3 “Employees” in Micropractice That Make It Possible to Have NO Employees

In this episode I share how I'm able to run a full, profitable primary care practice without any staff, including

• perks and downsides of having zero staff
• the 3 key "employees" that prevent me from drowning in scut
• why running a micropractice is only going to get easier
• how to get these "employees" to work for you

Plus a sneak peak of what's in store for the next free webinar, May 19th, 2025 @ 7pm CST via Zoom! See link below.

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!

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Transcript

Sonia Singh MD 0:01

Hey doctors. You're listening to the Micropractice 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, Sonya Singh, internist, PCP, and proud mother of two human babies, one for a baby and one. Life changing micro practice. I wanna empower you to push past whatever is 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, I have to share something funny with you that I just thought about today, which was, my husband was like, oh, how many episodes of that podcast have you done so far? And I was like, God, I think 30 something. And it occurred to me that I historically have hated the sound of my voice so much that I have never even recorded. A voicemail greeting on my personal cell phone ever, in my entire adult life, I have never had a greeting that's Hey, Sonya, you missed me. Leave a message.'cause just the thought of that was so cringe inducing for me. I was like, oh no, I just can't I can't do that. And here I am having recorded 30 something episodes of a podcast. So anyway, it just goes to show that you can get very comfortable with the discomfort and you can get past some of these hangups in the pursuit of entrepreneurship. And I'm glad I did. I'm glad that didn't hold me back. Today's episode is a good one. It's on the topic of Micropractice a little bit more specifically. So today I'm gonna talk about three quote employees I have in my micropractice that make it possible for me to have no employees. One of the most common reactions I get when I tell people that I have a solo practice and that I have no staff is what? How does, how could that possibly work? Aren't you just drowning in paperwork and prior auths and, scott, basically. And the answer is no. I really am not, I have 170 patients right now and I have a pretty active side gig going, and I honestly don't feel, I even at this point I don't know that I really feel this crunch of oh, I've really gotta hire some help. So how do I do that? And how can you do that too? I wanna basically give you that. Wisdom in this episode. I wanna recap a little bit why this is so important. One of the biggest perks of micro practice compared to any other private practice model is that you have typically no employee. Some people have a virtual assistant or maybe even a part-time assistant, but it's very possible to do this model with zero employees. Now, why is that a good thing? Number one, and most obviously, your biggest expenses are typically gonna be your people and your place. So the salaries and or wages that you pay to your employees are a big part of your overhead. And so when you have no employees your overhead can be much lower. Your profit margin's gonna be much bigger. And what that means is you need a lot. Fewer patients to cover your expenses and break even, and a lot fewer patients to become profitable and, a lot fewer patients to probably earn an amount that feels like fair compensation for you. And I think, finding a way to maintain yourself as a micropractice can be highly beneficial. So that's one. The other one is. That when you don't have staff, you don't have to spend time and energy recruiting, hiring, firing, training people, basically serving as the HR department for anybody on your team. Most doctors hate doing that stuff. That is not what we went to medical school and trained for a decade to do. It's stressful. It's not fun. It's very different than, what our normal skillset is. And I will say as the, my, my dad ha still has, but has had a private practice for, 40 years at this point. And my mom when I was like 10 or 11, took over being like the business manager and doing operations for the practice. So basically I grew up with, parents who were essentially running this practice together and it was very annoying'cause they were constantly talking shop. And the main thing that they would talk about was staffing issues. That was the primary thing that I would hear them get stressed about. Gonna quit, not showing up. So and so stole the copays. They were always having problems with staffing. And so just eliminating that entire part of running a small business or a private practice is a huge benefit to many people. Now there are also downsides to having no staff. And if you don't design your practice right, if you don't set it up correctly, it's simply not going to work without staff and you're going to end up having to hire someone. I have seen a lot of people with way fewer patients than I have have feeling the crunch and having to hire an assistant or, outsourcing someone for outsourcing the social media to somebody or hire somebody to do their marketing. And, I think a lot of that, so some of that is just a personal preference thing. I think people have different tolerances for doing administrative work or doing scut or doing social media or any of those things. For some people, they're truly just I am not cut out for this. I don't wanna do this. I'm gonna outsource it to somebody else. But for a lot of them, I think the issue is just that they did not design the practice. Dis efficiently or strategically. And thus they're in a position where they're getting overwhelmed with work that they don't wanna be doing, and they're having to then hire help. My goal for you is to put you in a position where