#1050 Dr. TJ Ahn: Why Diversification Is Key To Your Success
Dr. TJ Ahn is a first-generation Korean immigrant who came to America alone when he was only 19 without any connections or the ability to speak English. Determined to live the American Dream, Dr. Ahn spent the next 30 years honing his medical and business skills. Dr. Ahn is a pure-bred entrepreneur and is involved in other sectors, including real estate investing, business coaching, private- practice consulting, and marketing—all with one vision in mind: to help physicians build profitable private practices without the hassle of insurance networks.
Most online marketers do not know what HIPAA is. It is very, very dangerous as private practice owners to utilize this type of marketer for your lead generation and patient generation. Because most marketers use platforms, I am not going to name those platforms. Most marketers use non-HIPAA compliant platforms. It is not safe for doctors to use this because of patient information.
Even if you are generating leads, as soon as a patient opts in with their information (name, phone number, and email address) with the intention of you utilizing as a lead generation, contact them. It is still considered as PHI protected health information. Bring them into your practice; they may be a future patient.
HIPAA Compliance Marketing Course
Credit is now given to my friend and teacher John Hopshade. I took his HIPAA compliance marketing course and now I am helping other doctors, colleagues and my clients to make sure they are utilizing HIPAA compliant marketing. I am not going into details, but if you are already marketing for your private practice, make sure your marketer follows HIPAA rules and regulations. Between yourself and the marketer, have a business associate agreement with those two entities. It is a very expensive mistake you can avoid.
Penalty for non-compliance
Currently, I believe the government can fine you up to $50,000 or so a day if you’re not HIPAA-compliant. If you go to the government website, you will see a lot of ongoing cases which has something to do with HIPAA compliance and violating those HIPAA laws, regulations, and patient protected health information, etc.
If you are concerned, you can get in contact with me. I help my colleagues and clients to be HIPAA compliant with their medical marketing.
Are you familiar with the Chicago Restoration Hardware?
The owner purchased this whole deserted building loft and updated everything. He remodeled and created this awesome environment. Customers can come in and browse around. But in the middle of the building, there is also a restaurant that people can enjoy great food, wine, and drink. At the same time, they can look around. Everything can be done.
Niche Strategy
So why did I decide to speak about this? For you, as a private practice owner, something you should consider is to create a niche service. Unless you have something unique that you can offer to your patients, it is very hard for you to create a concierge practice. To do that, the first element is a niche. What is your niche? What is your unique service or treatment solution that you can offer your patients?
Valuable Resources
Great additional resources that you should look into are Michael Porter’s five competitive forces. They can help you understand strategy. The Five Forces will help you understand the environment that can affect your decision-making process for a strategy to build your hybrid concierge service.
There are the threats – the power of the supplier and the buyer, and obviously comparative rivals already in the market. So if you can research a little bit into the Five Forces, it will help you understand about concierge marketing and concierge medical practice.
Also, I am sure you are familiar with this, but Doctor Chan Kim wrote a great article about blue ocean strategy versus red ocean strategy. If you are not familiar, that is another great area to look into. As long as you practice in an insurance-based model without a specific niche, you are pretty much suffering. You are struggling in red ocean market i.e. an insurance-based model.
To all the specialists, if you are based on insurance reimbursement and are heavily depending on that, you are pretty much in a very tight competition. You are in a red ocean. You would have to play the volume game. Instead of a quality game, you are struggling so much to get more, more, more patients. Because your reimbursement per patient is so low, you have to work your butt off to meet your revenue demand every day, every week, and every month to play the volume game. Could you really provide the best quality service to your patients?
It is very hard unless you spend extra for more employees, more customer service, etc. It is very hard to provide quality care for your patients in that model. So look into that blue ocean strategy. Look into the five forces of the competitive market. And then again look into the hybrid concierge model where you can provide the best solution without hassles of an insurance network.
That is what I am coaching other colleagues and specialists in. I help you build that lucrative profitable practice model, while you provide the best care for your patients.
This is a sort of boutique practice or cash-pay patient model blended with an insurance-based model. So what does it mean?
As you know, if your private practice owner passes several years of reimbursement from an insurance plan, they have been steadily decreasing and hurting private practice owners. You feel it every year, the same procedure. As inflation is going up, the reimbursement has been going down tremendously. And of course, because of the inflation, your operating expense, payroll expense, everything else has been going up.
