*VALUING YOUR MEDICAL PRACTICE For Sale* | Poll: Selling Your Practice and Retiring — Where/To what type of entity are you planning to sell or getting offers from?
A personal challenge: Say something positive about your colleagues outside of DPC too. Patients are reading what you write and post online. Are you proud of your words and do you use appropriate language AND are you respectful of others and their opinions? What you write on Twitter or article comment sections gets read, shared and re-posted online. Regard for those Hospitalists, traditional practices, and Physicians outside of DPC who also work long-hours, pay mortgages and have student loan and business bills to pay is important. Are you giving them room to innovate as well? Do you have empathy and understanding when they ask questions? When was the last time you said something uplifting about them and their way or practicing medicine? It is obviously comfortable to them. Do they not want what is best of their Patient too? They may just go about it differently, and that’s okay. A personal challenge may be, how will you propel your uplifting message about the benefits of DPC … forward in a positive way?
Geoff Potts said on Facebook, “$225 (soon $300) per month is more expensive than many other options in concierge medicine. Unless there’s a complete overhaul of our system that leaves a lot of people without access to care.” ~Crain’s Detroit; March 2018
Paul Devine said “If an individual can afford this luxury, then let it be.” ~Crain’s Detroit; March 2018
Clearly, two different opinions.
“In the future, competition will be around the consumer and the relationship you can develop with them over their lifetime … soon, your competitors may become your partners.” ~Howard P. Kern, CEO of Sentara Healthcare, Healthleaders Article: Dec. 1, 2016 – Big Ideas: Aping Amazon
By Michael Tetreault, editor, The DPC Journal, Concierge Medicine Today, Concierge Medicine CANADA & The American Journal of Retail Medicine
Circa JANUARY 3, 2016 & UPDATED IN PART ON MARCH 13, 2018 – Today, the “DocPreneur” in private medicine is free from a lot of common healthcare hassles. Typically, they are the primary physician owner/operator of their practice, a creative timekeeper, a staff manager, an IT guru and a constant learner.
These “DocPreneurs” are also very smart. They are not afraid to challenge their patients, knee cap to knee cap, and push the practice boundaries to make things better. They are constantly looking for ways to enhance the next patient experience and consume new ideas like candy when it comes to creative patient retention strategies. Because of these unique qualities, the best physicians in private medicine are leaders with small egos, quiet and incredibly friendly and approachable. They are excellent listeners. Slow to anger … and they have traits that get the most out of people. It is those traits, unique to “DocPreneurs” that enable them to unlock the full potential of their patients and help them achieve common goals.
In a recent New York Times article entitled Can Netflix Survive In the New World It Created? by JOE NOCERA, he interviewed the founders and strategic leaders at Netflix and discovered some very interesting and insightful lessons which DPC can takeaway for themselves as well. Those lessons include:
- Moment(s) of Stability – A current moment in time [e.g. the marketplace of business culture] as a “period of stability.” Nocera writes, Netflix has spent much of its existence zigging and zagging, responding to the pressures of the marketplace. “When we were in the DVD business,” Reed Hastings, Netflix’s chairman and chief executive said, “it was hard to see how we would get to streaming.” Then it was hard to see how to go from a domestic company to a global one. And how to go from a company that licensed shows to one that had its own original shows. Now it knew exactly where it was going.
- Execution Challenges – “Our challenges are execution challenges,” Hastings of Netlfix noted. Asked what the competitive landscape would look like five years in the future, he returned to the analogy he used earlier with the evolution of the telephone. Landlines had been losing out to mobile phones for the past 15 years, he said, but it had been a gradual process. The same, he believed, would be true of television. Sound familiar to some of the challenges arising or fought in the past few years recently by other DPC Physicians you’ve read about or talked to?
