Paul Vigario on Scaling Medical Practices, Building Wealth, and Winning With AI

We cover three core topics, how to make money, how to invest money, how to give it a charity. This gentleman has done all three.

“Now, as you guys know, this episode will be under 40 minutes because the average workout”

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I actually physically work with them. So I've kept this podcast clean so that you can listen to this entire episode and there's not gonna be any commercials whatsoever. Now, without further ado, we're going to dive right into these three core topics. We're going to ask all the questions to Paul Vigario when he's going to do is give you

the quick two minute bio so we can get straight to the money. >> All right, my name's Paul Vigario. I'm the founder of SurfCT.com. I started my business over 25 years ago. We've worked with over 12,000 doctors and private practices in general over 36 billion.

It's a big number. 36 billion in health care revenue for doctors and health care. >> Okay, even though there was only 27 seconds, there's a lot of unpack there.

“These doctors and dentists and how do they come to you?”

How do they find doing why do they need SurfCT? They find us through our reputation or body of work. I also speak at a lot of universities and one of the reasons why they need us is because we help automate their practice and really create massive success for them. I've learned that in business because I'm involved in other businesses as well.

We're involved in a vineyard, we're involved in a restaurant group and I've really learned that all business in the simplest form is two things, attention and compliance. If you can gain attention, then you want to create a path to compliance. Most people are good at one thing and what do you think a doctor is good at? Attention or a compliance.

It's just compliance. >> Compliance, right? They became doctors by being compliant. They did their homework on time. They studied.

They were very, very comfortable. >> 12 years, yeah. >> Yeah.

And then they come out into the world and they're in a $200 billion industry and they're

very compliant but they're getting the information from the industry that quite frankly wants to keep them compliant, keep them in a box, keep them doing clinical work, and then it's really, really insurance driven. So a lot of doctors find out that they're actually operators, they're operators for this industry and they'll reach out to us and say, get me outside of the box.

And we, me with them, we work with them and really help them increase that level of attention and build systems that are truly theirs. Not systems to drive the insurance companies, not systems to grow this industry because if you look at a doctor's career, they'll go to school for 12 years and then they'll come out, they'll be an associate and then they'll start to practice and then they'll work for

30, 35, 40 years only to sell that practice. >> Do one thing, something like that. >> Yeah. >> And then they sell the practice at the end and I don't know any other business model where you pour three, four, five decades of your life and at the end you just sell it and that's

it. I mean, if you're going to flip a business that usually could happen within three to five years, like you go in very intentional but they pour their whole life into it and they have a good life, they have a good life. If you look at the stock of these publicly traded companies in health care and you look

at these insurance companies, they're growing hand over fist while the doctor's having a good life but somewhat stuck in a box, they have to go to that practice, they and life just passes them by. So we actually have, I do a program called Outside the Box and it's doctors have been coming from all over the country to see it and it really is guided to helping them get outside

“of the box to be able to grow their practice without them having to be there, right?”

Because ultimately they've created a job for themselves and we help them create a real

viable business like in grow and scale. >> So you walk into a dentist's office or doctor's office, what do you see, is it like the matrix? Oh, you got to fix this. Oh, this shouldn't be over here, why is the couch over there, why is this like, do you

see it like that? >> Yeah. >> What are most doctors and dentists?

What are they missing up on?

“It's where they're getting their information from, right?”

So in school, you know, they share notes with other doctors, they, you know, other students and they complete their curriculum and when they get out, they kind of, you know, message each other and say, hey, what are you doing about this, how are you going to build this, how are you going to build that? But the real question is where are they getting their information from?

And the industry, I mean, when you're operating, if you're a dentist and you're operating

in a $200 billion industry, you got to understand how powerful that industry is.

The dental industry is larger than the NFL, majorly baseball, NBA, NCW, all sports combined. All sports combined. All sports combined. All sports combined is something like 90 billion, the dental industry is 200 billion and growing.

>> Right. >> So they're getting their information from the wrong place. And so when I walk into a dental practice or a plastic surgery practice, I, I see a practice that was built to serve the industry. It was built to serve insurance companies, it was built to serve almost everybody but the

doctor themselves because the doctor is very compliant. So they're going to build this practice. You're going to take out this note, a million, two million, three million dollar practice. And then they're going to show up every day and work. Imagine if I came to you, Dan, and I said, hey, give me a million dollars and I'll build

the box for you to work in every day. But if you go on vacation, if you go to Mexico on vacation, you take your family out. You're not going to make any money that day. So if you go for seven days, it's going to cost you seven days. It doesn't make any sense.

