A lot of physicians reach a point where the usual way of earning more starts to feel pretty limited. You can see more patients, pick up another shift, chase the next productivity target, or maybe you decide you actually want to work a little less. But either way, your income and your time are still pretty tied together.

And for physicians, stepping outside that model can feel really uncomfortable because we're trained to be good employees, to be reliable, to say yes, not overstate what we know, and certainly don't think of our expertise as something we could build a business around. My guest today took a different path.

He built and sold a seven-figure software company while still practicing medicine, and he's since helped more than 1,000 physicians build businesses of their own. Not another job, not another version of the grind, something they actually own. And today we're going to talk about what that looks like and why it can be so hard for physicians to see the value in what we already know.

Well, hey everyone, and welcome to another episode of the Better Physician Life podcast. Thank you so much for being here today. So my guest today is Dr. Mike Woo-Ming. He's a practicing family physician, entrepreneur, and founder of BootstrapMD, where he's helped more than 1,000 physicians build businesses outside of clinical medicine.

And Mike has done this himself. He built and sold a seven-figure software company while still practicing medicine. He's launched multiple medical practices, written The Positioned Physician, and has put out the BootstrapMD podcast with more than a million downloads, which is a pretty incredible feat. And what I appreciate the most about Mike's perspective is that he's still seeing patients.

He understands what it means to build something while you still have clinic, charts, an inbox, and a life outside of work. So today, we're talking about how physicians can take what we already know and build something we actually own without just creating another job that takes up the rest of our time.

Dr. Mike Woo-Ming, thank you so much for being here, and welcome to the show. 

Michael, it's an honor to be here. Fan of your work, and again, excited to share some things with your audience that I think maybe they can take home with them today. 

Absolutely. So you've worked with more than 1,000 physicians who wanted to build something outside of clinical medicine. When they first come to you, what are they usually trying to get away from, when it comes to what their current life looks like? 

Well, it's funny. It really comes in two camps. I have some who already have an idea, or at least a semblance of an idea, and they want to know what they do. Maybe they've invented something, or they started an app or a website service or their own practice. So they know what they do, and they just need assistance in getting started or having someone coach or consult them to help them navigate that entrepreneurial path. 

And then the second type I have is folks who want to do something else, but in their mind it's other than being a doctor. And that one takes a little bit more work. And oftentimes I think when they want to get started, I would recommend they see someone like yourself for coaching because, as we kinda discussed before we got on the call, I see so many doctors, and they get it. They've been burnt out.

I've been in that position as well. And when they said that they want to do something else, I don't think they really understand the leverage and expertise that they've built as a doctor. And even having a license doesn't mean that you still need to practice 70-plus hours a week, but having a license opens more doors than not having a license.

So there comes a time where there's like, they’ve burnt out; entrepreneurship is maybe a path for them or may not be a path for them. And that's when I work with them; I kind of help explore that with them. 

Yeah. And it's fascinating, too, and I've shared this before. When I first decided to throw my hat out into the world as a physician coach, I had zero entrepreneurial bone in my body.

There was no part of me that ever thought I could ever own my own business. And there is a ton of mindset work that comes in there, to your point of thinking through why don't we think that we can do these things? Have you seen a theme, especially for physicians, of why we limit ourselves in that way?

Yeah, and it's not because physicians aren't smart or that they can't do this. It's just that we weren't trained for this. As you mentioned in the opening, some physicians don't like to hear it, but we're followers. We have a path. There's a path to becoming a physician.

You go to college, maybe you're pre-med, maybe you have to do volunteer work, get great MCAT scores, you know, and get great letters of recommendation so you can go to medical school, then get into the residency, kind of the same thing. Do well on your boards, do well on your different rotations.

And so it's a set path on there. With entrepreneurship, there is no set path. There's nobody making you accountable. You can decide to work on your consulting business this week, or you can decide to take the whole month off. It's really up to you on there. But that being said, too, physicians, we don't get any training or any business training.

I didn't, at least in medical school, on there. And you know, just like in education, or just like if you want to become a great gastroenterologist, a great surgeon, you gotta follow other great gastroenterologists, great surgeons, on in there. And the other thing too with being an entrepreneur is you gotta take risks.

We're trained to be risk-averse, right? So it's against our nature, and that's why it can be very difficult to do this alone, you know, to start up your own business by yourself. 

