Podcasts about so step

Dr's J and Santhosh are almost back from their holiday break, and in the meantime we invite you to continue a tour through some of our classic and most requested episodes with guest hosts of days gone by!In this episode, Dr's J and Praz, with special guest Emily Hook discuss the attributes and health of circus sideshow performers. Along the way, they cover the history of circus sideshows, the Coney Island NICU, the classes of sideshow acts, Geeks, the secrets of human pincushions, glass chewing, sword swallowing, circus endoscopy and intubation, fire eaters lung ,off season care, Ehlers Danlos syndrome, acrobat anesthetists and more! So Step right up, sit back and relax as we dive into the world of freakshow!Sources1)http://www.bmj.com/content/333/7582/1285ijkey=8559399d0af3cd2596c8540d8872c966fa286536&keytype2=tf_ipsecsha2)http://time.com/3711869/sword-swallower-paris-1945/3)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522406/4)https://tinyurl.com/yxhpcon4   Supporting us monthly has all sorts of perks! You get ad free episodes, bonus musical parody, behind the scenes conversations not available to regular folks and more!! Your support helps us to pay for more guest interviews, better equipment, and behind the scenes people who know what they are doing! https://plus.acast.com/s/travelmedicinepodcast. Hosted on Acast. See acast.com/privacy for more information.

In Episode 81, I gave you the first part of how to self-coach yourself in any challenging relationship and that first part is to take responsibility for your thoughts and feelings about this person. (Do not underestimate this step, my friends! Responsibility means getting out of victim mentality and it is HUGE!) Step 2 is to INTENTIONALLY decide to be in a relationship with this person. You heard me. You need to deliberately decide to be in relationship with them. To decide to be in a relationship, ask yourself:1. Who do I want to be? (NOT WHO DO YOU WANT THEM TO BE, who do YOU want to be?) 2. How do you want to behave? 3. How do you want to think about this person? 4. How do you want to act? There is SO MUCH power, especially at school, to decide that you will be a CERTAIN way no matter how someone else acts. So Step 1 is doing your own work of taking responsibility. Step 2 is deciding ahead of time who you want to be so that you are not a helpless victim without any power with this person. Step 3: Realize that everyone gets to act exactly as they want. It is EXHAUSTING to even think we can control others and we know we can't. To repair any relationship, only one person needs to clean up his/her side of the street. Ready to clean up yours? Don't miss this episode which is right on time for teachers and the school year! Resources: Follow Chrissy on Instagram @chrissyconcept. Sign up for a FREE 30 minute coaching call. More About Teacher Talk with Chrissy Nichols: Teacher Talk is the podcast for educators like you who are on the brink of burnout, or are already there. It's your guide to feeling better about being at school and being in your life. Your host, Chrissy Nichols, is a life coach for teachers. In her weekly episodes, she will give you quick tools, tips, and brain hacks to understand that there is absolutely nothing wrong with you. It's time to find the joy in teaching again and get back to feeling like the best version of yourself.

Welcome to the 4-part mini-series dedicated to helping corporate executive women create their "And Life," a life of career success and personal fulfillment. Last week we identified why we have started feeling trapped in our current lives. Today let's address the elephant in the room, why we want more out of life. Why do you want more? Now if you immediately said to yourself, “I am grateful for what I have, I don't want more” then listen up. As high-achievers, we don't say “we want more.” We say “I am working for more, I am pushing for more, I am striving for more.” We don't "want" for things, we put it in achiever terms and we go after more. So Step #1 in this process, answer these questions: Do you look at your life and wish you had more time to spend with those you love? Do you appreciate all that you have and more but tell yourself this is as good as it gets because you can't selfishly ask for more? Do you never feel satisfied, to the point that you are always striving for the next promotion, next project, etc.? If you answered yes to any of these questions, then the reality is that you want more. But here's the key point to this, which is actually step #2, consciously acknowledging what you're asking for more of. You're not asking for more success, you're asking for more happiness. They are not the same things! You can't feel frustrated, ashamed, or ungrateful for wanting more when you're asking for more of something you don't already have. Success and happiness are two separate life events. So when we want more, we tell ourselves we don't deserve it because we already have so much. But know this, wanting more doesn't mean: You failed You signed up for this life of success without fulfillment You're the only one People who love you want you to be miserable (they just don't understand why you are not happy already) Wanting more is normal. Wanting happiness and fulfillment is normal. Your goal is to let go of the internal conflict that you can't "want more" happiness because you're ungrateful. Remember, you're asking for something you don't currently have. Ready to take action and start working toward career success and personal fulfillment? Get your workbook for this mini-series and start creating your "And Life." Be Legendary!

Who doesn't love a good amusement, or theme, park?! They are awesome, but how did they get here? Who thought it would be a good idea to mixed a bunch of greasy food with a crowd of people and rides designed to make your stomach turn? We decided to take a deep dive for you and find the answers. So Step right up and enjoy this ride through the history of Theme Parks. In this episode we will learn about a number of parks like DisneyLand and Walt Disney World, Universal Studios Hollywood, Knott's Berry Farm, the many parks that resided in Coney Island, and many more. We did not realize the amount of parks that existed, or that parks had been around since the 1500s. Now of course the definition of 'Amusement Park' can be murky it its early history, but the fact remains that parks have been around much longer than we previously thought. We hope you enjoy this episode, and if there is more you would like to learn please let us know. Also, if there is something you would like to add feel free to reach out to us as well. Email us HDWGHpod1@gmail.com or follow us on our socials: @howdidwepod on IG and TikTok for the show @brandenbro94 on IG and TikTok for Branden @justareyes or justareyes.com for Justin Please subscribe and if you could please leave a written review it would help out a lot. Thank you Isaac LeSage for the Theme music. You are awesome, and everyone should take some time to check out the rest of your music. Thank you Oceas as always for sponsoring this episode. Visit oceasoutdoors.com today to find the greatest waterproof blanket that you didn't know you needed. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/justin-and-branden-reyes/message Support this podcast: https://anchor.fm/justin-and-branden-reyes/support

Lisa Thal is an Author, Speaker, and Business Coach.  Simplify Your Sales meetings. She wrote the book "Three Word Meetings."  Lisa coaches leaders on simplifying sales and business meetings with fun and interesting 3-word  topics to get your sales team motivated and inspired.  She has over 34 years of marketing, sales, and leadership experience.   The question is finding out what they are resisting. Let's keep in mind our goal is to earn that first conversation! So we can reach the next meeting!   Please think about this. 1% of companies are in the market to buy something today. That means 99% of other companies may need your product or service tomorrow. So until we find the 1% of customers that need us today, we may be facing sales resistances from the other 99%. That is a lot of sales resistance!     If you're in sales, you must expect to face some sales resistances; we all do. The question is, what are they resisting, and how do you over-come it?  This would be a great exercise to walk through in your next sales meeting.   7 Reasons Why your clients don't want to meet with you:   1. I don't need your product?  Most clients are already working with a vendor or may not need your product or service right now. That may be true, is there an opportunity to say a benefit to meeting with you, can be to validate the current vendor they are working with or discover how they can improve your current doing? We need to identify what your prospect must believe in buying from you.   2. Your product is not a good fit?  I would bet about 25% of your list prospects are not a good fit for what you have to offer. In the media industry, we are very clear on who is consuming our product every day. For example, we have a female-driven radio station that targets Moms with kids. I need to remove the clients I am targeting that want men 18-34 or 55+. Why? Because they have other options that may be a better fit. So Step one remove those targets and replace them with accounts or categories of business in your wheelhouse. Create case studies of proven success that you can share with them. Focus on the clients that can benefit from your product or services, so you are a good fit!   3.  I don't know your company? Unless your Apple, Amazon, Mercedes, or State Farm may not be familiar with your company. We may get some sales resistance when calling if they have never heard of our company. What can you do to make them more familiar? Market yourself and your company. If you missed Episode 91 on how to the 3 Strategies to generating leads on Linkedin with Jennifer Starling, I highly recommend listening to that podcast. Perhaps sharing a competitor's name, you do business with can bring fewer resistances to moving forward to learning more from you. Find a better way to market yourself, so you become more top of mind.   4.  Your price is too high?   You mean you haven't heard a client say you're not charging me enough, changing the proposal, and raising your price? Most of us listening has listened to the price resistance before? Our price is only too high when we have not proven that investing their dollars would have a payoff for them. What proof of performance can you share, so they stop resisting? A great way to address that would be Sharing proven case studies from other clients; other markets are having success is a great way. Client testimonials sharing I invested X thousand and got an X return. Digital Marketing shows you the metrics for every dollar spent. Every smart decision-maker expects an ROI.    5.  This is a Bad Time to buy.   Perhaps many of you have heard, Not Now? Try to uncover the Why? Why is now the wrong time to buy? I don't know about you, but most first calls don't result in, " Thanks for calling, I was waiting for your phone call, I cant wait to meet with you and hear about all your solutions to helping me"! More than likely, you will face resistance. Ask are you happy with where your sales currently are? Could they be better? I find it's only the wrong time when you don't have the right tactical plan to accomplish what they need.   6.  Resistance to Listen.  Are we tuned into what our client is telling us? Or are we thinking about what we will say next? Asking probing questions and repeating what they say shows them you are listening. Getting clear on how you can help them is critical.   7.  Your product or service is not a good fit.  Remember, about 25% of the prospects on your list are not great leads. Determine whether your product or service is a good fit. If it is not, they move on to clients that are a better fit for you. Identify the categories that are performing well for you and your company. Ask your best customers the number one reason they do business with you, of course, outside working with you! You may find verbiage to use when reaching out to other prospects.     So expect a little sales resistance. Research your prospect before you call or email them so you can identify the Why, the problem they have, or the opportunity or solution you can provide! Remove the 25% of accounts that are not a good fit. Keep marketing yourself and your company. Provide proof that working with you is a great decision!   And remember, to exist, you must persist!   If you think someone could benefit from this episode, rate it, share it, or subscribe at Itunes or Spotify, so you don't miss out on the next  three-word podcast.

