Episode 66: Plotting The Path To Pain Practice Partnership w. Dr. Joshua Suderman

Sep 28, 2020

This Episode

Interview w/ Dr. Joshua Suderman

You Will Learn

– Dr. Suderman talks about what surprised him the most about his private practice journey.
– How Dr. Suderman was able to become a strong vulnerable leader after graduating.
– Dr. Suderman says what the most challenging part of transitioning to practice ownership is for him.

Resources & Links

This week I am talking with a favorite past guest, Dr. Joshua Suderman. We discuss his journey from fellowship to building his own private practice. Dr. Suderman talks about many of the challenges that a physician has to consider but aren’t often talked about. He also discusses marketing strategies and the ways he has learned to build a strong and happy team.

Justin (00:03):
Hello and welcome to this episode of anesthesia and pain management success. I’m your host, Justin Harvey. This is episode 66 and I have a returning guest, dr. Josh Suderman who joined us way back in episode 36.

Justin (01:01):
We’re talking about prior authorizations and he’s done a lot of great work around advocacy for helping streamline this process for physicians, but ultimately for patients who need care. Dr. Suderman is double board certified in anesthesiology and pain management. He’s currently practicing in the grand Rapids Michigan area at the Javery pain Institute where he is a partner and he’s graciously offered to come back and tell us about his journey as a, you know, starting out as an associate physician, and then moving into that partnership track, and eventually becoming a partner in a private pain practice. So, dr. Suderman very glad to have you here today. Great. Hey, thanks for the invite again, looking forward to it. The funny thing about pain management, one of the funny things is that obviously you only train in academics up until the time when you finished fellowship. And then so much of pain management happens in the private practice setting and understanding the business dynamics is so important and understanding, you know, different practice models and compensation and all that.

Justin (01:57):
It’s all very, very important and relevant. And there’s very little preparation for physicians. Now, there were a few, I would say there are a few areas, a few organizations that are getting young doctors up to speed in Asmara and Aspen, and a little bit with the ASA, but by and large, this is an area where a lot more information is needed and is needed to be more broadly disseminated. So tell me about your experience as you’re finishing up at university of Michigan. What were the categories in your mind as far as what practice might look like and your understanding of sort of the career decisions that lay ahead? Right. You know, when I was in training I, I knew I didn’t have a passion to pursue research or, you know, teaching us to but I, I knew I wanted to have a job where I could help patients be successful in that regard, but also kind of balanced family life. And I knew that my wife and I had kind of a geographic area that we wanted to search for search within and private kind of fit

Dr. Joshua Suderman (03:00):
Within that rather than private practice first. And then we look somewhere. So that’s kind of where I fell into private practice and grand Rapids was close to family and in this area, pain management is performed by private groups. We don’t really have academic centers here, or if we do, they’re kind of peripheral in our specialty. So I knew that’s where I wanted to be in private practice, became that for me. But, you know, I didn’t really think about being a business owner. When I started out as an employed physician, I just knew I wanted to get a job support my family.

Justin (03:32):
You make a great point. And this is true in anesthesia as well. My wife and I, you know, she, she was recent where she’s about to finish residency. We’re looking at jobs and depending on where you’re at geographically, your practice type, maybe fully defined by the geographic areas in which you’re looking. So that is obviously a constraint that I’m glad you pointed out, but one of the challenges then if you’re in the private practice world, especially in what I’ll call like the smaller physician owned private practice there’s a lot of things you need to worry about aside from strictly patient care and clinical considerations. So tell me a little bit about your journey as you started to say, okay, I want to be in grand Rapids, looks like private practice is the thing. And specifically small physician owned, private practice. And therefore there’s a lot of implications for your intellectual journey starting at that point.

Dr. Joshua Suderman (04:22):
Yeah. And in a journey it becomes, and it’s intellectual, it’s spiritual, it’s emotional. There are implications that you just can’t even see. I mean, at first I was admittedly hesitant to think of myself as a business owner, but with all of the perceived extra burden that comes with that, you know, when you’re coming out of training, you just want to do medicine. And that’s the honorable thing. And did the business side of it is kind of slimy in some ways, you know, it’s literally least it’s perceived that way. It can be. But I realized that as time went on being a business owner really helps you take ownership of the trajectory of your career. There are so many factors that impact your ability to provide care billing, reimbursement interactions with staff, maintaining a healthy workplace and environment, in addition to your amazing smarts and procedure skills. So that the term business owner encompasses all these layers. And that’s part of the journey. I didn’t have a vision of that when I started, but I realized it was vital to understand what it means to run a business and give myself the best chance of success. Yeah.

