How To “Do Your Own Thing” in Private Practice

Radha Tamerisa, M.D.

I had no idea. Thank you for telling me. And that’s a great honor for me, thank you.

Cheng-Huai Ruan, M.D.

Yeah, no problem. By the way, we know this because, I do what patients do, I Google, and then you screen by like, GI doctor, and then you go on Google reviews and that pops up like the top reviews. And I was like, “Whoa, you’re number one.” That was really cool. So you must be doing something right, right?

Radha Tamerisa, M.D.

I surely hope so.

Cheng-Huai Ruan, M.D.

Yeah, great, so we’re gonna get right into it. So let’s talk about your background a little bit, because when we met, you were in your previous practice, right? How did you make that sort of transition from your previous practice and what was the structure of the previous practice into your own practice and business development and stuff like that? Tell me the story behind that.

Radha Tamerisa, M.D.

Absolutely. So, I came out of training here in Galveston and I wasn’t very sure of myself and I felt like I needed to be part of a practice that was already there. So it wasn’t really confident enough to go out on my own at the time. Ended up that I joined a group of two other practitioners who were fairly seasoned. They had been practicing for quite a number of years and had a very good established practice. And I was very fortunate because they were very kind to me. They nurtured me, they allowed me to do what I thought I needed to do and to grow and and support me.

So it was really a very nice practice. And I was there for about 13 years and I began to, I got to a point where I felt like I needed to do more for my patients. I felt like what I had learned in training was just not enough to really make a difference on some of the patients that I was seeing. And so you don’t, you only get so far when you keep prescribing a medication and doing the same tests over and over. And I realized the value of nutrition in the practice. So somewhere probably about, oh, seven, eight years ago, I really realized that there was a huge need for me to go a little bit beyond. 

I needed to talk about their stressors, I needed to talk about their nutrition to really make a difference. And so that’s when I started exploring that and what I realized very quickly was that the insurance model didn’t really support that. And so I felt really stuck. I felt like I was just not really doing what I wanted to do. And I also opened my eyes to the world of functional medicine. And so exploring that really, again, gave me a different perspective on what I could do in terms of offering a more complete GI care to my patients. And that’s where I sort of branched off and developed a practice that I think is more holistic, a little more involved in terms of really getting to the root cause of disease.

Cheng-Huai Ruan, M.D.

Well, so, but you were in that practice for 13 years.

Radha Tamerisa, M.D.

Yes.

Cheng-Huai Ruan, M.D.

So, it took 13 years.

Radha Tamerisa, M.D.

Well, again, I think it was comfortable. It’s kind of the fear of the unknown and I wasn’t sure would I be able to do this on my own or not and I was very comfortable in the practice.

Cheng-Huai Ruan, M.D.

I was saying, I was saying that 13 years is actually pretty short because a lot of people were listening to us. They’re like 25 years into practice, 30 years into practice. And they’re like, “I wanna do me now”. So I think that, I mean time is relative, but what you identified was that, “Hey, I want to do something that’s more fulfilling for my life.” And then you took a risk, right? And that risk, something triggered you, like there’s gotta be something that kind of triggered you to take a risk. Can you identify sort of one thing, or one event, or something that triggered you to take that risk?

Radha Tamerisa, M.D.

Well, I really didn’t feel like I was giving my patients the kind of care that I wanted to give.

Cheng-Huai Ruan, M.D.

Yeah, for fulfillment.

Radha Tamerisa, M.D.

Fulfillment, making a difference in people’s lives, not just referring out to other practitioners, like nutritionists or whatever, I wanted to be able to do some of that and understand more about where I could be more meaningful in the practice, in my practice and in my journey and in my care for patients, so that’s where that sort of triggered that whole process.

Cheng-Huai Ruan, M.D.

And that’s so powerful that you did that ’cause most people wouldn’t. there’s a level of comfort that you become accustomed to. And I feel like a lot of doctors just kind of shut down and you’ve been people who are listening to on the summit, probably already is feeling that way. And that shut down requires some sort of risk taking in order for some things to change. So, all right, let’s talk about your new practice. So I assume you kind of designed it to your liking, right?

Radha Tamerisa, M.D.

Absolutely, so in my practice today, I get to decide how I wanna run the practice. I get to decide who I’m gonna hire and who’s not a good fit for the practice. I really value my team members. So I often will ask them for their opinions and sort of factor that in as well. So the people who are on my team right now are people I really trust to continue to evolve the practice the way I’d like to see it. So I have a vision for the practice and the people that surround me support that vision and really align with the concepts that we’re trying to deliver.

