Building Your Own Practice: Navigating Challenges, Mentorship, and Sustainable Growth with Dr. Ryan Neinstein

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Join us for a riveting discussion with Dr. Ryan Neinstein, a medical entrepreneur who has successfully navigated the intersection of medicine and business. Dr. Neinstein shares his journey of building a thriving medical practice, highlighting the challenges, triumphs, and lessons learned.

Discover the key elements of scaling a practice, the power of mentorship, and the art of sustainable growth. Gain unique insights into the emotional rollercoaster of entrepreneurship, the role of leadership in maintaining stability, and the balance between risk-taking and stability.

Delve into the relationship between happiness and financial success, as Dr. Neinstein offers his perspective on personal fulfillment and prosperity. Explore the value of nurturing a strong practice culture, assembling a cohesive team, and the significance of mentorship.

Whether you’re a medical professional interested in entrepreneurship or intrigued by the dynamics of a successful medical practice, this episode delivers a wealth of wisdom. Join us to gain personal anecdotes, professional insights, and timeless advice from Dr. Ryan Neinstein, a trailblazer in medical entrepreneurship.

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Connect with Dr. Ryan Neinstein on Instagram

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Connect with me on my LinkedIn

The Saad Truth about Happiness: 8 Secrets for Leading the Good Life by Gad Saad

The E-Myth Revisited: Why Most Small Businesses Don’t Work and What to Do About It Paperback by Michael E. Gerber

Failing Forward: Turning Mistakes into Stepping Stones for Success Paperback by John C. Maxwell

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Full Episode Transcript:

Daniel Wrenne: What’s up, guys? Today I’m talking with Dr. Ryan Neinstein. Ryan is an extremely successful New York City plastic surgeon and the founder of Neinstein Plastic Surgery. He is someone that I would consider a true physician entrepreneur, one that has done a great job of fine tuning his business and building his brand.

Today we discuss the characteristics of a successful physician entrepreneur. We talk about how there’s no magic bullet in building a practice. We also discuss the importance of education, mentors, and doing work you enjoy. We talk about the idea of whether entrepreneurship can be a learned skill set or not.

And we explore this idea of failing forward versus perfectionism. And then we wrap up with some ideas for early career physicians that might be considering entrepreneurship themselves. I enjoy talking with Ryan today, and I’m, I’m really excited to share our conversation with, you know, I hope you enjoy it.

Daniel Wrenne: Ryan, what’s up, man. Thanks for joining me today.

Ryan Neinstein: Hey, thanks for having me. I’m really looking forward to this. 

Daniel Wrenne: Yeah, I’m always excited to talk about business and entrepreneurship, and I know you have a lot going on in that regard, and so I’d, love to get into that, but I think maybe before we, we start talking shop I would love it if you could share a little bit more about like yourself and like, Where you’re at and your practice and those sorts of things.

Ryan Neinstein: Sure. I’m a plastic surgeon in New York city and a little bit about me. I grew up in Toronto, Canada. I am the grandchild of Holocaust survivors and that imprinted this desire to serve and to work hard and be a meaningful. Contributor to society as I grew up sports became something that was very important to me, team sports specifically.

I played football and rugby. I always had this affinity to science, chemistry, physics, organic chemistry, those things made a lot of sense and career choice was pretty straightforward. You know, I wanted that intense team atmosphere of sports and, the certainty of science. So that led me to medicine, which led me to surgery.

And then my, inquisitive, curious mind led me to New York city. And 10 years ago I started a practice and today we’re one of the biggest practices in New York city and, growing quickly. 

Daniel Wrenne: Yeah that’s Really cool. I love seeing physician entrepreneurs, especially, I think it’s like one of the best solutions to a lot of the problems that are out there in, in healthcare and in medicine.

There’s a lot of problems that, that could be solved by creating your own business. 

Ryan Neinstein: And I didn’t know Literally until a few years ago that there was this entrepreneurial community, that there was this entrepreneurial spirit that undermined a lot of innovation in every field, probably is a leader of innovation in every field is entrepreneur, entrepreneurship in Canada, not that socialism, had a veil over everything we did, but besides rim, AKA Blackberry and the beer companies, like he didn’t really know much about, business.

We didn’t have the Andreessen Horowitz’s like those weren’t people we knew about in high school or in college in Canada. All these books that I read about what it’s like to be an entrepreneur, how to be an entrepreneur, how to be different, good parts of an entrepreneur. Those weren’t things that people read.

But I, there is this unbelievable spirit in this country. For innovation and entrepreneurship and I’m caught 

Daniel Wrenne: in that wave. 

