Paul Vigario on Scaling Medical Practices, Building Wealth, and Winning With AI ⚕️ E165

0:05Dan Fleyshman:Ladies and gentlemen, welcome to a special edition of the Money Mondays podcast. We cover three core topics, how to make money, how to invest money, how to give it away to charity. This gentleman has done all three. Now, as you guys know, this episode will be under 40 minutes because the average workout is 45 minutes. The average commute to work is 45 minutes. This episode will be under 40 minutes for your listening pleasure. Why do I say that? I want you to know what you're in for. We have a 93 % listen-through rate, which has helped us stay in the top 50 of all podcasts on the planet because of your help.

0:35Dan Fleyshman:Liking, commenting, subscribing, and sharing helps us a lot with this podcast. We've been running it ad-free, commercial-free, for almost three years now. I do work with Go High Level, but you don't hear me talking and reading for two minutes about them. I just actually use High Level for everything in my back end. I work with Fanbasis. There's no special affiliate code. Just go to Fanbasis.com, check them out. They're an amazing company. I actually physically work with them. So I've kept this podcast clean so that you can listen to this entire episode and there's not going to be any commercials whatsoever.

1:02Dan Fleyshman:Now, without further ado, we're going to dive right into these three core topics. We're going to ask all the questions to Paul Vigario. What he's going to do is give you the quick two-minute bio so we can get straight to the money. All right. My name is Paul Vigario. I'm the founder of surfct.com. I started my business over 25 years ago. We've worked with over 12 ,000 doctors and private practices and generated over 36 billion. It's a big number. 36 billion in healthcare revenue for doctors and healthcare. Okay. Even though that was only like 27 seconds, there's a lot to unpack there. These doctors and dentists and like, how do they come to you?

1:44Dan Fleyshman:How do they find you and why do they need Surf CT? to you? They find us through our reputation, our body of work. I also speak at a lot of universities. And one of the reasons why they need us is because we help automate their practice and really create massive success for them. I've learned that in business, because I'm involved in other businesses as well, we're involved in a vineyard, we're involved in a restaurant group. And I've really learned that all business in the simplest form is two things attention and compliance and so if you can gain attention and then you want to create a path to compliance most people are good at one thing and what do you think a doctor is good at attention or compliance just compliance compliance right they became doctors by being compliant they did their homework on time they studied they were very very compliant 12 years yeah yeah for like yeah two decades right and then they come out into the world and they're in a 200 billion dollar industry and they're very compliant but they're getting the information from the industry that quite frankly wants to keep them compliant keep them in a box keep them doing clinical work and then it's really really insurance driven So a lot of doctors find out that they're actually operators.

3:09They're operators for this industry. And they'll reach out to us and say, get me outside of the box. And we meet with them. We work with them and really help them increase that level of attention and build systems that are truly theirs. Not systems to drive the insurance companies, not systems to grow this industry. because if you look at a doctor's career, they'll go to school for 12 years and then they'll come out, they'll be an associate and then they'll start a practice and then they'll work for 30, 35, 40 years only to sell that practice. One thing, selling one thing. Yeah, and then they sell the practice at the end.

3:47And I don't know any other business model where you pour three, four, five decades of your life and at the end you just sell it and that's it. I mean, if you're going to flip a business that usually could happen within three to five years, like you go in very intentional. But they pour their whole life into it. And they have a good life. They have a good life. But if you look at the stock of these publicly traded companies in healthcare and you look at these insurance companies, they're growing hand over fist while the doctor's having a good life but somewhat stuck in a box. Like they have to go to that practice.

