While physicians are increasingly opting for employed models, some are unhappy with employment and are pivoting back to private practice. 

According to a survey from consulting firm Bain & Co., nearly 25% of physicians in health system-led organizations are contemplating a change in employers, compared to just 14% in physician-led practices. Notably, of those considering a switch, 37% are looking to move to physician-owned settings.

“We’ve seen this trend empirically,” Jeremy Shiner, founder and CEO of Myriad Systems, a provider of AI-driven healthcare practice management solutions, told Becker’s. “This shift is evident not only in direct primary care and physician-led concierge practices but also among providers who might not appear in the statistics — those working in hospitals while also running concierge practices on the side. The common assumption that private healthcare is disappearing in favor of hospital systems isn’t as clear-cut when we observe what’s happening in the field with our clients.”
​
Mr. Shiner has observed several factors driving this trend: autonomy, quality of care and physician burnout...

READ MORE

If you’re running a medical practice, you’ve likely felt the sting of rising insurance denials and
payment delays. It’s not your imagination. Rejection rates are climbing, hitting 10-15% or more
nationwide, and some claims are languishing past 90 days, especially with Medicare Advantage
and state-managed plans. As a Certified Medical Revenue Manager, I’ve seen this trend drain
cash flow and frustrate patients across practices of all sizes. The good news? You can fight back,
and it starts with a sharper focus on your front desk. Here’s how practice owners like you can
take control and keep revenue on track.

Why Denials Are Surging & Why It Hurts

The data paints a grim picture. A 2024 survey found 75% of healthcare leaders reporting more
denials than just two years ago, driven by tighter payer policies—think prior authorizations,
coding audits, and “medical necessity” disputes. Nationally, unresolved claims cost billions
annually, with hospitals alone losing an estimated $20 billion to write-offs and rework. For
smaller practices, even a handful of rejections can tie up thousands in revenue. Worse, up to
25% of these denials stem from avoidable front-end errors—outdated insurance info, missing
pre-approvals, or data glitches. That’s not just a billing hiccup; it’s a delay in patient care and a hit
to your bottom line.

Payers argue it’s about cost control, but when a claim sits unpaid or a patient faces an
unexpected bill, the burden lands on you. The fix isn’t waiting for insurers to ease up—it’s
building a process that stops denials before they start.

Your DIY Playbook: Strengthen the Front End

The front desk isn’t just a check-in point. The front desk is your first defense against revenue
leaks. With a few tweaks and the right tools, you can turn it into a denial-fighting machine. Here’s
what works:

Pre-Visit Prep: Most practice management systems, (like NextGen Office, Tebra, eClinical Works,
Athenahealth, etc.), offer real-time eligibility checks. Run a report 24-48 hours before
appointments to pull payer data: active coverage, co-pays, deductibles, and service-specific
benefits. It flags gaps early such as lapsed plans or pre-auth needs so you’re not blindsided.

Card Check Every Time: Ask for the patient’s insurance card at every visit, no exceptions. People
switch jobs, plans renew, or patient coverage lapses. Relying on last month’s eligibility info is a
gamble. Scan it, compare it to your system’s data, and re-verify if anything seems off. It’s a quick
step that catches errors that payers love to exploit.

Benefits Breakdown: Before services kick off, confirm coverage for that day’s procedures. Does
the plan need prior authorization for high-ticket items? Are there exclusions? A minute spent
here can save weeks of appeals.

Patient Clarity: Train staff to level with patients: “Your co-pay’s $25, but this might need
approval... do you want to go ahead?” Get waivers signed if coverage is shaky because it’s your
shield against post-visit disputes.

This isn’t rocket science; it’s simple discipline. Practices that tighten front-end verification see
denial rates drop by 20-30%, keeping cash flow steady and administrative headaches down.

Why It Pays Off

A solid front-end process isn’t just about dodging denials, it's more about control. When your
staff nails eligibility, claims go out clean, and payers have fewer excuses to push back. If a denial
does slip through, you’ve got documentation with dates, payer responses, and patient sign-offs
to fuel an appeal. Data shows over 50% of appealed claims can flip with the right evidence, and
that starts with what’s captured at check-in.

So, take it a step further: track your denials by payer and reason. Spot a pattern... like one
insurer rejecting 15% of claims on technicalities? Use it to renegotiate contracts or flag staff
training gaps. It’s not flashy, but it’s how you turn a losing battle into a winnable one.

