Every Stage of Growing a Medical Practice Explained

Want to scale your health practice and get your life back? Work with me 1-on-1 in our private advisory and mastermind - https://go.healthpreneurtraining.com/hp-mastery?el=yt-june21

Most health practice owners eventually hit the same wall. The business is growing, revenue is up, and patients or clients are getting results, but too much still depends on you. The next level isn't about doing more. It's about building something bigger than yourself. A business that scales without relying on you for everything.

That's why we created Healthpreneur Mastery.

Mastery is the private advisory board and mastermind for leading health professionals doing at least $500,000 per year who want to build a business that creates greater profit, freedom, and impact.

This isn't for beginners.

It's for practitioners, practice owners, and health entrepreneurs who know they're capable of building something much bigger and don't want to figure it all out alone.

Learn more about Healthpreneur Mastery here: https://go.healthpreneurtraining.com/hp-mastery?el=yt-june21

Your health practice is generating millions but your margins keep shrinking, your cost to acquire a patient keeps climbing, and ads do not work the way they used to. 

There is a specific reason this is happening, and it is not the one most practitioners think.

In this episode, I walk through a real $4 million practice case study where revenue is strong but cost per consult, cost to acquire a client, and shrinking ad efficiency are quietly eating into profit. 

I break down exactly how to diagnose where the leaks are in your funnel, why simply increasing ad spend makes the problem worse, and what creative mix and campaign structure actually mean for your Meta ads performance. 

🕰️CHAPTERS

0:00 The $4 Million Practice With Shrinking Margins
1:30 Breaking Down the Numbers: Cost Per Consult, CAC, and LTV
4:00 Why Rising Ad Costs Are a Permanent Trend, Not a Temporary Problem
6:00 Creative Mix vs Campaign Structure: What Actually Moves the Needle on Meta Ads
9:00 Why Ad Visibility Does Not Equal Trust
11:30 How Long-Form Content Builds the Trust That Lowers Your CAC
4:00 Why YouTube Content Outperforms Ads for High-Ticket Conversion
16:30 Turning Your Sales Team Into Order Takers With Time on Brand
18:30 The Long-Term Fix for Rising Acquisition Costs in Your Practice

Subscribe for weekly strategies on growing your health coaching or practice-based business: https://youtube.com/@Healthpreneur

🔗 RESOURCES AND LINKS
Website: https://healthpreneurgroup.com
Podcast: The Healthpreneur Show with Yuri Elkaim
Healthpreneur Website: https://healthpreneurgroup.com

❓COMMON QUESTIONS 

Why is my cost to acquire a patient increasing even though my practice is profitable?

Rising acquisition costs are largely driven by a lack of creative diversity in your ad accounts, which causes ad fatigue and pushes costs up over time. This is a permanent market trend rather than a temporary issue, since advertising costs almost always trend upward similar to real estate and other commodities, which means the long-term fix is improving conversion and lifetime value rather than chasing cheaper leads.

What should I fix first if my Meta ads are getting more expensive?

Creative mix and messaging diversity account for roughly 80 percent of the improvement available in a Meta ad account, while campaign structure accounts for only about 20 percent. You should focus on testing more diverse creative angles and hooks before increasing ad spend, because spending more money into an inefficient account will only make the underlying cost problem worse.

How does long-form content lower the cost to acquire a client in a health practice?

 Long-form content builds trust through time on brand, which is the bridge between getting attention and generating business. When prospects consume hours of your content before booking a consult, they arrive pre-sold and pre-qualified, which dramatically increases close rates and turns your sales team into order takers rather than people who have to convince someone from scratch.

ABOUT

I am Yuri Elkaim, founder of HealthPreneur. For over 20 years I have helped health coaches, practitioners, and wellness experts build seven and eight figure businesses online. This channel shares the exact strategies, funnels, and frameworks we use with our clients every day. New videos drop weekly.

#PracticeGrowth #CostToAcquireAClient #HealthPracticeMarketing #ContentMarketing #ScaleYourPractice

