The EntreMD Podcast

How Physician Entrepreneurs Burn Themselves Out (And How to Stop)

• Dr. Una • Episode 489

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Burnout doesn’t just come from toxic workplaces, it can also come from the business you built to escape them.

In this episode, I discuss a pattern I see far too often: physicians leave medicine to reclaim their time and sanity and then accidentally build a business that takes over their life and runs them into the ground.

If this sounds like you, then you don't want to miss this episode!

In it, I break down the three biggest mistakes that cause entrepreneurs to burn out. I also share stories and lessons from my own journey as well as powerful mindset shifts that will help you build a business that doesn’t own you.

If you’re growing fast but feeling more overwhelmed than ever, this is your sign: tune in now!

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Key Takeaways: 

  • 00:00 Intro 
  • 00:44 Are you experiencing burnout?
  • 04:34 Don’t be the only revenue generator!
  • 12:07 Stop being the only problem-solver
  • 15:54 Don’t let work time bleed into life time

Additional Resources:


When you are ready to work with us, here are three ways:

  • EntreMD Business School Accelerator - If you are looking to make a 180 turnaround in your business in 90 days, this is the program for you.
  • EntreMD Business School Grow - This is our year-long program with a track record of producing physician entrepreneurs who are building 6, 7 and 7+ figure businesses. They do this while building their dream lives!
  • EntreMD Business School Scale - This is our high-level mastermind for physicians who have crossed the seven figure milestone and want to build their businesses to be well oiled machines that can run without them.

To get on a call with my team to determine your next best step, go here ...

Speaker 1:

You can't be the only person creating revenue. You want to create other revenue creators. That way, you can expand their roles and stuff like that. If you needed to walk away, you could walk away. If you needed a breather, you could leave the breather. If you needed to take a long nap and you needed a day off, you could do it.

Speaker 2:

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:

Burnout is terrible, but burnout that you create by yourself as an entrepreneur has to be the absolute worst. Okay, One of the things that I see as physician entrepreneurs that happens is you know, maybe we work a job or we're partners in a practice or you know whatever that is, and you know, the demands become so much, the administrative burden becomes so much, then we get burned out and then our solution is I cannot work in this system. This system is toxic, this system is not supportive, this system does not allow me to live life on my terms and all of these things. So I'm going to become an entrepreneur and usually, when you start playing the entrepreneurial cards right, things start to fall in place. Where you're in control of your time, you're in control of your calendar. You're in control of your calendar. You determine how much or how little you want to work, the revenue starts coming in, you start getting in team members and we're like, oh my goodness, this is amazing. And then your business starts to really grow and then what I have found that people find is that they're like I feel a certain way and I don't like the way I feel, and it feels exactly the way I felt when I was burned out and left where I was to start my business. Anyway. They go from burnout to honeymoon, back to burnout.

Speaker 1:

Okay, and today, what I want to do is I want to show you how to stop building a business, stop building a practice that owns you, because when you build a business that owns you, burnout is inevitable. I'm going to make this super practical. I'm going to give you three things. I could give you five, I could give you seven, but I'm going to give you my best three. And what I really want you to do is I want you to treat this like a workshop. I want you to take these three things. I want you to audit your business, get them out of your business so you find yourself building a business that is sustainable, where, whether you're growing, whether you're scaling, you have a life.

Speaker 1:

You're not living in burnout, you're not wishing you could throw your business away, because this is the deal. I have seen many people throw their businesses away. Right, it started working, all that stuff. They're like I can't take it because I don't have my time, I'm not able to work out, I'm not able to spend time with my children, I'm not able to spend time with my family. This is no fun, I don't want it, right, and then they throw it all away. But when I look at it, I'm like, man, this had so much potential and not potential, like maybe somewhere in the sweet by and by. I do the math, I run the equation. I'm like this has so much potential but the owner didn't know to protect himself or protect herself from the things that will turn this into a nightmare. So I'm giving you this. So, as you take your business to seven figures, multiple seven figures, eight figures, all that, you're putting yourself in a position where you can enjoy the journey and the bigger your business grows, the happier you are.