Yeah, it’s, I am completely in that world myself and I love it and I’m sold on it. And I think from my experience in my day job, like working with physician families, it seems like not all of them are sold on it so much.

Like there’s a lot of them. Now some of them are, some of them aren’t, but I think there’s a lot of. potential for more physicians to be entrepreneurs? 

Ryan Neinstein: when I look at a business and I don’t know how you think, like in broad categories, people are either like really good at making a product like engineers or whatever, or delivering a service like surgeons, people are like, or they’re like really good at marketing, the razzle dazzle showman or the really good at operations.

Not the type you do in surgery, but you know what I mean, logistics, or they’re really good at leading like galvanizing and organizing physicians typically that everyone I know maybe they have one of those for that. Well, they should have one of those for they should be good at their job. But the other three, like the leadership, the logistics, and the marketing, like, that doesn’t exist.

And in their mind, they can’t really figure out, am I going to instill You know, how do you get there? Like, how do you get those three? They don’t want to hire someone because most physicians just kind of think like, Oh, I’m smarter than them. Why would I hire them? But at the same time, they don’t have any time to go learn those skills.

Cause they’re running a hundred miles an hour, trying to see enough patients to make enough money to live the life they want to live. 

Daniel Wrenne: Right. So it’s a conundrum. 

Ryan Neinstein: That’s a paradox, a paradox. And at some point, if you read the E Myth Revisited, you just got to, you know, or if you’re a fan of Paul Abdul, like, take a few steps back to go forward, 

Daniel Wrenne: you know?

Yeah. The E Myth Revisited is a really good one there’s too many people that start businesses for the wrong reasons. They don’t exactly realize what it means to start a business and they really are just good at making the widgets. And not running a business and their business fails because they don’t understand what all that’s entailed in running a business.

The problem with the myth, in my opinion, is that it kind of like discouraged. It’s not very like, motivational, I guess. 

Ryan Neinstein: It’s more like it needs to be. And that’s why I think the genius book, I think it’s. It’s very straightforward and if you listen to Alex Primozzi, it’s like, are you willing to do all these sacrifices?

And it’s not pretty, there’s very little recognition, but are you willing to do all these sacrifices? Because these are the sacrifices that are required to get a real, a real business meeting. Like if you go away for a week, Like the business still runs and every two seconds, like that thing works, like there’s systems and processes.

Daniel Wrenne: No, I think it’s good to read as a real life, sometimes punch in the face, like reality dose of what it is to go into entrepreneurship. In 

Ryan Neinstein: terms of the entrepreneurship, reading and mentorship. I mean, if you are not committed to those two things, I don’t think you’re, you have a chance in, in, in entrepreneurship.

Um, you know, I, I try to read at least a hundred books a year on, everything that we like. The, the personal development, the business development. Mm-hmm. The, how companies fail, how companies work, um, and then you gotta have your mentors who you lean on day to 

Daniel Wrenne: day. So do you think somebody’s like built for entrepreneurship?

Like if I read the E-myth, Or if I’m like just one of those categories, you’re, you’re breaking down, like, if I’m just like the widget maker, am I like not going to be an entrepreneur and never, never will be, or 

Ryan Neinstein: do you think I think like most things. You be, you become what you want to become and it’s definitely, I don’t think people are designed to be entrepreneurs.

I think people get sparked and, there is a memetic theory of most things, meaning like you, you were drawn towards things that excite you. Shiny object syndrome, you meet entrepreneurs, if you happen to meet entrepreneurs in your mid twenties, I promise you, and like you hang out with them and you like socialize, you’re going to become an entrepreneur.

Yeah. If you don’t, you probably won’t. 

Daniel Wrenne: Yeah. Have you ever heard the quote, you’re the average of your five best friends? 

Ryan Neinstein: Correct. I mean, most doctors don’t know any entrepreneurs, so it doesn’t even cross their mind. 

Daniel Wrenne: Well, what’s interesting is, um, one of the most popular topics we hear physicians wanting to learn about or, or, get into is real estate.

That’s kind of like bordering on shiny object. I mean, it’s a legitimate, you can do really well with real estate. But I think what they get sold a lot of times, or maybe what they hear is that it’s like make money in your sleep, passive income can be that. Ish. But like, I think a true real estate business, sometimes the people that you, you kind of look at, you’re like, man, that guy’s killing it and building wealth and real estate.

They are, they have turned it into an enterprise, which is in a lot of ways very similar to entrepreneurship and building a medical practice. 

Ryan Neinstein: Listen, my mentor, my kind of business and life mentor, he’s a real estate guy and, owns hundreds and hundreds of buildings nationwide. He’s putting probably more, because he’s older than me, time and energy into real estate development that I’ve ever put into surgery.

