733 Efrat Lamandre:

As entrepreneurs it often feels like our work is never done, so it is easy to fall into the trap of overwork, you know all that hustle and grind. And when we ignore our health – physical, mental and emotional – our businesses suffer along with us, as guest today – Efrat Lamandre shares today. Efrat is a trailblazing entrepreneur in the functional medicine space, and she’s got a lot to say you’re going to want to hear.

MELINDA

Hi, I’m Melinda Wittstock and welcome to Wings of Inspired Business, where we share the inspiring entrepreneurial journeys, epiphanies, and practical advice from successful female founders … so you have everything you need at your fingertips to build the business and life of your dreams. I’m a 5-time serial entrepreneur who has lived and breathed the ups and downs of starting and growing businesses, currently the game changing social podcast app Podopolo. Wherever you are listening to this, take a moment and join the Wings community over on Podopolo, where we can take the conversation further with your questions, perspectives, experiences, and advice for other female founders at whatever stage of the journey you’re at! Because together we’re stronger, and we soar higher when we fly together.

Today we meet an inspiring entrepreneur who says she became an entrepreneur because she was quote unquote “unemployable”.

Efrat LeMandre built her own Medical practice, EG Healthcare, now providing primary care to over 20,000 patients. Today Efrat shares how  takes conventional medicine to the next level with her signature process, The Knew Method, and how she empowers patients to realize that their symptoms are NOT in their head and helps them take control of their health destiny using a Functional Medicine approach.

Too many entrepreneurs sacrifice their health building their businesses. Most of us think we can do more than we can, and with an endless to-do list, it is easy to push the boundaries so far, we sacrifice our own health, and with it the health of our businesses.

Efrat LaMandre built her own healthcare business and along the way learned she had to honor her own health in the process to succeed. Efrat owns and operates her own Medical Practice called EG Healthcare. It provides pediatric, adult and geriatric care to over 20,000 patients. And not content running just one business, Efrat has taken conventional medicine to the next level with her signature process, which she calls The Knew Method, that’s Knew with a K.

The Knew Method helps patients take control of their health destiny using a Functional Medicine Approach that empowers them to finally realize that their symptoms are not in their head. As a result, she helps people optimize their health, prevent illness, reduce medication, and feel great. It’s a proactive approach to health care that avoids the need for what is better termed “sick care”.

She also owns a Medical Scribe company called Hawk Scribes, that allows providers to focus on their patients instead of charting.

So much to talk about today, so let’s put on our wings with the inspiring Efrat Lamandre, and be sure to download the podcast app Podopolo so we can keep the conversation going after the episode.

Melinda Wittstock:

Efrat. Welcome to Wings.

Efrat LaMandre:

Thank you so much. I’m honored to be here.

Melinda Wittstock:

I’m excited to talk to you. You’re the first person that I’ve talked to on this podcast, more than 750 interviews, who has your own medical primary care business. What made you leap into entrepreneurship with what you’re doing?

Efrat LaMandre:

Oh my God, that’s such a great question. I’m glad to be the first, thank you so much. What made me leap into entrepreneurship is the inability to work for others.

Melinda Wittstock:

Oh my God, I know that so well, you’re just describing me. I mean, I’m unemployable.

Efrat LaMandre:

I’m completely unemployable. And I didn’t realize while I was employed, I initially started as a nurse, I didn’t realize that I was the reason I had such a hard time is because I was never meant to be an employee. Took me a while to figure that out.

Melinda Wittstock:

And so what is it about that? I want to break that down. What makes you unemployable in that sense? What is it about you?

Efrat LaMandre:

It’s so funny because you would think someone who’s not a good employee doesn’t want to work or wants to vacation and that’s not the case, right? Because anyone listening, who’s an entrepreneur, you know you work 24/7. So it’s not laziness. It’s I really had a hard time having to punch in and punch out. I didn’t like having to sit in committees, I didn’t like to follow rules that didn’t make sense to me. It just was almost like an allergic reaction.

And so I didn’t realize that meant I was an entrepreneur, I just thought I was a rebel. And then after I became a nurse, I got my nurse practitioner degree. And again, I worked somewhere and I kept getting into trouble. And it was just silly things. Like I would just show up late two minutes and I thought it was just rebellion, but I just realized retroactively that I just didn’t fit well. And I mean, I did the work well, which is why I was never fired anywhere, but I just didn’t follow the rules.

