I recently connected with an extraordinary individual, who is a Renaissance Physician in the fullest sense! Dr. Roger Cicala is a fully transitioned, 100% non-clinical physician. I think Dr. Cicala's story is so engaging and powerful to me because, I cannot even fathom taking that 100% plunge into the non-clinical realm.
A part of me continues to cling to clinical medicine because I'm scared.
I'm scared I won't be good at something outside of medicine or healthcare, and I'm scared I won't be good enough to make a living doing it.
My friends and family know I have a business where I help medical clinic owners grow and scale their clinics so they can work as much or as little as they want and build long-term assets. But this is my part-time business, something I've been growing over the last year. I've learned about business, friendships, sales, life, etc.
I'll be the first to admit, when I lose money or something doesn't go right (and I learn a huge lesson) in my non-clinical business, I still have that comfort knowing that I still have a successful clinical career. I can see a paycheck every month.
So how does one take that plunge to go all in, 100% non-clinical? Let's find out!
1. Please tell us what you currently do today.
I’m the founder and part- owner of Lensrentals.com, which is the world’s largest camera and lens rental company. If you see photographs from a sporting event, watch a commercial or a music video, chances are pretty good it was made using our equipment. I own two smaller companies; Olaf Optical Testing, which tests camera lenses, and C-4 optics which makes specialty camera lenses.
I am retired from the day-to-day operations at Lensrentals but still fairly active there as a consultant. The other two businesses take up perhaps 20 hours a week of my time and honestly are mostly because I think they’re cool.
2. When did you decide you wanted something more than a clinical career? Did something happen that triggered this? Were you at a certain point in your career or life?
I was in my early 40s. I’d always been happy in medicine, but I wasn’t a ‘die with my lab coat on’ kind of doctor. I loved medical school and enjoyed practice, but it wasn’t my life. I made a good income, lived a good lifestyle, but didn’t have a lot of financial plans for my future. When my father passed away, I was suddenly aware that I had made no financial plans for my future and needed to do something to be secure financially. At the same time medicine was changing, I realized I was never going to make more money than I was making.
3. How do you deal with other physicians and non-physicians (and possibly your family and friends) who don’t understand why you want to leave clinical medicine?
Well, at first, they all thought I was out of my mind. I mean “You’re leaving medicine to rent camera lenses??????? Roger, maybe you need some therapy.” When I announced I wanted to go part time for 6 months and then leave, the medical director of my group patted me on the head and told me to talk our business manager so he could explain things to me. I showed the business manager my books and in 15 minutes he said, “you need to go part time to run this and leave in 6 months. This is awesome.” After that the rest of the docs thought we were both nuts.
I stayed friends with most of my partners and a few came and saw what I was doing. You know, they noticed I worked Monday to Friday and didn’t take call, etc. Within a year they talked about me like I had made parole early. “He got out. He’s doing great out there. He won’t be back.”
At this point I can’t think of one of my physician friends who isn’t a little envious.
4. What were the first few side hustles/businesses you tried? How did you decide on these to start with?
I had contributed to medical textbooks so I started writing as a side gig. At first contract work; I would ghost-rewrite physician chapters in textbooks when brilliant docs couldn’t write well. Then I started doing contract work for textbook companies, ghostwriting chapters in Nursing, paramedical, and medicolegal textbooks. Honestly, the money wasn’t worth the time it took; I made about $5,000 a chapter but a chapter took a month or more to finish. Next I wrote some medical books for lay people, got an agent, the whole deal. The idea was they had a 5 to 7-year life, I’d be getting royalty checks that whole time. I thought after I had 4 or 5 books out, that would be a great income stream. It ended up being an income trickle. I remember one 6-month royalty check that was about enough for a nice dinner out.
5. When did you make your full exit from clinical medicine? What were the steps you took to get there? Did you plan years in advance?
I started Lensrentals in 2006-2007. For a couple of years it was strictly a side gig, although it was growing rapidly. After that I wanted to keep my medical income so I didn’t have to take money out of the LR income stream to live on, I wanted to reinvest it all. By 2009 I thought I’d have to leave medicine and in late 2010 I did.
6. Were you scared the first year out of clinical medicine?
No, I was too busy to be scared. We were growing at 100% a year and I was working 80 hour weeks. I kept my licenses active and kept my CME current for a couple of years ‘just in case’, but really never considered returning.
7. How did you decide to go the route you did; why not pharma?
Well, my goal was more to build a business and equity, not to get a good job. I despise multi-level marketing; I know some people do really well with it but it’s too much rah-rah yay team stuff for me.
