Episode Transcript
[00:00:00] Speaker A: Foreign.
[00:00:11] Speaker B: Welcome to the Victory Show.
Hey victors. Welcome to this episode of the Victory Show. If this is the first time you're joining us, I'm Travis Cody, best selling author of 16 books and I've had the privilege of helping hundreds of business consultants, founders and entrepreneurs write and publish their own bestselling books. In my journey, I've discovered a fascinating pattern. Most businesses hit a revenue plateau and they struggle to break through it. So on this show, I sit down with some of the world's most successful CEOs, founders, leaders and business owners to uncover the strategies they used to overcome those plateaus and scale their businesses to new heights so that you can do the same. So get ready for some deep insights and actionable takeaways that you can implement in your life and business solutions starting now. My guest today is someone who brings both the the mind and body into healing with unmatched depth and compassion. Dr. Muhammad Ali Rafai is a board certified internist and psychiatrist and he's the CEO of Blue Mountain Psychiatry where he leads a team devoted to mental health and internal medicine across the Greater Lehigh Valley in Pennsylvania. He holds the prestigious title of Lehigh Valley Endowed Chair of Addiction Medicine and is a board certified in intern. That's a tricky one when I say in internal medicine in psychiatry, addiction medicine and psychosomatic medicine. A testament to his relentless pursuit of truly holistic, patient centered care, Dr. Refai has been honored as a fellow by the American College of Physicians, the American Psychiatric association and the Academy of Psychosomatic Medicine. He's also served as president of Lehigh Valley Psychiatric Society with where he's helped shape the future of psychiatric care in his region. With his unique ability to integrate disciplines, lead with the heart and uplift both patients and practitioners, Dr. Rafai stands as a beacon in modern medicine. Dr. Refai, thank you so much for being here today. I'm excited for our conversation.
[00:02:07] Speaker A: Thank you for having me today, Travis. It's a pleasure to talk to your audience about my life journey and the trials and tribulations of individuals who are in business and in private practice in medicine.
[00:02:23] Speaker B: Yeah, you, I, you know that was we were chatting earlier and you've had so there was a book a few years ago by oh, blanking on his name. Shoot, I can see his face.
It's called the entrepreneurial roller Coaster.
Darren Hardy. Darren Hardy got proper source him but you know, talked about the highs and lows of entrepreneurship and for you, you have such a unique experience because you're a doctor, you're in psychiatry, you have a clinic You've got people under you, but you faced a business challenge that I think most entrepreneurs never face in their life. So let's talk about that. What happened?
[00:03:04] Speaker A: Sure. Great. So I founded my own private practice, Blue Mountain Psychiatry, in 2012.
We were on the cutting edge of medical practice.
We did a lot of telehealth, telepsychiatry, telemedicine services, when they were not even fashionable. When they were not.
[00:03:25] Speaker B: You were groundbreaker.
[00:03:27] Speaker A: We were groundbreaker. We were on the cutting edge in 2012. I had started actually with a local hospital in 2006.
So when the pandemic hit in 2020, I had already done 14 years of telehealth experience and I was basically the go to source of training for other physicians for help from other health systems. Unbeknownst to me, I was in 2020 under the watchful eye of the federal government, our United States Department of Justice, the Office of Inspector General for Department of Health and Human Services.
They had, they had me in their, in their, in their site as somebody who they feel did not follow the rules.
And in November 2022, I was indicted on four charges of health care fraud stemming from the telehealth services that I have done between 2015 through 22.
[00:04:31] Speaker B: They went back eight years. That's crazy.
[00:04:33] Speaker A: Back, back eight years. And they were basically trying to.
Telehealth services had exploded at that time due to the COVID pandemic. And basically they were trying to make an example out of me. But, you know, I resisted. They asked me to plea. I did not plea. I told them that I have done nothing wrong, that I've done everything I in according with rules and regulations which they themselves did not know.
And we decided to go to trial. And in May 2024, we went to trial after about 16 months from my indictment, a six day trial and three hours of jury deliberation.
[00:05:20] Speaker B: Wow.
So we'll walk through the process there. But what was the effect on your business when you got hit? Did you have clients that stopped working with you or did like, did it cause your business to slow down? Or were you patients like whatever and people working for you?
[00:05:37] Speaker A: A nuclear bomb blew up in your, in your, in your business? Basically, it's just, just exploded. Used to have 30 employees and ended up with about eight employees only. So kind of just everybody left, everybody scattered.
Still kept a faithful group of employees that decided to stay with me and still get a faithful group of patients that stuck it with me and just said, Dr. Refi, we love you. We're going to stay with you. Doesn't matter what the government is saying about you. We love you. We're going to stay with you. And basically, a practice that was producing 3 to 4 million dollars in revenue just got reduced to rubbles. With this action of the government and.
