Why Entrepreneurs Get Stuck After Crossing $1M in revenue

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.

Well, hello, hello, my friend. Welcome back to another episode of the OnTraMD podcast. And as always, I'm super pumped to be in your ears. And today we're gonna talk about something that really could be an absolute game changer for you. Some of you, you are right in the middle of what we're gonna talk about. Some of you, this is something that you are headed towards, and so this is going to save you a lot of pain and suffering. Um, some of you have actually experienced this and come on the other side of it. But this principle holds true and you're going to get to this point again. And so maybe you didn't understand what happened the first time. Uh, this time you're going to understand it and you're going to be ready to handle it. So what we're going to be looking at is really the thing that makes people get to a point in business and get stuck. Okay? So for instance, in the beginning stages, you may have gotten this really great idea for a business that you want to run. And let me use Entre MD as an example. Right? So I, you know, yes, there's this idea that physicians need to acquire business skills so they can run really successful businesses and so they can help a lot of people and they can create financial freedom and time freedom for themselves, which is amazing. It does take, you know, a lot to get it off the ground. It is very doable. There's a framework to do it, but it does require work. And so a lot of times in the beginning, there's that hurdle, right? Getting to the first hundred thousand dollars in revenue. And there's a lot there to do with visibility, right? Like getting your name out there, putting yourself in front of people who don't know you, letting them know what you do, making offers, doing all of those kind of things. Okay, all right, so we did that and we crossed a hundred thousand dollar milestone. And then the following year, it's really kind of around doing a little bit more of the same, right? But revving it up. And you already have some credibility to go off, some visibility to go off of, but you're, you're really amplifying that. Maybe you go from like I did one on one coaching to group coaching and all of those kind of things to just you expand the bandwidth, you have to create these results. And so we did that and it got us to our first $260,000 the following year. And then, you know, you keep going and all of those kind of things. But typically you can get away with doing a lot of things yourself, leaning on, you know, maybe one team member and then a bunch of contractors and all of those things. And you can really get your way to a million, or you can get your way to 2 million, maybe even, um, but typically when you get to a million to 2 million, it looks like now nothing is working. And I'll explain what I mean by that. And so maybe when you started off your business, you're like, you know, I'm tired of being burned out. I want to be my own boss. I want to create my own hours and all those kind of things. And when you were at a hundred thousand, two hundred thousand, three hundred thousand, five hundred thousand even, it was like, oh, this is amazing, right? Because maybe you're bringing in more revenue than you've ever bought in. You're taking home more than you've ever taken in, but you're working less. And it's wonderful. But as you get to 1 million, 2 million thereabout, you start experiencing the familiar signs of burnout. And you're like, wait a minute, what did I do? I escaped the burnout. Somebody else created and I came and I created my own burnout, right? You start noticing that the systems you had that were wonderful were creating amazing results for your clients. And it was just beautiful. Now the systems are falling apart in a way. Things are falling through the cracks. You're getting complaints you've never gotten before. And you're like, what in the world?

Okay?

And then for some people, you even notice that your revenue is going up. And even when you talk about it, you realize that your revenue really is a vanity metric because even though the revenue has gone up, the expenses have gone up further, faster, and so your revenue is higher, but your profits are less. Right? And so it's just like, wait a minute, like, hold up. What in the world is going on?

Right?

What is going on? And you know, there are many things, there are many factors here and many things to talk about, but I want to focus on one of those things today. And the root of this particular problem that triggers this is that your business may have evolved much faster than you have. And the business requires a different kind of leader. And your evolution is required to become the kind of leader who can lead that company, who can take it to the next level while creating time and financial freedom, while not burning house, while having systems that are evolved and all of those kind of things. Right? So. So this is the way I want you to look at it. Okay? Now, one of the biggest problems that creates this problem is that we don't have the right teams. So we may have started off by ourselves with a few team members, maybe a team member and a bunch of contractors. But a lot of times the people we hire in the beginning phases of our businesses are people who can do tasks. They may be excellent at it, but they're people who do tasks. They're people who are producers. They're not necessarily your thinkers. And so while they take a significant amount of things off your plate, you are still stuck with all the thinking. You are the only person really driving all the results. And now your business is at a place where it requires more than one person. Okay?

So this is a way to look at it.