I am happy you're here! By coming to the notes section, you at least are intrigued about Movember. The information on how to join is below. Click on the link below to join the team as a member, build your own page, and choose your own goals. So Step 1: click on this https://movember.com/t/masonmovement?mc=1 Step 2: join as a member Step 3: build your own page If you can't find the team look for the team titled “MasonMovement” one word or Team ID is 2352799 So… The question is… are you in? Join here: https://movember.com/t/masonmovement?mc=1 This is my individual page: https://movember.com/m/wristtoe?mc=1 Three ways to participate: 1. Grow a mustache 2. Walk, run, hike 60 miles 3. Mo your own way...meaning, select your own challenge and make it happen! The challenge starts Sunday Movember 1st! --- Support this podcast: https://anchor.fm/PwRHPE/support

This is a continuation of our two part series from last week! Last week, I started a series called How to find your strength when you're feeling weak. And we talked about Step 1- moving over and resting. Trusting God in faith to handle things. Taking your Sabbath. We are not make everlasting, so we need to recharge. It was all about letting Jesus take the wheel and you need to realize you need REST. This week- it's going to be fun. If your nature is more of fight first, Part 2 is going to be right up your alley. Or you know what, even if you're not the put-up-a fight first women, this is still for you! Don't count yourself out for this because this is so important to understand and practice. But it's definitely the more “hands on” approach of finding your strength when you're feeling weak. “ Kingdom-style leaders who do this are a force to be reckoned with and make Satan quake because he has nothing in his armory to stop them.” -- Armory -- Armour -- The Armour of God. So Step 2 of finding your strength when you're feeling weak: put on that amour and protect yourself! The devil isn't a dummy. He is smart. He knows the exact atmosphere that is conducive to you creating your own self destruction. BUT- if I arm myself with the armour of God, I will be more aware of how the atmosphere around me changes! Let's go over them first and I will explain how they will protect you from yourself. How you can use them to fight off those things that wear us down and make us tired.You know that saying “be the woman who's feet hit the ground and makes satan say “oh crap, she's up.” Make him say oh crap she's up! Because you know how to use your armor, sister!! Make satan get on the defensive, backing up, doing what he can to keep you from scoring. Don't let him or any of this atmosphere changes keep you down, weak and exhausted. RISE UP!IG: @thebeautifullyenoughpodcastFB: Valarie ReynoldsMusic: https://www.purple-planet.comSupport the show (https://paypal.me/ValarieReynolds?locale.x=en_US)

On today's episode of Quiet Light, Dan Ashburn joins us to discuss negotiating terms with your suppliers. Dan is the co-founder of Titan Network, the Mastermind for Amazon sellers, the China Magic, the immersive Mastermind discussed in another episode. Tune in to pick up some awesome tips about how to save cash and boost the overall value of your business. Topics:  How he came up with this concept. Why face-to-face interaction is important. Forecasting sales, inventory requirements, and pay-out per unit. Using market data to help with forecasting. The formula/numbers Dan uses. Making sure your offer is win-win. Timing your requests. Having perseverance when it comes to your requests. Traveling to China. Transcription: Mark:       Shortly after you buy a business, you're obviously looking for any opportunities to increase your return on investment. Sometimes that's through growth, sometimes that's through different ways of cutting expenses. But oftentimes looking at your suppliers and the terms that you have with your suppliers can be an easy way to free up free cash flow or get better terms or be able to even get different rates. But how do you go about actually negotiating those terms? How do you approach the suppliers, especially when the relationship is new? If you're on the sell side, the same sort of questions applies; how do you approach suppliers in a way where you can increase your return on investment by negotiating better terms? Joe, I know you talked to someone about this and have some good tips here. Joe:          Yeah, Dan Ashburn from Titan Network. You know what? Just in the podcast, I'll just tell you right now, Dan goes through a step by step process to basically walk people through what to do, how to do it and get better terms with your supplier. And the ultimate result, whether you've got a straight-up e-commerce business, a Shopify store, or an Amazon business, or whatever it might be, even retailers that are out there importing from overseas. I hear it over and over again that when you make the right connection in the right way with your supplier, you can get better terms. The end result is more cash flow. More cash flow means you've got the ability to buy more inventory as you try to keep up with growth, which is often a good problem to have. But Dan talks about it quite a bit in there. And the piece that is forgotten and not all that talked about is people are always trying to drive top-line revenue. But if you can negotiate better terms with your supplier and then get a better reduction in the cost of goods sold, it's going to boost your overall value as well. Joe:          Hey, folks, Joe Valley here from Quiet Light Brokerage, and today, I've got Dan Ashburn on the line with me. Dan is the co-founder of Titan Network and I think China Magic as well amongst another a number of other pretty fancy titles and credits to your LinkedIn profile here that I'm looking at, Dan, but that's as far as I get with fancy introductions so why don't you tell the folks that are listening about yourself and about your background and what you do? Dan:         Yeah, sure. Thanks for having me, Joe. So, yeah, I'm the co-founder of Titan Network Mastermind for Amazon Sellers, co-founder, and co-organizer of China Magic, which is a trip where we take 100 people twice a year to source products over in China. We've taken over 500 people now and the co-creator more recently of Amazing Selling Machine. And then my team and I are responsible for delivering eight figures in sales on Amazon per year through my brand management agency. Joe:          That's an awful lot. How do you do all that and not lose all your hair? You got a nice head of hair there. So this is a prod for people to go to the YouTube channel as well. Dan:         Yeah, for sure. So I have a good team around me. I've got a good management team. I've got an executive assistant who makes me look really good. And then, yeah, I just got good people around me so it's pretty cool. Joe:          Okay. There are not a whole lot of Amazon sellers that we have on the podcast and that I deal with on a regular basis; I've been doing this for eight years that have a beautiful British accent. So tell me about that aspect of it. You've got; I don't know how many you said in terms of Amazon sellers, 1,600 that you work with or something like that. How many are typically US-based versus Europe based? Dan:         Yeah, it's a great question. I'd still say the majority of the market is in the US. I'd probably say it's a 70/30 split right now. However, Europe is growing and it's growing fast as markets like Germany, etcetera pick up. And if you combine the combined sales volume of Europe to the US, then it's a good opportunity. And Europe is definitely picking up. A lot of the Europeans are obviously using US as their main channel as the US seller are then coming out over into the European market to diversify. Joe:          Okay. So a quick side note before we get into the meat of this discussion is that Amazon has just made it a whole lot easier to transfer a European seller account. So that's real positive news. It doesn't necessarily have to be a stock sale anymore. It can be an asset sale and it's easy to transfer so positive stuff there. But today we're talking about a little bit of your China Magic experience and your China experience in general and negotiating terms with your suppliers to improve cash flow and to improve your bottom line and boost valuations, which is a breath of fresh air because you can't; you wrote that line when we talked about it because most people don't think about valuations when they're working with suppliers and things of that nature but you do. Dan:         Yes. So you've had Scott Dietz on a number of times now. Scott was very much a mentor of mine over the last few years and something Scott really instilled in me is what's good for selling your business is good for building and running your business. So installing that, combined with the challenges that I come across so many sellers have; there's one thing in this business that stops growth and that's cash flow, its cash on hand. We all know there are only three ways really to grow the business, sell more of the same products, sell additional products, or sell the same products in new marketplaces are really only the three ways. All three of those ways take cash and they take cash flow. So we very quickly; my team and I launched this, my team and I really set our minds over the last couple of years to how do we solve this problem for the accounts that we're involved in, the brands that we have stakes in, and the people that we're working with across Titan Network, China Magic, etcetera to really solve this problem. And that's where this working with a supplier to fund that growth, that whole concept really came from. And I'm really proud to say that the last year or so, the last 18 months, we've been getting some pretty impressive results where suppliers are letting us go north percent down, 10% on shipment, 90% two or three months thereafter so it's really positive. Joe:          One of the things I hear often is, yeah, I just got back from a trip from China. I was able to do this. I'm getting better terms here. I reduced my cost of goods sold here. I ate way too much and drank way too much and I feel like I'm a member of their family now. Is that what everybody has to do? Do they have to get on a plane and go to China to meet