The EntreMD Podcast

5 Fears That Stop You From Hiring A-Players for Your Practice & How to Overcome Them

• Dr. Una

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Sooner or later, every successful physician entrepreneur reaches a point where they need to start hiring A-players to propel their business forward. 

But when it comes to that point, many fail to hire the right people or to hire any people at all. 

They self-sabotage, and they come up with all sorts of excuses.

I’ve noticed there are 5 reasons why people do this, and we’re going to unpack and overcome every single one of them in this episode! 

I’m going to show you how you can bring high-capacity A-players to your team and create even more financial and time freedom for yourself.

Tune in!

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Key Takeaways: 

  • 00:00 Intro 
  • 02:38 My first hire
  • 05:45 Can you pay this person? 
  • 13:11 What will this person even do? 
  • 17:24 Does a bigger team equal more responsibility?
  • 21:52 What if they find out you don’t have it all together?
  • 24:36 Are you afraid of leading?
  • 26:49 Outro 

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Speaker 1:

You cannot answer the question of if you can afford this person without doing the math. So just think about it. I need to create a win for the person their salary. I need to create a win for the practice overhead is covered. I need to create a win for me, the owner. I get some profit and so when you look at this, you'll find out that, oh, I can actually afford Hi docs. Welcome to the EntreMD podcast, where it's all about helping amazing physicians just like you embrace entrepreneurship so you can have the freedom to live life and practice medicine on your terms. I'm your host, dr Una.

Speaker 1:

A time comes in the life cycle of a business where hiring high capacity team members becomes the thing that has to happen. But a lot of times, when it comes to that time, people are not able to hire them. They self-sabotage, they come up with all kinds of reasons. They stop themselves from bringing some of the most powerful people on their team. Now there are five reasons why I've noticed that people do this, and we're going to unpack that in this episode. I'm going to show you how to overcome every single one of them so you can bring high capacity 18 players rock stars on your team and create even more financial freedom and even more time freedom for yourself. So let's get into the episode Now. Everything that I talk about today is something that I have done, and so I started my journey as an entrepreneur 14 years ago, at the time of this recording, and I now lead multiple companies and I have had to hire a lot of people, and I have come to many points where I had the opportunity to bring somebody on who would have been a powerful addition to the team, but I didn't, and there are five reasons why I'm going to share those with you. Okay, now you may be looking at your first hire, or you may be looking at your 10th hire, or you may be looking on bringing on an office manager, a business manager, another physician any of these high capacity hires. I want you to listen like, really lean in, and this is one of these episodes that I'm going to tell you from the very beginning that you want to share with the doctors in your life. They will thank you forever, because I have coached hundreds and hundreds and hundreds of physicians and I will tell you almost every single time, one of these five reasons rears his ugly head and keeps physicians who are running really great practices or businesses in burnout, like. Imagine leaving burnout from an employee position to then suffer from burnout that you created by yourself. All right, so let's talk about these five things, and I think the first time this well, this showed up the entire time. I've talked about this on the podcast, but I think it's been a minute, so I'll start from here.

Speaker 1:

The first time I had to hire, my very first hire, was going to be a medical assistant, a front desk person for my private practice. So this was 14 years ago. I lived in all five of these reasons and because of that, I was my own front desk. I would pick up the phone and say thank you for calling IVD Pediatrics. This is Ella. Ella was my alter ego, right? I did not hire an MA. I worked up my own patients. I gave my own vaccines.

Speaker 1:

You will think this is completely crazy, but I did not even hire a biller In the beginning. I did my own billing by myself. I want you to imagine someone who knew nothing about entrepreneurship doing all of these things, right. So these five reasons showed up and then I overcame that and I hired my first medical assistant. Then my front desk person outsourced billing and all of those things. And then it came time to hire my first physician hire and I was like, oh my goodness, like think about you know how the payroll is going to balloon, like I don't think I can do this, right. But we hired, you know. Eventually I, you know, did some of the things I'm going to talk to you about and I brought this person on board and was a wonderful addition to our you know, to our practice and, of course, went on to hire many other physicians.

