Listen to the podcast here: Tips for ADHD Practice Owners
Episode Summary: In this episode of the DPC Pediatricians Podcast, Phil and Marina discuss practical, experience-based tips for ADHD practice owners, particularly those running Direct Primary Care (DPC) practices. They explore how ADHD traits—such as creativity, high energy, and big-picture thinking—can be strengths in entrepreneurship, while also acknowledging common challenges like overwhelm, inconsistent follow-through, time blindness, and difficulty with administrative tasks. The conversation focuses on building systems that work with an ADHD brain rather than against it, including simplifying workflows, outsourcing or automating tasks when possible, using external accountability, and creating routines that reduce decision fatigue. They also emphasize self-compassion, realistic expectations, and designing a practice model that aligns with personal strengths and limits, ultimately encouraging ADHD practice owners to embrace their neurodivergence as an asset rather than a liability.
Welcome to DPC Pediatrician. We’re Dr. Phil Boucher and Dr. Marina Capella, two DPC Pediatricians who are on a mission to share our love of direct primary care with you. Hey everyone, welcome to another episode of DPC Pediatrician’s podcast. Today is a really fun topic because it kind of came up last time when we were recording.
We were talking about, is ADHD more common amongst practice owners, DPC practice owners, that sort of thing. And we had kind of posited that it might be more common because we find that a lot of people seem to have ADHD from our discussions. And it’s definitely something that has been on our mind because what we were talking about last time was that it’s really hard when you are on your own.
When you have a big institution that tells you what to do and where to go and who you can see and how fast you have to see them and all those sorts of things, that does provide some external accountability and helps with the executive functioning. And then when you are on your own, like your day is your patience, but then you have all these other hours, especially in DPC, where you kind of got to figure out how to make your own to-do list and be responsible for your own.
And so we did a poll in both the pediatricians DPC group and the DPC docs group on Facebook. And overwhelmingly, people felt like they had ADHD or they felt that ADHD was more common. I don’t remember the exact poll numbers, but it was at least 75% agreed that either they had ADHD and it is more common or they don’t have ADHD, but they do believe that it is more common. So, I mean, that’s as scientific of a poll as we can get in 2026 and meets the rigors that we’re using to judge some other scientific measures at the moment. So the vibes are there.
We wanted to talk today about how as a solo private practice owner with or without ADHD, you can get more done. You can feel better about getting stuff done and not just get lost in all the tasks that you could do and everything along those lines. And I’m hoping to learn a lot from this conversation, and I’m going to lean on Dr. Capella to help me to get my executive functioning as a private practice owner skills up to snuff.
So Marina, talk to me from your perspective about what you see when it comes to private practice owners, DPC practice owners in particular, and where the issues come and kind of overlap with being solo, being on your own, and then also ADHD.
Sure. Well, I was of the persuasion that I do think it’s a little more common. And one of the reasons I think that is because you have to… have something really motivating you to leave the system. And that can be either a lot of frustration with the system.
I think people who have ADHD have a lot of ideas and a lot of creativity, not to say that they’re the only ones who have that, but, and so there’s sort of this desire to kind of like spread your wings and fly, right? Like what, I think I could do it better this way, or I think this should be changed, or this could be done another way. And so People with ADHD, because they have that ability to, in a way, be distracted in good ways, they have these ideas. And so the DPC model really enables a lot more freedom for people who feel that way.
However, some of the challenges that I see, I think two come to mind. First of all, This sort of this paralysis that can happen that I have all of these ideas, but oh my gosh, where do I even begin? I’ve heard physicians say, I need a coach or I need a helper.
I need an assistant to just even help me like make the list and get started and help keep me on track. Right. So there can be that. paralysis that comes with all of those ideas and all those desires to go in so many directions. Right.
And then the second one I would say is that time blindness becomes a bit of an issue that you think that you can get more done in a certain amount of time. then you realistically can, right? That might be a little familiar, Phil, right?
No, it was still a little. I mean, I’ll have to ask ChatGPT if I’m familiar with that.
That’s right. And I mean, for me as well, I think for the average person, we tend to be a little optimistic about what we can do and it can just be exacerbated for someone with ADHD. So those are the two things that I see. And then also just in general, like the organization skills,
when you are working as practice administrator, you’re overseeing payroll. If you have employees, you’re overseeing all the scheduling, you’re overseeing the website and making sure that your licenses are renewed and all of that stuff. It can get overwhelming in addition to patient care, of course, right.
