How to get your slice of a 5 billion dollar market, that is NOT control by insurance companies.

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Hey, everybody. Matt Gallogly with the Practice Profit System and another installment of our usually weekly podcast, unless I'm taking time off. I have today Donna White, who is not only a fellow Charlottean— that's not charlatan, by the way. We are Charlotteans, those of us that live in Charlotte. But Donna and I have known each other for quite some time. She actually lived in the same neighborhood as I did, which is— and our kids went to the same school together. But we wound up meeting each other through our work in the medical field. And Donna is the founder of bhrttrainingacademy.com. She is not a physician. She is a me, as I like to say. She is a person that kind of wound up in this wild and wacky world of medicine by accident. And today what we're going to do is we're going to talk about BHRT, not just the science of it, but the why of it. the why from the standpoint of why your patients need it, but why this is important to your practice and to the success of your practice. As you know, our mission here at SRP Medical Marketing is to help as many doctors break free of the chains of insurance-based care. I believe that is the future of our country and the future of our healthcare, is we need as many doctors as possible doing what's best for the patient, not what's best for the insurance companies. But more on that later. So, Donna, thank you so much for joining me today.

You're welcome, Matthew. I'm glad to be here. Glad to be with you all.

Just minutes away from my house, right down the street. And here we are on Zoom. Maybe we should have done this over a glass of wine.

Could have.

We could have, except for I'm in No Drink January. But that'll probably end tonight, halfway through the month. Okay, so, Donna, tell us about your background. How did you wind up in this world of BHRT? Because you're not a doctor.

That is a good question, Matthew. I got into this world of BHRT almost 30 years I'm now an antique, if you will. I'll be 60 on my next birthday, and I have literally been— Oh, you're 60? Next year. On my next birthday, I will be 60. So that does make me an antique, and that does make me qualified to talk about hormones because I have literally been on them for 30 years. And you said, how did I get into this? Because I was a hormone Train wreck, Matthew. I had an awful case of PMS in my early 30s, and I wanted answers. I didn't want Prozac. I didn't want to, you know, take antidepressants or, or, you know, some type of synthetic hormone. I wanted to know what was wrong and how to fix it. And what I realized was the more that I learned, the more people wanted to learn. And I realized physicians wanted to learn. So I've actually been teaching and training practitioners and helping women for, for 25 years or so. So, so as I learned about this back 30 years ago, we have a long history of the use of bioidentical hormones in this country, as well as research. We can talk all about that, but I've seen this go on for 30 years. I've watched this life-changing modality grow like crazy for the past 3 decades. So I know, I know you've seen the same in your role running men's health clinics. It's just grown. And that's because it works. There's science, there's data, and it makes a tremendous difference. 30 years ago, this—

you might as well have been saying, uh, let's, let's go to the moon in a cardboard box. I mean, this was— what was it like back then? Take us back to that journey, because 30 years ago, I'm not sure if Al Gore had really perfected the internet. This was what, the early '90s?

I mean—

It was.

And that's when practitioners really started prescribing bioidentical hormones. But Matthew, bioidentical hormones have been used in Europe for 50 years. 70 years at least, because they knew, you know, their medicine, one could argue that it's more advanced than ours in some ways. One could argue that, you know, this has been around for a long, long, long time. And what was going on back in the early '90s in America, practitioners were just realizing, hey, wait a minute, there are problems with these synthetic or non-bioidentical hormones. And we can explain the difference if we need to. There are problems, there are side effects, compliance is poor. But there's an option, another option, and that's these biologically or bioidentical hormones, human identical, whatever the word you want to use for this type of hormone replacement therapy. Providers started realizing, hey, wait, there's data. This data goes back way back to the early '70s when we first started seeing published studies, and it's been accumulating since then. So wait, there's data. These hormones are different. They work. And since then, we've just seen more and more data support their use. And then of course, as you know, practices are really bringing this in because number one, patients demand it. They want something that works without those same side effects or the risk profile that the non-bioidentical hormones, you know, bring to the picture for those patients.

Yeah. I mean, you know, obviously I'm on them. I'm 54. I started on them when I was 47. I was just recently at an event in Austin, Texas, and ran into some friends of mine that I hadn't seen for 10 years. So, you know, they last saw me when I was early 40s, and they all said, holy crap, what the hell are you doing?

What are you doing?

