"You can get past the dead end. You can break through the ceiling. I did and so have countless others."
Amy has built a successful wellness practice focused on HRT and weight loss, and now she is looking at how to improve profitability, streamline the business, and continue growing.
In this episode, Justin and Amy discuss pricing, medication costs, improving margins, recurring revenue, and the importance of diversifying beyond weight loss. They also explore expanding into women’s HRT, developing simple clinical protocols, and hiring additional providers to create a practice that can grow beyond the owner.
If you are building a wellness practice or looking for ways to make an established practice more profitable and scalable, this conversation offers practical ideas for taking your business to the next level.
00:00:02:12 – 00:00:24:08
Unknown
Greetings. This is Justin Alan with the elite 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.
00:00:24:08 – 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. You do not have to take 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. And I’m here to show you that path. This podcast is what I do. 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 a nurse practitioner and myself.
00:01:09:03 – 00:01:31:00
Unknown
It is real. Is it scripted? 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.
00:01:31:02 – 00:01:45:23
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. On to the episode.
00:01:46:01 – 00:02:05:08
Unknown
Everyone today will be talking to Amy, who is a nurse practitioner operating her own wellness practice where she only provides HRT and weight loss services. She says the business is doing quite well, but needs assistance with the 28 day beyond use issue. Automating her practice and pricing her services appropriately. Amy, are you.
00:02:05:10 – 00:04:01:04
Unknown
Thanks for hopping on here. So tell us a little about yourself. How long you been a nurse practitioner for? What sorts of things you’ve been up to and, knows a little bit background on how you started your practice and kind of what you’ve been up to.
00:04:01:06 – 00:04:17:23
Unknown
Well, good for you. So, yeah, I mean, you jump right into it. That’s, you know, since you graduate school, which. Yeah, I mean.
00:04:18:01 – 00:05:04:00
Unknown
Right.
00:05:04:02 – 00:05:11:05
Unknown
Here.
00:05:11:07 – 00:05:21:16
Unknown
Yeah.
00:05:21:18 – 00:05:51:18
Unknown
And. Yeah. Be absolutely. Nickel and dime. Yeah, I get it. But, yeah, you made a good point there. I’ve said it before, like, what is the worst that can happen? I mean, you are a licensed, skilled professional. If you had to go get a job for $75 an hour. Boo hoo. I mean, you’re still doing better than most people like, you know, the the.
00:05:51:20 – 00:06:09:00
Unknown
I hear you, I hear you like ye. I think I would rather go be a bartender than work in the hospital again. Like. Yeah, well, I think I would be.
00:06:09:02 – 00:06:22:01
Unknown
Yeah. Something super easy like that. Yeah. You know, but yeah, I would, I would be a bartender before I ever worked in urgent care or something in the higher percent, like low stress, easy as hell cash tips. You
00:06:22:03 – 00:06:30:18
Unknown
with people all day. Like, I would much rather do that. Like. Yeah. Yeah. Okay. Yeah. No. Good for you.
00:06:30:18 – 00:06:58:07
Unknown
Okay. So, I mean, hell, you’re on track to do probably 8 or $900,000 gross this year, as long as you can maintain the same trajectory. So that’s fantastic. You know, I mean, you’re in your second, third year of this practice. I mean, the next 12 months, you probably will hit $1 million gross. Now, that’s obviously, you know, there’s a lot of factors involved there that are ultimately out of your control.
00:06:58:07 – 00:08:07:21
Unknown
Right? But, you know, you didn’t mention that weight loss, you feel like it could be falling off a little bit. And is that your biggest? Is that your biggest money generator?
00:08:07:23 – 00:08:26:02
Unknown
So what would you estimate percentage wise? How much percent? What percentage of your business is weight loss? What percentage?
00:08:26:04 – 00:08:48:06
Unknown
Yeah.
00:08:48:08 – 00:09:07:04
Unknown
Yeah yeah okay. So I know we’re going to talk about a different few different things here. You know some questions that you had. But let’s I want to tackle this real quick too because I want you to be able to sustain this revenue because I want you to be able to build $1 million business. I mean, that’s a that’s such a huge milestone to accomplish, you know, for for any entrepreneur.
00:09:07:06 – 00:09:36:01
Unknown
I mean, let’s get real here. I mean, most entrepreneurs, most businesses will never generate $1 million a year revenue, okay. Most will never hit that and then most will never, ever even hit $1 million net. Okay. So, you know, that’s even a rare feat and a bigger milestone, but it is possible. And so your margin right now, I mean, you only have one employee, I’d say probably like, what, 60% or something?
00:09:36:03 – 00:10:50:09
Unknown
Wow.
00:10:50:11 – 00:11:09:09
Unknown
Yeah. There’s definitely some things you’re you need a button up. I mean, if you want to scale this thing. I just got done finishing up recording our, we have a new mastermind coming out and how to scale, how to scale your practice to the next level as recorded, the core curriculum for that, actually little like yesterday.
00:11:09:09 – 00:11:31:22
Unknown
So this is all fresh in my mind. And so, if you want to scale this practice, you definitely need a button up. These margins hitting not not not getting the 40% and only having one employee. There’s there’s definitely there’s some significant leaks here. Okay. Your margin should be at least 45% if not a little bit more okay.
