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Discover the strategic methods for reaching your maximum potential as a doctor and never have to worry about having enough income ever again.

Article #50   Sept. 2013          

“Why Do the Secret Sources of 95%
of Your Private Medical Practice
Income Remain Hidden In Plain Sight
and Neglected”

“When and if 8 out of 10 doctors finally recognize the
true root source for over 90% of their practice income, they then lack the necessary marketing knowledge and motivation to effectively create a system for practice that will triple their practice income persistently
year after year.”

If there ever was a time in the medical practice history timeline when private practice physicians should seek-out and use the medical practice business tools now available, it’s today. I’m not talking here about tools to enable doctors to work harder, see more patients each day, or change their practice location to affluent neighborhoods.

I am talking about the statistical facts that demonstrate the sound validity for every physician and healthcare provider to focus an extraordinary amount of attention on the real source
of their professional business revenue.

Why this is so critical to the survival of private medical practice today

Investigations, surveys, and many clinical studies have confirmed that about 60% of new patients join your medical practice as a result of other physician referrals.

Approximately 35% of new patients join your medical practice as a result of referrals from your own patients, word of mouth, and specific marketing tactics promoting your practice. That leaves 5% of drive-bye patients to make up the difference.

Many of the marketing tactics referred to here happen coincidentally and go unrecognized by the majority of medical doctors. Many doctors know that some things they do result in acquiring new patients but fail to see the need or advantages of creating an ongoing framework for a perpetual flow of
new patients.

What goes unrecognized by private physicians today is the necessity of gaining business knowledge, if for nothing else than to save their own asses in medical practice.

The root question is……why is it that the revenue connection between acquiring new patients on a perpetual basis through unsolicited  referrals doesn’t seem to impact physicians
strongly enough to inspire them to take any action to
increase the process?

Beyond that, why is it that most physicians and other medical providers believe that they deserve a continuous flow of spontaneous unsolicited referrals throughout their medical practice careers?

Beyond that, one has to ask in light of your knowing that increasing the flow of new patients through referrals increases income and that 90% of those new patients arrive in your
office because of referral sources, why any doctor neglects
such an obvious and profitable source of continually growing their medical practice business?

What are your reasons for neglecting your primary referral income sources?

1.    Did you not know where your new patients
     are really coming from?

2.    Weren’t you aware that your practice income
     was so closely tied to referred patients?

3.    Were you not thinking that referred patients
     had such a profound effect on your
     practice income?

4.    Are you so arrogant that you expected to get
     all those referrals because of your reputation,
     medical talents, medical school prestige,
     sociable personality, and excellent treatment
     of your patients, absolutely earned it for you?

5.    Later, when your practice competition increases
     as other doctors move to your community, did
     you believe that your referral patient’s volume
     would keep rolling in the same as before?

6.    Did you never come to realize that today
     in order to survive in private medical practice
     it’s mandatory to do what you have avoided for
     years… start to market your medical practice,
     promote your practice and yourself, and
     do this using effective business and marketing

When you apply some realistic thinking to this whole referral process and how important it is to your professional career survival today, you likely will understand why you haven’t
done as well as you had expected in your practice.

Today, if you are new in private medical practice, you probably are wondering why I need to talk about these factors. It’s easy to understand why.

The fact you are so busy with loads of new patients joining your new practice that you are undoubtedly convinced that there will be no end to this tsunami of new medical patients. Unfortunately, new doctors in private practice often fall into
this trap.

Older doctors usually have run the gauntlet of private medical practice ambushes. They are quick to understand what needs
to be done to remain in private medical practice financially. Even they are lost in the new healthcare environment.

That’s because 99% of doctors have never been taught nor
took the time to learn the basics of running a business. The
best you can do is stumble along using trial and error as
your crutch.

The "get referrals" game

Once you accept the fact that 60% of your new patients
joining your practice are referred by other physicians, it
should wake you up. The fact that 35% of new patients originate from your own patient referrals or word of mouth, should stick in your mind. Those patients don’t just show
up in significant numbers on their own accord.

If you don’t know how to play the game and play it well, you always may be able to sell your medical practice to your
local hospital and serve as an employee in your own practice.
In that situation you no longer make the big decisions. You
are no longer your own boss.

