"You can get past the dead end. You can break through the ceiling. I did and so have countless others."
In this episode, Justin sits down with Samantha to break down the real challenges she’s facing while trying to grow her HRT practice. Like many new practice owners, Samantha has already taken the leap, but now she’s dealing with the frustrating reality of low patient volume, slow growth, and uncertainty around what to focus on next.
Together, they unpack what’s likely holding her back, where her strategy may be falling short, and what she should be prioritizing to start gaining traction in a competitive HRT space. This episode is a real-world look at what happens after you launch, when things don’t grow as fast as expected, and what it actually takes to turn things around.
If you’re building an HRT or men’s/women’s health practice and feel stuck, Samantha’s situation will probably sound very familiar.
Justin Allan Montgomery (00:01.23)
Alright, we are recording. Everyone, this is Justin. one second.
Justin Allan Montgomery (00:09.986)
Hi everyone, today we’ll be talking to Sunny who is a family nurse practitioner. Currently she is working part time as a clinical instructor for BSN students while she operates her own wellness practice where she provides hormone replacement therapy, weight loss and lymphatic drainage services. She’s needing help with determining if she needs to accept insurance, increasing patient volume and complimentary services to add. Hey Sunny, how are you?
Samantha (00:33.009)
doing well. Thanks for your time today.
Justin Allan Montgomery (00:35.65)
Yeah, thanks for hopping on here. All right, cool. So tell us a little about yourself. How many of you a nurse practitioner before and what sorts of things you’ve been up to.
Samantha (00:43.127)
I just became a nurse practitioner in October of 2025. And before becoming a nurse practitioner, I opened this business as a wellness spa where we specialize in post-operative care for elective cosmetic surgery. do lymphatic drainage and non-invasive body contouring. And then after I…
earn my certification, we transitioned to a wellness clinic and started offering the other services like weight loss and hormone replacement therapy. So it’s been great so far. It’s just kind of a little bit slow in this early part.
Justin Allan Montgomery (01:21.24)
So you had this clinic as an RN and then you became an NP. I’m assuming with the main goal of expanding services in your practice or did you have another goal of maybe getting a job or something? were your, I what was your objective of becoming an NP?
Samantha (01:36.427)
The goal was always to work in the, well, have the practice and expand, you know, as a nurse practitioner, not necessarily to get a job, but I did see a position that came across that’s kind of interesting and I’m trying to decide if I’m going to do that. It’s a great opportunity, but I don’t know, I’m kind of stuck. I’d like to see my business, my practice flourish.
to the point of not having to work for someone.
Justin Allan Montgomery (02:08.206)
Yeah, so, I mean two things there I guess. Number one is that, mean, expanding your practice and growing that business and whatnot’s always gonna pay a lot more than working for someone ever will, you know? I mean, you’re building something that will pay you long term and pay you a lot more and give you hell of a lot more flexibility in terms of just, you know, your time and stuff goes.
And so, you know, then having a job on the other hand is, you know, you’re kind of tied to it and you’re kind of capped and then it takes away the time you can put into your business. So, what kind of, I guess what kind of position is it?
Samantha (02:46.711)
It’s an NP position in the breast surgery clinic and it be the typical four 10s, four 10 hour shifts. And the hospital is building an APP team basically. So they’ve got a lot of new initiatives going and making it welcoming for new grads. I have not worked as a nurse practitioner outside my clinic and.
Kind of struggled with that imposter syndrome in the beginning not so much now I mean I’ve been operating independently as an RN in the clinic, but You know just probably thinking about gaining some experience Outside of the clinic so to speak and I have interviewed for it. It sounds like they want to offer me the position Which the start date would be like in August or something like that because they would have to do all the credentialing stuff, but I’m still
I love working in my clinic. love having that business and I just need, it’s a volume problem for me, if that makes sense.
Justin Allan Montgomery (03:52.44)
Well, I don’t know if that’s the best position to take to gain experience as an NP. I mean, you’re gonna be kinda really just doing one thing.
Samantha (04:01.847)
Yeah, it’s like seeing the, it’s like post-op patients and doing a lot of education and all of that, you know? Yeah, I think I’m just in my head a little bit about wanting to make sure that my practice is successful and not having to be concerned about finances and all of that stuff. It’s more so that, you know?
Justin Allan Montgomery (04:18.381)
Yeah.
So then, yeah, I think a job like that is gonna just, if anything, it’s gonna stifle your growth. I don’t think that’s gonna help you grow. mean, yeah, like that’s just right. You’re gonna be just doing one thing. Like, sure there’ll be some other little things thrown in there, but overall, it’s just gonna be post-op breast mastectomy, whatever it is, and it’s just like…
Samantha (04:30.761)
I know. I kind of know that, you know what I’m just…
Justin Allan Montgomery (04:50.478)
it’ll stifle your growth. That’s gonna be taking away 40 hours a week from you that you could be potentially doing some other stuff and really diversifying your skill set. I understand it from a financial standpoint. need money to pay your bills and stuff, so I get that. Let’s just talk about that real quick. Where are you financially, I suppose?
You work at this little part-time thing at the school teaching BSN students clinical rotation stuff or whatever. You got some money coming in from your practice. like, what does your income coming in look like compared to your income going out look like?
Samantha (05:25.26)
Mm-hmm.
