"You can get past the dead end. You can break through the ceiling. I did and so have countless others."
In this episode, Justin is joined by Salina, a family nurse practitioner who has built a successful DPC and wellness practice. They discuss expanding the practice with additional providers, creating new service lines, increasing patient lifetime value, and using a lean business model to grow without unnecessarily increasing overhead.
The conversation also explores Salina’s interest in expanding into men’s health, how to structure and compensate a part-time provider, and how building a team can create additional revenue without requiring more of the owner’s time. Justin and Salina also discuss whether pursuing another certification makes sense when it doesn’t directly support the future she wants to build.
For nurse practitioners who have already built a practice and are thinking about what’s next, this episode offers a practical look at scaling with intention, staying aligned with your goals, and building a business that creates more freedom over time.
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 – 00:01:56:12
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 Amazon everyone. Today we’ll be talking to Selena who is a family nurse practitioner. Currently, she is operating her own DPC and wellness practice where she focuses on primary care services, hormone replacement therapy, and a variety of other wellness services.
00:01:56:13 – 00:02:20:23
Unknown
She is needing assistance with what direction her practice should go. Hiring another nurse practitioner and how she can utilize her new upcoming psych certification in her practice. Aisling, how are you? I’m good. How are you today? I’m good. Thanks for hopping on here. So, tell us about yourself, Ellie, the nurse practitioner four. And then tell us a little bit how you kind of went from being employed to, running your own DPC practice.
00:02:21:01 – 00:02:41:12
Unknown
So I’ve been in health care since I would say I was 11. I used to go to nursing homes with my mom, actually pushing the patients to to bingo or to lunch. So that’s like my earlier, just experiences with health care. And when I graduated high school at 18, I got my CNA and then a couple of years later got my LPN.
00:02:41:14 – 00:03:01:18
Unknown
Then I got my earn at 24. And then I was like, I’m done. I’m completely done. There’s an incident at the hospital. I was trying to tell the doctor what to do. He didn’t listen to me. My patient died. And so I, that night, the next day, I started school for my masters. So I did my masters.
00:03:01:20 – 00:03:21:20
Unknown
In 18, I finished as a family nurse practitioner. I worked in. As soon as I finished, I got a job at, like, a federally qualified clinic. So it’s more of a local clinic just a few minutes from home. So it help with the work life balance from going from 12 hour shifts at the hospital, and med surge to doing the primary care part, which I always love to do that.
00:03:21:20 – 00:03:41:19
Unknown
Anyways, just having so many years in, in the industry. Anyways, after about three years of doing that, I was working for a boss who just really wasn’t good. He would hire medical assistance that had never had experience and so they were actually can maybe he met him at a restaurant. He’s like, oh, you look nice. You should be a medical assistant.
00:03:41:21 – 00:04:01:05
Unknown
So just dealing with that in the beginning, I always reteaching people. I had been a director of nursing over a nursing home, so I knew a lot of the administrative policy stuff. So I kind of fell into opening my own practice just because I figured I could do a lot more with just the things that I had accrued over my healthcare career.
00:04:01:06 – 00:04:22:07
Unknown
So that’s how that started. Yeah. Okay, so you’ve been, you’ve done the full gantlet of nursing, CNA, LPN, CNA, LPN, Director of Nursing Methods. Yeah, all of it. Yeah, yeah. Okay. So you got a unique perspective. You got a unique experience I’m sure. I mean, you know, you can relate. You mean you can relate to everyone, right?
00:04:22:07 – 00:04:46:01
Unknown
I mean, you’ve been there. Yeah. So, that’s a pretty powerful, powerful skill to have. Really. So, Yeah. Well, good for you. Okay, so you started this practice when, 2001, or 2021. Actually, I started right after the pandemic. So when the pandemic happened, as I’m sure a lot of people had that transition in terms of going into their own thing, already as nurse practitioners.
00:04:46:01 – 00:05:07:17
Unknown
But when the pandemic happened, there was so much confusion in the building because I didn’t have a boss that did a really good job managing. The medical director, he was already 75. His son was a CEO. So there wasn’t a lot of guidance. And so I kind of helped them to navigate the whole process, putting in policies, calling the patients, rescheduling, doing all of that.
00:05:07:19 – 00:05:29:00
Unknown
And, it was during that time that I was like, I can do this. You know, I could I could open my own thing. So that’s that’s how it kind of started. Yeah. Okay. So you’ve been open for about 4 or 5 years now. When were you able to quit your job and go full time into the business?
00:05:29:02 – 00:05:54:13
Unknown
So funny story. I know there’s a lot of people that are trying to figure out, like, how to transition the non-compete. So my non-compete was for ten miles, and so I opened up in, like, a neighboring city, my official practice location, which was just, a lease. I actually never saw any patients there. I opened up, signed a lease, and there was actually me and another nurse practitioner who was still a student at the time, finishing up.
00:05:54:17 – 00:06:16:23
Unknown
So we opened together. But then she I talked to a lawyer, and, he was just like, no, you should probably not do it together. Like, just create two LLC and work together. So when I approached her with that, she decided that she didn’t want to continue because she didn’t want to do the work. I hate to say it like she it was just too much, instability for what she really wanted.
00:06:16:23 – 00:06:41:14
Unknown
And so we separated amicably. And so I kind of continued on my own eventually, I’d say about three months. Then I couldn’t make it to the other location just because I was working, because I didn’t want to drive there. So I ended up renting out a room. It was about 100ft². I just put a exam table in there and a desk, and I did that for a full year.
00:06:41:14 – 00:06:58:13
Unknown
And I just saw patients on my lunch break, so I didn’t tell them. They didn’t say anything about it. So I’d say about two and a half, three years. And it was getting to the point to where I was seeing patients on my lunch break, which was 12 to 1. And then I go across, after I leave work, I go and see patients.
00:06:58:15 – 00:07:14:07
Unknown
And I have probably about 50 patients. I hired a medical assistant, and I realized that I needed to go more full time. So about three years and I went full time. So that’s about two years ago. And I ended up buying my own building as well. So there a lot of a lot of things in there.
00:07:14:09 – 00:07:29:22
Unknown
So yeah. Good for you. Yeah. It was my building is across the street from my previous medical office that I worked at as an employee. So they wouldn’t they don’t want me to leave. So I said, well, my building is across the street and I don’t want it to be a conflict. And they’re like, no, no, no, it’s fine.
00:07:30:00 – 00:07:51:06
Unknown
Well, because they were married insurance and I wasn’t billing insurance, so it wasn’t really a huge competition for them since they were managed managed Medicare. So. Right. Right. Yeah. Yeah, I think that I think you did the right thing, not worry about the non-compete, just doing it. I mean, am I supposed to give legal advice on this podcast or through Eve calls or anything like that?
00:07:51:06 – 00:08:10:02
Unknown
You know, but like I always tell, like, so someone ever emailed me about or non-compete or whatever, I always basically start, you know, I start with, okay, if it was me, I would just do it, like, don’t worry about it. You know? I mean, the chances of them finding out, I mean, is, oh, you run your mouth.
00:08:10:06 – 00:08:26:13
Unknown
I mean, they’re probably not going to find out. And if they do, and sometimes they don’t care. Like, as long as it’s not directly conflicting, like they just correct, you know? Right. If you’re working for a primary care practice that accepts insurance and you’ll open a primary care provider that accepts insurance down the street, and yeah, that might be an issue, right.
00:08:26:13 – 00:08:45:16
Unknown
But like if you’re working for a hospital or a primary care practice or urgent care or working in the E.R. or something illegal, start a cash based practice. They don’t care. It’s not competition. Right. So it’s good for you. You just did it. That’s how you should do it. That’s my. That’s what I usually advise people to do.
00:08:45:18 – 00:09:05:01
Unknown
So. Yeah. Good for you. Okay, so obviously worked out for you. So. So, so now you’ve been doing this, full time for 2 or 3 years now. You own your own building. Good for you. What you should do if you’re really gonna, you know, really go all in on this. So good for you there.
00:09:05:03 – 00:09:23:17
Unknown
How is business in general right now? Now, you’re you’re a solo provider. What do you do in revenue wise, if you don’t mind? Just came on. Oh, of course I would like to go back, because I know that on a lot of the podcasts, you talk to people about renting. But in my case, I lived in such a small city.
