Operator: Welcome to today’s episode of True to Form with your host, President, and Co-Founder of Crystal Clear, highly regarded speaker, and two-time Inc. 500 Entrepreneur, Tim Sawyer. True to Form is a podcast that highlights leaders, making headway in the aesthetic, anti-aging and elective medical industries. Learn from the experts to discover the secrets to success and the pitfalls to avoid when it comes to growing your aesthetic revenue with the authentic, the transparent Tim Sawyer.
Tim Sawyer: Good morning and welcome back to True to Form. I’m your host Tim Sawyer. Today we’ve got an incredible episode for you today an amazing guest, a good friend of mine and really a modern renaissance man when it comes to anti-aging, wellness, and aesthetics, Dr. Michael Bedecs from Portland, Maine. He just got to practice in Jupiter, Florida. Welcome to the program Dr. Bedecs.
Dr. Michael Bedecs: Good morning Tim. Nice to hear your voice and nice to be here.
Tim: We appreciate it. One of the things I wanted to mention I noticed and I’ve been out there that the main part of your practice empires is in Portland and I don’t know if you knew this. But my dad grew up in a little town called Mount Vernon, Maine and he has got 13 brothers and sisters, and literally I know and not to paint Portland as a rural startup, it’s certainly not; but not too far away out in the woods my dad literally they ate what they hunted and whatever they grew that was kind of their deal, and then he made his way to Massachusetts. So I love that part I spent many, many summers in and around Portland chasing frogs and catching worms and enjoying the quiet life. But Portland has changed quite a bit now, right, from the restaurant culture-
Dr. Michael: Oh, yeah. We’ve got flush toilets and heat in the houses and all kind of stuff now, it’s really gone a long way. Actually Portland is a pretty sophisticated town in some levels. I think I just read somewhere that it has got the highest restaurant per capita ratio of any place other than maybe San Francisco, which is crazy and it’s got a lot of culture in this little town, pretty fun.
Tim: Yeah, a great quality of life and a relatively affordable cost living. So let’s talk about that. You’ve been able to do quite a bit in that marketplace and you’ve got the location. So there is a few practices that you’re part of in Portland as well in Jupiter, talk a little bit about the practices that you’re running now and how you got started in a-.
Dr. Michael: Yeah, sure. I basically tell people that I’m a recovering conventional doctor that I practiced conventional medicine for a number of years. I was primary care, did colorectal surgery for a while. I’ve done a few things. I recently retired as a medical examiner in Maine and I recently gave up being a ring doc for the cage fighters and liability finally got to me on that one.
Dr. Michael: Yeah, it was fun. It’s a fun thing to do. But that’s a pretty rough sport on people. So I got interested in lasers early on during my colorectal phases. I was doing laser hemorrhoidectomies and I got interested in some small laser procedures 25 years ago, tattoo removal, port-wine stains and started getting interested with different lasers, that progressed into developing an interest in the new area of injectables. Botox was just becoming popular and then the folks from Canada were making big waves up there and watching it come into America.
So I got into it fairly early. I have a pretty large cosmetic aesthetic practice called the Cosmetic Enhancement Center of New England with a very talented partner Dr. Maria Atkins, who runs most of that. I have the Age Management Center, which has offices in Portland, Maine and in Florida. And then I also have a wound and vein center where we do EVLTs and manage basically that industry of those kinds of health issues. It’s kind of interesting because that one is still one based on insurance based model; the other ones are non-insurance based models.
Tim: And that’s really big part of the crux of what I was wanting to talk to you about today and super excited, and that is the notion of — and you and I’ve been talking about this how — we go to A4M every year and for those of you who don’t know what the A4M is, that’s the largest anti-aging conference at United States; it happens two times a year once in Orlando in May typically and then in Las Vegas. And I’ve been going to the show for years; Dr. Bedecs has been a presenter and faculty. He has been part of the association forever. And he has built this incredible empire around a cash-based medical practice both at the Jupiter location, the aesthetic clinic, the anti-aging clinic.
And so one of the things you would talk about, let’s get right to it. The question is why do so many people spend so much time, energy, effort, money searching online, learning about converting their business to a cash-based medical practice, spend the money to go to show, flying in airplane, go to talk to people like Dr. Bedecs who have already successfully done it. And then give into the anxiety or the fear whatever it is when they get back to their practice and they never do it. So can you speak to that Dr. Bedecs and the process that they need to go through and any encouragement that you could offer them?
