what medical schools don't want you to know


What Medical Schools Don’t Want You to Know

A Guide for Doctors to Get More Balance

in Their Life

by Mike Woo-‐Ming MD MPH


In this short guide, you are going to read things that medical schools would prefer you not know. And not just medical schools. Insurance companies. Medical recruiters. Medical conferences. And even some of your colleagues. In fact, I was even told by prestigious medical conference organizers that I not talk about this subject. I was once invited and “de-‐invited” (If there’s such a word) when they got notice I would speak to physicians about this particular topic.

Medical Conferences Don’t Like Doctors to Talk About This Topic.


In fact, if you are happy at working for a big medical conglomerate company, getting a regular paycheck, and the perks that come with that job such as medical insurance and 401Ks, then I would actually suggest you to stop reading this right now. So if you are still here…I’m assuming you are probably not happy where you are in your medical career. I’m guessing you are either: * Considering leaving medicine or are already out * Starting your journey into medicine and are worried about the horror stories current doctors are having * Just curious at the title and wondering what the heck this guy is talking about! …So do you have an idea of what this subject is? It’s ENTREPRENEURSHIP. Specifically it’s physicians who are ready to leave traditional medicine and are ready to venture out of their comfort zone. The inventors. The trailblazers. The consultants. Those who start their own practice despite the worst time in medicine to do so. Now please don’t get me wrong. I have nothing against doctors and health care professionals having a JOB. But with physician job dissatisfaction at an ALL TIME HIGH, can we recognize there is a problem?


“Having great numbers of physicians unhappy, disgruntled, who can’t wait to retire, is not a great promotion for the profession” – David Korn, Former VP, American Association of Medical Colleges So what are the reasons for doctors being so unhappy? Recent surveys say the top reasons are declining reimbursements, working more hours for less pay, uncertainty of government interference, and regret of career choice. 6 out of 10 doctors would retire right now if they could. If you wake up in the morning, dreading coming to work every single day, and can’t wait until the day ends, then warning bells should be ringing in your head right now.

I have come to the conclusion that the only logical path to the insanity which is known as practicing modern medicine is to forge your own path. The answer is becoming an entrepreneur.


When I left my group practice in 2004 I thought I had very little options. I’ll sum up my story quickly, but if you have visited my website IncomeMD.com you have probably heard this umpteenth times, so I’ll give you the short and not-‐so-‐boring version: I was a Mayo Clinic family trained physician and worked in a multispecialty primary care practice in North San Diego County. I was working 50-‐60 plus hours a week and running different heads of department – urgent care director, nursing home director, quality management committee, EMR implementation director (that was my favorite position(NOT!). You name it, I did it. None of which resulted in an increase in pay. Running between a full panel of patients and full hospital call with an average of 12 admissions a night and 100+ phone calls on the weekend I thought I could do it all. If you work harder, meant you were a better doctor, right? Until roughly five years in practice when my walls were shaken to the core. My son Ryan developed traits of autism at 4 years old. He became my main focus. I wanted to go to every rehab and speech class, talk to every doctor, and consult with all the neurologists I knew trying to better understand his condition. (Information is much more prevalent now, thank goodness). When I tried to ask for time off to the powers that be, I was told over and over again, that now wasn’t the time. So I quit. Now, not the “2 week notice” quit. I had to pay just less than 5 figures to get out of a shareholders agreement I had with my group, and then they begged me to stay 6 months to ease the transition to a new doctor. Of course being the good soldier I did what they say. Plus it was not easy to say goodbye to patients, but in the end family came first. I think many doctors who plan to leave the bedside, have guilt and would feel the same way. Now my actual leaving required time and thought. I’m not one to make rash decisions. My departure was planned a year in advance. And it was probably one of the biggest and best decisions I ever made in my life.


I knew I wanted to start my own business. I’ve always been entrepreneurial, even in medical school when I started a test preparatory company for aspiring doctors. Although this business was successful, I also had some bumps and bruises along the way. I had a series of business failures – everything from starting a medical spa in Belize, to an online startup that went bust. But to quote Thomas Edison, with every failure I was one step closer to success. Eventually I started to realize that I had to find a business mentor to show me the ropes, and have an actual plan. I understood the importance of writing down goals and more importantly implementing them. None of these tactics were taught to me in medical school. I developed an internet company that I started from my laptop. I learned the importance of online marketing and lead generation. I ramped this up so when I announced my resignation, by the time I left I had already generated a 6 figure income outside my doctor’s salary. This led to a 7 figure software company that allowed me to travel around the world and in which I was able to sell just a few years ago. And more importantly, Ryan who is now a teenager, got the help he needed with early intervention, and is doing a lot better (and be honest, more computer savvy than me these days!). Of course being a serial entrepreneur means you can never rest on your laurels. Today I run a publishing company, as well as a medical marketing consultancy that helps clinics with search engine optimization and online branding. And recently I went back and invested into creating my own age management practice and now help run several lifestyle medical clinics up and down Southern California. But I’m doing so on my terms. And I’m having a ball doing so. It’s what Michael Gerber, the author of the best seller “The E-‐Myth”, calls “working on your business” not “in your business.” I created my own position that allows me to work when I need. In the last year, I have traveled to Bermuda, Italy, and Spain with my family, with plans to travel to Croatia and Turkey in the upcoming months. I’ve been invited to speak at places


