By Dr. Keith Roxo, Guest Writer

When starting a medical consulting business, there are many factors to consider. You need to think about the scope of the business.

  • Is this intended to be your full-time job?
  • Is it intended to be a side hustle with the possible option to become a full-time business?
  • Will you always perform this work solo, or do you intend to have employees?
  • Are you going to work in person, or will it be remote/virtual?
  • Perhaps the most important aspect of starting a medical consulting business is to figure out what you have to offer—what is your niche?
  • Where do you go for guidance on how to start a business?
  • How will you stay organized?
  • How will you deliver your product to the client?

There are many resources to the point where it can be overwhelming—a paradox of choice.

I had known that I wanted to work for myself for a long time so I had been reading various books and consuming other resources either online or in person over an extended period of time. This article discusses how I found my niche and what tools I found to be very beneficial. You may find some benefits to learn from my experience.


Finding a Niche for Your Medical Consulting Business

My name is Keith Roxo. I am a Top Gun graduate fighter pilot, and I have an FAA pilot certification to fly airliners. I am also a physician that is board-certified in Aerospace Medicine. That is my niche.

I wanted to start a business that I could do part-time while still in the military but would be something I could easily transition to when I finally leave active duty.

During medical school, I considered other specialties, but my love of aviation won out. In training, I was criticized by some attendings for “not wanting to take care of sick people.” But there are many pilots who get sick, too, and they need help getting better. And they need to get back to their livelihood.

Pilots need to meet very specific medical standards to fly. For the pilot, the relationship between them and the physician is generally seen as one where they can only break even. If you were medically qualified before your exam, the best you could do is still be medically qualified after. But if you had a problem, that might put an abrupt halt to your flying. When a pilot seeks their FAA medical certification via a physical exam with a qualified Aviation Medical Examiner, they can receive their certificate, be denied their certificate, or be deferred to the FAA for further evaluation. A deferred evaluation can take 6-12 months—maybe even more.

I wanted to be the kind of doctor I want as a pilot. Because of my background, pilots tend to trust me more. Once I showed that I could help people medically and keep them flying, I developed a bit of a reputation in my area. Soon, pilots from other units—other bases even—were asking me for help.

One day, a military reserve pilot asked if I could help a friend of his. I said, “Sure, have him make an appointment.” But this friend was not in the military; he was a civilian airline pilot. He could not come to my clinic on base. I eventually realized that I didn’t necessarily need to be the treating physician and the flight doctor; I just needed to give pilots the guidance they needed to work with their own doctors.

A good friend of mine from flight school went to medical school as well. Truth be told, he did it first, and I stole his idea. He was noticing the same things I was. We decided to join forces, and the combination of our backgrounds and expertise put us in a position to capitalize on a niche of medicine that is largely unknown and underserved.

We call our business Wingman Med and that's who we are—pilots helping pilots achieve FAA medical certification with confidence. As pilots and physicians, we speak the language of both professions. We have the expertise in aviation medicine to help bridge any gaps in understanding the FAA medical certification requirements. For clients who may get deferred, we can reduce that time to an average of 0-4 months. For professional pilots, that is the difference between full-time income and whatever disability they have. For recreational pilots, it means they can get back to what they love faster.

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Inspirational Resources to Build Your Business

Having the ability to do the work can get you a job, but that isn’t enough to build a business from scratch. You need to be concerned about the long-term plan from the beginning. There are several books that heavily influenced us in the early stages of development. I believe these two were key to our faster-than-expected growth.

One book is called Company of One: Why Staying Small Is the Next Big Thing for Business. The staying small concept really appealed to me. Having been part of an extremely large bureaucracy—the military—for several decades, I wanted to be free from the rigidity that large organizations have. The book discusses how you can focus on providing superior service in order to charge a premium.

Another interesting concept from the book was that you can never give away too much free information. You are effectively highlighting your own expertise, and chances are the client’s issue is complex enough that they will still need you. We decided to develop regular blog posts and offer free initial consultations. Sometimes, we can help a pilot in just 15 minutes because it just isn’t as complicated as they assume. But if we can’t, we can explain the situation and how we can help. Many of our Google reviews are from clients who didn’t pay us a dime. But they send us a lot of referrals.

Another book that was very helpful was Building A StoryBrand: Clarify Your Message So Customers Will Listen. It provides a basic roadmap for how to set your initial marketing strategy that is baked into the core of your business. The overarching message is that you make your customer the hero of their own story. The customer is Luke Skywalker, and you are Obi-Wan guiding them to their own success. In our case, the customer is the flight lead, and we are their wingman.

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Maximize Business Efficiency

As an entrepreneur, you are doing EVERYTHING when you first start. Much of it is completely new to you. Efficiency is vital to effectively produce work, but you also need it for growth. And when you start from scratch, you need to grow. I wanted to deliver a highly personalized service but one that was relatively scalable. This is a tough combination to make, and maximizing efficiency is the only way I could think of to do it.

