Direct / Retainer primary care practice from scratch (not hybrid) - any tips?

[Guest guest]

Dear group members,

I wanted to introduce myself since I am new on the list. As new as I am, I would

like to first state that I read almost all exchanges in full on these subjects

from this wonderful group. The group allows to read exchanges spanning years

back, and that's exactly what I have done. I say this as I don't wish to waste

anyone's time to repeat what's been clearly exchanged in public here in the

past.

Also I already feel like I got to know a few of the vocal voices here, the

amount of info you shared in the past is invaluable. Thank you for all that.

Don't think that others do not use what you wrote even years later.

I am in CA's silicon valley area (Palo Alto presently to be exact), made the

move from NY with my wife , who is a DO, a couple of years ago with our two

small kids.

My own background is IT and business, I run my own small Internet business for

many years now (Internet radio out of all things). My wife is working as a

hospitalist for a few years now ever since she finished her residency.

My dear wife is not exactly " content " with her hospitalist gigs. She loves the

work, loves the medicine and helping patients (cliche?), and the type of cases

she gets to see. But she's dissuaded by the bureaucracy processes, management

treatment, and the like that often comes with institutional health places. She

is very good with people, but the institutions aren't perfect for making the

best of that. More still, she would like to be more part time, to be more

involved with the kids most of all, but also to have time for self (which

includes continuing education and improvement).

So after much consideration, we are considering opening up a primary care

practice for her here in the bay area. I'd be the business guy, she'd be the

caring doctor.

As many of you can attest, in today's environment it would be down right

impossible to build a " regular " practice, and still continue to be part time. A

huge patient panel is not going to make her happy, so this is out of question.

We both agreed that quality (in terms of time spent, and personal attention

provided that is), rather than quantity (huge patient panel of 10-15 minutes

each) is the way to go.

So the idea we have is to start a retainer practice (think MDVIP and the like,

but without using such companies. As an aside, I wonder if the rapid growth of

MDVIP itself may turn it into an institution of sorts and become less personal,

food for thought). Concierge is the term you all know, but I like many of you I

have a feeling, really dislike that name for it.

TO THE QUESTION:

Many of the retainer practices I've read about are either hybrid models

(upselling regular patient panel on retainer benefits).

And almost all non-hybrid retainer practices became such after converting from

their previous practice. This no doubt, gives a practice the initial boost of

paying customers. You would agree that your first 50-100 patients is the hardest

and most important, after that word of mouth can work much better.

So the question is, what about retainer only practices from start? Do you run

one, or know someone who does? Do you have any tips on what worked to get your

first 50-100 patients? What worked, what didn't? Did you offer any discounts for

the first year to get people on board (assuming that was legal)? Did you offer

any formal or informal referral fees to non-medical people (such as barbers,

accountants, merchants, again assuming that's legal)?

And yes, I have already gone through the marketing pages such as this one:

http://idealhealth.wikispaces.com/marketing

I would just like to hear at least some anecdotal evidence of what seemed to

actually work for people.

Your insight appreciated in advance. Sorry to have made my intro long. I thought

it might benefit people in the future as they read this to see where I am coming

from.

Sincerely,

Ari Shohat

Levin-Shohat, DO

467 Hamilton Ave, Ste 25

Palo Alto, CA 94301

ashohat[AT]gmail dot com.