Some People Own a Business. Some People Own a Job. Featuring Mike Milligan, EP 285
Most healthcare practice owners can tell you exactly how their patient scheduling works. Far fewer can tell you exactly how their money works. In this episode of The Thriving Practice Podcast, Tracy Cherpeski talks with Mike Milligan, founder of One Oak Financial, about what actually separates a thriving medical or dental practice from one that's just barely surviving — and it's rarely about revenue alone.
Mike built One Oak Financial as a B Corp certified firm after spending his early career on Wall Street, where he watched profit consistently win out over people. Today his firm focuses on high-income earners, especially physicians and practice owners, helping them build written financial plans instead of reacting to market headlines or copying whatever their neighbor in the medical complex is doing.
This conversation is a practical one for anyone thinking about time management for healthcare practice owners, reducing taxes for physicians, or building a genuinely profitable medical practice without burning out in the process. Mike's central message: money is oxygen for a practice, but purpose is still the heartbeat — and you need a real plan to hold both at once.
Key Takeaways
There's a real difference between thriving and surviving. Thriving practice owners run their business like a CEO. Surviving owners are doing everything themselves, often heading toward burnout.
Some people own a business. Some people own a job. The difference comes down to systems, delegation, and who's really in the driver's seat.
A written financial plan is the most important financial document a practice owner can have — more important than any single investment, will, or trust.
Taxes may be the biggest expense a practice owner never addresses. Without a proactive conversation with a licensed professional, owners can give away 4–8% of their income every year.
Money scripts and behavioral patterns often drive financial decisions more than logic does — which is why good financial planning often looks a lot like coaching.
Q&A
What's the real difference between a thriving practice and one that's just surviving?
According to Mike, a thriving practice owner leads like a CEO — directing the business rather than doing every task themselves. A surviving owner is stretched across every role, which is where burnout tends to creep in. He's seen both states in his own business and says the shift usually comes down to systems and the willingness to let go of tasks that don't require the owner's specific expertise.
How much money might practice owners be losing by not addressing taxes?
Mike says practice owners who aren't having regular, proactive conversations with a licensed professional about reducing taxes can be giving away 4–8% of their total income every year — money that could otherwise go toward growth, retirement, or the life they're actually working for.
Why does Mike say a financial plan matters more than any specific investment?
A written plan, Mike explains, gives practice owners a way to make decisions in advance instead of reacting emotionally when the market gets volatile or a family member asks to “invest” in something. Once the plan reflects a person's real goals and values, the plan makes the decision — not fear, and not whoever's asking.
Why do so many practice owners struggle with the business side, even years in?
Mike points out that many practice owners started as clinicians, not operators, and only discover the gaps in their business education years into ownership — things like how to negotiate a lease, structure payroll, or understand the full range of taxes a business actually owes. He speaks from experience, having made many of those mistakes himself when he started his first company.
Episode Highlights
Mike's path from twelve years on Wall Street to founding a B Corp certified financial firm
What “impact over profit” actually means while still pursuing Inc. 5000 growth
The real difference between a thriving practice and a surviving one
Why “some people own a business and some people own a job”
How money scripts and behavioral patterns shape financial decision-making
Why a written financial plan beats any single investment, will, or trust
What practice owners are really losing by avoiding the tax conversation
Mike's advice for staying grounded amid market fear and headlines
Where to find Mike's book and how the Thriving Practice Community fits into this conversation
Memorable Quotes
"A thriving practice just doesn't work in the practice. They really lead it like a CEO." — Mike Milligan
"Some people own a business, and some people own a job." — Mike Milligan
"The financial plan is the most important financial document you can ever have. It's not a mutual fund. It's not an ETF. It's not even a will or trust. It's the financial plan." — Mike Milligan
"Taxes are the biggest expense you ever have in your life." — Mike Milligan
"Money is oxygen — it's what allows you to continue to expand a practice and help more people. But purpose is the heartbeat of a business." — Mike Milligan
Mike Milligan's biggest message for practice owners is a simple one: get the plan. Not another product, not another headline-driven decision — a written financial plan that reflects your actual goals, so the plan can make the hard calls instead of you making them under pressure. If this conversation moved you the way it moved Tracy, share it with a colleague who's still avoiding that money conversation. Visit mikemilligan.com to learn more about Mike's work and explore thrivingpracticecommunity.com for resources to help you build a practice that truly thrives.
Guest Bio:
Mike Milligan is the founder of 1.oak Financial, a virtual financial planning firm built around one idea: "Be One of a Kind." A Certified Financial Planner with over 30 years of academic and professional experience, Mike has been featured on CNBC, Fox, ABC, and NBC. He is an adjunct professor at Old Dominion University, host of The One of a Kind Financial Show Daily and the Ideas by Mike podcast, and author of The One of a Kind Financial Plan and Retirement Déjà Vu. Mike lives in San Juan, Puerto Rico, with his wife and three dachshunds.
Find Mike:
1.Oak Website: https://1oakfinancial.com/
Mike Milligan Website: https://mikemilligan.com/
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