Is Your Concierge Membership Practice a Best Kept Secret?

image of physician holding stethoscope

Find out how to get out of obscurity and become known as the leading authority among your concierge physician competitors

Many concierge physicians contact me because I wrote the book (literally) on Concierge Medical Practice Design. Some have not yet launched their practice while others did it themselves and realize they made some mistakes or that they had hired consultants to help them but things didn't work out as planned or the consultant failed do deliver a strategy that worked or the strategy wasn't executed properly or as planned. In any event, they come to me with their current situation and ask for help.

Funny, few ever call me to say, "I have too many patients signed up and I cannot keep up. Help me hire another practitioner." Most thought it would be a cinch to transition from 3500-4500 patients in a managed care business model to 300-600 patients paying cash. After all, it was in the numbers, right?

No. It wasn't.

Physicians who go out on a limb to build or rebrand and relaunch and walk away from managed care (HMO, PPO, Medicare Advantage) contracts that supply an endless stream of patients are often frustrated because their new practice isn't delivering on three key promises:

  • Freedom of pricing and service delivery and product design.
  • More personal time – so you can work and play, and enjoy the fruits of your labor.
  • Freedom from managed care plans and other restrictive relationships – so you can work with the patients you want to work with.

In my work I’ve had the opportunity to speak with hundreds of physicians to discover what holds them back from success. I offer a complimentary 15 minute chat by phone to listen to what they think holds them back.  The stories vary from not enough cash, to bad patients and employees, to the market and the economy… and on and on and on. At the end of the day most of the reasons are reduced to one major correctable problem: They are trapped in obscurity.  They are a best kept secret.

Many were disappointed with the payouts and antics of managed care plans but they forgot one reality: The discounted reimbursements they accepted were in trade for patient steerage. They didn't really need to market or build a brand, they simply needed to have available appointment slots in their calendars. They had also heard that if you set up marketing (a/k/a "a Facebook page") people find you on Facebook and are somehow magically motivated to call and pay you more than a thousand dollars a year for the bragging rights to say that they have a concierge doctor. Oh yeah? How's that working out for you?

They were also under the impression that social media marketing is free and it will get you patients. Facebook is social media, so where are all the patients?

Business Development: not as easy as most physicians believe

I truly believe that physicians don't give much thought to business development.

First, they don't know much about it. They weren't trained what it is or how to do it. There's no school to matriculate and there are almost no seminars or workshops offered in this particular domain. When workshops are scheduled they may be at a location or on a date that's not convenient. Given how small the audience is on a local or regional level, seminar sponsors don't schedule this topic often because the revenue potential is very low per event. And what is of interest to those exploring concierge medicine is quite different from those already launched. The nation's only trade association went out of business a few years ago. It's money making strategy to sustain itself was conferences. They attempted 3 interim and one national conference a year and couldn't survive.

Second, most don't even think about it at a day-to-day level. Therefore, they don't really look for articles on what and how to learn it themselves.

Third, they tried and didn't get very far on first attempt. Smart as they are, that bruises their egos. Besides, many are reluctant to "sell". Actually, in all businesses, 70% of owners fall into this category, not just doctors. If they aren't reluctant to sell, they belong to the smaller 30% of "dabblers". Those who try Google Ads, Facebook page, one or two blog articles. They never learned how marketing and advertising really works. And, they haven't really studied their business adequately and that of their competitors to learn from primary-owned research, where their business comes from.

Fourth, they did a little in the beginning of the conversion to concierge medicine, and got some patients, so they figured that the trajectory would continue and it hasn't. Meanwhile, they are now busy taking care of patients in their new micro practice and what time they spent of business development in the past is now crowded out by patient care. Business development is not what they got into business to do, right?

Fifth, they have no established brand. Selling professional health services is not easy.  Especially when patients have insurance, but are no longer permitted to be your patient and use their insurance at your practice. That changed with several of the major health plans and PPOs last year. You didn't get a notice because they changed the provider manual and your contract allowed them to change policy and provider manual without requiring them to give you notice and negotiate an amendment to your contract. That's because you didn't know how to analyze and negotiate your managed care contracts in the first place. you didn't know what to look for and where to push back.

When a salesperson sells a tangible "product", they get a commission and someone else manages the workflow from that point on. But when you try to sell professional services you’re both the salesperson AND the product. You’re “selling” yourself.

