Practice Profile: Prime Institute

Urology Times’® Practice Profiles series takes readers behind the scenes of US-based urology practices. From solo practitioners to large groups, each installment highlights these practices’ unique qualities, successes, and challenges. To have your practice featured in this series, please email Hannah Clarke at hclarke@mjhlifesciences.com.

In this installment, sisters Amy Pearlman, MD, and Michelle Pearlman, MD, highlight Prime Institute, the practice they co-founded in South Florida.

Could you provide some background on yourselves and your practice?

Amy Pearlman, MD

Amy Pearlman: I am a board-certified urologist, fellowship-trained in men's health, genitourinary reconstruction, male infertility, and prosthetics. I directed the Men’s Health Program at a large academic institution in the Midwest for nearly 5 years prior to relocating to South Florida to start my own practice with my twin sister, Dr. Michelle Pearlman.

Michelle Pearlman: I am a Physician Nutrition Specialist and board-certified in internal medicine, gastroenterology, and obesity medicine. I was faculty at the University of Miami for nearly 5 years prior to co-founding Prime Institute. My current practice focuses on nutrition and weight management from a [gastrointestinal] GI perspective.

What are some challenges that you faced in getting started? How did you overcome those challenges?

Amy Pearlman: Just like there is never a perfect time to buy a home or have a child, there is no perfect time to make a major career transition. My sister and I were simply both at a time in our lives when we could take a risk to leave a secure, stable, busy academic practice to start our own practice.

The time we spent at our respective academic institutions provided us the opportunity to build a significant foundation of knowledge, expertise, and skill, all of which have been critical to create a solid foundation for our new practice.

What are some wins that your practice has experienced since getting started?

Michelle Pearlman, MD

Michelle Pearlman: Being able to minimize our overhead has been a game-changer. The money we are making is going back into the business to help support its continued growth and innovation.

Amy Pearlman: Because we are business owners, we can pivot in real time as circumstances necessitate. We are currently figuring out the types of services and packages that are of interest to our patients and community members and are making changes to our practice and services in real-time to best accommodate the wants and needs of the people we serve.

Michelle Pearlman: We recently joined the local chamber of commerce, allowing us to rapidly and efficiently network with other South Florida small businesses interested in co-educational events, community engagement, health and wellness, and helping community members maximize the time they have on this earth (particularly relevant in South Florida where there are endless possibilities for entertainment). Despite our businesses and expertise being in very different industries, we are working together to enhance the success of one another.

What conditions do you treat? What services do you offer?

Amy Pearlman: At Prime Institute, I decided to focus my time offering services for male sexual health, male hormonal health, and genital reconstruction. As my practice and team continue to grow, I hope to expand my services to include sexual and hormonal health for people of all genders. My sister often treats the entire family unit. The husband calls in and says, “I want to see Dr. Michelle for weight loss” and his wife chimes in with, "Well, you're not going to be the only one losing weight. I want to schedule an appointment too." Our hope is to offer expertise and services that may optimize the health of the entire family unit when it comes to sexual and nutritional guidance.

Michelle Pearlman: At Prime Institute, although I am a gastroenterologist, I primarily focus on nutrition, sports nutrition, and weight management. The cool thing about nutrition is its profound impact on every living organism. It's not just about eating–it's about eating the optimal foods for the bodies we have today, not the bodies we had 10 or 20 years ago.

I continue to be fascinated by the significant overlap between the needs of Dr. Amy's patients and my patients. A lot of men who struggle with their weight or who report lack of motivation, fatigue, or aren't quite sure what to eat, also have low testosterone or sexual dysfunction. We enjoy being able to offer comprehensive, collaborative treatment plans for our mutual patients.

Amy Pearlman: Both of us have very niche practices at Prime Institute, and yet we are able to offer lifestyle guidance and interventions that address each patient in a holistic fashion. So, even though I'm trained as a surgeon, much of my therapeutic benefit starts with communicating with patients and educating them on the basics of nutrition and exercise in ways that help them make healthier lifestyle choices immediately.

What is the makeup of your staff and the roles associated with your practice?

Michelle Pearlman: I am the CEO, the CFO, the COO. I'm the “logistics” personnel, focusing on the numbers, the finances, the bookkeeping, and the day-to-day operations. Now, I don't manage all of these tasks every single day, but I do oversee the consultants we hired whom are experts in their respective fields.

Amy Pearlman: I get some of the fun titles, like, Chief Research Officer, Chief Marketing Officer, and Chief Outreach Officer. Delegating roles and tasks began with the two of us defining our skillsets and what we like doing.

Now, there are plenty of things that we don't like doing that we still need to do. I'll give you an example: HR. I have zero interest in being the Director of HR, but that's a role that right now I assume–which means I get to hire and I also have to notify employees if and when we need to let them go. Our team is small and, particularly as a new, growing business, we’ve had to let one of our employees go as our practice needs were changing. I had to learn how to navigate this process in a way that was ethical, in good faith, and demonstrated respect for our employee.

Much of what we're learning is not within our fields of gastroenterology and urology. Rather, it's learning the basics of succeeding in our other roles (e.g., me as an HR director and my sister as CFO). In academics, most of the people we surrounded ourselves by were other doctors and health care providers. Now, most of the people we surround ourselves by are bankers, accountants, lawyers, folks in hospitality, fashion, and the restaurant business.

Sickness is treated in hospitals and clinics. Wellness happens when people make healthy lifestyle choices in their everyday lives. Our mission is to collaborate with local business that make it easier for people to make healthy lifestyle choices.

What are some unique elements to your practice?

Michelle Pearlman: There are 3 that come to mind, which are basic, but critical.

Time. Most of my initial consultations are anywhere from an hour to an hour and a half, sometimes 2 hours. But our schedule is built in a way where if someone needs to talk to me for 2 hours, then I sit with them for 2 hours. I don’t have to rush and I am never double booked.

Access. Particularly with the services that we offer, many of our discussions are very sensitive. By the time someone realizes they need help for weight management or for sexual dysfunction, they're often ready to get on a program—the last thing they want to hear is, "You'll see Dr. Amy Pearlman in 4 months.” If people are interested, and if we're the appropriate provider for them, then we arrange for a timely visit.

Preparation and follow-up/follow-through. In order to maximize the time we have with patients during their clinic visits by engaging in meaningful dialogue, we provide patients with personalized resources before and after each visit. These resources include links to videos, society guidelines, articles, and collateral specific to our practice and service offerings. Various online platforms can help organize these resources (we recently started using WellPrept, which allows our team to easily send content to each patient based on their specific concerns).

The follow-up/follow-through is arguably one of the most critical aspects of patient success.

If we're seeing a patient, making recommendations, and then a patient asks, "Well, when can I follow up with you?" and we say, "looks like I have availability in 6 months," we are not setting our patient up for success. Being accessible through our electronic health portal system and allowing patients to follow up when they feel it’s necessary (whether it’s in a week, month, or 6 months) helps engage our patients in the treatment process.

Amy Pearlman: We are able to offer value at Prime Institute because the foundation upon which our practice was founded and is growing is on our ability to offer our patients time, access, preparation, follow-up and follow-through along with our years of experience and expertise in our respective fields.

You can learn more about Prime Institute here.