In this episode, Barbara and Jeff discuss:

  • How to create an autonomous business
  • What is “Fire Yourself First” about—a book written by Jeff Russell
  • How and where to find extenders

Key Takeaways:

“Don’t feel overwhelmed. There’s a better way and a different way to practice medicine.” – Jeff Russell.


Connect with Jeff Russell:







Connect with Barbara Hales:

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Dr. Barbara Hales: Welcome to another episode of Marketing Tips for Doctors. I’m your host, Dr. Barbara Hales. Today, we have with us Jeff Russell. He is a best-selling author, renowned speaker, and accomplished entrepreneur. As the founder of many successful businesses and the author of his latest book, “Fire Yourself First,” Jeff is an expert in helping business owners break free from the daily grind. What I’d like to point out at this time is that even if you have a very busy, successful medical practice or alternative healthcare practice, many people are now going into what we call a side hustle, another business affiliated or associated with that, to bring in additional income. Jeff doesn’t come by marketing alone lightly. He has been associated with the healthcare field for over 20 years, was involved with the International Association for Physicians in Aesthetic Medicine, and had an aesthetic medical spa. Welcome to the show, Jeff.

Jeff Russell: Thank you, Barbara.

Writing the Book “Fire Yourself First”

Dr. Barbara Hales: So, what our listeners would first like to know is what was the inspiration for writing your latest book?

Jeff Russell: You know, what’s interesting is it was almost by accident. I had, by design or I guess by need, 11 years ago when I opened up my medical practice with my partner. We both had full-time jobs. She was an OBGYN delivering babies, and I had a full-time business as well. I founded the International Association for Physicians in Aesthetic Medicine. So, we were teaching Botox and fillers, aesthetic procedures that many physicians add to their existing practice, or as you mentioned, now do as a side hustle if you don’t have a practice. So, it’s an easy start. We both had full-time jobs, and we couldn’t really be in the business or practice every day, all day week. So, we thought, how are we going to do this?

We actually created, or I created, systems and processes, SOPs, so that people, we could hire someone. Our first hire was a nurse, and we gave her the instruction manual on how to open, how to close, how to do patient consultations, how to do the procedures, and then we let her run it. When she got too busy, we hired another nurse. When they got too busy, we hired another nurse. Now we have five nurses working in that clinic. My partner, the OB-GYN, only works for about two to three hours a month, and I work about an hour a month in it. So, the practice really ran itself. What I realized was you don’t need to be a key part of the practice. What’s amazing about medical esthetics is the provider doesn’t even have to be on-site; you just have to be able to delegate to the proper scope of practice person. So, with nurses, they can pretty much do all aesthetic procedures. When you have estheticians or laser technicians, their scope is a bit more narrow. So, when I looked back 11 years, I thought, “Wow, here’s a practice I work two to three hours a month in, and it’s just running itself.” So, I actually fired myself from my practice before I even knew I had done it.

Dr. Barbara Hales: So, did you have new employees and nurses work on you first?

Jeff Russell: That is one of the side benefits of the practice. Absolutely. I’m always there as a patient. So, absolutely. And probably, I buy equipment that could benefit me as well. Being in my 50s, I’m like, “Okay, this is the time things start to go sideways or downwards.” So, absolutely.

Dr. Barbara Hales: So, no wrinkles for you.

Jeff Russell: Not unless I want them.

Dr. Barbara Hales: And you would want them because?

Jeff Russell: You know, you can’t look… There’s that LA look where you get the frozen face. That’s just not for me. I just want to look like I’m relaxed. Like I just came back from a family vacation for two weeks and looking relaxed and not too angry or anything.

Dr. Barbara Hales: Well, of course, working two to three hours a month or a week, whatever it was that you said, is enough to make you look very relaxed.