Cheng-Huai Ruan, M.D.

Right, so you said earlier that you wanted to incorporate some nutrition into the practice, but the insurance model didn’t align with that, but you still currently take insurance, correct?

Radha Tamerisa, M.D.

Correct, correct, I do and I have really found a way around it and over the years I’ve always thought, should I do insurance, should I do cash pay? And what I realized is that the people who need us the most are the people who may not be able to outlay the cash that it takes to really take advantage of our services. So I have continued to use the insurance model and I feel like I’m successful in that model. And I think it can be done and that’s what I intend to stick with.

Cheng-Huai Ruan, M.D.

Well, that’s great, so I think one valuable aspect of sort of starting your own thing and practice is, don’t let the business sort of drag you away from what you really wanna do, because it’s all about who you wanna serve. It sounds like who you want to serve, a lot of those people are within the insurance model or they can’t afford the cash model. And so, and there’s nothing wrong with doing the cash model, for those of you who are listening, because if you want to serve that population, that there’s nothing wrong with that. Another part of the summit, I interviewed Dr. Daniel Amen who’s been doing the cash model for over two decades. And there’s nothing wrong with that because it’s really about the people that you really want to serve. And there’s no two people that are the same. So I commend you for staying with the insurance model and being one of the few integrative gastroenterologists in the nation, so thank you very much for that.

Radha Tamerisa, M.D.

Thank you.

Cheng-Huai Ruan, M.D.

It’s great ’cause I can send all my patients your way, so it’s kind of nice.

Radha Tamerisa, M.D.

That’s great, we appreciate that.

Cheng-Huai Ruan, M.D.

No problem. So, and so, tell me some pain points that you kind of experienced when you were trying to start the practice. What did you run into that you didn’t really expect?

Radha Tamerisa, M.D.

So, I think it’s all about identifying your patient, selecting the right person for what you think they need to do in terms of taking control over their health. And I really have to meet patients where they are, right? So if they’re resistant, if they’re not quite where I would like to, I know what journey I’d like them to take towards better health, but they have to be on board too. So I think one of the most challenging things is education and making sure that the patients understand where we’re coming from, why we’re recommending the things we’re recommending. I often think that they may be a little bit skeptical, about where we’re coming from. And I try to tell them that we’re really coming from a good place in terms of our concerns, that we expect to guide them through this whole process. And I think that’s really the key is understanding your patient and meeting them where they are.

Cheng-Huai Ruan, M.D.

Yeah, that’s so important. And I call it expressing your intentions because you can’t expect the patients to know that your intentions are good, you want what’s the best for them. You got to speak it out loud. And I think that has to come from every member of the staff, especially in an integrative health practice, right? And so we have to give them that, so that they can have that level of safety and certainty. So then we know when they come into the practice, Ruan Telemedicine, they’re in a safe place. And I don’t think that’s done very much within medical practices, ’cause I did not learn that in residency or medical school, But let’s talk about some challenges of you running the business when you first started. Are there any like business challenges that you ran into, that you didn’t really expect?

Radha Tamerisa, M.D.

There are. And I think when you adopt a model like we have, which is an integrative practice, you’re really counseling them on so many levels. And I think the biggest thing for us is time constraints, right? And so when you’re in an insurance model, you’re used to seeing a certain number of patients and you’re quick and you’re kind of in and out. But when you’re talking to them about their lifestyle and their stress and their diet and their, whatever else is going on, it really takes time. And so my visits are never gonna be 15 minutes long, as much as, we think that that should be it, it just doesn’t happen that way. 

So I think, and that impacts the business model, right? So you’re not gonna be able to keep that volume. So at some point, you’re gonna have to figure out, you talk about the important things that are at hand right now. And then you see them over the course of time and sort of address the issues as you can prioritize them. So I think that’s probably one of our biggest challenges in this model. 

Of course, you always wonder when you hire a nutritionist, for example, what does that look like? How is that gonna be funded? How are you going to support that? And what does it take for us to be able to fund a good nutritionist? Because they are very knowledgeable. Their training is really robust and so the person that I have in the practice as our functional nutritionist is highly trained and so of course, she needs to be able to see a certain number of patients to be, at least break even/profitable, however, we might look at that. But so those are some of the challenges of course, in making it work in this model.

