Mindset Shift: Scale Your Practice with Math & Marketing

Omar Khateeb

Absolutely, Dr Ruan, thank you so much. We see very much eye to eye as pioneers and visionaries as to how do we take medicine and take it forward. And so it’s an honor to be here. I’m very happy you put the summit together and you brought all these world-class people. I’m very humbled just to be even listed among those kinds of names. And so it’s an honor to be here and I’m excited to share some fantastic knowledge and strategies with everybody.

Cheng-Huai Ruan, M.D.

Yeah, awesome, so let’s kind of dive right in. And Omar, we met through the company that you’re currently working with which is Gentem Health, which is an artificial intelligence based revenue cycle and billing company. But we’re going to go, our topic today is going to be more about automation in terms of bringing those patients and keeping those patients and provide a hands-down, wonderful experience for them, which they actually deserve. And that’s how we survive as physicians. And that’s how we scale. So first of all, I want to talk about, for the last two years, I would say, we’ve seen a shift and one can call it censoring and one can call it clickbait. But let’s just talk about, there’s a shift in the marketplace of people latching onto things that may not necessarily be true, but it’s very marketable. And I think that physicians are honestly on the opposite end of that, where we have a BS meter that can go off because of our education, but we can’t really necessarily say that because of restrictions that we have. So how do we as physicians leverage the social media algorithms and leverage our voices to be heard?

Omar Khateeb

Yeah, absolutely, it’s a great question. And just for those watching to kind of add a little bit more credibility as to like, well, why should we listen to this guy? Me, I actually spent some time in medical school in Texas, went to Texas Tech University, left about halfway through to pursue a career in technology. And my own father was a general surgeon, owned his private practice for over 35 years, the last 10 years of it was in varicose veins. So I have a very deep respect and more importantly, understanding of the culture that is medicine. You can’t just say and do anything you want as a doctor. I mean, you could, but it’s a great way to wreck your credibility. 

So how do you walk that fine line of being engaging and engaging on social media, but then not ruin your credibility, because you’re right, there’s a lot of regulations, there’s a variety of things. So the first thing I would say is, let’s start with the basics, which is you have to come to terms with the fact that people consume information in different ways, right? And that means your patients, and that means before they become your patients. Because before somebody becomes a patient of yours, they’re like everybody else, and they’re consuming content on social media, and without them knowing. 

For example, let’s look at the world of let’s say super, super alternative medicine, such as when somebody is trying to sell, let’s say, oils or crystals. And they’re just saying like, this can cure anything. That is as kind of like a mimetic or a meme, where maybe somebody is not knowing the exposure that’s having to them, but the point that they have a problem, that’s the solution that comes to mind. Nothing wrong with that. But there is something wrong with it when that’s the only approach when it comes to solving your medical ailment. 

And so as a physician, you have to find ways to take your knowledge as a clinician and amplify it through social media, what does that mean? I’ll give you an example using my father, my father used to take his knowledge of varicose veins, and the kind of conversations you have with patients, what is it, what causes it, all these kinds of things. He would find, this is back 10 years ago, ways to put that information on Facebook and even on his website and proliferate it. So that way, when people are learning about it, he has that information out there as a respectable physician versus what they might read on a forum. Now with today, your question is specifically around some of these like hot trending topics like COVID is for example, one of those things.

Cheng-Huai Ruan, M.D.

Absolutely, yeah, huge.

Omar Khateeb

Yeah, and so one of those things of what I would say is something that’s interesting that physicians can learn from. You can learn a lot from observing your peers. And a lot of physicians, sometimes I think, we get trained to be very skeptical of things, which is fine, but you can’t be skeptical of things all the time in business, because sometimes you just have to say, I don’t like this, but I can learn from it. So, perfect example is how dentists and to another extent, plastic surgeons, hop on trends. And so a perfect example of that, and again, I don’t know how you would relate this to COVID, but just on super hot trends, we always see sometimes certain medical videos or things where it’s like a viral video, right? 

What a lot of dentists do, or some really popular ones, is they go on Instagram and there’s a filter where you can see the video that’s being shown and it shows their reaction, right? And so a dentist will show the video that they’re watching and then have reaction and comment over it. So that’s something that, if there’s a vehicle for attention, taking that vehicle, but then jumping in as yourself and commenting on it is one way that as a physician, you’re going to assert your professional opinion on things and educate the public. So, for example, if you look at, and again, this isn’t as controversial as COVID, but one of my friends, , a fellow Texan, he’s a spine surgeon out of Dallas. There’s all kinds of viral videos of athletic, or people just doing dumb things and hurting themselves. 