Samantha (05:34.743)
It’s it probably it matches to be honest. My husband does work. I’m married. He does really well So I’m not hurting financially and the BSN Clinical instructor pays pretty well per hour. I mean and it’s very flexible So I don’t I don’t know what I’m But it’s not a nurse practitioner related at all, you know, and so I want to just make sure that I
and being the best provider I can be from the NP standpoint. Like nursing, got that down packed. And so that’s why I was like, should I get a job as a nurse practitioner? you know, I have the stamina and the, you know, motivation to go full force. I just need some strategies, I guess.
on the MP side, like the clinic has been functioning well. It’s been doing well all of this time. It did slow down a little bit after COVID because there was an influx surprisingly of plastic surgeries because people were home a lot more. So that’s starting to taper or it’s more steady. It was booming for a while in 2021, 2022. So that’s kind of leveled out and
Yeah, and the body contouring is very seasonal. So I just want to get to that point where I feel comfortable not having to work for someone else, if that makes sense.
Justin Allan Montgomery (06:59.02)
Yeah, I mean, think the BSN, you know, the teaching the BSN students is, yeah, it doesn’t really help you grow as a professional really, just kind of a job and it’s easy brainless stuff really. But I mean, it pays you some money, it’s flexible. Like that’s the exact kind of job you want if you’re trying to grow a business, okay? Yeah, so I would say don’t get rid of that.
Samantha (07:16.599)
Yeah.
Samantha (07:21.279)
Understood. Yeah.
Justin Allan Montgomery (07:27.758)
If your husband is fairly financial secure and does pretty well for himself and you’re not having to stress out too much about money, you’re in a very fortunate position that a lot of people are not in. And so I would take advantage of that and I would just double down on this business. That’s what I would do, okay?
Because you’re in a good spot. You’re fresh out of school. You already have an established business that now you just need to pivot this thing into something else. You need to just grow it into more of a broader wellness practice versus something that just does lymphatic drainage and body contouring and stuff. So you want to expand this thing. How old are you? I’m just curious. 51.
Samantha (08:06.837)
Alright.
Samantha (08:12.343)
I’m 51. I’m a young 51 though. Like physically, you know, but I know I don’t want to work forever, but I do have, you know, I’m pretty upbeat and very active. yeah.
Justin Allan Montgomery (08:15.404)
A young 51.
Justin Allan Montgomery (08:26.626)
Yeah. Okay, so then why not just double down on this thing? So let’s figure out how to grow this business to something else, bring it to the next level. And yeah, I would say the job thing, would just push that out of your head. I know you said you had an imposter syndrome kind of thing going on. The thing about imposter syndrome is that it is a label that you put on yourself, okay?
It is a limiting belief that you put on yourself. You literally put it on yourself, okay? It doesn’t mean it’s true by any stretch of the imagination, right? Yeah, that’s just what limiting… Yeah. So like, that’s just limiting beliefs in general, right? Most of them are bullshit. Like, they’re bullshit, right?
Samantha (09:07.755)
Yeah. I mean, then I agree with you 100%.
Samantha (09:15.967)
Yeah. Mm-hmm.
Justin Allan Montgomery (09:20.622)
And you just have to just tell yourself this is just a thought that crossed my mind and This thought crossed my mind and it stuck for some reason right? so like we all have a bunch of messed up thoughts go through our head every single day every single one of us do and Do those stick of course they don’t you know what mean? Sometimes they do though and the imposter syndrome thing is usually a thought a limiting belief that that ends up sticking
Samantha (09:32.043)
Yeah.
Justin Allan Montgomery (09:50.478)
And the only way to break out of it is you just tell yourself it’s not true. just every time it pops up in your head, just tell yourself, yeah, that’s cool. Well, it’s not true. And then just move on. You know what mean? And it’ll.
Samantha (09:53.911)
Keep going.
Samantha (10:06.465)
Mm-hmm.
Justin Allan Montgomery (10:08.374)
and it’ll break that cycle of that thought being sticky, so to speak. So don’t worry about that. You don’t need to go out and get a bunch of experience if you don’t, you know, I just don’t think it’s necessary if you want to focus just on your practice, right? I mean, think about it, okay? Just one reason why I ask you how old you were. You’re 51 years old, right? Your goal long term is what? Do you want to work until you’re, do you want to be an NP until you’re 80? Do you want to be an NP 60?
Samantha (10:20.63)
I do.
Samantha (10:36.119)
No, I’d like to retire financially wealthy at 55 to be honest and I know it’s going to take some work but I’m willing to do like I yeah that’s my goal.
Justin Allan Montgomery (10:38.652)
What’s your goal?
Justin Allan Montgomery (10:45.869)
Yeah.
Okay, you got four years to accomplish this goal, so you’re gonna be a pretty busy girl, all right? So four years is not that long to be able to develop that kind of financial freedom, so you’re gonna have to really build this business in a way that is extremely passive in nature.
selling it four years from now, might not be realistic, six or seven, probably a little bit more realistic for that. I mean, it just depends on how much it hits. So like, if your goal is to be just kind of done at 55, 56, 57 or whatever, let’s just call it you want to be done in the next five to eight years or something, then is going out and getting a job to get more experience as an MP, is that going to facilitate that goal?
Samantha (11:23.275)
this.
Samantha (11:35.593)
No it will not, to be honest. I’m Amy Younge.
Justin Allan Montgomery (11:37.804)
No, will. Yeah, it’ll prevent you from reaching that goal. You what I mean? Yeah.
Samantha (11:44.587)
That’s true.
Yeah, I guess too, like I was thinking about like my husband as well, you know, he we do fine like financially we all as well, but him too is like looking like, okay, the business you got that you’ve got the practice and all of that, but it’s not like the volume is not there to be honest. And he’s like, are you going to play nurse practitioner? Are you going to get a nurse practitioner job? What are we doing here? So I got to, and like I said, the clinic has been open. So he’s used to me doing that. And you know, people kind of forget
but that’s a viable business that has been, you know, I have a customer base and all of that. So I’m just building up my patient panel now.