Cheng-Huai Ruan, M.D.

Yeah, so identifying centers, whether they’re cost centers or profit centers, you kind of need the numbers behind it to look at that, right? And sometimes that may not be so easy, especially with the insurance model, because you have to determine the revenue cycle so there’s money stuck in aging claims, 90 day plus aging claims and all that predetermines what happens within the insurance model and it could be very challenging unless you have some sort of engine or some sort of know-how or knowledge to get that information. So let me ask you this, because this next question I am not gonna understand, are there any specifics to sort of starting your own business and running a business as a woman?

Radha Tamerisa, M.D.

And that’s an interesting question because I do think we face some unique challenges, although I never, in my mind, that was never a barrier to anything that I did. Uniquely, I think we deal with a lot of different things and as women, we worry about how do we handle the kids and the family life, and then how do we balance out that work life? And, I’ve always thought in my head, I’m gonna do the best I can, in everything that I do, right? So it wasn’t ever an option for me to have a business or deliver care that was suboptimal. So when you want to do the best you can in every facet of your life and similarly with my kids, I have three boys and my parents supported me a lot through the initial stages of my practice. And as the kids got older, of course, it got a little bit easier for me to do the things that I wanted to do. And now I have two in college and one still in high school, and I think they’ve done okay. And we’ve managed to sort of be able to handle all of the pains that came our way. But I do think as women, that’s one of the barriers. Of course we are still a minority in the GI world. I think, the-

Cheng-Huai Ruan, M.D.

Big time, yeah.

Radha Tamerisa, M.D.

Although, we women have become more and more predominant in the GI space, I do think that when I first started, I was certainly one of the few female GI’s, even in the area. So I think, overcoming that mindset and sometimes your male colleagues may look at you like, “What do you know, can you really do this? And you need to be confident of yourself and show them that, yes, you’re just as good as anybody else.

Cheng-Huai Ruan, M.D.

So the top rated gastroenterologist in the Greater Houston area is a woman, so that’s something right? No, that’s great. So, earlier you mentioned the kids and everything like that, and a work-life balance can be quite difficult, especially as a business leader, entrepreneur. So let’s talk about that for a second, because I recently discovered you do something really cool. I’m not gonna talk about it ’cause I don’t even know what it is specifically, but I saw your post on LinkedIn with an art piece. And so, if you could just kind of tell everyone what you do and why you do it, that’d be great.

Radha Tamerisa, M.D.

Yeah, absolutely. So again, I think this leads back to taking care of yourself and making sure, because life is stressful and there’s so many different levels of stressors out there. And I’ve realized over the years that I have to take care of myself and my own mental peace, because if I don’t do that, I can’t take care of everybody around me.

Cheng-Huai Ruan, M.D.

Right, absolutely.

Radha Tamerisa, M.D.

So exercise has become a really big part of my journey to my own better health, of course, nutrition has always been a piece, but during COVID, COVID was an interesting time and I think the stress levels sort of flared, and I am not somebody who’s used to sitting at home. And so I found my peace in artwork and I’ve dabbled in art over the years, but have never really had the time that it takes to dedicate to it. So what I did was start learning about resin art and so that’s what I do. I do resin art pieces. And basically this is a technique of just, and I learned it actually online, so I didn’t really, it wasn’t a fancy class or a course or anything. I just did it from the comfort of home and watched a lot of videos and took an online course and sort of started experimenting with it. And it’s fun, when I do my art, I get to zone out and it’s just me and my art piece and it’s wonderful.

Cheng-Huai Ruan, M.D.

That’s cool, yeah. One of my friends asked she was in your office, and I think you have a piece that’s in your lobby, right? On the right-hand side and she took a picture of it. It was like, “Oh, look what Dr. Tamerisa’s doing,” and I was like, “What, that is so cool.” No, that’s brilliant, that’s amazing. And so, and here’s the thing. And I think what I see is that most docs, like especially during the pandemic, there’s nothing wrong with distractions, I think, as long as like constructive, like learning a new skill, the resin art and stuff like that. But some people can sort of develop some negative habits during that as well, maybe not eating so well, not exercising, alcohol, whatever it is, right. And so the fact that you actually like learn a new craft and you’re able to put it out there. I mean, this is just so much power to you on that, because that is such an accomplishment. And yeah, I didn’t know you took an online course for it and you did all that. I mean, that was beautiful, so good job.