What are you doing? Right? They're all fat and, you know, wrinkles. And, you know, I'm blessed because I have the skin of my mother, and she— I don't think she ever had a wrinkle at age 85. But, you know, it's, it's interesting to me because, you know, I'm always fascinated by trailblazers. I'm always fascinated by somebody that says, you know what, I don't care that there's— this is not accepted. What were some of the— let's— I want to talk about the hurdles that you were facing, not only from with patients, we'll get to that second, but what were some of the responses that you had when you started going to your practitioners and asking them about this?

That's a good question. The answer that any wise practitioner is going to be asking is, Show me the data. And we had it. We had it even back then. And like I said, it's just grown like crazy ever since. But that was probably the biggest thing. Because when it comes to bioidentical hormones, and, and this is one thing that I really noticed early on, people are confused. Practitioners are confused because this whole— even the term bioidentical, it's technically slang. And all it really means is that these hormones are Molecularly identical to human endogenous hormones. So they're exactly the same. And back in those early days, a lot of practitioners didn't know you could even get bioidentical hormones, or they thought they were the same. They're, they're very different. So it's all about the— I hope you don't mind if I get technical just for a minute here.

Yeah, please do.

It's all about the shape of the molecule. And from Chemistry 101, we know that it's the shape of that molecule that determines the actions and effects. So So hormones have a very specific molecular structure. And I like to use that analogy that hormones are like a key and they fit into a lock and each key has its own unique cuts and grooves and so forth and fits perfectly into that lock. Well, hormones in the body are the same. They have their own unique molecular structure. Like estradiol has a structure, insulin, testosterone, DHEA, and so forth have their own unique molecular structure and they fit perfectly into their hormone receptor. Insulin's got a receptor, so does estradiol, testosterone, and so forth. So when you use— well, that leads to, how do we get these bioidentical hormones? Well, they're actually, they're made from plants originally. Way back in 1942, an American chemist named Dr. Russell Marker figured out how to take a chemical compound from the wild yam plant called diosgenin and turn it into the same exact molecular structure as estradiol or testosterone, whatever. So they are synthesized in a laboratory, but the end result is exactly the same as a human endogenously produced hormone. So if you like rub on hormone cream, I don't, you know, people are familiar with that, or testosterone, or, you know, use an estrogen patch or a testosterone cream that's bioidentical, it's exactly the same. And your body cannot tell the difference if you made it. Or if you rubbed it on or whatever. There's different delivery systems, which we can mention if we'd like to at some point. So they're exactly the same and their action and effect is the same. So, but if you were to use a non-bioidentical hormone, well, a non-bioidentical hormone could be animal-derived, as in Premarin, the estrogen from pregnant mare's urine. Premarin, great for menopausal horses, by the way, but not so much for us menopausal women. So non-bioidenticals are either animal-derived or just simply synthetic. They're just different, different molecular structure. So then if we go back to this lock and key example, it's like forcing the wrong key into a lock. I don't know if you've ever done that before, but it doesn't fit perfectly. It doesn't dislodge. It just doesn't work very well. Therefore, there are side effects. So what we know very clearly from the data is that non-bioidentical hormones have a greater risk factor, especially when it comes to breast cancer and cardiovascular disease and so forth. So they are very different. So back in those early days, there was just so much confusion amongst practitioners as to, well, what are they? Aren't they the same? Don't all hormones, hormones work the same?

Right.

No, no, no, no, they do not. We knew it back then, but now evidence has really supported that.

You've been obviously at this for 25, 30 years.

Yes.

Let's talk a little bit about— so you started doing this on yourself, right? Or through a doctor. It's not like you were—

Right, right.

Putting incisions in yourself in the mirror. But then you started really kind of working, if I remember correctly, really in the day-to-day of a clinic and helping patients take them to the promised land. What was that like? When did that start? What were some of the challenges that you faced? What were some of the major ahas that you started to see?

I did start working in anti-aging practices about, you know, over 25 years ago and built 4 of them. And what I did was help these practitioners learn the science, the data, the foundation, how to assess the patients and, you know, how to test hormones, all the processes that it takes to bring this into your practice and work with these patients, um, and get the successful outcomes. So yes, I built 4 different practices here in the Charlotte area, also in the Triad area, Greensboro and High Point. And some of those early challenges weren't necessarily with the doctors. All you have to do with the providers is just teach and explain, and they get it because, you know, hormone replacement therapy is very logical. It's logical. If your hormones are low, you replace with the same thing that's missing. It's just like, you know, if you didn't make enough insulin, Matthew, you would take insulin and you would have it monitored and you would take just the right amount. Thankfully, I know you don't have to do that because you are in great shape. But But it's no different than—

Exactly.