In the beginning of your business, maybe you're a 20% activity. And when I talk about 20% activity, this is based off of the Pareto principle, which says that 20% of your activities will create 80% of your results and 80% of your activities will create 20%. And so as an entrepreneur, as a leader, one of the things you want to do is you want to live in the 20%. Why? Because 20%, there are fewer activities, but they're more high yield activities. Right? Like, the problem with the 80% is just so many things, but it creates so little results. Right? Like, so we don't want to live there, we want to live in the 20%. But the thing about the 20% is there's no standard 20% activity. That 20% evolves as your business evolves, as you evolve as a leader, right? So in the beginning of your business, there are things that you did that were part of your 20%, responding to every single thing on social media, doing all of your social media thing, editing your videos, all of that. Like maybe you did all of that and that was good and well, because you know, your, your, your content, the conversations you were having, the offers you were making, all of those things were the things that were driving your results. But as your business gets bigger, some of those things then become 80% activities where you now need other people who will do that, right? And so I want you to start thinking that way. So a lot of times when we get stuck at that million or 2 million is because now a different 20% is required of us, but we're still doing the 20% from way back when. And those 20% things probably still need to be done, but they need to be done by your team so you can up level the 20% activities that you're doing. Right? And so for instance, you know, when I think about what I do at this stage in my business, you know, if I want to live in my zone of genius and live in this 20%, my, my core activities really are around coaching, right? Like the direct coaching that I do, it's around content creation. And when I say content creation, I'm talking about, you know, for my podcast, my YouTube channel, creating curriculum for the Entre MD Business School, creating the frameworks, creating the books, like all of that is all about, that's downloading all this IP that I'm walking around with in way that are, you know, like higher and higher level ways that will help my people get bigger and bigger results, right? So there's the code chain, there is the content, and then there's a collaboration. And collaboration really is with two groups of people. One is with my team, where I understand is my, it is my responsibility to catch, to cast vision. It is my responsibility to coach them up, to hold them to the higher standards possible, to help them, you know, help me accomplish the vision while accomplishing their vision, right? And so we're creating this really beautiful win win situation. And the other part of the collaboration is really around, you know, building relationships with people who have all the people I need to talk to, right? Like my mission is to help 100,000 physicians. Well, I don't know 100,000 physicians, right. But I know all these people who lead communities of physicians, people who are stakeholders in the healthcare space, people who are decision makers and all. Like these are relationships that I need to cultivate, right? So, so the other stuff is, is noise, right? Like all these other, there's all these other things that really my team takes care of, right? So that I can sit in this area and you know, like, do the work that only I can do and do it at the highest level. I keep evolving, keep doing it at a higher, higher levels. Like I invest so heavily in being able to upgrade my leadership, upgrade my ability to create visibility, upgrade my understanding of business and business concepts so I can simplify it. And so that as doctors, this becomes something that is readily accessible to us. And you know, like to be able to sit in that. There is no way to do that without team, without team, I'll be stuck addressing every single customer service thing, addressing every single email, you know, like creating my content myself. In canva, I would like. There's so many things that just need to come off my plate and not to get people who would do tasks, but people who I can delegate outcomes to. For instance, in my private practice, I can meet with my practice administrator and I can delegate actual outcomes. These are the number of patients we want to see this month. This is what we want our gross collection ratio to be. This is how many reviews we want to have. The how. She can figure out the how because she's a high capacity team member, right? I don't have to deal with the how. And so when we have our meetings, we're talking about outcomes, we're talking about this, we're running through strategy and all of those kind of things. But she's not a task, she's not a producer, she's not somebody who just runs tasks. She's someone I can offload the task and the thinking of the task too, right? And so one of the primary things that keeps people stuck when they get to that one, maybe $2 million mark is that they do not have the team that allows them to offload. What now they're 80% so they can adopt the new 20%, right? And so I, I want you to, as we talk about this, I want you to think about, you know, like your role, how you are leading, what kind of team you have, the things that you have on your plate. Are you in your 20%? Are you in your 80%? Like, where are you? What is your next critical hire? These are things you need to think about if you truly want to have, you want to grow your business, you want to have a significant impact. Your thinking, hyper growth and all of Those things you cannot escape a team. Team is so important. So for instance, in the entrepreneur business school, there is a tier of the entrepreneur business schools called scale. And this is for entrepreneur physician entrepreneurs who have crossed the $1 million mark are dangerously close to it and they are in hypergrowth and