21 Feb 5 Strategies To Grow Your Private Practice, with Dr. Lee Schwartzberg.
As a part of my interview series with prominent medical professionals about “How To Grow Your Private Practice” I had the pleasure of interviewing Lee Schwartzberg, MD: Board Member of OneOncology and Executive Director of West Cancer Center, a founding practice of OneOncology.
Dr. Schwartzberg was the founding editor-in-chief of the journal Community Oncology and currently serves as the editor-in-chief of the Practice Update Oncology website and is on the editorial board of both the Journal of Supportive Oncology and The ASCO Post.
Besides serving as a reviewer for many prominent medical journals, including the New England Journal of Medicine and the Journal of Clinical Oncology, Lee is also a member of the board of directors for the National Comprehensive Cancer Network where his major research interests are new therapeutic approaches to breast cancer, targeted therapy and supportive care.
Thank you so much for joining us! Can you tell our readers a bit about your ‘backstory”?
I became interested in oncology early in my medical training. I did my fellowship in oncology and hematology at Memorial Sloan Kettering and was prepared to practice in an academic setting where I could also focus on research.
I had personal relationships with the physicians who turned out to be my founding partners at West in Memphis. We all shared a vision to conduct research in the community setting. That original vision is what we’ve accomplished over the last thirty years: replicating the best of academia in the community setting to give patients access to the highest quality care while also conducting research so patients also have access to clinical trials in their community.
Making the shift to the community setting was a major turning point in my career. It was also a huge leap for me personally moving from my home in New York City to Memphis, Tennessee — a state and city I had never visited up until that time.
What made you want to start your own practice?
I was always interested in “higher-stakes” medicine. When I entered medicine, oncology was the highest stakes of all specialties. Early in my career, patients just didn’t survive, but there was a glimmer of hope in understanding the biology of cancer. Back then, we were only at the dawn of being able to take all the science and figure out ways to deliver it to patients. That’s what excited me then and is what still excites me today: delivering scientific discovery to improve lives.
Another important impetus for my partners and I when we started our own practice was the ability to identify new trends early on. We’ve been early adopters and made relatively wise choices that have benefited patients. We did that early on in the life of our practice, and it’s paid off in the form of better patient care.
As one example, we were the first group practice to invest in a CT machine outside of the hospital setting. At that point, for a group practice, it was unheard of to invest significant resources into technology but putting the CT machine on site in our center improved care in just about every case. It changed how we read images for patients and enhanced our care. Today, CT is ubiquitous in every group practice, large or small. I’m proud of the decision we made, the risk we took, and the value the CT technology afforded us to deliver to our patients.
Another example is in precision medicine. Four to five years ago at the beginning of precision medicine, we recognized the value of knowing the genetic alterations in cancer so we could get our patients into the right clinical trial. We established our involvement early in precision medicine, and now it’s being used in academic centers.
The bottom line: being an early adopter has been invaluable as we started and grew our practice.
Managing being a provider and a business owner can often be exhausting. Can you elaborate on how you manage both roles?
I agree!! It’s exhausting!!!!! Being a business owner and managing a business is challenging. They do not teach business management in medical school or fellowship training. I learned from making mistakes. The competitive environment of managing a business today is dramatically more complex than it was 30 years ago. We wouldn’t be successful today if we used the same approach as we did back then. We felt our way along. There was room to make mistakes as a business owner. And we made plenty of them — and we tried as best we could to learn from each.
Generally, now my business advice to physicians is: don’t try this at home. Get the expertise you need. It’s rare for a physician to have business skills or a desire to learn them. Physicians need to know there is help, and that they should learn from those of who’ve gone through it. My fellow OneOncology physician executives, Drs. Jeff Patton and Jeff Vacirca, and I try to put our teams in successful positions by serving as the interface between the business and the clinical worlds. In these two vastly separate worlds, it’s important to have someone who speaks both languages and understands both sides. I’ve learned how to navigate this over the years.
As a business owner, how do you know when to stop working IN your business (maybe see a full patient load) and shift to working ON your business?
Physicians in general, and me specifically, tend to be perfectionists. We are wired to do as much of the job as possible. This is especially true of my generation of physicians who were trained with this perspective in mind.
