For the Entrepreneurial Physician: Create your first info product in 5 easy steps

I have decided to write an occasional "how-to" series to walk you through the steps of a handful of new potential revenue-generating business activities. I hope this will be helpful .... and I will depend on getting your feedback to give you more of what you want, and to shape this series to be useful! Do we have a deal?

Today's "How-To" is how to inexpensively create a simple information product in a CD format that you can either give away as a marketing tool, or sell to clients or patients.

Step 1: Pay attention

Your best products will provide information and solutions to the most commonly asked questions in your business or practice.  For example, if you have a newly diagnosed asthmatic, there might be a number of questions that your patient will need answered.  Or you may have observed that many of your pre-op patients express similar concerns or questions. Or, if you're in business, you may be thinking about developing an FAQ column for your newsletter.

The secret here is to be observant about what is on your customers' or patients' minds, or where you feel you have to repeat your responses several times a day or week. 

Step 2: Draft a script

Once you have determined what you content is going to be, write out a simple outline or draft a more detailed script. The ideal length for a CD is between 40 and 55 minutes of spoken content. Practice speaking the content to feel more comfortable - make sure you time yourself.

Step 3: Sign up for a digital recording account

You no longer need a recording studio to create and publish a decent audio recording.  Current technology has made it a whole lot easier.

My favorite digital recording service is AudioAcrobat, a remarkably simple and intuitive web-based application. It's the service I use every month to record our complimentary teleclasses. AudioAcrobat enables you to record conversations by telephone, or via a microphone into your computer and they then host all those huge recorded audio files on their servers, for the princely sum of $19.95 a month. Once you sign up for an account, you will receive notifications of free telephone-based trainings that are repeated every week.

PS: If you sign up through this link, I will receive a little credit!

Step 4: Record your content

To record your content, you pick up the telephone, dial the AudioAcrobat number and access code that you have been assigned with your account, introduce yourself and the title of your content, speak your script into a landline telephone as if you are giving a conversational lecture, hang up and return to your computer.  Within a few minutes, your recorded audio file shows up on your personal AudioAcrobat page.  You then re-title the recording (instead of "Saved phone recording"), and download it to your computer in a specially designated folder.

You will then need to copy this to a recordable CD (a CD-RW).

Step 5: Get set to publish your CD

At Kunaki, you can create your own CDs, in jewel cases with your custom-designed case covers, that can be ordered in quantities as low as one at a time - a kind of "print-on-demand" service. The typical cost for producing a CD is $1.60, irrespective of the number you order.

Here's how you do it.

1. Create a user account
2. Download a small piece of CD-DVD publishing software to your computer
3. The publishing software will guide you through the process (this is from their website):

• You select the product type (audio, video, ebook, game, data), and enter product information like title, publisher, author.
• You select and design your jewel case, and disc label print. Use our automated design system or custom design your own.
• You select the disc content by selecting your existing source CD (the one you downloaded your recording to) that you have placed in your E:drive or F:drive.
• Your product design, and content are compiled into a master product you test and review.
• You click the publish button and your master product uploads itself to our facility.
• Your publisher account is created for you. You manage and order your product by accessing your publisher account.

    4. To add a custom photo for your jewel case, instead of using the template images provided by Kunaki, you can go to iStockphoto.com (you can sign up through this link as well) and, using keywords, search for and then select royalty-free images for as little a $1 per image.

    5. Save your photo or photos (you might want one on the front cover and one on the back) to your computer, and then when you are asked to upload your photo from your computer to the Kunaki webpage, do so. See what your case looks like with the front cover, back cover, inside left side, and CD label itself.

    6. Select the "Custom images" option. Once you are satisfied with how your product looks, all the information will be sent in a digital file to Kunaki, ready for production!

    7. Kunaki will go so far as to set up a sales page for you (for an extra fee). Here again are some details from their website:

• The service lets you outsource: order acceptance, manufacturing, packing, shipping, and customer service.

• You set the retail price and we set up a sales page for your product. We accept credit-card orders on your behalf; and manufacture and ship directly to your customers. We provide you with accounting data, customer names and addresses, and send you a monthly check. You can expect to receive the check on the 15th of each month.

• We add a handling fee of $3.00 to your retail price when accepting orders on your behalf. Each month, we send you a check for the quantity sold multiplied by your retail price minus the manufacturing cost ($1.60).  

So, for example, if  you want to net $20 per CD, you need to charge $21.60 (to cover production costs) and then Kunaki will actually sell it for $24.60, to include the $3.00 fee for handling sales and fulfillment (filling and shipping the order).