Justin Allan Montgomery (12:25.794)
That’s what you need to focus on, right? That’s what you need to focus on. That’s what’s gonna help you reach your goal, not getting some job. So I’d say just push that thought out of your head, all right? You do not need to get more experience to do what you wanna do to accomplish your goal. It’s not necessary. I I talked to an NP, I think, just a couple weeks ago or whatever, and she started her business right out of school.
no other experience whatsoever and her practice is doing very well. Like she’s making more money than she probably a lot of like probably most MDs make. And she’s like, yeah, like she’s like a year and a half, two years out of the NP school and she’s making more money that most MDs make. Okay. Yeah.
Samantha (13:02.945)
Hmm, I’ve probably heard that episode.
Samantha (13:11.543)
That is awesome. That’s what I want to do.
Justin Allan Montgomery (13:16.47)
Okay, if that’s your goal, then let’s just stick to that goal. So, you need increase patient volume. So break this down for me. So, you provide a variety of services. You provide weight loss, hormone replacement therapy, lymphatic drainage, body contouring. Give me a percentage of what percentage of your patients would fall in each one of those categories.
Samantha (13:20.183)
Okay.
Samantha (13:40.159)
Okay, for the body contouring is my number one customer base. It’s probably about 60%.
It is seasonal however, but it does bring in really good good money after that would be lymphatic drainage probably about 30 % and Some other little post-operative stuff that I do Saroma drainage and other little things that relate to post-op Would be that? Probably about 15 % not much and then with my new NP services like 5 %
about 5%, you know. Word is just now getting out. I’ve done some marketing, not a whole lot. That’s probably my issue is marketing and visibility as well. The plaza where I am, I don’t have a sign up yet because I knew that the name was going to change. I need to get that done for sure. I have signage on my door, but not overhead sign.
Justin Allan Montgomery (14:50.99)
Okay, and I’m curious, what does your business do in terms of revenue goes? Just, you know, tell me monthly or maybe what, what it do.
Samantha (15:01.717)
Yeah, so we do about eight to ten thousand dollars a month because I’ve been doing it very part-time. are appointment only. So probably about eight to ten thousand dollars a month with the body contouring. Profit, I do have a body two body contouring specialist that I give them 50 percent and I have a massage therapist that helps me with.
Justin Allan Montgomery (15:18.286)
Is that profit?
Samantha (15:31.447)
Lymphatic drainage so my profit margin is about 30 % To be honest about 30 to 40 % Effort yes
Justin Allan Montgomery (15:40.014)
She’s making a few thousand dollars a month.
Justin Allan Montgomery (15:45.724)
Justin Allan Montgomery (15:50.03)
50 % is pretty, pretty generous.
Samantha (15:52.969)
is steep. Yeah, I know. I know, but they are so loyal. They’ve been with me for years and I don’t have to worry about anything. Like they open and close the clinic, the clinic by themselves and, and all of that. They do little extra things too that I need. So I kind of put golden handcuffs on them a little bit. So to speak. But yeah.
Justin Allan Montgomery (16:12.386)
Yeah. Okay. How many patients come through this door every month? Estimated.
Samantha (16:23.927)
I would say It’s better to say in like how many appointments per week or so to speak because we have we buy packages or they purchase packages so We do about five to six per day that we’re open so Five to six people appointments per day and we’re open probably about four days a week. So 20 ish
Justin Allan Montgomery (16:45.144)
See ya.
Justin Allan Montgomery (16:53.644)
She had 80 appointments a month.
Samantha (16:57.013)
Yeah, roughly 50 to 80, yes.
Justin Allan Montgomery (16:58.253)
like that.
And out of that 50 to 80, how many of those are actual like individual different patients?
Samantha (17:09.911)
Maybe 20, because I’ll do two appointments a week. Yeah, about 20.
Justin Allan Montgomery (17:17.55)
I gotcha. Yeah. Okay. So like 20, 25 % of something. the 80, 25 % of those appointments are actually individual different people. Yeah. Okay. So yeah, 20 people or so. Okay. So you got 20 people coming into this practice every single month.
Samantha (17:22.167)
Mm-hmm.
Samantha (17:27.028)
Exactly.
Samantha (17:35.979)
Mm-hmm.
Justin Allan Montgomery (17:38.986)
you should be trying to first off sell them on the new things that you’re trying to do, right? I mean, you know, body contouring and lymphatic drainage and things like this. I mean, I would say most of this hormone replacement therapy and weight loss stuff is totally applicable. I don’t want you to, I don’t want you to break something that’s working. Okay. I mean, even though this business isn’t tremendously profitable,
I you’re still making some money. So I don’t think I would touch that stuff very much unless you want to, like, do you want to grow those services?
Samantha (18:19.103)
Not really. mean, I’d like them to stay as they are and just focus on the nurse practitioner stuff, you know, because those ladies pretty much handle all of that for me now. And I want to build up my patient panel. I’ll just leave that as it is. you know, I’ve been marketing to them and stuff, but I don’t necessarily want to grow it because, you know, if something happens where they’re not able to do it anymore, then that will fall back on me to do it.
Justin Allan Montgomery (18:46.616)
So, I mean, obviously try to market the people you already got. So make sure you have flyers up and things like that inside the office, things that they can easily see, right? That’s the easiest way to do it. It’s complicated. You probably have a very large list of patients that you have seen over the last four or five years. Do you have their email addresses?
Samantha (19:08.437)
Yes, yes I do.
