I’ve seen far too many Doctors stop casting a clear and compelling vision to their Patients and, at the same time, be unwilling to confront the brutal reality.
By The DPC Journal/Concierge Medicine Today, Editor-In-Chief
Updated Summer 2022
Most concierge doctors and yes, even a few DPC physicians practices are looking to grow their practice in the second or even third year.
And Physicians over the years echo the sentiments that the first year has it’s challenges but year 2 and 3 require just as much intentional effort. But, year one is really more about stabilizing the new Patient membership, proving the pricing model can actually work locally and even making those much needed adjustments internally to assure future sustainability and prepare for new growth.
However, at about the 18-36 month mark a lot of Physicians tell us they read a fork the road that was a bit of a surprise. A lot of Physicians we’ve interviewed over the years said that the practice naturally goes one of two ways.
The first is a bit of downer because they find membership naturally hits a stalemate. It plateaus around the 150-ish member mark. Growth is literally an uphill battle for new patient members and it is seemingly impossible to get new patients.
“We can typically tell when some Physicians reach this plateau in their membership, especially the younger practices,” said one marketing consultant we spoke to. “Because they’ll be a lot more active on social media. They’ll be commenting on every post that their peers put out there, which by the way Patients don’t ever see or care about. Or we see them posting a lot more on Twitter and even making Tik Tok videos.”
The second path is where new membership hits hard and fast and shortly the Physicians finds he/she has a waiting list.
So, how do you know which path you will take in your practice?
Well, it’s our observation that a good consultant, accountant and business planner usually can help and they do. Peer to peer interpretation is often not helpful because they don’t know or understand your local economy or what’s happening potentially in your local market. Don’t get me wrong, peer-to-peer interaction from a business perspective is useful, but only to a point. Bear in mind a peer may have a similar business model as you but their experience is singular. Don’t be evangelized to believe that what worked for them will also work for you.
For a list of those resources helping Physicians, click here.
The truth is that you reap what you sew. If you exercise and eat right you reap the benefits, right? The same holds true when you run a business.
I was reading an opinion post/blog by a Physician giving other Physician readers business advice. His thoughts boiled down to this … Align with physicians of similar mindsets [within this tribe/community], reread a couple basic business books, take some classes, and learn from our [eg. within this particularly tribe/community] elders.
7 Signs You’re Suffering From Insideritis
Author and expert communicator Carey Nieuwhof writes “If someone has to learn code to join your organization, you likely won’t have many people joining.“
Fortunately or unfortunately the majority of the Physicians we interview who do run successful medical practices don’t subscribe to the insideritis mindset.
You see if you want to live in the land of average and plateau your practice, that’s fine. You’ll serve your community with your brand of service and that’s perfectly fine. But if you want to scale your medical practice and not shed the shared values and unique culture that helped make you unique in the first place you have to put in the work, plan with intention and get outside perspectives.
Haven’t we seen where insideritis has taken all of us?
If your goal is to simply do the minimum and not provide any more than basic customer service and limit member benefits in order to keep your costs down, then you’re going to live in the land of average. And there’s nothing wrong with that.
But, the Physician readers who subscribe to our publication(s) don’t see the world of medicine that way.
You see the second path is a bit more uncommon For Doctors. It is a road less traveled. It is filled with curves and at times, there are no guardrails on sharp corners. It’s very easy to remain comfortable. Growth is hard and the truth is, a lot of Doctors like the comfortable routine they’re used to. But I want you to live up to the generous expectations you have for your self and your practice. I want you to give generously to charity and pour out every bit of energy you have to your Patients and your family. Because ‘It is no longer about being the best Doctor in the world any more. It’s about being the best Doctor FOR the world, FOR your Patients and FOR your local community.’
