked. And it worked because we tested, we asked them, we paid attention to conversations, we over communicated. And I want you to do the same thing. Okay? So now that you're in the era of pivoting, you also have to be in touch with your ideal clients. You need to be talking to them to figure out how to tweak what you're doing. Remember the way this works, you may think you know what the patient needs or the client needs, but the patient or the client knows what they want. This is the disconnect, okay? They know what they want. You know what they need. For instance, I talked to weight loss doctors and they're like, yeah, what they need is wellness. It's a whole thing, not weight loss. I'm like, I understand what you're saying, but that's not what they want. What they want is weight loss loss. You know what they need, right? So what you need to do is in marketing, you have to give them what they want, right? Which is weight loss. And when they come to you, give them what they need, which is all around wellness. So I'm not saying be a fraudster, like, promise them something I don't deliver. Remember, in your wellness is weight loss, right? So, but you're giving them the whole package, what they need, right? So in communicating to your patients, to your clients, you need to be telling them what they need. So you have to what they want. So you have to be in tune with what they want. And you get that from them, not from you. Okay? So don't be the person who wants to catch a fish, and you know, the fish wants worms, but you're like, no, you need a hamburger, right? They are not going to touch your hamburger. You need to give them. You absolutely 100% need to give them what they want. Okay? All right, so I want you to apply this to your business today, okay? I want you to look at some of the assumptions you made. So maybe you made an assumption, it didn't work, and you gave up on it. No. Now it's time to go back and tweak. Right now is the time to go and contact your patients, your clients, have your staff get on the phone, listen to the conversations that are being had. Tweak, tweak, tweak. Don't just make one assumption. Base everything on that assumption and go away. Okay? All right. So in this era of pivoting, I'm sure this helps a ton. Go apply it, and I will see you on the next episode.
If you love this podcast, please take a moment to subscribe, share, and review it on itunes as you go about your week. Remember, you're not just an md, you're an entree md. Don't forget to tune in next week.
For another great episode.
Until next time.
More from Dr.
The Business Of Coaching With Physician, Lawyer And Executive Coach Dr. Adam Harrison