August 11, 2025 • 24 mins
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The number one reason for pain and suffering in cash-based private practices is bad pricing.
I see it all the time… Doctors charging prices that either don’t cover their costs or leave them overwhelmed and underpaid. If this sounds familiar, you’re not alone. But here’s the good news: you can fix it. In this episode, I’m showing you exactly how to set your pricing right so you can build a practice that’s profitable, sustainable, and enjoyable.
I’ll walk you through the simple math behind pricing and the key principles you need to consider when choosing your price point. From understanding the relationship between your pricing, patient load, and revenue to knowing the three key choices you have when your numbers aren’t adding up, this episode is packed with actionable tips to help you make informed decisions.
Tune in!
—
Key Takeaways:Â
- 00:00 IntroÂ
- 01:40 The overarching principles of pricingÂ
- 03:37 Million-dollar mathÂ
- 04:30 Examples of pricing strategies
- 08:23 Three options if you don’t like your potential revenueÂ
- 10:26 Lean into the value that your offer
- 14:09 High ticket vs. low ticket modelÂ
- 18:25 Your homework
- 22:33 OutroÂ
—
Additional Resources:
- Learn more about my 12-month program.
- Interested in 1-on-1 coaching? Apply here.
- Grab a copy of the "The EntreMD Method" book.
When you are ready to work with us, here are three ways:
- EntreMD Business School Accelerator - If you are looking to make a 180 turnaround in your business in 90 days, this is the program for you.
- EntreMD Business School Grow - This is our year-long program with a track record of producing physician entrepreneurs who are building 6, 7 and 7+ figure businesses. They do this while building their dream lives!
- EntreMD Business School Scale - This is our high-level mastermind for physicians who have crossed the seven figure milestone and want to build their businesses to be well oiled machines that can run without them.
To get on a call with my team to determine your next best step, go here ...
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Many people tell you oh, in pediatrics you can't
build a seven-figure practice,blah, blah, blah, blah.
No, you can't.
Last year we did about 1.7million and it's a low-ticket
model.
You have to understand this.
Business is math.
Business is an economic sport.
Hi docs, welcome to the EntreMDpodcast, where it's all about
helping amazing physicians justlike you embrace
(00:20):
entrepreneurship so you can havethe freedom to live life and
practice medicine on your terms.
I'm your host, dr Imna.
The number one reason for painand suffering in cash-based
private practices, which I havestudied for over six years now,
is bad pricing.
Okay, and the way thistypically works is people either
(00:44):
think about a price they feelgood about, they feel like this
is what people can pay, or theypick a price that they see other
people charging.
They just pull off a price offthe internet and they're so
unhappy with the results thatthey get.
And so today, what I'm going todo is I am going to show you
how to pick the pricing for yourown cashless practice, and this
is a pricing that will makesure thatbased practice.
And this is a pricing that willmake sure that you're
(01:05):
profitable.
This is a pricing that willmake sure that you enjoy the
work you do, you have the timeoff you want, you're serving the
number of people you want tohave, like you are.
You have a practice by design,okay, not by default.
And so recently in the EntremetBusiness School, one of the
students she has a privatepractice that's going to start a
cash-based practice.
That's going to start acash-based practice that's going
to start off in a few monthshere and she says you know, dr
(01:26):
Una, I'm so confused I don'tknow what to do with my pricing.
I stopped to walk her throughthis concept and I figured I
would share it with you, becausethis comes up so much and if
you get this, you're going toenjoy your practice so much more
.
Okay, all right.
So I want to give you a fewprinciples here, and these are
important.
All right, so I want to giveyou a few principles here.
These are important, these areoverarching principles.
The first is there's no rightor wrong.
(01:46):
You know, sometimes people arelike if you charge, you know,
higher, then you're bad, if youcharge lower, then you're good.
There's no right or wrong.
I mean, it just is rightBecause you want to build a
business, and no matter whattype of business you, it is a
win for your patients or win foryour clients, and it is a win
for you.
(02:07):
It needs to be a two-way street, right and so there is no right
or wrong and I'll walk youthrough that.
The second overarching principleis when you choose your pricing
, you also have to choose theconsequences of your pricing.
You don't get to pick andchoose.
By choosing the pricing, youchoose the consequence okay, and
(02:27):
, for instance, if you look at avery broad way of looking at it
and I've talked about this alot on the OnTrimmed podcast
there's an episode I did that isthe business math, right, and
the math needs to math.
So, for instance, if you choosea higher price, then you also
have the luxury of having fewerpatients.
If you choose a lower price,then you have to have the number
(02:48):
of patients you need to get towhere you need to get to right.
Like you don't get to choose,you don't get to choose both.
Okay, you can choose thepricing and you choose the
consequences, right.
If you choose a higher pricing,then you also choose the
consequences of getting good atselling.
Like you're not going to getaway with not doing that, okay,
all right, and then you know.
(03:09):
The other principle is.
You know and I alluded to thisa little bit is that the
prevailing prices are wonderful,but they have to work for you.
Okay, we work too hard to nothave businesses that we love.
Okay, we did the whole pre-medthing and we did the high school
thing so we could get a goodpre-med program.
We did pre-med, we did medschool, we did residency, some
of you did fellowship.
(03:29):
You did all of these things notto get to a place where then
you build a practice that youhate.
You want to have a practicethat you love, okay, all right.
So let's look at what I callmillion-dollar math.
Okay, this is million dollarmath for entrepreneurs.
Okay, I want you to think of itthis way X plus Y is equal to Z
.
Okay, now, x plus Y is equal toZ.
(03:50):
Let's take some things here.
So X could be you know how much, you know what's your monthly
membership costs, okay.
So you know $60, $100, $150,$200, $500, whatever.
It is okay.
And then that's X, and then Yis your panel size, okay.
So you may say I wanna have 300is a number I hear a lot in the
(04:12):
DPC world, right, like so yousay you wanna have 300 people,
you wanna have 200, you wannahave 500.