Radha Tamerisa, M.D.

Yeah, thank you, thank you, so much.

Cheng-Huai Ruan, M.D.

And so what do you think was sort of your mindset in the engine that during times of stress that you wanted to be more creative or dedicate your time to this? Because I think most people kind of crumble under this stress, but like creativity came out of yours. So what do you think was the mindset behind that?

Radha Tamerisa, M.D.

Yeah, well, I was really fortunate and I think we have to take life as it comes and these challenges are going to come our way at certain points in our life. And I think not letting that get you down, but using that energy to create something that is positive and for me, there was a little bit of a need. I wanted to cover my walls, but I didn’t ever find the right pieces or have the time to go shopping. And I said, “Well, let me just see if I can create my own art out of it.” And I had the time.

Cheng-Huai Ruan, M.D.

It’s so fulfilling too,

Radha Tamerisa, M.D.

It was very fulfilling. 

Cheng-Huai Ruan, M.D.

much more fulfilling than buying a piece, yeah.

Radha Tamerisa, M.D.

Yeah, yeah and I enjoy it and it’s nice to see it up on the walls and people appreciate it. And it’s a really nice feeling.

Cheng-Huai Ruan, M.D.

And what’s interesting is I think that if your patients look at it and say, “Hey, wow, you did something like that,” it puts you in such a unique spot into their brains, because patients may not remember like what you say to them, but they’ll always remember how they make you feel or how your lobby makes them feel, right. And so if you have sort of this art piece on there as an expression of you, or represents you, that’s a beautiful thing and I call that passive, it’s a passive energy, meaning that there’s something that you do, you create and you put it on somewhere and you share it and that’s passive energy. 

So art for use one of them, social media is another one. So you create value online, I used to post photography, all the photographs I used to take, looking at macros and stuff like that, so that was sort of my portfolio that I built online. And I still have patients like, “Hey, Dr. Ruan, why don’t you post this photos anymore?” I was like, “Oh man, ’cause I got two kids now.” And so it’s so interesting because people remember stuff like that. And these are some of these patients, I haven’t seen in years. So I get some messages from them about my original photographs and how they made them feel. So you never know like how impactful you are for people in general, until you kind of put yourself out there and put your creativity out there so, much power to you.

Radha Tamerisa, M.D.

And I absolutely believe that and I think that’s a healing technique in itself, right? And so it’s not necessarily about patient outcomes. It’s about how they feel as they are under your care, or as you’re guiding them through this and I think if they can feel the genuine feeling you have for them, they will get better, it’s just a matter of perseverance.

Cheng-Huai Ruan, M.D.

Yeah, in my interview with Dr. Amen, he talked about authenticity. Like, for you not to burn out, you really have to be authentic with yourself, your spouse, the loved ones around you, with your patients, with your staff and that authenticity really has to come through. And there’s a level of vulnerability that can create trust and a beautiful lasting connections. And I think, I used to, well actually, when we first met, I used to manage a lot of hospice patients, right. And so I did this post, and people still talk about it, is “The Top Ten Things I Learned From the Dying”, it’s really conversations between me and the people who know they’re about to pass away. Whether it’s in a couple of days, a week, a couple of months, most of them are cancer patients and stuff like that.

And one of the things that I wrote on there, the number one thing I wrote on there is that no one has ever regretted working too little, right. They always regretted not connecting with someone or a group of people, their family, at the end of life, right. And I feel like I’m always reminded of that, because that every action that I want to take, I want to be proud of because these things are gonna be there forever, that artwork that you did in your lobby, it’s gonna be there for a long time, it’s probably gonna be passed on to generations, that Instagram post that you have will be there for the great, great, great grandchildren ’cause Google indexed it already, so it’s already there, right. 

And so I think everything that we put out there is building on our own legacy. So it’s really important not to put a lot of negativity out there because that negative energy just compounds and it can actually can compound to several generations down. And that’s all, we’ve seen a lot of our patients, and the people we work with as well. So I think as physicians, it’s okay to have a duty for ourselves as well and that’s something I learned, not when I first started or not when I finished residency it’s much later, it’s okay to have some self care, even though it feels a little guilty for me.

Radha Tamerisa, M.D.

