"You can get past the dead end. You can break through the ceiling. I did and so have countless others."
In this episode, Justin and Luke discuss what it takes to scale a successful practice beyond the owner. They cover hiring and compensating providers, creating clinical protocols and systems, expanding through telemedicine, and building a team that can support continued growth.
They also explore patient referrals, local marketing, increasing patient lifetime value, and new revenue opportunities that can emerge as a practice grows.
If you’ve built a practice that’s working and are wondering how to take the next step without simply adding more hours to your own schedule, this episode offers a practical look at what that transition can look like.
00:00:02:12 – 00:00:24:07
Unknown
Greetings. This is just an hour for nurse practitioner. Welcome to the Elite Nurse Practitioner Show podcast dedicated to nurse practitioner entrepreneurism and achieving financial freedom, where I talk directly with nurse practitioners who need help. Listen up. Our market is saturated. Jobs can be scarce. We are underpaid. We are undervalued. We are taken advantage of by the sharks within the healthcare system.
00:00:24:07 – 00:00:47:14
Unknown
And frankly, screw that. Sick of it. It’s time for a change. And listen, I’m here to help make that happen. We are powerful. We can forge a path. We are in control of our career and ultimately our financial and personal well-being. You do not need to submit to healthcare ministry and your doctor who you don’t have to take the easily salary.
00:00:47:16 – 00:01:08:22
Unknown
You do not have to work 50 to 60 hours a week. There is a different way. I’m here to show you that path. This podcast is written for. I have not talked to the nurse practitioners of this podcast prior to the call. Outside of an email exchange to schedule the episode. What you’re about to listen to is a consultation session between the nurse practitioner and myself.
00:01:09:03 – 00:01:31:00
Unknown
It is real. Is it scripted? It is unplanned. I have no idea what we’re going to talk about. Anything and everything can happen. During our conversation, the nurse practitioner. These episodes are struggling with an issue in their professional or financial life. They have reached out to me for help. My goal is to help the nurse practitioner with actionable advice that will enhance their professional, business and financial life.
00:01:31:01 – 00:01:59:10
Unknown
My other goal is to hopefully help my nurse practitioner, sisters and brothers build a more productive, powerful and free life. So I hope the content information within these podcast episodes does just that. All right unto the upset everyone. Today we will be talking to Luke who is a family nurse practitioner. Currently, he is operating his own mental health clinic and states business is doing well, getting assistance with hiring new providers, scaling the business so it doesn’t require his input, and streamlining his overall process.
00:01:59:12 – 00:02:20:23
Unknown
Hey Luke, are you good? How are you doing, Justin? I’m doing good, man. Thanks for hopping on here. So, yeah. Tell us about yourself. How long you been a nurse practitioner for? And I guess how you started your mental health clinic and got to the point where you’re at the other side. I’ve been a nurse practitioner since 2021, primarily worked as a nurse and then nurse practitioner in the E.R., and then did urgent care.
00:02:21:01 – 00:02:37:14
Unknown
And when I was in urgent care, stumbled across your podcast and, Com and was thinking about starting up an urgent care and then saw your model for a mental health clinic. And the more I looked into it, the more I decided that was the route I wanted to go. And I looked around my area of gone.
00:02:37:14 – 00:03:01:11
Unknown
There was, no mental health clinics around in a pretty populated area. In North Texas, and so decided to open one up in, one was there, like I said, it was November of 2024 and, March of 25. I hired, medical assistant to help out of the clinics, and she’s now kind of the office manager.
00:03:01:13 – 00:03:26:08
Unknown
And then in August of 25, I went full time, quit my job, just work at the at the at the mental health clinic, and, now I’m one year later and have more patients than I can handle. I need to hire on another nurse practitioner to, start seeing patients so that I can focus more on, the business side of things and not be swamped with patient care.
00:03:26:10 – 00:03:46:07
Unknown
Yeah, I am sure you are happy that you do not open up an urgent care. Yeah. No kidding. Every time I drive by one, I’m like, oh my gosh, if other than that, that have been a nightmare. Yeah, man, I know, I mean, I know people who start urgent cares and, you know, they make a lot of money, but man, the headaches with it.
00:03:46:07 – 00:04:01:07
Unknown
We just. Yeah, we drive me nuts. I need to. Yeah, yeah, I mean, you, me both worked in. That was enough for me. There’s no way I’d open it. Yeah, exactly. Exactly. Yeah. But, look good for you, man. So you start a cash based men’s health clinic. It’s doing pretty well. If you don’t mind. Kind of.
00:04:01:07 – 00:04:26:20
Unknown
Where are you at revenue wise, I guess. So you went kind of. You went all in on your. On your own about a year, year and a half ago. So how like, how’s it going? You want to give the specifics? Just an estimates fine. Okay. So, I’m give you kind of specifics ish. Last year, from January to July 31st, gross profit was around 105,000 this year.
00:04:26:21 – 00:04:56:20
Unknown
In that time frame, January to July 31st, we’re at about 270,000. And then, net is I think, we’re doing pretty good. I think this year it’s around 150,000 net. With that gross after operating expenses being 270, so now so you’re pretty clear, about 300,000 this year? Yes, sir. That’s what I’m, shooting for, so.
00:04:57:01 – 00:05:16:00
Unknown
Yeah, that’s good, man. I mean, that’s more money than, you know, a lot of MDS make, like. Yeah, you know. Oh, good for you, Phil, man. Oh, thank you. Very, very surprised and happily surprised to see it growing so well. And, you know, I haven’t put a whole lot of effort and, advertising a whole lot.
00:05:16:00 – 00:05:46:03
Unknown
I think last time we spoke in, August of last year before I quit, did this full time, you kind of mentioned maybe doing some billboards, just based on my location. And every time I put one up, it’s definitely bumped up. The amount of patients I’ve gotten, pretty significantly. It’s been a worthwhile investment. But other than that, I’m, you know, primarily to see patients on Fridays and Saturdays currently, and then do a wisdom business stuff on, you know, Mondays through Thursdays.
00:05:46:05 – 00:06:05:10
Unknown
Before we got as busy as I am now. Now, it’s basically just patient care, like follow up calls and things like that Monday through Thursday, and then new patients on Fridays and Saturdays. But, but before that, you know, things were just kind of grown organically. Word of mouth now feels like it’s kind of really taken off.
00:06:05:12 – 00:06:30:15
Unknown
And so yeah, now one down, how to how to proceed from here is, and get other people to start seeing patients is, top priority right now. Yeah. Okay. So let’s start first with the advertising aspect, because I think some people listening to this, would be interested to know kind of what you’ve done. So you did do the billboard thing and it did work for you, which in my experience, it either works or it doesn’t.
00:06:30:19 – 00:06:54:05
Unknown
So, I think it really depends on the area that you’re in. I think that it ultimately is going to come down to how big of an area it is. How many people in your area will be driving by that sign, etc. so if you don’t mind, maybe share some details on kind of like, you know, kind of what’s the size of the town, the region that you’re in, where did you put the billboard ad, that kind of thing.
00:06:54:07 – 00:07:24:06
Unknown
Okay. Let me see. Let me see how many people are in the county, because the county is kind of, that doesn’t have any means. Health clinics. And we’re kind of in the central location of the county. I want to say it’s like 100 and 120,000 or something like that. I guess it’s actually around 190,000 in the county.
00:07:24:07 – 00:07:42:18
Unknown
And put up the, the billboards on a couple high traffic areas, in that area. They’re not too expensive just because it is still kind of a rural county. But my next goal is to open up more on a central highway that runs through the main city. But I didn’t want to do that yet.
00:07:42:18 – 00:08:04:19
Unknown
And then get an overload of new patients. I’m trying to offload patient care, so, that’ll probably happen after I get another nurse practitioner on board, but, Yeah, that’s that’s kind of, a general overview. Yeah, yeah. Okay. That’s been kind of my, my experience with it is that the billboards tend to do a lot better in more rural areas with fewer people.
00:08:04:19 – 00:08:28:03
Unknown
Like, you would think that putting a billboard, somewhere that, you know, where there’s millions of people would be good, but it’s just it just doesn’t do well because there’s so many billboards. People are driving, right? Yeah. You know, and like, it just it just doesn’t typically work very well in very, very highly populated areas. But in more rural areas, the billboard works well because almost everyone in the county at some point will drive by it and see it.