As I’ve grown, I’ve had to learn it is more efficient to get the job done by delegating and managing the tasks. Not doing so leads to burnout. It’s been a difficult lesson to learn. I’m better at it now than I was when we began West, which has been humbling. You have to delegate and manage to succeed. For me, that’s translated to cutting down on my patient obligations. That’s difficult, especially when you’ve been practicing for a long time and love the patient interaction. As I’ve cut down on my patient load, we’ve worked as a team to ensure the patients I do see have access to me and my staff just as they would if I was practicing full time.
From completing your degree to opening a clinic and becoming a business owner, the path was obviously full of many hurdles. How did you build up resilience to rebound from failures? Is there a specific hurdle that sticks out to you?
There is a specific failure that sticks out to me that has helped build resilience. Through personal relationships, we had an opportunity to open a clinic in Singapore — half way around the world. The principle was sound then and remains correct today: Bring expertise and use it in an emerging market where people need access to care. We were a group of people proactively running oncology practices 12 hours apart, meaning we had to run operations 24 hours a day — which stretched us. What I learned from that experience is that not every opportunity — even those built on sound principle — should be executed. And if the opportunity is pursued, it must be pursued in a way that doesn’t compromise your core mission.
What are your “5 Things You Need To Know To Grow Your Private Practice” and why?
- Relentlessly focus on the patient; their care and their experience.
- Understand your market. Identify opportunities to grow and focus on those that are high-growth, not necessarily every opportunity.
- Hire high-quality individuals to grow your practice. There is a difficult dynamic between speed of growth and having the best team — both administrators and providers — to manage expansion. Focus on hiring outstanding talent, not just who is available. My philosophy is to never sacrifice quality for speed. I much prefer to wait for the right people to match to the right opportunity rather than settle for less. We’ve really excelled at this at West Cancer Center!
- Invest in innovation; technology is important for growth. It is a scary proposition, but very important. That first CT machine we purchased was a lot of money, really a fortune in those days. But it worked for our clinic and, more importantly, for our patients.
- It’s okay to learn from your mistakes. Everyone makes mistakes. The key for growth is to learn from your mistakes and not repeat them. In a partnership, it is very difficult to look each other in the eye and say: “that wasn’t a good decision, let’s try it another way.” That’s not how we’re wired as human beings, but it’s paramount for growth — professionally and personally.
Many healthcare providers struggle with the idea of “monetization”. How did you overcome that mental block?
If we make sure we do what’s best for the patient, it should be best for physicians as well. Aligning patient and physician outcomes is best for everyone.
What do you do when you feel unfocused or overwhelmed?
I sometimes have trouble completing tasks, and I used to have trouble saying no. I really get excited about new things! But those projects are only worthwhile if they get completed. My to-do list can be overwhelming; it often has more “to dos” than “completed” tasks. But, at the same time, I do perform well under pressure, and I use high-pressure situations to become very efficient. I constantly walk a fine line between balancing taking on too much and stimulating my professional curiosity with new projects.
I’m a huge fan of mentorship throughout one’s career — None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
The most important mentor to me has been Dr. Bill West, the founder of our practice. What I learned from Bill was having a vision and bringing it to life. Of all the people I’ve known (and I’ve known some brilliant people), Bill remains the person with the best vision and clearest path for achieving it. The other thing I’ve learned from Bill and my other co-founder, Dr. Kurt Tauer, is respect for everyone. I attribute much of our success to our focus on valuing everyone’s contribution to the practice. A physician is no better than anyone else. We are all part of a team to take care of very sick individuals. We treat them like family because that’s the way we would like to be treated if we were in the same situation.
What resources did you use (Blogs, webinars, conferences, coaching, etc.) that helped jumpstart you in the beginning of your business?
It was such a long time ago, it feels like a different world. The most important resource I had was leveraging personal relationships to engage individuals with expertise I wanted to better understand. Today, while expertise is more democratized and available in infinite forms, I still believe personal relationships with individuals, who have an expertise and have been through similar situations, are extremely valuable. Today, I still learn by talking to other practices and physicians to learn how they addressed and solved problems.
What’s the worst piece of advice or recommendation you’ve ever received? Can you share a story about that?
I’ve received some bad financial investment advice. It seems to me doctors tend to be susceptible to bad financial advice. I’m no exception.
Please recommend one book that’s made the biggest impact on you?
I don’t read a lot of business books, but Good to Great by Jim Collins had a lot of value and changed my thinking.
Where can our readers follow you on social media?
I am not a huge social media person, but you can find me on Twitter @oncSTATdoc. You can also get updates from OneOncology on Twitter @OneOncology and on LinkedIn.