Office Hour March 16, 2026: Scaling Your Practice: Hiring, Expansion, and Smart Growth Decisions

Episode #5 March 15, 2026

Clinical Business Framework Office Hour March 16, 2026

Staten Island Office Expansion Plans

Florence discussed her progress on opening a second office location in Staten Island, including ongoing construction of a ramp for handicap access and the need to relocate a gas meter. She plans to hire at least one neurologist by year-end, with the goal of having one physician and one PA in each office, and is exploring options for the large available space including potential subletting or expanding into neuro-preventative care. She noted that despite nearby Sinai University Hospital hiring four neurologists, there is still significant demand for medical services on Staten Island.

Second Medical Office Expansion Plans

Florence discussed her plans to open a second medical office location on Staten Island, which is closer to her current Brooklyn residence than her first office. She explained that the Staten Island location is becoming more attractive due to rising real estate costs in Brooklyn, offering tax advantages for commuters from New Jersey. Florence shared that she needs to see 12-13 patients to break even, and is considering a salary-based compensation structure rather than RVUs, with plans to review bonus structures after the first year of operation.

Medical Professional Salary Expectations Discussion

Florence and Jennie discussed salary expectations and revenue metrics for medical professionals. Florence shared that starting salaries in New York City are around $300,000, with higher amounts for those with fellowship training and procedural experience. They explored the financial implications of a 4-day work week, comparing full-time (5 days) and part-time (.8 FTE) compensation structures. Jennie advised Florence to calculate and compare these numbers to ensure they align with market rates and protect her interests, particularly regarding malpractice costs and revenue generation.

Neurologist Demand and AI Tools

The group discussed market demand for neurologists in Staten Island and Brooklyn, noting limited competition due to few existing neurologists and many being at retirement age. Natasha shared a tool using Claude AI for medical billing modeling, which can help calculate physician salaries and expenses by conversing directly in Excel. Florence expressed interest in improving her Excel skills and noted challenges with finding information quickly in ChatGPT projects. Jennie suggested using the dot dot dot function to extract and organize information more effectively.

Healthcare Provider Credentialing Processes

The group discussed credentialing processes for new healthcare providers, with Florence explaining that she currently credentials new hires under her group practice while waiting for full credentials. Natasha shared that her organization typically has a 2-month window between contracting and hiring, allowing time for credentialing, with Medicare taking 3-6 months while private insurances are processed within a month. The discussion also covered IPA membership processes, with Florence noting that joining an IPA group could take 2 months due to board meetings, and the group explored ways to optimize timing for new hires to maximize benefits while minimizing costs. Jennie provided guidance on calculating provider expenses, suggesting that benefits typically account for 30% of salary, and recommended using revenue per visit metrics to project annual costs and revenue.

AI Tools Discussion and Strategies

The group discussed their experiences with AI tools like ChatGPT and Claude, with Natasha sharing how she uses "act as an expert prompt engineer" to get more effective outputs. Vineka noted that Claude performs better than ChatGPT for certain tasks, particularly in critical thinking, while Natasha explained how she uses both tools for strategic planning and other business tasks. The conversation highlighted the importance of learning how to effectively use keyboard shortcuts and prompts to optimize AI interactions, with Natasha emphasizing that proper prompting can significantly improve results.

ChatGPT Strategic Planning Experiences

Natasha shared her experience of creating a 20-page strategic plan on a plane and using ChatGPT to refine it, ensuring it did not contain sensitive financial data. She discussed using the tool for difficult conversations, receiving critical feedback, and improving her approach by prioritizing interpersonal struggles. Jennie described her use of ChatGPT for financial analysis and planning, emphasizing its ability to process detailed data and provide insights. Florence expressed her journey as a beginner with ChatGPT, highlighting the need for better prompting techniques to optimize its use. Vineka inquired about the differences between using ChatGPT for conversations versus projects, and Jennie explained her preference for using it for document creation and pre-conversation planning.

ChatGPT Project Organization Strategies

Jennie discussed her approach to organizing information using projects in ChatGPT, explaining how she categorizes clinical and financial data to create reusable frameworks. She demonstrated how she applies this method to evaluate service lines like Prolia and develop models for recruitment and ramp-up periods for different physician career stages. The group discussed strategies for managing chat conversations, including splitting chats into new conversations and adding valuable content to project behaviors, with Jennie warning about the importance of not deleting documents that could reduce the project's memory capacity.

Neurologist Recruitment Template Discussion

Jennie shared a prompt template with Florence for recruiting a neurologist, explaining it was adapted from her Independent Physician Launchpad project. She demonstrated how to create a new chat within the project and showed Florence how to organize and manage different chat threads. They discussed compensation structures and market data for neurologist recruitment, with Jennie offering to send Florence the prompt via email for reference.

Revenue Cycle Dashboard Access Issues

Jennie and Florence discussed accessing and sharing a Revenue Cycle Dashboard in Kajabi, which Jennie planned to organize into a resource library for easier access. Florence encountered issues logging into Kajabi and subscribing to calendars, which Jennie helped resolve by confirming the correct email address and subscription settings.

Business Planning and Travel Updates

Florence shared her upcoming trip to Paris and discussed using the Fork app for restaurant reservations. Jennie recommended using ChatGPT to create a custom business plan and values statement, suggesting Florence use the plane ride to journal and distill her thoughts. Vineka attended a business conference and met with an audit biller to clarify goals and procedures for tracking revenue and insurance claims.

Process Optimization and Claim Collection

Vineka discussed the need to optimize current processes rather than making significant changes during an evaluation period, emphasizing the importance of understanding existing issues before implementing new systems. Jennie highlighted the potential for increased profitability by improving claim collection and suggested aligning incentives with the billing process to encourage better performance. Florence shared challenges with Medicaid claim syncing and reporting discrepancies, which Jennie advised addressing with the service provider, Athena. The group agreed to continue discussions after Florence returns from a brief trip.

Episode Transcript

# **CBF Session – March 17**

**Jennie Eckstrom: **So you're opening your second location. Tell me what that's going to…

**Jennie Eckstrom: **Look like for you, in terms of, like, how are you going to…

**Jennie Eckstrom: **Ramp that up, utilize that space.

**Florence Shum: **Yes, so basically, I was planning to hire…

**Florence Shum: **At least one neurologist. Ideally two by the end of the year, so then this way will be at least one physician in each office.

**Florence Shum: **with one PA in each office.

**Florence Shum: **And…

**Florence Shum: **And probably by next year, then I would want to hire another PA. So it's kind of like one physician per, like, a PA kind of thing.

**Florence Shum: **And then…

**Florence Shum: **I am still not quite sure what I'm going to do yet for the whole building for my second location, because the space is quite big.

**Florence Shum: **And,

**Florence Shum: **So that's why I was kind of thinking, like, if I should maybe sublet it a little bit in the meantime.

**Florence Shum: **Or even subletting for, like, physical therapy or something like that.

**Florence Shum: **I've thought about even, like.

**Florence Shum: **Kind of, like, expanding the area of, like,

**Florence Shum: **neuro-preventative care, but I haven't really…

**Florence Shum: **learned too much about that. I mean, it's kind of an interesting area to explore.

**Florence Shum: **So I just want to see what other services I can provide.

**Florence Shum: **Since I have the space now, I just need people. I just need other providers.

**Florence Shum: **So, I signed, an agreement with a recruiting firm.

**Jennie Eckstrom: **Okay.

**Florence Shum: **So there's some movement there right now, like, there are, some people she's in touch with, asking questions, so that's…

**Florence Shum: **you know, maybe promising, but nobody really, like, come through yet, but at least it's more than what I've gotten so far.

**Florence Shum: **You know, on my own, so…

**Jennie Eckstrom: **So… Huh?

**Florence Shum: **Yeah. And the interesting thing is, you know, Staten Island, it's a very small… I mean, the space-wise, it's not a small borough, but it is kind of isolated.

**Jennie Eckstrom: **Because of the water, right?

**Florence Shum: **Yeah, exactly. So, because of just a…

**Florence Shum: **Geographically, like, the residents who live there, like, tend to want to stay on the island.

**Jennie Eckstrom: **Hmm?

**Florence Shum: **as much as they can. So it has about, like, I think over 500,000, residents, so it's only two hospitals. And, for the longest time, I know the big one, which is part of the Northwell system, the, Sinai University Hospital.

**Florence Shum: **So they have been trying to hire, neurologists for the longest time, and they actually did.

**Florence Shum: **They hired 4 neurologists.

**Jennie Eckstrom: **The hospital did, one of the systems.

**Florence Shum: **Yes, so I don't know if… like, the recorder asked me, oh, how do you feel about that? Like, are you worried? I'm like, well, I'm actually friends. My friends are actually in the hospital list.

**Florence Shum: **Conveniently! So he's the one who told me they hire four, like, two, I think, are vascular, one is MS, one is movement, so in a way, it doesn't really… it's, like, different from what I offer.

**Florence Shum: **So it's still more hospital-based, so I don't think it's gonna…

**Florence Shum: **really affect me too much, because I think there's too many patients to serve.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **So… but, I don't know, I think it's so… it's good to know that people don't want to, you know, like… I… because for the longest time, I always thought that maybe people just don't want to go to Staten Island, you know? It's like…

**Florence Shum: **It's not that attractive.

**Florence Shum: **But they hire 4 people, so maybe it's promising.

**Jennie Eckstrom: **Yeah, something wants to be there.

**Florence Shum: **Yeah. Okay.

**Florence Shum: **Hi, Natasha!

**Jennie Eckstrom: **Hi, Natasha!

**Natasha Beauvais: **Hi!

**Natasha Beauvais: **Good to see you guys!

**Jennie Eckstrom: **It's good to see you, too. We were just chatting about, Florence is just getting ready to open up her second location, and so we're talking about how she's…

**Jennie Eckstrom: **Using that space and what her plans are for it.

**Natasha Beauvais: **Where is it again?

**Florence Shum: **I'm in New York.

**Florence Shum: **So, my current office is in Brooklyn, and the second location is on Staten Island.

**Jennie Eckstrom: **Okay.

**Natasha Beauvais: **Oh, okay, got it, yeah.

**Jennie Eckstrom: **That was the piece, because I was like, I thought you were in Brooklyn, but… Is it…

**Natasha Beauvais: **I could imagine that would be amazing if you're on Staten Island not to have to travel. That would be amazing.

**Florence Shum: **So, my… so my… where I live right now is 10 minutes from my Brooklyn office, and about 20 minutes to the second office, so it's really going against traffic.

**Natasha Beauvais: **Oh, okay.

**Florence Shum: **So it's really just kind of crossed the bridge and, like, not too far from the bridge.

**Natasha Beauvais: **Okay, that's good.

**Florence Shum: **Yeah, so in terms of commute, it's not bad.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **Is the… is housing on Staten Island, is it…

**Jennie Eckstrom: **is it a for… I mean, it's New York, but is anything relatively affordable there?

**Florence Shum: **Yeah, I think, you know, it's booming because everything is so expensive, especially in Brooklyn, so it's driving people across the bridge to Staten Island, and…

**Florence Shum: **I lived there for, like, 10 years while I was doing my residency and my work.

**Florence Shum: **Because my previous job was on Staten Island, the previous practice, so I'm familiar with it, and it has grown so much since we left. We moved back to Brooklyn.

**Florence Shum: **And, because of the real estate that's so expensive, like, people feel like, well, you know, with that same amount of money, I can get a house on Staten Island.

**Jennie Eckstrom: **Right.

**Florence Shum: **these days, yeah.

**Jennie Eckstrom: **That's what I was wondering.

**Florence Shum: **Yeah, no alternate side parking, so that's become… that's why I'm more attractive. Like, basically, any houses that's

**Florence Shum: **like, sort of decent. It sells so quickly.

**Florence Shum: **none of, not enough supply.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **But as a recruitment feature, like, being able to come to a place where you could potentially

**Jennie Eckstrom: **You know, think about a home, or ultimately have that be something that's possible.

**Florence Shum: **The way I used to work, like, we had… we have other physicians actually work in New Jersey.

**Florence Shum: **crossing the bridge to Staten Island. So, it's actually interesting because tax… there's more tax savings that way.

