Forewarning…

This is not just a short article for hormone and weight loss clinics (although it will directly apply to you).  This is an in-depth resource that shares the exact steps we have taken to grow profitability —with ZERO debt — three multi-million dollar businesses that operate without me (the owner). 

Throughout this article, there will be several links to outside resources to aid you in getting out of working in your business and growing your company profitably well beyond the 10+ million dollar mark.  

All of the stories in this article are accounted for to the best of my knowledge. To help make these stories more applicable to you I may have a couple of events in a slightly different order.

Please feel free to jump around to find what suits your company best!

If you are interested in learning more about Duzer Group and how we can help you scale your business profitably using digital marketing, please schedule a free no-cost consultation by following this link. 

Introduction

Hello everyone! My name is Todd VanDuzer and I am the CEO & co-founder of three multi-million dollar businesses: Elite Vein Clinic, a vein clinic; Natural Med Doc, a naturopathic and functional medicine practice; and founder of Duzer Group, a digital marketing agency. 

You might have read my previous case study on “How Elite Vein Clinic Generated 1.27 Million Dollars in Their First Year of Business” that I published in February 2021. 

Fun fact: Elite Vein Clinic made just over 2 million dollars in revenue in 2022. We expect to double again this year. 

For this case study I will be doing a deep dive into the business started by my wife, Dr. Sarah Bennett, and myself a couple of years ago: Natural Med Doc. 

I will share the exact steps we took to:

1. Generate over 300+ new patients interested in naturopathic and functional medicine, hormones, and weight loss space with only 1 location. 
2. Leave on a 3-month honeymoon last summer while all 3 companies had record months & quarters…

…and how you can do the exact same. 

Natural Med Doc is a naturopathic and functional medicine clinic.

We help patients increase their energy, lose weight, resolve their anxiety, and live their best life.

We have transformed hundreds of lives and through the help of:

• Duzer Group (my digital marketing agency)
• The customized step-by-step protocols my wife has created for our providers
• The help of our incredible team of health advisors, providers, MAs, scribes, receptionists, and others.

We have created a replicable system that:

1) Helps patients become problem aware of their health concerns (digital marketing)

2) Motivates them to eliminate them (sales)

3) A data-driven protocol that dives into the root cause and resolves them! (data-driven medical protocols)

I have been hesitant to share our success for this company and start providing “done for you marketing services” for this space for one primary reason: 

“Of other medical clinics taking our strategies and running with them in areas we may one day want to operate.“

However, after additional reflection, speaking with mentors, and analyzing our goals and motives in life, we have come to the conclusion we can’t do this alone. 

We need other medical clinics to join in this movement to help patients become aware of our broken healthcare system and to take action to live their best lives! 

Patients are tired of our current healthcare system. They are crying for help! 

Functional medicine works holistically, considering the full picture of your physical, mental, emotional, and sometimes even spiritual health.

They consider factors like diet, genetics, hormonal changes, prescription, over-the-counter medications, and other lifestyle components.

Patients want to dive into the root cause of their health concerns. They want to live longer and feel “younger” for longer. 

And, fortunately, we live in a time where this is possible! 

In fact, my 71-year-old father and 66-year-old mother, who are both part of our program, were mountaineering up Mount Rainier in Washington last summer!

They say they feel better than when they were in their fifties. 

How? 

Lifestyle changes & anti-aging therapies like hormone replacement and peptides. 

And the best part?

This area of medicine is profitable and pays in cash, so no more dealing with insurance. 

So how do you generate more profit and free up YOUR time, all while helping more people live a better life? 

5 Steps to Scale Your Business 

Our goal for Natural Med Doc was straightforward: help patients live their best lives by using my wife’s skillset as a naturopathic doctor and my skillset as  a digital marketer.

However, my wife Sarah (girlfriend at the time) had spent her entire twenties in school studying her craft and had the desire to travel the world. 

I said, “First, let’s build a business over the next couple of years that will allow us to step away and travel!”

She was doubtful at first… but we went after our goal. Fast forward 2.5 years, and we were leaving for our 3-month honeymoon out of the country with multiple thriving businesses, all with record quarters and months. 