Who does it affect?
Is it only hurting private practice owners? No, not only private practice owners but it is also detrimental to the patients. Why? Because patients’ insurance premium has been going up every year. Their annual deductible is not uncommon to see – $5,000 and $10,000 a year in network benefits with coinsurance 20% to 30%.
Even if you want to provide the best treatment option to your patients, if they have this type of insurance plan with a huge deductible, it is very difficult for them to accept your treatment solutions. It is actually very difficult for private practice owners to survive with current, typical insurance-based models that you have been used to.
Time for Change
I do not know if you have been practicing for many years, or you are just out of practice, or you are a resident who is ready to come to the real world. Really, if you do not shift, if we do not convert or at least consider, it is very difficult to survive. Only current practice models may work through ACO, HMO or to the big hospital to get volume feed from this big network with the current reimbursement.
Now, what is the disadvantage of that? Your revenue may be okay in that model, but how many patients do you see with that type of model (volume base model, insurance-based model)? You are contracted and you have to see just so many patients a week. How can you expect to provide the best quality care to your patients if you have to see 200 to 300 patients a week?
Again, you have to be employed by a hospital and they have a lot of staff. I know the physician’s assistant or nurse practitioners are taking over lots of doctor’s responsibilities just to save money from bleeding the insurance company money, government money, or a hospital. It is a very, very difficult situation. So by incorporating the hybrid concierge model for private practice, it just makes sense because now you participate in only certain insurance network plans that are fair.
Even if you are in a network, patients still have to pay a lot of huge deductibles. It is almost about the same in-network or out-of-network. It is a matter of if you can provide the best treatment solutions. I think that is what matters the most. So, you do not get your decision process to choose the proper treatment plan. It does not get influenced by what insurance or if that is covered by insurance. So, by establishing and building a preconceived model:
you can focus on patient care
you can focus on choosing the right solution for each patient
you can provide the best possible quality care with time
My Experience
So right now, I practice a hybrid concierge model. I only participate in two insurance plans, so it is possible. Then, I can see 10 to 12 patients a day. But you can provide the best quality time and undivided attention to your patient, each patient. And you can provide the right treatment for each patient. So that is really why I am encouraging private practice owners to seriously consider a hybrid concierge model.
A 3-Step Strategy
Now, how do you do that? In the next six months, this is where I believe you need to invest your time and your resources.
You need to develop a niche skill set. So no matter what type of specialist you are, there has to be a niche treatment solution that you commit time to get better at. Learn more, study more and invest. Have a strong focus on a few niche skill sets so you can build authority in that treatment solution.
You need to study and understand medical marketing and patient psychology. As a physician or a surgeon, it is very difficult to understand how patients think in the decision-making process. Most surgeons and physicians are used to diagnosing the problem and just letting the insurance deal with it.
You need to develop communication skills. Without proper communication skill sets, it will be impossible to build concierge, boutique or patient-pay model practice. I am not teaching you how to sell like in typical sales. You are providing a service. If you believe your service is the best and patients are in-network, out-of-network or out of cash, they still have to pay.
If you do not know how to close that gap during the doctor-patient consultation phase, there will be no exchange of service. There will be no treatment solutions, therefore you will not help your patients. And if you believe in certain services, that niche skill set is great for patients’ health and a better life. If you are not able to communicate with your patients properly, I strongly believe you are doing a disservice to your patients.
So, I hope these 3 steps have awakened you a little bit if you are thinking about a hybrid concierge model.
Minimally Invasive Surgery (MIS) has been around for more than 40/50 years. There’s been some upturn and downturn.
Now as I accidentally found out about MIS in a cadaver lab in New Orleans, something struck me. This could be it! I remember I was about to quit and go into another business but something struck me. There’s an attractive side to MIS, that little portal that most patients are not aware of. Nowadays, all other parts of the body are been done using a minimal incision approach so why not the foot?
MIS has a steep learning curve but once you can go over that hump there are a lot of benefits.
MIS reduces post-op swelling
If you are traditionally trained like I was, you know that it is difficult to avoid the post-op swelling. No matter how you dissect that tissue, it’s difficult to avoid it. But just by the fact that you have to create a larger incision, it’s almost unavoidable to develop some post-op swelling.