such as Holland, China and Singapore. I’ve been to Australia and New Zealand so many times I’ve lost count. So why am I writing this? Because I made a goal a year ago to help 1,000 health care professionals break out of the rut. Because I am seeing too many of my colleagues struggle, trying to figure out what to do next, I’ve made it a personal mission to help as many doctors as I can. I’ve counseled many physicians who’ve made the transition and their lives are better for it. I’m hoping by reading this it will help aspire those who feel they are working for a paycheck and nothing more. Now before you decide to go out on your own, here are some things to think about first. Ask yourself these questions before you make the leap:

1. What is the real reason you want to leave? Many are just content with their current job but maybe you are just having friction with higher-‐ups or certain co-‐workers. Can you change positions or take on a new challenge? If it’s really bad, change jobs. A change of scenery rather than a change in career is all you need.

2. Are there any deeper underlying issues besides unhappiness? I remember consulting with a radiologist who said she was depressed. When I asked her how long she was depressed, she said 25+ years. But she said she lived a certain lifestyle and couldn’t afford not to leave. Doctors tend to be the worst patients, and I certainly believe that. Get professional help if you suspect there are psychological issues at play.

3. Are you comfortable going 6 months without a paycheck? Whether you

decide to start your own business or start a non-‐clinical job you can expect a significant drop in your revenue. If you want to do this, start by slowly cutting back your hours. When I quit, although financially we were in a good place, my wife convinced me to find something part-‐time which I did so for a year.

Now if you have decided to make the leap out of a regular job, where do you go and what do you do?


If you really feel clinical medicine isn’t right for you, but still want the comfort of working for a steady paycheck, there are still many options. You can check out my nonclinical resources at IncomeMD.com for organizations and coaches that can help you.

If you want to work from home, telemedicine businesses such as Doctor on Demand are always look for doctors and many times you can set your own hours or even work when traveling.

Locum Tenens is also a good alternative as well.

But just as I mentioned despite the flexibility these jobs will give you, bear in mind you are still working for someone else. Nevertheless most doctors do not realize how many options they actually have. So is life really that better as an entrepreneur?

It certainly isn’t less hours. I still work as many hours as I do before. As I’m writing this it is early Sunday morning. An entrepreneur’s life can be 24 hours a day / 7 days a week. It certainly isn’t less stress. When you have your own practice or business and you are responsible for the financial lives of your employees (as well as yourself) it can be daunting. As an entrepreneur you have to be willing to take risks, which many doctors are taught to be risk averse. It certainly isn’t glamorous. Although there are some famous entrepreneurs such as Steve Jobs and Elon Musk who blazed trails, there are shows like the Shark Tank where you see would be entrepreneurs fail on their feet. It may feel awkward to tell family and friends why you don’t have a “regular job”. Now that I convinced you why not to be an entrepreneur, I can think this picture describes it best….


The financial freedom of owning your business allows you the flexibility you might not get elsewhere being a paid employee. Now you may be saying how can I do this as a doctor? To answer that question is what philosopher Jim Rohn states it best in that “we get paid to bring value to the marketplace”. To understand this further, the purpose of a business is to create something of value that people will want to buy. Although I own conventional businesses and medical practices, I have created my position so that I focus it on offering services so I am not the main producer of that value. Rather, I have service providers who do most of this work for me. In my marketing business, I have employees, freelancers and independent contractors who perform the majority of the value. In my medical practices, I oversee doctors, nurses and midlevel providers who can provide the bulk of the services. I try to avoid to perform a procedure where I am the only one who can do that procedure. My role is the visionary, thinking of ideas or involved in the marketing, and then having others perform the implementation. Of course there are always exceptions to these rules, but I work when I want to work without the dependency of a paycheck.


