Voices in Health and Wellness
Voices in Health and Wellness is a podcast spotlighting the founders, practitioners, and innovators redefining what care looks like today. Hosted by Andrew Greenland, each episode features honest conversations with leaders building purpose-driven wellness brands — from sauna studios and supplements to holistic clinics and digital health. Designed for entrepreneurs, clinic owners, and health professionals, this series cuts through the noise to explore what’s working, what’s changing, and what’s next in the world of wellness.
Voices in Health and Wellness
Why Independent Medical Practices Are Disappearing - And How One Is Thriving with Dr Neel Shah
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Cancer care is consolidating, costs keep climbing, and more clinicians find themselves employed by giant systems. So how does an independent oncology practice not only survive, but grow to around 15 doctors while promising faster access and lower-cost care for patients? We sit down with Dr Neil Sharp, a haematologist and oncologist in Northwest Indiana and a leader at Northwest Cancer Centers, to unpack the real mechanics behind building a community cancer centre that patients trust.
We talk about the leap from “a practice” to “an organisation”, the sleepless early years, and the business skills medical school doesn’t teach: hiring, communication, decision-making under pressure, and keeping a team aligned when the stakes are life and death. Dr Sharp shares concrete operating choices that shape patient experience, from seeing new cancer diagnoses within 24 hours to building a foundation that helps with everyday needs like fuel, groceries, and childcare.
We also get into the hard systems issues: private equity incentives, hospital reimbursement advantages, prior authorisations, and why independent practices are often the lowest-cost place to receive the same care. On the clinical operations side, we explore how oncology has expanded from a few dozen drugs to hundreds, what that means for staff training, compliance, oral oncology pharmacy services, and how nimble groups can adopt new therapies quickly, sometimes faster than major academic centres.
If you care about independent practice, oncology leadership, patient access, and the future of healthcare delivery in the US, this conversation is for you. Subscribe, share with a colleague, and leave a review with your biggest question about keeping high-quality care independent.
Guest Biography
Dr Neel Shah is a hematologist and oncologist at Northwest Cancer Centers, an independent, multi-location oncology practice serving patients across Northwest Indiana.
After training at Rush University Medical Center, Dr Shah joined a fellow physician in developing an independent oncology practice that has grown from a single rented office into an organisation with approximately 15 doctors.
Alongside his clinical work, Dr Shah teaches at Indiana University School of Medicine and is involved in developing the practice's research and clinical trial programmes. His approach combines access to advanced cancer treatments with a commitment to patient-centred, community-based care.
He is also president of a charitable foundation supporting cancer patients with practical needs, including transportation-related expenses, groceries and childcare.
An advocate for independent medicine, Dr Shah believes that physician-led practices can deliver high-quality, accessible care while remaining financially sustainable. His experience spans medical practice growth, healthcare leadership, staffing, reimbursement challenges and the evolving role of technology in healthcare.
Contact Details
- Website: https://www.nccindiana.com/
- LinkedIn: https://www.linkedin.com/in/neel-shah-297a76b/
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About the podcast
Voices in Health and Wellness features conversations at the intersection of medicine, lifestyle, and human potential, with clinicians, scientists, and thinkers shaping the future of care.
About Dr Andrew Greenland
UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. Trained in both conventional and root-cause approaches, Andrew helps people optimise health, performance, and longevity, with a focus on cognitive resilience and healthy ageing.
Why Independence Still Matters
Dr Andrew GreenlandSo welcome back to Voices in Health and Wellness, where I speak with healthcare practitioners, founders, and practice leaders about not just the clinical side of healthcare, but actually what it takes to run and build the organizations that deliver care. So today I'm joined by Dr. Neil Sharp, a hematologist and oncologist based in India, Indiana. Neil is also the founder of an independent oncology practice that's grown to around 15 doctors, which makes his story particularly interesting at a time when we're seeing so much consolidation across healthcare. So, Neil, I'd love to welcome you to the show and thank you very much indeed for joining me today.
Dr Neel ShahUh thank you, Dr. Greenland, for having me. Um I am uh just to be clear, uh my uh partner is the original founder, and I joined him right when he took over the practice. And thankfully, we've been able to uh grow the practice, as you said, and um take care of the people in our area in a high-quality way at the lowest cost.
Dr Andrew GreenlandAmazing. Thank you for clarifying. So, Neil, could you start by telling us a little bit about your background and your journey into medicine and ultimately what led you into hematology and oncology in the first place?
