As a part of my interview series with prominent medical professionals about “How To Grow Your Private Practice” I had the pleasure of interviewing Dr. Dominique Fradin-Read.
Dr. Dominique Fradin-Read, M.D., M.P.H. has spent a great part of her career focusing on preventive and anti-aging medicine. She is dedicated to helping her patients stay healthy and maintain their energy and youthful attitudes as they get older. She practices what she likes to call “vitality medicine,” addressing lifestyle changes, improving each patient’s metabolic functions, and optimizing body and mind biochemistry as needed. Her favorite topics are hormonal balancing in both women and men, weight loss programs, and her French natural approach to skin and hair rejuvenation.
My back story is both pretty simple and quite full. I started my career in France, opening my own practice at the age of 25, and prevention immediately became my passion. I moved to the U.S. for romantic reasons in 1999 and got married; I then had to re-do all my medical studies. I passed the various required medical exams, finished an internship at UCSF, and completed a residency in Preventive Medicine while simultaneously earning a Master in Public Health at Loma Linda University. I obtained my board certification in Preventive Medicine in 2006 and later became a fellow and board-certified in anti-aging medicine. I worked for several years as a staff physician, first at Loma Linda’s Center for Health Promotion and later with renowned dermatologist Dr. Howard Murad with whom I collaborated on the concept of “beauty from the inside out.” Lastly, I served at LifeSpan Medicine with Dr. Chris Renna.
I see two reasons for this
1) I believe that I always had the mindset of an entrepreneur. This might come in part from the example of my dad who was a very successful CEO and who sent me to Dale Carnegie to learn the techniques of leadership and communication. I opened my own first practice in France at a very young age and then a second one when I was still living in Europe. I worked for a few years for Abbott Laboratories in France, developing marketing campaigns and managing a group of sale representatives during the launch of product for meal replacement and weight loss (Substi 500). I had fun teaching my team about nutrition and weight-related health risks, and I really enjoyed the idea of working with my own staff and sharing my passion and enthusiasm for health and prevention.
2) My ideas expanded, however, after I moved to California and worked for a few years in various medical practices where I observed the way that medicine is practiced in America. I began to think that, as I was lucky enough to have received medical education both in Europe and in the U.S., my true mission was to incorporate some aspects of European medicine in my current practice in the hope that this blend might benefit the health of my patients. I wanted to contribute something unique to the American healthcare; this would be my way to return the warm welcome that I had received as a French physician when I came here to live.
For me it is a question of organization and time management
My first rule is: “My patients will always come first”. Thus, even if I am in the middle of an administrative task, when a patient calls or needs something urgently I give priority to his/her need and return later to my managerial duties. As this is a fundamental aspect of my practice, I have no hesitation doing so.
My second rule is to reserve at least a full day of the week for all the administrative tasks. I have to admit that, so far, that day has been Saturday; I hope to be able to handle business matters in the near future on a weekday, as I recently hired a wonderful nurse practitioner to help me with patient care.
My third rule is to hire the right people to help me with the business part of the practice, to train them well, and to trust them once they are ready for the job. Knowing how, when, and what to delegate is a very important part of running a practice, especially when you are involved in the daily patient care as I have been so far.
My last rule is to know my limits in terms of energy and health and to stop and get some rest long before I might become overwhelmed because of exhaustion. I know that I need to go to sleep early in order to be in good shape the next morning, and I try to respect decent bedtime hours on a daily basis. My patients smile each year when August comes around, as they know that this is when Dr. Read takes three weeks off to get to France for her “self-rejuvenation” treatment. They are nice enough to respect this, and they try to request all their refills and ask their questions before I leave for Europe.
Please see rules one through four above!
In looking back, I honestly cannot say that the path was “full of many hurdles” or failures. While it was not always easy, it was not that complicated either. The most important factors were to make the firm decision to open my own practice, and — once that decision was made — to believe in the success of the idea and do everything possible to reach my goal. As a European, I often had heard about the “American dream” and about the premise that everything was possible in the United States as long as you had both courage and some talent. In time, I discovered that the American dream is real.
I had in mind a quote from a French philosopher: “Il n’y a rien de plus puissant qu’une idee… quand elle vient a maturite” (“Nothing is more powerful than an idea…when this idea comes to maturity”). After a few years of working as an employee and thinking about the dream of opening my own practice, I was ready; the idea had reached maturity, and I needed to take the professional plunge.