00:09:23:23 – 00:09:48:09
Unknown
It has about, I don’t know, 30, 50,000 people is not a lot. In in the middle of I always like to say the heart of Florida. So the I literally found a building and it’s to, like it has two suites and both suites are 1200 square feet each. And it had already been a previous medical office, which is crazy.
00:09:48:14 – 00:10:08:00
Unknown
So it already had the rooms and the, the all the things already there. And I ended up getting it for like 200,000 including like the lot. Right. Including like so I just wanted to say that allow for people who were kind of like, well, I don’t know if I should rent to this, like, it’s okay to buy it.
00:10:08:00 – 00:10:26:01
Unknown
And so I actually rent it out. In the beginning I had like an aura, a tenant already ready to sign up. So I’ve had the same tenant for five years because they’re like a national train chain, brand. So it’s kind of like like that paid for the mortgage while I was still building my practice. So I wasn’t really nervous about it.
00:10:26:03 – 00:10:49:03
Unknown
And it’s in the heart of the city, so it’s at a major four way intersection. So I never really did billboards and all that stuff. I did put a couple signs out and that. So I get a lot of my advertising from. So yeah, good for you. You did the right way. That’s more. Yeah. Yeah. I mean, if you’re going to like, even if you could buy a building and you can lease, you know, another space in it to pay for the mortgage, I mean, it’s a no brainer to do that, you know.
00:10:49:03 – 00:11:06:11
Unknown
So yeah. Good for you. You’re building equity into, you know, you’re building equity in, in a location. I’m sure it’s probably already appreciates my already worth more than what you bought it for, I’m sure. Oh, definitely. Yeah. You know, hell, probably maybe even double what you paid for it, right? So you got a hell of a deal.
00:11:06:13 – 00:11:29:14
Unknown
Pretty close to the village itself. So, of course, several years ago, like it’s already. Of course, I’m sure equity has is paying for itself. Yeah, yeah, yeah. Good for you. Yeah. I mean, the opportunity that you, you know, you had isn’t very common. It doesn’t come around very often, but like, you, you you saw the opportunity took advantage of and you didn’t hesitate.
00:11:29:14 – 00:11:57:08
Unknown
So that’s that’s really what you should do in business. I think people overthink stuff. You know, they get analysis paralysis and then the opportunity then goes by and an opportunity never comes around. I mean, the thing is, is that in life in general, right, like opportunities come and go and sometimes you get an opportunity that’s really a once in a lifetime opportunity, and you really should take advantage of it if you can, because that opportunity is going to come around again.
00:11:57:08 – 00:12:17:07
Unknown
And and I think a lot of people think that it’s going to and it’s not like this is why you hear these once in a lifetime, once in a generation opportunities, and you got to take advantage of it. When it comes to business investing and just, you know, other things in your life as well. So, yeah, I commend you.
00:12:17:07 – 00:12:37:10
Unknown
Good for you. So, so revenue wise, how are you doing in your business? So my first year I had a couple of patients, but I wasn’t really doing anything I like. I started with family, and then just to kind of get the kinks worked out and how to order labs and draw blood. And funny enough, that was my biggest concern was drawing blood.
00:12:37:10 – 00:12:59:06
Unknown
But obviously I figured that out. So the first year I made probably $2,600, just again, because I wasn’t really doing it. And then the next year it kind of went up and the next year went up. So now I’m averaging between 55 and 60 a month, so that if I have $60,000 a month, gross. Yeah. What do you net and what’s your margin for 50%?
00:12:59:08 – 00:13:15:18
Unknown
I think close to a 40%. Yeah. I have a really low overhead. So again, I don’t worry about like the rent because I have the tenant, my staff, I have two medical assistance. They both work part time, but I pay them more. But I have a higher expectation for what they’re going to do during the day.
00:13:15:20 – 00:13:37:00
Unknown
So. And they’re both part time, so they kind of. Yeah, they stagger their shifts so that things recover. But, yeah, I don’t really have a lot of expenses, except for, of course, when you buy your weight loss medications or your HRT stuff, like you have your margins on that, but typically that’s, I don’t know, 600% margin.
00:13:37:01 – 00:13:58:01
Unknown
It’s a lot. Yeah. So like I market out pretty good. Yeah okay. Good for you. I mean you’re you’re falling into the averages that you should fall into right? I mean typically with a cash based practice, you most people should be eating 40 to 50% margin. And you’re right there. So, you know, good for you. You’re clearing 250, $300,000 a year, which is.
00:13:58:03 – 00:14:22:01
Unknown
Yeah, I mean, for an NP let’s close the second hundred. You’re you’re clearing that. Oh you’re saying that profit. Gotcha. Yeah. Profit. Yeah yeah yeah I wish it was 700,000. Right. Yeah. You wouldn’t be on this call. You wouldn’t really need help doing what you’re doing. But. Yeah. Yeah. 40%. Yes. You’re clear. 253 and $1,000 a year.
00:14:22:01 – 00:14:43:01
Unknown
I mean, that’s what you’re paying yourself, basically. So, you know, that’s that’s impressive. You know, I mean, that’s as much as, you know, some MDS make. Right? And, you know, and you’re working you’re working. How many hours a week? Realistically, I work Monday, Tuesday and Wednesday. So I work 24. And you can add maybe like an hour or two, like today.
00:14:43:01 – 00:14:58:21
Unknown
I just stopped by to do the call, but and then there was a patient that ended up walking in for chest pain. Again, that’s the DPC part. And so my medical assistant is here. She did the EKG. I looked at it and I was like, oh, you’re you know. So I did like a ten minute visit with her.
00:14:58:21 – 00:15:27:23
Unknown
And so I say probably closer to 26 hours a week. So you’re working 26 hours a week, making 3000 $253,000 a year. I mean, you know, when you when you extrapolate that and, you know, I mean, if you were working full time, I had a full time schedule, you’d be making 500,000, right. Like, so you’re working part time, making what a lot of people make for me help more than what they make full time.
00:15:27:23 – 00:15:48:18
Unknown
Right. So like, good for you. Yes. All right. You’re doing exactly what you need to be doing, and you should be doing like when you got a business that’s actually truly working and have sufficient and optimize. You make a lot of money, you work less. That’s how it should be. So, so good for you. All right. So let’s talk about what, what you need help with.
00:15:48:18 – 00:16:22:22
Unknown
So, you were talking about before we hopped on the call, you’re kind of talking about the the direction of this practice and kind of the transition that you want to make here. So, I guess walk me through what, what your vision is and what what direction you want to take this. I really don’t like I, I love what I do, obviously as a as having been in the field for so long, I think that my altruistic attitude towards my patients is sometimes because with my membership, the DPC membership, I started out at $59 a month.
00:16:23:00 – 00:16:51:13
Unknown
And that’s for DPC, that’s unlimited, whatever. And most people don’t abuse that. But of course you have some people that do. And then just this year I went to $89 a month. And again, it’s the same thing. You have the ones that do well and then the ones that, you know, the select few that don’t. So I think my what I’m trying to figure out is, am I getting burnt out on the primary care stuff because of the ones that keep, you know, like every week it’s something different.
00:16:51:15 – 00:17:10:17
Unknown
Again, I don’t do there’s not I know that a lot of people are afraid of DPC, just because of the time demands and like the return on investment. But for the most part, I’m pretty good at what I do. So I don’t have after hours. I, you know, my hours are actually 9 to 4, right? They’re very basic.
00:17:10:19 – 00:17:36:21
Unknown
I don’t really get calls after hours. If I do, it’s once every 2 to 3 weeks for something, you know, someone develops something all of a sudden. So I’m just trying to figure out in the direction of primary care, like, should I continue to to take on the primary care patients or add another nurse practitioner to do that, specifically ten on and on her she comes in on Thursdays because right now I’m not doing Thursdays.
00:17:36:23 – 00:18:04:00
Unknown
So that’s that part. And I know I actually did hire someone, but she’s a friend and she doesn’t want to get paid. She’s learning. She has her own thing that she’s trying to do, but it seems like she’s getting more value out of learning. But I there’s a whole thing about that. But I’m just trying to figure out whether or not I should really go out and hire someone that I’m actually paying to do as a ten year contractor, versus a friend who’s kind of like, oh, I’ll see you on Wednesday.
