How a Family Medicine Physician Freed Up Enough Time to Build Two Businesses
Part II of my conversation with Dr. Bart Kaczmarek on permission, the shrinking gap between an idea and the first move, and what physicians get wrong about capacity
In Part II of my conversation with Dr. Bart Kaczmarek, we’ll learn about the $250 first version of DoctorFlow, and how he gave up a six-figure paper stake in a business for $1 in order to regain focus.
We also discuss what it’s like now for him to work roughly 25 clinical hours per week, and Bart's argument for what the real thing holding physicians back is - and a hint - it’s not time or money.
Physician Vantage Studio - Interview 02 - Dr. Bart Kaczmarek, Family Physician, Founder of DoctorFlow - Part II
Scott
So now, you created all of this while seeing patients full time and teaching residents. How did you protect the time to build CRAFT [see part I of the interview] and DoctorFlow? Where did you find the time to develop all of this?
Bart
It came out of necessity. What’s my next step, what’s the lowest-hanging thing I need to fix to be more efficient? If one nurse helps me but I don’t have enough of her time, I need to hire another one. Then, how do I manage two or three nurses without them bumping into each other? That’s what created the need for a tool that tells my prepping team where to go first, and leaves a sign for me - where do I go next, and for what? Is it a diabetes follow-up? A joint injection follow-up? A cosmetic procedure? So I walk in already knowing who’s next and what kind of encounter is waiting behind the door, just by looking at DoctorFlow. It became a tool almost as a natural next step.
DoctorFlow is essentially room flags, reimagined for 2026, with separate views for the prepping team and the doctor, handoff messaging, and a lot of automated functions. And the most beautiful part at the end is the KPIs - I know exactly how much time I spent in the room versus not in the room, which tells me lost opportunity for income. That’s what I track, to see which parts of the day I can fill with more patients. I’m never idle. I’m always moving room to room, using my time at the highest possible capacity.
Scott
So tell me a little more about DoctorFlow itself. You described it as the 2026 version of flagging the room, giving you information, data, and metrics. Tell me what it is at a high level, and how it works.
Bart
It’s a hardware system - tablets mounted on every patient room door, and a set of TVs in high-traffic areas. Some of our clinics have one screen, some have two, three, or more. There’s software running on them that separates a queue for the prepping team and a queue for the doctors, and it enables handoffs. Say my patients are all prepped when I walk in, but then someone mentions, ‘can you also give me a TDAP vaccine?’ I say, of course, and my nurse will be right in - I leave the room, press a button, and she’s flagged to come back in for the vaccination while I move on to the next room. I’m not looking for anybody.
Those handoffs are incredibly useful. I used to yell down the hallway looking for my nurse, or ask my secretary, ‘where’s my nurse?’ while she was on the phone saying, ‘wait, wait, I’m on a call.’ Now none of that happens - the system tells me which room is prepped and ready for me next, and I just keep moving. My longest gap between patients is the walk from room one to room seven, maybe fifteen steps. That’s my longest break. A perfect day for me is zero breaks all morning and completely continuous patients all afternoon - a hundred percent utilized day.
Scott
I love it. So how long did it take from the idea - let me create something like DoctorFlow - to formally systematizing what you were doing? How long from first thinking of it to having it fully built and ready to implement, both in your own practice and in other practices?
Bart
That’s actually a deep question, with a lot of context. I realized we were moving to a larger practice, and paper flags on the door wouldn’t work anymore for seven or nine rooms - we’d all be confused. So I hired an IT contractor off Fiverr, and he built an app for me for $250. That was it. I started using it, and it was great.
Then someone saw me using it and asked, what is this? I explained what I used it for, and they said, why don’t you sell it? I said, sell it? This is just me, I’m this weird guy, nobody works the way I do. But it started growing on me, and eventually I thought, let’s go for it.
The gap between building something for yourself and preparing it for the market is the main problem. There was so much I didn’t know, and had to learn - I’m still learning. I can teach other doctors about efficiency, but I’m a student when it comes to running a business, sales, marketing - an enormous amount of knowledge I didn’t even know existed. But I’m grateful, because I’m having fun learning it, discovering what I’m doing wrong all the time, and correcting it. That’s been fabulous.