When we returned in October of 2022, we decided we were going to double our patient volume and go from 40 – 50 new paying patients per month to 100 per month by Q1 of 2023. 

So in Q4 of 2022 we:

•  Secured a new larger building to move into in February,
•  Hired another provider to start in January, bringing our total to 4, and
•  Hired another tw2o health advisors to handle inbound calls / leads… 

…and were ready to double in size! 

We went from 137 leads in November, to 189 in December, to 326 in January! 

We did all this with ZERO debt, while paying ourselves fair market value wages and being profitable! 

How did we make all this happen?

Below are the exact steps we took over the past three years to get to where we are today and how you can do the same! 

• Step 1: Understand the 4 Most Important Numbers of Your Business. 
• Step 2: Gather Data On the Top Pain Points of the Patient
• Step 3: Focus Your Advertising,Messaging, and Services Around Those Paint Points
• Step 4: Develop an Operating System and Track KPIs For Each Job Role
• Step 5: Scale Your Business 

Step 1: Understand The 3 Most Important Numbers of Your Business. 

Having been an entrepreneur since I was 16 and having several failures and a couple successes, I quickly realized that knowing the numbers is one of the primary areas you need to focus on to increase your chances of success. 

However, there are many different numbers you can track. 

Which ones do you focus on and ensure are non-negotiable? 

I have boiled it down to three. These are the same three we ensure every client we work with has figured out.

They are what allow you to scale a company profitably and start looking at advertising as an investment rather than an expense. 

• Investments are only investments if they generate you a predictable return (things like advertising, new providers, etc.).

• Expenses are costs associated to keep a business afloat (such as rent, front desk staff, etc.).

It’s important to understand the difference between the two and to treat them differently. 

You should not be scared to spend more money on advertising — even during a recession — or hire another provider (revenue generator) if you have these three numbers dialed in. 

What are they? 

I wrote a more in-depth blog article and created a video that dives into each of these numbers in more depth that you can check out by clicking here. 

Below is a brief explanation of each:

1) LTV – Average lifetime value of the customer or patient overtime.

• Before you can start growing your business you need to know what the average lifetime value of your customer is. How much revenue will they generate you over a 1-year period?

2) Consult to Desired Outcome – Conversion rate

• After a patient has a free consultation with you, how many “purchase” your offering and move forward? What percentage convert? 

3) Cost Per Consult  – Per advertising channel

• What are you willing to pay to acquire a lead who turns into a consult? 
• If you know what your consult to desired outcome conversion rate is and your LTV (remember, that’s the value or revenue generated from the customer over 12 months),you should be able to figure out what your ideal cost per consult is while still making a hefty profit. 

Our goal with our clients is at least 100% profit.

Check out my blog article & video to better understand these numbers. I also share my 4th most important number as well. 

In our case, before we started advertising, we estimated our LTV, consult to desired outcome rate, and cost per consult.

This gave us a baseline of what we were willing to spend on advertising as long as that cost per consult came in at x.

Step 2: Gather Data On the Top Pain Points of the Patient

When we started the business at the start of 2019, we were unsure of the problems and pain points of the patients we were looking to serve.

Sure, we had researched our competitors and had a general idea of the services clinics were offering — hormone replacement therapy, peptides, pain treatments, and med spa services, for example.

However, we didn’t know the true data-driven challenges patients faced and their pain points related to them.

Having read the book Ask by Ryan Levesque, I used the formula in that book to generate a questionnaire through Typeform that every potential patient went through to gain insight into their needs and pain points.

We still use this same questionnaire in our marketing funnel which can be found by clicking here. 

I knew that by asking the right questions, I could gather the data that would allow Duzer Group to create ads with messaging that spoke directly to the patient’s primary pain points.

This would help lower our CPM (cost per mille, or cost per thousands of views), CPC (cost per click), CPL (cost per lead), and ultimately Cost Per Consult. 

The questionnaire had 2 primary purposes:

1. Get insightful data that we could then use to create ads to drive our marketing acquisition cost down.
2. Create micro-commitments from the patient to increase their commitment to our service and decrease no-shows. 