Speaker 1:

And then, when we got over to the EntreeMD side, I got to a position where I was like I need to bring on an executive assistant or I need to bring on somebody else who could facilitate classes and all of those things. Again, a lot of these things were their ugly heads. So I've had a lot of experience with this. When it was time to bring on a practice manager, I was like, oh my goodness, I'm going to add this to the payroll, like all kinds of stuff. Okay, so I have a lot of experience other than the experience I have from coaching people. So I wanted to really lean in.

Speaker 1:

Okay, why is it important that we talk about this? It is really critical because, with your journey as an entrepreneur. The beginning part of your journey is taking your business to profitability, really Like that's kind of where your focus will be marketing, selling, all of those kinds of things. But once you get there, your capacity to serve people would be limited because you're one person. Your capacity to bring in new patients or new clients will be limited because you're one person. Your capacity to bring your business to or new clients will be limited because you're one person. Your capacity to bring your business to the professional phase will be limited because there's a limit to the knowledge base you have. Your ability to continue to grow your business while you maintain a life that you enjoy. Right, it will be limited if you do not have people, and the more high capacity people you have, the more peace and quiet you have in your business, the better everything will be limited if you do not have people, and the more high capacity people you have, the more peace and quiet you have in your business, the better everything will be.

Speaker 1:

So I run multiple businesses but I still have time to travel. I still have time to spend with my kids. I have Meets Week meaningful time with kids as a daily thing that I do. I'm able to homeschool my kids, I'm able to mentor hundreds of people outside of what I do with the business school. I have so many lives going on at the same time, but there's no way that would work if I did not have a high capacity team. So this is something you want to really spend time figuring out, embracing the discomfort getting done, because it will change everything for you.

Speaker 1:

So let's talk about the things that come up. The first thing that comes up is can I pay this person? Right, like so you brought your business in, but you know you brought your business to state of profitability, but you're you know you have like five roles, right, and so when you start out, you know, like getting other people to fill these roles, like you're the owner and you're the manager, and you're the CEO, and you're the technician who's doing the actual work, and you're the accountant and you're the lawyer, and you're everything right. And once you start, you're like, oh, my goodness, it was so much cheaper before. Not really, you were doing five jobs. But anyway, can I afford this person? Can I afford to pay this person? And this is a great question, right, because we talk about profits a lot, and if your business is not profitable, you have to shut it down, right, but this is the deal, right? This is one of those things where the more information you have, the more confidently you can make the decision. So let me explain this a little here.

Speaker 1:

When you bring somebody on, you want that person to be able to create a win-win-win situation. So this hire is a win for you, it's a win for well, not in that order it's a win for the person you hire, it is a win for the business and it is a win for you, the owner Okay, because of course, you're separate from the business. So what does that mean? It's a win for the person in the sense that they get to be paid well. It is a win for the business in the sense that the overhead is taken care of. It is a win for you, the business owner, because this role creates a profit, right, like you are taking on the risk of building the container where this person can thrive. So profit is deserved, right, like it really is. So that role should be able to create the payroll for the person, so the revenue that you pay, the income you pay the person. It should be able to create the overhead associated with that role and it should be able to create a profit for you.

Speaker 1:

Now, if you're able to work out this equation where I'm bringing in this person, I am going to pay them $100,000 a year, but this person is going to be generating 400,000 in revenue, and so maybe 100,000 goes to this person, maybe 100,000 goes to overhead and all of those things, or even more if it's a private practice maybe 50%, so maybe 200,000, and then 100,000 goes to you as profit. Do you see, like that's a win-win situation. And if you're able to plot that out, then hiring that person is not a problem because the person is not costing the company anything. The person's salary is an investment, right? So when you wonder, can I pay this person, that is not a question that you can answer without numbers. So you may think, well, it's my first year in business, maybe I can't pay this person. Or you know we have a lower profit margin, so we can't pay this person. That's not how this works. You actually need to go work the numbers right, like what will this role generate? And you might go like I don't know what the role will generate. You want to look at and this is the owner job, right, you're going to have to do this. You want to look like what are the revenue generating opportunities here?