Dr. Michael: Well, first of all, yes, and it’s not only that it’s the same thing as bringing a laser into your business. Someone convinces you that if you buy a hair laser that you’ll have to work again for example, and you can put that right into your existing business. The truth of the matter is, is and the interesting part is that’s really — we’re really serving two different kinds of patients. In the case of my non-insurance bases practices, I refer to them as clients because in that regard, we really are more into the customer service business and we should talk a little bit about making that switch.
There is a head switch that doctors have to go through and medical professionals and providers. I want to be clear that I just want to stop using the term doctors because I have two extremely talented nurse practitioners who are as good as any, better than any physicians that I met in the kind of practice that we’re doing, so providers in general. One of the main reasons that becomes a problem is providers get all fired up, they go to these meetings, they come rushing back to their office and they say to their help, oh, you won’t believe it, we’re going to start this all new thing. I’m going to have anti-aging, we’re going to have people, it’s going to be cash-based.
We’re going to have new people coming in. And the staff looks at the provider cross eyed and say, oh my God, the phone is ringing so much now, we’re going to need no computers, we’re going to need no help, are we going to do that. And there is this sabotage that occurs from –
Tim: Yes, that sabotage.
Dr. Michael: And so that when I do consulting work for startups I start with a staff. One of the important things also to realize is that when I had my colorectal practice in the waiting room where people who are not happy to be there, they were sick, they were hurting and they were only could be there because of their insurance. The medical practice I have in the — our cosmetic and our functional medicine practice is one where people are happy to be there. They’re not sick, they’re not hurting, they’re not optimal when they first join us but that’s where we take them because this practice is not really dealing with sick people, we’re dealing with people who are not optimal. They’ve already been to a couple of doctors and they’re just not getting their needs met.
So that’s what we’re doing. In order to do that you have to start with the staff themselves, have to take a different headset. When a person who is sick comes into your office there is a confrontational thing and the staff gets this idea that this could be — we have to be careful, we could be looking at lawsuit, we have to protect ourselves. And the providers often practice with that sort of mindset. When people come to see us now these are happy people delighted to be here smiling, you know, having a good time and for whom paying cash is not — is something that they actually are okay with.
So they help themselves, your staffing has to be same when with the kind of people coming in and realizing that this is now a customer service business, I’m in the customer service business.
Tim: You know, what’s interesting. Yeah, not to interrupt you but that point and that’s a second time you brought that up. It seems like you’ve got your arms around pretty well your arms around the fact that essentially it’s a retail business. And so all the laws that apply to other retail businesses like customer service apply to this. And one of the questions that I have is because when as I travel Dr. Bedecs and I’m speaking to doctors who are considering making the switch. One of the things that will come up the most will be, well, you got to understand my people could never do that. And I think there is a couple of things going on there.
But one of them is if you take somebody who has been in a traditional medical business that has accepted insurance and they’ve got millions of forms that need to be filled out, they hate the doctor, the doctor hates them. And then you try to put them into this type of model, I would think part of the challenge is if you’ve got somebody sitting behind the desk who themselves could never fathom paying to be better, then it would be tough for them I would think, right. And how do you go about you’ve been training them –.
Dr. Michael: It’s impossible. I oftentimes one of my recommendation is start with new staff. If you’re going to keep your existing practice model in the insurance based world and you’re going to try to do both, it will be almost impossible to do it with the same staff.
Tim: Well, but that’s probably where a lot of folks freak out, right as they think I can retool my-. So let me ask you this: what’s the encouragement? Now you’ve been doing this for a long time and I’d like to know when you started Portland versus Jupiter and kind of the evolution of those practices. But what was the a) the moment you said, hey, this is what I really want to do. And then b) kind of step one, two, three, how do you push through the staffing issues, the marketing issues, the service issues?
Dr. Michael: Well, we initially try to do it like everybody does, try to have one waiting room and both the anti-aging clients and the surgical clients in the same area. We quickly found out that’s not going to work either. You really can’t even mix them up together because these are happy people versus unhappy people. And the staff themselves have trouble making that transition if you’ve got both folks to deal with. So that’s the first thing you really have to think about doing is how you’re going to create a maybe it’s different days, maybe it’s the office it’s another little office next door but creating some way that this is a different experience.
