Voices in Health and Wellness

Treating the Person, Not Just the Pain with Dr Mila Mogilevsky

• Dr Andrew Greenland • Season 1 • Episode 3

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What happens when a dedicated clinician decides to build a pain management practice that breaks all the rules? Dr. Mila Mogilevski joins us to share the compelling story behind Unique Pain Medicine, her thriving New York-based practice that's challenging conventional approaches to treating chronic and acute pain.

From day one, Dr. Mogilevski set out to create something different. While traditional pain medicine often defaulted to opioid prescriptions, she established a practice focused on comprehensive, multidisciplinary care. "Primary care doctors would call me saying 'I'm sending you so-and-so, he needs Percocet,'" she recalls. "I'd say 'slow down, that's not what's happening here.'" This revolutionary stance has evolved into a holistic approach combining interventional techniques, regenerative medicine options like PRP and stem cells, and wellness services—all designed to treat the whole person rather than just managing symptoms.

At the heart of Unique Pain Medicine's success is an unwavering commitment to personalized care. With locations in Manhattan and Brooklyn (and a third on the horizon), Dr. Mogilevski's team guarantees patients will see physicians—not mid-level providers—and strives to accommodate same-day appointments. This dedication creates a stark contrast to the corporate healthcare trend sweeping through the industry, where small practices are being "gobbled up" by private equity firms and large organizations like Amazon. "The moment clinics get bought by private equity, it becomes all about the numbers...and patients get sidelined," she explains.

Despite substantial challenges—including 75% overhead costs in expensive New York City and the pandemic's disruption to office worker patterns—Dr. Mogilevski remains optimistic about the future of boutique healthcare. She believes there will always be demand for alternatives to impersonal corporate medicine, especially when built around a team that prioritizes cooperation over competition. "That's sort of the secret sauce," she shares. "Be happy while you work and try to work together."

Ready to discover how small, patient-focused clinics are reshaping healthcare delivery? Subscribe now to hear more conversations with innovative leaders who are putting care back at the center of healthcare.

🔗 Guest Contact & Socials 

Dr. Mila Mogilevsky, DO
Medical Director, Unique Pain Medicine, PLLC 

📍 Manhattan Location
369 Lexington Ave, 19th Floor
New York, NY 10017 

📍 Brooklyn Location
626 Sheepshead Bay Rd, Suite 520
Brooklyn, NY 11224 

📞 Phone:  929-363-0303
📠 Fax: (347) 252-6731
🌐 Website: https://uniquepainmedicine.com
✉️ Email: milam@uniquemed.com 

🔗 Follow Unique Pain Medicine: 

 

Dr Andrew Greenland:

So welcome back to Voices in Health and Wellness. This is where we speak with leaders and innovators and passionate advocates reshaping the future of healthcare. I'm Andrew Greenland, I'm the host of this podcast, and today's guest brings a powerful mix of clinical expertise and entrepreneurial grit to the conversation. We're joined by Dr Mila Mogilevski, medical Director of Unique Pain Medicine, a thriving New York-based practice that's redefining how chronic and acute pain are treated, with a focus on real outcomes and deep patient care. With two locations in Manhattan and Brooklyn, mila and her team serve a wide range of patients, using evidence-based medicine and multidisciplinary approaches to restore function and dignity, to heavily help people living with pain. We're going to really talk today about a number of things, but one thing I really want to talk about is the disturbing trends that are threatening the future of small health clinics, because we're all working in our spaces sometimes quite small operations and I really want to get Mela's perspective on that. But without further ado, I'd like to welcome you and introduce you, mela, to the show.

Dr Mila Mogilevsky:

Thank you so much, Andrew. Thank you for having me.

Dr Andrew Greenland:

Well, you're very welcome and perhaps you could tell us a little about your role in unique pain medicine and actually how you got into this space, because it's obviously chosen a particular path, so always interested to hear how people end up doing the things that they do sure?