Speaker 1:

So let me give you an example, a simple example. Let's say you are bringing an office manager on and you're bringing an office manager on and they have many things that they're going to be responsible for About two of the things they're going to be responsible for is one they're going to make sure that your schedule is full at all times. Let's say you decided I want to see 20 patients a day. I want me and the other doctors in this practice to see 20 patients a day, okay. And let's also say that you've not been able to keep an eye on the biller and so, because of that, your AR, your accounts receivable, is ballooning and you're like okay, I want somebody to keep a pulse on this so that we are collecting all the money that we're supposed to collect. Okay. So let's say that's what the person is doing. Let's say you're a coach. You want to bring somebody on, because maybe you have a hybrid model where it is group and it is one-on-one coaching. You cannot fulfill all of that, but if you bring this person on, you can hire more people, okay.

Speaker 1:

So let's look at how this works. So for the practice administrator example, let's say that a patient visit is worth a patient counter is worth $100. And none of these numbers are really real. I'm just making them up because ones or zeros, it's easier to do the math. Okay, so let's say it's worth $100 per visit and you realize that even though you want to see 20 patients a day, most of the days you're seeing 15 or 16. Okay, so let's say 16. So that means there's four holes in your schedule. And if you calculate that that's $400 a day and for a week it's $2,000 a week, multiply it by 50, right, 2,000 times 50, that gives you $100,000. So that means you have a potential $100,000 that you're leaving on the table.

Speaker 1:

Okay, now let's say that your AR is ballooning and your front desk is not collecting the money like copays and deductibles, and all of that because you don't have the bandwidth to keep an eye on your biller. And you do the math and realize if the biller was doing their job, we could be recouping another $100,000, $200,000, $300,000, $400,000. And you may think that's ridiculous, but trust me, I've seen these numbers a year in revenue, so I want you to think of it. So let's just say, $100,000. If you keep an eye on the biller, another $100,000, if you close up your schedule, that means this person can bring $200,000 in. And so let's say you were thinking about, like, maybe this person is an office manager, this was somebody that you're going to be paying $50,000, $60,000. And you're like, oh my goodness, I don't think we can afford it and all of those things. Do you see, now that you can set this person up to do the work that really matters in your practice, and they could potentially bring in for only two roles now, for only two things they're doing, they could potentially bring $200,000 in. So what it then means is it's too expensive not to pay somebody $60,000 to do that, because you're saving $60,000 and losing $200,000. So all of a sudden, it's no longer can I afford this person? But like, oh my goodness, like I cannot afford not to have this person, right?

Speaker 1:

So let's talk about the coach. You have the hybrid model. You have a high ticket offer it's $20,000, but there's some one-on-one coaching aspects to it. And now you're at full capacity and so you could bring in another 20 clients, but you can't because you don't have the capacity to do the one-on-one Okay. So I want you to think about it. You pay a coach, right, and I'm just going to use a hundred, you know, like, let's say, a hundred thousand a year, because it's easy to measure. Of course, they do this in sessions and all that, but I just want you to follow me with this right. Okay, so you can bring in another 50 people in. Okay, so it's 20,. You can bring another 50 people in, so it's 20,000 per person, which means, if you bring in another 50, that's a million dollars. That's a million dollars.

Speaker 1:

And so you, bringing on somebody that you pay six figures is giving you the capacity to bring in an extra million in revenue. What do you do? You pay that person all day, every day and twice on Sunday, right, like? So you cannot answer the question of if you can afford this person without doing the math. So just think about it. I need to create a win for the person their salary. I need to create a win for the practice Overhead is covered. I need to create a win for the practice Overhead is covered. I need to create a win for me, the owner. I get some profit, right, and so when you look at this, you'll find out that, oh, I can actually afford them. Okay, all right. So that's the first thing.

Speaker 1:

The second thing is what will this person do? And we've already looked, okay, so, but let's, let's backtrack. What is this? You're burned out because of all the things you're doing. You know what you could do with extra time.

