Working Smart In Medicine For Maximum Income Generation - Part 2

Hoover  20 Mar, 2007  Business Medicine

This post is part two in a two-part series. Please read part one for an introduction on working smart in medicine for maximum income generation.

Yesterday I told you that I was going to give you an example of how to exchange low-paying time for a passive income that will pay you for a lifetime.

In order to do this, let’s think inside of the box - a “doc in a box.” Yep, urgent care.

Urgent Care Is In Its Infancy

Urgent care is gaining in popularity, and when Wal-Mart starts experimenting with something in their stores, you better start taking notice. I predict that urgent care is going to explode over the next 10 years.

Now, I know what probably 75% of you are thinking right now. Urgent care physicians are paid very low salaries, so how in the world can this represent exchanging that on-sale time for premium-priced time?

Did I ever say you had to employed by somebody else at one of these urgent care centers? That’s mistake number one. You are already in the mindset that your time is on sale. The first thing is to get rid of that mindset and shoot for a new one - one where your time is valuable.

Business Medicine

Instead, let’s open a single urgent care center. Just one to start out with. Being low on funds and new at this whole entrepreneurship thing, you’ll probably want to practice some at your new facility. This is different than being employed by somebody else, though. You are now working for yourself. No matter how hard you work, you are working for you. You have more control over your free time and your paycheck. You are taking the right steps towards passive income.

As your business grows, and more physicians are employed by you to practice at your urgent care center, you are starting to see a bigger return on your investment. Perhaps you start taking more time off and your paycheck stays the same, or you choose to work more while writing yourself a bigger check each week. Flexibility is starting to come into play.

With all of this nicely positive ROI and flexibility, you choose to stop practicing altogether. At this point, you are the practice manager. Years of practicing and running the business simultaneously has taught you valuable skills. These are skills that your classmates who also matched into family medicine don’t have. These physicians are continuing to make the average family doc salary while working even more.

Business Expansion

You’ve seen the success of your single urgent care center, and you’re quite confident that you can duplicate it. Let’s open another one and do the same things. Except this time, you don’t have to practice. Let’s staff it from the get-go with physicians (or nurse practitioners) who would rather work for somebody else than work smarter. These people are a valuable commodity to you. Thank God you took the time to learn just as much about business as you did medicine. Take advantage of this.

Before you know it, you have a network of urgent care centers spread through a state, a region, or nationally. You do nothing but recruit physicians or nurse practitioners to work for you, or you can pay somebody to do that for you.

At this point, you have reached passive income status. In most cases you’re making much more than average physician salaries and working as much as you want to, when you want to.

You have taken a specialty where the average physician exchanges their time for money at rock-bottom prices, but you are now making a huge premium for your time.

That’s exactly what these guys did.

At the Wal-Mart locations, once signed in to see a doctor, patients can shop and be signaled by pager or cell phone when the doctor is ready. A queue screen in the center lobby of the clinic will give minute-by-minute wait times.

Putting The Pieces Together

  1. Find a specialty that you love, or at the very least can be happy practicing
  2. Work smart to leverage your time versus income
  3. Start thinking about and actively creating passive income streams
  4. Duplicate, duplicate, duplicate
  5. Reap the rewards over time

I used urgent care as an example, but you could use any business strategy at all from investing in high-yield funds to starting other businesses completely unrelated to medicine. Ryan wrote up a nice post at SDN outlining some other strategies. I’m not saying this is easy. It’s not, it takes tons of work. The vast majority of business fail within the first year.

If you take nothing else away from this post, please remember this: Medicine is a business. If you want to go above and beyond and really blow your income numbers out of the water, you are going to have to start treating it as such. Even if you choose a low-paying specialty like family medicine, you too can make much more than the salary figures you see quoted, but you must first put yourself into the right mindset.

In the end, it’s all about what you want. Do you want to be somebody else’s employee or a 20% shareholder in a partnership track for the rest of your life, always having to pull your own weight to make your quota?

Or do you want to be the CEO?

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12 Comments so far »

  1. The Peanut Gallery said

    March 20 2007 @ 8:08 pm

    Great posts. Thanks for sharing info on how not to be a slave to the system forever. I’m in my third year of medical school and wonder whether I want to do this long term. It really does suck.

  2. Hoover said

    March 20 2007 @ 8:20 pm

    Anytime TPG. Never give in to the system. We have way too many freedoms and options in this country to settle for being chained down wage earners.

    Medicine will give you the income levels to break free and create your own income streams. If you’re unhappy in medicine but choose to stay in, then set your sights on building passive revenue streams as soon as possible.