00:18:04:00 – 00:18:16:03
Unknown
But it’s not really like I’m not actually paying for, oh, she’s coming in, he’s showing up, but I’m not paying her and I’m helping her with her build her own practice as well.
00:18:16:05 – 00:18:42:20
Unknown
I mean, I could backfire on you. Just be careful. You know, luckily, she’s an hour away, so. Okay, so then you don’t worry too much about it. No. Okay. Okay. So then, we’ll ask you then let’s do a service breakdown real quick. So you’re you’re grossing $700,000 a year, give or take. And what percentage of that is DPC and what percentage of it is HRT and stuff like that?
00:18:42:22 – 00:19:05:17
Unknown
I would say 50% is probably DPC just, but the DPC patients bring in the HRT. So I am maximizing on the patients that I have in selling. And I’ll you like last month I did a promotion half off hormone replacement therapy lab. So a lot of my patients took advantage of that and turned into, you know, HRT, TRT, you know, all of that.
00:19:05:17 – 00:19:29:22
Unknown
So I’m reselling to them, you know, the same patients as I’m getting a new patients. So. Okay, so 50% is the, the DPC subscription and the other 50% or the other services HRT raised or to weight loss, whatever. Yeah. Yeah. Okay. And the, the 50% of wellness services that you’re doing all of those. Yeah. It’s all good.
00:19:29:22 – 00:19:54:23
Unknown
All of those patients, all of those patients are established DPC patients as well. Or some of them just separate. They just want they you know, so with my practice, you have to be a member to do anything. Okay. So okay, so you are increasing the lifetime value of every single customer. Yes. So even if someone comes in and they say, hey, I only want to do HRT, you still have to be a member.
00:19:55:04 – 00:20:22:00
Unknown
Whether or not you take advantage of the, primary care services, you still have to pay the $89 a month. So. Got it, got it. Okay, smart. You’re smart. You’re a smart girl. Yeah. So that’s why I didn’t, like, increase my DPC prices to, like, 150 a month or something like that. Because at the end of the day, it kind of offsets because even if they’re not doing the primary care, they’re still they still have to be a member to do anything.
00:20:22:02 – 00:20:40:08
Unknown
Got it. Okay. So then ultimately you just got to get the DPC patients in the door, right? You don’t want to market separate stuff like that. You want to get the DPC. You want to build that up and then you’re selling on additional services as they come in and come established, etc.. Correct? Both. So I have like pamphlets for HRT.
00:20:40:08 – 00:21:00:13
Unknown
I have pamphlets for I.V. hydration, and then I have pamphlets for primary care. So a lot of the times what happens is, is you’ll have someone that comes in for primary care and then they turn into an HRT, or you have someone who comes in for HRT and they’ll turn it into a DPC as well. So across the board there pretty much is it’s all it’s all included in the membership.
00:21:00:15 – 00:21:20:02
Unknown
Except for, of course, the labs and the medications. Right. So I mean, so it’s a concierge practice pretty much. Yeah. And wherever they want, you just. Yeah. Okay. So. Yeah. So, I mean, you definitely go, you know, you could definitely have different verticals in this business where, you know, you get the primary care vertical, you get the hormone replacement therapy vertical, weight loss vertical, whatever.
00:21:20:02 – 00:21:33:21
Unknown
Right. You market those separately if you want or, you know, put them on your website, etc., if someone was interested in it. I mean, always you never turn away a patient, right? Don’t you never turn away a customer. So okay, so just keep doing what you’re doing. Let’s not change any of that. I mean, what you’re doing is working.
00:21:33:23 – 00:21:55:07
Unknown
So, you know, you’re you’re it’s going to be $1 million business in the next year, you know, 1 to 2 years probably. So keep doing exactly what you’re doing. There’s no reason to fix what’s not broken. Right. So let’s not talk about any of that. Like you got that going. Okay. So so you want to bring in another provider then.
00:21:55:09 – 00:22:14:23
Unknown
You said you’re getting burnt out on the primary care aspect of that kind of. And so you’re hesitant about increasing the patient volume there. Now, do you enjoy doing the wellness service stuff though? Are you burnt out on that? Do you enjoy doing that? No, I like to do it. So I of course I listen to a lot.
00:22:14:23 – 00:22:43:16
Unknown
And so I was looking into going into the direction of men’s Health, specifically staying where I’m at, doing what I’m doing. So seeing those patients, bringing in a MP for the primary care and selling patients on the HRT as well. But hey, Celine is not seeing anyone anymore for primary care. But we have another provider here. And then she takes those patients, the new patients on, and then I can focus more on the men’s health because we just had a huge gym to open up.
00:22:43:21 – 00:23:01:10
Unknown
I’ve already been there. I told her with the owner all that stuff. I mean, it’s a million and $2 million gym, like, it’s huge. And they’re having a open house tomorrow. So I’ll be going there and handing out my stuff. And a lot of my guys already go to the gym. A lot of the contractors are already my patients because I have a lot of small business on the patients.
00:23:01:12 – 00:23:19:17
Unknown
So for the most part, I’m just thinking of going in that direction a little bit more for myself. Not necessarily the practice, but for myself, because as you have mentioned a lot, men are a lot easier in terms of managing and not having to make so many changes. So and I’ve done your course on the men’s health too.
00:23:19:17 – 00:23:43:04
Unknown
So yeah. Yeah, it’s easy. I mean there’s nothing to it. I mean it’s one of the easiest things you can do. It just it is. Right? I mean, I’m sure you can agree there’s no men’s health in the city, so in the morning, there is nothing here. And so what I’m thinking when the lease is up with my, you know, tenants that that turns into a specifically just a men’s health clinic.
00:23:43:06 – 00:24:05:16
Unknown
So. Yeah. Yeah, you can do that. I mean, you know, you can go that route if it, you know, if that makes sense to you. I don’t see an issue with that. If you feel like there’s, you know, if I, if, if you can justify it. Right. But, I mean, you have another I mean, you have, you know, another four days out of the week at this practice that you’re in right now that’s not being utilized.
00:24:05:16 – 00:24:25:12
Unknown
You’re only utilizing it three days a week. So it’s like, I don’t know I don’t know if I would I don’t know if it’s necessary to open up a completely different location next door. But I own the building. Well, no, no, I know that. But you have someone there paying your rent. Yeah, you’re paying your mortgage. You’re paying your loan.
00:24:25:12 – 00:24:45:04
Unknown
Right? So it’s like, is it necessary to do that? I mean, to be honest with you, I don’t think it is. You have a clinic already. It’s established, furnished and everything that’s not being utilized four days out a week, right? Right. With with men’s health in general, you own you you will only need to see patients one day a week.
00:24:45:06 – 00:25:02:11
Unknown
That’s all you will need to do. And you could fit a minute here or there every once in a while as well if you want to. Right? But you could make Fridays Salinas Men’s Health Day and just operate at the same practice if you wanted to. I don’t want to work more. All right, fair enough. So then you can just do it on Mondays or something, right.
00:25:02:11 – 00:25:37:20
Unknown
And then do primary care Tuesday, Wednesday, Thursday or something. But most men will like they will adjust their schedule to see you. So okay, I get what you’re saying. So even if I did Thursdays because again, it’s just whenever, whenever I’m working, it’s primary care hormone replacement. Stop doing that rehydration. So it’s kind of like stacked. I think that when I was thinking of the men’s health, it’s because, for instance, with primary care, if I have a lady in the room doing a pap smear and the walls are they’re not thin, then, but you can hear because some guys are very, you know, loud.
00:25:37:22 – 00:25:56:07
Unknown
And so it’s kind of like I’m in there doing a pap where as my medical assistance are rooming a guy in, they’re just being you. Hey, how are you? Like it kind of, I’m sure would make a woman anyone feel uncomfortable while I’m down there if, like, looking at things. Oh, yeah. Especially with men’s health practice. Man to dollar fill she gave me is awesome, you know?
00:25:56:07 – 00:26:17:23
Unknown
You know what I mean? So that was the logistics of having more men coming in versus my women patients. Because even with the male HRT, you know, when they’re having issues down there, like you got to go down there and look. So having your full practice with them doing this. Right. So oh just saying health, they make sense.