Speaker 1:

Okay, let's look at three things that now. There are three things. When I see them in a business, I know this person is like full speed ahead, heading to a business that's going to burn out. They're building a business that cannot survive without them, right, which means burnouts, which means they can never exit it, and stuff like that. You know I train my people, for instance, in the on-train business school, the frameworks I give the students. These frameworks are designed to help them build businesses they can exit from, and many people in the beginning I'm talking about exit they're like I haven't even, like I'm only a year in. I don't think I'm going to want to exit. I'm not exiting now or whatever. But as they go on their journey and they find that they're needing time and they find that, oh my God, I need to take this time off, life happened, I need to take that time off, or whatever. It then dawns on them the beauty of what they've built. They built a business that does not own them. They built a business that doesn't depend on only them. All right, so let me give you those three things and I'll give you the solution for all three.

Speaker 1:

The first thing that sets you up to have a business that owns you. The first thing is you're the only revenue generator. Okay, you are the only revenue generator. The day you don't show up, there's no revenue to be had, and many people build their businesses this way. Many people build their businesses where the only person bringing in money, the only person doing the heavy lifting, is the owner. Everybody else is kind of just there, right, either they're doing random, unrelated tasks or they're doing important tasks, but they're serving the patients and clients. They're not necessarily creating revenue and stuff like that, and you're not intentional about this. You can build a business doing 500 in revenue. You're strong enough. You can build a business doing seven figures and you are the only revenue generator.

Speaker 1:

This is called the beginning of a nightmare. It's not one of those things that are urgent and important. This is not urgent and important, but if you don't address it, it becomes urgent and important, okay, okay. What is the solution for this? If you're the only revenue generator and I want you to think about this and they'll say, oh yeah, there are many of us. No, if I was gone from my business for a week, if I was gone for two weeks, would everything come to a halt or would things be able to still go on Right, okay, so what do you want to do with this? What is the solution? You want to start thinking about replacement from day one, and when I say day one, I mean from the beginning of your business. But if you didn't think about it in the beginning of your business and you're 10 years in and you're 15 years in, you're 20 years in today's day one for you, okay, you start thinking about it. What is my replacement? And it may not necessarily be for your role. It could be for your role, but it's it's. It's also like how can every person in my company be a revenue generator? So I will give you two examples. Okay, so one.

Speaker 1:

This was a doctor in the entreme business school who was like okay, so I need to make up for the fact that we're not going to have any revenue because I'm going to go on vacation. I'm like what? Like no, you have a whole team and they're still going to be earning money and they're going to be coming to the office. And so I said to her I said okay, you have team members. What revenue generating activities can they be engaged in while you're not there? What could they be engaged in so that they are creating revenue, even though, in this circumstance is probably going to be like revenue, you will still have to do the delivery, but they can drum up the business, right? I said what could they do? And initially she was like you know, I don't know. You know, usually I just you know, I have them, you know, attend some trainings, I have them clean. I was like there is no revenue to be had from training or cleaning, right, so they should train, they should clean and create revenue. What could they do?

Speaker 1:

And then so she started thinking about it. She's like, well, I have a number of referral sources. They could go deep in those relationships with those referral sources and there's some people who don't refer to us yet. They can go meet with them. I'm like perfect. Then she says there are some people who have outstanding balances. They can call to collect on those outstanding balances. I'm like wonderful. And she says, oh, we have people who are overdue for appointment. They can call all those people so that by the time I get back my schedule will be full. I'm like fantastic, right. And she says, oh, we have this vertical that does not require a physician. They can execute on it so they can fill their schedule and do that. Then I'm like, there we go, there we go. And so here she is. She goes on vacation for two weeks and for those two weeks her team members are there generating revenue every single day. So she can have her two weeks in peace, so she's not setting herself up for burnout. So in a way, her practice can work without her herself up for burnout. So in a way, her practice can work without her. And then she comes back and the people that were there created revenue. It's a way of thinking.

Speaker 1:

Now for my private practice. I've had a private practice for the last 15 years and when I started, I started with the intent that I was going to give this 10 years and after 10 years I was going to retire. Okay, and it's not a recommendation, it's just that for me, I knew that I had, there were so many things that I needed to do with my life that I was not going to be in an exam room nine to five till I was 60 or 70. I just knew that was not a thing. How did I know? I knew All right. So I'm not recommending it, I'm just sharing my story.

