In this episode, Anne Truong MD, a successful private practice owner, returns to share her journey of transitioning from an insurance-based to a thriving cash-based practice focused on sexual health. Dr. Truong discusses the importance of niching down your services to focus on a specific offering that provides high profit margins and aligns with your passion as a physician.
Learn how niching down can help you optimize your marketing efforts, attract your ideal cash-pay patients, and create additional passive income streams. This episode is the first in a 3-part series with Dr. Truong, designed to help physician entrepreneurs transform their practices with actionable strategies for finding their niche, attracting patients online, and creating membership programs.
Join us in the upcoming Medical Practice Profits Challenge – Starts April 30!
Transform your medical practice by saying goodbye to declining insurance reimbursements!
For more details:
https://practiceprofitschallenge.com/
Transcrip:
Dr. Mike: [00:00:00] Hey guys, it’s Dr. Mike Woo-Ming, welcome to another edition of BootstrapMD, the podcast for physician and healthcare entrepreneurs. We’ve been a little bit on tighter practice on schedule, and we are so excited to bring a series of interviews with my good friend, Dr. Anne Truong. We’ve had her on the Call before as she is a medical practice owner in Virginia.
She’s a very successful sexual health practice and we are excited because we are bringing together a what we call [00:01:00] a challenge. You’re going to know more about that in just a moment. In just a few minutes or just later in the program about how it works If you are thinking about starting a practice or maybe you already have an existing practice already And I maybe want to incorporate cash based services into your practice, but perhaps you’re doing a cash based Services.
Maybe you have a med spa. Maybe you have a clinic right now, but you want to, maybe you want to turbocharge that a bit more, get more profits, get a bit more security. As we can’t always count on insurance to help us pay the bills and keep us growing. And, we have discussed about cash based practices and I wanted to focus today on especially if you’re a practice right now and you’re saying, maybe I want to get into cash based services, but I don’t know which direction to go to.
You want to sit down, take notes. We’re going to be covering that today. But before we get into it, I want to introduce my friend, Dr. Anne Truong. Anne, how are you doing? [00:02:00]
Dr. Anne: Thank you. I am doing very well. I’m really excited for us to be working together on the medical practice profit challenge. I don’t think anyone had done a challenge like this before and with me and you doing this and really to really help doctor make a profit because you cannot continue a business right now.
With taking insurance and so I’m happy to be here and to contribute and to spread the message to help doctors make more money so they can really enjoy being a doctor again. It’s important for me because my daughter right now is taking her first board of usmle board to become a doctor. She just finished her second year and I really want to set up the landscape for her in the future to enjoy you what she loved doing and really enjoyed being a doctor because right now as all the doc, most of the doctors we see and some of the doctors I’m talking with have been just out like really one to three years [00:03:00] already thinking about transitioning because they’re already burnt out.
So I’m happy to be here and to talk about, our challenge that is coming up.
Dr. Mike: Okay. Yep. But we’re gonna teach you just a little bit more exactly what is a challenge. What’s that encompasses, but I want to get into the topic first that we have on hand and that is deciding on a niche for your medical practice, specifically with a focus on cash based services. Just for people who may not know you maybe just a little bit of kind of your background a little bit about your practice and perhaps how you decided on your niche as well.
Dr. Anne: Right? I’m a PM& R, a physician, and I’ve been doing interventional pain management since I’ve been out of practice at 1997 and was taking insurance where and was growing the practice to about 6 providers and 35 staff was working long hours when making less and less money every year. [00:04:00] I was getting burnt out before even burnt out was even a word used because I was not a good person to be around. And I decided, and I actually started having PVC. I started having PVC and I keep getting sick all the time.
I was always having the sniffle and I just thought because there’s allergies. And then one day a good friend of mine who’s my primary care is my primary care. His office is right next to me and I walked over. I said, I’m having trouble breathing. And he put the, he listened to me and he put on EKG.
And I had continuous PVC. God knows how long that was, but that’s why I was so tired. And he said, you got to do something. I’m going to put you on beta blocker. I said, no way. I am not going to be on a beta blocker at that time. I was actually yeah almost 50 at that time. And so I decided I need to do something.