And the experience itself it’s like when you walk into it’s like you walk into your lawyer’s office, it doesn’t look like a doctor’s office, it’s comfortable, it’s cozy, there is pleasant music going on. And so again, it’s the experience you have to rethink about this being a pleasant experience. And the reason is this. This is the most important thing that anyone needs to know. And this has to do with maintaining your clients. Client acquisition is when you’re going to hear me say this a lot, you’ve heard me say this. Client acquisition is very expensive and this –.
Dr. Michael: So client retention is absolutely important. In a traditional practice most doctors really don’t care if they come back or not because there is a wedding list for two months and they have no idea who is coming in that day. This is an annuity-base practice like many of us do is must — you must take in consideration making that client happy so that they will return. If you lose clients you’ve lost a whole lot of groundwork and money to acquire them. So again client acquisition is important so client retention strategies are extremely valuable and the only way one of these practices survives.
Tim: Wow, and the thousands of people that attend A4M that the doctors or staff members for some of them that’s a hard mental shift, right is to understand yes, I do have medical skills, yes, I do have medical training; but then again, there are a lot of –.
Dr. Michael: You know, who shifts the hardest are the ER people, and those are the ones oftentimes that are the ones most interested in making transitions because it’s a hard job, it’s a lot of stress. You can only do it for so long and looking for something else to more for career into. But there is this, there is the quintessential freedom as freedom mentality for an ER. You have no idea who is coming back and maybe hope they don’t.
Dr. Michael: So that is not the case. So those both the staff and the provider have to get into a headset that you are creating a retail type business. If you want to see that in this purest form go into any Apple store and then ask for it.
Tim: Right, that’s a great point. And you know, when we talk about and you’re a smart guy around the metrics and I want to get into that in a minute. The client acquisition is expensive, right, this is in where they’re just in network and they’ve got, you know you’re the doctor that lines up with their insurance, it’s we need to acquire them and we need to keep them. And that’s a concept that a lot of folks struggle with. And as you think about your marketing budget you have X amount of dollars that you spend per year to acquire customers.
But then you’ve got to have some pretty specific practices in place for retention, right. And I think don’t they cost you — we usually we look at particularly in aesthetics and you’ve got a pretty big aesthetic practice if it costs you 15 to $50 to find somebody minimum $50 in some cases then we should probably have 5 or 10 bucks set aside per client per year to retain them, whether it’s through marketing or events or whatever, so talk a little bit about that.
Dr. Michael: Yeah, that’s true. And marketing budgets in general is one of the things that we oftentimes get into can be tricky, because what if once in the startup phase one of the things that seems easiest to cut out is the marketing budget and if you’re getting a little tied at some point and that’s the last one you want to cut out. So the client retention strategies aren’t necessarily as expensive but they’re tedious and time-consuming, and the staff has to be as the staff needs to understand why you’re doing that. Because there again if you have a traditional medical staff they are not really empowered or thinking about hoping that Mrs. Jones come who just yelled at them because of their copay hoping she comes back again. They’re not really hoping for that but that they’re feeling –.
Tim: They’re hoping for God sake.
Dr. Michael: Exactly right, exactly right.
Tim: You know what, I have one more question because and then I want to get into the incredible wellness model that you built. So you don’t want to lose guys, I love talking with you and I really mean that. And you understand that to do this correctly, whether it’s in the aesthetic piece or on the wellness side, anti-aging side. And in some case even just running a business that even on the insurance side I sense from you that leadership is a big part of your thinking. And so for example when you just said to me well, Tim, you’ve got to help them understand and a lot of times I talk to doctors and they don’t think it’s their job to help their employees understand.
And they don’t think it’s their job to get into some of the details around creating a world-class patient experience. And so before I ask my question I’ll just share with you quickly. I was at an event in Beverly Hills over the weekend and I’d been asked to come down and give a couple of talks and I was in the main stage area. And so the folks and I know doctors get tired, they’re in that room for a long time. And there are a lot of clinical conversations and talks that are being given and everyone is sitting politely taking notes. And then I got up to give my best 15 minutes on leadership and 40% of the room got up and took that opportunity to take a break. And so what that told me outside of you know me probably being a sore loser because no one want to hear me talk.
I mean, there were a couple of hundred people there but with maybe to make this transition and to run it successful elective medical practice it does require some leadership. But I feel like the community and I could say to myself part of it might not be putting enough emphasis on that. So how do you address that?