00:08:28:03 – 00:08:44:08
Unknown
Right? So. Right. Right. Yeah, yeah. So it works. Yeah. It works really, really well. So okay. Good job there. And so that’s really the only advertising you’ve done. Now you’re just it’s just word of mouth at this point. That’s pretty much it. Yeah. And that is word of mouth and Google reviews. And people would just find us on Google.
00:08:44:08 – 00:09:09:06
Unknown
So yeah. Okay. So mostly just organic at this point. I think that, what happens with most clinics is that, typically at the very beginning is when you had to spend some money advertising just to get the word out there to make, you know, just so people realize that you even exist. And then once you hit a certain point, you have you know, so many patients that, word of mouth then really does begin to snowball.
00:09:09:06 – 00:09:26:07
Unknown
And you don’t really need to advertise that much anymore. So, you know, you got your Google business listening. I’m sure you got lots of reviews on there. You got a website, you got the SEO stuff going for you, then you got the word of mouth. So, I mean, at this point, you know, would advertising be worthwhile or not to you?
00:09:26:07 – 00:09:44:04
Unknown
I think that, you know, you’re making some decent money right now. So why not throw a little money at it just to see what happens? You know, once the infrastructure is in place to handle that new patient volume. So, you know, maybe putting another billboard up, and a higher traffic area, I would say. Why not?
00:09:44:06 – 00:10:07:08
Unknown
Because you a few thousand bucks or something. Give it a try, see if it works. Otherwise, though, you know, if you want to, you probably can get away with not really advertising much at all. If you don’t want to and save yourself the money. Gotcha. Okay. Yeah. So, now what you can do is try to start incentivizing patient referrals and word of mouth.
00:10:07:08 – 00:10:26:15
Unknown
You should definitely do that. Yeah. So do you have a referral or loyalty program or anything? I do, right now it’s kind of like, if you refer three patients, then you get 150 bucks, credited to your account to use however you want to. So, you know, a lot of guys that are on TRT will use peptides and things like that too.
00:10:26:15 – 00:10:50:03
Unknown
So, basically just give them rather than refunding them, you know, for a month or something like that. And we just give them $150 to apply to their account. However they, however they choose to you like, they don’t really. I haven’t really set up the infrastructure to emphasize that a whole lot. Recently put up just a TV screen with, a, slideshow on it in the lobby that has that on there.
00:10:50:06 – 00:11:11:08
Unknown
And I know you’ve mentioned before kind of structuring your emails, so they all include that information in there. And, I have not taken the time to do that yet, but, that needs to be a priority is getting that implemented so people can become more aware of that. Yeah. For sure. Dude, you know, always hit the lowest hanging fruit stuff first, right?
00:11:11:10 – 00:11:32:08
Unknown
You know, a mentor of mine years and years ago told me that, you know, it’s always cheaper to advertise to your current customers and to find new customers. It always is. And it’s so true. Right. So it’s always just. Yeah, it’s always easier just to increase the lifetime value of each customer and just advertise directly to them.
00:11:32:08 – 00:11:51:00
Unknown
So so email you have the slide show in your lobby is a good thing. Maybe give them like a a little mini brochure or something, attach it to their lab report when they, you know, when they’re checking out, just whatever you can do to really put it in front of their face. Have your medical assistant maybe mention it as well at checkout.
00:11:51:01 – 00:12:10:06
Unknown
I mean, just there’s just a lot of little low hanging fruit things that you can do. Just, put it in front of their face and they know that it exists. Right? Because I know a lot of, a lot of clinics, especially some men’s health clinics that, that do that and do very, very well with kind of just a patient really referral thing.
00:12:10:06 – 00:12:37:15
Unknown
Yeah. So I would definitely I would definitely hit that hard before you start, dumping money on outside marketing sources, like eating that billboard, I would just say I would double down that first, make sure that is going to optimize and ready to go before putting money into an advertising, because dude, you might not need to the clinics that the clinics that I’ve sold, for people, the people who do, you know, $1 million plus net a year.
00:12:37:17 – 00:13:14:03
Unknown
So the vast majority of those people, the vast, I mean, 90% plus, don’t advertise at all. It is almost all word of mouth now, they advertised at first like you did, but when they get to a point, they don’t need to anymore. So I think you’re probably getting pretty close to that point. So congratulations, right? Yeah, I think we should it, yeah, I definitely to emphasize that more, has definitely been a like a time just to focus on prioritizing that and then, find like newsletters like sent out like monthly or bi monthly or anything like that, to be beneficial and then highlighting that in those newsletters or anything like
00:13:14:03 – 00:13:33:21
Unknown
that for. Yeah. For fitness. Okay. Yeah. Yeah, absolutely. 100% man. Just whatever you can do to get them to open up the email to take a look at it, you know, whatever you can do, even doing like a direct mail kind of thing to all your patients, even even past patients or something kind of left, that can work very well.
00:13:33:21 – 00:13:53:18
Unknown
And you don’t necessarily have to spend money with a direct mail company to do that, because you already have all the addresses, you have all the market demographic information already, you know, all it takes is just basically printing off a bunch of letters and popping something in and just sending it out to everyone. So, Got it. Yeah.
00:13:53:18 – 00:14:10:06
Unknown
What I did with, with my clinic, it kind of in the beginning phase of it, the first year or two of it. What I did was I just paid my, I paid my niece and nephews to basically just literally just sit there and write out, like, 200 envelopes and just put a flier that put it off.
00:14:10:06 – 00:14:27:18
Unknown
I just I paid them to do it, you know, I paid them like 100 bucks. And then I had them, I had to put the stamps on it and everything, and I just then took it over the post offices, dropped them off, you know, so what happened Stuart. Yeah. Yeah yeah, yeah. Oh yeah. I got boys. They need some work to do.
00:14:27:18 – 00:14:45:03
Unknown
And they’re always looking for ways to make money. So yeah. Yeah. Exactly. You know, and pay your boys the going rate that I have that, that a, that a direct mail company would charge that way. Yeah. I don’t know, 4 or 5000 bucks and pay your kid. Right. You know. Yeah. Yeah. So, so, yeah.
00:14:45:05 – 00:15:06:18
Unknown
So I would probably do that, do the, do the email. Email. Super easy and cheap to do. And then, just at the end of calls as well. You can even bring it up yourself, the provider, you know, you guys can bring it up to I used to do that as well. So, just okay, whatever you can do to just get in front of their face if you do that, I think that you’ll find yourself getting a lot, of a lot of referrals.
00:15:06:20 – 00:15:28:18
Unknown
There’s been guys in my men’s health clinic that, they would literally refer to so many people, they were literally receiving free treatment from us, because they were just referring so many people. Right. And it was just like, dude, like, you know, like you’re basically paying for your treatment. And to me, it was it’s totally worth it, you know what I mean?
00:15:28:19 – 00:15:48:04
Unknown
Yeah. So, so anyway, so yeah, I would focus on that now let’s talk about the infrastructure though. You, I mean, you’re in need to have the infrastructure in place to handle the increased patient volume, right. If you don’t, then you’re going to be kicking yourself in the foot and just pissing people off, basically. So, you don’t you don’t want to do that?
00:15:48:06 – 00:16:09:10
Unknown
Yeah. Yeah, a lot of clinics, I’ve seen them do that where they’ll do some marketing spree or whatever, and they get all these phone calls and all this interest, and they simply just don’t have the resources or infrastructure in place to handle it. And then they found themselves literally just wasting money because they couldn’t take the patients on.
00:16:09:10 – 00:16:36:23
Unknown
And at the end of the day, it kind of I it, it can’t I mean, it it leaves a bad taste in those patients mouth and they’ll never they’ll just leave. They’ll never come back. Right. So. Right. So let’s talk about the infrastructure. So you yourself, how many more patients can you realistically take at this point? So I have, I mean, man, realistically.
