Congratulations on starting your very own medical practice. This is an exciting and sometimes scary endeavor, but you CAN do it! You ARE doing it. You’ve done your research, checked in with your community to see what is most needed. You’ve integrated what the community needs with what you do best. You are ready.

There are several marketing strategies that will help you get the word out and attract the patients who need you most.

  1. Specialization/Niche Marketing: This messaging is focused on the unique expertise that you bring to the marketplace. This is where knowing yourself well and communicating what you offer is everything. If “wordsmithing” is not your forte’, ask for help!
  2. Relationship Marketing: For many who are building practices that are patient/relationship focused, this is easy. Use a series of questions to help patients identify with who you are and what you offer. For example: “Do you wish you had plenty of time with you Dr, to describe in detail what you most need? Do you want to see someone who listens to what you say and isn’t staring at a computer screen? Do you….?” Communicating your message from the standpoint of relationship, helps you connect with the right demographic for you!
  3. Undercover Marketing: Using social media is an easy and stealthy way to engage with your audience. Sharing anecdotal stories that don’t violate HIPPA rules, blogging, engaging your audience through polling, posting pictures– are all examples of interactions that are not perceived as marketing. Other examples include holding free on-site classes, facilitating on-site or online support groups, on-site community meetings, etc. Just tell your on-going story and invite others to participate–the best undercover marketing possible.
  4. Word of Mouth Marketing: Incentivize patients to tell their neighbors, friends and colleagues by offering premium healthcare served your way. Share your gratitude with patients for their participation in your successful practice. Engage patients in group visits, leveraging shared experience to build your practice. Create a FB and Instagram presence, the modern day version of the backyard fence. Stimulate the buzz by engaging with it.
  5. Paid Advertising: Not my favorite way to market your practice, but still an option in some areas. For those rural communities where the local paper or nickel ads flyers are popular with consumers, this is a viable marketing strategy. Use your discernment to choose paid advertising carefully. It is easy to sink a ton of money into paid advertising that doesn’t work, so use caution.

There are many marketing strategies being peddled out there, but the above list is tried and true. Most of these strategies require minimal time and energy. That’s the goal…minimal effort for maximum results!


How to Market Your Practice

STAGE ONE—The Introduction

You’ve put a ton of work into starting your clinic. You’ve asked what people want and need. You’ve been careful to differentiate what you offer vs what is available in your community. Now it’s time to actually open the doors. What’s the best way to announce your Grand Opening? You may decide to have a soft opening first where friends, colleagues and your inner circle are invited to experience your clinic first-hand. This helps to build your confidence and fuels the word-of-mouth networking that is invaluable.

About a month after your soft opening you’ve probably seen a couple of patients as a result of your soft opening event. Your confidence is increasing everyday and now it’s time to formally make an announcement. Time to create some buzz and excitement. Below are some good places to advertise the birth of your clinic! Buzz Marketing

Grand Opening Announcement to:

Chamber of Commerce
City Club
Social Media- Instagram, Facebook, Pinterest, LinkedIn
Nickel Ads
Flyers posted—Health Food Store Bulletin Boards, Schools, Library, Small Employers, Yoga and Fitness Centers
Local Churches
Community Center

STAGE TWO—Relationship Building
Your Grand Opening event is over. Whether you are pleased or disappointed with the outcome, now is the time to passionately push your vision forward. Keep the conversation going. Ever been at an event where you are introduced to someone who then retreats into stony silence as you try to carry on a conversation? Too many times that is exactly what happens with new practices. We introduce ourselves and our clinics. We make a small splash, only to retreat into our clinics, obsessing about who is or isn’t walking through our doors. So how do you keep the conversation going? Talk to everyone. This is called Business to People Marketing. B2P 

Whether you are at the grocery store, paying a bill, at the health club or elsewhere in your community…tell people about what you are doing. Frame it as something you are passionate about. Two sentences and a warm smile goes a long way and gets the word out.

When patients start to show up, deepen the conversation. Develop a relationship and begin to build trust. It is only a matter of time before that casual conversation, those few seeds you planted at the beginning, take root and you realize you have your first loyal patients. Loyal patients love to get the word out about their awesome experience with you. Loyalty Marketing is powerful. People want to help. In this scenario, they get to help their friends AND YOU!

Relationships are not only personal, however. You can take your newfound confidence and begin to connect with local businesses. Form some alliances with like-minded community leaders who would love to be a part of your vision. If you are an introvert, focus less on the conversation and more on the vision. It’s easy to talk one-on-one about what inspires you. You aren’t selling anything, you are sharing your vision. Your community NEEDS you! Share unabashedly. This is Call to Action Marketing. CTA

Want to know more?



