[INTERVIEW]
Ronda Nelson: Your functional medicine practice is not stuck because you need another certification. I know, kinda rude. But listen, if your schedule has way more holes in it than you want, your revenue’s inconsistent, and you keep wondering why people are not saying yes, it’s likely not your clinical skills. It’s far more likely that your business has a big, fat leak — or more than one leak — and no amount of clinical training is gonna fix a broken business structure. So today, that’s what we’re gonna talk about. I’m gonna help you figure out what’s preventing you from growing and what you need to do first.
Welcome back to The Clinical Entrepreneur. This is where we talk about clinical thinking and all kinds of things having to do with business strategy, what it takes to make a practice actually work — not one that just looks good on paper with a brick and mortar and a shingle. We are getting into the real details about what it takes to be a great clinician and also to have a great business.
Today, we’re gonna talk about one of the most important — and I think over-assumed — patterns that I see with practitioners all the time. Practitioners like you. You wouldn’t be here if you weren’t good at what you do. You wanna learn, you wanna grow, you wanna know more about how to do what you do better, how to hone your craft.
The problem that I see is that practitioners are smart. Everybody’s clinically sharp. You know how to do all the things. You care about your patients. You’ve taken all the courses. You’ve got the certifications. You know more about mitochondria and hormones and detox and stealth pathogens and blood sugar than the average human should ever be legally allowed to know — but yet your practice still struggles. It’s not growing the way that you want it to. The schedule is inconsistent. Your revenue is inconsistent. Patients don’t say yes. They go, “Hmm, need to think about it. Maybe I just need a little bit more time,” or, “I’m not ready to make that commitment,” whatever it is. And you’re left thinking, “Wait a minute, I know I can help you. Why are you not saying yes?”
So then what we do is we fall back on the excuse — and I’m gonna call it, I think it’s an excuse — the excuse, “Well, I just need to learn a little bit more. Let me go take a few more certifications. Let me go take a few more courses.” But I wanna challenge that. I don’t think that that is actually the problem. I think that’s the excuse, but I don’t think that is the actual problem. The problem is, your business structure is not strong enough to carry the clinical load that you’re capable of providing. That’s all. It’s inside the business that’s the problem. It’s the way that it’s structured that is the issue.
So there’s something that I like to call the clinical skills trap. And as you might imagine, this is when you just keep going after more and more and more certifications. And I’m not saying that you shouldn’t educate yourself — you need to, because if you’re going to help people, then you do have to have a solid foundation. I don’t want you going in and just buffaloing your way through something, making recommendations that aren’t gonna work. We don’t wanna do that. But what happens is — I’m just being honest — what happens is we hide behind the clinical certifications because we don’t know what to do in the business. So we make it about the clinical certifications, and we just kind of pretend that the other part isn’t broken. For sure, if I build it, they will come. Because the learning feels safe. It’s what you already know. It’s what you can fall back on. It’s another diploma, another certificate you can put on your wall. It feels safe.
All of that is not wrong, but what about improving your consultation process? What about asking hard questions when a patient ghosts you after you’ve done a consultation — like a free call, or they came in for a first appointment and they never come back? What about your pricing? What about your follow-ups? What about how you communicate what it is that you do? Are you communicating it clearly and effectively and efficiently? I don’t know. But all of those things feel very, very vulnerable. I mean, if you’re really honest, they do. They feel scary because we don’t know how to manage them. We don’t know what to do with them. So we’re gonna default back to what we are comfortable with, which is the clinical education.
So it’s more about how you are in the business, as well as how the business is set up to support you, the provider. It’s about how you communicate, how you sell. I know nobody wants to sell, but listen — like it or not, my friend, you are in a business where you kinda have to sell yourself. You sorta do. That’s what you do every day. You just don’t wanna tell the truth about it, and I’m just calling bluff on it. We just need to tell the truth about it. That’s all. It’s about how do you structure the way that you make your recommendations? Are you still fee for service? Do you do a 12-month care plan and then everybody’s like, “No way, I’m not buying that”? How is what you’re recommending structured? How do you guide them through the process? How do they know that they’re still on target? Those are all structures within the business. We think that they’re clinical, but they’re not. It’s really a business structure around a clinical problem. We’re building a scaffolding to house managing a patient — a problem — and this is where a lot of us get stuck. Not because you’re not clinically great, but it’s just because you don’t know how to do the business part, and so then we kinda run away. Because you can be clinically brilliant and still have a very structurally under-built practice, and that’s what I see most often.