Dr. Michael: Oh, yeah, if you’re not willing to put and that will say a different way. Working in this kind of environment there is two ways that you end up you spending time: one is working in the business; and one is working on the business. And those are two very separate concepts. In a traditional medical model, the idea of working on your business, finding ways that will make your business more attractive, more suitable, more easy for traffic to move into to watch different, to look at different kind of products and services you can offer that takes time, there is a lot of time involved.
So for someone who thinks that they’re going to jump out of their drudgery insurance based model where you’re basically a slave and walk into something where it’s all cash based, and that’s going to be the easiest thing you ever done, do yourself a favor, stay as a slave. You’ll actually already know — you already know what you got there. But this is for somebody who is going to pay attention to some of the details or at least have the ability to hire somebody as a manager who actually can pay attention to those details. When we hire staff, one of the most important things we look for is had they ever had any experience in big-box retail because you hire someone who is in big-box retail they’ve already been through angry customers, how do you approach people, they have the whole customer service thing down. This is about customer service what we do.
Tim: Right, they got the medicines.
Dr. Michael: All right, the medicine is simple. It’s making the experience robust.
Tim: Right, all right, now here is what I really want to talk. I’m excited about this next piece. I’m a believer in it as you know I’m a hormone replacement guy, I do a little testosterone and I’ve been grateful for it to be exposed to that. But you created a really cool business model. And to the extent that you’re willing to share about that business model so you’ve created the first doctor that I’ve met that’s created a successful subscription based wellness business. And I think it’s relatively unique in this space, definitely forward thinking.
And like I said the extent that you want to talk a little bit about how did you come up with the idea for the subscription based model where you’ve got monthly billing going on and then how you developed everything from your practice model, the branding, the legal considerations, talk a little bit about that process?
Dr. Michael: Well, that’s about a day’s worth right there. [Crosstalk] Yeah, when I work with individual because I do some work as a consultant. When I work with the individual clients we start picking away at where they are from — what experiences have they already have. In my case I didn’t have a business background, so I had to sort of really get on to understand all right from the very beginning budgets and pro formas and how to look at individual performing, which looking at for example of the kinds of procedures we do taking stock of which ones are working, which ones are not because that will help guide the how you spend your marketing dollars.
But I mean just to go back I got started because I wanted to build a practice that I would be — that I would want to go to. I had retired from colorectal surgery, I had a hand injury, I really couldn’t do the surgery anymore. So I was like sort of reinventing myself. And for me and was in my late 40s it was about the time that I actually started getting personally interested in hormone replacement and optimal wellness. And so it was a journey that I was working myself and once I realized the power of this I realized that there is going to be a lot of people who would want to know about this.
But I also was tired of getting beat up for $0.39 on the dollar having to hire two FTEs just to chase insurance companies down. And at the time I wasn’t really — I really didn’t know if there was enough I could acquire enough people out there to actually make this kind of model work.
Dr. Michael: And so the idea was I did it over time, did it slowly. I kept my surgical practice while I was building the concierge-type practice until I got to the point where I really did convince myself that there are enough people who would not only benefit but would enjoy what I’m doing. So the idea was to first of all it’s just based — the model is based on concierge type practice. And if there is any word more bastardized in concierge medicine someone tell it to me because it’s a mess out there. What we see now is a big-box concierge medicine which means — see, if you can grab $1000 from somebody and then still build your insurance for prestige if you do in your office. I don’t get it, but I guess it means that the doctor now promises to call you or promises to I’m not sure what, but it’s not the kind of — to me it was kind of a marketing scam.
Tim: Yeah, and where to your point has changed a little bit. So when I hear you know, one of the guys come to me and say, oh, I’ve got this guy starting a practice its concierge. I think okay, he is working out of his home or she is working out of their home and they’re driving around with needles in their bag going to people’s houses and doing injections, that’s we see that use which I feel like is a completely inappropriate use of the phrase concierge because like I said I was in Beverly Hills over weekend and when you hear concierge that means these are the go to people, these are the — they’re going to give me the greatest service, the best experience. And I think that that phrase has been bandied about a little too much and it’s kind of lost its impact if you will.
Dr. Michael: Well, concierge in my world means that we manage pretty much everything, not only the customers, the client experience, but we also manage the client’s medications, vitamins including not only what they get, where do they get it from, and how do they get it. So my clients don’t go to the pharmacy. We make arrangements for things to be sent to them. We have a — the way we do it is we have a monthly fee that includes the access to the provider and the core medications that one might use. Now there are some variations because for example, in some products like vitamins, everybody in our client base or everyone is a one-off to us.