**Florence Shum: **You don't have to.

**Jennie Eckstrom: **in Jersey.

**Florence Shum: **Yeah, living in Jersey, just crossing the bridge, so you don't have to pay the New York City tax.

**Florence Shum: **Commuter tax, and like, just the extra taxes.

**Jennie Eckstrom: **Hmm… And I'm assuming that those are things that your recruiter is leveraging, those sorts of… Pieces.

**Florence Shum: **She's just kind of sending, like, the flyer out, just to…

**Jennie Eckstrom: **C.

**Florence Shum: **People ask questions, and then, like, when people are asking questions, she's kind of, like, CCing me to it, and… I guess I'm supposed to answer? I don't know, and these people just kind of…

**Florence Shum: **You know, asking, like, oh, you know what the hours, how many patients I'm supposed to see, like, that kind of thing.

**Florence Shum: **Yeah, so… Yeah, it's all linked.

**Natasha Beauvais: **Take care.

**Florence Shum: **Very, very preliminary, interactions.

**Jennie Eckstrom: **Do you feel like you are starting to get a sense of how many patients that… You…

**Jennie Eckstrom: **Need somebody to see, and what that recruitment package looks like.

**Florence Shum: **So I…

**Florence Shum: **basically try, you know, the service line, based on the service line that we did, like, that practice. So I kind of based,

**Florence Shum: **Like, a salary range with… not the complete overhead, like, with the, you know, the staff, but just calculating, like, malpractice, like, insurance, like, things like that.

**Florence Shum: **I think they have to see at least 12 to 13 patients for me to, like, kind of break even.

**Florence Shum: **Just to, like, break even.

**Florence Shum: **So,

**Florence Shum: **I know, like you said, like, in the beginning, it would be a loss, I have to carry them, you know? But…

**Florence Shum: **I still meet people, I can't see everybody.

**Jennie Eckstrom: **100%.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **I mean, I took out a business loan for the payroll that I was planning to use for that reason, because I understand that.

**Jennie Eckstrom: **And that's a loan as opposed to a line of credit.

**Florence Shum: **Oh, actually, it's a line of credit, yeah.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **That's certainly how.

**Natasha Beauvais: **Buh.

**Jennie Eckstrom: **Wrap folks on.

**Natasha Beauvais: **How are you going to pay the new person? Like, you're recruiting a new person for this new practice?

**Florence Shum: **Yes.

**Natasha Beauvais: **So how are you going to structure the salary?

**Florence Shum: **Structured a salary, well, it's gonna be, like, depending on the experience, right?

**Florence Shum: **It's depending on the experience, and if they do, like, procedures or not, there's a… I have a range.

**Natasha Beauvais: **And then…

**Florence Shum: **So there's some people asking me about RVUs, right?

**Florence Shum: **But, I don't do RVUs.

**Florence Shum: **I'm not as familiar with RVUs. I would rather based on collections.

**Florence Shum: **But I was thinking for the first, like, 1 or even 2 years, probably,

**Florence Shum: **I would kind of, like, I don't expect them to, like, you know, necessarily, especially the first year, to…

**Florence Shum: **Like, break even.

**Florence Shum: **Right? So, I was… Going to…

**Florence Shum: **kind of like, this is what I'm expecting, like, by one year, like, 15 patients a day or whatever, and then,

**Florence Shum: **I don't know about, like, a bonus structure yet for, like, first year, because they're so new.

**Florence Shum: **I don't know, it's still… still in the planning. I'm not sure.

**Jennie Eckstrom: **So, there's a couple, and Natasha may share what she does, but there's, you know, a couple different structures that you can do. Oftentimes, you know, having a salary guarantee, but making sure that you're not doing any bonuses until you're starting to see that.

**Florence Shum: **there.

**Jennie Eckstrom: **production metrics are met. Right. So, you know, like a 60-40 split is something that can be used, you know, where they're covering all of their overhead, and then once they get above that 60%, then you can start to bonus, right?

**Jennie Eckstrom: **Do you have a sense of what… I mean, obviously there's probably a sense of, like, the overall, all package, but, like, what that salary looks like, expectation-wise on a monthly basis?

**Florence Shum: **Oh, salary? I think, and I looked it up, too, like, on…

**Florence Shum: **In New York City, it's probably around 300,000 stores.

**Jennie Eckstrom: **I feel like that's what you told me when we chatted.

**Florence Shum: **Even with, like, a graduate, like, new graduate, it's already, like, 300. So, if they are…

**Florence Shum: **have some fellowship training, and they do procedures, would be more.

**Florence Shum: **So, I don't know that… what that range would be, like, 300 to 350? Maybe even more? I don't know.

**Jennie Eckstrom: **Big monthly nut to crack, yeah?

**Florence Shum: **Yeah!

**Jennie Eckstrom: **Yeah, cause that, what's that, 20… 5 a month?

**Florence Shum: **Salary-wise, right?

**Natasha Beauvais: **Have you… have you tried to?

**Jennie Eckstrom: **That's 25 at 300.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **So…

**Jennie Eckstrom: **And you think at 13 patients a day, 5 days a week, you break even at that with your malpractice and your…

**Florence Shum: **So, I was, where's my paper? I kind of did it very roughly. Let me see if I have it.

**Florence Shum: **Because… I was… so the way… because we do… we do bill, like.

**Florence Shum: **what do you call that? Like, cognitive, like, cognitive planning?

**Florence Shum: **cold.

**Florence Shum: **which pays… pretty well.

**Florence Shum: **Like, a lot more than, 205.

**Jennie Eckstrom: **Right, okay.

**Florence Shum: **So, that's why, even for my PA, she…

**Florence Shum: **Like, per visit, she's getting, like, $170.

**Florence Shum: **Right, about one second. Okay.

**Florence Shum: **provision.

**Jennie Eckstrom: **That's for her collection on that visit, that's not her bill.

**Florence Shum: **I mean, no, no, no, like, in general, with, like, all his 213, 214, I just calculated all her visits, and then divide that by, like, the collection.

**Florence Shum: **So, I… just on average.

**Jennie Eckstrom: **Okay.

**Florence Shum: **So…

**Jennie Eckstrom: **Average revenue per visit for probably established patients is 170.

**Florence Shum: **Yeah, it was a little higher than I expected, but I think it's because of all the memory patients that we have.

**Florence Shum: **That helps. And then, we also have, like, some 215s, you know, because they're complicated, or time that we have to spend on that.

**Florence Shum: **And then, I think mine… my collection is about 180 to 1… I think closer to $190 per visit.

**Florence Shum: **Something like that.

**Jennie Eckstrom: **Yeah, so it's great to have that, like, revenue per visit number, that metric that you can then use and back

**Jennie Eckstrom: **calculate, right? Because you do a 5-day-a-week clinic, right?

**Florence Shum: **My office, so my Brooklyn office is open 6 days.

**Jennie Eckstrom: **Okay.

**Florence Shum: **the San Juan office, I'm thinking to open 5 days, and I'm actually.

**Jennie Eckstrom: **honey.

**Florence Shum: **Spring a 4-day work week.

**Jennie Eckstrom: **So is that $300,000 based upon a full-time FTE, and then if somebody does a 4-day work week, then it's a .8 FTE?

**Florence Shum: **I'm actually basing on working 4 days for full-time. I don't know if that's smart, but that's what my PAs are doing.

**Florence Shum: **Like, doing 4 days.

**Jennie Eckstrom: **Yeah, I mean, you can… you can structure it in a couple of ways, right? I mean, if the… if the market rate is 300 to 350, but that's at an FTE, a full FTE, which would be 5 days a week, or say 20 days a month.

**Jennie Eckstrom: **you know, on average, and you're looking at 16 days a month, or .8 FTE, you know, that's a lifestyle change, right? So… which is great for the person who doesn't… I mean, that's what I work. I don't… I can't imagine working, 5 days a week, because I've never done it.

**Jennie Eckstrom: **But also recognizing that that is… that's sort of a lifestyle… those are lifestyle dollars, right?

**Jennie Eckstrom: **So, so as you are in your competitive market and know what that looks like.

**Jennie Eckstrom: **giving something that can be compared, sort of, apples to apples. This is the 5-day-a-week FTE.

**Jennie Eckstrom: **At this… at this salary.

**Jennie Eckstrom: **But if you want to do a .8, actually have that number be one that you can, you know, that you could compare, and then they can decide, right? But it also protects you, because if you take…

**Jennie Eckstrom: **out.

**Jennie Eckstrom: **You know, another almost 80 visits out of the month at your 170.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **I mean, you're… you're… I guess it's another, like, $14,000, right? So…

**Jennie Eckstrom: **So just sort of things to think about and play with those numbers of what that looks like, knowing that your, you know, your benefits are gonna be, you know, on average. I don't know what your malpractice, you're covering their malpractice?

**Florence Shum: **Yeah, malpractice. I mean.

**Florence Shum: **It depends if they're graduates or not, so for me, I pay around $31,000? $31,000? Yeah.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **Oh, actually, my friend who is still working my previous job, he works 4 days.

**Florence Shum: **He's about 80 patients.

**Florence Shum: **a week.

**Jennie Eckstrom: **Right.

**Florence Shum: **That's full-time.

**Jennie Eckstrom: **Yep.

**Florence Shum: **So… I'm pretty sure he's getting paid, like, 300-something. 300-plus in the range.

**Florence Shum: **So… Yeah.

**Florence Shum: **I'm just hoping that that person will be productive.

**Jennie Eckstrom: **Well, plug your numbers so that you understand and know that you… you're gonna have that… that leg time, and that, you know, 18 to 24 months to recoup the expense that you put into them is not, you know.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **uncommon.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **I mean, I guess depending upon what the demand is for

**Jennie Eckstrom: **you know, in the Staten Island space, or in the Brooklyn space.

**Florence Shum: **Yeah, I mean, the demand is definitely there, because there are people asking about, like, when I'm gonna open, like, you know, there's definitely,

**Florence Shum: **like, need for it, and that's why I thought that was a good market, because it's actually not that much… there's, like, basically not much competition.

**Florence Shum: **Just because, like, There are very few neurologists to begin with.

**Florence Shum: **Besides the hospital system.

**Florence Shum: **So, and then the wrong… Yes, sorry.

**Florence Shum: **And then the neurologists that are still in private practice are, like, older. They're kind of, like, in the retirement age, you know, so…

**Florence Shum: **So that's an advantage for me, I guess.

**Florence Shum: **But, yeah.

**Jennie Eckstrom: **Natasha, what has your recruitment experience been like?

**Florence Shum: **Yeah.

**Natasha Beauvais: **Just one question for you, Florence. I just went to the gym.

**Natasha Beauvais: **do you… how good are you at running those quick spreadsheets? Like, are you really easy with Excel, or do you need a little…

**Natasha Beauvais: **trick.

**Florence Shum: **I am not good. I always have to ask my bookkeeper to, like.

**Jennie Eckstrom: **Hmm. Huh.

**Florence Shum: **my stuff.

**Natasha Beauvais: **So I really just learned this amazing Hack that is totally… Critical for business owners.

**Natasha Beauvais: **Do you ever… do you use Claude AI?

**Florence Shum: **No, I use ChatGPT.

**Florence Shum: **But I think…

**Natasha Beauvais: **If you get Clawed AI, Yeah. For $20 a month.

**Natasha Beauvais: **And you open up the screen, you can… you can put it on co-work mode.

**Natasha Beauvais: **And if you put it on co-work, you can… or you can actually… it doesn't even have to be on co-work mode. If you open up Excel, you can…

**Natasha Beauvais: **add Claude into your Excel? Like, do you have Excel?

**Natasha Beauvais: **Literally, you can just talk to it.

**Natasha Beauvais: **So you… it's… it's Claude embedded in Excel.

**Florence Shum: **Oh.

**Natasha Beauvais: **And you can just say, I'm a neurologist in New York City.

**Natasha Beauvais: **The average salary for starting doctors is $350,000.

**Natasha Beauvais: **I want you to act as an expert medical…

**Natasha Beauvais: **Billing Advisor, and helped me figure out

**Natasha Beauvais: **everything I need to figure out before I offer a salary to this Doctor.

**Natasha Beauvais: **I think she's gonna work 4 days a week.

**Natasha Beauvais: **I think I… my average reimbursements are $170.

**Natasha Beauvais: **For each patient, to be conservative.

**Natasha Beauvais: **She's gonna get 6 weeks of vacation, and 11 holidays, or whatever you're gonna give her. 9.

**Florence Shum: **I know, right? And…

**Natasha Beauvais: **So then she's really only gonna be working 45 weeks a year.

**Natasha Beauvais: **Four days a week.

**Natasha Beauvais: **So, can you show me a spreadsheet where you model

**Natasha Beauvais: **How much money she's gonna bring in.

**Natasha Beauvais: **Oh, wait a minute, I forgot, her malpractice insurance is this, and she's gonna need a nurse, and so that staff member's gonna cost this, and her computer's gonna cost this.