Dr Neel ShahYeah, actually, you know, uh I didn't actually have anyone with cancer in my family. So um I was the first doctor in my family, basically. I am the first doctor in my family, so um I didn't have much guidance. Um, but when I once I got into medical school, um took taking care of uh patients. I I teach at Indiana University Med School, and and what I tell the students is kind of find out, A, do you want to talk to patients or not? Because there's a lot of medicine jobs where you don't need to talk to patients. And then B, do you want to take care of adults or kids? And for me, I wanted to take care of something serious. Um, and there was so much research in hematology, oncology, we've come such a long way. Um, that you know, some of it's just fortunate timing, as as everything, many things are in life. Um and uh thankfully I get to do uh what I love what I love every day. Thank you. Really helpful background and
From One Office To Cancer Centres
Dr Neel Shahcontext.
Dr Andrew GreenlandCan you give us a maybe a picture of the practice as it stands today and what your own role looks like in your practice?
Dr Neel ShahYeah, um, we have independent uh physicians and mid-level providers. Um we're Northwest Cancer Centers in Northwest Indiana. And um basically our goal is we have a mission statement to take care of patients. Um we started off with one office that we're renting. Um now we have multiple locations throughout Northwest Indiana. And really, we continue to try and bring you know the best doctors, the best technology. And that's another thing that's changed is because of the internet. Um in fact, uh when I was in med school, I'm not sure we could even do this, what we're doing right now. Um, 15 years ago, it it would I'd have to wait in line to use the internet. Now, um, thanks to technology, you know, we're able to move things uh at a faster pace. Um we have clinical trials, uh we literally are just on the cutting edge. We just um uh are able to invest in in cold caps for patients so they don't lose their hair. Um, so you know, we've really grown and uh we didn't have any mid-level providers originally, so we we've really been able to encompass a full kind of breadth of care.
Dr Andrew GreenlandThank you. Maybe we can rewind a tiny bit. So, how did you go from practicing medicine to becoming the founder or co-founder of an independent oncology practice?
Dr Neel ShahYeah, um uh as I said, um basically I was working for a large health organization, and uh uh the foul the founder is a friend of mine, and he was practicing in northwest Indiana, and he reached out to me and told me that uh you know, come come join him and we could grow this practice um independently of a of any other system. And and um, you know, thankfully in the United States, it also provides the lowest cost of care to patients. Um and so we just we kind of took a chance and and thankfully we were able to continue to grow and open up different locations. And I think um that's a result of a lot of a lot of different um things. But I think originally it was just the hard work of taking care of patients, um, getting uh a good reputation that our practice takes really good care of patients better than anywhere else in the area. And obviously um when you're when you're scared and you you have a diagnosis of cancer, you want to go to a qualified doctor that's that's local. And northwest Indiana is a very local place. Um so um I'm I'm trained at Rush University Medical Center, as did our founder. So that's where we met, and we decided to bring that same level of care from Rush, which is like one of the top universities in the country, to the local area in in Northwest Indiana.
Dr Andrew GreenlandThank you. And you called it a practice a few times, but actually there must be a point when you actually you realize you're not just building a practice, you're building an organization because that's what it's become now. So, where was that point when it's kind of growing from a practice to something bigger?
Dr Neel ShahWell, I think at some point um uh my partner and I realized that um the office we're renting, we were running out of space, and there really wasn't a very good facility in Northwest Indiana that was comfortable for patients. And so when we decided to make the leap and build our first uh cancer center, um that was when you know we took a lot of risk, but we just thought we could build something that was really beneficial for patients. Um, and um, you know, once that happened, uh we realized, you know, that you know, we were kind of either going to sink or swim at that point. And luckily, um, you know, uh thanks to I think uh, first of all, the patients that we take care of who were privileged to do that. Um the community itself for the support of wanting, you know, something that's an organization like us to kind of be the leader in cancer care in our area. And um number three, you know, I I think we've built a really good team um in Northwest Indiana to help take care of patients.
Business Lessons Medical School Missed
Dr Andrew GreenlandWhat's the part of running a medical practice that your medical training prepared you for the least? I mean, I might say that I don't think medical training uh prepares anybody for running a business, but from your perspective, what do you think was the biggest gap from medical training in terms of being able to go forward and build this organization?
