By Michael Tetreault, Editor-In-Chief
Do You Have What It Takes?
The staff at The Direct Primary Care Journal, asked some of the industry’s new and innovative leading DPC physicians and Concierge Medicine practice business owners, ‘what are the traits of a Docpreneur or subscription-based business owner?’
Op/Ed | Price shaming? DPC vs. Concierge Medicine.
From the onset, the idea of starting or even moving your medical practice into this marketplace seems inspiring but also intimidating.
Scholars, physicians, business experts and venture capitalists say direct primary care is a growing industry. But, as we’ve learned over the years, the best doctors share a collection of characteristics, from the ability to tolerate risk, treating 5 to 9 patients per day, keeping their price point under $100 per month, risking reputation over reward to passion and self-belief in a niche-industry.
Story continued below photo …
FREE PHYSICIAN SELF-TESTS | Do You Have What It Takes To Enter (Either) Membership Medicine or Start and/or Operate A Subscription-Based HealthCare Delivery Model?
To begin, physicians explained this process as a marathon, not a race. More of an ultra-marathon really, dependent upon which individuals you might talk to. Nonetheless, you have to be able to live with uncertainty and push through a crucible of challenges and obstacles for a couple of years.
“DPC allows me to have the time to care for patients rather than third party payers,” writes Dr. Eric Potter to The DPC Journal. Dr. Potter is a DPC physician at Sanctuary Medical Care which services the Middle Tennessee-Nashville region and Northeast Tennessee/Southwest Virginia. “Many more doctors turn over a new leaf with DPC.”
RELATED STORY | BUSINESS of MEDICINE | LISTEN | EXCLUSIVE
DPC Journal SPOTLIGHT: One of Our All-Time Favorite Interviews … Meet The Town Doctor, Dr. Robert Steves
“I received a phone call the other day from a physician in Winter Park Florida,” says Tiffany Sizemore-Ruiz, D.O. of Choice Physicians of South Florida. “She was calling just to thank me for answering her questions about [this industry] a few months ago, and encouraging her to start her own practice. Today, her practice is thriving and she said that ‘she is happy with her schedule, her life, and being able to practice medicine that way it is meant to be practiced.’ I was so happy to hear that I helped a fellow physician and colleague, and even more happy to hear that she was doing so well!”
“The conversion process is not an easy one,” said Jeffrey S. Gorodetsky, M.D. of Stuart, FL. “My staff and I are cognizant of the fact that we must consistently communicate the benefits of this choice in care, with the challenge to increase my [memberships] numbers and convert other patients.”
RELATED STORY | PHYSICIANS | CAREER CHOICE
SONJA HORNER: ‘The Clock Will Help You Decide, DPC or Concierge Medicine.’
“If you possess excellent communication skills, around the clock dedication and the desire to promote optimal health in pursuit of excellent medicine, then concierge medicine is for you. It’s the best career choice I’ve ever made.” ~Brian Thornburg, MSM, DO, PA, FAAP Innovative Pediatrics
Second, it’s commonly presumed that doctors who enter direct primary care must disconnect from all insurance and payor relationships. What most doctors who’ve been there and done that will tell you is … ‘I’m fueled by a passion to help my patients. I’m now allowed the opportunity to problem-solve and make life a little easier, better and cheaper for my patients.’
“My experience as a working physician in both the emergency room and in the intimate exam room lends itself to promising the best care — whether the patient faces a life-threatening illness or simple routine care,” said Dr. Christy. “I believe in treating the whole person, meeting them wherever they are in their journey toward better health.”
Managing Fear, Uncertainty and Potential Failure.
“The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition.” ~Thomas Edison
Third, the ability to successfully manage fear. Risk-taking goes with the territory when you talk about direct primary care with most physicians, consultants and staff. ‘I don’t think my patients are going to like this,’ most say. But your ability to withstand the pressure and overcome the obstacles of uncertainty and potential failure and see the other side before others do is what makes a successful direct primary care physician, notes one industry consultant. He sees that the ability for doctors to control their doubt and fear as the most important trait of all.
“Do not be afraid to try something new. If we do not try to do things differently, primary care will continue to languish and we will have a harder and harder time attracting people into the field and ensuring that primary care survives for us, our children, and our grandchildren. You do not have to do it all at once, though – a lot of practices are trying to develop a hybrid model, gradually moving more and more of their Patients to the DPC model. It is challenging to do this if you are caring for large numbers of Patients, but practices are finding ways to do it.” ~Dr. Erika Bliss (former CEO of Qliance) | Equinox Primary Care, Seattle, WA
“With so much attention to physician burnout and the high cost of care, the discussion spends far too little time talking about the lack of time most primary care docs have for their patients. Before I left my old practice (nearly 7 years ago!), I was increasingly burdened by the fact that I was increasingly being robbed of the time necessary to give good care. I was spending too much time dealing with red tape from the insurance companies and from the rules from the government aimed at “improving care.” Since quitting, I’ve yet to see more than 15 patients in any given day, and am often reminded how much my patients appreciate the time I can spend with them.” ~Dr. Robert Lamberts, Augusta, GA; Article: Time to Listen, 2019
Vision and Task-Specific Confidence.
