This 36-minute visually gorgeous movie will zap you in the amygdala and hopefully leave you inspired to examine your work and life ... and decide what really matters to you.

Are you still passionate about medicine? Redesign your life to re-own and re-exercise that passion.

Tired of the grind? Lay yourself off and get involved with something you care deeply about.

Hate it when Monday arrives? Decipher what is missing from your days and add it back in, even in mini-bite sizes.

Set aside 36 quiet minutes. Fire up the movie and step briefly into the shoes of the many laid off workers in the movie. Share momentarily the beauty of the lives they have each uniquely discovered or recreated. And then reflect on your own opportunities to make lemonade. Go on - I dare you!

(thanks to Seth Godin for refreshing my evening with the movie)

Is it because we weren't taught about its importance?

Or that we feel it's tacky and beneath us?

Or that it just plain scares the heck out of us?

It used to be, even when I started out in my family practice, that you just had to treat patients well, spend a minute or two extra with them and (hopefully) provide decent medical care, and that would be enough to guarantee building a steady medical practice.

Those days are gone, unless you're the only game in a small town!

Now, it's vital that you understand what your patients are seeking as they look down their provider list and decide who to select (usually requires an email to a buddy or work colleague!). If you're a specialist deriving most of your business from referrals, you'll need to be the professional your referring doctor knows, likes and trusts.  And if you have moved on to build a non-clinical business, you'll need more than ever to figure out where your business is most likely to come from and how to build fruitful relationships.

These are the 5 mistakes I encounter most commonly in my physician business coaching work, with a few hints for how to change:

   1.  Lack of a Plan

Marketing doesn't happen by accident. And it isn't effective when it consists of a few scattershot activities you launch into when the flow is slow.

The best marketers know that marketing is intentional, systematized, and consistent.

A thriving business has a marketing plan that lays out what activities are to occur at what times of the week, month and year, and adapts to feedback and results (or lack thereof)!

   2. Limited to just one activity

Does your marketing plan consist of a yellow page ad? Or an ad in the local paper? Or perhaps you hang out in the doctors' lounge hoping to meet a few colleagues?

Worst of all, do you believe that, because you just paid to have a cool website created, your marketing will now take care of itself?

Effective marketing consists of a number of well-orchestrated and executed activities, from any of the following 8 areas:

          * direct contact (emails, letters, cold calls etc)
          * writing and publicity: newspaper columns, guest blog posts, articles, press releases and being quoted in the paper
          * speaking: from brown bag luncheons to teleclasses to keynote presentations
          * networking
          * obtaining referrals
          * promotional events
          * Internet marketing
          * advertising

   3. No follow-up:

This, in my books, is a major crime! Or at minimum a wasted opportunity. If someone has made the effort to be in touch, to come in and see you even just once, to ask a question, then this is your opening to follow up. Find out whether they got what they were looking for, ask how they are doing, ask how their cat is doing -- anything!! Use your imagination here!

The only way to ensure that you and your staff do this is to have a consistent follow up policy and practice in place. And to measure how regularly you are accomplishing this. Strive for 100%.

   4. Being cheap

And I don't mean with just money! Given that so many marketing activities can be undertaken at little or no cost with the sea of technology we're  floating in, you can't afford to be cheap with your time.

I intentionally placed advertising last as it is typically the most expensive method of marketing and I'm not sure how many people will buy anything other than a commodity or an easy-to-describe product on the basis of an ad. Prove me wrong, all you ad men!

Well-done Internet advertising using Google Adwords and other equally targeted tools can work well - but then that is not expensive. Billboards, brochures scattered around, radio spots - these are much harder to generate a return on investment.

Wouldn't it be smarter to take that same money and spend it on a tech-savvy articulate assistant who could create and maintain a Facebook fan page, tweet twice a day, or write a blog post? Or how about putting a Speakers' Kit together, with 3-5 current and fascinating topics in your field, writing a dynamic cover letter and having that same assistant research 10 speaking venues that you could mail your letter and kit to?

   5. Ignoring your community

As a physician practice or business owner, you occupy a place in your community. This community may be local and geographic, or it may be virtual and global. It's a huge mistake (or to be kind, a missed opportunity) to fail to appreciate your potential role as a leader and contributor of your "people".

