"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 Jennifer Jersan, a family nurse practitioner of 16 years and owner of Elevate HRT. After 16 years in the traditional primary care setting, Jennifer turned in her notice and is officially betting on herself full-time.
On their conversation they talk through practical strategies for building momentum, creating a service model that fits both the provider and the patient, and keeping the process simple while laying the foundation for long term success. The conversation also touches on balancing career goals with lifestyle goals, and how small consistent steps can create meaningful growth over time.
Whether you are a solo practitioner looking to scale, or an employee looking for the confidence to finally quit your day job, this episode is packed with the raw, common-sense business advice you need to grow a profitable, cash-based practice.
Justin Allan Montgomery (00:00.91)
Look it up. We are recording. Hi everyone, today we’ll be talking to Jennifer, who is a family nurse practitioner. Currently, she is working full-time at a primary care practice.
And while her part-time wellness practice continues to grow, she offers hormone replacement therapy, weight loss, peptides, IV infusion, and some aesthetic services. And she states the practice is doing well. She’s needing help with transitioning from being a full-time employee to being self-employed full-time, hiring some employees, some employee considerations, and overcoming the fear of the unknown. Hey Jennifer, how you?
Jennifer Jersan Elevate HRT (00:31.634)
Good, how are
Justin Allan Montgomery (00:32.866)
Good. Thanks hopping on here. Thanks for hopping on Memorial Day. You can tell that we’re real dorks when we’re doing this on a holiday. Yeah. Yeah. Cool. anyways, but tell us about yourself. How long you’ve been a nurse practitioner for and kinda what you’ve been up to?
Jennifer Jersan Elevate HRT (00:35.954)
Yeah.
Jennifer Jersan Elevate HRT (00:39.228)
I know, right? All right, that’s how it is.
Jennifer Jersan Elevate HRT (00:48.143)
I have been a nurse practitioner for 16 years. primarily done primary care, family medicine up until about three years ago. when my own personal health journey got me trying to find somebody who knew anything about hormones. And then a good friend of mine was like, You need to start your own hormone business because people need to know about this. And I was like, Okay. And so did hormones for about a year, added some weight loss. we had the opportunity last year to
acquire a much larger space. And so I I own a larger building and I sub rent to a nurse injector, a massage therapist. We’re trying to get a lot of inclusive wellness stuff here. I’d like to get a mental health therapist in here. And all the while like my hormone wellness, vitamin infusion stuff is growing also.
Justin Allan Montgomery (01:38.51)
Okay. So you start this practice when?
Jennifer Jersan Elevate HRT (01:41.364)
July of twenty three.
Justin Allan Montgomery (01:43.544)
Okay, so three years almost.
Out of all the services that you offer, which one’s the most profitable? Hormones. Hormones. Yeah, yeah. and if you don’t mind, what are you generating monthly estimated?
Jennifer Jersan Elevate HRT (01:52.286)
Hormones. Yeah, without a doubt. Yeah.
Jennifer Jersan Elevate HRT (02:00.057)
about twenty thousand dollars a month. This year I just started doing it two days a week. Up until this point I was only doing one day a week because I was four days a week at my full time job. Now I’m two days here, three days there, and I’ve turned in my notice there. So starting in August, I’ll be full time at my own business.
Justin Allan Montgomery (02:20.526)
Okay. So you generate about twenty grand a month. Is that profit or is that just gross revenue? That’s just gross revenue. That’s gross. So you’re profiting what, ten or twelve thousand dollars? Yeah. Something like that. Yeah. okay, so let’s talk about first the the transition from going from full time employment to
Jennifer Jersan Elevate HRT (02:25.278)
That’s just gross revenue. Mm-hmm. Yeah. Yeah.
Justin Allan Montgomery (02:42.188)
being self employed full time. So basically, you know, being a full time employee to being a full time entrepreneur, right? it is a it’s a terrifying transition. It just is. It is for everybody. I mean most people anyway. Some people don’t really have a problem with it ’cause their business is generating so much money they don’t care. But for most people it is a it’s it’s stressful. It was stressful for me too when I finally quit my job and went, you know, full time, betted you know, betted on myself one hundred percent, right? it was stressful for me as well.
Jennifer Jersan Elevate HRT (02:46.919)
Mm-hmm.
Justin Allan Montgomery (03:11.894)
So I think I’ve said this in other podcasts before as well. I have never heard from another nurse practitioner who was working part time, full time while they also were getting their business going. I’ve never heard anyone who regretted quitting their job and focusing on their business 100%. I’ve never heard anyone who regretted that decision. Okay. So keep that in mind. All right.
Jennifer Jersan Elevate HRT (03:29.873)
Yeah, yeah.
Justin Allan Montgomery (03:35.22)
No one’s ever regrets that because when you can invest a hundred percent on your business, you will be amazed at how fast they can start growing. All right. ‘Cause I mean, just think about how much energy and time you spend over here on this job. What happens when you now have that energy and time, right?
Jennifer Jersan Elevate HRT (03:42.077)
Mm-hmm.
Justin Allan Montgomery (03:51.948)
Yeah. so so just you know, the transition is i it’s scary. So let’s talk about let’s talk about more of the objective more of the objective stuff behind this so it’ll help ease your mind. So so right now, just give me just you know estimates here. I don’t need I don’t need exact numbers. But like your living expenses, you know, in in life. What do you spend on a monthly basis, give or take?
Jennifer Jersan Elevate HRT (04:14.652)
Mm-hmm.
It’s around seven thousand dollars, give or take.
Justin Allan Montgomery (04:21.004)
Yeah. Okay. and do you have an emergency fund saved up? Yes. Yeah, okay. Three months, six months, what?
Jennifer Jersan Elevate HRT (04:25.755)
Yes.
it’s probably two and a half months, not quite three months yet.
Justin Allan Montgomery (04:34.414)
Alright, watch bump that up to three months when you can, you know. Yeah, if you know if you can. so you got three months of expenses in the bank, right? So twenty something you know, twenty something thousand dollars. do do you have a spouse that works?
Jennifer Jersan Elevate HRT (04:36.816)
Yeah.
