How I’m Leveling Up My Businesses in 2025: BTS Practice & E-Course Updates

In this episode I take you behind the scenes of BOTH of my businesses (Juniper Modern Primary Care & Micropractice Mama)  and share some of my goals & priorities for 2025 including

• how my goals have changed in year 4 compared to years 1-2 in practice
• why I'm moving away from social media
• the new perk I added for my practice members
• exciting updates to my signature E-course
• the importance of framing goals in terms of value added, rather than just $$$

If you're enjoying this pod, I would love to connect! Real human feedback is so deeply appreciated. Here are a few ways to reach me:

Connect with me on IG @soniasinghMD
Email me at sonia@micropracticemama.com
Learn more at www.micropracticemama.com

The Micropractice 101 E-Course is available NOW. Learn more or enroll here: https://micropracticemama.thinkific.com/courses/micropracticemama

And if you're not sick of my voice yet, check out my other podcast with Dr. Rebecca Berens: The Antisocial Doctors on Apple Podcasts or Spotify!

Sign up here for the Micropractice Memo to get weekly tips, updates and resources on all things micropractice and motherhood in medicine: https://micropracticememo.myflodesk.com/s51y9r3knn

Transcript

Sonia Singh MD 0:01

Hey doctors. You're listening to the micro practice mama podcast, a podcast for women physicians who are striving to practice primary care sustainably and creatively with autonomy, authenticity, and joy. I'm your host, Sonia Singh, internist, PCP, and proud mother of two human babies, one for a baby and one life changing micro practice. I want to empower you to push past whatever's holding you back and make the leap to launching a practice. that aligns with your values and priorities and finally allows you to take care of your patients, your family, and yourself in the ways that you want and deserve. Are you ready to make the leap? Let's do it. Hey Doctors! Today's episode was actually meant to be one of The very early of the year episodes. Cause it's a, setting goals for the new year type of deal but I just kept getting distracted by other topics. And so here we are in mid to late February finally covering this topic, which is, I titled it, how I'm leveling up my businesses in 2025, but really what it is. Just a behind the scenes look at what my goals are for the two businesses that I run, which is Juniper Modern Primary Care, my direct care micro practice and micro practice mama, which you're consuming content from right now. And I know this is a little bit like breaking the fourth wall, but I thought it would be helpful and informative and maybe it would be interesting for my listeners as well. I decided to go ahead and talk about. Both businesses instead of just the practice. So I'm going to go through basically what kind of my overarching goals are for each of the businesses or one of the ones I'm focusing on for this year. And then for each of them, I had three things that I'm going to try to do in order to achieve those goals. So I'll start with my practice Juniper. So I'm in year four of the practice. I have around 165 patients right now, and I have a wait list, and so I've been holding. Steady around 1 65.'cause I feel pretty good at this level. I feel comfortable with what I'm making. I feel like I need to keep it at this level if I wanna continue investing time and energy into Micropractice Mama. If I didn't have a second business, I think I would definitely keep pushing towards. 200, but right now I just feel especially with a one year old, I just don't have the bandwidth to grow it much more. So my goal for this year, previous years, the goals have really been grow. And this year, my goal is really to retain my current patients, make them healthier and find ways to add more value to the membership. Especially for patients who are relatively healthy or who are lower utilizers of the service. Because a phenomenon I notice pretty often is I'll have a mom that's in the thick of the, first year with daycare, lots of viruses and bugs coming home, like really spread thin and stressed out. I'll have that woman join. And then like a year and a half goes by. They start to have less and less of the viral infections or they know how to handle them because we've talked through it so many times. And then they don't really need me that much anymore. And I find that those people sometimes leave the practice. Not always, but sometimes leave the practice. And, this practice model really depends. On having a mix of patients who are complex and are higher utilizers and patients who are more healthy and lower utilizers. And so you don't want to lose those, healthy patients and suddenly end up with a disproportionate number of really high needs patients. Rather than cherry picking or eliminating, or trying to exclude the patients who are more complex and have higher needs or have health anxiety or. Whatever, that requires more time and attention rather than doing that, I really want my focus to be like how do I make the membership in the practice still feel really valuable to people who maybe don't need to see me that often, I have a few ideas of how I'm going to do that. One is I've decided this year to make basic labs in my practice, which is. the ones I order the most often, CBC, CMP, A1C, TSH Lipid Panel, B12, Ferritin. That's not an exhaustive list, but basically all the ones I order commonly, I've decided to make those included in the membership fee and not bill for them. So why would I make that decision? I looked at the numbers and basically, So basically, the way I do it now, I order the