Dr Neel ShahI I just don't know that medical training prepares you to basically uh and and I'm not even sure if it should or not. I'm not here to judge that, but um talking to people, I think um whether it's uh patients or you know, staff or um other business vendors, um, I think that uh training sometimes is uh something that I think was is is missed, uh, you know, uh public speaking even. Um I think all those things um can be trained to a certain degree. Um and I think you know uh potentially we need uh a little bit better uh at that. And you know, I'm hoping in the United States that things start turning around. I'm hoping some of the laws start turning around where um it's not as advantageous. Uh it's more advantageous for the public, certainly, and for the cost of healthcare in the United States for independent practices to continue to thrive. But as you said at the beginning of your podcast, most doctors in the United States are employed by uh by a hospital or some other larger entity.
Dr Andrew GreenlandSo I guess you have a lot of learning as you go along, a lot of learning by experience. What's what is it that you've learned about running a practice today that you wish somebody had taught you when you first started out?
Dr Neel ShahUm, I I I would say uh being being patient and things are gonna work out. Uh I think uh uh you know you have a lot of sleepless nights when you're trying to keep the doors open, or there's something like COVID, we had to navigate through COVID. Um, but I think um that uh you know being patient, certainly there's some decisions that I think uh that we could have made uh that we didn't, or other decisions that maybe that we made too quick. And um I think I've learned as we go along that just taking a second and reviewing everything, um, now we have AI tools to help us do that. I think those are probably, you know, that that's probably the most uh important thing. But um, you know, I gotta say overall, you know, we're very lucky that uh we have a great team and and you know, uh as I said, I'm one of you know uh one of the co-founders, but you know, uh our our founder, our president, you know, friend of mine. Luckily the relationships, and I think it's still a relationship business. I think a lot of businesses are still relationship business. Uh so I think we just have developed good relationships with our staff, with the community, and with our patients.
Dr Andrew GreenlandThank you. So you obviously had a lot of success in building the organization. What are the the things that have been important to get right from the perspective of an individual physician in terms of being able to build something much bigger that's independent practice for around 15 doctors?
Dr Neel ShahUh you know, it it's not as complicated as the question is complicated, but it's not as complicated as it sounds really. I I think I'm lucky that the business I'm in is just doing the right thing. And if we can do that in a uh make sure that we are collecting, we are well, let's start with just developing a reputation as a physician. I I mean, I think one of the ways I've been able to do that is I think people can three see through, I think only adults are are are listening to this podcast, so people can see through bullshit. So ultimately, you know, you can't trick anybody, um, and you shouldn't want to. And in what we do as a medical practice is we just take the best care of the patient as possible. I'd like to think that um, and some of the rules we have uh that we put in place, you know, if a patient calls, if someone has a new cancer diagnosis, they get seen within 24 hours by one of our physicians. I mean, that's I think by and the the the a human picks up. I mean, that's something that other places just don't do. Um, you've heard of people waiting for appointments. Um, I think number two, every physician that we brought aboard, our organization is top-notch. I mean, all of our physicians, I'm from Rush, our physicians are from Northwestern, University of Chicago, University of Illinois, Loyola. Um, so really the best institutions in the United States that we have picked these physicians, and they're not only extremely smart, but they're also um just really good people. And um I think with with that, making sure we just treat people the right way, trying to be as patient as we can, because healthcare is complicated. It's about understanding the point of view of our patients um and trying to do our best for them and within the rules. So we have a foundation, that one I'm the president of, where if someone needs help with gas, groceries, childcare, we've developed that. So, really, I mean, it's it's hand in hand doing the people sometimes. I think there's a confusion about um trying to grow a successful organization and doing the wrong thing. Like they have to somehow to grow and be successful, you have to cut corners or you have to do the wrong thing. I really just don't believe in that. I think you can do the right thing and grow and be a successful organization. And I think we've done it the right way. Um, we're not perfect, but we we we certainly try our best.
Dr Andrew GreenlandSo
Consolidation Pressures And Survival
Dr Andrew Greenlandwe're seeing a lot of independent practices being acquired by private equity groups and health systems and academic institutions. Yes. Why do you think that's happening from your perspective? Because this is something this is very much, well, very unique to the US in some respects. So, what's your perspective on this?