Jennifer Jersan Elevate HRT (04:48.41)
I do have a spouse. He has been staying home, juggling family and kids while I’ve been working both the jobs. Now that I am going to full time in my business, that’s gonna make my schedule more flexible so he can go back to work and you know, I can get the kids to school and you know, all that stuff. So that is gonna be transitioning. He’s gonna be going back to work.
Justin Allan Montgomery (05:08.726)
Okay, and he’ll make I mean, you know, he’ll make some money, right? Yeah, yeah, yeah. So that’ll help. Okay. so
Jennifer Jersan Elevate HRT (05:11.748)
Yeah, right.
Yeah.
Justin Allan Montgomery (05:17.376)
you are making twelve thousand, ten or between ten and twelve thousand dollars a month profit right now in your business, right? So, so you’ll have that I mean that’s gonna cover your expenses, no question about it, right? So from a financial standpoint, there’s not really a whole lot to worry about here. especially if your husband begins working again. So, you know, let’s just say as an example here that he brings in let’s just say he brings in two thousand dollars a month or something, okay? then that leaves you with a five thousand to, you know,
Jennifer Jersan Elevate HRT (05:23.28)
Mm-hmm.
Jennifer Jersan Elevate HRT (05:36.101)
Mm-hmm.
Jennifer Jersan Elevate HRT (05:43.612)
Mm-hmm.
Justin Allan Montgomery (05:47.286)
to to make up for it. Yeah. So that leaves you with your business another five to seven thousand dollars a month in your business that you can invest back into the business to get this thing growing over the next year, right? So from a financial standpoint, I you know, from objectively here, you should be fine. Are you worried about that at all?
Jennifer Jersan Elevate HRT (05:47.749)
Cover, yeah.
Jennifer Jersan Elevate HRT (05:59.141)
Mm-hmm.
Jennifer Jersan Elevate HRT (06:07.044)
Not so much that. I’m just worried about like, what if something happens and I have to have surgery and I can’t work you know, like those big one off things that can be catastrophic for anyone?
Justin Allan Montgomery (06:16.886)
Yeah. that’s the problem with being a business owner, right? You don’t have anyone else who can, you know, take take take the responsibility. Yeah. Right. so that is a that is a big issue. especially being self employed, especially being a solo provider practice, right?
Jennifer Jersan Elevate HRT (06:25.679)
Right.
Justin Allan Montgomery (06:36.884)
If you get sick, if something happens, you are not generating income right now, basically, right? I mean you might have some people on subscriptions. You’ll probably still be bringing in some money or whatever, but you will no longer be see you know, you you will no longer be seeing new patients. Follow-ups and stuff could be, you know, overlooked. so you mean you’ll still generate money, but it’s still ultimately relying on you. So the only way around that, you know, don’t waste your money on, you know, disability insurance or anything as being
Jennifer Jersan Elevate HRT (06:43.205)
Mm-hmm.
Justin Allan Montgomery (07:06.808)
self employed person, okay? Just don’t waste your money. you know, the only benefits you need to really worry about is health insurance. Everything else is whatever. yeah. So
The only way around it is is you have to have someone come in PRN to help you out, you know. So if you want this thing to grow and that is a fear of yours, then the only way to alleviate that fear is to have someone come in and help you. It’s the only way. There’s nothing else you can do to help alleviate that fear really outside of, you know, I mean, what’s the chances of something like that happening? Probably pretty low, you know, I mean one percent maybe, you know.
Take care of yourself, you eat right, you exercise, etcetera, right? But I mean fuck, you never know, you know.
Jennifer Jersan Elevate HRT (07:53.615)
Right. Well, and what’s like a couple of people that I know that are NPs that are really into this and it’s like my fear is, they want to get in and kind of see how it works and then start their own business. And so I’m, you know, I don’t necessarily wanna want to not help somebody, but I don’t want to pave the path for
Justin Allan Montgomery (08:14.776)
Fuck that, you don’t wanna help anyways. No, no. No. You wanna help them start their own business? Screw that. Like no. Yeah.
Jennifer Jersan Elevate HRT (08:21.093)
Well, if it gets them out of the the primary care world.
Justin Allan Montgomery (08:26.142)
Yeah, like you are a you are self employed now. This is your business. You do not you don’t want any competition. You want to limit that to the you know, as much as you possibly can. So I think I said this in I don’t know how many podcasts ago it was. It was sometime in the last like six podcasts or something. Basically when you hire an NP, to alleviate that fear of them
Stabbing you in the back, essentially, right? You teach them how to do all this stuff. They stab you in the back, they start your own thing. Maybe they even steal patients. I mean, that stuff unfortunately happens. And it actually happens quite often. All right. So you have to co you have to do this smart. Okay. You gotta be smart about this. When you hire someone, you need be very selective, all right? question, is your area fairly saturated? Is it gonna be difficult finding someone?
Jennifer Jersan Elevate HRT (09:00.601)
Right.
Jennifer Jersan Elevate HRT (09:20.516)
Saturated with NPs, yes, I feel like it is. I am the only wellness hormone IV clinic in this area.
Justin Allan Montgomery (09:29.634)
Perfect. Okay, so finding an MP is not gonna a problem, then, right? Like you’re not in rural Nevada where you know right, okay. yeah, okay. So be very, very selective here, okay. There are a lot of MPs out there that would love to make an extra couple thousand bucks a month, okay.
Jennifer Jersan Elevate HRT (09:37.751)
No. Now.
Justin Allan Montgomery (09:51.672)
Doing something like this. Very low liability, easy to learn, you know. so be selective. You need to find someone who has too much to lose going out on their own. Okay. Someone who doesn’t have the means to start their own business. All right. Someone who is decentivized to start their own business. Okay.
the example that I used, in a couple of podcasts ago was the NPs that work at my men’s health clinic, they work full time at the VA.
They are not going to leave the VA and their pension and their benefits to start their own business. They’re not going to, right? They’re 11, 12 years in. All they need’s eight more years to get full federal pension. They’re not leaving, okay? They got those handcuffs. So you basically you want to find someone who has handcuffs.