It’s very different if you start doing MIS. You’ll be shocked! There is very little swelling typically if it’s done properly. Just prepare yourself not to show your emotions in front of your patients when you first do it. Patients will eventually see it and leave great reviews. Their word of mouth feedback is not something you can manipulate.
MIS: Revenue up + cost down = higher profit
Increased Revenue
Your revenue will increase because of your reputation in your niche. You may opt-out from insurance plans (by the way my book about opt-out is coming out soon). Once you start opting out, you would be able to provide patients with great all-inclusive service at a premium price.
Reduced Expenses
You will unintentionally save on advertising costs. This is because you won’t have to spend much money to promote. Most times MIS promotes itself and your patients will promote you because they’re happy. Your biggest expense is the tax which you can’t do anything about. However, your second biggest expense is payroll.
If you check out the post about my office, you’ll see it’s efficient and modern. You can run your practice with just a few employees. You don’t need to have 4 or 5 employees. You don’t have to see 200 patients a week. And these approaches to your practice will significantly decrease your payroll expense. Very economical surgery equipment will drive your supply cost down too.
MIS fosters improved mental health
Think about this. You have to deal with your job, patients, employees. When do you have time to enjoy your family? You have to be mindful of your stress level. With MIS, you do surgeries at your office so you don’t have to commute or wait your turn at the hospital. You can enjoy your own place; it’s smaller with less work time and fewer patients.
These benefits I don’t mind repeating because I want you to know. But you have to follow the system and a good process so you don’t have to go through on your own. That’s why my mission came about. My passion was to coach and develop a proven system.
If you’re interested in learning more check out my program.
I made the video above to show you a complete tour of my podiatry office which includes my office-based surgical suite. Read below for more details.
So let’s start.
Now you don’t need a big, fancy 5,000 or 6,000 square feet office. What I’m showing is 1,800 square feet which I created for a foot and ankle practice with a built-in surgical suite.
This is my clean modern waiting area. I don’t participate in most insurance plans so I don’t have 50 patients a day. I only see 10 to 12 patients a day, working three and a half days a week.
Primary Treatment Rooms
Treatment room #1: This room is about 8’ by 8’ or 8’ by 10’. I have an MLS laser machine for post-op swelling or sports injury.
Treatment room #2: I have my shock wave and diagnostic ultrasound machines.
Treatment room #3: This room is 1,800 square feet. I do ABI tests for vascular study before surgery.
The Surgical Suite
The most important things for me are a mini C-arm and an Osada drill set for cutting bones and shaving bones. There’s also a digital pneumatic tourniquet but I don’t even use it anymore. Most MIS procedures are performed without tourniquets, avoiding possible vascular complications. Here’s a traditional digital x-ray setting.
My office-based surgery suite is about 15’ by 15’. It used to be about 12’ by 15’ but I opened the wall and made it bigger. You really need a 10’ by 12’ or 12’ by 12’ room for your office space. This is my office where I do most of my computer work, consulting work, and rest.
I also have a couple of bathrooms and then two autoclaves in a small room which is also a kitchen area. I also have one ultrasonic cleaner because as long as you have an office-based surgical suite, you have to sterilize everything. So that was a quick tour of my MIS practice with an office-based surgical suite.
Benefits of having an office-based surgical suite
Everything’s done right here. When patients come to my office, they enjoy so many benefits:
They don’t have to go to the hospital or a surgery center.
They save lots of money for coinsurance.
They don’t have to pay facility usage to a hospital or surgery center.
They enjoy comfort conveniences.
They don’t have to meet new people.
In another setting, patients usually have to go to a pre-op room along with many other patients. They have to wait for their turn to go to war then come out to the recovery room. Instead, they come here to the same office and the same staff that they’re used to. They just walk in from the treatment room, get the surgery done and go back to the treatment room.
The treatment room works as a recovery room. Most MIS procedures are done using local anesthetic, twilight sedation. But most of them can be done locally which is another plus. So patients don’t have to worry about complications from sedation anesthesia.
If you want to have an office-based surgical suite like mine join my MIFAS Accelerator 2.0 Program
As I said, I have a very flexible schedule: three-and-a-half days a week. Most of the time when I don’t see patients, I basically talk to doctors.