Yes, than any other, you know, area of endocrinology. If thyroid's low, you give the patient thyroid. If, you know, estrogen is low, you replace, and testosterone and so forth. So it's very, very logical. And these enterprising, open-minded practitioners back then, again, all we had to do is show them the data, show them how to do it, and, and the results with patients are really life-changing because you have to think about when somebody is low in hormones, you know, it could be male or female. If you're deficient in hormones, that impacts your life. It affects sleep, energy, weight, mood, almost every single area. And there's just hundreds of symptoms and issues and challenges that people face with low hormones. But the more practitioners started seeing these, these patients come back in and really notice a difference, that I think that's when it really, really really took off because of the difference in the impact that it makes for, for patients. I mean, it's really not uncommon to have patients come back in after, you know, having them put on, you know, bioidentical hormones or testosterone replacement therapy for men and say, look, you changed my life. I can sleep now. I can focus on work. And, you know, what women will say, my husband thanks you. You know, I feel like myself again. You know, I take I take tons of supplements, but if I miss a day taking fish oil, I don't notice. If I don't take my vitamin D or vitamin C, I don't notice. But hormones, you feel the difference.

Oh, God, yeah. I mean, you know, when I was doing pellets, I could tell. I didn't need to get a blood test. I'm like, my, you know, then wife would be like, you're really cranky. I'm like, oh, got it. I'll go get my blood work done.

Time for a refill.

Time for a refill. Yeah, it is absolutely amazing. So I wanna talk a little bit about the practices that you helped put this in, all here in the Charlotte market. How did you normally start? I mean, I know this was a little while ago and things have probably changed, but how would you start to approach— you would have buy-in from the doctor to do this, I'm assuming, right? But then how did you start to educate the patient?

Well, when you do a consult for hormones, what you just said is key. It really does require a lot of education 'cause not only are, you know, Providers not necessarily educated on bioidentical hormones because it's not taught in med school. If a doctor wants to learn TRT for men or bioidenticals for women, they have to go outside of medical school. They have to go to anti-aging conferences or take our training program. They have to seek that out on their own. So for patients, they also need education because they're they're confused. They don't you know they hear one thing on the media. They hear you know other practitioners tell them oh those are not safe. There's no research, which we know clearly isn't true. So that's one of the biggest challenges that practitioners face, and especially back in the, the early days, is just the confusion. So it does require educating the patient. And really, it's really kind of simple because when you show them a list of the symptoms of deficiency, they're like, that's me, I want that. So it just takes time.

It was as simple as an ADAM score, if you would. Right, of just asking the patient these things. Okay, so there wasn't any fancy rollout, it was just really being committed to that questionnaire of the patient self-evaluating themselves and telling you what's wrong?

Yes.

Okay, great. All right, I want to shift gears here a little bit because we've talked a little bit about your journey, but let's talk more about the doctors. Uh, you've worked with doctors for 25, 30 years, you've trained doctors all over the U.S. I know you're highly respected in the industry. I know you've spoken at A4M and all of that fun stuff, but what would you say is the biggest challenge facing the prescriber, the healthcare professional today in their practice?

In regard to hormones?

No, I mean just in general. Like, what do you— what's the number? Like, when people get on the phone with you and they talk about their practice, or they talk with your team about their practice, about the struggles that they're facing, What are they telling you? What do you hear?

Lack of good training. Where do I learn this is what they want to know, because patient demand is very high. There are— there is not, you know, there are not enough trained providers to help all of these symptomatic patients. Believe me, there's a lot of hormonal women out there. Don't say anything, Matthew.

There's more every day. Yes, yes. Never-ending. It's a never-ending cascade.

Yeah, there isn't. So anyways, there's really not enough providers well-trained in, in how to learn to prescribe and bring bioidenticals or testosterone or, you know, all of that into their practice. And how do they do it? So that's their challenge right now is how do I get up to speed on this? How do I make it profitable, which is your great area of expertise? They just want to get started because there isn't a deficiency of patients.