Jennifer Jersan Elevate HRT (10:35.256)
To start the room. Okay.
Justin Allan Montgomery (10:51.576)
Okay, to their full time job, all right. So someone who has a pension or something, all right? A mother who has four children or something.
She can’t afford or sh the she can’t afford to start a business. She doesn’t have the time to start a business, right? That’s what I mean by being selective. Just use common sense. You know what I mean? Be very selective. When you interview these people, ask them, where do you see yourself in three years? If they say, Well, I would love to have my own wellness practice, fuck them.
Jennifer Jersan Elevate HRT (11:07.723)
Risk. Yeah.
Jennifer Jersan Elevate HRT (11:27.16)
Yeah.
Justin Allan Montgomery (11:28.578)
Don’t even don’t even entertain it. And I’ll tell you what, they will say that to you. You’re like, why would you tell me that? You think I’m gonna hire you? No. So ask them that. It’s a simple question. It’s it you don’t care whether you don’t care what they want to do in three years. Who cares? You just want to make sure they’re not gonna stab you in the back, right? Yeah. So that’s kinda that that that’s basically how you navigate it. Ask them, where do you work? How is that going? Where do you see yourself in two or three years? Trust your gut.
Jennifer Jersan Elevate HRT (11:34.412)
Right.
Jennifer Jersan Elevate HRT (11:46.732)
Right.
Justin Allan Montgomery (11:58.606)
Okay. You get some young hotshot MP coming in who’s 26 years old, you know, who doesn’t have any who’s not married, who looks like a doll who wants to do aesthetics and whatever, you know? Come on. You wanna hire someone like that? No. Right. You know? You wanna hire a 45-year-old who been working at the VA for 10 years, who has four kids, that’s who you wanna hire. All right? Like, yeah. So if you do that, you don’t gotta worry about it. And the thing is too.
Jennifer Jersan Elevate HRT (12:11.981)
Right.
Justin Allan Montgomery (12:26.882)
You know, your business isn’t generating a whole lot of income right now. So, you need to find someone who is okay with it being a little slow right now. You know, find someone who just you know, tell them, be like, Listen, probably only gonna give you a couple hours a week right now. All right. I’m gonna pay you production, just pay per visit, all right?
Jennifer Jersan Elevate HRT (12:30.584)
Mm-hmm.
Jennifer Jersan Elevate HRT (12:39.201)
Okay.
Justin Allan Montgomery (12:48.814)
You come in, you see your patients, whatever. You can make a hundred bucks an hour, all right? Pay them fifty dollars a visit or something. Okay? We can talk about that in a little bit if you want. Just pay them production.
Jennifer Jersan Elevate HRT (12:52.663)
Mm-hmm.
Justin Allan Montgomery (12:59.764)
See the patients, treat them, and that’s it. And you’re gone. You make your own schedule. This is a dream for a lot of people, right? Make my own schedule. I see patients this is easy. Make production. You know, these people who make production, like this, they’re gonna average $100 an hour, which is really good money for most NPs, you know? So just tell them it’s gonna be a little slow at first. A couple hours a week. I’m gonna I’m you know, I’m gonna slowly build up your census. All right, but you know, give me give me a few months before I, you know, you start seeing, you know, before you’re working five, ten hours a week. That’s all.
Jennifer Jersan Elevate HRT (13:16.363)
Mm-hmm.
Justin Allan Montgomery (13:29.678)
you want from them is 10 hours a week, no more. Okay? 10 hours a week. When they hit 10 hours, you find another NP. When they hit 10 hours, you find another MB. You bear you are basically staffed by just a lot of PRN 10 hour a week MPs. You never want to hire someone part-time or full-time. Because they quit now you’re scrambling. There’s 500 patients over here that need to be seen because this MP quit who was working for me full full time. Now what do I gotta do? You know what I mean?
if they’re just few PRN NPs who only work five to ten hours a week, if they quit, you have a couple others, it it’s not a big deal. You know what I mean? Right. Yeah. So just kinda keep that in mind. So if you i for that fear, that’s what you’re gonna need to do. Now, do you need to do that right now? Probably not. I’d give it three to six months.
Jennifer Jersan Elevate HRT (14:05.665)
Right.
Jennifer Jersan Elevate HRT (14:14.847)
Right now. Okay. So I actually have no staff at all. I I don’t have a medical assistant and RN anything. So I’m doing everything. And I’ve looked at hiring an MA and then part of me is kind of like, by the time I pay them, I’m like, would it be better just to pay an RN and pay, you know, thirty dollars an hour plus give them however much they do per IV injection or, you know, something like that.
Justin Allan Montgomery (14:41.582)
well my question is how much do you make with the IVs? No.
Jennifer Jersan Elevate HRT (14:48.789)
Not much now because I don’t advertise it because I’m not here full time. I I don’t know how it it seems like that would be something really easy to do and good income. It’s just not and begin it might not be because I’m advertising, but I’m like, I don’t know that I want to dedicate a ton of time and money and staff and space to Ivy fluids.
Justin Allan Montgomery (15:08.482)
I mean, w what’s your profit on a on a on an average I V? Fifty dollars, seventy five dollars? I mean I mean usually seventy five. About seventy five bucks. Yeah. I mean, you know
Jennifer Jersan Elevate HRT (15:14.558)
I mean usually 75, 80. Yeah.
Justin Allan Montgomery (15:22.796)
And then mixing the bags and starting the IV and blah, blah, blah. It’s time consuming, it’s laborsome. You know, IV infusion is not a very scalable business model. Okay. It’s just not. Yeah, you have to hire an RN to do if you want. I don’t know if LPNs in your state can do it. If they can you might be able to pay them a little less, you know.
Jennifer Jersan Elevate HRT (15:34.582)
Mm-hmm.
Justin Allan Montgomery (15:43.496)
some states medical assistants can do IVs. In some states, you know. so I don’t know what the laws or regulations are like in your state, but you know, I know from I’m from Tennessee originally, I don’t live in Tennessee now, but I know in Tennessee I don’t even think I I don’t think L P N’s could start I Vs. It had to be an RN, you know. So but like here in Colorado, I’m pretty like I medical assistants can start fucking I Vs, you know what I mean? And they can hang a bag. Yeah.
