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. Sanford J. Siegel.
As former President and CEO of Chesapeake Urology Associates (CUA) and United Urology Group, and now Chairman of the Board, Dr. Sanford J. Siegel focuses on expanding its business model as an independent medical practice to urology groups across the nation. Founded by Dr. Siegel in 1999, CUA has become one of the country’s most prominent urology practices and the largest in the United States. Dr. Siegel advocates for prostate health awareness and education, specifically in the African-American community where the cancer is most prominent and with a higher mortality rate.
Thank you so much for joining us! Can you tell our readers a bit about your ‘backstory”?
The path I chose in life did not start as you might think. I took the long road with many twists, turns and roadblocks — many of them caused by me. Dating back to elementary school, I may have been the class clown, and no one would have characterized me as a great student — I even had to repeat the fourth grade. In fact, that trend continued well into high school as I hardly graduated.
And, that’s not even the half of it. I started my medical schooling at a medical university in Guadalajara, Mexico, where everything was taught in Spanish. By some miracle, I was able to transfer to the University of Maryland School of Medicine for my clinical years and graduated with a medical degree. Fortunately, I landed a solid residency at Temple University. Even then, you’d classify my performance as a fair resident, not the best. From there, I had a tough time getting a job out of Temple and ended up in Wilkes-Barre, Pennsylvania. From day one, I could see the writing on the wall, and they told me I would never make partner. So, I came back home to Baltimore. I didn’t know any practices or doctors, but I knew the area and found myself more determined than ever to achieve what I set out to do.
Ultimately, I did achieve my goal despite the barriers in my way. In August 1985, I opened my own practice as a solo urologist and only collected a little over $300 my first month. Today, we provide treatment and care for over 300,000 patients a year and generate a lot more than $300 a month. It’s amazing what you can accomplish with a vision, motivation and determination to succeed.
For those who aspire to a career in medicine, please know you may not jump start your career as the shining star or the stellar performer that everyone expects of you. You must possess a vision with the unrelenting desire to overcome adversity despite all odds. With that, no one can stop you.
What made you want to start your own practice?
Many doctors know very early on in life they want to work in the healthcare field and have a natural curiosity for the profession. The same holds true for me. As part of the aftermath of a fight with my brother (that I’m sure I won), I had sliced my arm wide open and was immediately fascinated by the gash and the doctor who cleaned my wound and sewed me back together with stitches. I knew then I was going to be a doctor.
It wasn’t until my third year of medical school that I knew my path would lead to urology. At that point in your schooling career, medical students participate in different rotations. I did four weeks of urology my junior year. This rotation not only offered me the opportunity to learn about urology from real-world experiences but allowed me to cross paths with the then-Chief of Urology at the University of Maryland, Dr. John Young. He was one of the most fabulous men I have ever met, a true mentor and teacher. I thought to myself, “if everyone in urology is like Dr. Young, then that’s what I want for my career.”
Having faced many obstacles to this point, including nobody wanting me to join their practice upon my return to Baltimore, I realized I needed to start my own practice and from now on control my own destiny. I was a solo practitioner for seven years before bringing in a partner, Dr. Kenneth Langer. With great ideas and a go-getter mentality, Dr. Langer complemented my innate ability to execute and get things done. We made a great team and, in 1992, we began to grow our practice and developed our first surgery center. This growth started a model and a trend that continues to this day.
Managing being a provider and a business owner can often be exhausting. Can you elaborate on how you manage both roles?
It’s about walking down a road, coming to the fork in the road, deciding the best road to take and taking it — taking advantage of all opportunities. It is also about taking risks and not fearing failure. It is the understanding that no one person can do this alone. You must surround yourself with good people. I continued to hire and partner with good, well-trained urologists and business people to support our patients and catapult our growth — I maintain this philosophy to this day.
In addition to creating a good team with good people, you also have to go with your gut. Many times I will choose to follow my instinct rather than to rely only on data — it is a practice that proved successful over the years. Case in point, in 1999, we navigated through our first merger to create Chesapeake Urology Associates. The urology group we engaged for the merger had 45 years in the industry; we had seven years at the time. I knew their experience and brand in the community could only provide positive energy and serve as a catalyst to our already growing practice. We went from six doctors to 14 and expanded our practice in the community with this merger.