00:11:32:03 – 00:11:57:06
Unknown
40% minimum. Right. So the low hanging fruit stuff first. So I want you to like the credit card processing fees. If you’re paying 4% something’s wrong. They’re they’re ripping. You want something else. Something’s wrong. And so you need to take a look at that and really try to break it down. Maybe even get it to your bookkeeper or your accountant or something and be like, hey, can you take a look at this as well?
00:11:57:06 – 00:12:16:23
Unknown
This is what ChatGPT is telling me. It’s 4%. What are you seeing here? Take a look at that. If it is 4% or, you know, even 3% or whatever, you need to find another payment processor, you need to find somewhere that’s going to be a lot cheaper because that’s that’s ridiculous. It should be 22.5 at most. Okay.
00:12:17:01 – 00:12:46:15
Unknown
So that would give you 1 or 2% additional margin. All right. So these little tiny things they add up right. So 1 or 2% I mean if you think about it here, $1 million a year in gross. If you can say 1 or 2%, you’re talking about 10 or 20,000 bucks in pocket, right. Which, you know, I mean, that’s, that’s an if you, 1.5% pays your mortgage for I mean, that pays your that pays your rent for for your location for the entire year.
00:12:46:15 – 00:13:17:02
Unknown
Right. So, so I’d say start there and then, from the sounds of it to me, a 50% is going right out the door to pay for meds. Then that tells me that you are probably under charging for your services. Okay.
00:13:17:04 – 00:13:39:15
Unknown
Well, the the problem is though, and this and then I later I was talking about this yesterday. The mastermind is that the issue is, is that an increase in volume won’t necessarily improve your margin, okay. It just increases the volume of patients and increases the revenue that’s coming in. But it does not increase the revenue per patient, okay.
00:13:39:17 – 00:13:59:10
Unknown
Because that margins at margins are going to stay the same. It’s not going to change that much. Right? I mean, it’ll change a little bit, but not that much. So you’re yeah. So two things are happening here then. Probably because you know okay. The payment processing, there might be a couple little expenses here that are hidden in there that you might be able to cut out.
00:13:59:10 – 00:14:14:11
Unknown
Okay. Maybe some payments might be falling through with a few patients here. There. Maybe. Maybe you’re not catching. That does happen sometimes. Okay. And the patient won’t tell you they’re not going to delegate.
00:14:14:13 – 00:14:31:05
Unknown
They’re not going to. They’re not going to tell you. Okay. So there could be a few things like that that I might be able to squeeze that margin. You know, payment processing, missing some payments, the little tiny things like that. I should be able to bump your margin up by probably 3 to 5%. Okay. The big one, though is that medication cost a 50%.
00:14:31:09 – 00:14:59:15
Unknown
Okay. 50% is going right out the door for meds. And that that that seems high to me. Right? Typically for most these practices, it’s going to be more in the 30% range usually. Right. So you need to hit this on both ends. Number one you need to find cheaper meds okay. You negotiate the price with the compounding pharmacy.
00:14:59:17 – 00:15:22:13
Unknown
So a compounding pharmacy that you’re using, you’re sending these people hundreds of thousands of dollars a year okay. Like you are. Like you’re giving them quite a bit of revenue. And so you need to you need to negotiate your rates down. All right. So call up your account representative or whatever and be like, listen, this is where I’m at, okay?
00:15:22:15 – 00:15:40:08
Unknown
This is what it’s costing me. I want to keep my prices as low as possible, but this is what it’s cost me from you guys. Either I would like to stick with you. I know you where we’ve established a relationship, etc.. I want to stay with you, but I need some cheaper pricing or I’m just go somewhere else.
00:15:40:08 – 00:15:50:17
Unknown
It’s literally tell them okay.
00:15:50:19 – 00:16:00:13
Unknown
So then okay. Bye bye. How much do you know about.
00:16:00:15 – 00:16:36:16
Unknown
Okay, so you’re talking about you just cut. Okay. So you cut this by half. Okay.
00:16:36:18 – 00:16:44:20
Unknown
I mean, right, I mean, as long as the results.
00:16:44:22 – 00:17:09:21
Unknown
Yeah.
00:17:09:23 – 00:17:30:17
Unknown
Oh, yeah, a lot. I mean, compared to 2 or 3 years ago, for sure. Okay, so then you’ve hit that one. That’s probably your biggest. That’s that’s that’s gonna be your biggest driver right there. Right. So I mean, if you could cut that down by 50%, you just literally increase your margin by 25%. I mean, 20% up quite a bit.
00:17:30:19 – 00:17:40:01
Unknown
All right. So yeah. Okay okay. Okay.
00:17:40:03 – 00:17:53:01
Unknown
Okay. And then the other thing too that I talk about is that, increasing your price by just a little bit. Okay. Not much $5.
00:17:53:03 – 00:18:26:06
Unknown
No no no no don’t do that. Don’t do that unless you just want eight, okay? The only way that works is if the price of the product you’re getting is cheap as hell. All right. And then you could decrease your prices and still improve the margin. That’s the only way that works.
00:18:26:08 – 00:18:36:13
Unknown
Yeah.
00:18:36:15 – 00:19:18:05
Unknown
Yeah, yeah.
00:19:18:07 – 00:19:39:00
Unknown
Yeah. Okay. We’ll keep working on that. And then, like I said, you can increase your price by 5 or $10. No one will. No one will complain. All right. Yeah. So I’d say do those two things right there. Increase that margin. Get that up to closer to 50% if you can. And boom, now you’re making some real money.