00:26:18:02 – 00:26:34:09
Unknown
So yeah, you could just do one day a week and that’s there’s no women’s schedule that day. It is just it is just it’s your men’s health day. You could do that. If you want to keep your business a little bit leaner, you got someone already paying your loan off over here next door. It’s like, why mess up a good thing if you, you know, if if you don’t need to.
00:26:34:14 – 00:27:05:11
Unknown
So just put some thought into it because like I said, you have a I mean you have multiple days there that aren’t being utilized that you could utilize for the men’s health. All right. So if I was you at first, just do that model, do Men’s Health on Thursdays or whatever. Right. That’s the day that men’s health is, you know, just do a quick little switcheroo with some brochures out in the lobby in that kind of a thing or whatever, you know, just have something like underneath the table, the reception desk, and you pop up the Men’s Health name, you know, whatever.
00:27:05:16 – 00:27:22:01
Unknown
Like you can just do a quick little switcheroo. It’ll take you 15 minutes in the morning on that day, right? When people walk in, it makes it look like that’s the men’s health clinic. All right, you can do that. And then, you know, you could have, you know, you could tell them, like, you know, on Mondays, Mondays, Wednesdays.
00:27:22:03 – 00:27:36:02
Unknown
It’s when we do primary care. And that’s when, you know, some women and stuff come in as well. So if you can come in for your injection if you want on those days, if you want to, but just don’t be, don’t be surprised if you see, you know, an old lady in the lobby or whatever, right? I’ll tell you, most guys aren’t going to care.
00:27:36:06 – 00:28:00:21
Unknown
They’re just not going to. Okay. Yeah. The guys just yeah. They don’t they don’t care. So, so just, you know, keep yourself lean, keep your margins low. You know, I think that probably would be the smartest way to do it, because if you open up a men’s health clinic separately in the office next door that you do own, now you’re taking a hit on having to pay the loan yourself versus having someone else pay it.
00:28:00:23 – 00:28:27:04
Unknown
You know, all these utilities now that you have to pay for in the other location, you got to furnish it. You got it’s it increases the expenses. Okay. Now, if you did it as a completely separate entity, you know, if you wanted it, if it was a completely different business, separate entity, separate EMR, separate everything, then yeah, it has its own expenses and stuff, but you will be able to deduct those expenses if you just do that.
00:28:27:04 – 00:28:46:01
Unknown
The location that you’re in right now right. So that’s how I would approach it if it was me okay. So keep it in mind. Now if the men’s health clinic blows up. All right. We have 500 patients or so. This is becoming too much to handle. Then it would make sense to once the lease is over over here kick them out okay.
00:28:46:01 – 00:29:03:19
Unknown
It makes sense. That makes sense. Okay. But you do not need to do anything. You know, you don’t need to do that for. I mean you’re talking about two years out, you know? I mean, you’re talking a while still. So, so how would you do it? The location that you’re doing it. So. Yeah. So what you would do is you are not seeing any more new patients whatsoever.
00:29:03:19 – 00:29:20:04
Unknown
So I should hopefully open up a day for you, that you can just focus and do men’s health only. I think it’s a good move. It’s low stress. It’s low anxiety is low liability. You don’t really get burned out on it. I mean, it does become redundant. You know. It does. It’s the same thing over and over and over and over again.
00:29:20:06 – 00:29:44:02
Unknown
It doesn’t really require a whole lot of critical thinking. I mean, it’s it’s easy. I mean, I’m sure you can agree managing someone’s blood pressure is more difficult than men’s health. I mean, just it’s. Yeah. Yeah. You know, I mean, it’s it’s super simple. So, so if I was you, then I would. You do not necessarily have to create a brand new entity in everything for this.
00:29:44:02 – 00:30:08:01
Unknown
Just do a DBA and, you know, underneath just your LLC, you know, your, your, your, your, your DPC bras that you got right now still a DBA create another separate website, same EMR, same payment processor, same everything. Okay. That way just this is simple. And you just have different pricing over there for the men’s health, you know, the $89 a month, I would not I do not make it a concierge thing.
00:30:08:03 – 00:30:27:05
Unknown
It is a it’s still concierge practice, but everything included in it. That’s how you should do a medical health practice in Florida. You know, on your between 200 and 50, $200 a month is, you know, pretty market for men’s health. And so the visits are included, the testosterone is included, the supplies are included. You know, everything’s included in that price.
00:30:27:05 – 00:30:47:08
Unknown
It’s unlimited visits. It’s the same model you got, but you’re just charging more for it and including the med. Keep it simple. All right? That’s it. These guys will not take advantage of unlimited visits and stuff. It’s just like your DPC practice. You will have a couple who will be a pain, but he’ll even be less than the primary care paid, as I promise you.
00:30:47:12 – 00:31:05:00
Unknown
Right? So, But yeah, but you’ll always have a, you know, just always will have that. Wait. Just the patient usually will, you know, a hypochondriac who needs to be seen for everything sort of thing. So, so anyways, though. Yeah, I would say do that. I think it’s a good service line to, to integrate into your practice.
00:31:05:00 – 00:31:30:15
Unknown
You have no competition in the area whatsoever. So I mean, the, the chances of success are very, very high if not guaranteed. Right. So I think it’s a no brainer to do it. You know, everyone listening. It’s always, always, always offer a service or product in your area that’s not being offered. If you want a good I don’t ask me what what you know what you should open because I don’t know.
00:31:30:17 – 00:31:52:01
Unknown
All you got to do is just see if it if it’s not available in your area, offer it because there there is a need for it or guarantee there is. So you got 50,000 people in the city alone. And sure, there’s a lot of people in the county surrounding the city itself. So yeah, I mean, you have this 100,000 people and you just in your general service area and 100,000 people.
00:31:52:03 – 00:32:19:18
Unknown
I guarantee you that point, 5 to 1% of them would be all over men’s health. Right? So definitely worth patients. You’re getting you you’re making a lot of money basically. Right. For every 100 patients it’s $15,000. It’s what you’re making. The margin on men’s health is easily 5,060%. Right. So it’s a nice service line. It’s all yours. So build it out.
00:32:19:18 – 00:32:39:11
Unknown
If you enjoy doing it, do it. And so what I would do in terms of the direction of this practice goes that yes, you do need to hire someone, no question about it. You know this. So hire someone. This friend that you got right now is a very temporary, transitory kind of thing. So you can’t put your eggs in that basket.
00:32:39:11 – 00:32:59:01
Unknown
I think you know that. So hire someone who wants to see patience. You know, one day a week, ten, 99, eight hours a day or something. Start there. You’re not. Hire someone full time until you can justify it. Right. Which might not be at all.
00:32:59:03 – 00:33:19:08
Unknown
But who knows. So, you start with the same thing. Thing I talked about in all the other podcasts, you know, hiring the 1099, they can make their own hours, you know, whatever, whatever day they have off or after hours from their job or whatever. Let him come in, pay him. Strictly production, all right? And and just leave it at that.
00:33:19:08 – 00:33:39:20
Unknown
Now, the production model that I normally talk about, you know, with, you know what I recommend, you know, anytime you pay a provider $100 for new patients and $50 for follow ups, that is, that’s that’s above market rate. It just is right. For most of these kind of cash based practices. And so it’s above market rate.
00:33:39:20 – 00:34:04:00
Unknown
So you get above market results. So you can leave it at that if it makes sense. But if they’re only paying $89 a month and these are relatively simple visits, then you could probably get away with charging with with paying the PNP a little bit less. If you wanted to send me $5 for a new patient, you know, $35 for follow ups or something like that.
00:34:04:02 – 00:34:27:20
Unknown
Now, with it being DPC, I would imagine that a lot of the care is delivered via probably your clinical portal or something someone calls, leave a message, they just need a refill on something or you got a sinus infection. You call it antibiotic in form, that kind of thing. Typically telehealth, like, I think I still do have some structured like insurance based type structures, like, you know, someone text and say, hey, I have an infection.
00:34:27:20 – 00:34:48:07
Unknown
I still want to talk to them and see what’s going on to determine what they need and what they don’t need. So okay, okay. So then on average, okay, when you hire a new provider, your margins go down about 20 to 25% okay. Yeah. That’s not going to be clinic y. It’s only going to be for the patient revenue that she’s generating.