As a business owner, how do you know when to stop working IN your business (maybe see a full patient load) and shift to working ON your business?
I always knew my job was a seven-days-a-week job. In the beginning, and for the first 20 years of my career, I would see 25–30 patients several times a week, operating several days a week all while running the business. When I felt I was not able to focus and provide the quality care I was used to delivering, and that the patients deserved, I moved to a full-time position as CEO. Sometimes that’s a hard to recognize. Fortunately, I had been working with a CEO coach since 2010 that helped me greatly with that transformation. Most importantly, I had the support of my partners that allowed me to move into that full-time role.
By having excellent people working with me, I never found it difficult to strike a balance. I trusted my teams do their jobs, and they performed beautifully. The people around me executed the vision with precision and unmatched passion.
From completing your degree to opening a clinic and becoming a business owner, the path was obviously full of many hurdles. How did you build up resilience to rebound from failures? Is there a specific hurdle that sticks out to you?
The hurdles usually revolve around people who either don’t see your vision or think they can do it better than you. Getting people to march together can prove difficult. You have to set your vision, get people to believe in that vision, and not let people or obstacles get in your way.
Right out of college, I had a seasoned physician give me the worst piece of advice. This doctor, who happened to have also been one of my camp counselors as a child, reached out to me when he heard I planned to relocate back to Baltimore to practice Urology. He tried to persuade me not to settle in at Baltimore County General, where he was practicing but recommended starting at a suburban hospital much farther away. His recommendation only strengthened my resolve, and I later thanked him for that. I took it as a challenge and made it my quest to be successful. The first six weeks after I started practice in July 1985, I personally visited over 100 doctors in the Baltimore area to introduce myself, share my vision and to reassure them of my ability to provide quality urological care. I reached out very early on to make connections with referring doctors to show that there was nothing I wouldn’t do, no patient I wouldn’t see and no places I wouldn’t go. Later in life, that doctor, Dr. Melvin Kopilnick, who inadvertently created a fork in the road, became a very good friend and I took over his practice when he retired. I have continued to build up a tremendous network of friends and colleagues around the country that have helped me grow and bring benefit to CUA.
Taking risks is something most physicians don’t do well. Failure is okay as long as it’s not fatal.
What are your “5 Things You Need To Know To Grow Your Private Practice” and why?
- Begin with an inspiring vision of what you want to materialize. Set a direction and clearly define milestones to lead you there. We knew right from the start that CUA’s vision would be to provide high-quality, accessible and cost-effective care for our patients. All of our patients will receive a superior patient experience. This focus assures our sustainable growth for the future.
- You can’t get there alone. The vision creator often wants to take sole responsibility for the challenges and the successes. Don’t. It takes a host of people to help realize a vision. As we went from six physicians to 14 with our first expansion, to our present structure today of 125 doctors and almost 1,100 caregivers, we continue to surround ourselves with well-trained, like-minded urologists and the most competent business team to make our growth a reality.
- Hire the right people to help you execute your vision. Partnering with and hiring the right people will help you to see and navigate around the roadblocks. Just as I partnered with Dr. Langer in 1992 and knew our skillsets meshed, hiring the right people and letting them do their job is critical to success.
- Expanding a practice is not about making more money; it’s about expanding a caring culture, highlighting sound management, spotlighting superlative governance and continuing to recognize people for their efforts. With a commitment to the patient at the forefront, the profits will follow.
- Involve yourself in the community. Work defines a paycheck, care for community defines a legacy. Gravitas in the community affords CUA the ability to create greater awareness of who we are and what we stand for. Our culture has always sought to do unto others as you would have others do unto you — The Golden Rule. Treat people well, with respect and honesty, and they will follow you most anywhere and take a leap of faith with you. Trust will follow, I promise!
Many healthcare providers struggle with the idea of “monetization”. How did you overcome that mental block?
Allow me to first answer this question with a quote from George Merck Jr., “Medicine is for the patients, not for the profits.” As a doctor, you must subscribe to the philosophy of a commitment to patients before profits.