Justin (05:23):
And I’m glad you made that comment about the, sort of the dichotomy between the money and the medicine. I think this is such a false dichotomy and frankly, I have my own conspiracy theories about why this has perpetuated, but it’s so critical to have physicians in positions of leadership and advocacy and governance and building the systems and creating the policies. And I think that there are certain parties and entities out there in whose interest it is to sort of Pat the doctors on the head and say, you’d be a good doctor. You go take care of the patients and let us worry about all the scary, complicated money stuff. Cause it’s really over head. And that is obviously ridiculous in my opinion, but I think doctors can be intimidated sometimes or just say, okay, like, this is the thing for me. And that’s not the thing for me. And it creates this sort of cast system to some extent in a healthcare decision making vet, ah, once you, what, that’s one of those things. Once you see it and understand it, all of a sudden it’s everywhere and it’s at the bottom of almost every healthcare issue. And so I feel so strongly about trying to level the playing field informationally speaking. And that’s obviously one of the purposes of this podcast,

Dr. Joshua Suderman (06:32):
Your article, you posted yesterday about RVU. It gets to that a little bit. If people want to check that out, that three column image there really kind of pointed out where you may be employed, but you’re also vulnerable in that situation. If you’re an owner and you have some understanding of this and you can be nimble even in a crisis like we’ve had to be you’re actually less vulnerable in a lot of ways. So that’s probably for a whole nother podcast, but you know, I know you’re getting the word out in that post yesterday or in the recent future was excellent.

Justin (07:04):
Yeah. so you, you joined this practice with dr. Jhaveri and you had an idea that this is probably a place you kind of want to plant your flag and be for a while. And you were enjoying the experience clinically. Tell me about sort of the process, the dual process of kind of learning about what it means to be a practice owning physician, as well as the, on ramp to actual ownership and the conversations and the sort of the learning that happened as well as building a relationship with a potential future partner.

Dr. Joshua Suderman (07:34):
You know, from the beginning, I always knew there would be a discussion about partnership after my years, as an employed physician were up. I’ve also heard that partnership is not being offered to physicians as often these days, you know, it’s more and more difficult to, you know, make a living in private practice, declining reimbursement, and increasing regulatory burdens factor into that. But, you know, we developed a trust from the beginning that I knew, you know, when I signed on it, wasn’t a requirement, but I knew it would be a conversation and an option. And the more I went on as he, and I kind of got to know each other and trust developed and our relationship developed, and I learned from him, it just kind of naturally flowed into that because we’re a smaller group. And because we like we needed each other to survive. And if I didn’t want to uproot and have a big change in my life, I knew I would have to take on some of these skills. My practice pattern was individual and I was allowed to develop that however I wanted to, but I guess it was just through that relationship that developed that I knew I needed to keep talking about it and learning about this in preparation for when I need to make that decision.

Justin (08:43):
So it sounds like you had some clarity at the outset about expectations regarding the potential future availability of partnership. Is that fair to say? Yeah. And this is an area of, I’ve seen significant, it’s important to be aware of if you’re signing onto a practice or taking a job, what are the contractual, what’s the contractual language governing your path to partnership? Are there contractually defined checkpoints? If it’s like, we’ll let you know, after 24 months, if we like you or not, that’s very different than there’s a potential. After 24 months, we’re going to check in quarterly to see how it’s going and give you updates. If you’re deficient things to work on things we’re thinking about so that you don’t, you don’t burn two years of your life on an opportunity. Yeah,

Dr. Joshua Suderman (09:23):
It’s a spectrum too. It’s not that like, you always have to have the dichotomy of employed, then you better expect to be partner or move on practices, do this very differently. And it, what it means to be a partner here means something totally different in a different practice. What other setup just for your listeners to be aware of somebody works a certain number of years or months, and once they’ve turned positive for the group, then they are a partner and they have a say in taking, eating what they kill, but they have no say at the decision making table for the direction of the policy that’s for board members. So there can be a spectrum. And it’s not like our setup where basically once I’m partnership and now six years in actually August 1st, I finished my buy in. So I’m fully vested in all levels. This is kind of a timely podcast. So it’s been fun. And it’s been interesting in a very good way. So just for your listeners to be aware of you’re exactly right. No, the contractual language, no. What it, what these words mean and how they’re defined specifically because partnership, board member, whatever can mean different things and that needs to be spelled out.