Jennifer Jersan Elevate HRT (16:02.679)
Mm-hmm.
Justin Allan Montgomery (16:11.668)
So, you know, this is TMI, too much information. But I had a colonoscopy like two months ago. And it was a medical assistant who came and started the IV and hung the bag. Like I was like, wow, okay. So it just completely depends, right? try to get the lowest hanging fruit the cheaper the cheapest option. If it’s an RN in your state, it’s an R N. Now, you do not want to hire a full time RN for this, for your business. That it’ll eat your profits up so much.
Jennifer Jersan Elevate HRT (16:23.755)
Right.
Justin Allan Montgomery (16:37.77)
So with the IVs, if you can find an RN who is willing to work for you, PRN, who, you know, comes in for two hours on Saturday, two hours on Wednesday, whatever, right? And you just pay him per IV. That’s it. Don’t pay hourly, just pay him per IV. If your profit’s eighty bucks, give thirty dollars an IV or something. You know what mean?
Jennifer Jersan Elevate HRT (16:58.774)
Mm-hmm.
Justin Allan Montgomery (17:00.062)
And then that then you can just do that so that way you don’t have to worry about it. You can do that. But if you want to grow and scale this business, then you need to you you gotta have an MA or someone to be doing all this busy work. Like, that’s priority number one before hiring another NP, in my opinion. Okay. ‘Cause the fear of you not being able to see patients, something happening to you, that is such a small percentage chance
Jennifer Jersan Elevate HRT (17:18.422)
Mm-hmm.
Justin Allan Montgomery (17:28.29)
that I wouldn’t put all I wouldn’t put eggs in that basket right now. Okay.
But you having to go pick up your kid from school early because they’re sick, that is a much higher chance of likely you know, likely likelihood, right? That’s probably gonna happen. That it probably will, versus you having to have surgery and you’re out for four months, right? Like that’s probably not gonna happen. But your kids being sick probably will happen. So what do you do if you have to go pick up your kid from school, cause maybe your husband’s working or something, and you have four patients scheduled or something like that.
That you need to have someone there who can patient comes in and be like, she will be back. She had to go pick up her kid, whatever. Let me go ahead and get your vital signs. Let me go ahead and get these intake forms filled out. Let me you know what I mean? Like, yeah. So you need to have someone there who can answer the phone for you five, four or five days a week, who can start ordering meds from compounding pharmacies and supplies and be a receptionist. All you need is one person, just an MA. Okay, an MA can do basically everything. They’re trained to basically operate the office.
Right. That’s that’s gonna be your the best bang for your buck. It’s gonna be very difficult for you to scale and grow this practice without having some support staff like that. Yeah, it’s it is too much now. Yeah. I know.
Jennifer Jersan Elevate HRT (18:41.801)
Yeah, it’s it is too much now. And I know that will get better when I quit the other job, but I’m like, I don’t wanna spend my time prepping charts and ordering labs and yeah.
Justin Allan Montgomery (18:49.538)
That’s Yeah, that’s not that’s not income generating work. You need to be seeing patience. You need to be generating money, right? So you’ll have five to seven thousand dollars a month to invest in your business, right? It’s kind of what we talked about. Five to seven thousand give or take, right? Investing in an employee is investing in your business. So out of that five to seven thousand dollars, you hire an MA, pay them well, pay them twenty bucks an hour. Okay, don’t don’t nickel and dime these people. Don’t pay fifteen.
Jennifer Jersan Elevate HRT (18:53.393)
Mm. No.
Yeah.
Justin Allan Montgomery (19:18.892)
pay twenty, you get you will get so much better work from these people. Okay. They will like they will do so much better of a job for you. Okay. So twenty thousand dollars, I mean not twenty thousand twenty dollars an hour, how much does that come out a month? So do you want are you gonna want them working forty hours a week, thirty two hours a week? What do you think is what do you think is gonna be needed? Thinking probably
Jennifer Jersan Elevate HRT (19:39.304)
I’m thinking probably thirty, thirty-two hours a week in the beginning just so we see where things kind of level out at. Eventually it will be 40 hours.
Justin Allan Montgomery (19:46.06)
Yeah, okay. Yeah, okay. So you’re looking at twenty five hundred bucks, give or take, a month. Okay. Factor in some employment taxes and some other little things. Probably closer to about three grand. Okay. That’s what it’ll cost you is three thousand dollars a month to have someone who can do all of that bullshit for you that you don’t have to do anymore. That to me, that’s a worth that that’s worth the that’s worth the money. Yeah. You know?
Jennifer Jersan Elevate HRT (19:53.257)
Mm-hmm.
Justin Allan Montgomery (20:14.126)
Because now you can spend your time marketing, advertising, seeing more patients, working on the business, right? So that’s probably your goal number one. Yeah. Again, find someone who’s you you is trustworthy. If you know someone, always use a personal connection first, right? all the MAs that work at my urgent care, all of them except for one, came from the urgent care that work at my men’s health clinic. They all came from the urgent care I worked at.
Jennifer Jersan Elevate HRT (20:23.796)
Try.
Justin Allan Montgomery (20:42.732)
I worked with them for years. I trusted them.
Jennifer Jersan Elevate HRT (20:43.752)
There’s several that I know of that I would like to have and trust, but they all need health insurance and I’m just not there yet where I can start doing employee insurance and benefits and
Justin Allan Montgomery (20:50.957)
No.
Yeah, it’s gonna be too expensive. well what I usually do is I usually keep their pay just right below the Medicaid threshold. That’s what I do. I mean, they don’t care. You know. So yeah, I mean twenty dollars an hour in your state, I mean, you’re only looking at maybe that’s thirty thousand dollars a year or something. It’s still it’s really not that much. They probably will still hit the Medicaid, you know, if if they’re cool with that option, you know.
Jennifer Jersan Elevate HRT (20:55.207)
Mm-hmm.
Jennifer Jersan Elevate HRT (21:05.405)
Yeah, it’s an option.