After a couple of months of data, I started to see trends and quickly realized the top 6 concerns of our patients were: 

1. Low energy
2. Weight gain
3. Anxiety 
4. Brain fog
5. Depression
6. Low libido

Our open-ended question where we asked patients for their #1 single biggest health-related challenge right now and reason for reaching out…

…provided our marketing team with common phrases, diagnoses, health conditions, and more that we could use to further speak directly to the patients. 

We were now ready to scale our advertising… or so we thought.

Step 3: Focus Your Advertising, Messaging,and Services Around Those Pain Points

Now that we knew what we were willing to pay to acquire a customer and had the pain points and ammunition to bring in new patients, it was time to increase our ad spend and scale, right?! 

Not so fast! 

Next, we built a brand-focused, conversion-friendly, SEO-optimized website (yes, that is a mouthful).

You can learn more about the exact steps we took in my previous case study by clicking here. 

In short, we made sure that the website had:

• Included cohesive branding & responsive design (meaning the site is both desktop and mobile-friendly),
• Was conversion rate optimized (highlighting paint points and showing testimonials, for example), and
• Was SEO optimized (complete with location pages and Google My Business optimization).
  • I followed the same steps I talk about in my article “The #1 Marketing Channel That Gives the Highest ROI for Medical Clinics.”

We also created a couple of videos that explained our process.

Then we slowly started to increase ad spend using Google Ads, Facebook, and Instagram. 

Initially, my wife took the calls and offered a free in-person consultation with each interested patient. 

But after a handful of no-shows and a number of patients not committing to move forward, we realized that this wasn’t sustainable. 

Since we had no issue with leads, we decided to do the free consult on the phone and at the end charge them $200 for the new patient package. 

That worked. 

That price then increased to $300 to $400 to eventually $500 as demand increased.

My wife, being the sole provider, became too busy to do both the free consults and tend to the patients. 

So with my background in marketing and sales, I said, “Let me give the free consults a shot.”

Being conscious that I would be speaking with people about their personal health and well-being, I did my research and read books to uphold ethical standards while also helping potential patients live their best life.  

And what I came up with was not a “sales” script but rather an “insight sales” script, leveraging active listening and deep conversation.  

We then created a new position that would handle the free consults —The Health Advisor — and two months later, after reviewing the data, our consult conversion rate was at the same level as Dr. Bennett’s was previously! 

This insight sales script (which through thousands of consults has been continuously refined) has now been successfully used by 7 different health advisors who close an average of 45% of patients who jump on the phone with us. 

We now have a team of 4 health advisors and recently had our best selling week of 27 new patient packages in one week! 

However, now with this successful marketing engine, our company’s rapidly growing staff had very few systems in place to handle this growth. 

Dr. Bennett was running around like a chicken with her head cut off trying to hold it all together… and we now had plans to get married in 8 months and go on our honeymoon a couple of months after that.

We were in no way ready to leave! 

Step 4: Develop an Operating System and Tracking KPIs For Each Job Role

While hanging out with some friends over the weekend we told them, exasperatedly: 

“Next year we are leaving on a 3 month honeymoon, even if it means the businesses are not ready and they completely fall apart.” 

At this point in time the businesses were not ready.

I had just started Elite Vein Clinic about 11 months earlier.

Sarah was handling Natural Med Doc, trying to be a provider 2 days per week while running around and working multiple jobs. 

And Duzer Group had grown to a point where we needed to continue to bring on new clients to ensure we had the staff to support the marketing for our two businesses while remaining profitable. 

But we knew we wouldn’t be young forever and in the near future we would likely have kids, and at that point, we would probably not be able to have this trip, so it was now or never.

One quote I like to live by is: “You only live each stage of your life once and therefore you have no room to screw up.”

This was our honeymoon stage, and we would do it right — no matter the cost.

With that said… we also had no desire to let the companies that we had built fall apart. 

This gave us a deadline and a goal.

It was non-negotiable. We were going to make this work for Natural Med Doc, Duzer Group, and Elite Vein Clinic. 