[00:06:28] Speaker B: With everything going on, they don't go after the new guys that have only been around for two or three months that are like, hey, this. This clinic over here has only been doing telemedicine for three months and they build $2 million. They go after the person that's been around for two decades.
[00:06:42] Speaker A: Sure, sure. Yes, yes.
[00:06:44] Speaker B: Unreal.
So did the government apologize after they lost?
[00:06:53] Speaker A: The government did not apologize.
Apologizes.
The government never apologizes. And so I am actually now in the process. We put out a press release. We are in the process of filing a lawsuit against the government for this unjust prosecution that has happened to me.
And we're going through the legal process of kind of just pointing out what they did wrong and how there was a rush to judgment and how they, the government did not follow their own regulations and their own guidelines of how to do a prosecution.
[00:07:31] Speaker B: And shocking.
[00:07:35] Speaker A: I mean, the guidelines that are public and they did not follow it.
[00:07:39] Speaker B: So we're going unreal then. That's the thing that gets challenging with this stuff, right? Because you're so powerless with it. And then you look at it and they're coming after you for breaking rules, and then they're not even following their own rules, like, so positive.
You won the lawsuit. But this has also led you to working on a book about this whole scenario. Yeah.
[00:08:00] Speaker A: Yes. Yes. Yeah. So I'm in the process of writing a book. It's about, as we said, it's about 60, 70% done.
[00:08:08] Speaker B: What's the title again? I love the title.
[00:08:10] Speaker A: I Love the book. Dr. Not guilty.
[00:08:12] Speaker B: Dr. Not guilty.
[00:08:14] Speaker A: There's no book with that title. We searched and searched and searched. That's a unique new title. Dr. Not Guilty.
[00:08:21] Speaker B: That is.
[00:08:22] Speaker A: That.
[00:08:23] Speaker B: That's just crazy. Okay, now that's out of the way. Let's step back. I want to talk to you about, first off, why. Why did you choose to go into psychiatry?
[00:08:32] Speaker A: I always liked psychiatry.
So, so just. Just by. By. By history.
I was raised here in the United States, but my family is originally from Syria, from Aleppo, Syria, which is. Which is in the Middle East.
And there's a lot of psychiatric history in Syria. My hometown, Aleppo, Syria, has the oldest inpatient psychiatric hospital in the world, really built in 1400.
[00:09:03] Speaker B: You need to write a book about that. That's fascinating.
[00:09:06] Speaker A: To me, we'll write a book about that. That will be like book number four or five that you will help you with.
[00:09:15] Speaker B: Like, I have so many questions now. You just so rattled my brain of like, like that. That history is amazing to me.
Yeah. So was your family involved in that all or you were just exposed to that as part of your.
[00:09:28] Speaker A: So I have a cousin who's a psychiatrist.
I have another cousin who's a psychiatrist. So psychiatry is, has been, has been in the family for, for a while.
I liked to, to. To basically do psychiatry because I like to talk to interaction with people.
And after I finished my schooling, my medical schooling, I actually did some research with the National Institute of Health exploring kind of the chemistry of psychiatric illness, exploring the chemistry of medical illnesses. And this is before I went to residency and I decided that I want to integrate the medical part and the psychiatric part. So I did a dual residency in internal medicine and psychiatry.
[00:10:15] Speaker B: Wow.
[00:10:15] Speaker A: It's a five year residency.
[00:10:16] Speaker B: Glutton for punishment.
How did you sleep?
[00:10:20] Speaker A: No sleep. No sleep. We had, we had. Basically we were on call every third night.
We had. Basically we would work 120 hours a week.
It was, it was just punishment in. But, but learning and patient care and you become a solid physician that can service his patients and can be help for people. I also basically I was a scientist. So I actually, after my finished my residency, I said I'm not done.
So I went to NIH proper. I was at the NIH Clinical center in Bethesda, Maryland, where I spent three years doing more research on the psychiatric aspects of medical problems, specifically hepatitis C.
And I have between 50 or 60 scientific papers to my name.
[00:11:14] Speaker B: So what was it? All right, let's talk about that. What are some of the psychiatric symptoms of something like that?
[00:11:20] Speaker A: There's a whole host of psychiatric problems with hepatitis C, which is an infection that people attract from intravenous drug use, that people attract from blood transfusions.
And there's a whole host of psychiatric issues. Depression, anxiety, bipolar disorders, psychotic symptoms. And we worked on defining those at that time.
[00:11:47] Speaker B: And so was there just so I understand, like with bipolar, like were people who had a tendency to be bipolar with the hepatitis C, bring it on? Or could the hepatitis C actually create somebody being bipolar or being.