If I were starting out again in private medical practice, I would never consider doing it without having at lease a basic
business and marketing education. And, I would nurture the referral process so extensively that my peers would be utterly astounded about how effective referral marketing becomes.
How I would do this is discussed later in this article.

Consider the unique and profitable aspects of an established referral system you can put in place

Pay attention now to how you can breathe life into a referral system that not only can triple your medical practice business income but also provides a continuous and increasing flow of new patients into your practice while other doctors are
whining about losing patients.

Like every other potential profitable idea, you have to take action before anything happens.

Your mission is to build a referral network that 98% of other physicians dabble with, neglect to consider a serious or worthwhile endeavor, and aren’t willing to take the time to
even try it. The process is not new. It’s been a functional element of every successful business out there for centuries. Why is it not a diligent requirement in every medical
practice business?

When you visualize a referral system as a low cost, easily available, highly profitable, and fertile resource for growing your medical practice persistently over your career, you will
be amazed at how this one simple effort can make your
medical practice financially stable in any economy or
financially hostile environment.

Just think about the opportunity you have available right
next door.

Other physicians will always have patients that need medical care and  that they are not knowledgeable about or qualified
to manage. The medical patient’s doctor must refer them somewhere. Why not send them to you because you are the expert in treatment of that medical problem. You have an expertise that no other doctor has.

To make that happen you need to position yourself by means
of several methods of “positioning” to be the one doctor that first appears in the mind of the patient’s doctor the instant he
or she thinks about referring the patient to the best doctor around to treat that medical problem.

Go to my website “article archives” and read my discussion about “Positioning” (Article “H”)

Your familiarity with the 35% medical-patient referral group is a profitable advantage

Your medical practice success and profitability depends on the level of your effort to create a high-powered perpetual system to draw incoming patient referrals the day you begin your private medical practice. It’s a numberless nationwide
resource for obtaining medical patient referrals.

What if I was to tell you that this source of free referrals to your medical practice is profitable enough to keep you in business even if every physician in your community disliked
you and never sent you another referred patient again or ever.

And, that circumstance happens frequently in medical communities all over this country today for many biased and intellectually aloof reasons. I know it because I witnessed
many examples of it happening in my own medical
practice area.

The referral groups I’m talking about here are the para-medical businesses owned by healthcare professionals that exist in almost every community……from family counseling services
to chiropractors.

The most fruitful are those medical businesses providing services to clients and customers. Many physicians don’t think
of connecting with those para-medical businesses because of their own “positioning”, hierarchy level within the medical industry, and the advantages associated with maintaining the perception that they only associate with their peers for
referral patients.

Perceptions about referrals from other physicians
validate your credibility and trust...

  •   It validates your own expertise because other
    doctors refer patients to you.

  •   It provides you with the best quality of patients
    and no doctor wants that to be thought of as
    picking up scraps from elsewhere.

  • It implies high respect for how you manage
    referred patients.

  • It documents trust in your professionalism when
    referrals come from other trusted physicians
    and medical personnel.

  • It offers you a great deal of prestige because
    your qualities of referred patients only are
    derived from other physicians, implying you
    are not scraping the bottom of the barrel
    for patients.

1.     People who refer patients to you...

  • Other doctors to you

  • Yourself to other doctors

  • Your own patients

  • Social groups and friends

  • Medical organizations

  • Local healthcare businesses

  • Hospital employees

  • Charity groups

  • Family members

  • Medical referral services

  • Practice consulting groups

  • Business friends

  • Church groups

  • Fraternal organizations

2.     Media sources patients use to refer themselves
 to you...

  • Print media (yellow pages, medical
         articles, medical journals, etc.)

  • Social media (social networks, groups
         you belong to, etc.)

  • Advertising media (radio, TV,
         Internet, etc.)

  • Marketing media (direct mail, email,
         newspapers, publicity, press
         releases, etc.)

  • Conference DVDs, CDs, and video
         digital information

3.     Ephemeral sources that provide patient referrals...

  • By reputation.

  • By recommendations.

  • By news stories.

  • By public speaking.

  • By charity work.

  • By your books and articles.

  • By teaching and coaching work.

  • By casual conversations.

     How many non-physician healthcare providers do you think find medical problems their patients have that have to be referred to physicians? Most of these providers have the knowledge to recognize significant medical problems that they wouldn’t, or by law, can’t treat.