Transcript

SPEAKER_00 0:00

Most doctors and practitioners think that growing a practice is simply about getting more patients, but it couldn't be further from the truth because the reality is, you know, a practice doing 500,000 a year or 10 million a year are completely different animals. They require different people, different systems, and a different version of you in order to get to those different levels. Hey, welcome to the Healthpreneur Show. I'm Yuri El Kame, CEO and founder of Healthpreneur. You are listening to this because you are a health professional or coach who is committed and driven to growing a successful virtual practice or coaching business online. In these episodes, I'm going to give you the best of the best when it comes to marketing, sales, mindset, business growth in general to help you achieve those goals. So without any further ado, let's dive right in. Today I'm going to share with you the five stages of growth that every health practice goes through. No matter where you are, whether it's zero all the way up to 10 million plus, I'm going to show you exactly the five stages and who you need to become in the process to reach the next level. I'm sharing this from over 20 years of experience helping thousands of practitioners generate more than $217 million in their practices. So let's dive right in. So on the iPad, if you're got a cool visual that we've mapped out to show you these five levels, I'm going to take you through them one by one. Specifically in each level, look at the challenges, what you need to focus on, and the core question to ask yourself to get to the next level. So let's start off with the first level, which is right here, which is essentially zero to $100,000 in revenue. At this level, we'll call this level the practitioner. This is really where nobody knows who you are. You have no proof. I mean, maybe you came out of school a little more recently, uh, you don't have the reputation yet. So at this point, like you're really just doing everything, wearing all the hats, trying to get things going. Okay. So the focus at this stage here, as you can see, is getting patients and getting proof of concept, which means getting results for those patients. Over time, that body of work and that proof will compound and make things a little bit easier in terms of new patient acquisition. So for you, it really is about how do we get more patients? How do we obviously get proof of the concept of the work, getting results? That in turn builds your confidence, it builds more proof. And to be honest, at this stage, nothing else matters. Okay, so it's get patients, help patients, just rinse and repeat, rinse and repeat, rinse and repeat. Okay, don't worry about the business model, who cares about the systems? Just get people in, get them to pay you money, help them transform their life, rinse and repeat. And this will take you up to about $100,000 in revenue, maybe a little bit more, give or take. Okay, so a couple of mistakes at this stage that you have to be very, very aware of. And I'm sharing this with you because I have had conversations with practitioners who have stayed at this stage for like a decade. So here are the mistakes that I see so many practitioners make that I want you to avoid. So number one is building fancy websites. No one is looking at your website, no one cares about your website. So do not waste time with nonsense that doesn't matter. Who gives a shit about the business cards, the fancy websites? None of that stuff matters. Second thing is hiring too early. At this stage, you have to do everything yourself. Okay. You're gonna take the phone calls, you're gonna welcome people in. You don't have the luxury, unless you have a briefcase of cash sitting by your side, to hire a team because if you do, you have no margins and then you're just working too hard and you have nothing to take home. Third is putting the cart before the horse. At this stage, the only thing that matters, as we talked about, is generate patience, get them results, which essentially means make money and deliver on that. So don't spend time overcomplicating ops. Don't worry about the systems and the operations at this level. All that stuff will come in time, but for now it's too early to worry about that stuff. And then another big mistake is spending months on branding. Oh, I'm gonna hire this expensive agency to work on my branding, my color scheme, so that we have a beautiful website. No one gives a shit about your website. Okay, set it on fire. You don't need a website, you simply need a good offer that people will come into and then you transform their life. That's it. Okay, the website, sure over time, but trust me, no one sees it and no one cares. So at this stage, some of those mistakes you got to avoid, or most of those mistakes you have to avoid with respect to a layer of your ego that needs to be shed. So part of the growth of business is understanding, as you can see down here, what got you here won't get you there. So when I talk about practitioners being stuck at this stage for a very long time, it's because at any level of business, you have to become a new version of yourself. It's like a like a snake or a reptile shedding skin. You have to be able to shed a layer of yourself that no longer supports your growth. And it's gonna be the same with the people you employ over time. Some people are not gonna be able to grow with you, which is why not everyone's gonna be the right fit as you grow your company. But here for you, what you need to shed at this point is the tendency or the need or the belief that you have to be perfect. Nothing's gonna be perfect when you grow your business. It has to get going. Okay, it's more important that you get it going than getting it perfect. Are people gonna judge you? Of course, they're gonna judge you either way. But please understand you don't need to know what the whole bridge is gonna look like. You just have to build the first couple blocks. Your ability to relinquish perfectionism is one of the most important pieces at this stage of the business. Because if you don't, you are going to drive yourself crazy, going in circles, trying to make everything perfect, which simply doesn't exist. So at this stage, like the motto, if you're to tattoo anything on your arm, is speed beats sophistication, progress, not perfection. The core question you want to be asking yourself is only this. This is like just write this down. How do I get patients? That's it. You're good enough to help them, right? Like you don't need more certifications, you don't need to do weekend courses and advanced degrees. All of that stuff is playing it safe and hiding behind the fear of people thinking you're not good enough. But you are. You are. You spent half your life in school probably at this point. You have the protocols and the knowledge to help people, okay? Stop trying to get even better with more certifications. At this stage of the game, it makes zero