00:34:48:07 – 00:35:13:23
Unknown
Right. So instead of you having a margin of 40%, you’ll probably make 2,025% instead. Right? So just ensure whatever you charge, whatever you pay them aligns with that. All right. So just think to yourself, okay I need to pay this person this amount of money. But whatever I’m paying them, I need to ensure I’m still making at least 25% margin on it.
00:35:14:00 – 00:35:40:09
Unknown
So if the average patient is paying you $89 a month plus, you know, half of them are, you know, paying for some other things as well. Let’s just say the average amount you make off each patient’s $100 just for simple math, right. You want to pay, you want then you want your margin on that. So it’s about 40% of that, $40 of it is is profit if you pay expenses and stuff.
00:35:40:09 – 00:36:09:09
Unknown
So so you’ll need to make sure that the NP is getting paid about 20, $25 a month per patient on average. Right. Like does that like does that make sense? It does. Yeah. So you know for each patient then they would be making $300 a year give or take. And that maintains your margin okay. So you can either leave that a flat rate like that and be like listen for every patient you have, it’s $25 a month.
00:36:09:09 – 00:36:30:00
Unknown
While that might not sound like a lot of money, I will tell you this most people you will never talk to, right? So it’s easy money for you, right? So think about it as a long term investment. This just stacks and snowballs for you. Yeah. At first you might not be making a whole lot of money, but after a few months you will be making some pretty decent, some pretty some change.
00:36:30:02 – 00:36:52:18
Unknown
Right? So let me ask you, if you go that route because you want to make this worthwhile for the MVP working for you. Right. So if you go that route, how many patients do you think you could realistically stack on a provider within about three months? They’re working just one day a week, giving you just one day a week, maybe like eight hours a week or something like that.
00:36:52:19 – 00:37:12:01
Unknown
After three months, how many patients would you predict they would probably have? And that would be you transitioning some of your established patients to them. 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.
00:37:12:05 – 00:37:40:00
Unknown
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00:37:40:02 – 00:38:11:03
Unknown
If I can break free and the other countless nurse practitioners can break free and so can you. Additionally, please share this podcast with your other nurse practitioner sessions. For others out there. The more NPS that venture out on their own, the stronger our profession will become. Now let’s get back to the episode. We average about 3 to 5 new patients a week, so on average it would be about 20 at the max a month.
00:38:11:03 – 00:38:40:08
Unknown
So about 6050 to 60 patients. Yeah. Okay. Would you transition over any of your established patients to them? Probably not. Probably not. I think you should. I was going to say unless, unless it’s the ones that are like, they don’t really care. But obviously I have some spoiled people, so. Yeah. Yeah, I could, I guess is probably a better answer.
00:38:40:08 – 00:39:08:12
Unknown
Yes. Yeah. Yeah. Like, you know which patients won’t even want. They’re right. You’ll know this. I mean, I knew that when I, when I, when I did, when I made this transition, my mental practice, I knew that these, these guys are going to want to stay with me I King Gary they they will not go any you know with anyone else so but I would estimate that probably 25% of your patients probably would go or go over to this new provider without really caring that much.
00:39:08:13 – 00:39:32:06
Unknown
I would, I would, I would estimate. Right. So if that’s the case, if you could transfer over about 20 to 25% of your patients over to this provider, right from the get go, how many would that be? As I’m like going through the list of patients, I can actually just print off like a full list of my patients, like the whole, you know, practice, that would be close to 60, 60, 60 patients.
00:39:32:07 – 00:39:50:17
Unknown
Yeah. So then boom, there you’re there you go. After three months, they would have about 100 patients, right. Here you go I’m going to give you I’m gonna give you these 40 patients. These are established patients. They’re super easy. These people, they just need their refill. Every once in a while. You got to see him for sinus infection or whatever, right?
00:39:50:19 – 00:40:16:02
Unknown
Super simple. I’m gonna go ahead and just start you off with, you know, 40, 50 patients or whatever. Let’s start you off with these with these patients. So, you know, I pay you $25 per month per patient. So I’m going to start you off at 1200, you know, $1,200, $1,300 a month for working. You know what, 32 hours, 32 hours a month, something like that.
00:40:16:04 – 00:40:44:22
Unknown
So that comes out to about 40 bucks an hour. Now, that doesn’t sound all that great, right? But that’s the starting. But every new patient we get will be yours at $25 a month. After three months. Right. That would be said by about 50 patients average or something, probably about after about three months. Right. So, so if you do the math there, after about three months, they’d be making about 2500 bucks a month.
00:40:45:00 – 00:41:04:05
Unknown
Right now, you do that math. Now it’s 80 bucks an hour now. Now, as a ten, 99, 80 bucks an hour as an MP. That’s that’s pretty good. That’s that’s way above that. That’s probably more than what you’re going to make anywhere else in Florida for, you know, on it for primary care stuff, you know, 80 bucks an hour.
00:41:04:06 – 00:41:24:20
Unknown
And but the thing is, this is what you tell them. Like that’s just after three months, keep working. You keep doing it. This this number will go up. You can manage 100 patients probably. I mean, do you think they can manage 100 patients? Yeah, eight hours a week. Definitely. Yeah. Right. Right. Cause most it’s easy as hell. Yeah.
00:41:24:20 – 00:41:53:08
Unknown
Super simple. So you could tell them, like, after, you know, at eight hours a week, you have the capacity you probably have in about 150 patients or whatever. Right now you’re looking at $3,700 a month. I would like to say I really appreciate you breaking that down, because that was really one of my biggest issues with being, DPC is if I hire someone as a 1099 and they’re only working, you know, $100 per patient or $50 per patient, like, how does that work?
00:41:53:08 – 00:42:17:22
Unknown
Whenever they’re, you know, getting like a refill request or something like that. Like, I know you covered it in other podcasts, but like, how does that really help me when, say, it’s Tuesday and there’s a refill request for a patient that they establish, then I’m taking on the load. So it makes sense to do it in this frame, you know, in this model to just, okay, these are your patients.
00:42:17:22 – 00:42:34:18
Unknown
You’re coming on as a ten on your nine provider to manage these patients. So I like that. Yep. Exactly. It’s just a monthly rate. Keep this as easy as possible. You know you can tell them listen 90% of these patients you’ll be a barrier. You know, you’ll very rarely ever hear from them. There will be some pain in their patients.
00:42:34:18 – 00:42:59:03
Unknown
I’m sorry. That’s just that’s just what this is, right. But like but you know, after if you figure that they could probably manage 150 patients a month, on an average of eight hours a week, then once they hit that number and they’re making about 3700 bucks a month, something like that, give or take, you know, now they’re making 100, $1,020 an hour.
00:42:59:08 – 00:43:17:21
Unknown
That’s that’s good money. Right. And then you tell them like and then if you want, give me another day. We just keep stacking, you know, before you know it you’re making you know you’ll be you going be making $200,000 a year with me if you want to. And it’s easy work. So I think that’s how I would pitch it.
00:43:17:23 – 00:43:34:14
Unknown
I think that if you do it, that way, you get someone who wants to actually work, you know, not some lazy person, someone who wants to work and really earn what they, you know, earn what they’re working for. You’ll make what they’re actually worth, what they’re producing. Then I think that you can find someone who’s motivated, who would take advantage of that.
00:43:34:14 – 00:43:54:07
Unknown
It doesn’t sound that appealing at first, but if you break those numbers down for them and show them on paper like this, this is what it looks like. I’m starting off of 40 patients. So you are automatically making money. You’re making that much. But give me give me 12 weeks. I promise you this is what you’ll be making me at 3 to 5 new patients every single week.
00:43:54:07 – 00:44:17:07
Unknown
And you will get all those people right. They need to do it that way. Then after a year or two, that person’s following me. They get really good money. And you’re sitting back a good 20, 25% for doing nothing other than just managing them a little bit. Right. And then you can see how this thing you see, like you can see how this can scale, right?
00:44:17:09 – 00:44:42:09
Unknown
You do that, you’re making 25%. You’re working now seeing, you know, you’re you’re working, you’re 26 hours a week or whatever, making what you’re already making $300,000. That doesn’t change. It could go up a little bit with men’s health. Right. So you’re sitting back working 25 hours a week. Make it $350,000 a year for the work you’re putting in at 25 hours a week, which is crazy good money.