Creating an Operating System In 4 Steps

I was fortunate enough to have already had some experience with some of the steps necessary to systemize a business and create an operating system that did not require the owner to run. 

I don’t think we could have executed this that quickly if I hadn’t. (However, with proper coaching and support, I might have been able to.)

I have read several books on this topic, including Traction, Rockerfeller Habits, and Scaling Up (all amazing books that summarize my steps in a similar way below), and have listened to dozens of podcasts around this topic from owners who mastered this stage of business growth. 

A stage around the 1-5 million dollar mark, or 6 to 15 employees requires you to create a business operating system to get to the next stage 5-12 million dollars or 10 – 50 employees. 

I saw the stage we were at, and our honeymoon goal was forcing us to get through it faster than we ever would have! 

So how do you break through that stage of business?

You develop an operating system following these 4 steps.  

1. Pinpoint, Categorize, and Outline the Roles of Each Job
2. Develop an Organization Chart
3. Develop KPIs
4. Train Staff to Be Problem Solvers and Understand KPIs

Step 1: Pinpoint, Define and Outline the Roles of each Job 

First, we figured out all of the different tasks that were required to run the company.

We listed them and tried to fit them under each person’s role. After they had all been placed, we further defined each job and ensured every part had a responsible party. 

Then we created a checklist of precisely what the job role was and the tasks associated with that role.

Finally, we created a detailed document that acted as a “living document” — something another employee who had ZERO experience could take and read as a training manual. 

In addition, we created videos using a tool like Loom to record. They were not professionally made; they were simple videos of us explaining the job role using the screen share function and our laptop camera. 

These became (and continue to be!) invaluable resources.

They provide us with a safety net in case an employee quits with little to no notice. 

Step 2: Develop an Organization Chart  

Luckily for us, we already had an organizational chart. As I mentioned earlier, I have a degree in Business and have been continuously reading books in this area. 

However, what I hadn’t done was think about all the backups. 

So on our organization chart for every key role, we asked ourselves: if an employee or staff member quits when we are gone or are sick for a week, who is going to help support them?

Do they have additional training? 

By doing this, we could figure out a backup plan, cross-train staff on roles, and provide clear accountability and expectations of what the team would do in case this occurred. 

We were very fortunate to have thought about this ahead of time, because when we were gone we had 3 employees quit from 2 different companies. 

Our staff was able to follow our protocols and easily brought on a new member of the team that held the same values we do. 

Step 3: Develop KPIs (Key Performance Indicators) 

KPIs, or key performance indicators, allow you to see how different team members perform without micro-managing their work. 

They also provide a baseline of how other employees should perform in that role in case that employee quits.

The book Traction discusses how every employee should have a number. 

We developed KPIs for the operations team, marketing and sales, and financial. 

Some of the key items we tracked & continue to track weekly are:

• Lead Book Rate
• Lead Show Rate
• Health Advisor Sales Conversion Rates
• Doctor Membership Close Rate
• Doctor Churn Rate
• Front Desk Daily Task Completion
• Scribe Daily Task Completion

By tracking those every week, we can spot minor problems before they become serious problems.

It also provides us with the data we need to scale.

Step 4: Train Staff to Be Problem Solvers and Understand KPIs

We didn’t have the budget to hire an executive and didn’t want to raise money. 

My thought was: if I could grow as a leader, I could help others do the same. 

To further improve the system before we left, I created training for our company leaders to be better problem solvers.

I helped them understand: 

• Value vs. effort and SMART tasks
  • Focusing on tasks that have the highest value with the least amount of effort.
  • Ensuring those tasks for yourself and others you delegate them to are specific, measurable, achievable, realistic, and timely. 

• Understand that all decisions should be based on time value of money
  • Does this help the business earn more revenue?
  • Does this help the staff or business save more time?
  • Does this lead to less customer and patient frustration? 

• What problem-solving is 

• How to think analytically

• How to create systems 

Now I don’t think my short presentation fully transformed everyone into expert problem solvers or leaders.

However, I do believe it gave them a little bit more confidence to make decisions on their own and start the process of becoming true leaders of the company. 