So when people say, I’m going to get into real estate on the side, I’m like, well, the people I see who are doing really well in real estate, they’ve done like the 30 years that I’ve done in surgery in just that. So I don’t think it’s easy. no such thing as like a passive or, I haven’t found the, uh, get rich quick because, and I’m always told real estate is the best get rich flow kind of game.

Daniel Wrenne: Well, so what I find interesting is that and in some ways it’s kind of like disappointing is there’s a lot of really good physicians that I have come into contact with that like loved taking care of patients and did it, were in it for the right reasons, but then they got into real estate and they did really well with it and they got into real estate as a, I think the system of medicine drove them out.

Yeah. And they got into real estate and they, like many of their past, did really well in real estate and have turned that into a big enterprise and a lot of them are like completely out of healthcare. In fact, I work with a lot of them that are like really working hard to use that real estate business to get out of healthcare.

But what’s strange to me from the outsider looking in is that it’s like you can build an enterprise. You can be an entrepreneur within your specialty and build a practice. It doesn’t have to be, but it seems like there’s a disconnect there. 

Ryan Neinstein: I mean, you have to love what you do, right? It doesn’t matter what that is.

You also can’t compete with someone who’s having fun. So can’t make a business out of something you don’t like. It does. It’s just, it’s just not a thing. Okay. You don’t have to, like, if you’re going to, no matter if you want to do real estate, that’s fine, but you’re going to be doing it 24 hours a day for decades.

So you better love that. Surgery is 24 hours a day for decades. You better love that. You just got to pick, where your affinity is. I don’t think you’ll be ever be able, there’s no lightning in a bottle. There’s no quick buck and you know, it’s something is dedicated time and dedicated, you know, a dedication to improvement and that you have to enjoy it because otherwise you’re just going to be passively, moving through the motions and you’re not going to be able to accumulate enough.

Runway to get better 

Daniel Wrenne: and the person that does enjoy it that’s putting in the hours is gonna crush you I mean like they’re competitively wise they’re gonna just run circles around 

Ryan Neinstein: you and it could be with someone who’s having fun because they don’t run out Of gas 

Daniel Wrenne: no and that if you can find something that you enjoy you know that’s a key foundational thing is if You 

Ryan Neinstein: can find something, you know, I love surgery and I love building the teams around the surgical experience for the patient.

Daniel Wrenne: Do you like the actual practice? Do you like the surgery itself? Do you like the consults? Do you like the building the business? Do you like all of it? 

Ryan Neinstein: I love all of it. You know I love it all. I truly do. But like people are gonna be like, you can’t love everything. So, You always want to, I always want to be doing something that’s fun, right?

And surgery is so fun, but like now I’m shifting a little more towards the business development side as this newfound funness in my life. So like, as you know, over the next few years, I’m going to be transitioning to do less surgery, not no surgery, but less surgery and more business development to the practice.

And that’s The 

Daniel Wrenne: trajectory I’m on. the best business developers are the ones that. Love the widget building. Like, I think when you come from a place of like, I’ve done this thing a bunch of times and I’m an expert at it and I’m kind of gravitating towards marketing. I think those are the best possible marketers you could ever ask 

Ryan Neinstein: for.

The way I think about marketing is if you, if you were trying to sell something that you don’t believe in, that’s deception and manipulation. But, if you tried to, if you love that shirt you’re wearing, you just love it and you want it to sell it to your friends.

You’re not getting anything out of it, but you’re going to, you’re going to go through all these features, how it makes you feel. And you’re going to be like, you got to get the shirt from blah, blah, blah, blah. Like it’s not even sales. You’re just like, you hope someone else enjoys the experience of that shirt as much as you.

And that’s to me what sales is. So you have to make your team believe in you or whoever’s implementing the service. And when they do that, it’s very easy to share it with this, with your patients or prospective patients. And it doesn’t feel like sales. It doesn’t feel like you’re manipulating. 

Daniel Wrenne: I think when we were talking last time, you said something about marketing as an educational, from an educational standpoint and how physicians are so well positioned to be able to do that because you have the expertise.

Ryan Neinstein: Well, I think eyeballs on social media, which is the majority of, marketing and advertising these days, people are either drawn to entertainment or education. We have seen in medicine, entertainment, goofiness. Is it does not work. it attracts the wrong kind of ideas from the people and downplays the severity.

And you were seeing more physicians losing medical licenses for things they’re doing on. Social media. So, but people are drawn to entertainment or education. So, tell them about medicine. Tell them about surgery. And I do think you see amazing social media accounts from things like on toe fungus to like all these things that you think would be interesting to learn about and you’re like captivated because some doctor somewhere figured out a way to tell that story in a way that’s like captivating.