So he’ll often post videos onto Instagram , but then talking about how it affects the spine, or even let’s say, he posted a video of a really crazy injury. He’ll comment in the post a little bit about what’s going on . So again, the whole key is whatever’s getting the attention, it’s an objective thing, it doesn’t matter whether you like it or not, the fact is that people are putting their attention there. So how can you go where people’s attention already is, and show in a genuine, thoughtful, in a professional manner, education around. Don’t limit it to Instagram, Facebook, the other place is also Twitter. Twitter, I don’t find patients to be on as much, they are on there, as with Facebook and Instagram.

Cheng-Huai Ruan, M.D.

Omar, your audio just went silent all of a sudden, Like just now.

Omar Khateeb

Am I back, can you hear me now?

Cheng-Huai Ruan, M.D.

You’re back, what did you do?

Omar Khateeb

Hold on, we’re probably going to have to cut that out, I’m guessing, I apologize.

Cheng-Huai Ruan, M.D.

That’s okay, cutting’s not a big deal.

Omar Khateeb

Is the audio still pretty good?

Cheng-Huai Ruan, M.D.

Yeah, it’s still pretty good.

Omar Khateeb

Okay, so I’ll keep it on this. So I now have it coming out of my camera.

Cheng-Huai Ruan, M.D.

Okay.

Omar Khateeb

So this is why I need to get a a new mic because this keeps happening.

Cheng-Huai Ruan, M.D.

Yeah.

Omar Khateeb

So what was the last thing I said.

Cheng-Huai Ruan, M.D.

Well, you cut out for about good five seconds. Why don’t you start over at a segment-

Omar Khateeb

I was talking about Facebook, I remember.

Cheng-Huai Ruan, M.D.

Yeah, let’s just start with the Facebook comments. So we will start over again, let’s do it.

Omar Khateeb

Yeah, cut, so one of those things, so sometimes you don’t have to always create content. One thing that’s very surprising is that people actually spend time reading through comments on certain posts. And so a lot of times when you see a viral post on Instagram or Facebook, there’s going to be a lot of attention on that. So you, as a physician, again, if you have your name, MD, people are going to give more attention to your name because you have an authority piece on that, right? So even commenting on these posts help. The biggest thing here, again, Dr. Ruan, is to accept the fact that people’s attention, you do not have control over it. The best thing you can do is either create the same vehicles of attention that people want, or those vehicles of attention that already exist, go to them and engage as a physician so that you can start building your credibility. Just like you would in the real world, except this is more or less in the digital world.

Cheng-Huai Ruan, M.D.

That’s an interesting tactic, so I see a lot of physicians, commenting on things specifically like coronavirus, obviously it’s a trending topic, they’ll comment on ivermectin and hydroxychloroquine and all these off-label drug uses, which are a very hot topic right now. And they’ll do reaction videos. And that’s what I noticed. I was watching ZDoggMD the other day, and he’s like, he’s reacting. And Zubin was just reacting to very short clips of different things and him putting his take on it. Same thing with Tony Jung, the plastic surgeon. He was reacting to different implant sizes and stuff like that and sort of just trying to dispel some myths in a very comical way. So there’s a lot of people that kind of put their spin on it. And I think it’s very creative. And that’s what creates a lot of the viral culture behind this. 

But what you’ve noticed is no one really takes himself that seriously. There’s always a fun component to it. And I think that’s what humanizes physicians. And I think, on social media, there should be some sort of humanization. So, there’s a few doctors that talk out there, that can go viral, that have a lot of knowledge and information, but they generally have whiter hair and beards. And so it was expected of them to sort of have that sort of authority. But for the younger generation, like myself, and my colleagues, is that there’s just, it’s very raw and very real. And that’s what I’ve always appreciated about this, but my issue, and this is, and if you ever go to my Facebook, there’s a period of a year where I stopped posting for a specific reason. 

I commented much earlier on in the pandemic about the data of the first SARS, and vitamin D and how vitamin D can potentially help with coronavirus. And at that time there’s not much data on it. And then it was just a very simple thing that I quoted from a journal that was peer reviewed, and that got censored. And then I got restricted access from my internet account. And then now everyone’s talking about it ’cause it’s a thing now. And then not only that, and then when the vaccine came out and I posted hey, I got the vaccine and stuff like that. And I also talked about some other things you can do naturally, to help your immune system. Very, very, very minor stuff.

Omar Khateeb

There’s nothing wrong with that.

Cheng-Huai Ruan, M.D.

Very minor stuff, I apparently I violated community guidelines because I was already flagged from the first post about vitamin D. And then after that is more and more account restricted access. But what I was doing is I was actually trying to model after my other practitioners and what they were talking about, but they weren’t really flagged at the time, but I was one of the first ones to be flagged. So I think there may be some algorithm issues that were over there. And so we’re sort of in this society of, there’s a fear of censorship and there’s also a fear of being canceled, the cancel culture, if you will. And I talked to a lot of my physician friends, man, and they’re just terrified about social media in general. And they’re like, I’m just gonna put my head down and do my own thing right now, but there’s a lot of other practitioners that still want to be out there, they still want to be heard, because it provides a lot of pleasure and it also builds your brand. And so how, and here’s the question, I don’t have answers to this, is how the heck do you balance this? What do you do?