00:16:37:01 – 00:17:00:07
Unknown
Like while being able to manage the business or just doing patient care, I mean, both or I mean, you have to do both. So, yeah, I mean, I can’t I can hardly take on any more patients right now. Like I’m like I said, every day I come in like Monday through Thursday and I have a list of things I need to do for the business but end up doing primarily patient care, maybe knock out 1 or 2 things in the week.
00:17:00:09 – 00:17:23:17
Unknown
So, I think we’re somewhere between 303 and 25 recurring patients right now. And I really I mean, if I, if I want to focus on the business and do a good job at making sure it’s running properly, I don’t think I can take on a whole lot more right now. Okay. How, how far out are you booking new patients right now?
00:17:23:19 – 00:17:33:10
Unknown
1 or 2 weeks.
00:17:33:12 – 00:17:55:13
Unknown
There. You there? Yes, sir. Can you hear me? Yeah, yeah, sorry about that. We’ll edit this out. I’m on this cabinet. I’m at EDS on Starlink. So every once in a while, the cloud passes by or something. It’ll probably go up. So just FYI. But anyways, question. So realistically, how many, how long are you booking out right now?
00:17:55:15 – 00:18:13:14
Unknown
About 1 or 2 weeks. So. Okay, so you’re basically right. You’re right there at the cusp of needing a new provider. There because I, I’m you’ve heard me say this in podcast multiple times. If you’re booking out two weeks flight and hire someone else. So, yeah. So you’re right there. So, so let’s talk about that.
00:18:13:14 – 00:18:36:12
Unknown
Have you have you tried hiring someone yet? No, I hadn’t, not wanted to, you know, kind of pick your brain first and make sure I had everything lined up and then order to, to, go on that track, but, never tried it. Okay. So, do you have any specific questions? Ask me first with that before we kind of dive into it.
00:18:36:14 – 00:19:00:13
Unknown
Yeah. I mean, I know you talk about pay structure a lot and kind of paying per patient, seeing whether it’s a new visit, like $100 for new visit, 50 for follow up. Let’s see here with that, with that, $100 for new patients, $50 for follow ups. I will say that that is above market rate.
00:19:00:15 – 00:19:25:12
Unknown
Okay. Right, right. Yeah. So, you know, you could get away with paying less if you wanted to, but I find that if you, if you pay your, your NP, your PA, whoever, if you pay your providers a good rate like that, they they’ll stay on board long term. And the chances of them skipping out on you and opening their own thing up is pretty low because, you know, you put golden handcuffs on them essentially.
00:19:25:12 – 00:19:48:15
Unknown
So, right. Yeah. So that’s really up to you. A lot of places pay a lot less than that. Some of the really big clinics, you know, pay 35 bucks for visits, $50 for new patients. I mean, you could pay less if you wanted to, but, $100 for new patient, $50 for follow ups is way above market rate.
00:19:48:15 – 00:20:07:04
Unknown
And it really motivates people to, you know, to actually do a good job. So, I mean, that’s what I want. I want people to do a good job and keep their reputation up. And, and not have to worry about hiring new people all the time. And, you know, I because the turnover and all that. So I’d be happy to pay, you know, above market rate, to keep that in place.
00:20:07:04 – 00:20:30:08
Unknown
Yeah. And and do and your margin, the profit still on that is still really good, you know. Right. Yeah. You’ve done the math on and I’m sure it’s, it’s still really, really good for you as the business owner. Because I mean, you know, with men’s health, you know, and weight loss and HRT and stuff like that in general, in most these patients really call and open them every 3 to 6 months.
00:20:30:10 – 00:20:52:13
Unknown
You know, so on the on an average patient for an NP to see them, you’re only paying them 200, 250 bucks for the year. Right. And then each patient you’re going to, you know, you’ll make a profit of 12, 13, 14, 1500 bucks on that. So it’s still it’s still a good state. Yeah. So, so yeah, I would say stick with that model.
00:20:52:15 – 00:21:23:17
Unknown
Okay. Yeah, yeah. You any other questions? Yeah. Let’s see here as far as, like, you know, I’ve tried to like, find referrals from other people for employees, but probably had to, posting of a job listing. Do you know, like, what’s what’s the best places you found, like place job listings? Yeah. So, most people nowadays will use things like indeed.com, you know, and, they’ll use an D or ZipRecruiter, one of those big ones online.
00:21:23:18 – 00:22:02:08
Unknown
So, I mean, definitely do that. It does cost you some money to post a job listing on, like, indeed. So it’s not it’s not free. So what you could do though, utilize the resources that you have, obviously see, you know, talk to people that, you know, first off. Right, like, if you work with some, you know, with an NP, an urgent cares and at one point or your have some friends or whatever, always try to utilize those, you know, those those first level, kind of primary contacts, first if they fall through, then then yeah, you can post an ad on indeed.
00:22:02:08 – 00:22:26:17
Unknown
But one thing you can do is, you could post also like in the lead amp Facebook group or another Facebook group or something as well. Okay. I mean, there’s always going to be NPS out there in these groups that are looking for, you know, looking for some site income. Now, the thing is, those people will probably have to be mostly probably telemedicine, probably.
00:22:26:18 – 00:22:56:19
Unknown
Unless they just happen to be in your area and you’re kind of in a rural area. So, so you might not be able to find someone posting in a Facebook group, that’s actually in your area. But dude, you never know, right? Yeah. So one thing you could do that would help offload a lot of the work for you is if, let’s say you post on indie or ZipRecruiter first, or local job posting or use, you know, use some resources that you have for, you know, funding a local MP.
00:22:56:21 – 00:23:26:21
Unknown
You post on there and it’s just not gaining a lot of traction. Because maybe you hire someone local. That’s obviously the best bet. It sounds like you still see a lot of patients in person and that sort of thing. And so, so if you could do that, obviously go that route. But if it’s, if it’s crickets, sometimes in these more rural areas, it can be pretty difficult to find someone who meets who meets your criteria, you know, someone who’s just looking for some part time work, who has a full time job, who only wants to do ten hours a week or something like that.
00:23:26:21 – 00:23:45:11
Unknown
It might be hard to find someone like that, because, I mean, at this point, hiring someone full time would just. I just think it’d be dumb to to hire someone full time. You don’t need a provider. You just don’t get that done. Yeah. Yeah. So what you could do is you could hire an NP part time telemedicine only.
00:23:45:12 – 00:24:08:06
Unknown
So wherever they’re at in your stay or their lab licenses in the state, but they, you know, they live somewhere else, whatever. It doesn’t matter. Have them only see your established patients who really just need easy follow ups, right? Like the ones who are dialed in. Who? I mean, you do men’s health, man. You know, there’s some of these visits last five minutes, right?
00:24:08:06 – 00:24:32:23
Unknown
Right. You know, how are you doing? I’m doing great. Cool. Your lab looks fantastic. Keep you on the same protocol. I’ll talk to you in six months. I mean, it’s the easiest in the world, right? So? So, like those easy patients that just need the lab work, that just need to fall so they can get their script. You know, you could start putting those people on, on a telemedicine provider and just start having them see a lot of these follow ups for you.
00:24:32:23 – 00:24:51:12
Unknown
And then you continue to see the new patients until you can find someone local, who can then begin seeing new patients in person or whatever it is that you want to do. All right. Also, some patients, they’re not going to care if they see a provider via telemedicine their first visit anyways. You know, some patients just don’t care.
00:24:51:12 – 00:25:16:04
Unknown
They just want treatment. They could care less. So, so you’re gonna have to fill that one out, but, but yeah, that would be the route I would go. If you have trouble finding someone local gadget, would you, like, give new patients like the option, be like, hey, we can get you in in person, but maybe for a week or two, or we can get you in telehealth this week with a new provider, to try to incentivize people to go see the new provider if you’re Tillman.
00:25:16:04 – 00:25:38:18
Unknown
Only at that point. Yeah, 100%. Yeah, yeah, yeah. If your line of thinking is correct. So, always try to push people over those new people. Oh, I got, we got, you know. Yeah. That’s what a deal. That’s what we did at my mental clinic there for a while. You know, people were, you know, my ma would just be I, you know, just booked out for the next 3 or 4 weeks, but we could get you in with so and so, you know, they they could literally see you tomorrow with you.
