I am constantly thinking of new ways to do something or new ideas to bring to fruition. I am also open to changing things from the status quo. Because my operation is small, I can change protocols quickly, to improve the flow of things.
Dr. Celina Nadelman is a clinician and a pathologist who performs the best and most advanced fine needle aspiration (FNA) techniques and diagnostic procedures. Trusted by the finest doctors in the region to provide accurate diagnoses, Dr. Nadelman minimizes the need for more invasive and expensive procedures. One of only a dozen specialists of her kind in the entire U.S., Dr. Nadelman performs biopsies and immediately evaluates the specimen in her adjoining lab. Providing both services under one roof offers patients a one-stop, seamless experience, as well as a fast and accurate diagnosis. She has performed over 12,000 FNAs and has one of the highest rates of obtaining “diagnosable” samples on the first effort, virtually eliminating the need for repeat biopsies.
Where did the idea for your company come from?
I wanted to open a stand-alone, pathologist-run, FNA (fine needle aspiration) clinic that would offer superior “precise” and “accurate” care. However, the sound of Accurate & Precise Aspiration & Biopsy was a mouth-full. Therefore, I chose the wording to reflect what I was trying to achieve while being a bit more memorable. I also wanted the name to be broad enough to include biopsies of all nature (such as performing and interpreting core needle biopsies), in case I wanted to expand in that arena in the future.
What does your typical day look like and how do you make it productive?
On a typical day, I have many patients to see. To start the work morning, I prepare for the day by checking my patient schedule and reviewing each patients’ medical history. Once the first patient arrives, we discuss the upcoming procedure to ensure the patient is prepared and comfortable to begin. With the help of my ultrasound technician, I begin the fine needle aspiration procedure. Once cells are removed from the patient, I review them under a microscope to ensure there is enough material to work with and that the proper type of material was removed. When this is all complete, I bandage the site and review after-care instructions with the patient. I then repeat the same process for all patients I see that day.
As a pathologist, I am able to move on to a diagnosis after the biopsy is complete. If the material retrieved from the sample is sufficient, I will observe the sample to make an accurate diagnosis as to what type of material was retrieved. The results will be sent to the patient’s primary physician to discuss results within 24 hours of the initial biopsy.
How do you bring ideas to life?
I discuss ideas within my close circle to my husband and mentors. Then I think of a plan to execute them. My father was an entrepreneur who taught me to be perseverant. When I struggled to make a decision, he would remind me that I can always change the outcome if it does not go as I first expected. This gave me the confidence to take risks that I incorporate into my decisions today.
What’s one trend that excites you?
Molecular testing is an exciting topic in the field of thyroid cytopathology. In cases where the cytopathologist cannot determine if a sample is benign or malignant (atypical nodules), then molecular testing is an alternative next step to surgery. Companies like Afirma and Thyroseq are paving the way for molecular pathology by offering tests that look at the molecular signature of a benign thyroid nodule, or look at genetic alterations that predict the probability of malignancy, respectively. These tests help patients and their physicians decide how to proceed with treatment.
What is one habit of yours that makes you more productive as an entrepreneur?
My creativity. I am constantly thinking of new ways to do something or new ideas to bring to fruition. I am also open to changing things from the status quo. Because my operation is small, I can change protocols quickly, to improve the flow of things.
What advice would you give your younger self?
First, take out a larger business loan. You need money to make money, and it’s been hard to get things off the ground. I would also tell my younger self that a large part of my job will be educating other doctors and the general public that I exist! Many doctors have never heard of a stand-alone FNA clinic, since FNAs are more often performed by radiologists, surgeons, endocrinologists, etc. They are usually surprised to meet a pathologist who “sees” patients in an office.
Tell us something that’s true that almost nobody agrees with you on.
One of the things I ask for is for patients to be off of blood thinners, such as aspirin or NSAIDs for 7-10 days, provided it won’t put the patient in danger of a catastrophic event, like a stroke or heart attack. The reason for this is purely for microscopic purposes because as a pathologist/cytopathologist, I know what it takes to get a good sample, and what it takes to make a correct diagnosis. As the thyroid is a vascular organ, I like to minimize anything that would jeopardize the specimen, such as a bloody smear. By avoiding aspirin, I can get a better sample which makes diagnosing the mass easier and more accurate.