It can get overwhelming and someone who is not naturally organized can struggle more to keep on top of all those things. Right. Whether it’s struggling to keep up on notes because nobody is at your back saying, hey, these were due yesterday. You’re going to stay today until you finish them.
right or we’re going to withhold your paycheck until you finish them right so if you don’t have someone keeping you accountable that and you don’t have the systems and the processes in place to keep you accountable that can be a struggle so that’s
kind of what i see and i have even though i personally don’t don’t think i have adhd i have a husband with adhd i have colleagues with adhd i have an office manager and siblings with adhd so i’m very familiar with some of the challenges and of course we all
care for patients as pediatricians who struggle with ADHD. And we’ve heard their stories and we’ve helped their families navigate some of those challenges. So I’m curious, Phil, throwing it back at you, what do you think are some of the challenges? And let’s maybe dissect one of them and kind of come up with some ideas.
What works for one particular challenge?
I think, okay, let’s start with this challenge because I hear this a lot and I had posted in the DCVZ Facebook group or about something recently too, that was basically like getting lost in the research or the thinking about it and like just kind of very lightly dancing into the actual doing and then spending the
time like making lists and remaking lists and everything along those lines. And so I see that as a huge issue when you have gobs of time you start something, you think I’ll research it a little bit, maybe I’ll figure out how to do this new thing for administration or I’ll watch
some YouTube videos to get better at QuickBooks or I’ll try and start posting on social media, but then I need to figure out the lights or which camera to use or which app to use to edit or all the different things. You can get lost in that vortex of different choices
And then you just get paralyzed and think, okay, well, I can’t do all this now. I’m going to have to come back to it later to actually figure this out. And then you get busy with patient care, you get sick, you get busy with life, all those other things.
And it just never actually gets done and you don’t make the progress that you need to. And I think a recent example for me of like one of the solutions to that is to have an accountability partner. And I’m gonna just put you on the spot, Marina, and say that when we were doing the DPC summit,
the virtual pediatric DPC summit, you were, whether you knew it or not, my accountability partner of, I gotta get this shit done because Marina is counting on me to do this. And you’re like, wow. You’re probably like, wow, Phil needs some more accountability partners if that’s what we got out of that.
But I think having somebody as an accountability partner can be really helpful to stay on task and to stay motivated when you don’t have those externals like you talked about when it comes to somebody’s breathing down your neck saying, hey, you got to finish these notes or you’re not getting paid or we’re not getting paid
or we’re going to get audited or something along those lines. Nobody is looking over your shoulder. to check to see if you did that or if you ran payroll or if you did a P&L statement for the month of July or anything along those lines.
So I think one of the hardest things is just having that accountability because you don’t have somebody that’s looking over your shoulder. You don’t have somebody that’s saying, hey, if you don’t finish this, we’re not gonna pay you. And so it really becomes incumbent on the practice owner to figure those things out
and figure out all the practice administrative stuff. This stuff isn’t hard. necessarily some of it’s hard but most of it is something that that you could certainly hire out but it is difficult to figure out and it takes a lot of time to
figure out like how to file your taxes or pnl or all the different just like business side of things and i i have a lot of adhd meme accounts that i follow on instagram and one of them is like there’s the one rule in adhd it doesn’t have to get done it just has to be perfect
Oh,
I think that’s a huge thing for physicians who were born and bred to get 100% on the test and to get the high step one score and the high step two score and the residency interviews and to do the bang up job that we do as type A physicians. I’m not type A, but I’m
And so it’s really hard to to figure all those things out when you are holding yourself to that really high standard. But you also have clinical duties like your business is a business, but you also have the service and the care that you’re providing that is also really challenging and all the different clinical side of things.
And so it feels very lonely and it’s easy to put off things that don’t feel as meaningful or as interesting or as bucket filling. And so I think that’s one of the big issues that practice owners often face.
I agree. And I think that what you have to do if you struggle with this, and of course, everyone struggles to some extent. There are things that I hate doing. I have to renew some thing and it’s been on my to-do list forever.