I've seen people that spend 800, okay, so you want to have that
.
And then Z is your revenue,okay.
So X is your revenue.
Okay.
So X is your membership, yourmonthly membership, whatever
that price is.
Y is your panel size, z is yourrevenue.
So let me give you a fewexamples.
Okay, I took some time to do afew examples here.
(04:38):
So let's say you're like youknow, what I want to charge is
$60 a month, okay, and I want tohave 300 people.
For these examples I'll justuse 300 people.
I want to have 300 people.
You know that's the panel sizeI want and that's it.
That comes to $18,000 a month.
Okay, that's what it comes to.
And let me give you what itcomes to per year.
I'm really good at math, butyeah, okay, so $216,000 a year.
So if we go back to you gettingto choose, you can choose the
(05:01):
panel size and the revenue andthen you have to reverse
engineer to get how much yourpricing is, or you can charge
the price you want to charge andhave the panel size.
I have to be okay with therevenue that comes out on the
other side, but you cannotchoose all three numbers.
So let's say you're not $60 amonth, maybe you're $100 a month
okay, and $100 a month 300people.
(05:22):
That comes to to 30,000 a monthor $360,000 a year Okay.
Again, if you wanted to change anumber, you get two numbers to
play around with, but you don'tget to play with all three.
If you choose $150 a month, itcomes to 45,000 a month or
540,000 a year.
Or you choose 300 a month, itcomes to 90,000 per month or a
million a year, up to $90,000per month, or a million a year,
(05:43):
or a million and $80,000.
Okay, so you see how, likeright now, I did this math
playing only with the pricing,but you can play with the panel
size.
You may say, no, I want to keepmy pricing the same but I don't
like the revenue.
So I want to increase my panelsize, okay, or I'm fine with the
revenue.
Some people even said I'm finewith the revenue because I
really want to charge a littleand I'll do five locum shifts a
(06:05):
month to make up the difference.
Whatever, the point here is,you don't get to choose all
three numbers.
So this is what I think is acomplete disaster when you think
about cash-based practices.
I've heard people tell me.
This is doctors.
We're nice, we love people, wewant to help people, we want to
make a difference in the world,so this is what we do.
So this doctor says I wantpeople to have access to care
(06:29):
and so I'm going to charge alittle bit.
I'm going to charge, you know,$60.
That's what I'm going to charge.
And then I believe peopledeserve all the time that they
want to, you know, like all thetime with their doctor that they
deserve.
So I don't even want to have300 people, I want to have 200
people.
That's about how much I want todo.
Now.
This comes to less than$200,000 a year before overhead.
(06:52):
And the person is also I wantto be financially free, I want
to take X number of days off, Iwant to have this much in the
bank and all that stuff.
I'm like you can't choose allthree numbers.
You can only choose two numbers, which is a great deal if you
think about it, because you havetwo numbers, two out of three.
That's fair right, but youcan't choose all three.
(07:13):
And so if you look at therevenue and this is a number
most doctors will not thinkabout They'll think about how
much they're charged.
They think about how manypeople they want to have.
They'll think about the kind ofservice they want to offer.
They'll think of extra servicesto add on, and all they're not
thinking about the revenue.
Business is an economic sport.
You have to have all threenumbers, okay.
Okay, so you put all threenumbers.
This is how much I want tocharge, this is what my panel
(07:35):
size would be and this is howmuch I'm bringing in.
Many times when I have, it'smath, right, it's math, and
there's nothing wrong.
If you're like I only want tobring in $50,000.
That's fine, as long as you'rechoosing to do that, not that
you accidentally at the end ofthe year, you're like how come I
have $50,000?
Or you feel like they're sohard, I could work and I could
(07:57):
make more.
I'm like no, with this equation, this is your cap, this is it
right?
So if you do the math andyou're like okay, I'm doing 60 a
year, I have a panel size of300.
I'm bringing in $216,000 a yearand I don't like the number,
okay, and this is important,make sure you do your math.
If you don't like the revenuenumber before overhead, because
(08:18):
we're not talking profit, thisis overhead.
Okay, this is revenue overall.
If you don't like the number,you have three options.
Okay, these are the threeoptions and this is just the way
it is.
Okay.
What do you need to do if youdon't like your revenue number,
your potential revenue?
Number one you could chargemore.
Okay, you could charge more.
(08:38):
That's one way you can changeyour revenue number.
Number two you can have abigger panel size.
Okay, so maybe you're not doing300.
Maybe you're doing 350 or doing400.
Again, there's no right orwrong.
I'm not telling you what to do.
I'm showing you how to think ofit.
Think of this as informedconsent.
Right, we're giving you all thedetails you need so you can
make an informed decision.
(09:00):
Okay, so you can see somethingon the internet.
You can see something on theinternet.
You can see something somebodyelse is charging, you can see
whatever, but you know how tomake an informed decision.
Okay, so, number one you cancharge more.
Number two you can say no, Idon't want to charge more, I
want to see more patients, andyou can go ahead and see more
patients.
Right, you can say okay, I wantmy panels to be 400, or I want
(09:22):
my panel to be whatever that is.
These are literally youroptions as far as you're talking
about making money from thebusiness model you're in.
These are the options.
That's it.
So, number one charge more.
Number two increase your panelsize.
Number three if you're like Idon't want to do that, don't
want to do that, then find a wayto be okay with the number.
(09:44):
Find a way to be okay with$216,000.
To be okay with $216,000.
Find a way to go like maybeI'll make some cuts here, I'll
make some cuts there, maybe I'mgoing to take a locum shift,
whatever, I'm cool either way.
You want to do it.
But just understand you cannotchoose the panel size, the price
and the revenue.
You can't.
Once you choose the pricing andyou choose the panel size, it
(10:07):
will choose the revenue for youand you have to be okay with
that number or you have to playwith the numbers.