Justin Allan Montgomery (19:11.182)
So, you know, have an email list, start sending out some emails, because mean, you already have some established people. So you can just do that. That’s low hanging fruit kind of stuff. So ultimately, really, you’re almost starting a new practice within an existing practice, for the most part. Yeah. Yeah.
Samantha (19:13.643)
Mm-hmm. Yep.
Samantha (19:21.569)
Mm-hmm.
Samantha (19:28.107)
Yes, that is correct. That’s how it feels too.
Justin Allan Montgomery (19:33.55)
Now you have lots of Google reviews, I’m assuming people find you. Do you get most of your current patients from referrals or are people looking for you and they just find you?
Samantha (19:45.463)
both, but it’s mostly word of mouth. But we are easy to find on Google. We get a good percentage of people from our Google page, Google Business, and we have about 50 reviews, five star reviews right now.
Justin Allan Montgomery (20:01.102)
Okay, good. So, obviously leverage that. Are you in an area that’s saturated in terms of wellness stuff?
Samantha (20:10.707)
not saturated. There are a few providers. But when I search, don’t see it’ll go to like these organizations that are like within healthcare systems. Like if I type in hormone replacement therapy in my area, I think there’s two nurse practitioners that pop up. They’re not very close to me. But other than that, it’s mostly large healthcare systems that pop up even for weight loss. So yeah.
Justin Allan Montgomery (20:39.054)
So then it sounds like you probably have a fairly decent opportunity here. all you have to do, you don’t gotta reinvent the wheel here. You already have a website. You already have your Google business listing. You already have the infrastructure of this entire business.
you know, all have to do is just get some accounts with compounding pharmacies and, you know, update your payment processor and just do a few things like that from an infrastructure standpoint. So I think what I would do is if I was you is I would just rebrand a little bit. Do not change your name, okay? Like I wouldn’t change the name of your business. If anything, just maybe add a
the services to it is like, is the name of your business like something like a wellness clinic, like something wellness? Groove Wellness Clinic. So it’s a cool name. I like the name. I would say, so it’s called Groove Wellness Clinic and Groove Wellness Clinic just basically does body contouring and lymphatic drainage.
Samantha (21:28.075)
Yes, it’s Groove Wellness Clinic, yes.
Samantha (21:33.93)
Thank
Samantha (21:48.236)
Well, I just changed it to Groove Wellness Clinic. It was Lavish Care Spa before, so I’m transitioning from spa to clinic and I’ve added all of those services and rebranded on the website. So it’s been a huge transition that’s happened, but same existing customer base. We’re in the same location and all of that.
Justin Allan Montgomery (22:06.924)
and you were able to just go down your Google review and just change the name. Yeah. Okay, so you just dug some rebranding and stuff, right? Okay, so I think the biggest thing is that you need to make sure you need to start getting some reviews on there that talk about the weight loss and talk about the HRT, okay?
Samantha (22:10.571)
Yes, thank God.
Justin Allan Montgomery (22:27.116)
When Google goes out and searches, when you go into Google and you search, if you go into ChatGBT or Gemini or Claude or whatever and you search in there, it’s gonna just basically search for whatever keywords begin to come up. And so if your reviews have lots of keywords, HRT and weight loss and these sorts of things, then it’ll come up. So you need make sure you get some reviews on there for those services, all right?
So anyone that you’re seeing already, go ahead and get them to put some reviews on there. If you’re treating some friends or family or whatever, have them put some reviews on there. The thing about HRT and weight loss is that, and I’ve said this a thousand times on this podcast, is that most of these people are just looking for that service. They’re already looking for it. You don’t have to convince them that they need it.
Samantha (23:16.823)
Right, right.
Justin Allan Montgomery (23:25.322)
generally trying to get warm people to become a customer, right? You’re not trying to turn cold people into a warm lead and then convert them into a customer, right? You know, a lot of online businesses specifically and businesses in general is that you are trying to convince someone totally cold who has no idea what you do, has maybe not even maybe even heard of your services before.
Samantha (23:30.453)
Mm-hmm.
Justin Allan Montgomery (23:53.742)
trying to convert that cold patient into a warm, or that cold customer into a warm customer and eventually convert them into a pain customer. The thing about a clinic like this is that the majority of people are already warmed up to the idea. They’re already looking for this, right? So you don’t have to spend a lot of money just throwing a bunch of ads out there trying to convince people, okay? They’re generally looking for it already.
And the thing is that I think what a lot of people fail to understand in this space is that, and I talked about this in last podcast, what lot of people don’t fail to understand is that if you are just patient with it and allow it to just naturally happen, to allow the organic flow of customers and patients into the practice, if you just give it some time, it will grow because
how many warm people are in your area right now that say, want HRT.
Samantha (24:56.619)
I know lot.
Justin Allan Montgomery (24:58.19)
Probably a lot, but it’s still capped. You know what I mean? But people warm up to it throughout time. They listen to a podcast, read about it, whatever, right? More and more people warm up to it as they get older and as time goes by. So you just need to be able to make sure you capture those and it then snowballs, right? Your patient census just exponentially increases over a long period of time. It doesn’t happen over three months, you know?
Samantha (25:13.802)
certainly.
Samantha (25:26.903)
That makes perfect sense.
Justin Allan Montgomery (25:27.724)
Like right now, if you wanted to get everyone in your general area to your practice to get HRT, maybe 100, 200 people, maybe are actively thinking about it today, right? If you got them, then there’s no one thinking about it anymore. So now you’re sitting around waiting for other people, right? Yeah. So you just got to be patient and just extract those people who are warm. And you just do that by being
Samantha (25:40.875)
Mm-hmm.