Not too difficult, correct?

I challenge each of you to think of at least one product you could create in less than a month, that would provide valuable information to your patients or client. For not much more than $1.60 and your investment of time, you could have a customized information product to give away as a marketing tool. And when you see that there is a demand for these products, you can begin selling them from a simple one page website linking to the Kunaki sales page!

Who wants to take me up on the challenge? I'll be creating at least one myself!

Success can be found in the quality of your questions

Sometimes being entrepreneurial is simply a matter of figuring out how to do things more effectively, or how to get better results than your competition.

A recent Science Daily article titled "Patient compliance improves through 'motivational interviewing'" attracted my attention, mainly because I recall how challenging it was in clinical practice to have patients comply with my treatment plans.  Anyone have that same experience?

What was striking about the report was how a simple intervention, called motivational interviewing, produced dramatically increased results in patient adherence to recommended treatments

Some background here -- One of the cornerstones of health behavior change is a model developed by James Prochaska and Carlo DiClemente called the Transtheoretical Model of Change. It's a wordy name for a remarkably effective approach to helping people alter behavior.  Perhaps its other name describes it better -- the "Readiness to Change" model.

Simply put, individuals move through a series of five stages in the adoption of healthy behaviors or cessation of unhealthy ones:

• precontemplation - I'm not even aware of this yet
• contemplation  - I'm thinking about it
• preparation - I have a start date selected
• action - I'm actually doing it
• maintenance - I'm in it for the long haul

Your job as the professional prompting behavior change is to understand in which stage your patient is, and to match your recommendations or suggested treatments to the patient's stage.

And if you are a manager of people or attempting to be an "influencer", this information applies equally well to producing behavior change at work, or with clients!

So what is this "motivational interviewing"?

Dr's. Stephen Rollnick and William Miller, the authors of this intervention, describe motivational interviewing as .... a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.

In other words, the  motivation to change comes from inside the patient and is not imposed from the outside, the patient takes responsibility for resolving his or her ambivalence, and the physician or clinician works in partnership with the patient.

In spirit, it is a form of health coaching - as I described several years ago in an article called "From Healer to Coach—Physicians Face Dramatic Role Change for the 21st Century"

Perhaps you're wondering what the connection here is to being entrepreneurial.

To be skilled at motivational interviewing, you do not need years of training.  You merely need a couple of good books and a willingness to practice your skills.

The two books I recommend are "Motivational Interviewing" by Rollnick and Miller and "Health Behavior Change - A Guide for Practitioners" by Rollnick, Mason and Butler. Both books are filled with "how-to's" and examples.

By learning this method, you'll have up your sleeve a new approach to working with your patients that not only produces better clinical outcomes but also generates tremendous goodwill in those patients that enjoy being treated as equals.

And those are vital ingredients in the recipe for a successful practice!

Are you working for the wrong employer? An interview with Chris Ewin MD

Chris Ewin MD is a man with an opinion. Which is just what you'd hope for, coming from the President of an emerging Association of like-minded physicians.

And a man with a sense of humor, when he describes his Association as: "....the only physician-led trade organization to represent physicians who realize that they have been working for the wrong employer for too long".

As president of the Society for Innovative Medical Practice Design (SIMPD), Chris has helped the association evolve from a loosely affiliated group of physicians and professionals, with a common interest in developing viable alternatives for medical practice models, to a much slicker physician-led organization "promoting a direct financial relationship with patients in order to restore the integrity of the patient-physician relationship".

Chris was quick to point out to me that his own private practice, 1:2:1MD, is a retainer model practice in which patients pay an annual fee based on age for unlimited access to his services - and represents just one of the several clinical practice models under the SIMPD umbrella.

Listen to this week's "The Entrepreneurial MD Podcast" interview with Chris Ewin as he shares his vision for the future of primary care, as well as those of his organization and his personal clinical practice.

PS: For those of you who are new to podcasts, click on the greyish button with "Pod" next to the title, and hang on for a couple of minutes while it connects!

The Power of a Plan - How physicians can take the plunge into business

Most physicians claim to be risk-averse and offer up this trait as a reason to stay put and avoid changing their situation.

Surprisingly, many of those same physicians are engaging in risky behavior! I know this because I was one of them.

When I went into medical practice in 1988, I had no idea what a business plan was. And even if I had, it would never have occurred to me that I needed one. After all, I was a family physician, not a business person. I was just going into practice - like every doctor had done before me.