Speaker 1:

What I did was, you know, from the beginning I started thinking and I think part of it was you know, I read E-Myth Physician and just got this whole concept of you know. There's you the technician, which is what I do as a clinician, seeing patients, and then you the manager right, managing the team, all of those kinds of things, and then there's you the entrepreneur, the owner, right, and there are three different roles and your job is to kind of build a business assets, not to build a job, okay, so I think I learned that pretty early on. I started thinking about that early. But, mind you, at this time, when I started thinking about this number one, I didn't even think I could build a seven figure practice. I had been an employed physician. I was this person who was like I'm going to be really smart, I'm going to be a great doctor and I'll have a great salary.

Speaker 1:

Entrepreneurship was not something I thought about. At this point I didn't think I could build a seven figure practice and at this point I did not think I could pay another physician. The reason I'm telling you this is I'm telling you this so you can start from where you are. So, even though I had those limitations in my mind, I had those limiting beliefs. What I then said was like, okay, regardless, I set a date.

Speaker 1:

I was like I'm not 10 years, I'm done 10 years, I retired and I'm so grateful. I mean, we hit that at year nine. But I was like I'm retired, okay, and I also want to point this out right, like I hear people say to me, this is a total sidebar. I hear people say to me oh, my practice is driving me nuts, I want to, I want to retire yesterday, okay, and I always say this and you give it the runway that it requires. This is a multi-year process. It will not take 10 years. Okay, I told you where I started from, but this is different. Like on Trendy, we have so many resources to help you and stuff. It does not need to take 10 years, but you do need to give it some runway. It could be three years, it could be five years, depending on how strategic, intentional you choose to be and how willing you are to eat really big frogs, okay. So, cause they're frogs involved, okay, the first thing I did was I was like, okay, I can't pay a whole physician, so I could not even conceptualize having a six figure, multiple six figure salary on my payroll.

Speaker 1:

I was just like, forget it. But what I did do was I knew I could pay a doctor for a day right, I knew I could pay a doctor for a day. So I found a doctor who didn't really want to do all this stuff. She wanted to work a day a week, right, and so she wanted to work a day a week. I was like that is fantastic, and so I hired her really early on this must have been the first 12 to 18 months of my practice. I hired her and she came and she worked every Friday, but guess what that did for me? It meant every Friday, every week, I had a long weekend.

Speaker 1:

My practice didn't own me. I could travel, for you know, for three days. I could travel, for four days, I could, you know. I could spend time with my kids. I could do all of these things. And I started training myself to bring other people on right, and so I did that. I brought somebody on one day a week, then I brought a nurse practitioner I think it was on three days a week before I then hired my first physician and all of those things, and I just started creating multiple revenue generators. So I was not the only person creating revenue. Okay, so you can't be the only person creating revenue. You want to create other revenue creators so that that way you can expand their role, their roles and stuff like that. If you needed to walk away, you could walk away. If you needed a breather, you could be in a breather. If you needed to take a not long nap and you needed the day off, you could do it. So that's really important.

Speaker 1:

The mistake here is being the only revenue generator, and the fix is start thinking replacement from day one. Okay, all right. Number two is this is subtle and many people miss this. Oh, but it's such a drain. It's almost like every time you move away, your business will come to a standstill, right, if you don't understand this concept, and it will be so mentally draining. I cannot explain how mentally draining this is. And that mistake is being the only problem solver Okay, being the only problem solver. So, whenever anything breaks, dr Una, how do we do this? Somebody else saw a patient and a patient's parent is upset and the only person who can do the conflict resolution is you, dr Una. This mom is mad. You have to call her.

Speaker 1:

There was a shipment of vaccines that needed to come in and the shipment didn't come in. Dr Una, the shipment didn't come in. What do we do? Even thinking about it is so draining, it's so tiring, right. The way you fix this this is a problem. Okay. The way you fix this is you train your people to think. You train your people to be problem solvers. You don't make all their problems go away. Okay, so I learned this from Brian Tracing. Okay, if you have not read the book, eat that Frog 21 Ways to Overcome Procrastination excellent book. I recommend it everywhere. In fact, it's a bestseller on Amazon and I think I'm the reason because I've always recommended it to hundreds and hundreds and hundreds and thousands of people.

Speaker 1:

Okay, he talked about like when somebody comes in with a problem that see them as if they had a monkey. Right, they had a monkey on their shoulder and they came to you and told you about it and they took their monkey and left their monkey on your table. So imagine people keep doing that and doing that and doing that. At the end of the day, you have 25 monkeys on your table driving you nuts. My approach then became when somebody comes and says the vaccine shipment didn't come, what do we do? I'm like what would you like to do? And so when I started doing that with my team, they're like I don't know. That's why I'm asking you. I'm like perfect, so why don't you go think about it? Come up with three solutions, okay, and come tell me and I'll tell you which one and why. Now, it takes more time.