Daniel Wrenne: Yeah, and that is a skill set right there. 

Ryan Neinstein: it is a skill set, but you can go and hire people to help you. And you may not be the most boombastic, outgoing personality, and, look great on camera and this and that, but that doesn’t matter. As long as you continue to keep trying and keep doing, and you’ll be able to communicate with people that you want to.

Daniel Wrenne: Yeah, one of the differences I think between entrepreneurship and practicing medicine, or at least the culture of medicine, It’s like in entrepreneurship and in marketing, especially it’s like failing forward. It’s in fact, like with marketing, it’s like, let’s see how many times we can fail faster so that we can get to the solution quicker.

Ryan Neinstein: But in, well, the old marketing joke is like, I know half of my marketing works. I just don’t know which half. 

Daniel Wrenne: Right. I would go with like a quarter 

Ryan Neinstein: or lower, even though something’s working because you’re getting clients, but most people have no idea whether it’s their pay per click, their radio, their TV, their this, that, or the other.

Daniel Wrenne: Yeah. So you got to develop that muscle. That’s, that’s a little bit of a different, I mean, I think if you’re hyper perfectionist, you’re going to have a hard time being an entrepreneur. And I think in a lot of physicians struggle with perfectionism. Well, that’s going to make marketing challenging, I would say.

Ryan Neinstein: Yeah. You have to be moving forward. Like if it’s, if it’s perfect, it’s probably two years too late. I know, like they say that a lot of the entrepreneurial books, like you gotta get things moving and you want to be willing and able to grow and pivot as on the fly. 

Daniel Wrenne: I know you’re building you already have a big practice and you’re building it continuing to build it.

Is it, does the money come into it? Like, is that part of the motivation or a big motivation or all the motivation? 

Ryan Neinstein: one of the amazing things of having children is like your DNA lives on forever, your legacy. So one of the, and if your life is basically your personal and your professional life, and to me, If I can do like, what’s the version of like having kids at work?

It’s recruiting surgeons and growing their careers. And that to me is legacy, which, could be around a lot longer than we are, which, gives meaning and purpose to the time 

Daniel Wrenne: we are here. Yeah. So you can, you can affect when you start to employ people, you start to impact their livelihood 

Ryan Neinstein: and.

Well, just pure enjoyment of life. Like when you see your kid walk for the first time, it’s amazing. When you see the surgeon that you found, like at a residency or fellowship. Do like something amazing, you feel you get that like same dopamine rush and like you, you can keep doing that much easier than keep having kids.


Daniel Wrenne: yeah, yeah. And they, and they, they have a better return on investment to, I mean, dollar 

Ryan Neinstein: price, but correct. But I mean, that’s the main part of it. It’s just, it’s, it’s another way to enjoy the professional life. 

Daniel Wrenne: is your goal to be just continue to grow as, as long as, I mean, what are you building? 

Ryan Neinstein: I’d like to grow something that’s just essentially self sufficient where there can be, more of like a law firm where there’s just a constant evolution forever.

I mean, my dream would be that there’s some place that has my name on it. Actually, I give them sure they take your name off at some point, but someplace that I created and started, that just kind of goes on forever. That’s kind of my ultimate goal size wise. I don’t know if we go to different cities, different States, you start, as Alexander the great, you lose control of your kingdom as soon as you can’t touch it.

So you gotta be careful with your expansion. If I think there’s a total different skillset of building a business and scaling a business. That’s a whole new world. One of the things I always talk about in our office now is like our C suite team. Including me as CEO, like we didn’t go to CEO school, like we never, I didn’t hire, you know, I don’t have, I didn’t hire a professional CEO.

I didn’t hire a professional this, that, or the other. We’re like all learning this job on the fly, but I think that scale to the multi office multi state, I think that’s another new skill set that like probably is best served by someone who has done that before. 

Daniel Wrenne: Yeah, there’s a point. I feel like the entrepreneur’s role in small businesses, a lot of times.

You got to wear a ton of hats and that can be challenging to be an expert or impossible to be an expert at all things. Like you can’t be a CEO and a CFO and a 

Ryan Neinstein: CMO and a beginning. You are, you know, at the beginning, that’s the most period of any business is the, I remember when it was three of us in a room eating pizza, staying up all night, like those are all the best.

You know, most romantic time, but in reality, it actually sucked and it’s better now. You need to get to a point where you’re like, we need a professional at each stage. And are Are we going to grow internally? Because they understand the culture, or are we going to go externally because they have the skills and you have to decide how you want to do that. (Mid Roll) What about that 

time sucked? I mean, mostly because like you’re working, you have no money and you’re making no money and you really aren’t sure if anything you’re doing is really going to work. 