[00:12:04] Speaker A: It was both, actually. Wow. People who have bipolar disorder are more impulsive, they're more promiscuous. So they could engage in drug use, they could engage in unprotected sex. And so that places them at a higher risk for basically getting hepatitis C. And people who get Hepatitis C, they lose it and they're, they're, they, they become depressed and anxious and, and, and manic. So it's like a two way street.
So, so it's.
[00:12:36] Speaker B: So somebody that could have displayed no psychiatric symptoms beforehand can get a diagnosis and that could then like spiral them into.
[00:12:44] Speaker A: And lose it. Yes, yes, because, because actually Hepatitis C is a neuropsychiatric disease. The virus itself is a cousin, for example, of the encephalitis virus. So it goes into the brain. Even though it's a hepatitis virus, it's, it and its cousins, they go to the brain and so people just lose it psychiatrically and neurologically.
[00:13:08] Speaker B: Wow, that is so fascinating to me. So it really of all people, when.
[00:13:13] Speaker A: I was at the NIH Clinical Center, I worked with a very famous person that actually now is, people don't, don't, don't like him anymore. Dr. Anthony Fauci.
He was actually one of the people that we collaborated with. His office was across from my office. And this was his, his like not famous days in 2003.
Now he's an important person back in.
[00:13:39] Speaker B: The day when he's just a normal scientist.
[00:13:41] Speaker A: Normal scientist who would wear a lab coat, who would round with us, who would talk about patients and scientific issues. And now he's just a different caliber person.
[00:13:53] Speaker B: So. All right, so after. So thank you for all of that. That's fascinating. I just learned so much right there that we'll have to set up another episode just to talk about some of that stuff. But what I want to talk about for this particular episode is when, when did you decide that you wanted to start your own clinic? And, and when did, when did Blue Mountain kind of come into the picture?
[00:14:16] Speaker A: So basically what, what happened to me is I was, when I was at nih, I got involved into some very cutting edge treatments. One of the treatments is ketamine treatment. And ketamine is a treatment for, you know, it's, it's in the news now.
[00:14:32] Speaker B: And you were like doing stuff way before the general public was aware of that.
[00:14:36] Speaker A: This is, or anybody was, was aware about it. You know, there was the Matthew Perry, God bless his soul, sure. Who passed using ketamine now. But, but, but Ketamine, at that time, we ex, we, we basically tested it in clinical trials at NIH for treatment of depression, and it was very successful. And basically after I left nih, I wanted to do some of that research.
I also did some research on a novel treatment modality called transcranial magnetic stimulation, which involves applying a magnetic field to the brain to treat depression and anxiety and other symptoms. And those were kind of all kind of progressive, cutting edge treatments. So when I left nih, I came to the Lehigh Valley and one of the local hospitals hired me as like their chief psychiatrist.
And I spent about five years working for them. But I couldn't do any of the stuff that I liked. I couldn't do ketamine treatment, I couldn't do TMS because they said, we don't want to do these things. Insurance doesn't pay for them.
And basically these are cutting edge new things. And, and we, we don't want to do them. But what ends up ended up happening is I said, well, I want to try my. I'm gonna go out on my own and I want to open up my own private practice because I want to do these things.
And so I actually ended up going to a business school. I went to Carnegie Mellon and got a master's in medical management.
[00:16:10] Speaker B: Wow.
[00:16:10] Speaker A: It was a two year program.
And basically they told me how to, how to basically the business of medicine. I learned the business of medicine and Blue mountain psychiatry in 2012, and here I am 13 years later, and I'm, I'm on the bounce back.
[00:16:28] Speaker B: So let's, let's talk a little bit about that then. So you're leaving the, you know, a prestigious job at a hospital. Most people will be like, what are you're the head? Like, what are you doing? Like, that's a job. You're set for 30.
[00:16:39] Speaker A: You know, are you, are you crazy? Like, you want to try your own private practice? You want to just go out on your own and you're getting like a great salary from this hospital. You're the head of the department. What are you doing?
[00:16:52] Speaker B: So emotionally, how did you deal with your own emotions of making that leap.
[00:16:57] Speaker A: A leap of faith? I mean, I lost sleep over it many, many nights. And it was like, can I, can I, can I make payroll for my employees? Can I, can I, am I going to get, have enough money to, to feed my kids and send my kids to school? And it all worked out very well. It all worked out very well. And things will get better.
[00:17:23] Speaker B: All right, so we've got two hats here, which I love. You've got the researcher scientist hat, and then you also then took on the business owner hat. So that first three years of having your clinic, what are some of the big lessons you learned from wearing business hat that were surprising to you?