you don't have to do that for a long time. And truthfully, if your goal is to scale up at another dock, at another location, have a big panel, then hiring someone and growing your team is absolutely the right decision business wise. For me, my goal with Juniper, my own practice has always been to remain a micro practice. The goal was to take care of patients, take care of myself in a way that I felt good about and proud of, and felt fairly compensated for. And I feel like I'm there without any staff and perhaps I could. Increase my total earnings a little bit by growing and expanding. And to me, the responsibilities and stress that I would have to take on by adding other people to my team is, for me, personally, just not worth it. So anyway, I'm gonna try to share with you a little bit about what makes my practice work as a micro practice and how I can avoid having. Staff. So there's three main employees, quote unquote, that I think end up replacing a lot of the traditional employees in private practice that I am taking advantage of. So the first of those is my brand. If you've been listening to this podcast for a while, you've probably heard me talk about this, and you may be sick of hearing it, but I'm gonna talk about it again.'cause I really think this whole concept is. Underappreciated and misunderstood in the medical community. So for a lot of doctors, they hear me talk about, their professional brand or their clinic's brand, and they roll their eyes and they think, okay, yeah, whatever, lo a logo some colors, some fonts, like whatever you're just. Making it pretty that doesn't mean anything. That's not why patients are gonna come to see you. That's not gonna attract anyone to the practice. So what if it looks slick and you have nice furniture? That doesn't mean anything. So my response to that is if you are not designing your brand thoughtfully and intentionally and strategically. And in a way that is cohesive with who you are, the way you practice, who you wanna serve, what that person is looking for, then yeah, it's nothing but a bunch of colors in a logo and making stuff pretty, if it's not done strategically, it's not gonna do anything for you. And this is one of those classic examples where I think people do something badly and then they're like that doesn't work. And it's really because they didn't execute it right and they didn't do it correctly. It's not really that. That thing just doesn't work. Branding in the world of marketing strong branding absolutely works so. What exactly do, when I'm talking about, a strategically built brand? In the Micropractice Mama eCourse, I actually have an entire framework for building a brand. But it starts with your core, which is your purpose, your vision, your values. And then it moves to positioning who is your audience? Who is your market? What is the local market like how are people gonna find you? Where are you gonna be visible? And then we think about persona. So what is your personality and the personality of your practice? What is the voice and tone that you wanna come across in your messaging and in your content? What's your tagline if you have one? Then. From those things, you build the visuals, which are the logo, the colors, the fonts, which are all meant to, evoke a certain feeling in the person who's seeing it. And then lastly, it's the experience you're giving the patient. What is the patient journey like? How do they feel when they first come across you on social media? What is the first touch point? What are you sending them as the first welcome to your email list? What does it look like and feel like when they step into your office? How do you close the encounter and, how do you make them feel at the end of that visit? And then what is your customer service like going forward? All of that. Is your brand. I think when people think of just, the logo and the font and the colors and all of that, they're really just thinking about the very surface level and the tip of the iceberg. And when something is, a brand is built correctly, that. Really is just giving you a taste for everything else that's behind it, which is actually the important stuff. So I think that, from the beginning I have understood, I think part of this was because I. I just happened to hire somebody to do my visual branding who, prompted me to really think about that deeper part of the iceberg. And so that clicked for me early on and I was able to carry that brand strategy into all of my decisions going forward. I think if had followed me on social media at that time, and then you went to my website and then you showed up at my office and then, you met me and talked to me and all of those things were all very cohesive. I was the same person on social media. My voice was the same, my style was the same. I'm the same person when you come to the office and one of my friends. Who's been my friend for years and years came and visited me in Houston and I took her to my office and showed her and she walked in and she was just like, this is so you, and that was the biggest compliment anyone could have given me.'cause it felt okay, this is a really honest, accurate, authentic reflection of. How I am, like the, my style and my style of practice and all of that I think comes through in my website, in my social media, in, the experience that I'm giving the patient. And so I think if you can build a brand that is strong and strategic and cohesive and authentic to you like that, a lot of the work of selling the practice to somebody or selling your practice model or your practice style, whatever, a lot of that. Is going to happen on its own before you have even lifted a finger, before you have gotten on the phone. I have seen practices where, somebody has come to me and said, I'm struggling to get patients. I don't know what's going wrong. I just, can't seem to grow. And, for instance, one doctor I had