I've never seen that before.

So it's where they're getting their information from and we're able to really take the last 25 years of knowledge. And I've been studying patterns. I see what works and what doesn't work. And we look at what makes one doctor massively successful.

I have clients that do 20, 30, 40, 50 million in revenue. I have other clients who have become billionaires. And they're roommates in college or they're counterparts are struggling to do a million a year.

“I look at the pattern, like, what's the difference?”

And we bring that. We come into an office, we look at what they have, and we start to make adjustments. And it's really amazing what happens after that. Why should a doctor, a dentist, start to use social media? So many of them don't want to do it.

I'm not interested in it. Don't think it's going to help them. What would you say to that doctor, a dentist, and why they should utilize social media? Well, if they can't find you, they can't come to you. And so if all businesses are attention and compliance, most doctors, you know, almost all

doctors are very high on compliance. And they give very little value to the attention piece. And so most people are one or the other. Like if you look at your organization, you could probably identify like who's an attention person and who's a compliance person.

It's marrying those to you together. And now what started to happen is doctors have started to use social media. And again, it's where are they getting their information from? I don't know if you've seen this, but like dentists are dancing on social media. Sure.

It's like they're dancing. And I don't know what that's all about.

“I don't go to my dentist because he has dance moves, right?”

So they're just getting the wrong information. But I actually, you know, I believe that the industry benefits greatly from that because if the industry can keep them doing clinical work, the insurance companies can grow and so can the industry. And like I said, the doctor will have a good life, but why not have any extraordinary

life? Why not? You know, you've worked so hard, why would you come this far to only come this far? Right. And what's really interesting is that this has nothing to do with working harder.

This has to do with working smarter systems and processes. Systems and processes. Yeah. So for the most part, in our minds, pretty much every doctor dentists just has one location, right?

And you can actually know the math on that. But for the most part, it seems like most of them just have one location. But I've seen what you've done, you've scaled four locations here, 12 locations. There's some have 20, 30, 40, 50, 60 locations of certain types of brands that you're involved in or advising to.

What's the difference? What can they do if they want to decide, okay, I'm going to open my second or third location. Yeah.

The most important thing is to get your zero to one really, really dialed in.

I call it zero to one. So there's two avenues. There's zero to one, and then there's one to one hundred or one to ten or one to five. But those are the two buckets. And if you're zero to one was built through the industry, that's where you got your

information, it's never going to be like this perfect tire that can gain momentum. It's always going to have these flat spots where you as a doctor have to show up and push it. And that's one of the trickiest things about scaling. I've seen doctors try to scale a model that doesn't have that ability to grow.

And they just get themselves in trouble. So we really start the zero to one. We really start out with there are. So if they haven't started a practice yet, reaching out is great. If they have a practice, reaching out is great because we can go look at it and really

perfect that model. I almost call it a coffee shop. Like if you don't have the coffee shop like super dialed in and you have to be there every

Can't be in for different locations. But if you're in Seattle and you really dial in that coffee shop, and it really works really well. Customers want what you have like people want Starbucks, then you can scale that beyond belief.

In fact, if you're, you know, if you're significant other wakes up on Sunday morning and

“says, honey, get me a caramel frappuccino, you've got to go right there, right?”

You can't say, hey, I was, you know, at the gas station and this is a little bit cheaper. So they, they struggle with that, they, the model of the practice the way it's traditionally built is really designed to keep them, keep them there. Almost keep them in a jail. When I talk to a doctor and I say, hey, you know, does your practice feel like a jail?

A lot of them say, yes, and they don't understand how that happened. And it happened because of the information they're getting.

And the really amazing part is what happens when we come in and make these adjustments

and free them from that jail and people want to come to their practice. They're no longer dancing on Instagram being goofy and the practice is actually growing. So to answer your question, being on social media is very important piece of the attention part, but it's also important that we create a strategy, not that they just do whatever everyone else is doing.

So Dr. Dentist or just some listener out there right now starts to make more money. They go from 80 grand, 120 grand, 150 grand, they start making some really good money. One of their investment property sells, they got next to a quarter million, now they got some real cash that's been saved up. They got a lot of options, stock market, cash line businesses, their buddy wants them

to invest in the next pizza store, pizza place, their friend wants them to open a salon. They got all these options. What would you say to someone to think about how to decide what to invest into? Yourself. All right.

You got to invest into yourself. You got to put yourself first. In fact, you know, when you're on an airplane and the mass drop, the little video plays and we say, put your mask on before anyone else is because if you're in good shape, then you could take care of your family, you can take care of your business, and then you can

go after that and invest into other people. But what I tell our doctors is to build a brand, because that's going to give them a high level of attention, to build a brand, invest in that.