Justin (10:36):
Yeah. And I come back to the thing that I heard on the very first interview I did on this podcast with dr. J Greider, who said, if you’ve seen one pain contract, you’ve seen one pain contract, and unfortunately we’re going to give some rules of thumb and some paradigm, but every opportunity, every practice, every, it always needs to be individually evaluated and partnership might mean really not actual partnership in some circumstances. So as you’re you know, making this type of progress towards this big business and life decision, or are there any areas where you’re like, Holy cow, this is maybe one or two specific areas where I am entirely deficient in my current understanding of how things work. And I need to get up to speed. I need to find some resources. I need to do some legwork to become more well-informed. Yeah.

Dr. Joshua Suderman (11:21):
I think three areas jump out financial marketing and for lack of a cliche and catchy term emotional intelligence. So the first two are normal or natural. You would say in running a business, you gotta be aware of the financials and you gotta have somebody go with you like an accountant or a lawyer to understand what that balance sheet means. Where’s your column, what expenses are being taken from you and what are being attributed to you. So when people start out, I had no idea, but even though you’re the practice quote unquote from the day you start, the more productive you are, you’re you are what’s called absorbing overhead almost from day one, because the more production, the more use you have a clinic supplies. Well, if they didn’t go in, invest in a whole new building for you, you’re using the same inventory and work staff that was there before.

Dr. Joshua Suderman (12:14):
So now you’re shifting those expenses away from the partners and that’s making them more profitable. So understanding the financials of where in the mix of all those little lines and numbers, you’re actually helping out and you’re being positive from day one marketing, I got nothing on day one who wants to market themselves. We just want to take care of patients, right? Well, you know, the reason I’m doing this podcast and I could think about this is, you know, who Leon, our marketing director he is in touch with us weekly. We have someone amazing here who has taught me how to build your brand in an honest way. It doesn’t feel slimy. It’s just who you are. And isn’t that what medicine is, is the patient trusting you as a person. So it’s just taking that to a different population level, just like there’s population medicine and individual medicine. It’s just marketing yourself and who you are even straight out of training. And then finally, emotional intelligence. I had no idea how important that was for staff. You know, you’re a village, it takes a village. You are only going to be as productive as your staff, as much as your staff supports you in your role. And so those three areas really shocked me, but have been great here

Justin (13:27):
Makes a lot of sense. And I I totally agree that that’s sort of a perfect encapsulation of this stuff that there’s, there’s no room for in the med school curriculum for, for whatever reason. You know, that’s fine, but, but just knowing for physicians out there that there is a gap in these very critical areas is, is the beginning of, I think, progress in these ways. So as you said, I need to get up to speed on the financials. And if we kind of limit it to the strictly business categories for a moment, financials and marketing, as you said, I want to make progress. I want to be a contributor. You know, I’m thinking about buying into this practice. I want to start to grow the top line, top line, being revenue, and then work the, what we call the P and L the profit and loss, which is basically all the stuff you spend money on. And then the profit is the bottom line. So your, you want to grow the top line with marketing. You want to manage the P and L with business acumen. How are you getting educated? What resources are you leaning on? Is it just trial by fire? You just start sitting in with meetings with this CPA, you know, quarterly reviews or, you know, are there other things that you relied upon?