Are you seeing your doctors wanting to be more— are they looking at it first and foremost from an insurance play, or are they looking at more from a standpoint of adding the cash services?

And what's kind of your approach? Yeah, that's a great question. Really, I think bioidentical hormone replacement therapy fits best in the cash practice because, because of what you brought up earlier, Matthew, is that it does require education for the patient. You cannot get somebody's hormones back without educating them. Because remember, when we're talking about hormones, we're talking about thyroid, adrenals, glucose metabolism, as well as those sex hormones. So you can't do that in a 10-minute, 15-minute insurance billable, you know, situation. You really do have to spend more time with that patient. And, you know, these patients coming into these cash-based practices, they expect, and they should, time spent with them.

Yeah. And the interesting thing to me too is when I get a doctor that says, well, I think my insurance provider is, is going to cover it. And I always answer, well, I have a question for you.

Yes.

How long before the insurance company starts cutting how much you're reimbursed for this? Because they never have a history. I've yet to see where they increase the reimbursement rate. They always start high and they always seem to go low. I've never seen a situation where They let you charge what you're worth. So that's one of the reasons, aside from the medical benefit to the patient, it's one of the things that I love for a doctor to add in, or a practitioner to add in, is because it actually gives them control over their life and their business again, right?

It does, and it gives them freedom. They're not forced to see, what, 30, 40, 50 patients a day. They actually get to slow down and enjoying what they went to medical school for, was to help patients. They get to use their brain and think through, you know, how, how to, you know, create the best treatment plan. They're so much happier as a practitioner, so much less stressed. Speaking of stress hormones.

Yeah, it's funny because I'll say to the doctors, I'm like, how'd you like to see 8 patients and make 4 times what you're making right now? 8 patients a day. What? How do you do that? Get rid of insurance. Okay, so I want to talk a little bit. So let's, let's talk about Why someone should be learning BHRT. It's in your ebook, which we'll talk about how they can get that in a little bit. But you have 8 reasons why a practitioner should learn BHRT. We've talked about, you know, it's supported by the scientific evidence. What about— you have here, disease increases when hormones decrease. Can you talk a little bit about that?

Yes. So we kind of have this mindset in America that, you know, well, I'm getting older, I should have less energy. I should, you know, have these issues, but that's not really true. So when hormones start dropping down and specifically we're talking maybe testosterone or estrogen or progesterone as well, when those levels start dropping, you're at increased risk for the condition symptoms, but also conditions associated with lower hormone levels. Think about immune function. I mean, that's really important right now. Well, we know that hormones play a critical role. And when I say hormones, I mean optimal Levels of hormones play a critical role in immune function. They're anti-inflammatory. They protect against cognitive decline. You have a lot of hormone receptors in the brain, the heart. The greatest concentration of testosterone receptors anywhere in the body is not the genitalia; it's the heart. So the heart needs adequate levels of testosterone. Bones need testosterone. So we're talking heart, we're talking brain, we're talking bones. You know. We need adequate levels of androgens to build and maintain muscle mass. Over and above immune function, think about cancer. When progesterone levels are low, women have a 5.4-fold greater risk increase of breast cancer. So we need optimal levels of hormones to get rid of those pesky symptoms, but it's about more than that. So I'm so glad you brought that up. With that decline in hormones, yes, diseases do increase, but it's preventable. And we're not trying to stay young forever, but Matthew, if your eyesight goes dim and you need readers, what are you going to do? You're going to use readers. I mean, we—

All the time.

Yes. So why not optimize and feel good? And yes, I mean, hormones make a tremendous difference and we know their powerful effect. But when you add to that good lifestyle and exercise and eating right, we don't have to look and feel bad at 60, 70, 80. We can still maintain strength and, know, do the best we can with what we have. So it's, it's, it's anti-aging or preventive, whatever, you know, term you want to use. It's, it's all about protecting our health. And why not prevent as many diseases as we can? We have the knowledge.