And that is the other thing is people have to — your clients want to feel that they are getting an individual, personalized attention and that is what we do, we give them personalized attention. Once they start feeling that they’re being corralled into a sheep holding pen, then they become uncomfortable with that.
Tim: Do you think Dr. Bedecs that by having the subscription model and those payments automatically coming out, does take some pressure off the relationship that you’re not constantly talking about money?
Dr. Michael: Yeah, our clients are, it’s a monthly, it’s like a gym membership in a way and it is. So when our clients come for their examinations or they come to if they’re here to pick up something, there is — we rarely do is there any money exchanged at the front door.
Tim: I like that.
Dr. Michael: Yeah, and so that takes a little pressure off too, but I mean it’s still, you still have to recognize the fact that people are paying cash for services. And so making that service special for them so that they will continue to find value in it, and that’s part of the retention strategies. It’s just the easiest thing for provider if I tell providers to do is pretend like you were the client, what would your — what experience would you like when you came into the office. Would you like to wait for half an hour waiting for your appointment, would you like to have to deal with all the stuff traditional medical practices do. The other thing that we do is we do something that I started when I was a surgeon.
Whenever I did a surgery, the day after the surgery when they went home we call them that day. And one of my staff calls them every day, every day until they were pain free, could be a week, could be 10 days, doesn’t matter, we just keep calling them, stay in their space. The same thing for the client retention models is if you look at successful practices they will stay engaged with their clients, and that means — and to some people that means well, I’m sending them an email blast every two weeks, no, that’s not engaged, that’s just wait –.
Dr. Michael: So, finding strategies to help keep your clients engaged which will improve client retention strategies and also again once you start selecting for clients that will stay with you because you know, we’re asking our patients to spend several thousand dollars a year particularly. And I have clients who have been with me for decades at this point.
Tim: Yeah, I love the model and it seems like you have a predisposition that maybe a little different than some of your colleagues. So getting back to this approach so you provide consulting and I want to talk more about that before we end. So you go into the consulting scenario and you ask them, what have your experience has been, how has that gone for you. And then what’s like those simple one or two little moves outside of helping them with their just general business acumen like you said, looking at a P&L and realistically what –.
Dr. Michael: And that should be done before. Well, those looking at the financial side it’s like building a house, it’s a lot easier to make changes on paper than once you start putting the foundation in. So having those considerations when I look at realistically what are the steps that one might take because you’ve been to some courses, you’re pretty sure you know what medicines, what you’re going to do, and what services you want to provide. Now the question is starting to look what I would call developing your practice model. A practice model differs from one practice to another. I have some very good friends who are very successful and think same kind of relatively the same kind of business model that I have.
And some of them for example, we do complete physicals on all our clients that’s part of our intake. There are some practices that don’t do physicals that specifically don’t necessarily do complete examinations and they just will just work in the different sort of business model. So that’s one consideration is your facility. Are you planning on — are you simply simple? If you’re planning on doing rectal exams on males do you have a room that’s got a sink in it. So it’s certain to think about your practice model how your facility matches that layout.
Tim: Yeah. And so if somebody wanted to engage you, what’s the best because the folks are going to listen to this and they’re going to be interested and there is certainly no shortage of people who would love to make the incredible leap that you’ve made and it’s not easy one making to a cash paid model. How would, what’s the best way, is there an email that someone could shoot you a question on how to get involved?
Dr. Michael: Yeah, I would, but just bear in mind that I’m really not and I’m going to be straight up here. I’m not really looking for — I’m not soliciting a bunch of new clients for consultations. I do them sort of selectively and then only on a — it’s not a core business model and I enjoy doing it. Yeah, I enjoy doing it for a selective kind of people and I’ve done it both for physicians and for business people who hire physicians. You know, a lot of this what I’m talking, now let me tell you something about that. Some of the better run models that I’ve known and been involved with or help started up are where the one of the primaries is a business guy, not a physician because these would generally have more skill sets in understanding pro formas business model, startups and customer service so –.
Tim: The folks who follow us on the podcast they can reach out to us and we’ll prescreen him for you.
Dr. Michael: Well, you know what, Tim, what we should be doing if we find that you’re developing people with interest we probably could put together a nice eight hour seminar in looking at all the pieces. I sent you a list of protocols that some eight or 10 bullet points that I find valuable when I talk to people about starting up. And each one of those is a little sort of little mini session by itself.