With my MIFAS Accelerator 2.0 program, I meet with my current clients every week on Friday evenings. We do live coaching calls to discuss their surgery cases and their minimally invasive surgical skills. We also discuss office-based surgical suites like the one I showed you to help them set up their own custom layout. A lot of documentation is very important for office-based surgery which I provide during the coaching program.
If you are even remotely interested then watch this quick video on MIFAS Accelerator 2.0
Watch my free webinar on how you can skyrocket your practice profits with MIFAS and an OBS.
Is your Marketing really working? Do you know where your money is being spent?
How are you marketing your private practice? I talk to my clients and prospects at conferences or at my coaching sessions. They say:
“TJ, I allocate $3000 a month for my marketing. I think I’m doing okay.” “I’m spending $5000 but I don’t know if this is working.”
Most doctors say it blindly; either it’s working or not working. As a doctor, as private practice physicians, you increase your knowledge level in marketing because most doctors are obviously not good in marketing. I just want to make sure you don’t get taken advantage of by marketers.
If you’re currently using a marketing service, next time you talk to your marketer guy or gal or company ask them, “What is my marketing objective with your company or with your current campaign?” They’re gonna be, “Shoot! This doctor knows what he is talking about.”
There are different objectives in marketing, not just sales.
Have you heard about brand awareness? There are different categories in marketing. Are you doing brand awareness marketing? Are you doing, for example, social media post engagement, objective marketing, website traffic marketing?
All the things that I’m telling you right now have a different objective. So you can set different expectations and go for different results based on your marketing objectives.
One objective I haven’t told you is conversion. Have you done or ran a marketing campaign for conversion? That’s where you’re converting a prospect into a lead or even paid. That’s where it counts for patients coming to your door. That’s the conversion. It’s called CPL or CPC (cost per lead or cost per conversion).
These are the acronyms that marketers use. I want you to know this so you can ask your marketer, “What’s my CPL right now?” That means how much do you have to spend to get one actual patient coming to your door.
Do you know what is LTV? That’s the lifetime value that one average patient can bring to your practice, the revenue scale.
What’s your current marketing campaign running? It could be simple generic post or generic articles in social media. It could be Google SEO marketing. SEO means search engine optimization.
I want you to be aware of different kinds of marketing campaigns. Now, have you heard of a retargeting campaign? I’m throwing a lot of different terms out here so that you know.
Equip yourself is some digital marketing knowledge
If you say to your patient about first metatarsal, second metatarsal or any kind of surgical angles and other surgical terms, they wouldn’t know what you’re talking about. Same goes true when we talk about marketing with doctors.
The more equipped you are with terms and knowledge about marketing, the less likely you’ll be taken advantage of. And then you can utilize your budget more efficiently as far as marketing goes. You know where you are spending and how to spend your marketing budget properly.
That’s what I wanted to point out. So hopefully you’ll figure out where your money is going as far as marketing spend.
Hello doctors, let’s talk about goal-setting today. We set goals, however, they are very difficult to achieve. Do you agree with that? There are reasons behind it. You can blindly or vaguely set goals:
“I’m gonna make a lot of money next year.”
“I’m going to do more surgeries next year.”
“I’m going to be nicer to my family member next year.”
But goal-setting is nothing like that; these are not specific enough. I learned this and then I did some research and took a lot of business courses. You don’t have to because I want to provide some information and knowledge. If you are a private practice owner, you can apply this information and knowledge to your practice to increase revenue and monetize.
I use the elements of goal; the acronym SMART. You may have heard this one before but again I’m going to tell you anyways.
S – Specific
Your goal has to be a more detail-oriented specific goal.
M – Measurable
Your goal should be measurable.
If I say I’m going to lose a lot of weight, there is no measure. Measurable is “I’m going to lose five pounds in the next two weeks.” That’s more specific and measurable, isn’t it?
A – Attainable or Actionable
It should be set as an actionable task.
So instead of I’m going to lose five pounds in the next three weeks, I’d say, “I’m going to do 30 minutes three times a day, crunches and sit-ups every day for the next two-three weeks to lose 5 pounds.” That’s more actionable.
R – Relevant
You have to really resonate with your goals.