00:19:39:02 – 00:19:56:10
Unknown
I mean you’re still making you’re making good money already, but like, you’re making even better money, right? Yeah. So I would say focus on that, just a little growth, little scaling thing that you should be doing, but it sounds like you’re kind of, already going down that path. So, so well done. Okay, so let’s talk about a few of the things that you wanted to talk about.
00:19:56:10 – 00:22:07:07
Unknown
So you want to talk about this beyond use date 28 day things.
00:22:07:08 – 00:22:16:04
Unknown
You’re gonna lose your license unless a catastrophic event occurs, right? I mean.
00:22:16:06 – 00:22:19:13
Unknown
You know, like, yeah, it’s it’s such
00:22:19:19 – 00:22:25:09
Unknown
Every single person, every provider, every pharmacist knows
00:22:25:11 – 00:22:30:19
Unknown
All of us do. Okay, the only reason why is because the USB is covering their
00:22:31:00 – 00:22:37:22
Unknown
right? Their recommendations, and then some bureaucrat at the board of pharmacy or whatever is like, let’s do this. It’s all it is.
00:22:38:00 – 00:22:39:07
Unknown
You know, it’s
00:22:39:09 – 00:23:09:12
Unknown
I have I have had my mental health practice in seven years. I’ve had two people get an infection, and it was probably because they didn’t clean their skin or something. You know, it’s it’s complete nonsense. And I have never heard of a catastrophic skin infections, cellulitis, whatever from anybody doing this with a lead MP in for the last six, seven years consulting with people I’ve, I’ve never heard of it.
00:23:09:15 – 00:23:28:08
Unknown
No one’s ever told me they’ve never seen it. Yeah. Every once while you get a little infection, boil or something. I mean, come on, when you injecting your skin, that’s going to it can happen, right? Narrowing it down because the vial was 35 days versus 28 days. Give me a
00:23:28:08 – 00:23:52:06
Unknown
break. Come on. Like.
00:23:52:08 – 00:24:02:12
Unknown
Yeah, well, and, I mean, it’s going to just provide you what I can find online and it’ll give you the worst case scenario. It just depends on how you prompt it. It’ll give you the worst case scenario. Basically just tell you what I just said.
00:24:02:12 – 00:24:11:11
Unknown
Right? So, okay, I don’t worry about it. I don’t worry about it.
00:24:11:13 – 00:24:32:11
Unknown
We went decades not worrying about it. Why are we worry about it now? I mean, you know, this isn’t a this isn’t something you’re putting into a vein. This is an Ivy that I can understand for sure. I’m an ID, I can understand gaining something that you’re going to inject into someone’s
00:24:32:14 – 00:24:38:05
Unknown
spine or a joint. I get that, but a subcu injection.
00:24:38:05 – 00:25:01:07
Unknown
Give me a break. Okay, so I don’t worry about it. Now. This is. I’m not anyone listening to this right now. I’m not giving you medical legal advice at all. I’m just telling you my thoughts. I don’t worry about it. I know very I know most people I talk about don’t worry about it. Right. It’s just when you just you just said what you got to do.
00:25:01:08 – 00:25:33:05
Unknown
You teach people how you do sterile technique every time. Play with alcohol every single time you clean your skin with alcohol, every single time you use a new syringe, every single time. If you do that, the chances of infection are practically 0%, right? So.
00:25:33:07 – 00:25:42:20
Unknown
Yeah.
00:25:42:22 – 00:26:03:06
Unknown
Yeah. I would just, I it’s a case by case thing. You do what you want to do, but I would do a case by case. You know, you start ordering 28 date vials, and it just increases your cost, increases shipping costs. It’s, you know, it’s it’s completely unnecessary. It’s, it’s a total waste of resources, too. It’s a total waste.
00:26:03:07 – 00:26:22:22
Unknown
You know, I remember talking to pharmacists years ago, and I remember, I talked to multiple pharmacists. This was over multiple. They were calling any pharmacies once, any names or anything. But like, I remember asking them, they were just like, you know, we just got to put that 28 day label on there. But don’t worry about it.
00:26:22:22 – 00:26:40:13
Unknown
Those vials of testosterone are good for six months, or that ball of peptide is good for one year. I mean, these these guys, these pharmacies told me straight up, don’t worry about it. We just put it on there because we have to. That’s literally what these pharmacies have told me, you know? So like, I wouldn’t worry about it.
00:26:40:13 – 00:26:49:00
Unknown
I just I wouldn’t worry too much about it. It again.
00:26:49:02 – 00:27:10:18
Unknown
Well what pharmacy was it, Walgreens or something.
00:27:10:19 – 00:27:13:20
Unknown
Yeah.
00:27:13:22 – 00:27:26:03
Unknown
Yeah. It’s.
00:27:26:05 – 00:27:44:09
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 least np.com, and make sure to follow us on Facebook, Instagram and LinkedIn.
00:27:44:15 – 00:28:09:06
Unknown
Email subscribers will receive updates on new weekly podcast episodes, multiple weekly articles, we publish, new courses and everything else related to helping you succeed. 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.
00:28:09:08 – 00:28:23:11
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.
00:28:23:13 – 00:28:48:18
Unknown
Yeah. That’s. Yeah, I’ve, I’ve experienced that a few times with like a pharmaceutical grade ball of testosterone non compounded like those manufacturers produce them in like ten and oh vials and stuff. Yes I’ve seen that. I have personally used a ten mil while it lasted me six months almost. And I’ve had no issues at all. Still potent levels are still I know infections, right?
