Practicing physicians and enthusiastic entrepreneurs Todd Walker, MD, Justin Smith, MD, and Nathan Boes, MD, are founders of TurnKey AI Practice, an AI-powered practice-management and clinical workflow platform for independent medical practices.
The product joins an already crowded field of companies offering AI-powered ambient scribes and more.
“What sets us apart is we're ambitious,” said Dr. Smith, an orthopaedic sports surgeon and founder of Journey Orthopaedic Institute in Fort Mill, South Carolina. “We're going for the whole thing, from marketing, intake, triage, pre-visit brief, scribing, note generation, revenue-cycle management.” Their offering also involves “moving to the MSO [management services organization] layer, including collecting research data.”
Physicians can join a waitlist to access an early version of Turnkey AI Practice. Fueled by $1.64 million in investments from more than 20 practicing physicians who are beta-testing the platform and a grant from the American Shoulder and Elbow Society, Drs. Walker and Smith—both AMA members—attended the inaugural AMA Physician Entrepreneur Forum to learn about how to grow and run their business from similarly minded peers.
The AMA Physician Entrepreneur Forum is part of the new AMA Career Advancement Collective, a powerful new suite of educational programs and training that helps physicians develop and advance at every stage of their career.
From inspiration to entrepreneurship
Their entrepreneurial spirit was sparked during COVID-19 public health emergency, when Starbucks provided healthcare workers with free coffee. That only lasted a couple of months, but it inspired Drs. Walker, Smith and Boes to launch Morning Rounds Coffee, an online seller of coffees with names such as Do Not Resuscitate, Code Brown, CPR, Transfusion and The Night Shift, plus mugs and apparel. Up to 25% of profits are then donated to organizations that support healthcare workers.
That opened some doors and presented opportunities.
“We’d sit down with a CEO and he'd say, ‘Tell me about this Morning Rounds thing,’” said Dr. Walker, an orthopaedic surgeon with Texas Orthopedics in Austin. “And we’re like, ‘Actually, we're here to talk about TurnKey,’ and what the two had in common was it meant a lot to us to do something for physicians.”
Enthusiasm does not mitigate challenges, though. Never having raised investor capital increased the burden of responsibility in using that money wisely. Something as basic as time management becomes essential too.
“We're active, practicing physicians. We all have families,” Dr. Walker says. “My wife's a physician as well, so I can’t say, ‘Hey honey, you take care of the kid,’ and I think we all struggle with that. We heard that from a lot of the people at the [AMA Physician Entrepreneur] Forum.”
Dr. Smith described a lack of business training as one of the biggest hurdles.
“That can be intimidating,” he said, and can discourage physicians from pursuing ideas in the first place.
“What does a confused mind say?” Dr. Smith asked. “A confused mind says, ‘No’—and that's the biggest barrier.”
Physicians accustomed to working within established health systems may struggle to leave those structures and create something different. Dr. Smith said that when he first considered starting his own practice, he used artificial intelligence (AI) to fill in his own business knowledge gaps, namely finances, business and capital structures. He also used it to play out different scenarios, such as how many patients he needed to replace his salary, then stress testing the plan, including how and why it might fail.
“It's a cultural shift. As soon as you understand it, then it doesn't seem intimidating, and then you actually do it,” he said in reference to his own experience, as well as interacting with like-minded physicians. “It's refreshing to meet other people who think like me and have the spirit to break free. People like us can help decrease that barrier, help others and demystify the business aspect.”
From AI implementation to digital health adoption and EHR usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors. That includes the AMA Center for Digital Health and AI, which works to ensure physicians help shape how AI is developed, implemented and regulated across the healthcare system, with patient safety and physician-led care remaining at the center of those efforts.
Learning from those who’ve done it before
Dr. Walker found mentorship particularly helpful, especially after the two doctors built the coffee company on their own. One source of guidance and credibility has been a retired physician with experience developing startups.
“He has been there from the beginning, telling us what not to do, and that has saved us a lot of time and a lot of money,” he says. “Talking with investors with the backing of someone who believes in the product and what it can do for physicians has given us credibility.”
Another is the founder of a pediatric healthcare company, Alison Curfman, MD, who raised $200 million to start her venture, now valued at close to $1 billion.
“She's taken us under her wing and helped build and refine our ideas,” Dr. Walker says. She helped them refine their initial concepts, develop a go-to-market strategy, make connections and navigate the startup process. “These two people have made us go from this,” he said, holding his thumb and forefinger about an inch apart, “to this,” gesturing with his hands in the air and wide apart.
Dr. Smith enthusiastically echoed the value of mentorship.
“Find somebody who's done it before,” he said, quoting one of the AMA Physician Entrepreneur Forum’s speakers, Danish Nagda, MD, founder of Rezilient, who said that repeat founders have up to a 30% better chance of succeeding at new ventures. “Talk about increasing the odds! We have found a couple of such people [at the Entrepreneur Forum] who said they would be willing to advise us. Why would you not find a mentor that's done it before?”
Making time and making connections
Both doctors advise developing fearlessness when it comes to entrepreneurship.
“It's pretty scary to think about jumping into something other than seeing patients,” Dr. Walker said. “A lot of people are making products and inventing things. The hardest part is just to get going.”
He also recommended conducting a thorough time audit to understand how much of that commodity, already precious to a practicing doctor, is actually available. Start with getting up in the morning, include clinical practice during the day, as well as time at home that night with family.
“It's as much self-reflection as time management,” he said. “Know how much you are able to actually give. Be realistic about how much time and attention you can and can't devote to an entrepreneurial undertaking.”
Network and be open to new ideas, Dr. Smith added.
“Make connections in the entrepreneurial space,” he advised, describing how connecting with a nurse on the editorial board of Surgery Business Magazine led to an introduction to the editor-in-chief. Now Dr. Smith is a contributor.
“One of the problems with doctors is we all have this arrival fallacy. We all think, ‘Ah, it's going to be better when I get here,’ but it's all about the ride. Surround yourself with like-minded people who you enjoy being around.”
A new path to physician autonomy
The rewards of entrepreneurship for these physicians include creating something that aims to improve their peers’ working lives.
“We have the potential to change the way medicine is run for independent physicians and bring back some of that happiness and autonomy,” Dr. Walker says.
Because physicians experience healthcare’s inefficiencies, cultural barriers and regulatory complexities, they are particularly well positioned to identify shortcomings and develop practical alternatives. For Dr. Smith, that makes entrepreneurship about more than building a profitable business.
“Physicians naturally have a very altruistic impulse to create something that's meaningful and impactful in medicine,” he said. “When patients are frustrated, clinicians get frustrated. That means there's a demand and that's where entrepreneurs flourish. Now is probably a more opportune time than any other to become a physician entrepreneur.”