Yeah, and I've noticed a couple other things. Maybe you've seen this too. You were talking about risk-averse, but there's also this idea of the complete uncertainty around it as well.

As you were saying there, our medical training is a very clearly laid out path, and entrepreneurship can be all over the place. And tied into that, doctors like to do things as quickly as possible, right? We like to know when we're going to get there, and we like to get there as fast as we can.

And so I have seen in my own journey and in a lot of the people that I know in the entrepreneurial space, we can burn ourselves out in entrepreneurship in the exact same way we burn ourselves out in medicine. Trying to do it all so quickly while not really knowing what's working and what the path is.

Do you have any thoughts about that, or have you seen that yourself? 

Oh, all the time. You know, I came to doctors, and they said, "Well, I did this, and then I tried this," or, "I heard something like this, and it didn't work, and I'm ready to give up." You can't rely on double-blinded placebo studies to tell you the exact path of where you go to.

You know, one of the things, and it's like, "Well, what did you try?" You know, "Did you try this? Did you try that?" You can't say that in medicine, right? "Well, you know, I got this condition." "Well, did you try this? Or we could try that," and that doesn't fly.

That uncertainty can lead us, as a doctor; it helps us, right? It trains us because we want certainty. We want to make sure this is the right prescription for our patients. And in entrepreneurship, there are so many other factors that are in play that sometimes we can't control.

And having acceptance of the unknown is a kind of skill that you need as an entrepreneur just to keep yourself sane. 

Yeah, for sure. I think, and I want to be cautious here because it sounds like we are discouraging entrepreneurship because it's hard, and it's really just a matter of thinking about it more like a puzzle, right?

When you can think about the challenge as something worth solving. Because the piece here is in medicine: when you figure something out, like when you figure out how to do a colonoscopy, you then always know how to do the colonoscopy, and human anatomy isn't changing significantly enough that how you do it isn't changing.

Business isn't like that, right? So you might figure something out, and it might work for you for a while, but you have to be willing to shift and change and adjust, and you have to enjoy the puzzle piece of it. So to your point, a lot of doctors will get frustrated when things don't work, and that also, if you can think about it as a fun puzzle, completely shifts your mindset around the entrepreneurial piece.

One other thing that I've noticed that can be a challenge for physicians in entrepreneurship is getting paid for work that isn't seeing patients. Have you noticed that at all, in the physicians that you work with? 

Yeah. Here's the thing, depends on what type of business that you want to run, right?

When you're starting up a business, you're not getting paid per hour. You're getting paid per- let's say you start up a restaurant or something like that. So you got the revenue that's coming in, but guess what? You probably gotta pay for the cook, the waiters, the people who do your marketing, your advertising, the rent on it.

And then at the end, you know, maybe you'll give yourself a small salary. For most people, when they start up a business for the first two years, you don't pay yourself, right? You want the business to flourish. And that uncertainty and knowing where your income is going to come in can be pretty daunting on there, versus being a doctor, "Hey, I just need to show up. I get paid a salary. I see patients, and my income is dependent on that." 

That being said, as a business, you can get paid by being the owner, right? You're not the one cooking. You're not the one, you know, being the waiter for that. Maybe when you first start out, you are. But if you have a business on there, you get paid based upon what the service provides, where you are not yourself providing the service, which is unlike what we do as a doctor, right?

We get paid for our time. We substitute time for money. And that's, again, like you said, I don't want to denigrate entrepreneurship, but that's what keeps me going. That's what I enjoy is being able to produce something of value, a business, provide something of value, while I myself am not the person that is providing the value, if that makes sense.

100%. Yeah. And to that point, you've done a lot of this while continuing to practice clinically. Can you talk a little bit about what that experience has been like for you? 

Yeah. That's something that my wife keeps reminding me. When I first started my journey into entrepreneurship, it was actually as an intern, of all things.

So it's kind of an interesting journey. I was in family medicine. It was my specialty. I was at the Mayo in Arizona. I didn't want to be in the Midwest, but it was in the summer. I was an intern, and my wife was pregnant at the time.

She was working as a librarian at a local college. And then when she went on maternity leave, we just lost half our income. And I had purchased a house, one of the things that you're not supposed to do as a resident, but I didn't listen. And we'd purchased a house, and suddenly, okay, I'm making, you know, peanuts, right, as an intern.