difference and it's only going to prolong your growth in terms of revenue and your practice. Now, we all go through that, but we don't have to stay there because if we move to the next level, which is level two, this level is called the builder right here. So, here, if step one or level one was all about getting patients and obviously delivering results, now this level is all about building the systems to then replicate that at scale. So here we move from 100,000 a year to a million dollars in revenue. And again, there's obviously like, you know, a little bit of give and take, the numbers that are not exact, but at this level, you're you're building something, right? You're not just working with patients all the time. And so here, the bottle, like the challenge becomes that you become the bottleneck, right? So you're the doctor, you're the salesperson, you're the front desk, you're the admin, you're the marketer, you do everything. And so what happens is even though your revenue grows, your freedom disappears. And this is a really hard part about business. Like, so I actually think this stage or the two first stages combined are the hardest in business. I call it the zero to one. It's like zero to one, one being let's call it a hundred thousand or a million, whatever you want. Like either one, the first level or this level were combined. This is where most people get stuck because what happens here is you're growing through pain. And that pain is I'm having to, I feel like I have to work harder and I'm losing my freedom. I'm not seeing my kids, I'm working 20 hours a day, I'm thinking about work all the time. And so the goal here is that even though revenue is growing and maybe your profitability is growing as well, you have no time to enjoy that. So here the focus really becomes about building predictable systems. Okay, because if you become the bottleneck in this stage because you do everything, then we have to start to replicate you. We have to start to clone you. And that's how we do things, or we do that by building out the right systems. Okay. So we're looking at repeatable, predictable systems around patient acquisition. So in level one, you figured out how to get patients, most likely. You're still figuring that out in this stage, but now you probably have a bit more of a replicatable system. Like in our business, if you followed my work, you know, one of our acquisition systems is called the perfect client pipeline, right? That's dialed in. It's exactly what we need. Like we like literally to the letter know exactly step by step what that's gonna look like. There's no reinventing the wheel, none of that stuff. So here you have to figure out what that's gonna be for you, right? Maybe it's is is it someone coming in for a free assessment, a paid assessment? Is it a phone consult? Are we driving ads to a landing page? Like there's gonna be there's a lot of different ways you can get people in, but we have to systemize that and there needs to be data to support that. One thing I'll say here is that if you're relying solely on referrals, you don't have a business, right? Referrals in word of mouth are amazing, and congratulations if you're getting a lot of that. However, you have no control over that. And when I talk about building systems, build a predictable patient acquisition system. So, here, we need to build systems, we need to document what's working, and we need to create repeatable processes. We have to really start to extract what is it that we're doing so that eventually other people can start to do some of that for you so that you remove yourself as the bottleneck in your business. So, a couple mistakes at this level. One is that thinking hard worked as a strategy. It's not, right? Like you're gonna work hard at this level no matter what. It's about thinking smarter. Two, obviously, we talked about like thinking referrals or a business model, they're not doing everything yourself, right? Which is gonna be the tendency early on in the stage, right? So let's say you're between 100 and 250,000 a year, right? At that level, you're gonna be doing a lot of the stuff yourself. Again, it's still a little bit early to hire other people, but even before you hire someone, start to think about what are the things that I'm doing over and over again, and how do I start to document this? For instance, another mistake is hiring assistants or office managers too early before systems have been built. So let's say that you've never done uh, or let's say in level one, you've done a bunch of consults, right? People come to the into the clinic or you do them over the call over phone, over the phone resume, and you know that you can move those prospects into paying patients. Great. Well, here you have to document exactly what you're saying and exactly what that framework looks like. Because if you expect an office manager to come into the clinic and then sell as well as you have with no roadmap to follow, you're going to burn money faster than you can possibly imagine. Anytime you hire someone, you have to give them a roadmap, a system, an SOP, some type of documented procedure for how to do the thing, especially in the way you do things. So a lot of this level one and level two feels like a lot of work because you're doing everything, which is fine. But please understand there's a light at the end of the tunnel. But you have to start to document how you're doing things. So either you're typing this out in the Google Doc or you're creating a Loom video if you're on your computer and you're showing something of how to do the thing you do. Because from that Loom video, then you can have something like Claude AI Chat GPT. It will then take that Loom video and turn it into a step-by-step SOP. So when you hire an assistant or someone to do some of the back end admin, you now have a very structured procedure that you did once or a couple of times and recorded it. AI built out the SOP, and now you can give it to someone else. But if you don't have that, you can't create freedom. Systems, right, or a system, if we think of the acronym, saves you serious time, energy, and money. Okay. Without systems, you have no freedom. With systems, you have freedom. So at this stage, the belief that we have to shed, the later that we have to get rid of, is the belief that nobody can do it as well as you. This is why most people get stuck right at this level. And think about this in any aspect of your life. Nobody can wash my clothing as well as I can. Nobody can clean my house as well as I can. Nobody can make food as well as I can. Nobody can help my patients as well as I can. Nobody can clean my car as well as I can. Nobody can cut my lawn as well as I can, et cetera, et cetera, et cetera. Sometimes the biggest unlocks in your business have nothing to do with your business. So in order for you to graduate from level two to the next level, patients need to move through your practice and start getting results without your endure