We recently spoke to students at The Canadian College of Naturopathic Medicine on the theme of “Your First Ten Patients”. A good time as always, but we were nicely upstaged by superstar Mary Caracoglia, ND, who told the story of her remarkable first year in practice.

Mary received her license to practice and opened her doors in October. Twelve months later she had taken home over $80,000.

This is the how she did it.

What You Need to Know First

I want you to see this through the right lens. It’d be easy to dismiss this as good luck, the result of some special skill, or setting up in an area with no competition. None of that is true.

  • Mary’s area is “saturated”. The only naturopathic college in Ontario is in Toronto, and many practitioners stay there after graduation. While I don’t buy the competition excuse, really–and Mary is proof that it’s not a big factor–you should know that Mary accomplished what she did in a market that was by no means free of competition.
  • Mary’s not “special“. (No offense, Mary :) ) She’s wonderful, positive, bright and energetic, but most practitioners I meet have those traits in abundance. Like you, though, she has moments of uncertainty, fear, and disillusionment, too. In her words:

“I want to start off by saying that something most grads don’t talk about is the feeling that just after all of this school, all of these tests, all of this clinical experience…you can feel completely INCOMPETENT and scared out of your mind.” - Mary Caracoglia, ND

Mary’s just like you, folks. The difference is not in her personality. It’s in her behavior. Here’s my distillation of how Mary did what she did.

Strategy 1: Start Early

“Most grads from my class didn’t look for space during the summer… instead of starting work in October which was the earliest you could start once getting your NPLEX results, they had to wait until January.” – Mary Caracoglia, ND

Mary graduated in April, but had to study all summer and write board exams in August in order to finally get a license to practice by mid-autumn. Most practitioners simply wait until then to start the process of opening their practice. Not Mary. By June she was spending a day a week working on her practice–a practice that wouldn’t start until October.

Why it worked:

Starting early gave her several advantages:

  • Study breaks
  • A jump on the rest of her graduating colleagues
  • Time to form relationships
  • Time to pick the right location

The first two are nice, but not earth-shattering. The last two are game-changers, as we’ll see.

Strategy 2: Choose Your Location Wisely

“You need to spend a lot of time thinking about what you want…keep in mind that what you think you want will change the more offices you see and people you meet. I literally cold-called as many places as possible.” - Mary Caracoglia, ND

The last benefit of starting early–time to find the right location–was one Mary put to great use. She called over 40 offices inquiring if they were interested in renting space, and then gradually booked meetings to see the space, meet the players, and get more details.

Why it worked:

I don’t know of anyone who’s looked at that many spaces, but the logic here is pretty clear:

  • Other than buying a practice, your single biggest opportunity for new clients when you start your practice is referrals from other health care professionals…
  • …The easiest way to do get those referrals is to set up shop with someone busy who will refer to you like crazy…
  • …The easiest way to do that is to look around. A lot.

That’s what Mary did. She found two places with the right fit, that would benefit her the most. And by “benefit the most” I mean deliver referrals. A ten percent better split and a nice waiting room don’t mean anything if you’re not seeing any patients. You need the referral traffic.

If you’re starting out, or thinking of moving your practice, do some speed dating. Get on the phone. Visit as many practices as you can. And if you’re not thinking of moving? Maybe you should be…:)

Strategy 3: Focus Your Marketing on Personal Connection

“I met a great number of other health care professionals and created a referral network.

I literally stood at the front desk or hung around the waiting room in the offices introducing myself to patients checking in and out with reception. I told them who I was, and offered them a free consultation on the spot. Most people were willing and interested.” - Mary Caracoglia, ND

Why it worked:

Health care is a business that delivers very personal services to people. It’s no surprise, then, that the best way to grow that business is by forming personal relationships with people.

Mary did the usual marketing stuff. She’s online, but not in a big way. She wrote articles. She has a website and blog. But her most of her marketing was about creating relationships with people. Meeting local practitioners and business owners. Talking to prospective patients. Mary’s job is to treat people, in person. So she went out there and met people, in person.

Sound squishy? Hard? Not your bag, baby? It wasn’t entirely easy for Mary, either….which leads to the next strategy.

Strategy 4: Stretch Yourself

“That’s something [lack of confidence] you need to get over very quickly. There’s nothing special about me. I’m not shy, but it’s uncomfortable to go to a networking party by yourself. I was terrified. But you do it. And it gets easier.”

“You will have days where you question your decisions and question the path you chose…days where you need to push through because you are completely out of your comfort zone “- Mary Caracoglia, ND

The Mary that graduated in April, and the one that had a successful practice a year later were the same person, personality-wise. But they’re world’s apart in terms of their skills, experience and wisdom. Mary succeeded because she learned. And not just any old learning. She learned to connect with people. To market herself. To talk about what she does and why it works. She learned things that are scary to think about, but that deliver results.

Why it worked:

What Mary grasped intuitively is something we can all take to heart: The skills that got you to graduation aren’t the same ones you need to successfully grow your practice.

To grow a successful practice you need to continue to learn. It’s the way out of the Cave, as we call it in The Practitioner’s Journey. The good news is that you’ve already proven you can learn. Now, though, you’re going to have to do it in a new way: without a net. Far fewer lectures and textbooks, far more being scared out of your pants. You need to take some risks. Emotional ones, just like Mary.

Strategy 5: Decide to be Busy

“I was sick of hearing that it takes three years. You can’t expect people to just find you…be proactive and find them….Other practitioners are sitting in their offices. I’m parking myself in the waiting room. I’m talking to people.” - Mary Caracoglia, ND

Mary said one phrase to the students, and then later to me, many times:

“I just wanted to be busy.”

Seem simple? Don’t blow this off. This philosophy is what drove Mary’s actions.

  • She started right away, staying busy during her study summer schedule.
  • She decided to start two locations, instead of one, knowing that she wasn’t likely to stay busy full-time in one office right away.
  • Rather than sit in her office and hope, she stayed busy hanging around the waiting room, meeting new patients as they arrived to see other professionals.

Why it worked:

1. Practice success is directly related to practice activity. Note that Mary didn’t say, “I just wanted to have a lot of patients.” She said she wanted to be busy. And that was 100% within her control–she could be as active as she decided to be.

2. She was busy with the right stuff (see strategies 1 through 4). It’s easy to be “busy” hiding in your office, updating your FB status and checking email. Wrong kind of busy.

Can You Copy Mary?

Can anyone do this? I think so. Your mileage will vary, based on billing rates and practice models and a hundred other things, but the blueprint is there:

  1. Don’t wait
  2. Find a productive place to grow
  3. Get out there in the world
  4. Do what you’re afraid of
  5. Stay busy and focused

It’s not rocket science. Just that age old recipe of elbow grease, focus, courage, persistence and all the other good stuff that makes practices–and the world–go ’round.

And for you veterans: Your first day of practice might have been long ago. But you can have another first day tomorrow, right?

Join the Journey!

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1 Response » to “How To Earn $80K in Your First Year of Practice”

  1. Bonnie says:

    I would like to add that as a shyer and quieter practitioner this was really hard. It’s really important though. The other thing to remember is that those people in the field who talk the biggest do not necessarily know everything. They will try and make you feel like they do, but they don’t. In the last few years, I’ve found that often I disagree with what these people, who seem to have it all together and know it all and want to guide me. I also realize that I know more than they do. I’m just not broadcasting it. Most of that information has been with me since I graduated. I just didn’t know it–and of course when you’re quiet and shy, you’re going to be nervous so perhaps you won’t speak as clearly or remember everything you want to say. Practicing it until you can talk clearly to people and invite them to have a consult is huge. What a great idea for practice building.

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