Justin Allan Montgomery (21:23.354)
anyways though, so gonna keep that in mind, yeah. y you should be able to find someone who already has Medicaid or something, or maybe their spouse has health insurance. You probably can find someone who doesn’t actually need that. And, you know, you can tell you know, I don’t give you any benefits. You know, I might not give you benefits, but I do take care of you. I’ll fill up your gas tank. You will get bonuses if we’re doing well. You know, things like that. You take care of
And they don’t they don’t care about benefits. Yeah. You know? Yeah. So
Jennifer Jersan Elevate HRT (21:54.375)
Yeah. Okay. So since I’ve turned my notice in at my primary care practice, and I do see several in my hormone clinic that also see me at primary care, but now they want me to see them here as their PCP. And I’ve kind of looked at doing like a concierge direct patient care and they know I will not be taking insurance, but I just don’t know how
lucrative that is, how successful that will be, kind of what that looks like. If I want to go down. Cause there is a there is a really nice feeling of being like, this is abnormal. Take this up with your PCP when it’s not something specific to Hashimoto’s or hormones or you know what we’re directly talking about. And part of me is like, do I want to give that up?
Justin Allan Montgomery (22:40.918)
Right. Blood pressure, cholesterol, blah blah blah. Right. You wanna do that? You wanna make sure they have their colonoscopy scheduled, you know, like
Jennifer Jersan Elevate HRT (22:49.604)
I mean, we talk about that stuff, but it I’m not actively like, get this done you know, it’s it’s kind of the benefit of this role is I can like, look, you need to have your colonoscopy, this is why it’s important and then it’s somebody else’s fish to fry, essentially. Mm-hmm.
Justin Allan Montgomery (23:03.278)
Right, go see your PCP, right, right, right, right. So I mean, I think you’ve already answered your own question here. I think that, you know, is it worth it to you to do all that? It probably not, but at what price is it? Right? At what price is it actually worth that? You know? I mean, I know I know I’m I you know, I I know some NPs who have th
Jennifer Jersan Elevate HRT (23:19.324)
Mm-hmm.
Jennifer Jersan Elevate HRT (23:23.473)
Right.
Justin Allan Montgomery (23:30.296)
DPC and high ticket, you know, concierge kind of practices or whatever. and the people who have the high ticket concierge practice, you know, they charge twenty five hundred dollars a month. And for that, patient gets whatever they want. Hormones are included, peptides, whatever, you know. and I’ll also manage your blood pressure, I’ll manage your cholesterol, I’ll you know, I’ll also manage whatever, you know. At that price point, it’s worth the trouble, right?
Jennifer Jersan Elevate HRT (23:44.626)
Well yeah.
Jennifer Jersan Elevate HRT (23:55.954)
Mm-hmm.
Mm-hmm.
Justin Allan Montgomery (24:00.216)
Fifty dollars a month, that ain’t worth it. It’s not worth it, right? So the DPC people that I know, you know, usually most of the ones that are successful charge between the seventy-five to a hundred dollar mark, even maybe a little higher. I know one who charges a hundred and twenty. And they do pretty well, but they have a very high volume of pr of of patients. Now, for the most part, most patients will not be bothering you very often. They just won’t. You know? They’re just not going to.
Jennifer Jersan Elevate HRT (24:02.898)
Not worth it. Mm-hmm.
Jennifer Jersan Elevate HRT (24:26.546)
Mm-hmm.
Justin Allan Montgomery (24:29.15)
you know, if they call and they need some Z PAX or something or some Seftonir or Moxicillin ’cause their little kid has strep. Okay, yeah, fine, whatever. It’s it’s easy stuff like that, right? but you will have some pains in the ass. You will have pain in the ass patients. You do primary care, you know, you know you know who those people are, you know.
So you will definitely have some of those that will make your life like you’ll just tell yourself this is not worth $75 a month. This person is a pain in my ass. so it’s gonna be it’s it’s up to you. Do you wanna do that stuff? You know, a lot of your HRT patients, your weight loss patients, et cetera, they’re not gonna be part of that program. Some of them will. Most of them probably won’t.
When I integrated DPC stuff into my men’s health practice, I ended up scrapping it ’cause just not a lot of people were interested in it. You know. Some people were, but most people weren’t. They were just there for the hormone replacement therapy. They didn’t care about anything else. So you could create something like that if you want. My advice to you is be very selective on who you on who you allow.
Jennifer Jersan Elevate HRT (25:23.696)
Mm-hmm.
Justin Allan Montgomery (25:35.626)
scrap a low cost thing and maybe have a very high ticket concierge kind of thing. Try a thousand dollars a month, two thousand dollars a month, there are people who will pay that. Yeah. Think about it. Is there is there any
Jennifer Jersan Elevate HRT (25:46.117)
All right. Is there is there any like legal considerations to think about if I do take some of these people as primary care patients and then other ones I’m like, no, I’m not going to take you. No.
Justin Allan Montgomery (26:01.294)
It’s cash. It’s a cash thing. I mean, could someone complain about discrimination or something? I mean, that’s definitely a possibility, but it’s a private business. You can be selective, you know, with Medicare, you take Medicare, Medicaid and health insurance, you can’t you like you gotta accept people. You can’t discriminate people, you know, in in print you know, I I I you know, you can’t do that.
Jennifer Jersan Elevate HRT (26:25.199)
Right.
Justin Allan Montgomery (26:29.298)
If someone sends a patient to you and they send a patient to you, you gotta kinda see right? I mean, you can’t really do that, but with a cash pay private business, you can be as selective as you want. You know, you can basically just tell people, Yes, we are accepting new patients, but we are only accepting some patients. Please send us your medical records so we can review them to see if you would be a good fit. They send you
a problem list of fifty diagnoses, someone who’s allergic to potassium, you’d you know, n no, you know, actually I don’t I don’t think you’d be a good fit here.
Jennifer Jersan Elevate HRT (27:04.017)
Okay. And with that direct primary care model, are you on call twenty four seven or if you kind of established that in the beginning and be like, look, these are office hours. If you have an emergency outside of that, go to the hospital, or are you kind of responsible to be available to them all the time?