Scott
Would you say there wasn’t much delay between having the idea and tinkering with it, versus deciding to formalize it and bring it to other practices? Was that a quick ramp-up, both in terms of time and psychologically? Or did you sit with it for a while, thinking maybe I should just keep this in my own practice, before eventually deciding to make it something more formal?
Bart
It took me a little while, because I didn’t quite accept that it was possible - I didn’t see myself as someone who could build this for other people. At the time I was also involved in organizing medical buildings under the name Hope Health, as an equity partner in a new building, and I was already organizing work for other doctors using my system, so I was busy with that. Once I got moving, the execution itself wasn’t very long.
What I notice about myself is that the biggest result of all this learning isn’t the money. The biggest result is that the loop between having a concept and executing it keeps getting shorter and shorter. If I have a thought and decide to act on it, it’s not two weeks anymore, it’s not even a week. The shorter that loop gets, the more I know I’m actually learning. That’s the real payoff.
“What I notice about myself is that the biggest result of all this learning isn’t the money. The biggest result is that the loop between having a concept and executing it keeps getting shorter and shorter … the shorter that loop gets, the more I know I’m actually learning. That’s the real payoff.”
-Dr. Bart Kaczmarek
Scott
I like that. So when you approached other practices with DoctorFlow fully built out, and offered to put it into their practice, how did that go? What was harder than expected when you were trying to sell it to other practices and get it installed? Tell us about that part.
Bart
I realized I had a lot to learn, so I got myself a few books and started learning how to actually make offers and sell things. One of the first humbling lessons was that I had to make calls. I called everyone I knew from my contact list - made the list, printed it, called each person two, three, four times until I got through. Then I started making cold calls, which is extremely humbling if you’ve never done it. You become that same guy who calls you about duct cleaning. That’s how I reached my first customers.
Then we installed it, and I had to develop standard operating procedures for installation - it involves electrical work, hardware implementation, TV setup, staff training. We ran before-and-after surveys so we’d have a clear picture of the impact. Everything about it was new, but that was the journey.
Scott
So interesting. Now tell me how you made time for that within your typical week. Because as I’m hearing you talk, you have a busy day already, being maximally efficient, but you’re also building this new business to bring to other practices. Were you working on that in the evenings, the weekends? How did the architecture of your week actually come together?
Bart
I got used to getting up really early over the last five years - up at four o’clock every morning. I’d do an hour at the gym, and then I always had a bit of time for myself before everyone else in my time zone woke up. I leaned on that a lot, that discipline of staying on course.
The difficult part is that it’s never enough. What I’m learning at this stage is to stop always adding, because I’m fighting against my training as a physician. We’re trained in residency and throughout our careers to keep adding - scut work in residency is ‘go do five things,’ and the next night it’s ten things, and you just have to say yes and get it done no matter what. We’re trained to do that.
Scott
Yeah, exactly.
Bart
You mentioned earlier how CEOs are very focused on doing just two or three things - they’re trained to cut, to remove, to subtract from the plate. A big part of what I’m working on now is learning that skill. I’m still learning it. I’ve started removing things that no longer fit my focus. Recently, with a heavy heart, I stepped back from teaching medical students and residents - I loved it, but I realized I had to be more focused, so that cut had to happen. I also removed myself as a partner from the building I mentioned earlier, something worth probably a few hundred thousand dollars on paper. I just executed my plan of removing at any cost, and gave up my stake for one dollar, just to free up my mind for things I felt were a better investment of my time and focus. That’s a deliberate practice for me - removing. But it’s never enough.
Scott
That’s a great point. You have to be really judicious about where you’re getting the time from, and what you’re willing to let go of, if you want to layer on something new - because most physicians already have a full schedule, and it’s hard to add anything more. So let’s say a physician has a new idea they want to pursue, but a full clinic schedule. What would your advice be for their next 90 days? What should they do?
“You have to be really judicious about where you’re getting the time from, and what you’re willing to let go of, if you want to layer on something new - because most physicians already have a full schedule, and it’s hard to add anything more.”