So you have to have the clinical skill. I don’t want you to leave or think, “Oh my gosh, she’s telling me not to do any more education.” I’m not saying that at all. You have to understand, but just because you know how to do something clinically does not mean that you automatically understand how to convert a website visitor into a patient. Agreed — can we all agree on that? It doesn’t mean that you know how to present what you do in a clear and concise way. Can you say what you do in one sentence? The problem you solve in one sentence? If you can’t, then your patients can’t either. They don’t know how to describe it. They’re like, “Yeah, well, you know, he does some stuff, and it’s kinda weird — put your arm out and kinda press on it, it’s kinda weird, but I guess it works. I don’t know, but I feel better.” That’s probably not gonna convert many people. So we have to create that part of the business. You have to learn how to retain them and how to follow up with them.
Because if your practice isn’t growing, your income isn’t where you want it to be, the schedule has holes in it, and you’re financially frustrated — frustrated that you don’t have a retirement, frustrated that finances are nip and tuck, and you’re looking at your bank account to decide how much you’re gonna pull out for yourself — that’s not the best way to run a business, my friend.
So I want you to think about your clinical skills like an engine. You can have the best engine in the world, but if your tires are flat and the gas tank is empty and there’s a leak in the fuel line and your fuel filter is full, you’re not gonna go very far. That doesn’t mean your engine is bad or the car is bad. It just means that we need to do a little bit of a tune-up.
So these are what I call the business leaks. I want you to lean in here. If you’re not driving — if you’re safe — you can write these down because they’re good. There are essentially six leaks in a business. And when your business is not growing, when it’s stagnant or going backwards, we often think that we need more new patients. I hear this all the time from the CBA doctors. They all come to me going, “I need a better marketing strategy,” or “I need more new patients,” which is, aka, I have a dried-up funnel and I need more people in the door. Agreed — I’m not saying it’s wrong. But why is that not working? We need more leads, or more reviews online, or maybe more social activity. Whatever it is, before you just throw spaghetti at the wall and say, “Oh well, let me try that — I’m gonna post on social every single day.” Yeah, how many of us have tried that, myself included? And I just fall flat, because you know why? I hate it. I just hate it. So that’s not gonna work for me until I can figure out a way to automate it. I gotta figure out a different way to do it, and that’s what I wanna show you right now.
Leak number one is the visibility leak. This is where not enough of the right people know you exist. Let me say that again: not enough of the right people — for you, for your practice — not enough of the right people know that you exist. You are amazing. You know all the things. You’re super helpful. You’re committed. You are gonna go with them all the way across the finish line. That’s great. But if people can’t find you, they can’t schedule with you. That’s like simple basic math. So that’s when I hear practitioners say, “Oh, well, I just need more marketing.” Okay, maybe. Maybe you do.
But visibility isn’t enough. You can get them to you, but then visibility — leak number two — is the messaging leak. This is when people see your website, they see your posts online, maybe they’re on your email list, or they have a friend who’s forwarding your emails to them. But they don’t really understand what you do or who you help or the problem that you solve. And that matters because, again, how does someone communicate about what you do to other people if you can’t even articulate it? You have to be able to articulate it first. What makes you different? What makes your crayon sharper, brighter, and more amazing than all the other crayons in the box? That’s what makes you unique. The messaging has to communicate really clearly what you do. So if someone goes to your website and they’re kind of wandering around — click, click, “Oh yeah, that kind of looks good” — but your website says, “Helping you restore your health naturally.” Uh, that is an elevator pitch that isn’t gonna get anybody to ask you for your card. No one wakes up in the morning thinking, “Wow, I have a deficiency of natural health. I think today I need to find someone who can help me restore my health naturally.” I mean, maybe there’s some version of that, but usually there’s a problem underneath that. They’re tired, they’re constipated, they have brain fog, they have hemorrhoids, whatever it is. When your messaging isn’t clear, people don’t know how to interact with you, and they won’t stay. They just click away, and they go off into the internet abyss looking for somebody else that’s going to articulate their problem and show them that, “Yes, I understand, and I’m your person.”
