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Lessons in Greatness: One Woman’s Journey In Direct-Pay Medicine

By Michael Tetreault, Editor

On Patient Conversion:

Step 1 — Get your head straight. 

Personalized Healthcare, LLC was established in 2009 by Dr. Caroline Abruzese. Dr. Abruzese wanted to create a practice where the primary goal was to create and foster a community of health and wellness.

Dr. Caroline Abruzese: Why are you doing this?  Primary care physicians have a right to make a living. Making a reasonable living is not selfish, manipulative, or in conflict with your moral or ethical oaths and obligations as a physician.  The practice of medicine is capitalist overhead with socialist reimbursement.  I do not know of any other business that has been required to operate under these circumstances. You need to understand the reasons why this is good for you and why this is good for your patients.

Step 2 Practice answering questions and explaining your model to others.

Dr. Caroline Abruzese: When converting to an annual fee model, Many of us do not like the thought of “selling” or using our position and influence to sway a patient however, the most important step is expressing to your patients why you believe this would be a good choice for them.  This needs to be done in a tasteful and honest manner and for many of us it takes time and practice to feel comfortable having this conversation.  I was such a soft sell that I reassured patients that it would be fine to change to my partner and bragged about the other doctors willing to take over the remainder of the practice.  In an effort to be fair and unbiased, I appeared to lack confidence and undermined my own success.

Step 3 Educate your patients and know how to say things in many different ways.

Dr. Caroline Abruzese: Consider what elements are most important to express when speaking about an annual fee model and then write out what you want to share in a 2 minute conversation.  Patients have different levels of knowledge about finance, what is affordable and feelings about money so explain what the fee is annually and monthly.  For example, the annual fee is $1500. and this is equivalent to $125. per month.

Step 4 Always Ask What They Think.  

Dr. Caroline Abruzese: Leave your ego at the doorbecause people do not like change and will react in many ways This may be your only opportunity to correct false assumptions so it is important they are invited to be honest and your reaction is important.  Remember, this decision is about them even if it feels about you.

Dr. Caroline Abruzese: Deciding on whether you will accept the fee to be paid monthly is a big decision. Collecting money can take up a lot of your staff’s time.  With a few exceptions, I cannot afford to accept monthly payments. If you need to make an exception, I recommend a small processing fee and requiring the payment be made by direct deposit.

About Dr. Caroline Abruzese
Personalized Healthcare, LLC
800 Mt. Vernon Hwy, NE Suite 160
Atlanta, GA 30328
Office: 404-303-8889


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