4:19And life just passes them by. So we actually have, I do a program called Outside the Box. And doctors have been coming from all over the country to see it. and it really is guided to helping them get outside of the box to to to be able to grow their practice without them having to be there right because ultimately they've created a job for themselves and we help them create a real viable business that can grow and scale so you walk into

4:48Dan Fleyshman:a dentist's office or doctor's office what do you see is it like the matrix like oh you got to fix this oh this shouldn't be over here wait why is the couch over there why is this like yeah see it like that yeah what are most doctors and dentists what are they missing what are they messing up on they're it's where they're getting their information from right so in school you know they share notes with other doctors they you know other students and and they they complete their curriculum and when they get out they kind of you know message each other and say hey what are you doing about this how are you going to build this how are you going to build that but the real question is where are they getting their information from and the industry i mean when you're operating if you're a dentist and you're operating in a 200 billion dollar industry you got to understand how powerful that industry is the dental industry is larger than the nfl major league baseball nba combined ncaa all sports combined all sports combined all sports combined all sports combined is is something like 90 billion the dental industry is 200 billion and growing right so they're getting their information from the wrong place and so when i walk into a dental practice or a plastic surgery practice, I see a practice that was built to serve the industry.

5:58It was built to serve insurance companies. It was built to serve almost everybody but the doctor themselves because the doctor is very compliant. So they're gonna build this practice. They're gonna take out this note, a million, two million,$3 million practice. And then they're gonna show up every day and work. Imagine if I came to you, Dan, and I said, hey, give me a million dollars and I'll build a box for you to work in every day. But if you go on vacation, if you go to Mexico on vacation, you take your family out, you're not going to make any money that day. So if you go for seven days, it's going to cost you seven days.

6:28That doesn't make any sense. I've never seen that before. So it's where they're getting their information from. And we're able to really take the last 25 years of knowledge. And I've been studying patterns. I see what works and what doesn't work. And we look at what makes one doctor massively successful. I have clients that do 20, 30, 40, 50 million in revenue. I have other clients who have become billionaires and their roommates in college or, you know, their, their counterparts are struggling to do a million a year. I look at the pattern, like, what's the difference? Right. And, and we bring, we bring that, we, we, we come into an office, we look at what they have and we start to make adjustments.

7:10And it's, it's really amazing what happens after that.

7:13Dan Fleyshman:Why should a doctor or dentist start to use social media? So many of them don't want to do it, not interested in it, don't think it's going to help them. What would you say to that doctor or dentist and why they should utilize social media? Well, if they can't find you, they can't come to you, right? And so if all business is attention and compliance, most doctors, you know, almost all doctors are very high on compliance and they give very little value to the attention piece. And so most people are one or the other. Like if you look at your organization, you could probably identify like who's an attention person and who's a compliance person.

7:46And it's marrying those two together. And now what started to happen is doctors have started to use social media. And again, it's where are they getting their information from? I don't know if you've seen this, but like dentists are dancing on social media. Sure. It's like they're dancing. And I don't, I don't know what that's all about. I don't go to my dentist because he has dance moves. Right. So they're just getting the wrong information. But I actually, you know, I believe that the, the, the industry benefits greatly from that Because if the industry can keep them doing clinical work, the insurance companies can grow and so can the industry.

8:20And like I said, the doctor will have a good life, but why not have an extraordinary life? Why not? You know, you've worked so hard. Why would you come this far to only come this far? Right. And what's really interesting is this has nothing to do with working harder. This has to do with working smarter. Systems and processes. Systems and processes. Yeah.

8:36Dan Fleyshman:So for the most part, in our minds, pretty much every doctor, dentist just has one location. Right. And you can actually know the math on that. But for the most part, it seems like most of them just have one location. But I've seen what you've done. You've scaled four locations here, 12 locations there. Some have 20, 30, 40, 50, 60 locations of certain types of brands that you're involved in or advising to. What's the difference or what can they do if they want to decide, OK, I'm going to open my second or third location? Yeah. The most important thing is to get your zero to one really, really dialed in.