Think about:

· Dentists

· Chiropractors

· Nurses

· Physical therapists

· Physician assistants

· Nurse practitioners

· Nutritionists

· Family counselors

· Pulmonary therapists

· Midwives

· Psychologists

· Rehabilitation therapists

· Message therapists

· Many more that you know well.

Unlimited sources for medical patient referrals
are at your fingertips...

These are just a few categories and resources to consider working with to farm for patient referrals depending on your personal preferences, connections to, and interactions with.

In each case it all gets down to who you really are and discovering for yourself what it is about you that attracts referrals and new patients to your practice. Once you figure
that out, use those qualities to expand your attraction
even further.

Have you ever asked your patients what they like about you
or what they respect about you? You should!

Why would physicians ever want to seek referral patients from sources outside the professional medical community?

A few reasons might be...

  • During a doctor’s medical practice career in private practice, doctors rarely have more than 3 or 4
    doctors that ever refer patients to them. About 2
    or 3 of these referral doctors rarely refer any
    patients in significant numbers.

  • One referral patient’s dissatisfaction with your care
    often leads to never receiving another referred
    patient again from that medical professional. Unless you track your referrals well, you won’t know about the complaint nor the future lack of referrals from that professional. Patient complaints about you
    rarely result in feedback to you.

    But if never see a referred patient again a second time, you know something is up. When you see a referred patient for a consult only, you don’t expect them to come back.

    However, if you have treated that referred patient with your special rapport magic, you will often find that they will return to your care later when they decide to change doctors.

  • When and if you are a physician who chooses not to socialize very much with the medical community
    and its events, you commonly will not get many referred patients from medical professionals. They have to like you and trust your medical expertise before they will refer medical patients to you.

It only takes one untoward event, whether true or not, to destroy any referral sources you may have at the time.

That issue may happen anywhere… operating room… your office… in the outside community. When that event reflects an outrageous and unacceptable personal or professional issue concerning you or your behavior, your reputation within the community will often be spoiled to some degree. An uncontrolled outburst of temper is one of the most
common triggers.

Your marketing knowledge associated with the
60% category of patient referrals will become even more critical over time

The effects from the changes of the referral tide to your practice are significant... 

I would not hesitate to guess that the overall volume
of referred patients from other physicians has been decreasing in numbers significantly over the last decade. Huge changes in healthcare over the last decade and presently are reducing referrals being
made in private practice.

The most obvious changes that are occurring...

  • Doctors are moving their practices and changing locations today more than ever at a rate of 12
    to 14% a year. Your referral source is here
    today and gone tomorrow.

  • Rather than refer a medical patient to another
    doctor for a litany of simple medical treatments primarily done to avoid malpractice risks,
    doctors are now expanding what they feel
    competent to do in their offices and surgical
    outpatient centers. It has become a need to
    financially benefit themselves by increasing procedures being done by themselves.

    Examples are skin biopsies, excision of breast
    lumps under local anesthesia, removal of
    sebaceous cysts, proctoscopy, sigmoidoscopy,
    EKG’s, hypnosis, acupuncture, and etc.

  • With ObamaCare now at the precipice of legitimacy
    the shift of new and old medical doctors is rapidly moving towards finding employed positions.
    Although referrals are made commonly among
    the various managed care facilities, it becomes
    one of convenience and a number of restrictions.

    In a sense, large numbers of referring doctors
    that used to refer to their choice private doctors
    are now prevented from referral of patients to outside-the-plan doctors. The physician source
    for referral of medical patients in private
    practice is slowly disappearing.

     The above information provides sound reasoning for
radically escalating your knowledge and actions regarding
the creation of a hell-on-wheels system for recruiting new patients for your private medical practice… if you intend
to stay in private practice.

How you respond to and manage the referred patient is paramount to your practice destiny

Your response to that patient also includes how your office staff interacts with a referred new patient (as well as a referred patient you have seen previously).

Every single point at which your office staff members and yourself interact with any referred patient either creates a place of special hospitality where they feel quite comfortable, or a healthcare delivery environment that they perceive to be ubiquitous in nature
as expected.

Your aim is to make their visit at your office an experience to remember and one they would have no reservations about returning to again.

It means this patient should be treated in a much more thorough and professional manner than your own patients… for many reasons. I might point out that this is an investment in your future maintenance of new patient flow.

It’s common for a transient patient to return to a medical practice that treated them so well for all their medical care long term. 