If a patient came in with a high A1C marker, what would you do? You'd put them on type 2 diabetes medication. If they had high cholesterol, you'd put them on— unfortunately, they'd put them on a statin, which, you know, we don't want to go into that conversation. Then that starts blocking the production of the things we want. And to me, when a doctor says, oh, it sounds risky, I'm like, you want to tell me the HRT is more risky than a lifetime of being on statins and the muscle atrophy and the damage that's done to the body and to the liver? You want to tell me that this is worse than getting your client to lose 50 pounds so they're no longer type 2 diabetic? I think we have such a backwards way of thinking about this. I believe— I'd like to get your thoughts on it. I believe the number one thing we can do for our population over the age of 40-ish is for them to be on BHRT because the benefits far outweigh the downside risk. Your thoughts on something like that?

You're preaching to the choir. And it's not just that practitioners are doling out hormones, they're properly assessing patients. They're doing the correct type of labs. And health assessment and, and risk assessment as well to, you know, give patients what they need. Not every woman needs estrogen, not every woman needs testosterone, but if it's low, then they should. So it is about proper assessment.

I always love the number one thing that I hear. And my fiancée Katie, we've been together almost 4 years. She didn't start until about a year and a half ago, and she kept saying, I don't need it, I don't need it, I don't need it. She's the same age as I am. I'm not going to say how old she is because she'll kill me. But the, the thing is, is when she went on it, after about 4 weeks, she went, oh my God, I had no idea. Like, you don't know how bad you feel, right? How many times have you heard that?

But see, that's part of the confusion, Matthew, because people don't realize, you know, oh, they're having trouble sleeping. Oh, it's just stress. Well, yeah, it probably is, but it could be low estrogen. It could be low progesterone. They don't really always connect. People think, like, women think that they only have hormone problems if they're in active So some women are like, oh, I've already gone through that. I don't have any, you know, I'm fine. I don't know. Let me see your hormone test. I'm not sure if I believe that. Or some women think, oh, I'm too young to have hormone problems because, you know, I'm not having hot flashes. Au contraire, you know, there are teenage girls or, you know, girl women in their 20s and women in their 80s that if you check their hormones, um, you quite likely will find some, you know, deficiencies or even excesses. Some women make too much testosterone. And that's not a good thing either. So we don't always connect symptoms like sleep fatigue, can't lose weight when you're doing everything right, or depression or anxiety, and sometimes low libido. People don't always realize that that's actually from hormone deficiencies. So we're coming back again to the education component. It's not just about period problems; it's about these other symptoms as well.

Yeah, what's interesting is, again, Katie, she does a side project called Take Charge of Menopause, and they work with corporations to help them understand, you know, women as they age, they're not, they're not becoming a bitch on steroids. You know, they're— it's most likely menopause, right? You have to be—

You could be their poster child.

Yes, I know, right? I need to connect the two of you, or she has a partner in it. But it's interesting because I'll listen to her and her partner have these conversations, and they do interviews like this. And the interesting thing is every woman thinks it's about hot flashes and it's not. Like, Katie didn't have hot flashes. Lisa, her partner in this, has horrible hot flashes, right? Like, she'll start a call with, with the sweater on and by the end of the call she's got like a t-shirt on, right? She's sweating on the Zoom call. You know, she goes, all of a sudden I start undressing on the call. I'm like, oh my God, I hope I'm not—

you know.

The point is, is that every woman is a little bit different. Katie didn't have hot flashes, but what she had was she couldn't sleep. And she just thought— I mean, she was up every night at 2:00 AM. She went on treatment. She sleeps through the night consistently.

So glad.

Anxiety, all of those things. So let's talk a little bit more on the technical medical side of this. I want to go back to something you said a minute ago, and that is labs. What are some of the errors that you see people make with these labs? Is it just looking in a men's side? Is it just looking at their testosterone number? in the women? Like, what kind of things do people need to be looking for? I don't expect you to break down all of your hidden secrets, but give us some insights of why a traditional, just basic test is not going to give you the roadmap you need.