-Dr. Scott F. Cameron
Bart
The idea would be to start with things that are highest value for zero investment - that’s the C in CRAFT. Physicians typically undercharge. I’m speaking from the family medicine perspective, but outpatient doctors in other specialties could apply this differently. In Canada, family doctors are allowed to charge private fees within certain brackets, and almost nobody charges at the high end of that range. Most doctors sit on the lower end of the allowable fees.
One of the first things I’d suggest, to free up capital to hire help and not come home exhausted, is to start charging your existing fees at the higher end of the bracket. That’s what I did - some services went from $20 to $100. It sounds drastic, but from my own experience, nobody questions it. You just do it, and nobody leaves your practice. If someone genuinely can’t afford it, I have room to waive the fee - I’m not charging everyone ruthlessly. A good example: I implemented a block fee for extra services, things like notes and paperwork, around $250 to $300 a year per patient. Out of a 4,000-patient practice, maybe three or four people ever asked me to waive it, and I agreed. It’s not hundreds of people - most people are able to pay. There are other steps too, but I’d start with the lowest-value, zero-investment moves - just adjusting a number or reorganizing your work. That’s the C in CRAFT.
Scott
So that’s a way to get some of your time back, or generate more income and trade that back for time. And once you have that, if you have another idea you want to pursue or a business you want to build, you now have more bandwidth, more time, or more capital from your existing practice to put toward that new venture.
Bart
Right, you can hire someone to help with the things you don’t want to do, which is what’s hurting so many doctors right now - they have so many things on their plate they wish they didn’t have to do. That’s the easiest way to remove it for good, and it’s self-funded. Everybody wins, including the people you hire, who now have a job. Everybody’s happy.
Scott
That’s right. Do you think it’s accurate to say what stops most physicians from starting is time or money, or is it permission, or something else?
Bart
I think it’s permission, and the mindset of thinking about an outpatient practice from a different perspective, rather than the one we know from training - what are my colleagues doing? Instead, think from first principles: does this need to be me? Do I have to do this? And if I don’t, can someone else do it for me, and how do I pay for it? Try hiring someone for it. If they say they’re not comfortable with a task yet, that’s fine - how do we train residents? See one, do one, teach one. It’s the same idea. If you’re a partner to that person and they’re eager to learn, you can teach your staff a great deal, and that’s how it’s worked for me. It’s the mindset.
Scott
See one, do one, teach one - right. I love that, and I can’t say I disagree. It’s not so much a resource you’re missing as a mindset shift that has to happen first, and then you figure out the rest. We’re all smart and resourceful enough to work out how to make it happen.
So, when you transitioned from pure clinical work to clinician-plus-builder - physician innovator, physician builder - was there any imposter syndrome you dealt with, and if so, how did you handle it?
Bart
It happens quite a bit for me, at least. In my family practice, I’m talking with patients many times a day, and I like to treat it as a partnership, even in a very short appointment. I’ll say, listen, I have to be honest, I don’t know. How to help your back pain, or your chronic cough where everything looks fine but you’re still coughing - honestly, I don’t know, and probably nobody else does either. So here’s my suggestion, let’s try this, let’s try that, what do you think. I come out of the room with a real sense of imposter syndrome fairly often, and it actually makes me more humble with my patients.
With the building side, the constant learning has a similar effect - it puts me in my place and makes me aware how early I still am in that whole process, how much is still ahead of me. People who’ve built real companies are so much further ahead, with so much more knowledge and experience. I’m always inspired by a colleague of mine, a spinal surgeon out of Cleveland Clinic who did his residency and fellowship at Rush, who gave up his medical practice entirely to build companies. He’s probably a hundred-million-dollar-plus investor and innovator now. He always inspires me - I look up to him whenever I think about it.
Scott
That’s interesting. It’s good to have that humility about what you’re doing, both medically and as an entrepreneur - sometimes you don’t have all the answers, but that doesn’t mean you can’t try your best, be honest, and figure it out. I like that the humility carries over from the physician side to the builder side.
So these days, with a busy practice seeing 80 patients a day - I read that you handle that panel and you’re home by 5pm every day, working less than 40 hours a week. Is that accurate? How do you make it all fit into one week without overflowing past 5pm?