without your direct involvement in every step. We've worked with thousands of practitioners over the years, and one of the things that we help them do is build more leverage results. So instead of everything being one-on-one, and the only way your patients get a result is by speaking with you. What are ways that you can create systems on the delivery side where they can make progress even when they're not with you? We call this a dream come true system. It's a little bit different if you're a dentist or a surgeon where you're like actually doing the work, but there are still ways to create leverage in your delivery without you being there for every single thing. So the question here is how do I work less without hurting growth? And part of that means without hurting patient results. Okay. So the question I want you to write down is how do I work less without hurting growth or patient results? Now you don't necessarily know the answer to that question right now. That's fine, but it's a question for you to think about. Better questions lead to better results. And as you move through level two, now things start to get really fun and also really challenging in business. So once we've unlocked level two and we've moved and we've kind of shed that skin of I don't need to be the center of attention, I don't need to do everything myself. Then and only then are we able to potentially get into level three. And level three is right here, which is one to three million in revenue. And this is about moving from being the builder into becoming the leader. Now, this is a really, really hard part about like a really tricky. I mean, I'm gonna say this for every all these levels, okay? Like every level feels challenging because it's a new level, new level, new devil. Okay. And why it's challenging as the owner or the CEO or the founder of your business is because you have to become a new version of yourself to get to the next level. Remember, what got you here won't get you there. What got you out of Egypt won't get you to the promised land. So you might be the best practitioner on the planet, but if you're not a good leader, your business doesn't grow beyond a million dollars. Period. End of story, full stop. There's no that's a non-negotiable. So here, the challenge is really about managing people and team performance. And you'll notice that it has nothing to do with you and your ability to help patients. Okay, now we have an identity crisis. Who am I? Am I a practitioner? Am I a technician, or am I actually building a business beyond me? And I'm not here to tell you you have to build a $10 million or $30 million or $50 million practice. Maybe you're happy just doing patient work forever. But I'm also going to show you, if that's what you want to do, I'm going to show you how you can do more of that as your business scales with less of the other stuff you don't want to do. So stick with me, we'll get to that. Um, by the way, if you like this kind of stuff and you're in a position right now where maybe you're between level two and level three or you know, somewhere in this neck of the woods, and you want my team and I to really help you in a much more advisory type of role to help you scale your practice, then you might be interested in our healthpreneur mastery. It's a high-level private advisory and exclusive mastermind for ambitious health professionals. And we work very closely with you to help you move through these different levels so you can scale your practice without killing yourself in the process. If you want to learn more about that and see if you qualify, there's a link in the description. You can check it out. But, anyways, as we're talking to level three here, a couple challenges. Number one, your business outgrows your ability to manage it andor people. Your team gets larger, and the team at this point might be two people, three, five people, it's somewhere in the neck of the woods. Communication starts to break down. Um, mistakes are going to increase because when other people do stuff, mistakes are gonna happen, right? We all make mistakes, even if we're doing this stuff. So you, as a practitioner, as the leader of your business, end up spending more time here managing and leading other people, sometimes and actually seeing your patients. It doesn't always have to be like that, but you're spending more of your time, not just dealing with patients, but also dealing with team. And this is where many practitioners, many entrepreneurs, they run into this one to three million mark and they're like, honestly, I don't, I don't want to do this. I'm gonna start a new business. They love the zero to one, they love the hustle, they love the energy behind it. But as soon as they have to start building a team and become a leader, they call themselves a serial entrepreneur. So instead of moving through this and growing into the next level, they start back at zero with something brand new. This is um, there's nothing wrong with that, right? But I've noticed this in a lot of friends and a lot of colleagues I've seen, like they get to this like two, three million mark and they're like, honestly, I'm not cut out for this. And they go back to zero, start something new, and then they deal with the same challenges in that other business once they hit the same level, right? So it doesn't matter if you're starting a new business, you're trying to scale this practice, open up a new location or anything. If you're not willing to build the skill set and the character traits to move through this level, you're gonna hit the same roadblock, the same ceiling in the next thing you do. So here, the focus is on hiring, it's on leadership, it's on culture, and it's on management systems. This has nothing to do with patient care. In level two, we talked about starting to build systems. Level three is about building people, hiring team, and maybe a core leadership team. Maybe it's one or two people in the leadership, might be a COO. It doesn't have to be called that. Maybe a director of operations, office manager who runs the show behind the scenes, whatever it is. But you need a couple key people to free you from getting into the minutiae. And at this level, there are certain things you're gonna be very aware of that you don't like doing and things that you do like doing. So, as an example, maybe you don't enjoy doing sales, maybe you don't enjoy doing admin charting, which I'm assuming you don't like doing anyways, all that stuff has to start getting off your plate. If you're like me and probably most of the practitioners we've worked with, you probably just want to teach and share your message. Amazing. So marketing stays on your plate, but it doesn't necessarily mean that you have to be the one who is pressing upload on YouTube or upload on your phone or on Instagram, right? You might have support around that. So, again, people are very important at this stage, right? So we talk about in the first level is patient care, level two