Establishing a Vision for Your Direct Care Practice

When Tom Blue offers advice to direct care practices trying to find their vision, he often starts with a simple question: “What is the value proposition you’re bringing to the market?”

There are several ways to think about answering this question. It can be focused on what you’re trying to do to make your customers happy, or, to put it another way, who you’re trying to be of service to. “Many think that they’re clients are anyone,” Blue explains. “In private medicine, you can ask questions like: do I want to cater to kids? Athletes?” Understanding your target audience is key to establishing a vision.

But there are often considerations that fly under the radar. Many doctors, given their training, understandably consider their relationship with the customer above all else. But Blue presses people to consider how they can turn their business into an asset for retirement. “The value proposition isn’t just on you, the doctor,” he explains. Eventually, you need to consider the whole of the business’s financial health— profit, staff, expenses, etc. “Thinking about this requires doctors to step outside themselves.”

When they first start to think about private medicine, doctors think they’re selling more access to themselves. The doctors expect to make house calls, schedule visits over e-mail, skype, cell phone, etc. because traditionally, “The biggest complaint is a lack of access to them.” But to Blue’s mind, when you’re creating a vision for your private practice, “Stopping at access is cheating yourself at looking at something special.”

Two Visions

So you don’t want to think purely in regards to access and customer relationships. With direct primary care, there’s a real opportunity to deliver care in a better way. The first opportunity is for practices to work with pricing outside the insurance system. This provides an opportunity for practices to go to great lengths to create “transparently priced, new ways to pay,” Blue explains. Some of these new ways to pay could include discounts for labs or services. Essentially, the practice could provide wholesale primary care services. The idea is to create a better primary care experience. “Think Southwest Airlines,” Blue explained as way of comparison. “Southwest provides air travel accessible to everyone with a whole different vibe.” With direct primary care, practices aren’t “changing the medicine, but changing the way we consume it.”

But there’s another way to think about primary care. This way is more holistic, and instead of considering transparency and new ways to approach old financial models, this vision considers what complete financial liberty would shape primary care. In other words, its building a business model from the ground up. Reinventing. This approach to primary care is seeking to create both a functional and integrative medicinal model. A lifestyle change, in other words. Towards this end, doctors should look at the cause rather than the treatment of symptoms. “It’s the next era of medicine, the future of medicine,” Blue believes. At its focal point is the idea that medicine should be approached in a different way and the provider must question everything about how we’ve approached medicine in the past.

A One Year Plan

But doctors should not just look at how they approach their customer relationship or their finances, but to come up with a “one year plan.” This plan considers what it’s like to be a patient of your practice for a year. “Create a journey map,” Blue calls it. What are the touch points? What’s the cadence of it? What is your prevention plan, where do you interact, when, do you have a health coach? Blue advises “choreographing for the year. This tends to bring a lot of details and color to the plan,” he explains.

Through planning for a year, doctors will discover that they have more than one patient profile. You’ll have to consider whether you’re appealing to the healthy/health promotion crowd. And then you’ll have people with complex medical problems that you’ll have to sort out as well. In essence, you’ll need to start considering your approach to wellness and prevention as compared to a longer term care plan: Am I serious about both of these types of patients enough to create program for each of them? Often, people create a one size fits all and find that the healthy patients subsidize the unhealthy. This, Blue has found, isn’t a recipe for long term success.