Tired of taking the pittance offered to you by insurance companies for your services? Or, are you looking for a medical side-hustle to make a few extra mortgage payments? Before you burn out or make a major financial mistake, consider your options. There are several that may interest you, says Doug Graham, Senior Management Consultant at Doctors Management. But proceed with caution. You must deal well with change to consider any of the alternative approaches in this post, Graham says. “You’re going to be on call 24-7. You will be spending a lot more time with patients. You’re going to be delivering better healthcare, but it’s going to be very different from what you’re doing. You need to know how you’re going to adapt to that new model. You’ve got to really understand how you’re really going to change.” Option 1: Direct Primary Care If you’re looking to get out of the insurance game, Direct Primary Care (DPC) is a sound option. DPC is a subscription-based business model in which patients pay a monthly fee, usually between $25-$100, for access to your basic services, such as lab work and wellness visits. Your primary client base, Graham says, is going to be Millennials and Gen-X-ers. “The reason being is that they may or may not want to be involved with insurance companies, paying those astronomical insurance premiums every month.” DPC offers the major advantage of upfront pricing. Fees might be higher than insurance, but there are no billing surprises for patients. DPC usually offers physicians the opportunity to spend more time face-to-face with patients, Graham says. EMRs become a thing of the past under this mode (unless you want them). You can maintain patient records as you see fit. Consider the following example: An internist working a fee-for-service practice in the suburbs of Atlanta wants to become DPC. The doctor is in their mid-40s, works five days weekly, and has a large patient base. Graham estimates that this doctor could expect annual revenues of about $350,000-$400,000 in about one or two years, once they reach 500-600 patients. The major caveat is that the doctor will retain only about 5-10 percent of their existing patient base. That means the doctor will have to hustle to bring in new patients. Option 2: Concierge Medicine The revenue stream is slightly different for concierge medicine. Doctors generally can charge a higher monthly membership fee — between $125-$250 — because they are providing a higher level of service. “The main thing about concierge is that it’s all about access,” Graham explains. For the higher fees, patients receive on-demand access to the doctor. Concierge physicians often provide more comprehensive testing and lab services, personalized medicine, expanded office hours and more face-to-face time. While a higher-paying gig is great, a patient in need could interrupt you at any time. Concierge medicine tends to attract a more affluent, older client base. Concierge physicians will sometimes bill insurance companies and Medicare, making this a good supplemental income source. Whereas DPC offers more barebones services, concierge medicine often provides personalized wellness plans based on extensive testing and genetic health profiling. The same internist described in Option 1 could expect to make $350,000-$400,000 in about one or two years with concierge medicine, but they would need fewer patients: about 300. Keep in mind that the doctor would still lose about 5-10 percent of their existing patient base, and they would be charging a higher fee under the concierge model. Option 3: Ancillary Services Graham has seen physicians successfully incorporate ancillary services into their practices. These added revenue streams can be something as simple as bringing on a massage therapist, or as complex as offering more personalized medicine supported by more comprehensive labs. One example he cited, noting that he has no affiliation with the company, is Cleveland HeartLab. This service, and similar ones, support customized wellness plans for patients, drilling into their metabolic and vascular profiles. Home visits may also be another ancillary service worth considering, or possibly telemedicine. Some doctors will even accompany patients to the ER. In many cases, patients will pay a premium for the convenience of telemedicine or a home visit. Doctors also can still bill insurance. Important Considerations Graham cautions that none of these options is to be undertaken quickly or lightly. “Physicians must really take a long look at the market that they’re in,” he says. “The biggest thing the doctors need to convey is the value that they’re going to bring by having the patient pay that fee.” For doctors looking to eliminate insurance, it’s best to have an established practice and patient base. Many of your patients will not be coming along for the ride. Also, being located in a higher-income area does not equate to higher fees, Graham cautions. And be sure that you have enough population density to support demand for these new services. TL;DR If you’re tired of dealing with insurance, or looking to bring in more money, here are some options: Direct Primary Care: A subscription-based service that covers basic preventative medicine, labs and wellness visits. Concierge Medicine: A higher-end product that gives patients more access to you and more personalized health and wellness plans, based on enhanced diagnostics Ancillary services: You could offer something basic like massage therapy, or more complex, such as advanced diagnostic services and personalized medicine. Home visits and tele-health are also possibilities. Source