vast majority of my labs through LabCorp because that's who I have a really good contract with, and I select client bill when I place the orders, which means that LabCorp is going to bill me rather than the patient or the insurance for the price of the labs according to my cash pricing. So at the end of the month, I get a big bill from them with All of the labs I've ordered for my patients and I pay it and what I had been doing in previous years was every time I put in a lab order, I would generate an invoice for the patient and I had all of the prices, preloaded into hint, which is my billing platform and I would generate an invoice of whatever I ordered and email it to the patient and then if the patient did not pay the invoice and the lab had been done, usually after like at the end of the month, I would go through and go ahead and process all the payments from whatever card they had on file. Okay. All right. So honestly, the system was fine. It was working. I just really did not enjoy the whole process of creating an invoice, sending it to the patient, tracking it, following up, processing the payment. I just found that to be, annoying administrative work that I did not enjoy. And so when I looked at the numbers, my monthly bill with LabCorp is usually between 300 and 400. And especially now that I take fewer new patients, oftentimes the most labs I'm going to order is on the first floor. first visit and once I've done my workup of whatever I think, the routine labs and ongoing labs are usually not as big a cost. So I've seen the total lab bill kind of drift downwards to this 300, 400 per month amount. And so Now that I'm there, I feel like I guess I could, this is probably maybe, a few hours worth of work. And what is my time worth per hour? I'd like to think my time is worth at least 150, 200 per hour, at least. Is it really worth my time to be generating these invoices and following up and, hunting them down? processing the fees and all of that stuff. Probably not. So the normal business, advice would be outsource that delegate it, hire somebody cheaper labor than yourself to go ahead and do that task for you. But, part of the beauty for me of micro practice is not having to hire somebody, not having to vet people, not having to HIPAA train anybody, just all of the things that come with having Employees and staff, even if it's just a virtual assistant, I just love not having to do that. For me, I was thinking, okay, can I accept 300, 400 as a loss? And just not charge people for most of these labs. And actually, it's, it's not going to be a 300 or 400 loss. It'll probably be less than that because, for instance H. pylori testing would not be free or included in the membership, and that's 37. I do that sometimes. There's going to be at least a couple hundred dollars That I won't see in revenue per month for not charging people for these labs. But to me, the benefit of me not having to do that busy work and the added value for patients who are members is huge. And when I made the announcement, I made the announcement, my first newsletter of the year. The feedback was wonderful. People were so pleasantly surprised that, oh, I'm paying, something got added. Like normally you get emails that the price is being raised and instead I was like, now this thing is free. And so it's been a couple months now that I've been doing that and I, I've really only had one patient that I felt asked me for a lab that she might've otherwise not asked me for, cause she was like but it's free. It's yeah, it is, it's up to you. I probably would have waited a couple more weeks to recheck your iron or whatever, but we can do it now. Overall, I don't think it's going to lead to some crazy surge in utilization or request for labs. It doesn't seem that way so far. And it's worked out nicely for me cause I spend a lot less time generating invoices. So that is the first big change I'm making in my practice. The second big change I'm making in my practice, or I guess on the, Practice management side is I'm shifting my energy away now from doing social media and focusing on doing deeper dives on topics that I think are relevant for my patients and sharing them in a monthly newsletter. So I used to do newsletters pretty consistently in the first couple years of practice. And then, quite honestly, I just once I got pregnant, had the baby, it fell off the wagon, never really got back on. But, now that I don't feel like I have to. Split my attention with marketing and recruiting new patients and I, I'm really more focused on adding value for the patients I have. I think it's nice to be able to just transfer that energy into really communicating with the patients who wanna listen to what I have to say and who I have a direct line of communication to. And who I know already value my opinion because they've chosen me as their PCP. I already have done January's and February's newsletters and I've actually, outlined topics for the rest of the year. Those might change though as things, topical stuff comes up in the news, but January I talked about flu I also talked in January about health risks of alcohol, which have been in the news a lot lately and shared my thoughts on that. I shared recommendations for my favorite non alcoholic beverages. For February, I did a whole little blurb about the health benefits of warm touch or hugs. And what was the other topic? I can't remember. Maybe measles? I can't remember. It was like something in the news. So basically, there, there are times when I start thinking about a topic and I think, Oh, I should get on Instagram, make a story about that. And now instead of