Introduction

In a recent episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed Dr. Michael Ast, an orthopedic surgeon specializing in adult reconstruction and joint replacement surgery. Beyond being an accomplished clinician at the Hospital of Special Surgery in New York, Dr. Ast also lectures often on business and career issues, and is especially passionate about teaching younger physicians how to build their practices and career success.

From athlete to orthopedic surgeon

Dr. Ast’s path to medicine was shaped early by his experiences as a Division I gymnast at Temple University. Frequent injuries brought him into contact with orthopedic surgeons, sparking a fascination that eventually led him to apply for a combined undergraduate and medical program at Temple University, gaining admission at just 16 years old. The program allowed him to condense eight years of study into seven, seamlessly integrating undergraduate and medical coursework. His early exposure to the world of orthopedic surgery, combined with his athletic background, fostered a deep desire to help others recover from musculoskeletal injuries, a motivation that continues to guide his practice today.

Dr. Ast emphasizes that while his formal education included little exposure to finance or business, his curiosity about these subjects grew organically. College courses in business and finance, coupled with mentorship from savvy colleagues, helped him gradually build a foundation in financial literacy. These experiences informed his belief in the importance of equipping physicians with practical knowledge beyond the clinic, from personal wealth management to the business operations of medical practice.

Choosing the right first job

When selecting his first position after fellowship, Dr. Ast weighed multiple factors beyond salary or immediate clinical opportunities, prioritizing location, practice need, and the potential for growth. Crucially, he joined a practice with a retiring surgeon in his specialty, which allowed him to inherit an established patient base. Another distinguishing factor was the practice’s proactive approach to marketing, which included hiring a dedicated professional to establish relationships with local referring providers, hospitals, and physical therapists. At the time, this approach was uncommon in private practice but proved invaluable in building his reputation and patient base.

Dr. Ast notes that understanding local market dynamics is key for physicians looking to establish themselves. Beyond relying on anecdotal knowledge from colleagues, physicians can leverage data-driven strategies to identify referral sources, untapped markets, and growth opportunities, tactics often underutilized in private practice but standard in broader business contexts.

Building a brand in medicine

One of the central themes of Dr. Ast’s discussion was the importance of brand building for physicians. He underscores a dual approach: excellence in clinical care and strategic professional outreach. Physicians must first prove themselves to be outstanding clinicians by taking care of patients, supporting colleagues, and maintaining professionalism across all interactions. Reputation is often shaped as much by how surgeons treat their staff, OR teams, and referring providers as by their technical outcomes.

The second dimension involves proactive brand development, including outreach to referring providers, engagement with local communities, and even interactions with competitors. Dr. Ast illustrates that early-career physicians can strategically “say yes” to opportunities, take on challenging cases, and assist colleagues, thereby building trust and a strong reputation. He also highlights that vendor partners and industry collaborators can provide valuable market insights to help physicians grow their practices in ways that are both ethical and effective.

The role of education and mentorship

Throughout the episode, Dr. Ast emphasizes the critical role of continuous learning. His own career benefitted greatly from mentors (both physicians and CEOs) who guided him in understanding practice operations, financial concepts, and strategic growth. He strongly advocates for structured education in business, finance, and entrepreneurship for physicians, noting that gaps in formal training can leave doctors vulnerable to suboptimal practice arrangements.

Dr. Ast has taken his philosophy further by developing educational programs for joint replacement fellows across the U.S., offering mentorship, practical advice on practice management, and guidance on wealth planning, all supported by grants and non-industry funding. His goal is to empower the next generation of surgeons to navigate their careers with both clinical excellence and business acumen.

Conclusion

Dr. Michael Ast’s conversation with David Mandell provides physicians with actionable insights on building a successful career that integrates medical expertise with strategic business thinking. From leveraging mentorship and learning continuously to cultivating a strong local brand and understanding market dynamics, his guidance underscores the importance of proactive professional development. Whether early in practice or at a career transition, physicians can benefit from adopting Dr. Ast’s philosophy: prioritize clinical excellence, learn relentlessly, and approach the business of medicine with the same rigor and curiosity applied to patient care.

Click here to listen to the entire conversation with guest Dr. Michael Ast and host David Mandell, JD, MBA, or access the full library of Wealth Planning for the Modern Physician episodes and subscribe on your favorite podcast platform.

David B. Mandell is an attorney, wealth manager, author, and partner in the wealth management firm OJM Group, LLC, where he and his team provide comprehensive and multidisciplinary financial planning services tailored specifically for physicians across the United States.

David hosts the Wealth Planning for the Modern Physician Podcast, now in its fifth season with over 95 episodes and 50,000+ downloads. The show focuses on the unique wealth planning concerns faced by today’s doctors and features interviews with physicians across specialties and stages of their careers, as well as insights from financial and industry experts. Listeners gain practical tips on building wealth, protecting assets, reducing taxes, and achieving long-term financial goals. Click here to listen and subscribe.

He is also the co-author of more than 15 books, including the newest release, Wealth Strategies for Today’s Physician: A Multi-Media Playbook. This innovative guide includes over 250 pages of actionable content and more than 90 embedded links to videos and podcast episodes. Organized into seven key strategies, the Playbook helps physicians reduce taxes, invest wisely, choose the right insurance, protect their assets, and plan for retirement. Click here to get your free print copy or eBook download, available exclusively to members of the KevinMD community.

David has spoken at major national medical meetings, including those hosted by the American Academy of Ophthalmology, the American Association of Orthopaedic Executives, and the International College of Surgeons. He earned his bachelor’s degree from Harvard University, his law degree from UCLA School of Law, and his MBA from UCLA Anderson.

Connect with David and OJM Group on their website, LinkedIn, Facebook, Instagram, YouTube, and X @OJMGroup.

Disclosure:

OJM Group, LLC. (“OJM”) is an SEC-registered investment adviser with its principal place of business in the State of Ohio. SEC registration does not constitute an endorsement of OJM by the SEC nor does it indicate that OJM has attained a particular level of skill or ability. OJM and its representatives are in compliance with the current notice filing and registration requirements imposed upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in those states in which it is registered or qualifies for an exemption or exclusion from registration requirements. For information about OJM, please visit http://adviserinfo.sec.gov/ or contact us at (877) 656-4362.

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