the manufacturer and supplier or is it just something that helps but there are other ways to do it? Dan:         Look, there are other ways; there are always other ways to do it. You can get this done over a Skype call or a Zoom chat like we're having now but if you're serious about growing the business and you want to go in and get the times that you want, then every time in every case, physically being there in China in the room, staring the person in the face, building a real relationship with that person gets the better result every time. And where we've had a good result virtually, it's always been as a result of following up physically with someone. So we've already been earlier in the year or we may be met them at the last Canton Fair but there's always been that physical interaction. And I think what people underestimate about China is the business culture out there is relationship-driven. It's all about building that relationship. It's all about going and having that male drink and some of the alcohol stuff that they put in front of you to really build up that relationship. And there's so many benefits to that relationship much further beyond payment terms and cost of goods sold even down to stuff like it's coming up to Chinese New Year that productions run is full. And because you have that relationship, they bump you to the front of the production line, which keeps you in stock. Joe:          So let's get to specifics for the audience then. For people that are; and talk to them as if maybe they're your clients, they may be somebody that just bought an Amazon business from Quiet Light Brokerage or they're somebody that listens and is getting expert advice from folks like you. What are the first few steps that somebody should take? And I know this is general information for general people, specific would be if you were talking to one. What do you advise somebody to do? Dan:         Okay, cool. So first off, we need to understand what terms do we need to achieve and what are we aiming for? What's our goal? So the first steps or so of executing this process before you got to China or before you attempt to do this virtually is we need to put together a sales forecast. We need to understand what am I expecting to sell over the next 12 months and include uplift for Q4 based on historical dates or if you're selling seasonal products, make sure you're including all of that uptick and then break down what you plan to order. So once you forecasted those sales, understand what inventory requirements you have and what your current order rate would look like with your supplier over the course of that year. Then figure out with that information what is the payout per unit on your sales? So you need to calculate the Amazon payout per unit after all fees and marketing costs. So within our brands, we work to operating 10% advertising contribution or true A-costs whatever you want to call it. And we factor all of that in and we figure out after storage fees and etcetera, what is our P&L per unit? Joe:          Did you say 10% advertising; is that what that was? Dan:         Yeah. So as a PPC contribution, margin, or a true A-cost; whatever you want to call it. Once we're out of the launch phase and we're in some maintenance we factor in a 10% margin for advertising. Joe:          It's great, we do key financial metrics anytime we list a business for sale and typically see the ad cost somewhere in that 8 to 12, 8 to 15% range so 10% is a good number. Before you go on too far, so you've talked about doing a sales forecast and of course, that leads into inventory need forecast. The question often comes up, what's the best software if there is such software for inventory management and sales forecasts? Do you use some or do you create it with Excel spreadsheets? Dan:         So we keep it simple. We do all of this in Google Sheets. We have adopted a new inventory management system and I'm pretty impressed with it if you wanted to talk about that. But we do all of this in a basic Google Sheet template. And if you want, Joe, I can have that template sent out to your subscribers. But yeah, we just use a Google template, we use a Google sheet and we just manually plotting in numbers, manually forecasting out. It's nothing fancy. If we want to work with someone at more advanced than we'll offset pull in an accountant or a bookkeeper; someone that's more savvy with the numbers. But we're just using historical data to forecast the future 12 months. Joe:          And you're pulling that data from Amazon or from QuickBooks; where are you pulling it from? Dan:         Yeah. Typically, depending on the account that we're working with or depending on whether it's an in-house brand or a joint venture type relationship, we will take the initial data from Amazon. So we'll take your initial sales data. And then if we can sanitize that data with actual validated bookkeeping records, then obviously we will do that. But for the sake of this exercise, it doesn't need to be 100% accurate. This is a forecast and everyone knows; I think what everyone gets is they get that analysis paralysis on forecasts. Because I think what if I don't meet the forecast or how do I know what it's going to sell? You've got to take the best guess and if you haven't got 12 months of trailing data, go use tools like Keeper to look at your number one like for like competitors trailing 12 months of data. Just use data in the market to be able to inform your own self forecast. Joe:          So doing a cash flow forecast or I'm sorry sales forecast leads into what your inventory needs are. You're doing that in Google Sheets and what's next from there? Dan:         So before we can move onto the next stage, we then have to figure out what our payout per unit is, because these three pieces of data, the sales forecast, and the inventory need forecast as you call it, and then the payout per unit factoring in a rough 10% advertising contribution. That gives us all the information that we need to be able to produce an accurate cash flow forecast. So what sellers I find out doing most that aren't taking on external cash or external funding, they're kind of running on this system of hope. They kind of think or hope they'll have the cash in the bank for the next inventory order, but they're not really forecasting enough ahead to say, will I have enough cash on hand to be able to fund my next inventory order to meet demand of growth and not run out our stock at the same time? But without those three data points, without knowing how many you're going to sell, what inventory you need to meet that demand, and what your cash payout per unit is, you can't put together a cash flow forecast. So once you've got those three data points, we then put together our cash flow forecast. So to give you sort of a demonstration of this, we base it on our current term. So let's say typical terms, 30% deposit, and 70% before shipping. That's pretty much most the market. Joe:          Pretty standard. Dan:         Yeah. So we will forecast our cash flow based on those terms for the products that we want to negotiate. So you might have one product with a supplier or you might have 10 but you just do it for the group of products that you're talking about with the supplier. So we'll have the sales forecast at the top of that cash flow forecast. Then we'll have a payout forecast which is based on sales. It's just that payout per unit multiplied by the number of units we expect to sell in that month. That gives us our total cash pile for that given month. We then factor in some fixed costs. So things like employees, software, training, salaries, costs that we know we're always going to have. And then we might factor in some ad-hoc costs like travel conferences, going to China Magic twice a year. God, I'm plugging that. So we factor in those hard costs and then that gives us a forecast month by month, January through December. If we go for the annual calendar year of what our cash on hand looks like. Then we just have to plugin based on what we know we have to order what cash output; what cash outlay do we need to factor in based on 30/70 payment terms. That then gives us an accurate view of where we're going to have a deficit on cash, where we're going to be up on cash, and what that looks like for the next twelve months. Does that make sense? Joe:          It does. You sound like a grown-up here, running a business with real numbers and doing some analysis. Dan:         I'm trying to. Joe:          Congratulations. And that's what you teach the folks at Titan Network as well. You're going through this with them Dan:         Yeah. Joe:          And do you produce video walkthroughs on how to do this with examples? Dan:         Yeah. So we've got like the whole step by step. Within Titan, we have something called masterclasses and we've got an entire master class on supply payment negotiation with all the templates, negotiation, soft scripts, ways of approaching; I'll give you some secret sauce in a minute but even like a presentation that we use to present this information to the supplier, all of that is all inside of Titan. And our Titan members; I mean, the results that we're getting, someone got a 50 grand credit line off the back of this. Joe:          Wow. Dan:         I can't count how many now; it's got to be 20, 30 members in the last few months alone that are getting terms, even just improved terms like 20% down because the raw material costs are quite high, but then they're not paying 40% until 30 days after shipping and the remaining 40% until 60 days after shipping, which means they've been selling the product likely for 30 days before that balance is due, which just opens up so much opportunity because you can afford to sell more product cause you can order more inventory. You can afford to expand into new markets because you can afford more inventories. Or you can afford to launch new products. And for anyone that's doing some serious money in this business, they know launching products is the fastest way to grow it. So, yeah, I mean, the results are quite stellar and we're doing some good things in time for sure. Joe:          It's all good stuff. Everybody listening certainly needs to do it if they're not doing it now. So once you've got all this