thinking of that, I think, let me do a deeper dive on that. And then let me actually put a whole little paragraph in a graphic about it in my newsletter. And that's honestly been nice for me because it contains a lot of my thoughts. It forces me to filter like, okay, what do my patients really want to hear about? And then let me think about it and formulate my thoughts into something very coherent and send it out. And it just gives me guardrails otherwise with. stories and Instagram. It's so easy for me to just pop on and rant about random things throughout the week, which is fine. I think when you're in the growing phase that, really helps patients get to know you better and, decide if you're a good fit and build that no and trust factor. But right now I'm in a different chapter with different needs and I feel like this has been a very positive change for me. Lastly, and honestly, I'm still fleshing this one out, and I don't know exactly how it's going to look, but I really want to find a way to build more community in my practice. I think a lot of the patients that come see me have certain shared values, and they clearly have similar priorities in some ways. And I have been on this whole, I've been a huge fan of Vivek Murthy, the previous U. S. Surgeon General. I'm like a fangirl for him. And one of his big pushes has been addressing the epidemic of loneliness and the importance of community and connection, how that's really one of the things that's been lost over the last few decades and contributes so much to how well or unwell we feel. And so I've started asking all of my patients now, I always ask about diet, hydrations. Sleep, exercise, and stress. In first visits and all their physicals. And now I've also added social connection and purpose to that. And it's so funny how like you, you don't know so many things if you don't ask them. So like I never used to ask about low libido. And no one ever talked to me about low libido. Now I have it on my forums as a checkbox and like over half of the patients check it. And so now I talk about all the time. No one ever came to me saying I'm lonely like that wasn't I'm sure maybe a few patients have, but that really wasn't something I heard often as a PCP. And now that I asked this question about social connection, I find that it's actually incredibly common that patients will say that they're really not finding time to see their friends or people that they care about. That, they are going months without speaking to people that they used to be very close to. And it's just, when I think about my own life and I think, gosh yeah, I. If I didn't have friends that kind of aggressively put dinners and trips and things on the schedule, I could easily fall into that same pattern myself, and it would certainly affect my well being. So I've started asking that question, which is then, made me see that, okay, there is like this clear need for, community and connection. And how can I perhaps facilitate that amongst my own patients? I'm still trying to figure out how I can do that. I had a loose book club the first year that I started the practice. I shared the books every month on Instagram, on my email list, to my patient newsletters. We never actually had meetings to discuss the books. I was just like, this is what I'm reading this month and I recommend and here are the things I love about it. It wasn't quite, there was, we didn't meet and discuss it. And I would love if I could find the time and get coordinated enough such that, we could have even quarterly, like some type of practice event where people could actually mingle and meet each other and, connect on something. I think that would be fantastic. A couple of other ways I'm thinking of building this community is in my newsletters, incorporating a member space. I used to do that on my practice Instagram. I think it was very effective marketing because it helps people see that other people like them are joining this practice and spending this money and doing this thing. So it, it's social proof that other, others are seeing value in this. And also, part of the reason I did that was to highlight my own patients who are small business owners and, support their businesses. When I'm sharing it in the newsletter, I, wouldn't really be for marketing. It would be to say, Hey, there's somebody else in this community that may offer a service or a product that you might like. Maybe you're looking for a hairstylist. Or a realtor, or an interior designer. I have all of those people in the practice. It might be nice, rather than going to Google just using people in this network and in this community and supporting them as well. Those are a couple of, the things that I had in mind. I'm open to suggestions of how you might build community in a small practice like mine. So if you have any, send them my way. But that is one of the things I want to try to prioritize and think about more this year. Okay, so that, those are all of my things that I'm doing with the practice this year. Not all of them, but hit the highlights. Now I want to talk about MicroPractice Mama. So I'm taking you, I'm breaking the fourth wall here, taking you behind the scenes. What is my goal for MicroPractice Mama this year? I see this very much as still like a baby I am still in the workshopping phase of figuring out. What works and what is the ideal format, timing, type of content. Like I, there's so much I'm still trying to figure out about micropractice mama. I would say my overall goal for this year is simply to help more physicians start successful micro practices. And, part of doing that means. Getting in front of more