[00:17:39] Speaker A: I learned a lot about marketing. I, I learned about a lot about customer service, business planning.
I learned about A lot about accounting, the importance of, of, of making sure that, that you have accounting. And actually, that was one of the things that saved me in this, in this lawsuit with the government is that I had solid accounting. I had, I had an. We had hired an accounting firm. We had solid numbers. And the government didn't even want to approach it because they had, they had their agent from the Office of Inspector General for Department of Health and Human Services. And on the stand, my lawyer asked him, it's like, okay, you're an accountant. Did you look at the account accounting of Blue Mountain Psychiatry? Were they fudging the book? Were they doing anything? Were they making money? Were they losing money?
You saying that Medicare paid them that much and they stole that money? Well, did you look at how much salaries did they pay? Did they pay how much. How much electricity did they pay? How much was their rent? And they never did any of that. The jury really saw that. I mean, like you, you, you prosecute somebody for millions of dollars and you don't have a couple of hours to do paper and pencil and just do their accounting. And whether they.
[00:19:02] Speaker B: Yeah, it's in. You kind of think they, like, because they're the federal government. You sometimes wonder if it's so scary to be indicted by the federal government. And they know that probably 90% of people settle that they just get lazy. Right? We're going to scare this guy.
[00:19:19] Speaker A: This is what happened. This is what happened. Really, really. What happened is just they, they, they did not think that we were going to go to trial. They did not think.
[00:19:28] Speaker B: What did they, what did they want to settle? What do they say? Hey, pay us and we'll go away?
[00:19:32] Speaker A: No, no, there was no pay my payoffs and it will go away. It's like you, you admit to criminal charges, you go to jail and you pay us in. And so, so go to jail, do not collect 200. And it's like the monopoly.
Go straight.
[00:19:50] Speaker B: So their deal was, hey, you've settled with us, you'll only go to jail for eight years instead of 12.
[00:19:55] Speaker A: They wanted 40 years.
40, 40.
The rest of my life to spend it in jail. And if I had pled they have, maybe they would have settled for three to five years.
[00:20:09] Speaker B: So when you lawyered up and said, we're going to court, did they go, wait, what?
[00:20:13] Speaker A: Oh, yes. Oh, yeah. Wait, what? It's like, what happened? What happened here?
[00:20:18] Speaker B: Unbelievable.
[00:20:18] Speaker A: And they kept, they kept telling my lawyer, the evidence against him is overwhelming. How is he? Does he want to go to trial?
And my lawyer says, okay, okay, yeah, yeah, we want to go to trial.
And basically they brought their witnesses. I only had two witnesses. I had an expert coder who said that everything I did was right. And I had a, a fellow community psychiatrist, not from this area, who came and said, this is bread and butter psychiatry. They, there's nothing here. They, they didn't. They didn't fudge anything. They didn't, they didn't break the rules. They saw these patients. You, you didn't bring any patient where you say they said they saw them and you didn't. You. You can prove that they didn't see them and, and basically is. Is just their case fell apart and the jury is like, this is, this is.
[00:21:08] Speaker B: Why do you like, I want to make a movie about this whole experience now.
This is unbelievable.
Well, so as a business owner, I always hear about, you know, that your accounting is really important, but from a business perspective, it's always like, oh, in case you ever get audited. And you're going like, now, if you ever get sued by the federal government.
[00:21:28] Speaker A: Oh, I did not tell you I did get audited. So, so basically, as. As a prelude to this, they had it. They had us audited for four years in a row by the Internal Revenue Service.
Four years in a row. Nothing. Nothing.
[00:21:43] Speaker B: Zippo.
[00:21:43] Speaker A: Actually, there was a year where the IRS had to pay us.
[00:21:47] Speaker B: We.
[00:21:49] Speaker A: They, they discovered that they made a mistake. Comedy of errors, and they paid us back. And, and, and, and, and they brought. The government didn't even bring the. I mean, if that. You audited somebody for four years, you bring it at least to the trial and say, oh, look, this guy is fudging the books. And it's like they didn't even mention it.
[00:22:10] Speaker B: Unreal. Unreal. Okay, so how, How. What was the growth like with your, with your, your clinic? You started off with you and a couple employees.
[00:22:19] Speaker A: Like, how long did it take you and one secretary. All right, one, One secretary.
[00:22:24] Speaker B: And how did that growth go then over those. Because you eventually ended up with 30 employees, right?
[00:22:29] Speaker A: 30 employees. The first. First year I, like, I made like.
[00:22:33] Speaker B: $50,000 compared to your salary. Hospital, that was probably a little lower.
[00:22:40] Speaker A: Yeah, absolutely.
I was like 16 of that.
That was 2012. And it grew very, very well because basically, word of mouth, we started getting contracts to staff facilities. We started getting.
