This podcast allows me to meet some innovative and trailblazing entrepreneurial physicians and this episode is no exception!
You’ll meet Brook Choulet, MD, a concierge psychiatrist, real estate investor, physician coach, and now practice owner. Hear her story how she started her concierge practice while in fellowship, and already has plans for her second clinic!
You’ll discover how her upbringing molded her to become a physician entrepreneur, and why being underestimated became the drive for her to succeed.
Learn how finding an underserved niche in her community, led to over 150 cash paying patients in a few short months after opening. Prepare to be inspired by this lively interview!
Dr. Brook Choulet’s Website:
Dr. Brook Choulet’s Physician Coaches Profile:
Mike Woo-Ming: Hey guys, this is Dr. Mike Woo-Ming. Welcome to another edition of Bootstrap MD. We’re continuing our series where we are spotlighting some really cool physician coach. Yet coaches are out there in the trenches, and I was really excited about. My next guest… Interestingly enough, my good friend, John Jurica every now and then he says, I should have this guest on, I should have this guest on.
And our next guest is one that he specifically said, I need to reach out. And just so happened. She reached out to me, which is great. What we will be interviewing today is a concierge psychiatrist. She was raised in San Diego, which is where I’m at right now, graduated from La Jolla Country Day.
She got her bachelor’s degree, medical degree at the University of Missouri, Kansas City and a rigorous six year BA MD program. She obtained her medical degree at the age of 24. She trained in General Psychiatry at University of Arizona to continue to try to get in child and adolescent psychiatry through creating the university’s fellowship program right in Phoenix.
Now get this guys. She’s currently in her last year of your program. And she already has got her practice up and running. It’s called chalet wellness. She tells us all about it, and she is in fact about to launch her second practice. And I’m so excited to have. A physician who from the beginning knew that we’ll talk about if she did or not wanting to start up her own private practice, as majority of physicians are in.
Possessions, not that there’s anything wrong with it. It just seems that we’re a dying breed or these practice owners. So I’d like to welcome to the program. Dr. Brooke chalet, Brooke, how you doing?
Brook Choulet MD: Thanks for having me here today.
Mike Woo-Ming: Yeah. I had to look at your bio twice, so they say, oh, you’re still completing a fellowship and then you’ve already have your own practice and you’re already setting up a second one. Is that correct?
Brook Choulet MD: It is correct. I am launching in about a month. The second one.
Mike Woo-Ming: This is amazing. I work with a lot of doctors and I think we talked beforehand that, doctors that maybe know some of them aren’t in psychiatry. They want to start up a program.
But even like a telemedicine program, there’s still a little bit skiddish and, doctors were risk averse as Maybe just tell us about your background and where did this entrepreneurial sense come from? Because I think you probably have to make, you’re probably.
Brook Choulet MD: Yeah. So I am still not really sure where I got that background from. My mom has been in private practice for over 25 years, but by herself. So she’s always been a one woman show. Does her own scheduling, billing, all of that. So this was a unique thing. When I brought this to my family this is what I’m thinking of doing, and I want to take the jump and they’re all like, are you sure?
Are you taking on too much, too fast? And I’m like, no, I’m just, I’m going to go for it. So it really was my idea while I was in training in residency and really thinking about, what’s in the future, am I going to do a hybrid, play it safe where I take a part-time inpatient job and then try and start my practice.
And that didn’t sound all that great to me. So I was like, I’m just going to go for it. I’m going to get this up and running with. Ready before I finish and I can just launch into a full time practice.
Mike Woo-Ming: I think part of it too is… let’s talk about your mom, some of you may or may not know she’s actually, well-known here in the San Diego area.
I don’t know the best way to describe it, a psychiatrist to celebrities might be, if someone would be able to hear her name, is that where we would most likely hear.
Brook Choulet MD: Sure. Yeah, probably she has, I call it a following. So her name is Dr. Donna Kashani. She has been in practice for a long time and she really does provide direct care to all of their patients.
They all text her, call her schedule with her, see her, and it’s really a closed relationship that she’s had with people over the years now, growing up, did you happen to visit her practice? Did you happen to like tag along what we’re going to just sense? Like where, when you started said, I think I want to go into this.
Yeah, my grandpa was also a child and adolescent psychiatrist. So I think I had it in the blood a little bit. But I just absolutely loved what she was doing, where in an outpatient setting and same with other specialties too. You’re really seeing change over time. And that got me really excited.
I know some people prefer inpatient, you treat things acutely, but for me, I really get joy out of seeing people improve over a long period of time.
