Helping a Medical Service Business Scale

Added: 2026-05-05

[00:00:00]So, really quickly, thank you for sharing your rhinoplasty journey. I share it with our patients all the time.

[00:00:05]Like it's not always real like that.

[00:00:07]Mhm.

[00:00:08]>> Oh, nice.

[00:00:11]I got a nose job?

[00:00:12]>> [laughter] >> I said rhinoplasty so it could be kind of code.

[00:00:15]Um but so I looked at the margins like you had talked about because uh they were low and to get to 80% I have to almost double the cost of the kits that would be added to the surgeries.

[00:00:27]The problem I have is that the patient care coordinators who sell the surgeries, they're like they're not going to buy that. But they do buy that when we're talking straight to the consumer. Do I need to stepstone whereas just pick a price that at least gets me one call with them and upgrade it myself or like the hospital side, they can't collect payments at all.

[00:00:50]They're just willing to send us all the patients and we can sell them.

[00:00:56]I had a question. I have to ask what the kit is. So, the kit is a mental health, nutrition, and coordination call before and after surgery.

[00:01:03]>> Isn't there semaglutide, too? And semaglutide as well. So, and bariatric surgery as well. So, when >> nose job? No, no. [laughter] Oh my god. Okay. I was No, it's okay.

[00:01:14]So, when as you know going through that process, there are some things that you find out in recovery. We want to make sure they find out and are educated before so that they can maximize their recovery with nutrition, with coordination, and with mentally because it can be mentally taxing as well. So, we do that for plastic surgery. We do that for bariatric surgery, people who are going through weight loss, and then we also do that for semaglutide patients who are losing weight fast so they need that same kind of support. I just want to know if you're thinking what I'm thinking. Probably not. Like what do you think? Oh, so the 80% gross margins So, I'll just make this for everybody. So, we we talked last night. Um I have a rule of thumb for services which is I if I'm doing service, I want 80% or higher gross margins cuz this is very hard to make money without that like it's just it's just very tough. And sometimes like I hear it all the time they're like I I don't know what's wrong with my business. It's like dude, your cost basis is 50 and it's it's service.

[00:02:08]It's like you're starting at 50 and then you got to do everything else and then you have this much left over. It's just it's tough. And I prefer 90, 95, you know, like much higher margins if I if I can get if I can do it. Um And so, I think that one from the sales perspective is probably a compensation thing which means that like you can double the price and then you can 4x how much you're paying them. And then all of a sudden that may very much change like move the needle for them to make it worth that uncomfortable 2 seconds. Um the second thing is that if the if the if the hospitals are referring you, you know, referring directly to you, then I don't think you have to worry about those at all. Like just say the higher price. So, it really just comes down to the question of how do I get the uh patient care providers? I think that's what you said. Um to >> the 80% going to cover their bonus? Cuz right now we give a PCC bonus. For every kit they sell, they get a little kickback. We pay them >> the answer is yes. So, gross margins are on delivery. And so, we have like the whole point of having a higher price is so that you can spend more in acquisition. And so, commission is included in the acquisition cost. Okay.

[00:03:09]So, even the background of the patient care coordinators? The patient care coordinators work directly for the surgeon. So, their job is to sell the surgeon and sell the surgery. So, what we do because we handhold the patient, they're no longer on the phone for hours with the patient that already had surgery or that's going to have surgery.

[00:03:27]They're talking to a patient who's looking to have surgery, who's going to book a surgery. So, we're taking away that office burnout, the high anxiety patient. That is how we're pre-creating more income producing activity for the office.

[00:03:39]>> She's customer service for surgeons.

[00:03:41]Yeah.

[00:03:42]>> Outsourced.

[00:03:42]>> Okay, yeah. No, I picked that up as we were talking cuz I was like the patient care coordinators.

[00:03:47]>> Yeah, so but the patient care coordinators, they're the ones that have to unless it's mandatory, which usually takes us about 90 to 180 days to get there. In the beginning, it's a opt-in opt-out. You're having the surgery. We partnered with POP. You should add this.

[00:04:03]Then when they see like, "Wow, this is taking a lot of our plate." Then they're like, "Just add it to the surgeon's fee." But typically, they don't want to do that right away.

[00:04:13]The question was around price. And so, I think the answer is yes.

[00:04:17]Price it in and then the extra gross margin can go to the sales rep. And that can help speed things up in the beginning and then eventually they'll just include you in part of the package and you won't have to worry about it.

[00:04:26]But I think having even artificially high in the beginning to like get them going and kind of teach the behavior is a good idea.

[00:04:32]If that's the constraint.

[00:04:34]And would you just have one price for everything? Because right now it's rhinoplasty is this, major weight loss surgery, combo surgery is this. Because some rhinoplasties >> Is the delivery the same?

[00:04:46]It can be. Well, if you make the delivery the same, then you can make the price the same. It should be. Well, then why don't you do that? Okay. Remember we talked about this? Right. Just streamline it. Okay.

[00:04:54]>> If it's like more or less the same thing, it's recovery, they have to know these four things, then like just it's just it'll make the whole business so much simpler. Okay. If you're a business owner and you are not growing as fast as you'd like, I'd like to give you a free gift. So, my team and I put together the 100 million dollar scaling roadmap, which is basically 200 hours of us looking over all the portfolio companies we've had and what stages of growth they went through and more importantly, where they got stuck and how they got past it.

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