“And then from there, if you want to do something else with your money, that's a little”

bit different. But the first thing they have to do is invest in themselves, build a brand and invest in that. So you've mentioned that you have other ventures. Now, you've got your core business that you've had 12,000 clients on, but then you

started investing into actually scaling some of the salons and scaling some of the dental practices and investing in some of them involved in a winery, et cetera. Like, how did you decide the things that you were looking into? I've learned that for me, it's about the people. And you know, early on, I made some investments that just didn't make any sense at all.

And so today, when I meet really great people, I want to be surrounded in those networks. Yep. And I want that kind of energy in my life. So I'll look at people. I'll look at numbers.

I'll make sure the business can make money.

I always say, like, show me how we make one dollar first.

Like, that's really, really important. Everyone's like, oh, we're going to make millions going to be amazing. And show me one dollar. Yeah, show me one dollar. Show me how we take this and make a dollar.

And from there, that's, you know, a compliance piece, like I can buy it here and do there. And then I start to look at the attention piece and how can we draw attention and how can we really scale it. So scaling is something that I'm very passionate about. I got involved in a vineyard and now we started a national wine club.

They were selling wine in a small town and now we're selling wine all over the country. So that's really amazing. But I actually made my decision because of the people involved. I look at the people. I look at the family.

I get to know people.

“And I say, are these the type of people that I want to be around and do they lift me?”

Because we all know you're around the right circles. You're around the right people. They lift you. But if the opposite is true, too. So there's a investment theory that you guys have heard me talk about occasionally.

It's called 40, 40, 20. I want to do 40% low risk. I'm hoping to make between five and nine percent for the year.

I want to do 40% medium risk, hoping to make 10 to 30 percent for the year, and 20% is my

shot at glory. It's a very high risk. If it works out, I want something crazy to have an A to X, 13 X, etc. If it doesn't work out or takes a long time, I'm hoping for the medium risk and the low risk to cover the high risk.

The medium risk side, this is real estate, cashflow and businesses and the stock market. Low risk, CDs at your bank, STP 500, things that are solid and tried and true that have been around for many, many years. Okay, on the investing side, they did it. They made the money.

They sold their practice, they got $4 million in the piggy bank, but they're bored now. They don't have to go to work anymore. They're not walking into their doctor office anymore, like they did for the last 30 years. How did those people decide, okay, well, now I just have capital play with. My house has paid off.

The kids are off to college. Like, what would you say to that person? Move slow. Yeah. Move slow, right?

There's so much time doing this and it's exciting and then when that happens and they get that influence cash, you know, you have a lot of new friends, everybody's reaching out

Yeah, there's a lot of.

So I would say slow down, you know, I always say, hey, if you don't do it today,

you can do it tomorrow. And I'm a huge proponent, by the way, once you have a business that we have to move quick. Go. Right.

But once you get that big payday, take a deep breath and ready, ready, ready, ready, ready, aim, aim, and then shoot. Right. Because I think preserving wealth is very different than creating wealth. And I literally think it's like a shift in a transmission like it's a completely different

set of rules. And one of the biggest mistakes I see with my clients, because we do that, our clients make 20, 30, 40, 50, 100 million dollars. And they call me up and like, Paul, this is amazing. Now what?

Yeah. And then they're like, now what's next? They have a lot of energy. And they're shocked when I'm like, drink it up, go to Turks and take those for a month. Right.

I can't hang on on the beach for 30 days.

“I've been going a million miles a minute, I was like, I know, you have to like literally”

train yourself to just slow down. Because now that you have it, it's a different set of rules. And you know, we all know that saying easy come, easy go. If you're, if you're playing by the rules of creating wealth, once you, you already have it, you can lose it pretty quickly.

So let's talk about the charity side. Is there for doctors, dentists, or just households in general, how would you say to someone why they should be involved in philanthropy, whether it's money, time, or energy? I think it's really good to, to be pulled to something, to have something that is bigger than ourselves, right?

And I actually, when I talked to doctors or people in general who are depressed or are just not very happy, it's really all about them, and they can't get out of themselves. In terms of charity, I would, I would pick something that, you know, pulls you that really, you know, connects with you. I saw this recent interview between Tony Robbins and Alex Hermosian, and Alex donated

all this money to schools, but didn't feel good about doing it, and Tony brought up an interesting point. Like, hey, you don't even have kids, right? So when it comes to charity, I think you got to find something that like really, really resonates with you.

Yep.