is systems. Here it's team. The bigger the dream, the better the team. It doesn't have to be a big team, but it needs to be a better team. So let me talk about some of the mistakes here. And I've made all these mistakes, just so you're aware. Okay, I've been building businesses in the health space for the past two decades. I've made all these mistakes. Number one is hiring friends. Oh man, I've got this girl who's helping me out with my social media. Like, I don't ever want to hear that. Oh, I like my friend's sister's daughter is helping us out with our Instagram. Oh shit, like please no. If you hire shitty, cheap people, that's exactly what you're gonna get. In life, you get exactly what you pay for. The only thing, the only time I've not seen that to be the case is wine. I don't drink a lot of it, but like I've also had $900 bottles of wine, and many of them are not much better than $20 bottles. Outside of that, you get exactly what you pay for. So hiring friends, family, uh just anyone who's at an arm's length, hiring or keeping C players, like these are the people you're like, oh my god, there's no way. But you know, like you know they're gonna be, they're gone, right? But you keep them around because you're like, shit, if I get rid of them, I have to do this stuff again. Those are C players are known as cancers. C players are known as cancers. They're not good enough to do the role, but you keep them around. And not that they necessarily spread cancer to the team, unless they have a really bad attitude, but they erode the standards for you and your business. And that's the biggest problem is if you keep these people around, their standards are so low, and you know this, but you're holding on to them because you don't want to step back into doing the work. Get rid of them. The sooner the better. Hire slow, fire fast. When you know, you know. And I'll tell you this: having hired hundreds of people over the years, they're not gonna get that much better. On day one, or even in the hiring process, if they're not superstars, I'm not holding my breath. Okay, unless you're willing to work with someone and cultivate them and and grow with them for years, you're not gonna get someone who comes in on day one. And uh, if they don't blow you away, they're not, it's not, it's not gonna be much, much better. We hired a director of marketing a while ago, spent six weeks in the hiring process, recruiting firm, the whole bit, hiring the whole, like the whole crazy process we go through. Hired him the first day on the job. I fired him. Unfortunately, in business, it's not like sports, like you can't review game tape. The game tape is when they're in the role a lot of times, as much as you do in the hiring process. So if he was in the role, I saw some stuff immediately. I'm like, dude, at this level, there's no fucking way you can make this like no way. If you don't understand this, there's I'm not I'm not spending my time. Multiple six-figure salary gone, day one, finished. I don't have time for this shit. Okay, I don't know if you do, but I don't. That's the big thing. And then the biggest mistake I can personally attest to on this one is avoiding hard conversations. Everything you want is on the other side of a couple hard conversations. And in my previous business, I kept someone in our team. I actually probably kept a couple of people on our team for two plus years because I knew in my mind, I'm like, there's no way, but I was avoiding hurting their feelings. I'm like, it wasn't hurting their feelings, it was actually doing them a service. If I pulled them, it wasn't a good fit. They could find a better fit somewhere else. The big mistakes here, you have to become a better people person. You have to become a better leader of people and manager of people. And that's not always easy to do. I can definitely attest to that. So, what we have to shed at this level is the need to be the hero. It's not about you anymore, it's about the team. The best teams are built around the right system, the right infrastructure, the right culture, not any individual person. So, graduation requirements to go from level three to level four, which we'll get to in just a second. You need strong management that begins to form. And the practice continues to grow even when you're not present. So if you take a week trip with your family, like it's not like hell breaks loose. It's not that shit falls through the cracks. Like the practice runs smoothly and it can still grow without you being there. If we can't do that, then we can't get at a level three and we stay stuck there. So the core question you want to ask yourself at this stage is. Is how do I scale beyond myself? Write that down. How do I scale beyond myself? And that you don't have to have the answer for that now, but I want you to write these questions down and think through them on a regular basis, if this is where you are. Okay? So that's level three. Quick little break in the show for you. Are you in our Healthpreneur Hub Facebook group? If not, I want to hook you up. I share some amazing resources in there, including free reports, videos, trainings, obviously more connection to me. And we have thousands of other health professionals and coaches who are in that group actively seeking to grow their business online. If you'd like to join us, let me hook you up with a link. It's healthpreneurgroup.com forward slash hub. That's forward slash H U B. Once again, that's healthpreneur group.com forward slash hub. Go there now, join the group. And when you're in there, just drop me a little note to welcome yourself, let us know what you're up to. And I look forward to seeing you inside, connecting with you a little bit more personally. And once again, that's healthpreneur group.com forward slash hub. Now let's get back to the show. And level three is a tricky spot, but if you really want to start to unlock major profit and major net free cash flow coming into your world and really start to dominate your space, then we want to move into level four and above. And this is really where you move from being the leader into becoming the owner. And the owner, what I mean by this is the owner of an asset. Like if you own a home, you own the home, right? The home is working for you. And just by being there and existing over time, it grows in value. The same thing happens here with your practice. You are the owner of the practice. You invested in it in some way, shape, or form, monetarily in your time to build it up to where it is now. And now you want, at this stage, we're talking revenue of three to 10 million dollars. And eBay or profit depends on your practice, is going to be half a million to maybe a million at this point or more, depending on what the top line revenue is. But here it's like we're moving out of practitioner mode every level. And now it's about leading and building better teams. How do we lead and build better people? So we move from team in level three and level four