information, the forecast and estimates and things of that nature what do you do with it? Dan:         So once we've created that cash flow forecast based on our current terms, so 30/70 we then produce a second forecast and we play around with those terms. So the example of I'm looking as a reference in front of me here is 20% deposit, 35% 60 days after shipping, 45% 90 days after shipping. And this is actually a live case study on one of the ASINs that we run. So we will adjust the cash flow to the new terms to then demonstrate what that does for our cash flow. And at this point, this is all internal. This is all internal reporting, preparation to support and enable the negotiation. So I know here, just look, I'll read us some numbers because obviously, I can't cast the screen. On our 30/70 our cash on hand column across the bottom January was in this example 5,000, February is 3,000, March goes into a 2,000 deficit, April goes into a 4,000 deficit because we've paid out that 30% deposit on this inventory order. Joe:          Can you just with those numbers do you have a ballpark total revenue figure as well? I'm just curious. Dan:         Yeah, we do. So down here we've got a total payout figure in this example because we haven't got the retail cost in here. We just track basically what cash flow we receive from Amazon so it's on the end of the column. But if it scales up; this was an example of a new product launch achieving 300 in the first month to a thousand units in the 12 months; very, very conservative forecast. Joe:          Okay, so what happens when you flip this to the new terms that you're trying to achieve? Dan:         So interestingly, the cash outcome; so at this point, we're not forecasting what additional inventory we can get so the cash outcome at the end is the same. So December, for instance, in the 30/70 on this example, the cash outcome for December, cash on hand sorry is 79,000. It started at 4,000. In the after states 20/35/45 again it's 79,000 at the end of the year in terms of cash on hand. But the difference is I don't have a single deficit in my 12-month run because I've been able to achieve better payment terms. So that's sort of step one of this process, cash flow forecasting existing terms and saying where your deficits are and then making sure that you can negotiate payment terms that mean you never run out of cash. You never need to go into any credit line, credit cards, any sort of equity or debt financing, because you're always going to have positive cash on hand to fund the growth of your business. Joe:          So what do you have to say to those people that are listening saying, okay, I got this, I'm just going to ask for these better terms and they don't do this work and they don't do a presentation the way that you want, what it is their supply going to say? Dan:         It's funny, actually, because one of the things we normally go to; this is a typical role play and if I ever talk about this on a stage and you lied and or anything like that, this is how it typically goes. You send an email that goes, hey, I need some better terms. Can I pay you the balance after shipping? The supplier email backs no. You sit there drinking FML like, what am I going to do? Yeah, most people just go give me better terms, a supplier goes no. And if you think about it, these factories; these suppliers, how many brands are asking them daily? How many of their customers because they're supplying hundreds if not thousands of customers. Joe:          Yeah. Dan:         I'm just saying give me better terms. I hope you sat there as a factory owner going well what's in it for me? Joe:          Right. Dan:         You have to answer that question of what's in it for me. It's got to be a win-win relationship. Joe:          Let's get to it then. The next stage is I mean, obviously, you're seeing so no deficits, which is great. The entrepreneur is sleeping better at night. They've got a little more cash for themselves, but also cash to probably buy more inventories which is what's in it for the vendor, right? Dan:         Absolutely. So with everything we do, we have to approach these relationships as a win-win deal. Having been to China more than a dozen times now, I've taken over 500 people. I have been involved in a number of these negotiations at lower levels and much higher levels. It is all about the relationship. It's all about the win-win. And you have to present what's in it for them. Why should they risk that workflow, their cash flow? Because I sense you're asking them to fund your business. Why should they risk that inaudible[00:20:16.2]. So the outcome for everyone has to be a benefit. So the way we do that is there's a five-step process to presenting a win-win. And this is what we break down into a presentation and we've got templates for etcetera. So Step 1 is the opportunity and the conversation that you're trying to get across is there's a big opportunity to make more sales. That's kind of the message you're trying to get across. And the reason it's better to do this in person as well is you can take; if you've got like a logistics manager or sourcing agent on the ground. All of our Titan members benefit from Titan sourcing, so we provide this to them on the fly. But yeah, if you've got that on the ground, you can then have that person translate but also be like an internal ambassador for this process. So step 1, the opportunity. There's a big opportunity to make more sales. Step 2, the challenge. The challenge is I can't order enough inventories to fund and meet the demand of my growth because of cash flow. And that's the challenge that you need to communicate. You can't fund your growth because of cash flow, and that's limiting your ability to grow because your sale is outgrowing your cash impact. I lose sales and as a result, the supplier, the factory that you're dealing with is going to get smaller orders. The solution is better terms so we can order more inventories. The whole objective here is better payment terms, more cash on hand, and allowing you to order more inventory just to grow faster; to compound that growth faster, the benefit, larger orders for the supplier, more sales for us. So that's kind of the five-step story that your supplier, your factory really needs to understand from this process. I'll read… Joe:          Read them off. Yeah, you were just going to do it. Yeah, read them off real quick one more time. Dan:         Opportunity, challenge, impact, solution, benefits. So they really need to understand each one of those points and then we're going to break down exactly how we do that. Joe:          Okay. So look, I haven't been to China before and I want to ask you about that a little bit, but I know that there are benefits for the manufacturer because you're going to be placing more orders. What's their recourse if you don't pay on those notes or is the risk so low because you've been there, you've met with them, didn't rush on building a relationship. Dan:         So you're not going to get this sort of payment terms on your first order. We have, however, had a number of success stories on their first order, even just slight movements like 20/80 on the payment terms or a slight reduction in COGS because we're guaranteeing more orders. We are getting some traction on first orders. This is more for sellers who are probably more your audience, Joe, who are sort of gearing towards exit. I've got an established relationship inaudible[00:22:54.8] the second to third order is kind of the sweet spot that you can start bringing this up. And if you bring it on early in the relationship, every time you place a bigger order, you can revisit these terms, you can revisit the relationship. So for the factory, yes, of course, there is risk involved, but they're weighing up the relationship with you and there are other insurances and stuff that you can bring up without getting too technical. You kept their eyes on ways of ensuring the order and stuff which can give a lot more confidence to the supplier but we don't do that most of the time. It's just purely based on the relationship and your order history. Joe:          Okay, so any more steps after the 5 that you talked about there? Dan:         Yeah there is. So that's the story we've got to present but when it comes to actually presenting that you've got to back that story with data. So they have to believe you and they need to see the numbers for themselves to tick that logical box. You've ticked the emotional box, you've got the relationship. They believed your story. Now you've got to present the data to back your story. So the six-step process to presenting the win-win, one is the growth potential, two is a product by product sales forecast. So that forecast to we produced in the beginning, we're just going to take the sales aspects of it and present that in a nice presentation. We're going to then present the order values to meet that demand and we're going to show them the before and after. We don't get into showing them the internal cash flow or the profit or anything like that. We just show them on the current payment terms this is what we can afford to order, on the new payment terms this is what we can afford to order. And what they're going to say is an order of say, 5,000, 10,000 units but with the new payment terms, I might be able to order 20,000, 25,000 units. So they're going to see a drastic change in the volume of units that you're able to order if they just work with you on the payment terms. Now, once we've done that, there's two other points. We always present what out of stock means. So most factories and suppliers don't really understand what it means when you're out stuck financially from a sales perspective. Sure they're being hammered; you're sort of getting on email, you're getting on Skype, you're doing you thing saying well I need this order, can you push it? Can you put it to the front of your production line and you're sort of pressuring them. But because you're pressuring them so much they're not really thinking about the impact on sales. So you can show the cost of being out of stock from a point of re-launching, lost sales velocity, lost growth. So maybe you've lost a couple of places in rank which has actually brought your growth percentage down, the