9:06I call it zero to one. So there's two avenues. there's zero to one and then there's one to 100 or one to 10 or one to five but it's those are the two buckets and if your zero to one was built through the industry that's where you got your information it's never going to be like this perfect tire that can gain momentum it's always going to have these flat spots where you as a doctor have to show up and push it and that's one of the trickiest things about scaling i've seen doctors try to scale a model that that doesn't have that ability to grow and and they just get themselves in trouble so we really start the zero to one we really start at what there are so if they haven't started a practice yet reaching out is great if they have a practice reaching out is great because we can go look at it and really perfect that model i almost call it like a coffee shop like if you don't have the coffee shop like super dialed in and you have to be there every day to make coffee you can't scale

10:02Dan Fleyshman:that to Starbucks. You can't be in four different locations. Right. But if you're in Seattle and you really dial in that coffee shop and it really works really well and customers want what you have, like people want Starbucks, then you can scale that beyond belief. In fact, if you're, you know, if your significant other wakes up on Sunday morning and says, honey, get me a caramel frappuccino, you've got to go there. Right. You can't say, hey, I was, you know, at the gas station and this is a little bit cheaper. So they struggle with that. The model of the practice, the way it's traditionally built is really designed to keep them there, almost keep them in a jail.

10:42When I talk to a doctor and I say, hey, does your practice feel like a jail? A lot of them say yes and they don't understand how that happened and it happened because of the information they're getting and the really amazing part is what happens when we come in and make these adjustments and free them from that jail. And people want to come to their practice. They're no longer dancing on Instagram being goofy. And the practice is actually growing. So to answer your question, being on social media is a very important piece of the attention part. But it's also important that we create a strategy, not that they just do what everyone else is doing.

11:20Dan Fleyshman:So doctor, dentist, or just some listener out there right now, it starts to make more money. They go from 80 grand, 120 grand, 150 grand. They started making some really good money. One of their investment properties sells. They got an extra quarter million. Now they got some real cash that's been saved up, but they got a lot of options. Stock market, cashflow and businesses. Their buddy wants them to invest in the next pizza store, pizza place. Their friend wants them to open a salon. They got all these different options. What would you say to someone to think about how to decide what to invest into?

11:50Yourself, right? You got to invest into yourself. You got to put yourself first. In fact, you know, when you're on an airplane and the mass drop, the little video plays they always say put your mask on right before anyone else's because if you're in good shape then you could take care of your family you can take care of your business and then you can go after that and invest into other people but what i tell our doctors is to to build a brand because that's going to give them a high level of attention sure build a brand invest in that and then from there if you want to do something else with your money that's a little bit different but the first thing they have to do is invest in themselves build a brand and invest in that.

12:23Dan Fleyshman:So you've mentioned that you have other ventures. Now you've got your core business that you've had 12 ,000 clients on, but then you started investing into actually scaling some of the salons and scaling some of the dental practices and investing in some of them involved in a winery, et cetera. Like how did you decide the things that you were looking into? I've learned that for me, it's about the people. And, you know, early on I made some investments that just didn't make any sense at all. And so today when I meet really great people, I want to be surrounded in those networks and I want I want that kind of energy in my life so I'll look at people I'll look at numbers I'll make sure the business can make money I always say like show me how we make one dollar first like that's really really important everyone's like oh we're gonna make millions gonna be amazing show me one dollar yeah show me one dollar show me how we take this and and make a dollar and from there that's you know a compliance piece like I can buy it here and do there and then I start to look at the attention piece and how can we draw attention and how can we really scale this?

13:22So scaling is something that I'm very passionate about. I got involved in a vineyard and now we started a national wine club. They were selling wine in a small town and now we're selling wine all over the country. So that's really amazing. But I actually made my decision because of the people involved. I look at the people, I look at the family, I get to know people and I say, are these the type of people that I want to be around and do they lift me? Because we all know you're around the right circles, you're around the right people, they lift you. But if the opposite is true too.