Omar Khateeb

You, I’ll tell you, and this is just one man’s opinion. I’m not a physician myself, but as I mentioned, I mean, aside from my father being a physician, I spent a large part of my childhood and young adult life learning the culture of medicine. The problem with physicians is they’re very opinionated people and they’ll fight for things, but then they’re very quick to give up control. And I mean, look at how healthcare is run today. And I think a lot of physicians would agree, part of that is that they didn’t fight to have the final word on a lot of things and to have influence, and some somebody else did. And I think the same thing has happened with social media, which is, if physicians decide that they’re going to just, hey, this is too hot to handle, I don’t want to deal with this. 

Someone else is going to, and someone else is going to control that narrative. And it’s just one other thing that physicians, they’re at risk of giving up. And so, I’m not telling you to go on and get involved with content involving COVID and vaccines, you don’t have to, but there’s a variety of other topics that patients and people need to know about, that you can have a very positive impact on. And if you’re not the one going on social media to create some kind of content and narrative, and people say, well, I’m only one person. Well, yeah, but when more physicians do it, that’s how you put out appropriate information and fight disinformation. Because again, there’s plenty of people out there who are not physicians, who are willing to put out their own narrative, and make a quick buck off of people. And here, just regarding vitamin D, I actually, before the pandemic happened, actually right in February or March, when we first went into lockdown, because of a physician who posted a video about vitamin D, and it was coincidental, ’cause I saw this video like a few months prior, just about like staying healthy and decreasing viral load for flu and everything. 

He talked about vitamin D and supplementing with like magnesium and zinc and vitamin C, the moment the pandemic happened, my wife and I, vitamin D supplements, we went on that regimen for a full year, no problems. We ended up traveling, we did end up getting COVID. we were over it in about three or four days, we handled it very, very well. And I credit that physician for making that video, explaining, hey, here’s one other way to decrease viral load. And again, this is like pre COVID, but it just so happened I watched it, and it had an influence on me. That could be any physician, and again, you don’t have to make like super over produced videos. You don’t even have to do infotainment if you want. But take to these platforms because they exist for a reason and they can give you a lot of power in your business. That’s I think the biggest thing and Dr. Ruan, you’re a perfect example of that. Would you not agree that social media has had a positive impact on your patients and business overall?

Cheng-Huai Ruan, M.D.

Oh yeah, absolutely, and I’m building social media, and every year I feel like social media changes in the way, the environment changes quite a bit, especially this year. And so, yeah, I see building an online reputation as a duty, because it is equity. Because I mean, if you think about what you see online, it’s the star reviews, five star reviews, if you think about what people talk about you. I mean, your great grandchildren are going to see those things because that’s not going away anywhere. When Google indexes you, it’s there maybe for centuries.

Omar Khateeb

Google owns the internet, I’m not sure if everybody here knew about this, but they own the internet.

Cheng-Huai Ruan, M.D.

They own the internet.

Omar Khateeb

You’re creating a digital version of yourself. You’re absolutely right. And I think the other thing is, put it like this, let’s make it as simple as possible. So as a physician, you create some videos talking about some questions that every patient asks about. Let’s say it’s an orthopedic surgeon. So every page is going to come and they’re gonna have a certain set of questions they’re always gonna ask. Take those 10, 15, 20 questions you often get asked about certain procedures or whatever, Pay 500 bucks, have somebody come in and film you, do a quick, one, two minute video, answering these questions, throw them up on YouTube, throw them up on your Facebook page. And then create like a blog answering these things, So that, that way, when people have these questions, they’re able to find them. 

And when I say find them, a lot of physicians think too big, they’re thinking, they’re trying to compare their practices to like a tech company, which nothing wrong with that. But most physicians are just trying to serve their local community. So focus on that, because somebody who is in the local community, who knows of Doctor Jane Doe or John Smith or whatever it is, they’re going to feel a lot more comfortable going to your website or your Facebook page to get information. Because I can speak anecdotally for myself and other friends. 

A lot of times when we’re looking for medical information, we’ll go to a local doctor’s page. ‘Cause it’s like, hey, that’s a doctor in the community that I know, or I’ve seen around. That’s like trustworthy information. And when that doesn’t happen, that’s when patients end up on all kinds of different websites and Facebook forums, and then they follow this rabbit hole. And it’s no wonder that patients make very bad decisions. Because again, you have to use these tools that are in front of you. Whether you like it or not, it has nothing to do with you like it or not. It is what it is.

Cheng-Huai Ruan, M.D.