I prepared a long “To Do” List and started working on the project, weekend after weekend, while still working as an employee during the week, and with the help of my husband and three close friends who knew my secret and were involved in the project. I hired professionals in accounting and from the medico-legal field to make sure I was not missing anything. I gradually wrote all the documents that were necessary for the practice, designed my website, and connected with pharmacists and colleagues to build a network of referrals.
My determination was also strengthened by my previous experience as an equestrian. I recalled a motto that our instructors had used when urging us to guide our horses successfully as they jumped over obstacles: ”Calme, en avant, et droit”, (“Stay calm, go ahead, and straight forward”). As a physician, I had the feeling that if, I followed this motto, all would go well. And it did.
Perhaps my biggest hurdle has simply been the need to avoid putting too much on my plate and the occasional struggles with time constraints. One day, for example, I was in a hurry to attend a conference in the midst of all my other duties. I had had a slight argument with my husband early that morning, and I was under a lot of stress when I finally got into my car and turned on the ignition. I was still in the garage when I heard the ring of my telephone inside my purse on the passenger seat. I tried to reach into my bag — and suddenly I heard a big noise, felt a horrible jolt. My car had stuck a pillar in the middle of the garage, and oil and water were leaking furiously underneath. I had just crashed my nice blue Jeep Cherokee, and I had the feeling that its prognosis was not going to be good. My car was indeed a total loss, unfortunately; the incident was a sign that I needed to slow down before something more serious might happen to me. Happily, I have learned how to better manage the demands on my time since then!
1) Medical knowledge and professionalism: Be good at what you do; know your limits and what you do not want to do. Constantly learn and stay up-to-date to offer the best care possible to your patients and become a pioneer in your field. While in Las Vegas recently for our annual conference on preventive, regenerative, and anti-aging medicine, I attended an interesting workshop on wellness and prevention. Based on what I learned there, I am now working on developing new treatment plans and programs at VitaLifeMD. They will benefit patients who want to keep their health and vitality at optimal level as they get older. I am currently trying these treatments on myself in order to be able to share my personal experiences with my patients in a few months.
2) Team-building: I believe in the concept of “one team, one philosophy.” Find the right team to collaborate with you. Treat everyone with respect and consideration, be fair in any situation, and offer the right training for each position. Engage your employees in the success of the practice and reward them for their good work with personal recognition and opportunities for growth as well as financially. My staff knows that I see VitaLifeMD as ourcompany and that we thrive when everyone is involved and effectively communicates the message of what we do. I take every opportunity to share my passion and educate them about prevention and wellness. Recently I gave them in-depth training in a new treatment that helps restore energy in case of fatigue. I offered a free treatment to all my employees. They all became enthusiastic about it and started talking to others about their own experiences and the benefits of the new treatment The demand for the treatment increased so dramatically during the following week that we ran out of the product quickly and had to reorder twice as much of it in the weeks that followed
3) Patient-driven practice: Make your office a welcoming and happy place where patients like to come and rest. Listen to their recommendations or requests with regards to the way you run the practice. Our patients are also our customers; in addition to trying always to provide the best medical care, we aim at offering a warm and pleasant environment, and we make sure that all aspects of the practice are running smoothly. When I opened the VitaLifeMD in October 2015, there was no front-desk receptionist for a few months, and several patients complained about it. A patient of mine who had been under my care for more than ten years followed me when I opened my practice, but she suddenly decided to go elsewhere as her she had a bad experience in scheduling her appointments and complained about the waiting time in the office. We remedied the problem by hiring a nice receptionist who has since played an important role in the smooth functioning of our practice. The patient who had left has since returned and has acknowledged the improvements we had made after she left.
4) Be curious and stay open to any opportunities: As your practice grows, you meet interesting people, and various unanticipated opportunities may arise. I first met actress Gwyneth Paltrow, for example, when she came to me as a patient. Gwyneth had heard about my experience in treating hormonal imbalances in peri-menopausal and menopausal women. During our consults, I explained that this was one of my favorite topics and that there was a need to de-mystify the term “menopause” which had such bad press in our civilized countries. We soon realized that we both were passionate about the topic and that there was a great need to help and educate the many women who experienced inexplicable symptoms and considerable discomfort during menopause. Shortly thereafter, Gwyneth asked me to collaborate with goop in various settings. I was interviewed for an Q&A article “Don’t Call It Menopause,” and I participated in the popular wellness summit “In goop Health” in Los Angeles in June 2018. Because of my experience in treating patients with natural supplements, Gwyneth subsequently asked me to help formulate a multivitamin/supplement pack designed to regulate hormones in women in their 40s, 50s, and 60s. The result was the creation of “Madame Ovary,” a comprehensive nutrient-packed blend that includes vitamins, phytonutrients, brain- and heart-support omega-3 fatty acids, menopausal symptoms-calming herbs, mood-support adaptogens, and thyroid-function natural mineral aid. These packs already have done wonders for several of my patients, and they hopefully will help many more women in the future.