Toxic Training and Work Environments for Physicians

Your Unique Way of Practicing Medicine

The way you practice medicine is unique. You may have been trained with hundreds of others who received identical training. You may know “best practices” inside and out. But the way that you and you alone treat patients, is as distinctive as your fingerprint. No one can duplicate your skillful style and personality. No one else is delivering medical care YOUR way. This is very good news. Today, professional success depends on differentiating yourself.  It can be difficult to identify your key qualities and unique traits after years of keeping your head down, trying to be invisible. It’s time to take an inventory of what it is you offer? What do you bring that no one even knows about?

Sometimes comparing and contrasting what you do with those around you, helps. When identifying what others are doing in your field, you will notice overlaps, similarities, AND you will notice  big differences. How might you emphasize those differences? Use dynamic language. Don’t be afraid to shine! Need help identifying what makes your practice unique? Call me. Let’s talk.


Feeling Trapped

Are you highly independent….headstrong even? And yet you feel helpless to change your life circumstances? This is a common issue with physicians. It all starts back in medical school. You figure out very quickly that you don’t know enough. This is reinforced by instructors. You are told how hard it will be to learn what you need to learn, how difficult the testing will be. You are told what medicine looks like, what you can do and what you can’t do. And you begin to internalize the message that you are helpless to change the system, helpless to have power over your own life.

Terry was an oncologist who had made it through medical school at the top of his class. Residency was hard, but he made it through okay. He was hungry. He was exhausted, but he made it. Years later he found himself in a practice with partners he didn’t really respect. He dreaded going to work everyday and found himself feeling smaller and smaller and smaller.

One particular day when the office manager was giving him a hard time, he snapped. He said some things he shouldn’t have and then an hour or so later, refused to see a patient who didn’t have insurance. It wasn’t surprising that the next say he was called into the administrator’s office and read the riot act for being abusive. He couldn’t believe it! That now he was accused of the very behaviors he said he would never participate in was unthinkable. What had happened to him? He began to feel depressed, anxious. He decided it was time to reach out for help… and yet he knew it was situational. He never had problems with depression or anxiety before medical school, before he opened his group practice. A few days later, Terry decided he had had enough. He was listening to a book on tape as he drove into the office and in a moment of perfect clarity, he realized that the life he was living was not the life he wanted. That the way he was practicing medicine was not okay!

He walked into the office with great determination. He set up a meeting for noon with his partners and he sat down with them in an uncompromising and assertive way, declaring that he was cutting his hours, going to part-time. No one pushed back. He was shocked! He went home early and told his wife. They celebrated. Now he was finally going to be home more. He was finally going to be present.

Change can begin today. It can be as simple and straightforward and laser focused as Terry’s. Please don’t wait for external circumstances to dictate your future. Don’t wait for that large malpractice suit to take you out of medicine. Don’t wait for your husband or wife to leave you, or for your depression to become so severe that you stand on the very edge of the abyss. Decide today that you are choosing freedom. That you are choosing to backtrack, to go back to that original dream. To change your life circumstances to such a degree, to feel empowered, to feel humble, to feel hopeful. That is what we are offering you here.  Headstrong and Helpless Ebook

Headstrong and Helpless from Sydney Ashland on Vimeo.

Inspiration vs Competition

Most of you are competitive. Not necessarily cut-throat, get out of my way, competitive, but at the very least competitive with yourself. You are SMART. You love a challenge. You don’t want to be bored. Pamela and I know that about you. We’re the same way! That being said, when does inspiration become competition?

I’ve watched Ted talk or YouTube videos that inspire me. I’ve been transported from the mundane to heights of imaginiation, infusing my practice with life giving energy. I’ve also watched videos that have turned me cold, left me feeling like I’m somehow “less than,” fueling a deeply competitive place that isn’t enjoyable. It’s awful to feel like you are achieving less than your peers, not measuring up to your true potential. I wobble on the edge of frantic energy when that competitive energy is engaged. I want to PROVE myself. I can do what you are doing. Let me show you. But, often because this competitive energy is grounded in insecurity or trying to keep up, it is energy that I cannot sustain. Eventually, I skulk away from this experience, feeling crappy and like I’ve somehow lost my edge. I don’t want that for any of you!