Tim: Well, I think for those of you who are listening, you heard it. Dr. Bedecs is officially offering me a partnership in an eight hour seminar that I would love — if the experience face-to-face working with you be anything like the time we’ve just spent. I always enjoy talking with you and I think it’s refreshing because I think you get how to speak to people’s listening. And what I mean by that is you understand the practical challenges. And so I’ve been struggling with this idea in our own marketing through Crystal Clear. And in our society how we always tend to focus on the hyper growth practices in our talk track.
So I’ve got a software marketing company and I say well, look at this guy, he is amazing, you know 10 million a year in revenue and then you go to the shows and they say well, look at this guy 20 million a year revenue. And we create in my opinion this false narrative to your point that and I actually just wrote an article about I’ll send it to you that says you know if you buy this laser or if you employee this business methodology or you hire this marketing company then somehow magically you’re going to be vaulted into the elective medical elite.
And I think that almost it turns some people off because the average guy is he is struggling with okay, I’m making $150,000 a year whatever the number. I used to make 250 or 300 how do I get back to the 300 where my life was. And I think we need to in the community speak more to that, right that through small incremental changes over time and hard work you’ll get there but there is no magic pill, right.
Tim: Yeah, there is no magic pill. But if you’d like let me just why don’t we just run down a few bullet points if someone is listening who wanted to sort of get an idea of what are the sequences of things that you might want to consider.
Dr. Michael: Let’s do it.
Tim: Yeah, we just talked about the first thing I suggest people do is develop their practice model, which means are you going to take cash or not. And if so, what are you going to provide, what services are you provide, are you going to do hormone replacement, are you going to do any injection work, aesthetic work. What are the core deliverables that your business model is going to incorporate because that will also help you understand what kind of facility you should have and how many rooms and patient flow. In my facility for example, one of the things that we do is since we do a fair amount of HRT, hormone replacement, we do a lot of — we train people to do their own injection.
So part of our business model is the initial consultation and examination training and then closing. So how you set up that experience just think of what will your patient’s office experience will look like? Will they go from the waiting room to the consultation room? Do they go to an exam room, training? Do people come to them that they go to a room, you just think about the flow and what you’re trying to create. Forget about the medicine for a minute, just put yourself in a position of how do you move around the office and how does it feel comfortable for you and the staff.
Tim: Great point.
Dr. Michael: I start looking early on at a couple of things that are really important. Obviously the web design early on is going to be an important because this all has to do with implementing an identity and branding. You want to put yourself out there on a brand. I sort of — I think that branding yourself as the doctor or the provider is one way to do it. You may want to just brand the clinic because that way if you bring in a partner you’re not the only one that you want everybody wants to see they’re coming to your clinic. So brand identity and web design all tie into that. And maybe not your expertise so that you know and that also speaks to how you drive traffic. Everybody wants to start driving traffic day one without thinking about the other kinds of things going into that. So legal considerations.
This is important because for those who are going to maintain their current insurance based models or a portion of it, you have to be a little careful and then vary by state. And so getting an attorney who should know about this might be helpful. For example, estrogen deficiency is an ICD-9 code. So if you are taking insurances and then you start charging people cash for helping them through menopause; well, that could be an issue because you might be in violation of your insurance contracts. So this is where having a different office, different days, every state does it a little bit differently.
You have to have a way to differentiate your insurance versus your non-insurance if you’re going to do both. If you’re going to do both — if you’re going to go all the way and I thought a Medicare and then really do it then you don’t have to worry about that. But again getting some legal help in what you need to do would be important.
Dr. Michael: Staff selection and training becomes the next thing that I start talking about. I can’t even begin to tell you how important this is. The success of my clinics is totally not me, it is totally my staff. It’s my staff we talk to on a daily basis, my staff takes care of fulfillment, my staff knows if the kids have been to the soccer game and won, my staff is the reason people keep coming back. And so choosing appropriate staff and then training them in that kind of a model. Again, if they’ve had experience in the traditional medical practice either they got to be able to shift gears or –.
Tim: Or you shift gear.
Dr. Michael: One or the other. The next one is very critical. It’s an EMR and I say EMR versus CRM, you have to be able to track stuff. This is going to be very critical. And since in my world we don’t care about ICD-9 code — ICD-10 codes now know [Indiscernible] [00:40:00], we don’t really care about the insurance aspect of this. So our EMR isn’t really looking to make sure that we did three different systems with four different exams of the ear, nose and throat because we don’t do that. So we don’t have to do that. But the EMR is important both as a tool that helps you make sure that you’re doing the right thing for your clients but also that helps you in the marketing piece.