Some doctors believe that referred patients take it for granted that their doctor has referred them to a doctor with the same characteristics and personality as their own doctor, which is rarely true.

For this reason, it is incredibly important to start off with a referred patient in a soft and pleasant manner that would surprise even your own mother.

If you can’t usher in such a scenario, then fake it. At least it would help to prevent the loss of 20 future patients that you would never see who heard the story this lady or man would tell about their, “terrible medical visit with that ________ doctor.” 

When you greet that patient for the first time, it’s essential that you do two things that instantly set up the integrity of the rest of the visit. These should always be the first two things you do every time you greet any patient at any time… even your own patients you have followed for 20 years.

You make direct eye to eye contact and physically touch the patient in some manner, handshake, pat on the back, grasp on the forearm, etc.

These two techniques instantly insure the mind of the patient that they are right then the center of your complete attention. Nothing in medical practice is anywhere near as persuasive as these two gestures done at the right time.

If you want to add a bit of spice to those two techniques, immediately include a verbal polite question that always results in a “YES” answer. “Isn’t it a beautiful day out there today (if it actually is)?”

Just because the car salesman pulls the same sales technique on you when you go to buy a car, a series of simple everyday questions that draw yes answers from you right at the start, doesn’t mean it is less efficient in your medical office.

It’s a subliminal persuasion technique where a series of yes responses automatically creates a positive permissive attitude in the mind of a patient, making them, or anyone, much more inclined to respond to the later questions in a positive way, “Would you love to buy this car today?”

In a medical interaction something like, “I’m prescribing this medicine that I want you to take for the next 7 days. It’ll cure your boil infection on your butt.” And, the patient is happy to comply. 

Understanding that about half of your patients won’t take all the pills you prescribed, it’s a very persuasive means of inspiring most of those patients to take all the medication without spending time explaining to them all the consequences of not taking all the medication.

We all know that explaining the consequences of not taking all the medicine prescribed, if time permits, is the absolute most persuasive way to convince patients to do as you say just out of fear. Persistent problems with that medical issue may recur if meds are not taken as you have prescribed. 

You will instinctually spend more time with a new referral patient to accomplish all the above advantages.

Referred patients should be scheduled for longer appointments for this and other reasons. To be deliberately more tactful, you place yourself in a position of being more thorough in answering the patient’s questions.

Take longer than usual to explain your findings and treatment options and take more time blending social conversation into the medical one than you would normally do.

Another very effective tactic to use to make a patient more comfortable is to permit the presence of a family member or friend in the exam room during the consultation (never children under the age of 10 to 12) and later during your post exam discussion and follow-up visits for that same problem.

A young child or baby in the exam room will always compromise the attention of the patient, create distractions to your medical comments, and create a potential medical liability for you whether you believe it or not. In pediatrics, it’s a different story… there are always exceptions.

Here are a few more of my favorite methods to create a perfect patient referral visit...

  1. Permit the patient to disrobe and put clothes
    back on in private... not while you stand there
    with your back to them or not.

  2. If possible, have cloth, not paper gowns
    for patients.

  3. Never leave this patient in the exam room for
    more than 5 minutes alone.

  4. Make the discussion about your findings and treatment options with the patient outside the exam room if possible (office or consult room).

  5. When possible, call and inform the patient’s
    own doctor of your thoughts right in front of
    the patient at the time.

  6. When language is a problem, make sure the patient brings an interpreter person with them
    to the scheduled referral visit.

  7. Avoid answering any phone calls during the
    visit… emergencies are the exception. The one other exception might be a doctor calling you.

  8. Be sure to maintain a conversation all through
    the office visit… even when you are reviewing
    the patients records... (on the PC or in their
    folder) silence by you in the patient’s presence
    for 3-5 minutes or more disarms patient rapport and aggravates patients.

  9. When confronted by a hostile patient, don’t
    argue about any point they make… never argue with any patient. Instructional and informative debate is fine.

  10. Review the entire patient’s medical information
    just prior to entering the exam room, or speaking with the patient... don’t enter unprepared about responding to their medical needs.
    At the very least, know the patient's name so you can greet the patient using their name.

  11. Humor is very helpful for relaxing a patient when used with patients that your feel are receptive.

  12. Always review the exact information that the referral doctor spoke, sent, or faxed to you about his patient, with the patient, at the beginning of the visit so all discrepancies are quickly ironed out.