What to do? Walk away from any message that feels like pressure. Don’t even engage it. Instead, return to those inspiring messages that fuel your dream. You can and will do this. It takes time. Nurture your dream. Take your time. You have time. There are a lot of amazing people out there who are doing wonderful things who challenge and inspire me. I can’t hear enough about what they are doing! I will carve out time in my day or night to inspire myself. Feeling discouraged? Seek out inspiration!!

Financial Shame and the Holidays

pexels-photo-534229.jpegPeople presume and assume that you are financially flush, able to do whatever you want for friends and family this time of year. It can be jarring when you are faced with the reality of your situation–credit cards maxed out, cash flow difficulties, no end in sight. You are NOT alone. Gone are the days when M.D. behind your name ensured financial ease. The answer doesn’t lie in pretending or avoiding. Instead, embrace the truth. Talk about it out loud! Let someone help you come up with a plan. You don’t have to continue this way.

Top 10 Fears that Hold Doctors Back

Podcast Link

Top 10 fears that hold doctors back: 

1. Low self-confidence

2. Financial concerns

3. PTSD/guilt

4. Family responsibility

5. Anxiety and depression

6. Health issues

7. Addiction

8. Isolation

9. Lack of direction, passion, purpose

10. Abuse cycles.

So how do we overcome our fears as physicians? How do we build our self-confidence?

(Listen to podcast for complete analysis)


PTSD-Are you a victim? (Excerpt)


Pamela Wible: We just got back from leading a physician retreat and this is actually my 16th physician retreat. Sydney, you’ve been co-facilitating these retreats with me for years and I just want to check in with you on something that I’ve noticed. I’m realizing more and more how many physicians are suffering with PTSD, even residents and medical students at the very earliest stages in their careers. Are you noticing that?

Sydney Ashland: Pamela I just got off the phone with a physician who specialized in emergency room medicine who is haunted by PTSD, survivor guilt, feels a total disconnect from the practice of medicine. I just find it so tragic that the very people who save hundreds and thousands of lives yearly are left as mere shells of the people they used to be. They’re no longer able to relax, feel joy. They’re stuck in this never-never land of misery and pain. It’s just so maddening to hear the same stories over and over when it feels so preventable. We just have so few medical professionals that are trying to serve so many people. I know that administrators feel crushed by the numbers, the health issues, the lack of consistent healthcare. They’re trying to stay competitive and profitable. I understand that.

Schools are trying to stay cutting edge, but no one is really coming up with those commonsensical answers, those interventions that can keep our medical warriors, our medical geniuses in the field. Instead, everyone shows up as victims. The hospitals, the medical schools blame high overhead. Insurance companies join in that refrain as well, and there’s a lack of innovative programs and strategies to address these needs. Everyone is passing the buck and the problems are not only exacerbated but they seem like they’re escalating. Is that your perception?

Pamela Wible: Yeah. I’m seeing more and more, and even younger people who are trying to flee their profession before they’ve even started practicing really, right?

Sydney Ashland: Yeah. I think part of that is that these medical schools are trying to prepare these students for the unbelievable pressures and stresses that they’re hearing about and know about in the medical field. Instead of really resourcing medical students and residents, it’s depleting them, it’s leaving them scarred and stressed and with post-traumatic stress disorder. Then they can’t practice medicine. They’re not going to survive post-residency. That’s what I find so, for lack of a better word, I’ll use it again, so tragic. It’s a tragedy.

Pamela Wible: I definitely want to go through some of the, maybe top five things that I’ve noticed that lead to PTSD in medical students, residents and physicians. There really is a lack of leadership in medicine. What’s ending up happening is you have the old guard just preparing people to do it the same way we’ve always done it because that’s how we’ve always done it. The world is not what it was 20, 30, 40 years ago. There are so many things that have changed in medicine. To have this knee-jerk reaction to lock medical students back into this regurgitation-memorization cycle when we can obviously access things at our fingertips. We need to have the joy of learning. We need to stop pushing people to continue in a system that’s obviously failing and imploding, right? We need new thinking. We need new ways of training physicians. We need to stop terrorizing them and violating their human rights.

Sydney Ashland: Exactly. We need leadership to do that. I feel a call to action for those in leadership positions right now to be brave, to find their courage and to begin to address these problems. For those that are in the rank and file who feel that conviction, that energy of activism within themselves to step forward as the new leaders, because that’s what it’s going to take in order to create the change that is necessary. I know that you and I, outside of the system, are trying to serve as leaders for those who feel like they need to leave the systems in order to not only live their dream but live their passion with attending to patients and serving their communities.