Samantha (25:48.695)
Bye.
Justin Allan Montgomery (25:57.568)
easily found. I mean, that’s just what it is. You need to come up when people search for you or when people search for hormone replacement therapy, when people search for weight loss, when people search for peptides, when people search for body contouring and lymphatic drainage, whatever, you need to come up, all right? Almost everybody uses their phone to search for a new business, for a new practice, for a new clinic, whatever. For a new restaurant, almost everybody uses their phone, right?
Samantha (25:59.672)
Thank
Justin Allan Montgomery (26:27.0)
few people, it’s word of mouth. But if someone’s just looking for the service, they’re gonna use their phone. And so you just gotta make yourself easily found. And it’s not rocket science. It’s just general SEO, GEO strategy, okay? So search engine optimization, generative engine optimization. That’s where people find you on chat, GPT and stuff like that, right? The way you do this is by just having lots of content on your website, all right? Lots and lots.
Samantha (26:48.758)
Okay.
Samantha (26:54.711)
Okay.
Justin Allan Montgomery (26:56.768)
of content, lots of articles explaining these things, right? Why premenopausal women should consider HRT? Why postmenopausal women should consider HRT? Why testosterone is important in the 50-year-old female? Blah, blah, blah, blah, blah, blah, blah, blah, blah. You just write a shit turn. A blog, basically, on your website, correct, right?
Samantha (27:08.193)
Okay.
Samantha (27:18.325)
like the blog.
Justin Allan Montgomery (27:24.258)
Just write a shit ton of articles and have them on your website. Publish a new article.
Samantha (27:27.383)
Okay, I don’t have that, so I will definitely do that. Okay.
Justin Allan Montgomery (27:31.758)
Yeah, like just blow that up like once a week minimum, okay? If you really wanna hit it hard, get 20 or 30 on there as quick as you possibly can. Just publish 20 or 30 on there over the next two weeks, okay? Have lots of reviews on your Google reviews that talk about this, that mention your business’s name and you offer HRT or weight loss or whatever, okay? Doing these things right there.
Samantha (27:36.864)
Okay.
Samantha (27:47.585)
Yes.
Justin Allan Montgomery (28:01.602)
That’s literally all you gotta do. That’s it. You will start popping up on ChatGPT and on Google searches a lot more. Throw some videos on your website too. Just upload them to YouTube and just link them to your website. That’s great too. Okay? It’s a good way to do it. Another thing I’ve talked about before and I talked about quite a bit actually in a couple podcasts ago was community engagement marketing. All right? Community engagement marketing works great.
Samantha (28:03.349)
you
Samantha (28:15.884)
Okay.
Samantha (28:30.987)
That was one of my questions too.
Justin Allan Montgomery (28:31.31)
Yeah, a guest I had a couple weeks ago, I don’t know when this one’s gonna be released, so it should be, I’m recording this before that episode was actually uploaded, so I’m sitting here making this up right now as we’re recording. But the podcast a couple weeks ago, once this is released, the majority of her patients, almost all of them, have came from community engagement marketing and then the of mouth that happened after that. She has spent barely any money on.
at all. She goes into Facebook groups, mom groups, whatever it is, and just is part of the community and just contributes, posts messages, replies to people, offers free advice, right? You throw it out there. People ask, are you seeing new patients? In fact, yes, I am. Here’s the link to my website. You just pop it in there on the comment. Don’t actively sit there and try to promote your practice. Don’t make a
Samantha (29:04.363)
Wow.
Justin Allan Montgomery (29:33.582)
Post. No, no, no, no, accept your new HR team. Don’t go in these groups with post shit like that. That’s the number one way to get banned. You know what I mean? So don’t do that, but just be, just engage with the community and they’ll give you opportunities to promote your business in a very passive way, right? Yeah, if you do, just those things I just told you right there, you will grow. Nice, slow and steady, okay? Nothing crazy, not 100 patients a month.
Samantha (29:34.711)
Right,
Samantha (29:50.783)
Understood.
Justin Allan Montgomery (30:04.494)
Maybe 10, maybe 20, all right? Over a period of a year, it’s a couple hundred people. Over another year, snowball word of mouth happens. Then you have 500 patients. And by year three or four, you have a fucking thousand. Like, that’s how you grow a business. It’s just that right there. Like, that’s how you grow one of these. Now, if you want to spend a lot of money on advertising, you certainly can.
Samantha (30:06.999)
Okay.
Justin Allan Montgomery (30:33.878)
It will accelerate the process, but there’s no guarantee it’ll actually work.
Samantha (30:38.647)
Mm-hmm. Okay.
Justin Allan Montgomery (30:40.066)
Those things I just told you to do, I guarantee you those were worth
Samantha (30:44.309)
I’m like super excited about the articles thing because you’re right. If you go to Google and search a topic, it’s going to bring where the heavy content is. That just clicked for me just now. That’s awesome. Yeah.
Justin Allan Montgomery (30:59.47)
Yeah, exactly. So yeah, that’s just how it works. then the AI, AI now, if someone is searching, hey, I want to see someone for hormone replacement therapy in my area, who do you recommend? It’s just going to scroll through the area, through your regional area, and just look for websites that have lots of those keywords and that content.
Samantha (31:08.225)
Mm-hmm.
Justin Allan Montgomery (31:25.422)
and then it’s gonna piece it all together. if you have 150 articles on your website talking about this and you have 200 Google five-star reviews, it’s going to recommend you. It’s going to, you know what I mean? Yeah. So that’s what you do. If you want to, you could spend a little money advertising it if you want, but advertising on social media is a waste of time, okay? No, I’m not gonna say. Yeah.