“It’s good to have that humility about what you’re doing, both medically and as an entrepreneur - sometimes you don’t have all the answers, but that doesn’t mean you can’t try your best, be honest, and figure it out. I like that the humility carries over from the physician side to the builder side.”
-Dr. Scott F. Cameron
Bart
It’s actually less than forty. I’ve started cutting my days back further to make room for the building side. I’m also lucky to be in a capitation model, which lets me care for patients remotely and delegate to my staff. At this point I’m working about 25 hours a week, and billing probably four to five times the average family doctor in Ontario. It’s not because I’m smarter or have extra funding - I’ve just organized myself within the existing rules, which is why I feel so confident talking about this. I think there’s enormous unused capacity in how doctors work, and I’d love for any doctor who wants to change how they work to make use of what I’ve built. The capitation model helps, but a lot of it just comes down to how I’m organized.
“At this point I’m working about 25 hours a week, and billing probably four to five times the average family doctor in Ontario. It’s not because I’m smarter or have extra funding - I’ve just organized myself within the existing rules…I think there’s enormous unused capacity in how doctors work.”
-Dr. Bart Kaczmarek
Scott
Interesting. So if you’re doing 25 hours a week of clinical time and seeing that many patients, is a good chunk of the rest of your week going toward DoctorFlow these days?
Bart
Yes, most of it goes toward DoctorFlow. I’ve hired a few people to help me at this point, which has been a big release. I’m applying the same framework to my company in a way. It’s generating revenue, but it’s not fully self-funding yet - it’s bootstrapped, so whatever I make in my practice, I put toward making it work. It’s an exciting journey. I also have responsibilities with my kids - I take my son to soccer or basketball almost every day of the week, so when I get home, I’m not sitting down, I’m a driver.
Scott
That makes total sense. If you’re building something substantial, you have to spend real energy and time on it, even when you’ve hired people. So the underlying design makes sense - compress your clinical hours, use one chunk for building the business, another chunk for family. If you try to layer business building on top of a 40- or 45-hour clinical week, things burst at the seams - you can only sustain that for so long.
So tell me - where does DoctorFlow go from here? What does it look like in three years? What’s your vision?
Bart
DoctorFlow is designed specifically for very busy outpatient practices seeing a hundred or more patients a day, whether that’s one doctor or several, typically ten-plus rooms. The ideal customer is a busy walk-in clinic or urgent care, with high turnover, a lot of patient movement, and a lot of coordination needed. That’s where it shines. In three years, I see this in about 150 clinics across Canada and the US. The target for this year is 20 to 25. I’m a hundred percent sure it’s a tool that will become very valuable for very busy practices.
Scott
That’s wonderful. I can see this appealing to a physician who wants to keep or even increase their revenue while drastically cutting their hours - freeing up a half day or a full day a week, or at minimum cutting off charting after 5pm to protect family time. Or it could appeal to someone who wants to generate more income from their practice without expanding the hours they work. So those two types of physicians - would you say that’s an accurate way to describe who DoctorFlow is built for?
Bart
Yes. I’d add that it’s for doctors who genuinely want to save every ten seconds of their time. The clearest example is an extreme one: an outpatient doctor seeing 20 patients a day with two rooms has almost nothing to coordinate. Someone seeing a hundred patients a day across seven rooms with a team has a lot to coordinate. Those are the doctors who see the value in ten seconds. That’s actually one of my qualifying questions: if I saved you ten seconds per appointment, would you take it? People who say no probably aren’t the right customer. People who say they’d love ten seconds back on every appointment - that adds up to a lot of minutes in a day - those are my kind of doctor, and I think DoctorFlow works well for them.
Scott
That’s a good distinction. I also read that you founded Landmark Knee this year. What is that, and how does it fit into everything else?
Bart
It’s a company providing a cross-border service for American patients, offering an ultrasound-guided knee injection treatment that’s innovative and not yet available in the United States. It’s a business that leverages a market that doesn’t have access to that treatment yet. Since my location is about five minutes across from Detroit, a lot of patients drive or fly in and drive over. I’m in a central location in the city.
