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April 21, 2019
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It’s Easter Sunday, at least for most of the world. I’m Greek Orthodox, and our Easter is next week, so today is our Palm Sunday, which means tomorrow is Chocolate Bunnies and Peeps on Sale Day! Whatever your religion or beliefs, it is a time to reflect on life’s journey since last year, and the new lessons learned along the way. I know I haven’t posted a blog since Christmas because (thankfully) I’ve been too busy, so for inspiration, I looked all the way back to one of my first blogs (Reflections after Week One), and made a few modifications:

  1. There are a lot of good people out there who want you to be successful. I already thanked the people who helped me get started, but I would be remiss if I didn’t thank the people who helped me keep it going- besides Stacey and Benny, of course! Special mention to Jessica Browning Schraufnagel from St. David’s, Kristen Largent from Ascension Seton, and Cindy Gall from Austin Cyberknife for introducing me to primary care providers that have been sending me patients, Crystal Lilley Boynton from AthenaHealth for her unwavering support, Zack Ragsdale from Catalyst Consulting for convincing me that (almost) every insurance is worth taking the first year, and finally my accountant Greg Caudell, who was (and still is) the steady voice of calm optimism when I would “occasionally” freak out about how bad I thought things were going.

  2. Sometimes, you have to do this alone. Business startups are all about controlling costs, which means you can’t pay people just to sit around, waiting for the phone to ring. That means everyone has to wear many hats, including you, Doctor, so when all your phone lines are busy, or you give your employees the afternoon off, you have to be willing to occasionally wear the receptionist hat and answer the phone yourself. When I first started doing this, I was worried that patients would find it weird or unsettling. However, I soon realized that it gave me a closer connection to my patients that they never experienced before, and while they are initially caught off-guard when I answer the phone, they appreciate that it is not somehow beneath me to talk to them. Additionally, I have also gained a much deeper appreciation of what my employees have to endure.

  3. Not everyone should do this. Contrary to my original blog, I have to admit that starting your own medical practice is not for everyone. These days, there are serious headwinds, and you have to have serious stomach lining to put up with the ups and downs. You also have to be comfortable with the fact that you will not be able to pay yourself for at least 1.5 to 2 years. I heard this from multiple sources in different industries, and I didn’t want to believe it, but it’s true. Save it up, borrow it, or pay yourself from a previous startup, but plan on being the last one paid. I am glad to say I am well on my way, and it has not changed my opinion of whether or not this was the right decision for me. Hands-down, I would do this again, and I have already started to coach others on how to do the same successfully, but this is one of the first pearls of wisdom I share with them.

And with that, I hope you all enjoyed a joyous Easter with your family, and I look forward to doing the same, while feasting on roasted lamb, next weekend!

December 25, 2018
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As 2018 winds down next week, we will be reminded about what a terrible year this has been. To recap, we witnessed:

  1. Catastrophic hurricanes in North Carolina and Florida, and deadly wildfires in California
  2. Mass shootings in Parkland FL, Santa Fe TX, Pittsburgh PA, and Thousand Oaks CA
  3. A growing refugee crisis on our southern border
  4. Numerous government scandals, indictments, resignations, and now a shutdown
  5. And most recently, a stock market that has fallen nearly 20% (so far)

Tragic events have also hit close to home, as some of my closest friends are dealing with serious illnesses. It is easy to get despondent, but it’s Christmas Day, when we should all look for a glimmer of hope and optimism. Like many of you, I spent this morning enjoying the look on my kids’ faces when they opened their Christmas presents. Not being satisfied, I played old tapes of past Christmases, when they were even more joyful! I can’t say that most of those toys lasted a year before they were broken or forgotten, but the memories of being together at Christmas will last a lifetime!

Like many of you, at Greater Austin Urology, we’ve also seen our ups and downs this year, but I remain focused on True North, and what it will take to get us there. Everything else is just a detractor and a temporary road-bump. I can’t help but think of the words of the late comedian George Carlin, who said it best: “Don’t sweat the petty things…and don’t pet the sweaty things!”

