On the homepage of her marketing firm's website, Nancy Latady makes a powerful claim that speaks to the many practitioners working in a system that they no longer believe in: It can be different. From the very beginning, she was certain that a hopeful message would resonate with medical professionals who felt overwhelmed, overworked, and unable to fathom a way out. But her message wasn’t some clever marketing ploy; Latady knows from personal experience that possibility models motivate people to make change.
“I’ve been a provider, I’ve been a manager, and I’ve been a consultant. Right before I became independent, I was working within the hospital system. Our whole strategy was to bring physicians under the umbrella of the hospital as a means of driving patients into that same system. The perfect storm of insurance reimbursement decline, exacting coding requirements, an increase of patient volume, and a simultaneous decrease in primary care physicians’ incomes all converged to make obvious to me the total dysfunction of the healthcare system. I started having a difficult time justifying why I was supporting any of it.”
Although concierge medicine had been on her radar for nearly fifteen years, it was the increasing adoption of private medicine models and the subsequent rise of the Direct Primary Care movement that proved to Latady that a new mode of doing business in the medical community was not just necessary, but also possible. “When I realized I was ready and able to change my focus, I did. Now, I’m working with medical professionals across the country who want to transition to or launch a new practice under private medicine models.” This emphasis has been beneficial not only to the doctors whose practices she helps transform but also to her own sense of professional fulfillment. “I feel like I’m solving problems on all different levels. The doctors have been burnt out by the old system, so we work to solve that problem. They have been unable to provide optimal medical care, so we work to solve that problem. In the process, doctors develop a renewed sense of energy and engagement, and patients start receiving better care.”
Misapplying the Possibility Model
Many doctors frustrated by the healthcare system find inspiration in peers who have already made the switch to Direct Primary Care. While Latady emphasizes the positives of this pattern—particularly the domino effect of more doctors joining the movement—she also acknowledges that it often renders marketing strategy as an afterthough. “Instead of doctors looking at their own situation and trying to figure out what they’re looking to achieve, what their patients need, and what would be supported in their market, they tend to look towards other practioners and say, ‘I’ll do what they did, I’ll price the way they did, I’ll look for the same patient following as they did.’ These tactics don’t often lead to successful practices.” This problem became more apparent to Latady after attending a Direct Primary Care conference in Kansas City. “I asked people, ‘How did you decide on that initial price point?’ And they would respond, ‘Well I know this other doctor who started there and it seemed to work out well enough for them.’ For me, the jumping off point should really be figuring out what’s going to a be a viable practice model for each doctor based on how many patients they have, the supply and demand of their particular market, and what they are seeking to deliver to their patients. Simply piggybacking onto someone else’s business plan doesn’t take those variables into account.”
Latady sees this trend as evidence of doctors’ enthusiasm for the Direct Primary Care model and eagerness to get out from under the hospital system as soon as possible. “They’re chomping at the bit. Once they’ve considered it, they really can’t go back. They can’t undo the realization that medicine can be different. I used call the start of our business planning 'feasibility studies' because doctors would come to me asking if another model was possible for them. I don’t even call them that anymore. Now, most doctors just come to saying, ‘I’m doing it, I just want to know how to do it successfully.’”
Mapping Long-Term Success
Regardless of a client’s goals or starting point, Nancy and her team stress the importance of the planning phase upfront. “Doctors often come in wanting us to put their website together right away so they can advertise their new practice. They’re anxious to get going, and they don’t know what they don’t know.” From a business development perspective, Latady sees moving too quickly as a liability to future stability, so she works to channel those doctors’ energy and momentum towards designing a tailored business model. “We take them through a clear development process, where we plot out how things look for them financially in terms of expenses, revenue, projected number of patients, duration of patient increase, and strategies for covering their deficit in the meantime.” An essential ingredient to covering that deficit is getting as many existing patients as possible to come over to the new practice as soon as it’s started. Strategizing with doctors to make that happen, Latady admits, can pose it’s own set of challenges.
Doctors who have spent their entire careers under the insurance model don’t often consider their relationships with patients as a financial transaction. The increasing number of third parties involved in the traditional medical model obscures pricing and makes it difficult for both practioners and their patients to know exactly who is paying for what. Latady says this creates problems when it comes to strategizing for higher patient transition rates. “Doctors don’t tend to understand business development because they’ve never done it before, so figuring out the value proposition—or even getting them to think of it as such—is a critical step.” Latady emphasizes the importance of carefully planning out how to introduce the idea of private practice to existing patients, especially when they are already getting high quality care under the traditional model. “You’re asking people to pay out of pocket, but, in most cases, they’re already getting that high level of care from their doctor. Many of my clients say that they’re already acting like concierge doctors—they’re just not getting paid for it. Most doctors aren’t willing to give substandard care, so they try to beat the clock, which takes a tremendous toll on themselves and their families. But their patients don’t see that side of things, and they tend to be really happy with their care. So when all of a sudden the doctors tell them that the model needs to be changed because it's no longer sustainable, they're essentially telling patients,‘You’ve been getting everything for free, and now we need you to pay for it.’”