Justin Allan Montgomery (27:21.688)
Again, it depends on the price point. Someone’s paying you five thousand dollars a month, it’s twenty four seven. You know what I mean? If they’re paying you seventy five, it’s you can call between nine and five o’clock. You know, like it’s that’s completely your decision. It’s it’s based off the value you wanna give these people, right? What’s the value you wanna give them? If they’re paying you three thousand dollars a month or whatever, then it needs to be pretty high value.
Jennifer Jersan Elevate HRT (27:29.808)
Mm-hmm. Mm-hmm.
Jennifer Jersan Elevate HRT (27:50.554)
Mm-hmm.
Justin Allan Montgomery (27:51.35)
It’s fifty dollars a month, it’s pretty low value. I mean yeah. And if it’s an issue, don’t call, send a message through the clinical portal or something, you know what I mean? That way your phone’s not blowing up. But I would if I was you, I’d advise I wouldn’t I I I don’t think you need to do that. I think you can find I think you can make plenty of money with HRT and these wellness services alone. I don’t think you’ll need to dive down that. I really don’t.
Jennifer Jersan Elevate HRT (27:54.575)
Okay.
Jennifer Jersan Elevate HRT (28:15.258)
Mm-hmm.
Justin Allan Montgomery (28:18.19)
Unless you want to do some kind of high level concierge kind of thing. That’s fine. You can do that. You know. You won’t get very many patients. That’s fine. You don’t need that many patients to make that profitable. Right.
Jennifer Jersan Elevate HRT (28:28.836)
Right. So I’ve got some patients that do hormones and I’ve got some that do a weight loss membership and just trying to figure out like the ones who do both. Or if I have a husband and a wife doing a hormone membership, like, do you offer like discounts for families or if you start pairing things together, peptides and hormones or peptides and weight loss? Like is it easier just to
I don’t know what’s best to do is like a monthly recurring membership, what’s best just to charge per item.
Justin Allan Montgomery (29:02.852)
I think it’s a good idea to have recurrent income in your business. It just is. I think that you need to have at least the the parent service, the foundational service that they’re there for needs to be the membership, the subscription. So if they come in wanting hormone replacement therapy, that’s what they pay monthly for. $150 a month, two hundred dollars a month, whatever, right? They want weight loss with it, you don’t want to charge them two hundred dollars a month for weight loss. You just charge them per vial.
You know what mean? They’re already paying you for the base service. The base service, the foundational service, includes visits. Okay? Doesn’t really matter what you what what the visits for, it’s included, right? So if they’re paying you two hundred dollars a month for hormone replacement therapy, and they want to start weight loss, fine. This bottle trzepatite is three hundred dollars. That’s just how much it is, right?
And I’m not gonna charge you now a subscription of four hundred and fifty dollars a month for weight loss. The other you know, the hundred and fifty dollars is for the visit kind of part of it, right? No, no no. That’s the visits are included in the base foundational stuff, right? So they come in for you for weight loss, then yes, you would charge the four hundred dollars a month or whatever it is. That’s the base foundational. Then they later on they’re like, Hey, I’m interested in hormone replacement therapy. okay, well, you know, the cream and stuff over here for hormone replacement therapy is it’s a hundred dollars for a thirty day supply versus the two hundred
dollars a month. Like does that make sense? Yeah. Yeah. So you always want them on some kind of foundational subscription based model is what you want them on. And then everything else is a carte, essentially. Okay. Packages for couples or whatever. Yeah, sure. Give them a little bit of a discount. Why wouldn’t you? You know? If they’re both coming in for HRT, do you really want to charge them four hundred dollars a month? Three fifty is fine. You’re still making good money. You know? Right. Yeah.
Jennifer Jersan Elevate HRT (30:26.381)
Yeah. Yeah, that makes sense.
Jennifer Jersan Elevate HRT (30:50.05)
Yeah, right. Okay.
Justin Allan Montgomery (30:59.15)
So you have any more okay, so any more questions about the transition from full time employee? Like are you y you’re good? I don’t I think I’m
Jennifer Jersan Elevate HRT (31:06.958)
I don’t I think I’m I’m good with that. I’m just ready to close that chapter and yeah.
Justin Allan Montgomery (31:10.85)
Yeah. Yeah, okay. All right. Yeah, you’re not gonna regret it, trust me. You you won’t. You will be like, This is this is what everyone says. I should have did this earlier. That’s what everyone says. Okay. So that’s probably what’ll happen to you too in the first couple months, you’ll like, God, I wish I did this a year ago. so yeah, okay. So any other questions about who to hire, how to hire them? Do you feel pretty comfortable with all that?
Jennifer Jersan Elevate HRT (31:33.998)
I feel pretty good with all that, yeah.
Justin Allan Montgomery (31:36.088)
Yeah, okay. So to summarize that up, MA first is probably who you’re gonna need. Maybe a contracted Ara to do IVs if you want to. Telling you though, IVs just aren’t that scalable. Like I just don’t think it’s really worth your time. Do vitamin injections instead. You know what I mean? The margin’s so much better, it takes less time, it’s easy. Yeah.
You need to focus on the HRT. That’s gonna be the service that you will scale with. Okay. Weight loss, I mean, hey, if you’re still making money with weight loss, great. There’s no one else in your area doing it, great. C keep making that money, all right. Weight loss though, unfortunately, is just one of those things that’s just it’s really decreased a lot in the last couple of years. I’m sure you’ve seen it yourself. you know, people can just get semaglutide or zepatite, whatever from some online place and you know.
Jennifer Jersan Elevate HRT (32:21.005)
Mm-hmm.
Justin Allan Montgomery (32:27.352)
for nothing. yeah. So that’s not very scalable. so focus on the scalable stuff. HRT is scalable. A lot of people are gonna need it. There’s you know, millennials now are you know approaching their mid forties. The you know the older millennials. They are going to be looking for HRT now, you know.
All the Gen Xers that most of them are probably wanting HRT or on it. You know, the boomers now are all seventy year old plus people, you know. they’re just using Medicare, so they’re not really much of a market right now unless they have money. so that’s scalable. So focus on that. The peptides. Focus on the complimentary services, focus on the stuff that complements HRT. Okay? The peptides, the vitamin injections, aesthetics if you wanna do if you wanna do some aesthetics, do some aesthetics. I mean I do you feel like it’s best?