May the blessings of the Holiday Season be with you and your family. Merry Christmas, everybody, and best wishes for a healthy and prosperous 2019!

October 31, 2018
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Howdy folks! I know it’s been far too long since I last wrote on my blog, but it’s Halloween, and the holidays (even Pagan ones) have a way of inspiring me to reflect on the past and write about it.

October has been a truly historic month for Greater Austin Urology. We saw a record number of patients and made a little money accordingly, which is always nice when you’re starting out. I performed my first robotic prostatectomy (with the expert assistance of my good friend, Dr. Sandeep Mistry). And we launched an innovative treatment for prostate cancer, HIFU (which stands for high-intensity focused ultrasound). Our first 2 patients were already out dancing and jogging less than a week after their surgery. If it’s as good as advertised from a cancer-cure standpoint, it will truly be a game-changer!

Most importantly, we have an entirely new team, with some familiar faces. Stacey Hardt is our new office manager. She worked with me in a similar capacity at my previous job, and for some strange reason, she was willing to take the plunge and do it again! Joining Stacey is my new nurse, Benny Reeve. He was my very first nurse at my previous job, and I watched him climb the ranks to become an RN. He has a regular job, but luckily for us, he was willing to help us out in clinic a couple of days a week.

Finally, this month was historic for others as well. Speaking of my previous employer, on the first day of this month, they announced plans for a $14 billion merger with the largest hospital system in the Houston area. Or was it an acquisition, in which case, who bought whom? Doesn’t matter. 14 years ago, another relic from the 19th century, K-mart, bought/merged with Sears in an $11 billion merger. And, wouldn’t you know it, this month they also made history, only this time it was by declaring bankruptcy. I guess bigger isn’t always better, especially when you don’t adapt to changes in your industry and take your employees and customers for granted, while your competitors and new industry disruptors continue to crush you on service and price.

Now that’s spooky scary- time to go trick-or-treating! Happy Halloween, everybody!

April 26, 2018
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Howdy folks! I know, it's been a while since my last Blog, but I've been busy trying to Make Urology Greater Again. Plus, I've been searching for something meaningful and positive to say, since my mom thinks my past blogs sounded a little bitter. What do you think?

Overall, I'm alive and well in the great city of Austin, TX, so life is good. Greater Austin Urology is gradually filling up with patients, both old and new. I have performed my first 2 robotic cases, and they went well. And on April 12, we celebrated our second month in business with a Grand Opening/Open House at the office. Many thanks to everybody who pitched in to make it successful: Glen Dyson and Lance Gay from Cogentix, Britney Blankenship from Touchstone Imaging, Danny Williamson from 180 Medical, Landon Groff from J&R Medical, and last but not least, my parents Nick and Vasso Jacomides, for coming all the way from Houston to bring baklava!

Of course, there have been some down moments too. Starting and running a business, especially a medical practice, is not easy. There are serious headwinds that eventually force many of the small fish in the ocean to seek power in numbers, whether it be with big hospital systems, big multi-specialty clinics, or big single-specialty practices. I really think there are a lot of people out there who want to see me and others like me fail, but I keep looking for allies to help me win the battle. Unfortunately, while attending one of those meetings yesterday, my car got broken into and my laptop was stolen. Don't worry- all of my data is password-encrypted, but it still sucks nonetheless. I feel like the only doctor who had a worse week than me was Ronny Jackson, Trump's doctor and failed pick for VA Secretary!

It's easy to get despondent, but lately whenever I start to feel this way, for some strange reason (for which I'm sure I will catch a little grief), I think of the words to the song "Roar" by pop diva Katy Perry:

"You held me down, but I got up. Get ready 'cause I had enough. I see it all, I see it now. I got the eye of the tiger, a fighter, dancing though the fire, 'cause I am a champion, and you're going to hear me roar, louder, louder than a lion, 'cause I am a champion, and you're going to hear me roar!"

I know, make fun of me all you want, but the best days of Greater Austin Urology are ahead of us. I won't go down without a fight, and it's going to take a lot more than petty larceny to get me down. So time to jump on the bandwagon, everybody, because I am a champion, and you're going to hear me roar!



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