**Natasha Beauvais: **And, like, at the very bare minimum, I, you know, I have to cover Third.

**Natasha Beauvais: **Her computer, her EMR registration, For staffing, if you need staffing.

**Natasha Beauvais: **her… like a… some… Maybe a percentage of the biller, or whatever else you need to include.

**Natasha Beauvais: **And then you can even say, what am I forgetting?

**Natasha Beauvais: **what else should I put into this model? And then it will tell you, like, you could say, ask me another

**Natasha Beauvais: **5 or 6 questions so that I can do a better job at this.

**Natasha Beauvais: **And then it'll say, well, what about this, this, and that? And then you can answer.

**Natasha Beauvais: **no, I don't need this, this, and… but I do need that.

**Natasha Beauvais: **And then it will really just create a model for you, and then you can be like, okay, 2 days later I slept on it, and I thought of a different thing.

**Natasha Beauvais: **You just go right back into it, and you can say, hey, model it this way, I just thought of it this way.

**Natasha Beauvais: **And it takes… it takes it literally one minute, and it… and no money, for $20 a month.

**Florence Shum: **Yeah, I need to work on the Excel. Yeah, I have… I started having these kind of conversations with ChatGPT, and it becomes, like, really long, and, like.

**Florence Shum: **like, go back to, like, where I started from, and, like, you know, so sometimes it's a little hard, but, that's a good idea to put it on Excel sheets, so then I can play with the models, right? Like, because there's a formula there, so then, like.

**Natasha Beauvais: **Yup.

**Natasha Beauvais: **Well, the formulas are not awesome, actually, if you're doing it with co-work, and you have to sometimes go back and say, wait a minute, I don't see any formulas here, you just gave me all the results. I want it with formulas, and you have to…

**Natasha Beauvais: **Know how to redirect it?

**Florence Shum: **Hmm.

**Natasha Beauvais: **And you might be getting already everything you need with GPT, so maybe I'm telling you something that's actually…

**Natasha Beauvais: **Yeah, I'm just actually…

**Jennie Eckstrom: **plugin, if, you know, as you create good GPT models, like, out of the box.

**Jennie Eckstrom: **GPT is not, you know… I mean, it needs to be trained, but…

**Florence Shum: **Yes.

**Jennie Eckstrom: **those are the things that I've… that I've plugged into my GPT. You know, I've got several projects, and this is one of them.

**Jennie Eckstrom: **So, it'll be interesting, because I've got a lot of this data. I'm just throwing that…

**Jennie Eckstrom: **That in and seeing.

**Jennie Eckstrom: **Susan's here.

**Florence Shum: **Hmm.

**Jennie Eckstrom: **But it is, it's a matter of understanding what are the numbers and what are the…

**Jennie Eckstrom: **The metrics that you need to use, and what are the levers, so that as somebody negotiates, you understand what work pieces… where you have room to negotiate, and where you don't.

**Florence Shum: **Right.

**Florence Shum: **Hi, Vinico!

**Jennie Eckstrom: **Hello?

**Jennie Eckstrom: **Hello? Yeah, I have not jumped… I know you've done a great job of jumping into… into Claude, Natasha. Did you ever use chat this way?

**Natasha Beauvais: **I do use chat, but I use much more of Claude, so I… I have both. Sometimes I'll keep them, like, simultaneously running different things.

**Natasha Beauvais: **Sometimes, sometimes…

**Natasha Beauvais: **GPT has, like, can handle, like, a larger document to edit or something. I think Cloud does a better job with writing, and I've just gotten

**Natasha Beauvais: **really used to it. I'm, like, I'm pretty much dependent on it.

**Natasha Beauvais: **Especially if I want to do a project.

**Natasha Beauvais: **And then, I mean, you can use projects in GPT, and that's a great way to keep all your, like.

**Natasha Beauvais: **GPC, I think you can do projects and then add to the files, and so, like, if you have… if it creates a spreadsheet for you and you want to keep track of it, you can put it into the file for that project, so that then you just have a…

**Natasha Beauvais: **Like, each project has a folder of all the files that you have.

**Natasha Beauvais: **Talk to it, and that's an easy way to keep track, so you don't have to scroll, scroll, scroll.

**Jennie Eckstrom: **Right.

**Florence Shum: **Yeah, my… my… like, the… for example, like, you know, one of the projects was the… my bonus, agreement for my, PA that I just created, and it's kind of, like, embedded in there, so instead of, like, a separate… almost like a link where I can get to it quickly, I have to scroll up to find that.

**Florence Shum: **after, you know, they gave me, okay, this agreement, and I'm like, okay, I want this, this, this, and then…

**Jennie Eckstrom: **Yeah, you can… you can go into your dot dot dot, and you can pull that out into a new project.

**Jennie Eckstrom: **So… so go in… so the bottom of it, where you can either, like, put, like, thumbs up, thumbs down,

**Jennie Eckstrom: **Or, I don't know if you ever have chat read back to you when you're, like, not at a place where you can… I use chat a lot in my car, and when I'm brainstorming. But there's a… there's a function where you can click on the dots and actually pull that into a new project.

**Florence Shum: **Yeah, I think I tried that, and then I still had trouble…

**Florence Shum: **like, finding it. I think I just have to kind of figure out what's…

**Florence Shum: **how to get the information that I need quicker.

**Natasha Beauvais: **You can even ask it. You can literally scroll up to that thing, and then you can say, hey, this is the thing that I want, but I can never find it. Can you teach me

**Natasha Beauvais: **Can you teach me a better way to use this? Because I keep losing it, and then it will teach you how to use itself.

**Florence Shum: **Yeah.

**Florence Shum: **Okay.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **So, but starting with, I mean, using yourself as a model, using your PA as a model, but you're gonna be, you know, from your expenses, you're gonna be a better model for a physician, understanding what the salary is and what

**Jennie Eckstrom: **You know, what… what you think that ramp-up time will be.

**Jennie Eckstrom: **You know, when they bring in 24… you know what your lag time on your, your collections are. Maybe you're working on that. So, you know, that first, you know, 6 months, you probably, you know, you're going to be in the hole, so you've got your… you've got your line of credit to cover that.

**Jennie Eckstrom: **But when do you start to see at least them not maybe paying back everything, but when do you start to see that contribution now offsetting what you're paying for both them and their expenses?

**Florence Shum: **Yeah,

**Florence Shum: **I think, initially, while I'm credentialing them, I would just bill under the practice, so under myself, right, in the group, under the group, so this way, like, I'm not holding the claims.

**Jennie Eckstrom: **Right.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Can you do that if you are still…

**Jennie Eckstrom: **working… I know you can do that with a mid-level. Can you do that with a physician?

**Florence Shum: **They did that when I joined my previous practice.

**Florence Shum: **Yeah, in the group.

**Florence Shum: **I don't know. I will ask ChatGPT.

**Jennie Eckstrom: **Yeah. Or know, you know, which of your insurers that you know you can credential quickly, and then knowing that, like, Medicare and Medicaid sometimes are a slow boat to China.

**Florence Shum: **Right, yes.

**Jennie Eckstrom: **may defer…

**Florence Shum: **Three to… 3 to 6 months, yeah.

**Florence Shum: **And, I mean, Natasha, when you, like, hire, how do you guys do it? Do you hold the claims? I know, when I spoke with Prania, like, she told me that they hold the claims until they get credential.

**Natasha Beauvais: **As soon as we contract with somebody, we're usually not hiring them the same day, so we usually have 2 months. Yeah. So, we start to credential them as soon, like, the day that they sign. Like, literally as soon as they sign, we're starting their credentialing. And the Medicare takes a little bit longer, but the other insurances take less than a month.

**Natasha Beauvais: **Oh, wow. And so, we can usually get the private insurances going, and then within 60 days, we have Medicare.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **Because… so I'm part of an IPA, and the IPA group helps us do the, credentialing, because they credential with, like, about 20 insurances.

**Florence Shum: **for them to do it, they… the… my new hire will have to join the IPA, and that process sometimes takes about 2 months, because they have their board meetings, like, every other month.

**Florence Shum: **To… to basically vote in, like, the new applicant.

**Natasha Beauvais: **How could you time it so that you maximize that memory?

**Jennie Eckstrom: **admin.

**Natasha Beauvais: **Like, what would be the right…

**Natasha Beauvais: **Sequencing of, like, if she were gonna sign on…

**Natasha Beauvais: **Like, the… you know, how many days before that first meeting would you… would be ideal to get her to register to join that?

**Florence Shum: **like.

**Natasha Beauvais: **And made better.

**Florence Shum: **If we can get all the paperwork done in, then, like, the next board meeting, they will be able to review everything.

**Natasha Beauvais: **So you could just make that a requirement of what you're doing to say, you know, we'll…

**Natasha Beauvais: **Pay… you can even pay them for the timing, or you cannot, but you can say, like, we have to have this done, we're signing this day, and you have to have this paperwork done the next day.

**Florence Shum: **Hmm.

**Natasha Beauvais: **That's just a… requirement of… getting started. How hard is the paperwork?

**Florence Shum: **not too bad, because the IPA takes care of all, like, it's basically all the licenses. My office manager did it for my,

**Florence Shum: **for my two PAs, right? I did it for myself back then, and then, so it's just, like, your license stuff, like, the routine stuff, it just, like, the application itself is not very extensive, it's not very long.

**Florence Shum: **So, but they just need, like, malpractice information and things like that, so I have to…

**Florence Shum: **cover the malpractice first before I can even submit it to them, and I don't know if they need to be even on par with Medicare first before they would take the applicant, so I have to find out the detail, because both my PAs

**Florence Shum: **have Medicare already.

**Florence Shum: **So, they made it a little easier, but if it's, like, a new graduate, I don't know what they would have.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **You could also bake that into your start time, though, right? So…

**Jennie Eckstrom: **So if you know that you've got that.

**Florence Shum: **Yeah, I mean, even if I sign someone right now, realistically, I'm thinking they probably won't start until, like, 3 months.

**Florence Shum: **Right? With, like, all the paperwork and everything. So hopefully they'll be in something.

**Florence Shum: **Bye then.

**Florence Shum: **You know, at least get the balls out.

**Florence Shum: **You know, like, a bit.

**Florence Shum: **Boom.

**Florence Shum: **I mean… I don't know, I have to at least interview some people first.

**Florence Shum: **And see what I can afford, what I can truly afford, right?

**Jennie Eckstrom: **Yeah.

**Florence Shum: **I mean, it's easier if they do procedure, then, you know, they'll be able to cover themselves easier, but…

**Florence Shum: **Someone is, like, a movement disorder specialist, or, like.

**Florence Shum: **I mean, I saw candidates, a headache specialist, and I'm like, I don't know how much…

**Florence Shum: **procedures they do besides Botox for headaches, which…

**Florence Shum: **I mean, I do them too, but that's… It's not very…

**Natasha Beauvais: **Headache specialists are so critical in my area. We're, like, desperate for headache specialists.

**Jennie Eckstrom: **Right.

**Florence Shum: **Even us, too, because all these patients are, like… Well, there are some that, just don't accept any insurance, they just, like, you know…

**Jennie Eckstrom: **Yeah. Well, that's the other thing, it happens, but…

**Florence Shum: **Yeah.

**Vineka: **Jenny, do you have a quick, kind of…

**Vineka: **you know, you have all these, like, Google Sheets and calculators and things like that, of, like, what is the…

**Vineka: **like, Florence was asking, how do… I need to find out how I can… what I can afford as provider. Do you have, like, a kind of a template to plug in some things so we can be like, ta-da, I could do this?