Dr. Joshua Suderman (14:30):
I remember looking for a bunch of books on Amazon we’re doctors, right? We’re going to look at that handbook, or, you know, as I was in training, a transition to PDAs, and now we have smartphones, I’m really dating myself even at almost 40 here. It’s pretty crazy. So I tried to do a lot of that, but it’s kind of nebulous when you don’t have one of your own balance sheets right in front of you and your eyes start to like boggle those numbers, our accountant in this group, I am so lucky that we have the accountant. We have, Dave is so experienced and he did just what you said. He just sat down with me and started to explain things. Now, if you’re at the phase where you’re thinking about buying in, you may not have access to the company, lawyer or accountant. There are people out there that will help you with this. And in fact, I got a reference from faculty and my training program to do these kinds of things for my first contract. So yes, sit down with an expert and go over that and kind of learn it in real time, just like in medicine, right. You can do all the bookwork from an Amazon book, but you know, you got to go in and see a patient. So get the real stuff in front of you with that expert. That is, I’ve just, that’s how I’ve learned. And it’s finally making sense, maybe a little bit

Justin (15:41):
In front of the listeners who maybe have specific questions. There’s obviously different experts for different types of questions. And I’m, I’m glad to try to connect you with the right resources. If you have questions. You’re like, I want to know how to understand my practice P and L or I want to know what the implications are for buying in structured this way. Drop me a line just in an anesthesia success. I’d be glad to, if I can’t answer your question, I’ll connect you with someone who can, cause I obviously bump into lots of these people doing what I do here, but I want to hear dr. Suderman a little bit about the structure of kind of your agreement with dr. JV. And how did he, did you guys have checkpoints or hurdles you had to clear, or how did he, how did you earn his trust over time and how did you structure that deal?

Dr. Joshua Suderman (16:24):
I think earning trust comes from just practicing together, being open to his advice. Private practice, obviously different than academics. So understanding how private practice works and building that patient relationship and building your patient population. We knew the way it was set up is that for three years I was employed. And actually my contract at that time allowed me to take home a percentage of the profit I generated for the company. So I had some incentive, but I also had a base salary for three years. And that was kinda nice. At three years then we sat down and we decided on a, either a different trajectory towards partnership, or at least there was an option, you know, that we could have discussed continuing with that employee based contract. So that was kind of the progression. And then from there, the next three years have been, I have a salary I share in the expenses and then I also have an additional buy-in amount and that amount comes out of my column. And then after that, I take home a hundred percent of what’s left over, not just a percentage that was profitable for the company. So three and three there.

Justin (17:37):
Okay, awesome. And did you have help structuring that? Did you guys have lawyers or how did you come to that arrangement?

Dr. Joshua Suderman (17:42):
So dr. [inaudible] Had been doing this for a long time and he has been through a lot of w has worked with lot of younger positions. So he brought this contract with him. It wasn’t so much negotiating that timeline in that format. But it was more me understanding. And then at the phase of starting towards partnership and buy-in, it was understanding what is this buying amount need, you know, and, and how do you come at that? Well, okay. That gets back to understanding the balance sheet and it’s kinda cost me this much to start. And you know, I I’ve invested this much in you and I think that right there, a little asterisk is where a new physician after hearing this can say, okay, how have I helped you to, I think I could have had a better, not that I got duped, but I’m just saying, I think I could have now having more awareness of that, would’ve made me feel more empowered at the bargaining table. And then it’s just, Hey, I’ve just personally put in a lot of work and I need some return on that. And then that’s where that buy-in KML. And we had Frank discussions about that. Me and, you know, lawyers and accountants and, well, I don’t know, well, I think this, and then we just agreed on it and started a different the next three year process.

Justin (18:53):
Got it. So that makes sense. So the first three years was a flat salary and some percentage upside. That makes sense. And then the second three was where the buy in commenced. So it sounds like your compensation was the same, but there was an element of you buying the equity from dr. Jeffery through that second three year period. And it sounds like that came out of your pay and it wasn’t in the form of like a loan or something.

