Concierge Physicians Face Continual Challenges with Disruptor Brands

Does your value proposition change over time? Yes. If you don’t continually adapt and face the new challenges posed by the disruptors your brand either dies or becomes irrelevant to buyers. (Think adaptive/specific immunity).

What does that title mean? Which brands are disruptor brands?

The local hospital foundation

The local hospital foundation in my town supports foundation donors by creating the pathways to rapid access to care by the hospital system’s employed physicians – both PCP and specialists. It’s a way they thank donors. Need an appointment? Can’t get in? Make a call to the foundation office and just like magic, you’re in. That disrupts the whole membership fee value proposition of rapid access that many concierge physicians advertise.

The telehealth platform

The insurer plan to which your patients subscribe has just added a telehealth platform for “Dial a Stranger”. There is no cost to use the system. Suddenly the value of your “Members Only” telehealth and telemedicine amenity is neutralized to a commodity status. How do you compete with free?

Health plan prohibitions

The health plans to which your patients subscribe didn’t change their contract with you, they changed their policy handbook – with you. Suddenly operating a hybrid concierge practice where people subscribed to managed care plans may no longer be charged a membership fee for concierge level up amenities (things without CPT codes) paid for by a membership fee, as the plan “deems” your fee a ruse for balance billing. Your only options are: capitulate or become non-participating and continue on as a concierge doc, but you can no longer accept or be steered patients by the plan as an in-network provider. Will patients remain if there is a double deductible (one for in network services, one for out of network services) and a higher copay, plus an annual membership fee to be a concierge practice member? That’s a lot to ask. Is what you offer worth it – to them?

Health plan competition

Some health plans are now rolling out their own branded concierge level of service as a new product tier. The concierge subscription is built into the premium. Subscribers to the health plan pick from an “exclusive” list of physicians – who are employed by the health plan or health system that owns the health plan. The amenities you offer are matched point by point. Did you expect that alternative reality when you wrote your business plan? What’s youralternative reality risk mitigation response?

Provider competition

Not only are there primary care physicians still transitioning to concierge and direct pay practice models… now in states where Nurse Practitioners have autonomy, they are also launching concierge and direct pay practices. And specialists are too. The specialists are selling the fact that for many patients with chronic complex problems, they can serve as primary specialist and care coordinator. Then there’s the medical home practices. They may not self-identify as “concierge” but the product is clearly differentiated from that of a generalist managed care participating PCP, specialist or patient centered medical home. And many doctors chuckle when they call me and say, I’ve been providing concierge level care for years, only now I want to charge a fee for doing so. How do I flip this around?” Ummm, you can’t do what you’ve always done and now charge for it. That goes against human nature and blasts the patient’s brand experience and pushes it all the way to the minus side on resentment alone. The value proposition can never be the same as it was.

Healthcare consumerization isn’t “happening” – that train left the station long ago

Did you have a reservation for a seat on that train or are you just now arriving on the platform and realizing the train left hours ago. Ugh what a sinking feeling. Now what?

Back to the strategy drawing board? Perhaps. It depends on what you put on the strategy drawing board before. Was yours a product strategy without a branding strategy? If yes, take three steps back and go build the branding strategy and then re-assess product design and brand user experience. Do it now before your house of cards comes tumbling down with a tiny gust of wind. You are very vulnerable if you built your “product” as a copy of someone else’s product… or worse if you paid a consultant to complete a scope of work to make a copy of someone else’s product for you. If they were true professionals, they would have had the courage to tell you you need to set the brand first and then develop the product. Building a product for which there is not targeted ideal customer is short-sighted indication of an amateur. I’d have more patience and understanding if you as the doctor do this yourself – but zero tolerance for people who charge you a fee for their work any more than for a doctor who charges everyone for cookie cutter treatment pathways and protocols without a proper diagnosis.

In business, branding is the diagnosis.

Diagnosis is the distinctive characterization in precise terms of genus, species or phenomenon. Branding is the diagnosis of who will become a customer, why, how, and what they need and how you solve that need. See the parallel? The how you will solve that need is the product design part. It comes last.