momentum of growth. And for them, they're not going to be getting as frequent orders because that volume is down, meaning you're not placing as bigger orders. So you can still present the loss to them as well, which is a nice sort of stick to underpin the whole thing. And then finally you go right to solve this problem; this challenge, to order more from you and to recover was it, defend against that potential loss of being out of stock. These are the payment terms I need. And you just present the data to back the story. And it's quite easy, there's a whole template towards it in terms of how we do that. You can use screenshots out of your Amazon seller central accounts to back the data; you can use Keeper screenshots within the presentation as well as just sort of showing screenshots of that spreadsheet you really want to be showing the analytical graphs to back that data because it really gives that visual representation. Joe:          I'm sorry so let's just put in the; so for every 10 people that go through this process and try to renegotiate terms to go through the full process, they do it right. They do the projections. They do everything that you've talked about so far, which I think is eleven steps after they're doing the sales forecast, do 9 out of 10 of them get better terms or 10 out of 10 or 2 out of 10; what are the odds? Just put it into a realistic perspective for the audience. Dan:         So if you are already working with the supplier, you're already in communication. You're not just… Joe:          Yeah, let's assume that somebody has been placing two, three, four, five orders. A lot of people if they hadn't done this, they'd been placing the order for two or three years. Dan:         Yeah, so that person I would be as confident to say that eight in 10 people. I am yet to come across a relationship of that stature that's established with good communication where you won't end up better off. Now, you might not get the terms that you want straight out the gate, but I guarantee if they value your business, which they should do by that point you've got a relationship, you will end up off in a better place. So 90 to 100% of people will end up better off. 80% of people will execute to a point where it impacts customer for sure. Joe:          And this includes a trip to China because you're presenting it in person? Dan:         Yeah, this is like optimum. You've gone to China. Think about how many requests these factories and suppliers get from brands in the west as they say it asking. And then think about the percentage of people that actually get on a flight, fly to China, sit in the office, drink sake and do all that good stuff. That is going to be like 98 and 2%. So who are they going to prioritize? They're going to prioritize those showing real commitment. Business is about commitment. Business is about doing what you said you would do. And I think that's all this is. It's as simple as that. Joe:          Yeah, the 80% of people that have established brands can certainly get better terms with these vendors. Are you seeing; obviously they're ordering more and with higher volume orders comes lower cost of goods sold. How do you negotiate a lower cost of goods sold? Is it strictly volume based or do you make that part of this overall presentation that you're looking for terms and lower COGS at certain levels? Dan:         Yes. So what we do is we hold that conversation. So in any negotiation, you need the person you're negotiating with to say yes a few times. You need to get them to agree and we need to chip away at the yeses. So what we do is we hold that COGS conversation right until the end. So once we've gone through showing the growth potential, the product by product sales forecasts, showing the order values to meet the demand before and after if they give us these terms, the impacts of being out of stock, and then say this is the payment terms we want and always start higher, by the way. Always start higher than you actually need because there will always be a piece of negotiation. They will turn around and say, yes, hopefully. That's the goal. That's our amount in agreement. It might not be what you want, but they might say, well, on this one, we'll give you this and if you meet the demand, then on the next one we'll give you this. We might be a bit of an up curve. We then turn around and just say so now I'm placing a bigger order, I get a better price, right? And you'll find about half the time they'll smile and laugh at you and say, yes, the other half the time they'll say, let's talk about that in the next order. But yeah, you have to put a bit tongue-in-cheek in whether you have to build the relationship, play on the relationship. Joe:          Is this done over dinner or is it done over a desk; how do you see it most often done? Dan:         Typically, it would be done; in most cases, it's going to be over some sort of food environment, some suppliers and factories would like to get the business done and then go for dinner. Most likes to get the relationship piece in first. They want to sort of learn about you, your family. They want to give you some food, take you to lunch. And then during that process, we'll then bring it down to the conversation. Now, it's important to say it won't always happen there and then in the room. A lot of the time you'll present this, you'll throw in that thing at the end that says, so now I'm placing a bigger order do I get a better price and be a bit cheeky with it. And a lot of the time they're going to turn around and say well, look, we need to run our raw material costs. We need to look our production workflow. We need to speak to our internal production manager. We'll get back to you within a few days. So depending on how long you're in China, it could be back when you were in America or back in Europe. You'll jump on Skype and they'll go, okay, cool we've run the numbers. It makes sense. Yes, we can do that. So it kind of happens like a bit of a fluid conversation during the social aspects. Sometimes you'll sit in an office and just get it done. But most of the time it would be over some sort of lunch or something like that. Joe:          I got you. Okay, any other steps that you want to review? Dan:         No, we're good. So really just remember, it's a win-win. Do your internal prep; what they say is the success is in the preparation, success in the planning. Do your planning, and then make sure you're presenting it in a way that presents it as a win to them. And yes, you can achieve this virtually over the internet, but you're going to have 100% better results. And if it's okay, Joe, I've got some examples here, actually. Joe:          Yeah. Dan:         So Case Study 1, 30% deposit, 70% before shipping, after 0% deposit, 100% percent 60 days after shipping. Joe:          That's a beautiful outcome. I can't imagine anybody would be upset about that. Dan:         No, it's cool. That was actually inaudible[00:31:13.0] and my business partner and Sarah, who's head of Titan Sourcing that negotiated that one. The next one was 30% deposit, 70% before shipping after we got a 30% deposit because the raw material costs were quite high on this product, which you have to still work with them on, and then it was 20% percent before shipping. So we pay sort of 50% and then we got 50% percent 30 days after arrival at Amazon FBA, which meant we had 30 days of sales before having to pay the remaining 50%. Case Study 30% deposit, 70% on the approved inspection report. That was a bit of a quality assurance thing there. After we got a 20% deposit, 35% 60 days after shipping, 45% 90 days after shipping so that was a nice one. And then finally, the fourth one and I've got some bonus tips at the end if you want them, Joe, 20% deposit, 80% before shipping. That was the terms we had so it was a bit nicer on the frontend. After we got a 10% deposit, 40% on landing in the USA, and 50% 60 days after landing. Joe:          Wow. Dan:         And these are typical; I can stand there and say now these are just four cases that we've done we've got a whole Titan network full of members that are doing the same. Joe:          Yeah. No, I want to hear about the bonus tips. Also want to hear briefly about China Magic and maybe we can have Athena on to talk about it. Just let me ask; go ahead into the bonus tips and then then I want to talk briefly about China Magic. Dan:         Yeah, sure. Because there's loads of benefits above and beyond obviously COGS and terms. Joe:          Yeah. Dan:         Okay, so tips to success face to face always will produce a better result. They often pay for the trip and that's what you got. Think if you're looking at a cost offset, you'll often get to pay for the trip in the renegotiation. Always ask for more than you need; really important. You probably won't shake hands there and then as I said. Make sure if you come to see the boss, you don't want to be waiting on a middle person or a middle man so they then you have to go and sort of do the translation. You want to be in front doing the deal with the boss. Before you go into that environment, before you even head out to China, if you've got a representative from that factory or you've got a sourcing agent that handles that relationship for you, then get them onside. So run through the presentation with them first so that when they're in the room, they've already done the thinking, they're already standing there, and they can get the buy-in of the boss in the room. Consider consolidating your orders to one supplier. It gives you more buying power. And one thing we're a big fan of in Titan and in China Magic is leveraging an outside adviser. Because then you can play the whole good cop bad cop. If you want to maintain a good relationship you can bring in someone that's like an external advisor to crack the weight a little bit and you can call them your finance person. You can call them whatever you want to. That allows you to do that. And remember, every relationship and supplier cash flow is different so you have to really; don't just tell them what you want, understand what they need, and bring the two together. And this is counter-intuitive but it's often being willing to pay more to achieve the terms especially in the beginning. So one thing you can do is