And my wife, we just lost half of our income. And so I was too young to moonlight, so where am I going to get an extra job? So what I did was, this is back in the '90s, I started a service online, an online business. Basically, the business was to help; I based the business on what I knew.

And I knew how to get into the residency of my choice. Mayo was my first residency. And so what I did was I helped other medical students, and then it turned out to be a lot of international medical graduates to get into the residency. So I created products and courses that catered to that.

Now, I'm not telling you I got rich off it, but it really helped me out at a time when we were really struggling, helping to pay our mortgage. I was able to purchase or lease a truck, so things that just helped us keep going on there. And what I realized was, hey, now I have something that is making me money, but I'm not the one actively working in that business.

Who was my person who was doing it was my wife. She was a librarian, and she did things like review personal statements, how to interview in residency, and different things. We had different products at the time on there. But it just shows me if I can provide something of value in there, I myself have to be the person that has to provide the value.

Amazing. And I'm curious, because you're talking about this very busy time in life. You're an intern, you're married, you have a newborn at home. And there are a lot of physicians who, when we are talking about building something outside of clinical medicine, simply think, "I don't have the time for this."

And so how did you do it? 

You know, there is this thing about that keeps you on track, and for us it was paying the mortgage. So there was a need to actually do this. It's, you know, putting food on the table. And so one thing that I've learned in my 10-plus years of working with doctors is you have to have a need.

You have to have a need to actually want to do this. And, hey, let's be honest, right? We generally have a high net worth and income. We don't usually have to do this. I've worked with non-physicians where this was their only choice. I worked with non-physicians for a long period of time who were in the corporate world.

They quit their job, they got laid off, other different reasons, and they had to make it work. And so they did whatever they could, hopefully morally and ethically, to make that business work. I'm not saying that a physician can't do it on their own, but you kinda have to miss that grit, that gumption to actually want to go and get that done.

For the most part, we're able to put food on our table. We're able to live nicely. If it doesn't work, sure, maybe we invested some money on it, but it's okay for the most part there. Which, you know, a lot of times we just don't have that drive, and really, as an entrepreneur, you need to have that drive.

Yeah. What's your why? Why do you want this so badly? And I will offer here: a lot of physicians are thinking about this as an escape hatch, and that can be helpful, but I find that running towards something is a lot more motivating than running away from something. 

So when you know what you're building, you know why you're building it, you know why it's important to you, it makes it easier to give up, you know, bingeing a TV show at night or doomscrolling on social media, in an effort to work on this thing that you really want. So getting clear on why you want the thing, because you've already said it can take a while to build something to the degree where it can start to replace some of your doctor income.

What do you say to doctors who are looking to build something and they're wondering, "Is this a viable business option?" How do you help them sort through, "Am I going to ever make money on this thing?" 

Yeah, and that's a great question. And I also just want to focus on that why.

So when they come to me and, you know, when I can look back at all of the different clients that I've worked with, they already have the answer to that why. There was something that was driving them. There was something bigger than themselves that they want to get accomplished. I'm just thinking back to some of the clients that I currently work with.

You know, I'm working with a doctor who is involved in fertility, and she's building this telemedicine site because she sees difficulties for some of, like, say, for example, rural patients to get access to these kinds of things that she wants to teach, like education. So that is what's driving her. 

Another doctor that I'm working with who is in the emergency room, he's probably pretty much retired from his ER work, but he is a cyclist, and he loves working with other cyclists to optimize their health, and he has delved into lifestyle medicine, and that is his passion. And now he's built a practice that caters to that, and that's his why. 

Like you said, when I have doctors who don't know their why, but the thing is, it doesn't mean they don't have enough ideas. The problem is they have too many ideas.

So I don't want to dox any of my clients I'm working with, but I have one who has 10 different ideas she wants to do. And so what we go down to is, "Okay, let's go down, tell me why you want to do this." And so I often write them like, "On a scale of one to 10, you know, is this something that could fulfill your lifetime work? Why do you want to do this?" 

That's important, so they have to have that why. And then the second thing is, what is the service that you want to do? And then we just look at, like, the service or products, or what are they doing. You know, what are their competitors in the market?