Speaker 1:

There are things you wish you could get off your plate, but this is what the problem is. We are so intimately connected with our businesses and sometimes the separation becomes hard, so we just think I'm the only one who can do this. This is something that I do, nobody else can do it. Nobody else can do it like me, some of them. You don't even realize you're doing. So I talk to doctors all the time and they'll tell me well, that only takes me 10 seconds. That only takes. And I'm like no, it doesn't. You have to plan it, you have to do it, you have to execute, you have to follow up. It does not take you 10 seconds, right? So what am I going to have this person do?

Speaker 1:

Okay, now, to solve this, there's a simple exercise. I did not call it easy, but it is simple and it really is to kind of do an audit, right, like, so, let's say, you want to bring an executive assistant on. You do an audit. What are all the things I do to run this business? The emails, the scheduling, the appointments, the pitching, podcast, all of these things. You document them. And then you ask yourself this very important question of these things, which of these things can someone other than me do Not? Can I do it as well as I do? Like? Which of these can another human being do? So I'll give you an example. Now.

Speaker 1:

Hiring is something I really struggled with. Delegating is something I really struggled with, and so you know, there was a time where I had built my business. I had a team, like a small team, but like so this is second business EntreeMD. I had a small team, but we were doing good, and then I started getting to this point where I was like I'm busier than I need to be and I feel like I'm getting a little burned out. Like what is this? Like I can't say I was at burnout, but I was. I knew if I didn't take care of business I would get there and I was like but there's nothing I can give anybody. Like I do the things only I can do Always a lie. So anyway, I almost always a lie, I guess I can't say always, but anyway I said okay, so I still remember that day.

Speaker 1:

I sat down. I said you know what? Let me document all the things I do every day for EntreeMD. So I documented what I do for the newsletter. I documented what I do for the podcast. I documented for what I do for the newsletter. I documented what I do for the podcast.

Speaker 1:

I documented for what I do in the Entremet Business School. I documented what I do to put myself out there. I documented everything and I started looking at the things that I was doing that somebody else could do. I got 27 things, 27 things. So I went from oh, I don't think there's anything to give an executive assistant to like oh my goodness, can one executive assistant do all of this? Now, of course they could, but do you see what I'm saying? Like 27 things, okay, so you have to stop to look at what you do, look at what you have on your plate, and not say anything like this takes a minute, that takes five seconds. No, like, just stop and look. And so I was able to. I want you to imagine what life would be like. Just sit with this thought for a second If you could offload 27 things that you're doing right now.

Speaker 1:

Okay, now you may say I'm not trying to hire an executive assistant, which that is fine, but it's the same thing with the practice administrator. If you run your own practice, there are a lot of things you do that are practice management that somebody else could do. So it's the same exercise. What are the things that I'm doing that a practice administrator can do? And you start documenting it and you find out that you have a lot of stuff for someone to do for you. Okay, it could be any role, right? Okay, so the solution to that is this exercise. What is it? You know, document everything you're doing and then ask yourself what is it on here that somebody else can do? Okay, now you also want to make sure that you know this relates to the first thing you also have revenue generating activities that this person is doing so that that person can pay for themselves. Okay, all right.

Speaker 1:

So number three I hear this a lot and people would say, oh, my goodness, if I have a bigger team, that is more responsibility. Now, the first part of that responsibility is I have to figure out payroll. We've already talked about that piece. The other responsibility is. You know, I have to manage this person, I have to train this person, I have to coach them. Like I remember hiring people and going like, oh my goodness, why? Like I didn't say this intentionally, but why can't they read my mind, why can't they just do these things? Why can't they just figure out life? Why do I have to coach them through and all of those things? But this is the deal. I'm going to give you an example.

Speaker 1:

Okay, now, at this stage in my life, I don't cook, I don't clean, I don't go grocery shopping, I don't go clothes shopping. I mean, go if you like it, I just don't, so I don't do it. I don't manage my email. I don't manage my calendar. I have so many things going on at the same time that I don't have my hands in. I have the time to travel. I have the time to homeschool my kids. I have the time to travel. I have the time to homeschool my kids. I have the time to lean into things that matter to me. I have time to work on my legacy. I want this to be said about me when I'm dead and gone and I'm working on it. I have time to do all of that, and I'm not the only one.