Melinda Wittstock:

I think all entrepreneurs are rebels though.

Efrat LaMandre:

Yeah, yeah.

Melinda Wittstock:

I think all entrepreneurs are rebels inherently because we see something that we don’t like or we see a problem and we kind of volunteer to go out and fix it because inherently we’re change agents. And that is-

Efrat LaMandre:

Yes. In fact, that’s what I define myself in my bio. I say, I’ll see a problem, I’ll fix it, and I’ll create a business around it. That’s exactly what we are, we’re problem solvers. And then sometimes you’ll see a problem in an institution and it’s being solved in the most inane way. And I can’t handle it.

Melinda Wittstock:

Okay. So when you were looking at, I mean we could deep dive into healthcare and all the things that are wrong with it. What was the main hair on fire problem that you were like, “Okay, enough, me, Efrat, I’m going to go and figure this out.”?

Efrat LaMandre:

Okay, so when I got my NP degree, I worked in an office that served the underserved community in New Jersey. And the way they had it situated, I thought was really cool, because they created pricing strategy for people who didn’t have insurance that was affordable. Because there is a segment of the population that is not eligible for whatever reason to go to a clinic, but is also not eligible or cannot afford insurance. These are hardworking humans who need access to care and the system fails them. For whatever reason, I won’t get into that.

So this clinic was really innovative in that it charged, at the time it was like 50 bucks for a visit. Which is affordable for most people. Again, people who that’s not affordable for will probably be eligible for a clinic. 50 as opposed to your average doctor’s office 300, 400. And I really liked that, that really appealed to me. So I turned to my wife and I said, “I think we could do this closer to home.” So we decided to kind of take the idea and run with it.

So we realized that we could offer the same thing locally. And that’s the initial idea behind EG Healthcare. It then evolved into a full medical practice that takes insurance as well. But we’ve always kept that special program for people who don’t have insurance for whatever reason and don’t qualify to go to a clinic. And it’s been so rewarding to be able to offer both options for people who have insurance, people who don’t have insurance. So that was the initial kind of spark that started EG Healthcare.

Melinda Wittstock:

And you really offer a lot, I mean, pediatric, adult, geriatric and you serve 20,000 patients. That’s incredible [inaudible 00:05:27] your company must be huge.

Efrat LaMandre:

So it just started off me and one assistant and I’m telling you, we high fived each other if we had five patients a week. And I mention that because for any of the entrepreneurs listening out there, don’t give up, it’s coming, it’s coming. So five patients a week we were like, “Wow, we made it.” And now we see 70 patients a day. So it started off one way and then again, each thing evolved as the need arose. So pediatric, adult, geriatric, I’m a family NP so it makes sense, what I did was I took over a few pediatric practices and then offered the care to their parents. Because as a mom, I knew that I would take my kids to the pediatrician, but I never went for my own primary care.

So I knew that offering family care, especially for moms, but certainly for dads out there, but generally speaking, it’s the moms who bring them in. They’re bringing their kids in for their annual because moms tend not to miss that. And now were also taking care of mom. So it was a business strategy that came out of my own experience. Of course you’re taking kids for labs and their vaccines if that’s what you’re down for. But moms tend to not do that for themselves unless they’re sick.

So family practice evolved from that. And then when COVID hit, we realized that our geriatric population was not coming out. And so we developed a home care visit practice. So we have a nurse practitioner that goes to their homes for anyone over 65. And that’s just stayed since COVID. And that’s been really helpful for patients. Not necessarily bad bound patients, but first of all, over 65, especially in the winter, or maybe they’ve just got a knee replacement or whatever keeps a over 65 year old, makes it a little difficult to come out. So what started off as, “Hey, I’m really scared to come into the office because of COVID.” Now has become a convenient way to access care.

And then lastly, I promise I’ll take a breath in a moment. Lastly was the integrative practice, which is called the KNEW Method, and the Knew spelled with a K. Is again, as a result of my patients who needed more. And I’ll tell you more about a personal journey in a moment. It’s patients who needed more than what primary care offered. So the whole thing evolved, as I would see a problem I was like, “Well, I could fix this.” And then I created a division of the business around it.