Leak number three is the conversion leak. So now you’ve got people — let’s say you’ve gotten them in. You find the right people, they’re on your website, and they book a consult or they get on the phone with you, but then they don’t move forward because in the business we don’t have those systems set up that help us convert them. This one is where our ego gets involved, and we start beating ourselves up. “Well, must be me. I must not… somebody else down the road does it better,” or “I didn’t say it right.” We beat ourselves up, and it’s not likely you. More often than not, it’s that your recommendations were unclear. You didn’t speak clearly to their problem. Or the way that you talked about the pricing — what it costs to work with you — doesn’t have context. Or you just threw out a big ballpark price and said, “Well, it’s gonna be about this much money,” or “It’s gonna take about six weeks.” People don’t wanna buy about. They don’t wanna buy maybe. People want certainty. And when you are clear and you are certain, they’ll draft off of your confidence. They’ll lean in and say, “Oh, wow — she says she’s gonna help me, and I’m not gonna be bloated anymore. Yes, I want that.” Because you communicated it clearly. You’re clear about what you offer, you’re clear about what you do, you give it context. And I would argue that they also need a clear path. When patients come in and you say, “Okay, well, you know, let’s try this for a few weeks” — I am a no on that, 100%. That’s not confident. Confidence is, “This is how long we’re gonna take. We’ll reevaluate at the end, and if we need to keep going, we will, but I think we’re gonna make really good progress within X weeks.” That’s what they want to hear. So that’s how our consultation often breaks down.
Leak number four is the offer leak. This is when everything in your practice is built around one type of structure. Let’s say it’s fee for service — you’re just offering one-off visits, or a random protocol. “Oh, that’s a stealth pathogen protocol,” or “That’s a weed and feed gut repair protocol,” or, “Just come back when you don’t feel well. Let me know.” Ugh. You should strike that phrase from your vocabulary: “Let me know.” That’s the worst thing you can say. No, that’s not a confident practitioner — that’s like, “Well, you know, la-di-da, just let me know when you’re ready.” That’s not a good business model. You can’t build a business on “let me know” or “let’s just see how it goes.” They want confidence. They want your confidence. They want a path. They wanna know exactly what the plan is. If I was gonna pay money to you and have you help me with my health, I would wanna know what you’re gonna do, ’cause then I don’t feel safe. Put yourself in the patient’s shoes. Would you sign up with you? It’s a great question. Would you? If you were doing a consult with you, would you? And the fastest way to know that is to record yourself. This is painful, friends — it is painful. I have done it. It is not fun. But you could record yourself, and then if you really wanna get vulnerable, you could upload that recording to AI and say, “Could you please tell me how I can improve my consultation process?” Mm, mm, mm — that’s when it gets spicy right there.
So the patient needs to know: Where are we starting? Where are we going? What are the milestones? How long is it gonna take? And what is it going to cost? When you’re offering one visit at a time, don’t be surprised when the patients make decisions one appointment at a time. You’re offering it one appointment at a time, and they will decide one appointment at a time whether they wanna come back or not. And when they don’t, don’t be surprised — because you didn’t give them another offer. You didn’t give them another container. They’re just working within the container, the fee container, that you provided them.
Leak number five is the follow-up leak, and this, I think, is like the silent killer. So somebody reaches out on your website, but it’s been two years since you checked the links on your Contact Us page. And you go there, and you fill out your Contact Us form, and it goes to a 404 page — which basically means it doesn’t exist. Or it goes to an email, and you don’t see it because you forgot that that page is connected to an email that you don’t even use anymore. And all this time, you’ve maybe had people reaching out, and they never heard back from you because you weren’t paying attention to your website. This is a big leak — the follow-up leak. The devil’s in the details, right?
So if someone has a consult and they say they need to think about it, what’s your follow-up? Do you have a follow-up? My guess is — I don’t know, I’m feeling kind of saucy today — my guess is you probably don’t, because you don’t wanna be pushy. Be pushy. Not obnoxious, not hardcore, not going to their house with a pen and a paper saying, “Sign here.” I’m not asking you to do that. I’m just saying follow up. “Listen, I was thinking about you. What questions can I answer for you about helping you with your bloating issue? ‘Cause I really do want to help you, and I know we can get this resolved for you. Have you had a chance to talk with your husband yet? What kinds of questions do you think your husband’s going to have?” That’s the follow-up. That’s caring. It’s not pressure. It’s just caring. You’re just caring. The follow-ups are where we drop out.
