Know yourself, and know your limits. Try to assess whether or not you might be cut out for private practice, to begin with. It’s one thing to pursue something you’ve never done before that might scare you; the reward is often worth the risk. That’s different than exhausting yourself on a path that’s not meant for you. A good starter question to ask yourself: How did you feel as an on-call senior resident, when you were alone, and in charge of a chaotic floor? Timid, scared, exhilarated? If you’re paralyzed by the thought of that, you might want to reconsider the private practice.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Loren E. Isakson, MD, MS.
Dr. Isakson is an internationally educated physician — board-certified in both allergy/immunology and pediatric medicine — and an Inlightened expert. As owner and founder of North Star Allergy, Asthma & Immunology, P.A., he provides dedicated care to patients of all ages in New York, Georgia, and Florida, and is particularly passionate about the development of novel immunotherapeutics for those with complex immune deficiencies. Uniquely attuned to the intersection of medicine and entrepreneurship, Dr. Isakson serves as a mentor and advisor through ScaleHealth and USF’s Student Innovation Incubator and previously established a fully functioning allergy and immunology clinic at MacDill Air Force Base.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
I was always interested in science and problem solving, which originally drew me to biomedical engineering an undergrad at McGill University. It didn’t take long for me to realize that I really enjoyed the biomedical side of things — and the potential impact of scientific therapies — so I majored in the multidisciplinary field of physiology. I took the MCATs prior to pursuing a Master’s in Biotechnology at UCONN. I completed several lab rotations there and benefited from a broad exposure to different opportunities, including summer cancer research training with the National Cancer Institute. Inspired by a visiting scientist there and my own desire to transition from bench to bedside, I started looking at medical schools and decided on the Sackler School of Medicine in Tel Aviv, which offered an incredible experience to gain a global perspective. I completed my residency in pediatric medicine at Schneider Children’s Hospital in New York (now part of Northwell Health). Post-residency, I tried to balance patient care and research by working simultaneously as a pediatric urgent care attending physician at Schneider’s and as an allergy and immunology researcher/Associate in the Department of Medicine at the Albert Einstein School of Medicine. I went on to complete my fellowship in allergy and immunology at the University of South Florida (USF), and briefly considered pursuing a PhD in translational medicine before going completely clinical. I’ve been in Florida ever since, where I helped launch an enduring allergy and immunology clinic at MacDill Airforce from scratch, and oversaw all clinical operations there for almost six years. After I started night school for my Master’s in entrepreneurship at USF, I was inspired to tackle my next challenge and opened my own private practice, North Star Allergy, Asthma and Immunology, P.A., in 2019.
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?
From coaches in high school football to collegiate lacrosse, my lessons in resiliency and getting back up after getting knocked down started early. In my clinical career, one of the biggest mentors was an allergist I trained under in fellowship. A widely respected MD and former president of a national allergy society, he always challenged me to do better, but in a supportive and gentle way. He held me accountable and was invested in such a manner that I never wanted to let him down.
What made you want to start your own practice? Can you tell us the story of how you started it?
In large healthcare systems — both academic and military — there’s a lot of support and routine structure, but there are also ample challenges related to resource allocation and securing stakeholder support. For someone like me — who sees solutions to problems, understands the health and economic impacts, and is eager to act — the idea of setting out as an entrepreneur was exciting. It’s a lot like being an allergist, really: we start with low doses of a high-risk activity as the standard of care. Go slowly and build over time. A lot at once might kill you, but steady progression mitigates risk and often yields great outcomes.
Can you share the most interesting story that happened to you since you began your career?
I took the initial consult on a dire case of a child with what was found to be a rare genetic mutation that presented with an unusual constellation of symptoms. The patient’s immune system was severely compromised and she had silver (yes silver) colored hair. She eventually lost pigmentation in her skin, and required a few operations when she was not able to eat. Over two years, we worked hard as a multidisciplinary team to essentially reconstitute her immune system through stem cell transplants. It was a joy to see her eat and walk again. If I recall correctly, one report our team had obtained indicated that at that time, the patient was perhaps one of only 60 cases like this reported in the world, 11 of which were in the US.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
It’s important to understand and be honest about the fact that medicine is a business, all the way down to the individual level. You can’t focus on the person in front of you and provide services patients need if you’re worn down by operating costs. Healthcare should always be service before self, but never service instead of self. So many caregivers lose sight of that, and end up burning out, which negatively impacts everyone. Back office operations need to be optimized in order to provide impactful care and a great front of the house experience for the patient.