Yeah, that brings up a really good point of how your online presence is directly synchronized to your work flow within your practice. And I can’t tell you how many times I post a video on Instagram and my staff’s like, okay, you didn’t warn us you would do that. And now we have bunch of phone calls and emails and stuff like, I’m like, oh, I’m sorry. And so even before I post anything, yeah, it’s a good problem to have. But before I post anything, I have to warn my staff, hey people, I’m about to post a thyroid video. And people with thyroid issues are probably going to call and want to make appointments. So the first, I’ll say year and a half of the current practice, Texas Center for Lifestyle Medicine. 

So I would make a video of the week. And then the next day I will go live on Facebook, talk to them about a video I made, and then whatever topic that is, every one that is in the waiting room has that specific condition and the next week it’s something else. So it’s almost like you’re picking and choosing who you really want to see and talk about. And I’ll never forget the feeling that I’m like, wow, I’m like, is it just me or am I seeing the same patients? And my office manager was like, duh, you just did a video about Hashimoto’s thyroid disease on Monday. I’m like, oh yeah, I did, I didn’t think about that, you know.

Omar Khateeb

I loved that you mentioned that because again, looking at, and this is why Gentem exists. I mean, Gentem thing is we want to help private medical practices stay independent. And the way we do it is through the automation side of revenue cycle and billing. But this is all, when when people say science is a means to an end. The means is really just getting knowledge. That’s why you run experiments, is to learn. The end is control, we want to control certain things. So in your own way, physicians complain about like, I get this random patient, that random patient. You can control this a lot more than you realize. And what you just shared is a great example of that. 

So I have a bone to pick, to be honest with you, ’cause I went through a process earlier, ’cause I actually just moved. So I need to find a doctor and I’m trying to find one. And here’s the frustrating thing I went through. I searched online, wonderful portal, owned by United Healthcare, which is the biggest health insurance company in the world. There’s like 1100 providers for this specialty that I was looking for within 100 mile radius. You know what I filtered to see how many of them had online scheduling, how many there were, there’s two, literally two-

Cheng-Huai Ruan, M.D.

Out of 1100?

Omar Khateeb

Out of 11, I’m not kidding you, I thought it was a mistake and I looked, yeah. And then, I’m like, okay, so I’m not going to schedule online, I’m gonna call. Then when I try and pick one, I can’t tell who I should pick, none of them have reviews. So I’m like, okay, let me search them. Do they then have a Facebook page? And I can’t find anything. So how am I supposed to, as a patient, decide who I should go to. At the very least, I don’t need to see a Facebook page, but at least if I see a video I’m like, oh, I really like this doctor, I want to go see them. And so it’s extremely frustrating as a patient, because we have this expectation as the consumer everywhere else. But yet when we go into medicine, if you want to talk about it, this is not exactly marketing automation, but it’s automation, have something where it’s easy for patients to schedule, that’s the point of automation, that frees up your staff. 

And that bit of time that your staff freed up, which I can imagine, if your staff isn’t having to answer phone calls and schedule appointments, they have some time to help you with marketing, maybe creating some content and assets, right? That’s the way I think automation should be thought of. And Dr. Ruan, your practice is a great example of this, which is what are some things that we can automate that’s going to make our patients’ lives easier and happier? And then because of that, we’ve now freed our staff up and our providers up, to do things that are more important, providing better care, patient education, doing a Facebook Live. I guarantee you that if I go and audit a physician’s office right now, I’ll find one stupid thing that they’re wasting time on doing like, let’s say doing phone scheduling. And with that time, they might end up with an extra hour or two that week, which can be used to do those events, like a Facebook Live to answer questions with people in the community. This is how a physician has to think about marketing.

Cheng-Huai Ruan, M.D.

Yeah, I think so. So that ties it perfectly that it may start with marketing, but it ends up affecting your operation and your revenue and then your revenue cycles. So another thing that I didn’t even think about until you just mentioned it just now, is that from the revenue standpoint, like making money, one of the great tools that we have, through Gentem actually, is that we have visuals, we have visuals, and then we also have different service lines and profit centers still, With automation, it sort of allows us to allocate our human resources, to sort of pad up some of these service lines that we know are generating the revenue. And we know that we can pad up these services and it’s what people are actually asking for. And that becomes its own thing. 

So it positively reinforces me. And I’m very proud of my clinic saying, hey, we have this fantastic, cancer survivor program that we got going on, and this is what it looks like, and this is the structure behind it. So I think knowing in numbers really frees you up to do the things that you really want to do and be creative with your practice and having people on board. And not only that, it dictates how you really want to market. So it’s not really a surprise. Like right now, me personally, I love like neurology. I’m an internal medicine guy, but I love neurology. So 85% of what I see is neuro-psych at this point, that’s like my thing, right? So it’s dementia and Parkinson’s and all the stuff like that. But I also know that because it’s a profit center for me, I can take my time, have one hour sessions with people, so I can take my time, do things, there’s certain procedures that we do so that we can build something out of it. 