for, you know, since the beginning of the year. So we're talking about six weeks at this point. We have been talking about team and leadership the entire time. Like the entire focus of the first quarter of the year is team. Why Once that is in place, it is unbelievable how much like, I don't know how to describe it, right? The amount of freedom to then up level, right. It's unbelievable the amount that you create. So I want you to think about this, okay? So I have homework for you. This is really an episode you're going to listen to, come back to listen to again and come back to. But what I want you to do is I want you to do an audit. Okay? So audit number one, I want you to audit your team. What kind of team do I have? Do I have a team of people who are only people who can do tasks that I can't really, I can't delegate any outcomes to, Right. Because I have to tell them how to do everything. They cannot, you know, take an outcome and run and say, okay, this is the plan and go for it. Right. What kind of team do I have? That's number one. Number two, you want to start thinking which of my team members are people who can be coached up where, you know, okay, have this person and they're hungry, they want to do more, and they have the capacity to do more. But I've not been able to, I haven't been a present leader to coach them up, to cast vision, to show them what they could be doing, to show them how to do it, you know, like, I haven't been able to do any of those. So who are the people on your team who could come up to the next level? Okay. And then the third thing to think about is, what is my next critical hire like? Okay, I'm at this level, Dr. Una, you're right. I'm at a million dollars. I'm at $1.5 million and you know, my books look good, but I'm miserable because there's so much on my plate. I, I, I can't, I don't even have white space to think on all of those kinds of things. Who is the next critical hire? Like, this person is somebody that is not someone who just does tasks, but this is someone who can be responsible for outcomes, but at the same time, the outcomes that they're going to take off your plate is one higher that once you get this person on board, you'll be like a breath of fresh air. Like breath of. I mean, like beautiful fresh air. Who is that person? Right? And you want to kind of document that and what would they do and what would their job description be and all of that and actually start looking for that person. Start looking for it. Okay, so this is kind of the conversation I want to leave you with, because this is the deal. I remember when I first started engaging in this process, you know, well, for the second go round, because I did it for my practice a long time ago, but I did it again, you know, because, you know, my private practice for the last two years has really run without me. Right. I have a. I have a great team on board with that. And then, you know, with Entre md, I got to this point where I had to start doing this over again. And, you know, getting to that point and really bringing the team on board and doing the work and all of that, which is still, you know, like, it's always going to be an ongoing process. But I remember delegating the first time I got like a high capacity executive assistant and I got so much stuff off my plate that I almost became a little confused. I was like, what am I going to do with all this free time? Like, what am I going to do with it? Right. And of course I was evolving. So of course it didn't take me long to figure out what to do at the time. But it's that level of freedom that it creates for you so that you can then ascend and do higher level tasks that will bring even bigger results. Okay? So this is something that is available to you. So I want you to think about bigger results in less time, with no burnout, with more financial freedom, not only for you, but you now you're creating opportunities for your team and now you've learned this, so this becomes something that you continue to do better and better and better so you can continue to have a bigger impact in less and less time. That is something that can be an absolute reality for you. And I want you to start embracing that process. And I will tell you about the process, that it is somewhat messy, but if you're an entrepreneur, if you made it to the million dollar mark, then you do know that all of entrepreneurship is messy. Right? We just learned to be okay with the mess, right? And just grow and clean up as we go and So I want to invite you even if it seems messy, even if you seems unsure that you, you start embracing that whole process. But because I'm telling you, once you figure out the team piece, business becomes so much more beautiful. So much more beautiful. When I talk to the doctors in EBS scale and I look at what they're building and the teams they'. It's just phenomenal to see what happens once you start getting high capacity people on your team who can take outcomes like you just say this is a problem, fix the problem. You don't have to come up with the how. You don't. I mean, like it's, it's fantastic. So I want that for you. And of course, if you're, if you're like Dr. Un, I hear you, but I really do need support on how to do this. Like, I, I don't even want to try to do this all by myself. Well, of course you know that we're always available to support so you can, you know, a team, a call with my team to figure out how we can support you. It's on trendy.com forward/call and we'll be happy to do that with you. Okay. Well, as always, thank you so much for listening. And please, for every physician entrepreneur that you know, this is an episode you want to share with them, they are going to thank you forever because this is one of the most painful parts of business if it's not figured out. Okay, so share it with the doctors on your life. Share it with on social media. You can tag us hashtag on trend and let me know the biggest nugget you got from this and I will see you, my friend, on the next episode of the Entremdy podcast.