Speaker 1:

Quote I don't do that, and the more you do it, the more stressful your life will become. I don't do that. Now, what does that do? Number one it makes them think. And if you can have people who have hands that work and brains that think you are a blessed employer. Okay, number one is it helps them think. Number two if you are disciplined enough to tell them what you would do and why, then everyone becomes a masterclass you're giving them in problem solving. You are transferring the way you think and the way you problem solve to your team, which is a magical thing because it gets to the point where they're like I know what Dr Una will say, I know what Dr George will say, I know what they'll say because they've done this with you time and time again.

Speaker 1:

So when they come in and say, oh, I don't know this, blah, blah, blah, blah, blah, I see it as a monkey. I'm like you stay right there, you hold your monkey. Okay, you hold your monkey, I'm not taking your monkey, I don't want your monkey on my table, okay. And then I'm like you go figure it out. You come back, you tell, execute. And so I did this in my practice and did it and did it. I did it with my team and EntreeMD and did it and did it. I do it with PMT, all my companies, so much so that I'm surrounded by problem solvers, I'm surrounded with people with high quality thinking. I'm surrounded with that.

Speaker 1:

Okay, so being the only problem solver is a nightmare. And so the bigger your team gets, the more stressed out you are, the more mental clutter you have, the more you want to throw your entire business away. The problem is not the business, the problem is you're the only problem solver. Okay. So the builder has a problem, it's you. Okay. The coach has a problem, it's you. The VA has a problem, it's you. Like, no, have them think, have them think, okay.

Speaker 1:

Number three, third problem, is that we create a culture. So this is a personal culture for the owner. We create a culture where work time bleeds into lifetime. Okay, work time bleeds into lifetime. So what does that mean? What does that look like? Okay, you're at work in your practice or in your, in your, in your, whichever type of business you have, and you see the patients all day.

Speaker 1:

This happened to me. It was a turning point for me, right? I see the patients all day. I was gone in the morning before my kids came, you know, got up. I hadn't seen them all day. I got home and my kids came to hang out with me and you, you know these. Hi, mom. I'm like okay, hang on, let me go take a shower. So I do all of that stuff and I come out and I settle in because I still have 20 undone notes and I start charting. And they come back in, they want to come hang with mommy and all that stuff, and I'm like shoo, shoo, go away, I'm working.

Speaker 1:

In that moment I thought I said, okay, they woke up in the morning, I wasn't there, they went through their day, I wasn't there. I got back home and I'm also not there and I'm like there is something terribly wrong with this. And he said that if you don't focus I'm really paraphrasing here If you don't focus, if you're not diligent, if you're not a good steward of your hard time, which is when you're at work, then you're going to have to give up your soft time, which is your lifetime when you're at home. Now I'm going to tell you the solution. I'll tell you what I did, but I'm going to break it down in a way that you can get it, because it's again, it's a way of thinking.

Speaker 1:

So for me, I had to start asking myself the question, and you know I'm a big fan of asking better questions. The question then became how can I do all my work at work so that when I come home I can be at home. And usually the answer to that is you can't, because there's so many patients, you can't finish all your notes. Blah, blah, blah, da, da, da, da. Okay, but the truth of the matter is, when there's a will, there's a way, okay.

Speaker 1:

So for me, my solution then became I would get to the office and, as I saw the patients, I would chart, and I had an hour for lunch and I would use 30 minutes of that hour and 30 minutes of that hour and if there are any outstanding notes, any administrative stuff I needed to do, whatever, I would do it in that time. I would document as I went, document as I went, and the goal would be when I'm done, I'm done, and if, for any reason, I'm not done, my office opens at 9.30. That's a conversation for a very different day. I would rather go into the office 30 minutes earlier and finish thin than chart at home, and that became the end of me charting at home. I think after that I probably charted at home three or four times. I would not chart at home. And when doctors would come work with me, I'm like let me show you how not to chart at home. In fact, they would fight me for access to the EHR, like for remote access, so they can chart at home. I'm like guy, it's better for you to learn how to not need the access. They're asking me for the access, right, and to be fair, you may say but, dr Una, I need time for whatever. Fine, you may say I need an extra hour after work to finish everything I'm doing, that I'm going home, that's fine. But you've made the decision. You've made the decision that this is when I'm going to end my workday and this is when I'm going to start my lifetime. Whatever that is, then just don't allow the work time to bleed into the lifetime. It's not about stopping at five, it's about stopping when you determined you're going to stop Now.

