Secrets of an accidental physician entrepreneur

What do you get when you mix passion with expertise and curiosity?

You get Dr. Steven Ponder, a committed pediatric endocrinologist and diabetologist, who has become an equally enthusiastic entrepreneurial physician.

As a Type I diabetic since age 9, Dr. Ponder knows diabetes!

In addition to practicing medicine, Steve is also a business owner in MyGluco.com and DiabetesHousecall.com - two highly innovative companies involved in the delivery of healthcare to specialized populations.

In this week's 25-minute podcast interview, you will hear Dr. Ponder describe how he became an accidental entrepreneur, what he had to learn to build his business expertise and how he and his business partner have taken advantage of technology to deliver care to a far-flung population of diabetic children in Texas.

What the podcast doesn't do justice to are the additional "smart marketing" activities I discovered post-interview that Dr Ponder is engaged in:

• writing a blog
• writing a health column for a local newspaper
• doing a radio show that is picked up by his local PBS station.

As a contemporary "marketer" (this modest guy would hate to think of himself as such --  he would only think of himself as an educator) who is using all the recommended strategies for getting the word out,  it is no wonder he is "slightly famous" in his community.

Surgeon-turned-collaborator solves mysteries of physician-administrator relationships!

Kenneth (Ken) Cohn MD MBA is no ordinary general surgeon.

This is a man who looked at a layoff as an opportunity to keep his wife happy (smart guy!) by remaining settled in New England, and instead, made lemonade out of the lemons he was handed.

Involuntary unemployment provided him with the chance and time to go back to school to get his MBA at the Tuck Business School at Dartmouth, thus launching a whole new phase of Ken's professional development.

As the founder of Healthcarecollaboration.com and a self-employed consultant who helps hospital administrators and their medical staffs and physician communities get cozy and collaborative, Ken obviously has the patience of a saint (I know, because I have been there and struggled with that). And a delightfully self-deprecating sense of humor to match! He's also a thoughtful blogger.

And to keep his hand in, he maintains a practice as a locum tenens, getting to know many physicians and hospital administrators in the process. Good marketing, don't you think?

Listen to Ken share the lessons and insights that becoming an accidental and now very intentional entrepreneurial physician have presented to him.

Relinquishing the MD identity: A physician reveals her Artist

I'm always surprised by just how many physicians express their longing for an outlet for, or even an escape from, the relentless pressure to see insanely big numbers of patients a day to keep incomes stable or meet organizational demands. And to hear how stuck they feel about next steps.

Every now and again I encounter a physician who has decided to follow his or her heart.

Lissa Rankin MD is one such person.

Lissa is an OB/Gyn who has sensed a calling as an artist for many years now, and who felt compelled to step away from the rat race and then a bad job situation, and instead permit herself a year off.

Listen to The Entrepreneurial MD Podcast this week, with Dr. Rankin's frank revelations about clinical practice, her journey into the creative life (including that of author and blogger) and her willingness to tolerate and enjoy  "the freefall" that such an adventure entails. Her many months away from practice have been a time of self-discovery and creative exploration, and she is still unsure as to what the next fork in the road will offer. All she knows is that  she is having a lot of fun!

PS: Enjoy some of Lissa's striking art at LissaRankin.com and read her funny and candid "yoni musings" at her blog.

Steven Knope MD writes the first book on Concierge Medicine

Talking to Dr. Steven Knope is an exercise in fascination.

What is this French-horn-playing, Ironman triathletic, 3rd degree black belt-holding Kenpo martial artist up to now?

Stirring the pot of controversy it seems, with his newly released book Concierge Medicine; A New System to Get the Best Healthcare. As a two-time author and full-time practicing internist, Dr. Knope is ready to take on all that is wrong with the everyday practice of medicine.

In this podcast interview with Dr. Knope, you will hear how and why he got started in his concierge medicine practice in Tucson Arizona, along with his counterargument about the "ethics" of how medicine is practiced in the concierge model versus the HMO and third party insurance industry.

Above all, you will hear a physician who is passionately dedicated to improving the overall health of his patients through a relentless focus on customized exercise and nutrition plans along with health education provided without the constraints of "no time to practice properly".

When you are done listening to this intriguing interview, please come back to The Entrepreneurial MD Blog and share your comments and thoughts. 

Brief review of Concierge Medicine; A New System to Get the Best Healthcare (Praeger, 2008)

Aimed at lay people and potentially physician colleagues who are interested in understanding the rationale for starting a concierge or retainer practice, the book portrays the demise of the personally attentive "Marcus Welby MD-style" physician and the rise of the perpetually rushed and therefore more disengaged "provider".

Using the metaphor throughout the book of health as an asset to be invested wisely, Knope cites the three critical components of comprehensive healthcare: expert medical care, an appropriately tailored exercise program and a sound life-long nutritional plan. He draws parallels between the teachings of financial gurus about the creation and preservation of wealth, and his own about health -- the "great equalizer" between the moneyed haves and the penniless have-nots!

He makes a persuasive case for the style of medicine that can be practiced when there is a direct financial arrangement between physician and patient, and offers his argument for how this can be funded (high deductible policies linked to HSAs, sacrificing that daily latte and pack of cigarettes, amongst others).

I found the book both interesting as a personal story (after all I left the practice of medicine mostly as a result of my unhappiness with the environment in which I being forced to practice) and as a description of a model that, though not yet widespread, is emerging as a viable alternative to having disgruntled physicians leave medicine altogether, as I did!

The book doesn't offer physician colleagues a prescriptive "how-to". That is best left for organizations such as SIMPD and the myriad of consultants who have arisen along with the emergence of concierge medicine.

Instead, it puts forward the journey of one physician from frustrated practitioner to, dare I say it, joyful professional. And challenges patients to question and examine what they are getting for their or their employer's money under the traditional insurance-based healthcare practice model.

I daresay the book will frustrate the critics of concierge medicine, but that is what is so great about freedom of ideas and speech. At least one MD in the USA is a happy practitioner!

Want to boost your cash flow? A tool for physician real estate owners

The Entrepreneurial MD's Podcast this week is on an intriguing and obscure topic - previously unknown to me, and to many physicians I suspect. However, it involves tax savings!

Are you an owner or even part-owner of a commercial medical office building?
Or thinking of becoming one? 
Or other commercial real estate?
If so, it's time to sit up and pay attention as this information could make you smile, while Uncle Sam frowns.

In a podcast interview with Cherie Brown of Cost Segregation Services Inc (CSSI), I learned that there are relatively new accounting regulations that permit a commercial business owner paying income taxes to accelerate the depreciation on the building, thereby freeing up lots more available cash flow each month.

From their website:

"Cost segregation is the IRS approved method of re-classifying components and improvements of your commercial building from real property to personal property. This process allows the assets to be depreciated on a 5, 7, or 15-year schedule instead of the traditional 27.5 or 39-year depreciation schedule of real property. Thus your current taxable income will be greatly reduced and your cash flow will increase."

Although this may sound like dry "accounting-ese", I hope that the idea of saving beacoup bucks is catching your attention!

In order to qualify for cost segregation, you need an engineer's report that details all the specifics of your building - carpeting, cabinetry, wall attachments, walls, floors, ceilings etc! That is where CSSI comes in - they are the engineering company that generates the report for your CPA.

The good news is that Cherie is a capable translator, who manages to make an arcane topic understandable.

Questions, anyone?? :-)