The Misdiagnosed Practice

Tim Carger
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  • Medicine
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Being brilliant at medicine and building a brilliant business are two different skills. Each week, Tim Carger from Abel Practice, walks into a real medical practice to find the gap between them. Drawing on 20 years inside medicine, across hundreds of medical practices, hospital departments and medical businesses, Tim uncovers what's really costing that practice — revenue, reputation, sanity, and patients — and what he'd fix first if it were his own client. No compliance theory. No generic theories. Just the real diagnosis. The Misdiagnosed Practice, with Tim Carger.

Episodes

  1. Oct 21

    The Most Expensive Feeling in Medicine

    Two months into working with a GP practice, the owner told me nothing was really changing. His words: “I don’t feel as busy as I should.” He was wrong. Revenue was up 17%, without adding a single doctor. Billing per patient was up. Waiting times were down. Patients were happier and coming back more often. Every metric that mattered had moved in the right direction. He couldn’t see any of it. Because he wasn’t measuring his practice with numbers, he was measuring it with a feeling. And here’s the cruel part: the improvements themselves had made him feel less busy. So by his instrument, getting better looked exactly like failing. Busyness is the most seductive false metric in medicine. It’s always available, it costs nothing to check, and it’s trained into every clinician from their first year in hospital. It also measures effort, not outcome, and if it’s the instrument you’re using, every improvement you ever make is going to feel like a loss. This one’s different from most episodes of this show. It’s a practice that was genuinely getting better. The owner just had no way of knowing. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  2. Sep 1

    Your Practice Manager Isn't Managing

    I was on a scheduled call with a practice manager. Booked in advance, in the diary, a proper conversation about how her practice was running. In forty minutes, she was pulled away three separate times — a payment terminal, a patient question, a printer. She was excellent at her job. That's what makes this episode worth your time. Because she solved every problem that came to her that day, and not one of them was hers to solve. The obvious read is that she's overloaded and needs help. The real diagnosis is something else entirely, and it explains why this problem gets worse the better she is at her job. If you're an owner, this episode will tell you what you're actually paying for. If you're a practice manager, you've probably been interrupted twice since you started reading this. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  3. Aug 25

    Four People. Four Different Answers. One $250k Problem.

    I was checked in, sitting in the waiting room, ready for a procedure I'd booked over the phone the day before. Then the technician came out and told me they couldn't do it. They didn't have the equipment. They never had the equipment. And when I asked how I'd got that far, nobody in the building could tell me. Four separate contacts with the same practice. Four completely different answers. And here's what makes this episode worth your time: not one of those four people was lying, lazy, or unhelpful. Every one of them answered honestly, based on what they genuinely believed. That's the actual problem, and it's not a training problem or a hiring problem. In this episode I work out what it's really costing a practice like this, and the number is bigger than you'd think. If your patients get a different answer depending on who picks up the phone, this one's for you. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  4. Aug 18

    You Are Blockbuster

    I walked into a GP clinic in one of Melbourne's most affluent suburbs. The garden was let go. The light post out front was broken. And the plastic protective wrap was still on the chairs, never once taken off. This episode isn't about a clinic that's tired. It's about one that stopped trying, because for decades, it never had to. What most people would notice is a facilities list. What I noticed is a practice built entirely around itself, quietly leaving the door open for every patient's need it never bothered to solve. For a long time, that didn't matter. It doesn't work like that anymore, and if you've ever wondered what happens to a business that keeps optimising for itself long after the customer has other options, this episode has a very familiar answer. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  5. Aug 11

    The Referral Black Hole

    A specialist practice quietly loses one of its best referral sources. No falling out, no complaint, no single bad day to point to, it just fades. And when I finally worked out why, it had nothing to do with the medicine at all. In this episode, I walk through what actually happens on the other end of a referral, and why a referral isn't a transaction, it's a subscription. One the referring GP can cancel any time, silently, without ever telling you why. It's a two-sided story: what it looks like from the specialist's chair, and what it looks like from the GP's, because if you've ever sent a referral into a black hole and wondered what happened on the other end, this episode is for both of you. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  6. Aug 3

    The Doctor Was Brilliant. I Almost Left Before I Met Him.

    One of the best specialists I've come across, genuinely excellent, empathetic, gave me 45 minutes and complete clarity. And I nearly walked out before I ever met him. In this episode, I walk you through a real specialist practice; from the car park, to the front desk, to the waiting room — the 45 minutes before the consult that the specialist himself never sees. What most people would notice is a front desk that needs some polish. What I noticed is something much bigger: the most valuable asset in the entire building, quietly being devalued by the cheapest parts around it. If you've ever wondered why a brilliant clinician can still end up with an average online reputation, this episode is your answer. Curious how your own practice stacks up? Take the free Practice Pulse Diagnostic: https://forms.gle/9aGnZfMK6ubVrHGx5

  • 6 Episodes

About

Being brilliant at medicine and building a brilliant business are two different skills. Each week, Tim Carger from Abel Practice, walks into a real medical practice to find the gap between them. Drawing on 20 years inside medicine, across hundreds of medical practices, hospital departments and medical businesses, Tim uncovers what's really costing that practice — revenue, reputation, sanity, and patients — and what he'd fix first if it were his own client. No compliance theory. No generic theories. Just the real diagnosis. The Misdiagnosed Practice, with Tim Carger.

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