  3. The Peanut Gallery said

    March 20 2007 @ 9:41 pm

    My husband and I both have degrees in biomedical engineering. We’ve always talked about coming up with a device and starting a company. We’ll see what happens. In the meantime, I’ll likely do psychiatry as it’s interesting and I hate primary care/medicine.

  4. Ryan said

    March 21 2007 @ 7:37 am

    Probably my favorite post you’ve made, and the most informative.
    We had a financial advisor come speak to us a while ago who went as far as to say that Family Medicine doctors have more potential for this kind of practice than anyone else. It’s because primary care is solely dependent on patients coming into the office. They don’t have to worry about referrals, and thus it doesn’t matter if they piss off every other doctor in town. It’s the closest thing to direct consumer marketing physicians have.

  5. vijay said

    March 21 2007 @ 2:07 pm

    nice written..

  6. Hoover said

    March 21 2007 @ 4:30 pm

    Thanks for the comments everyone.

    Family Medicine is perfect for this line of work. Even thought it’s not the most desired specialty, I don’t think it’s all doom and gloom if you just look at the bigger picture.

  7. Anon said

    March 22 2007 @ 8:00 am

    Great post, but if you’re low on funds (having just graduated med school with a ton of debt) where would you get the money to open even one ugent care center. Doesn’t that call for $$$ to lease/rent space, order supplies & equipment, get business license/permits, etc?

  8. Hoover said

    March 22 2007 @ 12:15 pm

    Anon, you could try and get a small business loan through the SBA or work for a year or two to save some funds (and pay down some debt).

  9. Docta Jones - MSIV - future anesthesiologist said

    October 4 2007 @ 2:49 pm

    Banks are more than happy give you loans to put you more deeply into debt, they know that we have a high earning potential.

    To the author, great article. I plan on getting my MBA during my residency or after my residency. The only way to get ahead in this world is to create passive income.

  10. Wish I knew then said

    August 10 2008 @ 8:05 pm

    Great web postings! Allow me to impart a little wisdom looking at life from the perspective of a 50+ procedure oriented subspecialist.As an adolescent, I was groomed for medicine by a well meaning family with an immigrant mentality. I did not have the maturity and self-assurance to say “hell no” to becoming a doctor. I was always fun loving but good grades required to get into medical school ultimately ruled. I dutifully completed undergraduate, medical school and internship. My salvation was the 2 years I had to put into the public health service as payback for the 2 years of government financial assistance. I was assigned to a sleepy coal mining town in Pennsylvania and for the first time in my life, I was out of the achievement track. I enjoyed life like every “normal” person and realized what a pathetic illusion a life dedicated to medicine was. My driving force become maximum income/minimum hours/maximum fun and abandoning any thoughts of literally being owned by a practice (which is what having your own practice really means). Years later, I found a “sugar daddy” doc who made millions but took a liking to me and put me under his wings. Today, I make >400K and perhaps actually work 25 hours a week. I also have a family, became a pilot, learned to play a muscial instrument and went back to graduate school to study something that I actually gave a God-damn about. When I am in the hospital, I look at my overworked zombie colleagues and think to myself, “you don’t get it”. For me, the hospital is a place where I can make up for lost time and enjoy the company of hordes of beautiful, funny women. And the work gets done! Beats a corner office any time.

  11. disgruntled MD said

    August 31 2008 @ 11:53 pm

    Hi Hoover,

    I chance upon your website from google.

    As a medical person, how is it like to make a transition from a practioner to a business person (assuming in a non-medical related field)? Most of Medical training trains doctors to be risk adverse and always arrived at the correct answers or else (some dies or we get sued). We are so afraid to fail, owing to our education.

    Also, we tend to be rather dead serious in our talk and tend to ‘look down’ at sales people. Whereas in business, we need to sell ideas, services, products and our brand name. Was thinking of doing MBA, but then it’s another 2 years of getting old and wasted income.

    Do you know of any good number of physicians who have successfully make the jump? (besides yourself)

  12. malikite said

    September 6 2008 @ 4:16 pm

    digruntled MD,

    You say that you don’t want to do an MBA because of “wasted” income and getting old? I figure from you name that you are not enjoying medicine. So it would seem that you are wasting time doing something that you don’t enjoy.

    As for getting old, age is all relative.. There is no template anywhere that says after the age of xx (insert your own age) that you can’t obtain so and so degree, or you can’t succeed at something because you are too old. The only thing stopping you is your own insecurities.

    Business is a risk but so was medical school. You could have failed at that too. Your chances of success are dependent upon the effort that you put into it.

    If you want something different, go for it!

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