00:28:48:23 – 00:29:07:17
Unknown
But anyways, I had that push back one time from a pharmacist at Walgreens. We called in for a patient. He was out of town or something. I don’t remember the exact. I don’t remember the exact details behind it or something. And he ran out or I don’t know. Anyways, we call that into Walgreens. You know, we usually don’t call in the stuff to a retail pharmacy.
00:29:07:17 – 00:29:27:05
Unknown
It’s almost all compounding pharmacies. But every once in a while you got to make an exception for something, right? And so I remember we call it into Walgreens or something, and the patient goes and picks it up and is like, he gave me I it’s just like it’s all I got was like three one ML vials or something.
00:29:27:05 – 00:29:41:09
Unknown
And I’m like, what? And I remember calling in there and then my ma try to send the script in, and the pharmacies want to talk to me, and I talk to the pharmacist. The pharmacist is like the tenant over at the dose. You prescribe the oils, be on the 28 day use, you know, body whatever, blah, blah, blah, blah, blah.
00:29:41:09 – 00:29:53:18
Unknown
And I was like, dude, I know you’re following Walgreens protocol and procedure. I get it, man. So congratulations were never sending you another prescription ever again.
00:29:53:20 – 00:30:06:09
Unknown
This is ridiculous. You know what I mean? And yeah, so I’ve I’ve experienced that more on the retail side just because it’s a protocol. They don’t they don’t they a local compounding pharmacy.
00:30:06:09 – 00:30:28:17
Unknown
They have a lot more leeway with things. Right. Walgreens, Walmart, things like that. They have no leeway at all. They’re they’re they are just a Eric gear and the machine of that company. Right. So they had fall procedures and whatnot. So anyways, I don’t want to talk about this much because it’s one of those things where I’m telling it, you should do it the right way.
00:30:28:17 – 00:30:47:17
Unknown
But the standard is, you know, most people probably don’t. You know, it’s totally up to you what you want to do, if that,
00:30:47:19 – 00:31:28:13
Unknown
I don’t like I said, I don’t know very many people that actually follow that. I just don’t.
00:31:28:15 – 00:31:58:21
Unknown
Yeah. I mean, if the state’s knocking on your door and forcing you to do it, well, then you probably should comply, right? It seems more of a state by state specific thing. Really? You know, the states that I don’t anyways. But, like, the game day thing, game day is a corporate franchise, okay? They’re a corporate franchise who are going to look to exit at some point.
00:31:58:21 – 00:32:19:16
Unknown
You know what I mean? So they to do everything 100% by the book. So it’s a big difference between that and an independently owned practice. Right. So.
00:32:19:18 – 00:32:24:01
Unknown
They only go the total number.
00:32:24:03 – 00:32:29:09
Unknown
They only go based off the total testosterone number of 600.
00:32:29:11 – 00:32:40:14
Unknown
That’s ridiculous. Well, if he has an FBG of 90.
00:32:40:16 – 00:33:03:05
Unknown
Yeah I mean it’s it’s a huge corporate franchise thing, right? The way they practice, it’s going to be vastly different. And almost everyone who listens to this podcast, you know, we’re small independent practices. So they’re corporate. They have teams of lawyers and compliance people and all of this because like I said, they’re packaging this thing up. They’re going to sell it for billions of dollars.
00:33:03:05 – 00:33:26:20
Unknown
It’s what they’re going to do, okay. And they need to be 100% regulatory compliant with that. And so, yeah, that’s I think that’s ridiculous. Don’t even look at the free testosterone bioavailable testosterone because I don’t know I’m sure you’ve seen this before, but I’ve had plenty of guys come in who have total testosterone to 6 or 700, and their SB and their SPG is through the roof and they’re free.
00:33:26:20 – 00:33:40:21
Unknown
Testosterone is absolutely nothing. So it’s send them on their way. Yeah. You have every single hypo gonadal symptom in the book. Like it’s complete nonsense.
00:33:40:23 – 00:33:48:14
Unknown
That.
00:33:48:16 – 00:34:11:05
Unknown
Right. It’s really no concern. I’m not. It’s not something I lose sleep over at all. I mean, I’ve been on testosterone myself for now. I’m 42, so like eight years now. I think I started when I was like 34, something like that, 35 or something like that. I mean, I’ve like, I’ve had know, granted, I’m still young, but I’ve had no issues at all.
00:34:11:07 – 00:34:42:15
Unknown
I did a full I mean, comprehensive like longevity, physical thing that cost me thousands of dollars. And I did a full CTA, CTA, and you gram calcium scoring, eye mapping and the coronaries and all of that stuff. I mean, that thing was like $1,500 or whatever. My CTA result was literally perfect 0%. Anything 0% out. There’s gross plaque development, narrowing everything.
00:34:42:15 – 00:34:48:17
Unknown
Calcium score of zero. I have a heart of a 16 year old.
00:34:48:19 – 00:35:11:14
Unknown
You know, I mean, our blood pressure’s a little high, but it’s a genetic thing, you know? But, like, outside of that, though, I’ve had no issues. And every I’ve, every patient I’ve had at my men’s health practice have had no issues at all. We’ve been doing it for eight years now, seven, eight years now. No one’s had any issues at all.
00:35:11:16 – 00:35:18:17
Unknown
Well.
00:35:18:19 – 00:35:21:11
Unknown
Yeah, I can have around a waist.