Or the person starts in, and then they ghost you after a while. Do you ever call them back? Or do you just go, “Oh well, they just quit coming.” Oh my gosh — what they’re waiting for is someone to send an email and say, “Hey, I miss you. I care about you. Are you okay? Is there something I can do to help you? Would you like me to bring supplements by or something?” I know practices — doctors that did that — during COVID, they went and made house calls, dropped off supplements for their people ’cause they were too afraid to come in the office. That’s another conversation for another day. But how do you reach out and let them know that you care, that you’re there? We drop it on the follow-up. We just wait. “Oh, I’ll let you know.” “Okay, let me know.” That’s bad follow-up. Your systems in the business cannot be based on hope. They cannot be based on waiting for the other person to come back to you. Hope is a lovely thing, yes it is — but hope is not an email automation. Hope is not Mailchimp sending out emails, or GoHighLevel, or whatever you’re using for your CRM. That’s not hope. Hope is a plan. It is a plan that you know you’re gonna be able to execute.
The last leak is the retention leak. This one also is huge. So patients come in — it kind of ties with the other one — but they come in and they start, and maybe they finish your whole care plan. Maybe they do. And then they leave, and you never hear from them again. And you’re thinking, “Well, they need maintenance. They’re gonna need to get their blood drawn again in six months. We need to follow up.” They may feel better, and that’s great — but does that mean they have to be done with you? No. Doesn’t mean that at all. Sometimes they leave because they don’t know the next step. No one told them. No one told them to connect the dots between short-term symptom relief and long-term restoration of their health. Sometimes they leave because the plan was wibble-wobbly in the beginning — you know, one-off, “Come back. Let me know. Let me know.” Sometimes it’s just that they didn’t feel your confidence. And when the patient doesn’t feel you’re confident, they are gonna go look for someone who is. So we wanna keep the right patients engaged for just long enough to get meaningful results, and then move them or transition them into where we want them to go.
So if your practice is not growing the way that you want it to, the question isn’t, “How do I get more people?” The question is, “Where is my business leaking?”
Now, I have created something called the Practice Vitals Checkup. And if you’re listening and you think, “Okay, I know I’ve got some leaks, but I don’t know where the leaks are” — go take the Practice Vitals Checkup. It’s 10 questions, super easy, and it helps you identify what’s leaking in the practice, and then it gives you a practice health score. So you’ll find out what your silent killer is, what is the operational business gap that’s draining your revenue, draining your business success, and you don’t even realize it. And then you’ll get a prescription — in other words, a protocol, the recommendations, and the steps that you need to take to fix that leak. Go get that at rondanelson.com/practicevitals. I will put the link below as well.
All right — now let’s wrap this up. More training is not going to fix your patient — I think I’ve made my case. They find you through Google. They find you through a referral. They find you through Instagram. They find you however they find you. They want to book. They want to come in. They want to know that you’re gonna help them. They seem interested, and then your business structure — or the way that you communicate, articulate what you do — is floppy. And without that clear plan about how you work with every patient… every patient should be inside of a container, a container that’s built for them. And that container is from the moment that they contact you and reach out for that first appointment, all the way through — talking to them about making the recommendation, making the supplement recommendations, following up on the protocols, making sure that they’re ordering the right things and getting them from you, making sure that they’re followed up with and all their appointments are happening on time. That is the business structure that is most often missing.
The patients — you know, they want to feel cared for. But as soon as it starts getting floppy and wobbly, they leave. And we say, “Oh, well, they’re just not compliant. You know, these patients these days, they just don’t follow through. It just happens. They just get stressed out, and they just don’t follow through.” You see what’s happening? We’re deflecting — kind of like how we deflect when we just go take more clinical education, ’cause that’s safe. It’s easy to deflect when we don’t understand why. And I mean, really, I get it. We don’t want to look at the business because for most of us, business is hard. It’s hard for me too. Like, it’s hard for me. I may be ahead of where you are, but I don’t want you to ever think that I have it all the way figured out, because I still hit my head. I still bump along on things. I would much rather go to a training, read a big old physiology textbook. You put a big physiology textbook in front of me, and I am so happy. I go on vacation and I’ll take a clinical book with me. It just makes me so happy. What I need to be doing is researching how to automate my social media. I need to be working on the business.