I hired nurse practitioners, I had physician assistants, I hired other psychiatrists, and we contracted with private insurances.
And at our top, we, we made $4 million. Wow.
[00:23:11] Speaker B: And that was that. The year before you got indicted?
[00:23:14] Speaker A: The year before the Indictment.
[00:23:17] Speaker B: Wow. All right, so this all settled in.
[00:23:21] Speaker A: We will rebuild. This is like. Like a hurricane comes at your place, and you. You. You start from zero. Thank God I'm not starting from zero. That. That revenue didn't go down to zero. We went down significantly, like. Like to. To a quarter of what it was. But we. We're still here, and we're gonna rebuild and we're gonna. We're gonna come back stronger.
[00:23:43] Speaker B: So this is like, you know, the analogies to, like, I'm saying, like a regular entrepreneur, Right. A bricks and mortar person is so fascinating me, because let's just say I'm. Did somebody who's retail. Right. You have Doing really good, and then, you know, legitimately, a hurricane knocks down your store. Right. You gotta rebuild. Like, you did the same thing, just on a much more stressful level because it wasn't like a couple of weeks that got knocked down and rebuilt. You got drugged through. What was it, two years.
[00:24:13] Speaker A: Two years almost. Yeah. And where you could. You're gonna go to jail. I mean, that. That will be the end of your life, the end of your professional life, the end of everything that you. You've done, the end of your identity. You're gonna get another job, like a truck driver or. Or a fork.
[00:24:30] Speaker B: Yeah. Because you go to jail, you lose the license. Right. You'll never practice again.
[00:24:34] Speaker A: Absolutely. Yeah. Yeah.
[00:24:35] Speaker B: Boy, that's crazy.
Okay, so I'm. What I'm. You know, this show, we talk about people who scale, and so going from you and an assistant to 30 employees, you know, that.
[00:24:48] Speaker A: That.
[00:24:48] Speaker B: That's pretty significant. So what were some of the. The challenges from a. From a business owner standpoint of dealing with that growth? What were some of the things that came up that. That, you know, you had to kind of step into that you may have not thought about as a. As a researcher or doctor.
[00:25:06] Speaker A: Human resources, kind of making sure that. That we did everything. Everything right. Payroll, marketing, information technology.
Just. Just to give you.
We talked about the fact that this is a hurricane, but in the midst of this indictment thing, like another.
Another hurricane comes on top of that because there was this major ransomware attack on change health care, which is part of United Health Care, which were our biller. So I am indicted and I'm going to trial, and I'm like, I'm barely scraping by with my six, seven employees that stuck with me. And then all of a sudden, all the money stops. Your biller got hacked in a ransomware that.
Where they got the data of 191 million Americans and Some ransomware hacker group got it in somewhere in Russia and they started fighting over the money, and United Health Care paid them like $20 million. And they started infighting in between them, and they never gave them the ransomware code to, to open up the software. And, and I'm like, and I'm indicted. I have no money coming in. And, and basically, what do you do? So this is like, this is like a hurt.
[00:26:46] Speaker B: I love that you're laughing about it. So I, like, I love that. So this is what I seen earlier, like, emotionally, how, like knowing what you know about, you know, the human psyche, like, how were you personally dealing with. How did you maintain a positive attitude?
[00:26:59] Speaker A: I'm burning from the inside, but I'm smiling about it. Because now, now, like two years later, I'm like, how did I, how did I manage this? How did I not explode? How did I. Like, I managed it. We, we went through it. It's like the most stressful time in my life. But, you know, you, you, you go through it and you do it for your patients. Because I had, I still had patients. I still have people who depended on me who needed medications to survive. If they don't get their medications, they'll kill themselves.
So, so I'm like, I'm facing the, the struggle of my life. I'm facing something where I'm going to lose everything. I'm going to go to jail for four years, and I have 300, 350 patients that depend on me that I have to give them medications, I have to take care of them in the midst of this. And so that, that is a whole level of, of stress of like, what, what, what do you do? And, and I went through it and I survived. I'm here on the other side. I'm. And for that I'm stronger. And for that I'm writing the book. For that I'm. I'm suing the government and I'm going to write series of books.
[00:28:11] Speaker B: Wow. It's remarkable. I, you know, I just can't imagine the stress level a lot. That's why I'm so fascinated. You're just so, like, yeah, that happened. I'm so.
[00:28:22] Speaker A: Way you can do it because otherwise you could, you could like, scream and, and start punching and, and. But that's not going to get you anywhere.