I was also able to help them understand the importance of the KPIs: numbers that were red flags to be brought to my or another team member’s attention, and what numbers were good. 

By having:

• Clearly defined job roles
• Documentation of those job roles
• Accountability
• Backup workers who were cross-trained
• KPIs to track employees’ roles

…we felt confident that our operating system could continue to function without us.

Step 5: Scale Your Business 

We left on our honeymoon on June 30th, 2022 and came back on September 30th, 2022. 

We did a:

• Luxury safari in Tanzania
• Visited London
• Took a 2-week road trip in a van in Norway
• Went to Amsterdam & visited Prague
• Danced at Tomorrowland music festival in Belgium
• Went scuba diving in Lagos, Portugal
• Explored Barcelona
• Did a 7-day hiking trek (TMB) in Switzerland
• Paid a visit to Rome & basked in the sun on the Amalfi Coast, Italy
• Enjoyed a 2-week catamaran journey in Croatia
• Visited Tuscany and  Cinque Terre in Italy, as well as the French Riviera.
• Ended our adventures at Oktoberfest in Munich.

It was the most incredible trip of my life with the love of my life! 

Before leaving, we set up meetings with the team every 2 weeks for 45 minutes.

I meet with the leadership team of:

• Elite Vein Clinic – Office Manager & Billing Manager
• Natural Med Doc – Supervisor, Sales Manager, and Lead Doctor (Sarah)
• Duzer LLC – Project Manager and Head of CRO 

In addition, Sarah met with the doctors every 2 weeks for clinical assessments. 

In that short 45-minute meeting, we spoke about bottlenecks, goals, objectives, and what they planned on doing the following 2 weeks before we met again. 

6 weeks into the trip while we were in Barcelona, we worked for 3 full days to help put out any fires or fix any problems that we had spotted using the KPIs. 

In addition, my wife saw a handful of patients and I had monthly goal meetings with the team to set them up for the next 6 weeks.

And all three companies grew when we were gone, and even though there were a handful of small expected fires, and 3 people who quit and were rehired without us, the team was able to handle everything! 

We had a record quarter and record month for all three companies, and the team members developed skills and confidence that they otherwise may not have ever gained.

In fact, I would argue that us leaving for 3 months put our company in a better position than if we hadn’t left at all. 

When we got back we were ready to scale and doubled our business growth!  

For Natural Med Doc, we secured a new office, hired another provider, and more than doubled our lead flow. 

The team now could handle the business! 

My wife and I focused on growth and the team focused on delivering the value we promised to our patients. 

For the month of January we generated:

• 326 leads and made a record 
• 76 new patient sales in the last week of January, securing 27 new patient sales! 

To date, all three businesses still have ZERO debt and are profitable. 

In Conclusion:  How did we profitably increase our lead flow so quickly?

1. We understood the three most important numbers.

1. LTV
2. Consult to Desired Outcome — conversion rate
3. Cost per consult per advertising channel

2. We understood our patients’ pain points.

We used the ask method to understand our patients’ needs and based everything on what we did to fulfill those needs.

3. Focused our advertising on those needs and tracking the cost per consult for each advertising channel.

4. We developed an operating system that allowed our staff to handle the growth without us!

The honeymoon was a blessing in disguise.

It forced us to take the right steps in growing our business.

We couldn’t procrastinate on those steps because it was non-negotiable. 

We came back with a stronger company, better leaders, and KPIs that allowed us to invest more money into our advertising and know our ROI with certainty.

I write this case study to share our experience and help you do the same! 

We have successfully done this not only for my three companies but many of our clients as well! 

You might have seen some of their testimonials on our website on how we helped them generate 7+ additional figures per year in business. 

If you are interested in taking your company from 1 million to 10+ million dollars in revenue, please book a no-cost consultation by following this link below! 

If your business is a weight loss or hormone clinic, let’s 100% chat. 

First off, we believe in what you are doing to help people. 

Secondly, we have a proven step-by-step system we can implement to get you results yesterday. 

Click here to schedule a free no-cost consultation.