In this solo presentation, Matthew Gologli (who brands himself as a “Maverick”) discusses the unique stressors that physicians face when they transition from high‑salary, insurance‑driven practices to cash‑based or hybrid models. He explains how doctors who leave seven‑figure salaried positions can see their personal income plunge from $700 K–$1.5 M to around $100 K, creating financial pressure that ripples into family life—spouses and children must adjust to a reduced lifestyle. Gologli identifies the insurance‑based practice model (where 90%+ of revenue comes from third‑party payers) as the most stressful business environment because physicians lack control over time, pricing, and cash flow, and must constantly worry about delayed payments or clawbacks, which also strains the clinical team. To mitigate this, he recommends integrating cash‑based procedures that provide upfront payment, pricing autonomy, and predictable revenue, thereby reducing reliance on insurers. He concludes by promoting the “Business of Orthobiologics” (BOB) event, which blends medical science with business training to help physicians launch or convert to cash‑based practices.
Chapters
All right, let's talk about stress, and let's talk about specifically stress with doctors and how doctors deal with stress. Okay, let's take a look at some of the other issues of what is involved with being an entrepreneur. A lot of doctors, when they start their cash practice— I've had doctors leave $700,000 a year jobs, 7-figure a year jobs like $1.5 million a year To start a practice, and all of a sudden they go from bringing in $700,000 a year in personal income to paying themselves $100,000 a year. And they have, they have this lifestyle that they've built up at the $700,000 range, and now they've gotta manage to the $100,000 range. And so this causes a lot of stress. Doesn't necessarily cause stress at the, at the personal level. The stress that that can create is really in the family environment. You have a spouse who maybe they're working, maybe they're not. you have kids that are used to specific things, and young kids generally don't really understand why all of a sudden they can't go out to dinner every single night and get sushi and only eat half of it, right? Like, this is the stuff that you have to deal with. And so these common causes of stress— and the low income, by the way, is also driven by the fact that you don't feel like you're seeing enough patients or making enough money, which is kind of the bonus, if you would. I don't like to call it bonus. Let's call it the, um, The unintended bonus of running a practice or running any type of business is the stress that comes with having to produce revenue, produce income each and every single day. Hey, I'm Matthew Gologli, and I'm a Maverick. Well, what is a Maverick? A Maverick goes against the grain. We find our own way. And if you're sick and tired of being pushed around by the insurance companies, come join us. We'll show you the way out. And you'll love medicine again. All right, so how do you deal with stress? Well, let's talk first and foremost about the stress of owning an insurance-based practice. I believe that having an insurance practice where 100% or 90% of your income is coming from the insurance providers is the most stressful type of business environment that you can create. And the reason why is you don't control your time, you don't control what you charge, you don't control your money or when you get paid. And so this extra level of stress that comes with having an insurance practice where 90% of your income is being paid to you by a third-party payer creates a tremendous amount of stress because you never really quite know when they're going to send the check or if they're going to do a clawback. And so it creates all this stress. You create stress with your team. Your team is frustrated and they take out their frustration on you. And usually what happens as an owner, you don't really have anybody that you can share your frustrations with, right? You can't share it back down the chain of command because then they just think you're being mean. So to be able to manage with the stress, if you are 90+% insurance, you have to add in cash-based procedures. Because when you add in cash procedures, you get paid upfront. You get paid before the procedure is done. You can dictate what you charge. You can dictate when you get paid. And you're able to do the right thing for the patient. So, like I said, I'm gonna summarize this. I think the most stressful type of business environment that you can have, or business model you can have, is a business model that's dependent upon the third party giving you the money that you earned. And that's the situation that exists in the insurance-based care environment. Would you like to get some training on the science of business along with the science of medicine? Would you like to finally learn how to marry everything that you've learned in medical school with what you need to know in the business world to be successful? Well, we have created the Business of Orthobiologics event. You can check it out at the link that you see below or with our button that you see right here. And we affectionately call it the BOB because it's the Business of Orthobiologics. It's the only event in the world Where we spend half of our time talking about the science of medicine and the other half talking about the science of business. It'll give you everything that you need in order for you to start your own cash-based practice, whether you're starting from scratch or you're inserting it into an existing insurance practice. Join us. You'll see, it'll take you directly to the site. You can see where our next event is and learn all about it. We look forward to seeing you at the bottom.