So that’s when I decided to go to cash. Because I knew that with the current model at that time of taking insurances and workers [00:05:00] comp, it wasn’t working out and expenses were rising. So I downsized the practice from six providers to myself and to five staff. I got everyone their job and decided just to go cash or let my patient know.
Within I think 90 days, we actually did that at that time we had 35, 000 patient database. And of course, I knew that I was going to take less patient because I was going to go to cash. And I was prepared for that honestly. So my journey was that burnt out or being bought over or be an employee.
And I decided I wanted to stay in private practice and to continue doing what I’m doing. But part of what I also do is I also do regenerative medicine. So I use, I do PRP for pain, but then I thought in 2014, I got into using PRP for aesthetic and for sexual dysfunction. So I said that, we went over to [00:06:00] cash, but part of the thing was we were doing some cash based practices as well.
But at that time in 2018, I was doing pain. I was doing aesthetic. I was doing weight loss. I was doing IV therapy. And then I was also doing sexual health. It was a lot. Yeah, it was a lot on kind of a menu. We, that was a lot of things that we had to focus our energy on. So when I went to cash.
I knew that I needed to hone in on one service, but I have to say at that time, I also had a coach, I hired a coach in 2018 with my first coach. I pay him 50, 000 at that time for how do I transition to a cash based practice and be profitable. I knew that I didn’t know what I didn’t know.
So it’s that word when I first heard it, I said, what? I didn’t really understand it. But when you let us think it, you really don’t know what you don’t know. So you have to hire somebody or mentor or coach to guide you there. Who’s been there and who [00:07:00] already knows the pitfalls and who knows the best thing path going forward. And that’s why I hire a coach. And that was the best thing I did. And since 2018, I’ve always had a coach. So the coach at that time, advised me that I need to niche down because I’m going to go to cash. I need to niche down to what the heck. Does niching down mean and but let me before I say that let’s just say that okay So I went into cash in 2018 And since then we have not looked back and when we went to cash and we started niching down We made more money every year and over a year.
We didn’t make money with 2020 and you know during covid I also got sick as well and I was on near death. But the reason why I mentioned that was because I knew I had a second chance of life. And I knew that I wanted to make something meaningful of my life at that time. I probably have another 30 years on this earth.
And I wanted to [00:08:00] make do something that I wanted to do. And so, I went all in on online digital marketing. And so I became a digital marketer. I learned marketing. I learned to be a copywriter. And We hone in on sexual health, using stem cell therapy, hormones and shockwave. And we grew a practice now to not only in office treatment, but we also have an online coaching program.
We also have a newsletter, a membership, and we’re now cross our eight figure and making a figure for a year. And so and I want to share what are my experiences with other doctors. So getting back to that’s my story. So getting back to niching down in 2018. What is niching down when I first heard that word I didn’t know what the heck it is, and those of you that are listening it’s really meaning narrowing [00:09:00] down going deep you know. As doctors we can really do anything. Even if you’re a specialist you can probably do a lot of stuff. I’m PMNR, but I did two years of internal medicine before I did another three years of PMNR. So I can probably do, or I work in urgent care. I can probably do a lot of stuff as well, too. So Niche Down is like Starbucks.
What is Starbucks known for? Starbucks is known for coffee. Starbucks is known for great tasting coffee. You don’t go to Starbucks to get a salad or a hamburger, right? You go to Starbucks for coffee. And that’s what the brand is known for. But when you go to Starbucks, you can have they also sell salads and sandwiches and muffins and everything else, right?
Niche down mean being known for one thing and a market for one thing like be like a Starbucks. I that’s why I narrowed out on sexual health [00:10:00] for men. I focus on sexual health for men, mainly erectile dysfunction using PRP, platelet rich plasma, hormones and shockwave therapy.
So I create a package. I created irresistible package to deliver the service and I didn’t advertise and I didn’t I even put away the, the pain management part. I still do pain today, but I attract the patient for a reptile dysfunction, and if they have pain that I’ll take care of their joints once they come in for the technical health.