When I proposed this practice to colleagues working on expected practices for FNA doctors, people balked at the suggestion. One radiologist claimed it would delay the procedure and hamper the flow of patients to his FNA clinic. From my own empirical evidence of being in practice, when patients came to clinic or my office without stopping blood thinners, there was an increased rate of non-diagnostic samples, which meant the patients had to come back for a repeat biopsy. The cessation of blood thinning medication did not hamper the flow in my clinics either, so I still stand by this practice.
As an entrepreneur, what is the one thing you do over and over and recommend everyone else do?
I recommend everyone else learn to keep a close eye on your money. Out of necessity, I taught myself how to bill insurance companies for medical services rendered instead of paying a lot of money to outside billing companies to do it. However, it isn’t always easy. Insurance companies are in the business of avoiding payments and looking for loopholes to short payments. I want to be able to give proper superior care to as many people as possible, regardless of their socioeconomic status. So, I had to take control of my billing situation and learn how to maneuver the insurance companies.
What is one strategy that has helped you grow your business?
My business has grown through direct mail marketing and word of mouth. By building my reputation, people in turn will learn about my business. My referrals have grown because of the quality of my work and the trust level I’ve established with the doctors who refer me. They know I am accurate. More recently, I incorporated public relations internet marketing into my strategy. As a niche physician, potential patients may not know what to look for. By having my name and story online, people have the opportunity to learn about what I do and how to contact me.
What is one failure you had as an entrepreneur, and how did you overcome it?
One failure I’ve experienced is being too trusting of my staff and not providing enough oversight. This led to incomplete work, disorder in the office, and in worst cases, embezzlement. I have had to completely change my leadership style to micromanage all activities in my business from incoming mail to outgoing funds.
What is one business idea that you’re willing to give away to our readers?
One business idea I had is to open an American bakery food truck in Rome or on the coast of Italy because American desserts are so much better than Italian ones. Feel free to use this idea!
What is the best $100 you recently spent? What and why?
I recently bought a $100 massage for my husband and myself. I suffer from neck and back pain, so an exceptional massage is a great way to unwind as well as re-invigorate.
What is one piece of software or a web service that helps you be productive? How do you use it?
I use a homegrown software that allows me to accomplish all of my daily tasks. On top of that, I use the Google Suite office program to run my business. Google Calendar is especially helpful for me to set up appointments with patients. This software is so user friendly, organized, and it keeps my business efficient.
What is the one book that you recommend our community should read and why?
“Start with Why: How Great Leaders Inspire Everyone to Take Action” by Simon Sinek. In life and in business, it is crucial to focus on why you are motivated to do something before taking specific actions. Finding your “why” and letting it guide your choices will empower you and inspire others. Simonk Sinek also has a Ted Talk on the subject that is very enlightening.
What is your favorite quote?
“Haste makes waste.” This quote reflects my love to repurpose things. As the daughter of a Holocaust survivor, nothing in my childhood home was thrown away unless it was rotten, worn through or not usable. For example, I like to make delicious meals from left over dinners. The creative process in creating something from nothing is something I truly enjoy.
Key learnings:
• Strive to be creative and always be open to changing the status quo. By avoiding stagnancy or repetitiveness, it can provide unexpected improvements to your life and business.
• It is important to believe in yourself, even when others may not agree with your way of thinking. Just remember some ideas that work great for you may not work as well for others.
• Establish a circle of people you trust who will support and encourage your new ideas. If you doubt your ideas without the feedback of people who support you, then you may give up on a valuable opportunity.
• Do not be afraid to take risks! In life and in business, you can always change the outcome if it does not go as you first expected.
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Mario Schulzke is the Founder of ideamensch, which he started a decade ago to learn from entrepreneurs and give them a platform for their ideas.