“And I think it's important, because I think when you do something that's just not about you,”

it resonates with you, it pulls you, but it's, it's about community, it's about a greater whole. It, um, it creates a certain level of satisfaction and happiness, and I think it's important to do that in a way that you are happy about it. If you're kind of a check, doing it for, you know, the wrong reasons, or it doesn't feel

good, I think you got to reconsider that. But ultimately, there's something out there that connect with people and connects with you, and, you know, I have a saying in our company, our slogan is "Everything is connected."

And so I'm always looking for, to do something that's in alignment with a direction

I'm going in. So you can find a charity that isn't alignment with your values and your beliefs, and do that. And I think it'll, you know, it'll make you happy, I know it'll make you happier, and it'll, there's some, you know, I don't know if you want to call it karma, or, but there's

something in the universe that when you, you do right by people, it comes full circle. That's at least what I found. Yes. So what Paul said to get even more granular is something that's impacted your life, or someone that you know, whether it's a family or friend.

So if someone in your family has gone through breast cancer, has been homeless, grew up in an orphanage, et cetera, you are going to be more pull to actually help it rather than just donating 100 bucks, 1000 bucks, 10 grand, 100 grand, the math is irrelevant.

“How much you donate is relative to your financial situation?”

But it's going to drive you actually want to show up to the charity band, or show up to the children's hospital, or show up to do senior citizens home. If someone went through Alzheimer's or leukemia, et cetera, you're more like that actually get involved in it, post on social media, et cetera, because you are pulled to what you care about it, because you think of yourself, or someone in your ecosystem went through it.

So there's only one question I've asked every single guest over the last couple years,

and I've never gotten the same answer, and I'm definitely not getting the same answer

today. As you build all these businesses, wineries, salines, franchises, scaling, restaurant, groups, 12,000 clients becomes 50,000 clients, et cetera, and you have got a, let's call it billions million dollars. What percentage of your net worth do you leave to those children? That's a very question.

I, I want to create generational wealth, but I think that percentage will be secured in a trust, and they're going to have to earn it. I have a lot of clients who are very wealthy, and they just leave that to their kids, and there's no path to earning, and I

being like here Dan, I love you, here's the keys. By the way, we're in mid-flight, you know, they're my kids, so I'm, I'm dad, and then one day I'm out of the picture, because, you know, the two things in life that are certain, we're going to pay taxes, and we're going to die. I'm out of the picture, and here they are in a big 747 airplane, and they have no idea how to fly up, and that just doesn't end well. Yeah. Yeah. Yeah. All right. So, in our system today,

AI is coming, right? AI has been around for many years, but for many years, people couldn't spell AI. Now, it's become a much more prevalent. Doctors, dentists, or just people that own, you know, retail businesses, what would you say to them to research or study or start to watching out for AI? Is it important to them? It's extremely important. And in fact, I think this is where ownership matters the most, because the tasks of doing the thing

we talked about before, where, you know, doctors or operators are just operating, you know, Elon's coming out with robots now, and if you don't own something, and you've been doing it tasks and getting paid to do that, and now a robot can do it, and hey, I can do it. I think you're in big trouble long term. So, this is where I tell doctors, you want to have ownership, and you want to build a brand, you want to build a brand that people want, because like I

said, if, if, you know, your significant other says, honey, get me a caramel for a machino,

“you have to go to Starbucks, right? And if it's just a coffee, you can go anywhere, right?”

So, AI is a game changer, because it's going to free up a lot of things. But it's also

the reason why private equity is buying everything. I mean, they're literally, I don't know about you. I get emails all day, sure. I want to buy this. I want to buy that. We'll take this, we'll, they'll buy everything, because we're not, we're a lot closer than people realize to full automation. I mean, I got here today in a car that drove itself, 100 miles. Yeah, sitting in the backseat car just took me. Yeah. And so, so when you really understand how

quickly this is moving, the two things that matter most are ownership, and then building an actual brand that people want. Ownership is going to give you that compliance piece, like this is my piece, and this belongs to me, and the brand's going to give you that attention piece, and you need that, because if you're a great doctor, a great surgeon, and you're operating as just an operator, but you don't actually own anything, or you don't have a brand,

there are robots that are going to take your job pretty soon. Let me break down this real quick. Waymo, for example, if it comes at scale, well Uber and Lyft have millions of drivers. So does postmates, door dash, Instacart, and so many delivery services. If Waymo actually gets really good, or the Tesla version of Waymo gets really good, what happens to millions of jobs besides them just going away? Where do they go work? What happens when Elon really gets good at semi-tracks?