Dr Mila Mogilevsky:

um, you know, I think, um, you know, I would just start by saying that, um, I guess my, my whole entrance into medicine was a little bit different than others. Uh, before I became a doctor, I was a physical therapist and so I understood a little bit more about how to manage patients from the standpoint of, uh, you know, a provider who takes care of the patient not just medically but also rehab wise and a little bit more holistically. So the idea and this passion of having a rehab clinic, potentially working with patients that have chronic pain, was brooding for a long period of time, not just when I started medical school, brooding for a long period of time, not just when I started medical school. So medical school was just a natural progression to step it up from providing physical therapy care to providing full medical care for the patient. But when I was working as a physical therapist, I sort of noticed that it's this sort of personalized approach that physical therapists do, almost like hands-on approach, that a physical therapist use would be very helpful as a physician as well. And the idea of having my own private practice where I would really treat patients the way I think would benefit them best, is what brought me to opening my own clinic.

Dr Mila Mogilevsky:

I opened a unique pain medicine almost straight out of residency. I didn't really wait, I really just wanted to, kind of, you know, take it to that level. And it was a slow but very steady growth. It started with just me and then I started adding more providers and more staff to the clinic and so it wasn't like a fast dive in, but it was very steady and organic growth. We started with one practice, which was in Brooklyn just one location and then pretty quickly added the second location and, as of right now, we're actually thinking of potentially doing a third as well, um to sort of encompass, you know, more of new york city area and meet demands of um more patients, if you will amazing long answer to a short question, but yeah, what's I mean?

Dr Andrew Greenland:

and your role in the clinic. You're very much hands-on, I'm I'm figuring in the business okay so what does a typical day look like for you? Across your two sites, and obviously you're thinking about expanding into a third how is that going?

Dr Mila Mogilevsky:

to shift yeah, so you know, I, I, I have um. Besides myself, of course, I have three other uh doctors, and so there are two of us on each side. So two people are in brooklyn, two people are in manh, and also we have an anesthesiologist present in both locations for complicated cases or for cases that do require sedations. We do procedures involving injections, and some of them are painful and those are spinal injections. So, to be able to provide patients best experience, we always have an anesthesiologist on staff. It's also very helpful because they have a little bit more intense training should there be a problem or an emergency, and so these guys are always available not just available, but they're active players in our treatment team. So that's usually what we do.

Dr Mila Mogilevsky:

Because of, I think, of slightly different expertise that all of us bring to the table. We have anesthesiologists, we have rehab doctors with interventional pain training, like myself. We also have an internal medicine physician who is a sports medicine guy. Because of all those different assets that we all have, we are able to attract slightly different patients. So I would say that myself, personally, I see more female patients. Some of them are a little bit older, some are younger, but it's just naturally fit for me to see more women than men. And then other people see, like my internal medicine physician tends to attract more patients that are older, medically complex, and the other two physicians are attracting a little bit younger. One of our guys really likes marathon runners and he's very good with sports medicine-oriented people, so that type of clientele naturally gravitates to him. So it's really more like organically people and following develops as we go.

Dr Andrew Greenland:

Really interesting and obviously you're called Unique Pain Medicine. Yeah, so what are the things that make you unique from the more traditional pain management models? Obviously, you mentioned you perhaps get a slightly different patient mix. What are the other? Kind of ingredients for your clinic that make you unique.

Dr Mila Mogilevsky:

Right. So I think you know when I first started this whole enterprise. I call it unique because back in 2010, the idea of doing pain medicine was the idea of prescribing opioids and from the outset, I made it so that this was not going to be about chronic opioid management, that we would try to really treat patients from every angle and in doing so, the idea was to try to actually avoid putting people on opioids unless absolutely necessary. So that was the first thing that, in my opinion, was unique, because no one else did that. You know like I would have primary care doctors call me and say, hey, I'm sending you so-and-so, he needs Percocet, and I'm like whoa, slow down, this is not what's happening. What do you mean? You're a pain medicine doctor, of course-so he needs Percocet and I'm like whoa, slow down, this is not what's happening. They're like what do you mean? You're a pain medicine doctor, of course you're going to prescribe Percocet. Isn't that what you all do? So that was the first reason why I called myself not myself my practice unique.

Dr Mila Mogilevsky:

And then, slowly and gradually, we started introducing not just steroid injections that are something that every interventional pain medicine doctor, of course, does but we started doing more regenerative medicine, introducing PRP and adipose and also bone marrow stem cells that are now becoming a little bit more mainstream. Also collaborating with other specialists like physical therapists and chiropractors, really trying to get patients to be managed from every angle instead of just saying, well, here's your shot and go home and good luck to you. So really trying to make it a little bit more holistic for the patients. We're slowly moving into doing other wellness things like Myers cocktails, nad drips and NAD patches that will provide a little bit more energy to the patients. Could, if we could supplement just your general, you know, uh, straightforward interventional pain to to, to supplement that with with something else, with other things that will help patients to live better and stay healthier amazing.