You deliver value by giving medical and wellness advice. but only if your patients follow your advice and instructions. You solve problems but the solution is not exactly under your care and control. Your success as an advisor, (just like mine) is 100% dependent on when the one receiving the advice implements it as instructed. On the surface, your patients may indeed be willing to follow instructions, but other obstacles arise: time, money, life, stress, business, work-related travel, and other excuses.

Sure there are probably some other deliverables that are ancillary to your advice product, but at the end of the day, people are attracted to your intelligence, skill, wisdom, and experience–delivered as advice.

The three sales you must make to every concierge medicine member/patient

Every new patient who purchases your membership product buys three things, in this order…

One: “I have a problem and I believe you understand my problem.”

If they don’t believe they have a problem, they probably won't become a member. I face this as well.  But, can we agree, if a person doesn’t think they have a problem, they’re not (yet) ready to buy. They probably aren't even ready to read your ads, find you on Facebook, look you up on Google, or ask others about you. YOU ARE INVISIBLE TO THEM. YOU ARE OBSCURE.

If, on the other hand, they believe they have a problem but don’t believe you understand their problem, they’re not buying from you. Some doctors call me thinking that the complimentary 15 minute call is a "consultation". They want to prove to themselves and find validation that they are smart enough to solve their own problem and that they don't need to pay for "hand-holding" from me. (Not that I sell hand-holding as a professional service, but okay.)

Two: “I don’t know how, but trust that you can eliminate my problem.”  They buy YOU before they buy the solution.  I have many clients who decide they want to work with me before I know what the solution is and how to fix it. These doctors trust that I will analyze their situation and come up with a unique remedy and plan to eliminate the problem they perceive. I am like their trusted mechanic for their car. Only I work mainly with owners of upscale cars, not Yugos and the beaters they drove in medical school. The shade tree mechanic on the corner charges way less than the mechanic who specializes in upscale cars and has sophisticated equipment at their disposal for diagnosis and specialized tools to fix problems and decades of experience.

How about you? Isn't the reason you decided on concierge medicine as a business model because you believe you offer more than the managed care practice down the hall offering "3-minute drive-through" appointments to the masses? Without a brand, brand promotion and brand awareness, people have no clue you exist. YOU ARE INVISIBLE TO THEM. YOU ARE OBSCURE.

Three: “I believe you have the solution I want to buy and I understand how it will eliminate my problem.”  So many concierge physicians put all the focus on this third sell. They play the card that feels most comfortable: "You have a problem, I have the solution." But on their websites they don't list the solutions, they list the features (telehealth, time, SMS, Email, Cell Phone) instead of the why and the benefits. They probably didn't give much thought to the process that patients may not be able to translate the value of features and turning them into the solutions they need at the moment.  Selling on features turns you into a commodity seller that offers what everyone else offers and leaves you competing on price and location. Meh. YOU WILL REMAIN INVISIBLE TO THEM. YOU WILL CONTINUE TO BE OBSCURE.

After all, any licensed physician can deliver a “good enough” solution to solve the patient’s problem. While you don't believe that you are selling good enough, if you aren't convincing a prospective patient to transfer confidence to you, that you are "their doctor", always acting in their interest, and always bringing the right solution for them, YOU WILL REMAIN INVISIBLE TO THEM. YOU WILL CONTINUE TO BE OBSCURE.  After all, patients (usually) don’t have the expertise or inclination to truly judge what you’re presenting unless they are other physicians or perhaps nurses with lots of experience.

So how can you, a physician who went to medical school, internship, residency, and then on to start treating patients on your own, create a "sales experience" that facilitates new concierge medicine patients making those three buys, from you?

Change your thinking to change your circumstances

For me, in my practice, every new client is a happy event for me. I feel pride that they found me, pride that they trusted me, and excitement to work with them. If I don't feel these three basic emotions when I talk with you on that 15 minute call, I don't really want to work with you. After more than 3 decades as a consultant, with a healthy established client base, I don't need to take on projects I don't want, clients who don't resonate with my principles and ethics, or those who I can tell right away that they probably won't show mutual respect for my time and expertise. My clients mean more to me than a billable hour.  Please, go be someone else's problem client who needs that billable hour to make the rent this month. I am so past that.

You should feel the same way. But at first, you may not be able to be as selective. You targeted 300-600 patients to make the numbers you published in your business plan and budget proforma. But, first I need to ask some very blunt questions: Were your budget pro forma numbers right? Were your numbers realistic? Was your marketing strategy right? Are you sure? Are you chasing the "illusory perfect" number? Is that part of the problem?