Speaker 1:

There's so many doctors in the Entremet Business School who have been able to buy their time back. They're able to take a vacation every quarter. They're able to spend time in their marriage with their children. They're able to go back and do hobbies, whether that's karate or playing the piano and all kinds of fun stuff knitting, crocheting, all kinds of things. They're able to take care of their health, work out, do all of those things right. Imagine if you could do that right. Imagine if you could have a thriving business and you can have time. You can have time freedom. You can have time to go have lunch at your kid's school.

Speaker 1:

Okay, now, for 100% of the people who are doing this in the business school, in the entrepreneur business school, we call it building your dream business and your dream life at the same time. We don't believe in waiting. We've waited so long to become a doctor, to become the attending, to do all of that, so we don't wait anymore. We're doing this concurrently, but the prize for that is managing a team right If you think about managing a team just on its own, just to be managing a team right, like if you think about managing a team just on its own, just to be managing a team, it's like, oh man, I shouldn't have to do that. But when you think that if I do this work, not only do I empower somebody to work at their highest potential and have such fulfillment and satisfaction at work, I also get my time back, then it becomes worth it.

Speaker 1:

If you are going to lead 18 players, you are going to onboard them properly, you are going to train them properly, you are going to resolve conflicts properly, you are going to cast vision properly, you are going to coach them through, because life is going to show up and that is your opportunity to see can I save this hire or am I just going to lose them? Right, like, so you're going to do all these things and it may go. It may feel like, oh, I don't, you know, I don't want to have to do that. But one, you can look at it as a privilege, it's something we get to do. But two, you have to understand that the secret to time freedom as a entrepreneur, as a very successful entrepreneur, is a rockstar team. Okay, so the way it's.

Speaker 1:

Like I didn't like biology, okay, that was just not my thing. Right, but there's no path to medical school that I knew about that did not involve biology. So what did I do? I loved biology, right. And so the whole thing about bringing on leading, coaching, training your team. You can learn to enjoy that. You can realize that that's the work. That's the work for time, freedom and exponential increase in financial freedom. It's your team, okay. So, yes, it's more responsibility to manage, but is it doable a thousand percent? Can you do it a thousand percent? Why? Because leadership is a skill. You can acquire it, just like anything else, and if you could become a physician and you could build a thriving business, you can figure out leadership. Okay, all right. So in the Entrained Business School, we focus a lot on team, especially in EBS scale, like after you hit a million in revenue. It's kind of like team, team, team, team, team, like a thousand percent, team, right, and we focus on that because it's a skill and you can learn it. Okay, all right.

Speaker 1:

Number four. Number four comes up a lot, and number four is I am embarrassed that this new hire, this new rock star, high capacity hire, will find out that I don't have it all together, that my practice or my business is not as good as it looks or whatever, because, remember, you know everything that's wrong with your business, right? And it's like, oh, they thought I was all that and they're going to come in and they're going to say I don't have it together. And I understand that because I, like, there are many hires I've had to bring in. I was like, oh, my goodness, you know, but this is the deal, okay.

Speaker 1:

So there are a number of things that would be really important to remember and to really lean into. One of them is that your business will always be a construction site. There will always be something wrong with your business, and when I say something wrong, it's more like there'll always be something to improve, to make better, there will always be something that broke and you have to make it better, because guess what I mean. Think about it. When you take your business from a hundred thousand to a million, things break, because the thing that worked at a hundred thousand doesn't work at a million. When you take your business from two team members to 10 team members, things break because you know, like the two team member version of 10, they're completely different, and so there will always be things to work on, always.

Speaker 1:

And so, as parents, parents don't wait for their children to become Harvard-trained cardiothoracic surgeons before they're proud of them. They're proud of the little baby who is burping, looking at them cross-eyed, you know, pooping everywhere, peeing on everybody, spitting up on everybody and can't sit up, can't do anything. Parents are proud of them. Then right, they don't wait. So I want to invite you to be proud of the business that you've built, even though it's a construction site, because, guess what, it's always going to be a construction site.

Speaker 1:

The person you're thinking of, you know would judge you. Chances are they're inspired by what you're doing. And even if they do judge you, that's a little weird because if they could do it, they would have done it right. If they could, they would have right. So I want to kind of fall in love. It's not perfect and it's never going to be. It can be better, but your business is never going to be perfect. So if you're waiting for it to be perfect before you can celebrate, you're never going to celebrate it right. So that's kind of the way I deal with the embarrassment part.