Dr Andrew Greenland:

I mean, sounds like a very, very comprehensive holistic approach. I mean, have you got much competition that are able to deliver the kind of various things that you're able to offer your patients?

Dr Mila Mogilevsky:

You know, I'm sure we do, and I'll tell you, even in our building alone we have three other specialists that sort of you know work in the same with the same population and providing probably similar care and providing probably similar care. I don't know. I try not to look at others and I do this on purpose because I feel like you know, even if you're sort of doing the same thing, you're still doing it in your own way. I think what stands us apart from others, apart from everything else I've mentioned, is that we really try to provide boutique level of care. So if the patient calls in the morning, they're going to be seen the same day. 24 hours is really something that we push for, but ideally same day. And that's the first thing. And the second thing is that nothing against middle level providers.

Dr Mila Mogilevsky:

But we are not the kind of clinic that puts PAs first. And you know, a lot of times patients go to see a doctor, the doctor is not there. There's a nurse, practitioner or PA and again, not to diss them, some of them are great, but if you're a patient who is going to see a doctor, you should be able to see the doctor and not another provider in their place. So that, I think, is another thing that distinguishes us from others. We really try not to cut corners and if we stand for our brand if you're coming to see me, you're going to see me, you're not going to see somebody else To the point that we try to accommodate patients to make sure that they're seeing the provider they wanted. So, for instance, if somebody is sick, of course another person will cover, but that's an exception rather than a rule.

Dr Andrew Greenland:

Amazing. So one of the things we're exploring on this podcast is how smaller, patient-focused clinics are being challenged in today's environment. I just wondered, from your perspective, what are some of the big trends that you're seeing, or even some of the threats that you're seeing, in this field?

Dr Mila Mogilevsky:

Oh yeah, what are some of the big trends that you're seeing, or even some of the threats that you're seeing in this field? Oh yeah, I mean not to sound negative but, um, I think when I, when I first started out, um, in my, in my space, there were quite a few clinics, uh, just just around in our radius. Um, then, after covid, a lot of them dropped out. I just assumed that it's because, you know, covid killed like new guys. But now I see that it's because COVID killed new guys. But now I see that it's not just COVID which was horrific for us, but also people are being gobbled up by large organizations. I'll give you an example.

Dr Mila Mogilevsky:

We worked with a quite famous medical organization called One Medical. You've probably heard of them. This medical organization called One Medical, you've probably heard of them. It's a primary care doctors excellent organization.

Dr Mila Mogilevsky:

We used to send patients back and forth and then suddenly they disappeared and I was like what happened? And I found out they got bought by Amazon, and this is not uncommon. People get gobbled up. Clinics get gobbled up by private equity hospitals and large, huge financial organizations. And this is happening everywhere and not just our clinics, not just pain management clinics or doctor's clinics, lots of physical therapists, small boutique clinics disappeared in the matter of the last couple of years, again got bought by huge organizations.

Dr Mila Mogilevsky:

So this is a big threat to a small guy like us, and the only thing that I think we have for us that's always going to be present is that we are not going to treat patients like just another number. I feel the moment that people get bought or clinics get bought by private equity, it becomes all about the numbers. The idea is, we'll buy you for 3 million and we'll sell you for 9 million in like two years, and so the numbers, the outcomes, get pushed, financial outcomes get pushed and, as a result, patients get sort of sidelined. Um, and and I think that that's something that that small private practices still have an advantage in you know, we can't afford, uh, to sideline a patient, simply not first of all because it's not right, but also because if we lose one patient, we lose the following. So we fight for every single patient outcome and for quality of care. That cannot be compromised.

Dr Andrew Greenland:

Amazing. I like your ethos. I just wonder these small clinics that are being gobbled up, is it because the numbers are attractive to them for the proposition or they just can't make their business work because of rising costs or reimbursement issues or staffing?

Dr Mila Mogilevsky:

Absolutely not. I don't think it's a number game because of rising costs or reimbursement issues or staffing or kind of thing. Absolutely no. I don't think it's a number game. I don't think. You know, looking from like where I stand and other you know doctors that I talk to that are in private space, there is really no number that would be worth the freedom of seeing your patients, of running your own show, that thrill that you have when you're doing something you really believe in on your own terms it's invaluable. So it's not the money, it's more that you know they just can't stay in competition.