00:44:42:11 – 00:45:02:12
Unknown
Okay. I mean, if you do the math there, I mean, just off the top of my head here, you’re you’re making 250, $300 an hour, okay? You’re making really good money. You’re making more than a lot of surgeons make okay with the amount of hours that you’re working, right? You make a singer make it 3 or $350,000 a year.
00:45:02:14 – 00:45:32:22
Unknown
Now, you now have this other person over here that’s beginning to start generating patients, building their, you know, building up the volume, all this kind of stuff. And now you can see that now you’re making $30,000 a year as their census begins to grow, it can get too close to what you’re doing. Okay. Now you just turn that $3,000 a year into 400, $450,000 a year, and it just it just stacks.
00:45:33:00 – 00:45:47:01
Unknown
Right now, you’re still only work at 20 or about 25 hours a week for each new provider that you have coming on board. After a few years, you’re sitting back making six $700,000 a year, and you’re working 25 hours a week.
00:45:47:03 – 00:46:11:20
Unknown
Right. Yeah, I can take it. Well, sure. Everything. Yeah. You know what I mean. And then you get it five years from now and you have multiple providers working full time at that kind of exact same rate or whatever. You’re making $1 million a year profit, and then you turn around, sell the damn thing if you want. Do you want to do most likely?
00:46:11:20 – 00:46:36:10
Unknown
Well, I have, yes, eventually. But I will say this if you want to sell your practice, okay, like I, I broker practice is on the side. It’s pro I brokers.com us and we’re selling two practices right now actually we’re selling a telemedicine predominantly men’s health clinic. And we’re also selling a practice very similar to yours. It’s a functional medicine.
00:46:36:10 – 00:46:54:20
Unknown
It’s more of a functional medicine based kind of DPC thing. Okay. And we’re selling that practice as well. Both of these practices though, I have I have a rule I will not even entertain selling your practice unless you’re doing at least a million a year net. I simply will not. It’s a waste of my time. No one’s going to buy it.
00:46:55:01 – 00:47:14:09
Unknown
And if they do, they’re to lowball you. It’s only going to be worth your time. Okay? Once you hit that million net, that’s when it’s time that you could sell it for six, seven acts you make. You can make a nice chunk of change. Right. So, so it’s kind of keep that in mind long term. I think you could probably get there in five years if you do it the right way.
00:47:14:11 – 00:47:43:02
Unknown
Yeah, yeah, that’s the goal. I will say this. You do not want to put all your eggs in one provider basket, okay? You do not want to have just you and then one other provider. It’s full time because they leave. You’re scrambling okay. So you want to mitigate your risk here as much as you possibly can. So you need to build redundancies in the business in terms of providers okay.
00:47:43:05 – 00:48:08:14
Unknown
So it’s it’s best if you can get away with it. It’s best to have maybe from from a sales standpoint, if you want to sell your business later on, okay, five years down the road or something, it would be best for you to have 3 or 4 part timers, right? And then maybe just one full timer. The part timers can be just 1099 full timer.
00:48:08:16 – 00:48:31:14
Unknown
You you might have to transition them into a W2 at some point. But you want to build some redundancies. So what I would do if I were you is get this first provider under your belt, get comfortable paying them. Get comfortable with someone else working and seeing your patients for you. Get comfortable with, you know, putting your trust to someone else’s responsibility, somebody else.
00:48:31:14 – 00:48:52:01
Unknown
Okay. Get them up to a point where it’s really good for them. They don’t want to leave. Okay, Max out their schedule at 8 to 16 hours a week. Right. Keep them 1099. Once you do that, if they leave, it’s not the end of the world. You have to you have to work an extra day a week, right?
00:48:52:03 – 00:49:11:09
Unknown
It sucks, but it’s not the end of the world. They’re full time and they leave. It’s the end of the world. It’s got suck that just right now you’re working six days a week. Seven days a week can be awful, right? And you’ll be desperate to hire someone else and that’s when you make bad decisions, okay? It’s when you hire someone that’s really, you really should know.
00:49:11:09 – 00:49:33:18
Unknown
Hired. So get them maxed out at eight, 16 hours a week. Whatever it is you’re comfortable with, ten hours a week, whatever guy max amount. And then hire another one. Get 2 or 3 on board at a very, very part time hours. All right. Then the best one out of them. That’s one out of them, you know, and then approach him or say say something like, hey, do you want to or, you know, would you consider maybe moving into more of a full time position for the next six months?
00:49:33:20 – 00:49:53:12
Unknown
Let’s, let’s, let’s really build you up. And then you have, you know, three providers working for you or 3 or 4 providers working for you of 3 or 4, you know, three of them, 2 or 3 of them are very part time, ten and nine. And you got one that’s more of a full timer. When you once you do that, that’s when you’ll be hitting probably close to that million dollar work.
00:49:53:14 – 00:49:57:23
Unknown
Okay. Yeah, that’s how I would do it.
00:49:58:01 – 00:50:21:05
Unknown
Any questions there during the game. Yeah okay. Like I said another podcast before I just make sure they buy with you. Yeah. Yeah. Make sure they’re you know it’s not going to drive you crazy. You’re right. There is there is a similarity in our approach to practicing and and personalities as well. And exactly this is someone that you can hang out with after work.
00:50:21:07 – 00:50:27:05
Unknown
Yeah. You know I mean that’s NPS I probably could not hang out with. You have to work.
00:50:27:07 – 00:50:41:03
Unknown
A lot of you guys, I could probably people listen to this podcast. I probably could honestly, like most people listen to this podcast and people who do the elite employee thing, I could probably hang out. You have to work. But that’s only 10% of the employees. The other 90% I probably couldn’t really hang out with. You had to work.
00:50:41:05 – 00:51:06:09
Unknown
We probably wouldn’t. You’ve been saying something recently that’s been really sticking. Like the family business versus friends. So like, that’s just, you know, obviously, like we’ve we’ve been there, you know, being having to do these type of tasks and day to day and management and just learning, loving to learn like it shrinks your circle a lot. So yeah yeah yeah yeah for sure.
00:51:06:11 – 00:51:28:12
Unknown
Rochelle, Rochelle, we talked about so second piece, I think that I started school for that role. I started because I was doing this, I compe elite EMP course, because my son last year was diagnosed with high functioning autism. And so he’s 14. And, so then this year, just doing my research and videos and all that stuff.
00:51:28:12 – 00:51:44:10
Unknown
So coming into this year, I was like, just kind of learn a little bit more about it. Let me do this. I completely empty course I did that, and I was in the middle of that just because my personality and I start, I signed up for school once at the same time. So I got a year left.
00:51:44:10 – 00:52:11:08
Unknown
And every time I go into ChatGPT, I’m like, I don’t want to do this. It’s like, yeah, but you’ll have the degree forever. Like, just do it. But I it brings a different demographic that I’m not one of those type of people. You had a previous, psych MP that was doing like 70 people a day in tele health and stuff, and I was just like, I would never want to sit down and just go like, no, let’s change your at all this I changed to five vyvanse so it it opens up a whole new different thing.
00:52:11:08 – 00:52:29:02
Unknown
So I guess my question is it’s really not a question. I don’t know how you want to do it. I’m halfway through and I’m still like, I haven’t changed my mind. I’m still like dragging myself through it. So if that makes sense. But I’m the type of person to finish, like I if I start something, I’ve decided to do it.
00:52:29:02 – 00:52:59:02
Unknown
Like I’m like, okay, like I’m going to finish it, but at the same time I’m like, oh, it’s not even something I necessarily want to do. I’m a good family nurse practitioner. I’m a great family nurse practitioner. Like, I love what I do. I just don’t want to open up the practice to that demographic, because I already know if I’m sitting in the room with a patient who’s primary care, I’m going to be like, well, let’s try qual or let’s try this less, you know, like I just know that I’m going to do it, even if they’re only a membership patient.
00:52:59:03 – 00:53:09:20
Unknown
Like I know that I would probably, you know, want to treat them for that without giving them the additional cost of the fee for service to to go down that road.