It’s a business that helps fund DoctorFlow - a bridge, in a sense. It’s also been an exciting marketing and sales education for me. I’m learning all the levels of a sales funnel - I have people doing inbound and outbound sales for me, I train them, we practice scripts and objection handling. It’s an amazing training ground for things I wasn’t even aware existed before.
Scott
That’s so interesting. We really don’t get any of that in medical training - the business side of medicine is so new to most physicians, and people tend to learn it by trial by fire once they join a practice and suddenly become responsible for it.
I want to ask you about AI as well, obviously a hot topic for physicians regardless of specialty. From your perspective, what do you think AI changes about the career of a family medicine physician over the next five years, and what does it not change?
Bart
The general predictions aren’t very favorable to you, Scott - radiology is often cited as the first specialty facing real disruption. For family medicine, at this point AI mostly shows up as smarter dictation. I actually welcome patients who research their symptoms and come in saying, ‘here’s what ChatGPT said’ - I like that. It gives us something to briefly connect about, and patients are more informed. I think it will prepare patients better for appointments - maybe we’ll be able to send smarter pre-visit templates so they arrive better prepped, and visits will get shorter, if we use that opportunity well. I don’t see family medicine losing its human connection anytime soon - that’s a huge piece of it. I think AI will be an augmentation, not a replacement.
“I actually welcome patients who research their symptoms and come in saying, ‘here’s what ChatGPT said’ … it gives us something to briefly connect about, and patients are more informed. [ ] It will prepare patients better for appointments - maybe we’ll be able to send smarter pre-visit templates so they arrive better prepped, and visits will get shorter ... I don’t see family medicine losing its human connection anytime soon.”
-Dr. Bart Kaczmarek
Scott
Right, that makes a lot of sense. If you could go back to the very beginning of your journey as a physician, what would you tell yourself, if you could start over?
Bart
That’s a good question. I’d tell myself: it’s going to be completely different than you’re thinking. Keep your mind open, and keep investing in yourself, because a whole world of opportunity opens up. It doesn’t necessarily pay you in money - it pays in ideas, in being in a room with interesting people. Getting the chance to meet and talk with you right now is one of the rewards I get from my work, more than anything else. Just keep doing the reps, I think.
Scott
That’s great. Any general advice for physicians thinking about doing something off the default career script - what would you tell physicians who are interested in something beyond the standard, typical practice?
Bart
I’d say this not from the perspective of a business guru, none of that - from the perspective of a student. My advice is that you can learn almost anything from the internet now, which is maybe part of why traditional education is struggling. Just keep an open mind and keep learning. We’re all capable enough to have gotten to where we are, which means we’re capable of learning anything else too. There’s nothing about learning that should be a source of fear for us.
Scott
Wonderful. Is there anything else you wanted to bring up that I haven’t asked about, or that we haven’t covered today?
Bart
I think that’s it. This was really interesting, and I want to say I’m grateful to connect. It’s awesome to be here, and thank you for the opportunity.
Scott
Thanks so much. Bart, if people want to reach out to learn more about you or what you’re working on, where should they go?
Bart
You can find me at DoctorFlow.com - my email is info@doctorflow.com. You can find me on LinkedIn at Dr. Bart Kaczmarek, and on YouTube, where I have a channel about medical office efficiency.
I’d love to connect with people who have questions, who are struggling with how to innovate their medical office, how to regain control of their practice, how to just feel better as doctors. I think we’re in a bit of an identity crisis as a profession - we’re looking for more and not getting it, and that’s a real source of frustration. But we can achieve almost anything within the existing rules.
Scott
Wonderful. Thank you so much. And for those of you who want to learn more about the topics we’ve discussed today, you can visit Physician Vantage Studio and learn more about the mission at PhysicianVantage.com. Thank you very much, Bart - it’s been great speaking with you and learning about your journey, and I wish you all the success going forward.
Bart
Thank you so much. Thank you.
Scott F. Cameron, MD is a practicing radiologist, AI implementation leader, angel investor, and MRS Past President. He writes about physician career architecture at Physician Vantage Studio.