So the reason you niche down all your energy, all your marketing efforts, it’s geared toward one thing. So it’s like I correlate that as going to med school, when you go to med school, the goal is to take one test after the other to study and to graduate right. It was you had no other goal except that goal to go through med school the best you can same thing [00:11:00] with niching down your medical practice I’ve attended three conferences within the last like literally like month and I’ve been talking to medical doctors who is spinning their wheel they’re on the hamster wheel.
These are talented Medical doctor who’s been practicing for over 20 years, we’ve talked all over the world and who are the innovators, but yet they’re struggling to even make 7 digit a year, even make a million dollar a year. And they’re in their own practice, but yet they’re doing multiple service.
They do pain, they do weight loss, they do aesthetic, they do sexual health, they do hair restoration. So they think that the more service they do, the more money they’re going to make. That’s actually the opposite. It’s actually the opposite, because the more service you do, you have to figure out what to market, what to spend your energy on, right?
So who do you [00:12:00] market? If you do all that, who do you market? You market everyone. When you market to everyone, you market to no one. So you have to hone in on one particular customer and I will and that customer is the one that buy your one service and that is easier to focus on for marketing effort for messaging.
Messaging, meaning what you say to attract that particular customer and also what advertisement material that you put out as well, too. So when I learned that thought for me, it makes so much sense. And that’s in 2018, when all in on male sexual health and we have not, and I’ve been trying to tell the doctors that I met in the last three conferences is that, you don’t have to give up all the stuff you do, but just focus on one service [00:13:00] that give you the most leverage with the least expense.
So what I’m trying to say is that what is that service shouldn’t be doing spine injection that require you to pay a same day surgery cost a floral equipment, a tag dye and all this stuff and then your profit margin, probably 30%. You want to focus on a service that you want to niche down to that give you at least 70 percent profit, and not 30%. So that’s this is a tip. You’re listening to this. It’s you’re thinking, okay, if I want to niche down, which one should I niche down on niche down the one that give you about 70 percent profit with the least amount of time. You don’t want to do that and take you three hours to do with the least amount of time.
That’s the reason why I do sexual health for ED because it will take me about 15 minutes to do the procedure and all I have to do is just use platelet rich plasma, which is a kit. [00:14:00] And the shockwave machine, there’s no disposable, so I could just reuse it again. So my margin is about 80% percent at this point.
So that’s what I mean by leverage, the profit margin is the leverage. Think about that because the more you niche down your laser target on your message and on your marketing effort. It is just make so much easier for you and for your staff, right? Because your staff can, when they talk to a patient calling in or a prospect calling in, they know what to say, they know what the menus are, right?
And it’s also you can also decrease a lot of costs in your business as well too. Because when you niche down, I always think in my head. So if I think about buying a new machine or buying something new, I would always ask, is this gonna move the lever and give me more profit? And what I’m doing now [00:15:00] and that would say yes or no, because I would ask, I also see doctor do it by a new shiny machine, because when we go to conference, we go to the exhibit hall and we see all the nice new technology and so forth. And we go, yeah, I want to buy that but I have to tell you, I’ve talked to many doctors who will buy a laser machine for a hundred thousand dollars or more and then it sits there in their office and they’re not getting their patient in to cover the cost of that machine.
They’re struggling to bring patient in, so that way they can charge for the machine. They already, they either lease the machine or pay for the machine, and they’re now like scrambling trying to get some money for that. So you don’t want to do that. You always want to say, okay, is whatever machine you want, is this gonna be consistent with the services that you’re doing your niche that you’re doing is this going to make you money?
And pre sell it first [00:16:00] pre sell the services first before you even buy the machine. Why most doctor buy the machine and then we try to get patient for the service. But now you should think about how is that going to fit into your niche and try to pre sell that. So anyway, I want to plug that in because I did been to three conferences and that’s what I see at the commonality that doctors think that they can make more money if they do more services.
