The Practice Profit System

There are three things I believe wrecked healthcare in this country, and I have gone after two of them before: an Affordable Care Act that handed insurers the room to consolidate, and agencies that stopped acting like regulators. The third one is the one I take on here. Venture capital and private equity buying hospitals, buying practices, and inserting themselves between a doctor and a patient.

I start with the Stark Laws, because the history is the whole argument. In the late 1980s it became illegal to compensate a physician on revenue and performance the way you compensate a salesperson, after a stretch where drug and device companies were paying doctors a cut of what they recommended. Those laws never went away. They just stopped being enforced, and RVUs rebuilt the same incentive with a name nobody objects to. Then I tell you about a friend's wife in Arizona, walking fifteen blocks with me on a November evening with a slight limp, telling me over dinner that she had a hip replacement scheduled for right after Christmas. No MRI. No ultrasound. No x-ray. Ten minutes with the doctor. I am not a doctor and I am not going to diagnose anyone from a dinner table. I am going to ask why that surgery had to happen before the year closed.

From there I get into what physician surveys and the outcome research keep reporting about private-equity-owned facilities, the pattern nurses and their unions have been describing for years, and the reckoning I am starting to hear in whisper conversations at conferences. The roll-up strategy was supposed to buy leverage over the payers. The payers have worked out that they control the purse strings, and that a lower reimbursement rate turns a struggling hospital into a bargain. Then we get to the part that actually matters, which is you. You are the one holding the bag. You are the one taking the reputation hit for the seven minutes you are allowed to spend, because the patient has no idea there is a metric behind it. Private equity in hotels is fine. Private equity in golf courses is fine. In a room where somebody is frightened and in pain, it is a category error, and the word patient exists precisely because that person is not a customer.

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About the Host:

Matthew Gillogly is the host of Out of the System and the founder and CEO of the Mavrix Profit System. He is not a doctor, and he treats that as the advantage. While physicians were learning anatomy, he was learning business anatomy, and he brought it into medicine as an operator. He ran three clinics in North Carolina under a management arrangement built by the letter of the law, where the doctor owned the practice and made every clinical call and his company carried the business side, and those clinics became the number one provider of men's sexual health solutions in their market before he sold them.

He built Mavrix to hand that playbook to physicians who want out of insurance-dependent care, and he and his team have worked with hundreds of doctors on cash and direct-pay models. He spends most of his time making the same argument he makes here: the system is not broken, it is working exactly as it was designed to work, and the people it works worst for are the ones who trained the longest.

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I have been telling doctors for years that their payment processing is fine right up until the day it is not, and I finally brought on the person I built Mavrix Payments with to explain why. Chris Flores has run USA Payments for a decade, working almost entirely in healthcare, telehealth, and pharmacy. He opens with a client from telehealth's ground floor who could not get an account anywhere — Square, PayPal, Stripe all shut him down — and now does hundreds of millions a year. Then he lays out a framework most owners have never heard: three risk pillars — reputational, dispute, and regulatory — healthcare sitting squarely in the third. The moment you start shipping product or prescribing in a card-not-present environment, liability follows it back to the bank — and no bank wants another lawsuit at its door.

The story I tell on air is about one of my clients. Everything was running fine — until ten days later, when a twelve-thousand-dollar charge for an urgent biologics procedure got his account shut down and his money frozen overnight. Chris's response is worth sitting with: he sells prevention, but people call him for a cure once thousands are already held. He also points out what nobody wants to hear: everyone claims a great relationship with their banker, and six months later that banker has moved on.

Then it turns into the most honest leadership talk I have had on this show. Chris talks about the delegation problem — putting people into leadership roles without the experience — and how good intentions do not equal success. He talks about letting go of people who were nearly family, hiring inside his own family — he jokes USA Payments should be called Family Payments — and the moment, a few years ago, when he realized he was not in the right headspace and had to put family first. I share my version: the day I fired fifteen people in a row at the University Club, and how that permanently changed how close I let my team get. We land on the same conclusion from opposite directions. You can never afford the person you need to hire, and you should hire them anyway.

