By Michael Tetreault, Editor-In-Chief
Do You Have What It Takes?
Updated: JANUARY 2021 – The editor’s at Concierge Medicine Today (www.ConciergeMedicineToday.com), asked some of the industry’s leading physicians and business owners, ‘what are the traits of a concierge doctor [or DPC] physician business owner?’
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 concierge medicine is a growing industry. But, as we’ve learned over the years, the best concierge [and direct-pay] doctors share a collection of characteristics, from the ability to tolerate risk, treating 5 to 9 patients per day, risking reputation over reward to passion and self-belief in a niche-industry.
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.
“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 concierge medicine a few months ago, and encouraging her to start her own concierge 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!”
“Concierge Medicine, like it or not, exposes what has yet to be accomplished between the Patient and the medical practice and Physician,” adds Tetreault. “In this way, this unique version of healthcare delivery creates a healthy sense of organizational discontent. Change is hard. That’s why we’re all here talking about it. We can’t ignore what’s happening to Physicians and Patients. Neither today are satisfied and leaving the medical office exam room satisfied. Have you ever sat on the other side of the exam room across from a Physician lately? Have you listened to the frustration inside the waiting areas? We have. And what we discovered year after year is that change is critical to bringing the Patient and Physician closer together. It’s easy to keep slipping into old patterns that seem to work or reimburse at this rate or that rate but we never see or experience real change. Change is and can be a means to an end. Today, Patients want their Doctor to change the way they communicate with them. Change in healthcare today is modeled here in Concierge Medicine by marrying the Hippocratic Oath with the Golden Rule. That should be the reality and example every of Patient-Physician encounter in our communities. These Doctors, this industry, are simply early innovators leading by example. They’re living, breathing story tellers that Patients are embracing it too.”
“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 concierge numbers and convert my non-concierge patients.”
“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
“We must remove every possible obstacle from the walkway of the worried, restless, irritated, annoyed, fretful, angry, depressed, concerned patient,” says Michael Tetreault, Host of the CMT Concierge Medicine Forum and Editor of the international trade publication, Concierge Medicine Today. “The exam room, the staff, the hallway, the front office and even the parking lot must be ready to serve and receive every Patient with a smile … without frustration, without waiting or last minute interruption. This is hard work. It requires an extra step in preparation which most medical offices and corporate leadership running medical offices are simply unwilling and don’t want to do. It’s different I get it. But this is how we lead Patients into a trusted and confidence-based relationship with their Doctor … by removing every possible obstacle on their path, one day, one step at a time. The goal is progress, not perfection and we must continue to lean in and support Doctors and teams that are will to do what’s difficult and raise the standard of care to a higher level.”
Second, it’s commonly presumed that doctors who enter concierge medicine are driven to do so by money. 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.’
“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 concierge medicine 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 concierge [direct-pay] 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.
Concierge Medicine is not a new experiment. CMT speakers and organizations at the latest industry conference explained it’s the ‘modern version of how healthcare was delivered decades ago.’
“This is not a new concept or experiment,” adds Tetreault. “This is an old familiar model from decades ago brought back to life to help bring Patients and Physicians closer together. We can’t get there just by complaining about the same things, becoming tribal and siloed into our own camps in healthcare. We can’t keep listening to feel good theories, blaming bureaucracy or DIY-ing what we’ve heard for years. Our desire is for the Doctor-Patient relationship to be strengthened, a lot. We all know the relationship between Physician and Patient is an important one. But Physician’s tell us week after week that it’s been eroding for years now and very little is being done that stands up and does something about what’s happening. Concierge Medicine is not only a tool to aid in the fight with Physician Burnout, but Patient Fatigue and Patient Burnout as well. That’s a core belief behind our practical approach here at CMF and our new online, members-only Physician community, the FOR Doctors Concierge Medicine Forum. Most of the content our Physician readers and speakers present every week is not taught in medical school, not read in a medical text book, presented inside a CME event or taught at medical conferences. Our aim is to present and let you hear from your peers … teach what is not being taught and help you lean into every story you hear. We’ll place it into a webinar environment and bring to you on our stage each week, month and year … and present actionable steps you and your staff can do right away in your practice.”
Communicating 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 Dr. Carrie Bordinko, RN, BSN, MD– Founder and CEO of Benessair Health in Arizona.
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.
“I remember when I started my direct-access, home-based primary care practice (www.MetroMedicalDirect.com) in 2009,” says Raymond Zakhari, NP and CEO of Metro Medical Direct. “Patients were skeptical and reluctant because of how accessible and convenient the service was. They expected to be kept waiting on hold. Some seemed puzzled by the fact that when they called I answered the phone and knew who they were. One patient even inquired as to how come they only had one form to fill out. Direct-access primary care patients who have been referred post hospital discharge, have not been readmitted to the hospital in the last 4 years because I can see them without delay or red tape. In NYC, despite the high number of physicians per patient, particularly on the upper east side of Manhattan, direct-access primary care can still be a viable practice solution for patients and providers. It helps patients cut through the red tape that has become expected in accessing health care.”
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 concierge medicine or start a direct-pay membership program in your practice. 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.
“I think the overwhelming impact of the conference this year is how much engaging content on a variety of topics there were,” said one Physician attendee. “There’s truly something in this conference for everyone. The content was overwhelmingly useful and engaging, like always. We saw viewers address topics on the key issues of the day critical for Physicians and it provided a lot of hope in this challenging time which is my greatest testimonial. We as attendees bumped into practitioners from around the globe and we’re able to talk to experts and supporting organizations that can help us take the next step in cancer testing, precision medicine testing and even help from consultants and Physicians who’ve got the daunting task of helping Physician’s like me transition into concierge medicine.”
“One of our advisors to this event this year said something a few weeks ago that really resonated with our team and Physician speakers. ‘When the Doctor becomes personable, he/she becomes memorable … and when the Physician in our lives becomes memorable, they become invaluable. That is truly remarkable and worth remarking to others about,’” quoted Tetreault. “I’m well aware of the tension that exists in healthcare and the bristle that some out there give when confronted with two of healthcare’s most polarizing words, ‘Concierge Medicine.’ I welcome these conversations and will talk to anyone who will listen about this tension that exists. At the end of the day, we might not agree and that’s okay. But we all know that it might be something we want for our own mother or our very own kids. These are great Doctor’s who are constantly innovating. They’re learning the social graces (e.g. kindness and creating a better way or a closer relationship with a Doctor) necessary to compete for the trust and friendship of their Patients now and in the future. We’re simply here to share their stories and make sure others know about what great things they’re doing in this space as well.”
“One of the most difficult occurrences is when patients who does not understand the program or who philosophically disagrees with the membership fees (i.e. thinks this is for rich people) accuse the physician of abandoning them,” says one former Transition Manager in Arizona. “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 concierge medicine or direct-pay medical practice or 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.
Are these characteristics or traits in you? There’s only one way to find out.
The Concierge Medicine Forum, held annually in Atlanta, GA USA each year draws Physicians from a variety of medical specialties, backgrounds and countries. They do things a little differently than you might expect from a traditional medical conference. That’s because the organizers and speakers they select want you to be different. A lot of medical offices and Doctors blend into the culture and communities around them, without Patients and their community really even knowing they are there to help. The tools which the Concierge Medicine Forum provides each year equips Doctors to stand out, to make an impact and not go unnoticed. It holds up a mirror and talks about what its like to be a Physician today as well as what it’s like to be a Patient on the other side of the exam room. And when that reflection in the mirror lines up with the vision Doctors have for Patient Care in their own community we see Doctors, Patients and medical offices changed and the research is proving this to be true.