Dr Neel ShahI mean, it's simple. I don't know if even if it's my perspective, it's just it's financially uh viable or financially beneficial for um these entities to own oncology organizations. Um, and it makes, you know, quite frankly, you know, more income for those organizations. And, you know, there's a lot of business people and organizations. Listen, business people are not bad people. I'm not saying that. I'm just saying, you know, financially, um it knocks out their competition, right? Now they're not competing against physician practices, and then also it is uh financially beneficial for them. Now, hopefully, some of the rules will change where, you know, um, because in terms of the system, as you brought up, um one other thing that I'm very proud of is that independent physician practices are the lowest cost place to get medical care. So that's where I think we're not only have the best doctors, and we have, you know, we we think we have nice facilities, and we we think that um, you know, we're one of the best places to get care. I would trust my family to any physician in our practice. Um, but we also are the lowest cost. We have financial counselors, we we we just we have um help for patients with our foundation. I mean, um, and our foundation services every patient in the area, so they don't even have to come to us. We just provide it as a service to the community. Um, so I think all those things um you know put us in a good position. But to answer your question, it's really financial. Um, I I don't necessarily uh see uh larger organizations um providing better care at a lower cost. And that's why I'm kind of hoping that in the future that the rules will change a bit to allow physician practices to kind of re-emerge.
Dr Andrew GreenlandThank you. You mentioned sort of financial incentives, but are some of the reasons why these um independent practices are being brought up is because of the financial pressures they're under. And so rather than an incentive, it's more of a pressure they're facing to trying to survive in the climate, or is that is that irrelevant?
Dr Neel ShahNo, it's not irrelevant. You bring up a good point, and that's why we are constantly trying to make sure that we can provide for our community by staying open. Um, you know, we have rent to pay every month with all our um different locations, and you know, we we have a monthly meeting where we kind of review everything and make sure that we can continue to thrive as an organization and continue to uh provide services for patients. Um, but yes, it's very difficult. We're one of the few remaining um uh uh private organizations um left in the United States. Most uh oncologists are employed in the United States at this point. So most are working for a larger health system. And um, I think part of that makes us a little more nimble, though. We're able to um do things uh more quickly. For example, you may have heard of that new pancreatic cancer drug that was just approved. Um, we went through all the training and all that uh quicker than most of the larger universities um uh in downtown Chicago. So patients were actually driving from large universities to our practice to get that life-saving drug. So, you know, I think it helps us in certain ways. And obviously, we don't get reimbursed the way a hospital gets reimbursed. And so, as you said, there are financial pressures, but um I think if we can we can continue to uh uh run it efficiently and smoothly and and still provide really good care, we should be okay.
Dr Andrew GreenlandThank you. And on the other side of the coin, what's the price you pay for independence? What becomes harder because you've chosen to kind of do it yourself and keep it in-house.
Dr Neel ShahYeah, I mean, we um we certainly have to have uh, which we have a wonderful staff. Uh, you know, you realize you can't do everything yourself. I mean, when we started, I mean, we were there 13, 14, 15 hours a day. Um, now thankfully, I think we have staff. I think technology has helped uh make us able to automate lots of things that we were maybe doing manually. Um I'll give you an example. I remember when I started, we were doing manual charges for the when we saw patients that we took care of in the hospital. Um, and now we can do it on our phone, and that saved you know a few hours a week, which may seem small, but like it allowed us to do a lot of other things. Um, so I think if you can find the right technology, um, I know we're starting to look into even for our uh charting, you know, these different companies that are able to uh finish our notes uh in an automated way. So there's just a lot of way we we've been fortunate in certain ways that we've been able to um use technology um in a positive way to make sure that um you know make sure that we uh uh can move forward and we have the time too to um not only take care of our organization, but you know, take care of ourselves personally.
Dr Andrew GreenlandThank
Laws, Complexity And Modern Cancer Drugs
Dr Andrew Greenlandyou. And I think when we um chatted before, you mentioned that some state-specific laws make a significant difference to these models. How much does the regulatory environment environment determine whether an independent practice like yours can succeed?
Dr Neel ShahYeah, I mean, I think um uh every state has different laws. In America, the healthcare system, you know, quite frankly, not everyone even understands it. Um, but there's different insurances that are reimbursed different. Um, so there are just a lot of different variables when you think about an organization succeeding. There's just so many different variables very specific to our area, you know, our payer mix, our um uh the laws in the state and regarding, you know, uh reimbursement, um, all these things. So, you know, I think there are certain states that are a malpractice uh tort reform, you know. So for example, um uh Indiana um does have tort reform, which just means if there is a malpractice suit, it does go to a panel before it, not everyone can just sue doctors easily. So I think um all those things come into play when you think about uh organizational success, um the location and figuring those things out. So, you know, if there is an independent practitioner listening out there that is trying to start, you know, a practice, you know, I would say figuring out a lot of those details is extremely important to figure that out in the location that you're in.