13:49Dan Fleyshman:So there's this investment theory that you guys have heard me talk about occasionally. It's called 40-40-20. I want to do 40 % low risk. I'm hoping to make between 5 % and 9 % for the year. I want to do 40 % medium risk, hoping to make 10 % to 30 % for the year. And 20 % is my shot at glory. It's very high risk. If it works out, I want something crazy to happen. 8X, 13X, et cetera. If it doesn't work out or takes a long time, I'm hoping for the medium risk and the low risk to cover the high risk. The medium risk side, this is real estate, create cash flow in businesses and the stock market. Low risk, CDs at your bank, S &P 500, things that are solid, tried and true that have been around for many, many years.

14:27Okay. On the investing side, they did it.

14:31Dan Fleyshman:They made the money. They sold their practice. They got$4 million in the piggy bank, but they're bored now. They don't have to go to work anymore. They're not walking into their doctor office anymore like they did for the last 30 years. how do those people decide okay well now i just have capital to play with my house is paid off the kids are off to college like what would you say to that person move slow yeah move slow right because they've spent so much time doing this and it's exciting and then when that happens and they get that influx of cash yeah you know you have a lot of new friends everybody's reaching out to you there's a lot of so i would say slow down you know um i always say hey if you don't do it today you can do it tomorrow and i'm a huge proponent by the way once you have a business that we have to move quickly yeah right but once you get that big payday take a deep breath and and ready ready ready ready aim aim aim and then shoot right because i think um i think preserving wealth is very different than creating wealth and i literally think it's like a like a shift in a transmission like it's a completely different set of rules and one of the biggest mistakes i see with my clients because we do that our clients make 20 30 40 50 100 million dollars and they call me up and like paul this is amazing now what yeah and then they're like now what's next what's that they have a lot of energy and they're shocked when i'm like tranquilo go to turks and kegos for a month right i i can't hang on on the beach for 30 days i've been going a million miles a minute i was like i know you have to like literally train yourself to just slow down because now that you have it it's a different set of rules right and you know we all know that saying easy come easy go and if if you're if you're playing by the rules of creating wealth once you you already have it you can lose it pretty quickly.

16:29Dan Fleyshman:So let's talk about the charity side. Is there for doctors, dentists, or just households in general, how would you say to someone why they should be involved in philanthropy, whether it's money, time, or energy? I think it's really good to be pulled to something, to have something that is bigger than ourselves, right? And I actually, when I talk to doctors or people in general who are depressed or just not very happy, it's really all about them and they can't get out of themselves in terms of charity. I would, I would pick something that, you know, pulls you that really, you know, connects with you.

17:10Um, I saw this, uh, recent interview between Tony Robbins and Alex Hermosi and Alex donated all this money to schools, but didn't feel good about doing it. And Tony brought up an interesting point. Like, Hey, you don't even have kids. Right. So when it comes to charity, I think you got to find something that like really, really resonates with you.

17:29Dan Fleyshman:Yep. And I think it's important because I think when you do something that's just not about you, it resonates with you. It pulls you, but it's about community. It's about a greater whole. It creates a certain level of satisfaction and happiness. And I think it's important to do that in a way that you are happy about it. If you're kind of check doing it for, you know, the wrong reasons or it doesn't feel good, I think you got to reconsider that. But ultimately there's something out there that connects with people and connects with you. And, you know, I have a saying in our company, our slogan is everything is connected.

18:05And so I'm always looking for to do something that's in alignment with the direction I'm going in. So you can find a charity that is in alignment with your values and your beliefs and do that. And I think it'll, you know, it'll make you happier. I know it'll make you happier and it'll, there's some, you know, I don't know if you want to call it karma. or, but there's something in the universe that when you, you do right by people, it comes full circle. That's at least what I found.