That’s not true at all, and that is a myth, and that, buying a new machine will make you more money. Sometimes that could be true, sometimes that could not be true, because you buy the machine, but it’s your responsibility to get the patient in to cover your cost of that machine. Sometimes it will take you years to even cover that cost, especially that machine is over a hundred thousand as well, but the rec will tell you anything you want to hear, right? They’ll go, oh yeah, you buy this machine, you’re going to get 20, 30 patients in the office and so forth. But how are you going to [00:17:00] get patients into the office?
That’s more of a challenge, right? So that is we’re going to talk about that in our next part. But right now we’re just talking about niching. What niche should you do? So I spoke to a friend of mine who is a premier physician in regenerative field and he does you know everything he does hair, face.
He does ozone, prolotherapy, bone marrow, fat and PRP and the spine and everywhere. And we talked about it. We narrowed down to focus on one service. We narrowed down to doing the knee. Just the knee. Just platelet rich plasma to the knee. Why is that? Because the knee, you don’t need a fluoroscopy. You don’t need a metal jacket.
All you need is an ultrasound machine and a PRP kit. And he can do the knee in about 20 minutes. So you can knock out probably two or three patients in an hour and then package it with a [00:18:00] knee brace, package it with some supplement and also, this is another advanced strategy is to talk to a personal trainer or in town or a dietitian in town who can offer a free introductory visit to your patient after the treatment so that would they offer a free visit and then the patient goes there and the patient wants to continue with them.
They make the profit from that. But your patient get one free visit with the personal trainer or a dietitian. So for you, it’s a complete package. And then when you have that package, you can charge more because it is a package. It’s not just one service that you deliver, the reason why I mentioned packages that way, it allows you to thin out from the crowd and allow you to charge more for the service that you’re niching down to, because evidently when it was what I see too, a lot of doctors think that they need to charge less to be [00:19:00] competitive.
There is no advantage to be the lowest price or the second price a leader in your charge. Some doctors are charging like 400 for a platelet rich plasma treatment, and they profit maybe 100. That’s like It’s not worth it, right? It, that’s not something that you want to do, because that’s probably, that’s what, 25 percent of profit.
So the point is niche down because it’s easier for you to focus on and you get less distracted with other like buying equipment or other expenses. It’s good for your staff, and it’s actually will decrease your expenses easier for you to attract the ideal customer
AI: As a doctor, I wasn’t used to asking for help, especially when it came to subjects outside of medicine. But then I found [00:20:00] physiciancoaches.com . In an instant I found hundreds of experts to help me in all aspects of life, on areas I was afraid to ask dealing with burnout, starting a side gig, money management, even help with my marriage.
And the best part? Nearly all experts are physicians themselves. After reading their profile in a quick chat, I knew I found the right mentor for me. At physiciancoaches. com, help from professional colleagues is just a click away.
Want to stay up to date with physician experts and entrepreneurs?
Join the lounge to stay informed with physician insights and stories.
The latest physician, investor, and entrepreneur info emailed directly to you. Join the lounge at bootstrapmd. com [00:21:00] slash the lounge.
Dr. Mike: And I also think too, an important aspect is actually wanting to do, this service, whatever niche you are, you got to like the patients that you’re working with, so for example, in my case, we had a number of different services, but we found that, we focused on weight loss, one, it had great margins, but we were also liking the patients. They were being proactive and things they’re paying, to get better. And that might not be the case in all the different niches that you do.
For example, in my case, mental health, sure, it might have some great margins, but perhaps you might be struggling with dealing with your patients, with your staff. But again, every physician is different. You have to find out what works best for you. And I think, getting that great combo, great profit margin, making a difference in your patients.
And liking your patients, can really make a difference, especially perhaps you’re struggling with some burnout and it’s just not working for you. What do you say?
Dr. Anne: Yeah. Oh, definitely. You have the bottom line is, we’re as doctors, we went into [00:22:00] medicine because we want to help patients and or else we would have gone to 4 years of grueling, med school and working as slaves during residency.
When you and I went to residency, we were slaves. Yeah, we work 120 hours a week and being on call every third day, right? And there was no cap in the hours that you work at and anyway, you learn, you’ve gone through all that because you love what you’re doing, right?