We close on the medical industry itself. Chris sees cash pay accelerating, peptides and compounding expanding, and the same pattern he watched during the CBD boom of the twenty-tens — his line: the guy selling peptides online this week sold garage doors last week. His advice for doctors who have never gone beyond their clinic walls is simple: you already have a patient base, and it wants more from you than the one thing it comes to you for.

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About the Guest:

Chris Flores is the founder of USA Payments, the healthcare-focused payment processing company he has run for a decade. He spent his early career in marketing and business development, running his own agency until healthcare, supplement, and early-CBD clients kept telling him the same thing — great product, no way to take payments. So he sold the agency and moved into payments full time.

By his own account, he was in business at six, opening packs of Pokémon cards, pulling the shiny one, resealing the pack, reselling it at the park — until parents started knocking on his mother's door. By eleven, he ran an eBay store selling model ships sourced from downtown Los Angeles. He is first-generation American, son of parents who built insurance and import-export businesses, and lives in Los Angeles with his wife of thirteen years and two children. His company has grown from three people to roughly fifty, and much of this conversation is him thinking out loud about what that required of him as a leader.

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Connect with Chris Flores at USAPayments.com

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Lindsay Simone and I are both Charlotte people, so this one started as a hometown conversation and turned into something I think every clinician sitting in an employed job needs to hear. She was a decade into a big hospital system when she started asking questions and got told to go see the next patient. She had already enrolled in IFM back in NP school, which at the time was close to heresy, because four hours of nutrition training struck her as thin. When the job stopped making sense, she had somewhere to go.

What she built is a practice that runs on the opposite math from the one she left. Four patients on a heavy day. Sixty to ninety minutes each. Thirty days of food before a single hormone gets prescribed, and a flat refusal to treat anyone who will not do that part. We get into her own collapse and rebuild at thirty eight, her father coming off a statin he had been on for a decade and finishing at a testosterone level most men half his age do not hit, why she thinks obesity and metabolic health are the number one problem in this country, and what she has learned about GLP-1s that most of the clinics writing them have not. We also spend real time on the part nobody warns you about: that the business is the hard half, that she was never trained for it, and that the thing keeping her sharp is not a certification but a group chat full of providers arguing about candida on a Friday morning. There is no standard of care in this work. There is a standard of relationship with your peers, and Lindsay has built hers deliberately.

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Lindsay Simone, FNP-C, is a board certified family nurse practitioner and the founder of Simone Medical, a functional medicine practice in Matthews, North Carolina, focused on hormone balancing, medically assisted weight loss, peptide therapy and metabolic health. She came to nursing late, after a first life as a painter and sculptor, and enrolled in the Institute for Functional Medicine while she was still in nurse practitioner school, having noticed that her entire nutrition education added up to four hours.

She started her first NP job in a Charlotte hospital system in March 2020 and was sent home to see patients from her bedroom the same day. What she watched over the next few years pushed her out. Simone Medical began as a side gig and grew into a brick and mortar clinic with a health coach on staff and a patient list that still spans the state by telehealth. Lindsay trained through the BHRT Training Academy, where she now teaches in the cohort connection, is working through the A4M fellowship and a peptide therapy certification, and serves on the board of the North Carolina Integrative Medical Society. Her own turnaround is part of the pitch. At thirty eight she was handed four prescriptions in a single visit, including Xanax and Ambien, turned all of them down, and changed everything instead.

Website: https://simonemedical.com

Instagram: https://www.instagram.com/simonemedical/

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Kevin Nations and I have known each other for twenty years, and he is still the person I call when I want to think clearly about an offer. We start with the collision between efficiency and connection, because every practice owner right now is being told to automate more while their patients quietly want the opposite. Kevin's answer goes back to Stephen Covey. Seek first to understand. A patient who feels understood will trust your diagnosis, because that diagnosis is arriving from a place of empathy rather than from a platform of superior information.
From there we get into the part most practice owners get wrong. Kevin does not market by telling people their last choice was a mistake. He describes himself as the food truck outside the nightclub, meeting people who are already happy and simply hungry for the piece that was missing. He walks through how he opens a conversation by finding out what someone does not want, why letting a prospect self diagnose is the worst thing you can allow, and why asking for a decision protects your boundaries while demanding a yes violates theirs. We close on something he said that I had never heard him say in twenty years of friendship. The only thing between a trophy and atrophy is space.