Melinda Wittstock:

I love how your business evolved and what you mentioned about the gratitude of being excited just with your first five, five a week and you were high fiving each other. Often the more we’re in gratitude with what we’ve already achieved, the more we invite in of the same. And it’s something that it’s so easy for entrepreneurs to forget, because our heads are always ahead of the next milestone, the next milestone. And so you can be coming at it from a position of lack, which inspires more lack. And you just stay on that treadmill. But it sounds like you sort of intuitively knew a different way to grow. It sounds like it’s a bit “manifesty”.

Efrat LaMandre:

It’s a bit manifesty, but what you’re saying is correct, and it’s something I have to remind myself often because as entrepreneurs, we tend not to congratulate ourselves when we hit our milestone. All we do is keep moving the goal further.

Melinda Wittstock:

Exactly, I know, right? It’s so easy to do because you have this big triumph and it’s instantly forgotten because there’s something else, something else.

Efrat LaMandre:

Yeah, and you don’t take a moment. And I started realizing it more as the staff group. Because the staff needs a minute to be congratulated, right? So when it’s just you, you’re like, “Oh, let’s just keep going.” But then when you have employees and you just keep grinding, there’s moments where they look at me like, “Did you not see what we just accomplished?” And I’m like, “Oh yeah.” So it keeps me grounded in that way because sometimes in the moment that you’re taking too, because we all will take a moment to thank others and appreciate others. So that stop that we do for others, I’m teaching myself to in that moment also say, “Hey E, great job yourself.” So it is something that you have to remember to do because otherwise you will get burned out.

Melinda Wittstock:

So true. So I want to get into The Knew Method and functional medicine. So this sounds like it’s a lot more proactive care. Am I correct, understanding of functional medicine?

Efrat LaMandre:

Yeah.

Melinda Wittstock:

It’s a little bit different necessarily from integrative or is it the same?

Efrat LaMandre:

So I would say for me, it’s integrative in the sense that I will practice both functional and conventional, I have the ability to do so, right? Some people can only do functional because they can’t prescribe, they can’t order labs. Like if you’re a chiro and you don’t have the capacity in your state, you can only do functional. But because of my nurse practitioner license, I could do both. So I try to integrate the two.

But you are right on, and here here’s how I explain it. Conventional medicine, and it’s wonderful, I’m not against it in any way, huge fan. But it is limited. It is looking for disease. When you go to your primary care visit, you’re doing your blood work. Do you have cholesterol? Yes. Here’s some medication. Do you have diabetes? Yes. Here’s some medication. That’s an important aspect, but if you don’t have anything, you don’t have cholesterol, you don’t have diabetes, everything looks great, but you don’t feel well. There’s no room for you in conventional medicine. It deals with sickness. It doesn’t deal with wellness.

Melinda Wittstock:

Sick care system instead of a healthcare system.

Melinda Wittstock:

And so how much can the medical establishment move, as you are, to really optimizing the health of people and in essence, preventing disease, working with people to keep them well so they don’t have to suffer. I love that.

Efrat LaMandre:

Yes. Or if they already are unwell to give them other options. And before I explain what the other options are, I just want to take a moment and say that it’s not your primary care doc’s fault. They’re not bad, don’t get mad at them. It is just the tools that we’re taught in med school is to find the disease. And if there is no disease, there is nothing there. It’s like you cannot ask a plumber to fix your electric. So they’re not mean there’s no mal intent. It’s just the tools that we have. Now, if you’re sick, best place to be, let’s go. If you need certain medications I’m not against medications.

Now moving to the other side, if you’re not well, or if there’s some things going on and you’re only giving medication as an option, that’s definitely not enough. So let’s take, for example a lot of people are struggling with, I don’t feel well, do I have an autoimmune cooking? Maybe it’s my hormones, right? Or a lot of times there’s an insinuation that it’s in your head, right? A little crazy. Maybe you’re anxious about your health. That’s why I entitled my book, by the way, It’s Not in Your Head because it’s not in your head. The way I like to explain it is that something is cooking, just because we don’t know exactly what it is yet doesn’t mean it’s not happening.