**Jennie Eckstrom: **Ta-da! Well, that was part of what we were just sort of chatting about, but again, starting at that sort of service line level of understanding what somebody makes at full capacity is, I think, a great place to start, because a lot of those expenses that we talked about that, you know, that

**Jennie Eckstrom: **Natasha was alluding to, in terms of malpractice and, and, you know, insurance benefits and their payroll tax and all of that, end up being in that. So if you can capture those numbers of a mature provider.

**Jennie Eckstrom: **and you know where they're ultimately likely to get, right? And you know approximate patient volumes, and so, you know, Florence has done a great job of understanding what the revenue per visit, because that's a great metric to have.

**Jennie Eckstrom: **Right? If you can get an idea of, of

**Jennie Eckstrom: **how many days they would work in a year, based upon that number, and also then taking out their vacation time, because those are going to be days that you will… you will pay if they're truly a, you know, an employed provider and not, you know, working on a production model, then you can then

**Jennie Eckstrom: **create that into a 12-month… you know, you take your full year, break it down to a 12-month date, and then you can… you can sort of back-calculate from that. So, you're… Florence is getting a lot of those… a lot of those pieces.

**Florence Shum: **it's work to, like, even figure out, like, how much, like, you know, like, the malpractice was easy, right? But, like, you know, payroll tax, like, benefits, right? Like, things like that.

**Jennie Eckstrom: **Well, and do you have a sense, like, here in Montana, we typically will say that benefits are, about 30% of the salary. So your salary, you know, 30% of your whole number, in addition to your salary, is your benefit cost.

**Jennie Eckstrom: **And so whether that number holds true where you're at in terms of your insurance costs and your malpractice and those sorts of things, malpractice wouldn't really be a benefit, per se.

**Florence Shum: **Bye.

**Florence Shum: **I guess other expenses.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Yeah. So, but you should be able to calculate that for your two other PAs that you have, and at least get that idea. You should be, you know, if you're… if you're paying yourself a salary, that should also be a number that you can come up for yourself as a seasoned mid-career physician.

**Florence Shum: **Yeah, it was still… do my piece, yes, like the… the expense part.

**Florence Shum: **I just did the…

**Jennie Eckstrom: **Yeah, so we started at that top number, but again, going back and now getting, you know, on that P&L, getting at some of those expenses so that, you know, to Vinika's point, you have that data in front of you.

**Florence Shum: **Yeah.

**Florence Shum: **And then Natasha, like, suggested using Claude, like, the co-work space to… no, incorporating even in the Excel, on Excel.

**Florence Shum: **To use claw in it.

**Natasha Beauvais: **Yeah, yeah.

**Jennie Eckstrom: **Yeah, I'm gonna have to explore, Claude.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **sort of like 2 weeks ago when the, you know, the Department of War decided to use

**Jennie Eckstrom: **chat that everyone was like, I gotta get away from it, and I'm so deeply embedded into chat that to take that

**Jennie Eckstrom: **Institutional knowledge and transform it to another platform.

**Jennie Eckstrom: **is, A little interesting, but…

**Jennie Eckstrom: **But it sounds like it's been a great tool for you, Natasha.

**Florence Shum: **Yeah, I was watching, like, some videos on YouTube teaching people how to get the memories and all the data that you have on ChatGPT and put it in Claude.

**Florence Shum: **So that you don't lose it. So basically, so that Claude learns what ChatGPT learns.

**Vineka: **Natasha, I have to say, I asked ChatGPT if I, you know, like, what…

**Vineka: **I would need, and then I entered the information in Claude. So it said because I didn't have any documents that I'm reviewing yet, to just use the…

**Vineka: **Claude chat, and I compared the same questions in chat and Claude, and Claude was so much better. And then I also had it compare the two answers, and Claude told me, of course, why it was better.

**Vineka: **But why as well? And it did point out that ChatGPT is trying to be, like, the responses are good, but it's very polite. Let me tell you to the point. And I'm like, oh yeah, I like that.

**Florence Shum: **Yeah.

**Vineka: **It wasn't as much blah blah blah blah blah, but…

**Florence Shum: **The only thing I noticed for ChatGP is it's very agreeable. Like, agreeable for whatever I say, like, yeah, you're…

**Vineka: **Even when I tell it, like, it's okay, don't, you know, you don't need to be pleasing me, just tell me

**Vineka: **Think critically and tell me what the answer is.

**Natasha Beauvais: **I mean, two critical phrases that you should just write down and just use is…

**Natasha Beauvais: **Act as an expert prompt engineer, and get it to rate you a prompt.

**Natasha Beauvais: **And teach me to think like an engineer. How should I do this? And…

**Natasha Beauvais: **When you get it to… when you… let's say you want to do this project,

**Natasha Beauvais: **Florence, and you want to say, okay, how…

**Natasha Beauvais: **I want to use AI to help me create a model to figure out how much to pay a new associate, and then you…

**Natasha Beauvais: **what you can start with is to say, you can use this in GPT or in Claude.

**Natasha Beauvais: **Act as an expert prompt engineer. Here's what I want to do. You can literally dictate this.

**Natasha Beauvais: **I want to, you know, model all of the pros and cons of different pricings for this person that I want to hire. I think she's gonna make this much money. I think she's gonna need these types of benefits.

**Natasha Beauvais: **Don't answer the question yet. Give me a good prompt.

**Natasha Beauvais: **to help me… You know, to tell me how to guide you how to do this.

**Natasha Beauvais: **And then it will give you a prompt.

**Natasha Beauvais: **And then you read the prompt, and it might be two pages.

**Natasha Beauvais: **And then you edit the prompt, and you're like, no, it doesn't work that way in New York, do it this way instead. And you just tell it, update the prompt.

**Natasha Beauvais: **And then, once you get the prompt to be amazing, you'll be like, oh my god, I just did that! And then it will tell you how to do something amazing.

**Florence Shum: **Mmm.

**Natasha Beauvais: **So if you, if you, if you ask for the prompt first, your work will be, like, tenfold better.

**Florence Shum: **-

**Natasha Beauvais: **And you can ask it.

**Natasha Beauvais: **How to do things, like…

**Natasha Beauvais: **I can see that I'm not doing this the easiest way. Like, I've learned to not… to say, like, do this. Like, I used to say, like, can you create such and such a file, and then it would take, like, 10 minutes, and I was like, wait a minute, I didn't need that kind of a file. Like, can you…

**Natasha Beauvais: **Can you tell me how to do this the easiest way? All I want to do is copy and paste this into an email, and it's like, sure. And then in, like, 2 seconds, it's done. But if I didn't say that, if I told it, oh, put this into a Word document, or make it into a Google Doc, or something.

**Natasha Beauvais: **Then it takes 10 minutes, and I'm, like, wasting time.

**Florence Shum: **Hmm… Yeah. My father, of course.

**Vineka: **So, what, what was your first…

**Vineka: **thing you said again? Act as an engineer?

**Natasha Beauvais: **Act as an expert?

**Natasha Beauvais: **Prompt.

**Natasha Beauvais: **P-R-O-M-P-T, engineer.

**Vineka: **Wow.

**Natasha Beauvais: **So you're getting it to write a prompt. So it's like a coder, like an expert coder who's writing… giving it directions, but you're just telling it to do that.

**Natasha Beauvais: **And then it writes these amazing directions for you.

**Natasha Beauvais: **And then you can get really, really good outputs.

**Vineka: **But that's the chat part, right?

**Florence Shum: **To start.

**Vineka: **start.

**Natasha Beauvais: **Yeah, you can use that in…

**Natasha Beauvais: **in GPT or Claude, and you could do that within a project, or just in a regular chat.

**Vineka: **Okay.

**Vineka: **And then for the, like, when I use it on the computer, like, chat lets me talk to it.

**Vineka: **But Claude, it doesn't… it either wants me to write, just change everything to writing, or it doesn't capture as well.

**Vineka: **If I'm talking.

**Natasha Beauvais: **Right. Oh, okay. I mean, I had to ask it how to do that. I was like, how do I use a microphone with this thing? And it told me, you know, press Ctrl-H, or, like…

**Natasha Beauvais: **And then I press Ctrl-H, and this microphone shows up.

**Florence Shum: **Oh.

**Natasha Beauvais: **And then I… then I can use the microphone. But I didn't know how to do it either. It's not, like…

**Natasha Beauvais: **Raise your eyes.

**Vineka: **streams. Yeah.

**Natasha Beauvais: **Right, yeah. But it's… once you know how to do the keystroke for it, it's… it's instant.

**Florence Shum: **It's neat.

**Florence Shum: **To invest time to practice this.

**Jennie Eckstrom: **Yeah, I mean, that's… that's the whole piece, but I mean, it sounds like it's been an amazing tool for you, Natasha.

**Natasha Beauvais: **Yeah, I've been playing with it since maybe October, and it's been, very, very light-changing, like.

**Florence Shum: **Mmm.

**Natasha Beauvais: **Yep.

**Vineka: **What happened?

**Natasha Beauvais: **Good tool.

**Vineka: **With the… from the office perspective.

**Natasha Beauvais: **so many things. The first thing I did, I learned how to use that, and then I was on a plane, and I literally flew home from

**Natasha Beauvais: **some places, like 3 or 4 hours, and I was like, okay, I want to write a strategic plan for my business.

**Natasha Beauvais: **So I asked it to write… I told it everything I could tell verbally about my business.

**Natasha Beauvais: **You know, this is the size, number of employees, revenue, Profitability.

**Natasha Beauvais: **Problems that we're having, debt that we have, Partner buyout that we're doing.

**Natasha Beauvais: **I told it all these things. We used EOS, I told it all that.

**Natasha Beauvais: **Just whatever you can just verbally tell right off your top of your head.

**Natasha Beauvais: **And then I said, okay, I want to create

**Natasha Beauvais: **A strategic plan for the next 3 years.

**Natasha Beauvais: **and asked me 20 questions. First, you know, write the prompt, and then it wrote the prompt, and then I was like, okay, ask me 20 questions to make this even better in detail, so that it asked me 20 questions, and I answered those things that I forgot

**Natasha Beauvais: **To say to it.

**Natasha Beauvais: **And then…

**Natasha Beauvais: **within 3 hours on the plane ride home, I had this 20-page strategic plan, and it was amazing, but then I wanted to share it with my team, but it had all of our financial data in it, and I was like, I don't want to share all of the stuff with the financial data.

**Jennie Eckstrom: **Right.

**Natasha Beauvais: **So, then I just said, that's fine, but the audience for this is my

**Natasha Beauvais: **colleagues and two managers, and I don't want to give them all the financial information.

**Natasha Beauvais: **you know, change it and do it this way, and then change it and do it that way, and so you can just say, like, oh, I want more EOS, or I want

**Natasha Beauvais: **skip that project, you know, that was a bad idea, and then it just can rewrite it for you. And I was just… I was like, wow, I did not even know how to think in a strategic plan type of a way. And I've literally written a 20-page document that I've revised twice.

**Natasha Beauvais: **On a plane. On the way home.

**Florence Shum: **So…

**Natasha Beauvais: **that was, like, that was my first taste of, I can do something I have never even been able to think about before.

**Natasha Beauvais: **Like, I don't know how to tell it to do this. It's telling me how to tell it to do it.

**Florence Shum: **That's amazing!

**Natasha Beauvais: **Yeah. I've actually recently have had some really tough conversations, and I've put in all the notes, and I'm like, here's the problems I'm having.

**Natasha Beauvais: **here's the conversation I'm planning, I think I need to say these 6 things.

**Natasha Beauvais: **And then I said, act as a…

**Natasha Beauvais: **Act as an expert business communications, expert with change management, like an expertise in change management, and critique my notes and tell me what to do differently.

**Natasha Beauvais: **And it said immediately, if you start in with this.

**Natasha Beauvais: **people who don't have good trust are going to feel manipulated. You shouldn't start with that. You should start with this. And it changed the order of what I was saying so that I would more directly address the struggle that we were having interpersonally right up front.

