Money Checkup Podcast

Episode 51: Physician Leadership with Brent Lacey, M.D.

Dr. Brent Lacey coaches physicians in all phases of their careers. He works with doctors to find the right institution for their goals, to assume leadership roles and advocate for change within those institutions, to launch their own practices, and to master their personal finances. 

Though physicians typically work in silos, Brent says, COVID-19 has demonstrated how important it is for physicians to understand the inner workings of their hospitals or practices and to advocate for the changes they wish to see — and if the culture is too entrenched for those changes to occur, he encourages physicians to move on. 

“The most effective way to bring about change is to participate in it.” 

It takes courage to ask questions of leaders and to have difficult questions with them, but those are hallmarks of leadership too, Brent says. 

About the Guest:

Dr. Brent Lacey is a gastroenterologist who is passionate about helping physicians succeed with business and personal finances. He is the creator of The Scope of Practice, a website and podcast full of resources to help physicians learn how to manage their businesses successfully and master their personal finances. Dr. Lacey has coached hundreds of families to succeed in eliminating debt and has spoken to physician groups around the country on topics related to business and personal finance.  

Social, website, book link:



Twitter: @BrentLacey4

Instagram: @TheScopeOfPractice

Episode Highlights:

  • Dr. Brent Lacey started The Scope of Practice to give physicians the tools they needed to manage businesses successfully. Medical schools offer essentially no training in business or personal finance, despite how many physicians become partners in practices or launch their own practices. 
  • COVID-19 forced hospitals all over the country to cancel elective procedures, significantly reducing revenues. Hospitals that weren’t financially prepared cut physicians’ salaries and hours, which forced many physicians to realize that their employers weren’t as financially secure as they hoped. 
  • Brent thinks hospitals and physicians alike need to have cash reserves and multiple income streams. 
  • Hospitals that don’t make changes after the pandemic are making a “dramatic error,” Dr. Lacey thinks. He encourages physicians to get involved in decision-making at their hospitals, whether that means getting to know your Chief Medical Officer or department chair, joining a committee, or otherwise. If your hospital discourages you from speaking up, that may not be a place where you want to work. 
  • If you’d like more influence in the hiring process, start by working to foster the kind of culture you want to work in. To be more hands-on, seek out a position on an advisory committee or get to know your hospital’s human resources leaders. 
  • Physicians often work alone or in silos, which makes it hard to develop institutional or company culture. To set yourself apart as a leader, Brent recommends repeatedly emphasizing your mission and core values and celebrating moments when staff members exhibit those values. 
  • If you’re considering joining a practice, Brent recommends talking to someone who was recently hired, who can give you an idea of what it’s like at that institution. Ask specific questions like “what’s the best thing about this place?” or “what’s the one thing you would change?”
  • If you can, try to talk to someone who’s left the organization before you accept an offer there. They may be willing to say things about team dynamics that current employees are not. 

Words of Wisdom: 

“The most effective way to bring about change is to participate in it.” 

“The hospitals that are run by physicians, by and large, are safer, they are more profitable, and they have better patient satisfaction scores and higher employee retention rates. It’s just better.” 

“Physicians need to be banging on their leadership now, saying, ‘OK, how will we weather the next storm?’” 

“Start with the culture. Does your hospital encourage people to speak up? Does it encourage innovation? Does it encourage people to call out problems? If you don’t have that, I think that’s where you start. That’s an area where you can leverage influence.” 

“If you are constantly casting vision and reemphasizing your mission and your core values, then they will actually be known, and then they can actually be imbibed and practiced. You have to define your values, but if that’s all you do, you haven’t really accomplished very much. You need to be constantly, constantly, constantly talking about them.” 

“You won’t get answers if you don’t ask questions. If you’re trying to make changes, first you’ve got to believe that change is possible, you’ve got to believe that you can achieve what you want, and then just start going for it. Ask questions. Be dogged about it and keep hammering people until you find out what you want to know.” 

“Have the courage to ask tough questions and have difficult conversations, and have the courage to say, at some point, ‘you know, this may not be the place where I want to be.’” 

“You get one shot at being happy and successful in your career. There’s no reason to spend 30 years in a medical practice that you absolutely hate — so either decide that you’re going to participate and change it, or move on, and decide that that’s OK. But don’t settle for something less than exceptional.” 

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If you liked this episode, here’s another I think you’ll enjoy: Episode 38: Launching a Practice with a Partner

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