So that’s generated from the revenue side. And so the thing that I get lost in, and maybe you have an answer to this, is if I’m looking at what I have right now, and this is my baby, and once you nurture sort of this service in the practice, this is what a lot of physicians have issues with and mine too, and then I’m like, oh my God, I’m also seeing this, I have a diabetes clinic here. And I’m doing all this other stuff, but I want to dedicate time to neurology. How do I shift my patient population to this neurology population, of the people coming in through the door, prospectively, through marketing so that I can see sort my neurology practice. how do I necessarily do that through marketing?

Omar Khateeb

That’s a great question. Now, before I answer that, I want to ask this, let’s say in this case, you’re doing a lot of different things, but you want to build your neurology practice, because that’s what you want to focus on. In this, let’s say this made up scenario, would that also be the, it’s not the bread and butter of the practice yet, but you want it to be that, is that correct?

Cheng-Huai Ruan, M.D.

In my view, the bread and butter is whatever-

Omar Khateeb

Whatever yeah, yeah.

Cheng-Huai Ruan, M.D.

Whatever the new trending service line is.

Omar Khateeb

Let’s say it’s well, if you don’t mind, just ’cause it’s, it’s a great example, I’m gonna use my dad’s practice. So my dad again, was a general surgeon, so he was seeing people for gallbladders, he was doing breast work, he’s was doing a lot of different things, but there came a time where he said, he started doing more in office varicose veins treatment. And then he wanted to transition to that. So the way you do that is you have to pick something. If you look at all the great companies, when it comes to marketing, Apple, there’s two companies that just, when it comes to marketing, you have to pay respect to Apple and Nike is the other one. With Apple, when Steve jobs came back to apple, they were in a shambles, but you know why they were in shambles? Very much like a physician’s office. They had all kinds of products, maybe in the hundreds. The first thing he did, he cut the fat off. He’s like, we’re not doing this, we’re not marketing this. And he’s like, we’re focusing on this one thing we’re going to market. 

So as a physician, when you want to make that transition, take referrals for those other procedures and everything, like my father did, but he made a choice, he made a decision, the root word in decision, is to cut off, you’re cutting things off. So there is a clear choice and intent, where my father said, I am branding and marketing myself and talking about varicose veins, that’s it, end of story. Because then once you do that, that creates a signal, not only to your peers and your referral network, but also to patients, who are looking for that service. And especially today in 2021, the most popular brand of soda is Other. People are looking for other things, they’re looking for very specific stuff. And that’s why it’s not a coincidence that the more lucrative medical specialties happens to be the ones that start to really reach down and focus on a specific area. And so Dr. Ruan to answer your question, make that shift, and you have to, it’s kind of scary, but you have to make that shift and be brave and say, okay, if I’m going to focus on this one procedure, I want to be known for it. 

And it’s not enough just to change your name, on your building and tell a few people. You have to go online, you have to do some Facebook Lives, put up videos on YouTube, you have to blog about it, you have to find ways to repeat the content. So it’s not enough just to create content around, let’s say this one specific area you want to be known for. You have to find ways to distribute it. That could be like, perfect example, in your case of neuro-psych, let’s say you make five or 10 videos specific to patient questions that might be answered, go to your referring practices and say, hey, I’m starting to focus more on this, if you have patients come in and ask about this, here’s some links to some videos I’ve created, here’s some blog articles. Please use these and shared with your patients. Because now you’re proliferating that content. And then locally within your city, wherever you’re located, you starting to build your name as the person who’s known for blank. Very much like what my father did with varicose veins. That’s really the first step.

Cheng-Huai Ruan, M.D.

That’s such a great point because within like, and this is what I tell people too, is like, don’t let your specialty define you, you define your specialty.

Omar Khateeb

Bingo, exactly.

Cheng-Huai Ruan, M.D.

And I think that earlier you said the bread and butter, and that bread and butter is typically what’s associated with like a specialty, oh, I’m internal medicine, I have to do diabetes and hypertension, which I still love to do. But once again, I choose a path and it really rewards me. So I think most of the doctors listening to this has something that’s in their practice that they do, that they value more than others, not necessarily that they do best, but that they value like, oh, I’m an orthopedic surgeon, oh my God, I love it when I operate on patients’ left shoulder, for example, you could be the left shoulder guy. 

