How I lost sight of my own health care while creating a women’s health care company [PODCAST]

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“My world tumbled upside down. I was managing taking care of three children from home, helping them navigate the realities of our new world while trying to keep my staff employed and safe. I sadly said goodbye to many team members as they made the difficult choice to stay home. We had to figure out how to deliver health care in this new world, where PPE was not widely available, and so many questions lingered about the virus.

I had to put the needs of patients, staff, and my children before my own. That’s what we all do as mothers and as physicians. I underestimated how long the sacrifices would last. I watched my schedule increase from three days of patient care to five, along with running the business and managing employees, recording podcasts, and holding educational events. We run a health care business to educate, advocate for, and empower our patients. Yet, in the midst of all this, here I was at the helm, the unhealthiest I had ever been. I had abdominal pain, insomnia, anxiety. I had walked away from working out and was not careful about the food I was choosing to put into my body.”

Somi Javaid is an obstetrician-gynecologist and founder and CEO, HERmd.

She shares her story and discusses her KevinMD article, “How I lost sight of my own health care while creating a women’s health care company.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Here on the show, we have Somi Javaid. She’s an obstetrician-gynecologist, and she’s the founder and CEO of HerMD. She wrote the KevinMD article “How I lost sight of my own health care while creating a women’s health care company.” Somi, welcome to the show.

Somi Javaid: Hi. Thank you for having me.

Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?

Somi Javaid: Absolutely. I’m an OB/GYN, like you mentioned. I went into women’s health care because I nearly lost my mother at the age of 45 to cardiovascular disease, and I decided there and then that I was not going to be a barrier to women’s health care. I went to medical school and went on to residency, and then I had a very traditional job, but found I couldn’t be an advocate because I was seeing patients every 15 minutes. I decided right before my 40th birthday to buy a building and open a practice that was very patient-centric. I called it HerMD, and we just opened our second location and are planning our third already. So that’s my story. We specialize in menopause and sexual health care. We specialize in longer appointment times and making patients feel very, very comfortable in our space.

Kevin Pho: So tell me about that transition from a traditional OB/GYN job to something that you own. It almost sounds like a personalized private practice clinic, and certainly there are a lot of business aspects that go into that. So tell me about that transition into what you’re doing now at HerMD.

Somi Javaid: Yeah, it was absolutely crazy. It was awe-inspiring. I used parts of my brain I did not know that I had, and I had to develop skill sets that we traditionally don’t have as physicians. So I took a lot of courses. I surrounded myself, reached out to my network of people who were not only physicians who own their own practices, but business owners, accountants, and learned everything that I could in a very short amount of time. And then, as physicians, we’re used to on-the-job training as well. I was lucky that I had a very large patient following anyway, who did follow me as I opened my own practice, but I took a lot of courses and learned on the job, and I have grown the practice to nearly 8,500 patients in six years.

And I know a lot of physicians who want to open their own practice, and I encourage them to do so. But you’re right. And then, as I grew, I could no longer handle all portions of the practice, so I have hired people and brought them on to handle different portions of the practice, because I’m still very involved in patient care.

Kevin Pho: So as you said before, a lot of physicians, we don’t have the business training in medical school and undergraduate studies. So tell me, what were the biggest challenges that you face in making that transition to opening your own practice?

Somi Javaid: Yeah, so I don’t have an MBA, but I had a natural business sense, I think. And so there were a lot of things I didn’t know, even how to structure the practice, how to structure the corporation, and accounting, and getting accredited with medical billing, because we are an insurance-based practice. I had always been a hospital employee, a private practice employee; that was always done for me by the credentialing department. So learning how to do that, learning how to set myself up in an appropriate tax way, learning how to finance equipment and open certain business accounts, it was a continual learning process.

But what I was so surprised about: Physicians, we all are so used to working together as a team, because we care about patient outcomes, and business owners were so welcoming and so warm and so willing to help. And so that was my learning experience. And I’m still continually learning, six years into owning my own practice.

Kevin Pho: Now that you’ve had experience in both worlds, both as an employee and owning your own practice, if you were to start all over again, which would you jump into first?

Somi Javaid: A hundred percent owning my own practice. I have realized that I am meant to be a business owner and meant to be an individual. I really enjoy the autonomy. I enjoy being able to preserve that patient-physician relationship, and I do not appreciate being told what to do to make a hospital system or private practice more money. I don’t want anything interfering with my relationship with patients, because that’s why I truly went into medicine, and most of us do, for the love of the art of medicine.

So for me, I think that physicians, we’re smart people. I think we can learn the skills. Some of us may choose to get an MBA. But private practice, definitely. Especially the way insurance systems are pushing us, with lower reimbursements and having to see more and more patients, and with EHR, having to see a patient, make an assessment, do the physical exam, document, and place orders in a 15- to 20-minute window, I think, has put crushing expectations on a lot of physicians. And when we graduate, we’re so idealistic, and we want to make such a difference. I think private practice is the way to go, as long as you go in with open eyes and you’ve educated yourself about what it entails.

Kevin Pho: All right, so let’s transition now into the KevinMD article that you wrote. It’s titled “How I lost sight of my own health care while creating a women’s health care company.” Now, for those who didn’t read the article, can you just walk my audience through it and share the story of why you decided to write it?