18:31Dan Fleyshman:Yes. So what Paul is saying to get even more granular is something that's impacted your life or someone that you know, whether it's a family or friend. So if someone in your family has gone through breast cancer, has been homeless, grew up in an orphanage, et cetera, you are going to be more pulled to actually help it rather than just donating a hundred bucks, a thousand bucks, 10 grand, a hundred grand. The math is irrelevant. how much you donate is relative to your financial situation but it's going to drive you actually want to show up to the charity event or show up to the children's hospital or show up to the senior citizens home if someone went through alzheimer's or leukemia etc you're more likely to actually get involved in it post on social media etc because you are pulled to what you care about it because either yourself or someone your ecosystem went through it so there's only one question i've asked every single guest over the last couple years and i've never gotten the same answer and i'm definitely not getting the same answer today as you build all these businesses wineries salons franchises scaling restaurant groups 12 000 clients becomes 50 000 clients etc and you have got a let's call it a billion zillion dollars what percentage of your net worth do you leave to those children oh that's a great question i um i want to create generational wealth but i think that percentage will be secured in a trust and um they're gonna have to earn they're gonna have to earn it i uh i have a lot of clients who are very wealthy and they just leave that to their kids and there's no path to earning yeah and i just see absolute disaster sure it would be like me just giving you like a 747 airplane and being like here dan i love you here's the keys uh by the way we're in mid-flight is you know they're my kids so i'm dad and then one day i'm out of the picture because you know the two things in life that are certain we're going to pay taxes we're going to die i'm out of the picture and here they are in a big 747 airplane and they have no idea how to fly it and and that just doesn't end well yeah yeah yeah all right so in our system today ai is coming right ai has been around for many years but for many years, people couldn't spell AI.

20:44Dan Fleyshman:Now it's becoming much more prevalent. Doctors, dentists, or just people that own, you know, retail businesses, what would you say to them to research or study or start to watching out for AI? Is it important to them? It's extremely important. And in fact, I think this is where ownership matters the most because the tasks of doing, the thing we talked about before where, you know, doctors are operators, They're just operating. You know, Elon's coming out with robots now. And if you don't own something and you've been doing a task and getting paid to do that, and now a robot can do it and AI can do it, I think you're in big trouble long term.

21:25So this is where I tell doctors, you want to have ownership and you want to build a brand. You want to build a brand that people want. Because like I said, if your significant other says, honey, get me a caramel frappuccino, you have to go to starbucks right and if it's just a coffee you can go anywhere right so ai is a game changer because it's going to free up a lot of things but it's also the reason why private equity is buying everything i mean they're literally i don't know about you i get emails all day sure i want to buy this i want to buy that we'll take this we'll take they'll buy everything because we're not we're a lot closer than people realize yes to full automation i mean i got here today in a car that drove itself 100 yeah sitting in the back seat car just took me yeah yeah and so so when you really understand how quickly this is moving the two things that matter most are ownership and then building an actual brand that people want ownership is going to give you that compliance piece like this is my piece and this belongs to me and the brand is going to give you that attention piece and you need that because if you're a great doctor a great surgeon and you're operating as just an operator but you don't actually own anything or you don't have a brand there are robots that are going to take your job pretty soon let me break down this real quick

22:48Dan Fleyshman:waymo for example if it becomes at scale well uber and lyft have millions of drivers so does postmates doordash instacart and so many delivery services if waymo actually gets really good or the Tesla version of Waymo gets really good what happens to millions of jobs besides them just going away where do they go work what happens when Elon really gets good at semi-trucks I paid for my two semi-trucks from Tesla a couple years ago they're about to be here what happens when you've got around two or three million drivers semi-trucks I'm not saying they're all going to go away or every company is going to start buying Tesla semi-trucks but eventually they will i think 10 years from now there's gonna be no semi-truck drivers what happens to those two three million jobs that's what i'm saying like the guy that drives that semi-truck what job does he go get afterwards times that by two three million and so when you start to think about like what happens if millions of jobs go away when we go to chipotle mcdonald's jack the box etc you're already starting to see some of the times where you can order from the computer what happens if there's no cashiers you know that over five percent of our population has worked at mcdonald's in their life what happens if that number goes to zero or one percent we were out now uh we were out in la uh last week and we went to the tesla diner oh yeah yeah with all the chargers and and the car drove itself there and backed into the spot and uh my daughters wanted popcorn and we went in and optimus the robot served his popcorn no way yeah yeah working behind there and took the order you know and gave him popcorn it was really interesting my four-year-old dropped the popcorn and it fell all over the ground and the robot saw it really and got her another one oh my god yeah Yeah, that was last week.