physicians and, reaching more people with my message and whether that's, free through the newsletter or the podcast or, through the course, but in some way reaching more people. So I'm able to help more of them start successful micro practices if that's the right thing for them. Now, one of the things that I think should be a take home point of this entire episode is that in any business, your success is going to depend on your ability to. Listen to feedback, observe what's happening, see what's working and what's not working and to adjust yourself or pivot. And honestly, that is not an easy thing to do. There are times when it feels like you're killing your darlings because you had a vision of a specific thing and you liked it that way. That was the way you wanted it and it's not working or, it's not right for some reason and you've got to change it. With Micropractice Mama, one of the big pieces of feedback that I've gotten over and over again from random strangers and also from my own close friends who I know are willing to be honest with me is that they don't like the mama piece and that they feel that excludes people who are not mothers, who may still, you know, value and benefit from this content, but then don't really feel like it's for them. And if you're curious, why I chose. The name MicroPracticeMama and why I've continued to focus on that population this far. I talk about that on my website. I talk about that in the trailer for this podcast. I have talked about that on Nauseam, so I won't repeat myself. But suffice to say, I have heard the feedback. I am open to it. I don't want anyone to feel excluded. I agree that the majority of this content is applicable to basically anyone who is in medicine and interested in starting a micro practice. Perhaps I am, limiting the number of people that this reaches by focusing too hard on that. So I have taken that to heart and I've decided to do this rebrand and rename the course. I, my website and the podcast and my stuff will still be micro practice mama, but the course itself will no longer be just geared towards mothers. It'll just be a micro practice one on one e course and still be the same sort of step by step roadmap to. Get you from just developing an idea for your practice to actually opening your doors and having it be successful. So that is big change. Number one, that's coming this year. Number two. So I noticed that first I ran a beta class over the summer last year, and that was. Seven physicians and those people were getting one live module every week. I was basically using them for accountability and feedback because I was like, if I don't have the time pressure of seven other doctors looking at me every Friday for this content, I will probably not make it that fast. So we did live sessions and several people attended live. Other people would watch the recordings and what I found was that when the sessions were live. people were able to stay more engaged, and the people who attended those live sessions are usually the ones that were able to take action and progress towards their goals. Since I launched the official course in October, it's just. been on demand with once a month office hours so you can watch the content at your own pace whenever you want and then once a month I log on and anybody who's able to log on at that time gets to ask questions and I can try to help you with, things you're struggling with. And what I've observed is that the ones who attended the office hours were the ones that were rapidly progressing towards their goal and made it to the finish line. And Yeah, I had seven physicians in the beta class, and then I have five physicians in the cohort that started when I officially launched in October. And there's really only one or two that were coming to office hours and taking advantage of that. And one of them is Dr. Heather Jackson, who my last week's episode was a one on one interview with, and she opened her practice this week. So she did it. She went through the material exactly as suggested. She took advantage of the office hours and she's up and running now a few months later. And what I want is for more people to have access to that One on one support, because I think what happens is sometimes people get stuck, they reach a little roadblock, and they just need a little one on one help to push them over. And, what I've experienced on my end is just that the one on one interaction I have with other physicians who are doing this, is the most rewarding for me, like getting to know them, getting to know their vision, their inspiration, their why what they want out of the practice in medicine, and helping them translate that into what they're actually building is so deeply rewarding and satisfying and fun. And I want to do more of that, but I want to find a way to do more of that without I'm not repeating the same thing over and over to people, like I don't just want to do one on one consulting with everyone because so much of the stuff that I say is the same, so I feel like it's way more efficient for that to be communicated in the form of the e course. Basically, what I'm planning to do and this is like a little sneak peek if you're listening to this, is following the webinar, the course will go on sale, substantial sale, like big discount for one week, and that's to encourage people to join in these cohorts so that there's, a group of people going through it together at the same time and they can support each other, hopefully. So what I'm planning to offer this time as my free gift along with that is three sessions of one on one support. Initially I didn't want to offer something