if they're not budging, you can afford to give them a dollar bum pull over here now on a product to get them to nudge on the payment terms which is still going to give you more cash on hand and then come back to renegotiating the COGS once you're up at the higher volume because you've been off to some of the growth. Joe:          I like it. Dan:         And also take gifts as well; take presents. It works. It depends; there are controversial views on this. So Kian Golzari for instance who is a sort of an expert on China Magic everything; he's doing sourcing and product development. Kian loves; he's from Scotland, he's from Edinburgh, he loves taking some Scotch whiskey with him. Other people take chocolate. There's the whole red envelope with some cash in it for the children but that one's a bit more controversial. But yeah, just my advice would be take something that's important; not important but personal to you, and then that creates a talking point and it creates more of a relationship and a bond. Joe:          Okay, that sounds great. I think one of the most important things I see people that are running great businesses and eventually sell them, they're great businesses, do great for buyers. They really have been to China and they always wind up with either better terms or better COGS. It sounds like a scary place to me, though. I've never been so is China a scary place? Dan:         It really isn't. So when I first got involved in the early days with China Magic I went out there as a guest speaker and then ended up becoming a co-organizer with Athena. I thought the same but when you land; if you think like Guangzhou where the Canton Fair is. That's where we go. It's the biggest product sourcing Fair in the world. I think they start setting up 5 million products on display during the Canton Fair. They're used to receiving hundreds of thousands, if not millions of westerners through that fair over the course of 12 months. The airlines are efficient. The flights are cheap. I mean from the US, the flights are $500 on a good day it's $400. Joe:          Wow. Dan:         Yes. I mean, it's really cheap. That's for obviously economy. I got a first-class ticket; I mean first-class pod for two grand. Joe:          Wow. Dan:         So yeah I mean it's cheap. We head out there and we're picked up by a nice comfortable bus and we stay in the Four Seasons Hotel which was rated Forbes Best Business Hotel in the world 2019; the one where we go. So they look after us. We've got five staff service and food, good internet. We then head over to the fair. This isn't a market; there are other markets like Ebru and stuff which are a bit more like rack markets, Canton Fair is a professional establishment. All of the suppliers there are paying serious money to have a booth at this fair. So if they don't speak English themselves, they'll employ English speaking representatives. So you can have a really good conversation there. Sometimes you have to work with a bit of culture and there are definitely cultural barriers that you have to learn, like receiving a business card with two hands and showing that respect. It goes much further and Ken covers all this in China Magic. We go into depth like we spend some of that four hours just going into how to have a conversation with a supplier so that they know you are educated. But yeah I mean, to cut a long story short, it really isn't. Like I walk around in my shorts and my t-shirt, I go down and they've got little smoothie bars now I'm on the streets by the hotel. It's quite a pleasant place. Joe:          Fantastic. How do people learn more about Titan Network and then China Magic and again I think we ought to probably have somebody on for China Magic and what that event is all about because it's; I don't know, it's the next step. I don't know if I would want to go on my own and I assume that you would not recommend that. You go with a group that does this on a regular basis. So tell us about how more people learn about Titan Network and in particular this cash flow management renegotiation, all of the different steps that you've talked about. Dan:         Yeah, sure. So if you want to know more about Titan Network, we're an invite-only membership organization for Amazon sellers. We're going from strength to strength. And the thing about Titan Network is it's created by sellers for sellers. So it's not about any one person's success. It's not like a guru led thing. You can learn it at TitanNetwork.com. That's where you go and learn about Titan Network. And if you feel like you want to find your tribe and your family, then take a look there and you can apply for Titan Network. If you want to learn more about China Magic go to ChinaMagicTrip.com. It's got the full trip details on it. I'm going to give you access to a little special link. If you go to ChinaMagicTrip.com/masterclass we go into a bit more depth on these payment terms upon negotiation stuff. And it's got off-screen shares. You can actually see some of the slides. And that's all out there free of charge so you can go and take a look at that. Yeah, I'd love to do a follow up about China Magic. I'll bring Kian on, I'll bring Athena on and go into the depths of like not just payment terms and cash flow, but how do you build these relationships and how do you find these factories that you're not going to find in Ali Baba, how do you improve the quality, how do you differentiate products in 2020; yeah, we could talk about a lot. Joe:          Well, I think it's a great service to the people that are Amazon sellers or even just not Amazon sellers, other people that sell-off of Amazon need better terms as well. Dan:         Yeah. We're seeing Shopify sellers. We're seeing a lot of these influencers on Instagram that are realizing they've got an audience. If they apply a physical product to that audience, they're going to make money. We're seeing all these guys come along now because it doesn't matter whether you're selling on Amazon or Shopify, physical products are physical products. And to your point about going alone, there are seasoned travelers out there that will have no issue in visiting China themselves. But for me, it's about return on my time, a return on investment on my time so if I can go with 75 like-minded sellers at a similar point the journey led by multiple seven and eight-figure sellers, get shown 30 years' worth of sourcing experience across Marcy, Kian, myself and the team in a couple of days; so condense that learning period, get the COGS on payment terms on it and every single evening mastermind for four hours a night on every single area of the business, that to me is a bigger return on my time than just going over to China myself. So that's kind of my view on it. Joe:          Yeah, if I was in the e-commerce world myself, I'd be in. I'd want to bring my son though so he enjoys the world travel. Maybe in another life, I'm out of the e-commerce business myself. I'm an entrepreneur at Quiet Light Brokerage only. So listen Dan, I appreciate all the time you spent here. I think its great advice and I know from experience that people that exit their business for the maximum value end up doing a lot of the things you've talked about so thank you. I appreciate it. Dan:         Yeah, no there's just a final closing point now. We should tie this back to valuation. So you'd go how does this make my business worth more? Well, I think I'll just spin-off three raises in my head to maybe cut this in. One is it's going to make you more attractive as you've got solid foundation relationships with your supply chain and you're not relying on Alibaba or some sourcing agent. Buyers want to know you've got the full foundation. Two if you've got more margin, you've got more profit, more profit, bigger valuation. And three, if you've got better cash flow and more cash flow on hand, you can compound that freight faster which means you achieve your valuation faster. So that's how they tie it back to valuation. Joe:          And again, I say it and I'll stop saying because Mark keeps correcting me there's no fifth pillar. All of the things that you're talking about make you a better business person; somebody that others will trust because you're instilling confidence in them that will bring you better value as well. People if they trust you they're willing to pay more for your business. So Dan, great stuff, thanks so much for coming on the podcast. Dan:         I appreciate it, Joe. Thanks for the time. Resources: Titan Network China Magic Masterclass China Magic Trip Quiet Light Podcast@quietlightbrokerage.com  

In this episode, Dr’s J and Praz, with special guest Emily Hook discuss the attributes and health of circus sideshow performers. Along the way, they cover the history of circus sideshows, the Coney Island NICU, the classes of sideshow acts, Geeks, the secrets of human pincushions, glass chewing, sword swallowing, circus endoscopy and intubation, fire eaters lung ,off season care, Ehlers Danlos syndrome, acrobat anesthetists and more! So Step right up, sit back and relax as we dive into the world of freakshow!Sources1)http://www.bmj.com/content/333/7582/1285ijkey=8559399d0af3cd2596c8540d8872c966fa286536&keytype2=tf_ipsecsha2)http://time.com/3711869/sword-swallower-paris-1945/3)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522406/4)https://tinyurl.com/yxhpcon4Contact Us!Twitter: @doctorjcomedy @toshyfro @travelnmedicine Facebook: facebook.com/travelmedicinepodcastSquarespace: travelmedicinepodcast.squarespace.comPatreon: https://www.patreon.com/travelmedicinepodcastFind and Review Us wherever podcasts are availableRadiopublic: https://radiopublic.com/travel-medicine-podcast-6LMnw2itunes: https://itunes.apple.com/us/podcast/episodes-travel-medicine-podcast/id914407095stitcher: http://www.stitcher.com/podcast/travel-medicine-podcast?refid=stprGoogle Play: https://play.google.com/music/listen#/ps/Iebqxcseb4s6pu5sjyljwgqsbuyYouTube: https://www.youtube.com/playlist?list=PLr4fcpX27x2vcJT_zJq6qiBy0pK8WiEX

I would very much like to fix all of my challenges to living fully. However, I must first discover the blockages and challenges themselves! So Step 6 says we must live in tension: discover what needs fixing AND leave the fixing to God. That is a tall order for fix-it folks like me.