Dr. Joshua Suderman (19:17):
Correct. So I did, you could, I suppose, take out a loan from the bank and then just drop it to the company. And then you have eat what you kill a hundred percent in this situation. Well, then you have to bank, you got interest for me, it was actually pretax. So again, if on my balance sheet, you look at my column, one of my expenses, because now I’m not employed, but I’m going towards partnership. I’ve got a certain amount each month that just gets wiped out towards the company. And then after that, once that’s there, when we pay staff and we pay heating and lights and all that, then I can take home a hundred percent of what I make. What surprised you most about this journey? I think, I think that emotional intelligence part surprised me. I mean, early on, I got the sense that, okay, I’m going to need to grow marketing and I’m going to need to know financials. And of course, everyone knows that that’s going to be a little intimidating, but you know, just the daily work, it’s a grind and you got to have people around you that you want to come to work with and that underlies and kind of undergirds. And it has a foundation for you being successful financially emotionally, too in the community. And so kind of that, just that foundation that is there, that we, again, don’t learn about in medical school, but that then allowed me to understand more and be successful. Yeah.

Justin (20:40):
And I know whenever we spoke on the phone, it was a few weeks ago. You mentioned Bernay Brown, who, I’m a big fan of just talking about some of her work. And like she talks a lot about vulnerability and shame and how that interacts with ideas of leadership and organizational culture and things like these are all questions that, you know, as a graduating fellow, you probably had no clue how critical these things were going to be for you. So tell me a little bit about, you know, you really, you zoomed in on this emotional intelligence, how did you build those emotional intelligence muscles to turn yourself into a leader who was going to be able to care for staff and be empathetic and lead by example in vulnerable

Dr. Joshua Suderman (21:17):
Ability, humility, being clear in your communication and being okay just with each other’s mistakes and talking openly about them. I think it should build. And it has to build on the things that we naturally probably should do well as doctors anyway, but there’s this kind of hierarchy with medicine. There’s probably some pride that comes along with, through our years of training. We’re challenged to know something. So you gotta be strong and you gotta be right. But that goes out the window when you’re in private practice. Cause here everybody’s does have the same goal. You know, they’re not here to cut you down and pimp you for information. You know, they, they do, if you have the right staff want to help you succeed. And so Renee Brown talks a lot about this. This clear is kind right. So just talking and being clear about what you need, but then also if someone doesn’t feel confident making it a psychological and socially safe place and space to tell you, Hey, what did, what did you mean by that? Or what you went this ordered? What, or, you know, I realize you went through training with this, but in our clinic, or this is what we can do, and this is how we have to schedule it or do this procedure. Okay. I hear you. I want to learn from you and I want to build these connections so that we can all be successful together.

Justin (22:39):
Did you have any experiences either to the positive or to the negative in that department where you’re like, Oh man, I definitely need to get better at this or Holy cow, I’m glad I just read Renee Brown’s book and I just knocked it out of the park in that interaction. Yep.

Dr. Joshua Suderman (22:52):
Yeah. the clear is kind of saying, knowing that I, if I’m clear about what I’m thinking and my perception of it, it just right from the start that then that allows, that gives the other person the safe space and listen, you doctors out there, Hey, we are in a privileged, privileged position to create this space from the start. We can create an environment where people aren’t scared of doctors or intimidated, you know, that new man that’s starting out on Monday, right away. You’ve got the chance to create this space. And so I was surprised by how powerful that is. And it’s just a basic human thing that gets lost in the shuffle with your, the daily rigors of medicine and the hierarchy that we’re kind of all enveloped in when we come into medicine. So I was surprised by how well that works negatively.

Dr. Joshua Suderman (23:41):
I was definitely surprised by how I felt the need to like kind of clamp down and, and, and be this amazing doctor with all these skills right away and, and not, you know, learn from staff who have a lot of experience dealing with patients, especially pain patients and allowing staff to kind of, you know, ask for forgiveness, maybe not permission in some ways and, and being okay with that and trusting people because as a doctor, it’s the art of medicine and, and you gotta practice it every day. You don’t come in in a sort of get to be the expert every day that we all think we are going to be. And, and I had to learn some of that, but overall, it’s been great,

Justin (24:22):
The most challenging part of transitioning to practice ownership for you.