And now when you’re in practice reality hits so the bottom line that you have to love what you do and the patient that you work with and the service all right, and so that’s one thing and another thing is that about Niching down is that when you’re niching down is actually less stress on you as well, too Because you have less things to worry about as, as well, you just concentrate your effort on one service.
Like you said, you do weight loss, you attract the patient in for the weight loss, [00:23:00] but then once they’re in the office, they can get Botox fillers and other aesthetic stuff as well too in the spa, right? And you could do that as well as for me that’s what I do. I attract patient in for erectile dysfunction.
And then once they’re in, I can, I do hair restoration. I also do weight loss as well. And I also do the pain management, but that’s not what brings them to the door for because know this. Once a patient buy from you, whether it’s $7 or a thousand dollars, they are 22 more time to buy from you again, 22 more times.
Dr. Mike: Wow.
Dr. Anne: So get them in the door, even just $7, $27. All right? And once they get to know and trust you, they will buy more from you. And I can’t stress that enough. Can’t trust doctor enough to doctors is [00:24:00] that it’s the relationship building and getting a patient to spend more with you, right?
A lot of us, we’re used to the insurance company feeding us patient because of insurance, right? So the insure what patient if you take insurance patient come to you because you’re a part of their network but when you take cash, it’s a little different mindset, but the thing that even if they come in with just if you, let’s say you do you give them something that’s 27 dollars or just a small charge, they’ll more likely to buy from you again and again.
And that’s all part of the expertise of you and I know best about digital marketing and how to bring a customer online on YouTube or on Facebook, TikTok or Instagram to call your office or to get something from you online, either free or for a small amount, and then become a customer in your office or become a customer in [00:25:00] another service that you offer online.
Having said that, as physician, we can, we have a wide reach, more and then we then we think, because as physician, you are naturally an influencer online, you just don’t, you just because I will tell you what defines an influencer is somebody who has credibility, you have the credibility.
You’re a doctor, right? And you’ve gone to med school. Number two is expertise, knowledge. You have that. Yeah, you’re a doctor. You’re only missing the third component of influenza, which is reach. Meaning audience reach and online. And that’s something that Mike and I can teach you on how to reach the masses online.
And that way, they that way you get eyeball and they get to know you and trust you and to become a customer with you. It doesn’t have to be in your [00:26:00] office. That’s long as they know and trust you and follow you and that’s what we’ve done in the last four years, where we take a customer for from youtube just an online subscriber from youtube to buy to get a free ebook from us to subscribe to a newsletter and then eventually come to our office for our in office treatment at 12, 000.
So that is a journey that you eventually want to take a month and after that, they’re still in our world because they, we have the coaching program. So I love working with doctors. Building that model of passive income integrating with their in office service. So that way, when we’re sitting there like this, when you’re with your family, you’re making money.
And I love helping doctors do that because this morning I woke up, I saw on my phone and my [00:27:00] Stripe account that I made money while I was sleeping. I’m not Warren Buffet where I have all these thoughts or something, but I made money because I have a membership and I also have a store that a patient buys from.
So I’m excited about, helping doctors and my, and working together with my on helping you all really honed out and what is it that you need to do to attract your ideal customer that is ready to buy from you and as physician you are two thirds Two out of three there as an influencer, and when you’re an influencer and the more audience you have the more impact you have not only in money but the impact in changing people’s lives. I can’t tell you and yeah, I right now have 65, 000 subscribers on YouTube.
That’s not a large audience, but it’s a very engaged audience. And I can’t tell you how many [00:28:00] times I read comments and say, thank you, doctor. I’ve never heard this before. I made the change and now I’m starting to see improvement and I don’t know who that person is, that person. And we’ve had followers all the way from New Zealand and Nigeria and all over the world, and I’m now impacting them because of the information that I’m teaching them online that they watch on social media and doctor, if you’re listening to this, think about getting on YouTube. YouTube is the perfect medium for us to be on, to attract to be an influencer as well as attracting customers because YouTube is also owned by Google. Google is the biggest search engine.