Pamela Wible: Right. I just want to add in there. I haven’t really left the system. I am practicing medicine in alignment with my highest values. I still take insurance. I submit my own claims. I practice like any other physician would practice, but I am autonomous in my own clinic. Obviously, I’m a truth seeker and a truth speaker and I’m not afraid to tell the truth. That has made me, to some people, a little bit fringy. As far as how I practice medicine, I’m very conservative in my own practice. And I love to encourage others, nurse practitioners, PAs, physicians, veterinarians, others in healthcare to really take the reigns back on their profession and practice an alignment with the highest values that brought you here.

Sydney Ashland: Excellent clarification. Excellent. That is exactly what I feel convicted to join you in doing.

Pamela Wible: Before we launch in, I don’t really have these in any particular order, but I thought we could address the top five things that we both feel lead to physician PTSD. One thing I’d like to preface this conversation with is that it’s so very important to tell the truth. I think many of us scurry around the truth using words that are absolutely inaccurate like burnout. That’s a word that I do not use because it’s a victim blaming and shaming term that does not address the true reason for people feeling so discouraged and so unable to keep up. I want us to dive into the truth here and to encourage others who are listening to this to also use accurate and precise terms for what is causing the suffering in your life. Because if we didn’t do that with patients, we’d misdiagnosed people all day long if we just dance around the periphery with a double speak and inappropriate terms, right?

Sydney Ashland: Exactly. Yes. Give me some truth.

Pamela Wible: Yeah, I’m going to just give an overview here of the five that I came up with and then we can dive into each one. The first one in no particular order. Actually, the way I did organize these is chronologically. The order in which a new student, a premed, first day of medical school coming in would experience these things that would lead to ultimately a life that’s very disturbing and fits the criteria of PTSD.

Physician PTSD Quiz
Number one is medical training. We have a fear-driven medical education model that teaches us by terror. I want to address that. Number two, human rights violations that include chronic sleep deprivation, hazing, bullying, lack of access to food, water, inability to see your family, take care of your own bodily functions. Number three, vicarious trauma. Of course, high risk specialties like emergency department and neonatology and such are going to feel more of this vicarious trauma. Number four, losing colleagues to suicide. I bet there are hardly any physicians out there who do not know of another physician who has died by suicide and you’ve probably not been able to properly grieve the death of that suicide. This is terrible. You’re going back to work every day feeling at risk yourself and I want to address that. Number five is just the chronic toxic workplace environments that we are in every day. Shoved in this assembly-line, big-box clinics, which are dangerous for our own health and the health of our patients.

The first one here, medical training, I thought I’d share two stories that came to me. There are letters that I’ve received. These are actually published in the Physician Suicide Letters—Answered book, which is available free as an audiobook if this would help you. Anyone out there, you’re welcome to download this. Number one, this is from a retired specialist in her 60s who wrote me:

“I was happy, secure and mostly unafraid until med school. I recall in vivid detail the first orientation day. Our anatomy professor stood before an auditorium filled with a 125 eager, nervous, idealistic would-be healers and said these words. ‘If you decide to commit suicide, do it right so you do not become a burden to society.’

He then described an anatomical detail how to commit suicide. I have often wondered how many auditoriums full of new students heard these words from him. I am sure someone stood in front of us and told us what a wonderful and rewarding profession we had chosen. I do not remember those words, but I do remember how to successfully commit suicide with a gun.

One month later on the eve of our first monthly round of six exams in one day, I had my first full-blown panic attack. I had no idea what was happening. I thought I was losing my mind. I took a leave of absence and made up excuses. I returned untreated with maladaptive compulsive behavior, completed med school and survived the public pimp sessions and all the rest.

No one ever suggested that the process was brutal or the responsibility frightening and no one offered us help. I have maintained contact with only one colleague from med school so I do not know how the others fared.”

I just want to say I have chills reading this like every time. This is teaching by terror. What do you feel? I’m going to read another letter in a bit, but I want to know what do you feel?

Sydney Ashland: Well, one of the things that stuck out to me was the fact that this person had no idea what was happening to them. In the midst of this full-blown panic attack, they felt like they were losing their mind. When we are in a terrorized situation, and you talked about medical training as fear-driven and teaching by terror, we lose our ability to respond and we enter a place of high reactivity so that we are reacting to. That’s the whole panic attack.

She was having this huge reaction rather than being able to respond in the situation. We call our paramedics and firemen—first responders. We don’t call them first reactors. I don’t want somebody working on me who is in a reactive state because they are going to be so infused with adrenaline and stress hormones that they’re going to be in a high state of reactivity and not necessarily responding in a way that is thoughtful, that allows for pause, that helps them respond from a decisive place rather than reacting from a triggered place. That’s what stood out to me in that first story.

