In a candid solo episode of the Nico Misleh podcast, host Nico Misleh lays out a simple but powerful habit that changed the way he ran his clinic and scaled his practice. This episode is aimed squarely at clinicians and small clinic owners who feel trapped by daily operational demands. Nico argues that taking one dedicated day away from patient care each week is not indulgent. It is strategic. The goal is to move from working in the business to working on the business.
Why One Day Off Matters
Nico explains that many new clinic owners maximize face time with patients out of fear and scarcity. Early on, it feels like every minute in the clinic must equal revenue. That mindset keeps clinicians stuck doing repetitive tasks that an employee could do. Over time, it prevents growth. Removing one day from the clinical schedule forces a shift in focus toward systems, growth, and relationship building.
“Work on your business, not in your business.”
That idea anchors this podcast episode. Nico points out that seeing patients brings needed revenue, but it rarely builds sustainable systems, referrals, or operational efficiencies. The dedicated day off creates a predictable window to tackle the important work that is otherwise deferred to nights and weekends.
How To Pick The Right Day
Nico recommends using data rather than intuition. Review your EHR and practice manager reports to identify your lightest day of the week. Most clinics have one day where appointment volume is consistently low. That is the ideal candidate to reserve for business work. For Nico, Tuesdays were the least busy. Your day may be different, and that is fine.
What To Do On Your Day Off
Nico’s weekly day was never a vacation. It was concentrated, high-value work. Typical activities include:
- Operational Audits: reviewing profit and loss, spotting weak spots in workflows
- Patient Experience Improvements: addressing recurring complaints and system fixes
- Networking: meeting referral partners such as physical therapists, chiropractors, and gym owners
- Marketing Experiments: testing ads, social content, or outreach strategies for exposure
- Administrative Catch-Up: email triage or strategic hiring plans
Many of Nico’s Tuesdays were packed with back-to-back networking meetings. He deliberately traded immediate clinical revenue for long-term exposure and word-of-mouth gains. Those in-person conversations led to steady referral streams and meaningful partnerships.
Overcoming The Scarcity Mindset
One of the most honest parts of the episode is Nico’s admission that the decision to take a day off felt risky. It challenged family expectations and the “always grind” mentality inherited from previous generations of business owners. He emphasizes that taking a day away from seeing patients does not doom the practice. Instead, it allows the owner to apply their unique skills where they are most effective: building systems, delegating, and strategizing.
Balancing Family and Work
Nico shares how the weekly day allowed him to reclaim time with family without sacrificing business momentum. The focused workday eliminated many evening and early morning tasks. As a result, he was able to occasionally make breakfast for his kids and be present during moments that matter. The point is practical: strategic time away from clinic hours produces both business gains and personal wins.
Practical Steps To Start
For clinicians who feel nervous about a full day off, Nico suggests a gradual approach:
- Start with a half day, preferably in the morning. Mornings are less likely to be interrupted by late-day spillover.
- Block the time on calendars and communicate it to staff and patients.
- Use data to choose the lightest day and commit to testing the change for several weeks.
- If extremely busy, hire or delegate operational tasks so the owner can shift focus to higher-level growth work.
Tie-in With Hormone Replacement Therapy and Medicine Models
Nico connects this operational advice to the practice of Hormone Replacement Therapy and the larger contrast between conventional and functional medicine. Many clinicians launch their own practices because they are frustrated with conventional medicine and want to deliver more personalized care. To build a strong HRT practice, owners must invest time in systems that support quality care: patient education, streamlined labs and prescriptions, reliable follow-up, and community referrals. Taking a weekly day for strategic work makes that possible.
He also points out that different clinicians will lean into different growth activities. Some will enjoy ads and content creation. Others, like Nico, prefer face-to-face networking and relationship building. The key is to allocate time to those growth activities consistently.
Quick Checklist For The First Month
- Pick your lightest day using practice data.
- Start with a half day if a full day feels risky.
- Define 3 priorities for each nonclinical day: Systems, networking, and marketing.
- Track outcomes: Referrals gained, processes improved, hours reclaimed.
- Iterate after four weeks and scale the approach as results justify.
FAQ
Q: Will revenue drop if I stop seeing patients one day a week?
A: Not necessarily. In the short term, you may lose a few visits, but the focused work often produces more referrals, better systems, and higher capacity over time. Think of it as an investment in sustainable growth.
Q: What if I run the whole clinic alone?
A: Start with a half day. Use that time to systemize repetitive tasks and create templates staff can follow when you do hire. Even small process improvements compound quickly.
Q: How should I spend a half day versus a full day?
A: Half days suit administrative work and planning. Full days are better for networking, on-site meetings, and longer projects that require deep focus.
Q: Is this advice only for HRT clinics?
A: No. While Nico framed this within HRT practice building, the principle applies to many types of clinics and small businesses.
Q: How long before I see results?
A: Some benefits appear quickly, such as reduced evening work and clearer priorities. Referral and revenue gains from networking may take several weeks to months, depending on follow-up and consistency.
Join The Daily ConversationNico also invites clinicians and HRT enthusiasts to join his FREE Daily Newsletter for practical tips on HRT and clinic operations that help you grow your practice while protecting your time.
