Perfectionism, the Chair, and Why the Practice Never Gets Built

Transcript YouTube English auto-captions. Hey guys, this is Dr. Mike Wuing. Welcome to another edition of Bootstrap MD, the podcast for physician and healthcare entrepreneurs. I'm a family physician and serial entrepreneur. I've helped build and sold multiple sevenfigure businesses, including practices and software companies. And today, I own a number of different cashbased clinics in Southern California. And I also help physicians through my company, Bootstrap MD, and with Dr. of us helping you guys build businesses that actually make sense. So, I got a question for you today. When was the last time you made a business decision without spending a few weeks second guessing yourself? When was the last time you looked at your schedule and thought, you know what, I'm actually excited about today? And here's a big one. When's the last time you felt like you were in control of your medical career, but instead of just another cog in the healthcare machine? And that's what I want to talk about today. The stuff that really nobody really talks about in medical conferences. The hardest part about building a successful practice or side business isn't just the systems, isn't the marketing or even finding patients. It's what's happening between your ears. Now, I know what you're thinking. I deal with a lot of doctors and they actually tell me, "I'm the smartest person in the room. I don't need help with this. I've got the mindset down." But actually, I want to share with you the wakeup call that really changed everything for me. I was working as a family medicine physician and despite being relatively well- paid in sunny Southern California, I felt completely unfulfilled. I was seeing patients every 8 to 10 minutes. And I remember thinking, you know, I can't sustain this. Something bad is going to happen. But the real wakeup call came one Christmas morning when I was working at 4:00 a.m. in the emergency room with his older doctor in his 60s who looked about 80s. We were both sharing call. We were there, me because I was on call, but I found out he was there because he needed extra money from holiday pay. He wasn't there because he wanted to be. He was there because he had to be. And that's when I realized I was staring at my future if I didn't make some changes. Unfortunately, this doctor passed away before he reached 70. You see, medical school and residency condition us to think like employees, not entrepreneurs. We were doing everything right. We're trained to avoid risk at any cost. We always have to have the right answer before acting. And we do everything to ourselves because delegation might mean someone's getting hurt. But then when we graduate and wonder why we struggle with business decisions, it's like training someone to be a helicopter pilot and expecting them to drive Formula 1. So here's the identity crisis that every physician faces and it's really the thing that kept me stuck for years. You know, I had this voice in my head saying, you know, I trained my whole life to be a doctor. And if I'm spending all my time starting a business, developing my business, does that make me less of a physician? This identity conflict is real. I see it with my clients almost every single day. We tie our worth to how many patients we see, by how many hours we work. But here's what I learned after living clinical medicine for some time, helping build multiple businesses, and then eventually coming back to medicine on my own terms. You can be a great physician and be a successful entrepreneur. So, I'm going to share with you three mindset shifts that really changed everything for me. I've identified these shifts that separate those who thrive for those who seem perpetually stuck. Shift number one, I call it from being a perfectionist to iteration. In medicine, perfectionism saves lives. In business, it can really kill momentum. When I started my first cash pas clinic back in 2012, I made every mistake you can imagine. I was doing hormone therapy and I spent over $4,000 in mailers advertising free consultations. You know how many serious prospects that brought in? I had one guy and he wasn't even interested in testosterone replacement therapy. He wanted free medical advice about completely unrelated issues. My problem is I was trying to perfect everything before I launched. The location above was a noisy parking garage with steel doors that banged all day. I had cheap IKEA furniture. The reception desk I bought at a school surplus auction. But here's where I learned. Done beats perfect every time. The imperfect clinic eventually became the foundation for eventually selling that practice to other partners. It was the foundation for building sevenfigure practices. It wasn't because I waited until everything was perfect, but because I started getting real feedback from real patients. Guess what, guys? Your patient don't care if your logo is the exact right shade of blue. They care only if you can solve their problem. Shift number two, going from a clinician to CEO. This is about role identity. And I think it's where most doctors get stuck. And unfortunately, I learned this lesson the hard way. For the first two years of my clinic, I was doing everything myself. I was seeing patients. I was managing staff. I was paying bills. I was working harder than I was employed and barely breaking even. It wasn't what until I applied a strategy with what Michael Kerber talks about in his prenal bestseller, The E-Myth. It's important on working on your business, not working in your business. That's where everything changed. I hired a nurse practitioner. I trained my medical assistants to handle routine procedures and I stepped into that CEO role. The result today I average less than half a day a week in working in my practices. And the clinic generates consistent seven figure revenue. Why? Because I'm not the bottleneck anymore. Your patient don't need you to draw blood or confirm appointments. They need you to be the best physician you can to be where no matters. And I get it. I physician say, you know, I'll do that when I have enough money. The thing is, you're not going to get enough money until you embrace this change. Everything else, that's what we create systems and people for. And then shift number three, going from scarcity to collaboration. Medical training, I really think breeds this competitive mindset. You know, you need that one chief residence spot. You need that one fellowship. But in business, collaboration is really where the money is. I learned this when I was researching my market. Instead of seeing other weight loss clinics as competition, I studied what they were doing right and what they were doing wrong. You know, I studied these offers. I'm sure you've heard of Groupon. Not saying this is the way that you need to go, but it shared with me like what people actually wanted. It gave me data that one clinic had over 5,000 people buy their weight loss program voucher. They told me that was serious demand in