Dr. Joshua Suderman (24:26):
You’re vulnerable you as a, as a private practice owner. You, you own it, all that, everything from how you practice and you know, the patients you see too, if that staff member is mad or is having a bad day, or maybe somebody has a complaint against the office, or somebody drives up onto your drive and ruins the brick wall in front of your office. Is that a true story? Yes, it is. Oh man. I mean, it’s everything. Okay. So you sign up and you’re vulnerable for everything, and you gotta deal with headaches that you’re like, why did I go to medical school to deal with the paint on the wall, down the hallway? You know, do I make all those decisions? Do I take care of every nitty gritty little detail? No, but I’m aware of them. And that’s a part of being a private practice owner to some degree that not everywhere has it like that if you’re in a big group. Yeah. It’s going to be a portion out, I’m sure. But it’s just the two of us. And then we have three mid level providers and we’re a small group. And so vulnerability really, whew. That’s a lot to take on every day. Yeah.

Justin (25:40):
Are there any like specific stories or sort of like the tales from the trenches about business ownership or your, like you find yourself in that moment? Like, I could have never thought that, you know, during fellowship, when I was doing all these like advanced pain procedures, that I would have found myself fill in the blank as a practice owner

Dr. Joshua Suderman (25:59):
That I would to fill in the blank, I would have never thought I was talking about the things that I just mentioned, like paint on the wall, or, you know, an issue with landscaping out in the front, or, you know, in some ways, or like a staff member’s personal life that is impacting how we can deliver care here and what they bring to the table. And, you know, in some ways, if you say that to a fellow who’s going into private practice, they can say, yeah, okay. I can believe I’m going to have to deal with that. But until you do it, you have no idea how you’re going to have to grow as a person and all the stuff you learned in fellowship. That’s good right here, but you got to bring all these other things up to par to survive and to go home, not just overwhelmed and live life.

Justin (26:53):
Yeah. It’s, it’s hilarious. Cause I as a business owner, myself, an entrepreneur, I, I have a very, there’s a lot of corollaries in the financial planning and investment business and trying to help doctors solve these problems. And I, I frequently find myself having conversations that are not in the CFP curriculum and that’s kind of, that’s what makes every day worth getting out of bed for, cause he just and same with the emotional intelligence and being able to create a safe space. Like there’s a lot of, a lot of overlap. There,

Dr. Joshua Suderman (27:21):
There is enough that as the leader clinically, you’re also the leader business. You’re also the leader emotionally and as a doctor, you’re in a private bank you’re taking on all of that. So it’s a lot.

Justin (27:33):
Yeah. so you’ve also got Julio on here in the studio. He is your marketing director. You mentioned marketing is one of the things you needed to get up to speed on. Tell me a little bit about your journey there and the way you think about that for your

Dr. Joshua Suderman (27:45):
Practice. Right? At first I was like, what? Come on. I don’t want to market myself. You know, and this is, I I’m just, I’m great. Anyway, like come on, patients just come in the room and see me. You’ll love me promise, you know, and we’ve got lots of doctors in this area, so don’t worry. They’ll keep sending me patients and I’ll be fine to a degree. Yeah. You put, you hang a shingle. You’re probably going to see patients come in your door. It’s almost taking advantage of something that can make that even better for you. Not, not so much like marketing for this amazing pristine clinic, but it’s, it’s that it’s going to make the experience of your patient care, even that much better when you get your story out, when you build who you are into your social media and, and let that be an extension of you, patients are going to access that.

Dr. Joshua Suderman (28:34):
And then they’re going to come in and get that consistency. And they’re going to have certain expectations and knowledge of who you are. And that’s just really going to set the stage in foundation and plant a great seed for when they actually, when you actually walk in the door in the patient room. So it’s so valuable in that way. And then keeping patients established, keeping your face out there, interacting with them in that way. Because we rely on, mid-levels rely on other people to interact with the patient 90% of the time, rather than just face to face time with you, right.

Justin (29:04):
When it comes to things like the financials and the marketing questions, how do you and your partner divide the oversight of those areas? Is that something that was like, Oh, I naturally kind of fit here and you naturally fit there. Was there some arm wrestling or haggling over, Oh my gosh, I don’t want it.

Dr. Joshua Suderman (29:19):
Right. Right. I think every day, dr. JV and I think about, Oh my goodness, did we really sign up for this? You know, HR or marketing or financial, there’s probably something every day, any doctor’s going to feel that way. I think when I started to kind of dovetail into the ownership and management of the practice, it just kind of became, okay, I’m signing up to help where I need it. And you know, dr. JV needed this or the needed that marketing kinda came along. We tried to ramp that up about the time when I was becoming a partner. And I said, okay, I, I, you know, this is what the practice needs and I’m willing to take it on. So flexibility. And then week by week, day by day, we just kinda like, I know him, he knows me if, okay, he’s getting really overwhelmed with all of the things. I’ll take that. Or Hey, you’re really, some of it is you have skills for that, but some of it’s just, who am I played his full, helped me here. And let me know. And it’s just really nimble and flexible with a small group.