How to manage your interactions with the referral doctor to your advantage and his pleasure...

A reasonable volume and flow of communications with the referral doctor is the most effectual means of insuring future referrals from that doctor or office staff. It is a common professional courtesy and ethical behavior to instantly answer any phone calls from doctors.

When doctors take the time to call you themselves, you either take the call right then or lose any probability of future patient referrals from that doctor.

You obviously can’t stop in the middle of a procedure to answer the phone, but this is easily appeased by a staff member who explains the situation to the doctor on the phone and arranges
a time for you to call them back within a very short time
(within 30 minutes).

Usually the referral process is handled between the two office’s staff members by phone without the involvement of the
doctors. When a doctor is involved, the referral is often an urgency or emergency and should be handled the same day,
or within 24 hours at most.

The minimal array of communications sent doctor to doctor should be at least the following...

§  Responsibility for treatment and follow-up
visits and management. Most referral doctors
make it clear at the time of the request for their patient to be seen who is to do which part of the treatment and follow-up… them or you… or even
to keep the patient forever (ex. A dermatologist refers a pregnant patient to an OBG doctor).

§   Same day phone call back to the referral
doctor about your findings, thoughts, advice, treatment options.

§    Written communication reviewing the details
of your findings, thoughts, and treatment options… within 24 hours of consult.

§    If you are to treat and follow the referred
patient for that medical problem, then a follow-up written report and phone call back to the referring doctor about the recovery and outcome is important.

§   If the patient was referred only for a diagnostic and advice consultation, then all treatment will be done by the referring doctor.

In this case a written report of your findings, advice, and treatment options should be sent to the referral doctor to use as part of his or her education in case they are not fully informed of the most recent and upcoming new treatment options available.

At the same time, it is also wise to make it clear in the message that you would be happy to help them further at anytime with this patient, or even take over the care of the referred patient should
her own doctor run into problems with the patients treatment…  leave all options open.

Additional communications can be the elements that set you apart from, and above, what other doctors don’t or won’t do. Remember that marketing your practice is the foundation for your stability of income and referrals.

Here are a few more of my favorite methods to create a perfect patient referral visit...

  • Increasing hostility of the patient requires you to instantly leave the exam room, in silence, and let the office staff manage the patient. An apology at the time is ineffective, because the patient takes
    it as a form of intimidation.

  • Make every effort to avoid and prevent the presence of small children in the exam room... those over 10 years old are OK and rarely distract from the doctor-patient communications.

  • Occasionally photos of a patient's medical problem or disease is appropriate, with the patient's approval. It is an excellent means of verifying the problem for the medical record and serves as a means of confirming healing and response
    to treatment.

  • Offering medical handouts to the patient or special information and instruction is a very smart means of promoting your credibility and promotion of your practice, should the patient later return to your practice as a permanent patient.

  • Avoid sending the referred patient on to another doctor for evaluation or consultation without the approval of the primary referral doctor. It's not a rare happening.

The marketing rule and dogma here, is...

Do what other doctors are not doing!

Comment about marketing your medical practice to the best referral sources

Depending on your thoughts about the kind of medical patients you prefer to have in your practice, your marketing efforts should be directed to those referral sources. "Only send me patients that _________ ."

The most profitable resources for patient referrals are the doctors in your local city and medical community within a 7 to 10 mile radius. Some doctors prefer to deal in volume of patient referrals and some in quality of the patients referred to them. 

You are quite aware that you are able to see and treat only a limited number of patients per day, per week, per month. The level of income produced in your practice from that limited number of patients is dependent on many aspects of your practice business.  

Seeing referred patients that are in low income category, rarely become loyal patients, and encompass much more of your attention medically, which can result in a poor practice income.

If you deal in volume of referred patients, then you are forced to hire more staff. The extra employees are necessary to do more of the medical advice and instructions, manage minor treatments, and handle the majority of medical patients who don’t need to see
the doctor.

As a medical student in the early 1960s, I remember a center city OBGYN doctor associated with the teaching program known for seeing an average of 130 patients a day in his office, which was difficult for me at the time to comprehend. My mind kept wondering how that was possible and finally considered it just a myth.

It’s not difficult to understand now that it is possible to run 130 medical patients through your office daily, but it isn’t the doctor seeing most of those patients. It’s clear that this doctor was well ahead of the medical practice game by demonstrating the efficient use of midlevel medical providers.