What organizations or civic bodies should you be joining? What discussion boards can you be adding a thoughtful voice to? What non-profit boards can you sit on?

Not only will you expose yourself to more people to network with, but you position yourself as one of those professionals who are known, liked, trusted AND referred to!

Guest post By Lisa Tener, author and book coach

Have you noticed how many people are writing books lately? Maybe some colleagues and competitors in your field have recently become published authors.

Do you wonder if becoming a published author is for you?

A book can help you start a new business or take an existing medical practice or business to the next level. It can help you position yourself as an Expert in your field and open up new (or bigger) opportunities in public speaking, media attention, joint ventures and more.

Evana Maggiore, Author of Fashion Feng Shui: The Power of Dressing with Intention, has told me that she often hears from someone new who found her on the internet, read her book in a day and immediately signed up for her training program with a several thousand dollar price tag. Even those who don’t sign up for training often look for a fashion feng shui consultant who can help them dress their mind, body and spirit for powerful results. Evana’s book is out there attracting a following for her own business and businesses of FFS Consultants she trains 24/7—even when Evana is on vacation.

Aspiring authors tend to talk about their book to anyone and everyone—friends, family, people at cocktail parties. Mum’s the word. I’m not going to tell you they’ll steal your idea. That is extremely unlikely. The fact is, though, that the less energy you project outward about your book, the more you focus your energy inward into the writing. Talking about your book can take the place of writing it. Keep it quiet and write, write, write.

But wait. Before you just start writing mounds and mounds of stuff that someday you’ll have to wade through and organize and figure out how to put it all together into something coherent, take a deep breath and begin to plan.

Without a plan, how do you know what to do and how to get there? Everyone needs a plan. Plan your time; plan what you need to do; plan how to research your market before you begin; plan what you’ll do when you run into snags. Plan how you’ll get support, as well as any expertise you need. Support can come from a friend, colleague, writing cohort, coach or writing class. Expertise can come from people in your market (potential readers), editors, a writing coach, agents, publishers, colleagues and experts in your field.

Above all, have fun and stay connected to your passion for your subject. Writing a book, getting published and hearing from readers about how the book made a difference in their lives can be a peak experience. The more connect with what excites you about the subject, the more fun you’ll have.

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Lisa Tener is a published author and book coach. She teaches on the faculty of Harvard Medical School’s CME publishing course. Lisa has been interviewed on ABC World News with Peter Jennings, NiteBeat and PBS-TV and quoted in USA Weekend, Glamour, Family Circle, Body and Soul, Fitness, the Boston Globe and dozens of other publications. Her clients have been interviewed on Oprah, Montel and much more.

Join us at The Entrepreneurial MD for our free monthly Business Development teleclass in February with Lisa.   

His Wikipedia entry reads as follows:

Paul Craig Roberts (born April 3, 1939, in Atlanta, Georgia) is an economist  and a nationally syndicated columnist for Creators Syndicate. He served as an Assistant Secretary of the Treasury in the Reagan Administration earning fame as the "Father of Reaganomics".
He is a former editor and columnist for the Wall Street Journal, Business Week, and Scripps Howard News Service. He is a graduate of the Georgia Institute of Technology  and he holds a Ph.D. from the University of Virginia. He was a post-graduate at the University of California, Berkeley, and Oxford University where he was a member of Merton College.

In 1992 he received the Warren Brookes Award for Excellence in Journalism. In 1993 the Forbes Media Guide ranked him as one of the top seven journalists in the United States.

These credentials are enough to persuade me that his thoughts are worth reading and mulling over. As a critic of both the Democrats and Republicans, he strikes me as an independent thinker... which is to be admired, given the partisanship that we are facing daily in the media.

I came across a recent article of his titled "How Wall St Destroyed Private Medicine", an eloquent rant in which he makes three key statements:

1. "My doctor has more people employed doing paperwork than he does delivering health care."
2. "Corporate lobbies and campaign contributions use government power to create bureaucratized monopolies that destroy medicine for the practitioner and the patient. Wall Street pushes for greater shareholder earnings, which are achieved by denying care."
3. "The lobbies of greed rule America. The White House, Congress, even the federal judiciary are impotent in the face of capitalist greed. There is no government of the people, for the people, by the people, only the rule of private interests."