00:35:21:13 – 00:35:33:12
Unknown
That’s a short half lie there. I do much, Yeah, yeah. ACG or Klonopin. You know, one. But,
00:35:33:14 – 00:35:53:05
Unknown
Yeah. I mean, stimulates the pituitary, produce LH and FSH, which goes right through the testicles. Right. So yeah. Yeah, it’s a whole lot cheaper than ACG as well. But, I don’t know. I’ve convinced most my patients not really care. I’m like, the balls don’t do the work.
00:35:53:07 – 00:36:00:11
Unknown
Knock them.
00:36:00:13 – 00:36:08:04
Unknown
Whatever. I’m on. Listen, I’m on, on hCG I’m on, on Clomid. I’m on their marbles.
00:36:08:06 – 00:36:14:12
Unknown
I don’t care, I really don’t care. You know?
00:36:14:13 – 00:36:37:09
Unknown
Yeah, like most. Yeah. I just say one. You should just, you know, tell people just right from the get go, this is something that you’re going to expect. But don’t worry about it. It’s not that big of a deal unless your woman or your man or whatever really likes your balls. If they don’t, it doesn’t do the work.
00:36:37:09 – 00:36:50:21
Unknown
So who cares, right? Right, right. But yeah, that’s that’s kind of one of the big ones. Yeah, you’ll see that sometimes, but but yeah. Anyways, I think it’s, I mean, far as replacement therapy is proven to be pretty
00:36:50:21 – 00:37:19:18
Unknown
safe as long as it’s done within reason. I think the big thing with testosterone replacement therapy, is I think the big thing is that as long as you are metabolically cardiovascular, really healthy, and as long as your overall inflammation in your body is, you know, undetectable, low, then I think that you can take testosterone and anabolic steroids throughout your entire life.
00:37:19:20 – 00:37:41:12
Unknown
But it comes down to when you start adding, when there’s a lot more ingredients into the soup right of your body. Like if you think about your blood as a soup, right, what’s going on inside there? If it’s lean, right? If it is a simple ingredient soup, then the chances of something happening, things coagulating inside there clumping up and, you know, like basically.
00:37:41:12 – 00:38:01:23
Unknown
Right? I mean, if you think about it this way, this is just how it works, then the fewer steps in there, the fewer things are going to clump up and cause problems. Right. So, I think that as long as people are are metabolically healthy, this is why I like doing a very comprehensive, you know, very comprehensive laboratory on my patients.
00:38:01:23 – 00:38:23:07
Unknown
And I like to re check a variety of different labs on a regular basis every couple of years at least, you know, making sure metabolically healthy, not just checking the lipid profile, but also look at the apob, you know, the label protégé, like doing those sorts of things, checking CRP levels. A1 it’s it’s like making sure they are metabolically.
00:38:23:12 – 00:38:30:10
Unknown
All right. I have I have taken patients off of treatment because they are too much of a risk. I’m like,
00:38:30:10 – 00:38:41:01
Unknown
Your A1 C is eight, you are fat, you are hypertensive. You are too much of a risk for me. I’m not going to do it anymore. It’s not worth your hundred $50 a month is not worth the liability.
00:38:41:01 – 00:38:41:20
Unknown
It is not
00:38:41:22 – 00:38:58:04
Unknown
because you’re not listening to me and I kick them out. I just kick them out, get on my practice. No more. You smoke your out. Absolutely not your smoker. I’m not giving you testosterone samples that you know. Absolutely not too much of a risk. Absolutely not. Did the testosterone cause the blood clot?
00:38:58:04 – 00:39:01:11
Unknown
Did the testosterone cause the heart attack? No smoking there, but all it takes is one
00:39:01:11 – 00:39:18:13
Unknown
lawyer to twist it the wrong way, right? You know, and so I don’t, I don’t I take no risks there. All of my patients are metabolically healthy. They’re crops. I prefer to be, you know, undetectable every once while I might be a little higher, but whatever.
00:39:18:15 – 00:39:42:07
Unknown
You know, CRP is undetectable. I like clean lipids. You know, if they have really high red flag things like a super abnormal light bulb or, or Apple B liable protein, a that’s a big risk for me. And then your cardiovascular, are they healthy? You know, are they hypertensive. Is their blood pressure in check? That’s a big one to, you know, are they diabetic?
00:39:42:09 – 00:39:59:15
Unknown
So you want to make sure that these people are lean and clean, and if they are, then they can gracefully age with being on testosterone replacement therapy. I mean, if you look at guys like, you know, I would love to see Sylvester Stallone’s blood work, I would love to see his I would love to see his blood work.
00:39:59:21 – 00:40:17:17
Unknown
I don’t know if you follow. I follow him on Instagram because I don’t know, he just it’s entertaining. He has an entertaining Instagram profile. Guys like in his mid 70s. At this point that dude’s still juicing up. He still is, no question about it. Oral Schwarzenegger isn’t like you tell by. Yeah, you really tell he’s by that juice.
00:40:17:17 – 00:40:36:20
Unknown
Not much anymore. He’s blind. You don’t testosterone. That’s it. So that’s your Stallone. He’s still taking whatever he takes. I guarantee you he is. There’s no way you’re that big at 75 years old and not taking a variety of different things. He’s able to gotten away with it. Because I bet you metabolically, he’s perfect, right?
00:40:36:22 – 00:40:53:16
Unknown
Three in a pound. Who you know, who’s a metabolic nightmare. There’s no way you’d be able to justify that. You’re just not going to be able to. Right? So just.