Somi Javaid: Yes. I wrote this article on a particularly frustrating day. Everyone has their own stories from the pandemic, and as a physician and a mother and a business owner, I found myself in the midst of what I would call a storm. I was just trying to put out fires and dealing with COVID, trying to keep my patients safe with new regulations, trying to keep the business afloat, trying to keep my 18 employees safe at the time, right? This was before we had vaccines. And then all of a sudden, I had three children who were at school full time, which really allowed me to open my own practice, but they were home, and they were fearful as well. And I’m married to a physician who is an oncologist, so he was actually in the COVID unit.

So I’m trying to put out all these fires, and, as I wrote in the article, I’m very healthy. I’m a yogi. I love to be outside. I love to have that balance. And all of that went by the wayside, and I found myself eating in ways I traditionally don’t eat, not thinking about what I was doing. Exercise? Not in months. I wasn’t sleeping. I had severe abdominal pain. I actually developed a hiatal hernia, gained a lot of weight in a short amount of time, and just was not making wise choices. So here I was with this really large practice, advocating for women to take care of themselves, and I completely lost myself in that year.

Kevin Pho: So you talked about the competing priorities that you had, both with your job running a business and at home. What were some of the things that you did to help manage everything, or what are some of the lessons that you’ve learned after going through that?

Somi Javaid: So I definitely brought on some more help during COVID. Despite the fact that we did suffer some business losses, I was able to get some help to secure some loans, because as I was seeing patients, I didn’t have time to fill out all those applications. So definitely bringing people on to help me through it. I brought on help at home with the children. Even though they were older, they needed help with homework, they needed help staying focused on their Zoom classes. And so asking for help, definitely, that was the number one lesson that I learned.

And number two, as physicians, as mothers, if we don’t take care of ourselves, we cannot take care of others. And I definitely prioritized my children and my patients first. I don’t regret that; I just wish I would have also prioritized myself. But I’m recovering. I did get a health coach. I was able to do that; I realized not everyone can do that. But my sister was one of the people I reached out to, and I said, “I’m overwhelmed. Mayday.” And she introduced me to this executive coach, who really helped me start to get my life back on track.

Kevin Pho: What are some of the techniques that that executive coach did to help manage and prioritize things?

Somi Javaid: The first thing that she did was, she told me, “Take your Google Calendar, and just like you have patient appointments, just like you schedule everything for your children, start scheduling time for what is important to you, whether it’s getting back and hiking outside, whether it’s yoga, whether it’s cooking a meal with your husband. Do not be embarrassed to take your own time back for your own mental health.” And so that was the first thing that she did. The second thing was encourage exercise. And the third thing that she did was really help me prioritize allowing other people to help me and take over projects that I was working on at the company, and take them over permanently, not just because of the pandemic, but really being able to trust my team and let them take ownership over tasks that I didn’t need to be managing anymore.

Kevin Pho: We’re talking to Somi Javaid. She is an obstetrician-gynecologist and founder and CEO of HerMD. She wrote the KevinMD article “How I lost sight of my own health care while creating a women’s health care company.” Now, one of the things that I’m hearing is that you have had a lot of mentors, guides, and resources to help you along the way in managing everything. So for those physicians who also have a private practice and a very busy family life, what are some of the resources that you could share, online, in terms of where physicians can look for help?

Somi Javaid: Yeah, so definitely. In Cincinnati, for example, there’s a group of physicians that have come together; it’s an independent practice group. And so obviously during the pandemic we couldn’t get together, but once a month we try to get together at a restaurant or over Zoom. We share just stresses and joys and discounts on buying equipment together. So definitely look in your local communities. You can get online and create chat groups and reach out to each other.

There’s also, on Facebook, I’m sure you’ve heard of it, it was just on the “Today” show, a physician mom group, 76,000 women strong. We get on there with everything from child care problems to tough cases at work. So I definitely say, especially in this day and age, where people are still not maybe getting outside, use those Facebook groups or those social groups or your local groups to stay in touch with physicians and people that you know who are in the same boat as you.

I learned that I’m not alone. I learned to reach out and ask for help. And I think as physicians, we’re not used to that, because we’re usually the healers; we’re usually the ones offering help. And so this was a very, very humbling process for someone like me, who’s not used to asking for help.

Kevin Pho: The numbers of private practices over the years are slowly dwindling, and you really talk about some of the pros that private practice brings you. Now, not every physician, of course, is cut out for private practice. So what are the characteristics of physicians that will make them more suitable for private practice life?

Somi Javaid: I’d say the number one thing is you have to be passionate. You have to love what you’re doing. Number two, you cannot be risk-averse. There may be months where you have an unexpected bill, something breaks, the insurance payments don’t come in in 30 days; they take 45. So you have to be able to tolerate not paying yourself on a regular basis, every two weeks or every month. You have to be confident. You have to be willing to let other people help you and build a very strong network around yourself. So that’s definitely what I look for when I bring people even into my private practice: that they’re willing to do that and don’t need to be in a structured setting, and independent thinkers, physicians who are willing to think outside the box, for sure.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Somi Javaid: Twofold. If you want to open your own practice, do it. You will succeed. Physicians will find a way. And never, ever forget to take care of yourself.

Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.

Somi Javaid: Thank you.

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