So classically I’ll take diabetes as an example because people know it. If you’re diagnosed with diabetes today, it didn’t just happen today, right? For the past 10 years, let’s just say, you’ve been eating a certain way, it’s been cooking. Then you became prediabetic then became diabetic. On the day that you’re diagnosed, it’s been there for 10 years. That’s true for everything. If you are diagnosed with an autoimmune issue today, it didn’t just happen today. It’s been cooking for 10, 20 years. And during that time you’ve been feeling really off. Just because we didn’t put a name to it doesn’t mean it wasn’t happening.

So what functional medicine looks for is clues as to why you’re feeling a certain way, even though we didn’t put a brand on it of a diagnosis. And then it tries to find what’s causing it. Oftentimes it’s nutrition and other lifestyle issues. And by addressing the root cause of what’s causing it, we can improve the symptoms, reverse the disease, come off medications, et cetera, et cetera. So it’s really a whole different way of looking at health.

Melinda Wittstock:

Yeah, 100%. I remember the first time I ever went to an integrative medicine specialist and it was so interesting because the blood work was so in depth. She could see things that a regular test wouldn’t pick up, say around thyroid or whatever. If I went for like regular blood work, I’d be like normal, normal, normal, normal, all of that. Even with hormones, with all of it.

But she was able to see the markers of things that were developing much earlier and whatnot, just the subtleties. And just in terms of just vitamins, like, are you low on certain vitamins? Or what sort of food should you not ever be eating because they cause inflammation? Or however you look at it. And I remember, I mean it’s astonishing, even to the point of concierge vitamins for me. So I am just incredibly healthy all the time. I just don’t get sick, just because it’s preventative and it’s revolutionary.

Melinda Wittstock:

So wouldn’t it be amazing if everyone had that level of care? I mean, is that your ultimate ambition, to be able to take what you’re doing basically in the New York area and I don’t know, find a way to give everybody access to this? What has to happen for that to happen in our society?

Efrat LaMandre:

It can’t, sorry. I don’t know if you were hoping for a more positive answer. And I’ll tell you why it can’t, it can’t happen for a few reasons. So first of all, access for everyone in our society, I am trying to create access, it’s one of the reasons I put my information out on YouTube and on Facebook and on TikTok. And I have people nationally reaching out to me and working with me. So individually, whether they come to me or other functional medicine providers, yes, they can access it.

But if you’re asking systemically, is this something that could happen in our country systemically? It can’t for two reasons. One, the way this system is built, cannot accommodate for the amount of time that you need to really sit with your patient. By that I mean, if we’re in an insurance based industry, I spend like an hour with my patient each time. Insurance will not cover that. Insurance will give you, based on the diagnosis cost, based on how sick you are, maybe they’ll give you $50, maybe they’ll give you $75. There’s no way any doctor could spend an hour with someone for what insurance is willing to do so. An insurance based model does not recognize the amount of time you need to actually keep a patient healthy. It’s volume driven, you’re going to need to see so many patients an hour in order to keep your lights on. This is not a conversation of greed. This is literally just to keep your lights on. It is volume driven.

But the other side is that patients aren’t motivated. Like we tend to blame big pharma or the doc or the industry. But most patients are not motivated to make lifestyle changes, they are quite content to get their prescription and then come in every three months or every six months, depending on their disease and continue to eating the fast food and continue not to move. And anything else is too much for them. So it’s industry driven, it’s patient driven. And I don’t see that changing anytime soon. So we’re searching for each other. The patients are searching for functional providers like me, but I’m also searching for the patient that’s motivated and ready to make a change is because I can really impact their lives. But that is not everyone that is a candidate for this.

Melinda Wittstock:

Yes, it’s so true. So much of it’s to do with education Like just what we’re eating, what we’re breathing, right? So when you think of what’s next for your business, because we were talking about that earlier, there’s always something next for an entrepreneur. How do you see your business evolving and growing from where you are now and all the amazing accomplishments in growing to where you have?