Samantha (31:35.317)
Understood, okay.
Samantha (31:49.085)
Mm-hmm.
I agree. I’ve it before. It’s like,
Justin Allan Montgomery (31:55.424)
It’s kind of a waste of time. Now that’s not a blanket statement. Some people do very well advertising on social media, but I find it to be a very hit or miss thing. You know, don’t know why I think it’s demographic thing. You know, if you have a lot of people in your area who happen to be on Facebook, who happen to be this certain age bracket, maybe it works. You know what I mean? But it’s just a roll of the dice. Yeah.
Samantha (32:16.385)
Maybe.
Yeah.
Justin Allan Montgomery (32:21.958)
Google search ads can work, but it’s only necessary if you have a lot of competition. If you don’t have a lot of competition, you don’t need to really waste your money with Google search ads, okay?
Samantha (32:33.791)
I really don’t see much competition at all. So I’m excited already. I had questions, but you’ve been answering them along the way. So.
Justin Allan Montgomery (32:37.642)
If, yeah, exactly.
Justin Allan Montgomery (32:44.514)
And then, you know, the only thing I might recommend is, you know, maybe a billboard or something might not be a bad idea. That’s just more or less puts it out there in the community that you are doing this. You are providing these services. Don’t expect magic from it, but people will drive by. They will see it. Maybe it’ll click. Maybe it won’t, you know, maybe six months down the road, they say, Hey, you know what? I remember seeing this
billboard about HRT or something. Let me, what was the name of it? Groove something or whatever. You know what mean? Google. Like, you know what mean? Yeah, and they might find you that way. So maybe a billboard might be worth it if you want to, but like otherwise you’re not in a super rush here. You’re financially fairly secure for the most part.
Samantha (33:18.027)
Mm-hmm. Yeah.
Samantha (33:35.511)
you
Justin Allan Montgomery (33:35.662)
Your husband makes good money. You’re making a few extra bucks working part time. Your practice is generating a few thousand dollars a month for you. It probably pays for some of your fun stuff in life. And you’re not in a super big rush. like, why try to rush it when you don’t have to? And I think that if you’re just patient and do those things, it should slowly, it should slowly happen. But it mean it.
does take some work and it does take some patience, especially the community engagement marketing stuff. Like that takes work.
Samantha (34:06.827)
Yeah, okay, I’m willing to do it.
Justin Allan Montgomery (34:10.476)
Yeah, so any questions from a marketing standpoint?
Samantha (34:14.775)
The billboard was one of my questions and I was going to ask for some strategies in terms of getting more traffic to my website and you answered that with the blog. I did want to talk a little bit about insurance, accepting insurance. Because I do have a DPC on my website as well.
Justin Allan Montgomery (34:34.668)
All right,
Samantha (34:42.827)
I’ve had like a couple of people with some hypertension but nothing major and I’m still in the process of getting my DEA so I can’t yet prescribe testosterone.
Yeah, I was going to ask about what your thoughts are on insurance and I get it 100 % but are there any circumstances where it would be recommended like what I mentioned earlier, the area where my clinic is highly employed, everybody has insurance, know, it’s very suburban. There are some pockets of areas with households with more disposable income but not the majority.
Yeah, what do you think about that in terms of patient volume? I know the volume will come, what are the types of things that make people like who are entrepreneurs shy away from insurance besides the lower reimbursement rates and
and like the prior authors and all that stuff. Are there ever any circumstances where you would recommend somebody possibly consider doing insurance and still keeping the cash-based services though?
Justin Allan Montgomery (35:59.15)
Well, I I think the biggest reason why a lot of entrepreneurs in this space want to avoid insurance because it’s a fucking headache. mean, I can go into more details if you want, know, but like, yeah, you know, this thing about insurance is that it is a third party, right, is in control of your money.
Samantha (35:59.234)
hybrid mode.
Samantha (36:07.145)
Yeah, right.
Samantha (36:24.193)
Yeah.
Justin Allan Montgomery (36:27.256)
Third party controls how you get paid. So they are in complete control of how you make money in your business. So you are no longer, you no longer have a free business. You no longer have a business rooted in capitalism. You have a business rooted in more of like a socialism kind of thing where there’s a third party, something else that controls how you make money, right?
Samantha (36:30.881)
Yeah.
Samantha (36:41.503)
Understood.
Justin Allan Montgomery (36:55.758)
So now you gotta follow their rules, you gotta follow their regulations, you gotta follow all the bullshit that they have, right? And that’s just kinda how it goes. Now, okay, now with that said, all right, if you want to deal with those things, if you want to deal with the headaches and the complexities and the regulations and stuff, that comes along with insurance, okay? It’s not the end of the world by any stretch of the imagination. It’s not like it’s, you know, it’s not hard, it’s just…
Samantha (37:01.377)
Yeah.
Justin Allan Montgomery (37:25.356)
You just gotta do things a little differently. You gotta do little things a little bit more by the book, so to speak. If you go that route, I mean, it can pay off big time. Some of the most profitable practices I’ve seen are insurance-based practices.
Because the patient volume is tremendous. You see a lot of people because people expect to use their insurance. So your patient volume will be 75 to 80 % higher with an insurance-based practice and a cash-based practice. Now, it’s just a general rule of thumb. This is in scripture by any stretch of imagination. But it’s just like when you have a cash-based practice, you will notice a trend.
and this is fairly applicable from much people I’ve talked to and you know in my experience as well that for every four people that call your practice maybe one turns into a actual customer when you have a cash based practice. Okay the other three fall off because the price is too much it’s out of their reach they insurance and they expect to use it okay so you will you will begin noticing that kind of trend all right
Samantha (38:26.667)
Mm-hmm.