00:25:38:18 – 00:25:58:06
Unknown
You know, if you want to just get started. And I mean, more times than not, the patient just they didn’t care, you know, that. So yeah, you could, you could, you could definitely do that. So yeah, I think it’s part of what I would do. And then the patients that you have already, there are always will be some people who just want to see.
00:25:58:06 – 00:26:15:18
Unknown
Look, you know, they they’re just they’re not going to want to see someone else, and that’s fine. It’s just that’s just how it is. It’s just going to be that way. You know, my mental health clinic, I haven’t seen a new patient in years. I just I haven’t, and I’ve, I only see the follow up patients who just want to see.
00:26:15:18 – 00:26:31:12
Unknown
They don’t they don’t want to see anyone else. They’ve been with me now for six years, and they trust me explicitly. They don’t want to see anyone else. And, you know, it’s followed me. Whatever I still see in their easy visits. So, yeah. So just kind of begin talking to, you know, if you hire, providers, just start talking to your patients, you know?
00:26:31:12 – 00:26:46:09
Unknown
Hey, listen, I’m getting busy. You know, I’m booking out or whatever. So-and-so can see you for your follow up, you know, really quick if you or if you’re interested. They appear to provide the same cares I will. You have to worry about it won’t change anything. Everything looks good. You know, I kind of thing. You got to basically just convince the patient.
00:26:46:11 – 00:27:07:08
Unknown
Gotcha, gotcha. Okay. That’s good information I have so, let’s see here. We’re not like, I’m not, like, too far out of, like, a major metropolitan area. Maybe like 20 or 30 minutes. Do you still think it would be, you know, difficult to find, a nurse practitioner? Yeah. I mean, if you’re only 30 minutes outside of a pretty big metropolitan area, man.
00:27:07:08 – 00:27:30:02
Unknown
You mean, you know, with a million people or whatever, you’ll probably be able to find someone pretty easy. The thing is, though, like I said before, you need to find someone who who truly meets the criteria, right? Like someone who’s going to vibe with you, who’s going to vibe with the culture and, you know, and just the the general vibe of the, you know, the clinic.
00:27:30:02 – 00:27:48:10
Unknown
Right? You know, if you’re more of, kind of not by the book kind of guy, it’s real laid back, that sort of thing. You want a provider who who falls into that, right? You know, want textbook. You know, textbook. Nancy over there, who was a person in nursing school who is in the very front row raising her hand every single question you know, that’s that person.
00:27:48:10 – 00:28:10:14
Unknown
You know what, right? Yeah. No. Anyone listening right now, that’s who you are. That’s fine. But you just. You wouldn’t work very well at my mental health clinic, you know? So, like. Yeah. Definitely don’t want another person working here, so. Yeah. So just, you know, keep that in mind as well. Right? Like, do they actually vibe with you?
00:28:10:14 – 00:28:30:16
Unknown
And so, okay, when you begin becoming a lot more selective, you will find yourself throwing out 80 or 90% of the of the applications, or you’ll talk to me, you’re just like, man, there’s no one’s really hidden, right? Right. You could get lucky and find someone. The first, first interview. That’s possible. But, but you just got to be very, very careful.
00:28:30:16 – 00:28:49:01
Unknown
So, so there’s, you know, if there’s a metropolitan area with a million people close to you, then, you know, chances are a lot higher. You’ll find someone who meets your criteria. And another thing, too, is, you know, you never want to hire someone who do, who’s entrepreneurial, who is a go getter. You don’t want to hire someone like that.
00:28:49:01 – 00:29:06:20
Unknown
You want to find someone. Yeah. Who’s who? Just needs a part time gig. Make a few extra thousand bucks a month who works full time somewhere. You know that they’re not going to leave their job. That’s the kind of person you want. Because the last thing you want to do is train someone who’s a go getter on how to do all this stuff, and then they stab you in the back and start their own thing with the last.
00:29:07:02 – 00:29:35:12
Unknown
Right? Yeah. So. So just be careful with who you hire. You know, one question I always ask is, where do you see yourself in two years or three years? I know it’s kind of a cliche question to ask during an interview, but as a practice owner, as a business owner, it provides you a lot of information. You know, they say, you know, in three years, like, you know, I’d like to have my own practice.
00:29:35:12 – 00:29:53:08
Unknown
That’s someone you don’t want to hire, right? Right. You don’t want to hire that kind of person. So, Yeah. So find someone who is locked in at a full time job where they’re not going to leave. You know, I’ve mentioned this before in podcast. People who work at the VA are perfect. They’re not going to leave the VA.
00:29:53:14 – 00:30:14:05
Unknown
They’re just not right. They’re going to work there 20, 30 years and get their pension and their benefits. Like that’s what they’re going to do. They’re not going to leave. So that’s the kind of people you want. You want, you know, a mother of three who simply just doesn’t have the bandwidth to open up their own practice. You know, you want to say who just wants ten hours a week and wants to make a few thousand bucks a month?
00:30:14:05 – 00:30:34:02
Unknown
That’s who you want. Gotcha, gotcha. Okay. Sweet. And typically, do you find, like, you know, just one day a week for the nurse practitioner to work? Well, or will you just let them have, like, free reign if they want to work three days, whatever. And then they do that or. Yeah. Yeah, they’re going to be a 1099 contractor.
00:30:34:02 – 00:31:01:21
Unknown
And so you know, to meet the rule of 1099, they should be able to make their own schedule. Okay. Gotcha. Oh, just whatever availability they give you, you schedule patients on them. I mean, most patients are pretty flexible, during off hours, you know, so if you get a pay, you know, if you get a, if you get an employee in there or a PA or whatever who, you know, only wants to work on Wednesdays from 5 p.m. to eight, then.
00:31:01:21 – 00:31:25:07
Unknown
Okay, cool. You know, we’ll schedule patients on you during that time period. That’s fine. You know, or Saturday or something. Yeah. So just have them give you their availability and you just schedule around that availability. Okay. And what about like for all the staff like medical assistance that help with getting new patients in and stuff like that. Getting the vitals and giving the first a shot and all that stuff.
00:31:25:09 – 00:31:39:21
Unknown
If they work during like an off hour that the client typically isn’t open, do you kind of like, arrange to have a medical assistant there to help out with that? Or, you just let the nurse practitioner do it all on their own?
00:31:39:23 – 00:31:58:06
Unknown
All right. I hope everyone’s enjoying the episode so far. I just wanted to take a quick break to thank everyone listening, and also give a big thank you to all of my social media followers and email subscribers. If you haven’t done so yet, please subscribe to our email list at WWLP np.com and make sure to follow us on Facebook, Instagram and LinkedIn.
00:31:58:08 – 00:32:23:00
Unknown
Email subscribers will receive updates on new weekly podcast episodes, multiple weekly articles, we publish new courses and everything else related to helping remember all elite nurse practitioner courses are designed to help you build in each practice, increase your financial strength, and to break free from the rat race. If I can break free and the other countless nurse practitioners can break free and so can you.
00:32:23:00 – 00:32:43:01
Unknown
Additionally, please share this podcast with your other nurse practitioner sessions. And for those out there, the more NPS that venture out on their own, a stronger our profession will become. Now let’s get back to the episode. Yeah, that’s a good question. I think it really depends on who your knees are or if they’re down for that or not.
00:32:43:01 – 00:33:00:11
Unknown
I mean, if it’s an in-person visit, then, yeah, you probably want to have someone there. You don’t want to just have the NP do the check out and do everything. So. Yeah. Right. Yeah. So you’ll just kind of have to other feel that one out, right? I mean if it’s if it’s tailor made it makes no difference.
00:33:00:15 – 00:33:18:11
Unknown
Right. Patients for scheduled and then that’s it. They just log into your EMR. They see the patient. They then then you know and that’s it. Right. And then you can they will call them the next day and collect payment or during office hours. Okay. Gotcha. Gotcha. Okay. That makes sense. Yeah. But if it’s in person. Yeah, you’re gonna want to have someone there.
00:33:18:11 – 00:33:35:15
Unknown
So that would just be like, you know, your ma, you know? Hey, listen, you know, it’s Wednesdays. I really need you to work Wednesdays from, you know, 5 to 8. You know, I’ll pay you time and a half. I’ll pay you double time. Whatever. Gotcha. Yeah. You know, and for you to pay someone double time for a couple hours.