Efrat LaMandre:

Yeah. So what’s been really interesting is what initially started as a bricks and mortar company, which is EG Healthcare, and that still serves my local community. The KNEW method has allowed me to transcend physical borders and I have patients all over the country and I even have a few in Australia. And I don’t know if they discovered me on TikTok. So the next step is really utilizing the technology that the pandemic brought to our lives, which is utilizing all these e-visits and virtual options to really reach patients in areas where they don’t have someone like me around.

And that’s been amazing. I never thought that this is where I would go to. And social media has been the tool for that, because people are seeing it and they’re just like, “Wow, how can we work with you?” And so I guess to answer your question, it’s to become national. I mean, we kind of already are, but to really become a national presence, that’s the new goal.

Melinda Wittstock:

Amazing. So you also have another business, Hawk Scribes. What’s Hawk Scribes, what are you doing [inaudible 00:21:28]?

Efrat LaMandre:

I actually have two other businesses. I don’t know how much time I’m going to take, but Hawk Scribes.

Melinda Wittstock:

You’re a multi-preneur.

Efrat LaMandre:

So Hawk Scribes, again, came out of a need. One of the things I try to balance is yes, the primary care. So let’s put New Method on the side for a moment, primary care, EG Healthcare is yes, volume driven. But I never wanted the patient experience to suffer. And one of the reasons the patient experience suffers is because the doc has to write their charts while they’re in the room. So I’m sure many of your listeners are experienced that they’re talking and the doctor is typing. Now it’s not that the doctor is bad. Again, that doc has a family at home who wants to see him or her. And if they spend all their time charting at the end of the day, they’ll never get home. So the system has forced them to really do all the admin duty while they’re talking to you, put in all the charts. Because if they don’t put on the chart, they don’t get paid and blah, blah, blah, blah.

So scribing is a concept that’s existed for years, which is somebody comes in the room with you and listens to what’s going on and then creates a medical note. But that has its limitation, having another person in the room, et cetera. So I created a company that has virtual scribing. So scribes are not in the room, they’re on a device, they’re hearing what’s going on and then they’re generating the note for the doc. So it’s great because you as the provider are fully engaged, you’re not worried about doing your notes. You’re with the patient, you’re 100% present. And then when the provider is done, the note is ready to just review and sign. So it’s just a win-win and that’s what Hawk Scribe’s all about.

Melinda Wittstock:

So along your journey, and especially as a healthcare provider and practitioner Efrat, you would understand better than most why our own health as entrepreneurs is really important. And yet so many entrepreneurs put themselves last, putting ourselves last or burning out, looking after other people, all that kind of stuff. Was that something that you just knew intuitively and you’ve been in consistent practice with looking after your own health or have you fall into that trap ironically as well?

Efrat LaMandre:

No, I have to say it’s been at the forefront of my mind almost from the beginning. It’s always a work in progress and something we work on all the time, of course. But because of what I do at the KNEW Method, I really try to practice what I preach. First of all, to be with an integrity for what I’m preaching, but also because I really understand that the whole house of cards will collapse if you, the entrepreneur, are not taking care of yourself. It’s going to happen one way or the other. So even if you’re like, “No, no, I could do this. I’m not like everyone else.” There’s a lot of myths out there. The early bird does not catch the worm. You need to sleep. Okay? Sleep is critical for you. So if you’re thinking, “Oh, I just won’t sleep and I’ll get my stuff done.” You will collapse.

That concept of whatever doesn’t kill you makes you stronger, not true. It will just kill you slowly. So for example, stress, if you are going to keep stressing yourself and you’re like, “I got this, I could power through this.” And you just don’t learn how to manage your stress, that’s going to cause cognitive decline. That’s going to cause like autoimmune issues. So there are a lot of rah rah models out there that many of us kind of buy into. But ultimately it will damage you and it will damage your business. Because as an entrepreneur, you’re the one piece that cannot be replaced. So it’s critical, I have a whole lecture that I do. It’s called the health of your business starts with you. Because if you are not on top of it, if you’re not healthy, the business won’t be healthy.

So that means structuring your days. For example, I won’t open up my practice until after my workout hours. So workout first, time with my wife every morning, unless I’m traveling. That is a non-negotiable time, because social connections are important for your health. So that work life balance that you try to create for your employees, you have to create it for yourself and for your family. Because if you do all this and you never see your kids and you never see your spouse, what’s it all for? You’re going to feel a void. Your nutrition has to be on point. Otherwise you’re going to be exhausted during the day, you’ll have aches and pains and your movement has to be on point. So all of this for you to really be optimal, you have to put your health at the forefront for your business to be where it needs to be.