If you do it first or only, then you are guilty of malpractice because treatment without diagnosis is malpractice, right? So if the consultant or you did it without the professional advice of a consultant didn’t do the branding diagnosis for your business, and you designed a product that has now been challenged or made irrelevant by a disruptor, you have a big problem. Your business is at risk for collapse. If the consultant was not permitted to finish the work you hired them to do because you a) pulled the plug, b) changed your mind or c) ran out of cash to do the job, it is the same as if you hire an architect and they draw the plans up and you never get the funding to build the project. That’s not the architect’s fault. Is it?

Who is the architect of your brand?

What architects study are how to create or modify physical structures, such as buildings. But it also includes study of the technicalities of designing those buildings, as well as the method of construction. Building codes and regulations, engineering, product and materials, labor costing, procurement, style, data capture, measuring the building pad and the lot, shadow casts, physics, calculus, urban and regional planning, even a bit of public health. They generally need to complete an internship for 3 years to get a license. They design buildings that are attractive (to someone) functional (for someone) and safe. They cannot make something attractive and truly functional if they don’t know anything about the customer who will own or occupy it, right? That’s called speculation if they do.

Then there’s also architects that produce tract homes for a developer on a cookie cutter basis. You pick from three pre-concieved plans, pick the façade to at least make it “look” different on the outside, design your landscaping and voila! You have a row or a community built of tract homes. That’s going to attract and be functional for one buyer and not another. Branding and product design work hand in hand.

Who is in charge of brand reputation?

Nobody but you. Period.

How will you build a reputation for your brand? Through customer experience. Period.

Without customers and customer experiences, there can be no reputation. Every touchpoint in the customer experience relates to reputation. Each touchpoint is a building block for your brand’s reputation. Reputation may be measured by likes, follows, membership purchases, but there must first be something by which to measure. That measurement is the brand essence and its reputation. Without those things there’s nothing to like or dislike, right?

How will you design and architect your customer’s experience? By building and design and positioning your brand. With which touchpoints will they come in contact? You can’t know that unless you know the customers who will buy or are likely to buy. We do this through the science of psychographics, a qualitative methodology used to describe consumers on psychological attributes. Psychographics have been applied to the study of personality, values, opinions, attitudes, interests, and lifestyles. All are components of brand building, design and positioning.

Does your value proposition change over time? Yes. Because the competitors and disruptors that I listed above that come on the scene after you, the first mover, have settled in and become complacent. If you don’t continually adapt and face the new challenges posed by the disruptors your brand either dies or becomes irrelevant to buyers. (Think adaptive/specific immunity).

What will be their awareness and understanding touchpoints with your brand? Their pre-visit touchpoints with your brand? Their digital experience with your brand? Their appointment scheduling experience with your brand? Their diagnostic experience with your brand? Their treatment experience with your brand? Their payment and account settlement experience with your brand? These seven brand design questions should eliminate any misconception that branding is all about logos and colors and tag lines.

Two dimensions of brand value proposition

Emotional value: “I feel peace of mind after receiving health services, diagnosis or treatment from my doctor.” What would make your patients say that?

Symbolic (financial) value: “I feel like it was worth the cost to receive the best care and I am happy with how I chose to spend my money with my doctor.” What would make your patients say that?

All the “value-based purchasing” blather being bandied about, measured with tedious reporting to health plans, defended to Medicare, is just that: Blather for bloggers.

If people felt so compelled to proclaim to the world these two sentences about your service, value-based purchasing would be proven and indisputable. These two sentences, when proclaimed by your patients about their brand experience with your brand connect care to cost. That’s where value-based purchasing rubber meets the road. As a concierge physician, you must be able to “cause” people to say these two sentences with every transaction and encounter. If you don’t, can’t or won’t cause your customers to proclaim these two sentences to the world on your social feedback platforms and reputation platforms, your business and your brand and product as a concierge physician is at risk and in danger of demise.

As a concierge physician, you must have the courage and drive to constantly surveil the competition and the disruptors, and then decide how to adapt and face the challenges of disruptors head on. If all you do is build your brand and then tread water, eventually, you’ll run out of glycogen, and you know what ultimately happens then… right?