Today's podcast is all about overwhelm. Specifically, when all the changes you need to make to fall pregnant feel overwhelming. I totally get it. Don't eat dairy Don't eat gluten Go low tox in your make up Stop heating using plastics Meditate Do acupuncture ... and the list goes on! There are so many things you're 'supposed' to do or 'could try' to help optimise your fertility, and it can be totally overwhelming! So today, on the podcast I address this. #truthbomb I start off with a bit of a #truthbomb and that is to sit back and have some self awareness. Is it possible that what you're feeling isn't overwhelm because you're doing too much, or could it be something else, like fear, or guilt and instead of doing too much, you're actually paralysed with fear and not doing anything at all? So Step 1 to reducing your overwhelm is to do a little audit about what you're feeling, why, and how you can change. Change is ALWAYS uncomfortable. As human beings we are conditioned to dislike change, so there is always going to be a bit of push when it comes to making changes in our life, so we need to step back and assess what it is that we're actually feeling. Step 2 is to show gratitude. Sometimes it's easier said than done, but when you show gratitude, it sometimes makes the overwhelm... well... less overwhelming, and, if you don't have anything to be grateful for, check your pulse. No doubt if you're reading this, you are living in a first world country where we have access to wonderful technology, you no doubt have some great support in your life from friends/partners/family, plus many more things that you could be grateful for in life. Step 3 is the biggie - it's to take a step back Perfection doesn't exist. Meeting an adult with zero things on their to-do list doesn't exist, but we beat ourselves up when it comes to fertility because we so desperately want this! In the podcast I talk about where I 'dropped the ball' and how I refuse to feel guilty about it. You have to do what you can manage, and you also have to take things in small steps. Not only do you need to take things in small steps (and small steps by the way have been shown to be waaaay more effective at making lasting and sustainable change), but you should also acknowledge small wins that you might be having. I bet if you looked back and compared your lifestyle to what it was a few years back, you'd pat yourself on the back! There is a common saying, which is how do you eat the whale? One bite at a time.

Session 14 Today, we break down the match data, compensation surveys, and lifestyle reports for Emergency Medicine. If you’re interested in EM, this is a must listen. I also talked about dove into match data back in session 11 specifically on Anesthesiology and now I'm going to dive into Emergency Medicine. If you follow the NRMP results, Anesthesiology is first in the alphabetical order, followed by Child Neurology and then third, Dermatology. However, these two are relatively smaller so I'll reserve a separate discussion on the smaller programs at a later date. For now, let's focus on Emergency Medicine, which is a very popular specialty these days. [02:05] Emergency Medicine at a Glance Back in Session 2, I was able to talk to an Emergency Medicine physician and learned that because of the shift work and the amount of work, it has become popular. What is considered full-time for an Emergency Medicine physician is about 15-16 shifts a month. That is equivalent to three business weeks (Monday through Friday, five days times three) which means an extra whole week off per month. Of course shift work comes with some negatives which were also mentioned in that episode. [03:10] NRMP Match Data for 2016 First, check out this 120-page PDF document called, Main Match Results and Data for 2016. Looking at Table 1 (page 12 of 120) for this NRMP match data, Emergency Medicine has 174 programs, which means it has 55 more programs compared to Anesthesia with 119 programs. Of those 174 programs, there are 1,895 spots and this works out to almost eleven spots per program. It is a very competitive and a very, very wanted specialty that out of those 174 programs, only one program went unfilled. Number of applicants: 2,476 Number of available spots: 1,895 Number of applicants that matched: 1,894 Number unfilled: 1 Number of U.S. Seniors that matched: 1,486 (78.5%) As compared with Anesthesiology, 72% of those that matched were U.S. Seniors. Hence, Emergency Medicine is matching more U.S.-based Seniors going into Emergency Medicine. This possible means that there are less international students applying for Emergency Medicine and less students who didn't match right away. Looking at the total number of matches which is 1,894 (out of 1,895 positions offered), there was one spot in one program that went unfilled. This suggests how very competitive the specialty is with 99% were filled for Emergency Medicine. [06:18] Emergency Medicine and PGY1 Positions Last time, when I talked about Anesthesiology, Table 1 has PGY1 positions, PGY2 positions, and physician positions. Emergency Medicine, however, only has PGY1 positions listed in Table 1.0, which means that you don't go to do an internship separate from your Emergency Medicine residency because it's all built into the one main residency. It can be very confusing considering that different specialties have different terminologies. As with Emergency Medicine, it does not have other internship outside the program so there are are no PGY2 positions or physician positions available to apply to. [07:35] Applicant Types in Emergency Medicine Table 2 (page 16 of 120) of the 2016 NRMP match data breaks down the specialty and applicant type. For Emergency Medicine: Number of filled positions: 1,894 % of U.S. Seniors that filled: 78.5% Number of (non-Senior) U.S. Grad: 73 (almost 4%) - U.S. Grad means that you either took time off between trying to match and graduating from medical school. It's either you didn't try to match during your senior year of medical school or you didn't match and you took some time off and strengthened your application and reapplied and now are getting in. Number of Osteopathic students matching into EM: 224 (almost 12%) - These are osteopathic students that went outside of their AOA match, or national match, and applied through these MD programs instead of to DO Emergency Medicine programs. Number of Canadians: 1 Number of U.S. International medical graduates: 87 Number of non-U.S. international medical graduates: 23 (These are non-U.S. citizens that graduated from an international medical school) Number of unfilled spot: 1 Comparing it with Family Medicine, which you may assume as a primary care specialty to have a large percentage of availability for international medical grads, they had 382 international medical grads out of 3,083 spots, equivalent to 12% more or less. [11:20] Emergency Medicine as a Relatively New Specialty We learned from the Specialty Stories Podcast session 2 where we interviewed a community-based EM physician, that Emergency Medicine is still a relatively new specialty. Table 3 (Page 20) of the NRMP match data for 2016 shows the positions offered from 2012 to 2016. And Emergency Medicine (outside of the primary care specialties) is the fastest growing specialty out of all of the more sub-specialties. If you're interested in Emergency Medicine, that means there are more and more spots available every year which is a good thing. 2012 - 1,668 spots 2013 - 1,743 spots 2014 - 1,786 spots 2015 - 1,821 spots 2016 - 1,895 spots It's growing relatively consistently between 6.5% to 7% year over year. Now if you look at some of these other ones, the primary care specialties, family medicine growing 11.5% every year which is huge but expected for primary care specialty. Pediatrics almost 10% every year. But Emergency Medicine as a specialty outside of primary care is the fastest growing which is pretty awesome. [13:20] Osteopathic Students in Emergency Medicine The national matching service which is the DO matching service, their program has a 2016 program stat. If you Google ‘national match DO 2016,' I'm looking at a very different amount of data compared to the NRMP. While, the NRMP is 120-paged report, this specific list is just a one-paged website showing that Emergency Medicine for osteopathic students had 58 programs and 307 positions. NRMP has 174 programs and 1,895 positions. So a lot more MD programs which makes sense I think historically. Obviously there are more MD programs throughout the country since DOs are still relatively new in the grand scheme of things (Emergency Medicine is a newer specialty but still DOs being a newer breed of doctors). So they just have less of a footprint which is neither good nor bad but it's just what it is. So 58 programs, 307 positions available, and five of those positions went unmatched in the Emergency Medicine for osteopathic students in their matching in 2016. [15:20] U.S. Applicants & PGY-1 Positions Going back to the NRMP match data for 2016, Table 7 (Page 30 of 120), shows the number of positions offered and filled by US seniors and all applicants between 2012 and 2016. And so doing some quick math, the number of US students that are filling these spots for Emergency Medicine has basically stayed the same, around 78% to 80% every year, which is pretty good. It means U.S. applicants are staying very competitive for these programs. Table 9 (Page 37 of 120) of the NRMP match data for 2016 shows all applicants matched to PGY-1 positions by specialty from 2012 to 2016. Emergency Medicine being one of the fastest growing specialties out there or has been the fastest growing outside of the primary care specialties, applicants and students that matched made up the most out of any of the specialties, again outside of the primary care specialties. They made up about 7% every year since 2012, with the 2016 match data showing 7.1% of all students matching into a PGY-1 position, or matching into Internal Medicine. Now just for numbers here, 11.5% matched into family medicine, almost 26% matched into Internal Medicine, 6.8% matched into a PGY-1 only spot for Internal Medicine, and Pediatrics was 10%. So all of these big primary