Melinda Wittstock:

Oh gosh, 100%. I mean it’s interesting as entrepreneurs, right? Because we are likely to be under significant amounts of stress, right? I mean just depending on how good you are at handling uncertainty, depending on the type of business you have, how good you are at change, how good you are at being able to handle the things you can’t control. All those things are very stress producing necessarily, right? Especially if you have the type of business as I do, where you have to go out and really change behavior. You’re going for something big, you’re building basically a billion dollar business. And who you’re being is changing all the time, you do have all kinds of different pressures and competitive pressures and all sorts of things like that.

So invariably, I just think, “Oh my God, I must be just producing huge amounts of cortisol.” And the only way I’m able to deal with all of that is really through mindset, through things like meditation, through just getting up and taking the dog for a walk. Often having my best inspirations when I’m actually not working. But it’s been a discipline that’s evolved. And it sort of, at least personally for me, it had to get bad before I could actually say, “Okay, I’ve got to be consistent with meditation or exercise or not working crazy long hours.” And that kind of thing.

Efrat LaMandre:

Yes. So for some of us, we have to kind of fall flat on our face before we are like, “Wow, I really have to take this for real.” There’s no doubt. I mean, most of my patients come to me when they’ve hit a wall, like you said, things had to get bad. And there is a discipline around it. But we tend to be very disciplined for other things, like you’ll get your quarterly report done, then you’ll get your monthly reports done and you’re going to have a workflow of how you want your customer experience to be. And any successful entrepreneur, you guys definitely have workflows around things in your business that is very regimented and consistent. And this has to be part of that too. You have to at that workflow for yourself.

If you are at a place, for example, where you have advisors, if you have the CFO or a bookkeeper or an accountant, you also have to have advisors for you as a person. So whether that means a personal trainer, whether that means a mental health coach. The same thing that you are giving to your business, you have to give to yourself with the understanding that it is literally the heart of the success of your business.

I love that you mentioned time with your dog because time with your dog is so helpful in many ways. Anyone who has a pet, I’m going to tell you right now. First of all, it’s an automatic blood pressure reducer, by the way, multiple studies done on this, this is not just me just mentioning it.

Melinda Wittstock:

Yeah. My dog is my muse.

Efrat LaMandre:

The connection that you have. Yeah, brings your stress down. And here’s the other cool thing. So my entire world is about the microbiome, which is like the belly and the good and bad bacteria that live in your belly and how that affects everything. That’s the heart of functional medicine. But people who have pets have healthier microbiomes. So there is so much about having a pet. So if you’re not sure to get one, go get one right away.

Melinda Wittstock:

Just a hug of my golden retriever and instantly things are better. I’ll be having some issue with something going on and I just look up and he’s just smiling at me. And actually the thing that’s really interesting about a dog, and all animals, they’re in the present moment and they sort of remind you [inaudible 00:30:40] present, because we can so easily be in the past in the future and all this kind of stress. And so I really joke that Augie is my muse in that sense, right? Really, really helps. But it’s interesting. I never knew the link to gut health.

Efrat LaMandre:

Oh yeah. There’s so much linked to pets. And I have to say, having pet is also very humbling because you can feel yourself, be like, “Yeah I’m the man, I’m the woman. I got this going on. I got that going on.” And then you’re cleaning poop and throw up off the floor. And it [inaudible 00:31:13] you right back to like, “Oh yeah, I’m not that special. I’m cleaning poop or throw up off the floor.” And it’s nice, keeps you nice and humble and grounded.

Melinda Wittstock:

So if you were just to look back on your entrepreneurial journey so far, what would be the top three pieces of advice that you would give to other female founders at whatever stage of the journey that they’re at? Based on your own lived experience Efrat, things that you’ve had to overcome. What are your biggest lessons?

Efrat LaMandre:

Did you say specifically for women entrepreneurs?

Melinda Wittstock:

Yes. I mean for entrepreneurs generally, but this podcast is, we do have a lot of male listeners funnily enough, but yeah, geared primarily at women.