Justin Allan Montgomery (38:41.024)
Again, that varies greatly depending on what area you’re in, that kind of thing, but that’s about what I’ve seen. That seems to be about the number a lot of people kind of have that I’ve talked with over the last seven years of doing this. anyways, just keep that in mind. Now, if you can extract that other 75%, right? I mean, think about it. You’re gonna have a lot of patience, right?
Samantha (38:52.267)
something.
Samantha (39:10.07)
Yeah.
Justin Allan Montgomery (39:10.446)
You will have to essentially do a lot more fee-for-service kind of stuff to make money You have to see the patient you got a bill insurance for the visit. You got to do that versus a subscription based thing with cash is They pay you every month they get their med follow up with them whenever that’s just kind of it, you know So you will need to see the patients to generate income so you will be busier you will be seeing a lot more people
a lot more frequently because you want to get as many billings as you possibly can. So, if you do it, yes, you will make money and you will make money fairly quickly and you will grow this business significantly. Like this business will grow 50 % if not higher, faster than a cash-based business will. Okay? Especially if you’re providing…
especially if you’re doing HRT and weight loss and these sorts of things and you accept insurance for it, you’re get a lot of patience. A lot of patience. All right? So, yeah, I mean, it can work. If you wanna give it a try, you know, I mean, you will grow faster, which means you will have a lot more growing pains as you grow. You will need to begin hiring other people a lot faster. You will have to deal with…
the medical billing component of it, the coding component of it, you will need to make sure that you’re billing appropriately and you’re actually getting paid for the visits. Insurance companies like to just kind of ignore shit, you know? I talked to an NP a few weeks ago via email and come to find out the insurance company owes her something like 80 grand.
Samantha (40:46.977)
Yeah.
Samantha (40:57.753)
my God, what? my God, that is crazy. They have to pay it, don’t they? Eventually, they have to pay it, but they can take their.
Justin Allan Montgomery (40:59.5)
Yeah. For billings over the last year that they just didn’t pay.
Yeah.
Justin Allan Montgomery (41:08.75)
They don’t have to do a damn thing. No, do whatever they want. They can just say, well, we didn’t like the way you charted, or you need to fix this, you need to fix that. They can make it the biggest pain in the ass for you, just so you just give up. Yeah. Or it wasn’t submitted appropriately. You need to resubmit stuff. They can do whatever they want not to pay you, if they want. Okay, that’s what I’m saying.
Samantha (41:12.631)
Really? That is so crazy.
Samantha (41:20.607)
Samantha (41:32.715)
Mm-hmm.
Justin Allan Montgomery (41:36.942)
So you gotta have a rock solid medical biller who’s a shark who makes sure to stay on top of this stuff. Cause if you don’t, stuff will fall through the cracks really quick.
Samantha (41:40.94)
Yeah.
Samantha (41:46.833)
Okay.
Justin Allan Montgomery (41:51.054)
Okay, so if you wanna go that route, go that route. You probably will make more money and you will grow faster. I will say that, you will.
Samantha (41:58.168)
Okay, I’m highly considering it. Highly considering it with all the headaches and everything, know, understanding that that’s gonna be part of it. I just believe that that’s probably the route I’m gonna go outside of, you know, rather than getting a job for somebody else. If I’m gonna work for somebody else, you know, in that capacity, then I should go ahead and do it for myself instead.
Justin Allan Montgomery (42:15.692)
Now what?
Justin Allan Montgomery (42:22.606)
If you want to, yeah, I mean, like I said, it’s just, it adds a completely other layer of complexity to your business, okay? That’s just part of it. Now, what are you wanting to provide? Are you like, what, okay, so if you accept insurance now, the question is, what services do you wanna provide?
Samantha (42:29.227)
Yeah.
Samantha (42:41.687)
Just adding DPC to it. Just primary care, yes. Oh yeah, because it wouldn’t be direct primary care. would be, primary care. I’m still in the thought process about it. I’m still thinking about it, because I don’t know if I want to go that route with the chronic disease management, because that’s, I know that’s mostly primary care. That’s what it is. So, yeah.
Justin Allan Montgomery (42:45.058)
So it’s not DPC, it’s just primary care.
Justin Allan Montgomery (43:09.388)
God bless you if you do.
Samantha (43:11.157)
I know, I know, don’t, essentially I don’t want to. Yeah, I don’t want to do that, but I know that.
Justin Allan Montgomery (43:14.242)
like primary care providers are.
That’s the lowest paid provider. If that’s what you want to do, I’m telling you. Don’t do it. Just give this business a year. Just do the things I told you to do. It will grow. It will. Just be patient with it.
Samantha (43:22.967)
I
Samantha (43:32.055)
It’s not what I want to do to be honest. Okay.
Samantha (43:42.122)
Okay.
Samantha (43:45.983)
Alright. I am gonna do that. Okay. I got it.
Justin Allan Montgomery (43:49.774)
Okay? Insurance, it’s gonna take you six months first, okay? You’re get credentialed. It’s gonna take six months before you start accepting insurance. So, you will not be accepting insurance until probably September, okay? All right? And then you’re gonna have to then, yeah, so it’s gonna take you six months anyways, and then it takes you another 30 to 90 days to start seeing your first money from the billings, right? So, just consider it.
Samantha (43:54.359)
Mm-hmm.
Samantha (44:04.459)
Right.
Samantha (44:14.583)
Alright.