care specialties are 11.5%, 10%. Internal Medicine is huge at 26%. But Emergency Medicine has the largest number of students matching into it outside of the primary care specialties. Looking at Table 11 (Page 39 of 120) shows the osteopathic students matching into PGY-1 spots for these DO programs and Emergency Medicine is the highest outside of the primary care specialties at 9.3%. So 9.3% of all osteopathic students matching into an MD position matched into Emergency Medicine. [18:15] Emergency Medicine as Only Specialty Choice Figure 6 (Page 45 of 120) in the NRMP match data talks about the percentages of unmatched US seniors and independent applicants who ranked each specialty as their only choice. Emergency Medicine had 11.3% unmatched number and almost 6% of U.S. seniors that were applying for Emergency Medicine as their only specialty choice did not match. However, that data alone doesn't tell you enough actually. Here are comparisons of U.S. Seniors unmatched for other specialties: 8.7% of U.S. seniors unmatched for Psychiatry 20% for Neurosurgery 5% for Family Medicine 20.8% for Orthopedic Surgery So 6% of unmatched U.S. Seniors isn't very high and when you look at these you just have to question how competitive were these students for Emergency Medicine if they weren't matching? [19:58] SOAP Data Table 18 (Page 55 of 120) of the NRMP match data shows the SOAP data for 2015 and 2016. SOAP stands for the Supplemental Offer and Acceptance Program through the NRMP. These are for students that did not match, they find out before the actual match date, and they are given time to talk to programs that have some spots and hopefully match after they find out they didn't match to begin with. For 2016, Emergency Medicine did not participate in the SOAP. And that kind of makes sense because there was only one spot unfilled. [21:00] Charting the Outcomes - Emergency Medicine Switching over to the NRMP Charting Outcomes Report, which is another great 211-paged report. Chart 3 (page 10 of 211) shows the rates of U.S. allopathic Seniors. 91% of US allopathic seniors matched into their preferred specialty. Chart 4 (Page 12 of 211) shows the median number of contiguous ranks of US allopathic seniors. So when you make your rank list, you're ranking the programs that you interviewed at or applied to, and you rank all of the programs that you want to go to in order of how you want to go to them. The median number of contiguous ranks of those that matched for Emergency Medicine was 12. Those that did not match was 4. So these students that did not match were very, very selective with who they ranked. They were probably hoping to only match in a very specific part of the country or to a couple very specific programs. When you do that, the less schools that you apply to, the more strict you are with your availability to apply to a larger number of schools. This is going to limit your chances getting into medical school. That's exactly what happened here with students applying to Emergency Medicine is they didn't apply and they didn't match to enough programs. Again, 12 compared to 4 contiguous rank numbers. [24:23] Charting the Outcomes - Step 1  and Step 2 CK Scores Chart 6 (Page 14 of 211) in Charting the Outcomes shows the Step 1 Scores of U.S. Allopathic Seniors. For osteopathic medical students, they take the COMLEX Level 1. Osteopathic students can take the USMLE but we're focusing here on U.S. allopathic seniors. Those that matched into Emergency Medicine scored between 225 roughly and 245 which are great scores, and those that did not match scored in roughly 205 to 235. Their scores were much lower on the bottom end, and only went up to about the middle of the road for those that did match. So Step 1 scores mean a great deal for your ability to match. Just like a great MCAT score, it opens up a lot of doors. Looking at Chart 7 (Page 15 of 211) shows the Step 2 CK scores, Emergency Medicine, they were between 238 roughly and 255, and those that did not match were 224-ish to 242-ish. So again, lower obviously Step 2 scores. [25:54]  Importance of Research, Abstracts, and Publications Looking at Chart 8 (Page 16 of 211) for the charting the outcomes NRMP match data, research didn't seem to play a huge part in those that matched and did not match. The Mean Number of Research Experience for U.S. Allopathic Seniors was 2.4 for those that matched and only 2.2 for those that did not match. Though research that actually led to something seems to be more important. The Mean Number of Abstracts, Presentations, and Publications (Chart 9 - Page 17 of 211) for those that matched in Emergency Medicine, they had 3.3 and those that did not match had 2.2. [26:39] AOA Data Chart 12 (Page 20 of 211) shows the AOA Data, referring to the Alpha Omega Alpha which is the medical Honor Society. 13% of U.S.seniors that matched were AOA for Emergency Medicine and 1% of those that did not match were AOA. AOA seems to play a little bit of a role in matching to Emergency Medicine. It's usually the case with the more competitive specialties. The AOA seems to play a role, though is it really the AOA that plays a role, or just the fact that you have great grades? Obviously, having great grades leading to the ability to do well on your board scores. [27:31] Step 1 and 2 Scores and Distinct Specialties Table EM-1 (Page 60 of 211) in Charting the Outcomes Report shows all of the raw numbers. Mean USMLE Step 1 score: 233 for those that matched and 220 for those that did not match Mean USMLE Step 2 score: 245 for those that matched and 232 for those that did not match Chart EM-1 (Page 61 of 211) has the number of distinct specialties ranked by U.S. allopathic seniors. For US allopathic seniors that only ranked Emergency Medicine, 1,269 matched, 72 did not. That's 5.4% roughly of those that only listed Emergency Medicine did not match. The second column here in chart EM-1 shows that 88 students (column number two is if you had two programs or two specialties that you're ranking for). And so for students that aren't 100% in on Emergency Medicine, 88 of those matched and 40 did not. So if you look at that number, it's 31% of those that ranked two programs here did not match compared to 5% for those that are only ranking one. You need to make up your mind because you're obviously not selling the programs that you're interviewing at that you're dedicated to going to whatever specialty that you're interviewing at for that day. [30:43] Medscape Lifestyle Report 2017 Diving into the Medscape Survey Data for Emergency Medicine, and looking at the newest Medscape Lifestyle Report for 2017, Emergency Medicine. Slide 2 shows that 59% (at the highest) of Emergency Medicine physicians are stating they are burned out. What's interesting though is on the next slide, when it asks about the severity of burnout, Emergency Medicine is way down the list at 4.2.  So it's a scale from one to seven, Urology is at 4.6 at the highest, Infectious Disease is the lowest on this list at 3.9, Emergency Medicine is 4.2. So they're burned out but not the highest which is interesting. Not surprising for Emergency Medicine given that it's shift work, is that they are almost very close to the top, specifically, fifth on the list for which physicians are happiest. It looks like it's mostly based on outside of work. Urology is 76% are happiest outside of work, Emergency Medicine is 71% are happiest outside of work, and Emergency Medicine is 28% happiest at work. So there's a big discrepancy there, and obviously with shift work you have a lot of time outside of work which is great, and so Emergency Medicine physicians are loving that time, but they're getting burnt out at work. [32:26] Medscape Physician Compensation Report 2016 Switching one more time to the Medscape Physician Compensation Report for 2016. How much do physicians earn overall? Orthopedics at the very top just to give you some understanding of where we're at. Pediatrics at the bottom. Ortho at $443,000, Pediatrics at $204,000, and Emergency Medicine is almost in the middle at $322,000 a year. What's interesting in this compensation report is that they have a list here for which specialties have the most female physicians and Emergency Medicine is on the lower end of the list at 19%. OB-GYN unsurprisingly is 55%, Pediatrics, again unsurprisingly 53%. Emergency Medicine is 19%. We need some more female physicians in Emergency Medicine. So if you are a female, go for it. For physicians that feel fairly compensated, Emergency Medicine is top three at 60%. Dermatology 66%, Pathology 63%, Emergency Medicine right there at the top at 60%. What's interesting looking at Slide 17 here, Emergency Medicine has the fifth highest satisfaction overall for physicians at 57%. 60% being satisfied with their income, 66% would choose medicine again which is at the higher end, but only 44% would choose Emergency Medicine again. Now I have a hypothesis about this. I don't think it's Emergency Medicine necessarily that is causing this 44% that would choose this specialty again. Looking back, speaking to an Emergency Medicine physician back in Session 2, he talked about how Emergency Medicine doctors need to know a lot about a lot and I have a feeling that a lot of people go into Emergency Medicine because they haven't found that one thing that lights them up every day all day. And when they're practicing Emergency Medicine, at some point they realize what that thing is, and then they wish their whole time was spent doing that one thing, but they're ‘stuck' in Emergency Medicine. So although Emergency Medicine is nowhere near the bottom, it's still one of the lowest ones. You have Pulmonary Medicine which is kind of surprising at 37%. OB-GYN 41%. Unsurprisingly Internal Medicine is at 25% which is too bad. Links: NRMP Main Match Data for 2016 Charting Outcomes in the Match for U.S. Allopathic Seniors National Match DO 2016 Medscape Lifestyle Report 2017 Medscape Compensation Report 2016 Send me an email at ryan@medicalschoolhq.net MedEd Media Network Specialty Stories Podcast session 11 Specialty Stories Podcast session 2 Facebook Medical School Headquarters Hangout Page

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