You want one of the most important things that we do is the silliest little thing we do, which is send out a birthday card in our cosmetic practice, a birthday card. You know, people throw away things in the mail all day long when it comes to promotional but nobody throws away birthday gifts.
Tim: You’re right.
Dr. Michael: Yeah and so that costs nothing. Anyway so making sure that you have an EMR that really does the work for you. And there is a bunch of them out there I’m actually away from the free ones because that’s about how valuable they are.
Dr. Michael: And I mean, I have some and I’m not interested and necessary in promoting one to the other. But it took me a long time to find one that I think works well for what I have to do. So that’s important and you bring that on very quickly. You want to have that in place before you open doors for sure. I have the staff –.
Tim: Put that in the right technology in place.
Dr. Michael: Yeah.
Tim: And all of these things kind of go work in tandem. But I think to your point the person who just focuses on oh, I need five patients right now if they don’t put the infrastructure in place then the retention is going to be — it’s going to suffer, right.
Dr. Michael: Yeah, it is. And also a good EMR will allow you, it’s really they’re just so great now, you can — they fax directly to pharmacies, you can do your financial reporting to make sure that you can keep an eye on where the dollars are going, so that’s all important.
Tim: Right and then developing the startup budget.
Dr. Michael: Yeah, developing a realistic startup budget and a pro forma. No one is going to make money week one, but it will you should be able to somewhat predict where you become revenue neutral. And then how much is going to and you’re going to have, you’re going to want us plan to have enough resources to get to revenue neutral. And that’s just a function of how many clients you can accumulate in how short a time.
Dr. Michael: So and that goes back to your web design, your traffic, driving traffic and your marketing efforts. So setting fees policies. Next one setting fees policies, scheduling and procedures. Be clear about this stuff. You know, you want to not have any question. Your staff does not want to — you do not want your staff to be unaware of how much the charges are and how you’re marketing yourself. Be very clear about how you do that.
Tim: But train apparently with the staff probably is the key, right.
Dr. Michael: Yeah, absolutely is the key. One of the things that we do that’s what helpful for us is to train the staff to prequalify people when they call in. When I say that is one of the things that we do is we want to be careful that if we invite somebody in to do our screening because we offer free screenings we want to know that they are what we call prequalified. And that means that they understand that we do not accept insurances. They understand the relative sort of the relative general ballpark of costs and how our program works, because if we bring them in and halfway through the consultation they say, what do you mean you don’t take insurances we’ve just wasted a whole lot of time.
Dr. Michael: So in helping your staff. Once a staff is well trained they can actually do a whole lot about prequalifying clients and many times getting them ready to go quickly.
Tim: Right and that’s a good point and it speaks to your next point. But do you do through your website and anybody who wants it to check it out, it’s the age management center, its agemanagementcenter.com, correct?
Dr. Michael: Right.
Tim: Yeah, agemanagementcenter.com. Do you telegraph on the site I’ve been on it in a month or so that how do you I guess telegraph this is a cash pay business, right. This is not something you want to hide I would think it could be overtly-.
Dr. Michael: We don’t want to telegraph that. But again when people call and express an interest in what we’re doing right now the vast — because I’ve been doing this for a while, the vast majority of clients now are really from self referrals from other clients. I’ll tell you the truth, I had the hands that just be it’s every other method of marketing that we have in place.
Dr. Michael: So most people already know that going into this. But for those people who call up express interest in what we’re doing, we’re careful in a courteous and kind way to let them know; by the way, just couple of things about our practice you want to know, just to be sure you understand that we don’t participate with insurances for example, or although if you have a health savings plan that may work for you. So giving them alternatives to think about is important. So no, I don’t put that on the website, cash only, because I think that’s a little bit on the cheesy side. I would respond to that.
Tim: I agree. And then –.
Dr. Michael: But here is a thing to remind — just remember the people who call up and for whom that seems like a stretch for them, once somebody — because we have even people who have resources and are wealthy people are concerned about their dollars. Once they realize the value, the proposition that we’re providing and the value of what we offer, we offer something that no conventional medical practice can offer. We offer them a very wonderful experience, something I’m not going to get at these office.