Mike Woo-Ming: So you went to medical school, you knew which specialty you wanted to go into that safe to say.
Brook Choulet MD: Yeah, I was between, it was interestingly enough ophthalmology and psychiatry, which are totally different. But I just fell in love with psychiatry and wanted to pursue that.
Mike Woo-Ming: When did you have the idea, about having your own practice?
I would say it was about third year of adult residency where, people were starting to Moonlight making money that way. And I was thinking like, I don’t want to stay up all night and take phone calls trying to think of other ways that I could start making money while I was in training.
And I started thinking. Why can’t I just start my practice now, as soon as you’re done with your fourth year of adult psychiatry, you’re board eligible, so you can start seeing patients. And that would be at the end of the first year of the fellowship, if you fast track. So I was like, I am just going to get everything in line.
So I worked all of third year, pretty much on getting a website in place, picking the name. Filing for the corporation getting bank accounts, like all of the basic business things got that all in order. So then as soon as that July 1st date hit, when I became board eligible, I was ready to open the doors and see people.
It sounds like what you’re saying is easy, but I’m sure it probably wasn’t. It sounds like, how did you get all this information? Did you just read it in a book? Did you have mentors that you could talk to about vote in their own practice? Similar factors?
Brook Choulet MD: I think, talking to people in the community can be challenging if you’re looking for guidance, who, from people who are doing what you want to do.
So I actually reached out to some mentors on Facebook from other states who had their own private practices. And I spoke to them just like casually. Worked what didn’t work in terms of how to structure things. But then in terms of actually getting the business things in line, I did a ton of research.
I remember someone was like, oh, you can just hire a lawyer or, a tax person. And they will open an LLC for you. And I was like, questioning. I’m like, why can’t I do that myself like that? So I did research. I figured it out. Sure enough, you can do it online within 20 minutes in the state of Arizona. So I would say each piece as it came to me, I was like, I’m going to figure out how to do this on my.
Mike Woo-Ming: And was it completely virtual or did you ever get a chance to visit different clinics? How did that work
Brook Choulet MD: It was all virtual. So I had seen my mom’s clinic. And when we say clinic, like it’s literally a room, so right now, even I’m sitting in an executive suites, so there’s a bunch of other people in different areas. Tax lawyers, insurance, and then I rented an office just like my mom did and that’s really all I needed to get started. So that’s how I took that first small bite into things. I’m like, I’m just going to get a room and that’s what I’m going to start.
And then things quickly escalated from there. And now I’m building out a space to move into in two months since I have other people working with me. But I think just taking it one step at a time was really helpful for me not to just take the plunge into a really scary new thing.
Mike Woo-Ming: So tell us about your practice. Cause it’s a concierge practice for those who may not be familiar with concert medicine, you don’t take any insurance. No insurance. So tell us about your vision of what you saw in your practice and it’s has your vision come true?
Brook Choulet MD: Yeah. So during my residency, I would go to other sites in Arizona and see how other community clinics were run other outpatients.
And I think the thing I encountered over and over again was that the visits were so short and it seems like the actual face time with the psychiatrist. So little compared to what I think I wanted. And that’s what really got me motivated to be like, I don’t want, 500, 2000 patients, even if I had under a hundred, I really want to be able to spend that time with each person and be that kind of liaison with scheduling and kind of everything runs through me.
Because I think that’s a nice personal touch. I hate calling clinics and going through a long phone. Never getting to speak to someone even, or calling and being like number 20 in line. So I really wanted to deliver like direct care to patients. So that’s where the vision came from. And yeah, I’m living it.
I’m really happy that I’m able to spend an hour with patients and text them and just follow up. Be like, I hope you had a great first day at school or just even small things that mean a lot to people. So for me, I think that’s from.
Mike Woo-Ming: So one thing in business is we talk about is your USP, your unique selling proposition.
I’m sure you’ve heard about it. So let’s talk about chalet wellness. What differentiate your practice versus other psychiatrists practices?
Brook Choulet MD: I think accessibility, I think that’s the biggest word. So every single patient, once they get scheduled with the front desk person, they communicate with their psychiatrist or therapist or a psychologist directly from there on out.
So every single person calls in to make a new patient appointment, but then as soon as they have that first visit, they get their psychiatrist or therapist, cell phone number, email address, and there’s direct contact.
Mike Woo-Ming: No, I’m at your website, then it’s that a lot of people here on your website, how does that all, how does that all work? Did everybody decide if day one, Hey let’s join up with Brook. Surely that wasn’t the case.
