....and a ridiculous ton of work if you're operating alone.
To address this...yes, it is a lot of work..but that actually helps. I've become a commodity because of the level of service I provide. I might not be the smartest at this, and somebody may be better at that, but overall my service and dedication is what drives people to me.
Just like any commodity, scarcity drives the price up. I do have another person who helps me occasionally (not an employee, just someone I 1099) and what I have learned is that people want me personally, not other people. I tried to send him over to one clinic for routine things and the PA told me "But we really like you. We want you to come over."
So I've become a rare commodity and priced as such. There is only so much of me and whatever rapport I've built is worth the price for the physicians. Being personable goes a long way. Answering your phone at 6:30 a.m. on the first ring doesn't hurt either.
What I sell is peace of mind and comfort. Imagine the relief these physicians have when they can text me "could you please do this" or "my something is broken" and it is taken care of for them...no tracking the issues, no finding where I am at...they just know it will be done.