Go Justin Nabity

This is the DocNation podcast. We are a movement founded by doctors for doctors dedicated to empowering medical professional to reclaim control over health care decisions and advocating for their fair share of the industry’s resources. Please note the views expressed are those of DocNation and not necessarily those of our Guest or Reference Health centers. Well, welcome back to another episode of the DocNation podcast.

We’re excited to have Doctor Rashmee Patil on with us. And before we get into the conversation, we want to touch base on what DocNation is doing. We are in an era where so much control and so much influence has been stripped away from physicians that you have unlicensed, untrained, people who have never treated patients before calling the shots in health care.

And so we exist to make it possible for physicians to get back in charge, for doctors to have more decision making authority. And, we’re in a tough spot with what’s happened with the ten administrators for one physician. Now, when they used to be five physicians for every one administrator, it’s been a huge change. So we strongly believe that the ones who should be calling the shots and making the decisions are the ones who went through medical school, who went through residency and fellowship, and who actually provide care to patients, and that these big insurance drug companies and, the big health systems that really don’t have the qualifications to provide the care to the patient.

And so it’s a big concern. We’re consumers of health care ourselves, and we care about what we receive from our providers, our physicians. And so we want to see patients get more time with their physician. And so DocNation exists to advocate for you, the patient for you, the physician, and to make sure that you get that time with the patient that you need.

And, the care can improve where we’re spending way too much money on health care today. And the results globally, I guess on a global scale for our country are not where they should be. And so we intend to make a difference with that. And it’s fun having these kind of conversations to talk with leaders who don’t fit the mold or don’t go down the traditional path.

And so Doctor Patil is a board certified internist and hepatologist. She’s the CMO of Pinnacle Clinical Research. She founded the South Texas Research Institute to expand and clinical trial access in underserved communities and has led over 100 studies on liver disease, including NAFLD and Nash. She’s a frequent contributor to top knuckle journals. She is a national leader in advancing care and equity and metabolic liver disease research.

She’s not just an outside of the box thinker, but also a doer, and that’s one of the things we look forward to having her share her story with us today. And so, Doctor Patil, tell us about the unconventional path that you took.

Reid Lancaster

Whoa, whoa whoa! She’s she’s also she’s also an ex D1 athlete. Come on, come on now.

Justin Nabity

That’s true.

Dr. Rashmee Patil

Yeah, yeah. You left that very important fact out.

Reid Lancaster

Yes, yes. Okay, go ahead.

Dr. Rashmee Patil

Well, thank you first of all for having me. I really appreciate it. And just to give your listeners a little bit of, you know, sort of like a backdrop for how we met and interacted, I think, I, you know, I’ve been on this path now, kind of a nontraditional path for a while.

And, you know, we, I think through serendipity kind of met as I was looking to start a new venture. But all, back to the beginning. So, as you said, I’m a hepatologist by training. I have a real passion for liver disease, and I did internal medicine training. And then I worked for a while as a hospitalist, spent some time trying to really decide what I wanted to do, and then eventually pursued a fellowship in hepatology and liver transplantation at Baylor in Houston.

I’m a Texan, so I had spent a lot of time away from Texas but came back to Texas to finish my training. And then in about 2017, I was called by a couple of hepatobiliary surgeons who wanted to start a liver transplant program in South Texas, which is where I am now.

And it was really an interesting opportunity, and I wanted to go where I was needed, which is part of my—I’m sort of cut from that cloth. I want to go where I’m needed. And so I took the leap of faith, and I went to an area that is very underserved, that didn’t have a single hepatologist, really, and started to build up a practice and got a lot of good hands-on clinical experience.

Justin Nabity

And a hard decision to make—to go there?

Dr. Rashmee Patil

Yeah, I think it was hard because I had gone from—I did my training in Brooklyn, New York, so I went from Brooklyn, New York to Houston, Texas—the Medical Center in Houston—and then to very South Texas, which is a much smaller community. So it’s a much smaller medical community, probably 90% Hispanic.

So, you know, patients here are just different—socioeconomically depressed, don’t have access to a lot of things. And there wasn’t a liver transplant program here. Most hepatologists follow an academic route—they go work at a transplant program and they’re in a big academic system. So this was me starting something from scratch, which was very intimidating.