His words voice much of the frustration and impotence that so many physicians express to me. He has articulated some of what I find so troubling about healthcare here.

And I find myself grappling with questions such as:

• How should physicians respond to the mandate to improve US healthcare?

• Who should speak for us as a group?

• And, if entrepreneurship is The American Way, by symbolizing all that is creative, innovative and industrious about this country, what roles can entrepreneurial physicians play in producing better health outcomes more efficiently and at a more acceptable cost?

And I am curious, Is this issue on a par with votes for women and blacks, and workers’ rights?  A blog commenter remarked elsewhere in response to my comment about the Massachssetts result (partially quoted): "I hold both sides of the table (along with any Independents!) accountable to work out their differences and get something meaningful and useful accomplished."

His response: "With respect Philippa, this isn’t going to happen on anything meaningful. The GOP voted to a man and woman against what is really modest reform.

History tells us that in the western world things like votes for women and blacks, and workers’ rights, were only gained through huge struggle and sacrifice. Those with power and money do not as a rule sit round a table and give it up politely."?

Is he correct? Is this what it is going to take - a Civil Rights-size revolt? And are we ready for this?

The Society for Innovative Medical Practice Design (SIMPD) has estimated there are over 5000 concierge practices in the US (up from 500 in 2005), and according to the CDC as far back as 2006, 11% of practices were cash-only (I assume this includes all specialties).

In the face of (1) a primary care physician shortage, (2) healthcare reform that is going to up the ante with numbers of insured patients needing doctors, (3) physician exhaustion and discouragement at the "primary care lifestyle" (seeing one patient every 8-10 minutes) and  (4) the focus on developing Medical Homes, I'm beginning to wonder if the concierge-style practice might be the answer!

Who wins with this model?

• the physician who is able to limit his or her practice to 600-800 families/individuals, provide care in a way that maintains the passion for doctoring, make an acceptable living and enjoy a reasonable lifestyle. Even though the numbers suggest that concierge physicians tend to make slightly less money than their counterparts in traditional practices, their quality of life appears to improve dramatically.
• the patient with a health savings account/high deductible insurance plan whose health is monitored closely and conveniently (?email consults ?phone consults - less risky when you know your patients well), who gets his or her questions answered thoroughly and whose out-of-pocket expenses my be reduced overall
• primary care as a specialty, as the options become much more attractive
• employers who help their employees invest in their health by making it possible for them to become patients of the Medical Home concierge practice
• those insurance companies that "get it" - that their next successful product isn't a plain vanilla health insurance policy. Instead it's designed to encouraged patients to engage in preventive care, absorb routine care costs themselves (with HSAs etc.), and opt instead for affordable coverage to pay for more costly and unexpected services

Of course, it behooves concierge medicine practitioners to use resources wisely, familiarizing themselves with evidence-based guidelines and avoiding the temptation to soak the rich with Presidential Physicals that include annual "everything is scanned and worked up" studies! And it will serve them well to pick up a few coaching skills -- the ones I wish I had truly had and used as a family doc in practice!

Is it the answer??

I'd love to hear your thoughts!

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Here are a few resources for those of you considering a cash or concierge-style practice:

1. Cash practice alternatives; considerations for physicians
2. Concierge Medicine: A Market Based Solution for the Primary Care Shortage?
3. The Difference Between Concierge Medicine & Direct Primary Care
4. Concierge Medicine Today
5. Concierge Medicine - by Dr Steven Knope
6. Legal Implications of Concierge Medical Practice for Health Plan Providers and Enrollees (take note; this is an evolving area)
7. Marketing your clinical practices: Ethically, effectively, economically by Neil Baum and Gretchen Henkel

PS: I forgot to mention the Entrepreneur magazine article ("A model for health-care reform: opting out") I came across today that sparked this post! When this topic gets heavy play in a lay publication like this, I get the sense it's a real topic of interest!