[00:28:29] Speaker B: You know, I, Years ago, I worked with someone who, they run a very successful company. I think they were doing about 30, 40 million a year. And he was talking about, they had this business one time that, that was at the, at the peak was doing like $5 million a month. This is like or mid 2000s, the Internet, you know, guys were figuring stuff out and something happened to their payment processor and they went from making 5 million a month to like nothing, right?
And so the same thing, I think they had 100 employees and the payrolls were next week and there's no money coming in. And this guy was talking how they, it was him, his brother and they had a partner and, and he just, you know, lost his mind. It was like super emotional. I was like, oh my God, how are we going to deal with this? My life is over or whatever. And his older brother said that's not useful. We need to deal with the event, not the emotion.
And the reason I bring that up is he said so he's like, that was a big lesson for him. And his older brother was able to like, yes, we're really emotional. Nothing we can do about that. Here's the actual scenario. How do we deal with this thing right in front of us right here?
And the reason I bring that up is that his partner got super emotional and he told me, he's like that guy never recovered.
He went bankrupt. And then he essentially just went back to like a normal, I think you know, like a truck driver. Here's this guy that was running a multi million dollar a year company and emotionally couldn't handle the stress and it broke him. And he never, his business, he never started another business after that, just went into general labor.
So I just find that interesting that you've, you know, you went through, through that and, and, and here you are.
So what advice would you give to a business owner who, you know, maybe, you know, probably not indicted by the federal government, but maybe something happened and their revenue collapsed and they've got employees and they're sitting in a state of like, I'm not going to know what to do. As a, you know, scientist and a psychiatrist, what are some, what, some pieces of advice you could give them to help them to manage that scenario.
[00:30:31] Speaker A: As a physician, you like somebody who deals with medical emergencies, you gotta triage the situation.
So always want to make sure that you follow. I mean like, like we say with the CPR, your ABCs, your airway breathing and circulation. So make sure that your airway is still open.
You gotta, you gotta make sure that you still have an avenue to do business, that you still have revenue or, or if you decide that there's, there's no, this, this business is basically cannot be revived or is dead, declared dead and move on.
So, so you but, but you have to really do an assessment triage like, like a casualty scene. You got to go from, from one, one, one casualty to another. It's like, okay, can we save this person? No, we can't save this person. Let's move to the, spend time on something that we can save.
So, and then, and then do the airway, breathing, the circulation. So that's very important to kind of borrow that analogy from medicine because sometimes people just get, get stuck on, on things where you can't salvage it. It's unsalvageable. So you really have to make sure that you tend or give your attention to the things that are going to be, that you're going to be able to salvage things where you can, you can actually bring back to life to help you with your business. So I think that's like, that's the most important thing that people really get stuck on. On can't focus and just lose it and become emotional and, and, and lose sight of the fact that, you know, and they work on the, on the person who's basically gone and, or on, on the issue that's basically dead.
[00:32:29] Speaker B: Like the. Did you see the Deadpool and Wolverine movie?
[00:32:33] Speaker A: Yes, yes. Yeah.
[00:32:34] Speaker B: It's that scene at the end with the nice deadpool where the head's gone live, live is still pushing on his blood, going everywhere.
[00:32:42] Speaker A: That's what people do basically. Sometimes the business owners, when they, when they say when, when they face calamities, basically that's what, what happens to them is they, they lose track of the kind of the, the, the, the 50,000 foot scene of what's going on. And, and they're just in the moment there with that person. But I, I think that's, that's very important. And, and partly, partly is because of my training. I mean I would have people who are patients who are psychotic, who are flailing, who are, who are just hitting staff and things like that. And we got, we got to take care of them. And so exactly this is the situation where this is what I faced is, is basically a dire situation and you got to keep your cool, your composure and be able to manage the situation. And with God's blessing, I was able to come through on the other side.
Wow.
[00:33:42] Speaker B: Yeah. You know, I never thought about looking at the parts of your business from a psychiatric standpoint. You could, we could do a whole series here on. You know, sometimes pieces of your business are psychotic and we gotta, you know, gotta medicate them and give them some therapy.
[00:33:58] Speaker A: Absolutely.
[00:33:58] Speaker B: Parts of your business are going to be bipolar Be ready.
[00:34:01] Speaker A: Yes, yes. And you, you got, you got to see that, you got to see that and you got to be able to, to identify which ones are the psychotic ones, which ones are the bipolar and which ones that have a normal mood. And so you can actually focus your attention on the parts that are going to be crazy and the parts that are, that are just flowing very, very well. They could be on the background and you could tend to them at any time. But that's what happens with business owners. They mostly spend their times on the 20% problematic one problematic part of the business. The 80% of the business usually flows very well, but that 20% is the one that could be the demise of their business. So they have to be very careful about that.
[00:34:49] Speaker B: Yeah.
So let's talk about, excuse me, let's talk a little bit about leadership and leading a team.