If your intent is to create a medical practice primarily composed of well educated, medically informed, and well paying patients, you must focus your marketing efforts on the referral doctors who can send that kind of
patient to you.

Those well established referring doctors require a higher level of marketing to get their attention and to refer their patients to you. That’s why it’s so important to begin your medical practice in a location where this is possible and your mix with that society is possible
from the start.

This may not fit your ideas about the kind of practice you want, but it is the fastest way to wealth in the profession if that is important to you.

You can become wealthy in any practice setup if you know how to go about it. It’s a skill you will never be taught in your medical education. You learn that from life experiences, your friends and mentors, and from your own intellect and intuition.

If we all knew the secrets, we’d all be rich… if that was the goal of medical practice. Most doctors seek fulfillment in helping patients fight disease, trauma, and disability. Fulfillment is something wealth itself
doesn’t provide.

However, creating a high practice income by marketing your practice does not exclude fulfillment at the same time. I believe that high practice income is deserved
and provides more intensity of fulfillment because you are then able to afford learning new medical skills
and knowledge.  

You are a better doctor in the long run when you can afford to gather the knowledge and skills to maintain yourself on the cutting edge of medicine. In doing so you are able to serve your patients at a higher level of expertise. If that’s not true, then I will have
much to regret.

Even the minds of the world renowned business and marketing experts teach these very same steps to success in all businesses. I’m referring now to an article written by Dan S. Kennedy, considered to be the most in demand marketing strategist in the world.

The main points of his article are...
(Applying these comments to medical practice.) 

  • Word-of-mouth is the most effective business advertising.

  • The tremendous persuasiveness you have
    with your patients enables you to ask for
    their help to promote your practice.

  • People usually enjoy telling others about
    doctors they try and like. People love to be appreciated and that is gained by being
    helpful to others.

  • There must never be any form of pressure,
    bribes, or “inducements” used for creating
    this process.

  • Prospective patients are the lifeblood of your
    medical practice business. They are the
    greatest asset of your business.

  • Recommendations from your loyal satisfied
    patients are a profit multiplier for your practice.

“It’s not what you are going to do,
but it’s what you are doing now that counts.”

      ---Napoleon Hill

The author, Curt Graham, is a recognized author, physician, and entrepreneur with a passion for bringing reality to unacceptable issues about medical practice that demand attention, alternatives, and debate. His desire to make doctors think beyond the boundaries of usual thought is secondary only to his mission to reveal the consequences of having a fixed mind unable to benefit from experience, knowledge, and wisdom.Learn from his medical publications what isn’t taught in medical schools and that you must know today to maximize your potential and capabilities.
Click here now to learn how to reach your maximum medical practice potential.
©Copyright Curtis Graham, M.D., L & C Internet Enterprises, Inc., All Rights Reserved.

       handwritten signature of Dr. Graham


 Business Nudges......

one fox within a crowd of dogs

Opportunities are often hidden in plain sight just like this fox. It pays to be vigilant in your business to discover the factors within your medical business that most of us pass by and never see.

You may remain skeptical of the value of statistics, but this is one that if never recognized and never taken advantage of will continue to haunt your efforts to improve your practice revenue.

Knowing that the overwhelming sources of income from your medical practice comes directly from referrals to your practice, is something well worth your persistent attention and taking action. Creating every means of obtaining patient referrals is not difficult and is a business function that can be delegated to your office staff to perform. As always, your oversight
is required.


professional photo of Dan S. Kennedy, marketing strategist

Renegade Millionaire

By Dan Kennedy


"Oh The Dreadful Banality Of It All "

"When someone is successful, there is always a feeling
they were lucky. Luck plays a part, sure, but you
must have iron discipline and energy and hunger and desire"
   --- Faye Dunaway


Geez, another one. You may or may not be familiar with the comedian, Chelsea Handler. If you only know her from the ill-conceived, hastily cancelled network TV sitcom, you don't know her at all. She hosts her own late night show, Chelsea Lately, half her with a panel of comics, half  her
interviewing a celebrity.

She has a midget as a sidekick, sort of in the Ed McMahon role. Or satirizing that role. She works blue; she critiques celebs a la Joan Rivers and Kathy Griffith. Her show's popularity has steadily climbed, making a series of books topping the New York Times Best-seller lists and lucrative tours and ownership of other comedians and even an endorsement deal with a vodka possible.