Daniel Wrenne: Yeah. If that was all I knew, I’d be like, why did you keep going? 

Ryan Neinstein: Yeah. It almost makes no sense to start your own business.

It’s it, but at the same time, it’s thrilling. And like, you’re either like, I don’t know, elated or scared as an entrepreneur, like I’m never comfortable in my other it’s it’s either up or down, it’s like a bipolar 

Daniel Wrenne: emotion. Well, it is, and it is stressful to take the risk and have all these big decisions to make.

And but I think, I don’t know, everybody has stress in their life and in their profession. And I think one of the best things about, or comparing like a physician working in a giant hospital system to like. An entrepreneur, self employed, or even building your own practice physician is when you have those problems that come up, inevitable problems and stressors.

You can solve them. Like you’re actually responsible for solving them. Yeah, 

Ryan Neinstein: but you’re also responsible for 

Daniel Wrenne: creating them. Correct. You’re creating new ones all the time. Like you’re, you’re like swimming in problems actually, but it’s 

Ryan Neinstein: different. Listen, our job, I think all leaders job, the number one skill, I believe in a leader is like emotional stability.

Like you need to stay calm no matter how good something is or how bad something is, like someone’s got to be like. the rock in the room, there’s a great story about Ulysses S. Grant, who’s like one of my favorite, like American, history. If you’re a history buff people, getting a picture taken.

I can’t remember the name of the photographer, but like famous. photographer after the war and they’re in this room and the photographer goes go up and like open the skylight to his assistant because like there’s not enough light the guy goes up he’s playing on the roof the whole glass roof comes down and shatters and like apparently grant doesn’t flinch like it doesn’t like this glass on his whole body It doesn’t move and he’s like, I have somewhere to be just take the picture like, and he like cools a cucumber, like stillness is built in, I think the Brits call it being squared away and or having the right stuff.

And like, that is where leadership is. Because if you’re an emotional roller coaster, and everyone in your business is an emotional roller coaster, it doesn’t work. Someone’s got to calm everyone down. Yeah. 

Daniel Wrenne: No, 

Ryan Neinstein: I mean, we live like three blocks away from like where he died. It’s like, it’s so weird. It’s, you know, he has the biggest tomb in New York City, Grant’s tomb.

So I like, I’m always like, kind of like in this like world of Ulysses. 

Daniel Wrenne: Yeah. He’s, he’s one of my favorites. there’s a lot of good ones, 

Ryan Neinstein: but talk about a true American. He was 

Daniel Wrenne: like, he was, he had all the weaknesses and the strengths and unbelievable. Yeah. yeah. he did had a hard life and had lots of success and lots of failures. And I mean, I think that’s what it’s about is failing, learning to, grow from your failures and failing forward, that’s one of my favorite books is failing forward is learning to. 

Ryan Neinstein: I can’t remember who told it to me, but it’s like in life, you either, whatever happens, you either win or you learn, like not win or lose, like win or learn, like pick one.

Mm-hmm. nothing. You’re gonna like, you’re gonna get hit, you’re gonna lose things all the time. But like, did you step back? Did you really, did you really lose? Or like what could you take away? Is that a learning point? You can’t let success go to your, head and failure go to your heart, you 

Daniel Wrenne: know?

Right. You also have to learn to be humble. Yeah. Like when you have all the success, you have to learn to, that you’re actually not as big of a deal as you might think you are. You 

Ryan Neinstein: know, know thyself. And like, I think as you get more successful, there’s That’s when, like, more things are lurking around the corner.

Daniel Wrenne: Yeah. I think the other thing, too, is I imagine you’re getting a lot of requests for pe things and people and your time is starting to I imagine you’re having to start to say no a lot. 

Ryan Neinstein: Well, yeah. Like, Buffett says, the people who say no the least are the most success or say no the most are the least successful.

Or the most successful. So, you know, and the idea, you know, keep the main thing, the main thing, the main thing. And yeah, I’m probably, I’m probably not as good as like others. I probably take too many meetings, meet with too many people. There’s also this mentorship collaborative phase of medicine where like, not really, like if a medical student, a resident, a fellow, or someone wants to talk to me about their career and bounce it off my ear.

You know, I probably do that too much, but like, at the same time, like, I kind of like doing that. Yeah. 

Daniel Wrenne: So I’d be curious about the mentorship thing. You’re, you mentioned that earlier, like how important it was to educate yourself and have mentors in your life. And so is that still an active thing for you?