You know, you got to the point where we leading 30 employees. So what advice do you have to somebody who's maybe three employees and they're starting to scale and they know maybe this next year they're going to be 10 employees, so they're going to triple their employees.
How did you personally, you know, step into that leadership role as the company grew?
[00:35:17] Speaker A: Sure, sure. So, so basically I, part of, part of it is training. So, so I had, I, I, as I told you, I went to Carnegie Mellon and did the master's of medical management and training. And you know, I am good with, I tell people, I'm good with convincing crazy people to take medications to get them better. So, so imagine, imagine not being able to cajole my employees to work hard or to do the right thing.
But it was hard. It's hard. I mean, so you have a group of highly educated employees, nurse practitioners, physician assistants, other psychiatrists. And then you have the low level employees, the front desk people, the nurses, the billing people. So you had to have different levels of expertise with handling people. And I'm a psychiatrist and we had to learn personality testing and Myers Briggs and team building issues. And so bringing some of the science to that is very important. But knowing your employees is very, very important.
Knowing your employees, knowing who their spouse is, knowing their children, sending them a card on their birthday, kind of connecting them with them on a personal level because then they are going to be your best advocates. And actually in my legal problems, some of the, some of my best advocates were actually employees and patients that came actually to court and testified on my behalf to basically say this is a good doctor, everything is done the right way. And the jury heard that and so that was very, very positive.
[00:37:10] Speaker B: Wow.
With your own hiring, did you employ any personality based hiring practices or would you wait until after you hired them just to kind of have an idea of who they were?
[00:37:23] Speaker A: As a psychiatrist, I probably developed my own gestalt. So I never did like, okay, personality if I got along with this person. And I knew, and I was lucky because some of the people that started working for me, we got affiliated with a couple of universities. So the nurse practitioners that came to work for me were people that we actually trained.
[00:37:48] Speaker B: Wow.
[00:37:49] Speaker A: Basically we trained them and then when they graduated, they came to work with us. So we knew the person knew them.
[00:37:56] Speaker B: That's handy.
[00:37:57] Speaker A: Yeah. Because we trained them and they knew the system. They liked it or they didn't like it. I mean, so they got, they got basically to test drive the, the future employment place. If they like it, they stick around. They don't like it, go somewhere else.
[00:38:13] Speaker B: Yeah, you know, that's so important. And it's such a missing part of American culture these days. When I, when I was younger, I wanted to be. I thought about being a pharmacist.
And I grew up in a small community. My mom worked at a pharmacy. It was, you know, locally owned. Guy had his own pharmacy.
So in high school he hired me. I would go there three days a week and I would work in the pharmacy. And had I not done that, I would have had a very miserable career because I was there for about a year and was just going.
And you know, just sitting there watching with the one day going, this is the next 40 years of my life if I do this. I was like, nah, I can't.
And that, that re. That changed the director trajectory of my life.
Everything I'd been going towards at that point in time was geared towards that. But because I had a real world experience over two years of working on that industry, I was like, oh, yeah, no, this isn't for me.
And so anyway, I mean, what a fantastic thing for, for the people coming to work with you to kind of get a taste and see how you ran things and you know, also being able to, to walk into a job once they got done. That's fantastic.
So what's next for you? What, what this, what, what, what's the next three years? You know, three to five years look like for, for not only Dr. Refi, but Blue Mountain Psychiatry.
[00:39:31] Speaker A: Blue Mountain Psychiatry will get back on track. We are trying to recalibrate and growth again.
Basically, we're doing this much slower than what we grew before.
We are also doing the same thing. We are bringing in cutting edge treatments.
So we are basically, we're going to be a new site for this novel treatment that just got FDA approved. It's called prism.
Prism? Yes. And basically it employs artificial intelligence to do biofeedback. So basically a person will wear a helmet on their head that connects to different parts of the brain. And then this connects to a neural interface and a computer screen and it shows them a stressful situation.
Basically a doctor's office where everybody is standing up and fighting with each other. And the person is supposed to calm down, slow their breathing, focus and be able to get everybody to sit down and calm down and not fight with each other. And they do that through the neural interface with artificial intelligence.
It is FDA approved for post traumatic stress disorder. Now it is going to be FDA approved for depression and anxiety. And we're going to deploy it in our practice. We're going to be one of the first sites in the Lehigh Valley area. So bringing in some new things.
My legal, my legal battle has, has given me a lot of legal information.
So I just started a new business that is called SHIELD Support and help in legal and ethical defense. That's. Those are the acronym S.H.I.E.L.D. is it.
[00:41:33] Speaker B: So it's fascinating that something like that has not existed to this point, the amount that this happens. So I mean, that's.