You cannot just do some kind of unrealistic goal that doesn’t resonate or isn’t relevant to you, your personal development or your business. So it should be relevant.
T – Time-bound
This is very, very important because humans are notorious for procrastinating.
You and I both know if we don’t have a deadline, it’s very easy to put things off. So make sure to add some urgency to your goal setting.
Your action task is to write down one goal following the SMART principles.
What is an offer? What does that have to do with private practice?
So you may think, “Dr. TJ, is that like when I bought my house?” You wrote an offer and then you exchange. “Is that something that you’re talking about?” No!
In the business world, the offer is critical especially if you want to develop concierge practice. In the insurance-based model, you don’t need an offer. You just provide service, send the bill to the insurance company, and then they determine what is allowed. And then hopefully you get paid. That’s the insurance model.
But we’re talking completely different; we’re talking patient-pay model. Before we go there, the first condition is you are a doctor so don’t forget that. We are physicians. We are healers. Patients come to you to fix their problems and then you are morally and ethically obligated to provide a benefit, not harm.
Having said that, the offer is like a packaged service. It is irresistibly attractive and all the values are stacked in that package so that your presentation of the offer will be an experience for your patients.
People buy out of emotion more than logic.
To bring emotion out of patients, you need to craft your offer and your services as a package. For example, I’m a podiatrist. So let’s say a patient needs bunion surgery. You’d say you need bunion surgery and then pretty much that’s it. You may tell them some post-operative instructions like take medications but that’s it. That’s not an offer. That’s a very unattractive offer.
Now imagine if you package this bunion surgery, let’s call it Cinderella bunion procedure. (I just named it that but you can name your offer.)
You include all the benefits that can be complementing your main offer. So patients come for consultation every day. With my visit and x-ray let’s say they pay $225 to actually diagnose or evaluate their condition. If they go through bunion surgery – I’m talking about out-of-pocket patients – it costs, let’s say $3,000 for the procedure. With my offer, I give that $225 back if they decide to get the surgery done. So that represents their pre-op. All the detail of the pre-op is included in the offer. And all the post-op visits are included up to 3 months and cover:
CAM walking boots
splint dressing material
premium quality shower cover
post-operative laser treatment for healing
So you provide them a package. That is what an offer is all about
So what does this do for you? It makes you different. It makes you a niche service provider. It makes you care for patients. Patients will have different experiences; they’ll have different emotions when they hear about this offer.
Good luck crafting your offers! Comment below if you have any questions.
When it comes to choosing a specialist for patients’ problems what are they based on? Let’s say there are multiple doctors, and even specialists, in your community. So when patients choose which doctor they should go to, assuming two doctors have the same skills, which doctor do you think the patients are going to choose? What will the choice be based on?
The need to build authority for private practice owners
In fact, I took a special course. I invest a lot of money every year in personal development and business skills. I’m a podiatrist in Chicago and I focus on minimally invasive surgery. However, my practice model is based on the hybrid concierge model. To have a successful hybrid concierge model, you definitely need to have some balance not only for the surgical skills or your niche. You also need to develop business skills to run your medical practice more as a business.
You are providing a service and your main goal or objective is to heal patients and fix their problems. However, without knowing business skills – marketing, sales, and communication – in detail, we are busy running against the schedule. You can have all the excuses you want; however, certain skill sets you cannot outsource.
To build authority, you cannot outsource it.
The easiest, fastest way to build your authority without spending a lot of money is to build social proof now. You can build social proof through patient testimonial videos. I’m not just talking about written ones through proper videos. Patients speak patient terms. Patients speak from emotion. Patients speak from their experience instead of you telling people out there how good you are or how qualified you are. Basically, you are naturally being selected as the choice, the authority or leader or expert in your field.
So as I was saying, I spent a lot of money developing business skills. I took one course by Joel Bauer, a great teacher, and coach. He’s known as a mentor for well-known celebrities, mentors, and coaches. I took his course entitled “Live Authority Matrix”. Joel says in his course that you have to be the only logical choice by your customers or clients. In our case, I would say:
“You have to be the only logical choice by your patients and potential patients.”
You build authority and, again, the quickest and most efficient way to build your authority shift is to develop strong patient social proof through testimonial videos. If you want to see how it’s done check out my patient testimonial videos on my YouTube channel.