**Natasha Beauvais: **And then, it was amazing, and then I was like, act as a mediator and tell me what to do, and it gave me a different tip.

**Natasha Beauvais: **And then I sort of did some version of… some not-perfect version of that, but my conversation, I can tell, was so much…

**Natasha Beauvais: **better, because I got that critical feedback.

**Natasha Beauvais: **Like, but you have to tell it to criticize you, you know, like…

**Jennie Eckstrom: **You can tell it to be mean, Vanika.

**Vineka: **Not too mean, just… right amount.

**Jennie Eckstrom: **Yeah, but to not blow smoke, right?

**Vineka: **Right, exactly.

**Natasha Beauvais: **Yeah, you do have to say, do not hallucinate, like, do not hallucinate, give me data-based recommendations, like, I want this all to be, like, verifiable.

**Natasha Beauvais: **and think harder, like, you can tell it how much… how hard to work, you know? And it… and sometimes it'll say, oh, in order to make me think harder, you have to press the research button, and here's where the research button is, and I didn't even know where that was, or that it existed, but I did it.

**Natasha Beauvais: **you.

**Florence Shum: **Wow.

**Natasha Beauvais: **What do you use it for, Jenny?

**Jennie Eckstrom: **Oh gosh, I use it for everything. I actually really like to, I drop in a lot of financial data.

**Jennie Eckstrom: **And, you know, to help…

**Jennie Eckstrom: **like, when I was getting ready to… when I was considering going part-time, and what does this look like? Do I go part-time now? Do I go 6 months from now? Do I take a one-month sabbatical? So being able to put in a year of my financial data and get some of those questions, you know, back.

**Natasha Beauvais: **Cool.

**Jennie Eckstrom: **Understanding, you know, just really getting to that nitty-gritty of…

**Jennie Eckstrom: **Because some of the data that we get from our… we get good information back from our,

**Jennie Eckstrom: **our financial folks, but it's… it's not necessarily asking the questions that I would ask as I'm valuing, you know, my time. You know, as I am trying to put a lot of information in a way that then I can… I can then share it. I use it a lot to say, like, okay, this is the model in this space.

**Jennie Eckstrom: **Now let's actually make it one that would be more applicable across the board, or,

**Jennie Eckstrom: **So, I use it a lot that way.

**Jennie Eckstrom: **I use it similar to you in conversations, so just getting that sort of trial of external processing before I jump into a conversation, right? That actually helps me diffuse some of the emotion from a conversation.

**Florence Shum: **So…

**Jennie Eckstrom: **Yeah, I'm just sort of…

**Florence Shum: **Yeah, I'm still an amateur with this. I'm still using it almost like Google search. Show me how to do this! Show me how to do that.

**Natasha Beauvais: **Really?

**Natasha Beauvais: **You're gonna be great with those two changes, it will… you'll just… you'll… it'll be like a…

**Florence Shum: **Life-changing! I think it will be.

**Natasha Beauvais: **Yeah, it'll be, like, an algorithmic difference.

**Florence Shum: **Yeah, because I feel I don't know how to prompt it, you know, and that… I think…

**Florence Shum: **It's a lot of, like, runaround, because I'm not prompting it properly to really get the information that I want it to spill it for me, so it takes longer, much longer.

**Natasha Beauvais: **You can literally say that. I can tell I'm not prompting you properly to get the right information out. Teach me how to do a better job.

**Vineka: **Yeah, that's crazy, that's just nuts, that…

**Vineka: **you can tell it to prompt. Like, tell me how to prompt you better. That's just…

**Florence Shum: **Yeah.

**Natasha Beauvais: **It is crazy. It is.

**Florence Shum: **You're crazy.

**Vineka: **When do you choose chat versus a project? Because I feel like I'm so used to talking to ChatGPT that everything is… I just want to talk.

**Jennie Eckstrom: **Well…

**Jennie Eckstrom: **the way I use that is if I have a collection of… of documents that I'm creating, or if I have… say I've done, like, a really good… so, like, just like this, I… so… so, Florence, I was… I was working on just, sort of.

**Jennie Eckstrom: **going from the project that I have, which tends to be most of my clinical, financial data, I sort of created this, so I'm going to send you this, this expert prompt that I, that I came up with. But, so, anytime I'm talking about anything financial.

**Jennie Eckstrom: **that pertains to, practice of medicine, I'm actually throwing that into a project. So, anything that's mindset, I'm throwing into a mindset project, project, real estate things, I'll throw in. And then you basically then, in that project, are able to work off that collective memory.

**Vineka: **Hmm.

**Jennie Eckstrom: **Because it seems like in the regular… I very rarely do a new blank chat that's not out of one of my projects.

**Florence Shum: **Anymore.

**Jennie Eckstrom: **Unless I'm, like.

**Jennie Eckstrom: **tell me where to buy theater tickets at this theater in London. Now, that will go in its own little… little chat, right? But beyond that, I really leverage the projects and that memory that that creates.

**Jennie Eckstrom: **So, so, like, today we got… we were looking at our PearlDS service line, right? And so, I said, well, great, let's take that, and let's actually use this as a framework to evaluate all different service lines.

**Jennie Eckstrom: **Right? So we can…

**Jennie Eckstrom: **can say, you know, these are the things we looked at number of visits and payers, and whether we do a buy-in bill for certain, and whether we use specialty pharmacy for others, but you get that overall context. You're like, great, now let's use this and create a model that I can use to evaluate.

**Natasha Beauvais: **Oh, that's cool.

**Jennie Eckstrom: **injectables, like B12, or vaccines, or that. So when you get a good chunk of data that you like, and you say, how can I use this across my clinic?

**Jennie Eckstrom: **So…

**Florence Shum: **Hmm.

**Jennie Eckstrom: **Because you give it enough structure, like, great, let's not reinvent the wheel for everything that we're doing, let's go ahead and take this, just the same way that we use, you know, a physician service line, let's model this, using this mature physician service line, let's model this and what it would look like to recruit

**Jennie Eckstrom: **And what a typical ramp-up period would be, you know. So, that's how I like to use this data, so you're not continually reinventing the wheel.

**Natasha Beauvais: **That is a good point to use it for recruitment, because I haven't done that yet, and I really need to get better at recruiting.

**Natasha Beauvais: **In a more of a systematized Way for doctors, and

**Natasha Beauvais: **That's a good point. We could just put everything about it in a project, keep learning, keep learning, keep learning.

**Jennie Eckstrom: **And then you fine-tune it, and then you say, okay, well, this physician, you take a model that you have, like, what happened with your early career physician, what happened from your mid-career physician, you know, and what did those ramp-up time periods look like?

**Jennie Eckstrom: **And now this is the person I have, what should I expect?

**Jennie Eckstrom: **So I think the sky is really the limit, but I think the projects are where you basically get all that information in a way where you're not having to then start from scratch every time you start a conversation.

**Florence Shum: **The…

**Vineka: **Do you find that it kind of dwindles? You know, like, chat becomes more, like, rubbish. It gets kind of tired after the chat gets longer? Does that happen with the project?

**Jennie Eckstrom: **I definitely find some places where I'm like, okay, this conversation's over, and I'm done, right?

**Jennie Eckstrom: **But then you can… so… so, Florence, what it was is it was split the chat.

**Jennie Eckstrom: **There's the.

**Florence Shum: **Boom.

**Jennie Eckstrom: **The prompt is split to a new chat, so if you found something that you liked, That's.

**Natasha Beauvais: **Oh, okay.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **Versus having to go back, because

**Jennie Eckstrom: **just like you say, like, I may start in one conversation, and then ultimately get to a place, I'm like, oh, wow, that is gold, I need to remember that. I don't really care why we started this conversation in the first place, but this is the part. And so, I have not completely split off these, but I think that's what I…

**Jennie Eckstrom: **need to do. You just branch it into a new chat.

**Florence Shum: **Hmm.

**Jennie Eckstrom: **So…

**Florence Shum: **We chat inside that project, too, right? So it's, like, all in one place.

**Natasha Beauvais: **And then everything you like, you can just copy it and put it into the files in that project.

**Natasha Beauvais: **So, like, I was thinking about a long thing over the weekend, and every time it would give me an answer that I thought, yeah, this is kind of where I'm going. I would just copy it, put text it into the… like, put the text into the files.

**Natasha Beauvais: **And then I would just keep going back in that same conversation and keep working and working, but then…

**Natasha Beauvais: **It will save the important parts.

**Natasha Beauvais: **I mean, you can manually save the important parts, so that then…

**Natasha Beauvais: **As you keep talking, it's always using those… that collective body of knowledge as a… database to go.

**Jennie Eckstrom: **You can always… have you used the, the phrase, add to the behavior?

**Jennie Eckstrom: **No, that's another way to do that. So if you find something that you really like, you say, summarize this for me, now add this to the behavior of this project, or add this to the behavior of this GPT,

**Jennie Eckstrom: **So then that.

**Natasha Beauvais: **Oh, okay.

**Jennie Eckstrom: **refining it, because I have found in chat you get to a certain number of documents that you can add. I don't know if.

**Jennie Eckstrom: **Reach that threshold.

**Florence Shum: **Hmm.

**Jennie Eckstrom: **So…

**Natasha Beauvais: **Yeah, it will… it tells you, like, you have 2%, 5%, yeah.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **Yeah, and you have to be careful about deleting documents to make room for others, because it actually removes that portion of the brain. So, I don't know if you guys have done that.

**Jennie Eckstrom: **My husband was helping me once, and removed the brain of a big project I was… I was on. I'm like, no!

**Florence Shum: **Mmm.

**Natasha Beauvais: **You know, brother.

**Jennie Eckstrom: **So… Yeah.

**Natasha Beauvais: **I have to go.

**Jennie Eckstrom: **Okay, thanks, Natasha, it's great to see you.

**Florence Shum: **Okay.

**Natasha Beauvais: **Hey!

**Vineka: **Thanks, Natasha, I love your live workouts, and thank you for, sharing, Claude.

**Florence Shum: **Yay.

**Natasha Beauvais: **Okay, I hope it's fun. It's like, it takes off pretty fast when you just do that tiny change.

**Florence Shum: **Yeah. It's awesome.

**Natasha Beauvais: **Okay, bye guys! Okay, see ya!

**Florence Shum: **And you can… and we can do it, like, 10 o'clock, 11 o'clock at night.

**Florence Shum: **I have to text somebody.

**Jennie Eckstrom: **So this, I'm just going to share this with you. This is what I was creating, and again, from…

**Jennie Eckstrom: **This is from my project that's Independent Physician Launchpad, but this was the… can you see this screen?

**Florence Shum: **Yes.

**Jennie Eckstrom: **So this was the, the prompt. This might give you a place to start.

**Florence Shum: **Hmm…

**Jennie Eckstrom: **And I had it switch that you're the neurologist, that, term…

**Jennie Eckstrom: **So we might need to actually… this is evaluate the… wait, did I switch it down here? I said, okay, no, I said use this prompt to come from the perspective of the physician business owner who's recruiting the new neurologist, because initially it wanted to create it from… from the role of the person evaluating the offer for themselves.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **So… .

**Florence Shum: **Okay.

**Jennie Eckstrom: **So then, with this, then, these are your compensation structure, so you're looking, you know, at those things. These would be…

**Jennie Eckstrom: **So you basically would say, you know, you can fine-tune this to what works in your practice.

**Jennie Eckstrom: **if you have… if you have, sort of, the revenue model of what looks like… what it looks like for you or a PA, you might… you might include that in here, and you might include…

**Jennie Eckstrom: **What you know about those offers that have been extended to those four neurologists, if you know anything.

**Jennie Eckstrom: **Right?

**Florence Shum: **So… I wanted to ask, but I was like, hmm, that's probably sensitive. I don't know if he would know either.

**Jennie Eckstrom: **Well, but you also, there's… there's public data out there, so you could also…

**Jennie Eckstrom: **You could put your numbers, and then you could also say, compared to what, you know, again, still with that, for this role.