Like on, I know you say you’re a 

Ryan Neinstein: mentor every day, seven days a week, 365 days a year. and you can find mentor, like I kind of found mine by accident, like at a dinner party, kind of connected with, with a guy and like, we’ve just, he’s about 10 years older than me, incredibly successful, worldly, and is willing to like guide me, but that mentor mentee relationship has to go both ways.

Okay, so it’s not just me calling him every day. Hey, what do I do about this? Hey, what do I do about that? Even though he’s got this, mock is much more successful business. There are things about the world that I’m can share with him. And so that there’s a book back and forth, but, anytime I get a proposal for something, or I’m thinking about doing something, I need to, you need to be, have someone do the call.

Who’s going to be brutally honest with you and help you, think through that decision because most of us have shiny object syndrome. So you need someone to smack you down a little bit and you need multiple people like, and if you don’t have like your talk to your accountant, like you could use your accountant and a good lawyer or find your local, YPL or business entrepreneurship, go find people, but you better find smart people who you can ask questions to otherwise.

You’re on your own and like, I don’t care who you are. No one knows what to do. 

Daniel Wrenne: Yeah, we, we serve that role on occasion with clients that we’re working with. And not always, but I try to only give advice. It’s not, it’s difficult to do this all the time, but like only give advice when it’s requested.

And so on occasion, like. Clients will bring decisions to the table and solicit input. And I think that’s fantastic. And we encourage it because it’s just a second set of eyes and we’re like, get more opinions. It 

Ryan Neinstein: doesn’t have to do what they say, but a lot of times it helps clarify the decision algorithm.

Daniel Wrenne: Right. And you, and we typically, so I’m the third party, you know, it’s looking at it. I have more objectivity, but like typically. It’s kind of an emotional mess. Like they’re, they’re not quite seeing it. Yeah. Yeah. 

Ryan Neinstein: Yeah. So like just the other day, I remember I was looking at it like a space for expansion and like someone, I think whichever broker sent me like a proposal and I like forward it.

To my like, it meant and he’s like, I’m not even opening this, this look like you’re not going to this location. This is stupid. And you’re like, Oh, I just got like totally bamboozled by the broker. Like, and like, I would have gone through this, like, spent the next few months trying to figure out how to make this work.

And he’s like, just like, You’re not seeing what’s directly in front of you because of like the razzle dazzle this guy just gave you so 

Daniel Wrenne: did you know? Instantaneous like how do you find a mentor you like feel that like what’s the key characteristic that 

Ryan Neinstein: doesn’t you like? I find more and more all the time.

I mean a lot of the times I meet them at dinner parties, whatever, like you connect and you know, you actually get a sense that they are interested in you and your life and they want to show most very successful people I find incredibly successful, want to share how they got there. Like, they don’t want to just like sit on a pile of money in like a house by themselves, like.

Like they don’t, that’s just not the way they’re wired. Yeah. They want to get out and do stuff and, and they’re, are so far removed from the beginning of a business or like a little business, like a doctor’s practice that like, it’s nostalgic to them to like get involved on like, how do I hire an it company for like.

All my computers. And like, where do I get 25 computers? And like, do I go just go to Best Buy or is there like a place for your, you know, company or like, yeah, just stuff like that. They like, I found people like enjoy that. 

Daniel Wrenne: Yeah, there’s a, there’s a lot of questions that come with entrepreneurship and there’s a, it’s a million questions.

Everything is just another question. Yeah. And you can Google things and, but like you got it. I mean, you can’t put a, it’s, it’s so valuable to have. People in your life that I think the big thing 

Ryan Neinstein: is Surgical mentors too, like, you know, I know that like Dr. X, Y, or Z has an amazing operating room. Hey, where’d you get the surface?

Call them out. Hey, where’d you get the, how’d you get the surfaces that you got in the operating room? They’re like, Oh, you know, we found this really cool company in North Carolina. Let me send you the guy’s contacts, you know, like you got to just keep asking questions. You don’t want to be, you don’t want to be, you know, going through the 

Daniel Wrenne: world alone.

I think people that can speak truth is a big thing. I mean, most successful people I think should have, would have had to have a more likely chance of being people that are truth truthful and speak honest or direct. But I think that’s a big deal. 

Ryan Neinstein: I haven’t met, and people may disagree with this, I haven’t met a lot of very successful jerks.

I mean like very successful. Obviously there’s high paid jerks in every field. You get to this like super high echelon, like you really can’t accumulate that much wealth. Unless like thousands of people like you and like want to be around you and like want to help and like have you guide them like you can’t make that over decades and decades and decades like, you know, most incredibly successful people are incredible humans and that’s why they stay on top and keep rising.