is really about leadership. So a couple of the challenges here is this. So one is you don't have a people problem anymore. So let's say level three was a little bit more like maybe you, one or two other people that are a little bit higher up, and then you have a bunch of task rabbits, right? Maybe they all come back to you for like approval and you know the final say. That's okay to start. But here the problem becomes you have a leadership problem in terms of finding and developing and retaining good leaders who can run the show without your presence. And they're, you know, like you have to find very exceptional people here, or they've grown with you in the practice to the point where they can run the show. So I mean, I really, really hope that you can, I mean, you can find these people. And in our business, we have a few. And I'm very like, I can't even express how grateful I am for them because these are the types of people where it's it's like you hand them something or a project or an outcome, and the thinking is like, they got it. I don't have to check in, I don't have to like they, it's like the mentality is like, I got it, or they got it. And when you have those people, it gives you a tremendous ability to step back and relax because you're not having to micromanage. You trust them implicitly, and that's what I'm talking about. Leaders here. Also, bear in mind, as your business grows, as you stay in business for a long time, you'll go through periods of peaks and troughs. Think of COVID, right? I mean, I'd love to know from you. I mean, if you had a practice during COVID, I'm sure there was a lot of freaking out that happened. And what you want to have on your team, specifically on the leadership front, are leaders are wartime generals. They're not peacetime generals. Everyone will be happy and stick around when things are good and things are growing. But what happens when shit hits the fan? What happens when you can't open the doors? What happens when your revenue drops in half? The leaders you want around you are those who are willing to stick with you at the dip, not just those who are willing to stay at the top. And it's a really good test of your vision, your character, you as a leader, for the right people to stay with you through thick and thin. And so this is where the three to 10 million mark really becomes interesting is if you can get a few of those really amazing leaders in your team, everything starts to really take off. One great office manager is not gonna cut it at this level. So the focus in level four here, really about owning an asset, which is your practice, is building leaders. It's creating operational rhythms, and it doesn't have to be you who runs the whole show, right? They're gonna have their own departments. Um, they may develop middle management, so managers underneath them, depending on the size of the practice or if you have multiple locations, and obviously establishing accountability. A couple of mistakes I see at this level, and again, that I personally made, is promoting people without leadership skills. Now, this is one of the hardest pills for a lot of people to swallow. Just because you've had someone with you for a long time doesn't mean they should move into leadership. And just because someone outside has come from a leadership position doesn't mean they should be a leader in your company. I've done both. Um, I we've brought in very high-level leaders from recruiters outside coming in and very seldomly have those worked out in the long term. And I think for us, what we've recognized is there's a really important component to culture here. And there needs to be a very strong congruency in terms of like their experience, specifically in your field. So, like if you run a dental practice and you bring in a CEO who used to work at Coca-Cola, well, what the hell is that all about, right? It's so important to have as much of a match as possible. Same industry, same type of clientele, same type of business model is always gonna be better than something very different, even if they have the experience. So the flip side is well, do you develop? I call them stars and seeds. So the stars would be like the examples I gave you. They come in batteries included, you just plug them in, hope for the best. Seeds are like maybe they're entry level. Maybe they started with you back in level two and they've just grown over time. Maybe they're two, three years with you now, and they're starting to show leadership capabilities. And it's like, man, we can maybe ascend those people into those roles. At the same time, there could also be people with you from back in the day that have also been with you for two to three years, but they they simply don't have what it takes to step into leadership. We've had people in our own company who have been with us for three, four, five years. And we brought outside people in to lead those departments because those specific people just hadn't demonstrated that they can step into a leadership role. Nothing wrong with them. It just we knew that it didn't make sense. So sometimes you can grow within a role. You don't have to grow up a role. And we've also had other people who've been in a role for a few months and instantaneously we started to notice that they were making incredible suggestions, solving problems, taking initiative, and demonstrating leadership skills. And in those cases, those people moved from like just getting started, having the skill set, to leadership roles within a couple months. So being a great worker, manager, whatever doesn't make you a great leader, right? In sales, you could be an amazing closer, but doesn't mean you're gonna be a good sales manager, and vice versa. Uh so a mistake is like again promoting people into leadership that don't have the skills. Two is making every major decision yourself. You want to delegate decisions and empower your team to make decisions. Hey, that's a great question. What do you think we should do here? As opposed to saying, here's what we should do. There's a moment in time for you to just like, this is what we're doing, but there's sort of, you know, like it's very helpful if you have guiding principles and decision-making criteria. So other people on your team can make decisions on their own and really empower themselves to learn in that process. And also another mistake is staying involved in daily operations. So here, what one thing I want to mention. So here you typically have the opportunity of three to 10 to start to like you're gonna start to step back a bit. And in level two, we talked about how your revenue grows, but you have no freedom. Level four is where you start to buy back a lot of that freedom. You're trading profit though. Okay. So on $10 million top line, let's say your profitability is 20%, which is still pretty shit, but let's just say it is. So you're making two million net. And let's just say that that's like after tax. 2 million net, 20% net profit. You've got $2 million in the bank. That's pretty, that's pretty solid. But in level two, let's say on a million, you had 80% margins. Okay, cool. 80% is better than 20%, right? Not really, because you can't pay with percentage. 