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
Balancing both roles as an army of one is even trickier! I’ve been able to grow without hiring by leveraging tech-enabled services. In other cases, outsourcing with transparency — and vetting those partners heavily — has helped me keep my eye on the ball.
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
From a business perspective, I used to struggle with forming successful partnerships that contribute positively to, rather than taking attention away from, patient care. As a healthcare provider I am always rooting for the best in people. While I have focused on partners who deliver, I used to struggle with maintaining the ability to walk away when necessary. It’s challenging to ensure everyone is aligned on commitments and accountability, in a way that will prioritize quality, detect and solve problems, and reduce friction points along the way. The COVID-19 pandemic has made finding those partners even more challenging while many people are focused on just maintaining baseline operations and navigating the next day for their businesses. I overcame some of my earlier missteps by learning to use short-term, clearly defined contracts, free trials and demos as much as I have to in the initial stages of engaging with a potential partner in order to establish a productive working relationship. I stay away from lengthy contracts until a partner has proven themselves. Once proven, I am happy to extend myself for the long term to people that are as committed to their work as I am to mine.
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
1. Look for small and big wins (and losses) in life to get the confidence to adapt and move forward. Build upon those successes and ramp up — just like allergy shots! Our own internal fears and concerns are often the thing that holds us back. If past successes don’t readily come to mind on your own, speak with a mentor — like many of mine who encouraged me to gain broad exposure, which became a core theme of my career. A good mentor should also tactfully point out failures that knock you down so you can come back stronger and grow as an individual.
2. Service before — not instead of — self. You can’t pour from an empty cup. I still manage to play drums after 38 years and I’m currently in a rock ‘n roll band with other healthcare professionals. We manage to play some charity shows for good causes and that fills up our cups.
3. Be adaptable to new ways of thinking, within and outside of your organization. This is essential in healthcare, but really transcends all fields.
4. Know yourself, and know your limits. Try to assess whether or not you might be cut out for private practice, to begin with. It’s one thing to pursue something you’ve never done before that might scare you; the reward is often worth the risk. That’s different than exhausting yourself on a path that’s not meant for you. A good starter question to ask yourself: How did you feel as an on-call senior resident, when you were alone, and in charge of a chaotic floor? Timid, scared, exhilarated? If you’re paralyzed by the thought of that, you might want to reconsider the private practice.
5. Lastly, or maybe better, a good overall first step is to drill down: The American Medical Association has a nice questionnaire that actually helps physicians evaluate what sort of practice model they’re suited for; I had already made my decision when I became aware of it, but it did validate my decision after the fact. I wished I had access to that questionnaire years ago– I probably would have gone into private practice much earlier.
As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
Because it’s still pretty early on, and the pandemic has really impacted peoples’ comfort levels in seeking in-person care, I focused heavily on marketing, forming proper partnerships to support every aspect of the business, and optimizing technology to support telemedicine, remote patient monitoring, and virtual/remote clinical trials. It’s a mixture of everything, but I’m most closely focused on the tinkering needed to get the practice to hum at the moment.
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
It’s so important to have a routine and set time aside for exercise, meditation, and self-care, and if you can find a way to bind multiple things together at once, it’s even better. Everyone’s way of fulfilling these needs is going to be different. I previously only felt that I could retain complex material via reading and writing. With some initial apprehension, I tried learning by audio book. That has been a game-changer for me and I am improving with practice. I now listen to a lot of content on mental awareness, avoiding cognitive biases, and driving (not forcing) efficiencies. I get all of that done while going on a good bike ride, a quiet walk or catching some sunrays while land surfing on my custom longboard! Even short windows of time can provide a great learning opportunity. Don’t underestimate the power that even five minutes can have if used intentionally. Blending in family time is also a must. I coached my daughter’s lacrosse team in the past. While my original motivation was simply getting her into the sport, I’ve learned a lot about leadership from that group of eight- and nine-year-olds, and I was able to be physically active and enjoy forming great memories all at once.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
John Shed said, “A ship in harbor is safe, but that is not what ships are built for.” I never would have realized my potential if I played it safe. My career, my life, and the lives of the many patients I’ve had the privilege of caring for, would look very different.
How can our readers further follow your work online?
Thank you for these great insights! We wish you continued success and good health!