And she has just signed a contract extension through 2014 with the E-Network, at a base of $12-million a year, making her higher paid than David Letterman (in dollars per viewer). She may even be the highest paid comedy/ talk show host you never heard of.

And her secret? To many, bitterly disappointing. She is yet another superstar, entrepreneur and big moneymaker whose explanation of her success is positively banal. In an article in Daily Variety (7-25-12), the entertainment industry trade journal, Handler said: “MY SECRET IS that I just work really hard all the time.”

Say it isn't so. Tell us you have a secret for driving floods of traffic through your Facebook site and magically converting them to fast 'n easy fame 'n fortune. Or let us down easy by revealing you rose by dumb luck or who you knew or who you copulated with or through sheer, unique, genetic talent. Don't tell us you outworked and keep out-working everybody.

 Long slogs to distant comedy clubs, room-sharing with other comics in crappy motels, dead-end auditions, endless writing, refining, testing material, honing of wit and delivery and confidence, finally a break, another break, now prepping and doing a nightly show, managing a staff, pumping out one or two books a year, book signings, media tours, hitting the road for big payday shows at every opportunity, giving interviews, going on Leno, etc. as guest whenever invited and lobbying and wheedling for the invitations, and yes, engaging in every imaginable social media, and still, endlessly writing, refining, developing new material. This, the life of a millionaire?

'fraid so. The great actress Faye Dunaway told an interviewer: "When someone is successful, there is always a feeling they were lucky. Luck plays a part, sure, but you must have iron discipline and energy and hunger and desire." Hmm. She said exactly the same things Napoleon Hill said in his seminal book, Think And Grow Rich-in 1937 incidentally. And now, in 2012, Handler is an echo.

You can argue the world and technology and media have changed so much that Hill's advice or, for that matter, Dunaway's must be antiquated. Handler, of this moment, would differ.

Appearances are deceiving. If you watch Chelsea Handler do her act or her show, words like 'iron discipline' may not leap to mind. Behind scenes, bet that's what you find. If not, you wouldn't find a $12-million a year contract. Exceptions, in Hollywood and elsewhere, yes, but far fewer than
most imagine.

Most multimillion dollar successes' behind scenes realities
are, well, banal. Oh, and the other half of Chelsea's secret- "Although I like a finished product, I don't really enjoy doing anything." I get that question all the time: of all the things you do, which do you enjoy the most? It's a question born of the 'find and do what you love and the money will
follow' fantasy.

It's not how it really works. Like her, I enjoy the results. All the rest of it, not so much. I rarely whistle while I work. But I really enjoy the results.

DAN S. KENNEDY is a serial, multi-millionaire entrepreneur; highly paid and sought after marketing and business strategist; advisor to countless first-generation, from-scratch multi-millionaire and 7-figure income entrepreneurs and professionals; and, in his personal practice, one of the very highest paid direct-response copywriters in America. As a speaker, he has delivered over 2,000 compensated presentations, appearing repeatedly on programs with the likes of Donald Trump, Gene Simmons (KISS), Debbi Fields (Mrs. Fields Cookies), and many other celebrity-entrepreneurs, for former U.S. Presidents and other world leaders, and other leading business speakers like Zig Ziglar, Brian Tracy and Tom Hopkins, often addressing audiences of 1,000 to 10,000 and up.  His popular books have been favorably recognized by Forbes, Business Week, Inc. and Entrepreneur Magazine. His NO B.S. MARKETING LETTER, one of the business newsletters published for Members of Glazer-Kennedy Insider's Circle, is the largest paid subscription newsletter in its genre in the world.

Click the link below and take advantage of the free gift which will make you wealthy--if you are in control of your own life and career!

Articles © 2008/Glazer-Kennedy Insider’s Circle LLC.


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Profitable Practice Tips

1. Free healthcare help:
Provide sources of info for your patients when
they ask.

With the mobile phone revolution patients are able to access help from 6 most useful mobile sources:







2. Sell credit cards to your patients?

Major banks like Citigroup= CitiHealth Card

General Electric = CareCredit Card
(have 140,000 healthcare providers already signed up)

JP Morgan Chase = ChaseHealthAdvance Card


Advantages to providers:

*Patients can pay instantly for care.