The math has to math, okay.
So this is the way I want youto think about it from today.
I want you to be able to makeinformed decisions.
I want you to be able to builda practice that you love, okay.
Now somebody may say well, Idon't, you know, I don't want to
(10:31):
charge more, I don't think Icould charge more.
I'm not confident charging more.
That is a skill, the skill ofleaning into the value that you
offer, because you're like, ohwell, it's just one hour visits,
nobody pays for one hour visits.
People don't pay for one hourvisits.
People pay for results, right,and that results could be
whatever happens with theirsymptoms, depending on the type
(10:53):
of medicine that you practice.
The results could be that theyhave access to care.
The results could be that youknow they can get in next day.
They have the same doctor.
You have to find out what it isthat is valuable to your people
.
So, whatever that is, you haveto find what that is and lean
into it and understand thatpeople pay for it.
(11:13):
Now am I telling you, you know,go charge the most because
you're a greedy doctor?
No, but we live in an economicworld and sometimes you might
want to play with stuff.
I mean, there are doctors whocharge $100,000 a year.
There are doctors who charge$200,000 a year.
There are health coaches whocharge $75,000 a year.
Am I telling you to go chargethose amounts?
(11:34):
No, I'm just trying to help youunderstand that you thinking
people won't pay whatever that$750 for the initial visit,
right?
And so I just want you to thinkin those terms.
I want you to think in thoseterms, and so if you're thinking
(11:57):
about that, then you want tolearn that skill.
Okay, I have a podcast episodethat is called Ethical Pricing.
You want to watch that?
You want to check that out?
Listen to it.
I have another one where I talkabout falling in love with your
offer.
So you fall in love with theresults that your business
creates, right, and which makesit easier to charge, and all of
that stuff.
If you say, no, that's not whatI want to do, I want to have
(12:17):
more, I want to have a biggerpanel size Then the question
then becomes how can I give themtop-notch, wonderful care
leveraging a team or leveragingautomation or leveraging, you
know, like those kind of thingsso that I can see more people,
but in about the same amount oftime and with the same amount of
effort, right?
And so if you're decidingthat's the way I want to go,
(12:39):
then that becomes the skill thatyou need to learn, and so, yes,
you can do what needs to bedone so that you can build a
practice that is profitable.
I cannot tell you how manydoctors I find are comfortable
running businesses that are notprofitable, and I'm not talking
like they're ramping up or theycame on a bad month.
I'm talking like this is thewhole model.
(13:01):
The model is designed not towork.
I want to invite you to be thearchitect of your business.
And what architects do is theytake something that is an idea
and they map it all out on paper.
They don't start building andsay, oh, where are we going?
And stuff like that.
They don't do that.
They map it out all on paperand when they worked out
everything, they worked out thedimensions, they worked out
(13:21):
everything.
Then they come back and thenactually build the building.
I want you to build yourbusiness that way, because if
you do that, then you willunderstand it doesn't matter how
hard I work, this is nevergoing to create money.
It doesn't matter how hard Iwork, this is never going to
create financial freedom.
Right, and you have to decideif you want to do that or not.
Okay, you have to decide.
(13:42):
So don't forget X plus Y isequal to Z and you only get to
pick two numbers.
Okay, if you do the math andyou don't like the revenue you
end up with, you can change yourprice, you can change your
panel size, or you can get okaywith the revenue.
Okay, and I hope you don't getokay with a kind of revenue that
doesn't serve you.
Right, like again your business.
(14:03):
You want to create a win-winsituation.
You want it to be a win for youand you want it to be a win for
your patients.
Now let me just talk a littlebit about this whole high ticket
, low ticket type of model,because I have, you know, I run
five companies and I can use twoas an example.
I have what I would consider alow ticket business, which is my
private practice, which is myfirst business.
(14:24):
Now, my private practice is a.
There are a number of thingsabout it, so one is that it's
insurance-based, it's lowerticket, if you will.
It is also pediatrics, right,and you know pediatrics is one
of the lowest paying specialtiesand it is also about 50 to 60%
Medicaid and I left it that waybecause I want them to have
access to good care.
So you can see that Iintentionally chose a low ticket
(14:48):
model.
I intentionally chose a lowticket model.
Okay, I chose a low ticketmodel.
Now I also want to be able tocreate the revenue that lends
itself to profitability, right,where my practice is profitable,
I can pay my team, I can paymyself, there's a profit for the
business, I can fund myfinancial freedom and all of
those things.
So you see, I've picked twothings.
(15:08):
I've picked X and I've picked Z.
Okay, ok, so I picked thepricing right low ticket and I
picked revenue.
So what that means is I don'tget to pick panel size.
If I have a low ticket and Iwant to make good revenue, it
means I need to be high volume,and that is it Right.
So madness would be for me tosay, oh, I want Medicaid, I want
(15:30):
insurance, I want all of that,and I want them to have a one
hour visit.
This is not an equation thatworks.
The math is not mathing.
Okay, what that meant was mycore skill became the capacity,
the ability to build a system, ahealthcare system that allows
me to handle high volumes butstill give them a great
(15:50):
experience, because it is arequirement for my model, a
requirement, right, okay.
And so that's when we call ourdoor to door.
We call that whole journey theassembly line.
And we call it the assemblyline not because there's no
human connection, but because Iwant people thinking in terms of
engineering, efficiency and allof those things, and so we
(16:12):
study that.
We study that assembly line andall of those things, and so we
studied that assembly line.
We studied where the breakdownis.
I studied how to leverage teamto give people a wow experience
even though I'm not with them.
You know, like for an hour, Ibecame really good at you know,
quickly identifying what is themain reason why this person is
here, so I can solve the actualissue, and all of those things.
(16:33):
And I got really good at it.
I could have a day I see 25, 30patients and all of them are
like oh my goodness, dr Una isthe best right.
It's not accidental.