Well, that is a great question, Matthew, and I think there's 2 components there. Number one, or maybe more, maybe 3, um, when looking at labs, number one, practitioners that are untrained or new to this don't always test Enough levels. They're not looking at just— I mean, they're looking maybe just total testosterone, since you brought that up. But we need to look at other factors. We need to look at free and total testosterone. We need to look at DHEA. We need to look at, you know, TSH, free T3, free T4. We need to look at, um, you know, estrogen, progesterone. We need to look at all of the hormones because— and that's a mistake that a lot of practitioners don't know. Or maybe not a mistake, they're just not informed. Okay, so you have to look at all of these hormones because hormones interact, interfere, they work together. Um, you know, too much, you know, you have to look at adrenal stress hormones. If they're high, that can block out all the other hormones and affect how they work at the receptor level. So one issue, I guess, is not knowing which labs to run and not running enough labs. Then with interpretation, That's another issue because just because you fall into the normal range— well, normal range, which I know you can't even see my arms right now, can be really large. I don't want to have just barely enough hormone or whatever nutrient to keep me alive, Matthew. I want enough to make me thrive. So we want to learn to read labs from an optimal level, not just normal, because again, those ranges are too broad. And then the next thing is you have to know which medium to check. Because when it comes to testing hormones, there's dried urine, there's serum, there's capillary blood spot, there's saliva. There's pros and cons to each one of those. And all of those are well researched, but you have to know which one to run when and which one to run to monitor therapy.

So I was talking with a patient at one of my clinics and he was saying, well, my doctor says I don't need testosterone. And you know, you know the men's reading was I think the bottom level of the reading at that time was 350. Today it's now 250. I love how I love how the insurance companies keep moving it down. But it was 350 and he was like 365, right? And he was he was late 40s and he said, you know, I'm just going to take something over the counter. And I said, that's fine. You can do whatever you want. But let me I want you to think about something. Have you ever ever had a custom-made suit? And he goes, yeah, I've had a custom-made suit. And I go, which suit would you rather wear? The suit that you get at Joseph A. Bank and has to be altered or the suit that was custom-made for you? And he goes, I'd rather spend the money on the custom-made suit. I go, well, why? He goes, I look better. I feel better. I feel stronger. The suit off the rack that's altered just doesn't feel the same. And I go, that's what we do here is we're not giving you a suit off the rack. We're going to custom design this protocol specifically for you. So that it's going to be unique to you, that if somebody were to go out and try to put on that suit of yours, it's not going to fit as well on them no matter how much they alter it. And that really—

Great analogy. It is. And also, like, if you think about that range for testosterone, since you brought it up, 350 and now it's whatever, you know, is up to 1,200. Well, where was this, you know, Mr. Suit? Where was he in his 20s or 30s when he felt great and maintained muscle mass and was just killing it at work and, you know, know, trim waistline. What was his level then? I don't think it was 365. It was probably more like 800 or 10, you know, 1,000. And that's where we want to be.

Yeah. And, you know, everybody's like, oh, I don't want to be— I don't want to be like Barry Bonds. You know, that's kind of an old reference, but I've never had— we never really— I mean, occasionally a patient would bump up to 1,100 or maybe 1,200, but for a guy— and, you know, we only treated men, so I'm not as, uh, in tune from the female side, But the point is that it is the life changes that we saw in our clinics. I am such a believer, not only for myself, because I was at 92 before I started. Imagine that. I was at 92 when I started.

Wow.

Now I'm consistently right at 1,000. Okay, so do you have any really incredible success stories that you can share from a doctor standpoint of what has happened to their practice by installing Yes.

I can't think of a specific example, though. If we sat here long enough, I probably could. But just generally—

I'm putting you on the spot. I understand I'm putting you on the spot, Donna.

That's all right. What we hear consistently is they never, ever regret having learned how to do bioidentical hormones and get them, you know, get— help these patients. They never regret that, ever. Maybe somebody regrets buying a, you know, $300,000 laser because they can't make any money off it. I don't know. But they never regret learning how to get hormones into balance. And what the feedback they get— or well, more than just feedback— what they enjoy is patient satisfaction, greatly, you know, increased patient, you know, outcomes and satisfaction, increased revenue, and then practice growth. Because when you impact patients' life in this way and make such a difference in their symptomology, they tell their Friends, you—I mean—it just grows. It just grows organically. And then if you add expert marketing like you know how to do, it's it's an it's a no-brainer. It's just practice growth, patient outcomes, increased revenue, and it just brings so much peace and enjoyment. And providers, you know, I enjoy seeing patients again. I enjoy, you know, coming to work every day. So it's a big difference from the stress that a lot of our. And, you know, medical practitioners are having to endure.

Yeah, it takes care of burnout, and they can be a doctor again.

Yes.

You know, versus, versus an administrator for the, for the pharmaceutical insurance companies. What are some of the numbers that, like, some of your doctor clients have seen in an increase in revenue per month or per year by adding it in?