*Patients can pay for medical services that their insurance doesn't cover---like plastic surgery, veterinary bills, and cancer care.

* Saves doctors billing
 + collection problems.

* Can charge full cost
   of a procedure up front.

* Cards 0% interest
   first yr. then 25-
   30% after that.

Borderless Humor

"The early bird might get the worm, but the second mouse gets the cheese."

Goals - Plans

Teach your kids:

business principles,
-- moneymanagement,
--creative thinking,
--decision making,
--goal setting,
--faith in God,
the power of money

Inspiration Time

"It's not who you are that holds you back, it's who you think you're not."

---Denis  Waitley

Views I Only Share With My Friends--

What my medical career taught me.......
Click Here... and how it can help you manage your medical practice business at the highest level of expertise.

 Facts And Stats

1. Even the loud mouth supporter of the Democratic party, Howard Dean, M.D. admits that the Affordable Care Act Rate-setting won't work. (WSJ 9-5-13)

2. Medicare increasing readmission penalties for hospitals puts about 3,400 hospitals at risk today. Software for avoiding such penalties has been developed for predicting patients that are readmission risks.

Last year 2,214 hospitals were fined $227,000,000.

Two company startups have created that software and can be set up for $30K to $50,000 dollars.
Engineered Care Inc. and Predixion

(WSJ Aug. 8, 2013)

3. Your DNA genome:

--Scientists have identified 38 million variations of chemical letters in our DNA.

--That's 98% of estim. human variation in world.

--humans share about 98% of the DNA code that shapes development, health, personality.

--hereditary change of only one letter in code is known to increase risks of M.S.

(WSJ--Dec. 2012)


What Your Kids
Are Capable Of-

Permit and help your kids to become assets....

When you want to understand what your modern day kids are capable of and have the ability to do, regarding starting a business of their own, then hit the link below and give yourself a dose of inspirational enlightenment.....



New Important

Protect your practice using the strategies in this
 Ebook , which  contains the keys to your medical practice survival.

"How To Rapidly Propel Your Medical Practice Income To Unlimited Levels In 6 Months"
Click Here When you need expert help and advice, and when........

red checkmarkyou just don't know where to turn to get honest and reliable help with your battle to fight the external forces that compromise your practice revenue and growth.

red checkmarkyou want to improve your medical practice income dramatically in a short period of time.

red checkmarkyou prefer to find the means to reach your highest level of practice income and productivity.

red checkmarkyou demand effective and reliable means for preventing the financial collapse of your medical practice.

red checkmarkyou are determined to find ways to combat govt. fee restrictions that continue to increase.

red checkmarkyou recognize that what you are missing in your medical business are implementation of business principles and marketing strategies.

red checkmarkyou want to do it yourself and save a bunch of money.

red checkmarkyou are sick and tired of putting up with what you are being forced into doing with your practice to stay afloat.

red checkmarkyou are aware that no other physician author is making any effort to tell you what to do and how to do it effectively to reach your expectations you had for your medical career when you started.

red checkmarkyou understand the severity of being in a business without ever being taught the business knowledge to run it profitably.

red checkmarkyou insist on having a blueprint for your medical practice business that provides every key to your practice success at the highest level. 

References For Maximizing
Outside Income

best references for doctors who invest...

For Investing advice

   (Porter Stansberry)

2.The Palm Beach
   Letter--Mark Ford

3. Retirement Millionaire Newsletter.......
published by David Eifrig Jr., MD, MBA, Ophthalmologist, stock market expert.
(my choice)

call 888-261-2693

Note: I have no personal or business connections with these references other than subscriptions to their publications.  I suggest them because I do think they have unique value for investors.  You decide.

My Other Medical Websites 





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            spread eagle position

     photo of Dr. Graham and his two corpsmen in Vietnam 1965       photo Dr. Graham 1970's         photo of Dr. Graham's wife Linda          photo Dr. Graham--1990's             photo of my OBG medical practice group

Flight Surgeon Vietnam

Diet Worked 1980

  My Wife Linda

Retired 1999

Our Medical Practice Group
Graham, Mayo, Kaplan, Seibert, DelValle, Chuba

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Curt Graham, M.D.
2404 Mason Ave.  Las Vegas, NV 89102
E-mail = cgmdrx(at)
© 2004-2015  Curtis Graham, M.D., All Rights Reserved.