8. What is your day structured like now?
Well, I’m trying to learn how to retire, I don’t need to work financially, but I don’t have much in the way of hobbies. So, I’ve cut down to 8 hour days, and very little of the work I do know has deadlines. Olaf is a research company, we develop new testing methods and I employ a bunch of graduate student interns on and off site. I am retired from Lensrentals, other than, as they put it being “Our lovely and talented spokesmodel”.
I go in and do whatever interests me, but I take a lot more time off than I used to. I bought a house at the beach this summer and go down there once a month. I plan on maybe working two weeks a month next year. Unless I get bored. ☺
9. What do you do with MD degree? Do you still renew your licenses?
I did for about 3 years, but stopped after that. I felt like I was too far removed to just walk back into practicing and was comfortable by then that I’d never need to.
10. Did you take business courses? How do you know how to do all of this? Do you have a mentor?
No, I had no clue, and no. I looked into business mentors and incubators and consultants. It really felt like each of them had a fairly set ‘method’ they would push on me, and I’m cynical. I kept thinking ‘if this method is so great, why aren’t you out there making a fortune off of it instead of just charging consultant fees.
I had a very simple Southern philosophy: “Go where they ain’t”. When they said ‘462 people were successful doing this’ I heard ‘462 people already have a head start on you’. I got an idea that no one else was doing, my target market was the entire United States, and there was no competition. That made more sense to me than hearing ‘this is how Joe was successful in his town and you could do it in your town’.
That played out well. Around 20 other companies emulated our business model eventually. They were too late; we had too much of a head start. We grew really quickly because we were filling a vacuum. They entered into an area that already had established competition. Of those 20 other startups, one is still alive and doing OK. We absorbed 4. I think all the others have gone under.
All that being said, I’m really lucky. When I started this my son and daughter were in college. My daughter and her husband are both MBAs, my son is a JD and CPA. So, I had business consultants on deck when we got large enough to need them.
The hardest part wasn’t starting the business or making it successful, though. It was recognizing that after a certain size it wasn’t so much about my great idea and awesome guerilla marketing campaign. It was about good business practices that I knew very little about, and that it was time to turn it over to people who understood those practices. I did that (and I’ll admit there were some claw marks where I had trouble letting go) and the business went from ‘bigger than I had hoped’ to ‘bigger than I had ever dreamed possible’.
As a physician, I was used to managing small groups: 7 people, a dozen. When we got to 20 employees, I realized we needed structure and hierarchy that really, I didn’t have the skill set to provide. I think it’s around 180 employees now. I’d have long since lost my mind trying to manage that.
11. If a physician wanted to leave clinical medicine, what would you say to that doctor? What would be the steps you recommend?
First get your finances in order. I see a lot of people who want more income to let them buy a bigger house and a newer Porsche. If you’re in debt up to your eyeballs, you are going to have problems raising capital.
Then be ready to take a risk and to work your butt off. There will come a day when you have to say “Wow, I could lose everything!” and you believe in yourself and take a chance. There will come a day when you ask yourself if the extra hours are worth it. About a year after that day I looked around and went ‘wow, I can retire now’. I didn’t, but I could have.
12. Did you work with a physician coach at any point? Do you recommend transition coaches?
No, I didn’t and I really don’t have an opinion on that.
13. What kind of financial situation do you recommend a physician to be in, when he/she is ready to make the exit? Should all their loans be paid off, should they have a certain amount in savings, etc?
I don’t think there’s a point. You don’t have to be debt free, certainly. You need to have more capital available than you expect, and if you’re juggling credit cards and have more debt than you should you won’t be able to get it. But reasonable debt with a good payment history won’t be a problem.
My watershed month was this: I had spent all my savings, borrowed against my house and taken out a personal loan. I was out of funds and demand was huge. I ran up an $80,000 Amex bill buying more equipment and that bill was due at the end of the month. That month we did $82,000 and made the payment literally the day it was due. I was never badly stressed again, but I didn’t sleep much that month.
If I was to recommend an advisor for anyone it would be a “capital procurement helper”. I tried to get loans my first few years and got turned down right and left. When my daughter, the MBA, came on board I told her there was no way to get a loan, we hadn’t been in business long enough. She said OK, and the next day went out for an hour and came back with a $250,000 line of credit from a bank that had turned me down 6 months before. She said, “They remembered you. You went in there and talked about cameras and lenses and ideas. I went and talked bank.”
Wow, I learned so much! I loved the advice of "go where they ain't" and get a head start on your competitors! Also, it's very helpful to have lawyer and/or CPA in your family (hehe). I'll leverage my friend for that advantage.
Most of all, I'm so inspired that Dr. Cicala saw more to himself and his life (no pun intended) and pursued something entirely new. You can tell he pivots and adapts to change quickly, a major trait that is crucial to success in all aspects of life.
Thank you Dr. Cicala for sharing your time with us!