spoken to I looked at her website. I felt like it was not at all a reflection of her. Strengths, what kind of patients she was looking for. What her passions are, who she serves. None of it was coming across. It was just a haphazard website. And then it seemed like a lot of her strategy was oh, if I can get people on the phone, then, they can hear me and hear my voice and, get a sense for what I'm like and then they join. But you shouldn't be having to do that, if you have a really. Strong brand that already communicates all of that information to the patient before they even get to you. Then not only do you not have to do the work of selling for every single, person that comes into your orbit, but they're often warmed up to you by the time they come and see you because they've already gotten a sense of your vibe. And if they like that, they like the things you talk about, they like your messaging, they like, your style of practice, then. They're already primed to have a positive experience with you because it's already a good fit. I think sadly so many doctors just they're making these decisions about, what the website looks like and what the office looks like, and they're just like walking around home goods and this looks nice. Let's put this in my office. And I go to web designer say, I don't know, I like blue. So let's do some blue. And you know that, that's fine. And for some people I think it happens naturally because their taste and their point of view is just so specific. And so maybe it comes out, it just comes out, but for a lot of people I think they, they are just making decisions willy-nilly and not really thinking that strategically about it, and then feeling oh, that stuff doesn't matter. But it really does matter. It's a really powerful tool. So anyway, I would encourage all of you who are building a practice or maybe even rebranding a practice to invest upfront, in having somebody help you really build a specific strategic, thoughtful brand around your practice. Okay, so the first employee in my practice is my branding. Number two. Is a broad category, but number two, employee is my tech. So I would say the biggest things within my tech, I debated breaking this up, but I think the biggest things are really automations, processes that are automated and artificial intelligence, AI tools. Those two things, which I think, they have just proliferated and advanced so dramatically, even in the last few years that, this practice model of micro practice, I don't think would've been viable, 10 years ago, even, maybe even five years ago. But is very much possible now because of these. Tools. So I'm gonna quickly run through some of the big ones and how they replace people and basically help me avoid staff. Starting chronologically from when a patient might sign up, I use Hint for my membership management. So that means that the sign up to become a member is all online through Hint. And once they sign up, they all are set to autopay once a month. So the billing is essentially automated. If somebody misses a payment or their card gets declined it will automatically send a thing that's Hey, your payment has been declined. Do you have a problem with your card? Here's the portal to log in. It'll send auto multiple automated reminders, and then it'll also alert me that a patient's account needs my attention. I am not going in and invoicing everyone. I am not manually entering people into this system. There's no clipboard and paperwork that someone's filling out that doesn't, that's. Then getting scanned and then put into a computer, which I mean, can you believe we still do that in 2025? It's crazy that, normal practices are doing that. But anyway, so I'm essentially paperless and all of the enrollment and billing happens through Hint. And then Hint is integrated with a few other platforms such that when somebody signs up for my practice on Hint, it automatically generates a chart for them in my EMR, which is acute, and it also automatically adds them to Spruce, which is my HIPAA compliant patient communication. App, so that makes my life really easy. I'm not building a new chart for them, it's already, input and all their demographic information, contact information, everything is in there. They're also automatically added to Spruce so that if I do need to contact them before the appointment, I have an easy way to do that. I'm not looking up their phone number, putting it in my phone, blocking my number, none of that stuff. I'm just, I can go straight to Spruce, look up their name and message them so you know that. That automation piece is really nice. The way I've set up my practice, even though I have a bunch of different platforms they're not like one system, which there are options for that, but. The way I'm set up, it's multiple integrated platforms, but once they sign up in Hint, I have set it such that they get an automated email that gives them a link to my new patient forms, which I have through a different platform called IntakeQ and a medical records release, which is through IntakeQ that they can in e-sign on there. And then it also sends them my self-scheduling link, which is through my EMR. So again, no one's picking up the phone and calling my receptionist. Or, we're not texting back and forth about when that first appointment is going to be. They just have a link and they can look at the calendar in my schedule and they can set something up. Same for meet and greets. I have those scheduled through Calendly, which both Calendly and my EMR talk to Google Calendar. So essentially the only calendar I'm really dealing with in looking at. Is one Google Calendar. And so again, if patients are interested in my practice, they reach out to me by phone, by text. I tell them, Hey, if you'd like to learn more about my practice, you wanna chat and make sure this is a good fit. Here's the link to schedule a meet and