- Everyone is Waiting for It [e.g. DPC for example] to Explode, But It Won’t. It will have moments of gradual rise and falls but in an upward trajectory. It wasn’t meant to suddenly rise to the top. The acceptance of change in our healthcare culture and the way care is delivered will be gradually adopted, not suddenly in one year or even a decade. – “There won’t be a dramatic tipping point,” Hastings said of Netflix in the NYT article. “What you will see is that the bundle gets used less and less.” Back in 2006, the company set up a way to distribute independent films, called Red Envelope Entertainment, but it failed, and Hastings shut it down. (“We would have been better off spending the money on DVDs,” he told me.) Now it was going to give original content another try — with much higher stakes. The NYT article continues to say … Although news coverage now tends to focus on its shows, Netflix remains every bit as much an engineering company as it is a content company. There is a reason that its shows rarely suffer from streaming glitches, even though, at peak times, they can sometimes account for 37 percent of internet traffic: in 2011 Netflix engineers set up their own content-delivery network, with servers in more than 1,000 locations. Its user interface is relentlessly tested and tweaked to make it more appealing to users. Netflix has the ability to track what people watch, at what time of day, whether they watch all the way through or stop after 10 minutes. Netflix uses “personalization” algorithms to put shows in front of its subscribers that are likely to appeal to them. Nathanson, the analyst, says: “They are a tech company. Their strength is that they have a really good product.”
- The Doctor remains the primary reason a Patient will want subscription-based healthcare, not all the other stuff.
For now, even as Hulu and Amazon were emerging as rivals, he claimed that the true competition was still for users’ time: not just the time they spent watching cable but the time they spent reading books, attending concerts. Hastings was aware that even after the bundle is vanquished, the disruption of his industry will be far from complete. “Prospective threats?” he mused when I asked him about all the competition. “Movies and television could become like opera and novels, because there are so many other forms of entertainment. Someday, movies and TV shows will be historic relics. But that might not be for another 100 years.”
Today, I want to look at a few of these leadership qualities and traits. I also want to explain their importance in your practice.
4 Traits Of The Top Doctors in Private Medicine
Top Docs Act Decisively.
Physicians who venture into the world of entrepreneurialism need to be decisive. Decisive when it comes to managing tasks, treatment and the management of people who believe in a common vision for the practice. While input from all team members and employees (and outside trusted advisors) is encouraged … everyday decisions have to come easy, automatically, and within a reasonable amount of time. These decisions must come out of the practice’s leader and that leader must be prepared to act when it is necessary.
QUOTE OF THE DAY: “The consumers, as much as we’re trying to give them transparency, they take that for granted—and that’s not to say we won’t continue to focus on it, but we need to win on the customer experience,” he says. “It’s almost an Amazon-like agenda. It won’t surprise me if in 10 years we will have organizations like Walgreens helping consumers achieve value through the continuum, so we need to evolve. Our competitors may become our partners.” ~Healthleaders Article: Dec. 1, 2016 – Big Ideas: Aping Amazon
They Exude Energy.
Have you every heard someone say, “I don’t know how he/she does it?”
Top Docs not only have a lot of energy, they convey positive energy in their words and actions. From body language between patient and physician to how they interact with staff. Believe it or not, patients are very observant of how their doctor interacts, talks to and interacts with their staff. It’s a retention point for patients. If you’re a jerk, rude, demeaning or disrespectful, patients make mental notes of these interactions. It can really impact your patient retention when it comes to membership renewals.
They Empathize. They Uplift. And, They Never Villainize Naysayers.
If you talk to enough “DocPreneurs” in Private Medicine, the successful ones with full patient panels, you’ll find they keep the conversation positive. They see through the fog of negativity and look past the opportunity to gossip. They empathize and look for commentary, if appropriate to uplift and see the larger picture. At times, they’ll see how the conversation could be reframed and find a way to compliment the person behind the message.
Constantly Look for Combustion Points Within the Patient/Practice Experience.
I read this great book recently … (Disney Institute’s book “Be Our Guest: Perfecting the Art of Customer Service”). It talked a lot about “Combustion Points” in the customer service process and experience.