Dr Andrew GreenlandThank you. And when we talked about before, I think you told me that oncology has gone from about 30 drugs to more than about 300 over a 15-year period. So, from a business and practice and management perspective, what does that increase in complexity do to an organization?
Dr Neel ShahYeah, so you know, 15 years ago, as I said, um we just had 30 drugs and you know they were all pretty much IV uh infusions. Um now we have a pharmacy. So, first of all, from the patient care perspective, it's been amazing. Um, cancer deaths, which um seven out of ten people that got any cancer would pass away. Now it's it's I think less than four out of ten. Um deaths are down 30, 40 percent. Some of that is screening, some of that is catching um uh people stopping to stopping smoking, um, and some of that is these is these new medications. So we have a lot of tools to help patients, a lot of non-chemotherapy tools. Um, and those tools include not only chemotherapy, but uh vaccines, immunotherapy, uh targeted therapies, and as you said, the complexity of all those, including training for our staff in terms of side effects for some of these treatments, like bi-specific antibodies, um, making sure we have like a compliance officer, which we do, making sure that we we have an oral pharmacy so we can supply the drugs to our patient, as I was mentioning, that pancreatic cancer drug, um, making sure that we're um when we have a new treatment, a life-saving treatment or a treatment that extends a patient's life, that we're able to get it as fast as possible. And that involves developing relationships with everyone, insurers, um uh farm from uh pharma companies, um, our local vendors. So just really a lot of moving parts. Um, but as I said, I think if if this podcast is about, you know, how can organizations grow? I think the most important thing is uh picking the right people. And sometimes that takes a couple times. We we made a few mistakes in the past. Um, but right now, you know, fortunately, we just have a great team in place um and figuring out um, I think uh the the strengths and the weaknesses of your team, I think is certainly important. Um and I think that extends beyond medicine, right? Um, whether it's a marriage or um another small business. Um and I've taken some of those skills, I think, to other areas that I'm interested in. But um ultimately um I think developing a great team and knowing what's out there and letting people do their job, essentially.
Reimbursement Battles, Misinformation, Future Plans
Dr Andrew GreenlandThank you. So you've talked about many of the things that you're very proud of in the practice and the things that are going really, really well. But what are the things that cause you frustration or things that you're challenges you're having to overcome on a day to day basis at the moment in you know providing this really excellent service?
Dr Neel ShahUm, you know, certainly reimbursement from Insurers, or you know, if I prescribe uh, you know, making sure we get reimbursed, the the authorization process is still, you know, very difficult. We have a great team that that makes sure that we uh get reimbursed. Um, but you know, that's when you talk about keeping the lights on. Listen, the doctors are just, um, I know all of our doctors are, including myself, are just trying to prescribe what's best for a patient at the end of the day. And when we prescribe what is in the national cancer guidelines and what's the best drug that we we uh know that it's best for a patient based on our training, years of training, and then the insurance comes back and denies or doesn't reimburse or approves it, and then later down the line denies it. I think that's one of our biggest headaches, I would say, as you mentioned, to keep the doors um open. Um, you know, sometimes there's a drug that may be available for a patient. Um, and um I will have to either call the insurance company or call the pharma company and just get that, you know, fight for that patient. I I think you know, we we uh so that that's one uh thing that's been difficult to overcome, especially at the beginning. And then I think number two is actually the misinformation that's out there. Um most people are really good people, and I think most of us interact in the world this way. And unfortunately, you know, what we see on the news to me is not indicative of the average American who is just a hardworking person. Um, and they have a lot of costs as well. And so um, when someone is faced with some sort of diagnosis because of the amount of misinformation that's out there, it makes our jobs a little bit more difficult to kind of explain to the patient that certain treatments that they may have read about is not really going to help them, or IV vitamin infusions, you know, unfortunately are are unlikely to help with their cancer. And um, again, I really don't blame um the patients. I I think the system is designed to get the the maximum amount of clicks, which just means attention. That's the that's for many companies, that's how they make money by getting organiz by getting uh uh getting attention, right? And what we do is provide you know honest information that um you know tries to help people. So I think those things are probably the the biggest difficulty in in running an organization. And um, you know, having certainly I think having honest you you you as you get older, I think you get better at having just honest conversations even when you disagree with someone.