The Bigger Challenge and Your Power To Overcome It

This isn’t a blip; it’s a shift. Payers are getting tougher, and patients feel the squeeze. One in five
appeals succeeds when you fight, but you shouldn’t have to. You can’t fix the system, but you
can protect your practice. A quarter of denials are preventable, and that’s where your leverage
lies. Every clean claim is revenue secured, every patient informed is trust earned.

So, private practice owners, here’s your next move: peek at your front desk tomorrow. Are cards
checked religiously? Is your software pulling its weight? Are staff empowered to catch mistakes?
Small changes here can create a big ripple effect resulting in less rework, faster payments, and
happier patients. You’ve got the tools, so tweak them, test them, and watch the numbers turn in
your favor. The denial surge is real, but it doesn’t have to sink you.

​Written by: Tim W. Warren, CEO, CMRM

Do your doctor clients express concerns that they will lose their wealth?

What do you say?

Insights into what's happening in your clients' brains form the foundation for your most effective response.

People who fear losing it all are in their fight-or-flight reptile brains. They have the experience that their survival is on the line.

When your client's reptile brain is activated, they don't think; their options are fight, flee or freeze. 

The best way to respond is to remind your clients that they are safe right now. This helps calm the nervous system so that your client can ascend from the reptile brain to the thinking brain.

Spending time in the reptile brain places your clients at risk for burnout.

This is one of the topics I will address in the upcoming Masterclass "The Doctor Burnout Breakthrough."

You will take away:

My take on what doctor burnout is, and what causes it.

What I advise physicians whom I coach about how to break through burnout--and it's NOT what they think!

Show YOU how to break through doctors' attention bubbles with the burnout message.


My best,
Dr. Vicki

Imagine spending every day working with your ideal clients—the ones who bring you joy, energy, and satisfaction. Now imagine never having to deal with the headaches of a bad-fit client.
 
Sometimes, saying “No” to the wrong clients is the key to saying “Yes” to the right ones. It’s not just about filling your practice; it’s about filling it with people who belong in your sweet spot.
 
You already know from experience that there’s a high cost to accepting bad-fit clients. They often turn into time-sucking, energy-draining vampires. Worse, they’re more likely to file complaints, dispute fees, or even sue.
 
So, how do you spot these problem prospects before they become problem clients?

Click here to see the list of red flags to look out for. As you look at the list, consider, "Which of these 14 represent hot buttons for me?"

Believe people when they show you who they are! 

To your success,
Dr. Vicki

PS They say every woman should have a little black dress. I say that every financial advisor should have a "little signature talk" that helps prospects shift their perspective and make different choices.

My presentation about how to attract, engage and serve doctor clients is my signature training event. To reach more financial advisors, I will be delivering this webinar LIVE every Tuesday at 9 AM Pacific for the next few months. (Click here to register for the live presentation Tuesday, January 28th at 9 AM Pacific.) 

Would you like to go behind the scenes and see how I created this training, and why it works so well? Let me share what I've learned to help YOU build your signature talk. And here's the key. Your signature talk is not a "brain dump" of everything you know about building wealth. Click here to register for a training that will help you attract and engage more doctors on Thursday, January 30th at 9 AM Pacific. 

Pleased note: there are two links in this email for two different training offerings.

1. How to Acquire Doctor Clients Click here to register for the live presentation of my signature training Tuesday, January 28th at 9 AM Pacific.

2. Lessons Learned: How You Create Your Signature Training that WORKS  Click here to register for a training about how I constructed my signature training on Thursday, January 30th at 9 AM Pacific.

I travel in circles of entrepreneurs, and every day I’m learning about new sales and marketing applications of AI.

Have you put your toe in the AI water?

This is a very powerful tool. 

You can begin by opening a free Chat GPT account. 

Last week I was at a meeting absorbing a terror-inducing presentation about cybersecurity. Just for fun, I signed into Chat GPT and began this chat, “Please assume the identity of a financial advisor and write an article to clients about cybersecurity.”

Chat GPT generated a wonderful piece good enough to copy and paste and send to clients! 

As with any tool, AI needs to be managed in order to not do harm.

I got a cold text from a medical revenue manager who wanted my business. It was clearly generated by AI.

After a long rambling pitch it ended with, “Let me know your thoughts.”

I wrote back with this message: “This is spam. Please remove me from your list."

They replied (word for word), “Hello, Sir. We feel sorry if you are not comfortable with it. But [can] visit our pages/sites for more updates. We will ensure you everything would be according to HIPPA compliance.

Yes, there is no subject in the third sentence, HIPAA is misspelled and the language is stilted. 

I wrote back: “Great example of AI gone wrong.”