greet. So I'm not getting on the phone with people and answering questions about the practice. I do not do that at all anymore. I don't even, I don't answer any of the calls to the business line. I send everybody the link to self schedule through Calendly if they wanna learn more about the practice. That way we have a scheduled time to discuss. It's a. Concrete blocked off 15 minutes. And if they're actually a good patient and willing to invest and willing to wait, then they will do that. If there's somebody who literally wants antibiotic prescriptions that day, they're gonna move on, which is good for both of us. So anyway, scheduling is all automated chart creation. That part is automated. I still have to, move over information from my new patient forms into places in the chart that, that stuff needs to go. The problem list and the history and meds and all of that stuff. I think that, as EMRs get better and better, hopefully that will not be an issue at some point, but I do still do that. So anyway, there's all those platforms that are managing the day-to-day processes, and then there's also. Ai, which has been a huge time saving and energy saving tool for me. So I would say the most helpful application of AI in my practice is documentation. Essentially now it's like having a scribe, which is amazing. So I use a bridge for my documentation. It listens to my encounters, it generates a note. I can edit it, I can make it more or less detailed. I find that it's pretty accurate. And then other uses of AI in my practice, I use Doximity, GPT whenever I'm writing like a, obviously without the patient information, but I'll say, write a letter excusing a patient from work for X, Y, and z reasons until this date pending this blah, blah, blah. Or I'll have Doximity, GPT write me appeals for, PAs that have been denied. And it's so nice because it'll actually cite sources for you and try to make your case. I use open evidence totally, exclusively now. I don't even miss. I used to miss UpToDate and I,'cause I didn't buy it when I started my own practices was quite expensive. I used Medscape a lot. I would go to PubMed, but open evidence is just so efficient. It is an AI search tool for medical research. And if you. Are not using it yet. Oh my God. You need to get, up to date to me is up to date, is dead to me now. Like I exclusively use open evidence and now it's even better because you can get CME credits for your searches on open evidence. So this morning I just went and claimed like 12 credits from just the last couple of weeks searching and that's, most of us have to get 48 to renew our license every two years. So that's a pretty substantial amount for work that I'm already doing. So anyway. That is an awesome tool. And then lastly, I still use just good old chat GPT. Sometimes when, I mean I don't use it as much anymore'cause I don't do this as much anymore, but when I was more active on social media to market and promote my practice chat, GPT is a great tool to help you figure out content ideas or what are some topics that might be relevant to moms between the ages of 20 and four. It can just help you brainstorm in a way that you might otherwise do with, a social media consultant or a marketing person or someone who comes. And bounces ideas off you or says, Hey, what do you think about making a reel about celery juice or whatever. You can use chat GPT for that purpose. So all of these AI tools together, if you think about how powerful they are and how much time they save you and how many people they replace, they replace a scribe, they replace a receptionist. In some cases they replace an ma. They replace a biller, all of these tools together. Are just phenomenally powerful and I think we're just at the beginning of this. So anyway, employee number two is my tech, and so you gotta make sure you pick the right tech and that it's working for you. Okay. The last employee in my business is my patients. And that's not grammatically correct'cause it's plural. But anyway, my patient panel, last employee was my patient panel. So why do I think of them as an employee is, they're working for me in a way because. At this point, and really probably after I passed around a hundred patients, the vast majority of my growth was happening by word of mouth. So it was really my patients that were, marketing for me and becoming the champions of the practice. One of my patients was like, I'm an evangelist for you. Like I've told so many people about you in this practice. And that was when it clicked in my mind. I was like, yeah, these. These people are really, they're my marketers. They're out there really championing this practice. How do you get patients to actively spread the word for you and how you get them to do that work for you. I don't think it automatically happens. It can, some amount will automatically happen, but you can definitely actively make it happen. Okay, so the, here are a few tips I have for how you get your patients to be raving fans about you. And I actually have an entire episode talking about how you get people to be raving fans for you, but a couple of highlights. One is you've gotta knock their socks off. Especially in the beginning of a practice. You probably have the time and the energy and the bandwidth and the enthusiasm that you want to give them the best possible experience. What that means is, spending as much time as you can with them, really giving them, your full attention. Being prompt and responsive, getting their lab results back to them very quickly. All the things that are really hard to do when you're full and busy, or especially in traditional practice, you can offer, so much more when you're starting out. So one is just giving them that personal experience and really knocking their socks off. Second is, Being very transparent with them about your own journey and where you are, what your why is, and