“In selecting only a small population of clients and providing dedicated counseling sessions, sometimes as often as weekly, allows clients to actively participate in their care plan and to move goals forward at a real-time pace. This enables all of us to realize that healthcare can be a positive experience.” ~Dr. Carrie Bordinko of Consolaré Primary Care in Paradise Valley, AZ
Physicians who’ve traveled down this path over the past 15-years imagine another world free from insurance burdens and heavy administrative overhead. They envision spending more time with patients and enjoying the practice of medicine again. Oftentimes, these physicians and medical practice business owners will find themselves facing naysayers, says one doctors in New York. ‘We often see the future before it plays out. We have to be prepared to be several steps ahead of the market.’
If you’ve planned appropriately, conducted enough analysis and have sufficient research that you can provide the level of service you envision for your medical practices future to ameliorate the risk, you’re ready to take the next step.
In a new book, The Marketing MD, I’ve spent a lot of time talking with successful physicians [and unsuccessful ones too …] addressing the challenges and importance of planning before you move into direct primary care or start a direct-pay membership program alongside your insured patient visits in a practice.
“The healthcare industry is morphing and the innovation that is surfacing can often times improve the delivery of care to patients. Our expertise is in helping individuals and companies who are passionate about improving the delivery of healthcare and are committed to demonstrating improved patient outcomes.” ~Sonja Horner, Healthcare Business Innovator | Outcomes Advocate
What most direct primary care physicians will tell you is … it’s likely that you’re final service or product offering won’t look anything like what you started with. Planning ahead, being flexible and your willingness to defy conventional wisdom will help you respond to changes in the economy, insurance and market forces that seem to dislike your current operation. You have to be able to pivot when necessary.
“One of the most difficult occurrences is when patients who does not understand the program or who philosophically disagrees with the membership fees accuse the physician of abandoning them,” says one former Transition Manager in Arizona. “Direct primary care is all about behavior modification accompanied by simple answers to difficult and at times, confusing questions. Sometimes patients can be very vocal about their opinion of this and at times, be quite rude. This is very disheartening to most doctors, at least in the early stages of the transition process. ‘Saying goodbye’ to some long-term patients is one of the reasons many Physicians are reluctant to convert [to a Hybrid model].”
“Instead of viewing the status quo PCP model as the center of the universe. Maybe we should take some plays from the Retail Clinic playbook before we become obsolete.” ~Direct-Pay Physician, Dr. Robert Nelson of Cumming, GA.
Even the thought of starting a direct-pay medical practice or membership medicine program in your local community defies conventional wisdom according to many people in the healthcare marketplace. If you consider the fact that 13 percent of Americans are engaged in a start-up businesses, according to a Babson College report, doing what the majority of doctors are doing now a days is not in your future, you are a risk-taker.
“The #1 rule in successfully designing your new membership based practice is to start with defining the services you would like to provide to produce the patient outcomes you hope to achieve, then pick the model that best fits your “clock”, your marketplace and equally important covers your overhead.” ~By Sonja Horner, Healthcare Business Innovator | Outcomes Advocate
Are these characteristics or traits in you? There’s only one way to find out.
“I believe one of the keys to the continuing growth of Direct Primary Care (DPC) is integrating it within the employer sponsored health plans,” says Mason Reiner, CEO of R-Health, “which remain the primary means for paying for healthcare for the majority of Americans. However, for DPC to be a viable option for employers, there needs to be a critical mass of physicians offering it as an option in the employer’s geographic area. That is why we have focused over the past year on expanding our panel of affiliated physicians offering DPC in the Philadelphia region to nearly 100 (and growing), including Family Physicians, Internal Medicine Physicians and Pediatricians. The strong geographic coverage we have in the region has been a critical factor for the employer groups we have added as clients.”
Expert Advice, Guidance and Resources.
Our focus at The DPC Journal and our sister publication, Concierge Medicine Today (CMT) is on reporting and writing the news — not to sell you someone or something. You should choose who you work with — but you should choose wisely.
“Business is tough,” says Dr. Chris Ewin of 121MD in Fort Worth, TX. “If you are doing something just for the money, you are never going to enjoy it. You will be the hardest boss you have ever had. So, find something you love and pursue it. Follow this advice and you will set yourself up for an enjoyable future in medicine.”
Here’s where you might want to start …
By popular demand, we’ve assembled and added categories CLICK HERE [access our Bookstore]… to help doctors, business-owners and individuals connect with trusted, ethical, relational and knowledgeable insight in the concierge medicine and direct primary care marketplace that people can trust and we’ve thoroughly examined.