But I was interested. I wanted to sort of see what would happen. And so yes, it was hard, but I did it. So I came here, worked building a general practice for about two years, and at that same time I was introduced to my mentor who really opened my eyes to drug development and to the commercial side of medicine—something that we’re not really privy to as physicians in our training, or even post-training.

So I built up a clinical research program in the hospital system where I was working and focused on a progressive form of fatty liver disease called MASH. And it just blew up—it became very successful very quickly. We got a lot of studies, we enrolled a lot of patients, and then I started to have to answer the question: okay, what do I like doing more—traditional clinical practice or clinical research?

And it became sort of a tug-of-war. Unfortunately, not every hospital system you work in is going to see eye to eye with you. Sometimes they can’t see the vision. And so I decided, because I was being pulled in different directions, that I wanted to focus 100% on research. I left the hospital system and started my own clinical research site business. That was around 2020. And if you recall, in 2020 we had a small thing called COVID-19 happening.

Yeah, a bit of a global pandemic was around the corner. So we opened the doors April 4th of 2020. And I thought to myself at the time, I was like, oh my gosh, I think this is going to fail. I think I just risked my career maybe. Took on a little bit of financial risk—and you know, what’s going to happen? By the grace of God, or whatever you want to call it, we actually did very well. During the pandemic, we actually grew. We brought on a lot of clinical trials. We started with five individuals at our initial location, and by the time we had been around for two years, we had grown from five people to thirty people, one location to two locations.

And just really—it was a success story. So around 2022, I partnered with a larger clinical research site business called Pinnacle Clinical Research. They are leaders in liver disease research. Now we’re moving into other areas. I came on as the CEO of the combined business. So now I’m going from two site locations to five in Texas, overseeing that growing business. And since then, we’ve grown to sixteen sites across Texas, Nevada, and New Jersey.

So now I’ve changed roles into the role of Chief Medical Officer, but still, I mean, it’s a huge role and a growing company. So it’s been really exciting, very interesting, a very steep learning curve for me. I don’t have an MBA. I’ve never taken a business class before.

Justin Nabity

Did that hold you back? Did it prevent you from being able to do what you wanted or needed to do?

Reid Lancaster

Or did it slow things down?

Dr. Rashmee Patil

I think that it… you don’t know what you don’t know, right? And so I think there was a little bit of naivete at the beginning, which is kind of good in a way. Because I think when you don’t know what you don’t know, you don’t fall into this analysis paralysis trap, which a lot of physicians fall into—because we’re very cognitive, and we love data points. We want to know everything before we take a leap of faith. So I think it was a blessing that I didn’t have an MBA or tons of formal business training.

Because I had already proven to myself that this was a calculated risk. I had built a program…

Reid Lancaster

You got a real-life MBA. You got a real-life MBA.

Dr. Rashmee Patil

Yeah, I had already built a program within the hospital system. I knew what the contracts were like, what sort of revenue was coming in, the general overhead, how many people were needed. And I knew I could do it. I had some really great mentors and people supporting me, pushing me to make the decision. That’s a big part of it. You need people behind you or people who have taken that path before to tell you: you’re going to see success on the other side.

Justin Nabity

How much did medical school, residency, and fellowship equip you to do these things that aren’t the typical path—like signing a contract and working a job in a hospital?

Dr. Rashmee Patil

That’s a good question. I think being a doctor in general gives you resilience and the ability to grind it out. There were times during my residency when I wanted to quit. It was very hard. And so once you go into business, even though the decisions are hard and you’re making thousands every week, they pale in comparison to what you deal with in medical training and practice.

I had the confidence, even if I didn’t know everything. I knew I could learn. Doctors are curious, they’re smart, and they want to keep growing. If you don’t know it, you’ll figure it out.

Justin Nabity

So it’s like the boot camp prepared you—not necessarily with specifics, but with the endurance to move forward in an unknown environment. Fear is the biggest cancer in the world. And people fear what they don’t know or understand. You didn’t let that stop you. It sounds like you don’t regret it.

Dr. Rashmee Patil

No.

Reid Lancaster

I’m so thankful she said that. That might be the most important thing in this podcast. We have a powerhouse physician and a powerhouse businesswoman saying the business decisions are super doable. It takes courage, but they pale in comparison to what you face in medicine.