you know where you are as a business owner. And I have found that when I was open with people in saying. this was a really hard decision for me. This is a crazy thing that I've done to leave a very stable, traditional job and to do this totally new model and to be on my own. I'm doing it for my child because I just want to be a better mother to him and more present. And I so appreciate you taking a chance on me and trying this new model of practice and trusting me with your health and seeing value in it. That means so much to me and I'm so grateful to you for that. If you know of other people that would, appreciate this model of care. Please send them my way. I want this to work out so that I can continue caring for you as your PCP for as many years as possible. If you could, tell a few friends who you think might be looking for a PCP about the practice. And if you don't feel comfortable doing that, maybe just, leave a Google review. It doesn't have to have any words, it can just be a star rating if that's all you have time for. Any little bit of support for this practice. Helps people got that, people got that. There were very few people that I gave that pitch to that did not either write a review or, send a friend my way to a meet and greet or something. I think being open and vulnerable about where you are in your business makes actually a big difference. And people do respond to that. And then the last thing is what I just. Modeled there is just asking them to spread the word. Saying all that stuff and being grateful to'em and knocking their socks off, with the experience they're getting. All of that is wonderful, but you are allowed to actively just say to them. Hey, if you've had a good experience, please leave me a review. I'll shoot you the link and I would so appreciate a few kind words. If you have feedback for me, positive or negative, I'm very open to that. Please send it my way. If you have friends or family that you know are looking for a PCP, I would love to have more patients like you in my panel. You can say that and that works, and I'm telling you, even people who. Adore, love, and adore, you sometimes just don't think to tell other people about it, or they just don't think to leave you a review. They don't know if you read those or if those matter to you. But telling them Hey those really help people find me when they're looking for a PCP in this area, or those really mean a lot to me and responding to those, all of that really signals to your patients how important that is and that. That's something that does matter and is, something that's appreciated. And so they will do it. They will do it. All right, so those are the three employees. There's my brand, my tech, and my patients. So all of those things are working together to make my practice work without actual employees. Now, if the brand portion of this episode was intriguing to you and you were I've never really given it that much thought, what my professional brand is like, and I've never really put that much energy towards it. I have got a special treat for you, which is that on Monday, May 19th at 8:00 PM Central Time. I'm gonna be doing a free webinar on Zoom, talking about building your professional brand. So this webinar, I most excited about this one. Of all the ones I've done because all of the other ones were really geared towards just. People who are toying with the idea of micropractice or wanting to do micropractice and how do you start on that path? This, I think, is like the prequel to that. And so a lot of people, even people who never end up doing micropractice, I think could, physicians could benefit from, putting some time and energy into crafting their professional brand. One of the ways that can help you is that. It can influence the type of patient that's coming to your practice to see you. And so slowly over time, you can actually build a panel filled with the type of patient that you love. I think this, every time I see my ideal patient, which is like a woman in her late thirties or early forties, who's basically. Falling apart and like stressed and overwhelmed and physically falling apart. And that is just, that is my favorite patient to see. And I also love health anxiety, also love chronic pain. There's a lot of things I love that I would be willing to see all day, every day. And I think about how if I had been more intentional about my brand years ago, even as an employed physician, I probably could have attracted a panel of. Disproportionate numbers of those types of patients that I really love to serve. And as I serve more of them, I get better at serving them. So even though I'm a PCP and I mean I'm general internist and I treat everything, it feels nice to have an area of clinical passion and expertise that you become known for and you enjoy doing, and it makes your job more fun and joyful. I think this is a webinar that honestly could benefit a ton of physicians and it's. Totally free, no strings attached. I'm excited to share this information, so I'm gonna put the registration link in the show notes, and I'll be sending out multiple reminders via my email list, which is the Micropractice memo. You can also sign up for that in the show notes. I only send Max one email a week, and sometimes I go MIA, so it is not like a. You're gonna get spammed with a zillion email situation. And I try to make each of the newsletters, I send high yield and it's not just filler. Okay. Because I'm like very anti filler in all things. So anyway, there's that. Stay tuned. Next week I have a micro practice mama one-on-one, which are like. Usually the most popular episodes with a really awesome doc who was in my beta class last summer and is doing awesome. Make sure you hit follow or subscribe or whatever the thing is to make sure that you get alerts for new episodes,'cause that's gonna be out next week. All right, until then, bye bye.