Dr Andrew GreenlandYou've been doing this for a while. Is there anything that's um harder about running a practice today as compared to say five years ago?
Dr Neel ShahUm I think just those things. Um, you know, things are actually getting better because of um uh I think technology is allowing us to track everything better, um, to know, you know, if there's a problem. Um, but you know, really it's um the misinformation and um uh you know uh out there and then the reimbursement. I think those two things are still different they were difficult then, but they're just as difficult or more difficult now.
Dr Andrew GreenlandNow you're a co-founder, you probably wear all the hats at various points in the different roles that you have in your practice. What are the things that keep you up or wake you up at three in the morning that that worry you?
Dr Neel ShahI would say I the first five years, I would wake up a lot more at three in the morning. And it's not just because I had young kids, um, but I think I was certainly worried about the practice surviving um as an organization, as you said, keeping the doors open. Now that we've been established, that I think, you know, thankfully um the community, including the community leaders, have, you know, kind of recognized us as the leaders in oncology in Northwest Indiana. We're really proud of that. And we've, you know, as I said, we have a research program. We are constantly, as new drugs get approved, we're constantly putting them into place. We have a bi-specific antibody program. Um, so we're doing things that even universities don't do. So we've kind of, you know, we've kind of um grown enough to where I think making sure that we continuously uh can advance care um by watching um, you know, these on the business side of things, making sure that we're getting reimbursed for all the care we provide. I think that is uh essential to keeping our doors open. Um but at the at the same same time, if I'm being honest, um, you know, it was much more difficult back then. Now that you know we have a larger organization, it's difficult to watch everything. But at the same time, you know, that first few years was was some of the most difficult years that uh, you know, I think any founder or any business goes through. But certainly I very uh I it's given me purpose. I I see the pride in not just taking care of patients, but taking care, knowing that on the back end that we're taking care of them in the way that I will want my own family taken care of. And some of that has to do with the business side of things, as you said. Um, but I think if you can provide a service like that, then you'll be successful. Um, and obviously um making sure that you treat people properly, it sounds simple. Um, but you know, we do our best to do that.
Dr Andrew GreenlandAnd you were mentioning about keeping the doors open is a phrase you you used, and you've become very established over time. Is there anything over the next few years that could fundamentally threaten the independent model that you've built?
Dr Neel ShahAbsolutely. If there are laws that come into place that give hospitals even more of an advantage than they already have, then that would certainly threaten it, um, which just means that um they have better pricing on reimbursement. Um Dr. Greenland here, uh I explained this to patients. You come to my office and you get a $5 CBC, which is a routine blood test, right? If you go to the any hospital, it's $50, right? So, I mean, ultimately, there's just an advantage to that larger organization being able to charge more to the patient for the same service. Whether it's right or wrong is irrelevant. It just is what it is. So when you say that if they somehow blame the independent doctors for increasing healthcare costs and they cut our reimbursement even more, then I'm not, I think the number of independent doctors will go down more, and there'll be a higher cost to the system, of course. I mean, I mean, I'm giving you just one example. Some of these cancer drugs, which the doctors don't set the price, um, are thousands of dollars, and the hospitals can reimburse a lot more than an independent practice. So I think though that's the that would be one thing that could lead to the end of independent practices and increase the debt and increase health care and provide we know this, that they provide worse health care. I mean, at the end of the day, it's just bad in every way, but certainly, you know, independent practices like mine, we don't have lobbyists in Washington, right? We we just um try to take care of patients. We we don't have influence over, you know, um a lot of um you know politicians, and we're not really involved necessarily in making those rules because ultimately um care would be better, um, cost would be lower if there were a lot more independent practices.
Dr Andrew GreenlandYou mentioned the importance of your team. You've got a very strong team, you've made some, you've made a couple of mistakes with people in the past. What is your secret source for getting the right people? What what are the things that you've learned to look out for in people that really make them a success in your uh practice?