Pamela Wible: It just makes me wonder. She’s retired now, but gosh, how did she practice medicine? Did she carry this with her when treating patients? Was she still impacted by this?

Sydney Ashland: I’m certain she did. Absolutely. As we go through all the labels that you have identified as a part of the PTSD cycle in the medical field, we will, I’m sure, touch on other areas that she experienced, because you know she experienced human rights violations. You know that she experienced some vicarious trauma and then what are the characteristics when we are in those states.

Pamela Wible: Right. The next one I want to share is from a surgery resident. Again, that would be a high-risk specialty of witnessing all sorts of trauma. What I noticed when reading this, it brings up the fact that our attendings have been mistreated themselves during training. They don’t even have the teaching skills that they often need to handle these high-stress environments and teach in a compassionate way. I mean there’s multiple victims here, right?

Sydney Ashland: Absolutely.

Pamela Wible: Lisa, a surgery resident in New York writes me,

“I began my residency in California and during that time was very depressed, abused within my training program. My depression impacted my performance and I was eventually fired. I was lucky enough to find another position and continue my training, however, some days I feel my depression and despair returning primarily when I feel my career has been irreparably damaged by my departure from my first residency program.

Those feelings were initially tied to hazing and bullying that are an integral part of the educational program there. Sometimes, I can still hear those attendings in my head saying things like, ‘Watching you operate is like watching a retarded monkey.’ Or, ‘Do they ever teach anatomy at your medical school? Our students know more than you.’

It’s paralyzing. I am reaching out to you for two reasons. I’m interested in eradicating the abuse in medical education. I’d like to have a career in academics and to influence policy regarding the treatment of trainees. More importantly, can you help me make the flashbacks stop? Can you help me not worry so much about my future? Can you help me with my depression related to my change in career trajectory? Thank you for your work.”

I think when I first received this and I saw the flashback word was when I first realized this is PTSD.

Sydney Ashland: Full-blown PTSD. There’s an excellent book that Peter Levine has written about Waking the Tiger. He is an individual who worked at Walter Reed hospital for years with vets who have PTSD. One of the things I would encourage this woman and anyone listening is that in reading that book, you will be given some exercises that help you with the flashbacks. Where you can enter that place in your trauma and tell your brain a different story.

You have to be in a thoughtful place. You should be in therapy or have at least a supportive network to help you during this phase of healing, but the flashbacks can stop. You can move from reactivity to a responsive and thoughtful life. You can return to taking care of yourself and not continuing the abuse cycle, because so often people like Lisa leave their surgery residency, depriving themselves, treating themselves poorly, having circuitous and habituated thought patterns that are intrusive. So that even when they’re successful, what they are haunted by is that classmates taunting the time they made a mistake, that depression that ended up in them leaving medical training even though they continued somewhere else. It can be helped. There are interventions.

Idealism, Exhaustion and Mentoring

I rarely meet a healer whose career didn’t begin in idealism of some form. We want to be of service. We long to help and heal the masses. When our idealism unexpectedly meets the sabotaging unfairness(es) of this world, we are often left feeling depleted, discouraged and exhausted. It takes a lot of energy to maintain our sense of optimism when we are undermined or treated poorly. When large healthcare systems and universities do little more than give lip service to altruism, we struggle. We may start out believing we can change the world, but eventually we lose that hope, often losing ourselves in the process.

Often, after years of our ideals trickling away, there is little life force left. Feeling like the chronically anemic patient who is too tired to exercise or find joy in the living, we wonder when our energy will return. Lacking the energy to pursue anything, we sit and wait for things to shift, but nothing happens. We vaguely know we must do something, but have no tangible idea what that might be.

Our hope lies in returning to our dreams. This is why Pamela’s (Pamela Wible)  work is so powerful. She innately knows that the energy propelling us forward is the energy of dreams. We must return to our ideals of old and use those distant memories to help us create the new. Who was that idealistic person of the past? Did those ideals slip away as dramatically as a hemorrhage? Were they stolen away when our backs were turned, leaving us confused and barren? The way in which they disappeared is less important than retrieving their memory now. Return to your ideals and use them as compost to cultivate your dreams of today and tomorrow. Having trouble finding the road back to your idealism? Check in with your mentor. Ask them to accompany you back to the broken, abandoned dreams of yesteryear. Together you can recover those dreams and move forward.