Well, that's a good question. I think a minimal amount that, that you can expect if you don't know what you're doing, if you don't work, you know, with good marketing and people that can really guide you at least $1,000 to $1,500— $15,000— no, no, no, $1,000 to $1,500 per patient per year. And I would say that's on the low end. Maybe you're seeing, you know, a whole lot more with the practices you consult for. Most do. So that's what we're seeing, anywhere from $1,000, $1,500 to $4,000 per year for patient. It depends on what kind of services you give them. Maybe it's just straight hormones. Maybe, you know, there's other components you add. So it does vary and really does take, um, some good guidance. I wouldn't just hang up, you know, take a class and hang up a shingle. Oh, we do hormones. You need a little more help than that. But the good news is you really don't have to reinvent the wheel. There's great training available. There's great marketing resources available. And it's because, you know, now we have this 30-year history and then people have figured this out and marketing people have figured it out. All you have to do is get in the right programs or training or consulting to help you. And it's, it's not complicated. It doesn't take that long to grow a practice either.

You know, I always tell my doctors, this is the perfect bolt-on to your additional— to your existing services, because that's all the patient has to do is fill out that form. And if you're, if you're having, let's say on the low end, 20 encounters a day with patients coming into your practice, and you have them all fill out this form, let's say 15 out of the 20 fill out the form, out of the 15 I think 10 are going to be qualified, that they're going to need it just by looking at the form. And you should be able to close half of those. And it's not uncommon— front-ending HRT, I think, is very hard as the first thing because, um, for a lot of factors which I can go into another call. But really what this is, is this becomes the perfect bolt-on. And there's only 3 ways you can grow a business. I don't care what business it is. You either get more new patients, you sell your existing patients more, or you increase prices. And in this case, what we're doing is we're doing the second one. We're going to sell your existing patients more. And the great thing is, is there's such benefit to it. To me, there's more benefit to this than a $300,000 laser.

Yeah, it is a great add-on, but it's also a great key thing. So there are so many practices, that's where they start is hormones, because there's such a huge draw in that by itself. And then you can add on aesthetic services or weight loss or peptides or all these things. So It can be done either way. It's a beautiful cross-selling opportunity. For example, if there's a, you know, an aesthetic practice— a lot of, you know, aesthetic practices will go through our training, and it's the same patient, the same lady that's going in for Botox or laser or threads or whatever. She's got hormone problems and she's willing to pay for it. So great for cross-selling.

Yeah, and the peptides are amazing too. So, um, they're fantastic. Fantastic. All right, let's— last thing I want to kind of dig into is obviously you offer training on all of this through bhrttrainingacademy.com. I highly recommend what Donna does. I've had a number of my doctors go through her training. I've personally known Donna for a long, long time. I've seen her training business grow. I see the great results that she's getting. I hear from her doctors, and I highly, highly recommend her training. And Donna, there's another reason why I love your training is because a lot of the other groups out there that offer training, the doctor has to sign an agreement where they're going to buy all of their stuff through them. You don't do that, do you? You just— you tell us about what makes that different for you versus some of the other providers out there.

That's a problem. And we see that all the time. All we sell is training. All we sell is training. And unfortunately—

You're not selling the pellets. They don't have to buy the pellets from you. They don't have to buy the ProCarts from you.

And sadly, a lot of docs do not realize when they're, you know, maybe they want to learn how to do hormone pellets because they're very profitable, they're very, very popular. But then come to find out, they have to sign a contract where they have to purchase pellets from the company that they learn how to insert them from. They have, you know, 5-7 year contract, they can't compete, and they have to go through these, you know, Well, doctor, nurse practitioner, PA, you've got a dosing calculator right here in your brain. You do not have to give that money away per patient just to figure out how to dose them. We can teach you that. So that really bothers— I'm gonna, you know, soften and get off the soapbox.

On your soapbox. It's a safe place, Donna.