AI was going to have the last word. They shot back, “Sir, we are only doing marketing to expand out services. So that we may help physicians focus on patient treatment.”

Yikes!

I believe that AI will transform the way we attract, engage and serve our clients. 

Still, we need to use this tool with discernment. Spam is still spam. The message must still resonate. The call to action must still align with the level of trust built. 

What do you think?
 

To your success,
Dr. Vicki

​Like you, I have ideas about how I can help my clients achieve their goals. 

You’re most likely reading this email because you want to accelerate your practice growth by engaging and serving more doctor clients.

I divide the world into two sets of people: Suits and White Coats. 

Your prospect who is a Suit thinks and acts differently than a White Coat who sees patients.

My secret sauce is offering a bridge between the world of business and the world of medicine.

Since bridges accommodate traffic in both directions, I have two brands.

In my Thriving Doctors brand I serve physicians who want to build TrueWealth—which I define as the flip side of the coin as burnout. (I do not offer money management advice; rather I help physicians improve their relationship with money.) This experience gives me unique insights about what’s important to doctors. 

Through my Engaging Doctors brand, I help financial advisors like you understand what’s important to doctors, how they think and what inspires them to push the “buy button”

I found a marketing message that meets the moment and engages White Coats.

I created an offer to help financial advisors leverage this opportunity. 

Based on my perspective and experience, I projected that several hundred advisors would sign up.

Do you know how many of the thousands of advisors on my list took me up on this offer?

Four!

I thought I knew how my members of my financial advisor community would respond, and I blew it! 

As a financial advisor, you have ideas about marketing messages that will engage doctors—or any other group of prospects. You might be very excited about your message. You might think, “If this popped into my email, I would jump all over this!”

You might go all in and create craft a presentation.

However, your clients may respond differently than you expect. 

I promise you that a White Coat prospect will respond differently than a Suit will. 

Don’t guess when it comes to your marketing message. Test it. Tweak it. Masks sure it works before you go BIG.

 

What do you think?
 

My best,
Dr. Vicki

Hello,

When David Frisk Frick interviewed Paul McCartney for a Rolling Stone article, he asked the famed Beatle about the wealth the band created. 

Paul McCartney said, “Somebody said to me, ‘But the Beatles were anti-materialistic.’ That’s a huge myth. John and I literally used to sit down and say, ‘Now let’s write a swimming pool.’ We said it out of innocence. Out of normal, f*king working-class glee that we were able to write a ‘swimming pool.’ For the first time in our lives, we could actually do something and earn money.”

You want to drive revenue. 

What is your one activity that’s your version of “writing a swimming pool?”

I argue it’s building your list.

The single question financial advisors most frequently ask me is, “How do I get my message in front of more doctor prospects?” 

In the Cracking the Physician Code course--AKA "Medical Marketing School"-- we talk about three buckets of leads:
 
Family, Friends and Fans: people who already know, like and trust you.
 
Power Partners: people who have relationships with your ideal clients. You may call them centers of influence.  
 
Doctor Information Seekers: doctors looking for answers to their questions.

I am coaching a high-performing financial advisor on his way to breaking seven figures. My client told me, “I want to build an automated lead generation system so I can scale the business and have it generate income while I’m on vacation.”
 
We are implementing strategies and tactics to reach out to doctor information seekers—ie cold traffic. We’re filming video content for both organic social growth and paid ads.

Creating great content and crafting magnetic marketing messages does not happen overnight; we’ve made a significant investment into this campaign.

In the meanwhile, almost every week this advisor tells me about the wonderful new client he’s onboarding.
 
I regularly ask him, “How did that client find his way to you?” 
 
The answer is almost always the same. “It was a referral from an existing client.” Or, “It’s from the CPA who already sends me lots of clients.” Or, “It’s from someone in the audience at my recent presentation.”

And I regularly point out that the fastest, easiest an most effective lead generation system is this: invest to become the go-to guy or go-to gal among targeted groups of doctors who network together. 
 
Why?

The rate at which you build relationships with doctors is the rate at which you build trust.

Doctors are targets of financial predators; most doctors, including myself, have been victims in some way or another.

As you know, I’m a retired surgeon. How did I find my own financial advisor? I asked my physician buddy, who told me that his financial advisors did a good job for both his family and his wife’s nonprofit. 

Great! As far as I was concerned, I had chosen my financial advisor based on my trusted buddy’s recommendation.

Facebook ads may make complete sense for your practice. However, please take a breath and ask yourself some important questions: 

“Am I already reaching out to people who already know, like and trust me and letting them know I serve the doctors who serve our community?”
 