Our mission has always been to provide a superior patient experience. Over the past three decades, we’ve continued to provide high-quality care, marketing the services we offer as effective and efficient care. We hire doctors, grow our geographic footprint, build relationships with hospital partners and do many things in the community. All of these efforts allow people to recognize CUA as a caring place to go for care. Elected officials and decision makers know of us because we’re in their districts making a difference.
As an independent urology practice, we control our own destiny. Medicine is medicine, whether you practice in a hospital, academic or independent setting. The profits will follow as long as you provide high- quality accessible care.
What do you do when you feel unfocused or overwhelmed?
Not everything is always going to work out the way you hoped. If you do what is right, follow your instinct and treat people well, you will live to fight another day. I have always understood my mission in life, and that has given me a sense of purpose, keeping me from feeling unfocused or overwhelmed.
Since my diagnosis of advanced prostate cancer in 2017, my mission became even more personal. I am even more focused on fighting this disease for all men. With the supportive and dedicated people around me, it truly is difficult to lose focus. I intend to raise even more awareness, to serve as a stronger advocate for men’s health issues and to raise even more money to find a cure. With my team, family, friends and community by my side, we can accomplish great things.
I’m a huge fan of mentorship throughout one’s career — None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
Dr. John Young, as I mentioned previously, and Dr. A. Richard Kendall, the former Chief of Urology at Temple University Hospital, who instilled a love for urology and gave me opportunity. That is all someone like me needs sometimes, someone that recognizes you may have something special. I owe so much to these two men.
Of course, there are other people along the way who have helped me, especially employees at Chesapeake Urology. As a leader, how would I know what’s going on inside this large company and keep abreast of the morale and the concerns our employees have? It’s the special relationships I have with people I trust inside the company that help me appreciate the everyday struggles our employees live with and still work hard every single day to fulfill our mission. I assure you that made me a more compassionate leader; made me a caring leader.
You can’t achieve success unless you understand what the everyday caregiver experiences and feels. You have to find the time as a leader to touch your employees, listen to their concerns and fears. Some will take advantage of your good intentions, but never give up on them because most will walk over hot coals for you.
What resources did you use (Blogs, webinars, conferences, coaching, etc.) that helped jumpstart you in the beginning of your business?
I never got an MBA, and you don’t need to get one to do what I did. You need good instincts and the right people in your corner.
Let me tell you the best thing this company did. In 2008, with the approval of my physician partners, we built the CUA C-suite, which had previously been manned by physicians. That is until we decided to hire my next-door neighbor, Steve Bass, as CEO. I’ve known Steve for over 50 years, and there’s no one like Steve in the urology world or who has his diverse skillset. He built our C-suite and together they brought a business environment to the company that didn’t exist. We’ve now all been together for 11 years, and without question, the company wouldn’t be where it is today without Steve as our CEO.
On a more personal level, there was a time early on when I was struggling with my leadership skills and ability, and it was suggested I obtain a CEO coach. I can confidently say that working with Faith Mauro-Huse, PhD., as my coach saved me and possibly my tenure as the leader of CUA. Faith has since coached several of our doctors and non-physician team members within CUA. She helped me listen and lead better. She changed my life both personally and professionally. I can without hesitation state that without her, CUA would most likely not be where it is today, and I surely would not be the leader I am.
This company reflects a true team effort. I hate that I get all the praise for the success of this company and our philanthropy efforts because it’s not warranted. We should bestow the praise upon every single unsung hero who provides care for our patients throughout their entire journey. You could say that I drove the bus, but they were in the right seats. We’re a team, but more importantly, we’re a family!
Please recommend one book that’s made the biggest impact on you?
“Good to Great,” by Jim Collins. This book moved me. I even gave it to my executive committee members. After reading it, they came to understand our path to achieve greatness, the need to work together and the type of leadership necessary to guide us to sustained success.
Where can our readers follow you on social media?
Readers can follow and engage with me on Facebook and Twitter at @ChesUrology, as well as on LinkedIn.
For other incredible interviews, please check out our podcast: Healthcare Heroes.
A special thanks to Dr. Siegel 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!