Several years ago I created a product that helped businesses outsource their career and outsource their life. I think many physicians struggle when we have other people do our tasks. And it can be very daunting. We didn’t get to where we are without the help of others, and sometimes we forget about that. I’ve said this in the past: We tend to have control issues. And you’re only going to be able to scale your business somewhat, you’re going to hit that level because you can’t do it on your own.
And there was a book that came out that explored different million dollar businesses. Once they got to that one and 1.5 million dollar level, they couldn’t grow, because if you’re someone who in your business, you’re the bottleneck. You have to see all the patients that you have to answer all the phone calls, you have to be the one inputting all of the information and that kind of medical record. You’re going to only grow your business so far.
And to be honest, you’re probably going to burn out. And I learned that the hard way when I started my businesses. I know for many of you, and I hear from you guys, you’re saying, “You know, myself or my husband, he doesn’t like to give away part of our business, and we do everything we can to hold onto everything.” Your business is not going to grow. I spoke to my father who had his own clinic a few years ago. He said, “Mike, my business only grew, until I realize that I didn’t have to be in the business. I had hired other doctors to do all the work and now I’m thriving. My business is growing. And I only hit that at one level.”
And so for many of us, whether you are someone who is an employed doctor or you’re starting your own practice, or maybe you’re doing some locations on your own, we all need to be able to let go. So here are some strategies that I think could be helpful to you.
Now for an employed physician, if you work in a hospital, of course there’s only so much that you’re going to do. You are limited by the amount of autonomy. But there are some things that you could be doing on your own that makes you focus on specific activities in your business that’s going to really help you in your career.
So when I created my clinic, I realized that early on that I couldn’t be the bottleneck. I created my clinics based on that “I don’t have to personally be there.” I could have other doctors, I could have other providers who would be doing my work. And I needed to focus on my own business. The famous book EMyth covers this quite extensively. You need to start working on your business, not being in your business. And oftentimes we are the bottleneck for business.
So when you’re looking to outsource, what I encourage you to do is take out a piece of paper and just start going down all the tasks in your practice every day. What are the things that you are doing right now that somebody else could be doing, probably better than you and can be affordable that you could hire somebody to do the services? Again, my practice didn’t flourish until I realized I needed to let go. So when you’re looking at these tasks or if there are some qualities that I want you to assign on those tasks.
First of all, do you enjoy the work? If you enjoyed performing these tasks, I don’t want to take that away from you, because that contributes to your overall happiness in your career. I own both clinical and nonclinical businesses. I enjoy the marketing of these businesses. Yeah, I could probably outsource that or I could have a marketing company do that. But I personally enjoy that. And that’s talking about the overall marketing of it. Let’s say you’re going to be doing online marketing, and you’re going to be, you want to understand is how much does it cost to acquire a customer in your marketing.
Now that doesn’t mean I don’t like certain aspects of it. For example, I would love to give somebody the opportunity to put together my social media posts to work on starting up our Instagram page. But I want to understand the overall aspect of marketing. That’s something that I enjoy doing. It’s something I was brought up as someone who can get involved in online marketing early on. And it’s something that I like to do. But if you don’t like doing any of that, it’s better for you to hire a company to focus on the marketing aspect of it.
Now, if you own your own clinic, that’s where a lot of us has gotten into trouble, because we focused on what we were best at, which was performing the clinical duties of it. But if you don’t understand the other aspects of your business, those are the things that you need to know. Now, of course you can outsource that later on, maybe you don’t enjoy the business part of it. But if you want to have a successful business, you need to understand the intricacies of making that business, what it takes for you to become to make a profit with your business and then you can move on forward. But first off, look at the enjoyment.
Secondly, you want to focus on tasks that are revenue generating. What are the tasks that make you the most money? If you’re a doctor who loves to do procedures, and your procedures are the ones that’s bringing in the bacon, bringing in the money coming in there and then there were other type of procedures that you may not want to be involved with, then that’s what you need to focus on.
For example, if you’re a dermatologist and you enjoy doing nose surgery, and that’s what’s is a big moneymaker for you, shouldn’t you have somebody else focus on the other aspects of your business that maybe it’s part of your training, but let’s say you don’t need to work on removing warts or skin tags. And you can hire a physician’s assistant or a nurse practitioner or a registered nurse if they can do that in your area, to perform those parts of your business.
Again, it has to be something that you enjoy. If something that you do and you don’t enjoy it, then that’s something you need to take into consideration. You can divide it into so many different ways. What I want to look at are what are tasks that only I can do. What are ones that I need to do? So things like running the business, examining your competition, understanding every aspect of your business. That’s what you need to focus on. I perceive myself as more of the CEO of my business rather than just the employee.
There are other tasks, or what I call our equivalent tasks. These are tasks that maybe you could do them, but if money was no object, could you hire somebody to do those? I’m not someone who needs to brush up my ego. I see some doctors who, where they get in trouble, for example, is the clinic is all about them. They name their clinic about themselves. But what happens is if your Dr. Smith and everything goes to Dr. John Smith and you have the essence of the clinic, guess what’s going to happen when you’re going to try to let go parts of your clinic, you’re going to be kind of stuck because all the patients are going to want to see Dr. John Smith. They’re not going to want to see Dr. Mary Jones, who’s your associate. And that’s where you’re going to be struggling if you’re going to be naming the business after yourself. So that’s something to keep in mind. But if you name your clinic’s something kind of generic, then that’s something that you can have partners come in and seeing those patient for here. So divide looking at tasks that only you can do, tasks that are what I call the equivalent tasks. And then look at what are called outsource tasks or tasks that you outsource or in source. Are there people on your team, in your business that can be performing those type of tasks.