We chose Google Workspace because it is a pretty well-integrated office suite that can work from virtually anywhere and on any device. But even Google doesn’t have all the answers.

We need to review a fair amount of medical records. Some people are not comfortable emailing them. Files attached to the bottom of an email can easily be missed when dealing with a multiple-reply situation. Most email clients have file size limits. By using a secure document delivery service (we chose Content Snare), we can use branded and customized requests to gather information from clients. It integrates with Google Workspace and automatically drops the files in the client’s folder saving significant organization time. Content Snare also lets you limit the file types. By setting it to only accept PDF files, we don’t have to worry about doing any file conversion on our side or asking the client to send something again but in a different format.

One of the biggest things we did was deciding to use Customer Relationship Management (CRM) software to make sure we were keeping track of everything. We had started with spreadsheets and then task management software, but after a few iterations, we ended up deciding on a CRM. It really has been a game-changer. After trying out a few different options, we are using

top gun fighter pilot

Another critical time-saver was the use of web-based scheduling services. It used to take 3-5 back-and-forth emails to coordinate a good time for a free consultation. Now I just set my availability, the duration of appointments, and some other criteria, and the client gets to pick a time that works for them from a branded web-based interface. After evaluating many options, we chose Calendly. For setting up phone or video meetings, it is the best option. If you want to incorporate face-to-face events with additional capability, check out Acuity Scheduling.

Some things like Content Snare and Google Workspace have native interaction, but not everything does. To smooth out other processes, there are dedicated integration software services. When a client clicks on the “free consult” button on our website and fills out the information, it is automatically captured in our CRM software. If they book a consultation, it is automatically added to my calendar. If a client wants to sign up, I click a button in my CRM software, and all their necessary information is pushed to our billing system—no redundant entry that takes time and adds another place for user error. When the client pays, I click another button, and their information goes to the document service where I can easily customize a request.

Other services we are using: QuickBooks Online for bookkeeping and payroll (if you know your company will have many employees, you should look at Gusto for payroll and HR support), Stripe for payment processing, Constant Contact for social media posts and newsletters, Bigstock for photos, and Adobe Acrobat Pro for final document creation.

Here is a breakdown of some of the operating costs:

  • Google Workspace: $12/user/month
  • Content Snare: $1,000/year
  • $16/user/month
  • Integrily: $240/year
  • QuickBooks: $135/month
  • Constant Contact: $70/month
  • Adobe Acrobat Pro DC: $290/user/year
  • Dropbox Fax: $9.99 per month

Average that out, and it is a little under $600 a month. This is for our daily working tools that let us operate smoothly and efficiently. Much of our operations are automated, except for decision points and client interaction. This saves incredible amounts of time and limits potential errors. We also have advertising fees of about $1,000 a month, but that is going to vary based on chosen campaigns. Website development and hosting fees, along with SEO fees, will vary depending on what we feel we need to do.


You May Never Work Harder for So Little Money

We have been very fortunate that our consulting business has grown even faster than expected. We started in March 2021, and initially, growth was slow. But we leaned into avenues of exposure, analyzed what was working vs. what wasn’t, and capitalized on those things. We are playing the long game. Since this is a side job while we are still on active duty in the military and since the volume increased faster, and more, than expected, we had to get help and improve our efficiency.

We hired one of the nurses I had worked with before for a full-time role. We had an excellent working relationship, and I knew she was a quality person and nurse. But it also added complexity by having to figure out payroll and benefits. We put a lot of time and energy into discovering ways to maximize efficiency, and we are also bringing on a second nurse and looking to bring on a contract physician.

A lot of family time has been sacrificed. Many of my hobbies have been completely ignored over the last two years. But I think we are building something with real staying power.

To date, my nurse has made more money than I have from the business. That is partly because we pay her well but also because we are continuously putting the money back into the company.

It was more than a year and a half before we paid ourselves any salary. Heck, it was over a year before we were in the black. We were putting everything into the company from website development, search engine optimization, advertising, trade shows, etc. We have started to pay ourselves, and I think that we are at a place where we can pay ourselves regularly while still having money left over to continue building the business.

The work doesn't stop, especially not in the early growth stages. It is my business. If I’m not tending it, then it isn’t growing. But the sense of building something successful that lets me work in a field I enjoy is pretty amazing. I get to talk to other pilots almost every day—and I can help nearly all of them.

Can you take any of these lessons to help build your own business? What kind of impact could you make? What are the biggest potential pitfalls? Comment below!

[Dr. Keith Roxo is a Top Gun-trained adversary pilot turned Aerospace Medicine physician. He has more than 2,000 hours in a variety of high-performance military aircraft—including the F/A-18, F-16, and F-5—and he holds multiple military flight instructor qualifications. Keith also holds airline transport pilot and CFII certificates. His medical qualifications include board certification in both Aerospace and Occupational Medicine, and he is a HIMS-qualified FAA-designated Senior Aviation Medical Examiner. Keith provides aviation medical consulting with Wingman Med. This article was submitted and approved according to our Guest Post Policy. We have no financial relationship.]