Or you have, like one of my friends, Dr. Michael Kaplan here in Houston, he’s a ear, nose and throat doctor, but he is known as the sinus guy. Not the entire ear, nose throat, just the sinus guy. And he sort of made that brand for himself. So I think a lot of practitioners listening to this, think about what truly makes you happy within your practice. And it’s okay to pick and narrow that focus, but to do so you have to be strategic. And so, and I feel like, and where the risk comes in, Omar, is that as doctors, we have this sense of guilt, we are like, oh no, I can’t see you Mr. Patient anymore, because I’m doing this.

Omar Khateeb

Medicine’s culture is literally built on a hierarchy of guilt. When you’re put through medical school with your training, it’s just part of it. So we do this to ourselves all the time. But you’re absolutely right, which is like, things change, people are understanding. And my interview with you is fantastic, and one thing you, I might be slightly misquoting here, but you talked about how, if you don’t know the numbers, you don’t know your business, The numbers are your friend. And so, just to kind of tie a bridge here, like with Gentem, the one thing I tell our customers is that, we’re a data-driven platform and service. And there is reimbursement intelligence and medical practice revenue intelligence, meaning you got to know your numbers. 

And so when you have a platform that tells you that, you can see that, hey, this procedure is actually giving me the highest bang for buck, but I’m not focusing on it. And I do actually like doing this. So maybe I should start focusing and marketing on this. That’s a big thing for physicians that I love seeing at Gentem which is, certain surgeons who are doing a wide variety of procedures, would point out, Hey, you’re actually getting reimbursed at a higher rate doing this one procedure, but you don’t market it, why not that? And one surgeon even said like, yeah, actually I really like doing that procedure, why don’t I just focus on that? There’s nothing wrong with this. And I think again, the guilt and shame is always going to be there, but you have to get over it.

Cheng-Huai Ruan, M.D.

Yeah, so true.

Omar Khateeb

As you taught me Dr. Ruan, the numbers are your friend.

Cheng-Huai Ruan, M.D.

Yeah, math is your friend. I was never good at math, as Asian as I am, I was never good at math, but math is definitely your friend. So let’s talk about Gentem a little bit, because this is the company that we work with at Texas Center For Lifestyle Medicine, we actually just had our team strategy session with the Gentem team leader today. And it was just fabulous. And so marketing, you can’t talk about marketing without looking at the revenue. So if you currently have a practice, you currently own a practice or work within a practice. You got to know your numbers first. Then you figure out how to allocate marketing strategies towards the things that have good ROI or return on investment. And so it is so hard to get numbers in medicine, man, especially if you take insurance, because you have this thing called a revenue cycle, which I didn’t know what it was when I started the practice. 

But this revenue cycle is basically the amount of money collected through time and there’s denials and appeals and all stuff like that. But just to get like a dollar, you have to know how much money you spend to get the dollar. So we learned earlier on, and a part of what we were doing in IV infusion side, we were spending so much time getting that dollar, we’re spending about a dollar and 20 to get $1 back. Which didn’t really make any sense, we’re like, okay, let’s really narrow our focus here, let’s get rid of that. And that one strategy can really help us understand things. So, I think with the company Gentem, by the way, it’s a company that’s always focused on numbers. We are able to really make our own key performance indices, our KPIs, of what we like to see to know that we’re successful. So you’re the guy wearing the Gentem shirt. So I want to talk about this. And I think your CEO I’m gonna interview on another segment, so I won’t go too much into it. But I really want to relate once, again, the revenue cycle to the marketing ability. 

So let’s go back to a scenario, the one that you said earlier, so, hey, I’m a doctor. I really like fixing this thing, it makes me feel really good about myself, but the numbers aren’t necessarily there, but yet I like doing it. And so because I put value in doing this one thing, you may want to, hey, I’m okay with the numbers being less, because I’m way less burnt out doing this one particular thing. But here’s what I see Omar, and we experience this within our facility as well, is I see that the numbers aren’t transparent at all, at all through the payer systems, United Healthcare, Aetna, United, Cigna. I mean the most transparent one probably is Medicare, but it’s not all transparent. And then sometimes, you can get paid, a dollar and 70 short for a procedure all of a sudden, they’ll be like, oh, no, sorry, it’s a glitching error. And it’s been like that for the last year. Well, if you don’t catch it, you can’t take that money back. So there’s so much invisibility when it comes to the revenue cycle. And so how the hell do we deal with that?

Omar Khateeb

I feel like I would be supportive of this, but I’m just going to say that while I’m wearing a Gentem shirt, this is my personal opinion. Just to absolve my company. But I really don’t like insurance companies, because these companies are set up to screw over patients and doctors. And the fact that they answer to Wall Street, a lot of times, their thing is, they’re incentivized to make more money. Which means that if they find a way to not pay a physician what they’re rightfully owed, that’s what they’re going to do, and it’s not an evil thing, it’s just like human nature, it’s a business. And so what Gentem does is it provides that leverage to a physician. It provides that, I guess that ability to see what has been invisible and make it visible now. And we work very, very, hard to put it on a platform where it’s very simple to understand, it shows exactly what has been submitted, what your charges are and what you’re actually collecting, it’s very, very clear. And when you’re able to see that level of detail and it’s transparent, that’s when, and again, it’s not enough just to give the technology, that’s why we have team leads, that’s why there’s an education and support side of Gentem, that’s what brought me here is because we’re not just showing up and telling a medical practice, hey, just let us do the medical billing end, you don’t have to worry about it. 