I paid for my two semi-tracks from Tesla a couple years ago. They're about to be here.

What happens when you've got around two or three million drivers semi-tracks? I'm not saying

they're all going to go away, or every company is going to start buying Tesla semi-tracks, but especially they will. I think 10 years from now, there's going to be no semi-truck drivers.

“What happens to those two three million jobs? That's what I'm saying. The guy that drives that”

semi-truck, what job does he go get afterwards? Times up by two three million. And so when you start to think about like, what happens if millions of jobs go away? When we go to Chipotle, McDonald's, Jack-Mox, etc, you're already starting to see some of the times where you can order from the computer. What happens if there's no cashiers? You know that over 5% of our population has worked at McDonald's in their life? What happens if that number goes to zero? I won't

percent. We were out in LA last week, and we went to the Tesla diner. Oh yeah. Yeah, with all the chargers and the car drove itself there and backed into the spot. And my daughters wanted popcorn, and we went in and optimists the robot. Really? It was popcorn. No way. Yeah. Yeah. We're in behind there and took the order, you know, and gave him popcorn. It was really interesting.

“My four-year-old dropped the popcorn and it fell all over the ground and the robot saw it. Really?”

And got her another one. Oh my God. Yeah. That was last week. I don't think people understand. So last year in 2025, 62% of all venture capital went to AI. That's 266 billion dollars

when it's one category. Never happened in human history. One category got basically all the money.

We were going to start to see the effects of that in 2026 and 2027 as they deployed that 266 billion

So then deploy it. And then this year, it's mandatory for venture capital and private equity

to invest more into AI. They got to check a box. So hundreds of billions of dollars more capital is going to AI. You guys understand? You're already seeing things like Optimus Prime,

“robot getting on the floor and cleaning up. What happens when that's in all the households?”

Or in all the offices? What if maids? That thing that you don't really think much about because they're not seen. We don't really feel it. You go to hotels. Well, think about how many maids are in these tens of thousands or hundreds of thousands of hotels just in America.

Let alone all over the world. What if robots are the maids? Where did those millions of jobs go?

What are those? The millions of maids going to do? If millions of people are not cashiers, if millions of people are not drivers, if millions of people are not maids. These are basic jobs. What did they go do? What is the next job? If the next job is also a basic job covered by robot. I know it sounds like a conspiracy theorist, but this is becoming reality because you just dealt with it. They just picked up your popcorn last week. Yeah. And for one of our practices,

we took a call center that had 14 agents that would pick up and schedule appointments and talk to a patient about their benefits and have to look up their insurance benefits and all this work. And you get 14 agents. It's a 15 phone calls, 16 phone calls coming at the same time. You'll lose two, right? We just implemented a full AI call center and those 14 agents just sat there for a full week. And the phone would ring over to them if the AI couldn't handle it.

“And I think they got two phone calls. Oh my god. And the doctors call me like, what do we do?”

And I said, all right, well, let's sit down with each one of them and see kind of what their skillsets are because we're going to have to redeploy them somewhere. But I'm not sure we're redeploying all 14. Sure. Right. So no miscalls, more patients in the sea, full automation, no sick days, no sick days. And if you said, how much is my insurance cover that agent is able to pull that information within seconds versus a typical answer? Well, let me call them. Let me see

you're waiting on hold. It's full. No motion, no lunch breaks, nothing. None of that. None of that. And no pay roll. Right. But much better service, too. And that was the interesting part, is I would call the call center and I would enjoy talking about the agent, because it would just get me from point A to point B as quickly as possible. Yeah. All right, Paul, we're going to be able to find you on social media, where can they find the company? And if they know a doctor

dentist, where should they send them to? If they want to hire your company? Sure, you can go on you can go on our website, surfct.com, surfct.com. We're also on Instagram, surfct.com. And my

“personal Instagram, if you want to DM me ask a question, Paul Vigario. All right, guys, this is important.”

You may not be in the doctor dentist world, but you were listening to this podcast. It might be for someone from your past, present, or future. There may be some time you're at lunch or dinner, and someone's a doctor dentist or their dad is, their mom is, their son is their grand pies, etc. And you're like, oh, wow, I listen to that podcast with Paul Vigario. I can afford it to them. But wow, maybe I can send them surfct and you help your friends, grandfather, go from a $1

million clinic to a $3 million clinic because they hired his company. Keep that in mind as you

listen to the money money's podcast and in general, when you're listening and learning things, it's not just for you. It might be for your friends, family, and followers. I appreciate you guys. Check out Paul on this company as a cross social media. We'll see you guys next Monday, here at TheMoneyMundays.com.