How to Grow your DIrect Care Practice

You created your vision, wrote your business plan, and launched your website. You’re clear on the types of patients you’d like to work with and the number of patients you need for your practice to run efficiently and be financially sound. The challenge now is how you’ll attract new patients and grow your practice. 

For this post, we spoke with a handful of leading Direct Care providers to find out how they’ve been successful at attracting new patients and growing their practices. Here’s what they told us.  

Start with a Plan

Dr. Erika Bliss, CEO of Qliance, which serves more than 20,000 patients across six locations in Washington state, says it’s critical to have a plan to drive your marketing. 

“It doesn’t have to be a big slick marketing plan,” Bliss told us. “And it doesn’t need to be expensive.”

Your marketing plan is your blueprint that outlines the types of patients you would like to work with, the ways you plan to reach those patients, and the messaging that will resonate with them. 

For example, if you know you want to work with small business owners in your community, you’ll want to figure out how to reach them. As a small business owner yourself, perhaps it means joining a networking group for local businesses. 

Once you have a plan, Bliss says “getting known in your community is critical.”

To do this, she recommends speaking to the local community at churches, community centers, and YMCAs. Once you’re in front of these groups, the “key is shaping your message so that it’s appealing to the people who you’re talking to.” It’s important to think about their healthcare needs and how Direct Care could benefit them. 

For Dr. Ryan Neuhofel, who started NeuCare in Lawrence, Kansas right after finishing residency, he says his community involvement has been “by far” more productive to grow his practice than traditional advertising. 

“If you can get yourself in front of a group of people, whether it’s 10 people or 50, you’re more likely to convince them that direct primary care is a good idea,” said Dr. Neu. 

Dr. Neuhofel explained that the majority of people are still skeptical of Direct Primary Care, thinking that it’s too good to be true. To counter this skepticism he recommends giving the community the opportunity to see you and meet you.  

Get Systems in Place

In addition to having a marketing plan, Matt Blanchfield, an investor in Functional Family Medicine, a DPC practice in Albuquerque, New Mexico, says “practices must have a functioning backend before they do anything to grow.”

“If you don’t have a system that’s going to function at volume, you’re out of your mind,” said Blanchfield. “You’re going to crash and it’s going to be expensive.”

What he means is that a DPC practice needs to have a simple process for onboarding patients and handling billing. Blanchfield says it’s critical that all of the systems, i.e. the EMR and online payment system, work together. As part of streamlining your practice to prepare for growth, Blanchfield recommends getting rid of paper and bringing the contract online.  

Second to having these systems in place, is ensuring that your staff knows how to use them. The idea here is the systems are only as good as the people who are tasked to operate them.

In addition to having systems in place, Dr. Neuhofel recommends that DPC providers establish policies regarding how you will deal with billing issues. 

“If you think you’ll just set them (patients) up on auto-pay and it’s all going to work fantastic, you’ll be sorely disappointed,” he told us. 

He recommends that new DPC providers think through how they will deal with payment rejections and late payments, as well as figuring out who will be handling these aspects of the business. 

It’s About Hustle

Dr. Clint Flanagan, who launched Nextera Healthcare in 2011 and has since grown the Nextera Healthcare affiliate model to serve patients across six locations, considers himself a hustler.

“You can’t just throw up a website and expect that people will come,” Flanagan told us of opening a practice. “It’s not for the guy who’s going to sit back and send a few emails and just hope that just magically his practice is full and he’s going to be able to pay his staff.”

In the beginning, Flanagan and his business partner did a lot of grassroots marketing. To Bliss’ and Neu’s points, they joined local business groups like the Boulder Chamber of Commerce to build relationships in the community and share about the benefits of Direct Primary Care. The message they shared was a simple one -- Direct Primary Care is “changing people’s lives and they’re paying less than what they’re paying for their cell phone.”

Word of Mouth and Local Press

“Word of mouth is your strongest marketing tool,” said Bliss. 

Once a practitioner builds enough of a reputation, “then those folks tell a friend, who tell a friend, who tell a friend.” 

Bliss also stressed the importance of getting local press for your practice as a means sharing about Direct Care and attracting new patients. She sees press as one of the most effective tools “because it sticks around.”

According to Bliss once something is published in a print or online publication, it can easily be shared with your community via your website and social media. In the early days of Qliance, a  story written in a local paper called “The Stranger” was how patients said they found out about the practice even years after it was printed. 

“With the internet, it’s like having a million bulletin boards where you can post your article,” said Bliss. “It perpetuates itself.”

To approach your local reporters, Bliss recommends putting together “a dossier of articles” written about Direct Care. The message to the reporter would highlight the growth of the Direct Care movement and introduce the reporter to your practice and how it will meet the needs of the local community.

Digital Advertising

Blanchfield started and owned several multi-million dollar companies before becoming an investor in Family Functional Medicine. 

His experience as an entrepreneur taught him the value of “traditional sales and marketing”. Blanchfield believes that if you want to attract individuals, you need to be doing internet marketing. For him and Family Functional Medicine, this means investing in search engine optimization (SEO), a tactic of using targeted keywords to help a site get high-ranking within search engines like Google and Bing, a professional website, and social media. 