The author stated … A “Combustion Point” is a term Disney (yup, that Disney) uses to define explosion points within any person to person or person to practice interaction.
“… spots where even a finely tuned process can break down and, instead of contributing to a positive customer experience, begin to turn a guest’s good day into a bad one. It’s impossible to completely eliminate combustion points, but the goal is to stop them from turning into explosion points.” (*page 24)
Can you guess Disney’s combustion points?
One are the long lines guests stand in waiting for a ride or attraction. Another is a guest remembering where they parked their vehicle at the end of a long day. Good experiences can turn bad at these points.
It is important that your practice identifies common combustion points. Why do you think so many Concierge Medicine physicians removed completely the tired, ugly and dreaded “waiting room” from their practice over the past ten to fifteen years?
Yeah, this is what we’re talking about.
Disney says look for those places where guests complain consistently. If you don’t know where these are in your practice, this is your “ah-ha” moment and it is time to start asking more questions and paying closer to common, small and minor “combustion points” within your practice.
Traffic or parking may not be your combustion point. We’ve certainly heard from some physicians, it can be, based on their prime location. Combustion point. Another example is the time it takes to join sign-up as a new patient. Combustion point.
If you’re still having trouble determining what your combustion points are, Disney has found that combustion points are commonly found in four areas:
- guest flow
- staff/volunteer-to-guest communication
- guests with special needs
- poor process design
A combustion point in your practice could be how patients sign-up and pay for your membership(s). Another could be how you communicate with staff who want to do something on behalf of the visiting patient.
It really could be any number of things but it is important that you identify them. Maybe you can eliminate the problem. Maybe you can soften the combustion point by making the experience less painful.
People lead your practice. And people visit your practice. It will never be perfect. There are systems and processes that frustrate your patients. Your pateints are aware of them. Are you?
What can you do to create a better patient experience for them?
* For more information and discussion on combustion points and other Customer Service topics, see the Disney Institute’s book Be Our Guest: Perfecting the Art of Customer Service.
So where do we go from here in 2018?
Some Physicians, while we can say with great trend line certainty over the past three years, are a minority (e.g. less than 20%) of those polled who want DPC to remain at a fixed price point of less than $99/pmpm.
They tell the DPC Journal in the past 90-days that “Yes, DPC should be in part, defined by price alone. And, it should remain under $99/pmpm [or less]. Furthermore, those in this 20% category state that they do not want Physicians identifying with the brand of “DPC” to accept any health plan dollars from insurance companies or Medicare. Will that idea take hold for most Physician’s entering DPC in the next year to three to come?
Time will tell but the forecast is actually leaning towards two camps. Those include:
- Employer partnerships operating in metropolitan and suburban markets and;
- Independent/solo clinics operating in suburban and rural markets (many of which are now operated by DOs, MDs, and even PAs).
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2018: How flexible should the DPC model be to match existing state or federal laws?
Neither of the two listed above are bent on a fixed price point or plan dollar acceptance. Additionally, our DPC Journal Physician readers in the past quarter and now into 2018 say that what they want out of DPC is the following:
- Price shouldn’t matter. Each Doctor is different. Let them define their own value in the free market.
- It [e.g. DPC] should not be limited by pricing. Value is determined by services, education, demography and it is about direct patient-to-physician connection.
Some in DPC see employers as the long-term scalability play with the help of hybrid healthcare delivery models as the future of DPC. According to Advisory Board in the fall of 2017, they stated that large employers expect 5 percent growth in health care benefit costs for 2018, a National Business Group on Health survey finds. The survey found that employers expect to pay for about 70 percent of the cost associated with providing employees health benefits, while employees would be responsible for the remaining 30 percent, which would average about $4,400 dollars per employee. Employees would pay those costs via premiums, out-of-pocket health care costs, and health savings account contributions, “Wonkblog” reports.
With the new year now well behind us, challenging you and others to innovate, think positively and put the patient first … how will you propel your DPC clinic forward in a positive way?