Brook Choulet MD: So part of what happened was in the beginning, I was just trying to let people know Hey, I’m doing this. I’m a new psychiatrist in town, had a lot of. Coffee and lunch meetings, just introducing myself to other therapists in the community.
And pretty soon people were like, this sounds really cool. There isn’t really another psychiatrist like that. So pretty quickly I told my husband, I’m like, I know I’m not out of training it, but I think I want to start hiring people. So we really started thinking about that and I was really upfront with everyone.
Technically, I have another full-time job right now. Like I’m in training, but here is my vision for this clinic. Here’s all the things I’m doing to make this happen. And I would love for you to be a part of it. If that sounds like something you’re interested in. And so pretty quickly, I think within a one-month period, I hired four therapists and psychologists and a psychiatrist, and it went from.
Mike Woo-Ming: And so when did you actually open your doors?
Brook Choulet MD: July 1st of this year?
Mike Woo-Ming: July 1st of this year, now let’s talk about how did COVID affect you.
Brook Choulet MD: I actually think that mental health care was more needed during COVID. So I think there was just a lot more anxiety and stress and people who never had it. So I’ve been seeing a lot of other doctors or professionals, executives, attorneys, who they’re like middle, mid-career and they’re like, I never had anxiety before and now I’m super anxious and working through why that is. And I think COVID is a large contributing factor.
Mike Woo-Ming: So I want to talk about, your practice is still relatively new.
Has there been any things that you. We’re surprised given that when you open the city’s been smooth sailing since then?
Brook Choulet MD: I think what I learned was it’s really hard to let people go. So I had a person that I had interviewed for an administrative assistant position and they just weren’t answering the phone.
And I’m like, that’s a pretty key component into sitting new, to getting new clients. And I think that was really hard for me because I am young is feeling comfortable that this is my business and I can let people go and I can hire people. So I think for me, I was almost a little uncomfortable, like I’m only 28. Is this okay? So I think I had to get over that pretty quickly and just do what’s in the best interest of the kids.
Mike Woo-Ming: So let’s talk about your staff. Cause it’s always interesting to see how people have developed their staff. How many employees do you have? And then we can break down, what are the roles?
Brook Choulet MD: Sure. So I have an administrative assistant and then I have two psychologists, a therapist, and two other psychiatrists, and then a nutrition coach and soon a skincare specialist as well.
Mike Woo-Ming: Oh, wow. So how long were you doing it on your own before you realized you needed.
Brook Choulet MD: I was doing it on my own for about three months.
And then the calls really picked up. And I remember being like, I need help. Like I was in between didactics and trying to answer the phone. I was seeing outpatients and fellowship and I’m like, I can’t manage this anymore. Which was great because we got busy really quickly. We have over 150 patients in the clinic after only a few months of being open.
It just got really busy, really fast, and I had to make a move to hire someone
Mike Woo-Ming: Yeah. For myself. I’ve had an assistant Jenny’s been my assistant for 12 plus years. And I always tell entrepreneurs the first thing that you should outsource. Someone who can do your customer support and all those tests that you really don’t have to have time to do if you want to scale and grow.
So 150 patients is remarkable. Really commend yourself and that success. So how did that start? Was it just the networking? Did you do online marketing? Social media marketing? How did the word spread?
Brook Choulet MD: Sure. So I did a lot of meeting with other therapists. Like I mentioned, literally.
Google mapping therapists in Scottsdale emailing them, saying I wanted to meet and take them out for lunch or coffee and learn more about their practice and really just get myself enmeshed in the mental health community here. So that was a good referral source. And then as well my husband being in internal medicine, his group knew that I was opening this practice.
And a lot of them were great referral sources as well. And then Google Ads, I really just kept it simple. My main two marketing strategies were Google Ads and I printed out these really cute postcards. What I thought were cute. And then I had my assistant send them to all of the therapists and internal medicine doctors in Scottsdale. And that’s pretty much all the marketing.
Mike Woo-Ming: I love it. That’s a way of, ingratiating herself to the community. Did you ever get any push back? Did you, were there people who said,” hey, this might be some competition for me.”
Brook Choulet MD: I didn’t get any pushback. People underestimated me. I think they thought that, yeah, I think that the psychiatrist, I think that some of the other physicians who had been in the community for a long time kind of were more like “aw like you’re so cute. I’ll try and help you.” And it was almost, yeah. I don’t think that they really thought that I would take off this quick.
Mike Woo-Ming: Wow. So that’s probably just added more fuel to the fire that people can motivate. I don’t know if that aspect, if I felt like I was being slighted, I would just use that as more motivation to I’m going to open up in June.