**Jennie Eckstrom: **Ask what the average offers are for new or mid-career physicians in your area.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **So…

**Jennie Eckstrom: **But, let me,

**Jennie Eckstrom: **I'm gonna copy this for you, and I am gonna drop this into an email and send it to you.

**Florence Shum: **Oh, great, yeah.

**Jennie Eckstrom: **Just so you have a place to start from, but again, that… I'm doing that while we're having a conversation, right? Yeah. So it's not…

**Florence Shum: **Awesome.

**Jennie Eckstrom: **But, what I would encourage you to do, and I don't know if you can see over here, but I have all sorts of…

**Florence Shum: **Yeah.

**Jennie Eckstrom: **projects that I have going on at any given time.

**Florence Shum: **projects, yeah.

**Jennie Eckstrom: **And I just pop into that so that I have that memory.

**Florence Shum: **What's the top versus the projects? Like, the top stuff?

**Jennie Eckstrom: **Oh, well, I have… I must have actually… this must be my GPT, actually. I actually have custom GPTs.

**Jennie Eckstrom: **So,

**Jennie Eckstrom: **where you create a custom GPT, and you can do that for your, for your business. I find that the projects work about the same.

**Florence Shum: **Okay.

**Jennie Eckstrom: **So… but I think…

**Florence Shum: **Inside the project, how do I start, like, a new chat inside this project? Like, if I click chat new chat, it's just a new chat, right? Like, I have to.

**Jennie Eckstrom: **Well, so if you… so if you did a new chat, so let me just say this, like…

**Jennie Eckstrom: **Okay, so this is our neurologist recruitment prompt that I just did. Okay, so it goes… any of the chats that you have going on are down here, right? So if I wanted to… so say I wanted to,

**Jennie Eckstrom: **I decided that this was a good one. Let's see… out there…

**Florence Shum: **I think on the left side, I think, from the three dots on the left, like, on the chat, I think you can move it.

**Jennie Eckstrom: **I know, I'm just… but it's not the… These dots, let's see… Where are my dots here?

**Jennie Eckstrom: **Is it down at the bottom of it?

**Jennie Eckstrom: **These ones, let's see… branch…

**Florence Shum: **Brunch a new chat.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **So when it brands a new chat, it's like…

**Florence Shum: **So you see it in the left side, like, your chats?

**Florence Shum: **That's why sometimes I did that before, and I couldn't find… I don't know where it branched to.

**Jennie Eckstrom: **We're gonna see.

**Jennie Eckstrom: **I haven't actually done that.

**Florence Shum: **New project. Oh, nope, nope, nope, nope.

**Jennie Eckstrom: **I don't think this is a new project.

**Florence Shum: **I think I did that big one, I couldn't find it.

**Jennie Eckstrom: **Okay. Well, again, I think it's actually here. This is where I get to put it into my…

**Florence Shum: **Yeah.

**Florence Shum: **We Kuning neurologist.

**Jennie Eckstrom: **Because I don't think it goes to share, I think…

**Florence Shum: **That is the new chat, right, I think?

**Florence Shum: **I mean, the brand went into that, right?

**Jennie Eckstrom: **Yeah, I think it did.

**Jennie Eckstrom: **But yeah, because I have recruiting neurologist Physician, and this was the prompt, so this is the new one now, but…

**Jennie Eckstrom: **I don't know why…

**Jennie Eckstrom: **Yeah, it didn't… from what I created, but let me drop this into it. I'm gonna stop my share, but,

**Jennie Eckstrom: **There is a place, I don't know why I can't put it into the…

**Vineka: **There's another three dots there next to the thumbs up and thumbs down.

**Jennie Eckstrom: **Yeah, but that one doesn't, that one's just more actions, and that was…

**Florence Shum: **So, like, on the left side, the neurologist recruitment prompt, like, that one, like, if you… the three dots, I know you can…

**Jennie Eckstrom: **It didn't.

**Florence Shum: **Oh, hmm.

**Jennie Eckstrom: **Yeah, that one didn't go. So I'll have to find it. I… it's in here.

**Jennie Eckstrom: **Like…

**Florence Shum: **I'm clicking on the three dots in those chats, and I could move it to a project.

**Jennie Eckstrom: **Well, and that's what I feel like I can do as well, so I'm not sure what I'm not seeing right now. Sometimes it… it…

**Florence Shum: **it's…

**Jennie Eckstrom: **Okay, but let me drop this into, into an email for you, just so that you…

**Florence Shum: **Right. You know, you…

**Jennie Eckstrom: **You take it from there and decide, you know, what it is that you need, right?

**Vineka: **Would you… would you send it to me, too?

**Jennie Eckstrom: **Absolutely.

**Florence Shum: **Can you… last time, I think, on the WhatsApp, like, you mentioned that, yeah, certain Wii ports that really should be running.

**Florence Shum: **Like… Best, yeah.

**Jennie Eckstrom: **Did you… did you… have you guys gotten into Kajabi?

**Florence Shum: **Yes, I, went into Kajabi, let me just go…

**Jennie Eckstrom: **In Kajabi, under a replay, and I'm still trying to figure out the best way to… I'm actually thinking I'm just going to put all these documents into a resource library, because I think that's probably easier.

**Jennie Eckstrom: **So, but the revenue cycle dashboard, I think that was the one that we were chatting about.

**Jennie Eckstrom: **that was what sort of came out of our last office hours with you, Vinika, as we're sort of looking at,

**Jennie Eckstrom: **at where… what are our claims rates, and… and that was our lag time. So, that was the, are you able to see that in… so it would have been under… like I said, I think I'm going to have Jersey just create this into a…

**Jennie Eckstrom: **a resource library, because I think it'll be easier, but right now, it's under the March 19th, or March 9th

**Jennie Eckstrom: **office hour.

**Florence Shum: **Oh, okay.

**Jennie Eckstrom: **that, it's called the Revenue Cycle Dashboard. I think that's what you're referring to.

**Florence Shum: **Oh, okay. Let me try to log into my Kajabi, but…

**Jennie Eckstrom: **Here, let me just, let's see, can I e…

**Jennie Eckstrom: **Let me see if I can email it.

**Jennie Eckstrom: **To you without having it come out of…

**Jennie Eckstrom: **Here, let me… I'm gonna drop it into… WhatsApp and see…

**Jennie Eckstrom: **Let me just see what happens if I drop it in there, if that actually gets a document, or if you still need to get into…

**Jennie Eckstrom: **To Kajabi.

**Jennie Eckstrom: **Hmm…

**Jennie Eckstrom: **Does that… but you're not logged into Kajabi?

**Florence Shum: **No, I don't know, I saw it when I was on my iPad, and I'm on my laptop, and I'm not able to log in to Kajabi? It's one of those! When you say password, you know, it saves it, and then I don't know what.

**Jennie Eckstrom: **Oh, yeah, I just use… I use my keeper for everything. Florence, what's your email?

**Florence Shum: **So Dr. Shum… at, nyneuroCare.com.

**Jennie Eckstrom: **Huh, okay.

**Jennie Eckstrom: **I must, D-r-c-h-u-m at NY NeuroCare.

**Florence Shum: **S-H-U-M.

**Jennie Eckstrom: **SH, sorry.

**Florence Shum: **Yeah, NY NeuroCare.

**Vineka: **Okay, I am in Kajabi, so… where…

**Jennie Eckstrom: **It's, it's under, it's under last week's replay.

**Jennie Eckstrom: **Under the 9th, March 9th.

**Vineka: **Oh.

**Jennie Eckstrom: **Do you see it says revenue cycle?

**Vineka: **Oh, right under it, yes, yes.

**Jennie Eckstrom: **Okay, I just want…

**Vineka: **Oh, look at that!

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **So, it's a place to start, and in full disclosure, when I went back and looked at ours today, okay, just, Florence, make sure that this is the right one.

**Jennie Eckstrom: **S-C-H-U-M, just make sure I've got it.

**Florence Shum: **SAG on that.

**Jennie Eckstrom: **Oh, dang, let's see.

**Vineka: **And is there a C?

**Vineka: **I think it's no C, right?

**Jennie Eckstrom: **SH…

**Florence Shum: **Yeah, not… Okay.

**Florence Shum: **S-H-U-M.

**Jennie Eckstrom: **S-H-U-M, okay.

**Jennie Eckstrom: **I want to put a lot of letters in there.

**Florence Shum: **dot com.

**Jennie Eckstrom: **S… H.

**Jennie Eckstrom: **Oh, cause I… okay, it's alright.

**Jennie Eckstrom: **And you'd be like, I thought you were gonna send it to me!

**Florence Shum: **No.

**Jennie Eckstrom: **and WeineroCare.com.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Thank you.

**Jennie Eckstrom: **I don't know why you don't… I must not have emailed you from… oh, there you are!

**Jennie Eckstrom: **Interesting.

**Florence Shum: **mouth.

**Jennie Eckstrom: **I need it to, like, auto-populate.

**Florence Shum: **I don't know why, I'm having trouble with, like, the Google Calendar, because, like, Jersey said I'm subscribed, and I'm following, and I do it, but it's not…

**Florence Shum: **populating on my Google Calendar, it's not populating on my Apple Calendar.

**Florence Shum: **It's kind of annoying.

**Florence Shum: **So, I have to… I asked Roger about it, too. He's like, I don't know.

**Florence Shum: **These ideas! It's…

**Jennie Eckstrom: **The same recurring, it's the same… but that's crazy.

**Jennie Eckstrom: **So, do the… there are two separate ones. Do the, let me just see… Subscribe to calendar.

**Jennie Eckstrom: **Does it say when you click on it, does it, does it say that you're…

**Florence Shum: **Okay, I see one of them. Okay, the today, the Clinical Business Framework Office Hours, yes.

**Jennie Eckstrom: **And does that show up on yours?

**Florence Shum: **Yes, yes, I see it on my Google Calendar now. Oh my god. So this is, hold on…

**Florence Shum: **Next week, too, right? Wait…

**Jennie Eckstrom: **Yeah, we just kept them Mondays this month.

**Florence Shum: **Yes.

**Jennie Eckstrom: **Yeah.

**Florence Shum: **I will be in Paris next week, so…

**Jennie Eckstrom: **Wow, yay! Spring break! Well, and like I say, I mean, if folks aren't available, I don't, you know…

**Jennie Eckstrom: **I won't.

**Jennie Eckstrom: **But…

**Vineka: **Did you say Paris?

**Florence Shum: **Yes.

**Jennie Eckstrom: **Oh my gosh. Do you have, do you have the fork app?

**Florence Shum: **Which app?

**Jennie Eckstrom: **work.

**Vineka: **Like.

**Florence Shum: **Restaurant.

**Jennie Eckstrom: **app is, yeah, so it's basically like… it's like, OpenTable?

**Jennie Eckstrom: **It's called… I don't know if you can see. It's called The Fork, you can't see it. I'll have to… But…

**Jennie Eckstrom: **Here, you know what I'm gonna do? I know we're not in the.

**Florence Shum: **Oh, the restaurant book? The fork, the restaurant book? Is it green?

**Jennie Eckstrom: **Yes, but it's an app… And then,

**Jennie Eckstrom: **But the cool thing about it is if you find…

**Jennie Eckstrom: **Like, you basically can look for a restaurant right around where you're at, and what has availability.

**Jennie Eckstrom: **And for how many people?

**Florence Shum: **So…

**Jennie Eckstrom: **I don't… do you speak French?

**Florence Shum: **No. Okay, so…

**Jennie Eckstrom: **I don't either, and it was, like, overwhelming to, like… because I speak Spanish, so I feel like I should be able to walk in and have a conversation.

**Jennie Eckstrom: **But I don't speak French.

**Jennie Eckstrom: **You know? And other than pleasantries, right?

**Jennie Eckstrom: **By doing that, then I took away that, like, the angst of walking in, do you have a.

**Florence Shum: **B, do you have 6…

**Jennie Eckstrom: **space, we have these people, you know.

**Florence Shum: **For Paris only?

**Jennie Eckstrom: **Yes, I think so. They didn't… they had places elsewhere, but I don't think they had…

**Jennie Eckstrom: **Oh my gosh. Who's going? Is it your whole family?

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Okay.