Here are five simply ways that you can keep your medical practice off the road of average and on the path to awesome:
Keep a local Doctor’s/business owner’s perspective. When you initially change your business or pricing model to a subscription or membership, it is really easy to empathize with the pains felt by your Patients. Will they really get more time with you or is this some sales gimmick? Will I get referred off to someone else and lose you as my Doctor? But, you will also need your employees to help share this burden. Not in the form of allowing your staff to do the selling, but to share with them (eg your staff), what your patients are saying in response to your new membership. Talk to your staff, encourage and educate them about how to be excited about joining the practice. Allow your staff to step inside the small medical practice owner’s well-heeled loafers or high-heels for a moment and talk to your staff regularly about how you are making a Patient’s life easier with this new healthcare delivery model.
Build an internal philosophy of shared, common beliefs. As many industry insiders will tell you, staff and spousal belief in your new subscription-based healthcare delivery model is more important now than ever. It’s even more important than signing on a new patient. Really? Yes! Concierge Medicine Today (CMT) has interviewed Physician after Physician over the years in many major markets and found that the sentiment is the same. If you have even just one staff member in your practice that doesn’t think concierge medicine or your subscription pricing structure is a good idea – that bad attitude will begin to cost you patients, memberships revenue and even your reputation. Surrounding yourself with people you know, like and trust and that you have confidence in their belief in you can help you see your blind spots. So, ask them for help if you feel a check in your gut. Ask them to help you find the bad apple (if you have one that is) in your practice. You can either reposition them to employment elsewhere in the practice where patient interaction is minimal or ask them to potentially move on to another place of employment. You see every small medical practice has blind spots and Physicians need help cultivating a healthy culture. It doesn’t mean that all of your employees must think exactly the same way as you do. It simply means that you should be constantly creating a set of shared beliefs, belief in your new business and pricing model, forecasting benchmarks to your staff routinely and celebrating every achievement internally … whereby everyone employed by you has the same idea for how to accomplish these daily tasks, priorities, decisions and shared goals.
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Involve your spouse or at the very least, keep them tuned-in on your accomplishments at the practice. Many physicians and their spouses work together in the same office. Concierge Medicine Today has found over the years in the practices we’ve surveyed and the Doctors we’ve interviewed that … changing your business model to one that’s concierge or fee-for-care requires the joint agreement of both spouses, whether they work together or not, for the practice to succeed after month 18. Consultants and Doctors alike also note that If your spouse is not in agreement with the change, a transition to a concierge medical practice is not typically recommended by many consultants but may handicap the emotional state of the physician and ultimately the practice after the first year.
Create open channels of communication. Concierge Medicine Today reported in 2010, 2011, 2012 and now in 2022 that the majority of concierge medicine practices and even DPC clinics, now employ 1-2 people inside the practice (approx.. 62%). When your practice is small everyone wears multiple hats and experiences the practice from multiple facets and as a concierge medical practice grows and employees are added, communication among staff can become a maze and employees get pigeonholed into certain roles. Often times, the Doctor is the last to know. So a unique approach to keep a small practice buzzing is to make sure everyone (the Doctor included) rotates through the various positions within the practice from time-to-time, whether it’s the service window or in the exam room, whenever possible – remaining HIPPA Compliant of course. This unique approach we’ve learned gives the impression to Patients that this is a family business and everyone is friendly and capable. This unorthodox approach also forces everyone within the practice to stay close and connected to the Patients (eg. the customer).
Develop your concierge medicine practice culture outside of normal office hours. If you expect your employees to love your Patients, you as the leader of the practice must show some appreciation to your staff. To do this, it’s been said that Doctor’s or medical practice owners of the practice build-in each year staff regularly activities outside of the practice to connect, share and smile. For example, one day every year, take a scheduled work day off and take the entire practice staff (and their families if possible) on a group trip (a sporting event, volunteer opportunity like Habitat For Humanity or similar, amusement park, etc.) or even take them out to dinner. Typically the best times to do this are not around early January, not the start or end of the school year, and not Thanksgiving or Christmas (but those are important too). But it has been suggested by your peers that we’ve interviewed, that the Physician may want to consider these types of staff appreciation events in mid-March, July and even October.
Originally Written: Oct 1, 2013
Categories: DPC News