And the patients need to know that you are clinically solid, but behind the scenes they want to feel that they’re being taken care of. So if your practice isn’t growing, if you’re not getting the traction that you want, start by asking this question: Where are people dropping off? Are they dropping off before they ever schedule? You might be losing them on the website. Check out your website analytics. See how many visitors you have — you can do that. Your website, every website has this hooked up. Go look at what pages they’re visiting, how many visitors you had. Look at your Google Business profile. Are the numbers dropping? Where are they dropping? Are they inquiring — wanting more information and pricing — and then not scheduling? Or maybe they’re booking their consult with you, but then they’re not saying yes. They’re going, “Ah, I think I’ll think about it.” And your response is, “Okay, let me know.” Or are they starting work with you and only coming a couple of times and then dropping off? That means we need some follow-up. Or maybe they’re getting results and they’re happy, but they just feel disconnected. They don’t feel supported. Maybe they have to wait too long to hear back from you, or response time is slow, or your front desk is rude. Sometimes that happens. You have to start asking yourself the really hard questions. Identify where the leak is, and then put the fix in so that you can stop the leak.
Just pick one leak and fix that one leak. If you have a messaging leak, maybe find someone to help you write your emails a little bit better — or use Claude AI. If you have a leak in the way that you talk about what you do, maybe use AI to help you with some of that language and practice. Upload some of your consultations — just record them, they’re just being used internally — upload it and say, “What can I do to improve this? Listen to this and tell me what I can do to improve it.” So there’s lots of places that you can look. Just look for the signs. Look for the signs. Where are they dropping off? And then go find the fix.
So this is what I want you to walk away with today. If your practice is not growing, that does not mean that you’re bad at what you do. You are an unbelievably amazing clinician. But no one taught you how to run a business, and it’s okay. I just talked to a practitioner a few weeks ago, and she told me — she said, “I’m embarrassed to get on this call with you.” And I said, “Girlfriend, you’re in good company, ’cause we all are.” No one taught you. They didn’t teach you in school. You didn’t learn it in college. You didn’t learn it in grad school. No one taught you, which is a shame. Like, it’s a shame. So if no one taught you, then that means you’re gonna need some help. Some people come by it naturally — that’s fine — but you are probably gonna need some help figuring all this stuff out. So it just means that your business structure, you haven’t put as much attention into the business as you have developing your clinical skill. But now that you have the clinical skills down, it’s time to lean into the business structure and build a different process or pathway for the patient to experience.
You can improve your follow-ups. You can improve how you’re talking about what you do. You can improve your retention. You can work on getting more testimonials or Google reviews. And when you do that, all of a sudden, people start sticking. Like, they come and they stick. And lastly — tell yourself that you’re good at what you do. Don’t beat yourself up for being bad at business, ’cause you’re not bad at business. How can you be bad at something you don’t know how to do? If I’m bad at boxing — I’ve never boxed in my life — does that mean I’m a bad boxer? No. It just means I don’t know how to box. And then if I’m taking lessons and I’ve got a trainer helping me, would the trainer say, “You’re bad at boxing”? No. The trainer’s gonna say to me, “Good job. You hit the bag this time. You didn’t miss it,” or, “That was a great punch,” or, “You’re getting better,” or, “You’re getting stronger,” whatever it is. I’m learning. And that’s all. You’re just learning. You’re just learning a new skill. That’s all.
[CLOSING]
Ronda Nelson: So figure out where they’re leaking, and if you want help, you can always take the Practice Vitals Checkup. Go to rondanelson.com/practicevitals. That’s where you’re gonna grab that checkup. Go see what your score is, and it’ll give you some very clear instructions about what you need to do next.
And if you are ready to take your business to the next level and you wanna get on a call with me, we can schedule a practice strategy call. I’m happy to work with you and talk to you about what’s happening in your practice and decide whether Clinical Business Academy is the right fit for you to build the structure and the internal systems, the patient communication, emails — all of those things that will help you really start making that practice grow. To do that, you go to rondanelson.com/practicestrategy.
So first, go take that Practice Vitals Checkup, and I will see you next week on the episode. Take care, friends.
[END]