Hunting for a small business idea? Listen to your patients

A column about keeping your practice in good health

By Victoria Stagg Elliottis a longtime staff member. She covered practice management issues and wrote the "Practice Management" column from 2009 to 2013. She also covered public health and science from 2000 to 2009. Posted Sept. 7, 2009.

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Internist Richard Saitta, MD, wanted his patients to eat healthier, so he promoted a Mediterranean-style diet like the one he ate growing up in Europe.

He started teaching cooking classes because patients were interested in following the diet, but needed the skills to do so. Patients said they would like to eat these kind of meals in the hospital, so he launched Mediterranean Meals Inc. to make and sell prepackaged meals to local facilities. Then he created frozen dinners for patients to make at home.

Now Dr. Saitta is selling the frozen meals through major grocery chains around his home in Marco Island, Fla., and in other cities along the East Coast. His four children run the company, which sells 9,000 meals a month.

Dr. Saitta's plan is an example of what experts say is the best way to develop a side business to your practice -- respond to what your patients tell you. That way, you can find an untapped opportunity with a base of customers from the get-go.

"When we started, I financed the whole thing, and now it has become self-funded," Dr. Saitta said. "And when I tested [patients'] lipids and blood sugar and the numbers were lower, that was really the payback for me."

It is fairly common for new business opportunities to emerge from the market you already serve, said Raman Chadha, executive director and clinical professor at DePaul University's Coleman Entrepreneurship Center in Chicago. "And because physicians tend to have pretty close relationships with their patients, ideas come up fairly regularly," Chadha said.

Dr. Saitta was born in Italy, grew up in France and attended culinary school in Grenoble, France. He switched to medicine, but always has had a strong interest in food and nutrition.

Now he gets to enjoy both. The day-to-day production at Mediterranean Meals is handled by his children. But as the medical director, he is the public face of the business. His office, next door to the company, regularly smells of garlic and olive oil.

"It comes back together for me," he said. "It requires a lot of traveling, but it is not full-time. And I'm not ready to retire."

Capitalize on your skills

Experts say physicians who want to start an outside business do well to identify a market interest that matches the doctor's interests and skills.

But building that business doesn't stop there.

Dr. Saitta responded to changes in the market. When sales to health care facilities were squeezed by companies offering "surf and turf" at lower prices, he and his company realized there were other ways to get patients what they wanted and reach their customers. Through a distributor, the company now sells about 9,000 meals a month to local and national grocery chains. The meals, which feature whole grains and organic ingredients, retail for $5.49 to $7.49 each. Monthly revenue is approximately $20,000. A small percentage of the meals are sold directly through the practice.

At the moment, the company is breaking even, and future plans include developing a line of baby food.

Dr. Saitta also found trusted partners: his family members. They brought business and marketing skills he didn't have. Other part-time workers are hired as needed.

Experts say it is critical to recognize both your strengths and weaknesses and link with people who can fill any gaps.

"Generally you cannot create a business by yourself in your garage and have a chance of changing the world," said John La Puma, MD, medical director at the Santa Barbara Institute for Medical Nutrition and Healthy Weight. "Everybody in food and health believes that their practice or service can change lives, and the good news is that it actually can. But you need good partners who complement your strengths to have a successful business."

Dr. La Puma, who is also the cofounder of the health media company ChefMD, is confident in his media and research abilities. But he leaves marketing and producing to a partner with better skills in those areas. Through ChefMD, Dr. La Puma hosts a weekly healthy eating show on the Lifetime cable network, has authored several books and produces a handful of Web sites, including

Experts also said Dr. Saitta was right in not quitting his day job. It allows him to continue to bring the credibility of a practicing doctor to the product and keep a paycheck in case the business is slow to take off.

"Do not give up your day job. You need to not only have the income, but also the structure to continue learning about your area of interest," said Dr. La Puma.

An added consideration, however, that nonphysician entrepreneurs don't have is the need to balance ethical issues specific to the profession.

American Medical Association ethics guidelines advocate taking steps to minimize financial conflicts of interest that can arise from selling products in the health care setting. These steps include disclosing potential conflicts of interest. In addition, any health-related products should be scientifically sound.

Meals are available for sale in Dr. Saitta's office, although it is not part of medical care. The majority of people who buy from him directly are not his patients, but rather customers who have heard of his product, but have not been able to find it in the local grocery.

Victoria Stagg Elliott is a longtime staff member. She covered practice management issues and wrote the "Practice Management" column from 2009 to 2013. She also covered public health and science from 2000 to 2009.

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