Dr Mila Mogilevsky:

Just in our area, where we are in Grand Central, we have HSS, we have NYU, we have huge organizations right around, medical organizations right around us that offer the same thing sort of the same thing you know allegedly and have incredible amount of budget that they can throw at ads and everything else. So it's rough, but again, I don't want to sound negative because I think at the end of the day, a good guy wins. Not that they're bad guys, but I think they're better guys for our patients. And, as you alluded before, it's all about, you know, staying on top of the developments, going to conferences, reading, you know, trying to improve every single day, really try to push for good outcomes so that patients benefit. You know, that's really what it's all about.

Dr Andrew Greenland:

So this is obviously you talk about this as something you observe in the industry, but I'm guessing your operation. Do you feel relatively protected, in the sense that you have something which will survive and you won't feel that you're going to be gobbled up in the future because of the way that you do things?

Dr Mila Mogilevsky:

I, I do, I, I, I'm, I'm optimistic, you know. I think that there's always going to be, you know, a room for an alternative, right like if, if you go to the hospital and you get a horrible care and not all hospitals do provide horrible care but generally speaking, just from what I see, people get swamped in that bureaucracy where nobody actually takes the time to spend time with them because everybody is busy and they're big and they don't care. There's always going to be that alternative and I think that you know we may go through bad years or good years, but at the end of the day, I think what we have to offer will always be sought after. It's just a matter of sometimes, you know, pushing harder, being more creative, being more, you know, looking at things from a different angle. But overall, I think I'm optimistic. I have to be yeah, no, absolutely.

Dr Andrew Greenland:

I'm guessing the this threat is not unique to pain clinics. I'm guessing this really extends to much broader across outpatient health care. 100 yeah okay, interesting. So um, sounds like things are going well. You've got two clinics. You're thinking about a third. What are you? What is going well for you right now in the business? What are you most proud of in terms of how you do things?

Dr Mila Mogilevsky:

You know, I think every clinic is based on. You know the team that you have and I think that we finally got to the place where, you know, after many years of trying different people and having different providers, we are in a place right now where everybody that works in the clinic works together and overall it's a very friendly bunch of people. The doctors are young and driven and they are not as much in competition as they are in cooperation and that definitely shines through. We are friends not just inside the clinic but also outside. You know we go out, we do things together and that definitely helps the staff, I think, is overall amazing and everybody has that same mentality, Like we need to.

Dr Mila Mogilevsky:

You know we need to take it to the next level. We need to try to help patients. We need to call them. We need to take it to the next level. We need to try to help patients. We need to call them back, um, if they have a problem. So you know it's, it's. I think that's. That's sort of the secret sauce, right? You know, be happy while you work and try to work together. It is your clinic, is what is what is what your staff is so much of. It depends on how people feel when they come to work, and what they do, totally agreed.

Dr Andrew Greenland:

So is there anything that's particularly frustrating lately in the business, anything that's keeping you up at night as a practice owner?

Dr Mila Mogilevsky:

yeah, well, I think, as you said, as you alluded to before, you know there's a huge competition and you don't always know why people, you know, you always know. You look at the numbers, you know month per month, per month and, um, sometimes you have good days, sometimes you have bad days. And I think the the the patience to sort of just say, okay, you know, it's not a day-to-day situation, it's more like a period to period situation. Let's compare december this year to december last year, instead of saying, oh my god, this Thursday was horrible, what about Friday? Is it going to be worse? So you always have those thoughts that you kind of have to put in a back burner and be like listen, there are good days, there are bad days. What matters is that everybody is doing well, patients are healthy, no bad outcomes. That's really what it's all about Numbers. At the end of the day, we'll score them. You know, we want to make sure the patients do well.

Dr Andrew Greenland:

Brilliant. So I was actually going to come to that very thing about the metrics that you pay particular attention to. I mean, is it patient volume, outcomes, operational efficiency, all of the above, or do you have anything? That you particularly look at to kind of really get a gauge of how your business is doing it really is all of the above.