[00:41:41] Speaker A: That.
[00:41:41] Speaker B: Let's talk a little bit about that. That's fantastic. Where are you at with that? And some. If a doctor's listening to this and they're like, oh my God, I'm in sort of the situation. You were like, how, what is SHIELD? And how do they, how do they, you know, how is it going to support.
[00:41:54] Speaker A: Well, they can, they can go to www.shield.expert. we already have a website, Shield Expert. And basically they can connect with us and what we provide them is a service where we support them during legal problems.
And some of the legal problems are not just an indictment or basically a criminal issue with the government.
Doctors who are facing malpractice lawsuits, sometimes they become very emotional and they lose it. And what we do is we provide them support and counseling and hold their hands in terms of when they're going through legal problems.
We also, that that's not just for physicians because that could be provided to other people.
Every year there is between 70 and 80,000 people who are indicted by the federal government every year. Yes.
[00:42:58] Speaker B: Just by the federal government.
[00:43:00] Speaker A: Just by the federal government. Not, not, not. Not talking about. About.
Not talking about. Wow.
[00:43:06] Speaker B: I did not realize it was that significant.
[00:43:09] Speaker A: Yeah. Yeah. And so, so there may be some individuals who may be able to afford our services to where we would come and, and make sure that they're not in a situation where they're going to lose their mind or try to end their life or, or, or the. Or. Or the family stress, the stress of their family, the stress of their loved ones, what they're, what they're dealing with, and then their inability to deal with the situation with their lawyers. And so SHIELD is going to be that, that, that side business that may end up being my, my main business.
[00:43:44] Speaker B: Yeah.
[00:43:44] Speaker A: So it is growing. I already have, I already have three cases that I am helping facilitate. Paid cases where I, I'm being paid to support the individual who is facing legal problems, providing them support and manage the case with them, with the lawyer. I'm. I'm not a lawyer. I'm just a physician, but I can provide counseling and support. And we are branch also into, into the topic of managing witnesses, witnesses in civil cases, um, to see if they could be more effective witnesses. Wow.
[00:44:26] Speaker B: So in true entrepreneurial fashion, the, the lowest point of your life in business has become.
Could possibly be one of the biggest strengths that you have moving forward and could impact people.
[00:44:38] Speaker A: Turn it around. Basically. Basically.
Okay, you got me into this legal trouble. Well, let me see. Maybe I can help other people who are. Who were in the same shoe as I, as I was and, and see how can I can. And that may be different because if somebody had. Has the support during these tough times, maybe their decisions would be different. Maybe they'll decide, I want to go to trial. I'm not going to plea.
I didn't do anything wrong. But now with the plea agreements, people are just convinced you got no chance.
You're like, you better plea or we're going to come at you and you're going to lose at trial. And that. That is not true. And here's. I'm a testament to that situation.
[00:45:26] Speaker B: Yeah. You know, I heard somebody one time who. He's got a huge online presence and somebody asked him one time how he built the, the influence that he did. And it was, it was the most fascinating thing because he said I.
Because they were like, who's your ideal client and your avatar and who you're writing for and whatever. And he's like, I'm just writing to myself two years ago.
[00:45:47] Speaker A: There you go.
[00:45:48] Speaker B: And he's like, I look back two years ago going, what would. What do I wish I would have known two years ago. And here, here you are two years ago.
What would you like?
[00:45:57] Speaker A: This is my book, Dr. Now Guilty. What I wish that I had known two years ago in. In my. In my struggles with the government. And I'm putting all that information in there and just kind of telling stories of different doctors who face the same situation that I faced.
And our new. Our. Our second book, that's going to be People v Medicine. That's going to be a continuation of that, too.
[00:46:23] Speaker B: Wow. I love it. All right, so if somebody's listening to this, they want to connect with you. Obviously, we've got SHIELD Expert. Is there any place else they can. They can reach us? LinkedIn.
[00:46:32] Speaker A: They can connect with me on LinkedIn. I'm on LinkedIn. I'm Dr. Rafai on LinkedIn. They could find me very easily. They could. They could Google my name and find the good and bad Muhammad Ali Refai. They could find the whole story about me because I was at nih.
Most scientists who are at nih, a Wikipedia page gets developed for them. So I have a Wikipedia page that. My life story, too.
[00:46:59] Speaker B: Wow. That's fascinating. Well, Dr. Refai, what a remarkable journey.
So glad that you're where you're at. I'm glad that it's put you in a position to be able to build tools and help other people that were in that situation. So thank you so much for your time and for being here today.
[00:47:18] Speaker A: My pleasure. Thank you for having me. And for people who are. Who are out there, there's always hope. Never, never lose hope, and you can always rebuild.
Awesome.