To any physician listeners who are on the fence—about leaving the hospital, about going through a period without income—this should give you courage. Rashmee started a business on April Fool’s Day… in a pandemic. If that doesn’t give you courage, nothing will.

Dr. Rashmee Patil

Exactly. I don’t regret it. And even if it had failed, I always knew I could go back to traditional practice. That’s the beauty of being a doctor—you always have options.

It opened so many doors. I’ve now seen the commercial side of medicine. Drug development is exciting and innovative. It’s the intersection of science and patient impact. You get the best of both worlds.

And now, as CMO, I interview a lot of clinicians—principal investigators from all specialties. Many of them are tired of traditional medicine. They’re seeing 40 patients a day, burned out, unfulfilled. Clinical research gives them new fulfillment.

And so I see the trepidation. Somebody—you, one of you—had mentioned, “Oh my gosh, I’m leaving the traditional medicine path and I’m not seeing patients in the clinic the way I’m used to.” So I see that hesitation for sure. But there are ways to balance it, to keep your license current. You want to stay up to date with CME, with your board certification, and all of that. But you can still do a ton of different things with your medical training.

So that’s kind of the message I also want to give to clinicians—that clinical research is a really interesting way of maybe finding the satisfaction that’s been missing. And really, physicians need to be more involved in clinical research because we have a lack of investigators.

We have a ton of patients who suffer from all kinds of diseases, but they are siloed into community practices or healthcare systems that aren’t connected to trials. They’re not getting access because not enough physicians are participating.

Justin Nabity

We talked about that before. What is it—less than 10%?

Dr. Rashmee Patil

Yeah. I mean, I think it’s definitely less than 10%. I don’t know the exact stat, but there’s this trend where most physicians who become principal investigators only do it once—they’re a “one and done.” They do one study and they’re done. They say, “This isn’t for me.”

So I think it’s partly that many clinicians don’t know this is even an option. And also that once they try it, if they’re not supported properly or exposed to it the right way, they don’t enjoy it. But when it’s done right, and they’re set up well, most want to continue.

The physicians we have at Pinnacle who do clinical research? They never want to go back. We’re never going back.

Justin Nabity

One of the things we talk about a lot is how rampant depression, anxiety, and stress are in medicine—burnout among clinicians. It’s crazy how many medical students are on antidepressants and stimulants. It’s like 75%.

And if you study psychology, the root of so many struggles comes down to a lack of autonomy. Not having control. Not having decision-making authority. People feel helpless. And we hear it every week from physicians all over the country—they don’t have control.

You went through different phases—traditional, then in-between, and now something else. Where did you notice that shift from lack of control to having more control? And what did that do for you?

Dr. Rashmee Patil

Not everyone has an entrepreneurial streak that they can tap into, and I want to be transparent about that. Not every physician wants to be entrepreneurial. But those who do—those who have that little ember, that little spark—once they access it, there’s no going back.

So what happened for me was I had the example of my father, who owned his own practice. He spent so much time with me as a kid. He could take off whenever he wanted. He was my coach during my junior tennis career. He went on trips with me all the time.

But he told me all the time, “I can do this because I own my business. I own my time. I can do what I want, when I want.” And so I always had that in my mind. He had kind of—

Justin Nabity

Planted the seed.

Dr. Rashmee Patil

Yeah, he had planted the seed. Right. So once I started getting into the hospital system, it was fine. But once I had the idea that, “Hey, I think I can take this and do it on my own,” then there was no going back.

I loved the autonomy. I absolutely loved being a business owner. And personally, I really don’t ever want to be in a situation again in my life where I can’t control the decisions that are being made—or where I can’t see that the decisions I’m making are having a true impact.

And so much of that comes from having a seat at the table. The more bloated healthcare has gotten over time, the bigger the gap between the clinicians doing the work and the people making the decisions. The clinicians aren’t being involved in decision-making anymore.

In clinical research, it’s different. Yes, there’s consolidation happening quickly, but clinicians are still at the forefront. At Pinnacle for sure, but also more broadly. Many physicians own their own research sites.

And you have to be a physician to be a principal investigator. You can’t get around that. Pharmaceutical companies—at least for now—aren’t going to put a nurse practitioner or PA in that role, even if they’re very skilled. They want physicians. And physicians have a lot of say in how clinical trials are executed.