So if you produce your material in YouTube, it can be searchable on Google if you write if you use the appropriate keyword. But if you put your content out on TikTok or Instagram, Facebook, it’s not searchable by Google. So something to remember. I have a video that I put out [00:29:00] three years ago that is still getting views, is making me money on YouTube.
And I have a thousand videos now, so it’s like having a thousand products right now that’s out there on YouTube for people to consume.
Dr. Mike: Yeah. And I think let’s wrap this up here. This has been amazing. You guys. I know you’re going to want to re rewatch it. But the great thing is we’re going to have an next week coming on talking about how to attract patients online so you won’t want to miss it. But before we end the call we talked about this challenge that we’re having If you thought you’ve got you know, a lot of great information just over the last, half hour. What if we give you three days of this content power pack information talk about how to transform your practice We’re calling it the medical practice profit challenge and you want to do you want to talk about what this is?
Just give a little tease about this.
Dr. Anne: Yes, so at the medical practice [00:30:00] profit challenges, that’s exactly what it is where we’re going to do three days where you’re going to we’re going to do a little web masterclass, and then we’re going to give you some homework, and actionable homework that you can do that literally you can insert that into your practice and you’re going to see a difference because we want to over deliver to you. So Mike and I are going to do one day three days of training. The first day we’ll be talking about niching down and we’ll give you actionable worksheet to do. And the next day we’ll talk about how to attract a customer online and creating content, and we’ll give you another worksheet to do. And then the third day, we’ll talk about how to create an offer and how to create a membership. And then we’ll also let you know about our coaching program that we’re going to help you implement, and insert this into your practice so [00:31:00] that way you can start learning how to attract customers into patient online and create a passive income because, a medical practice, like any business, you are no different than a McDonald’s.
You’re no different than a Walmart because all businesses need three things, leads, or, customers. All business need to have to charge, right? So you need to know what your offer is. And number three is to have the same customer come buy from you over and over again.
So for those three days, we’re gonna focus on those three levers of business, how to get new customer, how to create an offer or service so good that they want to buy from you and that you can charge more for it. Number three, how to make that same customer buy more and more from you. Because if you have those three levers in your practice or your business you will never have to worry about burnt [00:32:00] out or be going outta business. But as a medical practitioner, you’re so busy and your head, looking down, trying to chart, trying to build and deal with all the operational headaches of the practice. And that’s where Mike has the expertise on on a cash based practice and I have the expertise on a marketing and creating a passive income stream.
So we, that is our jam packed three day challenge, but every day you’re going to get some actionable item to do and a worksheet and that will occur on April 30th at 8: 03 Eastern Standard time or 5:30 Pacific time. And then the next day will be May 1st, same time at 8:30 Eastern standard time, and then on Thursday, May 2nd as well. And you get a chance to ask questions on the third day, [00:33:00] and we may do some hot seat as well too. So we want to make sure that we over deliver for you and you get some actionable item from this. And no one will ever do this for you. And I think this is the first of what we’re going to do.
It’s a three day challenge that for me and Mike and just be there. You never know you may listen to one thing that may move the needle for your practice as well. And you can ask us questions on the third day. So we look forward to having you there and you can go to practiceprofitschallenge.com to sign up.
Dr. Mike: All right guys this has been amazing and practiceprofitschallenge.com as mentioned happening here at the end of April 30th over the span of a three days training everything you wanted to get started in your practice Involving cash based services.
We’re going to be covering it [00:34:00] We’ll also leave the link here in the show notes register. I know we’re going to be limiting it and the amount of students we want to accomplish. We want to help as many as we can. And I think you’ll be pleasantly surprised about how affordable this challenge is going to be.
So again, practiceprofitschallenge.com hope to see you there. And this has been amazing. But we’re, this is just the beginning of a series that we’re doing here in the podcast. We’re going to be covering next week about attracting patients online using social media. That’s something Anne does tremendously well.
And thanks again for joining us. Thank you guys for listening to the program and as always, whether you’re going to have ups and downs in your business, do something every single day to keep you close to your goals and keep moving [00:35:00] forward.