Are there people that are paying for this already? You know, that's a big issue on there. You could become the expert. I'm the expert at underwater basket weaving, but if nobody is paying for that service on there, it's going to be very difficult to start a business. It's difficult for, you know, at least with my clients, and of course we can always aspire to be, is to create something that is completely game changing there.

Let's say, like, an Uber, right? Uber was game-changing, right? It disrupted a whole industry there. But to do that, it takes a lot of time, and it takes a lot of money. You probably have to get venture capital to do that. I tell my clients, "You don't have to be the trailblazer."

Let other people go into their... Maybe they've had successes. Maybe you find someone who's got similar businesses, and then you're not saying you copy, but you emulate or you model or you do something that's different that differentiates yourself. That's when you can take it to the next level.

It is difficult if this is a completely, you know, mind-blowing concept that no one's ever done before. Sure, I commend you for doing that, but it's often a very difficult road to follow.

Yeah, and to that point, being a physician can sometimes be a differentiator in these different fields that already exist, but maybe there's not a doctor in that space.

Anybody who spends any time on social media sees there's always people online talking about health issues and medical issues. Very few of them are doctors. And for a long time, doctors have just faded into the background and let a lot of other people come to the forefront and talk about these things.

But we have genuine expertise in these areas. We just have to get more comfortable with putting ourselves out there and doing it... And I say that as somebody who was not comfortable being in front of a camera or wanting to do any of these things, and it took a lot of work to allow me to get myself to a point where I'm more comfortable talking in these spaces.

How do you help physicians do that work? 

Yeah. And oftentimes that is a reason why there's this why. Sometimes, I do like to challenge my audience on that. One of the biggest downloads that I got was when I shared that there is a person who was making $300,000 a year in the menopause space.

And guess what? She's not a doctor. But she had a story to [00:20:00] tell. And my thing is, you know, don't get upset or be jealous of it. Just do it better. If you are trained in menopause and an expert and you've seen 20-plus years of menopause patients, well, you have a voice, and that's an important voice on there.

So I challenge physicians is, don't hate the player that old saying it's part of the game, right? It's what it is, and what are we going to do about it? 

And so what I've been doing, and more physicians are now comfortable, in 2026 than they were a few years ago to, like, "Hey, you know, I have something to say, but it's also based on my expertise. It's based on research. It's based on actually treating patients for this 10-plus years, and I want to share with that what I think on there." 

And so I challenge them. Let's take back that health space because we can still be seen as leaders. We should be seen as leaders in the space.

But unfortunately, that's who the audience is going through. Through TikTok and Instagram on there, and it is exciting to see more physician voices, take back which should rightly be part of what we should be doing these days. 

Yeah. And honestly, that can be a part of your why also.

Helping to promote our profession, the thing that we all have worked so hard for. If not you, then who? So I mean, this has been another really important piece for me in saying, "Well, I can't expect other people to get out and talk about these things if I'm not willing to do it myself," right?

And so, getting comfortable with that idea. You know, it takes some work and some effort, but it's super important. As you look back on kind of the work that you've done working with over 1,000 physicians, is there anybody that shouldn't consider entrepreneurship or any type of physician? Who shouldn't do this? 

I know. Although it seems like we've been, like, downgrading entrepreneurship, and I hope that doesn't come across. But to be honest, a number of physicians shouldn't be in entrepreneurship. I think it comes down to: why are you actually doing it?

Like you said, if you're looking to find an escape from medicine, what we talked about, you know, before we got on the show today was that I see doctors who are burnt out just like yourself; you see them as well, and they just know that what they're currently doing right now is killing them or is draining them. They're lacking joy in their life. 

I thought the same thing when I was in group practice, and I was doing call, and call was pretty arduous, you know, every third or every fourth night. I found out I didn't realize I was underpaid. I was being asked to do lots of different things, like become a director of my urgent care, director of nursing home facilities, other different committees, and I wasn't getting paid extra for that. I just didn't know better because as doctors, we kind of say yes to everything.

At least, that's what I was trained for at the time. And I wanted to get out, and I go, "I'm done with medicine, and I don't want to do this again." But what I realized was I just didn't like that job. I didn't like that particular job. I'm a bit older now, but, you know, I think some of the people that are younger get it.