**Florence Shum: **The five of us, yep.

**Jennie Eckstrom: **Le Boucherons was, like, my favorite.

**Jennie Eckstrom: **In the fourth?

**Jennie Eckstrom: **Do I sound like I know things? I don't really know.

**Florence Shum: **That sounds… Very good.

**Vineka: **Sounds very French.

**Florence Shum: **I know, right?

**Jennie Eckstrom: **And I'm just… And Catherine took us to this place that had…

**Jennie Eckstrom: **like, all-you-could-eat, chocolate mousse at the end, from this, like.

**Jennie Eckstrom: **ginormous cauldron. I'll… I might have to sit.

**Florence Shum: **Yeah, you have to send me stuff, yeah, we're…

**Florence Shum: **I haven't planned, like, my husband… Roger's like, didn't you plan it? I was like, no, I didn't plan it yet.

**Florence Shum: **Like, I planned Disney, that's one day, and I booked Notre Dame for, like, a tour guide.

**Jennie Eckstrom: **Oh.

**Jennie Eckstrom: **We just walked through in the evening at sunset.

**Florence Shum: **Yeah, I wanted a tour guide for my kids.

**Jennie Eckstrom: **Oh, yeah.

**Florence Shum: **Yeah, and it's only, like, 90 minutes, not too long.

**Florence Shum: **So… So, it was okay, that's the only thing.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Okay. Well, I'm gonna send you this recruitment prompt, and again…

**Jennie Eckstrom: **I… I currently have found chat to be super effective for me, so I don't know that,

**Jennie Eckstrom: **I don't know, I sort of am of the opinion that

**Jennie Eckstrom: **The best AI tool is the one that I understand and can use.

**Florence Shum: **Yes, yeah, I agree.

**Jennie Eckstrom: **things.

**Florence Shum: **it that much in chat… like, Roger uses ChatGPT every day.

**Jennie Eckstrom: **Well, like I said, I would… I do think that if you can start to create a custom GPT of your company, right? Put in your business plan. If you've got, sort of, your… your statement of values that you've done.

**Jennie Eckstrom: **if you talk about, like, even if you sort of free-formed with chat and saying, you know, I really want to create just a position statement about what's important to me, what's important in this practice.

**Jennie Eckstrom: **And as I expand the values that I want to see happen, like, if you can start to have that conversation and distill that into a document, and that becomes part of the heart and the brain along with your business plan.

**Jennie Eckstrom: **In that custom GPT, then you can do things like this, right? Or you… you put the things like, now I've evaluated, this is how I want to do a bonus structure, how does this, you know, how does this relate to what my values are? So then.

**Jennie Eckstrom: **you know, working from that, that custom GPT, it already knows, it's already, you know, 7 steps down the road of knowing where you're starting from versus having to start each time from scratch.

**Florence Shum: **Yeah, okay.

**Jennie Eckstrom: **Yeah, so…

**Jennie Eckstrom: **So those may be some of the things that you start, you know, to work on so that.

**Florence Shum: **Yeah, I have a long clean ride, so, this will keep me busy.

**Jennie Eckstrom: **Although the bummer is that chat… well, I guess if you have Wi-Fi…

**Florence Shum: **Sorry about the Wi-Fi, because sometimes it's like…

**Florence Shum: **hit or miss, you know? Sometimes I get your Wi-Fi, sometimes I don't.

**Jennie Eckstrom: **So this is the other thing I do. I do a ton of, like, write… you might even just, like, free-form writing.

**Florence Shum: **No.

**Jennie Eckstrom: **And then afterwards, you take a picture of it, and you say, okay, this is what I've been thinking about, about my business. So you might… what you might do before you go is ask chat to give you a series of questions

**Jennie Eckstrom: **about your company to better understand as you move into recruitment, and just spend time… I don't know if you're a journaler or a writer, but that's what I do a ton. And then… or I do my journaling, and I ask chat to help me distill

**Jennie Eckstrom: **my writing. Like, half of my reflections that I share are born from about 5 pages of journaling that then I say, okay, help me… help me distill this into something I can carry with me.

**Florence Shum: **Hmm.

**Jennie Eckstrom: **So…

**Vineka: **Wow.

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Yeah, so… But that's how you could use that long plane ride to still get to the same end.

**Florence Shum: **Very good!

**Jennie Eckstrom: **Yep!

**Jennie Eckstrom: **Alright, you guys. Vanika, how'd your week go?

**Vineka: **I went to the business conference, like Dr. Una, and it was really, really good.

**Jennie Eckstrom: **Oh, good!

**Florence Shum: **Like, a live? Live conference?

**Vineka: **Live, yes. Did she do…

**Jennie Eckstrom: **Was it her one-day conference, or…

**Vineka: **your tumble?

**Jennie Eckstrom: **days? Okay.

**Vineka: **Just 2 days,

**Vineka: **And, before joining, I thought I was just gonna touch base with that audit biller for 15 minutes.

**Jennie Eckstrom: **Huh.

**Vineka: **But it ended up being 1 hour and 20 minutes, but now I know how to check,

**Vineka: **my procedure code, revenue per procedure code, and next she's going to find out how I can check the revenue… the procedure code per insurance, try to do that report.

**Vineka: **And then, I'm glad that I met, because the… we were talking about…

**Vineka: **the goals we were establishing was different, so there was a little bit of miscommunication when she met with the other biller, so it's good that we met today to clarify what I really want from it.

**Vineka: **which is kind of, like, from point A, from the time I see the patient to the time the, the bill, like, the insurance pays.

**Vineka: **I need to see all these steps there. Was this a way to do that, so they didn't have that.

**Vineka: **figured out. So now, next step will be to meet with the biller to explain that.

**Vineka: **And then… because, what she ended up explaining was how to go to Charm directly, as opposed to using the two systems, but that's gonna be, like, a gradual thing that we do, because at whatever we do, we have to finish the old system first.

**Jennie Eckstrom: **Right.

**Vineka: **And then also, in the middle of valuation, I… I need to ask a better question to ChatGPT or Cloud, but it said to avoid changing things right now in the middle of the valuation.

**Jennie Eckstrom: **Right. Right.

**Vineka: **just do what you're… what we're doing, but just optimize what we're doing. Right. So, I don't want to kind of start that. Plus, it will blur the lines, where it's… like, the biller already said, like, oh, for the whole period there, we only had 6,

**Vineka: **6 denials, and I'm like.

**Vineka: **I can tell you for one month, like, that specific… so I pulled up, like, what my VA created for just the one month, and there's a lot of… I'm like, I'm not counting, but there's a… that's more reds than we want, right? Right. Yeah, that's a lot of reds. That's just not just six denials for the year. That's, like…

**Vineka: **just one month and just offices, it's not even… it's Provado, not TMS, so…

**Vineka: **I think I needed to be in that. I just wanted them to, you know, like.

**Vineka: **do what you have to do, I… but I'm going to meet with the builder, too, along with her, so we get… like, that's… that's a frog, that's not pleasant, but it needs to happen.

**Jennie Eckstrom: **Right.

**Vineka: **And it's on my frog, so…

**Jennie Eckstrom: **Eat your frog. Eat your frog.

**Vineka: **Yeah.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **No, I think that that's great, because the more that you dig into this, the more then that you understand about the process, and what the steps in that process are, and where the potential for pitfalls are. But when you look at that whole list of reds.

**Jennie Eckstrom: **You should be able to say, you know, okay, are these because we didn't collect things up front, and that we need to be talking to the front office?

**Jennie Eckstrom: **Is it because something with how the claim was submitted was off, and is that…

**Jennie Eckstrom: **you know, based upon coding or, based upon the wrong insurance, you know, those sorts of things. Once you can figure out where those common pain points are, then you can develop tools around those specific pain points.

**Vineka: **Right, yeah.

**Jennie Eckstrom: **Yeah.

**Jennie Eckstrom: **Great.

**Vineka: **Yes. They're not gonna like that conversation, but… the audit biller is very nice, very… and I'm like, I need these numbers!

**Florence Shum: **So the, the audit, like, this is the audit biller that, like, show you basically what… like, show you how to run these reports on your EMR.

**Vineka: **No, she's trying to figure it out herself, like, what is… just looking at the EMR, how can we pull up the thing? And I'm like, okay, this will show us, like, what was paid and what was not. Will it show us? Because I know the patients, like.

**Vineka: **when the patient is calling to see, you know, like, what… or where check-in or my staff is bringing up to me, I know that some invoices have not even been created.

**Vineka: **that report is not going to show me that. I need it from beginning to end. If you can give me a report that shows me this, like, with a simple click, this is what we have.

**Vineka: **I don't care, that's great. But if you can't, then until you figure it out, let's emphasize, like, they're doing a Google Sheet already, let's optimize that.

**Vineka: **Or not. And me, without knowing anything, and what's the component of an AR report, what we created, just a few things, just like, I just asked my VA, you know, like.

**Vineka: **just put on this date was an… when was the invoice created? When was… was it paid or not? Was it not paid? Was it… was an invoice there? How much was paid? Partially paid? Okay, was there a copay? And now, Jenny, I think I'm gonna add the column of, was the right copay collected?

**Vineka: **And circle back to the front desk. But that's just off top of my head, which is not a biller head at all.

**Vineka: **If we're able to create that, why can't the biller create it on her… that's her job.

**Jennie Eckstrom: **Well, it's incentives, right? I mean, so right now, her incentive is not aligned with capturing every single claim.

**Vineka: **Exactly.

**Jennie Eckstrom: **Her incentive right now is a line to collect enough dollars that she feels is good.

**Vineka: **Yes, exactly.

**Jennie Eckstrom: **So that's… that's the alignment conversation that you have to have.

**Jennie Eckstrom: **Of, you know, of how… and perhaps there, you know, you ultimately get into some sort of incentive that says, if we can get to that 95 plus or the 97 plus of

**Jennie Eckstrom: **clean claims and collections, then we share some of that, but right now, we're not there, right? So, we know that we're leaving these on the table, and we gotta… we gotta figure out how to pick it up.

**Vineka: **Yes.

**Jennie Eckstrom: **So… Yeah, so it's just… and, you know, that's not limited, obviously, just to medical billing, right?

**Jennie Eckstrom: **I mean, I would say that we had this very similar issue with a rental manager for the longest time, because she was getting enough commission, so she didn't care where those came from, or what the downstream owner got. She just was looking for Knights Build, and knew that whatever

**Jennie Eckstrom: **the number was, she still got her number. So you've got to figure out a way to get you guys into alignment so you're both pulling the same rope.

**Vineka: **Right, exactly.

**Jennie Eckstrom: **So…

**Jennie Eckstrom: **But the exciting thing, I'm just gonna flip this around and be a little Pollyanna, the exciting thing is you're asking these questions. The exciting thing is that your business is likely… has the potential to be a whole lot more profitable than it is already without changing a single thing.

**Jennie Eckstrom: **But actually just collecting for the… for the care that you've provided.

**Vineka: **Yes.

**Jennie Eckstrom: **So, I think those are exciting.

**Vineka: **Yes, for sure.

**Jennie Eckstrom: **So…

**Florence Shum: **It's just…

**Vineka: **We can… we can all go to… to Paris.

**Jennie Eckstrom: **Oh my gosh.

**Jennie Eckstrom: **I want to go back to Paris.

**Florence Shum: **Mmm…

**Jennie Eckstrom: **Such good food.

**Florence Shum: **Oh, I know.

**Vineka: **I speak French, and sometimes we would go to the restaurant, and then they still… like, as soon as there's a

**Vineka: **a f… I don't… maybe it's…

**Vineka: **The… the… some places are, like, they don't want…

**Vineka: **foreigners or, like, Americans at some point, and it was like, nope, we don't have any… we're not seating anymore, we're not… and I'm like.

**Florence Shum: **Hmm.

**Vineka: **Okay, well, we'll find another place. So, it's good to have an app to spare you that, whether you speak French or not.