And I’m just like, I’ll get to it, I’ll get to it, but it’s not critical either. And so it’s really not causing any disruption in my work or in my ability to do things by not doing it, right? So there are things that we’re gonna procrastinate, but they’re low priority and they have low consequences,
so that’s probably okay, right? But then there are those other things that do need to get done and there are real consequences if they don’t get done. One of them that I think some DPC owners struggle with is keeping up on their notes. And of course, if we’re in the world of medicine,
all of us are familiar with that feeling of trying to keep up with notes and not being able to catch up. And sometimes we think, oh, in the world of DPC, there are far fewer notes and it’ll be a breeze to get them done.
But the reality is that because we have all these other things that we’re also trying to take care of, It’s not as easy as we think. And also one of the challenges I have faced is that because sometimes I’m spending a whole hour getting a really comprehensive history from a patient,
then I have a much longer note that I have to write.
Right.
And so it can be even more difficult to get the motivation to do that. So what are some things, some techniques that you’ve found from either yourself or from other people in the DPC community that can help to get those things done, to build up the motivation to do them,
to make sure that if there’s a deadline you have to meet, that even if it’s getting done at the last minute, it’s getting done.
Right. I mean, I think for me, I’ll take the first thing that you said, which was about notes. And for me, this was an issue that I’ve actually gotten much better at. I will not tell you, but it was certainly three figures of like notes at one point last year.
I had gotten done and knowing the volume of DPC versus regular, like 300 notes would be like three days in a typical practice. But in DPC, it takes a lot longer. So that was a lot of accumulated notes. And what I mean, I got caught up.
I just put the office on and I went through the notes and finished them. A lot of them I just had to sign on. I didn’t even have to do anything more. And so a couple of strategies that have helped me. One is
I try and finish my note at the counter before I go back to my office. Because when I go to my office, there’s 17 different windows here that distract me. But if I’m on my computer and I really just have my note window open on my laptop when I’m outside of the patient’s room,
it makes it much easier to just finish the note there. The other thing that has really helped me is having AI scribe to catch all the things in the notes. You don’t need it. I mean, I don’t use an AI scribe for a typical well check and I don’t use it for an ears
visit because those are too quick and you can just do nice templates for those. And I don’t really want to capture all of the parent questions about all the normal stuff. Like I know what I say. And if a parent says, Hey, remember, do you remember what you said?
I already know what I say about four months and starting solid food, whatever it might be. But for those complicated patients, I absolutely rely on the Scribe AI to catch all of those little things. And it works so well for me to then be able to really focus on the high yield stuff.
So I take my laptop in, I’ve got the Scribe going. I just use the free version of Heidi, if I can be honest. I will use, so we use Alation. I will use Alation Scribe and it’s got a really good Scribe too.
But most of the time I just use the free version of Heidi and I turn it on And then I have my iPad where I take notes and the notes allows me to capture like my biggest thoughts and questions. Well, Heidi captures all of the like details that I want to make sure and document that
are not as relevant in the, okay, here’s the questions that I have. Here’s the plan that I’m coming up with. Here’s what I think we should do next. Like those are things that I’m writing down on my iPad as we’re talking. But then Heidi is capturing how premature the baby was or the medications that they’re on.
We’ll just call those things out as we go. And then I know and can just bank on, okay, I don’t have to remember that right now. It’ll be in my note when I’m done. And so that is really helpful to stay up on those trickier, more complex notes.
Yeah. Okay. So notes is one thing, right? That’s clinically relevant. I always, part of my motivation for getting notes done is I don’t want to have to worry about them later. Right. And also if a family leaves and they request a copy of their medical record,
then I’m in deep doo-doo if I like have nothing for the last two years. Right.
Sure. Let me see what you’re going to take a couple of days. The faxes are so slow guys. Yeah.
Yeah, you can only recall so far back, right? I know that if it’s been over a month since and I haven’t done a note, it’s going to be really hard to recall what happened during that visit. But what about those other things like the, oh, I got to like renew that license or oh,
I got to like prepare for this review of my medical assistant or oh, I got to do, I don’t know, just all those other mundane administrative tasks that are not so motivating. How Can practice owners motivate themselves to get those done or chunk them into doable pieces so it doesn’t become overwhelming?
Because again, that like paralysis is very real. That overwhelm is very real, especially for people with ADHD.
Totally. I mean, there’s always something much better I can do than filing a document or like I’ll go to an email that says you need to fill out this licensure form. I click it. I don’t remember my username or password. I mean, as I say this, I’m like,
there is something that I actually need to do in that realm because I couldn’t get into my old account for one of the random things. A couple of things that have really helped me in that regard, and I feel like I’m, I’m Definitely. I’m going to push that back to you, Marina, to answer too.