Tim: And that’s the brand. We say brands come from within where you can’t manufacturer a brand from the outside; it’s going to come from the inside. So with the couple of minutes we have left, I know you wanted to at least share a little bit about your vendor selection process and the nutraceuticals that are used or how you choose the lab, spend a minute or so talking about that. And then ultimately kind of wrap this part of it up with launching the practice either a brand new practice or launching the practice inside, what’s probably the one big mistake people make and the one or two things they can do to get that early home run.
Dr. Michael: Well, yeah, vendor selection. Depending on how you — depending on your model there are revenue streams that you can develop from a number of parts of the practice. One could be nutraceuticals or vitamins, labs could be a vendor — you can choose or not choose to have labs as part of that revenue stream, how you supply your medications, there is a bunch of ways to do that, people do that in variations. But at the end of the day you want to choose your vendors carefully. What labs do you intend to use? What pharmacy do you intend to use? Who are your vendors for your nutraceuticals and what are their qualifications? So going through that and that’s usually a function of going to a lot of these meetings, meeting people try just figuring that sort of thing out.
But selecting vendors that work for you are important that work profitably as well. And also if you decide to bring aesthetics into your office, you have to — that’s a whole different conversation then, who will do it. But anyway that’s important to consider the vendor selection. I think we just talked about marketing and advertising. Oh, yeah, promotional collaterals. Be sure that as you develop your web design and so forth that you’re also developing collaterals for your office, handouts, brochures, things that people can take with them so that they can — that’s thoroughly important sort of thing.
Tim: And consistency across all mediums, whether it’s the site, social, email, collaterals like you said, it’s trading a brand and then experience is the key.
Dr. Michael: Right, launching your practice you know, there is a budget, you need to think about a budget and it’s going to cost a bit of money. You can get really twisted with — twisted around if you’re not careful because every newspaper and magazine is going to want to sell your color glossy whatever. We basically base our marketing budget on last month’s collections. We take a percentage of what we take on a regular basis and we cap our marketing budget. So I’m never — I don’t want to find myself in a position of getting this cool. There is a brand-new thing coming out, oh docs, you got to be in the spring issue of this or that.
Tim: So are you suggesting that doctors pay attention and run their business.
Dr. Michael: I think if you don’t run this as a business you must please go see in the ER you’ll be much better off.
Tim: I think you know, it’s money but how many times do you talk to somebody who is running the physician, surgeon whatever it is and they haven’t looked at it and you know there are any numbers until halfway through the year or they ended the year and their accounts says things didn’t go great. And you see this look of exhaustion and frustration because they just worked for a year for not a lot of money. And I think you take a little bit of a different approach to that. So what’s the one thing to avoid before we wind this down? Where does that person go you know that mistake that you’ve seen in the decades that you’ve been doing this over and over again, and what would be that one piece of advice around that?
Dr. Michael: You got to have patience, you got to have patience. It’s going to take a while to build this. So be realistic in your expectations about when you think that you will be able –this is going to take over your income stream for you. It’s going to take a little time. So be careful about expectations, that’s the one thing that I see people jump into this and if in 90 days their [Indiscernible] [00:50:55] of money they’re just wondering where did I go wrong.
Tim: Yeah, so managing your own expectations, right that’s –.
Dr. Michael: Absolutely.
Tim: It’s the problem. Well, Dr. Bedecs as I knew it would be, it was super informative and I always enjoy talking with you. You’ve got a great spirit about yourself and the way that you conduct yourself. And like I said in the outset, a true renaissance man, you’ve got multiple successful businesses, you’re doing it for all the right reasons, you wanted to have healthier patients and happier people around you. And I’m looking forward to it. So you’re going to be with us at the A4M coming up, it’s in Orlando. And I think the date was April and I missed it. But for those of you who are interested in meeting Dr. Bedecs, he will be at May 16th in Orlando at the A4M preconference. He will be part of the faculty that day, he will be available to answer any questions, make a friend, take a selfie, so we’d love to see you there. [Crosstalk]
Dr. Michael: And for those who are tuning into your webinar I’m happy to answer certain specific questions as people want to. And you can get me through my website, so look at the website they can contact me so that way to link.
Tim: You got it. Thank you very much Dr. Bedecs. Say, hi to your beautiful team that you have up there and let them know Crystal Clear is thinking about them. Have an awesome day.
Dr. Michael: You know the last one thing I will say, I got to say this for my team. I am so proud of my team. And whoever builds one of these, make sure you got people that you are proud of and you like, that’s important.
Tim: Boom; and on that note, have a great day everybody.
Dr. Michael: All right, see you. Bye.
Tim: Thank you.
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