00:53:09:22 – 00:53:30:03
Unknown
So I would tend to agree with your ChatGPT cheerleader. I mean, you got a year left to I know it sucks. I there’s no way in hell I would ever go back to school. There’s no way I wouldn’t do it. I know I couldn’t do it, I just I know I couldn’t, I would, I’d probably leave after a week.
00:53:30:05 – 00:53:58:17
Unknown
I’d be like, I am. So no, I’m not doing this nursing school crap again. And 63% of this is such bullshit. And so I think that you got a year left in the last year is going to be what? Most of all, it’s clinical stuff. And. Yeah, and I already have my clinic. I’ve already been doing some of the clinicals and it’s it really is a breeze most of the time I well I won’t I guess I won’t say that out loud just because there’s a just in case.
00:53:58:17 – 00:54:23:21
Unknown
Yeah. But for the most part it really isn’t a lot at all. Right. It’s not that much. And you do get that certification right. Which I mean, you can still treat most that stuff as a fam family nurse practitioner. I mean, do you need the psych NP to do that? Most of that stuff you don’t I mean, I treat you know, I mean, I have all I prescribe people to be appropriate or, you know, whatever.
00:54:23:21 – 00:54:30:19
Unknown
Right? Yeah. And so,
00:54:30:21 – 00:55:11:19
Unknown
Let’s just, let’s think about here what it is that you actually want to do with it. Okay. Because I feel like that while I agree with ChatGPT, I will disagree with it as well. If if you are not going to utilize it whatsoever. If you’re just like this, why did I get this? This is this was dumb. Like if you if if your heart says I’m not going to use this, I would just quit because it is a year of your life and it is going to be taking up time that you could be spending building out your mental health vertical, doing other things in your business that’s already profitable.
00:55:11:19 – 00:55:40:01
Unknown
You could grow it with that time, you know? And so we need to talk about what it is that you envision doing with it. So does your heart. And does your gut say, I’m probably not going to really use this or does your mind say that, okay, I could do a concierge mental health kind of a thing, and me having my psych NP does give me more of that street credit to do it right.
00:55:40:03 – 00:56:02:19
Unknown
Or I really I just really don’t want to do this. I really don’t want to have it. Really. What it is is that I have no intentions of, being an employee with a psych practice or anything like that. I don’t my biggest thing is, is I don’t intend to. In the beginning I was like, well, maybe I’ll add, you know, like a concierge psych practice.
00:56:02:21 – 00:56:19:08
Unknown
But then I thought about I was like, I don’t even want those phone calls, like, you know, oh my God, I had a panic attack today and ended it. Like, I get that already for some of my primary care, which is fine, but I don’t necessarily want that to be what I’m known for. Like it turns into, oh, and she does this.
00:56:19:08 – 00:56:36:02
Unknown
So, at the end of the day, my goal. I’m 41 now. So at the end of the day, my goal is to over the next couple of years when my son is finishing up high school, he’ll he just started as a freshman. So when he’s done, like I want to be more out than in if that makes sense.
00:56:36:02 – 00:56:55:22
Unknown
So I want to be more out of the day to day. The actual clinical practice. I want to be in my garden or on the beach or, you know, things like that. I don’t necessarily in the next four years. And plus he’s really good at what he does with football. So if I have to travel to his games, I want to be able to do that and, you know, go to all these different cities and stuff.
00:56:55:22 – 00:57:19:23
Unknown
So there’s, it’s just a life that I want to live. So it’s not necessarily like sitting in a room just doing telehealth all day. So. Right. So the only thing that would make it worthwhile to you is a very, very high ticket concierge site, kind of a thing. If you want to do that. Right. You wanted to I mean, had the psych degree give you some more, you know, your certification give you the skills, etc.?
00:57:20:01 – 00:57:42:01
Unknown
If you don’t if you if you just don’t have any interest in doing it, I would say then, you know, you you don’t need to do it to prove anything at this point. You don’t you’ve proven you’re a damn good primary care provider. You’ve proven that you’re a damn good business owner. Okay, now, I appreciate that getting a psych in.
00:57:42:03 – 00:58:03:10
Unknown
What’s what’s that proving? I mean, do you need more validation? No, not at all. I think that what happens is, is when you’re used to going back to school every three year, that’s. You forget that you don’t need to go back anymore. And so I think it was one of those moments where I was like, is this then about three years, it’s time to do it again.
00:58:03:10 – 00:58:27:20
Unknown
So, but yeah, you really, yeah, yeah, you’d be you’d be better off, like, if you like, if you have that itch to go back to school or whatever that need, you’re better off taking a course or taking advantage of some franchise opportunity or something to integrate near you. Better off spending the money and investing your time to to meet your goal.
00:58:27:20 – 00:58:56:16
Unknown
And your goal is to be out in 4 or 5 years. Like that’s your goal, or maybe even sooner. Getting your psych NP does not help you with that. I know it puts me back more in, so it puts you back, right? For NP, listen to this. I strongly urge against going back to school. I just I just do and that’s exactly the exact opposite of what’s pushed in, you know, pushed in the nursing field.
00:58:56:18 – 00:59:18:23
Unknown
You know, education is always a good thing. No it’s not it’s not especially some design thing from the NCC, these accredited nursing programs, blah, blah. What does this do for you? It would do. It does nothing. I really don’t think it I don’t think it does much for you if you have other goals, you know, like I, you said you had your DMP good for you.
00:59:18:23 – 00:59:32:11
Unknown
I, I never would get it. It would do nothing for me. It would really be a complete waste of my time. Right. So and going back to school in general would be a waste of my time. I don’t need to go back to school. I don’t want to learn something. There is something called ChatGPT in Gemini. In Claude.
00:59:32:11 – 00:59:48:06
Unknown
I can learn whatever I want to learn. I don’t need a textbook. I don’t need a professor. I don’t need a test to give me a woohoo feeling. Oh, I’m a 4.0 student. I don’t I don’t need that. Right? I know what I’m worth. I know what my skills are, I know what I could do and so do you.
00:59:48:07 – 01:00:10:11
Unknown
So I’m advised you I’d say yes. I’d say, hang that hat up. Yeah. You know, this. Yeah, I know, like you know it. I’d say, just give it up and it’s a waste of your time. It literally is a waste of your time, right? It’s not. It’s not in alignment for what I want to do for my future in general.
01:00:10:11 – 01:00:39:23
Unknown
And I just I was like, oh, this will make me a better provider specifically. But even with that, going into the direction of more of a select service, like with men’s Health, it doesn’t necessarily. Along with that. And just because I really enjoy helping guys to feel better, so I enjoy helping everybody feel better, but that’s just kind of like where I’m at, because I feel like I’ve sacrifice enough of time for patients who are non-compliant and don’t take their blood pressure medicine, like you said, and all that stuff.
01:00:40:04 – 01:00:56:04
Unknown
Then they come in and their blood pressure is 230 over 110 and you’re like, where is that? What are you doing? And they oh, I forgot, I didn’t take it this morning. So normally that’s like an hour and a day trying to give them clonidine wait it out. Whereas now I’m just like, go home, take a medicine, call me if you need me.
01:00:56:07 – 01:01:20:04
Unknown
So, don’t die, I thought. Yeah, yeah. Oh, yeah. It does nothing for you. And, you know, if you’re interested in some psychiatric things, you are a family MP. You can prescribe a lot of the stuff you can do. Oh, yeah. Stuff. Right. And if you want to learn more about OCD or something, just learn it. It’s not like, what do you need a professor?
01:01:20:06 – 01:01:42:16
Unknown
Do you need a professor to teach you that? We could tell you to read these chapters and stuff and give you a test. Those that do, right. Yeah. You know, I mean, I have I personally have a fascination with like treating some people’s depression, treating some OCD, you know, maybe a little bit of anxiety or whatever, or doing some ADHD stuff, like I have a fascination with that stuff and I can get you going.
01:01:42:16 – 01:02:01:13
Unknown
I can treat you more from a holistic standpoint. I want to just show a bunch of meds in your face, but I can help you with your depression, anxiety, OCD and stuff like that by optimizing your hormones, getting you want to ketogenic diet, etc. and my results are pretty damn good. I want my body to do that. I would be okay.