Justin (30:12):
Do you find that there’s a you’re you guys are able to cover for one another so that you can allow the other to get a little bit of breathing room when needed, like, can you go on a vacation and leave your cell phone and the vault in the hotel room and not look at it for a week?

Dr. Joshua Suderman (30:25):
Yep, totally. And we have help from our mid level providers. One physician’s assistant two nurse practitioners and we have our call system set up and, you know, just, you know, and it’s funny you say put the cell phone in the vault. I actually, you know, this is a light. I feel like I’m in a pretty life-giving specialty and set up to where if I need to go, if I go on vacation, I actually still have my cell phone with me. I rarely get called, but I still, like, I feel like I have enough bandwidth to say, Hey, Whoa, something came up and it’s unique to that patient. I don’t want to make dr. JV or, you know, the nurse practitioner would say, Oh, he’s got a lot on his plate, just a quick text. And that’s often just puts out the fire. You know, it gets my input. Even if I’m in Florida or I’ve had a state staycation here, I feel like I have enough life giving bandwidth that I could take a vacation and still have my cell phone. And I think there’s something to be said about that. I think that’s a positive thing that we’ve grown here that I can say that, whereas most, maybe a lot of other people say, Oh, vacation by turning it all off. I never want to talk to you for a week, you know? Right.

Justin (31:31):
Yeah. It makes sense. There’s there’s a book I read recently. I want to just shout it out here. Cause I think it might be interesting for anybody who’s listening. I actually have a copyright here. It’s called the partnership charter by this guy named David gage. I want to give a copy of this to a couple of people. If you, if anybody wants to leave a review for us at anesthesia success, anesthesia and pain management success. Now look us up on iTunes and leave a review, send me a screenshot. I want to send a copy of this. I’m currently evaluating partnership for myself, my own financial planning practice. This was hugely helpful in understanding who I am as a professional and a financial advisor and a business person and who my partner is and our strengths and weaknesses and giving us really great categories to understand one another and why we’re doing what we’re doing and what can help us succeed together. There’s a lot of overlap in what I read in this book and what would make for good partners in a medical practice. So I’ll send you a copy, dr. Suderman as a thank you for being here. We’d love to get this in some hands of anybody else, listening, who is interested in partnership and vetting some of these questions right now. In closing dr. Suderman, any other thoughts, wisdom, things that think this conversation wouldn’t be complete unless we mentioned that,

Dr. Joshua Suderman (32:42):
Right? I think, I think we covered a lot. I know we covered a lot. You add value the day you start. Okay. I’m just speaking to people who are getting out of training. Soon. You add value medically with your knowledge and you’re smart and you’re a great person, but you can add, and you should add value right away, emotionally, socially, spiritually, psychologically to your group that will create an environment and an atmosphere where you’re valued by the staff and the people you work with. And your partners will not lose sight of that, whether it be unconsciously or kind of semi consciously, you know, they will factor that into when they want to talk to you about longterm commitment. And so from day one, you know, just really be encouraged that you’re not an automaton and a little cog in the wheel here as a doctor, you have an amazing power to create an amazing workplace, but also be really productive and be profitable. And medicine is a business and you need to market and it’s okay to own that, but you can do it responsibly and love the people you come to work with each day.

Justin (33:54):
Absolutely. Well, dr. Josh, Suderman, it’s been a pleasure speaking with you today on our podcast. Thank you for joining.

Dr. Joshua Suderman (34:00):
Yeah. Hey, thanks again for the time. It was great to speak with you.

Justin (34:04):
If you liked what you heard this week, head on over to APM success.com, where you can find more content and free resources to help you build a successful career in anesthesia and pain management. If you want to leave a review in iTunes, I’d also really appreciate it. Thanks for using some of your valuable time to join me today on APM success.