On a personal note - having just returned from a vacation in Mexico with my family, I was thrilled to realize that I was really looking forward to getting back to work - I missed writing my blog and talking to my clients! Sick, isn't it?
It also helps that it is warmer in Los Angeles than it was on some of the days in Cabo San Lucas!
As someone devoted to helping physicians thrive as entrepreneurs, often within the context of their existing practices, I am always on the lookout for ways a medical practice can be more entrepreneurial.
An article from the Los Angeles Times, entitled Medical merchants: When doctors hawk products, patients aren't the only ones who pay a price showed up in my Inbox today. It resonated with me because I feel strongly that selling private label over-priced products to patients is the lazy person's path to being entrepreneurial. It smacks at best of a lack of imagination, and at worst of quackery .
I had an identical experience several years ago in a dermatologist's office, when I was pressured by the back office nurse to purchase a $29 tube of "special sunscreen for the face". I had detected the almost imperceptible signal given by the doctor to her nurse to push the product, and yet I still felt too awkward to refuse it, especially as the doctor had written IO ("insurance only") on my superbill. What a trap I had created for myself by accepting that IO! And how resentful I felt after leaving the suite. Similar to the subject in the Times article, I did not return to that office.
Like many physicians, I bet you've wracked your brains trying to think of ways to offset your declining income, with all the insurance cutbacks. However, as the article points out, pushing creams, vitamins and "pick me ups" is more likely to cause your patient to cringe resentfully as she forks over the cash, than to create an undying trust in your recommendations.
In the same way, adding testing like EMG studies and nerve conduction studies, or heel ultrasound to screen for osteoporosis can be justified only IF you are willing to use these technologies when indicated, and not as a slick way to generate extra revenue. What we know, per the Dartmouth Atlas of Healthcare, is that the mere existence of a technology means that it will be used, and almost certainly overused, without any improvement in patient outcomes.
I had to review a primary care physician's medical records last year - about 20 of them - and was dismayed to see that every single patient record contained spirometry studies and a urinalysis, irrespective of the presenting complaint. This is NOT entrepreneurial behavioral - this is a desperate attempt to rip off the insurance system without any benefit to the patients!
So what are some creative ways to be entrepreneurial in a medical practice?
Okay, I know that concierge medicine and medical spas are IN, but I believe that it doesn't take a drastic change in your practice to produce entrepreneurial results. It DOES take a deeper understanding of what your patients would value and therefore be willing to pay for.
Since I take the fierce stance that entrepreneurship is a radical act of creativity, here are some simple examples of what I picture an entrepreneurial medical practice to be selling or engaging in:
- patient education - such a group classes for diabetics, asthmatic teenagers, and new parents.
- information/education products - such as "self-catheterization" or "self-injection" technique videos, "how to use a pedometer for a 10,000 steps a day walking program" video and handbook, a "how to look your best after a mastectomy" guide, a "how to prepare your child for surgery" audio CD, or a book on "maintaining your spine and wrist health, for computer users" that you co-author with your favorite chiropracter.
- using technology to streamline office practice operations - such as web-based appointment systems for patients to schedule their own appointments (nope, you don't have to build it. It is entrepreneurial to purchase it and redesign your practice to derive maximum benefit from it). Or to begin using email more effectively to communicate with your patients.
- additional services and complementary therapies - such as acupuncture (many reputable schools now offer training for physicians), or renting extra or after-hours space to nutritionists, psychotherapists, or the master herbalists your patients are secretly seeing.
- office-based procedures that you would have referred elsewhere - such as getting extra training in minor skin surgery, lump and bump removal, performing colposcopies and infant circumcision.
What are your thoughts about entrepreneurial medical practices? I'd also love to hear of other examples of entrepreneurial activities everyday practicing physicians are engaging in - do you have any to share?