Justin Allan Montgomery (44:19.34)
I’ll leave you with this, we’ll just leave it at this. If you accept insurance and you begin building a business and you get sick and tired of accepting insurance, converting to cash only is a pain in the ass. You will lose the majority of your patients, they will leave, okay? So just keep that mind. Converting from cash to insurance later doesn’t, it doesn’t involve that. You will just get more patients.
Samantha (44:32.257)
Mm-hmm.
Samantha (44:35.669)
Mm-hmm. Gotcha. Yeah.
Samantha (44:47.339)
Okay. I see. Okay.
Justin Allan Montgomery (44:48.91)
Right? So keep that in mind. If you accept insurance now, going back a year from now, two years from now, you’re like, I’m sick and tired of this, I wanna go cash only, you will have to realize you’re gonna lose the majority of your patients.
Samantha (45:01.993)
I see. Okay. And did I hear on a recent episode that you accepted insurance for a short time as well? Yeah. Short time. you’re, you’re over it. Right? Yeah. Yeah, I got you. I’m like that. So I don’t
Justin Allan Montgomery (45:09.694)
yeah, for a very, very, very short, like a few months, a few months, three or four months. I was like, fuck this, I’m done.
This is my business. Don’t tell me what to do. You know? Yeah.
Samantha (45:28.255)
It’s just the volume thing, like I said, but I’m going to implement the things that you shared with me here and go from there. Yeah.
Justin Allan Montgomery (45:33.708)
Yep. Sounds good. Just be patient. That’s it. Just be patient. Okay. That’s the problem with lot of entrepreneurs. They’re not patient. got it. Million dollar businesses aren’t built overnight. They take a little while. You know? Yeah. So, all right. I got another call I got to hop on to. So, just last question. So, I’d like to end the episode with you asking me a question, a personal question or curiosity.
Samantha (45:38.217)
Okay.
Samantha (45:43.671)
You’re right. Okay.
Samantha (45:59.64)
I had a question a long time ago, but I found out the answer to that somebody asked it previously. So I was going to ask, would you ever go back for your doctoral degree as an. Yeah, like, no, it’s not going to benefit at all except to be called doctor. And then with all.
Justin Allan Montgomery (46:09.774)
Absolutely no. Absolutely not. the hell is that going to do for me?
Justin Allan Montgomery (46:19.47)
I don’t care. I could care less. Call me Dr. Mitt. I don’t, whatever. I really don’t care. don’t, my ego does not need to be stroked. You know, I don’t care. I don’t care about the letters behind my name. I don’t care about DNP. I don’t care about doctor. I don’t care. You know the letters behind my name are? NP. That’s sufficient for me.
Samantha (46:29.183)
I know that’s right, yeah.
Samantha (46:40.587)
That’s good, yes that works.
Justin Allan Montgomery (46:43.118)
You know, I don’t, yeah, so absolutely not. I know what would happen if I enrolled into a DNP program. I would quit within a week. I know I would. I’d be like, I’m not doing this. This is all horse shit. This is not gonna help me at all. What? This is not gonna help me critically think more. This isn’t gonna help me implement evidence-based care into my practice. You know, I know how to read clinical guidelines in a journal and stuff. I can do it myself. I don’t need to be told what to do, you know?
Samantha (46:51.477)
Yeah, me.
Samantha (46:56.159)
Yes.
Samantha (47:00.329)
I know.
Samantha (47:12.713)
Awesome. I feel that way too. have some peers that keep trying to pressure me or saying, you should do your DMP. I’m like, for what? Like it’s not going to benefit me at all. Like.
Justin Allan Montgomery (47:13.122)
So.
Justin Allan Montgomery (47:21.326)
For what? Right. You know, you’re 51 years old. You really want to go back to school for a year and a half, two years? For what? You know, had DMPs argue with me about this all the time. Oh, well, you just don’t understand because you never went through it. I don’t want to go through it. I don’t need to go through it. I’m probably honestly a better clinician than you are. And I’m a multimillionaire as well. The DMP is going to do that for you. You know?
Samantha (47:25.655)
Absolutely not.
Samantha (47:35.411)
Uh-huh. god.
Samantha (47:44.745)
Yeah, that part. That part. I’m trying to get to your status, Justin, so…
Justin Allan Montgomery (47:50.19)
Right. I don’t need it. It’s a waste of my time. If I was going to pursue a PhD, you know, to get a PhD in, I get a PhD in like biology or physiology and actual hard science. Yeah. Yeah. A hard science. You know, yeah. I got my first bachelor’s degree in biology and chemistry. My senior year, my senior year, my senior level biology classes.
Samantha (48:00.407)
Mm-hmm.
Right, right, right.
Samantha (48:08.735)
Understood.
Justin Allan Montgomery (48:17.794)
were 10 times harder than anything I experienced in my master’s program. 10 times harder.
Samantha (48:17.803)
Mm-hmm.
Samantha (48:22.263)
I can definitely probably agree with you on that. I’m sure it was.
Justin Allan Montgomery (48:25.998)
Yeah, like I’m just no, DMP is not going to challenge me. It’s just, I just know it’s not. It’s just going to be bullshit stuff. I’m just going have to just go through the motions and you know, yeah, no thanks. So anyways, good question. Yeah, I’m sure I’m sure it’ll piss some people off listening, but oh well. All right, cool. All right. Well, if you ever want to do a follow up, let me know. And like I said, just be patient. Okay.
Samantha (48:31.991)
time consuming. Yeah. Awesome.
Okay, I appreciate your time. Thank you so much. You too. Bye.
Justin Allan Montgomery (48:51.982)
You’re welcome. Take care. Bye.