Dr Neel ShahYou know, I know myself, I'm not always the most patient person. I think having patience um in understanding a problem is like really important when I also um am on the board of some startups and just listening to people and understanding that do they understand the problem and how are they going to approach solving that problem? And then just letting, if they're a good person that's well intentioned, I mean, I think for all of us, right? Even our friends, a lot of what we do is based on intention. We may say or do the wrong thing, but if the intention is good, we'll get it right eventually. So trying to figure that out um amongst um, you know, everyone we meet, really, even the doctors, right? I mean, even the patients are trying to figure that out. Is this doctor really trying to help me? You know? And I think when you're genuine, um, I think those types of things will will work out and you'll find the right people.
Dr Andrew GreenlandIn co-founder mode, um, what are the biggest drains on your time and energy in the practice? What are the things that you least enjoy doing? Obviously, you have to do as part of your role that you'd rather not have to do.
Dr Neel ShahUm I I think um, you know, you try, you you real, you know, when you go to work, you spend more time sometimes with your staff than your family, even sometimes. And you try to make everyone happy, but it's not always just gonna happen. You do your best. Um, and I think that is always the hardest thing for a lot of us is to try to make everyone around us happy um in many different ways, whether it's emotionally, whether it's financially. And um, I think that's that's hard to do on a day-to-day basis because some days are just not gonna be good days, or there is you know some issues that need to be fixed. And, you know, because we maybe because we've had so many COVID, we've had uh direco, you may or may not have heard there was something uh once in a thousand-year windstorm. I mean, you're talking like damage that looked like a war zone um in my area. And you know, we still were able to take care of patients. Um, and we've had so many things happen to us in a negative way that we've always overcome that. Um, so we're really, really proud of that. But I think that's the hard the hard that was originally very hard. Now it's gotten easier to just know that, hey, our power is out. What are we gonna do? We we're gonna, you know, still take care of patients, still figure out a way to keep our doors open and make sure the patients are getting you know the infusions that they need. Thank you.
Dr Andrew GreenlandIf I gave you a magic wand and you could um fix one thing inside the practice that you directly control tomorrow, what would that be if anything?
Dr Neel ShahOoh, um I'd say if we could um I I I think my biggest uh bane is that there's a lot of like we're having a nice conversation today, but when I see patients, the technology is not there to where I can talk and it clicks through and it creates my note and sends all my orders through. So right now I'm still messaging everyone on through a messaging app that we have in our system, or I'm talking a lot, and I think uh and then I'm typing and I'm thinking and I'm typing. I think if if things just happen, for example, I saw a patient went over everything, the note was just there, and then I wanted these orders and I wanted this follow-up, and I could just talk versus clicking, clicking, clicking on the computer. Um, I think if somehow uh that I think that's probably my biggest barrier to efficiency in the practice. And um, so I think that's and then certainly um, you know, uh we're always trying to just advance things, and sometimes uh there's a lot of red tape still. Um so we're we're just trying to move things along. There isn't anything specific though. Overall, it's it's it's been a tough but very rewarding journey.
Dr Andrew GreenlandFantastic. And in Kaising, what where would you like your practice to be in 12 months' time if you to kind of talk about your goals going forward?
Dr Neel ShahOh, I I think we've developed a model um uh that can be uh repeated. Um and our goal would be to continue to grow, to have the most, the the we already have more clinical trials and research than most universities, many universities. I would like us to grow to expand that program throughout our state and um be able to continue to provide patients with really the latest uh drugs when they run out of options, really. I mean, we have a lot of patients still that are dying of cancer, of course. So I think if we can do that um and uh collaborate with our local hospitals, again, as I said earlier, they're not enemies. They're they're doing what they do, but I think continue to collaborate uh with them. We have one uh partner in the area, but I'm hoping we can continue to have more partners in the area so that cancer care really is in the hands of the independent physicians that know what they're doing in every way, um, whether it's uh taking care of patients or even on the organizational business side of it. We we know how to do this. And so I think there's been a lot of resistance, um, certainly from certain hospital systems in our area. But I think if they realize it's best for the patient, and ultimately um I think if the rules bend in the way that we hope that they'll bend, then we'll be able to provide better care for the people in our area. And uh that's what I'm hoping for.
Dr Andrew GreenlandWell, with that, Nia Lovecha, thank you so much for joining me today. It's been a really interesting conversation. Thank you for sharing so candidly and honestly the inner workings of running an independent practice such as yours. I think you've managed to maintain an independent practice in the market where independence itself is becoming increasingly unusual. And I think there are many lessons that practice owners and uh people out there even outside of college can learn from the conversation. So thank you very much. It's been an absolute pleasure having you on the show.
Dr Neel ShahThank you for asking me to be here.