00:40:53:18 – 00:41:19:03
Unknown
It’s not worth it. It’s not worth the risk. I had a guy, a mighty guy that, This guy, this guy’s this guy’s somatic rate was always like 58, 59, 60, 61 is hemoglobin was like 2021. I’m like, dude, this isn’t worth it, man. I’m sorry you had to donate blood. Every two weeks, you can stay on testosterone.
00:41:19:08 – 00:41:36:16
Unknown
Your iron is nothing now. No. I’m sorry. You know that you were done. Like this is not worth. This is not worth it to me. I’m sorry, I’m sorry. And come to find out, he was a smoker. And so I was like, dude, you quit smoking, and maybe I’ll. Maybe we can start it back on treatment. And he just.
00:41:36:18 – 00:41:49:07
Unknown
He he refused. He refused to admit. He refused to comprehend that the smoking had anything to do with his elevated hematocrit levels. Refused. Refused. Okay, fine. Just keep smoking cigarets.
00:41:49:07 – 00:41:54:21
Unknown
This is a my concern. You’re a problem, not mine. At this point, I’m not taking that risk, you know?
00:41:54:23 – 00:44:56:00
Unknown
So anyway, it’s just food for thought for everyone listening. Yeah, yeah, yeah, yeah. Anyways, though, so what do you, what you what you want to talk about pricing. Pricing your services.
00:44:56:02 – 00:44:58:18
Unknown
Well.
00:44:58:20 – 00:45:12:23
Unknown
Yeah, I will say that you need you definitely need to diversify out of weight loss as much as you possibly can. I mean, once.
00:45:13:01 – 00:45:31:05
Unknown
Are these sites that are selling, you know, these GLP ones as research peptides and all this stuff? I mean, these things are slowly going to be shut down in time. But the problem is and then another will be opened up. So there’s no way that they’re going to be able to wrangle all of these in. There’s just there’s no way there’s no resources for it.
00:45:31:05 – 00:45:57:10
Unknown
You know, there’s there’s no one out there doing that, you know what I mean? And so it will continue and it will continue with peptides and stuff as well. Unfortunately. It’s just it’s just going to and I think that it’s it’s definitely hit the, the the margins on weight loss clinics. You know I I’ve said this before in other podcasts my barber sells peptides.
00:45:57:14 – 00:46:20:03
Unknown
Right. And it’s just like I don’t want to buy a peptide from you dude. Or go, really good source, man. They’re out of China. The Kessler stuff. Yeah, right. Yeah. Sure they do. No, but most people are short sighted. They don’t care. All they care about the price. Right. And I think that putting all your eggs in that basket is not a wise idea.
00:46:20:04 – 00:46:29:21
Unknown
I think that weight loss. I think you can still make money doing weight loss, but I think the, the golden time for it was about 2 or 3 years ago when you could make a
00:46:29:21 – 00:46:31:08
Unknown
ton of money with it.
00:46:31:10 – 00:46:39:06
Unknown
But I think that there’s still plenty of people who are willing to pay for, you know, pay for weight loss medications and do it the right way for sure.
00:46:39:06 – 00:47:01:03
Unknown
So there always will be a market for it. But I would be cautious if 80% of your revenues coming from weight loss, you want to try diversify out of that. I will say this right now as well. I sell practices for people and I cannot sell your practice if it is doing more than 20% weight loss, I cannot.
00:47:01:03 – 00:47:18:07
Unknown
No one will buy it. No one will buy it. Okay. These yeah. These private equity firm, these people who have these billion dollar funds and stuff. They’ve done the research. They know and they know that. Well, they would they they would they would they like your clinic. They wouldn’t touch it. No, I couldn’t sell your products. I wouldn’t even take you as a client.
00:47:18:08 – 00:47:42:17
Unknown
It be a waste my time to try to sell it. Right. So so you need to try diversify out of it and get that below 50%, hopefully. And even get it less than that if you can. Now you’re making a ton of money with it, so don’t stop doing it. But like if you can keep the same amount of patients that you got weight loss over here 80%, or you can expand this HRT arm and overgrow it, you’re well.
00:47:42:17 – 00:48:06:09
Unknown
Well, you’re doing $2 million a year now, right. So I would say that focus on the complementary stuff. If you’re not doing a subscription based thing, you really should. Okay? You really should. I’m telling you, it works better. It is something you should highlight. You should think about it, that recurrent revenue cannot be it cannot be beat.
00:48:06:14 – 00:48:35:08
Unknown
So I would say consider it a can. With women’s HRT, women’s HRT and women’s health in general is a growing field and it is very high demand and it will continue growing in demand. Men’s health is a great thing to do. It is. But there is a lot of competition out there because you said it earlier. It’s easy, it’s easy to do and it’s there’s high demand for it.
00:48:35:08 – 00:48:47:15
Unknown
It’s very simple. That will continue to grow. But there’s a lot of competition out there. Can you scale a men’s health practice to millions of dollars a year? Sure you can, but
00:48:47:17 – 00:48:59:23
Unknown
it’s going to be hard too. Okay, so with women’s HRT on the other hand. All right, that is still very scalable, very in demand and increasing in demand.
00:49:00:01 – 00:49:25:11
Unknown
And I will tell you this too. You know, I have contacts with over 250 different private equity funds that buy practices. Okay. So I talk to these people, I know what they want. And they love clinics that focus on women’s HRT. Right. So if they love that, so should you. Because trust me, they’ve done the research. They know, okay.