I was very clear that, becauseof what I'm trying to build,
this is what is required.
Okay, so that's my low ticketbusiness.
On the other hand, I haveEntremdi, and the Entremdy
business school, for instance,is a $30,000 product.
(16:56):
It's not low ticket, it's highticket right.
In that case, what becomes themaster skill?
I need to learn right.
So pricing became something youknow.
Pricing I had to learn that.
Selling I had to learn thatright.
Being able to create the valuethat people pay $30,000 for
right that became a master skillthat I had to learn.
(17:19):
So selling became this bigmaster skill, creating massive
results became.
Not that we didn't do it in theother model, of course we did,
but now this is even moreimportant, right?
Because then you're also goingto rely on repeat business and
all of these things.
And so I recognized that's themaster skill.
It wasn't the only skill, butif I was going to skip a skill
it would not be this one, and soI had to develop that.
(17:41):
So both businesses are thriving, like really thriving, and one
is a low ticket and one is ahigh ticket.
And so many people tell you oh,in pediatrics you can't build a
seven figure practice blah, blah, blah, blah, blah.
No, you can, you can.
I think last year we did about1.7 million or something like
that, and it's a low ticketmodel.
Do you see what I'm saying?
(18:02):
You have to understand this.
Business is math, business isan economic sport.
We get to pick two out of three.
We do not get to pick three outof three.
Okay, and so pick a model.
Obey the laws of the model whenyou pick X and Y, or X and Z,
or whatever.
Y and Z, just understand.
The third number is picked foryou and you must obey the laws.
(18:22):
You must obey the laws that goalong with them.
Okay, so what I want you to dois I want you to do your math.
Okay, I want you to do yourmath.
What is it going to be for you?
Okay, so this is how much Icharge.
This is the panel size I want.
That means my potential revenueis Z, and look at that number.
Okay, you have to look at thatnumber.
Then you know you canextrapolate what's your overhead
(18:44):
30%, 20%, you know whatever.
Before you pay yourself, likedecide and go like do I want
this, is this going to take mewhere I'm going?
Like you know, or whatever.
So you do the math, then youlook at the revenue and decide
is this good, is this what Iwant?
Like, is this my dream practice?
Am I going in the direction Ithought I was going in or I want
(19:04):
to go in?
Right, these are the questionsto then ask and, if there are
any changes, make them.
If there are any skills, youthen now know that, okay, this
is the skill I must focus onlearning and building and
cultivating.
Then it's time to cultivatethat.
Okay, but what I hope you'vewalked away with here is that
you know, like you know, Iwonder what I'll try, like you
can wonder, but at least now youcan decide.
(19:27):
Like this is what I want to do.
And I'll tell you what I toldthis doctor.
I was like I got it now, doctor.
And I was like, okay, great,another person who's going to
build a practice that you knowthey love.
But you know, in the course ofthat day, the call I had with
the Entrepre business schoolstudents, I was speaking with
another doctor and she wasasking about, you know, some
modifications she wanted to makein her business.
(19:48):
And you know I started askingquestions and the question was
to get to one point, which iswhere I hope you get to as well.
This is something I do witheverybody I work with.
I'm like what do you reallywant?
Okay, guys, come on, we did notget to choose what we wanted
per se in high school.
If we were going to go topre-med, you know we had to have
certain grades, all thosethings, in pre-med.
(20:08):
To med.
We didn't get to chooseResidency.
We didn't get to choose.
But now you get to build abusiness and a life by design,
and so when you do your math,you want to ask yourself is this
the life I want?
Is this the business I want?
The worst thing you can do well, it's not the absolute worst,
(20:31):
but one of the worst things youcan do is leave a job because
you didn't like it, leave ahealthcare system because you
didn't like it, leave workingwith someone else because you
didn't like it, and then youcreate your own business, and
it's not what you want.
This is the time you get tocurate what you want.
Okay, so I want a really smallpanel.
What you're saying is I want aboutique practice.
Okay, great, if you're going todo that and you're going to
(20:54):
earn, then you're going to needto charge more.
If you're going to need tocharge more, then you're going
to need to learn how to sell.
You're going to need to learnhow to position results and all
of those things.
If you're like man, I want asmany people as possible to have
access to care that I have abigger panel, I could afford to
charge a little less and all ofthat.
You might say you know, husband, I don't even need to do this,
right?
I just want to break even, okay, which I'm not a fan of, but
(21:17):
right, just figure out what itis you want and make sure that
your pricing, your panel size,your revenue, your skill set,
development all of that they'reall working to build what you
truly want.
With my private practice, Itruly wanted to build a health
system that could work withoutme.
I'm so grateful that I did it.
And so am I serving pediatricpatients?
(21:40):
Yes.
Am I in the office doing it?
No, but is it getting done?
Yes.
The older I get, the more I'mable to give it language.
I love to unlock the potentialof humans because I'm like, oh,
there's treasure in this one.
And so for me to be able to dowhat I do with EntreeMD I'm not
working.
I'm like having the time of mylife On this podcast.
(22:01):
I'm not working.
I'm having the time of my lifebecause I know there's so many
doctors who are not gonna feelintimidated, not gonna feel
confused.
They're not gonna go buildpractices that, by design, can
never work.
They're gonna build practicesthat work.
They're going to build livesthey love.
And I'm like whoa, this isamazing.
I talk about this.
I had a second location for myprivate practice.
I was just like, eh, this isnot what I want.
(22:23):
Now I want you to think aboutit.
Am I smart enough to do that?
Yes, do I have enough of abusiness acumen to do that?
Yes, was it there andprofitable?
Yes, I didn't want it, so Ishut it down, right.
So I want you to buildsomething that you love and it
really does.
Start by setting yourself up tosucceed, by actually
understanding what you're doing,where you choose a price or you
choose a panel size, or youchoose revenue or whichever.
(22:45):
So go do your homework.
I'm rooting for you.