“Am I building relationships with the right Power Partners?”
 
“Do my existing clients know the broad scope of problems I solve?”

Cultivate a culture of introductions. Grow your list of prospects by addling links in your chain of trust by beginning with existing relationships you have nurtured. It's the fastest, easiest and most cost-effective way generate more revenue.

Build lists of your people. That’s where the magic begins.  That’s how you “write a pool.”
 

To your success,

Dr. Vicki

 

PS If you’re planning for accelerated business growth in 2025, list-building is your rocket fuel. Want more information about how to achieve epic growth of your lists? I’m hosting The List Building 5-day Challenge December 2 to 6, 2024 from 5 to 6 PM Pacific each day. We’ll open registration in a week. Hope you join us. And tell a friend!

A massive wave of physician retirement is approaching.

Today, about one out of four practicing physicians is age 65 or older.

Practicing medicine during the pandemic was no picnic. 

Surveys show that between 50% and 60% of physicians were burned out last year.

All this means that large numbers of physicians are on the cusp of retirement. 

What does this mean for you?

As a healthcare consumer, be warned that we are facing an impending shortage of healthcare professionals. If you plan to get sick, do it now!

As a financial services provider, you have an opportunity to reach out to physicians and dentists actively planning their retirement. 

Do you currently have any resources about retirement you can give away?
 
Do you have effective, engaging questions you ask doctors prospects and clients about retirement?
 
Can you create a SHORT—1 to 2 page-- special report about doctor retirement? Some possible titles include:

The 5 Retirement Mistakes Doctors Make- And You Can Avoid

The Secrets of Successfully Retired Physicians

Costly Retirement Myths Smart Doctors See Through

Could you package the same content as social posts, videos or blog posts?

Do you currently work with doctors who were trained outside of the US? This will be the likely healthcare labor supply to fill the gaps left by retiring doctors. 

I got inspired to create a quiz about Doctor’s Retirement Preparedness Score. 

What do you think? How can you engage doctors riding the wave of retirement?  
 

My best,
Dr. Vicki

Every year I host a webinar about what's actually working in your efforts to attract, engage and serve doctor clients.

You're invited to this webinar update Thursday, September 19 at 9 AM Pacific.

Click here to register.  You will take away:
 

• 5 Trends That Impact Doctors in 2024/ 2025
• Habits of High-Performing Advisors
• The Most Common Mistakes Advisors Make
• The Keys to Success in the Medical Market
• Take a “Forgotten” Step to Generate a Higher ROI.
• What You MUST Do To Acquire More Clients.

Look forward to seeing you there!

To Your Success,
Dr. Vicki
Vicki Rackner MD
Principal, Engaging Doctors  Helping financial advisors attract, engage and serve more doctor clients.

PS Click here to register.  

Today, about three out of four physicians are employed by:

• Health-system owned practices
• Corporate owned practices
• Physician shareholder owned practices.

The split between physicians who have an ownership stake in the practice and employed physicians has radically shifted.

I grew up in Minnesota, and I was surprised when I visited my aunt hospitalized at the Mayo Clinic. Why were the hospital walls not painted pink? For years I heard my physician relatives talk about that "pinko organization." Private practice was the default physician practice setting in the early 60's.

When I came out of residency in the 80's, three out of four physicians were self-employed in private practice.

Thirty years ago, with the demands of managed care, increasing numbers of physicians were willing to trade their autonomy for the security and work-life balance offered by employment. By 2000, it was a 50-50 split and it increased to 70-30 split by 2010.

Then COVID hit. Employed physicians did not have the security they thought they had. Physicians saw pay cuts. Many hospitals did not contribute to physicians' retirement plans in 2020 to 2022. Some physicians saw their hours cut. Others were laid off.

Over the past two years, we saw a reverse trend. Increasing numbers of physicians hung shingles and went out on their own.

Join us for a live webinar Tuesday, August 13th at 10 AM Pacific to hear me share the data I've collected about physicians employment trends in the post-COVID world. Barring technical challenges, those who sign up will have access to the replay. Click here to register.

To Your Success,
Dr. Vicki
Vicki Rackner MD
Principal, Engaging Doctors  Helping financial advisors attract, engage and serve more doctor clients.

PS You''re invited to a live webinar The Business of Medicine: Post-COVID Physician Employment Trends Tuesday, August 13th at 10 AM Pacific. I'll share the data I've collected about physician employment trends in the post-COVID world. Barring technical challenges, those who sign up will have access to the replay. Click here to register.