like that because I truly was not, Sure. Whether one person was going to sign up or five people or 20 people, I just didn't, I could not commit, 60 hours of my time to this. Now I feel a little more comfortable that probably it's going to be a handful each time. And I can definitely, handle three hours over three months. With each of those students and I do think it will help the material be more sticky and more valuable to them if they have that kind of extra layer of handholding and support. I think it will make people more likely to be successful because I can help them, get over little stumbling blocks. And I think it'll be helpful for me to continue to improve the course through that feedback. And then finally, the last change I'm planning to make is I work really hard. If you're on my email list, you know that I work really hard on my newsletters. I try to actually make them useful and pack a lot of good content in them. I did a really big salary breakdown earlier this year I did a whole video on how to avoid malingers and energy vampires in your practice. I put a lot of actually time and energy and hours into those newsletters and sometimes there's a really good one that people don't get, they miss it and they join later and then they're like, what, can you send me that? And now I'm also planning to have all of the, like the newsletter archives available through the eCourse platform so that anyone who purchases the eCourse also has access to all of those old newsletters. And of course, you still have access to every new weekly newsletter for free if you're on the email list, which is called the MicroPractice Memo. And then, you still get lots of free content here on the pod. But again, this is an effort to give more value to the people who are choosing to invest in what I'm offering. Okay. So I've gone through sort of my goals for both businesses, a few tweaks and changes I'm making to each one. And I want you to notice one important thing. Neither of the goals were. How do I make more money? Is that surprising? If you really drill down on what I shared as my goals, really what the goals are for both businesses is to make the product or service that I'm offering better. And what I think not enough people realize or think about in business is that. If you want to be more successful and you want to sell more of your service or your product or retain more of your customers, what you really need to be asking yourself to do is make your product better. How do you make this product better? Now you need the marketing piece because you can have a fantastic product and no one can hear about it and people will not necessarily find you if you are not. Getting in front of people and making them aware that you exist. But I feel confident with both of these services that I am in front of people and I do have people's ears and I am trying to find ways with MicroPractice Mama to ensure that I'm helping people make the transformation or achieve the result that I am. I can help them achieve and that they want to achieve, which is opening a successful practice. And when I think about how can I help more physicians do that, the tweak, especially that I mentioned about adding one on one mentorship to the e course package. is really about that. It's me thinking of how can I ensure that these people get to the finish line and that they have success once they open. And I really think adding that one on one piece is the way to do it. Now that costs me something cost me, hours of my time and my life. And I am willing to make that, pay that cost because I think that will help actually. People achieve transformation and what will help other physicians decide that this is worth the investment is seeing their fellow physicians achieve the goal. And so that's really where I try to focus my energy. That's how I've focused my energy in the practice. And I think that's worked really well. And I would encourage you to constantly when you're thinking about ways. that you can improve, or why things are not going as well as you have wanted. Come back to, the heart and soul of your business, which is the product or service that you're offering, and ask yourself how you can make it better. Okay, I just said that, and now I'm like, Ugh, barf, that sounded like a little preachy, so I'm sorry if it sounded preachy, I didn't mean to. This is just me sharing, what has worked for me, and the attitude I have towards So anyway last thing I wanted to mention before getting off here is the webinar that is coming up February 26th, 8 p. m. central time. That will be on zoom. The registration link for that is in all of my weekly emails. It will be in the show notes. I hope to see as many of you, as many of you as possible there. It is titled Making the Leap Is Micropractice Right for You? So it's a little different than the webinar I did last time. Last time was really just an intro to micropractice. This time I'm going to try to really focus on information that I would want to share with somebody who is on the fence and trying to decide if this is something that they want. So I'm going to spend a little bit more time actually focusing on the downsides. Spilling the tea, like Here are the things that, here's the scud, here's the bad stuff, you need to decide if you're okay with this, if you're considering this model. Hope to see you there. I'm going to leave more time this time for a Q& A, I think it's going to be a little bit of a smaller group so hopefully it can be a little bit more interactive and I'm really excited and hope as many of you as possible can make it. So see you there. See you next Wednesday.