Understand that you can thriveas a DPC doc.
I've worked with so many.
So DPC, cash-based concierge,whatever that is, I've worked
with so many, whether you'reprimary care or specialty care.
So many who are thriving.
So many who are thriving, okay,and so I'm rooting for you.
(23:08):
All right, set the expectationthat you will win.
Do your math and make sure themath is mathing.
And on this episode I want tosay pretty pleased, with 72,000
cherries on top.
Please share this episode withanother doc who has a cash-based
practice.
If you're a part of a community, share it with them, but let
them understand the concept.
Remember there's no right orwrong.
They get to choose, but atleast let them know what they're
choosing.
Okay, rooted for you always.
(23:29):
I'll see you on the nextepisode of the Entree and Be
Podcast.
Many people tell you oh, in pediatrics you can't
build a seven-figure practice,blah, blah, blah, blah.
No, you can't.
Last year we did about 1.7million and it's a low-ticket
model.
You have to understand this.
Business is math.
Business is an economic sport.
Hi docs, welcome to the EntreMDpodcast, where it's all about
helping amazing physicians justlike you embrace
(00:20):
entrepreneurship so you can havethe freedom to live life and
practice medicine on your terms.
I'm your host, dr Imna.
The number one reason for painand suffering in cash-based
private practices, which I havestudied for over six years now,
is bad pricing.
Okay, and the way thistypically works is people either
(00:44):
think about a price they feelgood about, they feel like this
is what people can pay, or theypick a price that they see other
people charging.
They just pull off a price offthe internet and they're so
unhappy with the results thatthey get.
And so today, what I'm going todo is I am going to show you
how to pick the pricing for yourown cashless practice, and this
is a pricing that will makesure thatbased practice.
And this is a pricing that willmake sure that you're
(01:05):
profitable.
This is a pricing that willmake sure that you enjoy the
work you do, you have the timeoff you want, you're serving the
number of people you want tohave, like you are.
You have a practice by design,okay, not by default.
And so recently in the EntremetBusiness School, one of the
students she has a privatepractice that's going to start a
cash-based practice.
That's going to start acash-based practice that's going
to start off in a few monthshere and she says you know, dr
(01:26):
Una, I'm so confused I don'tknow what to do with my pricing.
I stopped to walk her throughthis concept and I figured I
would share it with you, becausethis comes up so much and if
you get this, you're going toenjoy your practice so much more
.
Okay, all right.
So I want to give you a fewprinciples here, and these are
important.
All right, so I want to giveyou a few principles here.
These are important, these areoverarching principles.
The first is there's no rightor wrong.
(01:46):
You know, sometimes people arelike if you charge, you know,
higher, then you're bad, if youcharge lower, then you're good.
There's no right or wrong.
I mean, it just is rightBecause you want to build a
business, and no matter whattype of business you, it is a
win for your patients or win foryour clients, and it is a win
for you.
(02:07):
It needs to be a two-way street, right and so there is no right
or wrong and I'll walk youthrough that.
The second overarching principleis when you choose your pricing
, you also have to choose theconsequences of your pricing.
You don't get to pick andchoose.
By choosing the pricing, youchoose the consequence okay, and
(02:27):
, for instance, if you look at avery broad way of looking at it
and I've talked about this alot on the OnTrimmed podcast
there's an episode I did that isthe business math, right, and
the math needs to math.
So, for instance, if you choosea higher price, then you also
have the luxury of having fewerpatients.
If you choose a lower price,then you have to have the number
(02:48):
of patients you need to get towhere you need to get to right.
Like you don't get to choose,you don't get to choose both.
Okay, you can choose thepricing and you choose the
consequences, right.
If you choose a higher pricing,then you also choose the
consequences of getting good atselling.
Like you're not going to getaway with not doing that, okay,
all right, and then you know.
(03:09):
The other principle is.
You know and I alluded to thisa little bit is that the
prevailing prices are wonderful,but they have to work for you.
Okay, we work too hard to nothave businesses that we love.
Okay, we did the whole pre-medthing and we did the high school
thing so we could get a goodpre-med program.
We did pre-med, we did medschool, we did residency, some
of you did fellowship.
(03:29):
You did all of these things notto get to a place where then
you build a practice that youhate.
You want to have a practicethat you love, okay, all right.
So let's look at what I callmillion-dollar math.
Okay, this is million dollarmath for entrepreneurs.
Okay, I want you to think of itthis way X plus Y is equal to Z
.
Okay, now, x plus Y is equal toZ.
(03:50):
Let's take some things here.
So X could be you know how much, you know what's your monthly
membership costs, okay.
So you know $60, $100, $150,$200, $500, whatever.
It is okay.
And then that's X, and then Yis your panel size, okay.
So you may say I wanna have 300is a number I hear a lot in the
(04:12):
DPC world, right, like so yousay you wanna have 300 people,
you wanna have 200, you wannahave 500.
I've seen people that spend 800, okay, so you want to have that
.
And then Z is your revenue,okay.
So X is your revenue.
Okay.
So X is your membership, yourmonthly membership, whatever
that price is.
Y is your panel size, z is yourrevenue.
So let me give you a fewexamples.
Okay, I took some time to do afew examples here.
(04:38):
So let's say you're like youknow, what I want to charge is
$60 a month, okay, and I want tohave 300 people.
For these examples I'll justuse 300 people.
I want to have 300 people.
You know that's the panel sizeI want and that's it.
That comes to $18,000 a month.
Okay, that's what it comes to.
And let me give you what itcomes to per year.
I'm really good at math, butyeah, okay, so $216,000 a year.
So if we go back to you gettingto choose, you can choose the
(05:01):
panel size and the revenue andthen you have to reverse
engineer to get how much yourpricing is, or you can charge
the price you want to charge andhave the panel size.
I have to be okay with therevenue that comes out on the
other side, but you cannotchoose all three numbers.