Jennifer Jersan Elevate HRT (33:11.989)
If you fe if do you feel like it’s best to offer any peptide or just start with a few and kind of I don’t it people will go on TikTok and they’ll be like, this peptide and this peptide and I’m like, before you know it, you got your hands in all the peptides and I’m like, I feel like we should just focus on some of the
Justin Allan Montgomery (33:21.614)
I think you want to.
Justin Allan Montgomery (33:31.842)
Right, I think when it comes to peptides, I think it’s the less is more mentality is probably better, you know. I agree with you. There are a lot of peptides. I mean, how many growth hormone releasing peptides are there? There’s a lot. Yeah. All you need is one. You know what I mean? Tesumorin.
Jennifer Jersan Elevate HRT (33:36.458)
Mm-hmm.
Jennifer Jersan Elevate HRT (33:47.425)
Mm-hmm. Yeah.
Justin Allan Montgomery (33:50.478)
Tesumorlin is superior, works great, very few side effects, good margin on it. That’s it. Why offer Ipamorlin? Sumorlin. Why offer all this stuff? You don’t need to do it. You know, I would say offer a handful of peptides, the more profitable ones and the more in demand ones. You know? I’m not a peptide expert, but like Tesla moralin’s gonna be a good one.
BPC is always going to be a good one. yeah, a lot of people love that for injuries, you know, or the T B five hundred combination with the BPC. the the copper ones, the G HK, C U, whatever those are, you know, that works pretty well. That people a lot of people like that. you know, there’s a lot of other ones as well, but you know, I would pick five to six and see what and just and just kind of go from there. If someone asks you for something very specific.
Jennifer Jersan Elevate HRT (34:14.188)
P P C
Justin Allan Montgomery (34:42.636)
Don’t tell them, we don’t offer that. You’re gonna have to look somewhere else. Don’t do that. Just be like I could probably get that for you. Let me take a look. You know what I mean? And then Yeah. but yeah, that’s that’s what we do at my men’s health practice. We offer like four. That’s it. It’s not we need to offer. Yeah. but yeah, so basically anyways, focus on the complimentary stuff that compliments HRT. That’s how you’re gonna scale this business, okay? yeah.
Jennifer Jersan Elevate HRT (34:46.774)
Right.
Jennifer Jersan Elevate HRT (34:50.22)
Okay. Yeah.
Jennifer Jersan Elevate HRT (34:56.524)
Okay.
Justin Allan Montgomery (35:09.484)
And then fear of the unknown. Is there anything unknown here? Anything else that you’re worried about?
Jennifer Jersan Elevate HRT (35:14.1)
No, I think it’s just normal questions. Like it’s it will get better as it goes on, I’m sure. Yeah.
Justin Allan Montgomery (35:21.994)
It will. Yeah. It’s it the first couple months gonna be terrifying. It’s just it’s it’s a little terrifying, especially like there happens to be a slow month or something. You’ll be like, shit, you know, it’s gonna what did I do? we’re gonna have to be kinda lean this month, you know, things like that and stuff will happen. That’s just part of being self employed. But the thing is is if it was easy everyone would be. Right? Like the reason why
Jennifer Jersan Elevate HRT (35:26.196)
Yeah.
Jennifer Jersan Elevate HRT (35:32.695)
Mm-hmm. What did I do? Yeah.
Jennifer Jersan Elevate HRT (35:48.492)
Mm-hmm.
Justin Allan Montgomery (35:51.722)
entrepreneurs and self employed people are the people in this country who are the wealthy ones. There’s very few employed wealthy people. You know what I mean? Most of them are business owners. The reason why business owners are wealthy is because they’re willing to take those risks. They’re willing to take the chances
They deal with the sleepless nights, they deal with the anxiety and the stress and they be comp and they’re compensated for it. When you work nine to five somewhere, when you g when you leave, you’re done. You could care less about that job, that business anymore. You don’t care, right?
You’ll play yeah. So that’s that’s just part of it. Now it will get easier for you as you begin. It I think for me really I think it was probably the two year mark, between the one and two year mark, somewhere in there, when I decided to go full time in on my businesses, where the stress and the anxiety just really just went away. I just I didn’t worry about it anymore at all. Like ’cause my business was so consistent with income.
And I had another business as well, you know, and I was investing my money and stuff. So long as you do it smart, all those all that stuff should go away for you. It should. Yeah. But I think that you need to focus on you need to focus on patient acquisition right now. That should be your number one priority.
Jennifer Jersan Elevate HRT (36:56.212)
Okay.
Justin Allan Montgomery (37:05.794)
I don’t think you need to spend a lot of tr time trying to develop new services and bring in new services and offer more stuff. I don’t think that’s necessary. I think you can d you can get away with what you got right now and just get more people in the door. So that extra five to seven thousand dollars a month that you have, three thousand will go to an MA, okay? That leaves you with another two to three thousand dollars a month to invest. You need to be investing that money into marketing. You need to be trying to get the word out, you need to be
Getting people through the door. That is your goal right now. So you now have all this extra time. That’s what you need to be spending your time with on. You know what I mean? You’re gonna so you know, in a couple weeks or whatever, whenever you quit your job and you go full time on your on your business, you’re gonna go there and you’ll have no patient scheduled. What are you gonna do? Well I’m
Jennifer Jersan Elevate HRT (37:56.135)
Mm-hmm. Well, I hired a marketing person last month and she’s it kind of with the intent of building up my schedule. And so now my schedule’s booking about three weeks out. And so hopefully just bridging that gap already with getting new people coming in. That way when I am here full time into July, early August, I will have more already established and on the schedule.
Justin Allan Montgomery (38:10.285)
Yeah.
Justin Allan Montgomery (38:19.918)
Okay. Okay, so you’re booking out three weeks right now. That’s okay, great. Now that’s gonna that that that’ll consolidate down to four days, right? Now you’re full time. Yeah. That’s good. So what that means is is that you now have these people who instead of being booked out three weeks in advance, you’ll see them two days after they call or whatever, right? Now they can tell someone else. Now now your word of mouth engine now will grow a lot faster. Yeah.