You’ll see this pile behind me. My nurse practitioner calls these piles doom piles. Didn’t organize, removed. And I have a lot of didn’t actually do, just put on a list piles. But one of the things that has actually helped me to sometimes be successful with this is blocking time on the calendar for the boring stuff.
And so I know on Tuesday afternoons when my energy for like creativity is lower, then I’m going to do those dumb administrative tasks. And then what I’ll do is I’ll pair that with my inbox, like my email inbox of like snoozing emails that then return to me on Tuesday afternoons.
And what that does is it lets me kind of have an inbox zero. like a temporary inbox zero, but then have them return back when I actually am going to be in the state of mind to do that. And I prepared myself for doing those boring tasks that nobody likes to do, but that are necessary.
What about you, Marina? What do you find is helpful for doing those boring tasks?
Well, I definitely have a lot of those that build up and I hate doing them. And little things can build up throughout the day. For example, yesterday I saw a kid for a two and a half year old physical and the mom asked about a multivitamin, but she had very specific requirements about multivitamin that meets certain conditions.
criteria and so i said you know what i don’t have one on the top of my mind but i will do a few minutes of research and text you back right so that didn’t get done yesterday i gotta do it today there was another kid who we had some concern for
like some hip issues and i had to do a little bit of investigation into like Does this really need a referral or not? And so that gets added to the to-do list. And then I have to refer a kid to the dermatologist. So that gets added to the to-do list.
So there are those sort of like clinical to-do things that can add up, and they’re not really part of the patient visit, but they’re important to follow through. Otherwise, our parents are not very happy with us, right? Yeah. There’s that. But then there’s also like, oh, I just got an email.
I have to renew my Cures account for my California medical license. Or, oh, I have to renew my UMA membership, my Utah Medical Association. Or, oh, I have to order that thing on Fullscript. So all those things. And what I’ve started doing the last year is that I have one of those little
to-do lists that has maybe like 15 lines on it and i say okay i have one for the things that i think i can realistically get done today in those moments between patients or during lunch or during my administrative hour and i’m allowed to fill
that list up to what will fit and i have another list the second page of that little to-do list is like the things that I don’t think I can actually get done today. And I’m going to put it on the second list for a day when I have outside of clinic
or when I have a block of administrative time, something that’s going to take maybe more focused effort. But I try to put all the little things that I think I can actually get done today on that first list and everything else on that second list. Because there’s also like the mental load. During the day,
what happens to me is that I might be getting ready for work or I might be having lunch and something pumps into my mind. It’s like, oh, I got to do that. Oh, I got to do that. Oh, I got to do that. But not everything has to get done today. And so some of that is discerning,
okay, what is something that I can put on my second lower priority to-do list? And what is stuff that I have to put on my Try to do today priority list. And that has taken some practice over time, just kind of differentiating between the two and deciding what list it goes on. And then also just celebrating.
If I only checked off half of the things on my I want to get done today to do list. then I’m happy. I still give myself credit for that. Hey, I knocked off half of that list, right? Now it’s only half. And then the next day,
what I’ll do is I’ll look at those lists from yesterday and just rewrite the stuff that is still urgent on that list and kind of carry things over. Right. That way they don’t fall off of the radar, but they’re still top of mind. And maybe I move them a little higher on the list to be like, okay,
I’ve waited to send that referral for like five days now. I have to do it today. Right. So that’s something that works for me. It’s just like good old fashioned paper to do list. I also have one on my cell phone on like Google tasks.
And so if I’m getting ready in the morning and I’m not at my desk where I have my written to do list, I’ll just put it on my phone. Then when I get to the office, I’ll take a glance at, okay,
what had I put for myself on my phone that I don’t want to forget now put it on paper. And You can do electronic, you can do paper, you can do whatever works for you, right? You can do marker on your mirror. Like I sometimes do that.
I’ve tried literally everything and I can tell you that keeping it simple is the most important thing because… I mean, in my entrepreneurial journey, I’ve used Trello, I’ve Monday, I’ve used Asana, I have Notion, I’ve used Motion, I’ve used like all of the different task management tools and basically what I’ve
learned and I’ve done handwritten ones and have little notebooks and things that I carried around in my pocket too. Whatever one you’re going to be consistent with is the best one. Absolutely. Yes. And it doesn’t have to be fancy. Like I wish I could be organized enough to put everything into motion,
which is like an AI assisted to do list task management thing. Like we got really into that, but it just made me feel bad because it kept bumping things and it like moves things along based on not doing them or doing them. And I was never doing anything. I just kept adding.