24:49Dan Fleyshman:I don't think people understand. So last year in 2025, 62 % of all venture capital went to AI. That's$266 billion went into one category. Never happened in human history. One category got basically all the money. We are going to start to see the effects of that in 2026 and 2027 as they deployed that$266 billion to hire smart people, build huge data centers, hire all the... They're going to do so many things to then deploy it. And then this year, it's mandatory for venture capital and private equity to invest more into AI. They got to check a box. So hundreds of billions of dollars more capital is going to AI.

25:26Dan Fleyshman:You guys understand? You're already seeing things like Optimus Prime robot getting on the floor and cleaning up. What happens when that's in all the households or in all the offices? What if maids, that thing that you don't really think much about because they're not seen, we don't really feel it, right? You go to hotels. Well, think about how many maids are in these tens of thousands or hundreds of thousands of hotels just in America, let alone all over the world. What if robots are the maids? Where do those millions of jobs go? What are the millions of maids going to do? If millions of people are not cashiers, if millions of people are not drivers, if millions of people are not maids, these are basic jobs.

26:03Dan Fleyshman:What did they go do? What is the next job if the next job is also a basic job covered by a robot? I know it sounds like a conspiracy theorist, but this is becoming reality. because you just dealt with it. They just picked up your popcorn last week. Yeah, yeah. And for one of our practices, we took a call center that had 14 agents that would pick up and schedule appointments and talk to a patient about their benefits and have to look up their insurance benefits and all this work. And you get 14 agents and 15 phone calls, 16 phone calls come in at the same time. You lose two, right? We just implemented a full AI call center and those 14 agents just sat there for a full week and and the phone would ring over to them if the ai couldn't handle it and i think they got two phone calls oh my god uh and there was just and the doctors called me like what do we do and i said all right well let's uh you know let's sit down with each one of them and and see kind of what their skill sets are because we're gonna have to redeploy them somewhere but i'm not sure we're redeploying all 14 sure right so no missed calls more patients in the seat full automation no sick days no sick days and if you said how much is my insurance cover that agent is able to pull that information within seconds versus the typical answer well what you know let me call them let me see you know you're waiting on hold it's full no emotion no lunch breaks no nothing none of that none of that and wow no payroll right but but much better service too and that was the interesting part is i would call the call center and i would enjoy talking more to the agent because it would just get me from point a to point b as quickly as possible yeah all right paul where can people find you on social media where can they find the company and if they know a doctor dentist where should they send them to if they want to hire your company sure you can go on uh you can go on our website surfct.com surfct.com uh we're also on instagram surfct.com and my personal instagram if people want to dm me ask a question paul Vagario.

28:02Dan Fleyshman:All right, guys, this is important. You may not be in the doctor dentist world, but you were listening to this podcast. It might be for someone from your past, present, or future. There may be some time you're at lunch or dinner and someone's a doctor dentist or their dad is, their mom is, their son is, their grandpa is, et cetera. And you're like, oh, wow, I listened to that podcast with Paul Vagario. I can forward it to them. Oh, wow. Maybe I can send them SurfCT and you help your friend's grandfather go from a$1 million clinic to a$3 million clinic because they hired his company. Keep that in mind as you listen to the Money Mondays podcast and in general, when you're listening and learning things, it's not just for you.

28:36Dan Fleyshman:It might be for your friends, family, and followers. I appreciate you guys. Check out Paul and his companies across social media. We'll see you guys next Monday here at themoneymondays.com.