Since it’s likely that new providers don’t have thousands of dollars to spend on hiring a digital advertising firm, and may not have the technical expertise themselves, Blanchfield suggests putting together a team “piecemeal”. For Family Functional Medicine, he has someone who does social media, someone who does SEO, and someone who takes care of the website. 

For Dr. Neuhofel, he found traditional forms of advertising ineffective at helping to grow his practice. After doing a little bit of advertising on the local radio and in the local paper, he advises new providers to be hesitant to spend lots of money on advertising.

Dr. Neuhofel went on to say that there is no one-size-fits-all approach to growing a practice. What might work for Family Functional Medicine in Albuquerque, New Mexico might not be what works in Lawrence Kansas. Dr. Neuhofel thinks it’s imperative that DPC providers look at their local community.

“Every community is unique, and the demographics and mentality are going to vary a lot from community to community,” Neuhofel said.

Know Your Personal Strengths and Be Yourself

Growing a practice is hard work. In addition to working with patients it means putting yourself out there in ways that may feel uncomfortable to a provider who has never had to work to find new patients.  

“If you’re kind of an introvert and you’re trying to grow this kind of practice, you’re going to struggle, and you might want get someone to help you,” advised Bliss. “The vast majority of people going into this business are a little bit more of extroverts, or can at least bring that out in themselves.” 

If you do decide to seek help to market your practice, and you’re not in a place financially to hire someone, consider trading services. Perhaps you can offer a membership in your practice in exchange for their business and marketing expertise. 

Dr. Neu says it’s imperative that providers are authentic with their communications. According to him, DPC is all about the personal relationship between the doctor and the patient. 

“I don’t think you need to be a marketing wizard or ad man to connect with people,” said Neu. “Most doctors who are not seeing much success on Facebook and Twitter are trying too hard to sell it,” Neuhofel said. 

Instead of using Facebook and Twitter as ways to broadcast your own internal news, use your social media channels as a way to share more about yourself and information that your fans and followers would like. Do you have a hobby you’re passionate about? Don’t be afraid to share about it on your business page. Is there something fun happening in your local community? Post about it on your social media. 

Approaching Payers and Employers

Both Flanagan and Bliss have seen tremendous growth in their practices through relationships with payers (insurance) and employers.

According to Bliss, the key to establishing these relationships is being able to provide “evidence that what you do makes a difference.”

“What this means is you have to be driving down the total cost of care,” said Bliss. “You have to actually show them that not only is what we [Qliance] save you going to cover what we cost, it’s going to give you net savings.”

When talking to employers, Flanagan positions Nextera Healhcare as a “win-win-win”. First, it’s a win for patients with high-deductible insurance plans who have to pay high co-pays or out of pocket for doctors visits. Second, it’s a win for the employer because they are able to save money on employee healthcare and still provide high-quality care. And lastly, it’s a win for Nextera Healthcare who gets to be the chosen provider for those employees. 

Another key factor to working with employers and payers is that the practice must have enough locations to meet the needs of a large payer or employer, or what Bliss refers to as “critical mass.”  

If you have critical mass, and are ready to approach an employer, Bliss’ advice is to get an introduction to someone as high in the company as possible. 

“CFOs are great because they’re looking at the bottom line of the health benefits costs,” said Bliss. “If you’re going to lower costs and improve health outcomes and productivity, they often times are the folks who are most interested in talking.”

Flanagan notes that critical mass was key to Nextera Healthcare being added to the health insurance exchange in Colorado. In order for Nextera Healthcare to be a viable option for residents seeking coverage they needed to expand from 5-6 clinicians to 30 clinicians across more zip codes. 

Dr. Chris Larson, who founded Austin Osteopathic Family Medicine, recently shifted his marketing focus from the individual market to small employers. Larson says that despite having just one office, he feels equipped to handle the healthcare needs of small employers through his use of telemedicine. 

For those employers who require more than one doctor and location, Larson’s participation in a direct care alliance will allow him to still be seen as a viable option. Through the alliance, which brings together a group of doctors around Austin, employees will have access to any of the doctors who are members of the alliance.

When asked how he approaches new employer prospects, Larson said it’s simple, he visits their offices. 

“That’s the only way that I’ve found that I’ve gotten any contact,” said Larson. 

According to Larson, employers are experiencing healthcare fatigue -- they’re tired of hearing how the next best thing is going to save them money. 

“It makes a difference when a doctor walks through their door, and says there’s something new I’d like to tell you about,” said Larson. “I don’t want to be a salesperson, but honestly that’s what it comes down to.”

There’s No One-Size-Fits-All Solution

If there’s anything we learned from the providers who we spoke with, it’s that there isn’t a step-by-step plan that’s perfect for every practice. In fact, many providers told us that their journey to grow their practice has been one filled with trial and error. 

That said, the following takeaways seem to ring true no matter the size or location of the practice:

  1. Get Your Backend in Order: Make sure you have the systems and policies in place to run smoothly as your practice grows.
  2. Be Yourself: DPC is a business about relationships, which means it’s important that your marketing be authentic and personal to you.
  3. Ask for help: You’re a doctor, not a marketing maven. Don’t be afraid to ask for professional help with your marketing and business needs.  
  4. Hustle: network and make connections in your community. Don’t sit back and wait for patients to find you.
  5. Try, Try, and Try Again: Starting a new practice is about trial and error. Try new things, assess how they’re working, and do more of the things that are working.