01:02:01:15 – 01:02:25:19
Unknown
Yeah, so that’s a quick buck. It sounds like a plan. Thank you. Quick. It’s I don’t think it doesn’t align with your goals. It does not align with your long term, you know, trajectory here. I mean, you are going to have a business that’s going to be worth $1 million a year net. You’re gonna be $1 million gross within probably a year or two.
01:02:25:21 – 01:02:45:07
Unknown
And then a couple years after that, you’ll probably hit a million net. And so you getting your psych MP will not help you with that whatsoever. Like you said, you will never work as a psych NP for someone you will never start your own sake and b practice. What the hell’s the point to waste your time?
01:02:45:09 – 01:03:01:13
Unknown
Yeah, I appreciate you. You’re welcome. Yeah, yeah. I mean, I have a feeling you do it. Don’t do it, Skip. I have a feeling you knew I was going to tell you that. Oh, of course I’ve seen you enough to know. And it just. I mean, it makes it makes sense for where I’m at in my life. So it does.
01:03:01:17 – 01:03:19:19
Unknown
And what I would, does the future. Yeah. I mean, if you were employed, you know, and you were sick and tired of being underpaid and you were having a difficult time finding a job and that sort of thing, you know, you were 33 years old or something. Go back, get my psych MBA, because I can get a job over here making, you know, $150 an hour or whatever.
01:03:19:21 – 01:03:41:12
Unknown
Yeah, sure. Right. But, like, you’re the same age as me. I’m 42. You’re 41. I mean, this this is going to help you meet your goals at this point. So, Yeah, I’d say just skip it. Focus on your business. I mean, you you got it. You have a hell of a business here that really has some real legs on it, and it has real.
01:03:41:12 – 01:04:03:11
Unknown
It has a real runway ahead of you that you can really you scale this thing significantly. I mean, you are just still in the infancy stages here, you know? I mean, you are you a few hundred patients and you’re doing this. Well, you’re making just as much money as a lot of MDS make, and you’re working 25 hours a week.
01:04:03:11 – 01:04:29:04
Unknown
I mean, you are you are in a very, very fortunate and privileged situation. And sometimes you just need to sit back and just be grateful for what it is that you got right in front of you, and take advantage of it and see how you can optimize it even further. Right. You know, gratitude in general. Like, you know, I’ve been putting a lot of thought into this lately.
01:04:29:04 – 01:04:50:23
Unknown
And, you know, gratitude is if you think about what gratitude is like, people don’t really think what gratitude is and what gratitude is, is imagine if this was taken away from you. How would you feel? Right? Yeah. If you if it was taken away from you and you feel horrible, then you should be grateful for that. So gratitude is right.
01:04:51:01 – 01:05:19:06
Unknown
So you have something right in front of you right now that is you’re very fortunate to have and you’re in a very privileged situation because you’re in you’re in the greatest country in the world. You are able to do what you’re able to do 25 hours a week. I mean, you’re if you really think about it, you’re top you are a top 1% income earner in the world, and you work 25 hours a week, like, you’re never good about it.
01:05:19:06 – 01:05:44:03
Unknown
Not enough perspective? Great. Be grateful for it, grow it even further and get to where you want to be sick MPG and help you with it. Thank you, I appreciate that. Hello. Now, any other questions? Nope. Because I get so inspired. Yeah. I like the end episode, with you asking me a question. Your personal curiosity, your question for me.
01:05:44:05 – 01:06:09:16
Unknown
I have more of a statement. I just want to say thank you so much for doing what you do. Like, even just as simple as you did an episode a few weeks ago where you were just talking about the changes of, like, just our country and what what the wars don’t. Because I don’t watch the news, and, and how AI is going to affect like our children or ourselves, our practices and how that’s going to integrate into like what we should be thinking about now.
01:06:09:18 – 01:06:31:09
Unknown
Even as simple as just using AI in our practices. Like, I really was kind of like, a John Connor’s mom. It’s kind of all in because it’s like an opportunity. And so, anyways, so I actually started using, you know, like just AI in, like my visits and stuff, and it has cut the 24 hours that I was here.
01:06:31:09 – 01:06:54:13
Unknown
It’s cut that even down so much more because now I’m not type I’m not doing this all day. And so and it’s and it gives me credit for the things that I forget to put in there or I don’t have the time to just type out. So I really appreciate you for looking out for us and doing those episodes too, where even it’s just you, you’re still putting the content out there and putting your thoughts down.
01:06:54:16 – 01:07:13:03
Unknown
So it really means a lot in our. And without you, I wouldn’t be where I’m at. So that’s one of the biggest things. So I wouldn’t be making almost 700,000 a year if it wasn’t for you. So, You’re welcome. It’s a pleasure. I mean, you know, there’s a lot of faces out there I’ve never met and have no, like, you know, no idea how I’m actually affecting them or.
01:07:13:04 – 01:07:29:13
Unknown
No. You’re making a huge difference. Even just my comfortability with going in the men’s health direction. During the clinics, I know that you have people that you coach prior to them actually opening, but for the most part, just adding those services and keeping us on track to like, hey, if it doesn’t make sense, then don’t do it.
01:07:29:13 – 01:07:51:18
Unknown
If it’s not in alignment with what your vision of your practices and why are you adding it? So, for instance, I have a lot of friends who do, cosmetic stuff and they have all these machines and they’re complaining about the machines. And every time someone stopped by, I go, no, thank you, I’m fine. Like, I’m already, you know, like, I’m definitely not wanting to do that.
01:07:51:18 – 01:08:17:01
Unknown
So I really appreciate you and everything that you do. So, you’re welcome. And again, this thing does not compliment, nor does it align with what you’re doing right now. It it doesn’t, you know, it’s a whole another line of service technically. So. Exactly. Right. So spend your time on working on your business because you still got you have so many like you’ve you have you have done the hardest thing.
01:08:17:03 – 01:08:44:19
Unknown
You’ve accomplished the hardest thing already building the business out and getting it to this point. The first $100,000 is hard to get to. The the 200,000 $300,000 easier than the 100,000, right? The 300,000 to 600,000 is easier than it was. Go for 100 or 200, and then 600 to 1 million is actually you will find that that’s actually easier to do.
01:08:44:21 – 01:09:05:16
Unknown
Then you go from 0 to 100,000. So you have already done the most difficult part of it right? You’ve given a time, you’ve been patient, you’ve endured the slow times, you’ve endured making no money, you’ve endured working for free. You have endured all of those hardships already. It is out of the way now. You never have to go back to that.
01:09:05:16 – 01:09:26:11
Unknown
You don’t. You’re done with it, right? You paid your dues and you paid your dues. Your entire career in health care. You know, you were a CNA, you pay your dues, right? So now getting to this next stage is going to be easier for you to do as long as you give it the time it needs to do it, and you give it the effort, it needs to do it.
01:09:26:11 – 01:09:49:00
Unknown
And you, if you lead your psych program, that gives you how many hours a week now and the energy and the time to put into it. So like you’re there, I would say that all it now, now all all it’s now it’s going to take for you is taking some risks. I mean, to go from 300,000 to 1 million is going to take risk.
01:09:49:01 – 01:10:06:10
Unknown
They just is. If it was easy and didn’t require risk, everyone would be a millionaire. Okay, so you’ve already taken risks before, so you know you’re going to be okay with it. So take risks. You’re going to trust other people to put responsibility in the people’s hands. You have to do some additional marketing at the new year. You’re going to have to get out there, put yourself out there.
01:10:06:12 – 01:10:23:17
Unknown
And by leaving the psych PE program and focusing on it and putting the time into it, you’ll get their hearts parts done. So congratulations. Thank you so much. I appreciate you. Yeah. Cool. Well, I appreciate you. And then, you want to do a follow up? Let me know. I’d love to know what you’re doing. And of course, go.
01:10:23:19 – 01:10:46:09
Unknown
All right. Thank you. Yes. Thank you. Thank you for listening to the show. The legal disclaimer the content of this podcast is meant for informational and 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. Please be sure to consult with your lawyer, CPA, medical director, and or your state’s practice laws and the most up to date clinical guidelines.
01:10:46:11 – 01:10:58:06
Unknown
As always, do your due diligence when it comes to any information found online in podcast. The content in this podcast is copyrighted by Galaxie Medical Southwest 2023, and it cannot be duplicated, rebroadcast it, or reproduced without our written permission.