80% of a million is $800,000. That's not a chump change, but you have no freedom. I'd rather take 20% of 10 million and have all the time in my life and 2 million cash in the bank. So what happens is as you grow, your revenue obviously grows. Profitability, if you're following this process the right way, generally goes down to a point. Now, you should not be dropping it to single digit profits. Like this, just be clear about that. But generally, as you scale, profit percentage goes down, but dollars in bank goes up. Because remember, 20% of 10 million is 2 million, 80% of a million is 800,000. That's two and a half times more profit, dollars in the bank, even though percentage is lower. So please keep this in mind. It's not about percentages, it's about actual dollars at the end of the day. What we have to shed at this level is control. This is one of the hardest things as a founder, CEO, head honcho to do. You have a spectrum. On one side is control and the other side is freedom. You cannot have both. It's a matter of how where you want to be on the spectrum. So if you want a lot of control, you're not gonna have a lot of freedom. If you're involved in every single thing, you're gonna feel like you can never switch off. If you have a lot of freedom, trust me, you have no control. And you have to have good infrastructure in place in order and the right people to have those decisions and operations run smoothly so that if you step away, things don't fall through the cracks or fall apart. Again, the key is being able to move your business in a direction where you do more of the things you want to do. Okay. So the graduation requirement to move from level four, so we're three to ten million up to the next level if we want, is this the business constantly grows through other people. You could literally have taken a sabbatical. I should did this a number of years ago. Uh, before I sold my other company, I took a three uh two-month sabbatical in the summer. I I was, I could not talk to anyone in our company. And it was a major stress test on the business. And I came back and everyone was like, honestly, man, it was better without you. And I'm like, perfect, let's sell this sucker. So you want to be able to grow your business through other people. You're not the special snowflake as as much as we think we are. Okay. So the core question here at this level, in order to move to the next level, is how do I get my team to win without me? How do I get my team to win without me? Again, just sit in your lawn chair, look at the sky, think about these questions. If this is where you are, and maybe there's an aspect of your business that takes up a lot of your time and energy, how do I get my team to win without me? If it's marketing, if it's sales, if it's patient care, whatever. In that specific area, how do you help them win without you? What do you have to do to train them, give them support, systems, procedures, clarity, ownership, and then give it to them and then let them do it. Cool? That's level four. Now, this is where the fun, well, I mean, it never ends and it never begins. It's all the same. So, level five, we move up here, and this is revenue-wise of 10 million plus. Again, these numbers are not exact, right? It might be 11 million, it might be 9 million, whatever, but you get the idea. So here we move from owner to industry leader. So, this is the point where you're no longer building a practice, you're building an institution. And I and I use the word institution very lightly. I'm not talking about like some conglomerate. I'm talking about an institution that leaves a legacy. Like it's just like everyone knows your brand, everyone knows you and the work you do in the field. This extends beyond the four-wall clinic. Like, this is where you start to become like a leader in your field. I want to be clear about something. You can also be a leader in your field simply by being way more visible and putting out a lot of content for a long time. There are many people who do that who do not run a $10 million plus practice. I know a lot of them, I've worked with many of them. And at the same time, I've also worked with people who make way more than $10 million who are not super visible and famous. So I'm not saying this is about becoming the nice Huberman. I'm saying in your niche, you just own the space. If you're the person for dental veneers, if you're the person for tummy tucks, if you're the person for hypothyroidism, whatever it is. Like in your space, you become the authority, the leader. Now, if you pair that with brands in terms of adding value and content at scale, that's when a lot of opportunities start to really fall into your lap because now you have the money and the time to do more speaking gigs, to write books, to do the big stuff. And that's where a lot of practitioners get excited. I use this example quite a bit of Dr. Oz. So Dr. Oz started off as a doctor, and then he specialized in cardiac surgery, right? And then he did that for a long time. And then he was invited onto the Oprah Winfrey show here and there. I mean, he became like the resident doctor of the show, and then he had his own show. And now he's like literally in politics and reforming healthcare or whatever he's doing. So nobody knew who Dr. Oz was. And he was in the trenches as a practitioner, he was doing his thing, building his skills, etc. And then he had a bigger ambition. So it's not to say you have to have your own TV show, but that's what the trajectory looks like in this context. Okay. If you want to do some of the bigger stuff from a sharing message perspective, that's totally cool. And maybe you don't. Maybe you just want to make bank. Maybe you just want to grow a lot of like locations and grow a huge practice and just completely stay anonymous. Totally fine, right? Either one can work, both can work together. I just want to give you a bit of that context. Focus at this level, again, it's going to be leadership, higher level. It's going to be vision, it's going to be strategy for you specifically. Um, capital allocation, resource allocation. Do we open up another location? Do we double down on this? Do we like heavily invest more in marketing or branding or other things? Et cetera. Okay. Your job as a leader is always gonna be to maintain the standards and also look at where do we allocate resources. That's always gonna be important for your specific role. A couple mistakes at this level. So solving operational problems is you're getting sucked back into grading graphics on Canva. It's probably the lowest example I can probably share, right? So you're doing like 10, 12, 15, 20 million, and then you're you're playing in Canva, creating a thumbnail. Don't do that stuff. It's actually funny how we talk