Yeah.
But I do it digitally simply because I don’t always have a pen and paper at the ready. And so what I’ll do is in, and I’m an Apple person, so it’s all Apple ecosystem. I use Apple notes to like, here’s my priorities for this month. Here’s what I’m gonna try and accomplish this month.
And then I will try every morning to look and use Apple reminders, which is like the to-do list, to actually make my to-do list based on my priorities for the month and also the things that I know that I need to get done. Like I need to send somebody a GARS form today.
So I put that on the list simply so that I don’t forget to send it to them later and everything along those lines. And that helps me, if I actually do it, to get the things that I’m supposed to get done done. I can get tons done.
The real question is, is it stuff that I was supposed to get done or not?
Yeah, definitely. And I think one challenge for many of us is also, let’s say you have 10 notes that have built up and you got to catch up on those 10 notes or you have something that was going to take a while. And getting the motivation to do that, to get started is really challenging.
So I’ve learned over time that I just have to trick my brain into just getting started. Because first of all, once I get started, then the momentum builds and often I find the energy change. energy to just keep going and finish it. And also sometimes we think something is going to take a lot longer or be harder
than it actually is. And then we get started and we are pleasantly surprised by the fact that it was not as hard as we thought it was going to be. Right. And so chunking things into like manageable goals. So, Don’t think, oh, I have to sit down and do these 10 notes. Just say, you know what?
I’m going to do one note right now. I’m going to start with one. And then if you only get one done, you still got one done. Give yourself credit for that. And if you end up getting five or 10 of them done, then you can feel extra good about yourself, right?
But breaking things down into manageable sub goals, I think is really, really important for brains that get easily overwhelmed with looking at the mountain and not even knowing where to start. So I would say that that’s one thing. And then also rewarding yourself, finding a way to reward yourself. Do you ever use that for yourself?
Like there are apps that have little rewards versus just you saying, okay, if I get this done, I can go home 20 minutes early today. Or if I get this done, I can spend 15 minutes on Facebook or whatever it is. What do you do, Phil?
Uh, I like, like if I did something that wasn’t on my to-do list, I’m going to put it on my to-do list just, just so I can check it off. Yeah, exactly. Skylight calendars at home and our kids use it for like their chores and everything like that.
And I caught my six year old the other day putting P on the, on the to-do list so that she could mark it off. Cause then like, it gives you this like cascade of emojis when you do something on the list. Um, I like to, if I can get this done, I can walk around the building.
It takes about four minutes to walk around the building, and I can always spare four minutes. So if I can just finish this, then I can just go for a walk around the building. Or I will plan sometimes to get tasks done. And I think I’ve told you I have a standing desk, which is great,
but I’ve recently got a treadmill pad. to go underneath it so i can walk and that has been a huge thing for me both from like the fun of getting to walk while i’m getting tasks done and to just plan ahead
of okay i’ve got this 30 minute block here i’m going to close my rings on my apple watch which gets me the dopamine and just the exercise of good and then get some things done between this patient and the next patient And so I think that that has been a reward for me too. And then like treats,
like I’ve got some granola bars and different treat things that I will let myself have if I can trick my brain into getting something done as well. So I think those are some of the main things that are motivational to me is like to get those sort of rewards.
I guess one area where I find that physicians are often struggling, or at least I hear this from a lot, is the distractions of screens. Specifically, like if you’re not busy, you can spend hours on social media. You’re feeling like you’re getting lots done looking through the Facebook DPC groups, things along those lines.
And I find that to be a huge source of distraction. And I don’t know about you, Marina, if you have a good balance of that or if you find yourself getting sucked into that or what’s your approach there?
Yeah, it’s one of those things that inertia has a lot to do with it. Like if you open the app and you start scrolling, it’s hard to stop scrolling. So I tend to not allow myself to scroll during the day unless maybe it’s like, okay, I’ve got
20 minutes for lunch, maybe like while I eat, I’ll give myself some time.
Right.