Highlighting Value--Without A Cost-Benefit Analysis
Many of the DPC doctors who contribute to our Best Practices series admit that discussing membership costs can be a challenge, and Latady agrees. “Even though rationally we all know why DPC and concierge medicine are valuable, it doesn’t necessarily translate in a brief conversation. It takes strategy and preparation to really get across the value of what doctors are offering under the private practice model.” Latady thinks practitioners too often shy away from really selling their practice because the terminology itself leaves a bad taste their mouths. “It seems like many of them think of marketing as a dirty word,” so Latady frames it this way: “Marketing is about education and communication"--skills physicians typically excel in. "If you have these services and capabilities that you can provide your patients, it’s only fair to communicate that so they can make a good decision. You’re not pushing anything on them, you’re just letting them know what you have to offer.”
Because so many doctors don’t like to engage with the financial aspects of building a practice, Latady thinks it’s essential to decide on fees they can get behind from the get-go. “The doctors have to believe in what they’re doing and why they’re doing it, but they also have to believe in their pricing. If they feel it's too high, they’ll end up apologizing to patients and lowering their prices. Right out of the gate, they have to feel like this is where the price should be.” But conveying value isn’t all about picking the most reasonable price, according to Latady. “While it’s a growing trend in the DPC movement to focus on affordability, it can be risky for the future of a practice to charge as little as possible to 'get by'."
Instead, Latady suggests engaging the patient-doctor relationship as a marketing strategy to get patients on board while providing doctors with a sustainable income. “It’s all about the emotional connection with the doctor. The patient isn’t making a rational decision typically. They may rationalize it later on in respect to their finances, but I think it has more to do with their fear of losing someone who has provided them with quality care and support in the past and who can be trusted to do so in the future.”
No one marketing strategy will be effective for patients across the board, and Latady thinks doctors should be cognizant of who will resist the new model and who will embrace it. Of course, it can’t always be predicted, but Latady notes a few ways to hedge your bets. “On the financial side, DPC can be really appealing to people who are self-employed or under-insured, with either no insurance or high deductibles. People who would save money by choosing higher deductibles with lower premiums and putting the savings towards a membership tend to really benefit from this model.”
When it comes to patients who already have quality insurance and care, Latady worries that doctors too often fall into the trap of using price analogies. “I see people likening the membership fee to the price of getting a Starbucks coffee everyday for a month. This can be effective in some cases, but again, I’m not a big fan of this method of selling because it often feeds into the idea that the value of DPC is all about the money when it isn’t.” Latady doesn’t think it’s possible to control people’s responses to a price tag. “It’s just like a health spa. People understand that they’re going to have to pay for the facility, the equipment, and the exercise classes. No matter how often they go, there is going to be a fee. Then the question becomes: ‘Is it worth it? What kind of value am I getting?’ And that can vary widely from one type of patient to the next."
Latady elaborates on what that variation can look like. “A physician’s practice will have patients in their seventies and eighties who often have multiple medical conditions and chronic disease. They might see the monthly fee as reasonable because they’re using the services frequently. Then you probably have some patients in their thirties who rarely go to the doctor, but maybe see value in the convenience of being able to make last minute appointments and not having to take time off work to come in. To reach a group of patients who are diverse in terms of their age and medical needs, doctors have to get creative with their messaging.” Latady and her team help their clients tailor these sales conversations, showing them how to articulate how the new model will benefit a particular patient and preparing them to answer any questions. “We want to make sure they’re ready for whatever comes their way.”
Branding for Beginners
While Latady has a lot to say about working on branding with her clients, this was the first thing out of her mouth: “It’s so much fun.” She admits that most doctors don’t think of branding beyond a name and a tagline, which is part of what makes working with them so enjoyable. “They’re not used to it. I mean the majority of people don’t understand how to create effective branding for themselves or their business, but my clients tend to develop a real appreciation for the process.”
Latady and her team equip doctors with the skills to create consistent, integrated messaging, visuals, and customer experience. “The logo, the clutter or simplicity of the website, even something like the phone message—these all speak positively or negatively to their brand. Phyiscians don’t often consider those small details as integral to effective marketing.” She shares a recent experience that proves how anything outside the medical arena often falls to the wayside in the patient onboarding process. “I work with a group of doctors who just had their first information session. They sent out a short letter about the time, place, and content of the meeting and waited for everyone to show up. The only thing on the table in the conference room was water and a plate of cookies. Really? This is your first opportunity to show that you’re health conscious, that you value their investment in you, and that you are willing to spend a little on them, too. At least have something a bit more bountiful.”
It’s clear from her playful laughter that Latady enjoys helping her clients learn from these kinds of slip-ups. Wall hangings, social media presence, and business development plans aren’t often the first thing on doctors’ minds, and why should they be? It’s not as if these are requisite skills they needed to graduate medical school. But that’s where Latady and her team come in. The testimonials from her many successful clients prove that her expertise marries well with her clients'; they focus on providing quality care and she makes sure they have people to provide it to.