Daniel Wrenne: you think more money? Always equates to happiness and better personalities, or is it like the personality comes first and then the money comes second? 

Ryan Neinstein: No, I you know, the more money you accumulate you realize that happiness and money have like very little correlation 

Daniel Wrenne: Yeah, however, there are extremely happy people with tons of money 

Ryan Neinstein: There’s extremely happy people with a tons of money.

They’re extremely happy people with no money. There’s miserable people with no money There’s miserable people with lots of money It’s you know, the strength of the personal dynamics in your personal relationships your social network your mental clarity All that there’s so much more What’s his name is a Canadian professor from Concordia believe sad gad gad sad.

I think his last name’s sad

I’m going to have to look book on the eight rules of happiness.

Daniel Wrenne: Yeah. 

Ryan Neinstein: I think it’s gad sad or sad gad. Yeah. 

Daniel Wrenne: I’m, I don’t have my 

Ryan Neinstein: keyboard. Got a good podcast too. But that book I glanced over, you know, it’s nothing you don’t know. Like spend more time with your kids. Like you’ll be happier. Yeah. But like, right. Paradox of like, you want to provide more. The only way to provide more is to do more.

And when you do more, you’re not around. So we’re always bouncing back and forth in that. 

Daniel Wrenne: Right. I think we all fall for, at occasion, different occasions of our life. Of thinking that the money is going to cause the happiness. It’s just 

Ryan Neinstein: difficult not to scoreboard and it makes life easier. you think because you can just watch the net, the score go up and you think you should be happier as the score goes up and then you realize you don’t.

And then you have to figure it out. But I think everyone, you know, read jigs it and finds the balance. If they are looking for balance. I mean, obviously there are people who will. You know, I walk to work in the morning in New York City and there’s like 80 year old guys like heading to the office and like, I have to assume these finance guys probably don’t need the money, but they just like want to keep rolling.

Like they don’t, that’s how they’re hardwired. 

Daniel Wrenne: Yeah, that’s a, I think if you enjoy going back to enjoying your work, if you truly Enjoy your work or maybe it’s the thing you enjoy the most of anything even yeah That makes a lot of sense now. That’s a good question I think for everybody is like what do you truly enjoy most and that’s not an easy question to answer Because there’s a lot of things and it changes, but it’s something to, I think, regularly explore.

Yeah, for sure. If I’m, early in practice or maybe even in training I think entrepreneurship resonates with a lot of early career physicians that have gotten a good dose of the system and they’re like, I, I really don’t, I would love to do it a different way. Yeah. What do you think is like a good.

Starting point. Like, how do you, I know it’s not really well taught in training. Like there’s not a lot of business. You have to 

Ryan Neinstein: decide when you’re ready to go on your own. And my suggestion is to, you want to transition to go on your own, meaning you have a job or you’re working for someone else and you should start your, you know, just get your LLC and start looking for a space and you should be doing like.

Five days a week working for someone out working somewhere where you get paid and then go to like four days, three days, two days, one and start building your uh, you have to figure out what you want to do and who you want to do it to because if you know what the avatar of your customer looks like, you can go out and find them.

Like if you know you want to do breast augmentations on 22 year old girls. That’s a lot easier, you know, you’re going to direct your marketing towards college age girls and you’re going to have college age, you know, flavor to the medium. So once you get good at something and you know who you want to do it to start building the people around you who are going to help you do that, you know, better it’s all said and done and then measure yourself in decades.

Most people, as Bill Gates says, overestimate what they can do in a year, but they underestimate what they can do in a decade, you know. It’s like a, it’s like a diet, like you can’t do it for two weeks and wonder why you’re not ripped. Like eat healthy and work out for 10 years and show me your body. 

Daniel Wrenne: Right.

Or do you like have one improvement a day? 

Ryan Neinstein: Yeah, I mean, comic habits, like, yeah, listen, if you got to have a disciplined routine and you got to hit it for like decades. And like, I don’t believe you can lose if you’re willing to do that. But I think there’s like 0.0, 0, 0, 0, 0, 0, 0 1% of the population who’s willing to do that?

Well, most people it’s bamboo tree. A bamboo tree can grow like 90 feet in six weeks, but only if you like water it perfectly under the ground for five years in this one spot. So like, are you willing to like do the five years of watering to like build the foundation that next, next piece and then, you know, success happens slowly then 

Daniel Wrenne: quickly.

And I think people think they see the person, they see the bamboo tree grow and they’re like, Oh yeah, I want to grow the bamboo tree. And then they’re like, they don’t see the part that happens before. 