We’re going to do the medical billing, but we’re going to transparently show you the data, we’re going to be held accountable, and we’re going to teach the physician, the practice manager, everybody in the organization, how to think about revenue cycle management. So you can actually really own the business, own the numbers, own the money, because once you have that, that’s when you can start acting like a true business owner, and you can say, hey, you know what, we reduced, and I’m quoting. I won’t mention the practice, we’ve reduced the number of our denial, our denial rate has gone down by like 10 or 15%, our revenue has gone up by eight or 9%. 

So we actually have a nice, good amount of cash coming in month over month, that we did not have before. So let’s take a quarter of that money and just invest it in marketing, maybe getting some content, paying for some paid advertisements. So that patients, whether it’s the actual patient themselves, or maybe their kids or somebody who’s taking care of them, sees some of this content about a problem they have, and then we’re the ones educating them, so that when it comes time for them to say, I need to see a doctor about this. There’s only one place that they’re thinking about. This same concept, Dr. Ruan, one that I just told you, this is how the biggest, most powerful companies in the world think about marketing, which is how do we become the source of education for this problem? So we teach this person the name of the problem, what the problem is, how to solve it. Because if you do all those things, they’re are going to come to you for the solution, And you can do that as a physician, but it only happens when you know what your numbers, when it comes to revenue cycle, you’re absolutely right.

Cheng-Huai Ruan, M.D.

It only happens when you know your numbers.

Omar Khateeb

Exactly.

Cheng-Huai Ruan, M.D.

I learned that the hard way.

Omar Khateeb

That is exactly right And even in the startup world, like, I go through a lot of venture capitalists’ decks, and there’s a few VCs who mentor me. And there’s a framework where it shows, because at the beginning you have to spend a lot of money on sales and marketing, but you don’t get there until you actually know your numbers, like your cost of customer acquisitions, how much is going into different parts of the business, because then you know what it’s going to cost to put into sales and marketing. And so then you know specifically, hey, I’m putting a dollar in, I’m getting two, three, $4 out. And if you’re not getting that, if it’s a negative, then it’s like, well, we have to figure something out here. You got to make more money or you have reduce costs, but you don’t know that unless you know the numbers.

Cheng-Huai Ruan, M.D.

Yeah, you’re absolutely right. And I call that a money machine. If you can put in a dollar and make two, then you basically have a money machine. And so to do that, you really have to know your numbers, but not do you have to know your numbers, you have to turn the numbers into words. Like I know my numbers, but what am I going to do with this? How am I going to lead my team with this? And what do I want to leverage? And this is not about chasing money. 

No, this is about chasing what you love to do as a practitioner, know your numbers, and your numbers and your desire may not match. For example, if you’re an OB-GYN, you really like OB, you like delivering the babies and stuff like that, while the GYN can make more money, but that’s not what your desire is. But you can say, hey, is it worth it for me to just go fully OB? Or if you are that orthopedic surgeon, hey, what if I just focus on frozen shoulders as a diagnosis? What does that happen to me? It may not make as much money as doing some of the other things, but this is what provides me with a lot of satisfaction, and the numbers will set you free. And that’s the takeaway here, is the numbers that you free, and that’s the most important thing I want people to take away from the Automation Summit, is that without knowing the numbers, you can’t automate things.

Omar Khateeb

That’s such a great way to put it. I love that you framed it that way. And you’re absolutely right, because again, let’s set Gentem aside for a second, let’s just put transparency into your data. How much are you getting reimbursed? Where’s the money coming in from? Once you get that clarity, you have a path to say, I do actually really love doing these one or two or three basic types of procedures. So now you actually have somewhat of a roadmap to say, well, for me to get to a point where that’s all I’m doing, this is what I have to do. This is how I should market, this is how many patients I have to see. And a lot of times, doctors who take that route, end up making more money in the long run, because that’s what they’re focused on, and that’s when people start flying in. There’s certain physicians, I know they’re doing in office kyphoplasty, which, yeah, it’s crazy, it’s actually a thing. And now at that point, now you go beyond your own community and that’s when people are flying in to see you, this is how you think about it as a business owner. 