So when focusing on the outsource tasks, what are the clinics, what are the typical clinic tasks that you generally see? Well, generally we see medical billing, right? That’s usually something where you can hire a company who focuses specifically on the medical billing. That’s probably what I would first start with: Having another company, who could do it faster and do it more cost effective then probably you can. Now, again, it’s something in your business if you take insurance, I don’t, but if that’s something in you’re busy, you need to understand what to making sure that you’ve done your due diligence, make sure this is a billing company that you can trust and that you know, because if there’s a billing, who is doing things that you don’t know about that keep running into trouble.
IT is something where you can outsource. In terms of transcription, I don’t understand why most people would want to have someone in source to do transcript, which you can get it so inexpensively now with these transcription companies I use. For my non clinical transcriptions, I used rev.com. But there are other transcription companies that focus on medical businesses that are out there that you can use. And again, most of these are done outside of the country and they’re inexpensive. There’s no reason why you should be doing your own transcription.
And then in terms of insourcing, look at your staff, what are the types of tasks that they can perform. When I first started my clinic, I made sure that whoever I hired, let’s say it was in the administrative part, they had mostly medical assistant training, but they can also do both front and back office, front office and back office parts of it so that they can use those interchangeably.
You want to make sure when you’re looking at hiring and unfortunately firing, you find and locate the best people there. So when you’re hiring people, make sure they’ve got different types of strength that you can utilize, because again, your most expensive output that you’re going to be doing is payroll. So you want to make sure that you’ve got people who are multifaceted that can perform different types of tasks. So, these ideas, these strategies, and everything, they’re not ideas, these are strategies that have been going on for a while.
But let’s say you’re someone who is employed, what can you do right now in your position? Again, for many of us, if you work at a hospital, you only have so much autonomy. There’s only so much that you can do. But I would argue that many of these hospitals out there, I mean if you’re looking at the amount of hospitals, I think that one of the statistics I’d showed is that an average doctor brings into a hospital nearly 2.4 million dollars. And if you’re a higher specialty such as cardiology or orthopedics, it can be 3.4 to 3.6 million dollars.
And again, your income is probably getting about, makes up about 10%. I don’t understand why they can’t have a scribe once they realize how cost effective it can be, because there is no reason why you should be staying up late at night, probably not getting paid for tasks where you’re inputting information, doing data entry. Hiring a medical scribe who’s in the room could allow you to become more efficient. It helps their bottom line. And that’s something you really should be able to negotiate.
So look at all your different tasks that you do. And not just in your clinical life, look in your personal life as well. What are the things that you can be doing that can really improve your life? What are the things that you’re doing right now? Then you could hire somebody $15 or $20, $25 and doing. I’ve had a personal assistant for going on 12, 13 years. My personal assistant, right now I’ve had for the last decade. We love her. And she helps every aspect of, parts of my business that I don’t personally like to do. I’m someone, I don’t like being on the phone, so she answers and helps me with my consulting in terms of scheduling potential clients, using online scheduling tools, sending a call, just personal stuff like getting the dog ready for the dog groomer.
I’ve had her get on the calls when I’m contesting something on a utility bill or the cable bill or something like that. Picking up dry cleaning, setting up, if I’m speaking somewhere, setting up airline tickets, travel. There’s so many things that you guys are doing on your own and you think you’re going to save a few dollars. It’s not worth your time. The average doctor, let’s say you make about $200 an hour, and you guys are doing $20 an hour tasks. You got to stop doing that. I bought a house, first out of residency and I spent every weekend doing weeding, and I hate gardening. If you love gardening and you enjoy it, then do that. For me, I hated doing it and it’s like, what am I doing this when I can hire landscapers here to do that. Again, if you love doing it, more power to you. I didn’t.
So our family, we’ve tried to outsource some things that we enjoy, either from nannies or tutoring, or house clean. But if you love cooking, like my wife enjoys cooking, we don’t outsource that. But that could be another task that you could do. And now with technology there’s so many different services that you can do. They can really make your life more enjoyable. So with technology, using virtual assistants is another way.
There are some companies out there like onlinejobs.ph, where you can hire someone, a Filipino who knows English. They can do a lot of these virtual tasks for $500 to $1000 or so a month. You can go to places like freelancer.com, fiverr.com to perform simple tasks that you could be doing. These are all things that you need to start thinking about doing and it’s going to really enrich your life.
What we’re seeing right now is most doctors are now being employed and being hospitalized. And most doctors don’t like it. They don’t like being employed and losing autonomy. Many of the doctors, I think according to one survey said that 45 years or younger doctors are significantly more likely to work for a hospital or hospital owned medical group compared to physicians in the next age bracket up. And they understand that it’s worrisome. But I think, to have better control, to be in a better position, I would rather risk having more opportunities that are out there, then losing my autonomy. My autonomy’s very, very important to me.
So the good news is there are more nontraditional options that are out there. I know many doctors have switched to telemedicine type practices. Having a more of a locums type life. These are things that you kind of do no matter what specially, for the most part. Of course, I know there’s some way you’re always going to have to be in the hospital. There’s nothing you can do about it. But start thinking about different areas where you could transition into other areas. Go part-time and look to other things.
For me, what’s important for me, is that we only have so much time on this earth. I want to spend as much time having fun as best I can. And there are some other options that you can do. One way that I’ve been helping doctors is to look at starting your own practice, a cash-based practice. But really stopped you from being handcuffed from insurance. And we’ve noticed more and more doctors are moving into that direction.
So whatever it is for you, it could be, this week start thinking about a simple task that you’re doing right now. You don’t realize what you’re doing it right now, then you can outsource. It’s going to make a world of difference. Start slow. And I think overall it’s going to really enrich your life. I’d love to hear what you guys are doing to outsource aspects of your life. Again, we only have so much time on this earth. The more we realize that, the better our lives are going to be enriched.