Dr Mila Mogilevsky:

I mean, you mentioned all of it. The efficiency, I think, is something that we need to work better on. It's always challenging, you know it doesn't take much to get thrown off course and you know small perturbations are always there. Patience outcomes is something we always drive for and it's not negotiable. The outcome has to be good or, you know, we will lose patience and, frankly, we'll lose our reputation. But the efficiency sometimes can be improved. For sure. You know the overhead, especially working in a place like New York City, can really drive you down If you overspend and it's hard not to, this will result in, you know, in quite a bad I shouldn't say bad, but it would be a challenging month if the overhead is pushed too high up, and as it is, I would say it's at least 75% on a good day 75%.

Dr Andrew Greenland:

Sorry, what's 75%?

Dr Mila Mogilevsky:

So your overhead, you know if you grow, say if you grow, I don't know, $100, you take home 25.

Dr Andrew Greenland:

Got it. Okay, that's interesting. Obviously, this is a global podcast. I'm actually in the UK, so we have a slightly different model over here.

Dr Andrew Greenland:

I obviously do some of the work I do in functional medicine is private based, but I still work in the health system, so one of the values of doing this podcast is getting a real global perspective. So we're just being practitioners doing different things in terms of different disciplines, but also in different countries. So this makes it all very interesting to hear about and, especially with you being in a very central location in the states, it's just really that's an interesting perspective. So, um, looking ahead to the next six to twelve months, what does success look like for unique pain medicine?

Dr Mila Mogilevsky:

six to twelve months. I think it's pretty short, still pretty short period of time. I think that right now, um, I want to push a little bit harder on getting a little bit bigger following in the city, in Manhattan. Brooklyn seems to have stabilized. Manhattan is still struggling I wouldn't call it struggling but still not as solid as I would like it to be, as it was before the pandemic. The pandemic.

Dr Mila Mogilevsky:

I don't know what's going on with you guys, but in our case, lots of patients, lots of employees of large financial organizations have not returned to work full-time. They're still like in a hybrid model, and our location, specifically to us, our location, is in Midtown, where most of most of it's not a residential location, it's where people work. So we lost a third of the patients that we usually had just because of the hybrid model, and so the challenge is to bring those people back or to get other sources of, to get to know other providers that could potentially send patients from their clinics on to us, that could potentially send patients from their clinics on to us. So it's about making more contacts with, you know, outside disciplines, as I alluded before. You know, we work with physical therapists, we work with spinal surgeons, neurologists, et cetera.

Dr Mila Mogilevsky:

But now I'm thinking, you know we should probably also work with psychologists. You know there are people that you know take care of patients, like acupuncturists, like biofeedback specialists. You know behavioral health people. That's sort of one of those untapped resources we didn't look into. And you mentioned wellness. I mean, that's all about wellness and I think that will tie in nicely with us. So sort of trying to do more of that. Uh, outreach, you know doing this podcast, as I think is also a little bit. It's not something I usually do very frequently, but I think it also will sort of drive maybe a lot of some another, you know, population of interested patients and clients really well.

Dr Andrew Greenland:

Hopefully that'll be the case. That's one of the reasons we're doing it just to get some visibility. So hopefully this will give some visibility to what you do and your approach and your ethos, which I really admire. And finally, if you had a magic wand and you could fix one major issue in your business today, what would that be? There may be nothing, but I'm just curious to know if there's anything that's like a big one.

Dr Mila Mogilevsky:

I would get rid of all the insurances and and the regulations and obstacles that they put in our um, in our path. Um, but that never, that probably won't happen. Um, but yeah, that would. That would be ideal, you know, have that freedom away from third-party peers and, just you know, have that direct interaction with patients. That would be amazing. But other than that, it's just continue pushing quality and continue pushing high standards of care so that patients respond well.

Dr Andrew Greenland:

Amazing. Milica, thank you so much for giving us the time to speak today.

Dr Andrew Greenland:

Really interesting hearing your conversation talking about what you do, your, the passion you have for what you do and the way that you've made it a really unique offering to patients. And this is completely my ethos. You know, I have very much about holistic and um holistic care complete, giving patients a good service and I'm really impressed with what you do. So thanks for your conversation. What we'll do if anybody wants to contact miller, who's listening, we'll put your details on the bio page.

Dr Andrew Greenland:

So if anybody wants to reach out or look at your socials, we'll put it on the final page, but yeah, thank you very much again and thank you and really good afternoon and all of our listeners, thank you very much. I appreciate.

Dr Mila Mogilevsky:

Thank you, thanks, guys, okay.