But I completely agree with you is that that’s the best way to look at it. And then let’s say, even so, you don’t make as much money as you did, or let’s say you you’re still at the same amount. What’s most important, as you pointed out, Dr. Ruan, is the satisfaction, and fulfillment. Physician burnout is on the rise and physician suicide rates are on the rise. Physicians that have a higher suicide rate by like 30% compared to the general population. It’s not by accident, it’s because I think there’s a lot of lack of transparency, they don’t know the numbers, and so as a result, every physician does what they think is the right thing to do, which is I’m just going to work harder. That’s not the solution.

Cheng-Huai Ruan, M.D.

Yeah, and a lot of times in working harder, the burnout’s even more because a lot of physicians don’t feel like they’re really appreciated. I am in some of these physician, like really large physician forums on Facebook. And what drives me nuts is just that the amount of griping and complaining that’s in there of something that’s seemingly small. And then there’s a lot of resentment that really occurs in the people that post those things. I just feel kind of sorry for them because they feel trapped, and trust me, I was one of those people back in the day, I felt trapped, but how do you get untrapped and you gotta start with the numbers. I think that for those physicians who are kind of listening out there, and if you’re in private practice, click on the link that’s with this video, just click on it. It is a free assessment that you have for your practice to to Gentem. I mean, it’s such a wonderful tool. When I clicked on it, that was probably one of the best decisions I made for this quarter.

Omar Khateeb

We’re so happy to have you too, absolutely. And speaking about the numbers, look, come to Gentem, we’ll do this free billing and reimbursement assessment. You’re going to learn a lot. We’re going to show you the data and numbers. It shocks everybody, but it gives you a place to start. And as Dr. Ruan pointed out, I’m very proud of our technology platform, but I would say I’m even more proud of our people, because each practice they get, we have a customer success team, We have certified RCM managers who work with you to really coach and teach you the business of medicine. And I think that’s a very empowering thing for a lot of people.

Cheng-Huai Ruan, M.D.

Well, I think, if people are listening to this and a lot of people really want to be kind of set free from some of the day-to-day stuff, you gotta have to be a little innovative and engineer things, but it starts by clicking that link and just say, hey, let’s see what the practice is doing. There’s not really any risk to it. But then I know some people are just like, yeah, I’d rather be blind to it right now because I really can’t take a lot of negativity. But those people wouldn’t be really listening to this video, to be honest with you.

Omar Khateeb

I think this summit has attracted thousands of really innovative people from around the world. I think they all came here for a very specific reason, but, as the old saying goes that the truth will set you free maybe, I guess in 2021, it’s the data will set you free.

Cheng-Huai Ruan, M.D.

Absolutely, the data will set you free. So well, great, so we’re going to close this with a question that I ask a lot of my interviewers, and is, I want you to kind of go back in time and I want you to go back, I’m going to say four years ago, Just imagine yourself four years ago. What do you know now that you wish you could tell yourself four years ago, if you go back in time? This gets everyone.

Omar Khateeb

You know what, I’ll tell you it. Because I’m staring at it right now, because I have it written up so I remind myself of this, watch your thoughts, because your thoughts become words, watch your words, because those words become actions. Watch your actions because those actions become habits. And watch your habits becomes those habits become your character. You got to watch your character because that becomes your destiny. And the the takeaway here is we literally do become what we think. It took me a long time, as you can see, I’m sitting in my library, I read a lot of books, a lot of old ancient books, there’s nothing new under the sun. And this is what I realized. 

And so as a physician, if you think that you’re just going to be in the rat race, you’re gonna be on this hamster wheel forever, that’s what’s going to happen. That’s why I think in this country, the first amendment is so important because in order to think, you have to speak, and the words you speak, you take action towards. So that is such an important thing. And it makes me sad to hear, you’re mentioning that some of these physicians are complaining in this group, but you really do become what you think you are. I think there’s even a quote, whoever you think you are, you’re right. That’s something that I wish I knew four years ago, because knowing that now, I mean, it’s definitely transformed my life very, very much so.

Cheng-Huai Ruan, M.D.

Well, that’s a wonderful takeaway. It’s a beautiful way to close this. So thank you very much. How can people find you on social media and whatnot?

Omar Khateeb

Yeah, absolutely, you can find me on LinkedIn, Twitter, Facebook, Instagram, YouTube, and Snapchat, just to look up my name, Omar M-

Cheng-Huai Ruan, M.D.

We’ll have the link in the video description, so people can click on.

Omar Khateeb

Just find me there. I would say the platform I’m most active on is LinkedIn, LinkedIn and Twitter, but I’m active on all of them.

Cheng-Huai Ruan, M.D.

Awesome, If you haven’t checked out his podcast too, it’s absolutely fabulous as well. Well, thanks everyone for joining us. We’re going to sign off and then we’ll head on to the next session. I’ll talk to you soon.

Omar Khateeb

Thank you you, Dr Ruan, it was a pleasure

Cheng-Huai Ruan, M.D.

Mm-hmm