Dr. Nikesh Seth - Owner, Integrated Pain Consultants

Born and raised in Scottsdale, Arizona, Dr. Nikesh Seth began his journey by studying biomedical engineering and pre-med at Johns Hopkins University. He then decided to return to Arizona to attend medical school at the University of Arizona School of Medicine. He went on to complete his residency in anesthesiology at the University of Texas in 2010, followed by an interventional pain management fellowship at Northwestern University in Chicago.

Dr. Nikesh Seth decided to return home to Scottsdale in 2011 to practice pain management. He worked as a partner at a couple of practices before starting Integrated Pain Consultants in 2016.

Dr. Nikesh Seth is a double board-certified pain management physician and anesthesiologist. He has been voted Top Doc in Phoenix Magazine every year since 2015. He also made the 30 People to Watch in 2017 list in the So Scottsdale! magazine.

When not at the office, Dr. Nikesh Seth spends his free time with his wife and two children, playing a bit of basketball and exercising to stay in shape.

How did you get started in Integrated Pain Consultants? What inspired you to start this business?

Pain management is a unique specialty in medicine. It’s one of the few specialties where you can make a difference in their life immediately. By trying to figure out the underlying reason for someone’s pain, you can then address the main underlying cause and their mechanism that is leading to their pain. And hopefully, by fixing or addressing that issue, you can change the patient’s daily function by removing their pain. That’s a very important reason why I went into pain management because I feel like I have a comprehensive approach to treating a patient. By doing something a little different, you can make a bigger change in the patient’s life and your community.

I like the ability to make a difference immediately in a person’s life as opposed to months or years of working on something. And the gratitude that you get from patients when you can do an injection or something and they suddenly feel immediate relief, and now they’re able to spend time with their family or their kids and go and do things they couldn’t do before. It brings me a lot of joy to see, and it keeps me going. It keeps me working hard.

How long did it take for you to become profitable?

It took a few years to become profitable. There were significant startup costs, and the number of employees it takes to run a medical practice was unexpected. There are a lot of services and procedures we offer that don’t get reimbursed by insurances. Those are costs that we have to absorb as a company, but it does provide excellent customer service. Despite that, we continue to do them for patients without reimbursement just because we believe it will benefit the patient in the long run.

Most of the time, patients don’t realize that insurance doesn’t cover one of their procedures because we tend to treat them the same. We keep going. But it has taken a few years to become profitable. We always have some months where we are not profitable, and we have other months where we are profitable, based on how insurance pays us.

When you were starting out, was there ever a time you doubted it would work? If so, how did you handle that?

I think that’s a persistent problem. We’ve had our practice for about four years now, and that comes up almost every few months, whether I think it’s going to work or not. I know the first six months to a year was extremely difficult because it takes a very long time to get a client base and to get credentials with insurances, and it takes even longer to get paid by some insurances. So, easily for the first six months, you’re in a negative deficit, and then you’re trying to climb out of that deficit for the next year or two.

But I continue to work extremely hard. I continue to provide excellent customer service. I continue to market our practice and built good relationships with other physicians and hospital entities in the community. And this allowed us to continue to grow, continue to bring on more providers. It also allowed us to continue to expand into more offices and more locations around town. But I think the number one reason for the success was our perseverance and our diligence.

How did you get your first customer?

I believe my first customer may have come from the patients that I took care of previously. I used to work at another practice before I started my own. A lot of my patients either searched me out and found me after I left that practice or came from referrals from other physicians we had worked with in the past. They continue to send us patients, and we continue to give them excellent service, so they keep sending us more patients. So, I think the first patient either came from my previous practice or came from one of our referral sources.

What is one marketing strategy (other than referrals) that you’re using that works really well to generate new business?

We do a lot of online blogs and publications that allow the community to research topics on their own. If these topics are of interest to or relate to certain patients, they can click on a link to be directed to our website to get some more information if they feel it will be helpful to them. Then if any of our treatment plans might be beneficial, they tend to call us, and we schedule them for a formal consultation.