So let's say you're not $60 amonth, maybe you're $100 a month
okay, and $100 a month 300people.
(05:22):
That comes to to 30,000 a monthor $360,000 a year Okay.
Again, if you wanted to change anumber, you get two numbers to
play around with, but you don'tget to play with all three.
If you choose $150 a month, itcomes to 45,000 a month or
540,000 a year.
Or you choose 300 a month, itcomes to 90,000 per month or a
million a year, up to $90,000per month, or a million a year,
(05:43):
or a million and $80,000.
Okay, so you see how, likeright now, I did this math
playing only with the pricing,but you can play with the panel
size.
You may say, no, I want to keepmy pricing the same but I don't
like the revenue.
So I want to increase my panelsize, okay, or I'm fine with the
revenue.
Some people even said I'm finewith the revenue because I
really want to charge a littleand I'll do five locum shifts a
(06:05):
month to make up the difference.
Whatever, the point here is,you don't get to choose all
three numbers.
So this is what I think is acomplete disaster when you think
about cash-based practices.
I've heard people tell me.
This is doctors.
We're nice, we love people, wewant to help people, we want to
make a difference in the world,so this is what we do.
So this doctor says I wantpeople to have access to care
(06:29):
and so I'm going to charge alittle bit.
I'm going to charge, you know,$60.
That's what I'm going to charge.
And then I believe peopledeserve all the time that they
want to, you know, like all thetime with their doctor that they
deserve.
So I don't even want to have300 people, I want to have 200
people.
That's about how much I want todo.
Now.
This comes to less than$200,000 a year before overhead.
(06:52):
And the person is also I wantto be financially free, I want
to take X number of days off, Iwant to have this much in the
bank and all that stuff.
I'm like you can't choose allthree numbers.
You can only choose two numbers, which is a great deal if you
think about it, because you havetwo numbers, two out of three.
That's fair right, but youcan't choose all three.
(07:13):
And so if you look at therevenue and this is a number
most doctors will not thinkabout They'll think about how
much they're charged.
They think about how manypeople they want to have.
They'll think about the kind ofservice they want to offer.
They'll think of extra servicesto add on, and all they're not
thinking about the revenue.
Business is an economic sport.
You have to have all threenumbers, okay.
Okay, so you put all threenumbers.
This is how much I want tocharge, this is what my panel
(07:35):
size would be and this is howmuch I'm bringing in.
Many times when I have, it'smath, right, it's math, and
there's nothing wrong.
If you're like I only want tobring in $50,000.
That's fine, as long as you'rechoosing to do that, not that
you accidentally at the end ofthe year, you're like how come I
have $50,000?
Or you feel like they're sohard, I could work and I could
(07:57):
make more.
I'm like no, with this equation, this is your cap, this is it
right?
So if you do the math andyou're like okay, I'm doing 60 a
year, I have a panel size of300.
I'm bringing in $216,000 a yearand I don't like the number,
okay, and this is important,make sure you do your math.
If you don't like the revenuenumber before overhead, because
(08:18):
we're not talking profit, thisis overhead.
Okay, this is revenue overall.
If you don't like the number,you have three options.
Okay, these are the threeoptions and this is just the way
it is.
Okay.
What do you need to do if youdon't like your revenue number,
your potential revenue?
Number one you could chargemore.
Okay, you could charge more.
(08:38):
That's one way you can changeyour revenue number.
Number two you can have abigger panel size.
Okay, so maybe you're not doing300.
Maybe you're doing 350 or doing400.
Again, there's no right orwrong.
I'm not telling you what to do.
I'm showing you how to think ofit.
Think of this as informedconsent.
Right, we're giving you all thedetails you need so you can
make an informed decision.
(09:00):
Okay, so you can see somethingon the internet.
You can see something on theinternet.
You can see something somebodyelse is charging, you can see
whatever, but you know how tomake an informed decision.
Okay, so, number one you cancharge more.
Number two you can say no, Idon't want to charge more, I
want to see more patients, andyou can go ahead and see more
patients.
Right, you can say okay, I wantmy panels to be 400, or I want
(09:22):
my panel to be whatever that is.
These are literally youroptions as far as you're talking
about making money from thebusiness model you're in.
These are the options.
That's it.
So, number one charge more.
Number two increase your panelsize.
Number three if you're like Idon't want to do that, don't
want to do that, then find a wayto be okay with the number.
(09:44):
Find a way to be okay with$216,000.
To be okay with $216,000.
Find a way to go like maybeI'll make some cuts here, I'll
make some cuts there, maybe I'mgoing to take a locum shift,
whatever, I'm cool either way.
You want to do it.
But just understand you cannotchoose the panel size, the price
and the revenue.
You can't.
Once you choose the pricing andyou choose the panel size, it
(10:07):
will choose the revenue for youand you have to be okay with
that number or you have to playwith the numbers.
The math has to math, okay.
So this is the way I want youto think about it from today.
I want you to be able to makeinformed decisions.
I want you to be able to builda practice that you love, okay.
Now somebody may say well, Idon't, you know, I don't want to
(10:31):
charge more, I don't think Icould charge more.
I'm not confident charging more.
That is a skill, the skill ofleaning into the value that you
offer, because you're like, ohwell, it's just one hour visits,
nobody pays for one hour visits.
People don't pay for one hourvisits.
People pay for results, right,and that results could be
whatever happens with theirsymptoms, depending on the type
(10:53):
of medicine that you practice.
The results could be that theyhave access to care.
The results could be that youknow they can get in next day.
They have the same doctor.
You have to find out what it isthat is valuable to your people
.
So, whatever that is, you haveto find what that is and lean
into it and understand thatpeople pay for it.
(11:13):
Now am I telling you, you know,go charge the most because
you're a greedy doctor?
No, but we live in an economicworld and sometimes you might
want to play with stuff.
I mean, there are doctors whocharge $100,000 a year.
