Category: Private Practice Mastery

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.

To your wealth & success,

TJ

What is a hybrid concierge model?

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.

1. 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.
2. 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.
3. 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.

To your wealth and success,

TJ

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.

TJ

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.

Dr. TJ

Today I’m going to talk about Authority.

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.

TJ

Today I’m going to talk about concierge practice. This is really for private practice owners with medical or specialty practices based on insurance payments. If you are waiting for insurance reimbursement, that’s not concierge. That’s insurance based pay model practice.

On the other hand, concierge practice is like a plastic surgery practice or dental practice. If you go to get a procedure done by a plastic surgeon or dentist, 9 out of 10 times you pay cash. So concierge model, or patient pay model, as I like to call it, is where patients pay out of pocket.

Is it worth it to consider a concierge model if your current model is based on insurance?

I’d say yes, 100%.

This is a tough time for physicians and surgeons who practice on a private practice basis because as you know insurance reimbursement is going down every year. They’re squeezing out. I practice in the Chicago area, so I’m not one of those just talking theories. I’m breathing it in every day and I’m leading and coaching other doctors, so I know what I’m talking about.

I converted my practice to a hybrid concierge model. That’s a new concept. Just as you have gas cars, electric cars, or hybrids, why not have a hybrid concierge practice? This means you’re somewhere between insurance-based and completely cash-based.

You cannot jump overnight from being insurance-based to concierge-based. What I’m suggesting is you convert from the worst insurance company model and you start opting out. You know insurance companies that keep delaying payments or keep denying, or sometimes they want you to pay them back. Take those out one by one.

Don’t do everything at the same time.

That’s going to be risky because you need cash flow to run a successful business. That’s the most critical element of running a business. You’re feeding and growing your business – like raising a baby. You need cash flow so don’t jump overnight but through the years.

I’m only participating in two private insurance programs. I’m not participating in Medicare, Medicaid. I’m not participating in all the PPOs, HMOs, and ACOs, except two, because their reimbursement is fair for physicians. Now I have total control, so I call it a hybrid concierge model.

Throughout this series, I’m planning to explain to you more about what it is, and why it’s important. Hopefully, I will provide you value and open your eyes to a way to grow and thrive your private practice.

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This article was edited from a transcript of this video.

An office-based surgical suite has a lot of benefits. Here are the main benefits to the patient and to you as the physician.

Patient benefits

Convenience and comfort: Your patients are already used to coming to your office, seeing the same staff, and the same environment so they’re used to it. They’re less nervous.

Huge out-of-pocket savings if you perform surgeries at your office-based surgical suite. I’m not talking about a billing facility fee or anything like that; you just bill straight, simple. Just like surgical procedures, you would bill at the surgical center or hospitals. You don’t need JCAHO or AAAHC certification or anything like that. Just like you perform P&A at your office, you’re performing other foot and ankle procedures at your office.

Less chance of hospital infection because you’re not taking your patients to the hospital.

Physician benefits

What about physicians? You have your own benefits too.

Greater Rewards: Insurance companies, including Medicare, reward you typically 20% more than hospitals or surgical centers for the same procedures. Insurance companies and government know you are saving them a lot of money, so why not reward you?

Huge saving of your time: Time is your most invaluable asset. You don’t have to commute to the hospital or surgery center. You don’t have to worry about traffic. You don’t have to worry about your own turns for your procedure since you do everything at your own office.

You are making yourself future proof. What does that mean? Value-based healthcare – MACRA and MIPS – is being implemented.

As you can see in this graph, we’re in a transition period. Once that data gets collected, they’re going to start rewarding or punishing, depending on your performance. What do they see? They see who saves the government or insurance company the most money. Because, it’s not going to be fee-for-service, it’s going to be value based. If you save them more money, you will be rewarded if you continue to choose to be in that network.

The most beautiful thing about the office-based surgical suite is that not many doctors have it. So you still have a unique positioning if you can market to your patient clientele in your community that you offer office-based surgery. You obviously get more attention because patients will prefer this.

There will be consequences

There was an article in social media about a patient who came out and was so upset and angry, frustrated, scared. She underwent some kind of shoulder and foot procedure and then she stayed at the hospital for a few days. She showed the bill on the article. It was $120,000 or something. The hospital charged $15,000 for “four little screws for foot surgery”. We’re talking about huge, huge costs for an individual patient.

Think about your own office-based surgical suite. Patients don’t have to worry about these types of consequences. How strong you will be? That’s why I’m a big proponent of the office-based surgical suite.

How to get started with Office-based Surgery

It’s not that difficult. You have to basically find a room, get the equipment, train your staff and get the documentation prepared. You may have to review training for staff: how to gown and glove, how to set up instruments, etc. Again, those are not difficult but you need to know the right sequence and the right system.

If you need help setting up an OBS or learning MIFAS please don’t hesitate to book a free strategy session with me and my team – Click here to book a time.

-TJ Ahn