Jeff Russell: Yeah, when I was looking back, I decided two years ago I would only work 10 days a month in all my six businesses. So in order to do that, they had to be running very well. The four steps of the “Fire Yourself First” book are really: first, you’ve got to have a purpose bigger than you. It’s not your practice, it’s not your business; your purpose has to be much bigger than that. The second one is you have to have a team in place to do all the procedures so you don’t have to. Hiring the right team was a very important second step. That’s sometimes the most difficult part for a physician, especially giving up control, right? As you guys know so much. I want you to maintain your clinical knowledge, but hiring people, and ordering supplies, is stuff you do not need to do. One of my nurses in a previous life was like a store manager at a retail operation. So she was perfect to handle clinic practice operations as well. I pay her an extra couple of dollars an hour, and that’s way cheaper than me doing it because I make more than a couple of dollars an hour.

Always look at how you can offload things. Then the numbers are important, right? How much do you spend on marketing? And how much do you get back? I know for aesthetic practices, the number one ROI is Google Pay-Per-Click advertising. People, when they want aesthetic procedures and many cash-based procedures, will type in the procedure and the city name. So I’m in Scottsdale, Arizona. “Botox Scottsdale” – when that comes up, I need to be showing up there. So you’ve got to have a good website that showcases what you do, before and after photos, and a good Google Pay-Per-Click campaign so that when people type in the procedures you offer, you come up. That’s one of my key numbers. I spend $5,000 a month on Google advertising, and I make $120, so that’s a good return on my investment. I’ll do that investment all day long. The last thing is, what are you going to do next? So if you go to 10 days a month and you have 20 days a month available, now you get to choose your life, which is so much more fun than grinding it out. You’ve all ground it out for your last 5, 10, 20, or 40 years. So now’s the time for you. Get off the grind.

Successful Marketing

Dr. Barbara Hales: Absolutely, that sounds very envious. On your ads, where did you find them to be most successful? Was it social media? Where was it?

Jeff Russell: I don’t have a lot of budget to build my brand. When I do my marketing, it’s lead generation marketing or patient generation marketing. I need to capture somebody who’s looking for my procedure now. With Google, you can choose the words they type in and when you come up. So for us, do I choose the words “Does Botox work?” No, not at all. That’s somebody in a research frame of mind, not ready to buy. But if they type in the procedure in your city, they’re ready to buy. So I want to come up. We tried marketing with Facebook, Instagram, and TikTok. I do spend money on that, but it’s a very small percentage, probably 2%. That is more for brand recognition. Even though people on Facebook fit my exact demographic, women 45 to 60, which is what I’m looking for, they use Facebook more for communication than buying services. So a better strategy for social media is to show before and after photos and be very educational about the procedures and services you offer.

One tip we did was one afternoon when we didn’t have any patients booked, the nurses did procedures on each other. While doing them, they took photos and videos. After about two hours of procedures, they had about 80 videos and 300 photos. We could repurpose those for social media. They’re not as valuable for Pay-Per-Click advertising because you can’t use images and videos, but for TikTok, Instagram, Facebook, our website, and our YouTube page as well. Remember, YouTube is the second largest search engine, so anything like that is great. You don’t need a video camera crew; people want authenticity. Even with your iPhone or Samsung Android camera, that’s good quality to show what you do. You can use it in multiple places, not only on your Facebook, which connects to Instagram and TikTok, but also on your website and your YouTube page.

Autonomous Business

Dr. Barbara Hales: Well, that’s very helpful to know. Tell me how entrepreneurs create an autonomous business.