So I think it’s refreshing for physicians to come into clinical trials right now.

Reid Lancaster

I see.

Justin Nabity

Get on it, Reid. She said “have a seat at the table.” I know what you’re thinking.

Reid Lancaster

Tell her.

Justin Nabity

No, no—you tell her. What does that remind you of? One of our previous guests?

Reid Lancaster

That’s one of our key things. I have a lot I want to say, but I’ll keep it brief. Back at the beginning of the podcast, Justin was asking if we learned anything about business during training. And it’s designed for you not to.

They want to keep you as a physician. But what I will say is—they don’t want you to have any business knowledge. That’s by design. Just so you know. That’s by design. If you spend ten years in school and can’t get six months of basic business education?

Dr. Rashmee Patil

Yeah, you can’t read a basic P&L, or create a pro forma. Yeah, yeah, yeah.

Reid Lancaster

That’s insane. The key player in healthcare doesn’t know how hospital finances work or any of that. Right? And that’s by design.

But I almost want to stay away from that—because every single podcast we hammer CMS cuts, we hammer hospital administration, and our listeners already know where we stand.

This episode is going to be a breath of fresh air. Because it’s like—okay, we know the problems. But here are solutions. Here are opportunities. And here is proof.

So I’m just grateful you were willing to come on and share your time. You are extremely busy, and you still took the time to share your experience. Because it’s not just a group of business guys saying, “You can do this.”

Not only can you do this, but we’ll help build it with you at DocNation. We’ve been working with you for months now. But this is proof.

Yeah, a seat at the table.

Give me the quote real quick, Justin.

Justin Nabity

Yeah. The phrase is: “You either have a seat at the table, or you’re on the menu.”

Reid Lancaster

Old school! Oh yeah, that was from an older physician we had on. That was such a great one-liner. He said, “You’re either going to have a seat at the table or be on the menu.” And it’s so true—not just in medicine, but in every industry.

I just don’t know any other field where the most important people—the ones doing the work—aren’t making the decisions. Physicians have no decision-making power anymore. None. You’re not being paid what you were in the ‘80s. There’s no autonomy.

That’s why we’re seeing a major increase in inquiries to DocNation. People want out. They’re on the fence: “Do I start my own practice? How do I do that? Where do I start?”

And you’re right—a lot of physicians suffer from paralysis by analysis. And it’s hard to see, because your dreams are right on the other side of your fear.

And Rashmee, you are proof of that. We’re just grateful for you. Grateful to know you. Grateful to be working with you.

Go ahead, Justin—I think you had something else?

Justin Nabity

Yeah. I was just thinking—what would you say to your colleagues or the next generation coming up? The ones who have these ideas and possibilities but aren’t sure?

Each of them has something unique. They have their own value. What would you say to ignite that in them? What would you say to yourself, back when you were debating whether to take the leap?

Dr. Rashmee Patil

Yeah. I mean, I think that you have to understand yourself and understand what is your risk tolerance. I mean, think about: what is the worst-case scenario here?

Like, say you’re thinking about starting your own practice, or opening some sort of new, innovative business that isn’t run-of-the-mill, or is new for your specialty. The worst-case scenario is—it fails, right?

But at the end of the day, the amount that you learn in failure is really going to set you up and help you learn how to be successful the next time. With the next iteration.

And you always have a backup. Being an employee—it’s not a bad gig, right?

Being a business owner has its own challenges. It’s tough. It has its own pros and cons. But I think if you recognize in yourself that you have an entrepreneurial spirit and you want to do something, you’ve got to go and just do it. Because no one else is going to do it for you.

So I think that as a business owner, you have a lot more autonomy. You’re able to create jobs. I remember creating jobs for other folks, impacting my community, setting an example for others who might follow. And it’s better for your patients—in terms of outcomes.

And at the end of the day, it brings a lot more satisfaction.

So I know the system is working against us in a lot of ways. But I think the more of us that are willing to think outside of the box, that’s when things start to change. That’s when the needle starts to move.

And from my perspective, clinical research really needs to be considered—as a way to bring in an additional revenue stream, to help build your brand in your therapeutic area, and to connect with pharmaceutical companies.

Because then you’re involved on the drug development side, and also on the commercial side as a key opinion leader when you’re prescribing. You have to understand how this all works—and who the stakeholders are.