You know, when I was into medicine, I thought that was like, "I'm going to work at this job for the rest of my life, get my 401k, and that's it." These days, younger folks, and older folks too, they tend to go from job to job. I didn't know that was an option. And so before you say you're done with medicine, the good thing about medicine, and this is what my dad told me, is there are so many things you can do in medicine that don't require seeing patients, if that's what you want to do.

There are certainly non-clinical careers you could do, like in utilization management. There are, you know, becoming an expert, working on different things like that. But then there are also ways that you can be in medicine. Our friends, Leo and Phoebe, you've had them on this show.

Telemedicine is something that I do on a regular basis. And I told them that if I knew about it then, that I knew 20-plus years ago, I probably wouldn't have left medicine at the time for a few years because it's given me so much flexibility and different options. Certainly, there's locum tenens that you can do.

There are other ways that your license has value. Before you quit medicine altogether, don't close that door, because having my MD has opened so many more doors for me than if I didn't have it. So I don't know if I answered your question, but you know, I think that's what I would recommend there.

It's probably just the job and maybe other circumstances that are going on right now. Don't quit medicine altogether before looking at the different options. 

Yeah, and to that, I will say based on that, there isn't a single physician who shouldn't explore entrepreneurship, because entrepreneurship, like we've already detailed here, can look like anything.

Entrepreneurship can exist within clinical medicine through things like telemedicine and lifestyle medicine and changing jobs and locums work, right? So, and then there is entrepreneurship outside of clinical medicine. 

And I know for me, this is probably the busiest I've ever been in my entire life with all of the different hats and roles that I wear, both as a full-time practicing gastroenterologist, as, you know, working in my side business as a physician coach, working as senior faculty for an executive coaching and consulting company, having a podcast, doing all of these things, and it has made clinical medicine sustainable for me.

When you realize it's not the only thing and you can look beyond that at all of the other options and possibilities, it just makes practicing medicine more sustainable. And so I'm going to encourage the audience here to come and listen to your podcast, "Bootstrap MD," to learn more about entrepreneurship and what that can look like for practicing doctors.

And if I could add, to your point is I work with physicians who maybe they don't eventually start up their own business, but what they've done is what I teach or teach them and I talk a lot about this in my podcast, is every physician should be their own CEO.

You know, it's kind of like being a high-paid sports athlete, right? They've got their own agent. They're being demanded by lots of different teams if they're a really great athlete. 

And that's how you should treat yourself like that. You have a skill. You've learned a set of skills, to quote Liam Neeson from Taken, that are very beneficial to others. And you have to stop thinking of yourself as an employee on in there. You can start or do anything that you want.

You can start up your own podcast. You can do volunteer work. You can do locums. You can be part of a committee for a new health tech company coming out there. And so you need to learn the skills about learning how to market yourself, how to become a leader, how to communicate.

These are all valuable skills as an entrepreneur. Learning how to delegate, learning how to, like, manage, you know, your multiple different ventures. It takes a lot of time and effort, and those are the skills, whether or not you decide to open up a side hustle or start up something to replace your whole physician income; those are skills that you can take to whatever you want to do.

So that's kinda one of the things that I try to teach, my clients, is learn these skills because they'll be invaluable to whatever you want to do. 

100% translatable skills. I have used these skills in so many different areas of my life, including parenting. Just tremendously beneficial skills that we learn in entrepreneurship.

Well, this has been amazing. I'd love for you to tell the audience where they can learn more about you and your work? 

Yeah. My main website is Bootstrap MD, bootstrapmd.com. We actually have a newsletter, and then, like, part of their newsletter, one thing we didn't get into is I'm big into AI. I think it's the next big thing.

You can't avoid it. But if you know how to do it right, I think that's one of the skills that a physician needs these days: how to utilize AI. What are the safeguards? What are the things you need to avoid? And one of the things, as part of the newsletter, is I teach you how to have your own chief of staff and using AI to do that.

So you get that for free. Just some things: if you've ever played around with ChatGPT and Claude, you know the benefits of doing that. Just taking it to another level and help managing the different things, the different activities that I do. I share that with you. The newsletter talks about other aspects of physician entrepreneurship, things that I've learned over time, that could be helpful to you.

So go to bootstrapmd.com. 

Amazing. Well, Dr. Mike Woo-Ming, thank you so much for being here today. To the audience, thank you so much for listening, and we'll see you next time on the Better Physician Life podcast.