That's like choosing to be unvaccinated or ignoring your car's "put on your seatbelt" warning signal in these times of declining reimbursement and rising costs. It feels vaguely irresponsible not to understand your own practice and how it provides your livelihood.

As I reflect on my medical practice days and the reasons why I chose to move on, I suspect that if I'd been more engaged in designing and operating the practice I truly wanted, I might still be providing care today on the Westside of Los Angeles. For it is my fascination with business and the possibilities it creates that is proving resilient.

Having gotten licensed as a One Page Business Plan consultant last week, I want to share my enthusiasm for the difference a sound business plan makes. I know this, because I now have a written business plan through 2008 for The Entrepreneurial MD!

First, I have to confess to having had nothing better than some sketchy ideas and a few written business goals in the past 5 years, so this is my first formal plan.

And here is the difference a good written business plan makes:

You'll have a life jacket. When you take the plunge into untested or even partially tested waters, unless they are of tropical placid translucency, it will be difficult to see exactly what lies beneath the surface. Rapidly moving waters will always be murky. One way to make sure your head pops up after the jump is to wear a sturdy, reliable life jacket.

Think of your written business plan as just that. Something to help you automatically pop up from the depths no matter what shape you're in.

You'll know which way to point your toes. If you've ever done whitewater rafting, one of the tips a good guide shares is "if you fall overboard, point your toes downstream". Why? Because it's better to see what you're going to bump into up ahead, and prepare to use your leg flexibility to control the impact rather than your head! In order to steer your feet in the correct direction, you need the assistance of that life jacket keeping your head out of water and freeing your arms to paddle.

Likewise, your written business plan will help you stay afloat so that you can anticipate and mitigate the bumps.

You'll enjoy the trip. Because we are risk-averse and sensible (or pride ourselves on that), isn't it more fun to anticipate our trip without anxieties about our safety? Or know that we've planned well enough (a credit card, some sunscreen, extra water etc) to indulge in unexpected side trips, detours and acquaintances, instead of fretting about whether we're likely to sink if we fall overboard?

A written business plan frees up brain space - no more carrying around all those details in your head - and puts you at ease. You have guidance and direction. If you've done a good planning job, you'll have a succinct map of what you're up to in your business and what your priorities are for the next several quarters. This information, in turn, spells out your action plans, and from these come your (manageable!) to-do lists. Now you can enjoy the ride a whole lot more.

Who has a business plan - for a practice, a start-up or an existing business? If you do, please share how it has helped.

At the end of 2008, I'll let you know how mine helped me!

Identity crisis - a shift from physician to entrepreneur?

Ivo Drury's insightful blog post about physician identity reminded me of a conversation I had earlier this week on the same topic with a physician coaching client.

She is an established physician entrepreneur with a growing business, who still practices clinical medicine part-time as a hospitalist and internist. In order for her business to move to the next level, she is being forced to consider leaving practice altogether to devote time to business expansion.

This loss of her physician identity feels both disconcerting and irreversible, and is creating stress.

It feels appropriate to share my experience of this dilemma here.

I recall my thoughts at the time of leaving clinical medicine to go full-time as a hospital administrator. My move out of practice was precipitated by realizing I'd been kidding myself in the belief that I could successfully divide my time between my hospital Medical Director role and my busy family practice patient load.

After much soul-searching, I concluded that what lit up my day was NOT placing a stethoscope on someone's chest, doing a Pap smear or writing a prescription. Instead, my joy came from talking to patients, somehow making a difference in their lives, and using my brain to "detect and solve".

I wasn't as attached to "being a doctor" as I imagined. My real attachments were to being an "interactor" and "problem solver". And at my core, I was still ME.

I was delighted to discover that what fulfilled me was translatable to other environments. And that wherever I went, there I was!

As a hospital administrator, the job I assigned myself was to talk to the doctors and hospital employees, detect and solve problems, and make a difference to their days.

As a physician business and leadership coach, I do much the same - I live and breathe our conversations, explorations and discoveries.

If you are struggling with a shift in identity, here are some questions to ponder:

• What do you love most about being a doctor?
  
• Which of these joys are portable or translatable to other careers or environments?
  
• If you are no longer a practicing physician, who are you?
  
• Who were you before you became a physician?
  
• What do you want your grandchildren, or a future generation, to say about you at your funeral?

And if you have any good suggestions to help other physicians who are engaged in this struggle, please share them here!