this market. And then instead of rather than trying to undercut them and go from a race to the bottom, I figured I had to differentiate. While they were just handing out medications, we added nutrition counseling with my medical assistant and registered nurse. We paid for them to get trained. While they offered commodity services, we focused on building relationships. The scarcity mindset states that I got to protect myself. I got to protect my turf. When you change to the abundant mindset, you have a different answer. You ask different questions. You want to say is what can I learn from what's already working. One keeps you stuck, the other builds you wealth. It's all about rewriting your money story. So, let's talk about how physicians often think about money. And I think most of us think about it completely backwards. As a family medicine resident, I started my first business. It was a test preparation company for aspiring doctors. I was working 50 to 60 hours a week in residency and still building this business on my spare time, which is often between 5 to 7:30 in the morning. Although that business was successful, I was still thinking like an employee. I was trading time for money, but just in a different format. The real shift came when I learned about building systems that generated revenue without my direct involvement. I hire had different services. I had my wife, she worked on critiquing personal statements and re helping them rewrite them. When I eventually was co-owner of a software company, eventually sold it, I realized I can make money from the work that I had done years earlier. That's creating revenue, but the revenue is value based revenue instead of timebased revenue. And here's a question that really changed my perspective. What happens to your income if you get sick and you can't work for 3 months? If the answer it disappears, you don't have a business. You really have a very expensive job. Let me show you some specific tools I use to maintain the mindset. These aren't theoretical and I do this every single day. I focus on what I call my goal getting six system and you can read more about it in my book, The Physician. I know, really bad plug there. You can also find search go to bootstrapmd.com search my podcast and you can find my episode where I talk about the GG6 system or the goal getting six system in depth. But basically every morning I review three main goals. I want to identify what limiting beliefs might be holding me back and I plan specific actions for the day. It helps keep me focused on building assets and just earning income. Another method I use is called time blocking, specifically CEO time blocking. Can you spend one day a week without zero patient care, just pure business development? And I know what you're thinking. If you got a busy practice, you know, Mike, I can't take a whole day away from my patients. But here's the reality. If you're always working in your business, you're never going to build something that works without you. Then another another strategy I have is that 30,000 ft view. You know, I regularly ask myself, am I using my talents to provide maximum value? Am I creating a legacy? Am I building something that I can pass on to my kids or am I just running in that medical hamster wheel? It's also important to have continuous learning. I still invest in business education, hire mentors, contribute to masterminds. The minute you think you know everything is the minute you stop growing. I want to share with you my clinic transformation. And this is how mindset shifts really create results. When I first opened my clinic, I was the typical control freak physician trying to do everything myself. The breakthrough came when I realized the clinic could only be profitable if I wasn't there. How can I create services that I can replace myself? I restructured everything around what I call the hive model. These are services that bring back patients regularly, like weekly weight loss check-ins and monthly hormone therapy. I hired a mid-level provider who is passionate about aesthetics. I trained medical assistants to handle routine procedures. I created standard operating rece procedures using loom videos. I created systems so patients weren't asking for me specifically. They were happy to work with my trained staff. The result is I work from working 5 hours a week to about now about 4 hours a week. The clinic now serves hundreds of thousands of patients, but my income isn't dependent on how many people I see, how many people the practice sees. And that's really the mental leap from being the technician to becoming the architect. And it's only possible when you change how you think about your role. And look, I've been where you are. I know the struggles of feeling trapped in a system that seems designed to burn you out. And I still go through this every single day. Still trying to make myself better, make the practice better, create systems better. But I know what it's like to wonder if there's something better out there. And here's what I want you to understand. Every sing successful physician entrepreneur started exactly where most of you are right now. The only difference is they decided to start thinking differently. This is going to be controversial, but you don't need an MBA. You don't need to reinvent the wheel. You just need to start thinking like the CEO of your own life instead of an employee in someone else's systems. The physicians who embrace this are winning right now. They're building wealth. They're working less. Actually enjoying medicine again. I'm not smarter than you. I aspire to be the dumbest person in the room in some of these masterminds. What I've learned is they just make different mental shifts. They chose to think in terms of systems instead of individual effort. They chose to build assets instead of just earning income. They chose to bet on themselves instead of hoping the healthare system would magically get them better. So here's my challenge to you. What is your next move? I want you to take time this week just to think what's one small step towards thinking like an entrepreneur instead of an employee. It could be as simple as tracking how you spend your time for the next 3 days or researching what other physicians in your area in your expertise are they charging for cash services. It's okay to start small but the best time to plant a tree was 20 years ago. The second best time is today. If you like what you hear, I would love you to be part of the Dr. community. You can go to school uh.com and search for Dr. Boss or you can go to school.com/dboss or you can follow my resources at bootstrapmd at bootstrapmd.com. We've got resources, case studies, a community of physicians who are actually living this life. Remember, you only get one life. Don't spend it working for someone else's dream when you could be building your own. As an entrepreneur, you're going to have your ups, you're going to have your downs. Do something a little each day to get you closer to your goals and keep moving forward.