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Kevin Nations is a sales and business strategist who has spent more than twenty years advising well known names across coaching, consulting, and internet marketing, including a long working partnership with Frank Kern. He is known for high ticket offer design, teaching business owners to structure pricing and positioning so a prospect either commits fully or walks away clean.
Kevin grew up in a multigenerational church family, and that upbringing still shapes how he thinks about persuasion. He watched congregations that preached the most rigorous doctrine stay small while congregations that genuinely connected with their communities grew, and he has spent his career applying that lesson to business. He works from a short and deliberately curated client list, runs live events alongside his daughter, and disappears into the desert in an RV when he needs room to think.

Facebook: https://www.facebook.com/KevinNations

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In this episode of Out of the System, I sit down with Dr. Ryan Meyers, owner of Movement Clinic in Lehi, Utah, and one of the people quietly training the next wave of doctors on hyperbarics, ozone, and regenerative work. Ryan went back to chiropractic school at thirty with a wife and two kids at home, and he says the line that has driven him since is from, of all places, the live-action Cinderella: "just because it's what's been done doesn't mean it's what should be done." That is the whole practice in a sentence. His wife's own multi-year recovery from chronic illness pushed him into functional medicine, and today the clinic runs almost as two businesses under one roof, a pay-as-you-go sports and rehab side and a package-based chronic health side.
The business half of this conversation is where it gets useful for anyone thinking about leaving insurance. Ryan has never run an ad. The practice is referral-only and award-winning, built on the idea that your best marketing is taking care of the person in front of you. He is direct about the two mistakes he watches new cash practices make: they under-recommend because they are scared of the number, and they discount themselves before the patient ever objects. We also get into why the sequence of a protocol beats the tools inside it, why he tells patients who "tried ozone once" that one session is like one trip to the gym, and why he thinks most entrepreneurs stall out for the same reason he has, holding on to the day-to-day when they are the visionary and not the operator. If you are a clinician who knows the care you want to give and is not sure the business can carry it, this is the conversation.

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Dr. Ryan Meyers, DC, CSCS, CCSP, is the owner and founder of Movement Clinic in Lehi, Utah, an award-winning sports medicine, rehabilitation, and regenerative practice that also runs a separate functional medicine arm for chronic illness. He earned a Bachelor of Fine Arts at BYU, went back to school at thirty for his Doctor of Chiropractic at Southern California University of Health Sciences, and put in roughly a thousand hours of outside training while he was still a full-time student, commuting between Utah and Southern California so his family would not have to move.
Ryan has served as an official provider for US Speedskating and has worked with NBA, NFL, NWSL, Euroleague, and Olympic athletes, and his clinic has taken Best in State for sports injury rehab and recovery. He specializes in chronic inflammatory response syndrome, or CIRS, and biotoxin illness, and he builds curriculum and trains clinicians nationally on hyperbaric oxygen therapy, ozone, and regenerative biologics. That side of his practice started at home, when his wife's long recovery from chronic illness sent him looking for answers conventional care was not offering.

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Matthew Gillogly is the founder of Mavrix Profit System, helping doctors escape the insurance trap and build thriving cash practices. A former PGA Golf Professional turned business strategist, he has scaled companies worldwide. 

He is also the host of the Out of the System Podcast, where he teaches physicians how to break repeating patterns, lower stress-driven decision-making, and build autonomy with clarity. Through his Flow Method, group calls, masterminds, and guided practices, Matthew helps doctors retrain the internal 'threat response' that can cap growth so they can practice differently, lead differently, and build a future that feels safe to step into.

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