Speaker 1:

I fall in love with what I have. I love my practice. I love the EntreeMD business school. I love EntreeMD. Are there things we're still working on? Yes, are there things we will work on until whenever the world ends? Yes, right, but I love what we have. I love the results that we've created. I love all of it. Okay, all right.

Speaker 1:

The final thing is the fear of leading Like. Why would somebody like X follow me? Why would somebody who has had 20 years experience as a practice administrator follow me? Why will somebody who was already a coach before I got certified as a coach follow me? Why would this executive assistant who had worked with the CEO of a company that was doing 10 million in revenue follow me? Why will they follow me? Why will they follow me? Why would they follow me? Right, and again, with this, this has happened so many times. I come back to falling in love with the business that I have. I come back to falling in love with the results that we create.

Speaker 1:

I lean into the vision more. I have an executive assistant who works with me, but when she's doing emails or she's getting me on podcasts and she's doing all of these things, she does not just see the task. She sees that she is part of the Calvary in medicine. She sees that she is part of the team that is going to help a hundred thousand physicians learn how to build profitable businesses so they can live life and practice medicine on their terms. She sees that she's taking doctors from burnout to their own businesses, to financial freedom, to time freedom. She gets the value of her work. Freedom to time freedom. She gets the value of her work right. So I lean into the vision, I lean into the work that we do, I lean into the story, I lean into the mission and I own that. So I may not be somebody else, but I'm me and what we're doing is so important.

Speaker 1:

And the other thing I do is I recognize again that leadership it's a skill and I can build it, I can learn to lead. There's a book that I've read many, many times. It is the 21 Irrefutable Laws of Leadership by John Maxwell, and I read and I apply, I read and I apply, I learn, I apply, I practice right Because it's a skill and so you can lead the person and you can become better at leading. And so the reason why I took the time to walk through all of this is because this comes up so many times. But you, my friend, are not going to. Your vision requires a team and your freedom requires a team and you. Maximizing your potential as an individual and maximizing the potential of your business will require a team, and not just any team, but a team of A players. And you are the woman, the man for the job. You can lead A players, but you want to lean into the things that stop you, overcome them and go all in.

Speaker 1:

Leading teams has dramatically changed my life on a personal and professional level, and I would love the same thing for you. So this is one of these episodes that I would say you want to come back, listen to again, workshop it. Maybe grab a few friends, workshop it together. Like, how's this fear shown up in my life? What decision am I making? And I want you to go start implementing. You have teams. Start practicing the things you've learned. You have a critical hire you've been stalling on. It's time to go put that ad out right and get that person on your team.

Speaker 1:

If you're like I really, really, really really know that I need support with this, then in the Entremet Business School, this is what we do. We understand this is one of the four major pillars building a profitable team, because my mission is to help physicians not only build profitable businesses, but to build businesses that can work without them. You have to have a team to do that. Okay, I have done that in my business. I just got off a two week sabbatical where I didn't do anything for any of my businesses my private practice I haven't set foot in in two and a half years and I'm not saying you have to do this, but I do want you to have options. So if you've been thinking about it, talk to my team. See if the EntreeMD Business School is your best. Next step it's EntreeMDcom forward slash call and you can schedule a call with my team there.

Speaker 1:

I want you to sit with me for 30 seconds and just imagine what life could look like if you could get 10 hours back a week. You could get 20 hours back. What life will look like if you can have four weeks, six weeks, eight weeks, 12 weeks and when I say 12 weeks I'm not making this up. There's an entrepreneur. She works a job, but she's learned how to do all the things and how to negotiate as a boss. 12 weeks off in a year. 12 weeks off what would you do with it? What if you could let your business run for a month without you? What will you do with that time this is all possible, but the pathway there is building a team, and you cannot let these things stop you anymore. Okay, all right. So remember, go share this episode with a doctor in your world, start applying them, come check out the business school if you need support with this, and I'll see you on the next episode of the Entrepreneur.