Efrat LaMandre:

So I think all the women entrepreneurs know this, that you have to do it 10 times better than your male counterparts. And that is 100% true if you’re thinking that it’s true, it’s 100% true, I’m sorry. So you just have to do better.

Melinda Wittstock:

I always want to persuade myself that it’s not actually true or that’s just in my head, but it is kind of true, yeah.

Efrat LaMandre:

Nope, it’s not. It’s definitely true. So what do I want to say? I want to say that if you’re looking up and you’re looking at someone else who has it all together, guaranteed that if there’s someone that you’re looking up to, they did the work. There really is no easy way to get there. It’s every day, all day, like you said, disciplined, regimented. It’s just like people who are physically look a certain way, they’re working out every single day. If you want to be in a certain place with social media, it’s really grinding and doing the things you don’t like to do, necessarily want to do every single day. So know that these annoying things that you’re doing every single day, they will pay off. And also know that the people who look like it was like no big deal, they did it. I don’t think there’s an easy way to get to wherever it is you’re managing to go, so keep at it.

Melinda Wittstock:

Yeah. 100%.

Efrat LaMandre:

That’s the first thing.

Melinda Wittstock:

Yeah just keep [inaudible 00:33:32] knowing it’s coming, you know?

Efrat LaMandre:

Yeah, it’s coming, but you got to keep grinding. Like it’s day in, day out. Whoever you’re thinking of in your mind that you want to be like, that person is grinding every day. And still is grinding. If they’re on top, they’re still grinding. It’s not possible any other way. It’s funny, I teach at the local college and I will inevitably have one class about how to open up your own practices for nurse practitioners. And I’ll always ask as a trick, “Who wants to open up with their own practice?” And some hands go up and I’ll ask why. And somebody in inevitably will say, well, I don’t want to work as much, I want to be able to go on vacation, I want to… and I was like, “Put your hand down.”

Melinda Wittstock:

That reminds me, I spoke at Google about 10 years ago on this exact, so this group of young Googlers about entrepreneurship. And I did the same thing, right? And about a third of the room was, “Yeah, because I don’t want to have a boss.” Okay. And then another because you have many bosses as an entrepreneur. They’re not necessarily visible, but apart from your [inaudible 00:34:39] your investors or your customer, like everybody’s kind of a boss in a weird way. And then the others were like you, like, “Yeah, I want to be able to take vacation, I don’t really want to have to work.” It’s like, okay next. But the people who said, “No, I just have a burning passion. Like I just can’t [inaudible 00:34:58] do this.” Okay, you guys. You guys are qualified, you know?

Efrat LaMandre:

Yes. So then I say, “I’m going to tell you what it takes to put a practice together. And if at the end of this, you still want it, then it’s right for you. And at the end of this, you want to run because I made you nauseous, at least it’s not for you.” Because I mean I paint the picture, and the ones that are like, “Yes, I still want it.” I’m like, “Okay, you’re in the right place.” Right? So the other piece of advice-

Melinda Wittstock:

Not everybody can handle the… I mean there’s a tremendous amount of deferred gratification, right? Because the tremendous reward at the end. Because basically you’re an alchemist, you’re creating value from nothing. And as you’re putting in all this work to grow the value, you’re going to have, depending on your business model, either it’s a cash thing or you’re spinning off more cash and increasingly passive income.

Or, you have a business like mine where you’re ultimately going to exit it because you’re just growing the the valuation growth. Like in the past 18 months, my company’s gone from being valued at like basically nothing, it was an idea basically two years ago, to closing around that values is at $32 million to the [inaudible 00:36:20] valuation of a hundred million by the end of the year. Okay. But have I paid myself?

Efrat LaMandre:

Have you?

Melinda Wittstock:

my gratification is delayed. That’s not for everybody. It’s hard because you go without things that you would like to have.

Efrat LaMandre:

Oh yeah. You have to live in the land of the gratification 100%.

