The Art of Running a Thriving Medical Practice
Dr. Nicole Basa didn’t just build a private practice—she built it from the ground up, with her husband and partner, Dr. Alan Abando, by her side.
In this candid talk, she shares what most people don’t see behind the scenes of practice ownership. The risks, the lessons, the wins that don’t always make headlines.
For any physician thinking about doing it their own way, this one’s for you.
You can watch this entire inspiring session—and earn free CE/CME credits—on the Learn at Pinnacle app. This episode is part of a rich catalog of empowering, actionable content designed specifically for women in medicine who are building lives and careers on their own terms.
Other topics discussed in the full session include:
Navigating malpractice laws and choosing a state for private practice
Strategies for community outreach and physician networking
Building a multidisciplinary bariatric program
Creating internal workflows to improve patient outcomes
Managing finances and evaluating growth opportunities
Choosing Surgery and Private Practice as a Woman
For many women in medicine, the road to surgery feels uphill—steep, lonely, and full of second-guessing. Dr. Nicole Basa opens her talk not with a strategic plan, but with an honest, vulnerable question: “Is this it?” Sitting at a Red Robin, exhausted from ER calls and cupcake deliveries to primary care offices, she and her husband wondered if this was the reward for all their hard work.
“We were tired, we were overworked. We were on an emergency room call a third of the month… and I thought, my God, this sucks.”
Nicole’s path to surgery wasn’t linear.
She stood out during her general surgery rotation—but still got warned off. Mostly by women.
They told her it would be too hard on her future family.
At the same time, her then-boyfriend (now husband) was getting nothing but green lights.
That double standard?
It lit a fire.
“If he goes into surgery and we eventually get married, I’m going to resent him probably for the rest of my life… So I thought to myself, ‘Screw it. I’m going to try to be a surgeon.’”
That choice—guided by instinct and clarity—set everything in motion.
Between the stress of couples matching, family expectations, and a state-by-state deep dive into malpractice laws, Nicole and her husband chose Texas.
Not by luck—but because it aligned with the kind of practice they were ready to build.
Takeaways:
Follow your instincts, not outdated advice. Even respected mentors can’t define your limits.
Use data to guide big decisions. Choosing Texas was a strategic, not sentimental, choice.
Normalize partnership in practice. Dual-physician couples don’t have to compete—they can collaborate.
For women in medicine facing career-defining decisions, Nicole’s journey validates the doubt, celebrates the courage, and affirms the right to dream big—on your terms.
Founding and Scaling a Practice
Launching a private practice is more than a clinical endeavor—it’s an entrepreneurial leap. Dr. Basa’s experience reveals just how little formal training physicians receive in business, forcing many to learn critical skills on the fly.
“We are not taught business in residency. Dentists have figured it out… but we don't.”
After selecting Cedar Park, Texas, for its new hospital and growth potential, Nicole and Alan were offered a hospital salary guarantee. Initially reassuring, this financial arrangement came with strings—limiting their freedom to invest in ASCs or innovate within their business. Reflecting back, Nicole now advises others to consider traditional loans and lines of credit for greater autonomy.
What You Need to Build a Practice:
Legal & financial setup: Choose your practice name wisely. Hire a solid CPA and set up QuickBooks early.
Insurance contracting: Use specialized firms to navigate increasingly restrictive private payer networks.
Staffing: Treat your team like gold—and be ruthless with toxicity.
“You need to go over this with your hires: ‘This is why you should not work for us… we want extraordinary people.’”
Dr. Basa is clear: culture isn’t a nice-to-have—it’s non-negotiable.
Even the most skilled team member can take a practice down from the inside if they gossip, stir drama, or chip away at trust.
That’s why she builds her team around shared ownership, mutual respect, and just the right amount of fun.
Nicole’s Hiring Pearls:
Communicate expectations up front
Fire fast when toxicity appears
Use 90-day evaluations to assess fit
Treat every role as mission-critical—especially the front desk
Pro Tip for Visibility:
Engage in the local community. From joining the Chamber of Commerce to attending health fairs and maintaining close ties with referring PCPs, visibility builds trust—and referrals.
For any physician building a practice, this section delivers not just strategy, but soul: grow the business, yes—but protect the culture like your life depends on it.
Turning a Medical Practice into a Wellness Destination
Starting out, Dr. Basa envisioned a multidisciplinary bariatric center. But early on, reality forced a pivot—bariatric volumes were low, the local market was saturated, and they needed to survive.
“We had to learn to pivot… I learned to do breast ultrasound, wound care… I scraped calluses off feet.”
Rather than view this detour as failure, Nicole embraced it as part of the journey—an expansion of her skillset, a safeguard for her business, and eventually, a stepping stone to fulfilling the original vision.
Key Expansions They Made:
Hired their own dietitian, coordinator, and coach
Added services based on patient pain points, like dehydration and emotional eating
Built a medical aesthetics arm for skin tightening and facial rejuvenation
Integrated lab draws, cardiac testing, and health coaching into a single destination
“If you can control it, you can make it better.”
One of the most powerful lessons Nicole shares is about internalizing processes. By taking ownership of every patient touchpoint—from stress testing to post-op skin support—they not only streamlined care, but elevated outcomes.
Stretch Zone > Comfort Zone
Nicole encourages staying in the “stretch zone”—where you feel nervous, but are growing. She credits this mindset with their ability to survive and thrive over 13+ years in business.
Even the decision to build their own facility was a leap into the unknown. But that leap became their legacy—a literal home for their vision of care.
“People think success looks like a straight line… but it’s a lot of mistakes, sleepless nights, and setbacks.”
Ultimately, their practice, now BNA Surgeons and Medical Wellness Center, stands as a model of innovation rooted in heart. They didn’t just build a practice. They built a movement—one that supports patients and each other for the long haul.
Conclusion
Dr. Nicole Basa’s journey offers a roadmap—and a mirror—for healthcare professionals dreaming of something more. Her story speaks directly to physicians who are:
Considering or already pursuing private practice
Passionate about business, culture, and patient-centered innovation
Tired of being told what they can’t do—and ready to claim what they can
Three Key Takeaways:
You belong in surgery—or any specialty you choose. Don't let others define your path.
Building a thriving practice requires business savvy, team culture, and relentless adaptability.
Innovation starts with listening—to patients, to your team, and to your own stretch zone.
So what can you do next?
Watch the full talk on Learn at Pinnacle to dive deeper and claim your free CE/CME.
Reflect on your own career path. Are you in your stretch zone, or stuck in your comfort zone?
Start planning. Whether you’re in year one or year twenty, it’s never too early—or too late—to build something extraordinary.
Because yes, this can be it. Your version of it. And you’re not alone in building it.