00:49:25:13 – 00:49:46:14
Unknown
They’ve done the market research. They’ve spent millions of dollars doing this market research. And they know that there is huge growth potential in the women’s HRT market and just the women’s health market in general, huge potential. And they are scooping up practices. I’m selling your practice right now where it’s about 70% women’s health. We’re going to sell this business so fast.
00:49:46:16 – 00:50:04:00
Unknown
I already have so many interesting client and interested clients that are one or interested buyers that want to look at it. We’re just not quite ready. Celia. We’re a couple weeks out still, but we have so many people who are just like knocking down the door to take a look at this practice. Okay, now the other hand, I got another one that I’m selling that’s predominantly men’s health.
00:50:04:00 – 00:50:10:14
Unknown
We’re having a lot more difficult of a time selling that one. Okay. So the women’s health I know is a little bit more of a pain in
00:50:10:19 – 00:50:22:23
Unknown
I do I get it, get it. But if you can try to simplify it as much as possible, then simplify it as much as possible. All right. And try to make it easy, convenient.
00:50:22:23 – 00:50:36:12
Unknown
Put it on a subscription based model, not making any money on it. Then you’re doing it completely wrong. You should be making good money on that. Okay, for the $200 a month, you should be making a pretty healthy profit. All right.
00:50:36:13 – 00:50:59:18
Unknown
Bolling, you should. I’m I I’m that’s the way to do it. $250 a month. You will make money. You will make good money. You make hitting 50% margin easy. Okay. So yeah, it’s you can expand out of the weight loss by focusing in on that a little bit more. Okay. There’s a lot of education out there about women’s HRT and women’s health and stuff.
00:50:59:18 – 00:51:19:03
Unknown
I mean, you probably have a good idea of how to do it. It’s not hard, you know?
00:51:19:05 – 00:51:38:09
Unknown
Well, the thing is, to Amy, is that you shouldn’t have to be doing it for much longer. Okay? You are all right. You’re doing well right now, right? I mean, you’re doing pretty good. I mean, you know, you’re making 250, 200,000 bucks a year profit right now from 2000.
00:51:38:11 – 00:51:42:08
Unknown
Probably more than that. You’re probably like 3 or $400,000.
00:51:42:10 – 00:51:56:21
Unknown
You know, that’s what you’ll clear over the next 12 months. Maybe a little bit more. If you get your margins up and you you’re scaled to $1 million, you’ll probably clear $400,000 in the next 12 months. So you’re doing very, very well. So.
00:51:56:23 – 00:52:01:22
Unknown
Oh, yes.
00:52:02:00 – 00:52:30:22
Unknown
Yes. So what you need to do is the business owner. This is with any business. Okay. What you need to do is that you got to do it yourself first for a little while. Dial in your clinical protocols dialing your procedures with it. Understand what people want. Understand what the women want. Understand how to price it appropriately. Understand how to sell them on the phone when they call, how to put this up on your website, and then develop some very simple clinical protocols that when you hire someone, they can just follow those.
00:52:30:22 – 00:52:51:00
Unknown
And it’s it’s it’s fairly easy to do. Right. So do it yourself for a little while. Prove the concept. Get the demand in there. All right. Get the growth to practice. Prove that it’s actually something people are going to buy and then double down on it and then hire another NP to come in ten, 20 hours a week and they can start doing all your women’s health for you.
00:52:51:00 – 00:53:12:03
Unknown
You can continue to focus or your men’s health component of it and do the easiest weight loss for cash, right? Yeah, you should look at weight. You should look at weight loss as something that generates a lot of revenue that you can reinvest into your business to grow out of weight loss. That way, that’s how you should be looking at weight loss.
00:53:12:05 – 00:53:34:14
Unknown
Yeah.
00:53:34:16 – 00:53:55:10
Unknown
It’s not it’s not terribly difficult. I mean, I’m sure there’s some people out there is going to disagree with me and that’s fine. But like, you know, I treat a couple dozen women in men’s health practice, usually like the wife of a patient or whatever I prescribe them. No estrogen. I prescribe them no progesterone. I put them on testosterone, I put them on.
00:53:55:12 – 00:54:01:14
Unknown
That’s it. They feel great.
00:54:01:16 – 00:54:06:15
Unknown
Yeah, well, testosterone is easy.
00:54:06:17 – 00:54:23:17
Unknown
It’s it’s.
00:54:23:19 – 00:54:27:14
Unknown
Yeah, that.
00:54:27:16 – 00:54:33:20
Unknown
Oh, Jesus.
00:54:33:22 – 00:55:05:11
Unknown
Yeah. I mean, I’m sure her husband and, Yeah. I mean, I’m sure husbands enjoy the increased libido are there, but, like, my lord, but, like. Yeah, I mean, come on, this is this is the easiest thing in the world to do. 5 to 10mg daily cream. That’s it. So you got to do it’s the he gets it gets their total testosterone level do about 100 ish every all every females HPG high.
00:55:05:11 – 00:55:43:01
Unknown
So then the free testosterone is going to be hanging out around five or whatever. Right. That’s it. They feel great. They feel fantastic. You do their blood work. There’s no side effects. They’re still in within range. Like it. That’s what I do. It’s yeah it’s easy.