Yes and I think it’s actually vital and like you said, you don’t learn that early on in your career. It’s something that you have to understand as you go along and realize how important that is, because that is something that will allow you to keep doing what you do as long as possible, right. Otherwise we do get burned out and becomes more difficult and challenging to go day after day.

Cheng-Huai Ruan, M.D.

No, absolutely. So you see some very complicated patients. I know, ’cause they’re mutual to our practice, so I know exactly who they are. So a lot of times with a lot of the really complex patients and time and energy, that’s dedicated to it, that’s got to have some stress associated with it. So how do you not let some of that really affect you, maybe when you go home and your personal life, like how do you draw that line, do you have a technique?

Radha Tamerisa, M.D.

Yeah, that’s a great question. And I probably do it without even thinking about it, but this is where your team is really important, right? So if I’m the one answering that phone call every day, or I’m the one answering that message that comes and sometimes multiple times a day from a particular patient, then it does get to you and it does get to be overwhelming in a sense. But this is where I think your team is really important. So I have a great support system and I use that support system to help me make sure that we are getting back to patients. So it’s not that we’re not answering those calls or messages, but maybe it’s not always me. It’s somebody else in the practice who’s helping me do that. 

Again, I think this is where sometimes you just have to detach and you got to do something that you really enjoy doing so that you can turn your brain off from all that stress. And I think it makes me deal with it better. So I think, I never want patient to see, maybe that I’m frustrated or maybe that I wish that they would do something different, but I will give that information to them in a very positive way. And that’s how I want them to see it as a positive change. Not a, “If you don’t do this, I’m gonna,” so I think as we manage our stress better, I think those delivery methods become more effective and you’re less likely to show a patient that you’re frustrated or angry or whatever. So I think that’s really the key is making sure that you have the people surrounding you that are helping you deliver the care that you wanna deliver and then detaching at certain times to make sure that you can kind of renew yourself and you can go back to work the next day and again, do what you want to do.

Cheng-Huai Ruan, M.D.

Oh, absolutely and I think that right there, that entire statement right there is why you have such a high rating on the Google reviews there. And so I think that you’re right. I think, and with me at Texas Center for Lifestyle Medicine, I have a large team as well and I think you’re right. It’s just so important to not let patients like notice some sort of frustration because a lot of the frustration it’s most likely not their fault is that maybe their messaging something that has triggered me from something that’s completely unrelated to this patient, maybe from another patient. And then so in that trigger becomes an annoyance and then sometimes you just have to say, “Oh, okay, let’s just take it down a notch.”

Radha Tamerisa, M.D.

Take a deep breath, take a deep breath.

Cheng-Huai Ruan, M.D.

Take a deep breath, and that’s literally what I do, I do some soft belly breaths, I do do some box breathing, actually makes me feel a lot better. And then afterwards, I go and I type and I’m like a different person after that. So, and I think that is crucial, not really just with patients, I think with personal life as well, because sometimes when you’re a physician, entrepreneur practice owner in private practice, you go home and yes, there’s a lot of stuff to be done at home. if I go home, I see this giant pile of laundry, I don’t want to necessarily get annoyed. I’m like, “Okay, let’s create a structure around this.” So that we can get things done and communicate with whether it’s our spouses or whoever we’re living with a significant other, or if you live by yourself, just have some structure to allow yourself to do nothing. Maybe have like 15 minutes a day where you just block out and literally just do nothing.

Radha Tamerisa, M.D.

There you go and that’s hard, it sounds really easy, but it is hard to sit and do nothing for that, what 15 minutes is not a long time, but how easy is it to just do that? So you’re right and I think that’s great.

Cheng-Huai Ruan, M.D.

Yeah, so this is a great transition. It’s really the last point I want to talk about, which is culture. All right, so I’m Chinese. I was born in China and I came to the United States. So I have a typical, what we like to call immigrant mentality, where like scheduling that 15 minutes of nothing is like a huge no-no my dad’s like, “What are you doing?” And I’m like, “Nothing.” He’s like, “What do you mean your doing nothing?” And my parents and I live in one household, so they’re always with me, we have three generations in one household-

Radha Tamerisa, M.D.

That is wonderful, wow.

Cheng-Huai Ruan, M.D.

Yeah, yeah, but sometimes I come home and it just feels like, “Dad, are you just judging me right now?” but I want to talk about culture for a second. ‘Cause all of us have sort of different cultures. And I feel like no matter what culture you’re in, there’s sort of sometimes there’s a bit of a blame on sort of the cultural background for a specific action. Have you sort of experienced any of that with your life?

