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3 Strategies to Break out of 'Assembly-Line Medicine'


A doctor who decided to build a better practice from the ground up shares her insights into what a practice can look like when it's designed by patients.


What would your practice be like if you had no receptionist? What would your practice be like if you had no more space than one waiting room? What if your patients designed your practice?

How would that change your practice? Could you imagine what that transformation would look like?

In a recent podcast I held, author & physician coach Pamela Wible, MD taught me 3 incredible business strategies for doctors. She emphasized that they can break free of assembly-line medicine by starting their own clinic.

Dr. Wible said, "I spent 10 years as an employee, as an unsatisfied employee and I just thought at the beginning well maybe it’s this one job... I tried everything: hospital based clinics, I tried small physician on practices, part-time, full-time, community health centers, migrant, farmers clinics... hopefully to find that ideal clinic that I have always been dreaming of, that I wrote on my personal statement when I applied to medical school and guess what! It’s not out there. There’s no job that you could just take on salary that I could find that I thought was anywhere near ideal. So I had a revelation that if I was going to work in an ideal clinic and be the doctor that I always imagined, I better do it on my own."

In her interview with me on, Dr. Wible discusses how she founded the ideal medical care movement. In 2004, Dr. Wible left assembly-line medicine and held town hall meetings where she invited citizens to design their own ideal clinic. Open since 2005, Wible’s innovative practice has inspired physicians to create ideal clinics nationwide.

Dr. Wible is not only inspiring physicians. She is inspiring patients, inspiring communities, and inspiring the world. She is showing us there is a different way. This interview really gave me hope and inspiration for our medical systems. She has been one of my all-time favorite guests on the Freedom Formula for Physicians Podcast!

As a matter of fact, her model is now taught in medical schools and undergraduate medical humanities courses and is featured in the Harvard School of Public Health’s newest edition of Renegotiating Health Care: Resolving Conflict to Build Collaboration, a textbook examining major trends with the potential to change the dynamics of health care.

In a report on how physicians are getting burned out, Vital WorkLife noted that almost 66% of respondents say more stressed than in 2011, 88% moderately to severely stressed and 46% specified severely stressed.

"Based on continued concern for physicians and witnessing the most significant changes in healthcare’s history, we measured physician stress and burnout. There is an urgent need for healthcare organizations to recognize and address this crisis; initiatives are needed for physicians to feel understood and supported by their leadership and to develop greater well-being," they wrote.

In the interview on Dr. Wible said, "I just had an epiphany: that I’m pretty miserable working for these ridiculous production-line clinics and it doesn’t look like the patients are very happy either and so if the patients aren’t happy, the doctors aren’t happy... why not get together and create a new model that will really work for us?"

So she led town hall meetings to get the whole community involved. She said, "I invited my entire community to design the first ideal clinic in the United States designed completely by patients and it’s kind of going out of a limb to tell people that in a month I’m going to open a clinic that’s designed completely by you guys, what do you want? I’ll do anything you want. I got a hundred pages of written testimony and what people wanted was just so simple, putting the end user in charge of designing the services that they want is a pretty smart move."

By holding these meetings, this led to a fully booked office for months on end because the end-user was involved in its creation. The patient was excited. They had a hand in creating this thing!

Lastly, the BIGGEST key I learned to her financial success is keeping her practice simple. It’s truly shocking that she has NO staff. In addition, she has an incredibly small office—only a bit over 200 square feet.

This keeps her overhead incredibly tiny. It doesn’t take much for her to be profitable.

Why can’t more practices do this?

The best business opportunities, in my opinion, are having that sweat equity of being a small business owner. For example, you could own the building rather than rent!

This model just got me so excited. I truly think every physician should be a small business owner. Not only do they get emotional freedom, they also can experience greater financial freedom and time freedom. They can control their own destiny rather than be on the assembly line.

There's so much in this podcast. Every physician should check it out and be ready to be inspired by Dr. Pamela Wible. She's wickedly smart, open, honest, and a down-to-earth person.

Check it out and enjoy!

Dave Denniston, Chartered Financial Analyst (CFA), is an author and authority for physicians providing a voice and an advocate for all of the financial issues that doctors deal with. He is the financial planning for physicians expert and author of 5 Steps to Get out of Debt for Physicians, The Insurance Guide for Doctors, The Tax Reduction Prescription, and his new book, The Freedom Formula for Physicians. He hosts a podcast for doctors and the issues they face at and can be reached at his website

Pamela Wible, MD, is a pioneer is the ideal medical care movement and recipient of the 2015 Women Leader in Medicine Award. She leads physician retreats to help her colleagues overcome abuse and open their own ideal clinics.

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