Brook Choulet MD: What’s interesting is I contacted all of them just to meet with them. I didn’t want anything from the psychiatrist. I really wasn’t looking for mentorship. I just wanted to introduce myself and just get to know who the other people in town were. So I definitely heard from them a lot more before I opened my practice than after.
Mike Woo-Ming: Okay. And they were just, most of them were pretty willing. And whenever perhaps a subset of them now you work with regularly.
Brook Choulet MD: Yeah. A lot of them were great. A lot of them were really helpful and send me their overflow. And there’s a lot of great people in the community here. So I’m very fortunate. I just really wanted to just let people know, like I was here and the doors were open.
Mike Woo-Ming: One of the things that I, I like to, when I interview docs in private practice is, think, oh you’re in private practice. You must be working 80 to a hundred hours a day, a week. And that’s true. We do use sometimes, but not all of us. Maybe you can go, what’s a typical day for you.
Brook Choulet MD: Sure. My day is probably very different than others in private practice because I’m still in fellowship. So I… get up around 6:00 AM and I do administrative stuff for my business until about eight.
Then I go to my rotations, I do my thing. And then around 4:00 PM all see afternoon patients or evening patients. And then I hate to admit, I do pretty much work until 9:00 PM to just make sure everything’s flowing well overseeing what’s happening, the scheduling, just because at the beginning, I think it’s most important that there’s a well-oiled machine
Mike Woo-Ming: By the time we’re actually recording this, it’s probably by about three months through your three and a half months, you open, why did you start to say, “you know what, I want to open a second one now!”
Brook Choulet MD: I think, just for all the entrepreneurs out there, I think that there’s a difference between being self-employed right, where you’re working your own hours and all of that.
And… Seeing your own patients, but if you’re not working, you’re not making any money. So there’s a difference between self-employment and then being a business owner. So to me, I think seeing my mom and the incredible thing she’s accomplished over the years, she is still self-employed. She is really protective of her patients and she really cares about her business. And I approached her and I’m like, look, this is worked for me. And I think that it would work in San Diego as well. And, people really value you in the community. And I think we should do this together in San Diego. And so it took some convincing, but at the end of the day, she was really on board and excited to grow her own name that she’s worked so long to build there. And so that’s what led us to opening a second one in San Diego, but under a different name.
Mike Woo-Ming: Okay. So you’re just going to use the protocol or strategies in, in Scottsdale and then apply it to San Diego. And will you, will she be seeing the patients then, and then having network?
Brook Choulet MD: So she already is pretty full. So she’ll be under the umbrella of the new clinic name and then we’re hiring another psychiatrist to start seeing patients there. And then I got my California Medical License as well to take some in both places.
Mike Woo-Ming: So it sounds like I’m, maybe I’m being a little overstepping bounds here but… it sounds like you’re building your empire.
Brook Choulet MD: I just think that this hasn’t been done. I think it’s really, and I think that people are lacking. A better understanding of good mental health care, because I feel like in the community, a lot of times mental health care is frowned upon or seen in a negative light because there are such short visits in the community which is understandable at times because there are so many patients that need to be seen, but I really wanted to find a way.
Patients could come in who wanted to, and see the same person for 30 minutes to 60 minutes to do therapy and medication management with the same person and not have to be handed off like to a therapist or then to another psychiatrist and simplify the process.
Mike Woo-Ming: Yeah. And definitely, I don’t know. It just seems like too in the media, we’re much more accepting of mental health. We saw that with the Olympics, with Simone Biles and Naima Saka and the temps player. It’s definitely been, it seems like it’s been more accepting. I know. Have you seen that from a clinical side?
Brook Choulet MD: I think so. I think that a lot of people are more accepting of mental health care.
And just saying I’m going to therapy or I’m on medications for depression. I do think that people are feeling more comfortable speaking about their mental health needs. And I know a lot of companies now are offering mental health days and, really acknowledging that a mental health day is just as important as a sick.
Mike Woo-Ming: Now I want to switch gears. Thank you for sharing this information about your concierge practice, but you also are involved in real estate. Tell us about that.
Brook Choulet MD: So during COVID our outpatient residency clinic got shut down and was in transition for about. And so I had always had a hobby of looking at homes and getting into rental properties.
So we had just done our second rental and I was like, told my husband. I’m like, Sam, this is ridiculous. Like we’re running the numbers. We are picking the homes. We are only seeing one or two homes each time we’re submitting. Like, why can’t I do this? Like, why can’t we just have one of us do real estate?