Efrat LaMandre:

Yeah. I just want to say two more things for your listeners out there. Join a board of your industry. So I sit on the board of the hospital and I sit on the board of nurse practitioners of the state. Join a board. And it might feel like a waste of time, it’s not. You’re going to get something out of it, whatever your industry is. And then be in an entrepreneur group where you are one of the smallest entrepreneurs. Because you will learn, you will feel like, “Oh I don’t want to do this Zoom, oh I don’t want to go on this mastermind.” Go on it. Because when you’re by yourself in your own business, it’s just you and you and your ideas and they’re not enough. They got you here, but if you want to go there, you need to hear what other people are doing. And you can’t really ask your partners or your friends because they tend not to be entrepreneurs. You need to be in a room with other entrepreneurs and hopefully in a room with entrepreneurs that are past you. That has been a game changer for me.

Melinda Wittstock:

Well, we all learn in a couple of different ways. We learn from people who’ve been there, built that before us. And those people tend to be quite generous. Like they’ve succeeded and they like to give back. But we have to develop the muscle to actually ask for help, which is something that I’ve seen a lot of women, including myself in my own journey, really have to learn how to exercise that muscle. Asking and actually being willing to receive. So that’s one thing, but also surrounding yourself with great mentors and advisors and coaches is absolutely critical for the very reason that you said. It’s so easy to get isolated and alone in this, because there’s very few people who really understand what you’re doing. Like your friends and family, even with the best will in the world, they don’t really understand. They don’t know, they’re not one.

Efrat LaMandre:

Yeah, no, they don’t get it.

Melinda Wittstock:

So they will say what they think are supportive things to you, but they may be the exact wrong thing to say, because they may be living out their own fears or they just don’t [inaudible 00:38:54] and they mean well, but they’re not helpful. So it really has to be from other people who’ve lived a kind of entrepreneur thing and can provide you with the sort of advice or just moral support that you need at all these different [inaudible 00:39:17]

Efrat LaMandre:

Because a non-entrepreneur will say, “Well then then just don’t do it, if it’s so stressful or just [inaudible 00:39:26]” I’ll be like, “What? You’re supposed to tell me to go harder.”

Melinda Wittstock:

Exactly. No, it’s really true. And it’s just even with your own team because as you grow and you hire employees, those folks are not entrepreneurs and we can think we want them to be entrepreneurs like us, but they’re not otherwise-

Efrat LaMandre:

They’re not, exactly right. So I’m going to recap those three things and then send something specifically to women. So one is keep grinding because no one gets on top without grinding, right? Second is join a board and third is entrepreneur group. But specifically for women,.

Melinda Wittstock:

Yes.

Efrat LaMandre:

It is not possible to do it all. So when you’re killing it at work, you may not be at your kids’ play. And when you’re at your kids’ play, you might not be killing the deadline at work. And that’s okay. Nobody can do it all. It is not possible. I raised my children, my children are now all… one’s going into college, the other two are post college. I raised my kids in my office. Other moms were baking cookies and that is awesome, I didn’t.

And I felt guilty the whole way, I came to some things I didn’t come to other things, they Ubered at a very young age. I felt guilty the entire way. This is something that is very specific to women because I wasn’t at every event at everything. But I just had dinner with my adult kids and the things that they said about me as they watch me at work, I couldn’t believe they were talking about me. So they are loving it, they love you. It’s okay that you miss the play because what they’re learning from you and what they’re seeing and what you’re bringing to their life is just as valuable, if not more valuable than being at every play. So it’s okay that you can’t do it all. In fact it might be even better.

Melinda Wittstock:

So, so beautiful. So Efrat, I want to make sure people know how to find you. And obviously if they’re in the New York area, use your services or all the best ways that they can connect with you or take advantage of all the other programs and things that you offer, what’s the best way?

Efrat LaMandre:

I appreciate it. So it’s called the KNEW method. New is spelled with a K because you always knew there was a better way. And you can really see me on every platform, YouTube, podcasts, Instagram, Facebook website is called theknewmethod.com. If you’re just interested to hear what functional medicine is about, just listen to, I really give a lot of content out there. I also have a book called It’s Not in Your Head. And if you message me on any platform, my team and I check 24/7. So you will get an answer back. That’s basically how to reach me.

Melinda Wittstock:

Fantastic. Well thank you so much for putting on your wings and flying with us.

Efrat LaMandre:

Thank you so much for the opportunity to do so, it’s been a pleasure.