Or after work, when I just, my brain needs something kind of more mindless to do, to just like come down from the day. But I try… I know it’s a time suck. And so if I have an hour of admin time and I have a to do list and I open my app,
I know that that’s just going to be a rabbit hole of scrolling. So I have to just exercise the will to not do that. Right. A lot of that is just practice. You learn over time.
Right.
Yeah. So I just try to limit it. I try to limit it. And nowadays your phone will give you like messages. You used your phone like 10% more than last week or 5%. So that can also kind of help to increase mindfulness about how much you’re using phones.
And there are a lot of apps nowadays that allow you to limit your time on certain apps that you struggle with that. then by all means, utilize technology for your benefit, right?
Yeah, I think that’s huge. So yeah, I don’t know if this happens to everybody, but mine always tells me when we go to church on Sunday mornings at nine o’clock, you know, like 9.07, then it’s telling me what my screen time was. So I don’t know if that’s intentionally like during church time or what.
But I have found that just for me, you can spend hours scrolling. And what I’ve found is that there’s plenty to learn and there’s great groups out there. Like I love the community of DPC doctors that is online, but you can spend a lot of time on there. And so for me,
I need to have these firm walls that I can’t climb over to protect myself from just wasting time. on social media, on Facebook and those sorts of things. One, I don’t have Facebook on my phone at all. And two, I have this app. I think it’s free.
It’s called Freedom that I put on my computer that I have it set. So only the last 10 minutes of any hour can I be on facebook in the dpc group or whatever anywhere on facebook or anything like that and it gives a little ding ding when it’s when it’s open and then a ding ding when
it closes and if i’m seeing a patient if i’m doing something else then i just miss that time but i know it’s useless to scroll over to facebook.com 2 15 p.m because it’s just going to have this green screen that says like you’re free to do other things right now
And that’s been a really helpful one for me. And then on my phone too, my wife and I have it so that like after 15 minutes of screen time, we’re just locked out for the day from Instagram or whatever it is. And I don’t know my password. Like she has my unlock password.
And so I can’t unlock it. There’s no Instagram emergency. I mean, I can take it to her and say, hey, can you unlock this for me? there’s an Instagram emergency going on. But I don’t because it’s some mutual accountability. And it also is like, I really don’t need to waste more time there.
So I think that that’s a big one too, especially when you don’t, again, have the external accountability of like, hey, you can’t be on this or, hey, you got 40 patients to see. You can’t scroll on Facebook for an hour and respond to comments and read people’s comments and get into all the weeds there.
You got to keep moving and seeing patients faster.
Oh, absolutely. Yeah. About a year ago, I started realizing that I was getting really overwhelmed with all the notifications on my phone. Every time I got an email, every time something on Facebook and Facebook has gotten really bad. Like it’ll send you notifications about crap that you don’t care about. And so I was,
I just went into my settings on my phone and I turned off almost all notifications. I only left them off for like phone calls and text messages. And that way when I do go on Facebook, it’s more intentional. It’s not as a reaction to, I got a notification.
It’s like, okay, once a day, I’m going to go check Instagram and Facebook. And nothing is urgent. If something is an emergency, they’re going to call you, right? They’re not going to be sending you a Facebook message. I found that turning off my notifications opened up a lot more time for me and it has been very liberating.
I want to touch on just two more things briefly. First of all, I would say for people who do struggle with ADHD and find themselves either getting overwhelmed with things or things are falling through the cracks, please, please ask for help. Enlist some sort of help.
You can have a virtual assistant that maybe you only pay for a few hours a week, but maybe you meet with them once a week. And that’s kind of your accountability partner. I have virtual assistants for DPC pediatrician and for my practice. And I meet with them like once or twice. Well, actually sometimes once a week,
sometimes every other week, but they act as my accountability partners. And so I’m trying to get better at posting on social media and Tiffany, my VA will say, okay, you promised me two videos. Did you do them? Did you do them? Did you do them? And so that helps, but also just do need a medical assistant.
Do you need an office assistant? Do you need an office manager? Whatever it is, depending on the size of your practice, your goals, your finances, I would say hiring help it like 99% of the time, is going to more than pay for itself because it’s going to enable you to accomplish
more of the revenue generating activities and offload those non-revenue generating activities of your practice. It’s going to free up time in your mind and space in your own nervous system that you don’t have to be worrying about those things because somebody else is there to help you do them. Right. So don’t,
hesitate to ask for that help if you feel like you need it. I feel like a lot of us hold ourselves back by not enlisting that help that we need when we need it. Now, that’s going to be a different stage for everyone. In the beginning, I was doing everything for my first year.