There are doctors who charge$200,000 a year.
There are health coaches whocharge $75,000 a year.
Am I telling you to go chargethose amounts?
(11:34):
No, I'm just trying to help youunderstand that you thinking
people won't pay whatever that$750 for the initial visit,
right?
And so I just want you to thinkin those terms.
I want you to think in thoseterms, and so if you're thinking
(11:57):
about that, then you want tolearn that skill.
Okay, I have a podcast episodethat is called Ethical Pricing.
You want to watch that?
You want to check that out?
Listen to it.
I have another one where I talkabout falling in love with your
offer.
So you fall in love with theresults that your business
creates, right, and which makesit easier to charge, and all of
that stuff.
If you say, no, that's not whatI want to do, I want to have
(12:17):
more, I want to have a biggerpanel size Then the question
then becomes how can I give themtop-notch, wonderful care
leveraging a team or leveragingautomation or leveraging, you
know, like those kind of thingsso that I can see more people,
but in about the same amount oftime and with the same amount of
effort, right?
And so if you're decidingthat's the way I want to go,
(12:39):
then that becomes the skill thatyou need to learn, and so, yes,
you can do what needs to bedone so that you can build a
practice that is profitable.
I cannot tell you how manydoctors I find are comfortable
running businesses that are notprofitable, and I'm not talking
like they're ramping up or theycame on a bad month.
I'm talking like this is thewhole model.
(13:01):
The model is designed not towork.
I want to invite you to be thearchitect of your business.
And what architects do is theytake something that is an idea
and they map it all out on paper.
They don't start building andsay, oh, where are we going?
And stuff like that.
They don't do that.
They map it out all on paperand when they worked out
everything, they worked out thedimensions, they worked out
(13:21):
everything.
Then they come back and thenactually build the building.
I want you to build yourbusiness that way, because if
you do that, then you willunderstand it doesn't matter how
hard I work, this is nevergoing to create money.
It doesn't matter how hard Iwork, this is never going to
create financial freedom.
Right, and you have to decideif you want to do that or not.
Okay, you have to decide.
(13:42):
So don't forget X plus Y isequal to Z and you only get to
pick two numbers.
Okay, if you do the math andyou don't like the revenue you
end up with, you can change yourprice, you can change your
panel size, or you can get okaywith the revenue.
Okay, and I hope you don't getokay with a kind of revenue that
doesn't serve you.
Right, like again your business.
(14:03):
You want to create a win-winsituation.
You want it to be a win for youand you want it to be a win for
your patients.
Now let me just talk a littlebit about this whole high ticket
, low ticket type of model,because I have, you know, I run
five companies and I can use twoas an example.
I have what I would consider alow ticket business, which is my
private practice, which is myfirst business.
(14:24):
Now, my private practice is a.
There are a number of thingsabout it, so one is that it's
insurance-based, it's lowerticket, if you will.
It is also pediatrics, right,and you know pediatrics is one
of the lowest paying specialtiesand it is also about 50 to 60%
Medicaid and I left it that waybecause I want them to have
access to good care.
So you can see that Iintentionally chose a low ticket
(14:48):
model.
I intentionally chose a lowticket model.
Okay, I chose a low ticketmodel.
Now I also want to be able tocreate the revenue that lends
itself to profitability, right,where my practice is profitable,
I can pay my team, I can paymyself, there's a profit for the
business, I can fund myfinancial freedom and all of
those things.
So you see, I've picked twothings.
(15:08):
I've picked X and I've picked Z.
Okay, ok, so I picked thepricing right low ticket and I
picked revenue.
So what that means is I don'tget to pick panel size.
If I have a low ticket and Iwant to make good revenue, it
means I need to be high volume,and that is it Right.
So madness would be for me tosay, oh, I want Medicaid, I want
(15:30):
insurance, I want all of that,and I want them to have a one
hour visit.
This is not an equation thatworks.
The math is not mathing.
Okay, what that meant was mycore skill became the capacity,
the ability to build a system, ahealthcare system that allows
me to handle high volumes butstill give them a great
(15:50):
experience, because it is arequirement for my model, a
requirement, right, okay.
And so that's when we call ourdoor to door.
We call that whole journey theassembly line.
And we call it the assemblyline not because there's no
human connection, but because Iwant people thinking in terms of
engineering, efficiency and allof those things, and so we
(16:12):
study that.
We study that assembly line andall of those things, and so we
studied that assembly line.
We studied where the breakdownis.
I studied how to leverage teamto give people a wow experience
even though I'm not with them.
You know, like for an hour, Ibecame really good at you know,
quickly identifying what is themain reason why this person is
here, so I can solve the actualissue, and all of those things.
(16:33):
And I got really good at it.
I could have a day I see 25, 30patients and all of them are
like oh my goodness, dr Una isthe best right.
It's not accidental.
I was very clear that, becauseof what I'm trying to build,
this is what is required.
Okay, so that's my low ticketbusiness.
On the other hand, I haveEntremdi, and the Entremdy
business school, for instance,is a $30,000 product.
(16:56):
It's not low ticket, it's highticket right.
In that case, what becomes themaster skill?
I need to learn right.
So pricing became something youknow.
Pricing I had to learn that.
Selling I had to learn thatright.
Being able to create the valuethat people pay $30,000 for
right that became a master skillthat I had to learn.
(17:19):
So selling became this bigmaster skill, creating massive
results became.
Not that we didn't do it in theother model, of course we did,
but now this is even moreimportant, right?
Because then you're also goingto rely on repeat business and
all of these things.
And so I recognized that's themaster skill.
It wasn't the only skill, butif I was going to skip a skill
it would not be this one, and soI had to develop that.
(17:41):
So both businesses are thriving, like really thriving, and one
is a low ticket and one is ahigh ticket.
And so many people tell you oh,in pediatrics you can't build a
seven figure practice blah, blah, blah, blah, blah.
No, you can, you can.
