Concierge Medicine & Direct Pay Practice




In most instances, physicians call Maria Todd because they are in one of four current situations:

Just completed residency - These physicians want to start their own private medical practice and have the freedom to control their work life balance. Many are parents of young children and like the freedom and flexibility to take time off to be home when the children are off school in the afternoon. They manage out-of-office patient interactions via cell phone, SMS and telehealth (synchronous or asynchronous). Some opt to launch a micropractice without a large support staff.  For these physicians, we find space sharing arrangements in non-traditional practice settings, arrange remote telephone answering and telehealth systems implementation, free and low cost electronic medical records software, simple, streamlined practice management and accounting tools, and we can locate minimally used office furniture and equipment to outfit your exam room and private consultation area.  In concierge and direct pay practices, very little space and furniture is necessary for lobby and waiting room areas.  Maria's  Healthcare Media Group creative team pitches in to design and maintain the practice website, patient portal, logo, graphics, print, digital and video content, brochure layout, photography, and more.

Leaving an established private group practiceThese physicians have decided that it is time to leave an established group practice to pursue a different approach to medicine. They need help with most everything associated with a new practice startup, including situation analysis and feasibility study and an exit strategy that takes into account any restrictions associated with a non-compete provision in their current situation. We find that they also need more support than other physicians in other situations because they will often work at the previous practice up until the last Friday before opening the new practice and have full schedules of patients. Maria makes one weekend a month available for physicians who require time with her after regular business hours.

Hospitalist leaving the employed setting - Some hospitalists become disillusioned or had a strategy all along to only do the hospitalist gig for a set period of time to gather income and save towards launch of their own practice.  Others were employed by a hospital in a hospital-owned practice setting and want to go off on their own. Because of the nature of the hospitalist employment setting, some physicians may continue working as a hospitalist for a few shifts each month for the first 12-24 months, while their concierge or direct pay practice grows. Just like the physicians leaving the established group practice, they may have non-compete restrictions. Often we begin with a situation analysis and brainstorming session to articulate goals and objectives. From there, we begin the work of a feasibility study to determine if the community can support a concierge medical practice or direct pay practice. We then set about all of the startup planning and preparation similar to what we do for physicians who recently completed residency. The initial brainstorming session is a flat fee consultation in the city where the practice will be established. The fee quoted includes consultant travel costs and the fee for the time for the consultation.  From there, most everything can be done via web-based meetings, conference calls and a few visits back to the location for things that are best done in person.

Established physician transitioning an established practice - Established primary care physicians and specialists have been jumping out of their existing business model to transition their existing practice to concierge or direct pay business models.  They usually face two critical decision options.: Jettison patients that won't pay the direct pay cash prices or membership fees, or transition them to the care of an associate or nurse practitioner or physician assistant and keep the business they already built.  While they don't need to start from scratch with new office, new furnishings, new staff, and new equipment, they benefit from a feasibility study, rebranding, public relations, marketing, and a website redesign.  They also benefit from a review of their managed care contracts to determine if they need to terminate them or simply continue with them for the concierge and/or traditional practice that they may transition to the associate, nurse practitioner or physician assistant.  Many physicians who organize this transition incorrectly find themselves in receipt of unanticipated payer termination threats because they didn't implement the correct transition strategy for the new model. We can help you avoid these hassles and headaches.  They also find that they may not need as many staff members and that current staff members may require training to cover new responsibilities such as membership sales and service. We can help with the reduction in force and alternative skills training.

How to get started

The first step is to call or write and tell us where you want to locate your new practice, your area of specialization, your current employment situation, your time line, and your budget. We typically start with having you read and work through Maria's Handbook of Concierge Medical Practice Design workbook, and then schedule a face to face consult. Optimally, this meeting takes place at your location, but alternatively, we can meet with you at our office in Denver, which is set up with conference rooms and work tables, white boards, and lots of resources we maintain in the office.  Afterward, depending on your needs, we can support most everything else via telephone and web-conference at our usual and customary hourly rates.  When we travel to you, the fee is inclusive of travel expenses, travel time and consultation time. Maria will not perform any work without a fully-executed fee agreement and modest retainer deposit. As the retainer deposit account is depleted, Maria requests a modest replenishment to continue working on your project.


[RIGHT]  THE #1 BOOK IN THE INDUSTRY.  The Handbook of Concierge Medical Practice Design written by Maria Todd is like no other book on the market. It was originally designed as self-help workbook book to help physicians plan, launch and operate their concierge or direct pay practice. Derive the greatest value from time spent with Maria during one-on-one consulting when you first read this book and begin your brainstorming and planning at a deeper level. It is now available for purchase at all major retail and online booksellers.

Denver-based consultant, award-winning speaker, trainer and author, Maria Todd, brings you her best insights and strategies from working on various healthcare, health tourism and international development projects in the USA, Europe, Asia, Latin America and Central America for over 30 years.

As part of her professional work as a consultant, speaker and author, Maria Todd reviews and advises clients on planning, launching and operating this new business model. She provides training and coaching on what to include in your membership offer and amenities package, how to operate a hybrid practice that still maintains some managed care and contracted reimbursement, and also how to terminate all contracts and Medicare participation status if you decide to operate on a 100% cash basis.

In addition to the USA, these private practice business models are also gaining traction in Spain, Italy, Greece, France, Germany, South Africa, UK, Australia, EMEA, Colombia, Peru, Brazil, Argentina, and Canada. Maria has worked on transition and startup projects in each of these countries and is considered a leading expert in the USA for those physicians that eschew the corporate-owned franchise models such as MDVIP, SignatureMD and others.  Maria also helps with hospital-owned concierge and direct pay practice startups for both primary care and specialty physicians.



Maria Todd offers Master Classes and Workshops

Learn about concierge medicine and direct pay practice models from Maria Todd.

Maria Todd frequently presents workshops, Master Classes, webinars and seminars for hospitals, clinics, trade associations, professional societies and also gives guest lectures at medical staff meetings and university programs.  In addition, she often conducts focused, custom training programs onsite for clients including the Cleveland Clinic, Bangkok Dusit Medical Services, the Korean Health Industry Development Group, The Monterrey Health Tourism Cluster, The Republic of South Africa, Opus Dei Health Systems, Adventist Health, Trinity Health (formerly Catholic Healthcare East), Order of St Francis, Gundersen Health, Spectrum Health, Marshfield Clinic, Pediatrix®, Glaxo, Bristol Myers Squibb, Allergan, the Veterans Administration, KCI, Hill Rom, and hundreds of other leading brands in the healthcare industry.

Maria trains physicians and healthcare executives on the business and operational differences related to concierge medicine and direct pay practice. Whether you want to launch a private practice or a hospital-owned or corporate-owned model, there are key differences in how you prepare your staff for the customer service requirements of these models, and also how you'll establish your professional brand, your package amenities included in the membership fee, and how you'll market and promote your new business model. She also covers use of social media as a marketing strategy, reputation management for physicians, public appearances and public relations management, e-newsletter creation, your member services handbook for patients, brochures, flyers and your website.

Maria K Todd, MHA PhD

Chief Executive Officer
The Mercury Healthcare Companies
600 17th Street
Suite 2800- South Tower
Denver, Colorado USA 80202


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