So I took that 30 day period. I signed up for an online course and I did the Arizona licensing requirements in that 30 day period of time. And I sat for the state test two weeks later. So last June, I got my Arizona real estate license and it makes things a lot easier in terms of being able to buy and sell for yourself… For friends and family, and really just as a tax advantage as well.
Mike Woo-Ming: Yeah. Talk about that a bit more if you’re not, obviously you’re going to make some money right on the commission you’re saving on the commissions, but what else does it allow you to do that? Just to get better access to the MLS.
Are we, or what are some things, for some of us who don’t know, what would be the benefits of being a real estate agent versus an investor.
Brook Choulet MD: So it allows you access to the MLS. You can go to any open house. So sometimes we feel bad if home came up and we wanted to see it in the next hour.
You don’t want to disrupt someone else’s schedule last minute. So we would just like drive and go. And I would let us into the open houses. So you get that kind of access. And then also you get access to tax records. So you can see like how much is still owed on a home or, when’s the last time they refinanced.
So you could have a better idea of what that person may be willing to accept in terms of an office. And then I think the most important thing is let’s say a home is 800,000 and you’re going to be getting a 3% commission. So that would be 24,000, then that the seller is going to be paying that regardless.
So would you rather have that come to you as an agent and pay taxes on that $24,000 commission? Or just say, Hey, listen, like I’m the buyer, I’m an eight. Can we just drop the price of the home to 20, $24,000 less, and then you’re not paying any taxes on commission, but you’re still getting the house at a decreased price.
So there’s a few different advantages that you can manipulate into the deal. Depending on if you wanted that cash up front, you could take that commission, but pay tax on it and get that 24,000 towards, your down payment or just bundle it in.
Mike Woo-Ming: I’m curious with your real estate background? I think one of the things that I regretted, so I got to med spa. I told you before, we’re going to go on, this is our ninth year ago. Now our 10th year is that I wish I would have bought, my office rather than rent. And just feel like I’m just like, running another check. My landlord just says, he’s getting increase my rent again.
Have you considered looking into commercial real estate for your own? With your medical offices
Brook Choulet MD: I did. And to be honest, like I think there was so much risk. I tolerated and starting this business. Taking on a massive commercial lease was a little too scary for me. So I think in the beginning, I just wanted to make sure this would work again.
There’s nothing else like this in Scottsdale where there’s both a mental health clinic and a wellness clinic all in the same place. So I just wanted to see for myself how this would go. And then also location-wise too in Scottsdale. Very expensive. And I figured with a new business, I would rather rent in a prime location and get my name known and then maybe consider commercial down the road.
Mike Woo-Ming: Yeah, I think LA Jolla is a little bit expensive too! Just a little bit. This has been great. All right. We only got a few more minutes left. This has been really enjoyable. I hope the listeners are definitely I think you’ve inspired some who may be looking into to concierge.
So what do you have anything coming up next that you need? We want to let the listeners know about or anything that you want to share?
Brook Choulet MD: In October, I’ll be speaking at the Concierge Medicine Forum in Atlanta on how to start a concierge practice in a year. So if you’re able to purchase the conference after that might be interesting to some of those out there who are looking to see how they should start a practice.
Mike Woo-Ming: Okay, perfect. And we’ll leave links here on the show notes, so you can find out more information. Or is it still virtual?
Brook Choulet MD: It’s actually in person.
Mike Woo-Ming: I miss that part. Wouldn’t be virtual in Atlanta, but anyway, this has been great. Thanks you for just sharing your journey. I think it’s very inspiring for someone so young, you’re already doing your second your second clinic, any last minute thoughts before we end.
No. I just always told people that they shouldn’t be afraid and they should just go for it. The worst that can happen is you stop and you go back to what you were doing before, or you pursue this on the side until you’re comfortable enough to leave your corporate medicine job, but just go for whatever you’re thinking of that you’re passionate about and it’ll work.
Awesome. Thank you, Brett. Good luck in the continuation of your fellowship. It still blows me away. And for everybody thank you. That Deloitte and I checked her out. Her website, your website again.
Brook Choulet MD: www.brookchouletmd.com. And that’s B R O K C H O U L E T. md.com.
Mike Woo-Ming: Perfect. Perfect. Go and check it out.
Go ahead and check out on the custody of ministry conference. You will be speaking at and as always guys, just don’t stop thinking about it and researching out it. Some of you are in the research money. You never get out of it at the end. You just need to go out there and do it and as always keep moving forward.