Radha Tamerisa, M.D.

Oh, absolutely, in every facet of my life and my parents are a big part of our lives as well. And we’re just literally a mile down the street from them and there’s a huge cultural influence on what I have done throughout my life. And there are certain expectations that you need to fulfill. And there’s a certain level of mentality that you want to please your parents, you don’t want to disappoint them, that you respect them and so you want to make sure that you are doing everything you can to maintain that respect and maintain their positive feelings towards you, right. So there is that cultural sort of process that occurs, I think, without even thinking.

Cheng-Huai Ruan, M.D.

Right.

Radha Tamerisa, M.D.

And you’re right and I do think that culturally, we are trained to go, go, go and don’t waste your time. And that self care aspect I think is really lacking in our parents because everything they did was for the benefit of somebody else in their life. They never really thought about themselves. They were never number one, right. And so, and then also, maybe as first-generation immigrants, it was a little bit different as well, ’cause they needed to provide, they needed to make sure that they could take care of their kids and that they were successful and huge pressure on education in our cultures as well, which I’m very grateful for because thank goodness that my parents did push me when I was younger to do the best I could. 

So I value that I treasure that, I think it was all in a good way. They meant for us to have the best of what they could provide us and the best for ourselves. So yes, there is a lot of cultural pressure. I think that thinking back and sort of now where I stand, I understand that self care is important. And I understand that I need to do that for myself. And so, even if my mom says, “Well, you’re going to get a massage,” or you’re going to do whatever it is, that I think I’m doing for myself, there’s a little bit of that guilt, but she understands now that that’s important to me and I understand how important it is for myself as well. So I think they come around and they do develop that understanding, it doesn’t come quickly, but it comes, yeah.

Cheng-Huai Ruan, M.D.

Yeah, I have a brand new tactic I just started using last month and I want to share it with you. And so whenever we go on sort of these mini weekend trips and stuff like that with my family and my dad just kind of looking at me, I mean, he’s invited, he never goes, but I’ll have sort of this new tactic, so whenever, like there’s a question about this and I’m like, “Thank you, mom, thank you, dad, for working so hard to allow me and our family to have this trip,” and I just pause and he’s, the other way.

Radha Tamerisa, M.D.

There you go, there you go. They helped you out, see?

Cheng-Huai Ruan, M.D.

Yeah, yeah, in my family, no one of my family expresses emotion. So when I say like that kind of throws them off a little bit, so, and then he’s like, “Carry on.” That’s sort of my new tactic behind that, but I think we do have to address the cultural aspect and it doesn’t matter where you’re from, there’s always a cultural consideration into our drive, the way we were brought up and everything like that. And I think that if we take this from a very holistic perspective, right? So this summit is called the Physicians Practice Automation Summit. So if you take this from a perspective of what automation is and it’s basically making some things that are very like automatic to allow you for that self care is allow you to have that creativity, do the resin art that you do. for me it’s definitely photography and now my girls have a YouTube channel. 

So I used to be a professional video editor, so I’m doing that too. So, that creativity is very needed. And I think for a lot of doctors, there’s just still a lot of guilt of dedicating time to self. So other distractions kind of come up and we’re here to really stop that, and I think you’re such a great example with the resin art and everything that you do, and you still have great reviews, but it’s also a work in progress, where I don’t think either of us are necessarily truly fulfilled where we want to be right now, but we’re still satisfied as long as we have that balance, right. So let me ask you this question. What have you learned now that you wish you knew when you first started the practice?

Radha Tamerisa, M.D.

Oh, I wish that I had opened my mind to some of these alternative treatment options. I wish I had learned functional medicine earlier in my career, because I think I would have had even more impact on some of the people that I’ve seen over the years. And I wish I really had that confidence in myself to do what I wanted to do at the onset and not to say that I didn’t have a great experience coming out and joining a practice. But if I had more confidence in myself, I probably would have done this, the practice that I have today, a lot earlier in my career, but I’m still so grateful that I made that transition and that I didn’t wait any longer than I waited to get to this point. So I want to say that if you guys, if there’s somebody out there that has a dream and a passion and a desire, don’t be afraid to take that risk and do what you think is best. And maybe sometimes things don’t work out the way we expect, but there’s always a way to find your end goal and make your dream come true. So I think fear keeps us sometimes inhibited to a point where it’s counterproductive. So don’t be afraid and take that risk. That’s right you gotta take that risk and go where your passion takes you.