00:33:35:15 – 00:34:00:11
Unknown
I mean, come on. Big deal. Right? Right. Yeah. Right. Okay. So. Yeah. Yeah. So any other questions there? Let’s see here on the job listing itself. What do you include on the job listing? Like you include the pay, pay structure for, a contracted employee or, and what are the information you put on the job listing?
00:34:00:12 – 00:34:18:04
Unknown
Yeah, but the pay, just be transparent. Don’t waste your time. Yeah, I’ll just tell. Okay. Literally what you’re going to make and you’re going to be making, you know, two, three, $4,000 a month, just, you know, put put a range there about what they’re going to make. So that way they understand what it is they’re going to make.
00:34:18:04 – 00:34:38:13
Unknown
So, you know, in the job listing, looking for someone who is looking for, you know, production get paid for what you do. You know, we’re going to pay $100 for new patients, $50 for follow ups. We are busy. So you will you know, you will do well, provider, you should average you anywhere between, you know, like I said, $3,000 a month or whatever.
00:34:38:13 – 00:34:56:10
Unknown
Just kind of do the math on that. Most of providers that work at my mental health clinic, they work very, very part time, ten, 15 hours a week and do most of that man over a month, and they’ll make 3 or 5000 bucks, 1099 cash walk and ten hours a week. It’s it’s it’s good money. So. Yeah.
00:34:56:12 – 00:35:18:02
Unknown
Yeah. So just kind of just, you know, just give them a range and just tell them this is kind of what this this is the, this is the job description. Make your own hours. Ideally, you know, you, you know, ideally, I would like for you to be experienced in this. If not, I will train you. Yeah, that’s one of those debates where, you know, is it better to hire someone who has no experience?
00:35:18:02 – 00:35:45:11
Unknown
You can train them on how you want patients to be seen. Or do you want someone with experience so you don’t have to deal with the headaches? Right. You know, it’s plus and minuses to both, obviously. So, you know, if it’s if it was me, if I was to hire a new provider at this point, I think I would probably I would like to find someone who has experience as long as the experience they have is aligned with the way I practice.
00:35:45:12 – 00:36:06:02
Unknown
Right. You wouldn’t want to hire an employee who works at an endocrinology office, right? They’re going to be a waste of your time, right? They’re not going to prescribe technology to anybody like it would be. You’re wasting my you’re wasting my time and my money, you know? So yeah. So, you know, it’s that’s kind of one of the things is to see what kind of experience they had.
00:36:06:02 – 00:36:22:21
Unknown
If they don’t have experience with it, then whatever, man. Men’s health is super easy to do, you know, so you can just train them on how to do it. It’ll take you a whole month to train someone. All right. Man. Okay. Good news is there’s a lot there’s a lot of men’s health clinics out there, right?
00:36:22:21 – 00:36:55:07
Unknown
Especially online ones. And a lot of kids out there now have this kind of experience, you know? So, so you might be right. Okay. Sweet. Well, hopefully so, because I need to get some more patients offloaded to someone else. Let’s see here. So as far as, like, refills for prescriptions and things like that for nurse practitioners that you hire, like, right now we just have like a task and off demand or whatever that comes up whenever they’re due for a refill.
00:36:55:07 – 00:37:14:12
Unknown
And then our office manager goes through those tasks for the week or whatever, and marks everyone who’s up to date on their payments as ready to be refilled. And then I’ll just go in, like on a Friday or Saturday and knock them all out. For, someone that I hire, are they going to be responsible for the refills for their own patients?
00:37:14:12 – 00:37:36:02
Unknown
And then just on the day they work that week, just knock out the refills for that week or, how do you work that? Yeah, correct. That’s pretty much what you’re going to do. You know, one thing that we do, we try the whole just whenever you come in on the day of the week that you’re working, just go and do your refills.
00:37:36:02 – 00:37:53:11
Unknown
But we found that a lot of patients, you know, they were running out and they could wait another week for the refill to be issued. And so, so what we moved to is just, you know, the providers, we just and they would just be like, hey, since you need to refill, I’m going to send you, you know, a refill link or whatever.
00:37:53:11 – 00:38:10:01
Unknown
They can just do the e prescription or whatever for it, you know? Okay. Okay. Yeah. So you can go. You do it that way as well. But, you know, ideally at the time of the follow up, just go ahead and do the refill at the same time. Now, that doesn’t work out each time. Right. But yeah.
00:38:10:01 – 00:38:29:00
Unknown
So just try to try to ideally get the refills done is whatever you have to do to get done ASAP. So I don’t know how that works. Okay. I don’t know if you guys do refills on a daily basis once a week, whatever. So just, you know, whatever works for you. Okay. Yeah, I kind of just do, like once or twice a week, typically.
00:38:29:00 – 00:38:45:10
Unknown
And just like, you know, do you want that or do with the next seven days or whatever? Yeah. So, in the, the providers that you have that do that, they don’t have any problem like being texted when they’re not working, for a refill or. No. No. Because, I mean, you’re paying them good money, right? Like.
00:38:45:10 – 00:39:03:11
Unknown
Right. I paid you 50 bucks for this follow up. It took you ten minutes to do, like they need the refill. I’m not going to pay you to do the refill. Now, that’s part of the visit, right? So. Right. So, yeah, I’ve never we’ve nuf we’ve never ran into an issue with that at all, so I okay, I wouldn’t worry too much about that.
00:39:03:12 – 00:39:21:06
Unknown
And if and if you do refills on a weekly basis or, you know, twice a week or whatever, then during the interview you just let them know, you know, we do refills on these two days. So I just I need you to be able to just, you know, be able to sign the, you know, sign up prescription or e-prescribing or whatever.
00:39:21:07 – 00:39:44:03
Unknown
On these days, it’s kind of just part of the job. That’s, that’s that’s when we issue the refills. So, so if you could do that, guys, yeah. Yeah. And you basically should do that. It should be, should be much of a problem. Would you structure that like in the contract itself to be like, hey, we’re paying you, you know, for the, this new patient, visit this for fall visit.
00:39:44:03 – 00:40:03:11
Unknown
And one of the expectations is that you do refills. Yes. They’re required. Yeah, yeah, yeah. So in the contract, just put refills. Need to be, you know, taken care of within 48 hours of the notification. If it is not only will we just we won’t pay you for that visit for the month. Simple as that. Until the refills done.
00:40:03:13 – 00:40:23:23
Unknown
Got you. Yeah. So just maybe, you know, make it crystal clear, but I. I wouldn’t worry too much about it. It really shouldn’t be much of a problem. Okay, okay, okay. Let’s see one thing to, common question that I get is malpractice, you know, how do you how do you cover the malpractice? Oh, yeah. Yeah.
00:40:24:03 – 00:40:53:20
Unknown
You know, how do you, you know, like, how do you cover the malpractice of a contractor? You can get a group policy for your clinic and then just add providers to it. You can do that. Sometimes it tends to be a little bit of a pain to do that and actually actually be more expensive sometimes. So what I typically will do is I’ll just tell them, listen, I’ll cover your malpractice insurance and you’ll after we hire you, and then I’ll just get them a policy through, like see them in that group.
00:40:53:22 – 00:41:08:13
Unknown
You know, see them in F group has those policies that are super easy to get online. Just basically put the information in and just, you know, click submit and you pay for it and boom, you’re insured. Like it’s super easy to do. And they had that option for part time people who worked less than ten hours a week.
00:41:08:17 – 00:41:25:07
Unknown
And so I would always select that as the option and I just pay for it out of pocket once I hire them and it’s good for one year. And then just name your name, your business on that policy, as an endorsement. So that way your LLC is covered in case, you know, in case they were ever sued.
00:41:25:09 – 00:41:45:03
Unknown
And so if you’re paying for it, then when you fill the application out, you could actually put, you know, additional coverage and name your LLC as an endorsement. It doesn’t cost anything extra to do that. And so you can do that. And, I mean, this depends on the state, but usually those part time ten hour policies, man, costs 800 bucks.