to practitioners who are like, oh yeah, like I could do a bunch of this stuff with AI. I'm like, dude, you will never get beyond level two, right? Yeah, you could figure this out with AI. Yeah, for sure. You could also walk from New York to Los Angeles, but why would you? It's gonna take you forever. What do smart people do? They get on a plane, five hours, we're there. So this is about a mindset that you have to really adopt. Remember, you can figure out all this stuff on your own. Like, obviously, with our YouTube authority engine, it's 100% done for you service. We've had some people like, yeah, I could probably just do this with AI. I'm like, dude, you're fucking, you don't get it. You're still playing small. You're saying you want to lead your market, but you're gonna figure all this out by yourself. You're still in level two. Chow, this is small fries. We're not talking with you. We're talking to people who want to lead and dominate their space and who want to who understand the value of partnering with the right people. As you grow your practice, it's not about how. It's not about how, it's about who. And this is a really important thing that we have to shed here is your ego wants to be needed. Okay. How do I do this? How do I fix this? Whatever. No, no, no, no. And you have to remove yourself from that and ask the question who? Who's done that? Who's gotten like who can help us get there faster? Who can help me save more time? Who, instead of me trying to figure this out on my own, who's done there, been there, et cetera. And that's the real value of that's why, again, like when I look at the practices that we've worked with over the past 20 years, the ones who grow the fastest, they ask that one question. They don't ask themselves, how do I do this? They ask, who's done this? And let me just like write in their coattails. And this is part of what our advisory mastermind is all about. It's not about you figuring all this stuff out. It's like we have all the playbooks, we have all the SLPs, we have all the people in the in the room who've been there and done that. And it's just a matter of do you want to be part of that or if you want to just keep figuring things out on your own. So um, again, if you want to learn more about mastery, if you're doing half a million or more and you want to scale. So if you're in the level two or higher, the link is in the description if you want to learn more about that. So, core question here two questions is how do I move from how do I do this or how do we do this into who has already done this? So, moving from how to who. Second question is how do I create value and leadership that lasts beyond me? How do I create something, an asset that lasts beyond me? That's a big thing. So, for our business, as an example, a healthpreneur, my mission all has always been to help a billion people improve their health. We're gonna do so by helping practitioners build better businesses. I've always seen this as a brand that extends beyond my lifetime, right? So when I think of ROI, small fries. What's the ROI over the next three months on this? I'm like, chow. My ROI is over 100 years, right? If you want to really become an industry leader and dominate your space and become the next Coca-Cola or whatever, like the healthier version of that, you have to think in bigger time horizons. Longer runways allow bigger planes to land. Small runways can only take two-seater Cessnas. Do you want to be a 747 or a two-seater Cessna? It's up to you. So, how do I create an asset, leadership, a legacy that extends beyond me? It doesn't have to be beyond your lifetime, but it just means, let's say, outside the four walls. So these are the five levels that every practice goes through. Like you can't skip from two to five. Like it's impossible. So as we've gone through this video, I want you to identify like where, you know, where are you? Like you don't have to let me know in the comments. You can if you want to. But the thing I want you to understand as we close this out is there's a very big difference between running a half million dollar practice and a five or ten million dollar practice. As you've seen, there are new versions of you that need to be created as you scale because what got you here won't get you there. You could be the world's best practitioner and means nothing when it comes to building a business, right? And so it's really a matter of like, where do you want to be? There's no, there's no like, there's no right way. Like, if you don't want to get to level five, that's cool. If you want to stay as a practitioner, you're more than welcome to. And the final thing I'll mention is like, you know, when I talked about a level four, for me personally to spend more time creating content, maybe you want to spend more time in patient care. That's cool. You can still do that in four and five, but you have to build an infrastructure around you where maybe it's not five days a week in the clinic, maybe it's two days, half days. A lot of our a lot of our clients love doing that because they love the patient work, but they still have time to go to the beach on Fridays. And that's what this is about. It's about growing a business that allows you to live a much better quality of life and help a lot of people and make a lot of bake. Okay. There's nothing wrong with that. So hope this has been useful for you. If it has, uh there's a subscribe button on somewhere on the channel. Make sure to hit that if you want more awesome stuff like this to help you grow your practice. And once again, if you're a practitioner, you got to practice doing at least half a million in revenue per year, and you want to scale and you want my team and I, our leadership team, to be an extension of your business with private advisory and a mastermind to collectively help you get there. Our mastery program could be for you. Click the link below to learn more to see what it's all about and if you qualify. For now, thanks for hanging out. And I'm sure there's another video that's gonna pop up here. Probably want to check it out as well. See you soon. Hey, thanks for hanging out with me in today's episode. Hope you enjoyed it. If you have, here's what I'd love for you to do next is if you're not already subscribed to the Health Printer Show, go ahead and hit that button wherever you're listening to this to make sure you do not miss a single episode coming your way. And while you're at it, why not leave a rating or review? It would mean a lot to me. And here's why. Because I lay in bed awake at night wondering, are you enjoying this show? Do you get a lot of value out of this? And I never really know until I hear from you. All kidding aside, I would really appreciate a rating review because, as you know, the more people know about this show, the more people we can help. And your ratings and reviews make a huge difference. So thanks for hanging out with me once again. And I look forward to seeing you in the next episode.