**Jennie Eckstrom: **Well, that's the.

**Vineka: **Because that is with speaking French, right? They're supposed to be nicer to people that speak French.

**Vineka: **And it… was not.

**Jennie Eckstrom: **Yeah, well, that's why I did that, because I just… it was too overwhelming for me, and that's where my, like…

**Jennie Eckstrom: **My social anxiety avoidance comes up.

**Florence Shum: **It's good to know if they have availability, too.

**Jennie Eckstrom: **Right.

**Florence Shum: **I'm gonna be like, hey, it says that you have.

**Vineka: **Yeah, exactly.

**Jennie Eckstrom: **You just make a reservation, and then oftentimes there's a discount if you make the reservation, because you go through the app.

**Jennie Eckstrom: **Like, and you could see which ones had the discount. So we would get, like, 20 or 30% off our meals at times.

**Vineka: **Wow.

**Jennie Eckstrom: **So, yeah, it was… I… I… yeah, I thought it was fantastic.

**Florence Shum: **Oh, jeez.

**Vineka: **There was one place that said… that had, like, a black… mini blackboard, and said, like, we are full, don't bother coming in, you're gonna waste our time, you're gonna waste your time, we are full, don't come in.

**Vineka: **I'm like, wow, way… like, that's some hospitality there.

**Jennie Eckstrom: **Wow.

**Jennie Eckstrom: **Now.

**Vineka: **But, yeah, I mean, they were full. There's one way to say it, and…

**Jennie Eckstrom: **Right.

**Vineka: **That definitely makes the point.

**Jennie Eckstrom: **Oh, it's gonna be a blast. You guys will have an amazing time. I'm so excited for you.

**Florence Shum: **So, yeah, I'm meeting my nephew. He is, studying abroad in London, so he's gonna take…

**Vineka: **Wow.

**Florence Shum: **There'll be 6 of us.

**Jennie Eckstrom: **Good.

**Vineka: **It's gonna be so wonderful.

**Florence Shum: **Yeah.

**Florence Shum: **So, I'll let you guys know!

**Jennie Eckstrom: **Yeah.

**Vineka: **pictures!

**Jennie Eckstrom: **Yes.

**Florence Shum: **Well, so I'm… I booked a photoshoot.

**Florence Shum: **It goes.

**Florence Shum: **First time, we're gonna do something like that for our family, but, you know…

**Jennie Eckstrom: **Yeah, well, I know that, like, Christy swore by it.

**Jennie Eckstrom: **I could just imagine my… Sort of looking at me like, what are you talking about, Mom?

**Florence Shum: **When I said that I booked something, all my kids were like, what?

**Jennie Eckstrom: **Okay, you need to go to this place called Chez Janu?

**Jennie Eckstrom: **That's the place with the, the giant cauldron of…

**Jennie Eckstrom: **You have to make reservations, but it was, like, the giant cauldron of chocolate mousse.

**Vineka: **How do you spell Janu?

**Jennie Eckstrom: **J-A-N-A-U?

**Vineka: **Okay.

**Jennie Eckstrom: **Chez Janu, is that how you'd say it?

**Vineka: **Jeanous?

**Jennie Eckstrom: **Jean-Noux?

**Vineka: **Jean Lou.

**Jennie Eckstrom: **Je ne pour les pour francais.

**Florence Shum: **Wow, look at you guys!

**Jennie Eckstrom: **No, I just said I don't speak French.

**Jennie Eckstrom: **Although my kids don't like how I say that.

**Vineka: **It sounded very sexy, Jenny.

**Florence Shum: **Yeah, French is a very sexy language.

**Jennie Eckstrom: **I don't know, there's, like, a ton of…

**Jennie Eckstrom: **Too many words. There's too many words. There's too many, like, little tiny baby words.

**Jennie Eckstrom: **Okay.

**Vineka: **Too many words in general, even from the same talk, if you translate it directly, it's like, why are you blabbering? Like, just keep it simple, can you?

**Jennie Eckstrom: **Giant cauldron of… Chocolate mousse.

**Jennie Eckstrom: **I'm sending it to you, in WhatsApp.

**Jennie Eckstrom: **Alright.

**Florence Shum: **Thanks. Jenny, so I'm looking at the, the revenue cycle dashboard.

**Jennie Eckstrom: **Yep.

**Florence Shum: **So basically, so I should have…

**Florence Shum: **like, I should be able to run these, let me see, these metrics.

**Jennie Eckstrom: **These should be metrics that you should…

**Jennie Eckstrom: **Follow. So you should be able to… on…

**Florence Shum: **The ADR is easy.

**Florence Shum: **Let's see, do not know.

**Jennie Eckstrom: **So you should be following, like, your clean claim rate, and then your denial rate.

**Jennie Eckstrom: **And then how many TAs it takes from when you see the patient to getting that claim out. That's your charge lag.

**Florence Shum: **Yeah, so…

**Jennie Eckstrom: **Which, I'll tell you that our clinic is, like, 30 days, so, you know, and Vinique and I were chatting about hers last week, but…

**Jennie Eckstrom: **But those are really great places to start to just follow your claims, right?

**Florence Shum: **Yeah, so my EMR has something easy for this part, at least. Like, I know, like, the charge lag.

**Jennie Eckstrom: **Okay.

**Florence Shum: **Denial, I don't know up front, but I remember I saw, like,

**Florence Shum: **the percentage of collection, I think they said we're, like, 94%, something like that?

**Florence Shum: **And then they claimed that it will never be 99%. I was like, what? Why not?

**Jennie Eckstrom: **Because you use your third-party billing company.

**Florence Shum: **No, this one is just from the EMR itself.

**Jennie Eckstrom: **Oh, okay.

**Florence Shum: **The unit itself, yeah. Okay. Not from the… I didn't even use… I didn't…

**Florence Shum: **maybe I could ask them to run some reports for me, but, like…

**Florence Shum: **But at least for…

**Florence Shum: **like, the claim denial rate? No, I don't know how to run that. I have to figure out how to run that report, and then… but the charge lag, I know, like, it takes about…

**Florence Shum: **For some insurances, like, around 30 days, but most of them…

**Jennie Eckstrom: **So that's your AR day, so that's not your charge lag, right? Your charge lag is, when is my note completed, and when does that…

**Jennie Eckstrom: **claim drop, right? So then your AR days, like, what are… what are your average AR days, and following that for the clinic as a whole, but then also per insurer. So as much as you can keep in that 0 to 30 day bucket.

**Jennie Eckstrom: **is gonna be the best, right? And then you'll have some overflow into that 60-day.

**Florence Shum: **Because my problem is… my issue is the Medicaid. I have to talk to my manager about it again, because,

**Florence Shum: **my Medicaid, it's, like, that bucket is, like, over $100,000, right? But then she said that it actually is a lot less than that, but because the EMR is not posting correctly, so we have gotten payments, but it's just not reflecting on it.

**Jennie Eckstrom: **Okay. So is that… is that clearinghouse not synced? Because this is the thing, you know, Vinika's is a manual process, but do you have a way for the clearinghouse where those payments come in to be synced?

**Florence Shum: **is not able to do that for Medicaid, which is very annoying, and then…

**Florence Shum: **So, my manager is saying that we… we use a VA company,

**Florence Shum: **so they help with scrubbing the claims, and I'm not sure how much they're doing in terms of, like, posting those to update it.

**Florence Shum: **Like, I wonder, like, just concentrate on that, can you just, like, update it? Like, I'm thinking in my head, like, just… like, I mean, it can't take more than a week if you just do that for 40 hours, no?

**Jennie Eckstrom: **Well, the other piece is, how is it working on other insurances? So, what is the process that is working, and how do you apply that process to Medicaid?

**Florence Shum: **Yeah, I have to look into that, because, the Medicaid is the big holdup, and, I think the issue is also because it's not syncing, that we have to request for the remittance from Medicaid, like, on paper.

**Florence Shum: **Okay. Electronically, we have to request for that, so that you can… we can then match it.

**Florence Shum: **For the clean.

**Florence Shum: **So it's, like, a long process, like, it's… Yeah, it's really… it's really… Frustrating, so I…

**Vineka: **Every time we call Medicare, they tell us to go online.

**Florence Shum: **Yeah, the Medicaid… it's the Medicaid.

**Vineka: **Medicaid, okay.

**Florence Shum: **No.

**Florence Shum: **Yeah, some Medicaid portion that somehow is not syncing. I mean, it's like $20 here, $20 there, but it all adds up.

**Jennie Eckstrom: **Right.

**Vineka: **No.

**Jennie Eckstrom: **Great.

**Jennie Eckstrom: **So…

**Florence Shum: **number doesn't… so my AR, it's not my true AR, and I don't really know what that real number is, that's the problem. I can never get it…

**Florence Shum: **To an actual number.

**Jennie Eckstrom: **So is that an EMR problem, or is it a Medicaid…

**Florence Shum: **I think it's both.

**Jennie Eckstrom: **reporting.

**Florence Shum: **So, usually, Athena… So, on the back end, so when the EOB comes in, it actually goes to Athena.

**Florence Shum: **But they do the posting, so they're my back office, so they do the posting.

**Jennie Eckstrom: **Okay.

**Florence Shum: **If it's slow with the posting, then it doesn't always reflect that. Like, we have gotten the money, but we haven't… we can't see, like, the AOB yet, necessarily, because the money is auto-deposited, right? So that's why it's not…

**Florence Shum: **So, for Medicaid, especially, then, we don't really know if that money is really pending or not.

**Jennie Eckstrom: **Yeah, so definitely trying to… so I would… I would probably start with Athena, and I would say, all of the other insurances are working, why is this not? And…

**Florence Shum: **Yeah, I think she tried to escalate that. I have to check with my… my manager. She's tried to escalate it, and it's kind of, like, gone nowhere.

**Jennie Eckstrom: **Okay.

**Florence Shum: **They do something that they can't solve, or they just don't care.

**Jennie Eckstrom: **Well, but you are… they… you're… you have a contract with them, correct?

**Florence Shum: **Yeah, yeah, so I'm going to, like, escalate that to my CSM person, because it's… it's not right.

**Jennie Eckstrom: **You don't want to create a manual workaround for a process that they should be handling.

**Florence Shum: **clean.

**Jennie Eckstrom: **So…

**Florence Shum: **Yeah.

**Jennie Eckstrom: **Kai.

**Jennie Eckstrom: **Well, good, so we'll see you then in a couple of weeks, because you're gone next week.

**Florence Shum: **Okay.

**Jennie Eckstrom: **Okay.

**Jennie Eckstrom: **And I'll drop… so, Vinique, I'll drop the… the link next week, and we'll just sort of touch base the day before, but I'm happy to continue to meet. So, if you want to continue to work, things.

**Florence Shum: **Sounds good! Thank you!

**Vineka: **When do you come back, Blonde?

**Florence Shum: **Oh, I'm just going, like, so we're leaving Thursday night, and then we come back on Wednesday, so it's, like, less than a week.

**Jennie Eckstrom: **Hmm…

**Florence Shum: **Yeah, not too long.

**Vineka: **It's gonna go by soon.

**Jennie Eckstrom: **Oh, man.

**Florence Shum: **I know, it's gonna be really fast.

**Jennie Eckstrom: **Yeah. So good, though.

**Jennie Eckstrom: **So good, I want to go back so badly.

**Florence Shum: **Yeah, so the good thing is, like, it's, like, a wet-eye flight there, so…

**Florence Shum: **It's like, we don't really lose as much time traveling.

**Florence Shum: **So…

**Jennie Eckstrom: **Good. Alright, you guys, have a great night, okay?

**Florence Shum: **Good night.

**Vineka: **You as well, thank you so much.

**Jennie Eckstrom: **You're welcome, take care.

**Florence Shum: **Bye!

Office Hour March 16, 2026: Scaling Your Practice: Hiring, Expansion, and Smart Growth Decisions

Clinical Business Framework Office Hour March 16, 2026

Staten Island Office Expansion Plans

Second Medical Office Expansion Plans

Medical Professional Salary Expectations Discussion

Neurologist Demand and AI Tools

Healthcare Provider Credentialing Processes

AI Tools Discussion and Strategies

ChatGPT Strategic Planning Experiences

ChatGPT Project Organization Strategies

Neurologist Recruitment Template Discussion

Revenue Cycle Dashboard Access Issues

Business Planning and Travel Updates

Process Optimization and Claim Collection

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