Ryan Neinstein: Everyone’s the overnight success. It only took 30 years, 

Daniel Wrenne: right? Yeah. But it, in reality, it takes a long time to.

Build up things, then they compound it compounds all these little successes compound to turn into a big, big success. And it’s like, your practice is like growing fast now and it’s compounding. And there’s a lot of bigger successes happening, but you also started out in like a room with three people, like kind of feeling like your head was cut off.

And you’re like, 

Ryan Neinstein: Which always keeps the fear level up. So like you never get comfortable. Most like most entrepreneurs and are never comfortable. Yeah. I bet you and Mark Zuckerberg are like stressed 24 seven. Even though, are 

Daniel Wrenne: you comfortable? 

Ryan Neinstein: Never like no, like I’m always like, you know, I have this massive payroll, these huge facilities, you know, all these things running through your head, your head of like, what happens, like if nobody shows up to, you know, like there’s always, yeah, no, I’m never like just cruising.

I’m always dialed in, 

Daniel Wrenne: but it would be kind of boring if you’re cruising. I mean, I 

Ryan Neinstein: don’t know. I don’t know any other way. Like. I don’t know any other way. 

Daniel Wrenne: Yeah. Well, I know we’re getting to time. I wanted to make sure and circle back on your end, where is the best place people can find out? I know you have a lot of good stuff on social media and that’s, that’s another thing.

I think you’ve done a really great job of. building. You were talking about people with social media that have done really well. You’re one of them. So 

Ryan Neinstein: I think we, you know, we, there’s no magic formula. It’s like, this is what we do. This is who we do it to. This is why we do it. This is why you need it and want it in your life.

And I’m going to do that every day for decades. And then I’m going to tell you a little bit about me, why you should trust me. You know, I’m very disciplined. I exercise, I read, I get up early and I spend my free time with my family. That’s what I want in a doctor. That’s what people like. 

Daniel Wrenne: Yep. 

Ryan Neinstein: It’s simple.

Yeah. It’s like, right. Yeah. There’s no razzle that like, I don’t need to do anything like magic. It’s like, you know, we solve people’s problems and we’re good people. And like, we care about the people we do it to. 

Daniel Wrenne: My 

Ryan Neinstein: recommendation for anyone, if you’re anyone starting a practice or any business, Recruit awesome people.

They have to have unimpeachable character and that have to be like committed to excellence. Like don’t recruit average and take care of your people. If you take care of your people and you take care of your patients, the, you know, the profit takes care of itself. 

Daniel Wrenne: Right. Yeah. And you can build a culture too.

I mean, it’s kind of fun to build a culture cause 

Ryan Neinstein: you can, and you build that at the beginning, but You have to keep you know, cultures like the mortar in the bricks or around the bricks in the foundation and like, you got to constantly renew it. 

Daniel Wrenne: Yep.

And mortar is necessary. The building falls down if there’s no mortar. Yeah. People are super important and you can see in like hospital systems when you get like grumpy staff that everybody’s depressed and burning out and that’s just chronic. I mean, it’s terrible for the system. 

Ryan Neinstein: Well, that’s because the people making decisions are too far away from the action.

Like most businesses getting more and more trouble as the people making decisions are farther away from the action. Right. That’s like why they had so many problems on submarine, on nuclear submarines is because like, especially the Russians, like, the captain had all the power, zero information.

The like, 16 year old kid with his like, loading nuclear warheads into like, had all the information and zero power and like, they never talked. So. 

Daniel Wrenne: Yeah, that’s a problem. 

Ryan Neinstein: It’s a problem. Yeah, you gotta like. You know, people, they got to communicate. 

Daniel Wrenne: It gets harder when you get bigger though. Yeah, but there’s strategies.

What’s the best place people can find information about you and your practice? Your practice website, I know is a good one. We’ll link to those in the show notes. Okay, 

Ryan Neinstein: listen, at Dr. Nienstein on Instagram and from there you’re going to see all the other physicians that work with me, Dr. Anna Steve, Dr.

Chris Vunderburg, our aesthetic injector, Dr. Nurse Tara, and you’ll see everyone on the team from there. 

Daniel Wrenne: Awesome. Well, it’s been fun. I’ve enjoyed chatting with you and I know you you’re in a nice sweet spot now that hopefully you can go enjoy your beach house that you’re hanging out at. 

Ryan Neinstein: I’m an entrepreneur and, uh, it’s, I got to call the office and we got, you know, fires to put out.

Daniel Wrenne: Oh, well, yeah. At least you’re doing firefighting in a nice, nice spot. 

Ryan Neinstein: I like being a firefighter. I’m okay with it. 

Daniel Wrenne: All right, man. Good catching up. Awesome. Thank you.