00:41:45:03 – 00:42:12:06
Unknown
1200 bucks. It’s really not that much. So I just look at it as an investment. Okay. Gotcha. Yeah. That’s really that’s better to do than, like, having them add the LLC as an endorsement on their current, malpractice policy. Okay. So if if they have their own personal professional policy, okay. You know, most people are just going to be employed and their employer covers are malpractice, right?
00:42:12:07 – 00:42:35:15
Unknown
Okay. In those cases, obviously, you know, it’s not going to cover them for working for you right now okay. If they have their own personal policy, then you can just tell them, hey, listen, you know, do you have your own personal professional policy? And they say, yes, ask him who’s it through? Make sure that policy covers them for, for for doing like men’s health distortion replacement therapy, HRT.
00:42:35:17 – 00:42:58:16
Unknown
And then if it does, ask them okay, well listen, if you already have your policy, I’m more than happy to reimburse you, you know, six months from now when you renew it. But if you already have one, there’s no point in buying you a new one right now. But I need you to log in and just name the LLC as an endorsement, and then send me a copy of the certificate of insurance so you can verify that it’s actually, you know, that that you know that they actually did it.
00:42:58:18 – 00:43:14:14
Unknown
Okay. Gotcha. Yeah. I mean, a lot of MPs now have their own personal professional policy anyway. So, so you actually might find that actually works out well, but if it doesn’t, you know, just pay the thousand bucks, it’s really the only thing you’re going to invest money wise into the, you know, into the provider. Gotcha. Okay.
00:43:14:16 – 00:43:43:05
Unknown
Good deal. Another question that I had was, we have like, a lot of patients that call for add on services like, peptides or weight loss, mystery peptides have really come explore it. So, as far as, like integrating that into the nurse practitioners workflow, would you like schedule if someone like a patient call, they said, hey, I’m interested in add on CJC with IV more or something like that.
00:43:43:07 – 00:44:14:03
Unknown
Would you schedule them for the provider that they’re under to be seen by them as like a follow up visit? So they can get that, service added on or because right now, how it kind of works is they call and I’ll either get a text from my office manager or the in May work in the front desk and they’ll say, hey, so so I was looking for information about CJC, which might give me a call giving them a call, and I’ll call them back and, give them information on it if they want to proceed with it, and they’ll pay for it and get it ordered, and then they can,
00:44:14:05 – 00:44:38:17
Unknown
pick it up at the clinic or get shipped to their house. So how would you, like structure something like that, like an add on service into the employees that you hire their, their work schedule? Yeah, that’s going to be, to be dependent on, on the MP. I mean, you know, if you get them laid back one day and you’d be like, yeah, it’s like going issue them, you know, 600 microgram, that’s small.
00:44:38:17 – 00:44:55:15
Unknown
And, you know, five days on, two days off or whatever, three month supply. And they won’t, you know, then they and they won’t be, you know, an actual follow up visit. So it’s that’s going to be more case by case based off of the MP that you hire. Yeah, my men’s health clinic, we kind of just do, you know, like, hey, so-and-so’s interested.
00:44:55:15 – 00:45:13:02
Unknown
Can we, can we prescribing the peptide? Yeah, sure. Just go ahead and give them this prescription and don’t even do a visit. You know? Yeah. Yeah. I mean, this stuff is so safe. I’m not really too worried about it. Yeah, but, but, yeah, it’s going to be solely dependent on the provider. So, so, yeah.
00:45:13:02 – 00:45:34:08
Unknown
So you have to just ask them what you know, what they’re comfortable with, etc.. They have to do a quick follow up visit or whatever. I would say something like, you know, it’s $100 for new patients, $50 for follow ups. That’s for our men’s health testosterone program. But sometimes they get like a peptide or something. And the visit literally lasts like five minutes.
00:45:34:10 – 00:45:48:17
Unknown
You know, we’ll pay $25 for those. It’s a five minute quick little visit for you. Make 25 bucks. You know, you do something like that. Yeah. You go for. That makes it, you know, a question of hiring.
00:45:48:19 – 00:46:06:19
Unknown
Let’s see here. As far as hiring goes, I’ve heard some of your advice on previous podcasts about, like, interview questions and things like that to make sure they fit in with your clinic. But you mind elaborating on that a little bit more? And, maybe give us some advice on what kind of questions to ask to see if they fit fit in.
00:46:06:19 – 00:46:32:04
Unknown
Well with, well, I guess with the yeah, the clinic vibe and. Yeah. So obviously the one I mentioned, right where you see yourself in two years or whatever, you know, get a good ride. And do most of my interviews with, with providers are extremely informal. You know, it’s just more or less me talking with them, you know, just feeling them out.
00:46:32:04 – 00:46:57:01
Unknown
I don’t really have a list of specific questions because it’s more it’s like you and me talking right now, you know, I just I just talk with them for 30 to 60 minutes. I give them a rundown on how it works. Do they have any questions? Are you comfortable prescribing testosterone or whatever? Off label? You know, a lot of stuff we do here is considered FDA approved, you know, for what we’re doing.
00:46:57:01 – 00:47:15:17
Unknown
We’re practicing outside of guidelines. Are you okay with that? Because if you are not I’m not going to heart. I don’t want to waste my time. Right, right. Like, yeah. So just like, be upfront with them, you know, tell them if you are, if you follow the guidelines. I make no money and I can’t justify hiring you and I am paying.
00:47:15:19 – 00:47:41:20
Unknown
You will be in and out of here. It’ll be a waste in both of our times. Right? So, so you kind of just have to just really feel them out on it and just. Okay. You know, I typically, I don’t mean I cuss, but I don’t cuss, like, a lot, a lot, but, I mean, I do, I do cuss, and so I do cuss during the interview because I want to feel them out.
00:47:41:21 – 00:48:14:00
Unknown
I want to make sure, yeah, they’re going to vibe with with my practice, you know, that could be seen as unprofessional and frankly, if you think it’s unprofessional, I don’t want to hire you, but you don’t. You’re you’re not going to fit in well, because that’s how the patients talk to this. Exactly. Right. So, so, you know, you kind of test them, you know, you throw, the F-bomb or something like that and just see how they react to it.
00:48:14:02 – 00:48:33:02
Unknown
And if they respond back in the end, they throw a customer here or there, then they’re they’re probably going to be kind of a cooler person to hire. Right. Right. So, so just little things like that. Your whole goal here is to feel them out, to make sure they’re going to fit in. They’re going to show up and do their job well.
00:48:33:02 – 00:48:58:06
Unknown
Right. You know, ask them about their experience, all that kind of stuff. And you want to make sure that they are going to be okay prescribing testosterone and seeing patients. The way you see patients, you know, more of the wellness model versus the endocrinology or the urology society model. Gotcha, gotcha. Do you have them, like, follow you for, a couple patients?
00:48:58:06 – 00:49:16:07
Unknown
Whenever you do, you hire on anyone or, you know, follow someone else. If you have other providers working for you just to kind of get the workflow there and things like that. Correct. Yeah, yeah. So, you know, at the beginning, you know, I had the providers follow me for 2 to 4 weeks, you know, and, you know, I paid them for their time.
00:49:16:09 – 00:49:39:05
Unknown
You know, I assume, you know, during training, I’ll pay you $75 an hour. You know, just kind of, you know, I’m sure you follow me as you see the sick patients, that kind of thing. I’ll pay, you know, I’ll pay five bucks an hour. Super easy. Basically, sit there and watch me and, you know, we’ll do it for a couple of weeks, and then once you start feeling comfortable, we’ll, you know, we’ll let you see some patients, and we’ll just schedule really easy patients on you it for super simple stuff.
00:49:39:05 – 00:49:56:16
Unknown
And I’m always available, via text or a phone call if you, you know, have questions on how to, you know, let’s say you a patient’s bloodwork comes back. It’s all funky. You know, how how do you approach this? Just just text me or call me and we’ll, you know, we’ll address that sort of a thing. So that’s kind of that’s kind of how I train them.
00:49:56:18 – 00:50:16:01
Unknown
You know, I wrote out like some basic clinical protocols at one point. And so they have like some basic clinical protocols to follow, you know, for men’s health, if, if, if a patient’s testosterone is over, you know, 750 total in their free testosterone and over 16 or something, and then they don’t really qualify someone like that, put them on Clomid as an example.