5) Keep your practice unique — what you offer to your patients, and the way you offer it. Your practice should be based on your medical education and expertise, but it also should reflect your personality and should be inspired by your life experiences. As a Frenchwoman who has lived in California for almost 20 years, I am inclined to offer a blend of care that combines science with art and focuses on a natural approach to health. A dear patient of mine one time told me, “I chose you because you have good instincts.” I believe that this is a reflection of my French medical training and perspective — a commitment to focus on the art of medicine and on the clinical evaluation of a patient before rushing to order expensive imaging and testing. Science and new technologies are important as well, of course, and I combine them as needed with the traditional European way to practice medicine. Finally, I acknowledge that I am an emotional person and that there is great emotional connection between my patients and me. I do care for them; I sense that they feel it and I believe that this is part of the unconscious healing from which they benefit.
I believe that the desire to open my practice and to realize my dream was so prominent in my mind that it overcame my fear of monetization. In retrospect, I do not recall having had too much anxiety about it. I had some savings that I used to finance the necessary expenses to launch the practice, design and build the office space, and pay both my employees and the basic overhead costs for a few months. I personally worked without salary for several months. I kept in mind the words often spoken by my father when he discussed his career successes — “no risk, no money.” I was convinced that, if we worked hard to offer good care and provide good service, most of my existing patients would follow me to my new practice. The risk, thus, was worth the effort. I am so grateful that most of my previous patients did in fact follow me; they have remained with us and have referred to me so many of their friends that I have had to hire a nurse practitioner to help me with our ever-growing patient load.
As a specialist in prevention, I try not to reach the point at which I might feel unfocused or overwhelmed. As I mentioned before, I know my limits, and I try to stop working before I get too tired. I fortunately have a high energy level and can work long hours. If I feel that I am becoming unfocused or overwhelmed, I leave the office right after my last patient consult and return early the next morning to complete routine paperwork. As I have never been a night person, I prefer to wake up early and finish my work when my office is quiet and no one else has arrived yet.
I am fully aware of the health risk of stress, and I try to protect myself from becoming overwhelmed. Exercise is my usual escape, usually outdoors and not too strenuous. After a good hike along the ocean with a friend, for example, I am as good as new. I also rely upon proper nutrition, a good regimen of supplements to keep me balanced, and some healthy, strikingly effective treatments for energy support as needed.
I have had several mentors in my life, and I am so grateful for ways in which each of them has helped my career. While there have been others, three particularly cherished mentors have been critical to my success.
My first mentor, in the late 1980s, was not a physician but one of the world’s most renowned French chefs: the legendary Michel Guerard, one of the founders of the French nouvelle cuisine. I had the opportunity to work with Michel both as the principal physician at his 5-star hotel and spa Les Pres d’ Eugenie in the south of France and as the Medical Marketing and Communications Director for his group. In both these capacities I collaborated with him on the medical side and helped develop weight management and nutrition programs based upon his famous new gastronomic slimming cuisine. I traveled with Michel all over France to market our programs. I learned the importance of “keeping the notion of pleasure” fully present in any nutrition plan, and I still incorporate this important aspect of a diet when I give recommendations to my patients.
My second mentor was Dr. Warren Peters, my attending physician during residency and Medical Director at the Center for Health Promotion at Loma Linda University. Dr. Peters is the physician who guided me in the development of my skills and expertise in hormonal treatment and weight management. During my last year of residency, he assigned me the best research project he could have found: a complete review of the literature on bioidentical hormones for both women and men. I already had an interest in weight management and hormonal imbalances. However, after two years of working on a regular basis under Dr. Peters’ tutelage, first as a resident and later as staff physician, my experience with and my passion for these topics grew even more, and this is probably why I now have so many patients who consult with me on these particular issues
My third great mentor is Dr. Howard Murad. I was lucky to meet Dr. Murad when he was looking for a physician to join his practice in El Segundo. At the time, he was developing the Murad Inclusive Health Center (MIHC), a center where beauty and health would be addressed jointly based on the principle that “optimal health” was necessary for what he termed “beauty from the inside out.” After I began work at MIHC, Dr. Murad introduced me enthusiastically to many of his patients; he organized several gatherings of patients at which I was the main speaker, and he always introduced me with generous and gracious compliments. I learned a lot from Dr. Murad and I deeply admire him as a healthcare leader whose sense of compassion and elegance are matched by his medical expertise and communications skills. He has a wonderful sense of humor which was particularly evident whenever we attended homeopathic classes together. It was Dr. Murad who really urged me to open my own practice when I was still hesitant a few years ago. He has become a genuine friend, and I am grateful for all his help and support over the years.