Jeff Russell: The key is it’s gotta be able to run without you. If your business or your practice is critical for you to be there, then you have a job. You may be paid by insurance or directly by your patients, or the hospital may be paying if you’re working through a hospital, but you actually just have a job. What we need to do is have a practice where you don’t have to be there and can delegate to extenders. An extender can be a nurse, LPN, RN, PA, esthetician, licensed laser technician, or medical assistant, depending on the procedures and what’s within their scope of practice in your state. You delegate those tasks, and that’s why it’s tough. For example, in a family practice, you only get paid when you see the patient. But in aesthetics, if someone’s having a chemical peel for melasma or rosacea, your esthetician, nurse, or medical assistant can perform it. When you’re not required to be there and have a team of extenders doing those procedures, that’s your first step to an autonomous practice. One of the benefits is that when you go to sell your practice, it’s worth more because you’re not critical of it. That really shows when you have that autonomous practice that runs without you. For all intents and purposes, our aesthetic practice is an ATM for us; it generates cash. We work when we want to work. If my partner wants to take a month off and go to Italy, she can do that, and the practice runs just fine without her.

What Makes the Book Unique

Dr. Barbara Hales: Well, those are really very helpful for us all. What makes this book different from other books on the same topic?

Jeff Russell: What I tried to do is, when I turned 50, I discovered I can’t handle as many topics as I used to. I like to simplify things and find that first domino that knocks all the others down. So I’m always trying to find what’s the easiest thing. This book, available in print as well as on Audible, “Fire Yourself First,” is all about four simple steps to starting this. You don’t have to start them all at once; you can slowly, depending on your situation, start instituting them. As I mentioned, the first one is really what’s your personal “why”? What do you want to do? If you didn’t have your practice, what would you do? The second one is, you’re going to need a team. It may be you, you may be doing the side hustle, and you’re the first and only employee. But you always want to think about who, not you. Who’s going to do these procedures, not you? Depending on the procedure, you may have to hire a mid-level nurse practitioner or physician’s assistant. But you may also be able to hire someone a little bit below that, like an RN or an LPN. So you have to know the scope. Who can do what, not you? The third thing is you have to know two or three numbers so you know whether your business is growing and successful. I have a whole section on creating dashboards and scorecards for you and your staff. The last thing is, what’s next? When you have a future in your mind, even if it has nothing to do with your practice today, it’ll actually start readjusting your decisions on what you need to do today to get there in five years. So I always like that big outside picture. You may hire an NP first because you want to be out of the country six months of the year, and that’s fine, but let’s just know what’s required.

Extenders to Hire

Dr. Barbara Hales: Listeners may be saying, “This sounds great, but where do I find these extenders to hire?”

Jeff Russell: So extenders are actually a great question. In aesthetics, I find the easiest and best extenders are licensed practical nurses (LPNs). Many of them work in old folks’ homes, doing what they do but not necessarily loving it. So when they come to work in an aesthetic or private clinic environment, they get very excited. LPN schools and recent graduates can be good sources. I can train them clinically, but I can’t train their attitude. I want someone with a positive outlook who enjoys doing procedures, which is crucial because most aesthetics and even weight loss involve procedures like body contouring, injecting Botox, micro-needling with PRP, and more. Look for candidates on platforms like Indeed, but the most important thing is referrals. Let your friends, family, and colleagues know you’re looking for someone, and they might recommend someone from their network.

Last Piece of Advice

Dr. Barbara Hales: That’s a great idea. Well, you’ve certainly given us a lot of tips. To end the session, I usually ask, “Are there one or two tips you’d like to give our listening audience?” But it sounds like you’ve covered many already. Are there any additional tips we haven’t touched upon?

Jeff Russell: Yes, one thing I’ve been hearing recently, especially since COVID, is that medicine is no longer fun. It’s become a grind, exhausting both mentally and physically. I want you to know that there is another way. By utilizing extenders in your medical practice, you can find relief and time to breathe. Don’t feel overwhelmed; there’s a better and different way to practice medicine. The biggest takeaway is that, don’t think you have to grind it out in the ER for 20 years. If you’re done, consider expanding and incorporating some more enjoyable aspects of medicine.

Dr. Barbara Hales: This has been a really engaging episode today. Thank you so much. This is another episode of “Marketing Tips for Doctors,” and you’ve been listening to me, the host, Dr. Barbara Hales, with Jeff Russell. Until next time.