00:50:16:01 – 00:50:35:09
Unknown
Right. You know, just really basic workflow kind of things. So just kind of, you know, type out very, very brief clinical protocols and how you like patients to be seen, you know, even use ChatGPT or Gemini or Clot or whatever to help you with that. And, okay. You know, once that’s built out, it’s built out.
00:50:35:09 – 00:50:51:13
Unknown
You have it now. So every single time you hire a new provider, you just like, here you go. Here’s the clinical protocols. I want you to follow this clinical protocol. I don’t really want you to deviate from it. And I don’t want you following endocrinology or urology safety guidelines. If you do, none of these patients are going to be treated right?
00:50:51:14 – 00:51:12:13
Unknown
Right. Gotcha. Okay. Yeah. Sweet. The clinical protocols already developed. Unfortunately, we in Texas are going to have a, a doctor that says you can prescribe here. So I wrote all those out when I was looking for one is to have them on board or whatever. But, good thing about that is, like I said, with the raid they’re already making, they’re.
00:51:12:15 – 00:51:33:02
Unknown
Well, it’s they’re made. They’re made. I mean, you you kind of have to, you have to have those things developed if you want to build a business that, that’s going to scale and grow. It’s just it’s really not right. Really not negotiable. So, so just look at it as a long term investment, into your business.
00:51:33:04 – 00:51:54:17
Unknown
Okay. Gotcha. Gotcha. Along those lines, too. I’ve been working on getting some, like, standard operating procedures done, kind of like you mentioned before. In other podcasts where, you know, when you’re doing a task, you just go through and scream, record it and, narrate it and that we have it on hand for, for future reference for new providers and things like that.
00:51:54:19 – 00:52:14:09
Unknown
I think I have most of, most of the critical stuff down for like a nurse practitioner, but is there anything in specific as far as like standard operating procedures go for a new hire or practitioner that you would recommend, like making sure not to overlook? It’s mostly the clinic. It’s mostly clinic. Clinic. You know, it’s it’s predominantly clinical.
00:52:14:09 – 00:52:34:00
Unknown
When you hire a provider, man, they don’t really need to know how your practice operates. You know, that’s for the medical systems, the receptionist and the office manager, etc. all they all they need to know is how do I treat the patient? And I work the EMR, how do I send the script in or whatever. Like that’s that’s basically it.
00:52:34:00 – 00:52:55:12
Unknown
So it’s it’s almost entirely clinical, you know, how to work your EMR and that sort of thing. I mean, nowadays, do most providers should be able to hop into an EMR and figure it out quickly? Right. And it would take you an hour to walk through an EMR with someone. Right? You do that during training? Yeah. So, so you don’t need a whole lot of protocols for providers.
00:52:55:12 – 00:53:12:16
Unknown
Most your, most your standard operating procedures are for your staff, not your not your providers. The clinical protocols are okay. Gotcha. Gotcha. Okay. I see.
00:53:12:18 – 00:53:33:12
Unknown
And paying them, I pay a monthly. Okay. Just pay them. Okay. Gotcha. Gotcha. Yeah. The same thing. Yep. Just pay them every month. If there are 1099, do they don’t need a bunch of paperwork or anything like that. It’s super easy. You literally just you haven’t signed a contract. Okay. And then you just get there, you know, you get their bank information so you can make a deposit every single month.
00:53:33:12 – 00:53:53:11
Unknown
And the measures that you just pay them every single month, you have your office manager go through their schedule at the end of the month and calculate out how many patients they saw, and then that’s what you pay them. It’s like it’s it’s that easy. You pay them and then that’s that’s it. So, literally all you have to do, man, it’s hiring a 1099 NPS, probably.
00:53:53:16 – 00:54:10:15
Unknown
It’s so easy to do. Okay, awesome. That was one of the questions I was going to ask. So, that you don’t have to fill in, like, is it any of the paperwork due to, to have to fill in anything at the end of the year for, for tax purposes, like any tax forms or anything like that for 1099.
00:54:10:15 – 00:54:48:13
Unknown
Yeah. Your accountant should issue them, like a K-1 1099. Whatever it is, it just basically says how much you paid them and that’s it. Okay. Gotcha. And they file their own taxes. They handle all that stuff. You have to worry about it. Okay. Yeah. So I just make sure that what I would do to let you hire a provider, you know, once you let them go, it’s a good idea to audit most of their charts for the first month or two and make sure that they’re actually you know, is treating people and not not just looking for an easy check.
00:54:48:15 – 00:55:11:02
Unknown
We had one, right? We had one employee one time that we hired man. And she just she would not prescribe anyone. Testosterone at their level was, like, greater than, like, 400. And I was just like, honey, I’m not I’m not paying you to do the right thing. According the urology society. I’m sorry. I’m not like you owe me for my time.
00:55:11:02 – 00:55:34:04
Unknown
And you are wasting my money. And I fired the other girls. Like, now we’re, you know, we’re done charging patients on you. Whatever. Yeah. Yeah. Like you a complete waste. And then she. And then, like, then she had her lawyer get involved, and they wanted a crash exit thing written, blah, blah blah. I’m like, honey, you think I care?
00:55:34:04 – 00:55:53:18
Unknown
Just get out of here. Like, you know, your non-compete I’m looking at. I don’t care, I don’t care what you do. Go get out of here. You know? So, yeah, he was. Yeah, I was in. I would be competing with your business anyways. If she’s now prescribing for less than 400 on the test. Exactly. So she was tech.
00:55:53:20 – 00:56:10:08
Unknown
She was textbook Nancy, dude. And I learned my lesson. I’ll never hire someone like that ever again. Ever. So, did you get an idea that she was like that when you interview, or is that kind of like, I kind of. But she told me she had experience with HRT and all this stuff, and I was kind of desperate.
00:56:10:08 – 00:56:34:17
Unknown
I was like, we just really need someone. And and and it bit me. And so that’s another, another lesson to do not be desperate. Wait. Okay. All right. Might be that’s a good thing to keep in mind, because right now I feel kind of desperate. So yeah, don’t don’t get desperate with hiring someone. Really, truly it is. It is better to just wait a month or two and hire the right person.
00:56:34:17 – 00:56:58:18
Unknown
Trust me. Gotcha, gotcha. Okay, good. Good to know. Yeah, yeah. So that’s pretty much a crash course on how to hire an MBA dude. But yeah, no kidding. Do you have any other questions in terms of hiring someone? I think we, I think we covered most of it. Has most of it. I well, let me see if.
00:56:58:19 – 00:57:16:20
Unknown
I guess, no, I think that’s pretty much everything I had questions about as far as hiring someone. Answered everything. Yeah. Yeah. I mean, obviously, dude, you you obviously have a business that’s working. Well, I mean, you’re, you know, you’re going to clear almost $100,000 this year profit and you’ve been open for a couple of years or whatever.
00:57:16:20 – 00:57:44:13
Unknown
And so, you know, you’re obviously doing well. You obviously know what you’re doing here. So you, you got a business that’s actually functional and that’s working. I think that just the bottleneck for you right now is just getting someone to start seeing patience for you. And we just talked about how to do that and, you know, hire someone, give them ten hours a week once they’re, you know, once they’re for hire another one.
00:57:44:15 – 00:57:58:06
Unknown
Okay. And then want to know, like, our two at a time, just do one until they’re filled up to you and then move on. Yeah, exactly. Man, do one at first so you can just kind of get your feet wet with it. So you go, you know, so you just get a good idea of how it’s how it’s going.
00:57:58:08 – 00:58:18:06
Unknown
And then once they’re once their schedule starts filling up, that’s when you’re gonna want to hire the other one. Okay. Yeah. So, I mean, your goal ultimately made, I think your goal should be, is to have two providers working for you ten hours a week each. You know, within the next 12 months. I would say that should probably be your goal.
00:58:18:07 – 00:58:42:23
Unknown
You okay? Probably have the patience already to do that if you wanted to. I mean, you could offload 20 hours of work a week to another provider right now. I mean, if you could do that, that you could do it faster if you want. That’s just going to be ultimately, it’s going to be up to you. When you do hire a provider, you know, another NP, your margins are going to be cut down by about 20%, give or take.
