Running a Family Medical Practice: The Secrets to Making It Work w/ Dr. David Shaker (Ep. 54)

The Business of Healing: Lessons from a Multigenerational Medical Practice

Physicians often enter the field of medicine with a singular focus on clinical excellence, dedicating years to mastering diagnostics, therapeutics, and patient care. Yet, one critical area remains underemphasized throughout their rigorous training: financial literacy. As Dr. David Shaker, a New Jersey primary care physician, aptly describes, “We’re some of the smartest people in the world, yet so many of us don’t understand money in medicine until it’s too late.”

This oversight isn’t just a personal burden for doctors—it shapes the future of their practices, impacts patient care, and contributes to physician burnout.

The Disconnect Between Medicine and Finance

Medicine's culture has long separated clinical knowledge from financial management, creating a misconception that merging the two compromises care. This mindset inadvertently leaves physicians unprepared for the financial realities of running a practice, negotiating contracts, or planning for their own futures.

Dr. Shaker, who runs Shaker Medical Group with his family, points out how this disconnect leads to disillusionment among young doctors. “We come out of medical school with little to no understanding of business structures or billing systems. By the time we learn, we’ve often missed key opportunities to build sustainable careers.”

Lessons from a Family Practice

Dr. Shaker and his brother inherited their father’s medical practice, which they have grown by taking strategic steps to balance patient care with business acumen. From dividing responsibilities—his brother handling finances while he focuses on marketing—to expanding their practice into new locations, they’ve built a thriving enterprise.

One of the keys to their success is the understanding that clinical excellence and financial strategy can coexist. For example, Dr. Shaker embraced the use of GLP-1 medications for weight loss, not just for their clinical benefits, but also as a way to differentiate the practice. “These medications let me stop other medications by addressing the root cause, like weight. Patients see better results, and our practice grows by word of mouth.”

Time and Financial Management

The burnout epidemic in medicine is often tied to poor time management and a lack of financial foresight. Dr. Shaker’s advice for physicians, especially those early in their careers, is to approach their lives with the same preventive mindset they apply to patient care.

He emphasizes protecting personal time and delegating responsibilities. “Don’t be too busy in your business to work on your business,” he says. By focusing on operational efficiency and hiring supportive staff, he’s been able to carve out time for his family and hobbies like fishing and golf.

Teaching the Next Generation

Dr. Shaker also serves as an associate professor, where he introduces medical students to the business side of medicine. His approach is simple yet transformative: teach the human connection in medicine first, followed by the operational realities of running a practice.

“I tell students, design the life you want and work backward to create it,” he explains. By emphasizing lifestyle considerations alongside clinical passions, he helps young physicians make more informed career decisions.

The Need for Systemic Change

Dr. Shaker’s story underscores the need for systemic change in how physicians are trained. Financial literacy, time management, and business acumen should be integral parts of medical education—not afterthoughts.

“Medicine is about people,” he reminds us. “But if doctors don’t understand the systems they work within, they can’t sustain their practices or their own well-being.”

In an era of increasing complexity in healthcare, it’s time for physicians to embrace their role as both healers and business leaders. Only by integrating these two disciplines can they achieve balance, avoid burnout, and provide the best care for their patients.