It took me a while to hire help, but I did get to that point where I realized what I could be much happier and more effective if I hire an office assistant and then it kind of moved forward from there. So Phil, who do you have in your practice,
in your life that helps you to do those things that first of all, you don’t want to do and it’s not really worth your time doing and also to help keep you accountable.
Well, I think from a, like, where should I start if I’m, if I’m a solo practice owner and I can’t keep doing all of this, like my practice is not growing because I don’t feel like I can take on more people because I’m doing all of these other things and have this never ending to do list.
Then I would start with the things that you can hire somebody virtually to do. and the things that you hate doing. If you hate bookkeeping, you can get bookkeeping done for you for less than $500 a month for sure, which if you can then spend more time doing other things or filling your bucket,
it’s going to be well worth that. Any aspect of things outside of going into the room, seeing the patient, there’s certainly somebody that can help with figuring out how to unload that or to make it easier on you to be able to move forward.
There’s a ton of doctors that have these services where they have a HIPAA compliant VA. So imagine that instead of having to go in and send all these referrals and sorts of things, You do your note and then your HIPAA compliant VA goes in and sends the referrals because they can read your note and see, okay,
they wanted a referral to allergy. I’m going to send that referral. There’s so many different ways that you can say, I don’t have the funds and space and all the different things to have a full-time employee yet. But I am going to outsource this and this and this to somebody so that I can regain
some of that time. I mean, I think if you think about somebody that has the responsibility and the salary in any business in town, if you go to any skyscraper in town, all of those executives have an assistant. And physicians have an assistant.
to never have an assistant and they do it all themselves from dawn until dusk and then beyond when really anybody else with that level of responsibility that real ability to generate revenue and the salaries that they they take in and all those sorts of things would have an assistant that was helping them to be successful so i
think physicians often sell themselves short of i gotta figure out how to do this on my own i gotta do this on my own i’ll just watch the youtube videos and do it on my own Our team is different. We have an office manager. We have somebody that specifically does like the bookkeeping and finance side of
the practice and all those sorts of things. We don’t have much clinical help. We have a nurse two days per week, but the rest of the time we’re doing the clinical stuff ourselves, which has worked out fine so far. But those are the main kind of help that we have that allows me to stay focused.
And the more that I can actually purposefully delegate to them, the better things go. And so my biggest bottleneck is myself and the more that I can just sit down and say, okay, If the priorities are this month or for this month are X, here’s what I need to do as the physician owner.
And here’s what my team can do to help and write those things out and like communicate it to people, which seems like duh, but it’s hard. If you actually get those done, then things actually get done and you get to see the fruits of your thoughts and your plans and the actions that you take come to life.
right absolutely yeah and i mean i love having an office manager you and i both have office managers and sort of like we don’t necessarily need full-time nurses i only have a medical assistant because i share with another physician for a specific type of visit that we do immigration medical exams that require phlebotomy all the
time and so If I didn’t have that, then I wouldn’t necessarily, I would probably have a part-time nurse or MA like you do. But that office manager is sort of a catch-all. It’s like, hey, I’m going to teach you how to renew my AAP membership.
That’s what I told her a few weeks ago, because I don’t want to do it anymore. And I don’t have to worry. So I’m just going to forward you the emails. You have my my information you have the credit card for the company like you can do this for me
right and then just a bunch of other things all those renewals i’m starting to offload all of that stuff on turn and so nice it’s so liberating obviously you’re ultimately responsible so having some sort of system in place where you’re checking in every few months and saying hey
Let’s go through their to-do list of this get done, this get done, this get done, right? But hey, someone else is there to do it. And I wanted to look into a local marketing opportunity. And I said, I don’t have time to do this. Erica, here you go. Do the research, then present it to me next week.
And we’re going to make a decision together as to whether this is a good opportunity or not. We also have like these… mill creek city council sort of events and once a month they have like a meet and eat and it’s nice to say what i can’t make it but you go represent the practice for
me and you like meet other local business owners and see if there are any opportunities so it’s just really nice to have that person now not every practice is going to need that person right but just be open to the possibility that you can enlist the kind of help that you deserve, that you need,
that you can use to make your life so much better and to do the things and focus on the things that you really enjoy doing.