In your occupation, are you responsible for generating your own income? Do you receive an hourly wage? Then what you are doing is you are substituting time for money. If you truly want the financial freedom you desire you need to learn to free yourself from the paycheck. I’ll give you the example of my father. A long time pediatrician, he worked for years for the federal government. He was headstrong, and if he saw something he didn’t like, he would let his supervisors know, often butting heads with the establishment. Then later in his medical career, he learned the skills and had the gumption to open his own practice. He did things differently and now has 3 doctors that work under him. And now he works about ½ day a week and rarely comes in to his clinic. He realized he was making more money and was having less stress then when he was the only one seeing patients. He states he makes more money then he ever has when he was commuting 2 hours a day back and forth to a government job.

This is what I term a “lifestyle business”. You let your business work for you, not the other way around. Now what surprised me was how difficult was it for him to finally do this. For many doctors it’s about losing control. We would not have gotten into medical and graduate school if we weren’t “control freaks”. Let’s say you are currently making $150 an hour. (OK for you orthopedic surgeons and high paid specialists out there, stop laughing) Are you currently doing work that is less than $150/hour? Most of us are. In the office, if you periodically answer your phone or are calling in prescriptions, you are getting paid less than your worth. If you are typing your notes into an EMR until 8 o’clock at night, you are getting paid less than your worth. And this applies to your own life.


If you mow your own lawn or pulling weeds in the yard, you are getting paid less than you are worth. Now if you enjoy doing those things, such as you like mowing your lawn, because you get to go outdoors and you get fresh air, then by all means keep doing it. But if you are doing this because you think you are saving money, you are not. The goal is to keep increasing the value on what you can provide. The problem is people want to make more money. Your focus should be on saving more time. We all have a finite number of years we will be on the planet. If you are substituting time for money then you are no different than someone who is working minimum wage at McDonald’s. Most doctors who burn out do so not because of the workload , but they feel they are not being properly reimbursed or they are losing control. If you want to make a million dollars a year that is roughly $480 an hour if you include weekends. That means you should not do tasks that are worth less than that! Now if you are an employee this will be difficult. That’s why I discovered early on I was certified UNEMPLOYABLE. I still love (and continue to love) medicine but I didn’t like what medicine was doing to me. I have different sources of revenue that will allow me to generate a healthy revenue while still maintaining my freedom. As a doctor you have excellent skills in communication and decision making, and many of you exhibit strong leadership qualities. That’s why entrepreneurship makes good doctors. So if you are looking to make the leap here is what I suggest. First don’t give up your day job. Discuss this with your significant other and make sure he or she is on board. However if you plan to leave you should start now with a “Date of Departure” in 6 months to a year.


You have to want to do this. I woke up (and continue) to wake up about 5am because that was the only time I could make my business work. Because I was determined to make it work. Perseverance is vital. For every hour I devote to my business, I was one hour closer to making my dream a reality. “What can you do today to bring you one step closer to your goals?” And that is the way you need to think. The second most important aspect is having a mentor. Are there people out there that are willing to help you? You want to seek out other business owners who have “been there, done that”. I spent so much time reinventing the wheel, when I found out the wheel was already reinvented. Do you know of someone you admire that is doing what you want to do. Seek them out. Buy them lunch or get a cup of coffee. Sharing knowledge with people who are more successful then me was crucial when I got started, and allowed me to get where I am today. Success leaves clues. Now many of you have asked how they can learn from me. I purposely have not been taken in any 1-‐on-‐1 clients, because frankly I just haven’t had the time working on launching and growing my own businesses. But as I said I’ve made it a goal of mine to help other health care professionals. So in order to reach my personal milestone, I’ve got some exciting news… I see many clinicians struggling because they are smart but often not “business smart”. I aim to help change that. I’ ll be doing a live “hands on” workshop that will be right here in San Diego. I’m calling it the IncomeMD Entrepreneur Bootcamp.

I will have my first workshop devoted to doctors and health care professionals in nearly two years. This will be a very small, intimate teaching environment to give you the tools you need to venture out on your own.

This will be a great opportunity for those who are ready to make the leap, or want to connect with doctors who already are.


At the workshop, will discover how to get the ideas of your head and implement. We will identify lucrative niche areas where doctors can get into quickly. Whether you want to become a consultant or start your own business online, we will focus on online marketing on how to get your message out to the masses. You will learn tactics that sharpen your skills in balancing being a health professional and working on your financial freedom. If you are ready to learn and network with other like-‐minded entrepreneurs this is the place you need to be. It will be everything I learned in nearly 20 years of entrepreneurship in a massive brain dump to help you get you where you want to be. Email me at [email protected] and I’ll send you all the details. I hope this guide was informative to you and look forward to hearing about your successes. Keep Moving Forward.

Mike Woo-‐Ming, MD MPH IncomeMD.com PS The IncomeMD Entrepreneur Bootcamp is planned to be kept small, no more than 20 people, to allow for more intimate teaching. If you would like to attend, please email me at [email protected]. I’ll leave you with my favorite quote…

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