I think last year we did about1.7 million or something like
that, and it's a low ticketmodel.
Do you see what I'm saying?
(18:02):
You have to understand this.
Business is math, business isan economic sport.
We get to pick two out of three.
We do not get to pick three outof three.
Okay, and so pick a model.
Obey the laws of the model whenyou pick X and Y, or X and Z,
or whatever.
Y and Z, just understand.
The third number is picked foryou and you must obey the laws.
(18:22):
You must obey the laws that goalong with them.
Okay, so what I want you to dois I want you to do your math.
Okay, I want you to do yourmath.
What is it going to be for you?
Okay, so this is how much Icharge.
This is the panel size I want.
That means my potential revenueis Z, and look at that number.
Okay, you have to look at thatnumber.
Then you know you canextrapolate what's your overhead
(18:44):
30%, 20%, you know whatever.
Before you pay yourself, likedecide and go like do I want
this, is this going to take mewhere I'm going?
Like you know, or whatever.
So you do the math, then youlook at the revenue and decide
is this good, is this what Iwant?
Like, is this my dream practice?
Am I going in the direction Ithought I was going in or I want
(19:04):
to go in?
Right, these are the questionsto then ask and, if there are
any changes, make them.
If there are any skills, youthen now know that, okay, this
is the skill I must focus onlearning and building and
cultivating.
Then it's time to cultivatethat.
Okay, but what I hope you'vewalked away with here is that
you know, like you know, Iwonder what I'll try, like you
can wonder, but at least now youcan decide.
(19:27):
Like this is what I want to do.
And I'll tell you what I toldthis doctor.
I was like I got it now, doctor.
And I was like, okay, great,another person who's going to
build a practice that you knowthey love.
But you know, in the course ofthat day, the call I had with
the Entrepre business schoolstudents, I was speaking with
another doctor and she wasasking about, you know, some
modifications she wanted to makein her business.
(19:48):
And you know I started askingquestions and the question was
to get to one point, which iswhere I hope you get to as well.
This is something I do witheverybody I work with.
I'm like what do you reallywant?
Okay, guys, come on, we did notget to choose what we wanted
per se in high school.
If we were going to go topre-med, you know we had to have
certain grades, all thosethings, in pre-med.
(20:08):
To med.
We didn't get to chooseResidency.
We didn't get to choose.
But now you get to build abusiness and a life by design,
and so when you do your math,you want to ask yourself is this
the life I want?
Is this the business I want?
The worst thing you can do well, it's not the absolute worst,
(20:31):
but one of the worst things youcan do is leave a job because
you didn't like it, leave ahealthcare system because you
didn't like it, leave workingwith someone else because you
didn't like it, and then youcreate your own business, and
it's not what you want.
This is the time you get tocurate what you want.
Okay, so I want a really smallpanel.
What you're saying is I want aboutique practice.
Okay, great, if you're going todo that and you're going to
(20:54):
earn, then you're going to needto charge more.
If you're going to need tocharge more, then you're going
to need to learn how to sell.
You're going to need to learnhow to position results and all
of those things.
If you're like man, I want asmany people as possible to have
access to care that I have abigger panel, I could afford to
charge a little less and all ofthat.
You might say you know, husband, I don't even need to do this,
right?
I just want to break even, okay, which I'm not a fan of, but
(21:17):
right, just figure out what itis you want and make sure that
your pricing, your panel size,your revenue, your skill set,
development all of that they'reall working to build what you
truly want.
With my private practice, Itruly wanted to build a health
system that could work withoutme.
I'm so grateful that I did it.
And so am I serving pediatricpatients?
(21:40):
Yes.
Am I in the office doing it?
No, but is it getting done?
Yes.
The older I get, the more I'mable to give it language.
I love to unlock the potentialof humans because I'm like, oh,
there's treasure in this one.
And so for me to be able to dowhat I do with EntreeMD I'm not
working.
I'm like having the time of mylife On this podcast.
(22:01):
I'm not working.
I'm having the time of my lifebecause I know there's so many
doctors who are not gonna feelintimidated, not gonna feel
confused.
They're not gonna go buildpractices that, by design, can
never work.
They're gonna build practicesthat work.
They're going to build livesthey love.
And I'm like whoa, this isamazing.
I talk about this.
I had a second location for myprivate practice.
I was just like, eh, this isnot what I want.
(22:23):
Now I want you to think aboutit.
Am I smart enough to do that?
Yes, do I have enough of abusiness acumen to do that?
Yes, was it there andprofitable?
Yes, I didn't want it, so Ishut it down, right.
So I want you to buildsomething that you love and it
really does.
Start by setting yourself up tosucceed, by actually
understanding what you're doing,where you choose a price or you
choose a panel size, or youchoose revenue or whichever.
(22:45):
So go do your homework.
I'm rooting for you.
Understand that you can thriveas a DPC doc.
I've worked with so many.
So DPC, cash-based concierge,whatever that is, I've worked
with so many, whether you'reprimary care or specialty care.
So many who are thriving.
So many who are thriving, okay,and so I'm rooting for you.
(23:08):
All right, set the expectationthat you will win.
Do your math and make sure themath is mathing.
And on this episode I want tosay pretty pleased, with 72,000
cherries on top.
Please share this episode withanother doc who has a cash-based
practice.
If you're a part of a community, share it with them, but let
them understand the concept.
Remember there's no right orwrong.
They get to choose, but atleast let them know what they're
choosing.
Okay, rooted for you always.
(23:29):
I'll see you on the nextepisode of the Entree and Be
Podcast.
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Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
NFL Daily with Gregg Rosenthal
Gregg Rosenthal and a rotating crew of elite NFL Media co-hosts, including Patrick Claybon, Colleen Wolfe, Steve Wyche, Nick Shook and Jourdan Rodrigue of The Athletic get you caught up daily on all the NFL news and analysis you need to be smarter and funnier than your friends.