We’ve had a lot of patients come in using this type of marketing. It does two things. It not only helps to educate the community about various common pain problems, but it also gives them hope that their pain can be improved or managed.

What is the toughest decision you’ve had to make in the last few months?

The toughest decision I’ve had to make recently has been trying to determine the direction of the company. We were trying to figure out how quickly we wanted to grow or how to become more efficient. In the end, we decided to focus on our current clients, focus on improving our current customer service, and as a result, we will continue to grow.

What do you think it is that makes you successful?

I would say that I’ve been very fortunate to have an extremely great education. I’ve attended some excellent schools across the country because my parents did push me extremely hard, and I believed in working hard at a very young age. So that background and that education allowed me to have a very in-depth knowledge of medicine and also pain management.

But the thing that allows me to be successful is the ability to apply that to patients and think outside of the box. I take on significantly difficult patients that have not found relief at other locations and other pain management practices, and we can make them feel better and solve their pain problems. As that word-of-mouth has gotten out, we’ve created a good name in the community. Our patients have told their friends, their providers, and their doctors about us, so we continue to receive new patients who have allowed our success to continue.

It comes down to a combination of a good education, thinking outside of the box, and providing excellent customer service to our patients.

What has been your most satisfying moment in business?

I would say it’s the little things. It’s the appreciation from a patient, like a thank you card. It’s the patient that comes back for a follow-up appointment and says they have no more pain. I would say that is the constant thing that keeps me going and my consistent happiness for having a business.

What does the future hold for your business? What are you most excited about?

I am excited about our continued growth. We have three offices now. I’m hoping we can continue to keep those offices busy by continuing to get more and more patients and by continuing to serve our community. That’s what excites me the most. I’m continually working on ways to increase our patients and to service more hospitals, nursing homes, and primary care providers, and helping their patients faster.

I like the fact that we are becoming more efficient in our practice. We’re becoming more technologically advanced, and we are offering great medicine. We are helping to fight the opioid epidemic and the opioid crisis by doing proper, well-researched opiate management. And we’re offering the full gambit of intervention, which is possible because all of our providers are double board certified. By doing this, we’re able to decrease the patient’s opiate use and get them more functional. All of these are things I am very excited about.

What business books have inspired you?

7 Habits of Highly Effective People by Stephen Covey.

Rich Dad, Poor Dad by Robert Kiyosaki and Sharon Lechter.

What is a recent purchase you have made that’s helped with your business?

On a small scale, we decided to make a significant investment in technology. We invested in many iPads for our front office so we can streamline the check-in process for our patients and automate a lot of it. This way, patients have more control of the check-in process and their patient information. At the same time, it’s making the process faster at the front desk.

What is the most challenging aspect of working in pain management?

I would say that it’s regulation. Currently, pain management is regulated significantly. It has a terrible stigma because of the opiate crisis, and now opiates are looked upon negatively in society and the community. This is something that we have had to fight and focus on.

Our practice has created policies to help us keep our patients safe, but at the same time, help them with their pain management. We believe every patient is different and unique, so not one single patient falls into a mold, and this is very difficult in our current situation with government and politics. As medical providers, we still have to treat each patient individually. For that reason, we have extensive discussions with our patients where we explain to them opiate and non-opiate ways, and non-pain medication ways to help their pain as well. Then we come up with a good game plan to help them long-term.

If you could discover a cure for anything, what would you choose?

Obviously, I’d love to see a cure for cancer, but I’m not an oncologist so I would leave that to the oncology professionals. In my world of pain management, with the number of patients I see, a cure for migraines and headaches would be huge because I do know how bad migraines can be for our patients and how it can completely limit their functionality. We do treat a lot of patients with both spine and joint issues; however, many of our patients do get significant relief from our intervention. Migraines, on the other hand, have very few treatments that exist except for medications, and all of these medications do have many side effects. Although they might help, it would be nice to have a non-medication based system to help patients with headaches and migraines so they can become more functional.

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