00:58:43:03 – 00:59:09:18
Unknown
So, so just you just plan on that. Yeah. You will see a small dip in, in your net income when you, when you do this. So don’t be surprised. But think of it as an investment because it will pay off. You will get much more of your time back. And then right when in a very short period of time, you’ll be making just as much money as you are now.
00:59:09:18 – 00:59:29:14
Unknown
But working half as much. So. Okay, that’s that’s kind of your objective. And then that way you can start working on the business and really, really focus on patient acquisition. You know, so like the two things that you need to focus on right now is getting yourself out of the day to day work. And hiring a new hiring.
00:59:29:14 – 00:59:47:17
Unknown
Another NB is how you’re going to do that. And then, and then patient acquisition, how do I how do I start filling up their schedules and how do I fill up the next person schedule? Like how do I really get this thing rolling? I was going to be your two big focus points over the next 1 to 2 years as you scale and grow this thing.
00:59:47:19 – 01:00:12:00
Unknown
And then the third thing too, that you should be focusing on as well, is how am I going to increase the lifetime value of each individual customer? What are additional questions? Sell them on to you know, let’s just say for just easy math here, let’s say that each patient nets you $1,000 a year, right? You know, you profit $1,000 a year off each patient, which sounds about accurate.
01:00:12:04 – 01:00:40:15
Unknown
If you have 350 patients. How do I get that? How do I get that from 1000 to 1100 or 1200. How do I do that? That’s all going to be the low hanging fruit thing that you should focus on over the next years. Well, you know, how do I do that? And ultimately that’s going to come down to selling them on, selling them on additional services or products that are complementary to what they do, or increasing your price by 5 or 10%.
01:00:40:17 – 01:01:03:15
Unknown
Okay. Yeah. And increasing your price by 5 or 10%. Usually most people don’t bat an eye at a 5% increase. Most people do it. So you might find yourself, you know, six months from now, maybe. Considering that, I would say really, really consider increasing your price by 5 or 10 bucks a month, most people will not really notice it.
01:01:03:20 – 01:01:13:14
Unknown
And for you as the business owner, you know, you’re talking about an additional 20, $30,000 in your pocket.
01:01:13:16 – 01:01:30:12
Unknown
Gotcha, gotcha. Yeah. So, any other questions? Let’s see. Oh. So again, write down some notes. What you’re saying here.
01:01:30:14 – 01:01:45:12
Unknown
I think that covers most of what I, what I need right now is just really trying to really get someone hired. And if you have the best way to do that and, what steps to take afterwards? So you you’ve kind of answered everything that I, I have a question over. Yeah. No, I think we covered pretty much the majority of what you need to know right now.
01:01:45:12 – 01:02:10:14
Unknown
At this point. You know, you’re at, an important juncture. And so, yeah, I wish you the best of luck with it. Like, they they appreciate that for sure. Like the in the episode with you asking me a question. You have a question for me, a personal curiosity or something like that. Okay. So let’s see, if you lost everything, had to start over from scratch.
01:02:10:16 – 01:02:31:22
Unknown
What would you spend your time doing day to day to get back to where you are now within 3 to 5 years? That’s a good question. I would figure out the biggest, the most, the most high ticket service or product I could develop. And who am I going to sell that to? I got I lost everything.
01:02:31:22 – 01:02:59:10
Unknown
That’s what I would really be focusing on right now. Like I would be focusing on more of like the real high ticket stuff. Gotcha. You know, either high ticket consulting or, you know, high ticket business consulting or high ticket like, concierge care or something like that. I feel like that at this point in my life, and from, you know, people I’ve seen and even things I’ve done myself, there’s a huge market for really high ticket services and products out there.
01:02:59:10 – 01:03:18:13
Unknown
There’s a lot of people out there that have a lot of money, and they’re willing to spend that money because they don’t know what else to spend it on, you know? I mean, you have a net worth of ten, 20, $30 million. Money is no object anymore. You don’t care, you know, spending on whatever you want. Right? And so, there’s a lot of people out there that have that kind of money.
01:03:18:15 – 01:03:39:10
Unknown
And so I think that’s what, that’s what I would for if I, you know, if I start all over, that’s what I focus on. Hell, I’m not even starting all over. Right? So, yeah, yeah. You think are you going to if you do that, do you think you’ll do you like the the concierge care yourself, or is this something you’re interested in doing still, like research practitioners perspective.
01:03:39:10 – 01:03:59:22
Unknown
Or you can get done with, patient care. Yeah. So, I mean, I have a few high ticket concierge patients that I, you know, that I see, I have kind of implemented it more or less under the table at my mental health clinic for some of the high rollers. And so we have eight, right? Guys. And, you know, it’s, it’s very, very profitable.
01:04:00:00 – 01:04:32:08
Unknown
And, and. Yeah. So, yeah, I’m toying around with the idea of a, this would be separate from elite. Envy has nothing to do with lead me, but, so it can be a completely different business model where, me and a buddy, you’re going to develop a hopefully we’re going to develop this, redevelop a very high ticket, franchise, more or less for, for clinic owners where they want you to get a great high ticket concierge executive health into their into their business.
01:04:32:10 – 01:04:49:06
Unknown
And then we’re going to create, like, a franchise model for that. And then we’ll create the lead generation tool as well to then basically, you know, you become a franchisee, and we’ll charge like, you know, $10,000 or something like that to become a franchisee. We do all the clinical protocols. We need to do all the business infrastructure.
01:04:49:06 – 01:05:12:17
Unknown
We give you all of that stuff. But this isn’t an education company. This is, this is a business, a business thing. And so we give you all the business infrastructure to to integrate this into your practice. And then, and then we also then feed you the leads for those high ticket concierge patients into your practice for, like, a monthly fee of, like, 500 bucks or something like that, to cover our marketing expenses to a defeated elite.
01:05:12:17 – 01:05:28:07
Unknown
So that’s kind of an idea. Then turning around with and kind of starting to work on. So we’ll see that. That’s a cool idea. But I was wondering why you haven’t, like, done like a franchise with your mental health clinic or something like that, because you only have like two locations, right? Correct. Yeah. The. Yeah.
01:05:28:09 – 01:05:51:14
Unknown
Okay. That was. Yes. There’s a, there’s that some thought about. Sorry. Was that ever something you thought about doing was like making that into a franchise too or. Yeah, I thought about it, but, I just feel like there’s so many men’s health clinics and franchises out there now. I mean, there’s a lot of them out there, you know, like game, right one, you know, and that’s then there’s, there’s there’s definitely other ones as well.
01:05:51:14 – 01:06:09:08
Unknown
And so I just feel like it’s, it’s a market that, I don’t know, I just feel like if I try to break into it, it would just be, it would just be more difficult than I think it would make you for it to be worth. And so I rather try something. I’d rather try something new. And so that’s kind of where I’m thinking for, for the executive health thing.
01:06:09:10 – 01:06:27:04
Unknown
So. Cool. Awesome. This is like an awesome. Yeah. Yeah. So if I launch it, you’ll see ads for it. I’m sure we got some, great question man, I appreciate that. So cool. I will listen, if you ever want to do a follow up, let me know. You know, I think that I think for 12 months and, you know, maybe we can do a follow up and see where you’re at.
01:06:27:06 – 01:06:54:05
Unknown
It sounds good. Thank you. Just. I really appreciate your help and, all your help over the years of getting this business up and running, so it’s been invaluable. You’re welcome. Appreciate it. Man. I. Yeah. All right, no problem everyone. Thanks. My thank you for listening to the show. The legal disclaimer the content of this podcast is meant for informational entertainment purposes only and should not be used as legal, financial, medical, regulatory or practice specific advice for information pertaining to your specific legal, financial, medical, or practice specific needs.
01:06:54:05 – 01:07:11:19
Unknown
Please be sure to consult with your lawyer, CPA, medical director, and or your States practice laws and the most up to date clinical guidelines. As always, do your due diligence when it comes to any information found online in podcast. The content in this podcast is copyrighted by Galaxy Medical Southwest 2023, and it cannot be duplicated, rebroadcast it, or reproduced without our written permission.