But that, but that really bothers us that they get locked into that. And then on top of that, those same type of, you know, companies that, that train and, and lock these providers into contracts don't teach the other dosing forms. They don't teach how to do creams or injections or how to, you know, support the adrenals or, you know, how to use, you know, how to, how to, you know, optimize thyroid function or, you know, glucose management. They're not teaching all of the hormones and they're not teaching all of the, um, dosing forms. That bothers me. So we— and they don't always teach male and female hormones. We need to do both. In our training program, program, it's not just me. We have hormone experts from, you know, women, male and female, and endocrinology. So many experts from across the country that teach in this training program. So this is not just a Donna White program. This— I am bringing you the cream of the crop to deliver this to our providers with no contracts or anything like that. And, you know, another thing we do a little bit differently too, Matthew, is we mentor our providers. We teach them how to how to read, you know, as they're learning, we help them with their cases. So we believe in having access, access to our instructors. So that, that's real important to us. We, we're just committed to these providers. We've got a community where we just help them get up and going, and then we introduce them to the great marketing gurus like Matthew Gallaudet.

There you go. There you go. We want— you know, I'm passionate about this space. I just think I think that you and I have talked about this quite a bit, as, you know, we grab a bite to eat or something like that. But I just really feel like, you know, the doctors, the medical professionals, nurse practitioners have been so marginalized in this community. It's funny when, you know, I'll be at the gym or at CrossFit and my friends will be like complaining about their doctor. Why didn't they do that, their normal insurance-based care doctor? And I go, because they're not allowed to. They're like, what? And when you explain to people really what goes on in the inner workings of what the doctor's restricted to be able to say or do or offer, or the Infuriates people. And that's why I'm so passionate about, like, let's eliminate— let's, let's eliminate a layer and get directly to the patient. Let's let the doctor connect with the patient. They're highly trained people. They know more than you think they know, right? I mean, I'm preaching now.

Let them be doctors.

Let them be docs. Let them be doctors. That's great. So how do people get in touch with you, Donna, if they want to learn more, learn more about your trainings and things of that nature? What's the best way for them to reach out to you?

Well, on our website, bhrttrainingacademy.com, you can go on there, you can talk with one of our, you know, schedule an appointment with one of our advisors. You can download our How to Get Started with BHRT guidebook. That'll, you know, go through the 4 critical areas or components that you really need to learn to start offering BHRT. There's some references in there and so forth. forth, we're happy to help. And when we talk to people, we're only looking for good fits. I'm not trying to, you know, enroll 200 providers a month. We're committed to, you know, I mean, okay, that would be great. But we're more concerned about delivering quality education. So if we feel like, you know, we're not a good fit, we'll tell you and we'll direct you where you need to go. So we're here to help. We're here to serve these providers that, as you're pointing out, have been underserved and overly marketed to by, by companies or, you know, from pharmaceutical industry, and so trapped in their day-to-day, forced to see so many different patients. We're committed to helping them, and we just like to serve them well.

Let's get them paid more than I pay my plumber or my cleaning ladies on a per-hour basis. So, you know, unfortunately, that is the case. Uh, I had a client— I had a doctor in one of my groups And, uh, he hasn't taken a paycheck in 3 years. He sees 32 patients a day. 30 on average, 32 patients a day. Hasn't had a paycheck.

You've got to help him, Matthew.

I am, I am helping him. Okay, we are. Okay, good. He is well on his way to selling, uh, much more. And, uh, so yeah, that's great. All right, well, look, Donna, thank you so much for taking the time. I'm glad we were finally able to connect. And, um, again, folks, check out Donna, check out what she does. Cannot recommend her enough. Um, I appreciate you, Donna, for taking the time, and I appreciate your passion for helping the doctors. Uh, we want to help get them the freedom they deserve. And you as well.

We appreciate what you do, Matthew. Always recommend your services. Thank you so much for helping our providers too.

You got it, Donna. All right, everybody, that's it for this week for the Practice Profit System. I'm your host, Matthew Gallogly. Check us out at srpmedicalmarketing.com. Get a free copy of my book, The Anatomy of a 7-Figure Medical Practice. There'll be more after this. Have a great day, everybody, and, uh, remember, stay classy. We'll see y'all.

Thank you so much for listening. If you liked this episode, take a moment and share it with your fellow medical professionals, or post a positive comment and rate it on wherever you just listened. Now don't forget, you can get a copy of my book, The Anatomy of a 7-Figure Medical Practice, for free, just pay $7.95 in shipping and handling. Plus, you'll get over $1,197 in free bonus material. Simply go to srpmedicalmarketing.com/book. That's srpmedicalmarketing.com/book. Thank you so much, and we'll see you next time.

Thank you.