Speaker 1:

Another way this shows up, especially for my cash pay people, is when they start their business. They say call me anytime. I'm like what do you mean? Call me anytime? You don't want people to call you anytime. What are you talking about? Right, call me anytime. So people are calling them for non-urgent things, you know, late at night and all these things, and they feel obliged that they have to do all this stuff and so they're working all the time, all the time.

Speaker 1:

So when you do that, you're not giving yourself time to be separate from your business. You're not giving yourself time to lean into family and truly be present. You're not giving yourself time to be on vacation it's truly a vacation. You're not giving yourself the time, the space to do any of that. You start feeling like you're handcuffed to your business. That's the way it will start feeling and I don't want that for you. That's what makes people throw away their businesses.

Speaker 1:

Same thing with a coach, and people may tell you the only time I'm available to be coached is at night. Now, in the beginning, you may be available at night and maybe that's what you want to do, but hello, you got to choose. If it's not working for you, it's not working Right, okay. So what is the solution to this? It's boundaries, it's boundaries, it's boundaries. Tell people when you're available for what and hold to it for you.

Speaker 1:

Okay, entremdcom, forward slash movement, you need to be in it because this is where we focus on the three things that will make any practice profitable. We focus on filling your schedule, helping you get paid for the work you do and building a profitable team. Okay, so three major things, major, major. But anyway, the meeting we have every week is at 12 noon and people are like why isn't it in the evening? Because I'm like, because I want you to be trained to do your work at work. I don't want you coming to learn about your business in the evening, I don't want you to do that, I want you to do it in the middle of the day. It's a discipline, it's a new way of thinking, right?

Speaker 1:

Okay, so when we talk about efficiency, so in this time block, how do I use this time block For you? That may mean you leverage a scribe For you, that may mean you leverage your team and you're really only doing what you do, what you can do, and the other stuff your team is taking care of it. So you can get more done in less time. Right, you want to start thinking efficiency. How can I do this in less time? How can I do this in less time? How can I do this in less time, so that my work time is my work time and I'm able to spend my lifetime doing life stuff? Right, and yes, of course there'll be the exception to the rule someday when this happened, but it should be the exception. It should not be happening often and it should not be routine.

Speaker 1:

So I want you to think about your practice, your business, your coaching business, whatever that is right when you're not the only revenue generator. Multiple people have generated revenue. For most people, this feels like huh, I can breathe, right, because now you're not the only person doing it, and that's what we teach you. Like in the profitable private practice movement is building a profitable team, like building a team that is generating revenue with you, okay. So imagine a team where you're not the only revenue generator. You have multiple revenue generators, so if you decide to stop and breathe, the business did not stop. Imagine where you have multiple problem solvers, where 80%, 90%, 100% of your team members are problem solvers, so you don't have to bear the weight of troubleshooting everything. And then where you work hard when you're at work and you're life hard when you're at life. You know what I mean. Like you get to do all that.

Speaker 1:

Think about how more your practice, your business, will be more peaceful. Your business most likely will be more profitable because you have more revenue generators and you have more problem solvers. Okay, you'll be able to disconnect, which most entrepreneurs cannot disconnect from their. Okay, you'll be able to disconnect which most entrepreneurs cannot disconnect from their businesses. You'll be able to disconnect from your businesses your business to recharge and all of that stuff. Just imagine what that will be like. That is fantastic and it can be yours. It can be yours. I've done this with multiple companies. It can be yours, okay.

Speaker 1:

So I want to invite you to do an audit. Who are the revenue generators, or am I the only revenue generator? Who are the problem solvers, or am I the only problem solver? Like, do I have any boundaries? Do I have a work time or am I always working Right? I want you to do that and I want you to make the necessary changes and I want you to start that journey, okay, of building a practice, of building a business that can work without you. Where you own the business the business doesn't own you. Where you don't create burnout, where you don't create a toxic work environment, because you deserve it. Okay. So I'm rooting for you. Go implement these. I can't wait to hear what you do in your business with these principles. Rooting for you always. See you on the next episode.