I attended a few coaching meetings in my field of practice, I read articles in peer review magazines, and I sought the advice of my mentor at Loma Linda University where I still hold an adjunct faculty appointment. I already had some good ideas about the medical aspects of the practice that I wanted to establish.
With respect to business aspects, my final decision to open my own practice was made in consultation with nutritionist Derek Johnson, a respected colleague who headed New Metabolism and who had referred patients to me for several years. Derek and his wife Lisa, his business manager, were interested in sharing an office with a physician, and he asked if I would be interested. Derek’s offer came just as I was beginning to brainstorm seriously about a similar project; we thus decided to join forces. Derek and his wife were extensively involved in the mechanics of launching my practice, and to date New Metabolism continues to share the office with VitalifeMD.
In addition, I received support from three good friends: Dr. Pejman Katiraei who had successfully opened his own pediatric practice a few months earlier, shared his experience, and gave me some advice; and two pharmacists who guided me through the practical and medico-legal aspect of starting an intravenous nutrients clinic.
Perhaps the worst professional advice that I ever received was offered by my program director when I was completing my first year of residency in internal medicine at UCSF. Although his advice at the time was well-intended, he did not know me well enough to understand my true professional values, goals, and aspirations. Had I followed his recommendation, I would have been miserable for the rest of my life and would have missed the opportunity to pursue my true vocation.
At the time, I was in the first year of a three-year residency in internal medicine in which I largely was repeating the training that I had received in Europe years before. At the same time, I was discovering the nature of standard-of-care in the United States. I was grateful to have been admitted to this reputable and competitive program and I appreciated the intense training in acute care and emergency medicine. Nevertheless, I knew that, in the long run, this traditional approach to medicine was not for me.
One Monday in October 2003, I experienced a revelation when the first patient assigned to me during my new clinical rotation at the ICU was the very same patient whom I had been asked to discharge from the VA hospital the previous Friday. This poor patient, discharged three days earlier for having brought alcohol into his room, was now in a full alcoholic coma, intubated, and fighting for his life. Fortunately, he did survive, but the dramatic episode prompted me to ask myself questions about my role as a physician and how I could help patients better in the future. I suddenly realized that I had to return to my first love: prevention. Having heard of several residency programs in preventive medicine, I immediately started to apply for a transfer. I soon was accepted by Loma Linda University, but I would need the approval of the UCSF program director in order to switch. Unfortunately, my timing was off.
When the UCSF program received the results of the in-service midyear examinations, I was identified as one of the top students — those whom the program director was determined to keep in the program. It is for this reason, then, that he offered me “bad advice.” After I asked him to approve my transfer to Loma Linda, he and I had several tense meetings in which he tried to convince me that switching programs would be a mistake. He argued that I had a great future working in the field of internal medicine and that I would obtain a job easily as hospitalist, as there was a shortage of such physicians at that time in the area. I responded that, while I truly admired the job of such colleagues, traditional internal medicine simply was not for me; my vocation was elsewhere. Finally after a good month of sometimes-difficult conversations, he reluctantly agreed to write me the letter of recommendation needed for the transfer. Now, nearly fifteen years later, I am confident that I was right not to follow his “bad advice;” and to resist his pressure as I did in order to be where I needed to go professionally.
I would recommend In Search of Excellence: Lessons From American Best-Run Companies by Thomas Peter and Robert Waterman. My father first read the book in the midst of his corporate career and later gave it to me when he retired. It was very informative, fun to read, and a welcome distraction at a time when I otherwise was buried in my medical texts. Aside from its content, the mere title of the book has become a constant motto for me. “In search of excellence” is still the way that I try both to practice medicine and to run my own practice.
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For other incredible interviews, please check out our podcast: Healthcare Heroes.
A special thanks to Dr. Dominique again! The purpose of this interview series is to highlight the entrepreneurs, innovators, advocates, and providers inside Healthcare. Our hope is to inspire future healthcare providers on the incredible careers that are possible!