And the more clinicians that get involved in clinical research, the more financially viable opening your own practice becomes. And you’re opening up access to clinical trials for way more patients.

That ultimately improves the speed and efficiency of drug development—and lets us innovate for future generations.

So I’ve seen it in liver disease—I’m a specialist in that—but I have colleagues who are working in neurology, Alzheimer’s disease, a lot of other areas. And it’s really rewarding.

But again, you’ve got to take that leap of faith.

And I would say the only other thing I’d counsel people to do is—get basic business training. If I went back, I would’ve picked up a basic book or two. You know those books that try to condense an MBA into like 90 pages? Pick up one of those. Just start to think like an owner.

There are a lot of great books out there. And look—we live in an era where there’s so much content available to you for free. Podcasts became my teachers, honestly. There’s a lot of great information. You can learn from so many people.

And I would also say: find a mentor. Or two.

So, you know, if what I’m saying today is sparking your interest, reach out to me. It’s important to seek out people who have done what you envision yourself doing. They’ve created a path. And you say, “I want that. That sounds interesting.” Ask them, “How did you do it? What are the tools? What do I do? How do I even access this type of opportunity?”

So—find a mentor. Super important.

Reid Lancaster

That is so good. And that is such a gracious offer.

I’ll say it like this: building a business is like building a baseball team. You’re not going to be the first baseman and the shortstop and the catcher and the left fielder. You’re good at certain things, and you know certain things, and you bring people in to help bring your dream to life.

You are directing and leading.

That’s one thing we talk about at DocNation. And another thing we do is—if you’re listening to this and you want a Business 101 class—we’ll take you through a six-week or six-month course.

So feel free to reach out to us. And if you want to get in touch with Rashmee, she just made that offer.

Dr. Rashmee Patil

And if you’re interested in that—

Reid Lancaster

Talk to us. Rashmee, I’ll leave you with this—unless Justin wants to close it out. You’ve gotten a lot of questions in. So can I go ahead?

Justin Nabity

I’m kind of taking over here. Go ahead.

Reid Lancaster

I think you’ve covered this mostly. But in all of your business and clinical experience—what’s been your number one favorite thing? What’s been the most satisfying part about business or medicine… combined?

Dr. Rashmee Patil

So I would say—combining the two, clinical research has allowed me to do that.

First, I’d say I found my niche, which I know is very rare. I feel very blessed. But I also love to help people understand how to access their best self so they can find their niche too.

I want every physician to stay in medicine, if possible. We have so many clinicians who are leaving or are dissatisfied, and we need clinicians. We need good doctors.

So I think what I’ve recognized—going back to your question about what’s been my favorite part—has been realizing that there’s a huge opportunity here to help.

I think I’ve gained so much from it, and now I’m in a mindset where I really want to be a conduit. I want to be a conduit for knowledge, for information, for a path to success. I just want to elevate as many of my colleagues as possible.

I still have a lot to do, and I’m still building my brand. But one thing I’ve really enjoyed—and this is just the beginning of doing it professionally—is realizing, thanks to Reid and Justin, that I can professionalize my brand more.

And I’m really excited to see what the next iteration of this looks like.

Every physician needs to understand that they have their own personal brand. We all bring something unique. And if you can figure out how to monetize that, that’s great—that’s amazing. But even before that, you have to understand that you are a brand. What you present is unique.

So how do you find that niche in your specific world?

Reid Lancaster

I’m so glad you brought that up.

If college football players, volleyball players, basketball players—under NIL, name-image-likeness—are getting paid to practice and play games… why wouldn’t a far more important group of people—physicians—not be doing the same?

Write a book. Build a website. You are a thought leader. Every one of you. Build that brand. Build your brand.

Thank you for sharing that, Rashmee. I didn’t know we were going to talk about that, but I’m glad we did.

And with all that said—you’re still very, very young. I cannot wait to continue assisting you for a long time to come.

And how gracious it was for you to share 45 minutes of your time and your experience with us—and to offer leadership to anyone listening who wants it.

Rashmee Patil, you are a special human being. We are grateful for you. Thank you for joining the podcast.

Dr. Rashmee Patil

Thank you so much. Really appreciate it.

Justin Nabity

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