Let's start by changing your thinking to begin viewing new patient acquisition as an event. When you attend a successful event do you find yourself thinking, "I can't wait to do this again!" But tell the truth, you don't start thinking,"Wow, all the pre-planning that went into this event must have taken a lot of courage, capital and coordination to make it turn out so successfully." You simply want to know how to buy a ticket for the next one and get dressed up, show up and have a great time.

The first way to overcome obscurity is to be 100% focused on understanding your practice, your patients, their psychographics, their medical needs, conditions, and understanding their world from their point of view. That's what brand creation is about. Understanding your "customer". That way your brand messaging and promotion is targeted to be relevant to your "ideal customers". So if you thought branding was about catchy slogans, tag lines, logos and symbols, and that's why you shrugged of brand building as "fluff", change your thinking. Because branding is not logos and slogans and tag lines. Without the brand research necessary to create your brand, you can't even begin to decide slogans and logos because you won't know what appeals to your targeted prospect. You won't know what ancillary services to offer or where you should be located, how to develop effective marketing and promotional messages and campaigns, or how to price your services.  This resonance provides intimacy and evokes feelings that you get it and your brand represents safety and security.

The second way to overcome obscurity is to build authority and trust. How do you do that?  Credibility is one way. How can you build credibility with strangers? By building preeminence in the mind of the customer. Advertising on billboards and bus benches doesn't do that, does it? A Facebook doesn't do that on its own, does it? A website doesn't do that on its own, does it? I can think of several ways but they all take time and some cash (not a lot). You can leverage social marketing and social selling, but only with the right messaging. Who will craft the message and the strategy to deploy to make the strategy come to life? On which platform(s) and how often.  This is why I said earlier that social media isn't "free" marketing even though the Facebook page is free to claim.

The third way to overcome obscurity is to build reliability. You must demonstrate reliability before you can do business as a physician. How? Licensing, reputation, testimonials, word-of-mouth, regular additions to content marketing, and a membership contract that explains what people get and can expect in exchange for the money they pay for the product in one lump sum payment for the membership fee. Those are just a few of the ways you build reliability that earns trust.

And none of these tactics requires you to "sell" or "pitch" to patients and prospective patients. You simply pre-sell your prospective concierge medical practice members by creating the belief and awareness before the sign up "event" (such as your initial meet and greet appointment where they ask their questions, get their clarifications and decide to buy a membership and pay their fees.) Your business development activity consists of freely educating your future members —helping them gain a deeper understanding of their situation and their options—without any expectation of return. This way you create the conditions that will support the sale on its own. When you do this effectively, they buy YOU, not the MEMBERSHIP and its features. 

And if you are effective, the method also scales and requires little, if any selling. But, in the background, just like the gala event you enjoyed, the mice are scurrying (you or your designee(s)) to use a bit of capital and courage and coordination to make things continue to move forward in the background. Neither you nor Ms Nancy at the front desk will have to actively "sell" memberships. And it won't take bus benches and billboards, and advertising in the local shopper paper or the city magazine, or radio spots or cable TV commercials as most advertising agencies will try to sell you, so they can earn commissions on expensive media purchasing and advertising contracts that cost a fortune and don't drive membership sales. All those things do is buy expensive "reach".

Keep in mind this Maria-ism in mind whenever someone wants to sell you "reach": "Reach≠Revenue."

The next step: The meet and greet meeting with a prospective new concierge member

Prospective members will appreciate a 15-minute meeting that provides an opportunity to meet you face-to-face and sell themselves that they are on the pathway to making the right decision to sign up. You don't take any history, you don't collect any PHI other than what it takes to make a non-revenue, non-billable appointment to chat with you for 15 minutes. They will do most of the talking if they are already pre-sold. You'll hear exactly what beckons to them, why they want to buy a membership and become your patient, and why they've already preliminarily decided to trust you, and they will explain why they should be granted one of the limited membership places in your practice. In other words, YOU WON'T BE PITCHING. You and your staff won't have to SELL. The 15 minutes will fly by and then you'll escort them to Miss Nancy so they can fill in the blanks in the membership agreement and accept payment.

When Ms Nancy takes their money and signed agreement she will in turn present them with a Member Handbook (a piece of content in the form of a booklet or brochure that needs to be created and printed) that explains how to use their membership to achieve better health and how the world of concierge medicine benefits them, their family, and keeps them out of the hospital and out of the emergency department, and helps them meet their health goals. It has all the names and other details you don't want to offer up free on your website to the public.

So how do you like this different approach to business development?

Are you ready to shift your mindset from sales drudgery and angst to this far more elegant and upscale approach? Do you want my help or do you want to do it yourself?