Jennifer Jersan Elevate HRT (38:22.379)
Uh-huh.
Jennifer Jersan Elevate HRT (38:28.468)
Yeah. Yeah.
Jennifer Jersan Elevate HRT (38:40.148)
Mm-hmm.
Jennifer Jersan Elevate HRT (38:46.792)
Yeah. This up until I got this marketing person last month, every everything we have done has been word of mouth growth from twenty twenty three till now. Like this is the first time we’ve used a marketing person. And and I think the growth has been good and steady considering it’s only been one day a week up to this point. So
Justin Allan Montgomery (38:55.159)
Yeah.
Justin Allan Montgomery (39:04.222)
you’re you you’re doing pretty good. I mean, you should be able to double that income in within six months, I would imagine. Okay? Within six months you should be able to double. Yeah. Then you’re going to have real problems. You know. They’re good problems. They’re good problems. But
Jennifer Jersan Elevate HRT (39:10.676)
Okay. That’s what I’m hoping for. Okay.
Justin Allan Montgomery (39:23.426)
They’re real business problems. Like they’re good problems to have. That’s gonna be where shit, I need another NP in here. Like I’m working full time and now I’m booking out three weeks. Right? That’s when you’re like, shit, like I need to get someone in here s ASAP, right? Like there’s gonna you’re gonna you’re gonna have good problems. yeah, so just kinda keep that in mind. But one thing, one tip for you that a lot of MPs that I’ve talked with have done very, very well with this tactic.
And you’re you’re gonna have time, okay? So you can spend time doing this, is that begin doing some community engagement marketing. Okay, it’s free, it just takes your time. So what you want what you want to do is you wanna find some Facebook groups, okay, some next door groups, whatever, okay, some online communities that are relevant to your physical community, okay? Your town, your county, whatever. All right.
And you need to go in and you need to find these groups, a men’s group, a women’s group, whatever. You need to go in here in these groups and you need to begin participating in these groups. People ask questions, you know. Hey, I’m in need of like you’ll be amazed if these questions will come up. I’m in need of someone who prescribes hormone replacement therapy. I’m in need of a primary care doctor. Blah, blah, blah.
And if you’re in that community regularly, you can answer the question. Hey, I happen to be seeing accepting new patients right now. Here’s my website. Click. Don’t go in there and advertise your practice. Don’t do that. Don’t go in there and be like just blasting and spamming. No, no, no. You never ever do that. You just participate. And when the check when the time comes, you comment, right? You answer a question. You provide a little value. You know, someone has a question about something, you answer it. You would be amazed that if you pop your link in there, you know, hey, I am accepting new.
Patients here, you know, come come check us out. Not only will that person click it, dozens of others will as well. Okay. People will start messaging you. Hey, you know, I’ve been thinking about starting testosterone, whatever. I have a question for you. You just answer it through Facebook Messenger or whatever. Hey, book book an appointment if you want. You know, you will be amazed at how well that works, and it’s free. And you only need to do it for a little while.
Jennifer Jersan Elevate HRT (41:24.839)
Okay, that’s a good idea.
Justin Allan Montgomery (41:46.328)
You do that for a few months, you will be have so many patients. Then word of mouth starts, you can just stop doing it if you want to. You know. So just quick tip for you, that’s free. Yeah. Okay. Yeah. Right. Any other questions?
Jennifer Jersan Elevate HRT (41:52.937)
Okay.
Okay. I will definitely do that.
I think that I think we’ve covered it all.
Justin Allan Montgomery (42:02.03)
Cool. All right. Well I like the end of the episode with you asking me a question. You have question for me or a personal curiosity or anything?
Jennifer Jersan Elevate HRT (42:07.675)
If you were to pick a whole career different career, not healthcare related, what would it be?
Justin Allan Montgomery (42:13.612)
Yeah. The answer that changes. I think I was asked that maybe like a year ago or something. it changes based off of market conditions and what’s going on in the world, you know, but like I still like I think that if I was to go back, I probably would have went into either like some kind of finance or I would have went to law school. I think I would have been a good lawyer. Yeah. Yeah, and I just I just like that stuff. I don’t know. I just it just
Jennifer Jersan Elevate HRT (42:19.475)
Yeah.
Jennifer Jersan Elevate HRT (42:35.304)
Mm-hmm.
Justin Allan Montgomery (42:43.438)
Tickles my fancy and my brain, you know what mean? Like yeah. So that’s what I would have done. I I w I am telling my children not to go into healthcare.
Jennifer Jersan Elevate HRT (42:45.861)
All right. Yeah.
Jennifer Jersan Elevate HRT (42:51.953)
I tell my kids the same thing. I will support any decision except healthcare because it is a shit show. It’s a shit show. It’s it breaks my heart. Like I was never like this when I got into it, but it’s sad. Insurance has ruined it. And I’m like, I cannot, I can’t handle it anymore.
Justin Allan Montgomery (42:55.79)
Yeah. Like isn’t that sad? I it breaks my mind.
Justin Allan Montgomery (43:08.94)
Yeah, it is. It’s it’s sad. Yeah, that’s almost everyone that I tell that to, it’s the same thing. Almost everyone agrees. Yeah, I tell my kids the same thing. Don’t don’t don’t get into it. I yeah, you know, I I there’s doctors, MDs that I know and they tell their kids the same thing. Like just don’t get into healthcare, you know. sad, but it is what it is, right? So yeah. Cool. right. All right, well thank you. All right, well thank you for coming up on here on Memorial Day and if you have any other questions or ever want to do a follow up, just let me know. All right, awesome, thank you. All right, take care. Bye.
Jennifer Jersan Elevate HRT (43:14.248)
Mm-hmm. Yeah.
Jennifer Jersan Elevate HRT (43:26.16)
It is what it is. All right. Well, thank you.
Jennifer Jersan Elevate HRT (43:34.344)
All right, awesome, thank you. Bye. Bye.