Cheng-Huai Ruan, M.D.

Yeah, so that’s such a great advice and I couldn’t have said it better myself, but definitely for the people who are listening to this, I think the drive for them to listen to this is that they’re taking that risk and either they’re thinking about doing it, or they’ve already done it, the early stages of doing it, or maybe they’re later, but they want to pivot and take another risk, right. And so we’re with you, we’re on the same crowd here.

Radha Tamerisa, M.D.

And I think it’s important too, to understand why you’re doing what you’re doing, right. And what your true, true passion is. I think, from a money standpoint or a profitability standpoint, that’s gonna come, it’s gonna come. If you truly do what you believe in, and you fulfill all of your goals and your dreams, don’t have money be the driver of what you do. And I think that’s really important because all too often, when money drives us things don’t go the way we want it to go. And so I’ve never thought about, “Oh, am I gonna make money this way, or that way,” I just do what I want to do, what I think is right. What I think my patients deserve and the money will come and I think that’s really important, so keep things in perspective and don’t let money be your goal.

Cheng-Huai Ruan, M.D.

No, absolutely. That’s such a great topic and I’m going to sort of leave with this one last question for you and it is where do you see your practice being in five years? What does that look like?

Radha Tamerisa, M.D.

That’s another great question and something that I am sort of toying with. And so, as we discuss the limitations on what we’re doing now is that we can only touch so many lives when we’re doing things in the fashion that I’m doing it right now, right? So I’m seeing a lot of one-on-one patients and I hire a multiple advanced-level practitioners like the PA’s in my practice, but it’s still one-on-one care. So I am hoping that at some point I can develop a group model where I can really touch a lot more lives in that timeframe. 

And I think that the benefits we’ve done a little bit of group work and the benefits of that are significant. And I think people not only are using a practitioner like myself to help them, but they’re also using their own peers. And so that impact is really different. And I think it’s really phenomenal. And so that’s where I’m hoping to take the practice where we can actually have some group visits and some one-on-ones and so that’s my next project. I have a lot of other things that I wanna do. I have books that I wanna write. I have courses that I want to develop. And so, those are all my goals over the next five years. I’m hoping that we will have some automation in the practice and that there will be a bigger reach for us as we move forward.

Cheng-Huai Ruan, M.D.

No, awesome and you’re in luck, there’s a whole section in the summit for group visits that we’ve already done. So, this is exactly what the summit’s for, to help with automation, and then also realizing dreams, what does it take for group visits and stuff like that. And there’s some other people who have sort of been in your shoes and wanting to do that, that’ve already done it. and it’s just great to have that community. So thank you so much for hopping on today. It’s been such a great conversation and it’s always nice talking to you, yeah.

Radha Tamerisa, M.D.

Thank you, thank you and I wanna commend you for all that you have accomplished because, when we met, we were in our former practices and I think we felt trapped in a way. And we had dreams and aspirations that we weren’t able to fulfill in that arena. But we both took that risk and we both moved on with pursuing our dreams. And I mean, you are definitely a role model for me and you are some of the inspiration that’s gotten me to where I am. So I have to thank you for that. You probably don’t even know that, but when we met-

Cheng-Huai Ruan, M.D.

No clue. 

Radha Tamerisa, M.D.

And you were talking to me about some of the things that you were thinking about, I’m like, “Wow, that’s fantastic.” And I wanna appreciate your role in even getting me to where I am. So I appreciate that very much. And I appreciate all the referrals and the patients that we take care of together. And you were super, and you are, how many years are you into your practice now?

Cheng-Huai Ruan, M.D.

Ah, not that many.

Radha Tamerisa, M.D.

Not that many, not that many, so you took that risk earlier in your career than I did in mine and I think that’s another, you’ve achieved so much, so congratulations to you and where you’re at and the lives that you’re touching. And I know that from the patients that we share, that they appreciate you very much.

Cheng-Huai Ruan, M.D.

Well, thank you very much. So I appreciate that. I’m going to totally take that segment and keep it for myself. All right, well, you have a wonderful day and for those of you who are listening, I hope you really inspired by this talk because I definitely am and just keep following your dreams, and keep following your passion, signing out.

Radha Tamerisa, M.D.

Thank you, bye bye.