00:55:43:03 – 00:56:11:03
Unknown
Yeah that’s I don’t yeah I don’t I don’t get that either. But it’s easy five ten milligrams a week okay. That’s it. Piece of cake daily. But you know.
00:56:11:05 – 00:56:23:21
Unknown
There’s dumb like it’s dog. Yeah I’m sure there’s.
00:56:23:23 – 00:56:29:22
Unknown
It’s not worth it.
00:56:30:00 – 00:56:37:12
Unknown
To literally be on the intake form. Do you smoke? Yes. You’re you’re not going be a patient here. Sorry.
00:56:37:13 – 00:56:56:13
Unknown
You know, I think he’s nicotine pouches or dip or whatever. That’s fine. I don’t care about that. Smoking. Yeah. I mean, smokeless tobacco, like, I mean, I mean, most people don’t even dip anymore, but there’s a lot of guys that use nicotine pouches. There’s no that doesn’t cause the same thing as smoking. Not even close. It’s not even in the.
00:56:56:18 – 00:57:34:12
Unknown
I don’t care about that. That’s fine. There’s no issue. There’s no impact for me. So that’s that’s not a pro-inflammatory thing. Like smoking is. Right? Yeah. Any other questions?
00:57:34:13 – 00:57:44:01
Unknown
That’s that’s just that’s just human nature.
00:57:44:03 – 00:57:55:07
Unknown
Yeah. I think maybe 5 to 10% are people of people are cut out to be a business owner. That’s, that’s, you know, and that’s how it and unfortunately, that’s how it has to be. Because if everyone was a business owner,
00:57:55:07 – 00:57:55:12
Unknown
their
00:57:55:12 – 00:57:55:19
Unknown
shit
00:57:55:19 – 00:58:01:03
Unknown
wouldn’t get done. Right. So there has to be the worker bee class. There just has to be.
00:58:01:03 – 00:58:27:15
Unknown
And so good. Whatever. Fine. Live your life. Who cares? It’s your life. This is my life, right? I would like to end up with you. Ask me a question. You have a question for me? Personal curiosity, whatever.
00:58:27:17 – 00:58:50:18
Unknown
Well, I mean, that was. That’s that’s one aspect of it. Yeah. I mean, the fishing’s pretty decent. You know, I mean, it’s beautiful. I mean, the mountains. I wouldn’t live in Denver. I mean, Denver’s Denver so far from the mountains. People don’t realize how far Denver is from the mountains. Like, Denver kind of sucks. Like, it’s it’s flat plains.
00:58:50:18 – 00:59:11:05
Unknown
It’s. And then you see the mountains in the distance. Right. So I live, I live much closer. I could drive ten minutes to the mountains, like the tip of my mountains are right here. Right? I could go ten minutes and hike one mile up and be a beautiful mountain lake. Right. So, so I came from the nature of it, and, you know, the fishing, the, the mountains, the forests, the the weather’s pretty nice.
00:59:11:05 – 00:59:31:18
Unknown
It’s fairly dry. You know, I, I came from the southeast, you know, the rainforest of the Appalachian Mountains. It rained every day, you know, that’s why it’s so green there, you know? But, But, yeah, here, like, you know, you little afternoon storm. That’s it. Right? It’s gone. Yeah. So bit of that. And then, the schools are the best in the country.
00:59:31:21 – 00:59:52:10
Unknown
Or, you know, we’re basically where we lived some of the best schools in the country. You know, I got, I got two boys now, and, that’s kind of pretty much. Yeah. Change of atmosphere and kind of, inherently a, nomadic person. So I really stick around more places. I have about a 5 to 7 year life span for anywhere I’ve ever lived.
00:59:52:10 – 01:00:15:00
Unknown
So, it’s just how I am. I built out, you know? So, Yeah, the cost of living out here is very high, though. So, Yeah.
01:00:15:02 – 01:00:24:15
Unknown
Yeah.
01:00:24:17 – 01:00:51:08
Unknown
Now, Denver is not a very good representation of Colorado. It’s a good representation of the people in Denver who are. They are their own type of people. And like the state votes that way in Denver and the entire rest, the state votes a different way. So it’s like, that’s just how it is here in Colorado. But yeah, yeah, but but the cost of living is it’s high.
01:00:51:08 – 01:01:11:00
Unknown
But I never really this is one of the first places I’ve ever lived where the cost of living is very high. One thing I’ve realized about living somewhere has a very high cost of living is that it keeps. It keeps trash out. And I hate to say that, so it might sound a little pretentious, but it keeps trash out.
01:01:11:02 – 01:01:22:03
Unknown
You know, when the average value of a home in, you know, a certain area is over $1 million, you know, get trashy people going to get here. So I don’t see bums on the streets. I don’t see people with
01:01:22:03 – 01:01:29:19
Unknown
signs at every traffic light. It from. I don’t see that here. And it’s so nice, you know. Yeah, it was a good question.
01:01:29:19 – 01:01:45:08
Unknown
So I appreciate you hopping on here. Yeah. That I’ve had people ask me how they can follow me personally. Deuce I thought I’d just drop that in here at the end of the podcast, too. So do you follow me on, Facebook or Instagram? Just just now in Montgomery? You. So anyone wants to be a friend, request of your friend, request whatever.
01:01:45:08 – 01:01:55:10
Unknown
Happy to have you follow me. And, appreciate Jamie. Right. Thanks. Bye.
01:01:55:12 – 01:02:14:21
Unknown
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. 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.
01:02:14:21 – 01:02:26:17
Unknown
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