Like,
yeah, maybe you taught yourself how to order vaccines in the beginning, like I did, but now do you really have to keep doing that forever, right? You figured it out so that you can oversee someone else who’s doing it, right?
Well, and I think part of it too, is being willing to like put down the type A, it doesn’t have to be done. It has to be, or it just has to be perfect sort of mentality of I’m going to delegate this and it’s going to reclaim some time for me.
And it might not get done perfect the first time. And that’s okay because we do this every quarter and we’re I’m going to show you how to do it. It’s going to be a C1, what is it called? C1, do one, teach one kind of perspective of you’re not going to be perfect at this either
person that I’m delegating to. And we’re going to, I’m going to show you how I do it. And then you’re going to do it. And then I’ll show you where I would do it differently and then move forward and ask me any questions that you have. But it’s, it’s hard, especially at first,
especially with your baby and you’ve been on your own to be willing and able to say, okay, I’m It might not be perfect and they might make a mistake here, but we have the margin to make a mistake. And we also,
I know that reclaiming my time and my mental energy is going to be well worth it in the end.
Absolutely. Yeah. I would say just generally to sum this part up is that if you struggle with ADHD tendencies, right, and you’re opening a practice or you’re getting to the point where you’re getting busy in your practice, please, please consider enlisting help and you can decide what kind of help is right for
you and you can take it a step at a time. Right. But don’t hesitate to ask for the supports that you need. There is no shame. There’s nothing wrong in asking for the support. Just like Phil said, there’s no CEO in any company who is doing everything themselves, right? And you are the CEO of your company.
So you need to let go of trying to do everything for yourself, right? Unless you are a tiny micro practice and you… And there are exceptions. We always say there are exceptions to rules. If you really, really love doing everything and want to have a tiny panel forever and you’re okay with that, that’s fine too.
But for the, for most of us, support is really important. And then I want to make one last point. So we see in kids with ADHD that sometimes what happens is that after a certain number of negative experiences related to their ADHD and they can develop a more negative self-concept about themselves, right?
They can say, oh, I’m always the one who’s tardy. I’m always the one who messes up. I’m always the one who lets something fall through the cracks. And that can happen to us as adults. And we can even carry that from our childhood, this negative self-concept of, oh,
I’m always going to fail at that or I’m not good at this or et cetera. Right. I’m curious, Phil, especially since you do a lot of work with kids with ADHD in your practice, what would you say to practice owners who are struggling with the adult version of that?
I think if I could do something for myself and for you, it would be to say, keep track of the things that you’re doing well. And spend some time sitting with those of the things that you’ve done, because oftentimes what we’ll do as physicians that are high achievers at baseline
is we don’t take into consideration or give the clout that it deserves all of the things that we do on a regular basis. And it might be as simple as helping a parent out to the car with their newborn baby. It might be diagnosing something that is common to you,
but was rare to the patient and walking them through that. Those are things that are second nature to us. And we don’t give ourselves credit for those because we just keep raising the bar. Well, yeah, anybody could do that. No, not anybody could do that.
And so I think if you can keep a mental track and show some gratitude towards yourself for the different things you do, that helps to negate all of those negative comments that as kids, they hear the negative comments from teachers and from parents and from coaches and all those sorts of things.
And those add up to 10,000, 20,000 more negative comments. As adults, it’s usually internal negative comments. Anybody can do that. Or, yeah, I diagnosed this rare thing, but my taxes were almost late or something like that. Giving yourself more credit for all of the things that you’ve done.
From opening your practice to growing your practice to caring for the patients that you’re able to in the way that you’re able to, like all of those things are risks and all of those things take guts and work and sweat and tears. And you deserve to give yourself credit for those on a regular basis of, yeah,
I didn’t get all these to-do lists done today, but here’s what I did do. Here’s what really was helpful. And yeah, you still got the doom pile behind you on the desk, but you did really help this family today that was really struggling. And so that’s okay.
The world’s not going to end because you didn’t finish your doom pile.
Absolutely. I totally agree. We don’t give ourselves enough credit for the amazing things we do as physicians. We tend to be more of the self-critical perfectionists. So taking some time, give yourself credit for all the amazing things that you do. That’s a great note to end on. Thanks for listening, everyone.
And we hope you found this episode helpful. And if you have any ideas that you would like us to help spread to other practice owners that have worked for you, feel free to reach out to us through our sub stack. We love hearing from you. Take care, everyone. Until next time.
